Monterey Bay Forum

There is an old adage: an hour before 12 is worth two afterwards. Any truth to that? The Chinese royal families thought the best time to sleep was between the hours of 11 pm and 2 am. For sure many people report that going to bed much later than normal and sleeping 7-8 hours does not result in feeling refreshed.

So for people with Autistic Spectrum Disorders and compromised executive functioning abilities – what to do?

Routine and patterns creating ingrained habits may assist. So first, figure out how to get to sleep at a set time. Then start moving that time back so you can sleep when it is dark and get up when it is light – or as close that as possible. In the evening stop both mental and physical exertion a couple hours before going to bed and plan to be in bed by around 10 pm. Do boring if need by, relaxing tasks the couple hours before bed. Using either a prescription or other means plan to go to sleep around 11 and up by 8 or so. (more…)

New way of doing Cognitive Behavioral Therapy (CBT) is to take a medication just before CBT that enhances learning and reduces fear and combine it with exposure therapy to address the fear. See below: (more…)

Clinical trials to start using D-Cyclosrine to treat socialibility dificulties. (more…)

DrCameronJackson@gmail.com

About half of all children with Autistic Spectrum Disorder (ASD) also have Attention Deficit Hyperactivity Disorder (ADHD) or some symptoms of ADHD either inattentive, hyperactive or combined.

Common symptoms of the inattention form of ADHD are: the person often has difficulty organizing tasks and activities; is often forgetful in daily activities; dislikes tasks that require sustained mental effort such as homework; often loses thing necessary for tasks or activities; easily distracted by extraneous stimuli; does not seem to listen when spoken to directly; has difficulty sustaining attention in tasks; and makes careless mistakes.

Children and adults who have some ADHD symptoms and Autistic Spectrum Disorder tend to have exacerbated impairment in adaptive behavior, working memory and general executive functioning . How do we know this? (more…)

by Cameron Jackson DrCameronJackson@gmail.com

MRI’s soon may be able to objectively and quickly identify children at risk of autistic spectrum disorders. And, further identify the sub-types or different expressions which can lead to more individualized treatment.

We know that cognitive behavioral therapy for depression can result over time in substantial changes in how the brain functions. So, likewise some day using MRI’s to measure change it should be possible to re-train the two hemispheres of brains to better communicate. And thereby reduce the symptoms of autistic spectrum difficulties.

Thus, instead of looking at autism as a lifelong developmental disorder we may view autism as a developmental delay which can be substantially improved. (more…)

How can young adults with autistic spectrum issues learn the social skills they need? Some are newly diagnosed for the first time. Some heard they have “non-verbal learning disability”. Others have been labeled with Asperger’s Syndrome.

There is Applied Behavioral Analysis (ABA) training. Theory of Mind training. What about virtual reality technology? Are there any virtual reality technology packages available t teach social skills? (more…)

written by Cameron Jackson DrCameronJackson@gmail.com

Does Peter — this is a hypothetical clinical case — suffer from NLD or Asperger’s Disorder or PDD-NOS? So some combination? What is the best fit? Many of the facts are true however names and identifying information has been changed to protect privacy.

Remember the children’s verse: “Peter, Peter, pumpkin eater… had a wife and couldn’t keep her… so he put her in a pumpkin shell… there he kept her very well… ”

It certainly was socially inept of Peter to keep his wife locked in a shell….Was that the best that Peter could do?

Non-verbal learning disability (NLD) was much talked about 10 years ago. Maybe because NLD never made it into in the Diagnostic and Statistical Manual (DSM-IV) it’s only known in certain circles.

In some ways NLD is similar to 298.0 Asperger’s Disorder — which is a diagnosis in the DSM-IV.

Many people somewhat approximate the diagnosis that are in the DSM-IV. The issue is to find the best fit.

Let’s see what is the best diagnosis for Peter. A number of facts are changed to protect privacy. Let’s see whether Nonverbal Learning Disability (NLD) or Asperger’s fit as a better fit for this young man.

