Pubmed du 29/09/19

dimanche 29 septembre 2019

1. Aydin HI, Sonmez FM. A novel mutation in two cousins with guanidinoacetate methyltransferase (GAMT) deficiency presented with autism. Turk J Pediatr ;2019 ;61(1):92-96.

Aydin HI, Sonmez FM. A novel mutation in two cousins with guanidinoacetate methyltransferase (GAMT) deficiency presented with autism. Turk J Pediatr 2019 ; 61 : 92-96. Guanidinoacetate methyltransferase (GAMT) deficiency is a rare autosomal recessive disorder of creatine biosynthesis. Here, we report 9 and 10-year-old cousins with GAMT deficiency caused by a novel mutation who both exhibited neurodevelopmental retardation, seizures, behavioral problems, and autism that began during early infancy. The patients were diagnosed as having only autism and followed for years without a specific diagnosis although they had very low levels of serum creatinine for several times. A novel nonsense mutation in the GAMT gene that caused cessation of synthesis of the protein encoded by this gene was identified in these patients. GAMT deficiency is a treatable inborn error of metabolism and should be considered for all patients with hypotonia, developmental delay, seizures and autism, particularly if low serum creatinine levels are observed.

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2. 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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3. 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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4. DeMayo MM, Young LJ, Hickie IB, Song YJC, Guastella AJ. Circuits for social learning : A unified model and application to Autism Spectrum Disorder. Neurosci Biobehav Rev ;2019 (Sep 24)

Early life social experiences shape neural pathways in infants to develop lifelong social skills. This review presents the first unified circuit-based model of social learning that can be applied to early life social development, drawing together unique human developmental milestones, sensitive learning periods, and behavioral and neural scaffolds. Circuit domains for social learning are identified governing Activation, Integration, Discrimination, Response and Reward (AIDRR) to sculpt and drive human social learning. This unified model can be used to identify social delays earlier in development. We propose social impairments observed in Autism Spectrum Disorder are underpinned by early mistimed sensitive periods in brain development and alterations in amygdala development to disrupt the AIDRR circuits. This model directs how interventions can target neural circuits for social development and be applied early in life. To illustrate, the oxytocin intervention is explored in context of the AIDRR circuits. This model shifts the focus from applying possibly-related broad treatments, to specifying and targeting the relevant circuits, at the right time of development, to optimize social learning.

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5. Durkin MS. Increasing Prevalence of Developmental Disabilities Among Children in the US : A Sign of Progress ?. Pediatrics ;2019 (Sep 26)

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6. Eades D, Leung P, Cronin A, Monteiro J, Johnson A, Remington A. UK dental professionals’ knowledge, experience and confidence when treating patients on the autism spectrum. Br Dent J ;2019 (Sep) ;227(6):504-510.

Background Over 1% of the UK population have a diagnosis of autism, and yet there is minimal information regarding the experiences of dental professionals working with people on the autistic spectrum. The current study is the first to investigate UK dental professionals’ knowledge of autism, their perceived confidence when treating autistic patients, and the factors that affect this.Methods An online, self-report survey was completed by 482 UK dental professionals and included questions on participants’ training, prior experiences and knowledge of autism, and confidence when treating autistic patients.Results Over half the respondents reported having no formal autism training but average knowledge levels across the whole sample were good. Conversely, levels of confidence were only moderate. Respondents often cited conflict between understanding the additional needs for successful treatment of autistic patients and a lack of resources to implement support strategies. Despite this, the vast majority were positive about making the necessary modifications to support autistic patients.Conclusion This study highlights ways in which UK dental professionals adapt their practices to meet the needs of their autistic patients, yet report only moderate confidence levels when doing so. Implications for future training initiatives are discussed.

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7. Fang H, Ke X. Structural Networks in Children with Autism Spectrum Disorder with Regression : a Graph Theory Study. Behav Brain Res ;2019 (Sep 25):112262.

