Pubmed du 27/09/19

vendredi 27 septembre 2019

1. Bauminger-Zviely N, Estrugo Y, Samuel-Magal K, Friedlin A, Heishrik L, Koren D, Bar-Yehuda S. Communicating Without Words : School-Based RCT Social Intervention in Minimally Verbal Peer Dyads with ASD. J Clin Child Adolesc Psychol ;2019 (Sep 27):1-17.

Despite their social withdrawal, school-age children with autism spectrum disorder who are minimally verbal (MVASD ; i.e., use a limited repertoire of communicative spoken words) have received few interventions supporting peer engagement. This study examined efficacy of a novel ecological randomized controlled trial-school-based peer social intervention-designed to increase social engagement (via available communication channels) in school-age peer dyads with MVASD. Fifty-four children with MVASD (8-16 years) in 9 Israeli special education schools were randomly assigned to conversation intervention, collaboration intervention, or waitlisted treatment-as-usual (control) group (n = 18 per group). Manualized conversation and collaboration interventions each included 60 lessons (15 weeks x 4), implemented by teachers at school and supervised by researchers. Pretest-posttest improvement in spontaneous peer interaction was measured via 3 data sources/methods : teacher-reported social behavior (Vineland : Socialization domain) and direct observations of children’s spontaneous free play (Modified-Classroom Observation Schedule to Measure Intentional Communication) and free conversation (Social Conversation Scale). Allocation group was masked from reporters/coders. As secondary outcomes, children’s progress was measured in executive functions (BRIEF Inventory), and communication (Vineland). Significant pre-post improvement emerged for both intervention groups’ spontaneous free conversation and for the collaboration group’s spontaneous free play. Teacher reports, although mixed, indicated that the conversation group’s socialization skills improved, but communication did not. Children in the conversation group also improved their metacognitive executive skills (e.g., planning, monitoring, organization). Strengthening this high-risk school-age population’s ability to interact more spontaneously with peers through conversation and collaboration intervention holds promise for reducing social withdrawal in MVASD.

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2. Cheak-Zamora NC, Maurer-Batjer A, Malow BA, Coleman A. Self-determination in young adults with autism spectrum disorder. Autism ;2019 (Sep 27):1362361319877329.

This study examined rates of and contributing factors to self-determination among young adults with autism spectrum disorder. Caregivers of young adults with autism spectrum disorder, 16-25 years, from five Autism Treatment Network sites completed surveys about their young adults’ transition experiences including the American Institutes for Research Self-Determination measure. Data were analyzed using univariate and multivariate analysis. Caregivers (n = 479) reported their young adults with autism spectrum disorder as having moderate overall self-determination (x = 38 ; standard deviation = 9.04) with low capacity (x = 15.3 ; standard deviation = 5.67) and high opportunities at home (x = 23.1 ; standard deviation = 4.59). Young adults with autism spectrum disorder with intellectual disability or severe autism spectrum disorder symptomology experience significant disparities in overall self-determination compared to those without intellectual disability and less frequent symptom expression and severity. Barring severity indicators, there were few significant predictors of self-determination. Findings show a breakdown in self-determination skill-building. Young adults with autism spectrum disorder with intellectual disability or severe symptomology experienced significant disparities in self-determination. These findings show that current promotion of self-determination is not meeting the needs of young adults with autism spectrum disorder. Future interventions must identify what supports young adults with autism spectrum disorder need to capitalize on these opportunities to be independent and exert autonomy in their daily lives.

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3. den Boer JC, Vlamings CM, Munsters NM, Servatius-Oosterling IJ. [Early referral of toddlers on suspicion of autism spectrum disorder]. Ned Tijdschr Geneeskd ;2019 (Sep 9) ;163

Early signs of autism spectrum disorders (ASS) can become apparent at the baby and toddler stage and a diagnosis of ASS can already be made at this age. In practice, however, it often takes many years before children with ASS are diagnosed and as a result these children miss the benefits of early intervention. Reticence in referral and diagnosis seems to arise from personal factors, diagnostic problems and organisational factors. Here we discuss these factors and stress the importance of referral of very young children on suspicion of ASS to paediatric and paediatric psychiatric institutions with expertise in diagnosing and treating young children.

