Pubmed du 05/04/19

vendredi 5 avril 2019

1. Ashworth M, Palikara O, Van Herwegen J. Comparing parental stress of children with neurodevelopmental disorders : The case of Williams syndrome, Down syndrome and autism spectrum disorders. J Appl Res Intellect Disabil. 2019.

BACKGROUND : Although parental stress is higher for children with neurodevelopmental disorders (NDs), it is unclear how this stress compares to more common NDs. The current study compared stress in parents of children with Williams syndrome (WS), Down syndrome (DS) and autism spectrum disorders (ASD). The impact of individual and contextual factors was also explored. METHOD : Parents of children with WS (n = 107), DS (n = 79) and ASD (n = 79) completed a background questionnaire, a parental stress questionnaire and a satisfaction with life questionnaire. RESULTS : Although all groups displayed similar levels of parental stress, the factors that influenced this stress differed between the groups. There were also differences for life satisfaction and relationships between parental stress and individual and contextual factors. CONCLUSIONS : Although parents of children with NDs are not at an increased risk of parental stress, the results suggest that interventions should be syndrome-specific.

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2. Brown HK, Cobigo V, Lunsky Y, Vigod S. Reproductive Health in Women with Intellectual and Developmental Disabilities in Ontario : Implications for Policy and Practice. Healthcare quarterly (Toronto, Ont). 2019 ; 21(4) : 6-9.

Reproductive healthcare needs of women with intellectual and developmental disabilities (IDD) have received little attention. Using health and social services administrative data in Ontario, Canada, we comprehensively documented the reproductive health of women with IDD, including their fertility rates, pregnancy outcomes and reproductive health after pregnancy. Our findings showed high rates of adverse health outcomes for these women and their babies, supporting the development of reproductive healthcare programs tailored to their unique needs.

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3. Ciarrusta J, O’Muircheartaigh J, Dimitrova R, Batalle D, Cordero-Grande L, Price A, Hughes E, Steinweg JK, Kangas J, Perry E, Javed A, Stoencheva V, Akolekar R, Victor S, Hajnal J, Murphy D, Edwards D, Arichi T, McAlonan G. Social Brain Functional Maturation in Newborn Infants With and Without a Family History of Autism Spectrum Disorder. JAMA network open. 2019 ; 2(4) : e191868.

Importance : What is inherited or acquired in neurodevelopmental conditions such as autism spectrum disorder (ASD) is not a fixed outcome, but instead is a vulnerability to a spectrum of traits, especially social difficulties. Identifying the biological mechanisms associated with vulnerability requires looking as early in life as possible, before the brain is shaped by postnatal mechanisms and/or the experiences of living with these traits. Animal studies suggest that susceptibility to neurodevelopmental disorders arises when genetic and/or environmental risks for these conditions alter patterns of synchronous brain activity in the perinatal period, but this has never been examined in human neonates. Objective : To assess whether alternation of functional maturation of social brain circuits is associated with a family history of ASD in newborns. Design, Setting, and Participants : In this cohort study of 36 neonates with and without a family history of ASD, neonates underwent magnetic resonance imaging at St Thomas Hospital in London, England, using a dedicated neonatal brain imaging system between June 23, 2015, and August 1, 2018. Neonates with a first-degree relative with ASD (R+) and therefore vulnerable to autistic traits and neonates without a family history (R-) were recruited for the study. Synchronous neural activity in brain regions linked to social function was compared. Main Outcomes and Measures : Regions responsible for social function were selected with reference to a published meta-analysis and the level of synchronous activity within each region was used as a measure of local functional connectivity in a regional homogeneity analysis. Group differences, controlling for sex, age at birth, age at scan, and group x age interactions, were examined. Results : The final data set consisted of 18 R+ infants (13 male ; median [range] postmenstrual age at scan, 42.93 [40.00-44.86] weeks) and 18 R- infants (13 male ; median [range] postmenstrual age at scan, 42.50 [39.29-44.58] weeks). Neonates who were R+ had significantly higher levels of synchronous activity in the right posterior fusiform (t = 2.48 ; P = .04) and left parietal cortices (t = 3.96 ; P = .04). In addition, there was a significant group x age interaction within the anterior segment of the left insula (t = 3.03 ; P = .04) and cingulate cortices (right anterior : t = 3.00 ; P = .03 ; left anterior : t = 2.81 ; P = .03 ; right posterior : t = 2.77 ; P = .03 ; left posterior : t = 2.55 ; P = .03). In R+ infants, levels of synchronous activity decreased over 39 to 45 weeks’ postmenstrual age, whereas synchronous activity levels increased in R- infants over the same period. Conclusions and Relevance : Synchronous activity is required during maturation of functionally connected networks. This study found that in newborn humans, having a first-degree relative with ASD was associated with higher levels of local functional connectivity and dysmaturation of interconnected regions responsible for processing higher-order social information.

