Pubmed du 09/03/19

samedi 9 mars 2019

1. Alaerts K, Bernaerts S, Vanaudenaerde B, Daniels N, Wenderoth N. Amygdala-Hippocampal Connectivity Is Associated With Endogenous Levels of Oxytocin and Can Be Altered by Exogenously Administered Oxytocin in Adults With Autism. Biol Psychiatry Cogn Neurosci Neuroimaging ;2019 (Feb 4)

BACKGROUND : Oxytocin (OT) plays a pivotal role in interpersonal bonding, affiliation, and trust, and its intranasal administration is increasingly considered as a potential treatment for autism spectrum disorder. METHODS : We explored whether variations in endogenous salivary OT concentration are related to interindividual differences in core autism symptoms and expressions of attachment in 38 male adults with autism spectrum disorder. Further, resting-state functional magnetic resonance imaging was adopted to specifically explore whether interindividual differences are reflected in the intrinsic network organization of key regions of the central oxytocinergic system. RESULTS : Positive correlations were identified between peripheral OT and expressions of secure attachment (the State Adult Attachment Measure and the Inventory of Peer Attachment), but no significant relationships were identified with scales assessing core autism symptom domains (the Social Responsiveness Scale and the Repetitive Behavior Scale). At the neural level, higher levels of endogenous OT were associated with lower degrees of interregional functional coupling between the amygdala and hippocampal regions. Interestingly, a single dose of exogenously administered OT induced a further reduction in amygdala-hippocampal connectivity, indicating that a higher availability of OT can alter the degree of amygdala-hippocampal connectivity. CONCLUSIONS : The identified associations between the oxytocinergic system, expressions of secure attachment, and amygdala-hippocampal pathways are anticipated to be of relevance for understanding the role of OT in modulating appropriate neural and physiological responses to stress and restoring homeostasis.

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2. Alexandrou A, Papaevripidou I, Alexandrou IM, Theodosiou A, Evangelidou P, Kousoulidou L, Tanteles G, Christophidou-Anastasiadou V, Sismani C. De novo mosaic MECP2 mutation in a female with Rett syndrome. Clin Case Rep ;2019 (Feb) ;7(2):366-370.

We describe a female with Rett syndrome carrying a rare de novo mosaic nonsense mutation on MECP2 gene, with random X-chromosome inactivation. Rett syndrome severity in females depends on mosaicism level and tissue specificity, X-chromosome inactivation, epigenetics and environment. Rett syndrome should be considered in both males and females.

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3. Arnold SRC, Uljarevic M, Hwang YI, Richdale AL, Trollor JN, Lawson LP. Brief Report : Psychometric Properties of the Patient Health Questionaire-9 (PHQ-9) in Autistic Adults. J Autism Dev Disord ;2019 (Mar 7)

Despite the high prevalence of depression and other mental illnesses in autistic adults, screening instruments such as the Patient Health Questionnaire (PHQ-9) have not been specifically validated in an autistic sample. Using data from two Autism CRC longitudinal studies (n = 581), confirmatory factor analysis supported the two-factor model (somatic and cognitive/affective) in the autistic sample and one-factor model in the community comparison sample. Confirmatory bifactor analysis also supported use of the PHQ-9 total score in autism. Good convergent validity was found with two measures of psychological well-being for PHQ-9 total and subdomain scores. The PHQ-9 is a useful tool for autism research allowing comparison across autistic and non-autistic participants.

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4. Crespi B, Dinsdale N, Read S, Hurd P. Spirituality, dimensional autism, and schizotypal traits : The search for meaning. PLoS One ;2019 ;14(3):e0213456.

