TIME Research

Why Girls With Autism Are Diagnosed Later Than Boys

They present symptoms differently than boys, which may result in missed diagnoses

A new study looking at gender differences among children with autism spectrum disorders (ASD) show that girls have different, less obvious symptoms compared to boys, which could be why they are generally diagnosed later.

“There are clearly major gender differences in prevalence of autism, with more than four boys being diagnosed for every girl. However, we have little understanding of the roots of these differences,” says study author Dr. Paul Lipkin, director of the Interactive Autism Network at the Kennedy Krieger Institute in Baltimore. “Are they biological, social, diagnostic, or tied to other factors, such as screening systems?”

Lipkin and his colleagues looked at data on people with ASD and their family members using the Institute’s online registry of 50,000 people. Almost 10,000 of them had reported how old they were when they were first diagnosed, and about 5,000 had undergone a test to identify their severity of social impairment. The study author’s results were presented at the Pediatric Academic Societies annual meeting in San Diego.

The researchers found that in general, girls were diagnosed with ASD later than boys. On average, girls were diagnosed with pervasive developmental disorder—an autism spectrum disorder that impacts basic skill development—at age four, and boys were diagnosed with the same disorder at about 3.8 years. Girls were diagnosed with Asperger’s syndrome around age 7.6 years, while boys were diagnosed around 7.1 years. Interestingly, the researchers noticed that the symptoms reported among the children differed by gender, too. Girls tended to have more issues with the ability to read social cues, and boys had more mannerism-related issues like repetitive behaviors including hand flapping. When boys were older, around age 10-15, they had more social issues like trouble communicating in social settings than girls did.

“These findings suggest that boys’ behavior are more apparent than the girls, with the potential for girls being more difficult to recognize,” says Lipkin. “Since the problems experienced by girls are in social cognition and require social opportunities, they are much more likely to be unnoticed until the elementary school years.”

The researchers say their findings suggest that the symptom differences may not only lead to delayed diagnosis in girls, but potentially missed diagnoses altogether. Understanding the various ways children with ASD present may lead to a better understanding of the disorders.

TIME Diet/Nutrition

Tyson to Stop Using Human Antibiotics On Its Chickens

Tyson Foods chicken products are displayed on the shelves of a Little Rock, Ark. grocery store.
Danny Johnston—AP In this May 3, 2009 file photo, Tyson Foods chicken products are displayed on the shelves of a Little Rock, Ark. grocery store.

The company plans to eliminate use in 2017

Tyson Foods, one of the world’s largest producers of chicken, announced on Tuesday that it plans to eliminate human antibiotics from its chicken flocks by the end of September 2017.

The move comes amid public health concerns over the over-use of antibiotics in farming and in humans, and how it can contribute to the growing global problem of antibiotic resistance.

“We’re confident our meat and poultry products are safe, but want to do our part to responsibly reduce human antibiotics on the farm so these medicines can continue working when they’re needed to treat illness,” Donnie Smith, president and CEO of Tyson Foods said in a statement issued by Tyson.v

TIME Health Care

Medics Race Against Time to Save Nepal’s Quake Survivors

Nepalese soldiers carry a wounded man on a makeshift stretcher to an Indian Air Force helicopter as they evacuate victims of Saturday's earthquake from Trishuli Bazar to Kathmandu airport in Nepal on April 27, 2015.
Altaf Qadri—AP Nepalese soldiers carry a wounded man on a makeshift stretcher to an Indian Air Force helicopter as they evacuate victims of Saturday's earthquake from Trishuli Bazar to Kathmandu airport in Nepal on April 27, 2015.

Short-term and long-term medical risks are numerous

Medical emergency responders are continuing to rush into Nepal as the country recovers from the immense earthquake that took thousands of lives. While the final death toll remains unknown—the Nepali Prime Minister said today some 10,000 may have died—medical aid groups say the timeframe is tight to save lives.

