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Early detection, intervention vital for identifying, destigmatizing autism spectrum disorder

Autism spectrum disorder is one of the more common childhood disorders, with the World Health Organization estimating that, globally, 1 in 160 children has autism spectrum disorder.

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Photo by Caleb Woods from Unsplash.com

Early detection and intervention for children with autism spectrum disorder could help millions worldwide gain greater developmentally appropriate skills, enhance independence, and harness their unique abilities, says an expert at Cleveland Clinic Children’s, marking World Autism Awareness Day on Friday, 2 April.

Cynthia Johnson, PhD, Director of Cleveland Clinic Children’s Center for Autism, said: “Early detection and early intervention leads to better outcomes. Increased awareness destigmatizes the diagnosis of autism spectrum disorder. While every parent views their child as a perfect gift, we want to tell them that identifying and treating autism spectrum disorder is not changing their child, but rather helping them to adapt and to capitalize on their unique abilities.”

Autism spectrum disorder is one of the more common childhood disorders, with the World Health Organization estimating that, globally, 1 in 160 children has autism spectrum disorder.

Autism spectrum disorder has two key components: lack of or weakness in social and social communication abilities, and presence of restrictive or repetitive behaviors, with identification possible as early as in the first year of life. While there is no one known medical cause for autism, research suggests a mix of many genetic and environmental factors are risks, such as older parents, premature birth, and environmental pollutants. Diagnosis can come from interviews with parents and teachers, along with specialized developmental tests.

“Parents with toddlers and preschool-aged children should be on the lookout for delayed speech and unusual communication development,” said Dr. Johnson. “Possible symptoms can include repetitive speech or phrases, lack of imitation of other people’s actions and emotions, atypical, repetitive and restricted play, engaging in repetitive motor movement such as hand flapping or finger flicking, or oversensitivity to sound. The earlier that we can identify autism spectrum disorder, the faster we can address these patients’ differences and hopefully offset a cascade of disruptions in early development.”

People with autism spectrum disorder are more likely to have seizures, epilepsy, gastrointestinal and nutritional issues, sleep disturbances, and anxiety.

Professionals focus treatment on one-on-one behavior therapy, and training parents on enhancing their children’s social skills. Technology solutions are also seeing increasing uptake among patients, according to Dr. Johnson. For example, children with autism spectrum disorder can use tablet devices with special speech software to better develop their multiple-word communication and vocabulary. As many people with autism spectrum disorder may be uncomfortable around people, they may be more comfortable to learn social skills from humanoid robotics that have fun and simplified expressions.

Medications are often used to treat disruptive behaviors and attention weakness and hyperactivity.

Dr. Johnson concluded: “Many people with autism spectrum disorder do want to be social and be part of their social community, they may just need to develop age-appropriate social skills and reduce interfering restricted behaviors. Medical treatment and applied behavior analysis can help patients become more independent. Many people with autism spectrum disorder are among the brightest people I’ve ever met. They have the ability to contribute to society in different ways because of their attention to detail, laser focus, mastery of fields, and thinking outside of the box.”

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Valentine’s Day pressure and dating apps linked to higher depression risk; clinicians explain why

Coupled with the already heightened stresses of Valentine’s Day, caused by unmet expectations and unrequited love, this time of year makes people more susceptible.

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As Valentine’s Day approaches, clinicians warn that the pressure to find a romantic connection is intensifying stress and low mood among singles, particularly those relying on dating apps. According to research from Flinders University, many dating app users report worse mental health and wellbeing outcomes (anxiety and depression) compared to non-users.

Coupled with the already heightened stresses of Valentine’s Day, caused by unmet expectations and unrequited love, this time of year makes people more susceptible.

The research highlights behaviours commonly experienced by dating app users, such as being ‘ghosted,’ which are linked with lower self-esteem and higher depressive symptoms, indicating that negative feedback on these platforms has measurable mental health impacts. Researchers found a pattern of ‘emotional exhaustion’ and reduced enjoyment among frequent users, consistent with the idea of dating app burnout.

“The prevalence of depressive symptoms and emotional burnout as a result of online dating is a clear indicator that we need to deepen our connection with ourselves first,” says Dr. Hannah Nearney, M.D., clinical psychiatrist and UK Medical Director at Flow Neuroscience, a company that develops brain stimulation tools for depression treatment.

“During the Valentine’s Day period, we put additional pressure on ourselves to find connection. In doing so, we can risk finding ourselves in relationships which are not fulfilling just to ‘validate’ ourselves.”

Among young adults, there is growing social pressure to not be alone, and dating apps have become a primary way to meet that expectation. In fact, a study published in the British Medical Journal (BMJ) found that people use dating apps for a mix of reasons, including finding long-term romantic partners and sexual connections.

This social environment can foster ambiguous connections known as “situationships”, wherein those involved continue to explore other options rather than settle into one relationship. According to YouGov data, half of Americans aged 18 to 34 have reported being in a ‘situationship.’

