Autism and Cancer

Let me start off by saying this: I have found no research or data that indicates your loved one with Autism is more likely to be diagnosed with cancer because of their Autism. I want you to absolutely understand that because cancer is a scary word. Autism is scary enough on its own and as you have been reading through my blog posts, there is a lot of stuff to know about it, so let’s not compound the Autism stress with scary words like cancer. I, personally, have lost three family members to cancer; cancer runs in my family, and to be quite honest I just don't like this disease.

So why post about it? Because there is a lot of information out there pertaining to a link between certain genetic codes, Autism, and cancer. Certain types of cancer are found to be more prevalence among individuals on the Autism spectrum and I think it’s important for you to know this exists.

The New York Times published an inflammatory and confusing article on this very topic basically stating that Autism has a link to cancer genes. I'm not going to spend much time on it. I prefer the USA Today article published in 2013 on this very topic. According to his article, researchers found in 10% of children with Autism have a mutation of the PTEN gene. This gene is linked to a number of cancers like breast, thyroid, and colon cancer. Autism is also found in approximately half of children diagnosed with tuberous sclerosis. This genetic disorder raises the risk of brain and kidney cancer. Researchers say that a very small proportion of individuals with Autism have PTEN mutations. Scientists have been able to genetically alter mice, with PTEN mutations, to mimic Autism symptoms. These animal studies had prompted a human clinical trial in which a drug is given to children who have Autism and the beginning stages of tuberous sclerosis mutation, scientists hope to wrap up this study later this year, in December 2014. I wouldn't expect to see an official publication of findings until 2015.

What is tuberous sclerosis? The Tuberous Sclerosis Alliance defines tuberous sclerosis (TSC) as a genetic disorder which causes non-malignant tumors in different organs, primarily the brain, eyes, heart, kidney, skin, and lungs. Approximately 1 in every 6,000 births and about 1 million people worldwide have TSC. The cause is either genetic or spontaneous. There are two types of TSC: TSC1- shows on chromosome 9 and TSC2- affects genes on chromosome 16. To understand more about genetics, please read blog series Understanding Genetics. 

TSC of skin

Forbes magazine published an outstanding article in 2013, also about Autism's links to PTEN. They do reference the outrageous accusations made by the New York Times in their article as well. According to Forbes, PTEN is the gene that regulates cell cycles and mutations to this gene have effects that are not just cancerous. PTEN's primary function is to keep cells from dividing out of control, it is also known as the tumor suppressor gene. Of course a mutation in this area could cause tumors to grow, since the cells are not being regulated by PTEN, but that is no guarantee that they will. They also point out that mutations to PTEN cause a type of Autism that is part of a syndrome that impacts head circumference, macrocephaly, along with other characteristics unique to its own disorder. Forbes reports that scientists have known about the link between certain types of Autism and PTEN for almost five years. Approximately 1 in 10 individuals with PTEN mutations also have Autism, which makes a PTEN mutation a risk, not a cause of ASD. Researchers believe that a PTEN mutation, along with other genetic variants may cause Autism in some individuals. Forbes makes a very important statement and I am going to quote it verbatim because it is put so well: "The mutations in the PTEN gene that are linked to autism tend to be different from those for PTEN-associated cancer." In fact a PTEN link to Autism would only affect 1% of the Autism population.

In 2008 SFARI published an article: Autism and cancer share genetic roots, researchers find. During a study which included 18 genes which may impact Autism, researchers found PTEN, TSC1, and TSC2, play a prominent role in cancers and also are linked to some cases of Autism. In mouse studies, removing these genes caused enlarged neurons, seizures, and Autism-like behaviors. For some children with Autism, researchers who suspect PTEN, TSC1, or TSC2, may use a cancer treating drug, Rapamycin, to help treat behaviors associated with Autism. (As you know there is no cure for Autism.) Researchers say that only 2% of those with Autism will have it due to a mutation on one of the three genes listed, but it could help point to the region of genes where things are going wrong.

So what other disorders are associated with Autism and cancer?

