Pubmed du 07/06/19

vendredi 7 juin 2019

1. Evangelho VGO, Castro HC, Amorim MR. Genetic Tests for Autism : The Challenges in the Laboratory Diagnosis. J Child Neurol ;2019 (Jun 7):883073819852236.

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2. Fisher WW, Retzlaff BJ, Akers JS, DeSouza AA, Kaminski AJ, Machado MA. Establishing initial auditory-visual conditional discriminations and emergence of initial tacts in young children with autism spectrum disorder. J Appl Behav Anal ;2019 (Jun 6)

Children with autism spectrum disorder (ASD) often display impaired listener skills, and few studies have evaluated procedures for establishing initial auditory-visual conditional discrimination skills. We developed and evaluated a treatment package for training initial auditory-visual conditional discriminations based on the extant research on training such discriminations in children with ASD with at least some preexisting skills in this area. The treatment package included (a) conditional-only training, (b) prompting the participant to echo the sample stimulus as a differential observing response, (c) prompting correct selection responses using an identity-match prompt, (d) using progressively delayed prompts, and (e) repeating trials until the participant emitted an independent correct response. Results indicated all participants mastered all listener targets, and the two participants for whom we tested the emergence of corresponding tacts showed mastery of most tacts without direct training. We discuss these results relative to prior research on listener skills and tacts.

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3. Guard A Ms OL, Konz M Ms OL, Smith Ro PhD OTFRF, Engel Jm PhD OF, Keating TP. The development of an iPad application for the pain assessment of individuals with developmental disabilities and complex communication needs. Assist Technol ;2019 (Jun 6):1-12.

Aims : Develop a new pain assessment for youth with communication challenges. The Guard-Putzer Pain Assessment Domains (gPAD) mobile application (app) was designed and tested as a universally accessible way for youth, ages 7-12 years, with a developmental disability (DD) to express their pain experiences through self-report. Methods : A two-phase process developed the design for an app, created an interactive prototype, and tested its face validity and user interface. This work included a comprehensive scoping review of current assessments and pain apps as well as a survey to obtain descriptive data on the clinical practicality of the gPAD to guide the app design. Additionally, 15 therapists reviewed the gPAD assessment. Results : Thirteen respondents (87%) agreed to the statement that they would use the gPAD for this population. School-based practitioners seemed to highlight the most significant needs for the app. Conclusions : Advancement of this app could mainstream the assessment of pain in youth with DD, and other potential populations.

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4. Hoang VM, Le TV, Chu TTQ, Le BN, Duong MD, Thanh NM, Tac Pham V, Minas H, Bui TTH. Prevalence of autism spectrum disorders and their relation to selected socio-demographic factors among children aged 18-30 months in northern Vietnam, 2017. Int J Ment Health Syst ;2019 ;13:29.

Background : Autism spectrum disorders are increasing worldwide and in Vietnam. This study reports the prevalence of autism spectrum disorders and examines their relation to selected socio-demographic factors among children aged 18 and 30 months in three northern cities/provinces in Vietnam, 2017. Methods : This was a cross-sectional study conducted among 17,277 children aged 18 and 30 months one city (Hanoi capital) and two provinces in northern Vietnam. The multi-stage sampling technique was applied in this study. We used M-CHAT to screen children with high risk of ASD. M-CHAT positive cases were diagnosed by pediatric neurologists from National Pediatrics Hospital using DSM-IV criteria. Descriptive and analytical statistics were performed. Results : The overall prevalence of ASD among children aged 18 and 30 months in the three studied sites was 0.752% (95% CI 0.629-0.893%). The odds of having ASD were statistically significant higher among (a) children living in urban area as compared to those from rural settings (OR = 2.7, 95% CI 1.73-4.21) ; (b) boys as compared to girls (OR = 4.04, 95% CI 2.57-6.35) ; and (c) children of mothers who worked as farmers as compared to children of mothers who were government staff (OR = 4.72, 95% CI 2.03-10.97). Conclusions : Our study revealed that the prevalence of ASD among children in Vietnam seems to be increasing. The significant correlates of ASD among the children were urban setting, male gender and mother’s occupation (farmer). Further and more in-depth studies on determinants of ASD are needed to provide insights into the problem.

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5. Leung RC, Pang EW, Brian JA, Taylor MJ. Happy and Angry Faces Elicit Atypical Neural Activation in Children With Autism Spectrum Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging ;2019 (Apr 10)

