By GERALD SCHOENEWOLF, PH.D.

Today, the often-repeated refrain is, “The cause of autism is unknown.” Yet, even though most so-called autism experts generally admit that the cause of autism has not been proven, they generally offer only non-environmental theories.

Bernard, et al., found in a 2001 article in Medical Hypotheses that mercury in certain vaccines caused autism. Cannell, also in Medical Hypotheses (2007), theorized that autistic children suffered from a lack of Vitamin D. Giulivi, et al., in a 2010 article in the Journal of the American Medical Association, blamed autism on something called “mitochondrial dysfunction”–the brains inability to produce energy.

A 2011 study by Ozonoff in Pediatrics which looked at more than 600 cases of autism and found that if a child has the disorder, a younger sibling has a 19 percent chance of also having it, concluded that autism is genetic. However, this statistic does not prove genetics as the cause, since it could explain family parenting patterns.

While none of these theories has been validated, much research has meanwhile been done with mothers who suffer from postpartum depression or major depression. A study by Laura Murray in the Journal of child Psychology and Psychiatry in 1992 showed that children of severely depressed mothers develop severe cognitive and relationship problems by 18 months (the time when autistic symptoms begin appearing). Salvanos, et al. studied 291 mothers and infants and found a strong link between postpartum depression and autistic traits. The article appeared in European Psychiatry (2009).

Other researchers, J. Hallmayer et al., stated succinctly what some have intimated. “We have to look at both sides of the coin.” His study in the Archives of General Psychiatry provided scientific evidence that both genetics and the environment produce autism. Using state records, the researchers, who were all at Stanford University, identified 192 pairs of twins in which at least one of the two had some form of autism. Among these sets, there were 54 pairs of identical and 138 pairs of fraternal twins.

What they found was that the genes twins share can increase the risk of getting autism by about 38%, but the environment that twins share may increase the risk an estimated 58%. The environmental risk is nearly twice that of genetics.

Evidence is accumulating that maternal depression leads to severe developmental problems in children. A study by the Kennedy Krieger Institute released on their website in 2008 found that 46% of mothers of autistic children reported being depressed following pregnancy. Ainsworth, in her famous study of attachment (Ainsworth, et al., 1978), found that children could develop an avoidant attachment, with symptoms very like the symptoms of autism, when they had a mother who was avoidant toward them as infants.

The increasing number of such studies seems to indicate that there is a relationship between a mother’s depression (and hence neglect) and a child’s subsequent development. The developmental defects brought about by postpartum depression are similar to those of autism. It therefore seems to follow that there is a relation between postpartum depression and autism.

The universal tendency to protect the feelings of mothers has perhaps led to the environmental theory of the cause of autism to be ignored. Mothers feelings are important. They do the very best they can, and they don’t get the credit they deserve. And it should also be noted that there are good reasons why mothers might suffer from depression, postpartum or otherwise, and they do not intentionally seek to harm their babies. I would suggest, however, that raising emotionally healthy children should be our number one priority. If it is true that postpartum depression leads to developmental defects, that is something that should be taken notice of.

Some would say that even if a mother has postpartum depression for a month or two, any damage done to the baby can be overcome later on. This is true, early damage can be overcome. However we are learning how crucial those first weeks and months of life are–and indeed, how crucial the prenatal period is, for development. Harm done then can affect a person’s personality and health the rest of his or her life if it is not caught in time.

Even if we don’t buy into this theory completely, we can still take precautionary measures. Common sense tells us a mother suffering from severe depression will not be able to provide the attention a newborn needs.

Therefore, if a mother has postpartum depression and can’t care for her baby, perhaps–for the sake of the child–someone else such as the husband or aunt or grandmother should step in.

BY DR. NOELLE NELSON

You should never be fearful in your marriage. Address hot-tempered outbursts from your spouse.

“ It is not acceptable for you to live in an atmosphere of fear. It will ruin your marriage.”
A husband gets angry and yells: his wife cowers. A wife gets angry and yells: her husband leaves.

These are common outcomes when a spouse flies off the handle, especially when the anger is a one-sided outburst, having nothing to do with a fight. It doesn’t matter which spouse is expressing their upset with anger, anger frightens the other.

Dealing with anger is a challenge! It is inevitable in a relationship as close and intimate as a marriage, for in marriage we tend to let our hair down, to be less inhibited than we would be with say, a co-worker or out in public.

Anne’s husband, for example, was fundamentally a good man. He was basically honest, reliable, trustworthy, responsive, responsible, appreciative of other people, and caring. He had none of the hallmarks of an abusive individual. He did, however, have a quick temper. He would flare up at minor annoyances and yell. He got away with it because he attributed his explosions to his passionate nature, and others accepted this characterization. His temper took its toll on Anne, however, as she became “a little mouse of a woman.”