The relationships of spirituality with human social cognition, as exemplified in autism spectrum and schizophrenia spectrum cognitive variation, remain largely unstudied. We quantified non-clinical levels of autism spectrum and schizotypal spectrum traits (using the Autism Quotient and the Schizotypal Personality Questionnaire-Brief Revised) and dimensions of spirituality (using the Hardt Spirituality Questionnaire) in a large sample of undergraduate students. We tested in particular the hypothesis, based on the diametrical model of autism and psychosis, that autism should be negatively associated, and positive schizotypal traits should be positively associated, with spirituality. Our primary findings were threefold. First, in support of the diametric model, total Spirituality score was significantly negatively correlated with total Autism Quotient score, and significantly positively correlated with Positive Schizotypal traits (the Schizotypal Personality Cognitive-Perceptual subscale), as predicted. Second, these associations were driven mainly by opposite patterns regarding the Search for Meaning Spirituality subscale, which was the only subscale that was significantly negatively associated with autism, and significantly positively associated with Positive Schizotypal traits. Third, Belief in God was positively correlated with Positive Schizotypal traits, but was uncorrelated with autism traits. The opposite findings for Search for Meaning can be interpreted in the contexts of well-supported cognitive models for understanding autism in terms of weak central coherence, and understanding Positive Schizotypal traits in terms of enhanced salience.

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5. De Crescenzo F, Postorino V, Siracusano M, Riccioni A, Armando M, Curatolo P, Mazzone L. Autistic Symptoms in Schizophrenia Spectrum Disorders : A Systematic Review and Meta-Analysis. Front Psychiatry ;2019 ;10:78.

Background : Recent studies have examined the association between autism spectrum disorder and schizophrenia spectrum disorders, describing a number of cognitive features common to both conditions (e.g., weak central coherence, difficulties in set-shifting, impairment in theory of mind). Several studies have reported high levels of autistic symptoms in population with schizophrenia spectrum disorders. Our study systematically reviews and quantitatively synthetizes the current evidence on the presence of autistic symptoms in individuals with schizophrenia spectrum disorders. Methods : A comprehensive literature search of the PubMed/MEDLINE, Cochrane Library, CINHAL, and Embase databases was performed from the date of their inceptions until March 2018. The primary outcome measure was the Autism Spectrum Quotient (AQ). As secondary outcome measures, we analyzed the AQ subscales. Data were extracted and analyzed by using a conservative model and expressed by standardized mean difference (SMD). Results : Thirteen studies comprising a total of 1,958 individuals were included in the analysis. Results showed that individuals with schizophrenia spectrum disorders have higher levels of autistic symptoms compared to healthy controls [SMD : 1.39, 95% confidence interval (CI) : 1.11 to 1.68] and lower levels of autistic symptoms compared to individuals with autism (SMD : -1.27, 95% CI : -1.77 to -0.76). Conclusions : Current findings support that individuals with schizophrenia spectrum disorders have higher autistic symptoms than healthy controls. Therefore, further studies are needed in order to shed light on the association between these two conditions.

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6. Favre MR, Markram H, Markram K. Individual Differences in Sensory Sensitivity : Further Lessons from an Autism Model. Cogn Neurosci ;2019 (Mar 8)

In this commentary, we join Ward (2018) in the usefulness of conceptualizing neural output in terms of signal and noise relationships, to create the missing links between neural, behavioral and subjective sensory sensitivity. We draw from our work in the Intense World Theory of Autism and the VPA rodent model, to complement the discussion the consideration of developmental time and function of the system, for a neural output to serve as a predictor of atypical outcome in sensory sensitivity, and guide personalized therapies.

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7. Garcia Durand J, Batista Geraldini SAR, Perez Paschoal L, Cangueiro L, Tamarozzi Mamede D, Scandiuzzi de Brito T, Vaz Marques M, David V, Lerner R. Case-contrast study about parent-infant interaction in a Brazilian sample of siblings of children with autism spectrum disorders. Infant Ment Health J ;2019 (Mar 8)

Siblings of children with autism spectrum disorders (ASD) present greater susceptibility to developmental problems, in comparison with siblings of typically developing children. The greater prevalence of mental health disorders among parents of children with ASD increases younger siblings’ vulnerability to emotional problems. The aim of this study is to compare the interaction between carers and babies aged 2 to 26 months (M = 11.7, SD = 6.9) who are siblings of children with ASD (ASD dyads) with the interaction of dyads of siblings of typically developing children (TD dyads). The protocol of Clinical Indicators of Risk for Child Development and the Coding Interactive Behaviour measures were used to evaluate interaction. ASD dyads presented higher scores of constriction in their interaction, P = .024, with babies presenting higher scores of withdrawal behavior, P = .003, and carers presenting higher scores of depressive mood, P = .008, when compared to TD dyads. The ASD dyads have interactive impairments more frequently than do the TD dyads.