BACKGROUND : Regression is frequently described in Autism spectrum disorder (ASD). Limited comprehensive studies have been conducted in patients with ASD with regression. PURPOSE : To explore the network topological properties in ASD children with (ASD-R) and without (ASD-NR) regression. METHODS : In this study, 29 ASD-R, 68 ASD-NR, and 40 children with developmental delay (DD) were recruited. We utilized graph theory to characterize the white matter structure networks by using diffusion tensor imaging and T1-weighted imaging on a 3-T magnetic resonance system. Statistical analyses were performed using IBM SPSS (version 23). RESULTS : ANCOVA showed significant differences in global efficiency, characteristic path length and sigma among the ASD-R, ASD-NR and DD groups, but the difference was not significant between the ASD-R and ASD-NR groups. There were 10 common hubs based on regional degree and regional efficiency in all groups. The hubness of the left superior frontal gyrus-dorsolateral, left middle occipital gyrus and right precuneus were enhanced (by regional degree) and that of the right thalamus was reduced (by regional efficiency) in the ASD-R relative to the ASD-NR group. After controlling for the course of regression, the CARS scores were significantly correlated with the regional efficiency of the right precuneus in the ASD-R group. CONCLUSIONS : The ASD-R children were different from the ASD-NR children in the distribution of hub regions, although there were no global network property differences between them. In ASD-R children, the right precuneus (PCUN.R) might play an important role and relate to autism symptom severity.

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8. Fujino J, Tei S, Itahashi T, Aoki YY, Ohta H, Kubota M, Hashimoto RI, Nakamura M, Kato N, Takahashi H. Impact of past experiences on decision-making in autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci ;2019 (Sep 26)

People are often influenced by past costs in their current decision-making, thus succumbing to a well-known bias recognized as the sunk cost effect. A recent study showed that the sunk cost effect is attenuated in individuals with autism spectrum disorder (ASD). However, the study only addressed one situation of utilization decision by focusing on the choice between similar attractive alternatives with different levels of sunk costs. Thus, it remains unclear how individuals with ASD behave under sunk costs in different types of decision situations, particularly progress decisions, in which the decision-maker allocates additional resources to an initially chosen alternative. The sunk cost effect in progress decisions was estimated using an economic task designed to assess the effect of the past investments on current decision-making. Twenty-four individuals with ASD and 21 age-, sex-, smoking status-, education-, and intelligence quotient-level-matched typical development (TD) subjects were evaluated. The TD participants were more willing to make the second incremental investment if a previous investment was made, indicating that their decisions were influenced by sunk costs. However, unlike the TD group, the rates of investments were not significantly increased after prior investments in the ASD group. The results agree with the previous evidence of a reduced sensitivity to context stimuli in individuals with ASD and help us obtain a broader picture of the impact of sunk costs on their decision-making. Our findings will contribute to a better understanding of ASD and may be useful in addressing practical implications of their socioeconomic behavior.

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9. Gegelashvili M. AUTISM AND DEPRESSION (REVIEW). Georgian Med News ;2019 (Jul-Aug)(292-293):54-56.

The present paper aims to summarize and review available research on the manifestations of comorbid depression in persons with ASD (Autism spectrum Disorder) and its impact on the course of autism ;as well as to review the pharmacological treatment of comorbid depression with ASD. The existence of a comorbid depression affects the state of individuals with ASD, which often remains unnoticed for the people around. Literary review permits us to get familiar with the peculiarities of clinical manifestations of comorbid depression in autism, risk factors for comorbid depression the importance of diagnosis and the methods of pharmacological intervention. Few issues have been identified : the necessity of raising awareness and drawing attention to the clinical features of comorbid depression especially in low functioning persons. The nessecity of regular screening persons with ASD screening of all persons having ASD for determining the existence of depression and suicidal thoughts. The necessity of adaptation of relevant diagnostic instruments, which will be an important aid tool to diagnose comorbid depression in autism. The necessity of more research to establish guidelines for pharmacological management of symptoms for comorbid depression disorder.

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10. 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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11. Haebich KM, Pride NA, Walsh KS, Chisholm A, Rouel M, Maier A, Anderson V, Barton B, Silk T, Korgaonkar M, Seal M, Lami F, Lorenzo J, Williams K, Dabscheck G, Rae CD, Kean M, North KN, Payne JM. Understanding autism spectrum disorder and social functioning in children with neurofibromatosis type 1 : protocol for a cross-sectional multimodal study. BMJ Open ;2019 (Sep 26) ;9(9):e030601.

