Autistic children thrive in mainstream pre-schools


In a world first, breakthrough research from La Trobe University has shown that toddlers with autism are just as capable of learning important life skills through early-intervention delivered in mainstream pre-schools as in specialised settings.

In a world first, breakthrough research from La Trobe University has shown that toddlers with autism are just as capable of learning important life skills through early-intervention delivered in mainstream pre-schools as in specialised settings.

Over a period of three years, 44 children aged between 15 and 32 months were randomly assigned to classrooms that included only children with autism or to classrooms with typically developing peers.

Using the same type of intervention method for all children – the Group-Early Start Denver Model (G-ESDM)* developed at La Trobe – toddlers with autism showed improvements in their vocal skills, social interaction skills, imitation, verbal cognition and adaptive behaviours, irrespective of their learning environment.

La Trobe researcher, Dr Kristelle Hudry, said the findings confirm supporting pre-schoolers with autism in mainstream early childhood settings is achievable.

“We found that the overall quality of the learning and teaching environment in the mainstream playrooms was exceptionally high and graded equal when compared to the specialised playrooms,” Dr Hudry said.

“This means the extra training and added requirements involved in including children with autism into mainstream classrooms didn’t detract from student development or reduce the amount of attention staff gave to typically developing children.”

A team of professionals and researchers across three centres – the Olga Tennison Autism Research Centre (OTARC) and the Community Children’s Centre (CCC), both at La Trobe University, and Gowrie Victoria – conducted the research.

CCC Director and Training Coordinator, Kristy Capes, said the results were a testament to educators, who went through rigorous training to provide the highest standard of teaching.

“The results give evidence for choice. We’re proud to have worked to fill a gap in autism research that could result in families being able to access specialised teaching and supports within their local community childcare centers,” Miss Capes said.

“We’ve helped toddlers with autism develop life skills that will help them in future – across both classroom settings. Our early intervention program ensures children aren’t just reaching their own developmental goals, but they’re learning how to generalise their learning in a group environment.

“Parents have reflected this is translating positively in the real world. Their children can now play in the sandpit or go to a party without feeling overwhelmed.”

La Trobe researcher, Dr Cathy Bent, said it is important for children with a disability to have the opportunity to learn with their peers in regular educational settings.

“It can also help prevent discrimination and negative social perception towards people on the spectrum, as it gives children without a disability the chance to become more accepting of diversity from an early age,” Dr Bent said.

The positive findings have encouraged the team at La Trobe to further their work in this area.

“We aim to start a new study next year with a particular focus on the training and support we provide educators – which is currently a very resource intensive model,” Dr Hudry said.

“Ultimately, it would be fantastic to see opportunities of this type available nationally for pre-schoolers with autism and their families.

“As a growing number of toddlers are diagnosed with autism, it’s becoming increasingly important to provide families with more choice.”

Autistic children can benefit from attention training – new study

Autistic children can benefit from attention training - new study
Autistic children can benefit from attention training – new study




Attention training in young people with autism can lead to significant improvements in academic performance, according to a new study.
Researchers at the University of Birmingham in the UK along with institutions in São Paolo, in Brazil, tested a computer programme designed to train basic attention skills among a group of autistic children aged between eight and 14 years old.
They found participants achieved improvements in maths, reading, writing and overall attention both immediately after undergoing the training and at a three-month follow up assessment. Their results are published in Autism Research.
Lead researcher, Dr Carmel Mevorach, in the University of Birmingham’s Centre for Human Brain Health, and School of Psychology, says: “It’s only recently that we have started to focus on the way autistic people pay attention in addition to, for example, how they interact and socialise. Attention is a fundamental cognitive process and better controlling it can have an impact on other behaviours, as well as on learning ability.”


In the study, the team worked with 26 participants with Autistic Spectrum Disorder (ASD) in the São Paolo ASD Reference Unit, a specialist children’s treatment unit. The children took part in 45-minute training sessions twice a week for 8 weeks.
Half of the group took part used a computer programme called CPAT – Computerised Progressive Attentional Training, that was developed in an earlier project by the Birmingham team in partnership with researchers at Tel-Aviv University in Israel. The CPAT programme includes training games targeting different types of attention, and at progressively more difficult levels.
The second half of the group were a control group and were given ordinary computer games to play. The trial was conducted so that none of the children, their families, or the researchers assessing them knew which group they were in and they were each simply told that they would be playing games that could help them in school.
Immediately after completing the training the CPAT group showed improvements in the number of isolated words they could correctly identify and read in 10 minutes (an increase from around 44 to around 53). They were also able to increase the number of words they could copy from around 18 to around 25. In maths, the CPAT group improved their scores by more than 50 per cent. All these improvements were maintained when the children were re-tested three months after completing the programme.


