Illustration by Laurène Boglio
Illustration by Laurène Boglio

By the Numbers: Black neuroscience speakers, mildly effective CBT, autism’s diagnostic odyssey

This edition of By the Numbers logs the continued underrepresentation of Black speakers at neuroscience meetings, mildly-effective cognitive behavioral therapy and early autism diagnoses.

Welcome to this month’s edition of the By the Numbers Newsletter. At Spectrum, we do our best to summarize the latest autism research findings. Sometimes, the best summary comes in the form of a chart or map. In this newsletter, we boil down interesting new research that is conveyed most succinctly by way of data visualizations.

Let us know what you think of the newsletter, or tell us about your own data-rich work, at [email protected].

Despite calls to action, Black scientists remain underrepresented at neuroscience meetings

Since the Black Lives Matter protests of 2020, the proportion of presenters at neuroscience conferences who are Black has increased by only 3 percentage points, according to a new analysis.

“It was about what I expected, unfortunately,” says study investigator Lewis Wheaton, associate professor of biological sciences at the Georgia Institute of Technology in Atlanta.

For the study, Wheaton compared the fraction of Black presenters at 18 neuroscience conferences that took place from May 2019 to the end of January 2020 with 18 meetings that occurred between October 2020 and the end of May 2021. Just three conferences during the earlier time period had any Black presenters, and Black scholars made up 1.2 percent of the total number of speakers. By the end of May 2021, those figures had risen only marginally: 7 out of 18 conferences had Black presenters, who made up 4.2 percent of the total number.

The findings appeared in Nature Neuroscience in November.

Cognitive behavioral therapy may be only mildly effective for anxious, autistic children

Autistic children tend to rate cognitive behavioral therapy (CBT) as less effective at treating their anxiety than their parents and clinicians do, according to a meta-analysis of 19 randomized clinical trials.

The result, based on data from 833 autistic children up to 18 years old, raises concerns about how clinical trials measure anxiety in young people, and who benefits from CBT.

“We fundamentally need to ask ourselves: If it’s working, then whom is it working for?” says study lead Shivani Sharma, head of the psychology division at the University of Hertfordshire in the United Kingdom. “Because it’s really odd that there’s such a difference between the clinician ratings, the parent ratings and then the person themselves, their own rating.”

The talk-based therapy is effective for treating anxiety and depression in non-autistic children, studies show. It has also been adapted specifically for autistic children. The meta-analysis confirms that CBT reduces anxiety in autistic children, on average. But it also underscores the wide variation in effect sizes across studies. The results were published in BMC Psychology in October.

Age at autism diagnosis, first intervention drops to under 3 years

Autism diagnoses in the United States now precede developmental services and interventions, according to a new study based on parent responses.

The analysis included data from 2,303 autistic children aged 2 to 17 years from the National Survey of Children’s Health, which asks parents questions about the children in their household. The selected participants, split into three groups based on their age, either had a plan for early intervention or had received special services to meet developmental needs.

The oldest children, aged 12 to 17 at the time of the survey, had been diagnosed at about 5 and a half years old, on average. Their first intervention or developmental service occurred at around age 5.

By contrast, the youngest cohort, aged 2 to 5, had been diagnosed at about 2 and a half years old and started their first intervention or developmental services at roughly the same age.

The results are based on parent responses to a question — How old was your child when a doctor or other health care provider first said they had autism? — so the findings likely skew toward younger ages than if the researchers had used clinical diagnoses. The results were published in Child and Adolescent Psychiatry and Mental Health in October.

Spectrum index:

Equal: The odds of obesity among autistic children aged 10 to 17 years compared with non-autistic children. The analysis, which appeared in the Disability and Health Journal in October, is based on 911 autistic and 26,246 non-autistic children. Data were adjusted for age, sex, race, geographic location and household income. The findings conflict with prior studies on obesity in autistic children.

Half: The fraction by which antipsychotics prescriptions dropped for Medicaid-enrolled youth in Philadelphia, aged 21 and younger, between 2014 and 2018. But roughly half of those prescriptions are still given for off-label conditions, especially attention deficit hyperactivity disorder and depression, according to a study published in BMC Psychiatry in October.

6.4 percent: The proportion of children born to women with diabetes who were later diagnosed with psychiatric conditions, including autism. The findings, based on more than 2.4 million babies born in Denmark between 1978 and 2016, show a link between maternal diabetes and increased risk for schizophrenia and intellectual disability. The analysis appeared in JAMA Network Open in October.

36 percent: The increased odds of autism for a child who has strabismus (misaligned eyes), based on data from more than 327,000 people with the eye condition in South Korea. Strabismus, which is treatable, was also associated with an increased risk of having a developmental condition and a decreased risk of tic disorder. The findings appeared in Graefe's Archive for Clinical and Experimental Ophthalmology in October.

25 percent: The proportion of children with tuberous sclerosis who were diagnosed with autism at a 36-month doctor’s appointment, according to a study of 138 children, published in Annals of Neurology in October.

75 percent: The proportion of autistic people, covered by Medicaid, who receive behavioral therapy after their diagnosis. The figure is slightly higher than for people covered by private insurance (72 percent), according to an analysis of insurance claims for 36,000 people. People covered by Medicaid, as opposed to private insurance, were also more likely to take at least one drug (62 percent, compared with 59 percent). The findings appeared in the Journal of Autism and Developmental Disorders in October.