Pubmed du 15/05/19

mercredi 15 mai 2019

1. Giofre D, Provazza S, Angione D, Cini A, Menazza C, Oppi F, Cornoldi C. The intellectual profile of children with autism spectrum disorders may be underestimated : A comparison between two different batteries in an Italian sample. Res Dev Disabil. 2019 ; 90 : 72-9.

Intelligence measures are typically used in the assessment of children with autism spectrum disorders (ASD), but there is a paucity of research on the implications of such testing. In the present study, we examined children with ASD using two of the most largely adopted instruments, i.e., the WISC-IV, arguably the most utilized scale in the world ; and the Leiter-3, a nonverbal scale that also excludes, from the IQ calculation, working memory and processing speed, which are points of weakness in ASD. Results showed that IQ and indices of these two batteries are strongly correlated. However, the WISC-IV IQ might underestimates the potential of children with ASD, particularly in children with a low functioning profile. These hold true for both the full scale IQ and three out of four indices of the WISC-IV, with remarkable implications for both assessment and treatment of these children. Practitioners working with children with ASD should be aware that the battery that they are using might severely affect the estimation of these children’s potential.

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2. Kawai N, Hirohashi Y, Ebihara Y, Saito T, Murai A, Saito T, Shirosaki T, Kubo T, Nakatsugawa M, Kanaseki T, Tsukahara T, Shichinohe T, Li L, Hirano S, Torigoe T. ABCG2 expression is related to low 5-ALA photodynamic diagnosis (PDD) efficacy and cancer stem cell phenotype, and suppression of ABCG2 improves the efficacy of PDD. PLoS One. 2019 ; 14(5) : e0216503.

Photodynamic diagnosis/therapy (PDD/PDT) are novel modalities for the diagnosis and treatment of cancer. The photosensitizer protoporphyrin IX is metabolized from 5-aminolevulinic acid (5-ALA) intracellularly, and PDD/PDT using 5-ALA have been approved in dermatologic malignancies and gliomas. However, the molecular mechanism that defines the efficacy of PDD/PDT is unknown. In this study, we analyzed the functions of ATP-binding cassette (ABC) transporters in PDD using 5-ALA. Most of the human gastrointestinal cancer line cells examined showed a homogenous staining pattern with 5-ALA, except for the pancreatic cancer line PANC-1, which showed heterogeneous staining. To analyze this heterogeneous staining pattern, single cell clones were established from PANC-1 cells and the expression of ABC transporters was assessed. Among the ABC transporter genes examined, ABCG2 showed an inverse correlation with the rate of 5-ALA-positive staining. PANC-1 clone #2 cells showed the highest level of ABCG2 expression and the lowest level of 5-ALA staining, with only a 0.6% positive rate. Knockdown of the ABCG2 gene by small interfering RNAs increased the positive rate of 5-ALA staining in PANC-1 wild-type and clone cells. Interestingly, PANC-1 clone #2 cells showed the high sphere-forming ability and tumor-formation ability, indicating that the cells contained high numbers of cancer stem cells (CSCs). Knockdown or inhibition of ABCG2 increased the rate of 5-ALA staining, but did not decrease sphere-forming ability. These results indicate that gastrointestinal cancer cell lines expressing high levels of ABCG2 are enriched with CSCs and show low rates of 5-ALA staining, but 5-ALA staining rates can be improved by inhibition of ABCG2.

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3. Ng QX, Loke W, Venkatanarayanan N, Lim DY, Soh AYS, Yeo WS. A Systematic Review of the Role of Prebiotics and Probiotics in Autism Spectrum Disorders. Medicina (Kaunas, Lithuania). 2019 ; 55(5).

