AUTISM FIRST STEPS
AUTISM DAILY NEWSLETTER
Saturday January 12, 2002
INDEX:
* Common drugs and the pursuit of a
good night's sleep
* No
hard evidence' to link landfills with child illness
* Disabled
teen treks 380 km around island
* Attention-Deficit/Hyperactivity
Disorder in Children and Adolescents With
Obsessive-Compulsive Disorder: Fact or Artifact?
* Measles
epidemic ruled out despite fall in MMR jabs
* Letter:
Our MMR shame
* Immune
Gene May Be Involved In ADHD Susceptibility
* Big Brother Goes to School
******************************
Common drugs and the pursuit of a good night's sleep
Sleep is an essential part of our lives. Yet, we know relatively little about
how sleep is regulated or what disrupts it. There are more than 90 recognised
sleep disorders, many of which are very common. For example, a recent report
estimated an 11·9% prevalence for insomnia in Norway (Sleep 2001; 24:
771-79). Many sleep disorders are associated with medical or psychiatric
conditions, but for each disorder some cases--no-one is sure how many--are
induced by commonly prescribed drugs. Little research is being done on these
side-effects, says Merrill Mitler (Scripps Research Institute, La Jolla, CA,
USA), who lists methylxanthines, ethanol, non-sedating antidepressants, and
anti-Parkinson's drugs among those that can disrupt sleep. "This does not
mean patients should stop their medication. Instead, doctors must learn to
adjust medications and their timing to minimise these undesirable
side-effects", he stresses. "We know a lot about what happens in our
brains when we are asleep and awake but we know much less about the control of
these events", explains Joan Hendricks (University of Pennsylvania,
Philadelphia, PA, USA). "If we could get at these basic mechanisms we
would be better able to help people with sleep disorders." Hendricks
studies sleep in fruit flies. "In these insects, which sleep for 8 h a
day, we have discovered that cAMP response-element binding protein [CREB]
promotes wakefulness. Sleep also promotes wakefulness, so maybe it acts through
the same signalling system", she suggests (Nat Neurosci 2001; 4:
1108-15). No prescription drugs directly target CREB but, says Hendricks,
"any drug that increases neural activity will upregulate CREB" and
could promote wakening. While CREB is a prime candidate for the body's wake-up
call, adenosine is the front-runner for a sleep-inducing signal. Accumulation
of extracellular adenosine in the brain seems to promote the onset of
sleepiness after prolonged wakefulness, explains Mitler. "Drugs containing
methylxanthines, for example some of the asthma drugs, probably cause sleep
disturbances through this pathway." And everyone knows about the sleep-disrupting
effects of the methylxanthine caffeine. What about other prescription drugs
that disrupt sleep? "Many neurotransmitters are involved in initiating and
maintaining sleep", says Timothy Roehrs (Henry Ford Hospital, Detroit, MI,
USA), "so any drug that disrupts normal neurotransmitter functioning can
have sleep-disturbing effects." Roehrs' recent interest is in ethanol
which, at high doses, can disturb sleep. However, ethanol can also be sedating.
Among its effects on neurotransmitters, ethanol works synergistically with 
-amino
butyric acid (GABA) to hold open the GABA receptor ion channel, thus
facilitating an inhibitory transmitter. Roehrs has found that low doses of
ethanol lengthen stage III/IV sleep in insomniacs but have no effect in normal
sleepers. Stage III/IV sleep is considered deep, restorative sleep and people
with insomnia tend to have less stage III/IV sleep than normal sleepers so
maybe this is why insomniacs will self-administer alcohol if given the chance.
Old hypnotics, such as benzodiazopines, suppress stage III/IV sleep but newer
hypnotics do not. However, says Roehrs, "if you compare old and new
hypnotics, even though the patient gets more III/IV sleep with the latter, they
typically report no subjective difference in the morning". The complexity
of the relation between sleep laboratory data and subjective reports is a
recurring theme in sleep research. Antidepressant drugs provide another example
and also illustrate the complex interplay between illness-induced sleep
disruptions and those caused by the cure. "The effects on sleep of
depression versus those of antidepressants are hard to tease apart", says
Karl Doghramji (Thomas Jefferson University, Philadelphia, PA, USA).
