Pubmed du 25/07/19

jeudi 25 juillet 2019

1. Alshammari MS, Afify AAM, Abdelhay O. Perception and convenience of caring for children with autism spectrum disorder among family medicine residents in Riyadh 2018. J Family Med Prim Care ;2019 (Jun) ;8(6):1902-1907.

Background : Autism spectrum disorder (ASD) is a group of childhood pervasive neurodevelopmental disorders characterized predominantly by persistent moderate to severe impairment in social skills, communication, and associated with restricted repetitive or stereotyped behaviors. Early diagnosis of this disorder is paramount, which then allows for a timely intervention to facilitate a positive prognosis. To the best of our knowledge, there is no study that has investigated the perception of ASD among family medicine residents in Saudi Arabia. Objective : To determine the level of awareness of childhood autism among family medicine residents in Riyadh. Settings and Design : A cross-sectional study was conducted in nine teaching primary healthcare centers in Riyadh. Materials and Methods : The questionnaire was adopted from Unigwe et al. study and distributed to 344 available physicians, of which 277 were received back completed. Results : Only 28 physicians (10.1%) answered positively if they had previously attended any ASD workshops or conferences. In addition, only 29 participants (10.5%) correctly answered 50% or more questions. The question that yielded the lowest scoring was "Recognizing the signs and symptoms of autism in individuals with good language and no apparent intellectual difficulties", while the question with the highest scoring was "Identifying stress in the parents and carers of my patients with autism." The regression analysis showed no association between the scores and the physicians’ characteristics. Conclusions : The results show a low awareness level and moderate to low level of confidence in the physicians ability to recognize, identify, or communicate in regards to ASD. We recommend integrating lectures and clinical exposure of ASD to the residency training program curriculum.

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2. Cao W, Song W, Li X, Zheng S, Zhang G, Wu Y, He S, Zhu H, Chen J. Interaction With Social Robots : Improving Gaze Toward Face but Not Necessarily Joint Attention in Children With Autism Spectrum Disorder. Front Psychol ;2019 ;10:1503.

It is widely recognized that robot-based interventions for autism spectrum disorders (ASD) hold promise, but the question remains as to whether social humanoid robots could facilitate joint attention performance in children with ASD. In this study, responsive joint attention was measured under two conditions in which different agents, a human and a robot, initiated joint attention via video. The participants were 15 children with ASD (mean age : 4.96 +/- 1.10 years) and 15 typically developing (TD) children (mean age : 4.53 +/- 0.90 years). In addition to analyses of fixation time and gaze transitions, a longest common subsequence approach (LCS) was employed to compare participants’ eye movements to a predefined logical reference sequence. The fixation of TD toward agent’s face was earlier and longer than children with ASD. Moreover, TD showed a greater number of gaze transitions between agent’s face and target, and higher LCS scores than children with ASD. Both groups showed more interests in the robot’s face, but the robot induced a lower proportion of fixation time on the target. Meanwhile participants showed similar gaze transitions and LCS results in both conditions, suggesting that they could follow the logic of the joint attention task induced by the robot as well as human. We have discussed the implications for the effects and applications of social humanoid robots in joint attention interventions.

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3. Casassus M, Poliakoff E, Gowen E, Poole D, Jones LA. Time perception and autistic spectrum condition : A systematic review. Autism Res ;2019 (Jul 23)

Problems with timing and time perception have been suggested as key characteristics of autism spectrum condition (ASC). Studies and personal accounts from clinicians, parents, caregivers, and self-reports from autistic people themselves often refer to problems with time. Although a number of empirical studies have examined aspects relating to time in autistic individuals, there remains no clear consensus on whether or how timing mechanisms may be affected in autism. A key reason for this lack of clarity is the wide range of timing processes that exist and subsequently the wide range of methodologies, research paradigms, and samples that time-based studies have used with autism populations. In order to summarize and organize the available literature on this issue, a systematic review was conducted. Five electronic databases were consulted. From an initial 597 records (after duplicates were removed), 45 papers were selected and reviewed. The studies are reviewed within different sections based on the different types of timing ability that have been explored in the neurotypical (NT) population : time sensitivity, interval timing, and higher-order time perception. Within each section cognitive models, methodologies, possible clinical implications, and research results are discussed. The results show different consistency across studies between the three types of timing ability. The highest consistency of results showing atypical time perception abilities is found in high-level time perception studies. It remains unclear if autism is characterized by a fundamental time perception impairment. Suggestions for future research are discussed. Autism Res 2019, (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : This systematic review examines the different types of timing and time perception behavior that have been investigated in autism. Overall, there are a number of studies that show differences between autistic and non-autistic individuals, but some studies do not find such differences. Group differences are more consistent across studies using complex tasks rather than simpler more fundamental timing tasks. We suggest that experiments across a range of timing tasks would be fruitful to address gaps in our knowledge.

