Pubmed du 11/07/19

jeudi 11 juillet 2019

1. Bartolotta T, Rizzolo D. Recognizing autism spectrum disorder. JAAPA ;2019 (Jul 8)

Autism spectrum disorder (ASD), previously called autism, is a developmental condition that can cause significant social, communication, and behavioral challenges. Early symptoms of ASD can easily be overlooked. Clinicians who can recognize the symptoms of ASD can help children get prompt referral to specialists and early intervention, which is key to improving developmental outcomes for children with ASD.

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2. Bobbette N, Donnelly C, Ufholz LA, Duggan J, Weatherbed E. Interprofessional team-based primary health care for adults with intellectual and developmental disabilities : a scoping review protocol. JBI Database System Rev Implement Rep ;2019 (Jul 8)

OBJECTIVE : This review aims to examine the state of the evidence for interprofessional team-based primary health care for adults with intellectual and developmental disabilities. INTRODUCTION : Adults with IDD have complex health needs, as well as experience health service inequities. Interprofessional primary healthcare teams offer access to comprehensive primary health care and are recommended as an approach to improve the health of this population. At present, limited information is available regarding what services interprofessional primary healthcare teams provide and how services are evaluated specific to the care of adults with intellectual and developmental disabilities. INCLUSION CRITERIA : This review will consider all studies that reference individuals with intellectual and developmental disabilities who are 18 years and over. It will consider all studies that refer to interprofessional healthcare provision within a primary healthcare team context. Interprofessional care is the term that will be used to describe services provided by interprofessional health providers (e.g. nurses, dietitians, social workers) in these teams. Work completed by physicians and nurses within traditional general practices will be excluded. METHODS : This review will be conducted according to the JBI methodology for scoping reviews. It will consider quantitative, qualitative and mixed methods study designs for inclusion. In addition, systematic reviews, program descriptions, clinical reviews and opinion papers will be considered. The review will consider all studies published since 2000 in English or French. All duplicates will be removed from identified citations. A data extraction tool will assist reviewers to identify and synthesize findings from selected papers.

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3. Crucitti J, Hyde C, Stokes MA. Hammering that Nail : Varied Praxis Motor Skills in Younger Autistic Children. J Autism Dev Disord ;2019 (Jul 11)

Previous studies measuring praxis abilities in young autistic children have only used praxis measures that were not optimised for autistic individuals. Hence, we used the FAB-R to measure praxis skills in autistic (n = 38) and typically developing (TD) children (n = 38) aged between four and 10 years. Praxis abilities were generally not different between autistic and TD children. However, total dyspraxia and errors during verbal command and tool use were impaired in autistic children from a specialist autistic school (SAS). In contrast, autistic participants from the GC typically did not differ in praxis performance compared to controls. Hence, praxis abilities significantly vary between autistic younger children. Exploring mediating influences of such variability is imperative.

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4. Davies K, Eagleson C, Weise J, Cvejic RC, Trollor JN. Clinical capacity of Australian and New Zealand psychiatrists who work with people with intellectual and developmental disabilities. Australas Psychiatry ;2019 (Jul 11):1039856219859286.

OBJECTIVE : To describe the characteristics and clinical capacity of Australian and New Zealand psychiatrists working in intellectual and developmental disability mental health (IDDMH). METHOD : Consultant psychiatrists (n=71) with an interest or expertise in IDDMH completed an online survey about their roles, experience and time spent in intellectual developmental disability (IDD)-related activities. RESULTS : Psychiatrists had worked in IDDMH for a median of 11.34 years and half (53.5%) reported expertise in the area. One-fifth of psychiatrists reported IDDMH as their main area of practice. The majority of respondents (85.1%) reported that they were working clinically with people with IDD. Respondents practicing clinically worked a median of 8 hours in clinical and 3 hours in non-clinical IDD-related work per week. CONCLUSIONS : Surveyed psychiatrists had considerable experience in IDDMH. However, their work in IDDMH represented a relatively small proportion of their overall work hours, and a minority of respondents were responsible for a large proportion of clinical work. Exploring ways to broaden capacity is crucial to ensuring the mental health needs of people with IDD are met.

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5. Eagleson C, Cvejic RC, Weise J, Davies K, Trollor JN. Subspecialty training pathways in intellectual and developmental disability psychiatry in Australia and New Zealand : current status and future opportunities. Australas Psychiatry ;2019 (Jul 11):1039856219839468.

