Pubmed du 20/06/19

jeudi 20 juin 2019

1. Albaum C, Tablon P, Roudbarani F, Weiss JA. Predictors and outcomes associated with therapeutic alliance in cognitive behaviour therapy for children with autism. Autism ;2019 (Jun 18):1362361319849985.

Therapeutic alliance is often an important aspect of psychotherapy, though it is rarely examined in clients with autism. This study aims to determine the child pre-treatment variables and treatment outcomes associated with early and late alliance in cognitive behaviour therapy targeting emotion regulation for children with autism. Data were collected from 48 children with autism who participated in a larger randomized-controlled trial. Pre-treatment child characteristics included child, parent, and clinician report of child emotional and behavioural functioning. Primary outcome measures included child and parent-reported emotion regulation. Therapeutic alliance (bond and task-collaboration) was measured using observational coding of early and late therapy sessions. Pre-treatment levels of child-reported emotion inhibition were associated with subsequent early and late bond. Pre-treatment levels of parent and child-reported emotion regulation were related to early and late task-collaboration. Late task-collaboration was also associated with pre-treatment levels of behavioural and emotional symptom severity. Task-collaboration in later sessions predicted improvements in parent-reported emotion regulation from pre- to post-therapy. Future research is needed to further examine the role of task-collaboration as a mechanism of treatment change in therapies for children with autism.

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2. Alharbi KA, Alharbi AA, Al-Thunayyan FS, Alsuhaibani KA, Alsalameh NS, Alhomaid MH, Albahouth IS, Hamid PF. School’s Teachers Knowledge About Autism in Al-Badayacity, Al-Qassim Region, Kingdom of Saudi Arabia. Mater Sociomed ;2019 (Mar) ;31(1):4-9.

Introduction : The growing number of students with Autism will set challenge to school teachers to become better prepared to take the necessary action to serve and to assist children with autism. Aim : The aim in this study was to assess the knowledge and attitude of school teachers regarding Autism Spectrum Disorder in Badaya city of Al-Qassim region, kingdom of Saudi Arabia, and to find out any differences in school teachers knowledge based on (gender, educational level, experience, contact with students with autism, type of school). Methods : a cross sectional study was conducted in Badaya City on school teachers from December 2017 until March 2018 to assess their knowledge about Autism spectrum disorder. Autism knowledge Questionnaire was completed by 248 school teachers participated in the research study, data was collected from answers of the 30 questions of the questionnaire for all participants, and analyzed using SPSS version 21. Results : total level of knowledge in our sample of school teachers was 48.7%, a statistical significant differences between school teachers’ knowledge based on type of school, contact with children with autism favoring public schools p value=0.00, and previous contact with students with autism p value=0.03 which have higher level of knowledge. Educational level, grade of teaching, experience, gender did not significantly affect teachers’ knowledge. Conclusion : School teachers had a weak level of knowledge about Autism Spectrum disorder. Previous contact with students with autism definitely raises level of knowledge.

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3. Alvares GA, Bebbington K, Cleary D, Evans K, Glasson EJ, Maybery MT, Pillar S, Uljarevic M, Varcin K, Wray J, Whitehouse AJ. The misnomer of ’high functioning autism’ : Intelligence is an imprecise predictor of functional abilities at diagnosis. Autism ;2019 (Jun 19):1362361319852831.