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4. Dekhil O, Ali M, El-Nakieb Y, Shalaby A, Soliman A, Switala A, Mahmoud A, Ghazal M, Hajjdiab H, Casanova MF, Elmaghraby A, Keynton R, El-Baz A, Barnes G. A Personalized Autism Diagnosis CAD System Using a Fusion of Structural MRI and Resting-State Functional MRI Data. Front Psychiatry ;2019 ;10:392.

Autism spectrum disorder is a neuro-developmental disorder that affects the social abilities of the patients. Yet, the gold standard of autism diagnosis is the autism diagnostic observation schedule (ADOS). In this study, we are implementing a computer-aided diagnosis system that utilizes structural MRI (sMRI) and resting-state functional MRI (fMRI) to demonstrate that both anatomical abnormalities and functional connectivity abnormalities have high prediction ability of autism. The proposed system studies how the anatomical and functional connectivity metrics provide an overall diagnosis of whether the subject is autistic or not and are correlated with ADOS scores. The system provides a personalized report per subject to show what areas are more affected by autism-related impairment. Our system achieved accuracies of 75% when using fMRI data only, 79% when using sMRI data only, and 81% when fusing both together. Such a system achieves an important next step towards delineating the neurocircuits responsible for the autism diagnosis and hence may provide better options for physicians in devising personalized treatment plans.

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5. Du Y, Li Z, Liu Z, Zhang N, Wang R, Li F, Zhang T, Jiang Y, Zhi X, Wang Z, Wu J. Nonrandom occurrence of multiple de novo coding mutations in a proband indicates the existence of an oligogenic model in autism. Genet Med ;2019 (Jul 23)

PURPOSE : Elucidating the genetic architecture underlying autism spectrum disorder (ASD) will aid in the understanding of its genetic etiology and clinical diagnosis. METHODS : A comprehensive set of coding de novo mutations (DNMs) from 4504 trios with ASD and 3012 control/sibling trios from several large-scale sequencing studies were collected and combined. Multiple in-depth analyses including DNMs burden, clinical phenotypes, and functional networks underlying the combined data set were used to evaluate the nonrandom occurrence of multiple extreme DNMs (loss-of-function and damaging missense variants) in the same patients. RESULTS : We observed a significant excess of multiple extreme DNMs among patients with ASD compared with controls. Meanwhile, patients with ASD carrying 2+ extreme DNMs had significantly lower IQs than patients carrying 0 or 1 DNM. Moreover, much closer functional connectivity than expected was observed among 2 or more genes with extreme DNMs from the same individuals. In particular, we identified 56 key genes as more confident ASD genes compared with other known ASD genes. In addition, we detected 23 new ASD candidate genes with recurrent DNMs, including VIP, ZWILCH, MSL2, LRRC4, and CAPRIN1. CONCLUSIONS : Our findings present compelling statistical evidence supporting an oligogenic model and provide new insights into the genetic architecture of ASD.

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6. Ford TC, Crewther DP, Abu-Akel A. Psychosocial deficits across autism and schizotypal spectra are interactively modulated by excitatory and inhibitory neurotransmission. Autism ;2019 (Jul 24):1362361319866030.

Continued human and animal research has strengthened evidence for aberrant excitatory-inhibitory neural processes underlying autism and schizophrenia spectrum disorder psychopathology, particularly psychosocial functioning, in clinical and nonclinical populations. We investigated the extent to which autistic traits and schizotypal dimensions were modulated by the interactive relationship between excitatory glutamate and inhibitory GABA neurotransmitter concentrations in the social processing area of the superior temporal cortex using proton magnetic resonance spectroscopy. In total, 38 non-clinical participants (20 females ; age range = 18-35 years, mean (standard deviation) = 23.22 (5.52)) completed the autism spectrum quotient and schizotypal personality questionnaire, and underwent proton magnetic resonance spectroscopy to quantify glutamate and GABA concentrations in the right and left superior temporal cortex. Regression analyses revealed that glutamate and GABA interactively modulated autistic social skills and schizotypal interpersonal features (pcorr < 0.05), such that those with high right superior temporal cortex glutamate but low GABA concentrations exhibited poorer social and interpersonal skills. These findings evidence an excitation-inhibition imbalance that is specific to psychosocial features across the autism and schizophrenia spectra.

