Pubmed du 14/08/19

mercredi 14 août 2019

1. Afzaal T, Waqas A, Naveed S. A Short Commentary on Non-specialist-mediated Interventions for Children with Autism Spectrum Disorder. Cureus ;2019 (Jun 4) ;11(6):e4831.

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disability delineated by social and communication impairments, restricted interests and repetitive behaviors, and sensory hypo- or hyper reactivity to sensory inputs. Early recognition and timely intervention are essential for individuals with ASD and the long-term prognosis for these individuals. The specialist-mediated interventions can be expensive for patients, their families, and the healthcare system. It is important to provide a naturalistic intervention, especially in the context of cost issues, the impact of early intervention of prognosis, limited resources in developing countries, lack of healthcare providers, and healthcare disparities. The current article reviews non-specialist-mediated interventions of children and adolescents with ASD.

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2. Amoruso L, Narzisi A, Pinzino M, Finisguerra A, Billeci L, Calderoni S, Fabbro F, Muratori F, Volzone A, Urgesi C. Contextual priors do not modulate action prediction in children with autism. Proc Biol Sci ;2019 (Aug 14) ;286(1908):20191319.

Bayesian accounts of autism suggest that this disorder may be rooted in an impaired ability to estimate the probability of future events, possibly owing to reduced priors. Here, we tested this hypothesis within the action domain in children with and without autism using a behavioural paradigm comprising a familiarization and a testing phase. During familiarization, children observed videos depicting a child model performing actions in diverse contexts. Crucially, within this phase, we implicitly biased action-context associations in terms of their probability of co-occurrence. During testing, children observed the same videos but drastically shortened (i.e. reduced amount of kinematics information) and were asked to infer action unfolding. Since during the testing phase movement kinematics became ambiguous, we expected children’s responses to be biased to contextual priors, thus compensating for perceptual uncertainty. While this probabilistic effect was present in controls, no such modulation was observed in autistic children, overall suggesting an impairment in using contextual priors when predicting other peoples’ actions in uncertain environments.

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3. Arroyo-Araujo M, Graf R, Maco M, van Dam E, Schenker E, Drinkenburg W, Koopmans B, de Boer SF, Cullum-Doyle M, Noldus L, Loos M, van Dommelen W, Spooren W, Biemans B, Buhl DL, Kas MJ. Reproducibility via coordinated standardization : a multi-center study in a Shank2 genetic rat model for Autism Spectrum Disorders. Sci Rep ;2019 (Aug 12) ;9(1):11602.

Inconsistent findings between laboratories are hampering scientific progress and are of increasing public concern. Differences in laboratory environment is a known factor contributing to poor reproducibility of findings between research sites, and well-controlled multisite efforts are an important next step to identify the relevant factors needed to reduce variation in study outcome between laboratories. Through harmonization of apparatus, test protocol, and aligned and non-aligned environmental variables, the present study shows that behavioral pharmacological responses in Shank2 knockout (KO) rats, a model of synaptic dysfunction relevant to autism spectrum disorders, were highly replicable across three research centers. All three sites reliably observed a hyperactive and repetitive behavioral phenotype in KO rats compared to their wild-type littermates as well as a dose-dependent phenotype attenuation following acute injections of a selective mGluR1 antagonist. These results show that reproducibility in preclinical studies can be obtained and emphasizes the need for high quality and rigorous methodologies in scientific research. Considering the observed external validity, the present study also suggests mGluR1 as potential target for the treatment of autism spectrum disorders.