"Also, two medications with similar effects on depression can have very
different effects on sleep architecture." Doghramji describes a study in
which the selective serotonin reuptake inhibitor (SSRI) fluoxetine decreased
sleep quality whereas the non-SSRI antidepressant nefazodone improved sleep
quality according to lab measurements. "Depression decreased equally with
both drugs and both sets of patients reported sleep improvements", says
Doghramji. "Similarly, the supression of rapid eye movement sleep [REM] by
tricyclic antidepressants has been correlated with efficacy. Many of the newer
antidepressants also decrease REM sleep but there is little known correlation
between this objective sleep measure and subjective responses. Our
understanding of the implications of these data is in a state of infancy, but
as a clinician I would tend to choose those drugs that improve sleep,
particularly for patients who have a pre-existing sleep problem." This
counts out most SSRIs, which probably cause sleeplessness by stimulating the
5HT2 postsynaptic receptor. Parkinson's disease is another illness in which
both the disorder and therapeutic drugs affect sleep. "There is a swamp of
contradictions in the literature about anti-Parkinson's medications and effects
on sleep", says Mitler. "We don't even have a good database on
L-dopa. Some reports say it is alerting; others say it sedates. We have to make
clinical decisions about which drug to prescribe in an information vacuum."
Mitler hopes to remedy this, at least in part, in his studies on L-dopa and
sleep patterns. No-one doubts, however, that dopamine agonists cause
nightmares, says James Pagel (University of Colorado Medical School, Denver,
CO, USA). "How many nightmares are associated with prescription drug use
is not clear but nightmare occurrence has been reported in the past 10 years
for 36 different drugs. Most are medications that affect neurotransmitter
levels", he explains, "but some other drugs also cause nightmares,
for example, ciprofloxacin. Until recently clinical trials did not ask about
dreaming as a side-effect. With standardised trial reports, at last we are
getting real data about the impact of medications on dreams. It's kind of
delightful to have that and it's going to shake up the whole field."
Others are less optimistic about progress in understanding how common drugs
affect sleep. "Drug manufacturers are not particularly interested in
showing the shortcomings of their medications", says Mitler. In the end,
concludes Hendricks, "we will probably need to unravel the molecular basis
of sleep regulation before we can understand how drugs alter sleep to both good
and bad effect". Jane Bradbury
http://www.thelancet.com/journal/vol359/iss9301/full/llan.359.9301.news.19081.1
******************************
No hard evidence' to link landfills with child illness
A STUDY of 83
landfill sites has not yielded enough evidence to link them to congenital
disease in the local population, the public health report revealed. The report
highlighted an unpublished study into whether proximity to landfill sites poses
a risk of children being born with conditions such as spina bifida.The siting
of landfill dumps around the country has met with huge opposition from locals,
many of whom are concerned at potential health hazards.Eugene Boyle, the
authority's director of mapping, said yesterday there was no hard evidence that
the sites contributed to high levels of congenital anomalies.Although there
were slightly elevated levels in some areas they were not enough to be
significant. However, the authority is to carry out further studies.Speaking at
the launch of the report, public health specialist Dr Marie Laffoy also called
for stricter enforcement of road safety legislation, pointing to findings that
only 50pc of people in cars are wearing seat belts.The authority is urgently
calling for permissible levels of blood alcohol to be reduced from 80mg/100 mls
to 50mg/100mls for drivers.Speed limits in urban areas should be reduced from 30mph
to 20mph and random breath testing should be started, she urged. The penalty
point system also needs to be launched without delay .It is estimated there are
up to 1,500 deaths due to unintentional injury every year and the decline in
mortality rates has been disappointingly low.Other causes include accidental
poisoning and falls among the elderly.Commenting on the continuing low levels
of vaccination take-up to protect against diseases such as measles, Dr Brian
O'Herlihy, Director of Public Health, said this generation has forgotten the
damage infectious diseases can do.He also blamed the ongoing reports in the
media linking vaccines to disorders such as autism for which there is not
scientific evidence. Chief executive of the health authority Donal O'Shea said
a major priority will be to reduce inequalities in health status and access to
health care.
Eilish O'Regan
http://www.unison.ie/irish_independent/stories.php3?ca=9&si=669825&issue_id=6697
Editors note: It sems to me everything is getting blamed on the autism and
vaccince connection.
******************************
Disabled teen treks 380 km around island
In an attempt to demonstrate that even disabled people can contribute to
society, 17-year-old Kazuma Tanigawa completed a 380-kilometer walk around
Okinawa on Jan. 1 in Naha. Tanigawa is autistic. Tanigawa left Naha on Dec. 22
and walked for more than 10 hours and 30 kilometers a day. Although tempted to
quit due to his initial exhaustion, Tanigawa found the strength to persist as a
result of the encouragement received from his family and from people he met
along the way. Despite experiencing the unfamiliar and unknown, he was
successful in overcoming some of the physical and mental obstacles presented by
autism.
http://www.japanupdate.com/previous/02/01/09/story7.shtml
******************************
Attention-Deficit/Hyperactivity Disorder in Children and
Adolescents With Obsessive-Compulsive Disorder: Fact or Artifact?