“There’s a very narrow window of opportunity for people suffering from major traumatic injuries to receive the care they need. It’s vital that people start to receive that kind of care within the first 10 to 14 days of the emergency,” says Paul Garwood, a communications officer at the World Health Organization. “The general rule is that for every one person killed in a disaster like this, some three people are suffering from major trauma injuries.” As time goes on, the risk they die from their injuries increases, he says.

Medical responders tell TIME that survivors’ injuries range from broken bones to head trauma to spinal injuries, and they require intensive and rapid medical treatment and many will require surgical interventions. “These are the major injuries we are seeing now and expect to be seeing in the thousands,” says Garwood.

Responders are also trying to get care to people in the rural affected areas that are still isolated. “We are extremely concerned about people in villages that we can’t reach. The people can’t get out by their own means,” says Patrick Fuller an International Federation of Red Cross and Red Crescent Societies (IFRC) spokesman currently in Kathmandu. “There are thousands of people who have lost everything.”

At the same time, other health challenges don’t go away just because there’s been a major earthquake. Doctors need to maintain routine medical care for people with preexisting conditions or pregnant mothers who may be giving birth. The WHO says it’s working to ensure the right quantities of medicine are available to treat people who require care for diabetes, cancer and heart disease, for example.

Dr. Poonam Khetrapal Singh, WHO regional director for South-East Asia says her teams are trying to anticipate public health needs before they present themselves. She has team members preparing for the possibility of a measles outbreak and an increased need for mental health care among survivors. “Even now I find that people are traumatized,” she says. “At the moment the devastation is just so much.”

Teams from Doctors Without Borders/Médecins Sans Frontières (MSF) have has arrived in Nepal and are currently assessing medical needs and sending surgical teams throughout the affected areas. An 11-member surgical team was sent to Kathmandu with a “rapid intervention surgical kit,” allowing the responders to start performing operations within 72 hours after the earthquake.

In a natural disaster, there’s additional environmental factors that can jeopardize human recovery. Supply systems like roads can become disrupted and access to food can become an issue. Loss of water and sanitation systems can create risks for communicable diseases. Fuller says many shops and markets are closed and food is becoming quite scarce. “In the aftermath of the earthquake, there is the danger of epidemics breaking out, including cholera, malaria and typhoid fever. Landslides and heavy rains pose a risk to people forced to sleep out in the open,” MSF said in a statement.

“We understand that monsoonal rain has come early in Nepal, so excess amounts of water and displaced populations accentuate the risk of communicable disease outbreaks,” added Garwood. The WHO says its sending medicines to deal with diarrheal disease outbreaks. The hope is that if such infectious disease arise, as they have in past emergencies, they can be contained.

“The greatest concern is speed,” says IFRC’s Fuller. “We have to reach them as quickly as possible.”

TIME Health Care

U.S. Lowers Recommended Fluoride Levels in Drinking Water

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Getty Images

The new, lower recommendations are the first in over 50 years

For the first time in over 50 years, the U.S. has lowered its recommendation on fluoride levels in drinking water to prevent tooth decay.

On Monday, the U.S. Department of Health and Human Services (HHS) released its recommendation for an optimal concentration of fluoride at 0.7 mg per liter of water. The previous recommendations, released in 1962, allowed for 0.7 to 1.2 mg per liter.

U.S. states and cities began adding fluoride to water supplies in the 1940s to aid dental care and today, 3 in 4 Americans with access to public water systems get fluoridated water. But an excess of fluoride can cause white spots on teeth.

The HHS says Americans today have many other sources of fluoride, including toothpaste and mouthwash. The agency says the new recommended level will maintain the positive effects fluoride has on tooth decay but reduce the risk of Americans getting too much exposure.

Also on Monday, the U.S. Food and Drug Administration sent an industry letter recommending that bottled-water manufacturers, distributors and importers limit the amount of fluoride they add to bottled water to no greater than 0.7 mg per liter.