Peter — not his real name — is in his middle 20′s. He went to private schools in Santa Cruz County and finished at an alternative high school. Both his parents finished college and work professionally. Peter is an only child.

From his father for years he heard, “Just step up to the plate… you can do it… Try harder…” Yes, Peter has low self esteem. (more…)

Big changes come in 2013 with publication of a new, updated Diagnostic and Statistical Manual (DSM-V). One category which changes considerably is autism.

One wonders how Aspies view the proposed changes. Aspies by definition are not as severely afflicted. Their special category evaporates under the new diagnosis of autism. Aspies as a diagnosis will cease to be. However, their affliction will still exist.

What defines Aspies? Often they are referred to as “little professors”. They know a great deal about a few subjects. Talking for Aspies is not a conversation but more like a monologue. Aspies often are precocious at language and may appear gifted. Aspies have difficulties reading human social signals. They often have extraordinary gifts. Some people describe Aspies as perfect counterfeit bills. Their social interactions frequently are a disaster.

Whereas in DSM-IV Autistic Disorder is the most severe condition and PDD-NOS less severe followed by Aspergers, in DSM-V there will be one description titled Autistic Spectrum Disorder or Autistic Disorder.

One thing missing from the proposed definition for autism is how to quantify the degree that the person is handicapped. As the number of persons with ASD balloons, more care must occur in determining the degree of impairment.

One defining characteristic of the new definition for autism is “failure to develop.. peer relationships…” Does failure mean zero, zip, no relationships? In contrast, Aspies can and do have one way relationships and they seek relationships. Aspies have substantial difficulties making successful relationships happen.

Another characteristic of DSV-V autism is “lack of social reciprocity…” Lack means zero, zip, no social reciprocity.
Below is the proposed new definition of autism: (more…)

Let’s imagine what might happen were President Obama given an ADOS assessment. An ADOS is administered one-to-one — not done here.

What the ADOS is: The ADOS assesses for autistic spectrum disorders. Adolescents or adults assessed with an ADOS are asked to do various tasks including: 1) play interactively with the person who is assessing; 2) demonstrate how to do an activity; and 3) tell a story based on a picture book which has no words.

One ADOS task is engaging in interactive play that involves joint attention and ability to change based on what the other person does. President Obama seems to engage in a lot of “my way or no way” behavior which is not interactive. When President Obama got the stimulus bill signed he immediately turned it over to Speaker of the House Nancy Pelosi to figure out how to distribute the “pork”. President Obama did not wield his mighty pen and interactively “cut” out pork. Overall global assessment: As Obama’s abilities to interactively “play” appear low, he gets a score of 2 for the joint interactive task.

A second task on the ADOS: The person must demonstrate both verbally and non-verbally how to do something in daily life. Getting bills such as ObamaCare passed has been part of President Obama’s daily life. Can you imagine President Obama — without a teleprompter — explaining with use of gesture and words how he got ObamaCare passed? On the demonstrate a Daily Activity task Obama scores another 2. The total score is now 4 points.

A third task on the ADOS: The person assessed must tell a story based on a picture book that has no words. So, imagine a picture book showing the Tea Party movement at various rallies. How might Obama tell that story? Can Obama see a series of pictures and make a coherent story about a major political event, i.e. the Tea Party movement? Doubtful. Hence, on the Tell a Story task President Obama gets another score of 2.

On just three ADOS tasks Obama is already up to a total score of 6. There are about 12 or so tasks on the ADOS.

Let’s hypothetically assume that President Obama can meet the ADOS cutoff score for a possible diagnosis of an autistic spectrum disorder. More information is necessary to assign a diagnosis of autism or some variation.

The foregoing gives you an idea of the kind of tasks persons must perform during an ADOS assessment. (more…)

Lots of children with autism are picky eaters. Frequently these children prefer pasta and carbs and reject various categories of food. So, maybe autistic children’s brains are not getting the proper nutrients? How to feed starving brains is a theory worth exploring. The company Curemark has an enzyme that may help autistic children to absorb the nutrients they need. (more…)