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Dr. Shahal Rozenblatt, Clinical Neuropsychologist, New York

JerusalemPost-Autism can temporarily affect younger siblings

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Health Scan: ‘Autism can temporarily affect younger siblings’

Study finds siblings of children with autism might develop more slowly.

Younger siblings of children with autism may have delayed verbal, cognitive and motor development in their early childhood years, according to a study carried out by Hebrew University of Jerusalem and University of California at Los Angeles. HU Prof. Nurit Yirmiya and doctoral candidate Yifat Gamliel and Dr. Marian Sigman of California found that some siblings of children with autism – ranging from 14 months to 4.5 years – were diagnosed with delayed verbal, cognitive and motor development. After the age of four and a half, most of those children were able to close the gap with other children of the same age who had siblings with normal development, except for some small delays in verbal abilities. The study has been published in the Journal of Autism and Developmental Disorders. The issue was edited by Prof. Nurit Yirmiya and Prof. Sally Ozonoff of the M.I.N.D. Institute at the University of California, Davis. They reported finding that 30 percent of children with older autistic siblings were found to have delayed development in the three areas studied, as opposed to only 5% in a group whose siblings did not suffer from autism. The reasons for this phenomenon, says Yirmiya, can be traced to the genetic tendency of children in the former group to carry an endophenotype of autism (an hereditary characteristic normally associated with some condition but not a direct symptom of that condition). “Siblings of children with autism are likely to inherit genes that will cause a weakened expression of autistic symptoms,” she explained. These can take the form of delayed linguistic abilities, difficulties in expressing feelings and making eye contact, and in social interaction. Yirmiya continued that such problems cannot be traced to an imitation of the older sibling with autism. “The children examined had other models that they could have imitated, such as parents, friends or other [normal] siblings in the family with whom they had frequent contact,” she asserted. The research tested 39 Israeli children who had older siblings with autism. The research also involved a comparison group with older siblings of normal development. The children in both groups were examined at four months, 14 months, 24 months, 36 months and 54 months. The results showed that there were no significant differences between the two groups at the age of four months. Most of the developmental delays were found in the first group from the age of 14 months until the age of four and half. After that, most of those in the group who had siblings with autism were able to close the gap between them and children in the comparison group, with the exception of a few children who persisted with some difficulties in verbal expression. Yirmiya said follow-up work should be undertaken into the elemental school years in order to determine whether there are symptoms such as learning difficulties, since these sometimes surface at a later age. She stressed that while the research does illustrate some developmental problems with siblings of children with autism, to a large extent these problems resolve themselves at a young age. Therefore, it is not clear whether prevention programs should be recommended for such children, especially considering the burden that the families are already experiencing. INNOVATIVE CENTER FOR BLIND-DEAF It’s hard enough to be blind; being blind and deaf is much more difficult. Now the country’s only learning center for the deaf-blind has joined the prestigious international Karten Network of centers for adults with disabilities, which is based in England, Scotland and Wales. The network aims at improving the quality of life and independence level of disabled adults with a supportive learning environment that uses state-of-the-art computer technology. The new Karten Computer-Aided Training, Education and Communication Center (CTEC) for People with Deaf-Blindness is located at Tel Aviv’s Center for Deaf-Blind Persons in the Helen Keller House is already helping 15 young adults learn communication, life and vocational skills. The Center for Deaf-Blind Persons, established in 1989 by the Beth David Institute, is the only Israeli organization that develops and provides comprehensive educational, rehabilitation and social services for this population. The most common cause of deaf-blindness here is Usher Syndrome, a genetic condition affecting an estimated 1,000 Israelis. Victims are born with hearing loss as well as retinitis pigmentosa, a progressive and degenerative eye disease. Students at the learning center range in age from 20 to 50. These years are considered a window of opportunity for individuals with Usher Syndrome, a time when they retain enough residual vision to prepare for total blindness. Several of the center’s staff members have Usher Syndrome themselves – a fact which helps them empathize with the students and set an example of success. The vision-hearing impaired need services and programs specifically designed to meet their needs. The learning center uses modern technology to teach the deaf-blind to read files via a Braille display or enlarged text, use e-mail and communicate via MSN messenger. Daily life skills include solutions to such mundane problems as how to get help in a store and how to use the bank, thereby gaining independent control of one’s finances. These skills are taught in one-on-one sessions, and can make the difference between isolation and dependence and an independent life. Leah, a 50-year-old from a poor neighborhood in Tel Aviv, is both deaf and severely visually impaired from Usher Syndrome. For years, she had used tactile sign language to communicate with friends and family, including her five children. Several months ago, despite her low self-esteem and poor reading and writing skills, she was persuaded to try using a computer at the new learning center. Since then, her progress has been remarkable. For the first time, Leah can communicate independently with her friends, make doctor’s appointments and carry out other activities that most adults take for granted. A generous donation from the Ian Karten Charitable Trust covered most of the necessary equipment and renovations, and paved the way for the enlarged Tel Aviv learning center to join the Karten CTEC Network. The new facility also has the support of the Ministry of Welfare and Social Services. Dr. Shlomo Elyashar, head of the ministry’s rehabilitation division, says the Karten center will greatly advance rehabilitation and education for the hearing and visually disabled.

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