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4. Girardi A, Hancock-Johnson E, Thomas C, Wallang PM. Assessing the Risk of Inpatient Violence in Autism Spectrum Disorder. J Am Acad Psychiatry Law ;2019 (Sep 25)

The Historical Clinical and Risk Management scale (HCR-20) is a structured clinical judgment tool used to assess risk of violence in secure settings. But the scale does not account for difficulties typical of patients with autism spectrum disorder, which are thought to contribute to their engagement in violent behaviors. The present study is a preliminary investigation of the association between risk assessment and physical and verbal violence in patients with autism spectrum disorder in a secure psychiatric hospital. Scores from the third version of HCR-20 (HCR-20(V3)) and violent episodes at three and six months following the initial assessment were extracted from an electronic record. The results support the use of the HCR-20(V3) to assess the risk of overall and physical violence but not verbal aggression. Future studies are needed to identify which factors are associated with violent behaviors in patients with autism spectrum disorder.

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5. Griffioen R, van der Steen S, Cox RFA, Verheggen T, Enders-Slegers MJ. Verbal Interactional Synchronization between Therapist and Children with Autism Spectrum Disorder during Dolphin Assisted Therapy : Five Case Studies. Animals (Basel) ;2019 (Sep 24) ;9(10)

Synchronizing behaviors in interactions, such as during turn-taking, are often impaired in children with Autism Spectrum Disorder. Therapies that focus on turn-taking generally lead to increased social skills, less interruptions, and silent pauses, however a positive non-demanding environment is therefore thought to be beneficial. Such an environment can be achieved by incorporating animals into therapy. Our study was guided by the following research questions : (1) How can we characterize the interaction between child and therapist during dolphin-assisted therapy, with regard to synchrony in verbalizations (turn-taking) and (2) does synchrony change over the course of six sessions of therapy ? To answer these questions, we performed a cross-recurrence quantification analysis on behavioral data of five children, to give a detailed view of the interaction between therapist and child in the context of dolphin-assisted therapy. We were able to detect synchrony (i.e., adequate turn-taking) in all dyads, although not all children improved equally. The differences might be explained by a delayed reaction time of some children, and their level of language development.

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6. Guthrie W, Wallis K, Bennett A, Brooks E, Dudley J, Gerdes M, Pandey J, Levy SE, Schultz RT, Miller JS. Accuracy of Autism Screening in a Large Pediatric Network. Pediatrics ;2019 (Sep 27)

BACKGROUND : Universal screening is recommended to reduce the age of diagnosis for autism spectrum disorder (ASD). However, there are insufficient data on children who screen negative and no study of outcomes from truly universal screening. With this study, we filled these gaps by examining the accuracy of universal screening with systematic follow-up through 4 to 8 years. METHODS : Universal, primary care-based screening was conducted using the Modified Checklist for Autism in Toddlers with Follow-Up (M-CHAT/F) and supported by electronic administration and integration into electronic health records. All children with a well-child visit (1) between 16 and 26 months, (2) at a Children’s Hospital of Philadelphia site after universal electronic screening was initiated, and (3) between January 2011 and July 2015 were included (N = 25 999). RESULTS : Nearly universal screening was achieved (91%), and ASD prevalence was 2.2%. Overall, the M-CHAT/F’s sensitivity was 38.8%, and its positive predictive value (PPV) was 14.6%. Sensitivity was higher in older toddlers and with repeated screenings, whereas PPV was lower in girls. Finally, the M-CHAT/F’s specificity and PPV were lower in children of color and those from lower-income households. CONCLUSIONS : Universal screening in primary care is possible when supported by electronic administration. In this "real-world" cohort that was systematically followed, the M-CHAT/F was less accurate in detecting ASD than in previous studies. Disparities in screening rates and accuracy were evident in traditionally underrepresented groups. Future research should focus on the development of new methods that detect a greater proportion of children with ASD and reduce disparities in the screening process.

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7. Hadad BS, Russo N, Kimchi R, Babineau V, Burack JA. Typical Utilization of Gestalt Grouping Cues in Shape Perception by Persons with Autism Spectrum Disorder. Perception ;2019 (Sep 25):301006619874681.

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8. Jo H, Eckel SP, Wang X, Chen JC, Cockburn M, Martinez MP, Chow T, Molshatzki N, Lurmann FW, Funk WE, Xiang AH, McConnell R. Sex-specific associations of autism spectrum disorder with residential air pollution exposure in a large Southern California pregnancy cohort. Environ Pollut ;2019 (Nov) ;254(Pt A):113010.