OBJECTIVES : This study aimed to examine the training experiences of and determine capacity to train future Australian and New Zealand psychiatrists working in intellectual and developmental disability mental health. METHODS : Australian and New Zealand psychiatrists with expertise or interest in intellectual and developmental disability mental health completed an online survey detailing their training pathway, support for subspecialty training and capacity to provide rotations in this area. RESULTS : Psychiatrists (n=71) indicated the most common reasons they started practicing in intellectual and developmental disability mental health, and these included seeing people with intellectual or developmental disability in a service in which they worked, or personal experience with intellectual or developmental disability. Compared to those trained overseas, psychiatrists trained in Australia or New Zealand had lower ratings of the sufficiency of education received in intellectual and developmental disability mental health. Of the total respondents, 80% supported the development of subspecialty training. Augmentation of intellectual and developmental disability mental health content in the intermediate stage of training was also strongly supported. Participants identified 80 potential six-month training rotations in this area. CONCLUSIONS : Psychiatrists working in intellectual and developmental disability mental health strongly support enhancements to intellectual or developmental disability training, including the development of subspecialty training, and can identify potential training capacity if such subspecialty training was developed.

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6. Flippin M, Hahs-Vaughn DL. Parent couples’ participation in speech-language therapy for school-age children with autism spectrum disorder in the United States. Autism ;2019 (Jul 9):1362361319862113.

This study examined parent couples’ participation in and satisfaction with speech-language therapy for school-age children with autism spectrum disorder in the United States. Responses from 40 father-mother couples (n = 80 parents) were examined across therapy components (i.e. parent-therapist communication, assessment, planning, and intervention). Descriptive frequencies, chi-square tests, intraclass correlations, and dyadic multilevel modeling were used to examine participation across fathers and mothers and within parent couples. Compared to mothers, fathers communicated less with therapists and participated less in assessment and planning. Fathers also had lower satisfaction than mothers with parent-therapist communication and planning. Although few parents participated in school-based therapy sessions, 40% of fathers and 50% of mothers participated in homework. However, few parents received homework support from therapists. Results are discussed in terms of clinical implications for interventionists to more effectively engage both fathers and mothers in family-centered speech-language therapy for school-aged children with autism spectrum disorder.

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7. Giserman-Kiss I, Carter AS. Stability of Autism Spectrum Disorder in Young Children with Diverse Backgrounds. J Autism Dev Disord ;2019 (Jul 11)

Determining diagnostic stability of ASD, as well stability of functioning in early childhood, is relevant to prevalence, best practices for communicating early ASD diagnoses to caregivers, families’ experiences, and developmental trajectories. Generalizability of findings from prior research has been limited by small and homogenous samples, short follow-up time intervals, and inconsistent diagnostic procedures. This report presents follow-up evaluations of 60 children (86.7% male, mean age : 51.3 months) with diverse backgrounds (79.7% racial/ethnic minorities) who received initial ASD diagnoses before 36 months of age (mean age : 27 months). Fifty-three children (88.3%) met diagnostic criteria for ASD at follow-up, a proportion consistent with previous studies. On average, children demonstrated significant cognitive gains and ASD symptom improvement. Clinical implications of findings are discussed.

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8. Grossi E, Buscema M, Della Torre F, Swatzyna RJ. The "MS-ROM/IFAST" Model, a Novel Parallel Nonlinear EEG Analysis Technique, Distinguishes ASD Subjects From Children Affected With Other Neuropsychiatric Disorders With High Degree of Accuracy. Clin EEG Neurosci ;2019 (Jul 11):1550059419861007.

Background and Objective. In a previous study, we showed a new EEG processing methodology called Multi-Scale Ranked Organizing Map/Implicit Function As Squashing Time (MS-ROM/IFAST) performing an almost perfect distinction between computerized EEG of Italian children with autism spectrum disorder (ASD) and typically developing children. In this study, we assessed this system in distinguishing ASD subjects from children affected with other neuropsychiatric disorders (NPD). Methods. At a psychiatric practice in Texas, 20 children diagnosed with ASD and 20 children diagnosed with NPD were entered into the study. Continuous segments of artifact-free EEG data lasting 10 minutes were entered in MS-ROM/IFAST. From the new variables created by MS-ROM/IFAST, only 12 has been selected according to a correlation criterion. The selected features represent the input on which supervised machine learning systems (MLS) acted as blind classifiers. Results. The overall predictive capability in distinguishing ASD from other NPD cases ranged from 93% to 97.5%. The results were confirmed in further experiments in which Italian and US data have been combined. In this analysis, the best MLS reached 95.0% global accuracy in 1 out of 3 classes distinction (ASD, NPD, controls). This study demonstrates the value of EEG processing with advanced MLS in the differential diagnosis between ASD and NPD cases. The results were not affected by age, ethnicity and technicalities of EEG acquisition, confirming the existence of a specific EEG signature in ASD cases. To further support these findings, it was decided to test the behavior of already trained neural networks on 10 Italian very young ASD children (25-37 months). In this test, 9 out of 10 cases have been correctly recognized as ASD subjects in the best case. Conclusions. These results confirm the possibility of an early automatic autism detection based on standard EEG.