There is a type of disorder that changes skin pigmentation and spurs the growth of tumors along the skin, brain and other body parts. It is Neurofibromatosis type 1 (NF1)and according to a 2014 SFARI article approximately 1/4th of those with NF1 also have Autism. NF1 is part of a family of disorders, which are extremely rare, and impact chromosome 16 along with RAS pathways. RAS impacts disorders like fragile X syndrome and TS. (To understand more about Fragile X, please see our blog series Understanding Genetics.) In the UK researchers studying a group of 207 children diagnosed with NF1 and administered an Autism screening questionnaire, the Social Responsiveness Scale, to half of them. Researchers invited a smaller group of these children to undergo further assessment and only 47 committed. So of their group of 47 children they conducted in person assessments. They found that 14 of the 47 had Autism, 13 showed some symptoms of Autism, and 20 did not have Autism. Based on this information they were able to estimate that as many as 45% of children with NF1 show features of Autism and 24.9% will receive a diagnosis of Autism. Based on some of this research, scientists believe in cases of NF, the cause of Autism may be due to a single gene, but more research is needed to prove this theory. 

So what about RAS diseases, without NF involvement? Again a 2013 SFARI article: Cancer pathway connects autism to set of rare disorders, answers our question. Citing an article published in the Journal of Medical Genetics this article states that one in four individuals diagnosed with RAS disorders also have Autism. The four RAS diseases are: Neurofibromatosis Type 1 (NF1), Noonan Syndrome, Costello Syndrome, and Cardio-facio-cutaneous Syndrome (CFC) (to learn more about any of these disorders please click on the name). RAS refers to the pathway of cells that signal the regulation of growth and development of all other cells. Mutations of RAS may lead to cancer, but may also influence the growth of cells like neurons. Of all the RAS disorders, NF1 has the strongest documented ties to Autism. 

Turner Syndrome vs Noonan Syndrome

As you can see the pathways of genes that have been linked to cancer, may play a role when mutated and lead to Autism. It is important for you as a parent to remember first, that these disorders are rare. They are usually discovered very quickly, and if your loved one has not yet been diagnosed with any of the disorders mentioned above, then it is very unlikely that they will not be. What this research does show us is a pathway that can be further studied in order to treat SOME types of Autism. It also gives great hope that the scientific leaps that are being made in this area will bleed over into other forms of Autism and better treatments could be established from it. 

Of course if you suspect any type of disease or disorder described in this post, I strongly advise you immediately speak to your pediatrician or family doctor. 

We hope this has helped you with an entry level understanding of the link between some genetics with ties to both cancer and Autism, but also explained the difference in their mutations. Please follow us on Facebook and Pinterest!

Autism and Diabetes

We have been taking Aiden to an Endocrinologist for high calcium levels. As I was sitting in the waiting room for one of his appointments today a question popped into my mind: Is there a link between Autism and diabetes? Our family has a history of diabetes and this disease is not uncommon in our culture. That question has prompted this blog. 

Evidently I opened a door to a huge topic and large body of research. Studies into diabetes’s affects on Autism are broken into two parts: a prenatal or gestational impact or an individual development of diabetes while suffering from Autism. 

First let’s review exactly what diabetes is. Diabetes is a disease that affects the metabolism of sugars. That is why it is referred to as a metabolic disease in which the body does not properly process glucose (sugar). The development of diabetes is due to one of three cellular reasons: 1- not enough insulin is being produced by the body, 2- the body does not react properly to insulin, or 3- both of these reasons combined. There are three types of diabetes: 

Type 1: Often referred to as juvenile diabetes, these individuals are insulin dependent for their entire lives. The onset of this disease is before the age of 40. Only about 10% of diabetes cases are related to type 1 diabetes. 

Type 2: This type of diabetes is usually due to one of the first two reasons listed above. Approximately 90% of diabetes cases are due to this type of diabetes. Overweight individuals have a much higher risk of developing type 2 diabetes. This disease progressively gets worse over time, but it is controllable and individuals may become insulin dependent as a result. 

Gestational diabetes: This type of diabetes only affects pregnant women. It is caused when a woman's body is unable to process sugar, causing a progressive rise in sugars in the blood. Only about 10-20% of women with gestational diabetes will need medication to control it, most can control this condition with diet and exercise.