Autism spectrum disorder (ASD) affects more boys than girls. Recent animal studies found that early life exposure to ambient particles caused autism-like behaviors only in males. However, there has been little study of sex-specificity of effects on ASD in humans. We evaluated ASD risk associated with prenatal and first year of life exposures to particulate matter less than 2.5mum in aerodynamic diameter (PM2.5) by child sex. This retrospective cohort study included 246,420 singleton children born in Kaiser Permanente Southern California (KPSC) hospitals between 1999 and 2009. The cohort was followed from birth through age five to identify 2471 ASD cases from the electronic medical record. Ambient PM2.5 and other regional air pollution measurements (PM less than 10mum, ozone, nitrogen dioxide) from regulatory air monitoring stations were interpolated to estimate exposure during each trimester and first year of life at each geocoded birth address. Hazard ratios (HRs) were estimated using Cox regression models to adjust for birth year, KPSC medical center service areas, and relevant maternal and child characteristics. Adjusted HRs per 6.5mug/m(3) PM2.5 were elevated during entire pregnancy [1.17 (95% confidence interval (CI), 1.04-1.33)] ; first trimester [1.10 (95% CI, 1.02-1.19)] ; third trimester [1.08 (1.00-1.18)] ; and first year of life [1.21 (95% CI, 1.05-1.40)]. Only the first trimester association remained robust to adjustment for other exposure windows, and was specific to boys only (HR=1.18 ; 95% CI, 1.08-1.27) ; there was no association in girls (HR=0.90 ; 95% CI, 0.76-1.07 ; interaction p-value 0.03). There were no statistically significant associations with other pollutants. PM2.5-associated ASD risk was stronger in boys, consistent with findings from recent animal studies. Further studies are needed to better understand these sexually dimorphic neurodevelopmental associations.

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9. Jyonouchi H, Geng L. Associations between Monocyte and T Cell Cytokine Profiles in Autism Spectrum Disorders : Effects of Dysregulated Innate Immune Responses on Adaptive Responses to Recall Antigens in a Subset of ASD Children. Int J Mol Sci ;2019 (Sep 24) ;20(19)

Changes in monocyte cytokine production with toll like receptor (TLR) agonists in subjects with autism spectrum disorders (ASD) were best reflected by the IL-1beta/IL-10 ratios in our previous research. The IL-1beta/IL-10 based subgrouping (low, normal, and high) of ASD samples revealed marked differences in microRNA expression, and mitochondrial respiration. However, it is unknown whether the IL-1beta/IL-10 ratio based subgrouping is associated with changes in T cell cytokine profiles or monocyte cytokine profiles with non-TLR agonists. In ASD (n = 152) and non-ASD (n = 41) subjects, cytokine production by peripheral blood monocytes (PBMo) with TLR agonists and beta-glucan, an inflammasome agonist, and T cell cytokine production by peripheral blood mononuclear cells (PBMCs) with recall antigens (Ags) (food and candida Ags) were concurrently measured. Changes in monocyte cytokine profiles were observed with beta-glucan in the IL-1beta/IL-10 ratio based ASD subgroups, along with changes in T cell cytokine production and ASD subgroup-specific correlations between T cell and monocyte cytokine production. Non-ASD controls revealed considerably less of such correlations. Altered innate immune responses in a subset of ASD children are not restricted to TLR pathways and correlated with changes in T cell cytokine production. Altered trained immunity may play a role in the above described changes.

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10. O’Connor C, Burke J, Rooney B. Diagnostic Disclosure and Social Marginalisation of Adults with ASD : Is There a Relationship and What Mediates It ?. J Autism Dev Disord ;2019 (Sep 25)

Adults with autism spectrum disorder (ASD) often experience social marginalisation. This study uses a vignette-based design to clarify whether diagnostic disclosure affects social marginalisation in workplace contexts. It investigates two potential mediators of this relationship : affective response to and theory of mind for people with ASD. Participants (n = 170) read a description of a hypothetical co-worker with ASD traits, whose diagnosis was either disclosed or concealed. Providing a diagnostic label significantly reduced participants’ desire to socially distance themselves from the target. This effect was mediated by positive affective responses. Diagnostic disclosure did not influence theory of mind for people with ASD but did increase tendencies to attribute primary emotions to the target ; however, this did not relate to social distance outcomes.

