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Illustration by Laurène Boglio
Illustration by Laurène Boglio

Community Newsletter: Autism assessment; cognitive aging; metabolic diseases

Discussion among autism researchers on Twitter this week swirled around how well pediatricians assess the condition, how it affects cognitive aging and how it alters cardiometabolic disease risk.

How accurately do general pediatricians assess children for autism?

This question was at the heart of a new study that caught autism researchers’ attention on Twitter this week.

Compared with an expert team of clinicians using the Autism Diagnostic Observation Schedule and the Mullen Scales of Early Learning, pediatricians correctly identify autistic children “almost 90% of the time,” tweeted study investigator Melanie Penner, senior clinical scientist and developmental pediatrician at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada.

But when pediatricians suspect a child does not have autism, they agree with the experts “only 60% of the time,” Penner continued. “More caution is needed for these children.”

The results, which Penner and her colleagues published last month in JAMA Network Open, show that some children can receive an accurate autism diagnosis from a pediatrician, Penner concluded.

And such diagnoses could “minimize time families will wait to confirm diagnosis and access support,” tweeted Justine Cohen-Silver, assistant professor of pediatrics at University of Toronto.

The work “highlights the importance of maximizing the excellent skillsets of well-trained generalists,” tweeted Eyal Cohen, professor of pediatrics and health policy, management and evaluation at the University of Toronto.

“For those interested in both excellence and equity in clinical services for autistic children, this paper … is the early clubhouse leader for the most important paper of the year,” tweeted Andrew Whitehouse, professor of autism research at the Telethon Kids Institute and the University of Western Australia in Perth.

Long waitlists for an autism diagnosis mean that a more flexible diagnostic process is needed, which is the direction they “have gone in Australia,” Whitehouse added.

The Australian diagnostic guidelines that Whitehouse and his colleagues adopted in 2019 “were a guiding light in thinking how we can approach diagnosis more equitably,” Penner responded.

Research about a different age cohort also cropped up on Twitter this week: a longitudinal study on cognitive aging in adults with autism, published in January in Psychiatry Research.

Beginning in 2011, the researchers followed 128 autistic and 112 non-autistic adults, aged 24 to 85, and tested them on 15 different cognitive measures at different times over 10 years. They found “no evidence for accelerated cognitive aging for autistic adults,” and age-related changes in cognition were similar for autistic and non-autistic adults, tweeted Hilde Geurts, professor of clinical neuropsychology at the University of Amsterdam in the Netherlands.

Longitudinal research on autistic people in later life is so rare,” tweeted Rebecca Charlton, senior lecturer in psychology at Goldsmiths, University of London in the United Kingdom.

Lucy Livingston, lecturer in psychology at King’s College London in the U.K., called the research “really important” in a separate tweet.

Lastly, Elizabeth Weir, research associate at the Autism Research Centre at the University of Cambridge in the U.K., tweeted a link to her editorial “about an important new meta-analysis on the #cardiometabolic #health of #autistic people.”

The meta-analysis found that autistic people have an increased risk of developing diabetes, dyslipidemia and heart disease. In the editorial, Weir wrote that this study fills an important gap in research on physical health problems among autistic people.

Weir also wrote that several studies suggest autistic people are dying younger than expected. Bernadette Grosjean, a psychiatrist, tweeted that “more research and more support” is urgently needed.

That’s it for this week’s Community Newsletter! If you have any suggestions for interesting social posts you saw in the autism research sphere, feel free to send an email to [email protected].

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