Two stories out in the past couple of days point to physical differences in autistics: faces and lungs. One study found that facial features were quantitatively different in autistic children than in non-autistic children. In MU study links facial features to autism , Janese Silvey wrote:
A new University of Missouri study shows that children with autism have slight differences in facial characteristics — a finding that indicates the disorder develops in the womb.
Kristina Aldridge, assistant professor of pathology and anatomical sciences in MU’s School of Medicine, worked with other researchers at the Thompson Center for Autism and Neurodevelopmental Disorders to analyze 64 boys with autism and 41 typically developing boys ages 8 to 12.
They used a camera to capture 3-D images of each child’s head and then mapped 17 points on the faces. When Aldridge compared the two groups, she found statistically significant differences in facial features.
It is perhaps not surprising that facial differences could be detected. Head circumferences are known to be often larger in autistics, and follow a different trajectory after birth. However, the authors point to prenatal development as possibly at play:
“We can look at a point in time when facial features are being developed and genes that are shared at that time between the face and brain,” Aldridge said. “This narrows the window of time and the candidate genes we might look at.”
Can Bronchoscopic Airway Anatomy Be an Indicator of Autism?
Barbara Stewart, MD*
Nemours Childrens Clinic, Pensacola, FL
PURPOSE: The purpose of this study is to investigate possible correlation between certain airway anamolies and a definitive diagnosis of autism and/or autistic spectrum disorder.
METHODS: IRB approval was obtained for a restrospective study to evaluate 49 patients with a diagnosis of autism or autistic spectrum disorder. These patients were seen in the pulmonary clinic with a diagnosis of cough that was unresponsive to therapy and who required further pulmonary work-up.Bronchoscopic evaluation of the airway was included as part of that work-up.
RESULTS: Bronchoscopic evaluations revealed the presence of initial normal anatomy followed by double take-offs in the lower airway (or “doublets”)in 100% of the autistic population studied.
CONCLUSIONS: There appears to be a correlation between autistic spectrum disorder and airway anatomy. This is a small study of 49 patients. More investigation is warranted.
CLINICAL IMPLICATIONS: At present autism is diagnosed through subjective observation of “autistic behaviors.” Autistic children with cough may be diagnosed objectively.
DISCLOSURE: The following authors have nothing to disclose: Barbara Stewart, Barbara Stewart
Not surprisingly, it is a pretty small study. (49 patients). This isn’t a study which says, “all autistic kids have these lung differences”. Rather it is, “of the autistic kids we saw in our clinic for persistent coughs had this anomaly”. Even still, it is an interesting finding if real. On thing this points to, that the author notes in the interview is that for this subset of kids, development went on a different path very early:
“I think the whole thing occurs embryologically—when the cell and egg come together and the fetus is formed,” she says. “It’s important for parents to know that.”
Jon Brock:
Can I put in a for my blogpost on the faces paper?
http://crackingtheenigma.blogspot.com/2011/10/many-faces-of-autism.html
That lungs paper is intriguing too. No idea what to make of it!
Sullivan:
Jon Brock,
thanks for the link. I've added it to the body of the article above. Your's is much more thorough than the brief mention above, and well worth the time for people to read.
brian:
Not surprisingly, it is a pretty small study. (49 patients).
Yes, but (1) the author indicated that she had also used a comparison group of over 300 children without ASD (although that wasn't included in the abstract) and did not find even one child in that group with this distinctive pattern, and (2) the author indicated that, to her knowledge, this pattern has never been described in the literature.
It's also worth noting that this trait should be set by about twenty weeks before birth. In that way, it's rather like the minor physical (facial) anomalies discussed here, as well as the brain overgrowth that apparently traces to before the 18th week of gestation discussed by Eric Courchesne at the recent IMFAR as indicative of unusual development long before birth in some children (49 of 49 in this pulmonary study) with ASD.
Sullivan:
brian,
I have to admit some restraint in this because of the obvious parallels that can be made...this is a case series. A true case series, not some lawyer/lawsuit driven pseudo case series. 49 autistic patients go to a single clinic (unrelated to autism) and all are found to have the same medical condition.
"Not surprisingly" in my mind is because it is a single clinic. With 1% prevalence of diagnosed autism, one would expect that the clinic would not see that many autistic kids. 49 kids from a single clinic is pretty high to me. But I don't know how big this place is.
brian:
Sullivan, the Nemours Children's Clinic in Pensacola is part of a large medical group that includes a couple of children's hospitals plus about two dozen pediatric clinics that are associated with other hospitals in four states. I'd guess that this was a retrospective review of patients from several of those sites.
Fortunately, at each branch point there is either only one branching airway (as in the 300 children without ASD) or more than one (two smaller, symmetrical branches in these children with ASD), so that's not a judgement call.
Two stories out in the past couple of days point to physical differences in autistics: faces and lungs. One study found that facial features were quantitatively different in autistic children than in non-autistic children. In MU study links facial features to autism , Janese Silvey wrote:
It is perhaps not surprising that facial differences could be detected. Head circumferences are known to be often larger in autistics, and follow a different trajectory after birth. However, the authors point to prenatal development as possibly at play:
A story from WebMD points to Autism linked to unusual shapes in lungs . The study was presented at a conference of the Annual Meeting of the American College of Chest Physicians as Can Bronchoscopic Airway Anatomy Be an Indicator of Autism?
Here is the abstract:
Not surprisingly, it is a pretty small study. (49 patients). This isn’t a study which says, “all autistic kids have these lung differences”. Rather it is, “of the autistic kids we saw in our clinic for persistent coughs had this anomaly”. Even still, it is an interesting finding if real. On thing this points to, that the author notes in the interview is that for this subset of kids, development went on a different path very early:
As also discussed on CRACKING THE ENIGMA as The many faces of autism
Can I put in a for my blogpost on the faces paper? http://crackingtheenigma.blogspot.com/2011/10/many-faces-of-autism.html That lungs paper is intriguing too. No idea what to make of it!
Jon Brock, thanks for the link. I've added it to the body of the article above. Your's is much more thorough than the brief mention above, and well worth the time for people to read.
Yes, but (1) the author indicated that she had also used a comparison group of over 300 children without ASD (although that wasn't included in the abstract) and did not find even one child in that group with this distinctive pattern, and (2) the author indicated that, to her knowledge, this pattern has never been described in the literature. It's also worth noting that this trait should be set by about twenty weeks before birth. In that way, it's rather like the minor physical (facial) anomalies discussed here, as well as the brain overgrowth that apparently traces to before the 18th week of gestation discussed by Eric Courchesne at the recent IMFAR as indicative of unusual development long before birth in some children (49 of 49 in this pulmonary study) with ASD.
brian, I have to admit some restraint in this because of the obvious parallels that can be made...this is a case series. A true case series, not some lawyer/lawsuit driven pseudo case series. 49 autistic patients go to a single clinic (unrelated to autism) and all are found to have the same medical condition. "Not surprisingly" in my mind is because it is a single clinic. With 1% prevalence of diagnosed autism, one would expect that the clinic would not see that many autistic kids. 49 kids from a single clinic is pretty high to me. But I don't know how big this place is.
Sullivan, the Nemours Children's Clinic in Pensacola is part of a large medical group that includes a couple of children's hospitals plus about two dozen pediatric clinics that are associated with other hospitals in four states. I'd guess that this was a retrospective review of patients from several of those sites. Fortunately, at each branch point there is either only one branching airway (as in the 300 children without ASD) or more than one (two smaller, symmetrical branches in these children with ASD), so that's not a judgement call.
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