INTRODUCTION : Children with the single-gene disorder neurofibromatosis type 1 (NF1) appear to be at an increased risk for autism spectrum disorder (ASD) and exhibit a unique social-cognitive phenotype compared with children with idiopathic ASD. A complete framework is required to better understand autism in NF1, from neurobiological levels through to behavioural and functional outcomes. The primary aims of this study are to establish the frequency of ASD in children with NF1, examine the social cognitive phenotype, investigate the neuropsychological processes contributing to ASD symptoms and poor social functioning in children with NF1, and to investigate novel structural and functional neurobiological markers of ASD and social dysfunction in NF1. The secondary aim of this study is to compare the neuropsychological and neurobiological features of ASD in children with NF1 to a matched group of patients with idiopathic ASD. METHODS AND ANALYSIS : This is an international, multisite, prospective, cross-sectional cohort study of children with NF1, idiopathic ASD and typically developing (TD) controls. Participants will be 200 children with NF1 (3-15 years of age), 70 TD participants (3-15 years) and 35 children with idiopathic ASD (7-15 years). Idiopathic ASD and NF1 cases will be matched on age, sex and intelligence. All participants will complete cognitive testing and parents will rate their child’s behaviour on standardised questionnaires. Neuroimaging will be completed by a subset of participants aged 7 years and older. Children with NF1 that screen at risk for ASD on the parent-rated Social Responsiveness Scale 2nd Edition will be invited back to complete the Autism Diagnostic Observation Scale 2nd Edition and Autism Diagnostic Interview-Revised to determine whether they fulfil ASD diagnostic criteria. ETHICS AND DISSEMINATION : This study has hospital ethics approval and the results will be disseminated through peer-reviewed publications and international conferences.

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12. Kirkpatrick B, Gilroy SP, Leader G. Qualitative study on parents’ perspectives of the familial impact of living with a child with autism spectrum disorder who experiences insomnia. Sleep Med ;2019 (Feb 7) ;62:59-68.

BACKGROUND : Sleep is an essential aspect of life and it is estimated that 40-80% of individuals with Autism Spectrum Disorder (ASD) present with insomnia. Insomnia relates to difficulties initiating and/or maintaining sleep which can be distressing for the child with ASD and their family. Despite the high prevalence of insomnia in children with ASD there is little qualitative data on parents’ perspective on the impact it has on the family unit. METHODS : This study presents findings from a series of three focus groups representing 15 families of children with ASD who experience insomnia. Focus groups were audio recorded and transcribed intelligent verbatim. NVivo 9 software was used to enable a content analysis. Text was coded and according to its content emerging themes were identified. Six main themes to include anxiety, dietary implications, bedtime routines, social exclusion, familial implications, and educational consequences emerged. RESULTS : The findings are discussed in relation to future considerations that may contribute to the development of best practice for sleep interventions for children with ASD. CONCLUSIONS : Qualitative data which considers parents’ perceptions of familial impact of insomnia may provide in-depth information for sleep clinicians working with families which could inform clinical decisions.

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13. Lundstrom S, Marland C, Kuja-Halkola R, Anckarsater H, Lichtenstein P, Gillberg C, Nilsson T. Assessing autism in females : The importance of a sex-specific comparison. Psychiatry Res ;2019 (Sep 13):112566.