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8. Green RM, Travers AM, Howe Y, McDougle CJ. Women and Autism Spectrum Disorder : Diagnosis and Implications for Treatment of Adolescents and Adults. Curr Psychiatry Rep ;2019 (Mar 9) ;21(4):22.

PURPOSE OF REVIEW : We review the recent literature regarding the implications of gender on the diagnosis and treatment of autism spectrum disorder (ASD) in women and adolescent females. We also discuss important clinical observations in treating this population. RECENT FINDINGS : Growing research supports gender specificity in ASD symptom presentation. Differing phenotypes, psychiatric co-morbidities, and level of "camouflaging" (behavioral coping strategies to conceal symptoms for use in social situations) are thought to further contribute to the discrepancy in prevalence rates and resulting misdiagnosis or delayed diagnosis in adolescent females and women. Both nosological and cultural factors appear to be contributing to differences in the diagnosis of ASD in women. These differences in presentation have important implications for late diagnosis, treatment of ASD, and the quality of life for women with autism.

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9. Hutchison SM, Muller U, Iarocci G. Parent Reports of Executive Function Associated with Functional Communication and Conversational Skills Among School Age Children With and Without Autism Spectrum Disorder. J Autism Dev Disord ;2019 (Mar 7)

Despite average or above cognitive and verbal abilities, many children with autism spectrum disorder (ASD) experience difficulties in functional and social communication. Executive functioning (EF) may be the cognitive and regulatory mechanism that underlies these difficulties. Parents rated 92 children with ASD as demonstrating significantly more challenges than 94 typically developing children on measures of EF (Behavior Rating Inventory of Executive Function ; BRIEF), functional communication (FC), and verbal conversation (VC) skills. For both groups, the BRIEF metacognition scale emerged as a strong predictor of FC, while the BRIEF behavior regulation and the inhibit scale were predictive of VC skills. These findings suggest that targeting EF domains specifically may improve FC and VC skills in children with ASD.

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10. Kulage KM, Goldberg J, Usseglio J, Romero D, Bain JM, Smaldone AM. How has DSM-5 Affected Autism Diagnosis ? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis. J Autism Dev Disord ;2019 (Mar 9)

We conducted a 5-year follow-up systematic review and meta-analysis to determine change in frequency of autism spectrum disorder (ASD) diagnosis since diagnostic and statistical manual 5 (DSM-5) publication and explore the impact of Social Communication Disorder (SCD). For 33 included studies, use of DSM-5 criteria suggests decreases in diagnosis for ASD [20.8% (16.0-26.7), p < 0.001], DSM-IV-TR Autistic Disorder [10.1% (6.2-16.0), p < 0.001], and Asperger’s [23.3% (12.9-38.5), p = 0.001] ; pervasive developmental disorder-not otherwise specified decrease was not significant [46.1% (34.6-58.0), p = 0.52]. Less than one-third [28.8% (13.9-50.5), p = 0.06] of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for SCD. Findings suggest smaller decreases in ASD diagnoses compared to earlier reviews. Future research is needed as concerns remain for impaired individuals without a diagnosis.

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11. Lai SS, Tsai CH, Wu CC, Chen CT, Li HJ, Chen KL. Identifying the Cognitive Correlates of Reciprocity in Children with Autism Spectrum Disorder. J Autism Dev Disord ;2019 (Mar 7)

This study examined the cognitive correlates of reciprocity in children with autism spectrum disorder (ASD). A total of 59 children with ASD were assessed with the Interactive Drawing Task, Theory of Mind Task Battery, Children’s Card Change Sort Task, and Children’s Gambling Task respectively for their reciprocity, theory of mind, cool executive function (EF), and hot EF. The correlational findings revealed that cool EF (r = .482 and - .501, p < .01) and hot EF (r = .396, p < .05) were significantly correlated with children’s total reciprocity. The regression models also showed that cool and hot EF abilities were significant predictors. Conclusively, cool and hot EF abilities are the correlates of reciprocity rather than of ToM in children with ASD.