Should you find yourself in a relationship with an otherwise good but quick-tempered person, here are guidelines for how to deal with their angry outbursts.

How to Handle Outbursts

When you first witness an outburst, wait until the two of you are in a calm mood and then ask your spouse in a matter-of-fact, neutral tone what hurt or bothered them to set your spouse off. If, indeed, it’s something that might disturb anybody, let your partner know that you understand that what happened annoyed them, but that their anger is frightening, and that this behavior is not healthy for either of you, and certainly not conducive to the wellbeing of your marriage.

If your spouse can hear you and is willing to accept responsibility for their temper, you can the move on to the next step: develop a “time-out” signal for each other, like the time-out sign used in sports, to cut short any outbursts. Agree with your husband or wife that when you make that sign, everything has to stop, right then. Once you’ve made the time-out sign, calmly let your spouse know that you need to take a break, and that you’re going to take a walk or a bath, or just go into another room—whatever works for you.

If, however, what set your beloved off is not understandable to you, or if he or she does not take responsibility for their anger, it’s imperative to get professional help as soon as possible. Similarly, if your spouse cannot deal appropriately with their outbursts despite both of your best efforts, you should seek help. It is not acceptable for you to live in an atmosphere of fear. It will ruin your marriage.

Noelle C. Nelson, Ph.D., is a relationship expert, popular speaker in the U.S. and abroad, and author of nine best-selling books, including “Your Man is Wonderful” and “Dangerous Relationships.” Dr. Nelson focuses on how we can all enjoy happy, fulfilling lives while accomplishing great things in love, at home and at work, as we appreciate ourselves, our world and all others. For more, visit www.noellenelson.com and follow her on Twitter @DrNoelleNelson.

By HOLLY BROWN, LMFT

I’ve got some pretty recent experience with this one, as my almost three-year-old has been alternating between intensely delightful and intensely–well, intense.

This can apply to your toddler’s tantrums (which tend to be brief) or meltdowns (which are protracted bouts of screaming and oppositional behavior that can go on for minutes to–worst case scenarios–more than an hour.) What’s key is focusing not on what they’re doing, but on what you should be doing yourself.

Challenging, I know, but here are some ideas to get you on a better path.1) Remember that your child will react to your reactions.

You might feel like there’s nothing you can do to prevent certain meltdowns, or to halt them once they’re in progress. And you might be right. But you do have the power to make them worse.

When your toddler is already feeling out of control, they’ll cue off your response. If you seem to be losing it, too, that can prolong the situation.

2) Be willing to step away if you need to, in order to regain your own composure.

Sometimes we think we’re helping our kids by staying close, even if we’re being triggered. We don’t want to abandon them in their hour of need. But sometimes staying close is only making the problem worse (see #1.)

3) Step away earlier than you think you need to, and do it in a healthy way.

If you remain in the situation too long, you’re more likely to register irritation and to become snappish. So it’s better to notice your own rising emotion and to say calmly (because you can still be calm), “I’m going to be over there, and when you’re calm, we can talk.”

The “over there” might be in the same room, or it might be outside the door, listening for when your child has calmed down. (Stay as close as you need to in order to ensure safety, while still giving you as much space as possible to regain your equilibrium.)

One thing that’s worked for me with my daughter when she is obsessively repeating the same thing (“I wanted the other diaper!”), I tell her that I want to talk to her, I want to be near her, but I won’t talk anymore about that one thing (i.e. “I’m not going to talk anymore about the diaper.”)

4) Know that your goal is to teach your child self-regulation, and you can only do that if you model it.

Enough said. Refer to #1-3.

5) Recognizing your limitations is a positive. Denying them only gets you in more trouble.

We all want to be good parents. If we’re constantly pushing ourselves to meet lofty standards and getting down on ourselves when we can’t meet those standards, we’re actually making a hard job even harder.

That’s true for the way you see your child. At this age, they’re going to have tantrums, and meltdowns. Accept that it’s going to happen, no matter how proactive you are. Because if you don’t accept it, you might be more apt to be frustrated and embarrassed (especially if it’s in public.)

Toddler meltdowns are not a sign that you’re a bad parent. It’s a sign that they’re in a developmental stage that is all about testing boundaries and limits and finding their voice.

Be kind to yourself, and to them.

***Holly Brown is a therapist and the author of the page-turning family drama Don’t Try to Find Me. For more on the book, visit her author page.

By TRACI PEDERSEN Associate News Editor

High-intensity focused ultrasound may help relieve symptoms of obsessive-compulsive disorder (OCD) in hard-to-treat patients, according to preliminary findings of new research.