Following the natural path of life, let’s begin with gestational diabetes's impact on the development of Autism. In 2009 the British Journal of Psychology published an article titled: Prenatal risk factors for autism: comprehensive meta-analysis. The researchers participating in this article put together over 40 years of research on the topic of prenatal risks for Autism. Obviously one of the many, many risk factors covered in this article is gestational diabetes. The researchers basically said this risk factor may play a contributing role in the child's eventual development of Autism, but the research was inconclusive; which told me that up until 2009, no one had considered studying gestational diabetes in relation to Autism. For researchers to include this information in their final publication indicates there is a high number of gestational diabetes reported in the mother's of Autistic children, but it was not directly linked as a possible cause in previous studies. 

In July 2013 CBS published an article: Study: Autism risk tied to mom's obesity during pregnancy. This article cites a study conducted by researchers with UC Davis MIND Institute in California. This ground breaking study included approximately 1,000 children ages 2-5 and their mother's medical history. The study found that women who were obese during pregnancy were 67% more likely than woman of a normal weight to have Autistic children. Maternal obesity also doubled the risk of developmental delays in children. Researchers also looked into the effect of gestational diabetes in these participants. They discovered that pregnant mothers with diabetes had a 2 and 1/3rds chance of having a child with developmental delays, when compared to healthy mothers. 

Researchers admit more tests and studies need to be conducted in this area. They theorize that obesity is linked with inflammation and sometimes elevated levels of blood sugar, and this blood may reach the developing fetus and damage the brain. This research indicates that obese women have a 1 in 53 chance of having a child with Autism. This CBS article goes on to explain that over a third of American women, in childbearing years, are obese and almost one tenth have gestational diabetes or type 2 diabetes during pregnancy. These conditions may be linked to neurodevelopmental issues in a child. Interestingly Autism rates have increased along with obesity rates. 

In October 2013 SFARI published an article: Diabetic jeopardy. It cites an study published in the Journal of Autism and Developmental Disorders. This study is important because it found that the risk of developing Autism also extends to women who develop diabetes prior to pregnancy. Symptoms of gestational diabetes may start early in the pregnancy process. Research into fetal development shows that key brain development stages for growing babies is in the third trimester and shortly after birth. During the third trimester, gestational diabetes will be at its peak, and the high levels of blood sugar may inhibit the flow of oxygen to the fetal brain, impacting brain development. Researchers reviewed 12 reports of diabetes during pregnancy and Autism in the child. In 9 of 12 studies researchers compared birth history of children diagnosed with Autism and controls. The three other studies followed children over time, both with Autism and without. All the studies showed that children are more likely to have Autism if their mother has diabetes during the pregnancy. In the first set of studies (9 of 12) researchers found that women with gestational diabetes double their risk of having a child with Autism. Maternal diabetes either before or during pregnancy increased the risk of Autism in the child by approximately 50%. The three longevity studies showed that pregnant women with gestational diabetes increase the risk of Autism in their child by approximately 45% and those who developed diabetes before pregnancy increased the risk by approximately 75%, when compared to healthy controls. Researchers also theorize that women with diabetes have a higher amount of inflammatory molecules in their blood, which may impact fetal brain development. 

So does an Autistic individual have a higher chance of developing diabetes, even if they were not born to a mother with diabetes?

This was my next question. When Aiden was born I had gained 40 pounds of pregnancy weight, but I had absolutely no signs of diabetes in any form. In fact my blood pressure was outstanding for someone carrying a child and my blood work came back normal. 

In 2005 the American Diabetes Association published a study: Type 1 Diabetes and Autism. This research study included 984 children with diabetes seen at the Diabetes Clinic in 2002. Of those individuals 9 were identified as having ASD, 7 boys and 2 girls. Of all the data they collected and case studies conducted the researchers concluded that an individual with type 1 diabetes may have a greater risk than the general population of having Autism. The ADA admits their sample size is small and they strongly urge a larger study be conducted. 

