Autism prevalence nearly doubles in Israel between 2017 and 2021. Why do you think this is?

Autism prevalence nearly doubles in Israel between 2017 and 2021.  Why do you think this is?
Autism prevalence nearly doubles in Israel between 2017 and 2021.

Autism diagnoses have increased worldwide over the last decade. Initially, autism rates in Israel were lower than those reported in the USA and Western Europe. However, a new collaborative study by Ben-Gurion University of the Negev, Clalit Healthcare, and the Israeli Ministry of Health has found a dramatic increase in the prevalence of autism in Israel between 2017 and 2021 with a 4-fold increase in young 2–3-year-old children and a 2-fold increase in older ages.

The team, led by BGU’s Prof. Ilan Dinstein, analyzed data from the National Insurance Institute (NII), which manages social security for the entire population of Israel, and from Clalit Healthcare, an HMO that treats 52.8% of the Israeli population. According to NII data, the number of individuals with a formal diagnosis of ASD, 1–17 years old, increased from 14,914 in 2017 to 32,222 in 2021.

“Autism prevalence in children 1–17 years old has almost doubled, autism prevalence in children 2–3 years old has increased by a factor of 4.4. This demonstrates a shift towards early autism diagnosis such that in 2021, the autism prevalence was 1% among 2–3-year-old children and almost 2% among 4–5-year-old children,” the researchers wrote.

From 2017 to 2021, autism prevalence rates of 2–3-year-old (day-care) children increased from 0.27% to 1.19% (>4-fold change), 4–6-year-old (pre-school) children increased from 0.8% to 1.83%, and 8-year-old children increased from 0.82% to 1.56% in NII data. Children 10 years old and older exhibited slightly smaller changes in prevalence rates.

“Our analysis shows that the autism population is growing rapidly, particularly at young ages, which means that education and healthcare services are confronted with a huge challenge to keep up with providing the necessary services,” says Prof. Dinstein of the Departments of Psychology and Cognitive and Brain Sciences and Deputy Director of the Azrieli National Centre for Autism and Neurodevelopment Research at BGU.

Research studies such as these are important benchmarks that government ministries can rely on in their preparations for assisting those with autism. Previous research conducted by Prof. Dinstein and colleagues has demonstrated that autistic children who are diagnosed earlier (as early as two years old), are three times more likely to improve in their communication and social skills in contrast to children who are diagnosed at older ages, but this requires intervention and the availability of services and support.

Dr. Dorit Shmueli, Pediatric Neurologist and head of Child Development in the Community Division at Clalit, “The increase in autism diagnosis is global, for many reasons, the main ones being the expansion of the definition, so that today it includes children with normal cognitive functioning, and an increase in awareness, both by parents and by educational frameworks. In Israel, the increase in requests for autism diagnosis and the dramatic increase in the number of children receiving a diagnosis is clearly felt in child development services, and a comprehensive national plan and allocation of resources are required to respond to the growing needs.”

Prof. Gal Meiri, Director of the Child and Adolescent Psychiatry Unit at Soroka Medical Center and Medical Director of the Azrieli National Research Centre for Autism and Neurodevelopment at Ben-Gurion University of the Negev: “The large increase in the prevalence of autism in Israel corresponds with global data in this field. This increase challenges clinicians and the various systems that provide services to children and people with autism and intrigues researchers in Israel and around the world. Autism is a disorder that accompanies people with autism and their families throughout their lives. The early and intensive intervention has been proven to be effective and advances children with autism, and the new data require attention and preparation by policymakers in this area so that proven interventions can reach every child and every person who needs them.”

According to Ronit Shussel, Director of the Knowledge, Research and Training Division at ALUT: “ALUT, the association that leads the treatment of autism in Israel, sees great importance in concentrating data about the autistic population in Israel and the various services they receive. Without the inclusion of data at the national level, the State of Israel will not be able to provide the population with available and high-quality services required to promote their optimal integration into society and the community. As published in ALUT’s Autism State Report for 2021-2022, there is already a significant shortage of educational, welfare and medical services, and without intervention and service planning, this gap will deepen in the coming years.”

“While it is important that the health system in Israel is diagnosing autism at very young ages, it is equally important that intervention services be available to those who are diagnosed – with such fast growth, this is clearly a challenge. Moreover, these children will likely require support at various levels during adulthood. This study is, therefore, a wake-up call for the government to start planning ahead,” says Prof. Dinstein.

The study was unique in using two separate datasets – one from the NII and one from Clalit – and cross-referencing them. The researchers could, therefore, estimate prevalence rates in the entire population of children in Israel with more confidence. The datasets are considered particularly dependable because the vast majority of parents of children with autism apply to one or the other institution for benefits and services. Revealing equivalent prevalence increases in both data sets demonstrates the reliability and generalizability of the findings and conclusions. Previous prevalence studies in Israel and worldwide have not compared findings across multiple sources in this way.

The study was also unique in breaking down the assessment by age groups corresponding to educational settings – an especially useful feature for government ministries and local municipalities to know where to apply their resources.

