Autism spectrum disorder (ASD) is a lifelong developmental condition that affects how an individual behaves, communicates and interacts with others. It's known as a ‘spectrum’ disorder because there are a wide range of symptoms which can vary in severity, and a person's diagnosis can fall anywhere along that spectrum.
Around 700,000 people in the UK are thought to be on the autism spectrum, and NHS figures from 2015 reveal that 24,000 with learning disabilities or ASD were at risk of admission to hospital.Later figures, from 2017, show that a third of people with autism in hospital had been there for two years or more.
Despite this gloomy outlook, the tireless work of researchers, campaigners, health professionals, and innovators could be about to change the clinical climate; ushering in a new era of progressive care for autism patients.
Following the widespread public interest generated by Channel 4’s recent “Are You Autistic?” programme and last week’s Autism Awareness Day, we guide you through four key breakthroughs with the potential to significantly improve quality of life for those on the spectrum.
(1) Genetic research into the causes of autism
Although the exact causes of autism are unknown, scientists believe that certain inherited genes can make a person more vulnerable to developing ASD. Since diagnosing autism can be difficult, researching the genetic side of the condition is integral to ensure that effective treatment can be prescribed.
In November 2017, a major breakthrough in finding the pathological mechanism for a certain type of autism and intellectual disability was made by researchers at the University of Nebraska Medical Center.
The study found that a mutated human Arid1b gene in a genetically modified mouse impaired GABA neurons, leading to an imbalance of communication in the brain. GABA (gamma-Aminobutyric acid) is a ‘downer’ neurotransmitter, which means that it helps us unwind and relax.
The cognitive and social deficits induced by this Arid1b mutation in mice suggest a potential therapeutic fix with a GABA receptor modulating drug - a drug that is normally used to treat anxiety.
More recently, two further new studies with mice suggest that a single gene, OTUD7A, accounts for most of the features seen in people missing a segment of chromosome 15. People with this genetic deletion often have a learning disability, epilepsy, language impairment, and - in around 15% of cases - autism.
But what does all this mean?
Well, by pursuing a more accurate genetic insight into the causes of autism, these studies hope to give clinicians more scope to offer an early diagnosis. What’s more, the findings pave the way for researchers to develop possible therapeutic treatments for ASD.
(2) Potential new medicines for the core symptoms of autism
It’s true that some autistic people may require medication to alleviate symptoms or conditions associated with autism (such as insomnia, depression, and epilepsy). Many autistic people even take repeat prescriptions for such symptoms.
However, there is currently no pharmaceutical treatment to aid the core symptoms of autism: difficulties with social skills and communication, restrictive interests, and repetitive behaviours.
Enter biotech.
In January 2018, the Swiss multinational healthcare company Roche was granted Breakthrough Therapy Designation by the US Food and Drug Administration (FDA) for its oral medicine Balovaptan.
Balovaptan is a vasopressin receptor antagonist (VRA) for individuals with autism. It works by preventing a molecule that's thought to influence social behaviour from binding to brain receptors.
The FDA based the designation on efficacy data from the second phase trial of Balovaptan in adults with ASD. Results not only showed that the medicine was safe and well tolerated; they showed it significantly improved social interaction and communication. A study of children and adolescents is currently ongoing, in partnership with the Montefiore Medical Center in New York.
Although the medicine is still under development by Roche, the initial findings are promising - suggesting an accessible pharmaceutical treatment for ASD may be on the horizon.
(3) Biometrics and autism
When we think of biometrics, it’s easy to conjure up images of James Bond-style fingerprint scanners in a secret underground lab, or of Facebook’s facial recognition software. Step aside Hollywood and stand back Silicon Valley, because biometric technology is increasingly playing a central role at the forefront of healthcare innovation - in the unlikely setting of Merseyside.
In March 2018, the Autism Together charity launched the £2.5 million ‘Future 50’ appeal to fund a trailblazing high-tech project with the potential to transform the care of those with severe autism.
The charity plans to build the world’s first autism assessment and diagnostic centre in the Wirral, which will see biometric technology employed to ‘see inside’ the bodies of individuals with ASD.