The BMJ study also found signs of obsessive-like app use driven by social expectations: 75% of users reported repeatedly deleting and reinstalling dating apps, with higher problematic use linked to more depressive symptoms and impulsivity, highlighting additional mental health concerns tied to excessive app engagement driven by societal pressures.

“Obsessive app use is not just about how often someone swipes; it shows up as an intrusive, distressing, and repetitive preoccupation which leads to losing control over our behaviour,” says Dr. Nearney. “Repeatedly deleting and reinstalling apps, checking your phone compulsively, and feeling more anxious, low or impulsive the longer you use them is a strong tell. When people feel pressure not to be alone, apps can start to feel less like a tool for connection and more like something they rely on emotionally. This is the point at which our mental health can begin to suffer.”

Expectations around love intensify stress, loneliness and disappointment, and this is especially noticeable around this time of the year. A study on suicide risk around Chinese and Western Valentine’s Days found that days before and after these holidays showed significant changes in risk compared with other days of the year.

Single women showed a 74% higher risk five days before Chinese Valentine’s Day, and married women a 60-86% higher risk around Western Valentine’s Day. The authors suggest these patterns may reflect unmet romantic expectations and distress tied to social narratives about love and connection. For those using dating apps, the holiday can act as a magnifier for already unmet hopes.

“Valentine’s Day can be reframed as a reminder that love doesn’t only come from a partner or a match on an app, but can take the form of self-love and looking after your mental health,” says Dr. Nearney. “This means practising self-compassion, staying connected to people in real life, and remembering that your worth isn’t measured by dating app metrics. Investing in friendships, community, and everyday moments of connection is far more protective for well-being than digital validation alone.”

By encouraging clarity in expectations in different parts of our lives, we can reduce ambiguity and emotional distress. Research consistently shows that stable and supportive relationships, either romantically or with friends, are strongly linked to better mental health and resilience.

Alongside meaningful social connection, maintaining well-being also benefits from regular activities such as exercise, learning new skills, creative pursuits, time away from screens, and even recently approved brain stimulation techniques, all of which support emotional balance and cognitive health.

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Brain injuries linked with potential risk of suicide, new study finds

People with head injuries were 21% more likely to attempt suicide than those without, even after adjusting for age, sex, deprivation, and mental health history.

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Adults who experience a head injury face a substantially higher risk of attempting suicide compared to those without such injuries, according to the findings from a new UK-based study.

Published in Neurology® the medical journal of the American Academy of Neurology, the study was led by University of Birmingham researchers. The paper is the first of its kind to examine suicide risk across all types of head injuries in a general population, moving beyond the traditional focus on traumatic brain injuries (TBIs) in military, athletic or hospital settings.

The population-based matched cohort study used nationally represented electronic primary healthcare records from more than 1.8 million adults, linked with Hospital Episode Statistics and Office for National Statistics data.

Researchers found that people with head injuries were 21% more likely to attempt suicide than those without, after analysing data across a 20-year period.

Key findings:

  • Researchers found that people with head injuries were 21% more likely to attempt suicide than those without, even after adjusting for age, sex, deprivation, and mental health history.
  • The incidence rate was 2.4 per 1,000 person-years in individuals with head injuries, compared to 1.6 per 1,000 person-years in the control group. This translates to an absolute increase in risk of 0.7% (1.3% vs 0.6%), yet the adjusted hazard ratio reported was 21%, and
  • Elevated risk was observed across all subgroups, including individuals with no prior mental health conditions, highlighting that head injuries alone are linked to increased psychological vulnerability.

Professor Nicola Adderley, Professor of Epidemiology and Real-World Evidence at the University of Birmingham and a lead author of the study, said: “Our findings show that the impact of head injuries are not limited to just physical symptoms or repercussions. They can have profound psychological consequences. Suicide risk assessments should be considered for anyone with a recent head injury, regardless of their mental health history, to improve and safeguard patient outcomes.”

In the UK alone, nearly 6,000 deaths each year are attributed to suicide whilst the number of attempts is significantly higher. The study’s findings showed that the risk of suicide attempt was highest in the first 12 months following a head injury, suggesting a critical window for intervention.

While the risk declined over time, it remained elevated compared to those without head injuries. Researchers also found that social deprivation and a history of mental health conditions further amplified the risk.

While suicide attempts were more common among those with head injuries, the study did not find a significant increase in deaths by suicide after accounting for competing risks such as other causes of death; suggesting that head injuries may lead to more frequent non-fatal attempts.

Researchers are calling for the following changes in healthcare settings:

  • Routine suicide risk screening in primary and secondary care settings for patients with head injuries.
     
  • Enhanced mental health support, particularly during the first 12 months post-injury; with public awareness campaigns to help families and caregivers recognise warning signs.
     
  • The development and testing of suicide risk assessment and prevention strategies for people with head injuries should be investigated, especially within the first 12 months post-head injury and irrespective of mental health history.

Professor G. Neil Thomas, Professor of Epidemiology and Research Methods and a lead author of the study, said: “These findings have implications for both clinical practice and health policy; highlighting the urgent need for targeted mental health and wellbeing support.

“The development and testing of robust suicide risk assessment and prevention strategies for people with head injuries should be further investigated; especially within the first 12 months post-head injury and irrespective of mental health history.”