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4. Bruyneel E, Demurie E, Warreyn P, Beyers W, Boterberg S, Bontinck C, Dewaele N, Roeyers H. Language growth in very young siblings at risk for autism spectrum disorder. Int J Lang Commun Disord ;2019 (Aug 12)

BACKGROUND : Children with autism spectrum disorder (ASD) show substantial variability in their language development. Language problems are highly prevalent in these children. In addition, the quality of early language abilities contributes to the overall development of these children and is highly predictive of their adult outcome. Yet, little is known about language development in children at risk of ASD during the first years of life. AIMS : To compare early receptive language (RL) and expressive language (EL) development in children at risk of ASD and determine predictors of language development. METHODS & PROCEDURES : Developmental trajectories of RL and EL were investigated from 10 to 36 months of age in younger siblings of typically developing children (LR-sibs, N = 30) and in younger siblings of children with ASD (HR-sibs, N = 31) using the Mullen Scales of Early Learning. Furthermore, both child and demographic characteristics were examined as possible predictors of language development. OUTCOMES & RESULTS : Both groups showed similar growth curves for RL and EL and the majority of the children showed average (within +/-1.5 SD of the mean) or above-average language abilities. Nevertheless, the mean growth of EL was lower and the variation in growth of both RL and EL was higher in HR-sibs than in LR-sibs. Furthermore, early child characteristics were predictive of language development in both groups. Yet, some child characteristics seemed to be of more importance in HR-sibs than in LR-sibs. Consequently, lower non-verbal abilities at 10 months in both groups and a higher degree of ASD characteristics at 14 months in HR-sibs may be indicative of difficulties in language development. CONCLUSIONS & IMPLICATIONS : HR-sibs show more variation in their language development than LR-sibs during the first 3 years of life. The majority of HR-sibs, however, did not present with below-average language abilities. Yet, early characteristics of ASD may be a red flag for difficulties in the language development of HR-sibs.

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5. Crespi B, Dinsdale N. Autism and psychosis as diametrical disorders of embodiment. Evol Med Public Health ;2019 ;2019(1):121-138.

Humans have evolved an elaborate system of self-consciousness, self-identity, self-agency, and self-embodiment that is grounded in specific neurological structures including an expanded insula. Instantiation of the bodily self has been most-extensively studied via the ’rubber hand illusion’, whereby parallel stimulation of a hidden true hand, and a viewed false hand, leads to the felt belief that the false hand is one’s own. Autism and schizophrenia have both long been regarded as conditions centrally involving altered development of the self, but they have yet to be compared directly with regard to the self and embodiment. Here, we synthesize the embodied cognition literature for these and related conditions, and describe evidence that these two sets of disorders exhibit opposite susceptibilities from typical individuals to the rubber hand illusion : reduced on the autism spectrum and increased in schizophrenia and other psychotic-affective conditions. Moreover, the opposite illusion effects are mediated by a consilient set of associated phenomena, including empathy, interoception, anorexia risk and phenotypes, and patterns of genetic correlation. Taken together, these findings : (i) support the diametric model of autism and psychotic-affective disorders, (ii) implicate the adaptive human system of self-embodiment, and its neural bases, in neurodevelopmental disorders, and suggest new therapies and (iii) experimentally ground Bayesian predictive coding models with regard to autism compared with psychosis. Lay summary : Humans have evolved a highly developed sense of self and perception of one’s own body. The ’rubber hand illusion’ can be used to test individual variation in sense of self, relative to connection with others. We show that this illusion is reduced in autism spectrum disorders, and increased in psychotic and mood disorders. These findings have important implications for understanding and treatment of mental disorders.

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6. De Stefano LA, Schmitt LM, White SP, Mosconi MW, Sweeney JA, Ethridge LE. Developmental Effects on Auditory Neural Oscillatory Synchronization Abnormalities in Autism Spectrum Disorder. Front Integr Neurosci ;2019 ;13:34.