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9. Jensen AC, Orsmond GI. The Sisters’ Advantage ? Broader Autism Phenotype Characteristics and Young Adults’ Sibling Support. J Autism Dev Disord ;2019 (Jul 9)

Siblings often oversee the well-being of an adult with autism spectrum disorder (ASD). The current study contributes to the literature by examining correlates of support provided to siblings in young adulthood in the context of the broader autism phenotype (BAP). Young adults (n = 866 ; Mage = 25.43, SD = 2.54 ; 55% female) reported on support provided to and the BAP characteristics of 1198 different siblings (Mage = 28.56, SD = 8.87 ; 50% female). Findings showed that young adults provided more emotional and practical support to sisters that they perceived to be higher in BAP characteristics. These findings suggest that sisters who have characteristics associated with ASD may be at an advantage in receiving support.

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10. Kumazaki H. [Current Status of Robotic Research for Individuals with Autism Spectrum Disorders]. Brain Nerve ;2019 (Jul) ;71(7):785-791.

Individuals with autism spectrum disorders (ASD) can face lifelong challenges. There are a variety of therapeutic and educational approaches, any of which may have educational benefits for some but not all individuals with ASD. The latest progress in humanoid robotics is remarkable. Many individuals with ASD are interested in robotic technology, and interventions using humanoid robotics have received ircreasing attention. In this paper, We will review the current status of robotic research for individuals with ASD.

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11. Parsons D, Wilson NJ, Vaz S, Lee H, Cordier R. Appropriateness of the TOBY Application, an iPad Intervention for Children with Autism Spectrum Disorder : A Thematic Approach. J Autism Dev Disord ;2019 (Jul 9)

This study aimed to explore the appropriateness of an ICT intervention, the Therapeutic Outcomes by You application (TOBY app), from the perspectives of the parents. Parental experiences of twenty-four parents of a child with ASD who had participated in a three-month trial using the TOBY app were collected using semi-structured interviews. Thematic analysis was conducted and themes were mapped against an appropriateness framework. Collectively, parents felt the TOBY app was relevant and important to them and their children’s needs, while expressing partial support of the TOBY app as : a positive experience for them and their children, beneficial for them and their children, a socially and ecological valid intervention, and an intervention that supported change and continuation in the skills learnt.

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12. Pua EPK, Ball G, Adamson C, Bowden S, Seal ML. Quantifying individual differences in brain morphometry underlying symptom severity in Autism Spectrum Disorders. Sci Rep ;2019 (Jul 9) ;9(1):9898.

The neurobiology of heterogeneous neurodevelopmental disorders such as autism spectrum disorders (ASD) are still unclear. Despite extensive efforts, most findings are difficult to reproduce due to high levels of individual variance in phenotypic expression. To quantify individual differences in brain morphometry in ASD, we implemented a novel subject-level, distance-based method on subject-specific attributes. In a large multi-cohort sample, each subject with ASD (n = 100 ; n = 84 males ; mean age : 11.43 years ; mean IQ : 110.58) was strictly matched to a control participant (n = 100 ; n = 84 males ; mean age : 11.43 years ; mean IQ : 110.70). Intrapair Euclidean distance of MRI brain morphometry and symptom severity measures (Social Responsiveness Scale) were entered into a regularised machine learning pipeline for feature selection, with rigorous out-of-sample validation and permutation testing. Subject-specific structural morphometry features significantly predicted individual variation in ASD symptom severity (19 cortical thickness features, p = 0.01, n = 5000 permutations ; 10 surface area features, p = 0.006, n = 5000 permutations). Findings remained robust across subjects and were replicated in validation samples. Identified cortical regions implicate key hubs of the salience and default mode networks as neuroanatomical features of social impairment in ASD. Present results highlight the importance of subject-level markers in ASD, and offer an important step forward in understanding the neurobiology of heterogeneous disorders.