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12. Lau WKW, Leung MK, Lau BWM. Resting-state abnormalities in Autism Spectrum Disorders : A meta-analysis. Sci Rep ;2019 (Mar 7) ;9(1):3892.

The gold standard for clinical assessment of Autism Spectrum Disorders (ASD) relies on assessing behavior via semi-structured play-based interviews and parent interviews. Although these methods show good sensitivity and specificity in diagnosing ASD cases, behavioral assessments alone may hinder the identification of asymptomatic at-risk group. Resting-state functional magnetic resonance imaging (rs-fMRI) could be an appropriate approach to produce objective neural markers to supplement behavioral assessments due to its non-invasive and task-free nature. Previous neuroimaging studies reported inconsistent resting-state abnormalities in ASD, which may be explained by small sample sizes and phenotypic heterogeneity in ASD subjects, and/or the use of different analytical methods across studies. The current study aims to investigate the local resting-state abnormalities of ASD regardless of subject age, IQ, gender, disease severity and methodological differences, using activation likelihood estimation (ALE). MEDLINE/PubMed databases were searched for whole-brain rs-fMRI studies on ASD published until Feb 2018. Eight experiments involving 424 subjects were included in the ALE meta-analysis. We demonstrate two ASD-related resting-state findings : local underconnectivity in the dorsal posterior cingulate cortex (PCC) and in the right medial paracentral lobule. This study contributes to uncovering a consistent pattern of resting-state local abnormalities that may serve as potential neurobiological markers for ASD.

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13. Little LM, Rojas JP, Bard A, Luo Y, Irvin D, Rous B. Automated Measures to Understand Communication Opportunities for Young Children With Autism in the Community : A Pilot Study. OTJR (Thorofare N J) ;2019 (Mar 7):1539449219834911.

Community participation is vital to children’s development and provides opportunities to practice social communication skills. Although previous studies suggest that young children with autism spectrum disorders (ASD) experience decreased community participation, there is little empirical evidence on the precise patterns of participation that may influence social communication opportunities. Therefore, this pilot study investigated the communication among families of children with ASD ( n = 5) versus typical development (TD ; n = 5) across various community locations. We used automated, objective measures : the Language ENvironmental Analysis (LENA) system to measure the amount of communication and integrated this with a Global Positioning System (GPS ; that is, Qstarz) to measure community location. Results showed that families of children with ASD and TD spent a similar amount of time in community locations ; however, there were differences in the amount of adult talk directed toward children with ASD versus TD across community locations. Findings suggest that automated measures may be successfully integrated to quantify social communication during community participation.

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14. Marino F, Chila P, Sfrazzetto ST, Carrozza C, Crimi I, Failla C, Busa M, Bernava G, Tartarisco G, Vagni D, Ruta L, Pioggia G. Outcomes of a Robot-Assisted Social-Emotional Understanding Intervention for Young Children with Autism Spectrum Disorders. J Autism Dev Disord ;2019 (Mar 9)

This study is a randomized control trial aimed at testing the role of a human-assisted social robot as an intervention mediator in a socio-emotional understanding protocol for children with autism spectrum disorders (ASD). Fourteen children (4-8 years old) were randomly assigned to 10 sessions of a cognitive behavioural therapy (CBT) intervention implemented in a group setting either with or without the assistance of a social robot. The CBT protocol was based on Rational Emotive Behaviour Therapy (REBT) principles. Pre- and post-intervention assessments were conducted using the Test of Emotional Comprehension (TEC) and the Emotional Lexicon Test (ELT). Substantial improvements in contextualized emotion recognition, comprehension and emotional perspective-taking through the use of human-assisted social robots were attained.