Previous studies have found alterations in 40 Hz oscillatory activity in response to auditory stimuli in adults with Autism Spectrum Disorder (ASD). The current study sought to examine the specificity and developmental trajectory of these findings by driving the cortex to oscillate at a range of frequencies in both children and adults with and without ASD. Fifteen participants with ASD (3 female, aged 6-23 years) and 15 age-matched controls (4 female, aged 6-25 years) underwent dense-array EEG as they listened to a carrier tone amplitude-modulated by a sinusoid linearly increasing in frequency from 0-100 Hz over 2 s. EEG data were analyzed for inter-trial phase coherence (ITPC) and single-trial power (STP). Older participants with ASD displayed significantly decreased ability to phase-lock to the stimulus in the low gamma frequency range relative to their typically developing (TD) counterparts, while younger ASD and TD did not significantly differ from each other. An interaction between age and diagnosis suggested that TD and ASD also show different developmental trajectories for low gamma power ; TD showed a significant decrease in low gamma power with age, while ASD did not. Regardless of age, increased low gamma STP was significantly correlated with increased clinical scores for repetitive behaviors in the ASD group, particularly insistence on sameness. This study contributes to a growing body of evidence supporting alterations in auditory processing in ASD. Older ASD participants showed more pronounced low gamma deficits than younger participants, suggesting an altered developmental trajectory for neural activity contributing to auditory processing deficits that may also be more broadly clinically relevant. Future studies are needed employing a longitudinal approach to confirm findings of this cross-sectional study.

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7. Ferguson BJ, Dovgan K, Severns D, Martin S, Marler S, Gross Margolis K, Bauman ML, Veenstra-VanderWeele J, Sohl K, Beversdorf DQ. Lack of Associations Between Dietary Intake and Gastrointestinal Symptoms in Autism Spectrum Disorder. Front Psychiatry ;2019 ;10:528.

Background : Many individuals with autism spectrum disorder (ASD) have significant gastrointestinal (GI) symptoms, but their etiology is currently unknown. Dietary interventions are common in children and adolescents with ASD, including diets with increased omega-3 fatty acids or diets free of gluten and/or casein, which may also impact GI symptoms and nutrition. However, little is known about the relationship between nutritional intake and GI symptomatology in ASD. The objective of this study was to assess the relationships between GI symptoms, omega-3 intake, micronutrients, and macronutrients in children with ASD. Methods : A total of 120 children diagnosed with ASD participated in this multisite study. A food frequency questionnaire was completed by the patient’s caretaker. The USDA Food Composition Database was utilized to provide nutritional data for the food items consumed by each participant. GI symptomatology was assessed using a validated questionnaire on pediatric gastrointestinal symptoms. Results : There were no significant associations between GI symptoms and the amount of omega-3 fatty acids and/or other micro- and macronutrients contained in the diet. Conclusions : This study suggests that dietary variations do not appear to drive GI symptoms, nor do GI symptoms drive dietary variations in those with ASD, although causation cannot be determined with this observational assessment. Furthermore, there may be other factors associated with lower GI tract symptoms in ASD, such as increased stress response.

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8. Field M, Dudding-Byth T, Arpone M, Baker EK, Aliaga SM, Rogers C, Hickerton C, Francis D, Phelan DG, Palmer EE, Amor DJ, Slater H, Bretherton L, Ling L, Godler DE. Significantly Elevated FMR1 mRNA and Mosaicism for Methylated Premutation and Full Mutation Alleles in Two Brothers with Autism Features Referred for Fragile X Testing. Int J Mol Sci ;2019 (Aug 11) ;20(16)