In contrast, the control group participants showed no evidence of improvement in any of the three areas.
The CPAT programme is currently included within the Teacher Training in Attention in Autism (TTAA) Erasmus+ project which has partners in Greece, Spain, Israel and the UK. The team is also carrying out local pilot projects with schools in each of the countries to enable teachers to embed it within their setting in whichever way they think will work best.
Dr Mevorach adds: “We’ve found that by giving teachers the freedom to experiment with CPAT we are finding out much more about its potential benefits. Autism is highly individual, so developing an intervention that can be tuned to a particular individual or setting is really key to success.”
The next stage for the research is to carry out a larger clinical trial to establish the potential impact of the intervention. The research was funded in the UK by the Economic and Social Research Council, part of UK Research and Innovation, and by the European Union’s Erasmus Programme.

One in four adults with depression or anxiety lack mental health support during pandemic But was this true for you?

One in four adults with depression or anxiety lack mental health support during pandemic
One in four adults with depression or anxiety lack mental health support during pandemic

A new national study published in Psychiatric Services finds that over a quarter of US adults with depression or anxiety symptoms reported needing mental health counseling but were not able to access it during the COVID-19 pandemic. Researchers analyzed data from nearly 70,000 adults surveyed in the US Census Household Pulse Survey in December 2020.

“Social isolation, COVID-related anxiety, disruptions in normal routines, job loss, and food insecurity have led to a surge in mental illness during the pandemic,” said lead author, Jason Nagata, MD, assistant professor of pediatrics at the University of California, San Francisco.

Nearly 40% of adults in the study reported depression or anxiety symptoms during the pandemic. Overall, 12.8% of adults reported an unmet need for mental health counseling, including 25.2% of those who reported depression or anxiety symptoms. Women were nearly twice as likely to report an unmet need for mental health counseling than men. Young adults also were more likely to report an unmet need for mental health counseling than older adults.

“Women have disproportionately borne the burden of childcare and caregiving for older adults during the pandemic,” said Nagata. “Young adults have felt socially isolated and experienced high rates of job loss.”

“Medical professionals, social workers, and clinicians need to proactively take steps to screen for symptoms of anxiety and depression and help clients to access mental health care,” said co-author, Kyle T. Ganson, PhD, assistant professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work. “Telepsychiatry and telemental health services can improve access for people with unmet mental health needs.”

“Patients have experienced several month waitlists for counseling or therapy during the pandemic,” said Nagata. “Policymakers should include more funding for mental health services as part of pandemic relief legislation and extend the use of telehealth to address the widespread unmet mental health needs of Americans.”

What should I eat to avoid heart disease?

Plant based food
Plant based food

 Plant-based foods should dominate heart healthy diets, according to a paper published today in Cardiovascular Research, a journal of the European Society of Cardiology (ESC).1 This comprehensive review of research on food and heart disease provides updated evidence on how much, and how often, each item can be safely consumed.

“There is no indication that any food is poison in terms of cardiovascular risk. It’s a matter of quantity and frequency of consumption,” said study author Professor Gabriele Riccardi of the University of Naples Federico II, Italy. “A mistake we made in the past was to consider one dietary component the enemy and the only thing we had to change. Instead, we need to look at diets as a whole and if we reduce the amount of one food, it is important to choose a healthy replacement.”

Overall, there is consistent evidence that for healthy adults, low consumption of salt and foods of animal origin, and increased intake of plant-based foods – including whole grains, fruits, vegetables, legumes and nuts – are linked with reduced risk of atherosclerosis. The same applies to replacing butter and other animal fats with non-tropical vegetable fats such as olive oil.

New evidence differentiates processed and red meat – both associated with increased risk of cardiovascular disease – from poultry, which shows no relationship at moderate intakes (up to three servings of 100 g per week). Red meat (i.e. beef, pork, lamb) should be limited to two servings of 100 g per week, and processed meat (i.e. bacon, sausages, salami) limited to occasional use.

Legumes (up to four servings of 180 g per week) are the recommended protein replacement for red meat. Moderate fish consumption (two to four servings of 150 g per week) is also supported by the latest evidence for prevention of heart disease, although there might be sustainability concerns. Poultry may be a suitable protein alternative to red meat, but in moderate amounts.

As for fruits and vegetables, given their strong association with a lower risk of atherosclerosis, daily consumption should be increased to as much as 400 g for each. Regarding nuts, a handful (around 30 g) per day is recommended.