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15. Masuda F, Nakajima S, Miyazaki T, Yoshida K, Tsugawa S, Wada M, Ogyu K, Croarkin PE, Blumberger DM, Daskalakis ZJ, Mimura M, Noda Y. Motor cortex excitability and inhibitory imbalance in autism spectrum disorder assessed with transcranial magnetic stimulation : a systematic review. Transl Psychiatry ;2019 (Mar 7) ;9(1):110.

Cortical excitation/inhibition (E/I) imbalances contribute to various clinical symptoms observed in autism spectrum disorder (ASD). However, the detailed pathophysiologic underpinning of E/I imbalance remains uncertain. Transcranial magnetic stimulation (TMS) motor-evoked potentials (MEP) are a non-invasive tool for examining cortical inhibition in ASD. Here, we conducted a systematic review on TMS neurophysiology in motor cortex (M1) such as MEPs and short-interval intracortical inhibition (SICI) between individuals with ASD and controls. Out of 538 initial records, we identified six articles. Five studies measured MEP, where four studies measured SICI. There were no differences in MEP amplitudes between the two groups, whereas SICI was likely to be reduced in individuals with ASD compared with controls. Notably, SICI largely reflects GABA(A) receptor-mediated function. Conversely, other magnetic resonance spectroscopy and postmortem methodologies assess GABA levels. The present review demonstrated that there may be neurophysiological deficits in GABA receptor-mediated function in ASD. In conclusion, reduced GABAergic function in the neural circuits could underlie the E/I imbalance in ASD, which may be related to the pathophysiology of clinical symptoms of ASD. Therefore, a novel treatment that targets the neural circuits related to GABA(A) receptor-mediated function in regions involved in the pathophysiology of ASD may be promising.

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16. Mepham JR, Boon FH, Foley KA, Cain DP, MacFabe DF, Ossenkopp KP. Impaired Spatial Cognition in Adult Rats Treated with Multiple Intracerebroventricular (ICV) Infusions of the Enteric Bacterial Metabolite, Propionic Acid, and Return to Baseline After 1 Week of No Treatment : Contribution to a Rodent Model of ASD. Neurotox Res ;2019 (Mar 8)

Propionic acid (PPA) is a dietary short chain fatty acid and an enteric bacterial metabolite. Intracerebroventricular (ICV) infusions of PPA in rodents have been shown to produce behavioral changes similar to those seen in autism spectrum disorders (ASD), including perseveration. The effects of ICV infusions of PPA on spatial cognition were examined by giving rats infusions of either PPA (0.26 M, pH 7.4, 4 mul/infusion) or phosphate-buffered saline (PBS, 0.1 M) twice a day for 7 days. The rats were then tested in the Morris water maze (MWM) for acquisition of spatial learning. After a recovery period of 1 week of no treatment, the rats were then tested for reversal of spatial learning in the MWM. PPA-treated rats showed impaired spatial learning in the maze, relative to controls, as demonstrated by increased search latencies, fewer direct and circle swims, and more time spent in the periphery of the maze than PBS controls. After a recovery period of 1 week of no treatment, these animals exhibited normal spatial reversal learning indicating that the behavioral cognitive deficits caused by PPA seem to be reversible.

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17. Miller RA, Ehrhart F, Eijssen LMT, Slenter DN, Curfs LMG, Evelo CT, Willighagen EL, Kutmon M. Beyond Pathway Analysis : Identification of Active Subnetworks in Rett Syndrome. Front Genet ;2019 ;10:59.