The procedure applies high-intensity focused ultrasound energy to heat and destroy diseased or damaged tissue through ablation (the removal of tissue).

The study is being conducted with 12 patients by Jin Woo Chang, M.D., Ph.D., at the Yonsei University Medical Center in Seoul, Korea. The results of the first four patients with six months follow-up were published in the Journal of Molecular Psychiatry.

Although many OCD patients improve with medication, some patients have debilitating symptoms that are resistant to treatment. For these patients, psychosurgery can be performed to destroy (ablate) a targeted region of the brain (anterior internal capsule) associated with the disorder.

The four patients, who suffered from disabling OCD that was unresponsive to medication, were treated with a focused ultrasound system called InSightec ExAblate Neuro. The treatment targeted the part of the brain called the anterior internal capsule.

All four patients had the targeted areas of the brain successfully ablated with no complications or side effects. They experienced gradual improvements in their obsessive-compulsive thoughts and behaviors and showed nearly immediate and sustained improvement in depression and anxiety which lasted over six months.

“There is a need for non-invasive treatment options for patients with OCD that cannot be managed through medication,” said Chang.

“Using focused ultrasound, we were able to reduce the symptoms for these patients and help them get some of their life back without the risks or complications of the more invasive surgical approaches that are currently available.”

“If these initial results are confirmed in the remaining eight patients in this study as well as in a larger pivotal trial of safety and efficacy, focused ultrasound could emerge as an alternative to surgery for improving quality of life in a cost-effective manner for patients with OCD,” said Neal F. Kassell, M.D., chairman of the Focused Ultrasound Foundation.

“This could also serve as the predicate for non-invasive therapy for other psychiatric disorders.”

The currently available ablative approaches are invasive or involve radiation, such as radiofrequency ablation, stereotactic radiosurgery, and deep brain stimulation.

Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by recurring anxiety-provoking thoughts (obsessions) that are alleviated only by ritualistic actions (compulsions). Severe cases can lead to overwhelming impairment and dysfunction.

OCD patients also have a high risk for depression, with two-thirds of OCD patients developing major depression. Chang plans to begin a study using focused ultrasound to treat depression in 2015.

Source: Focused Ultrasound Foundation

By TRACI PEDERSEN Associate News Editor

Parents should encourage their preschoolers to begin writing very early, even before they enter a classroom setting, according to new research published in the Early Childhood Research Quarterly. The study reveals how early writing — especially when it occurs before any formal education — plays a significant role in improving a child’s literacy level, vocabulary, and fine motor skills.

“Parents in the U.S. are obsessed with teaching their kids the ABCs,” said Professor Dorit Aram of TAU’s Jaime and Joan Constantiner School of Education. “Probably because English is an ‘opaque’ language. Words do not sound the way they are spelled, unlike ‘transparent’ Spanish or Italian.”

“Parents are using letters as their main resource of teaching early literacy, but what they should be doing is ‘scaffolding’ their children’s writing, helping their children relate sounds to letters on the page even though the letters are not transparent.”

Scaffolding is using a supportive, step-by-step instruction process to help the student slowly gain understanding and independence.

Aram has spent the last 15 years studying adult support of young children’s writing. A major factor of this support is using what she calls “grapho-phonemic mediation,” in which a caregiver actively helps a child break down a word into segments to connect sounds to corresponding letters. For example, parents are using this method when they ask their child to “sound out” a word as they put it to paper. This is different from the traditional model of telling children precisely which letters to print on a page, spelling it out for them as they go.

“Early writing is an important but understudied skill set,” said Aram. “Adults tend to view writing as associated with school, as ‘torture.’ My experience in the field indicates that it’s quite the opposite — children are very interested in written language. Writing, unlike reading, is a real activity. Children watch their parents writing and typing, and they want to imitate them. It is my goal to assist adults in helping their children enter the world of writing by showing them all the lovely things they can communicate through writing, whether it’s ‘mommy, I love you’ or even just ‘I want chocolate’.”

The researchers observed 135 preschool children (72 girls and 63 boys) and their parents as they attempted to write a semi-structured invitation for a birthday party. They analyzed the degree of parental support and assessed the children’s phonological awareness, alphabet knowledge, word decoding, vocabulary, and fine motor skills. Overall grapho-phonemic support by the parents was most positively linked to children’s decoding and fine motor skills.

“Scaffolding,” or parental support, was most useful in developing early literacy skills. “The thing is to encourage children to write, but to remember that in writing, there is a right and a wrong,” said Aram.

“We have found that scaffolding is a particularly beneficial activity, because the parent guides the child. And, if that parent guides the child and also demands precision in a sensitive and thoughtful way — i.e. ‘what did you mean to write here? Let me help you’ — this definitely develops the child’s literary skill set.”