Columbia_Top 10 Questions_4.15

Autism: The 10 Most Important Questions : 

BRONX-LEBANON HOSPITAL CENTER RAM KAIRAM, MD APRIL 16, 2010 Autism: The 10 Most Important Questions

10 Most Important Questions : 

10 Most Important Questions 1. Is the incidence rising? 2. Is it a genetic disorder? 3. Do vaccines or mercury cause Autism? 4. What is the developmental biology? 5. What is the neuropathology?

10 Most Important Questions : 

10 Most Important Questions 6. What are the co-morbidities? 7. How do we treat this disorder? 8. Is there a cure? 9. Planning for transition to adulthood? 10. What is new for 2010 – 2011?

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10 Most Important Questions 1. Is the incidence rising? 2. Is it a genetic disorder? 3. Do vaccines or mercury cause Autism? 4. What is the developmental biology? 5. What is the neuropathology?

Escalating Autism Incidence : 

Escalating Autism Incidence The CDC estimates that between 1 in 80 and 1 in 240 with an average of 1 in 110 children in the United States have an ASD. It is estimated that approximately 8,475 individuals in Bronx should be identified as having Autism.

Autism Rates: California Data : 

Autism Rates: California Data

Autism Rates from 1966 to 2010 : 

Autism Rates from 1966 to 2010

Number of Patients with ASD Diagnosis at Bronx-Lebanon : 

Number of Patients with ASD Diagnosis at Bronx-Lebanon

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Visits for Patients with Diagnosis of ASD

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Visits for Patients with Diagnosis of ASD

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Visits for Patients with Diagnosis of ASD

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Visits for Patients with Diagnosis of ASD

Autism in 2011 : 

Autism in 2011 2011: The American Psychiatric Association will publish the DSM-V.

“Autisms” : 

“Autisms” “People say that in autism, everybody is a snowflake.” ~ Dr. Susan Swedo, Senior Investigator at National Institute of Mental Health Dr. Swedo said the plan was to define autism by two core elements and to score them on severity: impaired social communication repetitive behaviors or fixated interests

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10 Most Important Questions 1. Is the incidence rising? 2. Is it a genetic disorder? 3. Do vaccines or mercury cause Autism? 4. What is the developmental biology? 5. What is the neuropathology?

Is this a Genetic Disorder? : 

Is this a Genetic Disorder? Monozygotic twins A:B 70% Dizygotic twins A:B 30% Siblings A:B 5% Next door neighbor A:B 1:110

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10 Most Important Questions 1. Is the incidence rising? 2. Is it a genetic disorder? 3. Do vaccines or mercury cause Autism? 4. What is the developmental biology? 5. What is the neuropathology?

Do vaccines or mercury cause Autism? : 

“The committee concludes that the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism. The committee also concludes that the body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism. The committee further finds that potential biological mechanisms for vaccine-induced autism that have been generated to date are theoretical only.” (IOM 2004, Immunization Safety Review: Vaccines and Autism) Do vaccines or mercury cause Autism?

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10 Most Important Questions 1. Is the incidence rising? 2. Is it a genetic disorder? 3. Do vaccines or mercury cause Autism? 4. What is the developmental biology? 5. What is the neuropathology?

Developmental Biology : 

Developmental Biology HEAD SIZE > 50% of Autistics are Mentally Retarded > 75% of mentally retarded have microcephaly > 35% Autistics have macrocephaly

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10 Most Important Questions 1. Is the incidence rising? 2. Is it a genetic disorder? 3. Do vaccines or mercury cause Autism? 4. What is the developmental biology? 5. What is the neuropathology?

Neuropathology : 

Neuropathology No observed abnormalities in: Neurons Glia Obigodendroglia Autistic individuals often have: Increased white matter

Moebius Syndrome and Autism : 

Moebius Syndrome and Autism

Mirror Neurons : 

Mirror Neurons Mirror neurons are endowed with the same mechanism: a mechanism that translates sensory information describing motor acts done by others into a motor format similar to that the observers themselves generate when they perform those acts. There may be a link between mirror neuron deficiency and autism.