’High functioning autism’ is a term often used for individuals with autism spectrum disorder without an intellectual disability. Over time, this term has become synonymous with expectations of greater functional skills and better long-term outcomes, despite contradictory clinical observations. This study investigated the relationship between adaptive behaviour, cognitive estimates (intelligence quotient) and age at diagnosis in autism spectrum disorder. Participants (n = 2225, 1-18 years of age) were notified at diagnosis to a prospective register and grouped by presence (n = 1041) or absence (n = 1184) of intellectual disability. Functional abilities were reported using the Vineland Adaptive Behaviour Scales. Regression models suggested that intelligence quotient was a weak predictor of Vineland Adaptive Behaviour Scales after controlling for sex. Whereas the intellectual disability group’s adaptive behaviour estimates were close to reported intelligence quotients, Vineland Adaptive Behaviour Scales scores fell significantly below intelligence quotients for children without intellectual disability. The gap between intelligence quotient and Vineland Adaptive Behaviour Scales scores remained large with increasing age at diagnosis for all children. These data indicate that estimates from intelligence quotient alone are an imprecise proxy for functional abilities when diagnosing autism spectrum disorder, particularly for those without intellectual disability. We argue that ’high functioning autism’ is an inaccurate clinical descriptor when based solely on intelligence quotient demarcations and this term should be abandoned in research and clinical practice.

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4. Castillo MA, Urdaneta KE, Semprun-Hernandez N, Brigida AL, Antonucci N, Schultz S, Siniscalco D. Speech-Stimulating Substances in Autism Spectrum Disorders. Behav Sci (Basel) ;2019 (Jun 12) ;9(6)

Autism spectrum disorder (ASD) is characterized by the core domains of persistent deficits in social communication and restricted-repetitive patterns of behaviors, interests, or activities. A heterogeneous and complex set of neurodevelopmental conditions are grouped in the spectrum. Pro-inflammatory events and immune system dysfunctions are cellular and molecular events associated with ASD. Several conditions co-occur with ASD : seizures, gastro-intestinal problems, attention deficit, anxiety and depression, and sleep problems. However, language and speech issues are key components of ASD symptoms current therapies find difficult to face. Several speech-stimulating substances have been shown to be effective in increasing speech ability in ASD subjects. The need for large clinical trials to determine safety and efficacy is recommended.

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5. Diop H, Cabral H, Gopal D, Cui X, Stern JE, Kotelchuck M. Early Autism Spectrum Disorders in Children Born to Fertile, Subfertile, and ART-Treated Women. Matern Child Health J ;2019 (Jun 20)

INTRODUCTION : We examined the prevalence of autism spectrum disorders (ASDs) in Massachusetts (MA) comparing children born via assisted reproductive technology (ART) and children born to women with indicators of subfertility but no ART (Subfertile), to children born to women with neither ART nor indicators of subfertility (Fertile). We assessed the direct, indirect, and total effects of ART and subfertility on ASD among singletons. METHODS : This study included 10,147 ART, 8072 Subfertile and 441,898 Fertile MA resident births from the MA Outcome Study of ART (MOSART) database linked with Early Intervention program participation data. ART included fresh in vitro fertilization (IVF), fresh intracytoplasmic sperm injection (ICSI), and frozen embryo transfer. We estimated the prevalence of ASD by fertility group. We used logistic regression to assess the natural direct effect (NDE), natural indirect effect (NIE) through preterm birth, and total effects of each fertility group on ASD. RESULTS : The NDE indicated that, compared to the Fertile group, the odds of ASD were not statistically higher in the ART (ORNDE 1.07 ; 95% CI 0.88-1.30), Subfertile (ORNDE 1.11 ; 95% CI 0.89-1.38), IVF (ORNDE 0.91 ; 95% CI 0.68-1.22), or ICSI (ORNDE 1.13 ; 95% CI 0.84-1.51) groups, even if the rate of preterm birth was the same across all groups. The total effect (product of NDE and NIE) was not significant for ART (ORTotal Effect 1.08 ; 95% CI 0.89-1.30), Subfertile (ORTotal Effect 1.11 ; 95% CI 0.89-1.38), IVF (ORTotal Effect 0.92 ; 95% CI 0.69-1.23), or ICSI (ORTotal Effect 1.13 ; 95% CI 0.84-1.52). CONCLUSION : Compared to children born to Fertile women, children born to ART, ICSI, or IVF, or Subfertile women are not at increased risk of receiving an ASD diagnosis.

