ask a researcher – Olga Tennison Autism Research Centre

Is a change in diet effective for children with…

July 30, 2019July 30, 2019

Complementary and alternative treatments such as the Gluten and Casein-Free Diet (GFCF), while not recommended in national and international guidelines on autism intervention, are extremely popular among families of children with autism, with a reported use between 52% and 95%.

The GFCF diet has been promoted as a treatment for the core symptoms of autism as well as the gastrointestinal (GI) symptoms that might be present in children with autism. The unproven rationale for this treatment is that GI and behavioural symptoms of autism originate from an impaired ability to break down dietary proteins present in gluten and casein, which would results in the formation of chemicals that cross the intestinal membranes, enter the bloodstream, and damage the brain.

This hypothesis was recently tested in a number of rigorous studies, all failing to show that children with autism have “leaky guts”. While anecdotal reports have reported improvement in autism symptoms with the GFCF diet, controlled studies have been limited. Based on preliminary findings, available research data do not support the use of GFCF diet as an effective treatment for individuals with autism.

However, given the real hardships associated with implementation of a strict GFCF diet, additional studies are needed to assess risk factors and possible markers that identify individuals who might benefit from these diets. Families must consider the implications of further dietary restriction in a child who may already have a limited food repertoire. Because bone loss has been reported in children on the GFCF diet, consultation with a registered dietician is recommended before foods are eliminated from the child’s diet. Proper nutrition is as important for people with autism as it is for anyone else.

– Dr Giacomo Vivanti

Adults with autism

Can a diagnosis of Aspergers in an adult have…

July 30, 2019July 30, 2019

Individuals with Asperger’s syndrome (AS) may have difficulty with social interaction that hinders them from successfully beginning, developing, and/or maintaining an intimate relationship with another person. To our knowledge, there has not been any published research conducted on the area of romantic relationships and adults with AS.

There are various challenges experienced by Neurotypical (NT) individuals who know someone close to them who has a diagnosis of AS. Examples of the challenges outlined in the literature vary from organising a holiday, planning a wedding, and maintaining a sexual relationship with a person diagnosed with AS.

Additionally, NTs may be in an intimate relationship with a partner with AS who has deficits in empathy and spontaneity. Therefore, there may be some personal costs associated with maintaining a relationship in terms of the mental effort exerted by the individual with AS to maintain the relationship and to their NT partner in having to change their expectations of the relationship.

While the literature does not explicitly address whether a formal diagnosis of AS will help couples in a relationship, a clearer understanding of the impact that AS is likely to have on a romantic relationship is likely to provide couples with an opportunity to explore strategies to resolve the unique issues that may arise within their relationship.

– Carmela Germano

Adults with autism

How do I help my teenage son with Autism…

July 30, 2019July 30, 2019

Often with autism, socialising for the sake of socialising seems pointless, and there needs to be a purpose for interaction with other people. So carrying out a task in the company of other people is one way of not becoming isolated. This might include a hobby club, a sporting activity, an environmental task in the community, learning a new skill, teaching or mentoring other students or getting a part-time job.

Having the company of people, and carrying out productive activities with them may be sufficient to prevent loneliness. If this is in a predictable, nonthreatening, non-judgemental environment, then trust will be built up, and companionship may extend to friendship with time.

If your son is standing off to one side, he may be observing and learning social skills, and may be working out whether any of his class mates are ‘suitable’ as potential friends. Alternatively, he may be watching people socialising and this may be emphasising their ‘differences’ to him and could be a bit demoralising.

Not all those with autism need a lot of friends, and this may be a time in his life when the benefits of avoiding activities in the company of teenagers outweigh the stress involved with doing so. Teenagers can be pretty full-on, and he may find it easier to make friends when everyone calms down a bit with age.

– Naomi Bishop

Ask an Autism Researcher

Can the use of ICT support the learning of…

July 30, 2019July 30, 2019

There are still very few studies examining the use of iPads in an attempt to support the learning of children with autism.

What we do know is that there is a long history of research examining computer-assisted instruction (CAI). From this, we know that some children concentrate better, are more motivated to engage, and at times perform better when taught with the assistance of a computer compared to face-to-face didactic teaching. We also know that some children with complex communication needs benefit from the use of low-tech and high-tech communication aids, designed to support expressive and receptive communication.

It would be reasonable to say that using iPads in the classroom has both potential benefits (e.g., student engagement and learning) and risks (e.g., distraction, lack of social interaction, cost/breakage). As with all technology used in the classroom, it is therefore a matter of weighing up the benefits and risks on a case-by-case basis.

– Dr David Trembath

Ask an Autism Researcher

What is the best evidence-based treatment for children with…

July 30, 2019July 30, 2019

A very good starting point for comparing different interventions is the Raising Children Network’s ‘Parent Guide to Therapies‘ which provides a description of the most commonly used interventions in Australia, as well as a rating for research evidence, time commitment required, and cost. Research Autism, based in the UK, provides a similar service and is also well worth a look.