Although fragile X syndrome (FXS) is caused by a hypermethylated full mutation (FM) expansion with >/=200 cytosine-guanine-guanine (CGG) repeats, and a decrease in FMR1 mRNA and its protein (FMRP), incomplete silencing has been associated with more severe autism features in FXS males. This study reports on brothers (B1 and B2), aged 5 and 2 years, with autistic features and language delay, but a higher non-verbal IQ in comparison to typical FXS. CGG sizing using AmplideX PCR only identified premutation (PM : 55-199 CGGs) alleles in blood. Similarly, follow-up in B1 only revealed PM alleles in saliva and skin fibroblasts ; whereas, an FM expansion was detected in both saliva and buccal DNA of B2. While Southern blot analysis of blood detected an unmethylated FM, methylation analysis with a more sensitive methodology showed that B1 had partially methylated PM alleles in blood and fibroblasts, which were completely unmethylated in buccal and saliva cells. In contrast, B2 was partially methylated in all tested tissues. Moreover, both brothers had FMR1 mRNA 5 fold higher values than those of controls, FXS and PM cohorts. In conclusion, the presence of unmethylated FM and/or PM in both brothers may lead to an overexpression of toxic expanded mRNA in some cells, which may contribute to neurodevelopmental problems, including elevated autism features.

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9. Grandisson M, Rajotte E, Godin J, Chretien-Vincent M, Milot E, Desmarais C. Autism spectrum disorder : How can occupational therapists support schools ?. Can J Occup Ther ;2019 (Aug 11):8417419838904.

BACKGROUND. : Children with autism spectrum disorder (ASD) face multiple occupational challenges in their school, and school staff need additional support to increase their participation. PURPOSE. : The aim of this study is to identify how Response to Intervention (RTI) could be used by occupational therapists to support school personnel who work with children with ASD. METHOD. : In a descriptive qualitative study, three discussion groups were undertaken with occupational therapists and school staff members in Quebec, Canada, to identify the main concerns regarding the participation of children with ASD in school activities as well as the actions to consider when attempting to increase school-related abilities. FINDINGS. : School staff members are primarily concerned with frequent outbursts and limited autonomy, along with low motivation and anxiety in children with ASD in diverse school activities and contexts. The actions identified provide guidelines for school and occupational therapist selection, the process to follow, collaborative practices, and support required. IMPLICATIONS. : A practice model is presented for occupational therapists who seek to develop school capacity to support the participation of children with ASD.

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10. Guerrera S, Menghini D, Napoli E, Di Vara S, Valeri G, Vicari S. Assessment of Psychopathological Comorbidities in Children and Adolescents With Autism Spectrum Disorder Using the Child Behavior Checklist. Front Psychiatry ;2019 ;10:535.

Autism spectrum disorder (ASD) is characterized by psychiatric and behavioral comorbidities. The Child Behavior Checklist (CBCL) provides valid and well-established measures of emotional, behavioral, and social problems in children and adolescents. The aim of the present study was to verify whether emotional, behavioral, and social problems were modulated by ASD symptom severity, cognitive development, gender, and age by analyzing the CBCL in a large group of children and adolescents with ASD. The results show that around 30% of participants with ASD exhibited internalizing problems and only 6% externalizing problems, with males exhibiting more internalizing problems than females. No correlation was found between CBCL scores and indices of ASD severity. However, higher CBCL Total Problems scores were found in older children and in children with lower cognitive abilities. The detection of behavioral and emotional problems allows children with ASD to undergo specific and individualized treatment that takes into account their psychopathological problems.

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11. Hamrick LR, Seidl A, Tonnsen BL. Acoustic properties of early vocalizations in infants with fragile X syndrome. Autism Res ;2019 (Aug 13)