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7. Friedman L, Sterling A, DaWalt LS, Mailick MR. Conversational Language Is a Predictor of Vocational Independence and Friendships in Adults with ASD. J Autism Dev Disord ;2019 (Jul 23)

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder, impacting social communication and in some individuals, aspects of language such as vocabulary diversity. However, we have only a limited understanding of the verbal language abilities of adults with ASD. The present longitudinal study examined conversational language and its impact on vocational independence and friendship status measured 5 years later in a sample of 84 adults with ASD. After controlling for IQ and childhood language, vocabulary diversity (a measure of structural language) predicted vocational independence and having friendships, while topic maintenance (a measure of social communication) predicted friendships. These findings highlight the importance of adult conversational language abilities for adult outcomes and quality of life.

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8. Gulati P, Jain P, Borlot F, Munn R, Ochi A. Teaching Video NeuroImages : Needle-like central spikes evoked by hand tapping in Rett syndrome. Neurology ;2019 (Jul 23) ;93(4):e422-e423.

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9. Hendaus MA, Jomha FA, Alhammadi AH. Vasopressin in the Amelioration of Social Functioning in Autism Spectrum Disorder. J Clin Med ;2019 (Jul 19) ;8(7)

Autism spectrum disorder (ASD) is a developmental disability described by diagnostic criteria that comprise deficits in social communication and the existence of repetitive, restricted patterns of behavior, interests, or activities that can last throughout life. Many preclinical studies show the importance of arginine vasopressin (AVP) physiology in social functioning in several mammalian species. Currently, there is a trend to investigate more specific pharmacological agents to improve social functioning in patients with ASD. Neurobiological systems that are crucial for social functioning are the most encouraging conceivable signaling pathways for ASD therapeutic discovery. The AVP signaling pathway is one of the most promising. The purpose of this commentary is to detail the evidence on the use of AVP as an agent that can improve social functioning. The pharmacologic aspects of the drug as well as its potential to ameliorate social functioning characteristics in human and animal studies are described in this manuscript. AVP, especially in its inhaled form, seems to be safe and beneficial in improving social functioning including in children with autism. Larger randomized studies are required to implement a long awaited safe and feasible treatment in people with a deficiency in social functioning.

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10. Jain A, Ahmed N, Mahour P, Agarwal V, Shrivastav NK, Chandrakanta. Quality of Life of Caregivers of Autistic Children and Adolescents Visiting Health Facilities in Lucknow City, Uttar Pradesh, India : A Cross-sectional Study. Indian J Community Med ;2019 (Apr-Jun) ;44(2):157-161.

Background : The lifelong responsibility of the autistic children along with the lack of knowledge, lack of treatment, and if treatment is available, it is unaffordable leads to deterioration of quality of life of the parents in several domains. Objectives : The objective is to study the quality of life of principal caregivers of autistic children and adolescents visiting health facilities in Lucknow city. Materials and Methods : The sample included 90 principal caregivers (aged < 60 years) of autistic children and adolescents aged 3-19 years and diagnosed with autism, attending government and private health facilities providing treatment for autism in Lucknow, Uttar Pradesh, India. Results : The quality of life of principal caregivers was found to be influenced most in the physical health domain (with least score). The predictors of quality of life of principal caregivers were type of family and knowledge regarding child’s problem. Conclusion and Recommendations : Thus, there is an immense need of increasing awareness through information, education, and communication materials, mass media, and discussions regarding autism.

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11. Maia FA, Oliveira LMM, Almeida MTC, Alves MR, Saeger VSA, Silva VBD, Oliveira VSD, Martelli Junior H, Brito M, Silveira MFD. AUTISM SPECTRUM DISORDER AND POSTNATAL FACTORS : A CASE-CONTROL STUDY IN BRAZIL. Rev Paul Pediatr ;2019 (Jul 18)

OBJECTIVE : To estimate the magnitude of the association between Autism Spectrum Disorder (ASD) and postnatal factors in a Brazilian population. METHODS : A case-control study was performed with 253 individuals diagnosed with ASD and 886 individuals without signs of the disorder. A semi-structured questionnaire and the multiple logistic regression model were adopted in the data analysis. To estimate the magnitude of associations, the crude and adjusted Odds Ratio (OR) was used. RESULTS : An association with the following factors was found : having been born with congenital malformation (OR 4.24 ; confidence interval of 95% - 95%CI 1.92-9.34), neonatal jaundice (OR 1.43 ; 95%CI 1.01-2.02), absence of crying at birth and seizure episode in childhood (OR 5.75 ; 95%CI 3.37-9.81). The magnitude of the association was higher in the children/adolescents who had two or more postnatal complications (OR 6.39 ; 95%CI 4.10-10.00). CONCLUSIONS : The findings of the present study suggest that malformation, neonatal jaundice, absence of crying at birth and seizure episodes in childhood are important factors to be considered when studying the etiology of ASD.