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6. Dowdy A, Tincani M. Assessment and treatment of high-risk challenging behavior of adolescents with autism in an aquatic setting. J Appl Behav Anal ;2019 (Jun 18)

Aquatic-based activities produce positive skill and health benefits for individuals with Autism Spectrum Disorder (ASD) ; however, aquatic contexts, such as the pool, introduce the risk of injury and drowning. This risk is heightened when individuals with ASD engage in challenging behavior in the pool context. The purpose of the study was to evaluate the effects of differential reinforcement without extinction for 2 participants diagnosed with ASD who engaged in challenging behavior when asked to transition from the pool. The treatment successfully decreased participants’ transition latencies and challenging behavior during transitions from the pool for up to 2 months following treatment. Lifeguard staff rated the procedures as highly acceptable and helpful, and noted high degrees of satisfaction with improvements for each participant’s behavior.

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7. Duggal C, Dua B, Chokhani R, Sengupta K. What works and how : Adult learner perspectives on an autism intervention training program in India. Autism ;2019 (Jun 18):1362361319856955.

A significant treatment gap exists in low and middle income countries such as India for children with autism spectrum disorder. The Autism Intervention Training Program, a comprehensive 6-month program for training professionals in transdisciplinary evidence-based practices to address concerns associated with autism spectrum disorder, was piloted in India to address this gap. This study attempted to capture the perspectives of trainees on the effectiveness of andragogical approaches adopted in the Autism Intervention Training Program and the impact of this training on their work. An exploratory qualitative study was conceptualized, and in-depth interviews were conducted with 11 Autism Intervention Training Program trainees. Trainees highlighted the benefits of a blended training format, peer learning, and a responsive, reflective, experiential, and respectful approach to teaching and supervision. The impact of the program was perceived through an increase in trainees’ knowledge and skills, impact on their organizations, and positive outcomes for children with autism spectrum disorder and their families. There is a need to develop and document comprehensive, contextualized, and evidence-based training programs for autism spectrum disorder professionals in low and middle income countries. Focusing on andragogical frameworks while conceptualizing and delivering these training programs is underscored, as approaches that promote self-efficacy in learners and enable transformative learning can lead to a cascading impact in resource-constrained settings.

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8. Durbin A, Jung JKH, Chung H, Lin E, Balogh R, Lunsky Y. Prevalence of intellectual and developmental disabilities among first generation adult newcomers, and the health and health service use of this group : A retrospective cohort study. PLoS One ;2019 ;14(6):e0215804.

BACKGROUND : Attention to research and planning are increasingly being devoted to newcomer health, but the needs of newcomers with disabilities remain largely unknown. This information is difficult to determine since population-level data are rarely available on newcomers or on people with intellectual and developmental disabilities (IDD), although in Ontario, Canada these databases are accessible. This study compared the prevalence of IDD among first generation adult newcomers to adult non-newcomers in Ontario, and assessed how having IDD affected the health profile and health service use of newcomers. METHODS : This population-based retrospective cohort study of adults aged 19-65 in 2010 used linked health and social services administrative data. Prevalence of IDD among newcomers (n = 1,649,633) and non-newcomers (n = 6,880,196) was compared. Among newcomers, those with IDD (n = 2,830) and without IDD (n = 1,646,803) were compared in terms of health conditions, and community and hospital service use. RESULTS : Prevalence of IDD was lower in newcomers than non-newcomers (171.6 versus 898.3 per 100,000 adults, p<0.0001). Among newcomers, those with IDD were more likely than those without IDD to have comorbid physical health disorders, non-psychotic, psychotic and substance use disorders. Newcomers with IDD were also more likely to have psychiatry visits, and frequent emergency department visits and hospitalizations. CONCLUSION : First generation adult newcomers have lower rates of IDD than non-newcomers. How much of this difference is attributable to admission policies that exclude people expected to be high health service users versus how much is attributable to our methodological approach is unknown. Finding more medical and psychiatric comorbidity, and more health service use among newcomers with IDD compared to newcomers without IDD is consistent with patterns observed in adults with IDD more generally. To inform polices that support newcomers with IDD future research should investigate reasons for the prevalence finding, barriers and facilitators to timely health care access, and pathways to care.