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4. Croteau C, Mottron L, Dorais M, Tarride JE, Perreault S. Use, costs, and predictors of psychiatric healthcare services following an autism spectrum diagnosis : Population-based cohort study. Autism. 2019 : 1362361319840229.

A number of cross-sectional studies report extensive use of psychiatric services and high healthcare costs in autistic youths. However, little is known about how the use of these services evolves from the time of diagnosis, as children grow up. Our objectives were to investigate the use, costs, and predictors of psychiatric services following autism spectrum diagnosis. We built a cohort of 1227 newly diagnosed autism spectrum individuals identified in the Quebec (Canada) Regie de l’assurance maladie du Quebec administrative database (January 1998 to December 2010). Mean number and cost per individual of psychiatric healthcare use (hospitalizations, medical visits, psychoactive drug use) were calculated yearly for 5 years following autism spectrum diagnosis. Mean number of psychiatric visits decreased over time by more than threefold (7.5 vs 2.1 visits) from year 1 to year 5, whereas psychoactive drug use increased from 16.0 to 25.2 claims. Psychiatric hospitalizations decreased during follow-up, but still represented the greatest costs per individual (CAD9820 for year 1 ; CAD4628 for year 5). Antipsychotics represented over 50% of drug costs. Mixed-effect model with repeated measures showed that previous psychoactive drug use was the strongest predictor of greater psychiatric healthcare cost during follow-up (odds ratio : 9.96 ; 95% confidence interval : 7.58-13.10). These trends contrast with guidelines advocating cautious prescribing of antipsychotics with periodical re-assessment of their benefit.

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5. Dijkhuis RR, Ziermans T, van Rijn S, Staal W, Swaab H. Emotional Arousal During Social Stress in Young Adults With Autism : Insights From Heart Rate, Heart Rate Variability and Self-Report. J Autism Dev Disord. 2019.

In order to better understand which factors play a role in non-adaptive social behavior in autism spectrum disorder (ASD) we looked into physiological arousal and awareness of one’s own emotions. Heart rate (HR) and heart rate variability (HRV) were measured during a public speaking task in 51 young adults with ASD and 28 typically developing (TD) controls. The results showed no significant group differences in baseline HR/HRV, HR reactivity (change from baseline to the speaking task) or self-reported emotional awareness. However, adults with ASD showed significantly lower HRV reactivity (p = .023, d = 0.6) compared to TD adults. These results suggest a mismatch between arousal regulation and emotional awareness, which may be related to problems in social adaptation in ASD.

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6. McDonald CA, Donnelly JP, Feldman-Alguire AL, Rodgers JD, Lopata C, Thomeer ML. Special Education Service Use by Children with Autism Spectrum Disorder. J Autism Dev Disord. 2019.

In the last decade, the prevalence of children with autism spectrum disorder (ASD) without intellectual disability (ID) in schools has increased. However, there is a paucity of information on special education placement, service use, and relationships between service use and demographic variables for children with ASD without ID. This study aimed to describe and explore variation in type and amount of special education services provided to (N = 89) children with ASD. Results indicated that the largest percentage of children received services under the Autism classification (56.2%) and were in partial-inclusion settings (40.4%). The main services received were speech (70.8%) and occupational (56.2%) therapies, while few children received behavior plans (15.7%) or social skills instruction (16.9%). Correlates with service use are described.