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12. Mangione F, Bdeoui F, Monnier-Da Costa A, Dursun E. Autistic patients : a retrospective study on their dental needs and the behavioural approach. Clin Oral Investig ;2019 (Jul 22)

INTRODUCTION : Autism spectrum disorder (ASD) is a lifelong heterogeneous psychiatric disorder that represents a challenge for dentists. The aim of this retrospective study was to analyse ASD patients’ dental needs and to investigate key factors influencing the behavioural management. MATERIALS AND METHODS : One hundred eighteen ASD subjects (levels 2 and 3 of the DSM-5), adults and children, treated at university dental hospital, were included. For each of them, an index card was created to record general and medical information, dental care progress and treatment management. Data were analysed to characterize this specific population in terms of dental needs, technical approach and follow-up. The relationships between care approach and age (ANOVA test), care approach and concomitant pathologies as well as care approach and required treatment (chi-square test) were evaluated. RESULTS : Almost all patients required oral care. No treatment could be provided under conscious conditions. Oral premedication and/or nitrous oxide/oxygen inhalation was significantly more efficient in children and allowed conservative procedures. In adults, general anaesthesia was significantly more employed. Few patients were followed up over a long period. CONCLUSIONS : The variety of autism spectrum disorders complicates the statement of guidelines for dental care. The development of the collaboration between psychiatrics and dentists emerges as a key factor to improve the quality and the success of oral outpatient treatment. CLINICAL RELEVANCE : Oral premedication and/or nitrous oxide/oxygen inhalation at high dose represented a good way to carry out conservative dental cares, with a significant efficiency in children. Nevertheless, in a considerable number of ASD patients, especially in adults, general anaesthesia could not be avoided.

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13. Mann CC, Karsten AM. Efficacy and social validity of procedures for improving conversational skills of college students with autism. J Appl Behav Anal ;2019 (Jul 22)

Better conversational skills correspond to a higher quality of life for adults diagnosed with autism spectrum disorder (ASD). In this study, we taught vocal-verbal responses discriminated by compound arrangements of concealed conversation partner mands to two college students with ASD. Participants learned to engage in self-questioning about their conversation partner’s behavior and to reinforce three concealed mands for termination of an aversive conversation scenario. We assessed generalization to conversation probes with trained confederates and to interactions with untrained conversational partners (e.g., peers, professors). Finally, we collected peer ratings of the social validity of changes in conversational behavior as well as participants’ ratings of study goals, procedures, and outcomes.

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14. Marquis SM, McGrail K, Hayes MV. A population-level study of the mental health of siblings of children who have a developmental disability. SSM Popul Health ;2019 (Aug) ;8:100441.

This study used population level administrative data for health service utilization from the Ministry of Health, British Columbia, Canada to assess the mental health of siblings of children who have a developmental disability. At a population level, the study found strong evidence that siblings of children who have a developmental disability experience higher odds of a depression or other mental health diagnosis compared to siblings of children who do not have a developmental disability. In addition, there was evidence that in families with a child with a developmental disability, siblings who are diagnosed with depression or another mental health problem use physician and/or hospital services for these conditions to a greater extent than siblings who are diagnosed with depression or a mental health problem but do not have a family member with a developmental disability. Evidence of increased depression and mental health problems existed across all income levels, indicating that other stressors may have an impact. These findings suggest that siblings of children who have a developmental disability are a vulnerable group in need of programs and services that support their mental health.

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15. Mouro FM, Miranda-Lourenco C, Sebastiao AM, Diogenes MJ. From Cannabinoids and Neurosteroids to Statins and the Ketogenic Diet : New Therapeutic Avenues in Rett Syndrome ?. Front Neurosci ;2019 ;13:680.

