Health Rounds: New test to hasten autism diagnosis

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By Nancy Lapid

Researchers have developed a new test that utilizes the ways toddlers look at and learn from their social environment to potentially diagnose autism and plan care earlier.

Children with autism process social interactions in different ways than youngsters without the condition and often go years without a diagnosis, delaying treatment.

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“Children who currently have limited access to expert care, and face two or more years of waiting and referrals before finally being diagnosed at age four or five, may now be eligible for diagnosis between the ages of 16 and 30 months,” said Ami Klin of the Marcus Autism Center of Children’s Healthcare of Atlanta, who headed the research team.

To develop the test, Klin’s team recruited children with symptoms that might indicate autism.

As the children watched video scenes of social interaction, their eye movements were monitored 120 times per second to determine what information they looked at and what they did not. The researchers then compared the children’s measurements to data from similar kids without autism symptoms, using algorithms to quantify similarities and differences at each moment in time.

In two studies involving more than one thousand toddlers, the researchers determined that the tool could objectively measure and quantify each child’s level of social disability, verbal ability, and non-verbal learning skills, according to a report published on Tuesday in JAMA Network Open.

In a separate study of 475 toddlers undergoing autism evaluations at specialized centers, the test was 78% accurate at identifying those who would eventually receive an autism diagnosis and 85.4% accurate at identifying kids who did not have autism, according to a paper released on Tuesday in JAMA.

The tool “is not intended to replace expert clinicians, but to supplement informed and experienced clinical judgment,” they said. “Families of children with autism benefit from clinicians’ support to translate assessment results into plans of care and support as needed.”

Daily consumption of starchy foods that can pass through the digestive tract without being digested, such as cooked and cooled potatoes, rice, and beans, can help reduce liver injury associated with non-alcoholic fatty liver disease (NAFLD), researchers found.

Those foods, as well as plantains, raw oatmeal and other whole grains, are rich in what is known as resistant starch.

To test their effect on NAFLD, 200 patients with the condition received either a resistant starch powder mixed in water or a placebo, twice a day, along with a balanced diet.

Four months later, participants in the starch group had a nearly 40% decrease in liver levels of a type of fat called triglycerides, compared to the placebo group, the researchers reported on Tuesday in Cell Metabolism.

The starch group also had reductions in liver enzymes and inflammatory factors.

NAFLD, which can lead to liver failure and contribute to type 2 diabetes and cardiovascular disease, currently affects nearly one-third of the world’s population, according to the authors. There is no approved medicine available to treat it, and many drugs tested as a treatment for a related fatty liver disease called NASH have failed.

“We are able to identify a new intervention for NAFLD, and the approach is effective, affordable and sustainable,” said study coauthor Huating Li of Shanghai Sixth People’s Hospital.

“Compared with strenuous exercise or weight loss treatment, adding resistant starch to a normal and balanced diet is much easier for people to follow through,” Li said.

In United States, survival rates for babies after premature birth, for children in emergency rooms for medical emergencies, and in adults after cardiac arrest are all lower for Blacks and other minorities than for whites, three separate studies published on Tuesday showed.

As reported in JAMA Pediatrics, researchers analyzed U.S. national data on more than 12 million babies born before 37 weeks of pregnancy between 1995 and 2020.

Although all preterm infants born in 2020 were less likely to die than in 1995, the gap in preterm infant mortality between mothers of differing races remained constant. As was true in the first three years of the study, in the last three years black infants were still 1.4 times more likely to die following preterm birth than white and Hispanic infants, the researchers found.

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The adequacy of mothers’ healthcare during pregnancy was one of the biggest predictors of preterm mortality across the study period, they also found. Infant mortality was 50% higher when mothers had not received adequate prenatal care.

In JAMA Network Open, researchers reported on 557,537 children treated for medical emergencies in 586 emergency departments across 11 states. Mortality rates were higher for Black children than for white children across the board, they found.

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