BACKGROUND : Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by significant impairments in social interactions and communication. The ability to accurately perceive and interpret emotional faces is critical to successful social interactions. However, few studies have investigated the spatiotemporal profile of the neural mechanisms underlying emotional face processing in ASD, particularly in children. The current study fills this important gap. METHODS : Participants were 55 children : 28 children with ASD (mean age = 9.5 +/- 1.3 years) and 27 control children (mean age = 8.5 +/- 1.3 years). All children completed an implicit emotional face task while magnetoencephalography was recorded. We examined spatiotemporal differences between the groups in neural activation during implicit processing of emotional faces. RESULTS : Within-group analyses demonstrated greater right middle temporal (300-375 ms) and superior temporal (300-400 ms) activation to angry faces than to happy faces in control children, while children with ASD showed greater activation from 250 to 500 ms to happy faces than to angry faces across frontal and temporal regions. Between-group analyses demonstrated that children with ASD showed similar patterns of late (425-500 ms) posterior cingulate and thalamic underactivity to both angry and happy faces relative to control children, suggesting general atypical processing of emotional information. CONCLUSIONS : Atypical posterior cingulate cortex and thalamus recruitment in children with ASD to emotional faces suggests poor modulation of toggling between the default mode network and task-based processing. Increased neural activity to happy faces compared with angry faces in children with ASD suggests reduced salience or immature response to anger, which in turn could contribute to deficits in social cognition in ASD.

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6. Li BL, Yuen VM, Zhang N, Zhang HH, Huang JX, Yang SY, Miller JW, Song XR. A Comparison of Intranasal Dexmedetomidine and Dexmedetomidine Plus Buccal Midazolam for Non-painful Procedural Sedation in Children with Autism. J Autism Dev Disord ;2019 (Jun 6)

Children with autism often need sedation for diagnostic procedures and they are often difficult to sedate. This prospective randomized double-blind control trial evaluates the efficacy and safety using intranasal dexmedetomidine with and without buccal midazolam for sedation in children with autism undergoing computerized tomography and/or auditory brainstem response test. The primary outcome is the proportion of children attaining satisfactory sedation. One hundred and thirty-six children received intranasal dexmedetomidine and 139 received intranasal dexmedetomidine with buccal midazolam for sedation. Combination of intranasal dexmedetomidine and buccal midazolam was associated with higher sedation success when compared to intranasal dexmedetomidine. Since intranasal and buccal sedatives required little cooperation this could be especially useful technique for children with autism or other behavioral conditions.

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7. Nilsson M, Handest P, Nylander L, Pedersen L, Carlsson J, Arnfred S. Arguments for a Phenomenologically Informed Clinical Approach to Autism Spectrum Disorder. Psychopathology ;2019 (Jun 6):1-8.

OBJECTIVE : The aim of this paper is to provide arguments for a phenomenologically informed clinical approach to autism spectrum disorder (ASD), including a plea for clinical attention to the self in ASD. METHODS : Central concepts of continental phenomenology, phenomenological psychopathology, and the phenomenological interview are presented, with an emphasis on the potential unifying qualities of an approach which includes the exploration of subjective and intersubjective experience. These phenomenological concepts and methods are contrasted with the current conceptualization of ASD, where the first-person perspective is not in focus. RESULTS : Contemporary phenomenological papers on ASD address key concepts like intersubjectivity, intercorporeality, and intentionality. However, insights from this theoretical field have not been followed up in clinical research and practice. Consequently, there is (to our knowledge) still a lack of phenomenologically informed clinical explorations of experience of self, others, and the world in ASD. CONCLUSION : A phenomenologically informed focus on the form and structure of subjective experience, including a focus on self-experience in ASD, can lead to new and important insights in relation to clinical differentiation between ASD and schizophrenia spectrum disorder.

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8. Reyes N, Walsh C, Soke N, Hepburn S. Changes in temperament over time in young children with autism spectrum disorder and other developmental delays : a follow-up comparison study. J Intellect Disabil Res ;2019 (Jun 6)

BACKGROUND : Although in the last decade some research has emerged on temperament in autism spectrum disorder (ASD), this research has primarily focused on the differences between children with ASD and their typically developing peers rather than the stability or change in temperament in this population. Thus, the goal of this study was to examine temperament over time in children with ASD, developmental delays (DD) and typical development (TD). Temperament differences were also compared among the three groups. METHODS : To accomplish this, parents rated children’s temperament at Time 1 (T1) and Time 2 (T2) using the Carey Temperament Scales (CTS). RESULTS : Results from the study showed that at T1, parents of children with ASD rated their children as more withdrawn (i.e. approach), and emotionally negative (i.e. mood), and less distractible and adaptable than parents of children with TD and DD. Also, children with ASD were rated as more intense and children with DD as less distractible than their TD peers. Similarly, at T2, children with ASD were rated more withdrawn, and emotionally negative, and less persistent, rhythmic, adaptable and distractible than children with TD and DD. Also, children with ASD were rated as more active than their DD peers. Regarding stability, parent ratings of temperament appeared stable over time in the TD group, but ratings varied substantially in the ASD or DD groups. That is, for the ASD group, activity and approach at T1 were significantly associated with their corresponding dimensions at T2. However, for the TD group, rhythmicity, approach, intensity and mood at T1 were significantly associated with those dimensions at T2. No associations were found in the DD group. Regarding change, parents reported change in rhythmicity, persistence and threshold between T1 and T2 in the ASD group. Similarly, parents reported change in rhythmicity, approach and threshold between T1 and T2 in the DD group. Lastly, parents of TD children reported change in adaptability, persistence and distractibility between T1 and T2. CONCLUSIONS : These findings are novel in that children with ASD appear to have less stable temperament profile and different change patterns than children with TD or DD. Similar to previous research, children with ASD were described by their parents as experiencing more temperamental difficulties.