Fragile X syndrome (FXS) is a neurogenetic syndrome characterized by cognitive impairments and high rates of autism spectrum disorder (ASD). FXS is often highlighted as a model for exploring pathways of symptom expression in ASD due to the high prevalence of ASD symptoms in this population and the known single-gene cause of FXS. Early vocalization features-including volubility, complexity, duration, and pitch-have shown promise in detecting ASD in idiopathic ASD populations but have yet to be extensively studied in a population with a known genetic cause for ASD such as FXS. Investigating early trajectories of these features in FXS may inform our limited knowledge of potential mechanisms that predict later social communication outcomes. The present study addresses this need by presenting preliminary findings which (a) characterize early vocalization features in FXS relative to low-risk controls (LRC) and (b) test the specificity of associations between these features and language and ASD outcomes. We coded vocalization features during a standardized child-examiner interaction for 39 nine-month-olds (22 FXS, 17 LRC) whose clinical outcomes were assessed at 24 months. Our results provide preliminary evidence that within FXS, associations between vocalization features and 24-month language outcomes may diverge from those observed in LRC, and that vocalization features may be associated with later ASD symptoms. These findings provide a starting point for more research exploring these features as potential early markers of ASD in FXS, which in turn may lead to improved early identification methods, treatment approaches, and overall well-being of individuals with ASD. Autism Res2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Although vocal features of 9-month-olds with FXS did not differ from those of low-risk controls, several features were associated with later language and ASD outcomes at 24 months in FXS. These preliminary results suggest acoustic data may be related to clinical outcomes in FXS and potentially other high-risk populations. Further characterizing these associations may facilitate understanding of biological mechanisms and risk factors associated with social communication development and ASD.

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12. Hillus J, Moseley R, Roepke S, Mohr B. Action Semantic Deficits and Impaired Motor Skills in Autistic Adults Without Intellectual Impairment. Front Hum Neurosci ;2019 ;13:256.

Several studies indicate the functional importance of the motor cortex for higher cognition, language and semantic processing, and place the neural substrate of these processes in sensorimotor action-perception circuits linking motor, sensory and perisylvian language regions. Interestingly, in individuals with autism spectrum disorder (ASD), semantic processing of action and emotion words seems to be impaired and is associated with hypoactivity of the motor cortex during semantic processing. In this study, the relationship between semantic processing, fine motor skills and clinical symptoms was investigated in 19 individuals with ASD and 22 typically-developing matched controls. Participants completed two semantic decision tasks involving words from different semantic categories, a test of alexithymia (the Toronto Alexithymia Scale), and a test of fine motor skills (the Purdue Pegboard Test). A significant Group x Word Category interaction in accuracy (p < 0.05) demonstrated impaired semantic processing for action words, but not object words in the autistic group. There was no significant group difference when processing abstract emotional words or abstract neutral words. Moreover, our study revealed deficits in fine motor skills as well as evidence for alexithymia in the ASD group, but not in neurotypical controls. However, these motor deficits did not correlate significantly with impairments in action-semantic processing. We interpret the data in terms of an underlying dysfunction of the action-perception system in ASD and its specific impact on semantic language processing.

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13. Knights E, Sunderland B, Parsons R, Ziatas K, Caccetta R. An evaluation of community pharmacists’ understanding of autism spectrum disorder : a cross-sectional study in Western Australia. Int J Pharm Pract ;2019 (Aug 13)

OBJECTIVES : To assess the knowledge and understanding of autism spectrum disorder (ASD) by community pharmacists, across Western Australia (WA) and evaluate the extent to which they incorporate ASD friendly practices in their pharmacy. METHODS : A cross-sectional study involved a postal questionnaire sent to a stratified random sample of 250 community pharmacies across WA. A score of >/=10/13 (>/=76.9%) appropriate responses to selected questions was considered an indication of ’good knowledge’ of ASD. Univariate associations between ’good knowledge’ and variables in the questionnaire were analysed using chi-square statistics, and multivariate analysis was performed using a logistic regression model. Demographic data relating to the pharmacy were used to determine the likelihood it was ASD friendly. KEY FINDINGS : Overall, 97/250 (38.8%) questionnaires were returned. There were 34/96 (35.4%) respondents classified as having ’good knowledge’. Stigma surrounding ASD was the single best indicator of ’good knowledge’ (P < 0.0001). None of the respondents indicated they catered specifically for ASD, and 38/97 (39.2%) reported that no changes were needed to their pharmacy to improve accessibility. There were a number of demographic features that increased the likelihood that pharmacies had the potential to be ASD friendly. CONCLUSIONS : Pharmacists overall had a basic understanding of ASD. Pharmacists who identified that stigma surrounding ASD existed in the community were more likely to achieve ’good knowledge’. There was a reluctance to improve pharmacy accessibility to patients with ASD. Pharmacists did not appear to incorporate ASD beneficial practices into their pharmacy and pharmacy environment.