DANIEL A. GELLER, M.D. ; JOSEPH
BIEDERMAN, M.D. ; STEPHEN V. FARAONE, Ph.D. ; KATHLEEN CRADOCK, B.A. ; LISA
HAGERMOSER, B.A. ; NOREEN ZAMAN, B.A. ; JEAN A. FRAZIER, M.D. ; BARBARA J.
COFFEY, M.D. ; THOMAS J. SPENCER, M.D.
Dr. Geller is Director of the Obsessive Compulsive
Disorder Clinic, McLean Hospital, and Assistant Professor of Psychiatry,
Harvard Medical School, Boston. Professor Biederman is Chief of the Joint
Program in Pediatric Psychopharmacology, Massachusetts General and McLean
Hospitals, Boston. Drs. Faraone, Spencer, Coffey, and Frazier and Ms. Cradock,
Ms. Hagermoser, and Ms. Zaman are with the Pediatric Psychopharmacology Clinic,
Boston.
JOURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT
PSYCHIATRY 2002;41:52-58
ABSTRACT Objective: To clarify whether the symptoms of
inattention and distractibility commonly seen in children and adolescents with
obsessive-compulsive disorder (OCD) represent true comorbidity with
attention-deficit/hyperactivity disorder (ADHD) or a manifestation of
obsessional anxiety. Method: Phenotypic features and functional correlates of
ADHD-like symptoms were examined in youths with and without OCD from a large
sample of pediatric psychiatry patients consecutively referred since 1997.
Results: The number, frequency, and types of core ADHD symptoms as well as
ADHD-associated functional indices were identical in all youths with DSM-IV
–diagnosed ADHD irrespective of the presence or absence of comorbid OCD.
Conclusion: These findings suggest that when ADHD-like symptoms are seen in
youths with OCD, they reflect a true comorbid state of OCD plus ADHD and that
the ADHD syndrome may be independent of OCD in comorbid youths.
http://ipsapp003.lwwonline.com/content/getfile/2600/88/11/abstract.htm
******************************
Measles epidemic ruled out despite fall in MMR jabs
BY HELEN RUMBELOW
THERE is no danger of a measles epidemic in Britain, the Government’s Chief
Medical Officer said yesterday in a significant reversal of previous advice.
Sir Liam Donaldson’s confident new approach contradicts the advice of disease
experts from the Public Health Laboratory Service. For several years they have
been issuing warnings that the low uptake of the MMR vaccine could lead to a
measles outbreak in Britain. Currently, 84 per cent of children are getting the
vaccine, the lowest level since it was introduced, and more than 10 per cent
below the World Health Organisation minimum to protect against outbreaks.
Government officials believe, however, that alarmist talk, heightened by the
furore when the Prime Minister refused to reveal whether his son had received
the MMR jab, is scaring parents. “There is no epidemic of measles and there
is no concern that there will be,” said Sir Liam. “There are not large
numbers of children dying of this disease.” This contrasts with the advice of
Mike Catchpole, director of the laboratory service’s Communicable Diseases
Surveillance Centre, who said last year: “We are below the critical threshold
at which point we run the risk of getting a large number of cases. We have to
reverse that trend because there is a significant chance we will get a major
measles outbreak or an epidemic.” The laboratory service said last night that
it was still concerned about measles outbreaks, especially in areas where
uptake was particularly low. In some boroughs in the South East, it is below 75
per cent, although the latest figures suggest that there could be a slight rise
this year.
Copyright
2002 Times
Newspapers Ltd. This service is provided on Times Newspapers' standard terms and
conditions. To inquire about a licence to reproduce material from The
Times, visit the Syndication
website.
http://www.jabs.org.uk/
******************************
Letter: Our MMR shame
The Independent - United
Kingdom; Jan 11, 2002
BY SUSAN HAMLYN
Sir: If, as Mr Wadeson suggests, we should "accept the minuscule risk that
we may be one of the unfortunate, rare individuals who suffer an adverse
reaction" to the MMR vaccine (letter, 9 January), then we must also accept
the damage done to these "rare individuals" as a necessary evil in
the interests of the majority. We must also, presumably, acknowledge our
responsibility to care for the damaged individuals according to their medical
needs and not force them to spend years in courts of law, making a case which
shames us all.SUSAN HAMLYNLondon W5All Material Subject to Copyright
http://www.jabs.org.uk/
******************************
Immune Gene May Be Involved In ADHD Susceptibility
The immune system may be involved in the susceptibility to childhood
attention deficit hyperactivity disorder (ADHD), according to Israeli
scientists.