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9. Fisher WW, Felber JM, Phillips LA, Craig AR, Paden AR, Niemeier JJ. Treatment of resistance to change in children with autism. J Appl Behav Anal ;2019 (Jun 20)

"Resistance to change" represents a core symptom of autism that we conceptualized and assessed as resulting in part due to factors known to govern free-operant choice. During a free-choice baseline, participants chose between problematic, resistive responses and an appropriate alternative response. During the asymmetrical-choice condition, we delivered their most highly preferred item if the participant chose the alternative response (i.e., differential reinforcement of alternative behavior [DRA]). During the guided- (Experiment 1) and singular- (Experiment 2) choice conditions, we prompted participants to choose the alternative response and then delivered their most highly preferred item (i.e., DRA with escape extinction). All participants learned to tolerate (Experiment 1) or choose (Experiment 2) the alternative response when we combined DRA with escape extinction. After exposure to escape extinction, two participants showed strong maintenance effects with DRA alone. We discuss these finding relative to the effects of DRA and escape extinction on resistance to change.

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10. Latinus M, Mofid Y, Kovarski K, Charpentier J, Batty M, Bonnet-Brilhault F. Atypical Sound Perception in ASD Explained by Inter-Trial (In)consistency in EEG. Front Psychol ;2019 ;10:1177.

A relative indifference to the human voice is a characteristic of Autism Spectrum Disorder (ASD). Yet, studies of voice perception in ASD provided contradictory results : one study described an absence of preferential response to voices in ASD while another reported a larger activation to vocal sounds than environmental sounds, as seen in typically developed (TD) adults. In children with ASD, an absence of preferential response to vocal sounds was attributed to an atypical response to environmental sounds. To have a better understanding of these contradictions, we re-analyzed the data from sixteen children with ASD and sixteen age-matched TD children to evaluate both inter- and intra-subject variability. Intra-subject variability was estimated with a single-trial analysis of electroencephalographic data, through a measure of inter-trial consistency, which is the proportion of trials showing a positive activity in response to vocal and non-vocal sounds. Results demonstrate a larger inter-subject variability in response to non-vocal sounds, driven by a subset of children with ASD (7/16) who do not show the expected negative Tb peak in response to non-vocal sounds around 200 ms after the start of the stimulation due to a reduced inter-trial consistency. A logistic regression model with age and clinical parameters allowed demonstrating that not a single parameter discriminated the subgroups of ASD participants. Yet, the electrophysiologically-based groups differed on a linear combination of parameters. Children with ASD showing a reduced inter-trial consistency were younger and characterized by lower verbal developmental quotient and less attempt to communicate by voice. This data suggests that a lack of specialization for processing social signal may stem from an atypical processing of environmental sounds, linked to the development of general communication abilities. Discrepancy reported in the literature may arise from that heterogeneity and it may be inadequate to divide children with ASD based only on intellectual quotient or language abilities. This analysis could be a useful tool in providing complementary information for the functional diagnostic of ASD and evaluating verbal communication impairment.

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11. Mandell DS, Candon MK, Xie M, Marcus SC, Kennedy-Hendricks A, Epstein AJ, Barry CL. Effect of Outpatient Service Utilization on Hospitalizations and Emergency Visits Among Youths With Autism Spectrum Disorder. Psychiatr Serv ;2019 (Jun 19):appips201800290.