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14. Li M, Li X, Xie L, Liu J, Wang F, Wang Z. Assisted therapeutic system based on reinforcement learning for children with autism. Comput Assist Surg (Abingdon) ;2019 (Aug 14):1-11.

Assisted therapy is increasingly used in autism spectrum disorders (ASD) for improving social interaction and communication skills in recent years. A lot of studies have proven that the form of interactive games for therapy has a good effect on children with autism. Thus, our study provided an assisted therapeutic system based on Reinforcement Learning (RL) for children with ASD, which has five interactive subgames. As is well known, it is necessary to establish and maintain compelling interactions in therapeutic process. Therefore, we aim to adjust the interactive content according to the emotions of children with autism. However, due to the atypical and unusually differences in children with autism, most systems are based on off-line training of small samples of individuals and online recognition, so the existing assisted systems are limited in their ability to automatically update system parameters of new mappings. The integration of RL and Convolutional Neural Network (CNN)-Support Vector Regression (SVR) was used to deal with the updating online of prediction model’s weights. The normalized emotion labels were evaluated by the therapists. Eleven children with autism as subjects were invited in this experiment and captured facial video images. The experiment lasted for five weeks of intermittent assisted therapy, and the results were evaluated for the system and the therapy effect. Finally, we achieved a general reduction in the root mean square error of the model prediction results and labels. Although there is no significant difference in Social Responsiveness Scale (SRS) scores before and after assisted therapy (p value = 0.60), in individual subjects (Sub. 1, Sub. 2 and Sub.3), the SRS total score is significantly reduced (Average drop of 19 points). These results demonstrate the effectiveness of prediction model based on RL and show the feasibility of assisted therapeutic system in children with autism.

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15. Munnich A, Demily C, Frugere L, Duwime C, Malan V, Barcia G, Vidal C, Throo E, Besmond C, Hubert L, Roland-Manuel G, Malen JP, Ferreri M, Hanein S, Thalabard JC, Boddaert N, Assouline M. Impact of on-site clinical genetics consultations on diagnostic rate in children and young adults with autism spectrum disorder. Mol Autism ;2019 ;10:33.

Background : Neurogenetics investigations and diagnostic yield in patients with autism spectrum disorder (ASD) have significantly improved over the last few years. Yet, many patients still fail to be systematically investigated. Methods : To improve access to services, an ambulatory team has been established since 1998, delivering on-site clinical genetics consultations and gradually upgrading services to 502 children and young adults with ASD in their standard environment across 26 day-care hospitals and specialized institutions within the Greater Paris region. The evaluation included a clinical genetics consultation, screening for fragile X syndrome, metabolic workup, chromosomal microarray analysis, and, in a proportion of patients, next-generation sequencing of genes reported in ASD and other neurodevelopmental disorders. Results : Fragile X syndrome and pathogenic copy number variants (CNVs) accounted for the disease in 10% of cases, including 4/312 (1.3%) with fragile X syndrome and 34/388 (8.8%) with pathogenic CNVs (19 de novo and 4 inherited). Importantly, adding high-throughput resequencing of reported intellectual disability/ASD genes to the screening procedure had a major impact on diagnostic yield in the 141 patients examined most recently. Pathogenic or likely pathogenic sequence variants in 27 disease genes were identified in 33/141 patients (23.4% ; 23 were de novo and 10 inherited, including five X-linked and five recessive compound heterozygous variants). Diagnosed cases presented atypical and/or syndromic ASD with moderate to severe intellectual disability. The diagnostic yield of fragile X syndrome and array CGH testing combined with next-generation sequencing was significantly higher than fragile X syndrome and array CGH alone (p value 0.009). No inborn errors of metabolism were detected with the metabolic screening. Conclusion : Based on the diagnostic rate observed in this cohort, we suggest that a stepwise procedure be considered, first screening pathogenic CNVs and a limited number of disease genes in a much larger number of patients, especially those with syndromic ASD and intellectual disability.