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9. Shah P, Livingston LA, Callan MJ, Player L. Trait Autism is a Better Predictor of Empathy than Alexithymia. J Autism Dev Disord ;2019 (Jun 7)

It has been proposed that atypical empathy in autism spectrum disorder (ASD) is due to co-occurring alexithymia. However, difficulties measuring empathy and statistical issues in previous research raise questions about the role of alexithymia in empathic processing in ASD. Addressing these issues, we compared the associations of trait alexithymia and autism with empathy in large samples from the general population. Multiple regression analyses showed that both trait autism and alexithymia were uniquely associated with atypical empathy, but dominance analysis found that trait autism, compared to alexithymia, was a more important predictor of atypical cognitive, affective, and overall empathy. Together, these findings indicate that atypical empathy in ASD is not simply due to co-occurring alexithymia.

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10. Stasolla F, Caffo AO, Perilli V, Albano V. Experimental Examination and Social Validation of a Microswitch Intervention to Improve Choice-Making and Activity Engagement for Six Girls with Rett Syndrome. Dev Neurorehabil ;2019 (Jun 6):1-15.

Background : The use of assistive technology, specifically microswitches, with children with RTT has been shown to effectively moderate the impact of their disability on their quality of life(-) by facilitating access to meaningful leisure and other activities. Objectives : This study aimed to evaluate the effectiveness of a microswitch intervention on increased choice making, engagement in a targeted sorting activity, and indices of happiness, and decreased stereotypic behaviors for six girls with Rett syndrome. Targeted dependent variables were also assessed at six months post-intervention. Following the intervention study, 90 external raters completed a social validation procedure. Method : An ABABAB experimental sequence was implemented for each participant with a cross-over effect. A social validation assessment involving 90 external raters was carried out. Results : Data emphasized an improved performance for each participants involved (i.e., adaptive responses). Five participants showed a capacity of independent choice. One participant seemed to be closely linked to the position of the container. Social raters favorably endorsed the use of the program since they positively evaluated the use of the technology on all the dimensions investigated. Conclusion : A microswitch intervention may improve choice making and activity engagement for children with Rett syndrome. Further research is needed on the development of more sophisticated forms of individualized technological options to improve opportunities for enhanced engagement and choice-making for individuals with RTT.

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11. Thabtah F, Abdelhamid N, Peebles D. A machine learning autism classification based on logistic regression analysis. Health Inf Sci Syst ;2019 (Dec) ;7(1):12.

Autistic Spectrum Disorder (ASD) is a neurodevelopmental condition associated with significant healthcare costs ; early diagnosis could substantially reduce these. The economic impact of autism reveals an urgent need for the development of easily implemented and effective screening methods. Therefore, time-efficient ASD screening is imperative to help health professionals and to inform individuals whether they should pursue formal clinical diagnosis. Presently, very limited autism datasets associated with screening are available and most of them are genetic in nature. We propose new machine learning framework related to autism screening of adults and adolescents that contain vital features and perform predictive analysis using logistic regression to reveal important information related to autism screening. We also perform an in-depth feature analysis on the two datasets using information gain (IG) and Chi square testing (CHI) to determine the influential features that can be utilized in screening for autism. Results obtained reveal that machine learning technology was able to generate classification systems that have acceptable performance in terms of sensitivity, specificity and accuracy among others.

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12. Weston CSE. Four Social Brain Regions, Their Dysfunctions, and Sequelae, Extensively Explain Autism Spectrum Disorder Symptomatology. Brain Sci ;2019 (Jun 4) ;9(6)

Autism spectrum disorder (ASD) is a challenging neurodevelopmental disorder with symptoms in social, language, sensory, motor, cognitive, emotional, repetitive behavior, and self-sufficient living domains. The important research question examined is the elucidation of the pathogenic neurocircuitry that underlies ASD symptomatology in all its richness and heterogeneity. The presented model builds on earlier social brain research, and hypothesizes that four social brain regions largely drive ASD symptomatology : amygdala, orbitofrontal cortex (OFC), temporoparietal cortex (TPC), and insula. The amygdala’s contributions to ASD largely derive from its major involvement in fine-grained intangible knowledge representations and high-level guidance of gaze. In addition, disrupted brain regions can drive disturbance of strongly interconnected brain regions to produce further symptoms. These and related effects are proposed to underlie abnormalities of the visual cortex, inferior frontal gyrus (IFG), caudate nucleus, and hippocampus as well as associated symptoms. The model is supported by neuroimaging, neuropsychological, neuroanatomical, cellular, physiological, and behavioral evidence. Collectively, the model proposes a novel, parsimonious, and empirically testable account of the pathogenic neurocircuitry of ASD, an extensive account of its symptomatology, a novel physiological biomarker with potential for earlier diagnosis, and novel experiments to further elucidate the mechanisms of brain abnormalities and symptomatology in ASD.

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