Attention deficit hyperactivity disorder (ADHD) is a common childhood
neurodevelopmental disorder. The causes of ADHD are unknown, but genetic
factors are important. Now Israeli scientists report in Molecular Psychiatry
the first findings supporting a possible involvement of a gene related to
the immune system in susceptibility for ADHD.
ADHD is a common neurodevelopmental disorder characterized by inattention,
hyperactivity and impulsivity. It affects 4-10% of school age children,
exacting a significant clinical and public health toll.
ADHD constitutes one of the main reasons for referral to
neurological/psychiatric treatment in this age group, and results in
exposure of many children to prolonged courses of stimulant medication such
as Ritalin.
Untreated, ADHD may lead to impairments in schooling and social adaptation
in a critical period of development, eventuating in damage to the child's
self esteem and personality development, with high rates of depression,
conduct disorder, school dropouts and substance abuse.
The causes of ADHD are unknown. Current theories suggest altered brain
activity of chemical transmitters such as dopamine and norepinepherine may
play a role. This is based on pharmacological observations showing reduction
in symptoms in response to stimulant drugs such as Ritalin which augment
dopaminergic and noradrenergic activity in relevant brain areas. However,
the current findings avoid simplistic neurochemical explanations.
Family studies suggest a major heritable contribution to ADHD, but the mode
of inheritance remains obscure. To date, the search for actual genes
involved focused mainly on the dopamine system, with some findings
suggesting a possible involvement of dopaminergic genes in risk for ADHD.
The current study is the first to report the possible involvement of a gene
encoding a modulator of the immune system in ADHD.
Recent evidence supports the involvement of immune modulators in brain
processes outside the realm of their classical role in inflammatory
responses. One of the major modulators, interleukin -1 (IL-1) is expressed
in the adult brain, and plays a role in maintaining neural plasticity,
neuroprotection and response to non immune stressors.
Recent theories suggest it may be involved in psychiatric disorders such as
depression. In addition, IL-1 has been shown to modulate neuronal cell
growth during embryonic brain development, and shown to promote the
maturation of dopaminergic neurons.
The authors hypothesized that genetically based differences in IL-1 activity
may result in altered dopaminergic neuronal maturation during early brain
development.
Such alterations may bear direct relevance to altered dopaminergic
reactivity implicated with the pathophysiology of ADHD. Moreover, IL-1 has
been also shown to modulate the release of dopamine and norepinephrine in
several brain regions.
Genetic variability in central modulation of transmitter activity may
similarly contribute to the expression of ADHD. Interleukin-1 receptor
antagonist (IL-1Ra) acts as a blocker on IL-1 receptors which are
distributed in the brain, serving to balance IL-1 activity.
The authors found a significant association of a common genetic variation in
the gene encoding IL-1Ra with ADHD. Children carrying a variant gene
sequence show a significant small increase in susceptibility to express
ADHD. If replicated, these results raise the novel possibility that
genetically based differences in immune modulators are involved in
susceptibility for childhood ADHD.
Authors of the study include R.H. Segman, A. Meltzer, V. Gross-Tsur, A
Kosov, A. Frisch, E. Inbar A. Darvasi, S. Levy, T. Goltser, A. Weizman and
E. Galili-Weisstub, all at institutions in Israel, including Hadassah-Hebrew
University Medical Center, Shaare Zedek Medical Center and The Hebrew
University, Jerusalem and Geha Psychiatric Hospital, Tel Aviv.
(Reference: "Preferential transmission of interleukin-1 receptor
antagonist
alleles in attention deficit hyperactivity disorder," Molecular Psychiatry
2001 Volume 7, number 1, pages 72-74.)
Molecular Psychiatry is published by the Nature Publishing Group. Its editor
is Julio Licinio, M.D.
******************************
Big Brother Goes to School
Districts nationwide are compiling huge databases on students, with the goal of
linking them via the Web
For Virginia mom Danielle Littlefield, the Internet Age
arrived with a thud when Fairfax County public school officials recently
completed construction of a $11 million computer database that holds 1,200
pieces of personal and academic information on each of the district's 150,000
students, including her son, Jeff. Among the data tidbits: Parents' salaries,
notes about children's behavioral troubles, learning disabilities, and
disciplinary problems. Also stashed: student photos, teachers' report-card
commentaries, and mental-health records.
