WEDNESDAY, Aug. 6 (HealthDay News) -- While poor eye contact has long been a suspected sign of possible autism, researchers at Yale University have used "eye-mapping technology" to prove that children with autism don't make eye contact like normally developing children do.

Published in the August issue of the Archives of General Psychiatry, the new research found that children with autism spent more time looking at an adult's mouth instead of gazing into the eyes.

"Just as the eyes are the window to the soul, the eyes are also a window into social development," said study senior author Ami Klin, director of the autism program at Yale University School of Medicine.

Klin said that by using eye-mapping technology, it's possible that a vulnerability for autism could be identified much earlier than is currently possible. And, he said, "The earlier we are able to identify children, the better it is, because early interventions make a difference in optimizing children's outcomes."

It's estimated that autism, a developmental disorder that disrupts communication and social interaction, affects about 3.4 out of every 1,000 children between the ages of 3 and 10, according to the U.S. National Institute of Mental Health (NIMH). Parents are generally the first to notice early signs of autism. The NIMH says that some known early signs that may indicate an autism spectrum disorder in a child include:

• By age 1, doesn't babble, point or gesture.
• Doesn't speak a single word by 16 months.
• By age 2, hasn't combined two words.
• Seems to lose language skills.
• Interacts poorly socially.
• Doesn't respond to his or her name.
• Doesn't smile.
• Makes poor eye contact.
• Doesn't appear to know how to play with toys and may repeatedly line up toys or other objects.

For the new study, Klin and his colleagues, including Warren Jones, compared 15 children with autism to 36 typically developing children, and to another 15 children who were developmentally delayed but not autistic. All of the children were 2 years old.

The children were shown 10 videos of adults looking directly into the camera and mimicking caregiving and playing with the child. While the videos were running, the researchers used eye tracking to assess the child's visual fixation patterns.

They found that children with autism spent significantly less time looking at the eyes than did typically developing children or the developmentally delayed group. Autistic children looked at the eyes about 30 percent of the time, compared to nearly 55 percent for both of the other groups.

Children with autism spent almost 40 percent of the time looking at the mouth area, while children in the other groups only spent about 24 percent of the time looking at this area.

Eye fixation in children with autism also appeared to predict the level of social disability. Those who had greater social disabilities spent less time looking at the eye area, according to the study.

"We've always had a sense that children with autism don't make eye contact, but this study confirms it in a higher-tech way," said Cynthia Johnson, director of the autism center at Children's Hospital of Pittsburgh.

Johnson said she'd like to see this study confirmed in a larger group of children. Klin added that he and his colleagues are currently conducting a prospective study in children at a higher risk of autism to see "if there's a derailment in the process of social engagement," and if so, when that happens.

More information

To learn more about the early signs of autism, visit the American Academy of Family Physicians' FamilyDoctor   Web site.

MONDAY, Aug. 4 (HealthDay News) -- A large proportion of American adolescents are getting early and regular exposure to violent movies, a new survey reveals.

The poll suggests that almost 13 percent of the nation's estimated 22 million children between the ages of 10 and 14 are viewing extremely graphic depictions of violence in film, whether in theaters, on DVDs, or on television.

"There's a lot of evidence to support the idea that when kids watch violent media, they become more aggressive," observed study co-author Dr. James D. Sargent, a professor in the department of pediatrics at Dartmouth Medical School in Lebanon, N.H. "And yet violent media has become easier and easier to access for children. So, for the movie industry, the message is that the 1960s ratings system needs to be updated and made more explicit and relevant to the way movies are being distributed and seen today."

"But also, parents need to be much more careful about how their children consume violent media," he added.

Sargent's and his colleagues' findings are in the August issue of Pediatrics.

The Dartmouth researcher pointed out that the advent of DVDs has meant that new and even more violent versions of R-rated theatrical releases often become available now in completely un-rated forms. These DVD versions may reach a much larger group of children than in prior years, when such movies could only be seen in a theater.

Another problem, he added, stems from the relatively liberal ratings policy currently in force in the United States -- one that allows non-adult viewing of R-rated theatrical releases when a child is in the presence of an adult escort. According to the researchers, this type of practice is prohibited in Britain and in some other European nations.

"And, in any case, the American movie industry rates itself," added Sargent. "So, how and why some movies get an R rating, while others don't, isn't always rational. Because it's like the fox watching the chicken coop, and the industry is not going to do anything that limits it from getting as wide an audience as possible."

In the study, the Dartmouth team examined viewing patterns tabulated in a national telephone survey of more than 6,500 youngsters between the ages of 10 and 14. The survey was conducted in 2003.

In the poll, the researchers focused on viewings of 40 of the most violent movies from among 534 of the most recent releases at the time. Some of these films included depictions of physical beating and torture.

All 40 movies, including Gangs of New York, Blade, Training Day, and the list's most popular feature, Scary Movie, were rated R by the Motion Picture Association of America and UK18 by the British Board of Film Classification.

The survey found that boys, older teens, minorities (particularly black children), kids from lower economic backgrounds, those with relatively bad grades in school, and those whose parents had lower educational achievement were more likely to be exposed to extreme violence in movies.

Adolescents with particularly high exposure to violent cinema were more likely to have a TV in their bedroom and to indicate that their parents let them watch R-rated features.

Dr. Christopher P. Lucas, director of New York University's adolescent health promotion and suicide prevention program ("STEPS") at the university's Child Study Center in New York City, agreed that adolescent access to violence-laden film has broadened significantly in recent years. However, he disputed the notion that the research to date has confirmed a solid relationship between adolescent exposure to cinematic violence and aberrant behavior.

