Oxytocin: Implications for Autism and Music

Someone asked me recently about the use of Oxytocin to help people with autism improve their social skills. I had not heard much about using this drug, so I did some investigating. I think some of the recent "buzz" about using Oxytocin may be from some new research that was published about genes in people with autism. Dr. Simon Gregory at Duke University used a controlled study to establish that in 20 cases of autism there was a problem with the OXTR gene that processes Oxytocin in the brain. Another study by L. A. Green et al also found problems with Oxytocin processing in children with autism. This is important because previous research has shown some indications that oxytocin can decrease obsessive compulsive behaviors, repetitive behaviors and increase the desire for social attachment. One study by Eric Hollander in 2003 compared giving Oxytocin or a placebo to individuals with autism and found that there was a significant decrease in the number of repetitive behaviors for the group receiving Oxytocin infusions.

The research seems to be showing that there is some relationship between autism and the genes that process Oxytocin. So far, the number of research studies are few. The studies also have small sample populations and have not been replicated. I think we are just at the beginning of understanding how Oxytocin might play a part in autism. Some people are theorizing that giving Oxytocin to people with autism might be helpful, but the research has only been able to demonstrate short-lived improvements from extra Oxytocin. These studies also used injected Oxytocin and giving the drug through nasal mist did not seem to have the same effect. Since the research is not clear about the possible problems with the brain processing Oxytocin, perhaps giving extra Oxytocin is not recommended since it may have negative side effects in other areas. Oxytocin, after all, is a powerful drug (Pitocin) sometimes used during labor to increase the strength of contractions.

So if injecting Oxytocin may create a temporary positive effect in some people with autism who may have a deficient processing mechanism, perhaps we can find a better way to supply Oxytocin or increase its uptake. Please bring in Dr. Hill of Arizona State University....

Dr. Hill started a research project last year to test Oxytocin levels in band students before and after playing in ensembles. These students do not have autism, but if there is evidence that music may increase natural Oxytocin levels, this may be an interesting basis for more research into why music has been so effective in helping many people with autism.

My initial thought is that it may explain why after about 5-10 minutes of a familiar music therapy session, children with autism usually settle down and increase their focus of attention. I have also noticed that many children with autism have a very positive association with music and the music therapist. Would music induced increases in Oxytocin account for the increased verbalization and social interactions that often occur during music therapy? I have not seen published results of Dr. Hill's study, but I anxiously await his findings.

Kindle Some Fun!

The local music therapists in Dallas/Fort Worth have recently been discussing the merits of digital readers. They mentioned the Kindle from Amazon which I have already had highlighted on Music Makes Sense for the last year. Amazon just came out with their newest version which uses 3G technology.

I think these devices are great ideas for therapists! They are super portable and won't add much to the huge amount of stuff music therapists usually port around. I imagine having song books and picture books at the tip of my fingers without the extra weight! Because they are 3G, you will also be able to download selections wherever you are and use the materials almost in real time.

Here is a nice video about how it works:

http://www.amazon.com/gp/mpd/permalink/m2EV4VGJ1ZQMQ7

And some details about the Kindle:

Slim: Just over 1/3 of an inch, as thin as most magazines

Lightweight: At 10.2 ounces, lighter than a typical paperback

Books in Under 60 Seconds: Get books delivered wirelessly in less than 60 seconds; no PC required

3G Wireless: 3G wireless lets you download books right from your Kindle; no annual contracts, no monthly fees, and no hunting for Wi-Fi hotspots

International Coverage: Enjoy 3G wireless coverage at home or abroad in over 100 countries.

Paper-Like Display: Reads like real paper without glare, even in bright sunlight

Carry Your Library: Holds up to 1,500 books

Long Battery Life: Read for days without recharging

Read-to-Me: With the experimental Text-to-Speech feature, Kindle can read newspapers, magazines, blogs, and books out loud to you, unless the book's rights holder made the feature unavailable

Free Book Samples: Download and read first chapters for free before you decide to buy

Large Selection: Over 350,000 books, including 104 of 112 New York Times® Best Sellers, plus U.S. and international newspapers, magazines, and blogs. For non-U.S. customers, content availability and pricing will vary.

Low Book Prices: New York Times Best Sellers and New Releases are $9.99, unless marked otherwise. When traveling abroad, you can download books wirelessly from the Kindle Store or your Archived Items. U.S. customers will be charged a fee of $1.99 for international downloads.

Christmas is right around the corner!

Checking In With Carly.

Carly update.

I discovered Carly back in April of this year. (click here for a link to my blogpost.) She had joined twitter and started following my tweets. She really has an amazing and inspiring story. John Stossel and John McKenzie recently did a story on her progress for ABC's 20/20. I thought it was interesting that Carly has so much to say, but is still shy about typing around new people. It was also insightful that her father had to apologize somewhat for having talked around Carly as if she did not understand before she started typing and demonstrated that she has a keenly observant intellect. Enjoy her story. We can really learn from her insights, although I think that she is the exception and not the rule for children with autism.

Side Notes: Obamacare

I would like to comment on the health care debate that is currently raging in Congress and America in general. Not only does this affect all of us, but it will also have implications for music therapy treatment options and reimbursement issues. With this in mind, our music therapy seminar class has considered the subject over the last several weeks in order to try and grasp the main ideas of the current plans being bandied around the legislature.