Biometric technology is able to measure tiny physiological changes such as surface skin temperature, heart rate, and sweating. For individuals with severe communication difficulties, lightweight biometric wristbands can be worn. These wristbands give real-time readings that will help carers identify periods of high anxiety, enabling them to step in and head off any dramatic behaviour changes.
This new technology has transformative potential and could aid those with autism, their families, care workers, and clinicians. By allowing carers and clinicians to assess individual needs, pinpoint the causes of distress, and preempt challenging behaviours, the wristbands could potentially make substantial savings to the public coffers. According to 2017 figures, autism care costs the UK economy an estimated £32 billion - so this innovation is certainly timely.
More information on the Future 50 campaign can be found here.
(4) Tech innovations for autistic children
For parents or guardians of children on the autism spectrum, it’s easy to feel powerless when trying to relieve your child’s frustrations.
Thankfully, we live in an age where tech solutions are constantly being found for life’s problems. As awareness of autism increases, so too do innovative tech-based solutions.
Some of the most prominent tools that are helping to transform the lives of autistic children include:
Proloquo4Text. This app encourages users to type their thoughts and then play them out loud. It also allows the user to select pre-programmed phrases that are commonly used, aiding those on the spectrum who experience communication difficulties.
Leka. This interactive device is a robotic companion that allows children to become more autonomous by practicing their cognitive and communication skills. Through a series of different actions - including playing sounds and music, lighting up, vibrating and speaking - Leka engages autistic children in multi-sensory activity.
Smartstones Touch. A handheld, stone-like device that connects to a mobile app and allows nonverbal children to communicate their feelings in pre-programmed words.
Synchrony. Music has been proven to help autistic children broaden their social and emotional skills, and this drum-like device helps them engage with others by responding to touch and only playing calming sounds.
Skoog. Another musical device, this customisable cube is designed for social play. Through its accessibility and inclusivity, Skoog allows users to start creating music without lessons or prior knowledge. It also connects to your iPad.
Through user-focused design, these tech tools offer children on the autism spectrum ways to improve communication with the world around them. The devices are testament to the hard work and dedication of those who seek to find solutions to complex health problems - and to the innovation and dynamism of the tech industry at large.
Thinking ahead
These groundbreaking innovations represent huge potential for the future of autism treatment. However, to ensure this progressive drive yields positive results for patients we need to collectively rethink our position on autism.
While some of the costs are justified, much of the £32 billion economic cost of autism is due to inadequate training, lack of knowledge, inappropriate use of scarce resources, and poor coordination of services.
Despite the high costs of care, the LSE report that autism research is allocated just £4 million of funding each year: far less than heart disease, cancer, or stroke. For each of the UK’s 700,000 autistic people, this is equivalent to a paltry £6 per year.
Without the appropriate funding, the kind of pioneering research we have looked at may be stifled. Thankfully, the determined work of campaigners and charities such as Autism Together, The National Autistic Society, and Autism Alliance are keeping ASD in the spotlight. Through increased awareness, we can bring down the needlessly high costs of public spending and redirect our money towards endeavours that will help - rather than hinder - autism treatment.
Increasing opportunities for autistic people
As a result of social stigma and poor support structures, people with ASD are more likely to be excluded from schools, suffer poor healthcare, and have a high risk of premature death.
The outlook is just as bleak in the workplace. According to the European Economic and Social Committee (EESC), people with autism face discrimination in the labour market. The EESC’s report estimates that less than 10% of people with autism spectrum disorders are employed.
This also needs to change, and it’s time to reconsider the way we collectively interact with autism.
With a brain that’s wired differently to a ‘neurotypical’ (non-autistic) brain, people with autism can contribute a highly unique and individualised skillset to prospective employers. In fact, the innovative thinking associated with ASD can even offer companies a competitive advantage, as this Guardian article explores.
As attitudes adapt, more and more companies are acquainting themselves with the benefits of encouraging neurodiversity within the workplace. Once we start to view autism as a natural variation in how people think, rather than an impediment or disease, the more inclusive our working environment - and society - becomes.
Source: Written by Joe Lofts. Please refer to https://www.echo.co.uk/blog/the-future-of-autism-treatment-4-recent-innovations-with-transformative-potential for full article.