Replacing animal products with a plant-based diet leads to weight loss, finds new analysis

Replacing animal products with plant-based foods, whether these were so-called healthful or unhealthful plant-based foods according to the plant-based diet index, is associated with weight loss in overweight adults, reduced cholesterol and fat intake, and increased fiber intake, according to a new analysis by the Physicians Committee for Responsible Medicine published in the European Journal of Clinical Nutrition.

“While a low-fat vegan diet rich in fruits, vegetables, grains, and beans is the gold standard for weight loss and improved health, the good news is that a plant-based diet that eliminates animal products and minimizes the consumption of oil can help with weight loss in people who are overweight,” says study co-author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine.

The findings are from a secondary analysis of a Physicians Committee study in which 244 overweight adults were randomly assigned to a vegan group that followed a low-fat vegan diet or a control group that made no diet changes for 16 weeks. Calorie intake was not limited for either group, and neither group was given diet quality instructions.

The new analysis assessed the association of a plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) with weight loss. The PDI measures adherence to a plant-based diet in general, the hPDI includes more fruits, vegetables, grains, and beans, and the uPDI includes more foods such as refined grains and fruit juices. The scores of all three indexes are higher with increased consumption of plant-based foods and reduced consumption of animal products.

In the analysis, all three scores increased for participants following a vegan diet, which was significantly associated with an average weight loss of about 13 pounds, due primarily to the reduction in fat mass and visceral fat. Increased consumption of whole grains and legumes and reduced consumption of meat, vegetable oil, and sweets in the vegan group was associated with weight loss. There was no change in scores in the control group.

What do new moms and roaches have in common?

New knowledge about the link between infection during pregnancy and autism
New knowledge about the link between infection during pregnancy and autism

Researchers are studying the dramatic physical transformation that some insects undergo to give birth to live young.

This includes suppressing their immune systems to accommodate babies, which is something some insects and people have in common. Understanding how these systems work can help improve treatments for fibromyalgia and other immune disorders.

Biologists at the University of Cincinnati were part of an international team examining the complex structural and physiological changes that take place in Hawaii’s beetle-mimic cockroaches, which give birth to live young.

“It’s not just immunology,” co-author and UC College of Arts and Sciences Professor Joshua Benoit said.

Biologists see similar changes in the insect’s trachea, its immune system and the outer layer of its exoskeleton called a cuticle, which transforms to make room for the babies.

The study was published in the journal iScience.

Cockroach mothers not only incubate their babies until they are the equivalent size of a 2-year-old human toddler, but they also feed them a milk-like nutrient they produce through secretory glands.

Nature has devised a myriad of reproductive strategies across the animal kingdom, said Bertrand Fouks, a postdoctoral fellow at the University of Muenster and the study’s lead author. From birds and reptiles to fish, lots of animals lay eggs. In mammals, egg laying is limited to echidnas, sometimes known as spiny anteaters, and the platypus.

“The beetle-mimic cockroach is one of the rare insects which has developed a complex structure to host the growing embryo similar to placenta in mammals, which made it a perfect model to investigate the evolution of live-birth,” Fouks said.

Beetle-mimic cockroaches have big advantages compared to those that hatch from eggs, Benoit said. Tinier babies that hatch from eggs are exposed to the elements where they’re vulnerable to far more parasites and predators and must immediately find food on their own.

“The class of predators really narrows when you give birth to live young,” Benoit said.

But live births require a far bigger parental commitment.

“It’s a pretty big investment. They can produce 10 juveniles per reproductive cycle compared to 70 to 150 eggs for other roaches,” Benoit said. “So their strategy is to produce fewer higher-quality individuals compared to more individuals with less investment.”

Researchers sequenced the genome of the Pacific beetle-mimic cockroach, the only roach that gives birth to live young. They performed comparative analysis with tsetse flies and aphids, which do likewise, to unravel the genomic basis underlying this transition from laying eggs to birthing babies.

They found that the biological changes that allow beetle mimic cockroaches to give birth to live young are similar to those found in aphids and tsetse flies, demonstrating convergent evolution, Benoit said.

Whether it’s a cow, a lizard or a roach, all undergo remarkably similar urinary and genital organ remodeling, enhanced heart development and altered immunity to accommodate their growing babies, the study found.

Researchers are interested in the link between our immune system and pregnancy. Women are less susceptible to infectious diseases but are far more likely than men to have autoimmune disorders such as lupus.

Benoit said some genes dealing with the immune system are down-regulated (the process of reducing or suppressing a response to a stimulus) during pregnancy. That can explain why some women who suffer from autoimmune disorders might see symptoms go away during pregnancy.

Benoit said they see similar effects in the cockroaches.

“These changes may facilitate structural and physiological changes to accommodate developing young and protect them from the mother’s immune system,” he said.