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11. Rescorla LA, Adams A, Ivanova MY. The CBCL/1(1/2)-5’s DSM-ASD Scale : Confirmatory Factor Analyses Across 24 Societies. J Autism Dev Disord ;2019 (Sep 27)

Previous research supports the CBCL/1(1/2)-5’s DSM-ASD scale (and its precursor, the DSM-PDP scale) as a Level 1 ASD screener. Confirmatory factor analyses (CFAs) with data from population samples in 24 societies (N = 19,850) indicated good measurement invariance across societies, especially for configural and metric invariance. Items 4. 25, 67, 80, and 98 may be especially good discriminators of ASD because they have tend to have low base rates, strong loadings on the ASD latent construct, and the best measurement invariance across societies. Further research is needed to test the discriminative power of these items in predicting ASD, but our strong measurement findings support the international psychometric robustness of the CBCL/1(1/2)-5’s DSM-ASD scale.

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12. Sahuquillo-Leal R, Ghosn F, Moreno-Gimenez A, Almansa B, Serrano-Lozano E, Ferrin M, Canada-Martinez A, Vento M, Garcia-Blanco A. Jumping to conclusions in autism : integration of contextual information and confidence in decision-making processes. Eur Child Adolesc Psychiatry ;2019 (Sep 25)

Individuals with Autism spectrum condition (ASC) present cognitive biases and a difficulty to integrate emotional responses in decision-making, which is necessary for adequate social functioning. Thus, understanding the underlying mechanisms of the altered decision-making in individuals with ASC may eventually have a positive impact on their social functioning. The Picture decision task was employed to observe the effect of new information (fragments of an incomplete picture), interpretative context (verbal cues), and the level of confidence on decision-making processes. Our study administered the task to 49 children with ASC and 37 children with Typical Development (TD). Children with TD showed a higher probability of success when an interpretative context was given. Conversely, children with ASC had an equal probability of success regardless of whether an interpretative context was provided or not. In addition, unlike children with TD, the level of confidence did not allow predicting the probability of successful decisions in children with ASC. Finally, children with ASC had more probability of jumping to conclusions, a decision made quickly with only one fragment of the picture while being completely sure of it. These results are discussed in light of current cognitive and emotional theories on ASC.

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13. Shnier D, Voineagu MA, Voineagu I. Persistent homology analysis of brain transcriptome data in autism. J R Soc Interface ;2019 (Sep 27) ;16(158):20190531.

Persistent homology methods have found applications in the analysis of multiple types of biological data, particularly imaging data or data with a spatial and/or temporal component. However, few studies have assessed the use of persistent homology for the analysis of gene expression data. Here we apply persistent homology methods to investigate the global properties of gene expression in post-mortem brain tissue (cerebral cortex) of individuals with autism spectrum disorders (ASD) and matched controls. We observe a significant difference in the geometry of inter-sample relationships between autism and healthy controls as measured by the sum of the death times of zero-dimensional components and the Euler characteristic. This observation is replicated across two distinct datasets, and we interpret it as evidence for an increased heterogeneity of gene expression in autism. We also assessed the topology of gene-level point clouds and did not observe significant differences between ASD and control transcriptomes, suggesting that the overall transcriptome organization is similar in ASD and healthy cerebral cortex. Overall, our study provides a novel framework for persistent homology analyses of gene expression data for genetically complex disorders.

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14. Simhal AK, Zuo Y, Perez MM, Madison DV, Sapiro G, Micheva KD. Multifaceted Changes in Synaptic Composition and Astrocytic Involvement in a Mouse Model of Fragile X Syndrome. Sci Rep ;2019 (Sep 25) ;9(1):13855.

Fragile X Syndrome (FXS), a common inheritable form of intellectual disability, is known to alter neocortical circuits. However, its impact on the diverse synapse types comprising these circuits, or on the involvement of astrocytes, is not well known. We used immunofluorescent array tomography to quantify different synaptic populations and their association with astrocytes in layers 1 through 4 of the adult somatosensory cortex of a FXS mouse model, the FMR1 knockout mouse. The collected multi-channel data contained approximately 1.6 million synapses which were analyzed using a probabilistic synapse detector. Our study reveals complex, synapse-type and layer specific changes in the neocortical circuitry of FMR1 knockout mice. We report an increase of small glutamatergic VGluT1 synapses in layer 4 accompanied by a decrease in large VGluT1 synapses in layers 1 and 4. VGluT2 synapses show a rather consistent decrease in density in layers 1 and 2/3. In all layers, we observe the loss of large inhibitory synapses. Lastly, astrocytic association of excitatory synapses decreases. The ability to dissect the circuit deficits by synapse type and astrocytic involvement will be crucial for understanding how these changes affect circuit function, and ultimately defining targets for therapeutic intervention.