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13. Robison MA, Mann TB, Ingvarsson ET. Life skills instruction for children with developmental disabilities. J Appl Behav Anal ;2019 (Jul 10)

The Preschool Life Skills program is an intervention package designed to teach functional skills to prevent problem behavior in typically developing children. The purpose of the current study was to evaluate the effects of the instructional package (renamed "Life Skills") with children with developmental disabilities. The program involved teaching 12 life skills to nine participants across four instructional units. The units were instruction following, functional communication, tolerance of denial and delay, and friendship skills. Teachers provided instruction through a three-tiered instructional approach, starting with class-wide instruction followed by small group and one-to-one instruction as necessary. We extended previous research by using visual prompts during all three tiers and progressively increasing intertrial intervals during one-to-one instruction. Results indicated that the intervention led to skill acquisition with all nine participants. The skills maintained 4 weeks after instruction ended.

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14. Rydzewska E, Hughes-McCormack LA, Gillberg C, Henderson A, MacIntyre C, Rintoul J, Cooper SA. Age at identification, prevalence and general health of children with autism : observational study of a whole country population. BMJ Open ;2019 (Jul 9) ;9(7):e025904.

OBJECTIVES : Reported childhood prevalence of autism varies considerably between studies and over time, and general health status has been little investigated. We aimed to investigate contemporary prevalence of reported autism by age, and general health status of children/young people with and without autism. DESIGN : Secondary analysis of Scotland’s Census, 2011 data. Cross-sectional study. SETTING : General population of Scotland. PARTICIPANTS : All children (n=916 331) and young people (n=632 488) in Scotland. MAIN OUTCOME MEASURES : Number (%) of children/young people reported to have autism and their general health status ; prevalence of autism ; prevalence of poor health (fair, bad and very bad health) ; odds ratios (95% confidence intervals) of autism predicting poor health, adjusted for age and gender and OR for age and gender in predicting poor health within the population with reported autism. RESULTS : Autism was reported for 17 348/916 331 (1.9%) children aged 0-15, and 7715/632 488 (1.2%) young people aged 16-24. The rate increased to age 11 in boys and age 10 in girls, reflecting age at diagnosis. Prevalence was 2.8% at age 10 (4.4% for boys ; 1.1% for girls), and 2.9% at age 11 (4.5% for boys ; 1.1% for girls). 22.0% of children and 25.5% of young people with autism reported poor health, compared with 2.0% and 4.4% without autism. Autism had OR=11.3 (11.0 to 11.7) in predicting poor health. Autistic females had poorer health than autistic males, OR=1.6 (1.5 to 1.8). CONCLUSION : Accurate information on the proportion of autistic children and their health status is essential plan appropriate prevention and intervention measures and provide resources for those who may put demand on services designed for autistic people.

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15. Sheinerman K, Djukic A, Tsivinsky VG, Umansky SR. Brain-enriched microRNAs circulating in plasma as novel biomarkers for Rett syndrome. PLoS One ;2019 ;14(7):e0218623.

Rett syndrome (RTT) is a severe neurodevelopmental disorder caused by mutations in the X-linked gene MECP2 (methyl-CpG-binding protein 2). Minimally invasive and accurate biomarkers of disease progression and treatment response could facilitate screening of therapeutic compounds in animal models, enrollment of better-defined participants into clinical trials, and treatment monitoring. In this study, we used a targeted approach based on analysis of brain-enriched microRNAs (miRNAs) circulating in plasma to identify miRNA biomarkers of RTT using Mecp2-mutant mice as a model system and human plasma samples. An "miRNA pair" approach, i.e. the ratio between two miRNAs, was used for data normalization. Specific miRNA pairs and their combinations (classifiers) analyzed in plasma differentiated wild-type from Mecp2 male and female mice with >90% accuracy. Individual miRNA pairs were more effective in distinguishing male (homozygous) animals than female (heterozygous) animals, suggesting that disease severity correlated with the levels of the miRNA biomarkers. In the human study, 30 RTT patients were compared with age-matched controls. The results of this study showed that miRNA classifiers were able to differentiate RTT patients from controls with 85-100% sensitivity. In addition, a comparison of various age groups demonstrated that the dynamics in levels of miRNAs appear to be associated with disease development (involvement of liver, muscle and lipid metabolism in the pathology). Importantly, certain miRNA biomarker pairs were common to both the animal models and human subjects, indicating the similarity between the underlying pathological processes. The data generated in this feasibility study suggest that circulating miRNAs have the potential to be developed as markers of RTT progression and treatment response. Larger clinical studies are needed to further evaluate the findings presented here.