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16. Su YE, Naigles LR. Online Processing of Subject-Verb-Object Order in a Diverse Sample of Mandarin-Exposed Preschool Children with Autism Spectrum Disorder. Autism Res ;2019 (Aug 11)

Grammatical comprehension remains a strength in English-exposed young children with autism spectrum disorder (ASD), yet limited research has investigated how preschool children with ASD process grammatical structures in real time, in any language. Using the eye-movement measures of Intermodal Preferential Looking, we assessed online processing of subject-verb-object (SVO) order in seventy 2- to 5-year-old children with ASD exposed to Mandarin Chinese across the spectrum, whose vocabulary production scores were dramatically delayed compared with the typical controls. With this Mandarin-exposed sample, we tested the extent to which children with ASD require (a) highly consistent input and/or (b) good discourse/pragmatics for acquiring grammatical structures. Children viewed side-by-side videos depicting reversible actions (e.g., a bird pushing a horse vs. a horse pushing a bird), and heard an audio matching only one of those actions ; their eyegaze to each video was coded and analyzed. Both typically developing children and children with ASD demonstrated comprehension of SVO word order, suggesting that core grammatical structures such as basic word order may be preserved in children with ASD across languages despite radical differences in language environment, social/pragmatic abilities, and neurological organization. However, children with ASD were less efficient in online sentence processing than typical children, and the efficiency of their online sentence processing was related to their standardized language assessment scores. Of note is that across both Mandarin Chinese and English, some proportion of minimally verbal children with ASD exhibited SVO comprehension despite their profoundly impaired expressive language skills. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Grammar is a strength in the language comprehension of young English learners with autism spectrum disorder (ASD). Eye-movement data from a diverse sample of Chinese preschoolers with ASD indicated similar grammatical strength of basic word order in Chinese (e.g., to understand sentences like "The bird is pushing the horse"). Moreover, children’s proficiency of sentence processing was related to their language assessment scores. Across languages, such knowledge is even spared in some minimally verbal children with ASD.

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17. Xu M, Xu X, Li J, Li F. Association Between Gut Microbiota and Autism Spectrum Disorder : A Systematic Review and Meta-Analysis. Front Psychiatry ;2019 ;10:473.

Autism spectrum disorder (ASD) is characterized by stereotyped behavior and deficits in communication and social interactions. Gastrointestinal (GI) dysfunction is an ASD-associated comorbidity, implying a potential role of the gut microbiota in ASD GI pathophysiology. Several recent studies found that autistic individuals harbor an altered bacterial gut microbiota. In some cases, remodeling the gut microbiota by antibiotic administration and microbiota transfer therapy reportedly alleviated the symptoms of ASD. However, there is little consensus on specific bacterial species that are similarly altered across individual studies. The aim of this study is to summarize previously published data and analyze the alteration of the relative abundance of bacterial genera in the gut microbiota in controls and individuals with ASD using meta-analysis. We analyzed nine studies, including 254 patients with ASD, and found that children with ASD had lower percentages of Akkermansia, Bacteroides, Bifidobacterium, and Parabacteroides and a higher percentage of Faecalibacterium in the total detected microflora compared to controls. In contrast, children with ASD had lower abundance of Enterococcus, Escherichia coli, Bacteroides, and Bifidobacterium and higher abundance of Lactobacillus. This meta-analysis suggests an association between ASD and alteration of microbiota composition and warrants additional prospective cohort studies to evaluate the association of bacterial changes with ASD symptoms, which would provide further evidence for the precise microbiological treatment of ASD.

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