Autism spectrum disorder (ASD) is diagnosed more often in boys than girls. Here, we compared the degree of autism - and related disorders - symptomatology in boys and girls with a registered diagnosis of ASD. We used parent telephone interview A-TAC (Autism-Tics, ADHD and other Comorbidities) ratings of 30,392 twins aged 9 or 12 (including 308 boys and 122 girls with National Patient Register diagnoses of ASD) participating in the Child and Adolescent Twin Study in Sweden. We used z-scores for ASD-symptoms, standardized separately for boys and girls. Boys with a diagnosis of ASD had a higher raw mean score than girls with a diagnosis on the A-TAC ASD domain. However, utilizing the z-scores, girls with a diagnosis of ASD deviated further away from the female population mean than did the boys with ASD from the male population mean. Girls also had higher standardized mean values for symptoms of Attention-Deficit/Hyperactivity Disorder, Learning Disabilities and Oppositional Defiant Disorder. The findings suggest that girls diagnosed with autism may represent an even more extreme end of the female population autistic features distribution, than diagnosed boys from the male population autistic features distribution. Future studies may benefit from examining the use of sex-specific cut-off scores.

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14. Moon SJ, Hwang JS, Kana R, Torous J, Kim JW. Diagnostic test accuracy for use of machine learning in diagnosis of autism spectrum disorder : A Systematic Review and Meta-Analysis. JMIR Ment Health ;2019 (Sep 24)

BACKGROUND : Over the recent years, machine learning algorithms have been more widely and increasingly applied in biomedical fields. In particular, its application has been drawing more attention in the field of psychiatry, for instance, as diagnostic tests/tools for autism spectrum disorder. However, given its complexity and potential clinical implications, there is ongoing need for further research on its accuracy. OBJECTIVE : The current study aims to summarize the evidence for the accuracy of use of machine learning algorithms in diagnosing autism spectrum disorder (ASD) through systematic review and meta-analysis. METHODS : MEDLINE, Embase, CINAHL Complete (with OpenDissertations), PsyINFO and IEEE Xplore Digital Library databases were searched on November 28th, 2018. Studies, which used a machine learning algorithm partially or fully in classifying ASD from controls and provided accuracy measures, were included in our analysis. Bivariate random effects model was applied to the pooled data in meta-analysis. Subgroup analysis was used to investigate and resolve the source of heterogeneity between studies. True-positive, false-positive, false negative and true-negative values from individual studies were used to calculate the pooled sensitivity and specificity values, draw SROC curves, and obtain area under the curve (AUC) and partial AUC. RESULTS : A total of 43 studies were included for the final analysis, of which meta-analysis was performed on 40 studies (53 samples with 12,128 participants). A structural MRI subgroup meta-analysis (12 samples with 1,776 participants) showed the sensitivity at 0.83 (95% CI-0.76 to 0.89), specificity at 0.84 (95% CI -0.74 to 0.91), and AUC/pAUC at 0.90/0.83. An fMRI/deep neural network (DNN) subgroup meta-analysis (five samples with 1,345 participants) showed the sensitivity at 0.69 (95% CI- 0.62 to 0.75), the specificity at 0.66 (95% CI -0.61 to 0.70), and AUC/pAUC at 0.71/0.67. CONCLUSIONS : Machine learning algorithms that used structural MRI features in diagnosis of ASD were shown to have accuracy that is similar to currently used diagnostic tools.

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15. Ostashchenko E, Deliens G, Durrleman S, Kissine M. An eye-tracking study of selective trust development in children with and without autism spectrum disorder. J Exp Child Psychol ;2019 (Sep 24) ;189:104697.

The purpose of this study was to explore whether children with autism display selectivity in social learning. We investigated the processing of word mappings provided by speakers who differed on previously demonstrated accuracy and on potential degree of reliability in three groups of children (children with autism spectrum disorder, children with developmental language disorder, and typically developing children) aged 4-9years. In Task 1, one speaker consistently misnamed familiar objects and the second speaker consistently gave correct names. In Task 2, both speakers provided correct information but differed on how they could achieve this accuracy. We analyzed how the speakers’ profiles influenced children’s decisions to rely on them in order to learn novel words. We also examined how children attended to the speakers’ testimony by tracking their eye movements and comparing children’ gaze distribution across speakers’ faces and objects of their choice. Results show that children rely on associative trait attribution heuristics to selectively learn from accurate speakers. In Task 1, children in all groups preferred the novel object selected by accurate speakers and directly avoided information provided by previously inaccurate speakers, as revealed by the eye-tracking data. In Task 2, where more sophisticated reasoning about speakers’ reliability was required, only children in the typically developing group performed above chance. Nonverbal intelligence score emerged as a predictor of children’s preference for more reliable informational sources. In addition, children with autism exhibited reduced attention to speakers’ faces compared with children in the comparison groups.