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder caused mainly by mutations in the MECP2 gene, being one of the leading causes of mental disability in females. Mutations in the MECP2 gene are responsible for 95% of the diagnosed RTT cases and the mechanisms through which these mutations relate with symptomatology are still elusive. Children with RTT present a period of apparent normal development followed by a rapid regression in speech and behavior and a progressive deterioration of motor abilities. Epilepsy is one of the most common symptoms in RTT, occurring in 60 to 80% of RTT cases, being associated with worsening of other symptoms. At this point, no cure for RTT is available and there is a pressing need for the discovery of new drug candidates to treat its severe symptoms. However, despite being a rare disease, in the last decade research in RTT has grown exponentially. New and exciting evidence has been gathered and the etiopathogenesis of this complex, severe and untreatable disease is slowly being unfolded. Advances in gene editing techniques have prompted cure-oriented research in RTT. Nonetheless, at this point, finding a cure is a distant reality, highlighting the importance of further investigating the basic pathological mechanisms of this disease. In this review, we focus our attention in some of the newest evidence on RTT clinical and preclinical research, evaluating their impact in RTT symptomatology control, and pinpointing possible directions for future research.

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16. Sayad A, Ghafouri-Fard S, Noroozi R, Omrani MD, Ganji M, Dastmalchi R, Glassy M, Taheri M. Association Study of Sequence Variants in Voltage-gated Ca2+ Channel Subunit Alpha-1C and Autism Spectrum Disorders. Rep Biochem Mol Biol ;2019 (Apr) ;8(1):56-62.

Background : Autism spectrum disorders (ASDs) (MIM 209850) are a group of distinct neurodevelopmental disorders characterized by impaired social interactions and communication abilities and abnormal repetitive activities. Many genetic variants have been shown to be associated with ASD. Channelopathies are among putative culprits in the pathogenesis of many neurodevelopmental disorders, including autism. The calcium channel, voltage-dependent, L type, alpha 1C subunit gene (CACNA1C) encodes an alpha-1 subunit of a voltage-dependent calcium channel. Genetic variants within this gene have been associated with psychiatric disorders including Autism Spectrum Disorders (ASD). Our aim was to determine whether the SNPs rs1006737, rs4765905, and rs4765913 were associated with ASD in an Iranian population. Methods : In the present case-control study we investigated the associations of rs1006737, rs4765905, and rs4765913 polymorphisms within CACNA1C and the risk of ASD in a population of 529 Iranian ASD patients and 480 age, gender, and ethnicity-matched healthy subjects. Results : None of these SNPs were associated with ASD risk in the assessed population. Although previous studies have shown an association between these polymorphisms and psychiatric disorders and an association between rs4765905 and ASD, we did not replicate those results in our study. Conclusion : Our data indicate that these CACNA1C variants are not involved in the pathogenesis of ASD in the Iranian population.

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17. Schneider M, VanOrmer J, Zlomke K. Adverse Childhood Experiences and Family Resilience Among Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. J Dev Behav Pediatr ;2019 (Jul 16)

OBJECTIVES : The purpose of the present study was to (1) examine the differences in adverse childhood experiences (ACEs) among children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and comorbid ASD/ADHD and healthy neurodevelopmental controls ; (2) explore the levels of family resilience across diagnostic categories ; (3) identify the differences in family resilience by the number of ACEs ; and (4) explore the interaction between ACEs and the diagnostic category on family resilience. METHOD : Participants were 2083 children between the ages of 6 and 17 years (M = 12.23, SD = 3.36) from the 2016 National Survey of Children’s Health. The majority of the sample were male (68.7%) and white (78.6%). RESULTS : Overall, youth diagnosed with solely ADHD had the highest number of ACEs (Madj = 1.94). In addition, individuals who endorsed exposure to 1 ACE reported higher levels of family resilience in comparison to those who reported 0 ACEs or 2 or more ACEs. Family resilience did not differ between youth who experienced 2 or more ACEs and youth who experienced 0 ACEs. Youth diagnosed with comorbid ASD/ADHD had the lowest levels of family resilience. Interestingly, family resilience did not differ between ADHD and neurotypical youth. CONCLUSION : Youth diagnosed with ADHD seem to be at the highest risk for ACEs. Those with comorbid ASD/ADHD report the lowest levels of family resilience when controlling for exposure to ACEs. Families of youth with ASD had lower levels of family resilience than those of neurotypical youth when controlling for exposure to ACEs, whereas families of youth with solely ADHD displayed similar levels of family resilience in comparison to neurotypical youth and their families. Results have implications for prevention and intervention with ASD and/or ADHD youth and their families.

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18. Shivers CM. Empathy and perceptions of their brother or sister among adolescent siblings of individuals with and without autism spectrum disorder. Res Dev Disabil ;2019 (Jul 20) ;92:103451.