In 2011 an article published by Science Daily linked autism and diabetes through hyperinsulinemia. This study, conducted by Rice University, linked Type 2 diabetes and Autism via an underlying impaired gluten intolerance and hyperinsulinemia. Hyperinsulinemia is a condition which there is high amounts of insulin in the blood, resulting in insulin resistance. Insulin resistance is associated with obesity and the development of Type 2 diabetes. Since gluten can increase insulin secretion researchers believe a low carb diet may help some individuals with Autism. Researchers also suggest gluten tolerance in pregnant women be tested as well. These researchers believe that insulin is a key element in Autism, due to its role in cognitive function and its affect on synaptic function. 

When I searched for an article explaining the insulin affect on synaptic function I found lots of research on the topic, but it was not easy to interpret. Rather than mislead or misinform you I think that it is best left to a medical professional to explain this impact, just know it could be playing a role in Autism. 

As you can see there is a lot of information to digest here. I find the correlation between diabetes and Autism very interesting. I hope more research in this area is released in the near future for parents to consider. This is just one more piece to a very big puzzle. 

Diabetes is a serious medical condition and it can be controlled. If you suspect diabetes in a loved one, please take them to see their general care practitioner or pediatrician. 

To read more about diabetes and pregnancy, please read this article from endocrineweb.

To read more about gluten and its impact on Autism, please read our blog: 
Autism and GI Issues: A Gluten Explanation

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Autism and Religion

I have wanted to post about Autism and religion for a while. After Aiden's diagnosis, I like some parents, drew closer to my religion for comfort. I happen to be Christian, but I have read about this phenomenon in Islam and Judaism. What about the individuals who are Autistic? My younger brother, who is high functioning Autistic, is also Atheist. We were raised in the same household, had the same experiences, and were exposed to the same environment, so why the religious difference?

One in every 68 children are diagnosed with Autism. The impact is felt among all races and religions. So let’s explore the perspective of religion in Autism.

In 2012 there was a boom of internet articles about Autism and religion. Researchers found that individuals with Autism or Autistic traits are less likely to believe in God, than neuro-typical individuals. This could be due to Theory of Mind. The theory of mind has been discussed in Autism and Criminal Behavior. Theory of Mind basically refers to the phenomena in which an individual is unable to understand what another person is feeling. Researchers theorize that people believe in a God and have personal relationships with that deity, therefore they worship and someone with Autism is unable to understand why a god would need to feel love through worship. A research article published in 2010 in the journal Child Development showed through brain imaging that the area of the brain responsible for theory of mind is critical when people think about God.

Researchers at the University of British Columbia and the University of California wondered if Autism interferes with theory of mind so much that it affected religious beliefs. They conducted a small study including 12 children with ASD and 13 without. They discovered that youths with Autism were only 11% as likely to strongly believe in God, as their typical peers. Canadian researchers also conducted a study of 327 college students with autism like traits, but without a diagnosis. They had the students fill out a questionnaire ranking the predominance of autism like traits and strength of their religious feelings. This study found that the higher the Autism score the less likely the person would believe in God.

What about neuro-typical individuals? A study conducted in 2007 of American adults showed that 77% of women believe in God, compared to 65% of men. Theory of Mind plays a role here as well, since women are more likely to be adept at theory of mind when compared to the average man. So gender may play a role in theory of mind and religion. If 1 in every 48 boys is diagnosed with Autism Spectrum Disorder than it is statistically probable that more Autistic men will not believe in God.

So what do you do? If you are religious and your Autistic loved one is not, I believe it is important to show acceptance. I often engage my little brother in philosophical discussions about religion. He refers to science often during these discussions and I respond. For instance, he refers to the Theory of Evolution as proof that God does not exist. I simply point out that it could be the will of God to allow the evolution to occur. He and I enjoy these discussions, not because of heated debate, but obvious open acceptance of each other's perspectives. The pillars of every religion preach love and acceptance of others and I find this to be vital in all aspects of life. You can only relay the information, it is their choice to accept it or not. Religion is an individual choice and an individual journey.