OBJECTIVE : Psychiatric hospitalizations and emergency department (ED) visits occur more frequently for youths with autism spectrum disorder (ASD). One mechanism that may reduce the likelihood of these events is utilization of home and community-based care. Using commercial claims data and a rigorous analytical framework, this retrospective study examined whether spending on outpatient services for ASD, including occupational, physical, and speech therapies and other behavioral interventions, reduced the likelihood of psychiatric hospitalizations and ED visits. METHODS : The study sample was composed of >100,000 children and young adults with ASD and commercial insurance from every state between 2008 and 2012. The authors estimated maximum-likelihood complementary log-log link survival models with robust standard errors. The outcomes of interest were a hospitalization or an ED visit with an associated psychiatric diagnosis code (ICD-9-CM 290 through 319) in a given week. RESULTS : An increase of $125 in weekly spending on ASD-specific outpatient services in the 7 to 14 weeks prior to a given week reduced the likelihood of a psychiatric hospitalization in that week by 2%. ASD-specific outpatient spending during the 6 weeks prior to a psychiatric hospitalization did not decrease risk of hospitalization. Spending on ASD-specific outpatient services did not reduce the likelihood of a psychiatric ED visit. CONCLUSIONS : The financial burden associated with ASD is extensive, and psychiatric hospitalizations remain the most expensive type of care, costing more than $4,000 per week on average. Identifying the mechanisms by which psychiatric hospitalizations occur may reduce the likelihood of these events.

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12. Wang Z, Wang Y, Sweeney JA, Gong Q, Lui S, Mosconi MW. Resting-State Brain Network Dysfunctions Associated With Visuomotor Impairments in Autism Spectrum Disorder. Front Integr Neurosci ;2019 ;13:17.

Background : Individuals with autism spectrum disorder (ASD) show elevated levels of motor variability that are associated with clinical outcomes. Cortical-cerebellar networks involved in visuomotor control have been implicated in postmortem and anatomical imaging studies of ASD. However, the extent to which these networks show intrinsic functional alterations in patients, and the relationship between intrinsic functional properties of cortical-cerebellar networks and visuomotor impairments in ASD have not yet been clarified. Methods : We examined the amplitude of low-frequency fluctuation (ALFF) of cortical and cerebellar brain regions during resting-state functional MRI (rs-fMRI) in 23 individuals with ASD and 16 typically developing (TD) controls. Regions of interest (ROIs) with ALFF values significantly associated with motor variability were identified for for patients and controls respectively, and their functional connectivity (FC) to each other and to the rest of the brain was examined. Results : For TD controls, greater ALFF in bilateral cerebellar crus I, left superior temporal gyrus, left inferior frontal gyrus, right supramarginal gyrus, and left angular gyrus each were associated with greater visuomotor variability. Greater ALFF in cerebellar lobule VIII was associated with less visuomotor variability. For individuals with ASD, greater ALFF in right calcarine cortex, right middle temporal gyrus (including MT/V5), left Heschl’s gyrus, left post-central gyrus, right pre-central gyrus, and left precuneus was related to greater visuomotor variability. Greater ALFF in cerebellar vermis VI was associated with less visuomotor variability. Individuals with ASD and TD controls did not show differences in ALFF for any of these ROIs. Individuals with ASD showed greater posterior cerebellar connectivity with occipital and parietal cortices relative to TD controls, and reduced FC within cerebellum and between lateral cerebellum and pre-frontal and other regions of association cortex. Conclusion : Together, these findings suggest that increased resting oscillations within visuomotor networks in ASD are associated with more severe deficits in controlling variability during precision visuomotor behavior. Differences between individuals with ASD and TD controls in the topography of networks showing relationships to visuomotor behavior suggest atypical patterns of cerebellar-cortical specialization and connectivity in ASD that underlies previously documented visuomotor deficits.

