diagnosing kids: recent publications

Study: Molecular Changes in Autism Span Cerebral Cortex

November 16, 2022The brains of autistic individuals experience widespread molecular changes across the cerebral cortex. The most differential changes occur in the primary visual cortex, according to a recent study published in Nature that analyzed 11 cortical areas of the brain.1 Most molecular profiling studies highlight changes limited to the frontal and temporal cortex.To further understand the brain pathology of autism spectrum disorder (ASD), researchers performed RNA-sequencing analysis on 112 post-mortem samples.

Consistent transcriptomic signatures of ASD were found across all cortical regions analyzed in the study. The greatest signal of expression came from the primary visual cortex (BA17).When compared to control samples, ASD brains demonstrated significantly reduced gene expression between regions of the cerebral cortex.

The primary visual cortex and parietal cortex (BA39/40), which function as primary sensory regions, exhibited significant patterns of attenuation. These results suggest cortical regions are more molecularly homogeneous in autistic individuals and pronounced in the posterior region of the brain.“It is interesting to speculate that the substantial changes observed in primary sensory regions may relate to the widespread sensory processing differences in ASD, which are so pervasive that they have been included in the DSM-5 diagnostic criteria,” the researchers wrote.An attenuation of transcriptomic regional identity (ARI) translates to a “reduction in the magnitude of gene expression” and was often used as a marker in the current study.

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[Self-Test] Eating Disorders in Children and Teens
Eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) typically begin in adolescence, but they are increasingly seen in younger children.Researchers have linked the rise of eating disorders in children and teens to the pandemic and the ongoing youth mental health crisis, among other stressors.12Social media may also play a role in driving body image dissatisfaction and negative comparison among teens.3 What’s more, children and teens with conditions like anxiety, depression, and attention deficit hyperactivity disorder (ADHD) are at greater risk for developing eating disorders.4 ,5Eating disorders are complex but treatable conditions. Early detection greatly improves recovery and health outcomes.If you are concerned that your child is showing signs of an eating disorder like AN, BN, or BED, answer the questions below and share the results with your child’s pediatrician or a licensed mental health professional who is experienced in diagnosing and treating eating disorders.If you or a loved one are suffering from an eating disorder, contact the National Eating Disorder Association (NEDA) for support, resources, and treatment options. Call or text NEDA at 800-931-2237 or visit www.nationaleatingdisorders.org to reach a NEDA volunteer.This self-test was adapted from materials provided in “Identification and Management of Eating Disorders in Children and Adolescents” published by the American Academy of Pediatrics.
AAP Recommends Mental Health Screening for All U.S. Youth
June 22, 2022Pediatricians should perform mental health screenings on all children and adolescents, evaluating for depression, anxiety, and suicide risk, says a new draft recommendation issued by the American Academy of Pediatrics (AAP).1 A response to the growing mental health crisis among youth, this AAP guidance recommends screening adolescents ages 12 and up for major depressive disorder and youths ages 8 and up for anxiety, even in the absence of documented symptoms.Earlier this year, the AAP recommended universal screening for all kids age 12 and older for suicide risk; for kids aged eight 8 to 11, screening was recommended only when “clinically indicated,” such as when warning signs were present.John Piacentini, Ph.D., a professor of psychiatry and biobehavioral sciences at UCLA, called the AAP draft recommendation important because “anxiety in children is often less easily identified than other disorders, such as ADHD, which can delay treatment.” Left untreated, he said, anxiety is associated with increased risk of depression, self-harm, substance use, and other health risks in later life.The AAP joined the U.S. Preventive Services Task Force (USPSTF) in drafting the screening recommendations and in noting a need for further research on evaluating younger children for mental health conditions.