Pubmed du 08/09/19

dimanche 8 septembre 2019

1. Baixauli I, Mira A, Berenguer C, Rosello B, Miranda A. Family Factors and Communicative Skills in Children with Autism Without Intellectual Disability. J Autism Dev Disord. 2019.

The primary objective of this study was to identify the profiles of families of children with autism spectrum disorder (ASD) without intellectual disability (ID) based on several risk indicators : sociodemographic and emotional indicators, parental stress, confidant social support, and coping strategies. A second aim was to determine the differences in communicative skills between children of family subtypes empirically established according to the aforementioned risk factors. Participants were 52 Spanish mothers and their children with ASD. Through cluster analysis, three subtypes of families were identified, classifying them as "high risk, moderate risk, and little risk". The "little risk" profile showed significantly less stress and greater use of coping strategies and confidant social support. Furthermore, the children’s communication exhibited better development, compared to children from the other family environments.

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2. James WH, Grech V. Is exposure to high levels of maternal intrauterine testosterone a causal factor common to male sex, autism, gender dysphoria, and non-right-handedness ?. Early human development. 2019 : 104872.

We present evidence that male sex, autism, gender dysphoria and non-right-handedness share a common cause, viz. high levels of maternal first-trimester intrauterine testosterone. This provides an explanation for the (as yet unexplained) co-occurrences and co-morbidities between these conditions and pathologies.

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3. Rothman J, Bartky EJ, Halas FP. Effect of L1-79 on Core Symptoms of Autism Spectrum Disorder : A Case Series. Clinical therapeutics. 2019.

PURPOSE : This study examines the effects of the tyrosine hydroxylase inhibitor L1-79, a racemic formulation of alpha-methylparatyrosine, in patients with autism spectrum disorder (ASD) in a prospective case series. The l-isomer formulation of alpha-methylparatyrosine, metyrosine, is approved for the management of patients with pheochromocytoma. METHODS : Six male and 2 female patients aged 2.75 to 24 years with ASD were treated for 8 weeks at L1-79 doses ranging from 90 to 400 mg thrice daily. Assessments at weekly intervals included the Aberrant Behavior Checklist-Community (ABC-C), Connor’s Parent Rating Scale (CPRS), and Clinical Global Impressions (CGI) scale. The Autism Diagnostic Observation Schedule (ADOS) was administered at baseline and week 10. FINDINGS : The ABC-C and CPRS scores improved between baseline and end of study for 7 of 8 participants ; most participants’ assessment scores decreased. At week 8, the CGI efficacy index was 05 for 6 of 8 participants, indicating modest improvement with at least partial resolution of symptoms and no medication adverse effects, and 09 for 2 participants, indicating minimal improvement and no change in status or care needs, without adverse effects. The mean ADOS scores improved by >/=31% for 4 of the 6 participants tested, with 1 patient experiencing a 47% improvement. Seven of the 8 participants previously taking psychotropic medications were stable without their legacy medications while receiving L1-79, and 1 patient resumed a single legacy medication at a lower dose. Three adverse events were reported ; symptoms were mild and resolved without change in therapy. IMPLICATIONS : These results suggest L1-79 may be a tolerable and effective treatment for the core symptoms of ASD, which must be confirmed with double-blind studies.

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4. Storch EA, Schneider SC, De Nadai AS, Selles RR, McBride NM, Grebe SC, Bergez KC, Ramirez A, Viana AG, Lewin AB. A Pilot Study of Family-Based Exposure-Focused Treatment for Youth with Autism Spectrum Disorder and Anxiety. Child Psychiatry Hum Dev. 2019.

Anxiety is a common and impairing condition in youth with autism spectrum disorders (ASD). Evidence supports the use of cognitive behavioral therapy for treating anxiety in this population ; however, available treatment protocols may be difficult to implement outside of research settings. The present study examined the efficacy of family-based exposure-focused treatment (FET) compared to a treatment as usual (TAU) control in 32 youth aged 6-17 years with ASD and co-occurring anxiety. Fourteen youth were randomized to FET, which included 12 face-to-face weekly therapy sessions lasing 45-55 min, while 18 youth completed the TAU control where engagement in psychotherapy or pharmacotherapy was at the discretion of the families. Results strongly supported FET with a 79% (versus 0% in TAU) response rate, 86% (versus 0% in TAU) remission in primary anxiety diagnosis, and large between-group effects on clinician-rated anxiety severity and most parent-rated domains of anxiety-related impairment. Among treatment responders, 2-month follow-up supported maintenance of gains. Overall, the study supported FET as a relatively brief intervention for the treatment of anxiety in youth with ASD, although further research is needed to replicate these findings and compare FET outcomes to more comprehensive interventions.

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5. Zhao J, Chen S, Tong X, Yi L. Advantage in Character Recognition Among Chinese Preschool Children with Autism Spectrum Disorder. J Autism Dev Disord. 2019.

This study examined Chinese character recognition and its cognitive and linguistic correlates in preschool children with autism spectrum disorder (ASD). Forty-seven children with ASD and 51 IQ-matched typically developing (TD) children were tested on Chinese character recognition, rapid automatized naming, inhibitory control, digit span, IQ, vocabulary, phonological awareness, morphological awareness, and listening comprehension. Chinese children with ASD showed strong character recognition skills. Unlike TD children’s character recognition, which was correlated with all the measured cognitive and linguistic skills, character recognition of children with ASD was only significantly correlated with rapid automatized naming, inhibitory control, and phonological awareness. Our findings suggest that phonological awareness and rapid automatized naming may serve as important predictors for possible advantage in emergent literacy acquisition in Chinese children with ASD.

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