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13. Watanabe T, Lawson RP, Wallden YSE, Rees G. A neuroanatomical substrate linking perceptual stability to cognitive rigidity in autism. J Neurosci ;2019 (Jun 18)

Overly stable visual perception seen in individuals with autism spectrum disorder (ASD) is related to higher-order core symptoms of the condition. However, the neural basis by which these seemingly different symptoms are simultaneously observed in individuals with ASD remains unclear. Here, we aimed to identify such a neuroanatomical substrate linking perceptual stability to autistic cognitive rigidity, a part of core restricted, repetitive behaviours (RRB). First, using a bistable visual perception test, we measured the perceptual stability of 22 high-functioning adults with ASD and 22 age-/IQ-/sex-matched typically developing human individuals, and confirmed over-stable visual perception in autism. Next, by employing a spontaneous task-switching test, we identified that the individuals with ASD were more likely to repeat the same task voluntarily and spontaneously, and such rigid task-switching behaviour was associated with the severity of their RRB symptoms. We then compared these perceptual and cognitive behaviours and found a significant correlation between them for individuals with ASD. Finally, we identified that this behavioural link was supported by a smaller grey matter volume (GMV) of the posterior superior parietal lobule (pSPL) in individuals with ASD. Moreover, this smaller GMV in the pSPL was also associated with the RRB symptoms and replicated in two independent datasets. Our findings suggest that the pSPL could be one of the neuroanatomical mediators of cognitive and perceptual inflexibility in autism, which could help a unified biological understanding of the mechanisms underpinning diverse symptoms of this developmental disorder.SIGNIFICANCE STATEMENTBehavioural studies show perceptual over-stability in autism spectrum disorder (ASD). However, neural mechanisms by which such sensory symptoms can coexist and often correlate with seemingly separate core symptoms remain unknown. Here, we have identified such a key neuroanatomical substrate. We have revealed that over-stable sensory perception of individuals with autism is linked with their cognitive rigidity, a part of core restricted, repetitive behaviours symptoms, and such a behavioural link is underpinned by a smaller grey matter volume in the posterior superior parietal lobule in autism. These findings uncover a key neuroanatomical mediator of autistic perceptual and cognitive inflexibility and would ignite future studies on how the core symptoms of autism interact with its unique sensory perception.

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14. Wilczynski KM, Siwiec A, Janas-Kozik M. Systematic Review of Literature on Single-Nucleotide Polymorphisms Within the Oxytocin and Vasopressin Receptor Genes in the Development of Social Cognition Dysfunctions in Individuals Suffering From Autism Spectrum Disorder. Front Psychiatry ;2019 ;10:380.

Introduction : Autism spectrum disorder (ASD) is found in virtually all population groups regardless of ethnic or socioeconomic backgrounds. Among others, dominant symptoms of autism persistent throughout its course of development include, inter alia, qualitative disorders of social communication and social interactions. Numerous studies have been performed on animal models as well as groups of healthy individuals to assess the potential role of oxytocinergic and vasopresynergic systems in normal social functioning. These studies have also discussed their potential participation in the development of social cognition dysfunctions in the course of ASD. This literature review aimed to identify studies examining single-nucleotide polymorphisms of the oxytocin (OXT) and arginine vasopressin (AVP) receptor genes and their differential effects on social cognitive dysfunction in the development of ASD. Methods : A systematic review of literature published within the last 10 years and accessible in PubMed, Google Scholar, Cochrane Library, and APA PsycNET databases was conducted by each author separately. Inclusion criteria required that articles should 1) be published between January 2008 and August 2018 ; 2) be published in English or Polish ; 3) be located in periodical publications ; 4) focus on the role of polymorphisms within oxytocin and vasopressin receptor genes in autistic population ; 5) provide a clear presentation of the applied methodology ; and 6) apply proper methodology. Results : From the 491 studies qualified to the initial abstract analysis, 15 met the six inclusion criteria and were included in the full-text review. Conclusions : The analysis of available literature seems to indicate that there is an association between social cognition dysfunctions in the course of autism and selected alleles of polymorphisms within the OXT receptor AVP 1A receptor genes. However, previous studies neither specify the nature of this association in an unequivocal way nor select genotypes that are the basis for this association.

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