"There's quite a lot of validity to what these researchers are saying," he said. "Children are definitely far more able to access this kind of violent material. And it's potentially worrying. But the evidence isn't really there yet that there's a negative consequence."

"That's not to say that there isn't one," Lucas stressed. "But there just aren't any studies that have shown a direct connection to problem behavior and what the connection is, independent of a host of other factors. For example, children who are more violent in the first place tend to be the ones drawn more to material that is more violent. So, even the direction of any relationship is not clear."

More information

For more on violent behavior in children, head to the American Academy of Child & Adolescent Psychiatry  .

FRIDAY, July 18 (HealthDay News) -- Infants who are predominantly breast-fed for the first six months of life are less likely to have gastrointestinal problems. But, they're more likely to be deficient in iron, and therefore at risk of anemia, according to a study that looked at 154 mothers and their babies in Guadalajara, Mexico.

"We are verifying previous findings that in low-income countries, exclusively breast-fed infants are protected from GI [gastrointestinal] infection but appear to be at greater risk for iron deficiency," said Noreen Willows, an assistant professor at the University of Alberta in Edmonton, Canada, and the study's lead author.

Willows and her team compared a formula-fed group of about 50 babies with 55 partially breast-fed and 49 predominantly breast-fed infants from birth through six months, noting episodes of GI infections by asking the mothers about symptoms.

They took blood samples when the babies were 6 months old to check iron status. Mothers with poor maternal iron stores are more likely to have children with low iron stores.

Infants in the predominately breast-fed group had fewer GI infections; just 18 percent had GI infections during the study, compared to 33 percent of those partially breast-fed or formula-fed.

But the predominately breast-fed infants were more likely to have low iron levels. While just 4 percent of those in the partially breast-fed or formula-fed groups had iron deficiency, 22 percent of the mostly breast-fed babies did. It's known that total iron concentration in human milk is low. If the breast-feeding mother's iron stores are low to begin with, it can make the iron status problem worse. In Mexico, 28 percent of women have such low iron that they have anemia, the study authors said.

The study findings are published in the August issue of The Journal of Nutrition.

Despite the higher risk of iron deficiency and potential anemia, Willows said that the "breast-is-best" advice stands. Iron deficiency is generally correctable with supplements, she noted, while GI infections can be serious and even fatal.

The study results apply much more to women in underdeveloped countries than those in the United States, because fewer American women have low iron levels, said Dr. Ruth Lawrence, chairwoman of the section on breast-feeding at the American Academy of Pediatrics, and professor of pediatrics and obstetrics/gynecology at the University of Rochester School of Medicine, in New York.

Other studies have found that formula-fed babies have more gastrointestinal infections, she said.

Researchers have found that ''breast-fed babies don't become anemic if their cords are not cut too soon," Lawrence said. Delaying the cut for as little as two minutes can help improve the baby's iron status and confer other benefits, she added.

More information

To learn more about breast-feeding, visit the U.S. Centers for Disease Control and Prevention.

WEDNESDAY, May 28 (HealthDay News) -- Much like the boy who cried wolf, a bladder that constantly sends signals to arouse the brain may end up being ignored in its time of greatest need.

That's the theory of Hong Kong researchers who compared the amount of arousal in the cortical area of the brain that occurs during sleep in children with a history of bedwetting to a control group of children. They found that children with a history of night-time accidents, also known as enuresis, had almost twice the number of cortical arousals compared to children who didn't wet the bed.

"We found that children with enuresis have more light sleep associated with frequent cortical arousals, but an inability to awaken completely. We speculate that the transition from light sleep to complete awakening, as elicited by the arousal center, may be paradoxically suppressed by long-term overstimulation by signals from the bladder," the study authors wrote.

The findings are published as a letter to the editor in the May 29 issue of the New England Journal of Medicine.

In the United States, bedwetting is a problem for as many as 5 million children, according to the National Institutes of Health. While there's no set age that children grow out of bedwetting, each year as children grow older, fewer and fewer experience enuresis.

Experts haven't yet pinpointed the exact cause or causes of bedwetting, but they do know that certain factors contribute to the problem.

"We know there's a genetic component. If both parents have a history of bedwetting, there's at least a 70 percent chance that the child will," said Dr. Jeffrey Stock, chief of the division of pediatric urology at Mount Sinai Medical Center in New York City.

Stock said there's also a connection between sleep cycles and bedwetting, and that the reflex that suppresses urine discharge is suppressed at night in children who wet the bed.

"The bladder in an infant works as a reflex organ and automatically contracts. But, we learn to suppress that reflex," explained Stock, who added that children who wet the bed at night usually control the reflex during the day, but when they go to sleep, they revert to the infant sleep pattern and don't suppress the bladder's reflex action.

Another possible factor is a hormone called anti-diuretic hormone that keeps the body from excreting fluids.

"Children who wet the bed don't make enough anti-diuretic hormone," said Dr. Francis Schneck, clinical director of pediatric urology at Children's Hospital of Pittsburgh. But, he noted that when kids are given a medication that replaces this hormone, only about six in 10 are helped, suggesting the problem has several components.

The new study compared 35 children with enuresis to 21 "control" children with no history of bedwetting. The median age of the children with enuresis was 9.5, while the median age of the controls was 10.3 years old.

The researchers found that children who wet the bed experienced more cortical arousals than children in the control group did. They also found that cortical arousals were associated with bladder contractions, suggesting a "bladder-brain dialogue," according to the authors. But, despite the cortical arousals and the bladder-brain dialogue, the children who wet the bed seemed to have an inability to awaken completely.

"This study gives us something to consider, but I'm not sure it will have a huge effect on the management of enuresis," Schneck said.

More information

To learn more about bedwetting and ways to cope, visit the Nemours Foundation KidsHealth  .