We take Aiden to church. There was a time when he resisted going. We think it was due to an experience he had with one of the child care workers. He was not abused in any way, but she was not as understanding of him as she needed to be in order to impact his life positively. We expressed our concerns to the church and they were very understanding. It took me a few weeks to get Aiden to go back to church with a new child care teacher. He had a wonderful time. Now he asks to go back to church, which is a positive thing I want to encourage. During the time he was resistant to go I did not force it on him and he stayed home. I made it a point to pray with him every night at bed time and sing biblical children's songs. I asked every week if he wanted to go, letting him know the option was open to him, but did not force my decisions on him.

You as a parent have to weigh the risks and reward for your own child. There is no one who can tell you what decision is right for your family. I simply share my personal experiences in hope that you can put these tools in your parenting toolbox.
If you would like to read more about Autism and religion I would invite you to read this list of articles:
Livescience: Autism May Diminish Belief in God
Huffington Post: Autism-God Study Suggests Disorder Makes Belief in Diety Less Likely
Psychology Today: Does Autism Lead to Atheism?
Science + Religion Today: Why are High-Functioning Autistics More Likely to be Atheists or Agnostics?

For coping strategies in a religious setting, please see this article:
The National Autistic Society: Religion- Going to a Place of Worship

1,000 Views- Thank you!

Our blog has reached 1,000 views. We are honored and thankful that all of our readers have allowed us to be part of their Autism journey. As always we hope and pray that you have found some answers to your questions and that we have provided a guiding light on your path. We have touched lives in the US, but also in countries like Russia, Canada, Ukraine, China, Australia, and the UK.

So from the bottom of our hearts we wanted to thank you all. Your views motivate us to continue our work. 

Vagus Nerve and Autism

I was looking for a source of inspiration for this post when I opened my email and found it, Vagus Nerve. The Asperger Experts were kind enough to briefly touch on this topic, peeking my interest enough to research it. So now I will share it with you.

So what is the vagus nerve? The vagus nerve is actually the vagus nerves; there are two on each side of the body. These two nerves run from the brain stem to the area of the body known as the viscera. The viscera are the internal organs in the main body cavity, ending in the abdomen. The vagus nerves are very important. These nerves regulate many bodily functions, including your heartbeat and respiration. They also regulate the chemical levels of the digestive system and track the nutrients taken in by the body.

Scientists are actively exploring the possibility that improper vagus nerve function impacts Autism. As we are learning in individuals with Autism the brain is reorganized in a disorganized patchwork of neurons. Scientist studying stimulation of the vagus nerve in rats are seeing a promising trend in the reorganization of the motor cortex. With training exercises, coupled with stimulation the brain's movement control system began to reorganize after just 5 days. Understanding how the brain networks itself is important to develop new therapies for Autism, along with stroke victims, schizophrenia, Alzheimer's, and dyslexia. If you would like to read more, please see this article by MNT.

Vagus nerve stimulation therapy or VNS is showing promise in other areas as well. VNS therapy is used to help treat epilepsy or gastrointestinal issues. A study published in 2010 and accessible through the US National Library of Medicine, addressed a small group of ASD patients with a VNS device, along with epilepsy patients without ASD. The researchers concluded that patients with ASD and epilepsy respond just as well as typical patients with epilepsy to VNS therapy; the researchers also note an improvement in the quality of life of these patients.

So how does the vagus nerve affect gastrointestinal issues? The stomach operates with strong muscular contractions, which push food through the digestive tract. Gastroparesis is a condition in which these muscles do not function normally and therefore prevents the stomach from properly emptying. This interferes with digesting and may cause vomiting and nausea, blood sugar problems, and nutritional deficiencies. There is no cure for gastroparesis. The cause of gastroparesis is not known, but it is believed to be caused by vagus nerve damage. A damaged vagus nerve cannot send signals to the stomach muscles properly and this may cause food to sit in the stomach longer, rather than move on with digestion. As you know from past blogs, doctors are finding that our loved ones with Autism are suffering with gastrointestinal issues at record rates. This could be a contributing factor to tummy troubles and Autism. Please feel free to read this article on gastroparesis by the Mayo Clinic.