When she first heard about the district's plans to build the data warehouse,
Littlefield formed a group to fight it. "Did we really need to be saving
records of Johnny's schoolyard fight for future employers to look at, for
perpetuity?" she recalls asking. But the database got built anyway. And
now, Littlefield is fighting efforts by school officials to link it to the Web,
where such data can be zapped among school officials in other districts without
parents' permission. "It's not fair," says Littlefield. "There
are some things, like my son's school records, that shouldn't be shared
broadly."
Littlefield is not alone in her concern. She and other parents are finding
themselves on the front lines of one of the nation's newest privacy battles, as
school districts from New York to Oregon begin replacing aging computer systems
with sophisticated new networks, powered by the Internet and capable of
tracking students' behavior from preschool through college.
"DESIRED OUTCOME." Just ask Gayle Cloud, a Riverside (Calif.)
mother of four, who worries that her state's new Student Information System
could represent the first step toward the creation of a Web-powered, national
student database "that could track my children from cradle to grave."
So far, school systems in more than a dozen states have linked their new
databases to a nationwide data-exchange program being organized by the
Education Dept. under a 1994 congressional mandate. The program would make
student information available to other schools, universities, government
agencies, and, potentially, to employers. Says Education Dept. Systems Chief
Gerry Malick: "Nobody is consciously trying to build Big Brother, but as
these databases develop and start 'speaking' to each other, a national student
database is the logical and desired outcome."
School officials in Washington and around the country expect to use it to help
them collect and distribute -- cheaply -- all sorts of information in the name
of improving education. Acknowledges John Barry, spokesman for the Pittsburgh
public school system, which is building a new $25 million database: "We're
not there yet, but yes, a national student database is where we're all heading,
one that we can tap into via the Web." Another worry: At the same time
this federal data exchange is being built, the Labor Dept. is building one too,
called WORKLINK -- which Labor officials say will be able to give employers
access to schools' databases.
BENEFITING STUDENTS? Though no abuses have been reported yet --
districts say the systems are still too new -- privacy advocates contend that
problems are inevitable. School privacy laws exist, but they ultimately put the
burden of protecting student data on school administrators, who have the most
to gain by implementing the new systems. "It's cheaper and more efficient
for schools to collect as much information as possible and share it as widely
as possible," says Fairfax County Information Superintendent John Gay.
To help quell privacy objections and to justify the multimillion-dollar
switchovers, some school districts have been launching sophisticated
public-relations campaigns to convince parents that the systems will boost the
quality of education. Lee Tack, superintendent for information systems for the
Iowa public school system, says the new databases will let officials analyze
how well schools are doing in various ways, including the effectiveness of
course offerings. For example, are students of a particular ethnic background
or gender doing better in math or English courses? Why is one school falling
behind others on standardized-test scores?
In Oregon, lawmakers are considering a statewide database that would analyze
the correlation between per-student spending and test scores across district
lines. Says Gay: "If we can establish student behavioral patterns over
time to measure how outside factors may be influencing a student's performance
in school, then we can intervene, and teach better."
Maybe so, but at what price? Cautions Littlefield: "Parents will need to
keep up pressure on school districts to make sure their child's problems in the
third grade won't cost him his first job." Parents will also have to make
sure that they and their children have the right to review those records -- and
a choice over who else gets to read them.
******************************
Autism
Awakening, Autism FIrst Steps Newsletter, or any staff do not endorse any
individuals, groups or programs. References regarding programs, meetings,
resources, research, opinions, treatment, etc., should not be interpreted as an
indication of endorsement. They are provided for informational purposes
only. This is an attempt to keep the nation advised to all diagnostic,
treatment, therapy, educational,
options available as well as legislative autism updates and more.
To View Newsletter Policies they are located at the Newsletter Website:
Direct Link:: Autism
First Steps Newsletter
http://autismawakeninginia.bizland.com/autismfirststepsnewsletter/
To have
friends, Family, or professionals join:
1. they can go to the above link
2. They can go to the Newsletter Group page located at:
Direct Link:: Yahoo!
Groups : AutismFirstStepsAutismNewsletter
http://groups.yahoo.com/group/AutismFirstStepsAutismNewsletter
3 Send a e-mail to AutismAwakening@aol.com and ask to be subscribed to
the free online daily newsletter
Visit one of the largest websites Commited
to bringing you the latest in news, options, and techniques, and more on Autism
located at:
Direct Link:: Autism Awakening 4 Kids
www.AutismAwakening.com
To Submit a story,
alert, readers post, or advertisement please e-mail AutismAwakening@aol.com
To be removed reply to this e-mail and requested to be removed from the list.