Background : Autism spectrum disorder (ASD) is a complex developmental condition typically characterized by deficits in social and communicative behaviors as well as repetitive patterns of behaviors. Despite its prevalence (affecting 0.1% to 1.8% of the global population), the pathogenesis of ASD remains incompletely understood. Patients with ASD are reported to have more frequent gastrointestinal (GI) complaints. There is some anecdotal evidence that probiotics are able to alleviate GI symptoms as well as improve behavioral issues in children with ASD. However, systematic reviews of the effect of prebiotics/probiotics on ASD and its associated symptoms are lacking. Methods : Using the keywords (prebiotics OR probiotics OR microbiota OR gut) AND (autism OR social OR ASD), a systematic literature search was conducted on PubMed, EMBASE, Medline, Clinicaltrials.gov and Google Scholar databases. The inclusion criteria were original clinical trials, published in English between the period 1st January 1988 and 1st February 2019. Results : A total of eight clinical trials were systematically reviewed. Two clinical trials examined the use of prebiotic and/or diet exclusion while six involved the use of probiotic supplementation in children with ASD. Most of these were prospective, open-label studies. Prebiotics only improved certain GI symptoms ; however, when combined with an exclusion diet (gluten and casein free) showed a significant reduction in anti-sociability scores. As for probiotics, there is limited evidence to support the role of probiotics in alleviating the GI or behavioral symptoms in children with ASD. The two available double-blind, randomized, placebo-controlled trials found no significant difference in GI symptoms and behavior. Conclusion : Despite promising preclinical findings, prebiotics and probiotics have demonstrated an overall limited efficacy in the management of GI or behavioral symptoms in children with ASD. In addition, there was no standardized probiotics regimen, with multiple different strains and concentrations of probiotics, and variable duration of treatments.

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4. O’Haire M. Research on animal-assisted intervention and autism spectrum disorder, 2012-2015. Applied developmental science. 2017 ; 21(3) : 200-16.

Including animals in autism intervention is growing in both research and practice. A systematic literature review was conducted to collate and synthesize all empirical research on animal-assisted intervention (AAI) for autism published from 2012 to 2015. Findings from 28 included studies revealed that AAI programs generally include one animal per participant with a total contact time of approximately 10 hours over the course of 8 to 12 weeks. Research methodology is diverse and though limited in many cases, has improved over the last few years. The most commonly reported outcome was increased social interaction, which was unanimously significant across 22 studies. The need for further research is highlighted, calling for a focus on refining AAI techniques, identifying optimal circumstances for positive change as well as individuals who may not benefit, and independent replication of high quality studies to move AAI from an enrichment activity to an evidence-based practice for autism.

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5. Peverill S, Smith IM, Duku E, Szatmari P, Mirenda P, Vaillancourt T, Volden J, Zwaigenbaum L, Bennett T, Elsabbagh M, Georgiades S, Ungar WJ. Developmental Trajectories of Feeding Problems in Children with Autism Spectrum Disorder. Journal of pediatric psychology. 2019.

OBJECTIVE : Although feeding problems are a common concern in children with autism spectrum disorder (ASD), few longitudinal studies have examined their persistence over time. The purpose of this study was to examine the developmental progression of feeding problems across four time points in preschoolers with ASD. METHODS : Group-based trajectory analyses revealed four distinct trajectories of feeding problems in our sample (N = 396). RESULTS : The majority of children showed levels of feeding problems that were low from the outset and stable (Group 1 ; 26.3%) or moderate and declining over time (Group 2 ; 38.9%). A third group (26.5%) showed high levels of feeding problems as preschoolers that declined to the average range by school age. Few participants (8.3%) showed evidence of severe chronic feeding problems. Feeding problems were more highly correlated with general behavior problems than with autism symptom severity. CONCLUSIONS : Overall, our findings demonstrated that in our sample of children with ASD, most feeding problems remitted over time, but a small subgroup showed chronic feeding problems into school age. It is important to consider and assess feeding problems in ASD against the backdrop of typical development, as many children with ASD may show improvement with age.

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6. Wester Oxelgren U, Aberg M, Myrelid A, Anneren G, Westerlund J, Gustafsson J, Fernell E. Autism needs to be considered in children with Down syndrome. Acta paediatrica (Oslo, Norway : 1992). 2019.