Even when we consider only those interventions for which there is good research evidence, we find that there is currently no single best intervention which works equally well for all children with autism. This is no doubt due in large part to the fact that the individual skills and needs of each child, and his or her family, are unique.

– Dr David Trembath

Ask an Autism Researcher

Can the Measles, Mumps and Rubella (MMR) vaccine cause…

July 30, 2019July 30, 2019

It has been shown that the evidence for the causal link between MMR vaccine and autism was weak at best, and incorrect at worst. Andrew Wakefield, who published this evidence has been exposed as fabricating his data. For a really quick overview and lots of extra reading on this go to his Wikipedia page.

Parental doubt and confusion is caused by the fact that first symptoms (if not diagnosis) are often observed at the time of, or shortly after, the vaccination, so there is a temporal link but not a causal link between vaccination and observation of first symptoms. Current research indicates some brain differences as early as six months in children who are not yet showing signs of autism but go on to do so in the second year of life.

– Dr Elfriede Ihsen

Ask an Autism Researcher

Is there a link between Rubella and autism?

July 30, 2019July 30, 2019

We are aware of just one study by by Libbey, J., Sweeten, T., & Fujinami, R. (2005, PDF 93.6 KB) has summarised the evidence for a causal link between prenatal maternal Rubella and Autism.

In this paper the authors conclude: “The best association to date has been made between congenital rubella and autism; however, members of the herpes virus family may also have a role in autism. Further research is needed to clarify … the mechanisms whereby viral infection early in development may lead to autism.”

It is well documented however, that prenatal maternal Rubella causes brain damage in the unborn child, especially when the mother contracts the Rubella virus in the third trimester. The extent of the brain damage and hence the impact on child’s development varies substantially, but some children unfortunately are intellectually, visually and/or hearing impaired. As the paper listed above suggests, there may be some link with autism as well, but more research is needed before it can be categorically stated.

– Dr Elfriede Ihsen

Ask an Autism Researcher

Can I pass Aspergers on to my children?

July 30, 2019July 30, 2019

This is a very difficult question to answer, because there are different causes for autism and Aspergers, with some of these conditions being highly heritable and others are not.

Most scientists agree that these conditions on the autism spectrum are caused by a combination of biological and possibly environmental factors, with the resulting genetic anomalies affecting brain growth and development. Possible environmental factors, such as parental age or exposure to toxins during pregnancy may contribute to some of the ‘autisms’. The genetic anomalies may or may not be inherited from the parents because some autism spectrum conditions are due to what is called ‘de novo mutations’. These are mutations that happen spontaneously, without a known cause, in the father’s sperm or mother’s egg, or early in the development of the embryo. To what extent the environmental factors contribute to these de novo mutations is not known.

When autism (or Aspergers) runs in families it is clear that they are at least partially inherited from the parents and/or the extended family. The parents or other family members may not necessarily have a diagnosis, but are carriers of genetic anomalies which in combination may cause autism in their offspring. And once there is one child with autism in the family the chances of this family having another child with autism increases from 1-2% (1 – 2 in 100 children in the general population have autism) to nearly 20% (1 in 5 children).

Exactly which genes and which combinations of genes are involved remain unknown, with between 300-400 genes implicated to date. Thus the consensus amongst scientists is that it is likely to be many genes and that variations may vary from individual to individual. This makes the calculation of risk in individual families extremely complex, if not impossible at this time.

If you are concerned about this issue of heritability, we advise you to consult a genetic counsellor who may help you identify some ways of decreasing risk, such as ‘sorting’ female and male embryos (as the risk of autism and Aspergers is lower for females). We do not necessarily recommend this intervention, and such approaches may be costly.

– Dr Elfriede Ihsen

Ask an Autism Researcher

Is autism caused by gut bacteria, as suggested by…

July 30, 2019July 30, 2019

This is one theory among many others put forward to explain the enigma that is autism.

Some children with an Autism Spectrum Disorder (ASD) appear susceptible to gastrointestinal (GI) conditions. Indeed, Autism Speaks, the US based organisation, funded the development of evidence-based guidelines for physicians to use to screen, assess, and treat GI conditions in children with autism, recognising that their treatment can improve the quality of life for these children and their families.

However, this research is in the early stages, with the findings to date providing no evidence that gut bacteria and their by-products cause autism, even a subgroup of them, or that treating the gut can alleviate the specific symptoms of autism.

Like the discredited MMR vaccine theory, the gut theory targets those cases of ‘regressive’ autism, where young children develop symptoms after a period of seemingly typical development. Regression most commonly occurs between 15 to 20 months of age, and these children tend to have more severe symptoms. Whether these are the children who are most vulnerable to GI problems remains to be determined.

Caution needs to be exercised in implementing treatments based on a theory with an insufficient evidence base. Unproven treatments can incur high costs to vulnerable families, often at the expense of securing effective behaviourally based intervention for which there is a solid evidence base.