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7. Mello S, Alper M, Allen AA. Physician Mediation Theory and Pediatric Media Guidance in the Digital Age : A Survey of Autism Medical and Clinical Professionals. Health Commun. 2019 : 1-11.

Research on physician mediation suggests that physicians actively discuss media use (e.g., seeking online health information) with their patients. This theory has been limited though with respect to incorporating key behavioral determinants, varied forms of mediation, and samples beyond primary care physicians (MDs). A survey of 335 U.S.-based medical and clinical professionals (MCPs) treating pediatric clients on the autism spectrum (e.g., pediatricians, speech-language pathologists) examined how they advise caregivers about managing their child’s recreational media and technology use, also known as media guidance. Results indicate the frequency of these discussions varies by MCP type. Hierarchical regression analyses show, as hypothesized, that additional behavioral and contextual determinants not previously considered (i.e., perceived norms, self-efficacy, information sources and child factors) are significantly associated with positive, negative and redirective mediation practices. Results expand existing theory and justify extending physician mediation research beyond MDs. Implications for clinical practice and health communication research are discussed.

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8. Meza RD, Beidas RS, Ehrhart MG, Mandell DS, Dorsey S, Frederick L, Oh C, Locke J. Discrepancies and Agreement in Perceptions of Implementation Leadership : Associations with Dosage of School-Based Evidence-Based Practices for Children with Autism. Administration and policy in mental health. 2019.

Studies demonstrate that discrepancies among leader-follower perceptions of leadership are related to organizational processes that may impact evidence-based practice (EBP) implementation. However, it is unknown whether discrepancies in leadership perceptions also predict EBP use. This study examined the association of principal-staff alignment and discrepancy in perceptions of implementation leadership with the dosage of three Autism-focused school-based EBPs, Discrete Trial Training, Pivotal Response Training (PRT), and Visual Schedules. PRT dosage was higher when principals under-rated their implementation leadership and when it was agreed upon that implementation leadership was low. Findings have implications for leaders support of EBPs implemented in school-based settings.

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9. Mul CL, Cardini F, Stagg SD, Sadeghi Esfahlani S, Kiourtsoglou D, Cardellicchio P, Aspell JE. Altered bodily self-consciousness and peripersonal space in autism. Autism. 2019 : 1362361319838950.

There is some evidence that disordered self-processing in autism spectrum disorders is linked to the social impairments characteristic of the condition. To investigate whether bodily self-consciousness is altered in autism spectrum disorders as a result of multisensory processing differences, we tested responses to the full body illusion and measured peripersonal space in 22 adults with autism spectrum disorders and 29 neurotypical adults. In the full body illusion set-up, participants wore a head-mounted display showing a view of their ’virtual body’ being stroked synchronously or asynchronously with respect to felt stroking on their back. After stroking, we measured the drift in perceived self-location and self-identification with the virtual body. To assess the peripersonal space boundary we employed an audiotactile reaction time task. The results showed that participants with autism spectrum disorders are markedly less susceptible to the full body illusion, not demonstrating the illusory self-identification and self-location drift. Strength of self-identification was negatively correlated with severity of autistic traits and contributed positively to empathy scores. The results also demonstrated a significantly smaller peripersonal space, with a sharper (steeper) boundary, in autism spectrum disorders participants. These results suggest that bodily self-consciousness is altered in participants with autism spectrum disorders due to differences in multisensory integration, and this may be linked to deficits in social functioning.

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10. Schuck RK, Flores RE, Fung LK. Brief Report : Sex/Gender Differences in Symptomology and Camouflaging in Adults with Autism Spectrum Disorder. J Autism Dev Disord. 2019.