For the healthy population, recent evidence does not support a requirement to use low-fat, instead of full-fat, dairy products to prevent heart disease. Rather, both full-fat and low-fat dairy products, in moderate amounts and in the context of a balanced diet, are not associated with increased risk.

“Small quantities of cheese (three servings of 50 g per week) and regular yogurt consumption (200 g per day) are even linked with a protective effect due to the fact that they are fermented,” said Professor Riccardi. “We now understand that gut bacteria play a major role in influencing cardiovascular risk. Fermented dairy products contain good bacteria which promote health.”

With respect to cereals, novel advice is given according to the glycaemic index (GI), where high GI foods raise blood sugar more quickly than low GI foods. High GI foods (i.e. white bread, white rice) are associated with an elevated atherosclerosis risk; therefore, consumption should be limited to two servings per week and they should otherwise be replaced with whole grain foods (i.e. bread, rice, oat, barley) and low GI foods (i.e. pasta, parboiled rice, corn tortilla).

As for beverages, coffee and tea (up to three cups daily) are associated with reduced cardiovascular risk. Soft drinks, including low-calorie options, are linked with higher risk and should be replaced with water except on limited occasions. Moderate alcohol consumption (wine: up to two glasses per day in men and one glass in women; or one can of beer) is associated with a lower risk of heart disease compared to higher amounts or abstinence. But Professor Riccardi said: “Considering the overall impact of alcohol on health, this evidence should be interpreted as the maximal allowed intake rather than a recommended amount.”

Regarding chocolate, the available evidence allows up to 10 g of dark chocolate per day. The authors state that “for this amount of consumption the beneficial effects exceed the risk of weight gain and its related harmful consequences on cardiovascular health”.

Professor Riccardi noted that eating should be enjoyable to motivate healthy people to make long-term changes. He said: “We need to rediscover culinary traditions such as the Mediterranean diet which has delicious recipes using beans, whole grains, nuts, fruits and vegetables.”

The authors concluded: “A strategy based exclusively on guidelines and nutritional education will not be sufficient to change the lifestyle of the population; policy options to be considered should necessarily include initiatives to facilitate production, marketing, availability and affordability of foods that are not only healthy but also gastronomically appealing.”

Adult ADHD is linked to numerous physical conditions

Adult ADHD is linked to numerous physical conditions
Adult ADHD is linked to numerous physical conditions


Adults with ADHD are at higher risk of a wide range of physical conditions, including nervous system, respiratory, musculoskeletal, and metabolic diseases, according to a large register-based study from Karolinska Institutet in Sweden published in The Lancet Psychiatry.

“Identifying co-occurring physical diseases may have important implications for treating adults with ADHD and for benefiting the long-term health and quality of life of patients,” says lead author Ebba Du Rietz, postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

ADHD is a common neuropsychiatric disorder characterised by inattention, impulsiveness and hyperactivity, and commonly treated with stimulant therapy (methylphenidates or amphetamines).

Previous studies suggest increased risk for a number of physical health conditions in adults with ADHD, but only a limited number of these associations have been thoroughly researched. Moreover, detailed treatment guidelines for adults with ADHD and co-occurring physical disease are largely lacking. Now, researchers at Karolinska Institutet have examined possible associations between ADHD and a wide range of physical diseases in adulthood, and whether genetic or environmental factors are involved.

Over four million individuals (full-sibling and maternal half-sibling pairs) born between 1932-1995 were identified through Swedish registers and followed between 1973-2013. Clinical diagnoses were obtained from the Swedish National Patient Register. The researchers examined the risk of 35 different physical conditions in individuals with ADHD compared to those without, and in siblings of individuals with ADHD compared to siblings of those without.

Individuals with ADHD had a statistically significant increased risk of all studied physical conditions except arthritis. The strongest associations were found for nervous system, respiratory, musculoskeletal, and metabolic diseases. The diagnoses most strongly associated with ADHD were alcohol-related liver disease, sleep disorders, chronic obstructive pulmonary disease (COPD), epilepsy, fatty liver disease and obesity. ADHD was also linked to a slightly increased risk of cardiovascular disease, Parkinson’s disease and dementia.

“These results are important because stimulant therapy requires careful monitoring in ADHD patients with co-occurring cardiac disease, hypertension and liver failure,” says senior author Henrik Larsson, professor at Örebro University and affiliated researcher at Karolinska Institutet.

The increased risk was largely explained by underlying genetic factors that contributed both to ADHD and the physical disease, with the exception of nervous system disorders and age-related diseases. Full siblings of individuals with ADHD had significantly increased risk for most physical conditions.

The researchers now aim to study the underlying mechanisms and risk factors as well as the impact of ADHD on management and prognosis of physical diseases in adults.