The research utilised data from the Clinical Practice Research Datalink (CPRD), linked with hospital and mortality records, covering a 20-year period (2000–2020). Ethical approval was granted by the Health Research Authority and CPRD Independent Scientific Advisory Committee.

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Gum disease may be linked to plaque buildup in arteries, higher risk of major CVD events

Effective prevention and treatment of gum disease, also called periodontal disease, could potentially decrease the burden of cardiovascular disease.

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There is increasing evidence that gum disease is associated with increased risk of cardiovascular events, including heart attackstrokeatrial fibrillationheart failure and cardiometabolic health conditions. Effective prevention and treatment of gum disease, also called periodontal disease, could potentially decrease the burden of cardiovascular disease, according to a new scientific statement published today in the American Heart Association’s flagship journal Circulation.

The new American Heart Association scientific statement, “Periodontal Disease and Atherosclerotic Cardiovascular Disease,” features new data supporting an association between periodontal disease and atherosclerotic cardiovascular disease (ASCVD) and updates the Association’s 2012 scientific statement. ACSVD, the leading cause of death globally, is caused by buildup of arterial plaque (fatty deposits in the arteries) and refers to conditions that include coronary heart disease, stroke, peripheral artery disease and aortic aneurysms.

“Your mouth and your heart are connected,” said Chair of the scientific statement writing group Andrew H. Tran, M.D., M.P.H., M.S., FAHA, a pediatric cardiologist and the director of the preventive cardiology program at Nationwide Children’s Hospital in Columbus, Ohio. “Gum disease and poor oral hygiene can allow bacteria to enter the bloodstream, causing inflammation that may damage blood vessels and increase the risk of heart disease. Brushing, flossing and regular dental checkups aren’t just about a healthy smile—they’re an important part of protecting your heart.”

Highlights of the statement include:

  • Periodontal disease is a chronic inflammatory condition affecting over 40% of U.S. adults over age 30. The earliest stage is gingivitis (inflammation of the gums due to buildup of oral plaque). If left untreated, gingivitis may progress to periodontitis, where the gums begin to pull away from the teeth, forming small pockets that can trap bacteria and lead to infection. The most advanced stage, severe periodontitis, involves extensive damage to the bones supporting the teeth; teeth may become loose and fall out. This stage often requires surgical intervention. 
  • Periodontal disease is more common in individuals with poor oral hygiene and other cardiovascular disease risk factors, such as high blood pressure, overweight or obesity, diabetes and smoking. The prevalence of periodontal disease is also higher among men, older adults, individuals with low physical activity and people affected by adverse social determinants of health, such as lower socioeconomic status, food insecurity and/or lack of access to health care including dental care.
  • Although periodontal disease and ASCVD share common risk factors, emerging data indicates there is an independent association between the two conditions. Potential biological mechanisms linking periodontal disease with poor cardiovascular outcomes include direct pathways such as bacteria in the blood and vascular infections, as well as indirect pathways such as chronic systemic inflammation.
  • Numerous studies have found that periodontal disease is associated with an increased risk of heart attack, stroke, atrial fibrillation, heart failure, peripheral artery disease, chronic kidney disease and cardiac death. Although periodontal disease clearly contributes to chronic inflammation that is associated with ASCVD, a cause-and-effect relationship has not been confirmed.
  • There is also no direct evidence that periodontal treatment will help prevent cardiovascular disease. However, treatments that reduce the lifetime exposure to inflammation appear to be beneficial to reducing the risk of developing ASCVD. The treatment and control of periodontal disease and associated inflammation may contribute to the prevention and improved management of ASCVD.
  • People with one or more cardiovascular disease risk factors are considered to be at higher risk and may benefit from regular dental screenings and targeted periodontal care to address chronic inflammation. Previous studies have found that more frequent tooth brushing is associated with lower 10-year ASCVD risk (13.7% for once-daily or less brushing vs. 7.35% for brushing three or more times per day) and reduced inflammatory markers.
  • More research, including long-term studies and randomized controlled trials, is needed to determine whether periodontal treatment can impact ASCVD progression and outcomes.
  • In addition, the role of socioeconomic status, access to dental care and other social factors that adversely affect health should be explored to develop targeted prevention and treatment strategies that can help reduce the prevalence and adverse outcomes of periodontal disease and ASCVD.

This scientific statement was prepared by the volunteer writing group on behalf of the Cardiovascular Disease Prevention Committee of the American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young; the Council on Clinical Cardiology; the Stroke Council; the Council on Basic Cardiovascular Sciences; and the Council on Cardiovascular and Stroke Nursing. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Co-authors are Vice Chair Abbas H. Zaidi, M.D., M.S.; Ann F. Bolger, M.D., FAHA; Oscar H. Del Brutto, M.D.; Rashmi Hegde, B.D.S., M.S.; Lauren L. Patton, D.D.S.; Jamie Rausch, Ph.D., R.N.; and Justin P. Zachariah, M.D., Ph.D., FAHA. Authors’ disclosures are listed in the manuscript.

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