“Community water fluoridation is effective, inexpensive and does not depend on access or availability of professional services. It has been the basis for the primary prevention of tooth decay for nearly 70 years,” said U.S. Deputy Surgeon General Rear Admiral Dr. Boris D. Lushniak in a statement.

TIME Careers

Women Earn 24% Less Than Men on Average, U.N. Report Finds

New report shows gender pay gap remains sizeable

Women are still earning significantly less money than men, despite working longer hours when paid and unpaid work is taken into account, a new U.N. report reveals.

The U.N. Women report shows that even though more women are in the workplace and taking on leadership positions worldwide, pay levels are nowhere near reaching equality worldwide. On average women around the world earn 24% less than men, the report says, and earn just half of the income men earn over a lifetime. Women in South Asia experience the greatest gender pay gap, earning 33% less than men. The Middle East and North Africa have a 14% pay gap.

Women do nearly 2½ times more unpaid and domestic work compared with men and are less likely to receive a pension. Only half of working-age women are in the workforce compared to three-fourths of working-age men.

As a solution, the report suggests creating an economy that prioritizes women’s needs. It provides 10 recommendations for governments and other key players to adopt, such as creating more and better jobs for women, reducing occupational segregation, and establishing benchmarks to assess progress in women’s economic and social rights.

TIME Research

Health Stores Often Promote Diet Pills to Minors

TIME.com stock photos Health Prescription Pills
Elizabeth Renstrom for TIME

Despite warnings that they are intended for adults

Health store employees will often promote the use of over-the-counter body-changing supplements to minors, despite the fact that they often contain warnings that they are intended for adults.

In new research presented at the Pediatric Academic Societies meeting in San Diego, researchers had study participants call 244 health food stores in 49 states and identify themselves as 15-year-old boys and girls. The researchers discovered that even though testosterone boosters are not recommended for kids and teens under age 18 without a medical reason, 9.8% of sales associates recommended them. Testosterone boosters contain messaging indicating they are for adults only, but 41% of the sales associates told the callers they thought were 15 that they could buy them on their own.

Health store employees would frequently recommend supplements for callers posing as teen girls who said they were looking to lose weight.

“Adolescents are being enticed by flashy advertisements and promises of quick, body-shaping results,” says Dr. Ruth Milanaik of Cohen Children’s Medical Center. “In this body-conscious world, flashy advertising of `safe, quick and easy body shaping results’ are very tempting to younger individuals trying to achieve ‘the perfect body.’ It is important for pediatricians, parents, coaches and mentors to stress that healthy eating habits, sleep and daily exercise should be the recipe for a healthy body.”

Though the research is preliminary and still a relatively small study size, The National Institutes of Health (NIH) says dietary supplements have not been tested for safety or effectiveness in kids. Despite the research and warnings, though, the study authors note that it is still legal for minors to purchase these supplements in 49 states.

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TIME movies

This Is Why Germans May Not Be Able to See The Avengers

Small theaters are upset over rental fee hike

Hundreds of small movie theaters in Germany are threatening to extend their boycott of the film The Avengers: Age of Ultron to include all future films from Disney in protest of the company’s rental fee hike.

193 towns in Germany refused to show the film after Disney raised its rental fee (the amount Disney collects from ticket sales) for its films from 47.7% to 53%, according to The Hollywood Reporter. The smaller theaters say this puts them at a financial disadvantage since Disney focuses its advertising on larger cities. This means they don’t benefit from the studio’s advertising and have to use more resources, which is why they’ve historically had lower rental fees.

Disney has told the theaters that it is not changing the fees, leading the theaters to argue that if Disney does not meet demands, the boycott will extend to all upcoming titles from the studio.

The size of the impact is hard to pin down. According to THR, the theater boycott includes 686 screens, but not all of the screens were going to show The Avengers. The loss of screens not playing the film is likely closer to under 200.