Pathway and network approaches are valuable tools in analysis and interpretation of large complex omics data. Even in the field of rare diseases, like Rett syndrome, omics data are available, and the maximum use of such data requires sophisticated tools for comprehensive analysis and visualization of the results. Pathway analysis with differential gene expression data has proven to be extremely successful in identifying affected processes in disease conditions. In this type of analysis, pathways from different databases like WikiPathways and Reactome are used as separate, independent entities. Here, we show for the first time how these pathway models can be used and integrated into one large network using the WikiPathways RDF containing all human WikiPathways and Reactome pathways, to perform network analysis on transcriptomics data. This network was imported into the network analysis tool Cytoscape to perform active submodule analysis. Using a publicly available Rett syndrome gene expression dataset from frontal and temporal cortex, classical enrichment analysis, including pathway and Gene Ontology analysis, revealed mainly immune response, neuron specific and extracellular matrix processes. Our active module analysis provided a valuable extension of the analysis prominently showing the regulatory mechanism of MECP2, especially on DNA maintenance, cell cycle, transcription, and translation. In conclusion, using pathway models for classical enrichment and more advanced network analysis enables a more comprehensive analysis of gene expression data and provides novel results.

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18. Morrison KE, DeBrabander KM, Faso DJ, Sasson NJ. Variability in first impressions of autistic adults made by neurotypical raters is driven more by characteristics of the rater than by characteristics of autistic adults. Autism ;2019 (Mar 8):1362361318824104.

Previous work indicates that first impressions of autistic adults are more favorable when neurotypical raters know their clinical diagnosis and have high understanding about autism, suggesting that social experiences of autistic adults are affected by the knowledge and beliefs of the neurotypical individuals they encounter. Here, we examine these patterns in more detail by assessing variability in first impression ratings of autistic adults ( N = 20) by neurotypical raters ( N = 505). Variability in ratings was driven more by characteristics of raters than those of autistic adults, particularly for items related to "intentions to interact." Specifically, variability in rater stigma toward autism and autism knowledge contributed to first impression ratings. Only ratings of "awkwardness" were driven more by characteristics of the autistic adults than characteristics of the raters. Furthermore, although first impressions of autistic adults generally improved when raters were informed of their autism status, providing a diagnosis worsened impressions made by neurotypical raters with high stigma toward autism. Variations in how the diagnosis was labeled (e.g. "autistic" vs "has autism") did not affect results. These findings indicate a large role of neurotypical perceptions and biases in shaping the social experiences for autistic adults that may be improved by reducing stigma and increasing acceptance.

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19. Rajan-Babu IS, Chong SS. Triplet-Repeat Primed PCR and Capillary Electrophoresis for Characterizing the Fragile X Mental Retardation 1 CGG Repeat Hyperexpansions. Methods Mol Biol ;2019 ;1972:199-210.

Fragile X mental retardation 1 (FMR1) CGG repeat expansions cause fragile X syndrome-the leading monogenic form of intellectual disability-and increase the risk for fragile X-associated tremor ataxia syndrome and fragile X-associated primary ovarian insufficiency. Southern blot (SB) analysis is the current gold standard test for FMR1 molecular diagnosis. Several polymerase chain reaction (PCR)-based methods are now available for sizing FMR1 CGG repeat expansions. These methods offer higher diagnostic sensitivity and specificity compared to SB analysis, significantly reduce the turnaround time and increase throughput. In this chapter, we describe a triplet-repeat primed PCR protocol that employs capillary electrophoresis to resolve the derived amplicon products, enabling precise determination of the FMR1 genotypes in both males and females and characterization of the CGG repeat structure.

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20. Rast JE, Roux AM, Shattuck PT. Use of Vocational Rehabilitation Supports for Postsecondary Education Among Transition-Age Youth on the Autism Spectrum. J Autism Dev Disord ;2019 (Mar 8)

Transition-age youth with autism (TAY-ASD) experience poor employment outcomes and gaps in services that could assist them in securing jobs. Vocational rehabilitation (VR) is a source of public assistance for people with disabilities seeking employment and TAY-ASD are a growing segment of VR service users. Postsecondary education (PSE) is essential for building vocational skills, contributing to employment satisfaction and better wages. VR provides services to support PSE success. Fewer TAY-ASD received PSE training from VR (18%) than TAY with other disabilities (32%), but more than TAY with an intellectual disability (15%). TAY-ASD who received PSE training were more likely to exit VR with a job. The importance of PSE to employment should be considered in TAY-ASD who seek employment supports.