So what is VNS therapy? A light electrical box is implanted in the chest, under the skin and a wire runs to the vagus nerve in the neck. The device is small, about the size of a silver dollar, flat, and round. The surgical procedure lasts a little over an hour to an hour and a half; it is typically an outpatient surgery. The device is programmed by waving a wand over the device in the chest. If you want to read more about VNS therapy, please see this article by the Epilepsy Foundation.

To read more about VNS therapy, please see this study published in Epilepsy and Behavior. 

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Social Prompting

"While we were at the pool yesterday Aiden found a little boy, about 5, he was interested in playing with. At first I thought the little boy wasn't interested and wanted Aiden to go away, but then something happened. After some brief social prompting, Aiden made a new friend. The little boy and Aiden made a connection and the two played until we had to leave. I was in awe while he actually engaged in a back and forth conversation, without my help. For Aiden, getting much past "hi" is hard with kids his age. They talked about likes and dislikes, about home life, and played games together. Our therapists would be over the moon to see that. I was sad to take him away, since I knew it meant so much to him. I don't think the other mom had any clue what that meant to me. I think if I had my sunglasses on I would have cried."

Social prompting is largely important and very easy to do. Modeling behavior is important, but talking your child with Autism through social interactions is also important. I wanted to take a moment to talk to you all about my personal experience with social prompting and tell you it’s not just a nice thought. Social prompting takes dedication and hard work on your part as a parent or caregiver. Sometimes when we, as parents, see our children struggling we just want take over them. So if we see our children struggling with social interaction, we want to talk for them. This is ok, for a short time, while they are learning. To talk for your child or loved one is to devalue them as a person. It demotes them. Let them speak for themselves as much as possible. Even non-verbal children and low functioning children can engage in a degree of social prompting.


It starts right away. Aiden, when he was in his 2's had no concept of personal space, and still sometimes regresses to that period. I would interject when I noticed discomfort in the other child's face. I would gently walk over to Aiden, remove his hand, and say "sometimes people don't want to be touched. You need to ask before you touch someone." Eventually it got better, now Aiden, for the most part, keeps his hands to himself unless prompted. For instance while teaching him the game of tag I would take him to the playground, run up to him in the midst of playing, tap him, and yell "tag you're it". I then would run away laughing, yelling "catch me Aiden!" He loves that. Teaching context of social interaction is important. When playing it is important for kids to understand they may be touched and that is ok, but when first meeting someone touching may not be appropriate.


During social interactions I would also point out the other person's facial expressions or bodily reactions to his presence, specifically a shy reaction. Children can be amazing teachers and individuals with Autism can learn from their peers with guidance. I remember Aiden's first recognition of shyness. We were at the park and Aiden ran up to a little girl. She pulled her body away and buried her face in her mom's leg. Aiden turned and looked at me with a "What do I do?" kind of face. I explained "Aiden she is shy. She doesn't know you and sometimes that is a scary feeling. We have to be gentle and very nice to her. Try telling her your name and ask her if she would like to play with you." The other mother seemed relieved. She tried to prompt her daughter to play when Aiden asked, but the little girl shook her head no. Aiden looked at me and seemed sad or disappointed. I said "That's ok. She's not comfortable yet, maybe she'll play in a little bit. Let’s go play on the slide and she can come later." The little girl never joined in, but Aiden now recognizes shy behavior and is nice toward children who exhibit this behavior.

Teaching my son to read the basic facial expressions of others has been important. Aiden has a doodle board, like a Magna-doodle I draw faces on the board and ask Aiden "is this a happy face or a sad face? Is this a sad face or an angry face?" Then we moved to my face. I would make faces at him and ask the same questions. He would laugh and laugh at that game. When he learns his words or math problems he gets rewarded for correct answers with a face drawn on the paper. He loves that.