This propaganda poster is actually right on the mark. Our class did a survey of health care systems in 10 countries around the world. I was assigned Japan, which has a very tightly regulated government run health care program. Every country we looked at also had some type of government run health care. In each case, our investigation found that longer wait times were one of the major complaints in these other systems. Interestingly, the longer wait times only resulted in shorter times with the physician. Since the government controls how much the doctors can charge for patient visits, the only way to make up the lost revenue is to see more patients per hour/day.

Our class actually had a very civil and productive discussion about the plan President Obama has put forth. There were arguments for and against, but we did not have a shouting match or anything so heated like the demonstrations shown on TV. It seemed that as a group of regular folks just trying to solve some problems with our health care system, we were able to rationally discuss the situation. Of course, we did not have to worry about being elected or pleasing certain interest groups.

I found it interesting that we could not find the details about the current situation of the health care legislation. We found the plan that Obama outlined, but the plan being considered in the finance committee does not look very much like the original Obama plan anymore. Senator Baucus has changed so much, including taking out the public option and not promising to cover all people, that no one really knows exactly what they are trying to accomplish. All of this information was found through third hand sources since the senators have been conducting all the discussions in secret. They have not even promised to post the final legislation for all to see on the internet before a vote.

Our class acknowledged that there are problems with the system in the U.S. Obviously the increase in cost every year is out of control and the U. S. government spends much more on health care than most other modern countries and provides less in services overall. We agreed that America excels in critical and acute care as well as having top of the line doctors and equipment. Other countries seem to have problems with quality control and customer service since the government control is not responsive to consumer driven sentiment. Some of the countries have successfully contained dramatic cost increases by regulating drug prices and drug companies and providing more coverage for preventative care. Unfortunately for the U. S., our population is much more diverse with many poor dietary and cultural habits that increase the health costs across the board. We do not have the benefit of a very homogeneous society like Japan. As the rest of the world becomes more metropolitan, many of America's health care problems are seeping into the systems of the socialist democracies and causing them to limit benefits or increase taxes.

After much discussion, our class decided to pretend like we were the Senate Finance Committee and hold a vote to see if the current Baucus bill should be voted out of committee to the full senate. I was surprised that the bill did not even receive one vote! The most liberal thinking class members were too upset that there was not a public option in the bill and the more conservative people were very concerned that there was so much deception about costs and increased taxes. Of course, since our class met, the bill has been passed out of the Finance committee in the real senate.

In my opinion, the entire Baucus bill seems to be a horrible injustice to taxpayers. The bill was only passed out of the committee by plain bribery on the part of Senator Baucus. People may call it bargaining, but when certain key states like Nevada, Oregon, Rhode Island, and Michigan are exempted from paying for some of the costs listed in the bill because they have Democrat senators, it is obvious what is going on. Seventeen other mostly Democrat controlled states also received special deals to limit the state's costs in the health care plan. Either every state should have an equal burden or the bill should not be passed. I think that the current plan is just a money grab from some people like the drug companies and medical device makers and reapportionment of the money to interest groups lucky enough to have their names mentioned. The last time I looked, music therapy was not on the list of the blessed! (Not that it should be.)

If you are going to change the health care system, then change it. The bills before congress right now mostly tinker around the edges and just play favoritism to one group or another. Since Democrats are in power, they should be honest and admit that it is probably over 90% of their interest groups that are getting the benefits. The options for health care will not increase as a result of congress passing any of the bills in the pipeline. There is not a bill offering a single-payer government run program and there is also next to zero proposal for any kind of market driven reform of health care since the conservative viewpoint has been locked out of any negotiations. Americans should not just throw their hands up in the air and say any reform is good. A vote for change does not abrogate our responsibility for due diligence in developing good ideas that make a difference!

To be honest, our class was very disheartened. In our examination of the details of the health plans and the process it is going through we found that the entire mess in Washington is so far removed from how regular people seem to think and act that we were at a loss for suggestions to improve the health care plan. We are even more concerned because we spent weeks looking at the issue to the best of our ability by looking for unbiased information and could not see how the current health plans will be successful in fixing anything. This Halloween, the scary thing is that most people will spend only a few minutes thinking about this subject while at the same time being informed by extremely partisan voices. Is this really in the best interest of our wonderful society and country? At the moment it does not look like anyone will be able to stop the legislators in Washington from messing things up once again although I am convinced that a much larger percentage than is reflected in the polls would oppose any legislation in its current state.

Washington D. C. - Where nothing makes sense and the keys to knowledge have been lost forever!

Autism on the Rise?

The October 5, 2009 issue of Pediatrics included a new report about the prevalence of autism. The study's findings were based on data obtained from a survey given to parents in 2007. The survey asked parents if their child had ever been diagnosed with an Autism Spectrum Disorder (ASD) and still had the disorder. Researchers discovered that the prevalence of children with ASD was 1 in 91 children. This number is much higher than previous estimates by the Autism and Developmental Disabilities Monitoring Network that found the prevalence of ASD to be 1 in 150 children.

How can we make sense of the large increase in numbers? Caution is advised since there has been a great deal of recent publicity about ASD as well as growing public awareness. This may have impacted the identification of more cases of ASD that otherwise would have been missed. Screening of younger children has increased and doctors are much more willing to make a diagnosis of ASD for children at an early ages.

Many education professionals are of the opinion that there has been an increase in the number of children with autism. Sometimes these educators and therapists have a skewed view because they may be in a school district that works very well with families who have children with special needs. Consequently, parents tend to flock to these school districts with good reputations and artificially raise the relative number of children with ASD.

Hopefully, more research studies will be put forth trying to figure out the true nature of our challenge with ASD. It is definitely a situation we would all like to have make more sense!

Click here for the abstract.