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15. Wang Q, Han Z, Hu X, Feng S, Wang H, Liu T, Yi L. Autism Symptoms Modulate Interpersonal Neural Synchronization in Children with Autism Spectrum Disorder in Cooperative Interactions. Brain Topogr ;2019 (Sep 27)

Previous neuroscience studies exploring the neural mechanisms of social deficits of individuals with autism spectrum disorder (ASD) have mainly examined single participants’ brain responses to pictures or video-clips displayed on a monitor from the perspective of a passive observer. The present study examined inter-brain communication between children with ASD and their parents in a socio-interactive context. We used a functional near-infrared spectroscopy (fNIRS)-based hyperscanning technique to simultaneously measure the prefrontal activations in 16 pairs of children with ASD and their parents in a two-person key-press task. The children’s task was to press a key together with their parents in a cooperation condition when a "go" signal was present or to press a key as fast as possible under the observation by their parents in a single-person condition. We also measured children’s severity of autism symptoms.We found that children with ASD showed increased interpersonal neural synchronization in the frontal cortex when engaging in cooperative interactions with their parents than when performing solo and non-interactive behaviors. Furthermore, this neural synchronization was modulated by the children’s autism symptoms, which also covaried with their cooperation task performance. That is, children with severer autism symptoms showed lower level of action and neural synchronization with their parents during cooperation. Our study moved a major step forward in understanding the neural correlates underlying social deficits in ASD and provided important implications for the treatment and behavioral training of ASD.

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16. Williams RJ. Sulfate Deficiency as a Risk Factor for Autism. J Autism Dev Disord ;2019 (Sep 27)

This is a study of water and beverages consumed during pregnancy by mothers of children with autism. Materials included vials for water samples and a survey to describe the water and beverages. Samples were tested for sulfate and surveys evaluated for average daily levels. Results were stratified for selected regions of the United States. Areas with the highest rates of autism showed a trend toward lower levels of sulfate compared to areas with low rates of autism (28% sulfate, n = 45, p = 0.059). Severe autism was associated with low sulfate levels while mild symptoms were associated with higher levels of sulfate (- 0.32 correlation, n = 86, p < 0.01). The results suggest that sulfate may be helpful in reducing both the incidence and severity of autism.

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17. Yusuf A, Peltekova I, Savion-Lemieux T, Frei J, Bruno R, Joober R, Howe J, Scherer SW, Elsabbagh M. Association between distress and knowledge among parents of autistic children. PLoS One ;2019 ;14(9):e0223119.

Understanding the overall utility of biological testing for autism spectrum disorder (ASD) is essential for the development and integration of biomarkers into routine care. One measure related to the overall utility of biological testing is the knowledge that a person has about the condition he/she suffers from. However, a major gap towards understanding the role of knowledge in overall utility is the absence of studies that have assessed knowledge of autism along with its predictors within a representative sample of families within the context of routine care. The objective of this study was to measure knowledge of ASD among families within the routine care pathway for biological testing in ASD by examining the association between knowledge with potential correlates of knowledge namely sociodemographic factors, parental stress and distress, and time since diagnosis among parents whose child with ASD is undergoing clinical genetic testing. Parents of a child diagnosed with ASD (n = 85, Mage = 39.0, SD = 7.7) participating in an ongoing prospective genomics study completed the ASD Quiz prior to undergoing genetic testing for clinical and research purposes. Parents also completed self-reported measures of stress and distress. Parent stress and distress was each independently correlated with knowledge of ASD, rs >/= 0.26, ps < 0.05. Stepwise regression analysis revealed a significant model accounting for 7.8% of the variance in knowledge, F (1, 82) = 8.02, p = 0.006. The only factor significantly associated with knowledge was parental distress, beta = 0.30, p = 0.006. Parental stress, time since diagnosis, and sociodemographic factors were not significant predictors in this model. We concluded that families require tailored support prior to undergoing genetic testing to address either knowledge gaps or high distress. Ongoing appraisal of the testing process among families of diverse backgrounds is essential in offering optimal care for families undergoing genetic testing.

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18. Zwaigenbaum L, Maguire J. Autism Screening : Where Do We Go From Here ?. Pediatrics ;2019 (Sep 27)

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