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21. Raza S, Sacrey LR, Zwaigenbaum L, Bryson S, Brian J, Smith IM, Roberts W, Szatmari P, Vaillancourt T, Roncadin C, Garon N. Relationship Between Early Social-Emotional Behavior and Autism Spectrum Disorder : A High-Risk Sibling Study. J Autism Dev Disord ;2019 (Mar 9)

Social-emotional behavior in autism spectrum disorder (ASD) was examined among high-risk (HR ; siblings of children diagnosed with ASD) and low-risk (LR ; no family history of ASD) toddlers. Caregivers completed the Infant-Toddler Social Emotional Assessment (ITSEA) at 18 months, and blind diagnostic assessment for ASD was conducted at 36 months. Results indicated impairment in social-emotional functioning among HR toddlers subsequently diagnosed with ASD compared to other HR and LR toddlers, such that ITSEA domains (Internalizing, Dysregulation, Competence) and subdomains predicted later ASD symptoms and diagnosis. Receiver operating curves of optimal ITSEA cutoffs ranged from 0.23 to 0.44 for sensitivity, and 0.74 to 0.89 for specificity. Although classification accuracy for ASD was limited, group differences highlight the importance of considering social-emotional development when assessing ASD risk.

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22. Rosen TE, Spaulding CJ, Gates JA, Lerner MD. Autism severity, co-occurring psychopathology, and intellectual functioning predict supportive school services for youth with autism spectrum disorder. Autism ;2019 (Mar 8):1362361318809690.

Supportive school services are a primary service modality for youth with autism spectrum disorder. Autism spectrum disorder, as well as co-occurring psychiatric symptoms and low intellectual abilities, interfere with academic achievement and therefore influence decisions about school services. Therefore, we examined the association of parent, teacher, and clinician ratings of autism spectrum disorder and co-occurring psychiatric symptom severity and intellectual functioning with school services. In total, 283 youth with autism spectrum disorder were assessed with clinical evaluation via the Autism Diagnostic Observation Schedule and parent and teacher versions of the CASI-4R ( Child and Adolescent Symptom Inventory). Full Scale Intelligence Quotient scores were obtained from case records. Clinical and teacher evaluations of autism spectrum disorder severity predicted services and were more strongly associated with school services than parent ratings. Teacher ratings were only associated with common school services (e.g. speech/language therapy, occupational therapy, and/or social skills training) frequency at medium and high levels of clinician-rated autism spectrum disorder severity. Higher IQ and parent-rated externalizing symptoms predicted lower likelihood of receiving school services, whereas internalizing symptoms were not predictive of school services. Autism spectrum disorder symptoms may overshadow externalizing and internalizing symptoms when considering school service supports. Results highlight the importance of evaluating autism spectrum disorder severity via multiple sources, especially in cases of unclear symptom presentation, when examining correlates of school services for youth with autism spectrum disorder.

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23. Soke GN, Maenner M, Windham G, Moody E, Kaczaniuk J, DiGuiseppi C, Schieve LA. Association Between Breastfeeding Initiation and Duration and Autism Spectrum Disorder in Preschool Children Enrolled in the Study to Explore Early Development. Autism Res ;2019 (Mar 9)