While watching videos or cartoons I will talk Aiden through some of the things that are happening. For instance, if in his cartoon a child gets a ball taken away and looks sad I will prompt Aiden through that. I ask "Aiden what happened? Is that little boy/girl happy or sad? Why are they sad?" I ask him these questions so I know he understands what is happening. I learned a lot from my younger brother, who in his adult years has been diagnosed with ASD. I remember so frequently he would ask "what happened" while watching a TV show or movie. My parents were dumbfounded by that question and they would say "have you been watching? Then you should know". I now understand that this is common among individuals with ASD. They do not understand the social context of what is happening and are asking for clarification. They are watching and they do know what has happened, but they do not understand it. It’s like being plucked from your everyday life and suddenly dropped in the middle of a foreign country. All the mannerisms, greetings, gestures, common social interactions would be foreign to you. For instance, did you know is some Asian cultures you bow instead of shake hands? Of course you did, but do you understand the meaning behind the bow? You're bow level is representative of social class or status. A poor man bows lower than a rich man, though they both bow to greet the poorer man must bow below the level of the richer man. But a rich man will bow lower than a teacher, since teachers are highly respected in Asian cultures. There are many other rules for bowing; it is not always liked to social status or class. Failure to properly bow is considered disrespectful. That feeling, not knowing, not understanding, is how your loved one with ASD feels in social interactions they struggle to understand.

How do you socially prompt a non-verbal or low functioning individual? Some slight changes will do the trick. First, talk. Talk about what you see, point it out. You can use TV shows, cartoons, and other children for this. Even if it feels like your child isn't looking at what you are showing them, point it out any way. "Wow, Caillou looks sad" or "Look how happy Caillou is!" Also talk about social context "Oh no, Caillou fell and is sad. Look he's crying. He must be hurt. Poor, Caillou." (Note: Caillou is a kid’s show on PBS and Sprout network. I love that show since emotions are exaggerated and discussed by the narrator.) After talking about it for a few weeks, try introducing pictures. Hold up two pictures, one happy and one sad. Ask, "Show me the happy face", and allow them to point it out. If it does not work, don't be discouraged, use the pictures as flash cards and show them individually. Model the expression on your face. Eventually it will click. Never under estimate the intelligence of your loved one with ASD. After happy and sad are mastered, try other emotions like angry or scared. Carry a chart with you and ask how they feel. Have them point to the feeling on the chart.

So what happens after they say "hi"? I would notice Aiden would say hi and not know what to do next. He would constantly repeat "hi" and strain the polite responses from his peers. That's when we moved on. "Aiden, ask them what their name is" or "Tell them your name" is next. Eventually that turned interactions into "Hi, I'm Aiden." This was great until he did not know how to respond after he got their name. A child would say "Hi. I'm Logan" and Aiden would light up. They responded to him and then we had to practice the ultimate goal: "Would you like to play with me?" After mastering that introduction Aiden would play with his new found friend and the conversation would flow. The introductory paragraph to this blog is a Facebook status I typed today. Aiden needed less social prompting than ever before. His conversation with the other child went so much further than ever before. He found ways to identify in a meaningful social interaction with someone his age. The dialogue was open and two sided, with appropriate feedback from both children. Aiden listened and appropriately responded. 

Above all else be encouraging, prompt speech, even if your loved one is non-verbal. Teach them basic sign language for emotions, like happy and sad. Always reinforce the method in which they choose to communicate with you. I frequently prompt Aiden to "use your words." Words don't always mean verbal words. Be persistent. Your loved one has the ability to accomplish so much, even if they are non-verbal that does not mean they are not intelligent. Look at Carly Fleischmann:

Social prompting and education is an important part of any child's life. Typical children will learn social interaction by observation and practice. Autistic individuals need more than that. Plopping them down in a play group will not always solve the social struggles; in fact it may promote isolation. Engage them, challenge them, and be there for them through the interactions they face. 

We hope you've enjoyed our post and it gives you ideas how to engage your loved one in social interaction. Above all we hope it helps you understand the importance of social education and inclusion in your loved one's life. 

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Autism and Anxiety

Anxiety disorders have real ties to Autism. Some individuals find that through treatment of anxiety their Autism improves as well. Its an interesting claim. .There is no doubt that anxiety deeply impacts all those who suffer with it and compounded by the sensory processing disorder component of ASD it can be a nightmare. So lets wade through this topic of Autism and learn the symptoms, treatments, and impacts of Anxiety.