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16. Thorkelson G, Laughlin SF, Turner KS, Ober N, Handen BL. Selective Serotonin Reuptake Inhibitor Monotherapy for Anxiety Disorders in Children and Adolescents with Autism Spectrum Disorder : A Chart Review. J Child Adolesc Psychopharmacol ;2019 (Jul 11)

Objective : Anxiety disorders are one of the most commonly co-occurring psychiatric diagnoses in youth with autism spectrum disorder (ASD), with a frequency ranging from 22% to 84%. Methods : We conducted a chart review of 29 children and adolescents with ASD who had been treated with selective serotonin reuptake inhibitor (SSRI) monotherapy for an anxiety disorder for at least 2 months. Subsequent chart reviews were conducted for the first follow-up visit within 2-6 months (M = 4.2 months) and the visit closest to 9 months posttreatment (ranging from 7 to 12 months ; M = 10.5 months). The presence of adverse events (AEs) was examined, and a consensus Clinical Global Impressions Improvement (CGI-I) score was determined. Results : Fifty-five percent of patients were given a CGI-I of "improved" or "very much improved" at the 9-month follow-up. Four patients discontinued treatment owing to AEs. Other reported AEs not leading to discontinuation included vivid dreaming, increased emotional lability, and irritability. Responders included a number of patients who had failed previous SSRI trials. Conclusions : This study suggests that SSRI treatment should be considered for individuals with ASD and anxiety disorders, even if prior SSRI trials have been unsuccessful.

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17. Trembath D, Gurm M, Scheerer NE, Trevisan DA, Paynter J, Bohadana G, Roberts J, Iarocci G. Systematic review of factors that may influence the outcomes and generalizability of parent-mediated interventions for young children with autism spectrum disorder. Autism Res ;2019 (Jul 11)

Parent mediated interventions have the potential to positively influence the interactions and developmental outcomes of children with autism spectrum disorder (ASD). However, a range of factors relating to children, parents and caregivers, and study design may impact on outcomes and thus the generalizability of these interventions to the broader community. The objective of this review was to examine factors that may influence the feasibility, appropriateness, effectiveness, and generalizability of parent mediated interventions for children with ASD. We conducted a systematic review, yielding 41 articles. There was substantial variability in the intervention type, intensity, and study quality. Notably, 46 different inclusion/exclusion criteria were reported across studies including factors relating to children’s development, access to other services, comorbidities, parental factors, and access to the intervention. Fifteen articles included examination of 45 different factors potentially associated with, or influencing, intervention outcomes including child (e.g., language skills, ASD severity, cognition) and parent (e.g., adherence and fidelity, education) factors. Although there is clear evidence for an increasingly sophisticated (e.g., systematic phased research for some interventions) and diverse (e.g., studies in geographical diverse contexts including low-resource communities) approach to research examining parent mediated interventions, there remains a need for improved study quality and measurement consistency in research, including a detailed examination of factors that may predict, moderate, and mediate intervention effectiveness for children and their parents. Autism Res 2019, (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Parent mediated interventions-in which parents adapt their own behavior or deliver interventions to help their children learn-appear to be effective for some children with autism spectrum disorder. In this review, we identified a range of child, parent, and study design factors that may influence intervention outcomes and ultimately the uptake of these approaches in the community. We suggest that research in this area could be further improved by ensuring that studies include diverse groups of children and parents, and by using study designs that help to establish not only if interventions work, but for whom they work best and why.

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18. Vasilevska Petrovska I, Trajkovski V. Effects of a Computer-Based Intervention on Emotion Understanding in Children with Autism Spectrum Conditions. J Autism Dev Disord ;2019 (Jul 9)

This randomized controlled study evaluated a computer-based intervention on emotion understanding in 32 children with autism spectrum conditions with and without intellectual disability (ID) aged 7-15 years. The intervention group (n = 16) used the program for 12 h while the control group (n = 16) was not included in any intervention or training beside the usual educational curriculum. After controlling for pre-intervention scores and symptom severity, strong positive effects were observed in emotion recognition from real face photographs and pictograms, as well as in understanding situation-based emotion across both intellectual ability groups. The typical and ID intervention groups performed significantly better on all EU measures, compared to controls, at the level of feature based distant generalization.

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