Autism the focus of Bogin pediatric lecture

TRUMBULL — Dr. Fred Volkmar recently typed the word “autism” into an online search engine and watched as 125 million hits popped up.

Many of the hits directed users to sites selling products and services, while others were simply useless, said Volkmar, an Irving B. Harris Professor at the Yale School of Medicine Child Study Center.

Figuring out which hits were valid and which were misleading or possibly harmful was a daunting task, Volkmar said.

“And if you’re a parent (whose child has autism) what are you supposed to do with all of that?” he said.

Volkmar spoke Wednesday at the 42nd Annual Maxwell Bogin MD Lectures in Pediatrics, which took place at the Trumbull Marriott and was sponsored by the Yale New Haven Health system and the Bridgeport Hospital Department of Pediatrics.

The topic of the lectures, which drew about 100 doctors and other professionals, was “Autism: Where Are We Now?” Previous topics have included transgender youth and Zika virus, among others.

Autism was chosen as this year’s topic because it’s an issue that affects so many in the pediatric field, said Dr. Harris Jacobs, head of pediatrics at Bridgeport Hospital.

“Over time, it’s become such a pervasive problem,” he said. “And not because there’s more of it, but because it’s diagnosed more often.”

Indeed, according to the Centers for Disease Control and Prevention, the number of children identified as having an autism spectrum disorder went from 1 in 150 in 2000 to 1 in 59 in 2014. An autism spectrum disorder is defined as a developmental disorder that can cause “significant social, communication and behavioral challenges,” according to the CDC.

During Wednesday’s lecture, medical experts discussed such topics as early markers of autism and diagnosis and clinical treatment of the condition. Volkmar was the last speaker on the program, and he talked about how the medical profession’s understanding and treatment of autism has evolved over the past few centuries.

Volkmar said the earliest reported cases of what was likely autism popped up in the 1800s in socalled “feral children” — children, usually living on their own, who are believed to have been denied contact with other human beings. More sophisticated definitions of autism began to pop up in the 1940s through the work of psychiatrist Leo Kanner and pediatrician Hans Asperger.

However, autism wasn’t officially recognized by the medical profession until the 1980s, Volkmar said. Autism became more discussed throughout the 1990s and particularly the 2000s, when there was “an explosion of research.” He said the number of research papers on the topic skyrocketed, from a few hundred in 2000 to a little more than 4,000 in 2017.

On the one hand, Volkmar said, that’s good, because it means there’s more knowledge about autism. On the other hand, not unlike those millions of web sites that pop up in an online search, Volkmar said, it’s hard to parse all that information for the data that’s most helpful.

Still, there is more known today about autism than there was just a few decades ago, he said. Volkmar discussed some of the work he’s done on how people on the autism spectrum view the world differently than socalled “typical” people.

“Autism is a problem of social connection,” he said.

For instance, Volkmar said, he did an experiment tracking the eye movements of people as they watched scenes from the classic Elizabeth TaylorRichard Burton drama “Who’s Afraid of Virginia Woolf ?” He said, during the scenes, the typical people were more likely to watch the eyes of the actors as they talked, while autistic subjects watched the actors’ mouths.

This likely contributes to some of the issues people on the spectrum have with social interaction, Volkmar said.

“When you focus on the mouth, you lose about 90 percent of relevant social information,” he said.

Despite the progress that’s been made, Volkmar said, there’s obviously more work to do. Though children who are diagnosed early and receive proper interventions can improve and become more functional, not everyone benefits.

“Not every child gets better, for reasons we don’t know,” he said.