Autism spectrum disorder (ASD) is more prevalent in males than females. Previous research indicates females camouflage ASD symptoms more than males, potentially contributing to the difference in prevalence. This study investigated sex/gender differences in behavioral phenotypes in 17 males and 11 females with ASD, as well camouflaging in ASD, in an attempt to partially replicate findings from Lai et al. (Autism 21(6):690-702, 2017). Overall ASD symptoms were measured by the autism spectrum quotient (AQ). Mean AQ in females with ASD was higher than males with ASD, with the difference approaching statistical significance. Camouflaging was found to be more common in females with ASD, and not associated to social phobia. Furthermore, camouflaging correlated negatively with emotional expressivity in females, but not males, with ASD. These findings strengthen previous findings regarding camouflaging being more common in females and add to the literature on how camouflaging may be different in females versus males.

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11. Tartaglia N, Bonn-Miller M, Hagerman R. Treatment of Fragile X Syndrome with Cannabidiol : A Case Series Study and Brief Review of the Literature. Cannabis and cannabinoid research. 2019 ; 4(1) : 3-9.

Fragile X syndrome (FXS) is an X-linked dominant disorder caused by a mutation in the fragile X mental retardation 1 gene. Cannabidiol (CBD) is an exogenous phytocannabinoid with therapeutic potential for individuals with anxiety, poor sleep, and cognitive deficits, as well as populations with endocannabinoid deficiencies, such as those who suffer from FXS. The objective of this study was to provide a brief narrative review of recent literature on endocannabinoids and FXS and to present a case series describing three patients with FXS who were treated with oral CBD-enriched (CBD+) solutions. We review recent animal and human studies of endocannabinoids in FXS and present the cases of one child and two adults with FXS who were treated with various oral botanical CBD+ solutions delivering doses of 32.0 to 63.9 mg daily. Multiple experimental and clinical models of FXS combine to highlight the therapeutic potential of CBD for management of FXS. All three patients described in the case series exhibited functional benefit following the use of oral CBD+ solutions, including noticeable reductions in social avoidance and anxiety, as well as improvements in sleep, feeding, motor coordination, language skills, anxiety, and sensory processing. Two of the described patients exhibited a reemergence of a number of FXS symptoms following cessation of CBD+ treatment (e.g., anxiety), which then improved again after reintroduction of CBD+ treatment. Findings highlight the importance of exploring the therapeutic potential of CBD within the context of rigorous clinical trials.

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12. Zhang L, Ma R, Yuan Y, Lian D, Qi X, Zheng N, Li K. The value of diffusion tensor imaging for differentiating autism spectrum disorder with language delay from developmental language disorder among toddlers. Medicine. 2019 ; 98(14) : e15058.

BACKGROUND : Impaired language function is frequently observed as an initial sign in people with autism spectrum disorder (ASD). However, clinically, the early stages of ASD are difficult to distinguish from those of developmental language disorder (DLD). OBJECTIVE : To evaluate the ability of diffusion tensor imaging (DTI) parameters for language-related white matter tracts (arcuate fasciculus) to differentiate ASD from DLD among toddlers. MATERIALS AND METHODS : We included 16 ASD toddlers with language delay and 18 DLD toddlers in this study. Magnetic resonance imaging sequences included T2-weighted imaging (T2WI), T1 3-dimensional magnetization-prepared rapid acquisition gradient-echo (3D MP-RAGE), and DTI. Tractography was performed using Neuro 3D in the Siemens Syngo Workstation, and fractional anisotropy (FA), average fiber length (AFL), tract volume (TV), and number of voxels (NV) were automatically calculated. Data were then analyzed using IBM SPSS Statistics 22. RESULTS : The ASD group exhibited significantly lower FA values, as well as significantly higher TV and NV values compared with the DLD group. With age as the covariate, analysis of covariance revealed different significances in TV and NV. Analysis of variance for AFL revealed no significant differences between the 2 groups. CONCLUSION : DTI parameters of arcuate fasciculus were useful for differentiating ASD with language delay from DLD among toddlers. DTI has the potential to provide an objective and effective method for aiding early diagnosis, early intervention and improving long-term outcomes of ASD.

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