BACKGROUND : Although clinicians have hypothesized that siblings of individuals with intellectual and developmental disabilities, including autism spectrum disorder (ASD), may exhibit more empathy and understanding of others, no studies have yet examined empathy among siblings of individuals with ASD. AIMS : The current study examined self- reported empathy and feelings about adolescents’ brothers or sisters with and without ASD. METHODS AND PROCEDURES : Adolescent siblings (age 12-18) of individuals with (n=26) or without ASD (n=48) completed an online survey with measures of empathy and their feelings about their brother or sister, as well as an open ended task asking them for three "magic wishes." OUTCOMES AND RESULTS : Siblings of individuals with ASD (ASD- Sibs) reported significantly more perspective-taking than did siblings of typically-developing individuals (TD-Sibs). Perspective-taking was significantly related to feelings of positive affect toward the brother/sister for both groups. ASD-Sibs also were significantly more likely to report wishes related to their family, while TD-Sibs reported more wishes for themselves. CONCLUSIONS AND IMPLICATIONS : Findings suggest that potentially higher levels of perspective-taking ability among ASD-Sibs may contribute to better understanding of and therefore more positive affect toward their brother or sister with ASD. More research is needed to understand patterns of empathy among ASD-Sibs.

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19. Toseeb U, McChesney G, Oldfield J, Wolke D. Sibling Bullying in Middle Childhood is Associated with Psychosocial Difficulties in Early Adolescence : The Case of Individuals with Autism Spectrum Disorder. J Autism Dev Disord ;2019 (Jul 22)

Sibling bullying is associated with various psychosocial difficulties. We investigated this in 231 individuals with Autism Spectrum Disorder (ASD) and 8180 without ASD between middle childhood (age 11 years) and early adolescence (age 14 years). On the whole, self-reported sibling bullying decreased from middle childhood to early adolescence. Despite this, individuals with ASD continued to report more sibling bullying as both perpetrator and victim in early adolescence than those without ASD. We found that self-report sibling bullying in middle childhood was associated with psychosocial difficulties in early adolescence. Moreover, individuals with ASD were more likely to report being bullied by both siblings and peers in middle childhood and this pattern of victimisation was associated with concurrent and longitudinal psychosocial difficulties.

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20. Unterrainer JM, Rahm B, Loosli SV, Rauh R, Schumacher LV, Biscaldi M, Kaller CP. Psychometric analyses of the Tower of London planning task reveal high reliability and feasibility in typically developing children and child patients with ASD and ADHD. Child Neuropsychol ;2019 (Jul 23):1-17.

The Tower of London (TOL) is probably the most often used assessment tool for planning ability in healthy and clinical samples. Various versions, including our proposed standard problem set, have proven to be feasible and reliable in adults. In contrast, reliability information for typically developing (TD) children and neurodevelopmental disorders during childhood are largely missing. Also, it would be highly desirable to attain a problem set that can be used across the whole lifespan. Therefore, here we examine reliability of our proposed standard problem set using a computerized TOL version in 178 TD children (two different samples), 49 children with high-functioning autism spectrum disorder (ASD) and 56 children with attention-deficit/hyperactivity disorder (ADHD) (age ranges of each group 6 to 13 years), and 130 young adults (age range 18 to 32 years). Greatest lower bound estimates of reliability were adequate to high in the two samples of TD children (.76 and .80) and high to very high in patients (ASD : .90 ; ADHD : .83). In young adults, all reliability indices were adequate to high. Moreover, a subset of four- and five-move problems exhibited sufficient performance variability and high part-whole correlations with the complete problem set in all samples. These findings demonstrate the reliability of the presented TOL problem set in both clinical and non-clinical child samples. A clinically feasible subset of four- and five-move problems is reflective of overall planning performance at all ages, hence enabling comparisons of planning ability within and between developmental samples across almost the whole lifespan.

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21. van Elst LT. [High-functioning autism spectrum disorders in adults]. Fortschr Neurol Psychiatr ;2019 (Jul) ;87(7):381-397.

High-functioning autism spectrum disorders represent an important differential diagnosis not only in pediatric but also in adult psychiatry as well as psychotherapy. Although the topic is getting increasing attention, especially in science, it has still barely arrived in everyday clinical life of psychiatric-psychotherapeutic care.

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22. Wild H, Tobe RH. Oral Contraceptives Reduced Pica Behavior in a Female with Autism Spectrum Disorder. J Child Adolesc Psychopharmacol ;2019 (Jul 24)

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