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16. Porokhovnik L. Individual Copy Number of Ribosomal Genes as a Factor of Mental Retardation and Autism Risk and Severity. Cells ;2019 (Sep 26) ;8(10)

Autism is a complex multifactorial developmental disorder characterized by deficits in communication and restricted interests, often followed by mental retardation. Autism spectrum disorders (ASD) are caused by defects in miscellaneous molecular mechanisms, many of which remain unclear. But a considerable part of the known pathways converges on protein synthesis or degradation processes at different stages in the dendrites, laying the foundation for a concept of disturbed "translational homeostasis" or "proteostasis" in autism. The protein synthesis is conducted on ribosomes, cellular organelles consisting from a complex of riboproteins and a ribosomal RNA (rRNA) framework. The rRNA is encoded by ribosomal genes (RG) existing in multiple copies in the genome. The more copies of RG that are contained in the genome, the higher is the peak (maximum possible) ribosome abundance in the cell. A hypothesis is proposed that the RG copy number, through determining the quantity of ribosomes available in the dendrites, modulates the level of local dendritic translation and thus is a factor of risk and severity of a series of neuropsychiatric disorders caused by aberrant dendritic translation. A carrier of very low copy number of ribosomal genes is expected to have a milder form of ASD than a subject with the same epigenetic and genetic background, but a higher ribosomal gene dosage. Various ways of evaluation and testing the hypothesis on clinical material and animal models are suggested.

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17. 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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18. Turner TN. Large-Scale Population-Based Assessment of Psychiatric Comorbidities in Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Biol Psychiatry ;2019 (Oct 15) ;86(8):e25-e27.

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19. 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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20. 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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21. Williams ZJ. A Bifactor Model of the Autism Spectrum Disorder Phenotype. J Am Acad Child Adolesc Psychiatry ;2019 (Oct) ;58(10):1019-1021.

I read with interest the newly published work by Kim et al. describing the covariance structure of parent-reported autism spectrum disorder (ASD) symptoms.(1) The authors compared many different latent class, factor analytic, and factor mixture models in a large, clinically referred sample, concluding that the ASD phenotype is best described by three continuous latent factors of social interaction, communication, and repetitive behavior. I found the study to be methodologically rigorous, employing robust estimation techniques, testing a wide range of categorical-dimensional hybrid models, and even replicating the rank-order of model choices in a separate sample. However, given the large reported interfactor correlations in the final model (r = 0.78-0.83 ; Kim et al., Figure 2), I was disappointed that the authors did not explore a bifactor model(2) of ASD phenotypic traits. In this correspondance, I aim to demonstrate the ways in which bifactor models provide further insight into the structures of complex psychopathological constructs.

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22. Zablotsky B, Black LI, Maenner MJ, Schieve LA, Danielson ML, Bitsko RH, Blumberg SJ, Kogan MD, Boyle CA. Prevalence and Trends of Developmental Disabilities among Children in the United States : 2009-2017. Pediatrics ;2019 (Sep 26)

OBJECTIVES : To study the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using the National Health Interview Survey. METHODS : Data come from the 2009 to 2017 National Health Interview Survey, a nationally representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder ; autism spectrum disorder ; blindness ; cerebral palsy ; moderate to profound hearing loss ; learning disability ; intellectual disability ; seizures ; stuttering or stammering ; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated and stratified by demographic and socioeconomic characteristics. RESULTS : From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%-17.8%, P < .001), attention-deficit/hyperactivity disorder (8.5%-9.5%, P < .01), autism spectrum disorder (1.1%-2.5%, P < .001), and intellectual disability (0.9%-1.2%, P < .05), but a significant decrease for any other developmental delay (4.7%-4.1%, P < .05). The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight >/=2500 g, and children living in urban areas and with less-educated mothers. CONCLUSIONS : The prevalence of developmental disability among US children aged 3 to 17 years increased between 2009 and 2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care.

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

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