Anxiety is a seemingly uncontrollable fight or flight response to a situation that causes an individual extreme stress. Anxiety in children is normal and every person experiences anxiety from time to time. Normal anxiety is not the focus of our topic today. We want to focus on the disorders: generalized anxiety, OCD, phobias, social phobia, panic attacks, and PTSD. There is no known cause for anxiety disorders. There is a strong genetic link between family members and anxiety disorders. Some of these behaviors can even be learned, especially in children. Symptoms of anxiety disorders of some kind include, but are not limited to:

• Excessive worry
• Sleeplessness or sleep difficulty
• Restlessness or fatigue during waking hours
• Trouble concentrating
• Irritability
• Depression
• Preoccupation or obsession with one subject
• Excessive thirst
• Stomach upsets, loose bowel movements, frequent urination, and gas
• Muscle Aches
• Headaches
• Dizziness
• Tremors

Cognitive Behavioral Therapy (CBT) is the most common anxiety treatment, it is also the most effective. This type of therapy uses gradual exposure to the item or thing that causes anxiety. It also teaches relaxation techniques and uses something called cognitive reconstructing. Which basically means that during therapy sessions the therapist uncovers the mental thought process of the patient and shows them where the process goes "wrong", then they assist the patient in reconstructing the thought process in a positive way. Essentially its a relearning process. Since CBT is verbally based it is difficult, to say the least, for some on the ASD spectrum to participate in this kind of therapy. Some medication maybe available to help control symptoms of anxiety. Please consult your mental health care specialist if you suspect anxiety disorder in your loved one.

The Indiana Resource Center for Autism published an overview of more than 31 studies which focused on anxiety disorders of children under 18 also diagnosed with ASD in 2011. The University of Amsterdam found that 40% of children with ASD had at least one co-morbid anxiety disorder. Based on these studies the types of anxiety disorders in youths with ASD differ. For instance Specific Phobias (ex: arachnophobia) is seen in approximately 30% of youths with ASD. Panic disorder is only seen in approximately 2% of ASD youths. 

In 2013, SFARI published an article highlighting the findings of a study published in the Journal of Child Psychology and Psychiatry. Approximately 84% of children with Autism are also affected by anxiety. Researchers studied 128 families with at least one child with Autism and 80 control families. When compared to controls the children with ASD experienced more forms of anxiety, according to their parents. The study also found that unaffected twins had a higher level of social anxiety, generalized anxiety, and panic when compared to controls. This is important because it suggests the shared environment or shared genetics with their ASD sibling puts them at higher risk of suffering from anxiety disorders. This study also found a strong link between intelligence and the type of anxiety suffered. Social anxiety is likely to be suffered by individuals with high intelligence. Separation anxiety is more prevalent in those with low intelligence. Children with ASD who demonstrate repetitive behavior are more likely to suffer from OCD. 

In March 2014 Scientific American published an article about anti-anxiety medications being used to "treat" Autism. Autism has no cure, I cannot stress that enough. These studies, published in Neuron, are preliminary in nature and are still in animal trials, but the results show promise. Mice bred to have Autism like symptoms are injected with low doses of anti-anxiety drugs show improved behavioral changes, specifically n social interaction. repetitive behaviors, and spatial learning. 

Anti-anxiety medications are made, in part, of benzodiazepines. This chemical agent enhances the effect of GABA neurotransmitters in the brain, acting like a kind of sedative. Benzodiazepines make the GABA neurotransmitters stay open longer, allowing the receptors to gather more information being sent to them. High amounts of benzodiazepine caused lethargy in the mouse studies and researchers are not sure why, so getting the dosage right is key. Some types of benzodiazepine's are already used to treat epilepsy. Over all anti-anxiety medications are generally safe to use and cause little side effects in otherwise healthy people. So researchers are excited about the possible positive effects in ASD treatment plans. 

As always, if you feel your loved one is suffering from a serious health issue, such as anxiety, please talk to a health professional. For more information on Anxiety and its relation to Autism please read these links:

National Autistic Society: Anxiety in adults with an autism spectrum disorder

Autism Speaks: Managing Anxiety in Children with Autism

KidsHealth: Anxiety Disorders

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