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10 Most Important Questions 6. What are the co-morbidities? 7. How do we treat this disorder? 8. Is there a cure? 9. Planning for transition to adulthood? 10. What is new for 2010 – 2011?

Co-Morbidities: Immune signs & symptoms & measures : 

Co-Morbidities: Immune signs & symptoms & measures Recurrent infections Autoantibodies Family history of autoimmune disease Autoimmune features Food alergies and sensitivities Atypical cytokine and chemokine levels Abnormal immunoglobulin levels

Co-morbidities (2) : 

Co-morbidities (2) Is autism a brain disorder or a Disorder that affects the brain?

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7. How do we treat this disorder? 6. What are the co-morbidities? 8. Is there a cure? 9. Planning for transition to adulthood? 10. What is new for 2010 – 2011? 10 Most Important Questions

Treatment and Education : 

Treatment and Education Behavioral modification and communication approaches Complementary Approach Dietary and Biomedical Approaches

Biomedical and Dietary Treatment : 

Biomedical and Dietary Treatment Secretin Medication Vitamins & Minerals Dietary Intervention

Complementary Approaches : 

Complementary Approaches Provide non-threatening way for a child with autism to develop a positive relationship with a therapist in a safe environment. Help by increasing communication skills, developing social interaction, providing sense of accomplishment. Music Therapy, Art Therapy, Animal Therapy

Neurodiversity.com : 

Neurodiversity.com Murder of Autistic Persons Google.com Murder-suicide-autism Stabile Exorcism Chelation

Quackwatch.com : 

Quackwatch.com DAT-Dolphin Assisted Therapy Chelation Hyperbaric Oxygen Chamber Horseback Riding Program Nutritional supplements- vitamins, minerals, amino acids, and essential fatty acids Special diets totally free of gluten (from wheat, barley, rye, and possibly oats) and free of dairy (milk, ice cream, yogurt, etc.) Testing for hidden food allergies, and avoidance of allergenic foods Treatment of intestinal bacterial/yeast overgrowth (with pro-biotics, supplements and other non-pharmaceutical medications) Detoxification of heavy metals through chelation (a potentially hazardous medical procedure)

10 Most Important Questions : 

7. How do we treat this disorder? 6. What are the co-morbidities? 8. Is there a cure? 9. Planning for transition to adulthood? 10. What is new for 2010 – 2011? 10 Most Important Questions

Is there a Cure? : 

Is there a Cure?

Autism in the Media : 

Autism in the Media Temple Grandin The Horse Boy Adam My Name is Khan

10 Most Important Questions : 

7. How do we treat this disorder? 6. What are the co-morbidities? 8. Is there a cure? 9. Planning for transition to adulthood? 10. What is new for 2010 – 2011? 10 Most Important Questions

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Transition Planning

Transition Planning : 

Transition Planning IDEA What happens when the child turns 21? Housing/guardianship The impact of an aging or deceased parent. Perspective found in “My Brother’s Keeper” The transition for individuals with autism from federally mandated services through the school system to adult services can be a challenge.

Support Group : 

Support Group

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“A Doctor to the Community”

10 Most Important Questions : 

7. How do we treat this disorder? 6. What are the co-morbidities? 8. Is there a cure? 9. Planning for transition to adulthood? 10. What is new for 2010 – 2011? 10 Most Important Questions

2010 - 2011 : 

2010 - 2011

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COMMUNITY-BASED AUTISM REGISTRY COMPREHENSIVE CLINICAL CARE THE SOUTH BRONX AUTISM CENTER LEGAL, SOCIAL, EDUCATIONAL ADVOCACY EDUCATIONAL INTERVENTION EVIDENCE-BASED CURRICULUM SUPPORT SERVICES MEDICAL HOME

Questions : 

Questions