Studies report inconsistent findings on the relationship between ASD and breastfeeding. We explored associations between ASD and breastfeeding initiation (yes/no) and duration (months categorized in tertiles) in the Study to Explore Early Development, a community-based case-control study in six sites in the Unites States. We adjusted for various child and mother demographic and pregnancy factors. Breastfeeding initiation was reported in 85.7% of mothers of children with ASD and 90.6% of mothers of controls. After adjustment, we found no significant difference in breastfeeding initiation (adjusted odds-ratio [aOR] : 0.88 and 95% confidence interval (CI) 0.60-1.28). However, mothers of children with ASD were less likely to report duration of breastfeeding in the high (>/=12 months) versus low tertile (<6 months) (aOR and 95% CI : 0.61 [0.45-0.84]) or the middle (6-<12 months) versus low tertile (0.72 : 0.54-0.98). The association of ASD and breastfeeding duration was slightly attenuated when the presence of the broader autism phenotype (BAP) in the mother was accounted for, but still remained for the highest tertile. This association does not appear to be totally explained by maternal BAP. We were unable to distinguish whether the difference in duration was due to difficulties breastfeeding children who later develop ASD, other factors not adjusted in our study, or greater ASD risk resulting from shorter breastfeeding duration. Longitudinal studies that compare reasons why mothers stop breastfeeding between ASD and controls and establish a temporal relation between ASD and breastfeeding are needed. Future studies should also evaluate interactions between ASD risk genes and breastfeeding. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : In this study, we compared breastfeeding practices between mothers of children with and without autism spectrum disorder (ASD). We found that the percentage of mothers who started breastfeeding was similar between the two groups, but mothers of children with ASD breastfed for a shorter amount of time compared to mothers of children without ASD. Future studies are needed to evaluate the reasons why the duration of breastfeeding was shorter for mothers of children with ASD compared to those without ASD.

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24. Stephenson KG, Luke SG, South M. Separate contributions of autistic traits and anxious apprehension, but not alexithymia, to emotion processing in faces. Autism ;2019 (Mar 8):1362361319830090.

Reduced eye fixation has been commonly reported in autistic samples but may be at least partially explained by alexithymia (i.e., difficulty understanding and describing one’s emotional state). Because anxiety is often elevated in autism, and emotion-processing differences have also been observed in anxious samples, anxiety traits may also influence emotion processing within autism. This study tested the contribution of dimensional traits of autism, anxious apprehension, and alexithymia in mediating eye fixation during face processing. Participants included 105 adults from three samples : autistic adults (AS ; n = 30), adults with clinically elevated anxiety and no autism (HI-ANX ; n = 29), and neurotypical adults without elevated anxiety (NT ; n = 46). Experiment 1 used an emotion identification task with dynamic stimuli, while Experiment 2 used a static luminance change detection task with emotional- and neutral-expression static photos. The emotions of interest were joy, anger, and fear. Dimensional mixed-effects models showed that autism traits, but not alexithymia, predicted reduced eye fixation across both tasks. Anxious apprehension was negatively related to response time in Experiment 1 and positively related to eye fixation in Experiment 2. Attentional avoidance of negative stimuli occurred at lower levels of autism traits and higher levels of worry traits. The results highlight the contribution of autism traits to emotional processing and suggest additional effects of worry-related traits.

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25. Wiklund M, Laakso M. Ungrammatical utterances and disfluent speech as causes of comprehension problems in interactions of preadolescents with high functioning autism. Clin Linguist Phon ;2019 (Mar 8):1-23.

This study describes the role of ungrammatical utterances and disfluent speech in the creation of comprehension problems between the participants in group therapy sessions of preadolescents with autism. The speech of the autistic preadolescents included frequent disfluencies and morpho-syntactic problems, such as wrong case endings, ambiguous pronominal references, grammatically incoherent syntactic structures and inaccurate tenses, which caused problems of comprehension. Three different interactional trajectories occurred when solving the potential problems of comprehension following the morpho-syntactically disfluent turns. First, the disfluent turn sometimes led to a clarification request by a co-participant, either a therapist or another participant with ASD. The preadolescents with ASD showed interactional skilfulness in requesting clarification when faced with comprehension problems. Second, in contrast, other occurrences included one or several self-repairs by the speaker with ASD. In these cases, the other group participants either did not react or they encouraged the speaker to continue using discourse particles. If the self-repairing disfluencies led to a persisting problem of comprehension, the therapists sometimes intervened and resolved the problem. However, direct interventions by the therapists were infrequent because the participants with ASD were mostly able to resolve the comprehension problems by themselves. Third, some disfluent and/or grammatically incorrect turns were not treated as problematic by the co-participants nor by the speaker himself. Abbreviations : ADE : Adessive ; ALL : Allative ; CLI : clitic ; GEN : Genitive ; INE : Inessive ; NOM : Nominative ; PER : person ; PL : plural ; PRT : particle ; SG : singular.

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