AIM : To analyse levels and profiles of autism symptoms in children with Down syndrome (DS) with and without diagnosed autism spectrum disorder (ASD) and to specifically study the groups with severe Intellectual disability (ID). METHODS : From a population-based cohort of 60 children with DS (age 5-17 years) with 41 participating children, scores obtained from the Autism Diagnostic Observation Schedule (ADOS) Module-1 algorithm were compared between those with and without diagnosed ASD. Children with DS and ASD were also compared to a cohort of children with idiopathic ASD, presented in the ADOS manual. RESULTS : Children with DS and ASD had significantly higher ADOS scores in all domains compared to those without ASD. When the groups with DS, with and without ASD, were restricted to those with severe ID, the difference remained. When the children with DS and ASD and the idiopathic autism group were compared, the ADOS profiles were similar. CONCLUSION : A considerable proportion of children with DS has ASD but there is also a group of children with DS and severe ID without autism. There is a need to increase awareness of the high prevalence of autism in children with DS to ensure that appropriate measures and care are provided. This article is protected by copyright. All rights reserved.

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7. Williams-Arya P, Anixt J, Ehrhardt J, Manning-Courtney P. Improving Access to Diagnostic Assessments for Autism Spectrum Disorder Using an Arena Model. J Dev Behav Pediatr. 2019.

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8. Wilson KP, Steinbrenner JR, Kalandadze T, Handler L. Interventions Targeting Expressive Communication in Adults With Autism Spectrum Disorders : A Systematic Review. Journal of speech, language, and hearing research : JSLHR. 2019 : 1-20.

Purpose The aims of this systematic review are to (a) synthesize the literature on interventions targeting expressive communication in adults with autism spectrum disorder and (b) evaluate the effectiveness of the interventions. Method The literature search resulted in 7,196 articles. The research team used 2 reviewers and consensus for title/abstract review, full-text review, and quality review. To be included, studies had to (a) include at least 1 adult (18 years of age and above) with an autism spectrum disorder ; (b) examine an intervention, treatment, or model of care ; (c) provide outcome data related to expressive communication modalities/domains ; (d) be experimental or quasi-experimental ; and (e) be published in English. Twenty-two studies (14 single-case design and 8 group design), with a total of 256 participants and varied interventions and outcome variables, met criteria for inclusion. Effect sizes are presented for group design studies, and visual analysis results are outlined for single-case design studies. Results Examination of treatment effects in the included studies showed positive effects, overall ; however, there was great variability between studies. Single-case design studies showed evidence of functional relations in all but 1 study, with most showing medium to large effects, as well as maintenance and generalization of gains. Group design studies showed a wide range of effects from near-zero to large effects. Differences in intervention strategies and durations, as well as in participant characteristics and outcome measures, presented barriers to aggregation. Conclusions This review highlights the need for increased high-quality research examining interventions targeting expressive communication in adults with autism spectrum disorder and also pinpoints interventions with potential for future study and use in this population.

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9. Wright BM, Benigno JP. Autism Spectrum Disorder and Sibling Relationships : Exploring Implications for Intervention Using a Family Systems Framework. American journal of speech-language pathology. 2019 : 1-9.

Purpose There is currently a very limited scope of research in the field of speech-language pathology on sibling involvement in the treatment of children with autism spectrum disorder (ASD). Principles of family systems theory (FST) recognize the interrelatedness and dynamic nature of the family unit, making it a relevant and useful guiding framework for future research and practice on sibling involvement in intervention. Method In this article, core principles of FST are reviewed, followed by the state of research related to sibling relationships in ASD, and roles of typically developing siblings and siblings with ASD in intervention programs. Implications for adopting an FST framework as well as considerations and future directions in this area of research and clinical practice are discussed. Results According to the principles of FST on the inclusion of siblings in treatment, there are several considerations to be made at the level of the child with ASD, the sibling(s), and the family unit. Factors such as developmental level, communication status, and areas of strength, challenge, and interest are key features of the children and family that will need to be addressed in order to promote positive sibling involvement and family functioning. Conclusions The development of family-centered sibling intervention programs for individuals with ASD is an area of research that warrants further exploration. With the guidance of the FST framework, researchers and clinicians can work to develop innovative interventions that consider the unique characteristics of each family to optimize outcomes at the levels of each individual, the sibling relationship, and the family as a unit.

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