[THR]

TIME movies

Vanilla Ice Defends Adam Sandler’s ‘Ridiculous Six’ Film

Actor Adam Sandler attends the SNL 40th Anniversary Special at 30 Rockefeller Plaza in New York, NY, on Feb. 15, 2015
Behar Anthony—SIPA USA Actor Adam Sandler attends the SNL 40th Anniversary Special at 30 Rockefeller Plaza in New York, NY, on February 15, 2015. (Photo by Anthony Behar) *** Please Use Credit from Credit Field ***

Rapper Vanilla Ice has defended Adam Sandler’s comedy The Ridiculous Six amid criticism over cultural insensitivity.

Sandler has come under fire after several Native American actors walked off the set arguing the film was offensive. The film is reportedly a spoof on the Western film The Magnificent Seven.

Vanilla Ice plays Mark Twain in the movie. The rapper defended the film to TMZ saying, “It’s a comedy. I don’t think anybody really had any ill feeling or any intent or anything. This movie isn’t [Dances] With Wolves, it’s a comedy. They’re not there to showcase anything about anybody they’re just making a funny movie.”

Vanilla Ice added that he does see both sides, saying he is part Native American.

[TMZ]

TIME Addiction

Hawaii Set to Become First State to Raise Smoking Age to 21

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

The bill covers both cigarette and e-cigarette use

Hawaii is set to become the first state to pass a law banning the sale, use and possession of cigarettes and e-cigarettes to people under the age of 21.

If a bill approved by Hawaii lawmakers on Friday is signed into law by Governor David Ige, adolescents will be prohibited from smoking, buying and possessing both conventional cigarettes and e-cigarettes. First-time offenders will be fined $10, and after that they can be charged a $50 fine or be required to complete community service, the Associated Press reports.

Some local governments have raised the smoking age to 21 in certain counties and cities — New York City among them — but if the bill becomes law, Hawaii will be the first state to do so.

Though the rates of high-school-age smokers have dropped in recent years, some 2.3 million children and young adults started smoking in 2012. In addition, a recent report from the U.S. Centers for Disease Control and Prevention revealed that e-cigarette use among middle-school and high school students tripled in one year.

If the Hawaii bill passes, it will go into effect Jan. 1, 2016.

[AP]

TIME Research

6-Month-Old Babies Are Now Using Tablets and Smartphones

smartphone-front-view
Getty Images

Babies are using mobile media

Over a third of children under the age of 1 have used a device like a smartphone or tablet, according to a new study.

The study, which was presented at the Pediatric Academic Societies annual meeting, showed that by age 2, most kids have used mobile devices. To reach these findings the study authors surveyed 370 parents of kids between the ages of 6 months to 4 years about their exposure to media and electronics.

Overall, technology in the home was common. The survey results show 97% of the families’ homes had TVs, 83% had tablets, 77% had smartphones and 59% had Internet access. According to the parents’ responses, 52% of kids under the age of 1 year had watched TV, 36% had touched or scrolled a screen, 24% had called someone, 15% used apps and 12% played video games. The amount of time the children spent using devices rose as they got older, with 26% of 2-year-olds and 38% of 4-year-olds using devices for at least an hour.

Given the ubiquity of electronics, it’s not so surprising that children come across media and devices in the home. Still, the researchers note that the children in this study were often very young and that the American Academy of Pediatrics (AAP) frowns upon television and other media exposure for kids under the age of 2. The AAP says excessive media use can contribute to school trouble, attention problems and obesity, according to studies, and that Internet and cell-phone use can be platforms for risky behavior.

The survey results also suggest that parents let their children use media or mobile tech as distraction. For instance, the study showed 73% of surveyed parents let their kids play with mobile devices while they were doing chores around the house. Sixty percent said they let children use them while running errands, 65% to calm their child and 29% to put their kid to sleep. Just 30% of the parents in the survey said they spoke to their pediatrician about media use.

“A better understanding of the use of mobile media in young children and how it varies by population groups is critical to help develop educational strategies for both parents and health providers,” the study authors write.

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