Pubmed du 09/05/19

jeudi 9 mai 2019

1. Cervantes P, Kuriakose S, Donnelly L, Filton B, Marr M, Okparaeke E, Voorheis K, Havens J, Horwitz S. Sustainability of a Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service. J Autism Dev Disord. 2019.

Children with autism spectrum disorder (ASD) are frequently hospitalized within general psychiatric settings, which are not usually designed to meet their needs. An initial evaluation of a care pathway developed for youth with ASD receiving services in a general psychiatric inpatient unit (ASD-CP) showed promise in improving outcomes while using few resources (Kuriakose et al. in J Autism Dev Disord 48:4082-4089, 2018). As sustainability of inpatient psychiatric initiatives is imperative but rarely investigated, this study examined the stability of ASD-CP outcomes during an 18-month follow-up period (n = 15) compared to the 18-month initial evaluation (n = 20) and 18-month pre-implementation (n = 17) periods. Decreased use of crisis interventions, including holds/restraints and intramuscular medication use, was sustained in the 18 months after the initial implementation period. Implications and limitations are discussed.

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2. de Vega M, Padron I, Moreno IZ, Garcia-Marco E, Dominguez A, Marrero H, Hernandez S. Both the mirror and the affordance systems might be impaired in adults with high autistic traits. Evidence from EEG mu and beta rhythms. Autism Res. 2019.

The association of autism spectrum disorder (ASD) with an altered mirror neuron system is still controversial. At the same time, the processing of object affordances by persons with ASD is a neglected issue. In this electroencephalographic study, adults differing in their autism quotient (AQ) scores were selected. We found anomalous modulation of mu and beta rhythms in high-AQ, compared to low-AQ persons, while they watched a set of goal-directed manual actions. This confirms that observing actions involving implicit intentions most clearly reveals the impairment of the mirror neurons system (MNS). The high-AQ group also showed anomalous mu and beta modulation when they looked at pictures of manipulable objects, indicating a deficit in processing motor affordances. We conclude that high-AQ adults have neural impairment of both the MNS and the affordance systems, which could underlie their relational problems with both people and objects. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Adults with autistic traits (high-autism quotient [AQ] scores) and matched controls (low-AQ) observed intentional hand actions, and pictures of manipulable and non-manipulable objects. The high-AQ group compared to the control group, showed anomalous modulation of the electroencephalographic motoric rhythms (mu and beta) while observing familiar goal-directed actions, confirming an impairment of their mirror neuron system. Also, their brain rhythms were anomalous when they watched manipulable objects, which suggest a dysfunction in their relation with objects (affordance system).

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3. Hillman H. Home-Based Video Modeling on Food Selectivity of Children With an Autism Spectrum Disorder. Phys Occup Ther Pediatr. 2019 : 1-13.

AIM : The purpose of this study was to evaluate the effects of video modeling - in the home setting - on food selectivity of three children with an autism spectrum disorder. METHODS : Using a multiple baseline experimental design, the researcher implemented an in home video modeling intervention during dinner for all three participants. Intervention consisted of a video modeling condition, a video modeling plus reinforcement condition, and follow-up probes conducted for five months after the departure of the researcher. RESULTS : The video modeling alone resulted in an increased acceptance of food by participants. When reinforcement was added to the video modeling, a higher level of food acceptance occurred for all three participants. CONCLUSION : The results suggest that video modeling was effective in increasing food acceptance, but food acceptance was higher for all three participants when reinforcement was added. Follow-up probes conducted for five months after the departure of the researcher suggest that the video modeling intervention was responsible for the increased food acceptance.

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4. Hutchins NS, Burke MD, Bowman-Perrott L, Tarlow KR, Hatton H. The Effects of Social Skills Interventions for Students With EBD and ASD : A Single-Case Meta-Analysis. Behav Modif. 2019 : 145445519846817.

Social skills interventions are critical for promoting social, emotional, and behavioral competence for students with or at risk of emotional and behavioral disorders (EBD) and autism spectrum disorders (ASD). This single-case meta-analysis examined the effects of social skills interventions (SSIs) for students with EBD and ASD. Effect sizes were calculated for 78 cases across 25 included studies using a nonparametric effect size, Baseline Corrected Tau. The overall weighted mean effect size of 0.54 suggested a moderate effect across the 25 studies. The overall weighted mean effects for studies reporting maintenance and generalization data were 0.68 and 0.37, respectively. Potential moderators examined (disability, intervention design, intervention delivery, methodological quality) were not significant. As such, they did not moderate the outcomes for participants. We conducted a post hoc analysis and hypothesized that between-study differences may be more meaningful than the similarities shared by participants in the same moderator groups. Implications are discussed on using SSIs to address the social, emotional, and behavioral challenges of students with or at risk of EBD and ASD.

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5. Sedgewick F, Leppanen J, Tchanturia K. Autistic adult outcomes on weight and body mass index : a large-scale online study. Eating and weight disorders : EWD. 2019.

PURPOSE : There has been a wealth of work on the weight outcomes of autistic children and young people, generally finding that they are more likely to be overweight or obese than their non-autistic counterparts. There has not been the same focussed study of the weight outcomes of autistic adults, however. This study, therefore, sought to examine the relationship between weight outcome and being autistic in adults. METHODS : Data were collected as part of an online study looking at eating, autism, and relationships. 665 people gave demographic and mental health information, and group differences and robust regressions were conducted. RESULTS : Autistic adults were more likely to be in non-healthy weight categories than their non-autistic counterparts, i.e., more likely to be underweight, overweight, or obese. There were no interactions between autism status and mental health impacting BMI, although both anxiety and depression predicted higher BMI in the sample overall. CONCLUSIONS : We conclude that while some weight patterns from childhood and adolescence continue into adulthood for autistic individuals, this is not necessarily a straightforward picture, and would benefit from further in-depth and qualitative study to understand the processes at play. The lack of interactions between mental health and autism, however, should provide professionals with confidence in supporting healthy weight management among autistic people. LEVEL OF EVIDENCE : Level III, cohort study.

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6. Straus J, Coburn S, Maskell S, Pappagianopoulos J, Cantrell K. Medical Encounters for Youth With Autism Spectrum Disorder : A Comprehensive Review of Environmental Considerations and Interventions. Clinical medicine insights Pediatrics. 2019 ; 13 : 1179556519842816.

Approximately 1 in 59 youth are currently diagnosed with autism spectrum disorder (ASD), a neurodevelopmental disorder. In comparison to typically developing peers, youth with ASD encounter hospitalization at higher rates due to their heightened health care needs. While visiting the hospital is a stressor for youth with neurotypical needs, the experience contains unique challenges for those with ASD. This systematic literature review highlights research that considers the psychosocial impact of the hospital environment on the coping and adjustment of youth with ASD. Specifically, the review focuses on recommendations and interventions that may be used by health care professionals while supporting this population as they encounter the health care system. Ninety-six articles were identified as meeting inclusion and exclusion criteria. The findings suggest that practicing clinicians should implement a wide variety of interventions for youth with ASD including diversion techniques, comfort positions, and picture schedules. Although there are published evidence-based interventions for supporting youth with ASD in the hospital, most clinicians lack ASD-specific training. This article concludes with recommendations for future research.

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