A step closer to injection-free diabetes care: U of A’s innovation in insulin-producing cells

Using a patient’s own stem cells to replace insulin-producing cells “the horizon” for treating diabetes, says researcher
Using a patient’s own stem cells to replace insulin-producing cells “the horizon” for treating diabetes, says researcher

A University of Alberta team has developed a new step to improve the process for creating insulin-producing pancreatic cells from a patient’s own stem cells, bringing the prospect of injection-free treatment closer for people with diabetes.

The researchers take stem cells from a single patient’s blood and chemically wind them back in time, then forward again in a process called “directed differentiation,” to eventually become insulin-producing cells.

In research published this month, the team treated pancreatic progenitor cells with an anti-tumour drug known as AKT/P70 inhibitor AT7867. They report the method produced the desired cells at a rate of 90 per cent, compared with previous methods that produced just 60 per cent target cells. The new cells were less likely to produce unwanted cysts and led to insulin injection-free glucose control in half the time when transplanted into mice. The team believes its efforts will soon be able to eliminate the final five to 10 per cent of cells that do not result in pancreatic cells.

“We need a stem cell solution that provides a potentially limitless source of cells,” says James Shapiro, Canada Research Chair in Transplant Surgery and Regenerative Medicine and head of the Edmonton Protocol, which has allowed 750 transplantations of donated islet cells since it was first developed 21 years ago. “We need a way to make those cells so that they can’t be seen and recognized as foreign by the body’s immune system.”

The researchers suggest this safer and more reliable way to grow insulin-producing cells from a patient’s own blood could eventually allow transplants without the need for anti-rejection drugs. Recipients of donated cells must take anti-rejection drugs for life, and the therapy is limited by the small number of donated organs available. 

Shapiro says further safety and efficacy studies will need to be carried out before transplantation of stem-cell-derived islet cells is ready for human trials, but he is excited by the progress.

“What we’re trying to do here is peer over the horizon and try to imagine what diabetes care is going to look like 15, 20, 30 years from now,” he says. “I don’t think people will be injecting insulin anymore. I don’t think they’ll be wearing pumps and sensors.”

Study examines the devastating impact of loneliness on Autistic people – As an autistic person, are you ever lonely?

New research has revealed just how acutely Autistic people experience loneliness contradicting the stereotype that they avoid seeking meaningful social relationships
New research has revealed just how acutely Autistic people experience loneliness contradicting the stereotype that they avoid seeking meaningful social relationships

New research has revealed just how acutely Autistic people experience loneliness contradicting the stereotype that they avoid seeking meaningful social relationships.

Loneliness negatively affects physical and mental health in both neurotypical and neurodivergent individuals and rates of loneliness are up to four times higher in Autistic individuals than their peers. Autistic people also have a greater vulnerability to the negative physical and psychological consequences of loneliness.

However, social environments often act as barriers, making it more difficult for people with higher levels of sensory differences to interact with others.

A new study, which has just been published by journal Autism in Adulthood, investigated Autistic people’s experiences and sought to not only quantify the level of distress associated with loneliness but also to provide a qualitative insight into Autistic adults’ loneliness.

The authors include Dr Gemma Williams, a public health research officer in the School of Health and Social Care.  She said: “In the quantitative part of the study, our results indicate that sensory differences are related with higher loneliness and associated poor mental health in both Autistic and non-Autistic adults. This effect was exacerbated in Autistic adults due to a greater presence of sensory processing differences.”

For the qualitative part of the study, she collated first-hand reports from Autistic adults on intense loneliness and the obstructive role of sensory environments which refute stereotypes about Autistic adults lacking social motivation.

For example, one of the participants explained that where people live can have a big impact on their social interaction. She said: “The cost of transport in the city, it’s really quite expensive and prohibitive for some people. So, especially if people are out of work or in transient work or zero-hour contracts where they don’t know how much or how many hours they’re gonna get from one month to the next.”

During a cost-of-living crisis, meeting up for activities may be out of reach for many individuals, but Autistic people are especially vulnerable as they frequent experience financial inequalities relating not only to a lack of employment opportunities and support but also access to benefits.

Taken together, the research team’s two studies confirm that loneliness is significantly related to feelings of distress and poor mental health in both Autistic and non-autistic adults.

Moreover, experiencing sensory differences in a world that does not accommodate for variant sensory profiles may drive people to become increasingly isolated, contributing to feelings of loneliness.

One participant described the difficulties she had experienced in making friends: “Sometimes I have trouble having a conversation or to be understood because I don’t have the same thought process. Which makes it weird sometimes and people are wondering ‘what are you saying?’ or ‘I can’t understand what do you mean?’”

Another added: “I’m trying to reach out, I’m trying to find my people, but it all still feels a bit hopeless.”

As sensory differences are especially prevalent in the Autistic community, they may compound other societal, social, and affective factors, ultimately giving rise to higher numbers of loneliness and associated distress.

Dr Williams added: “Our research highlighted how painfully loneliness is often experienced by Autistic adults. We conclude that to enable meaningful and inclusive social interaction, a real societal effort is needed to create spaces that consider the sensory needs of all neurotypes.”