Pubmed du 19/11/19

mardi 19 novembre 2019

1. Carnett A, Ingvarsson ET, Bravo A, Sigafoos J. Teaching children with autism spectrum disorder to ask "where" questions using a speech-generating device. J Appl Behav Anal ;2019 (Nov 17)

Children with autism spectrum disorder (ASD) who have limited speech are often taught to communicate using a speech-generating device (SGD). We evaluated procedures for teaching a mand for information (i.e., Where is [item] ?) using an interrupted behavior chain procedure. In Experiment 1, all participants (3 children with ASD who communicated using an SGD) acquired the target mand but transfer to a novel stimulus did not occur. In the second experiment, 2 participants were taught to approach alternative communication partners when the first partner did not provide the information. The second experiment also included procedures to test whether the responses were under the control of appropriate motivating operations (MOs). Generalization across communication partners occurred with both participants, but transfer across behavior chains with only 1 participant. The results of both experiments suggest that teaching multiple behavior chains and evaluating MO control may be necessary to establish generalized manding for information.

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2. Desaunay P, Postel C, Bensaber F, Gonneaud J, Baleyte JM, Anger M, Guenole F, Malvy J, Bonnet-Brilhault F, Eustache F, Desgranges B, Guillery-Girard B. Prospective Memory in Adolescents with Autism : A Preliminary Study of the Impact of Memory Load. Dev Neuropsychol ;2019 (Nov 18):1-11.

We evaluated event-based prospective memory (EBPM) in adolescents with Autism, varying the load of the to-be-performed intentions. We included measures of inhibition, working memory and binding. Results showed that increasing the retrospective memory load reduced performance in controls. In Autism, adolescents were impaired in the low load condition with normal performance for the ongoing task, with the reverse pattern in the high load condition. EBPM may be impacted in Autism due to difficulty to process ongoing and EBPM tasks simultaneously possibly because of restricted inhibitory control.

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3. Duan W, Wang K, Duan Y, Chu X, Ma R, Hu P, Xiong B. Integrated Transcriptome Analyses Revealed Key Target Genes in Mouse Models of Autism. Autism Res ;2019 (Nov 19)

Genetic mutations are the major pathogenic factor of Autism Spectrum Disorder (ASD). In recent years, more and more ASD risk genes have been revealed, among which there are a group of transcriptional regulators. Considering the similarity of the core clinical phenotypes, it is possible that these different factors may regulate the expression levels of certain key targets. Identification of these targets could facilitate the understanding of the etiology and developing of novel diagnostic and therapeutic methods. Therefore, we performed integrated transcriptome analyses of RNA-Seq and microarray data in multiple ASD mouse models and identified a number of common downstream genes in various brain regions, many of which are related to the structure and function of the synapse components or drug addiction. We then established protein-protein interaction networks of the overlapped targets and isolated the hub genes by 11 algorithms based on the topological structure of the networks, including Sdc4, Vegfa, and Cp in the Cortex-Adult subgroup, Gria1 in the Cortex-Juvenile subgroup, and Kdr, S1pr1, Ubc, Grm2, Grin2b, Nrxn1, Pdyn, Grin3a, Itgam, Grin2a, Gabra2, and Camk4 in the Hippocampus-Adult subgroup, many of which have been associated with ASD in previous studies. Finally, we cross compared our results with human brain transcriptional data sets and verified several key candidates, which may play important role in the pathology process of ASD, including SDC4, CP, S1PR1, UBC, PDYN, GRIN2A, GABRA2, and CAMK4. In summary, by integrated bioinformatics analysis, we have identified a series of potentially important molecules for future ASD research. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Abnormal transcriptional regulation accounts for a significant portion of Autism Spectrum Disorder. In this study, we performed transcriptome analyses of mouse models to identify common downstream targets of transcriptional regulators involved in ASD. We identified several recurrent target genes that are close related to the common pathological process of ASD, including SDC4, CP, S1PR1, UBC, PDYN, GRM2, NRXN1, GRIN3A, ITGAM, GRIN2A, GABRA2, and CAMK4. These results provide potentially important targets for understanding the molecular mechanism of ASD.

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4. Fleury-Teixeira P, Caixeta FV, Ramires da Silva LC, Brasil-Neto JP, Malcher-Lopes R. Effects of CBD-Enriched Cannabis sativa Extract on Autism Spectrum Disorder Symptoms : An Observational Study of 18 Participants Undergoing Compassionate Use. Front Neurol ;2019 ;10:1145.

Autism Spectrum Disorders comprise conditions that may affect cognitive development, motor skills, social interaction, communication, and behavior. This set of functional deficits often results in lack of independence for the diagnosed individuals, and severe distress for patients, families, and caregivers. There is a mounting body of evidence indicating the effectiveness of pure cannabidiol (CBD) and CBD-enriched Cannabis sativa extract (CE) for the treatment of autistic symptoms in refractory epilepsy patients. There is also increasing data support for the hypothesis that non-epileptic autism shares underlying etiological mechanisms with epilepsy. Here we report an observational study with a cohort of 18 autistic patients undergoing treatment with compassionate use of standardized CBD-enriched CE (with a CBD to THC ratio of 75/1). Among the 15 patients who adhered to the treatment (10 non-epileptic and five epileptic) only one patient showed lack of improvement in autistic symptoms. Due to adverse effects, three patients discontinued CE use before 1 month. After 6-9 months of treatment, most patients, including epileptic and non-epileptic, showed some level of improvement in more than one of the eight symptom categories evaluated : Attention Deficit/Hyperactivity Disorder ; Behavioral Disorders ; Motor Deficits ; Autonomy Deficits ; Communication and Social Interaction Deficits ; Cognitive Deficits ; Sleep Disorders and Seizures, with very infrequent and mild adverse effects. The strongest improvements were reported for Seizures, Attention Deficit/Hyperactivity Disorder, Sleep Disorders, and Communication and Social Interaction Deficits. This was especially true for the 10 non-epileptic patients, nine of which presented improvement equal to or above 30% in at least one of the eight categories, six presented improvement of 30% or more in at least two categories and four presented improvement equal to or above 30% in at least four symptom categories. Ten out of the 15 patients were using other medicines, and nine of these were able to keep the improvements even after reducing or withdrawing other medications. The results reported here are very promising and indicate that CBD-enriched CE may ameliorate multiple ASD symptoms even in non-epileptic patients, with substantial increase in life quality for both ASD patients and caretakers.

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5. Geier DA, Kern JK, Geier MR. Down Syndrome as a Genetic Model to Evaluate the Role of Oxidative Stress and Transsulfuration Abnormities in Autism Spectrum Disorder : A Ten-Year Longitudinal Cohort Study. Dev Neurobiol ;2019 (Nov 19)

Autism spectrum disorder (ASD) is a neurodevelopmental disorder in which evidence reveals oxidative stress and transsulfuration pathway abnormalities. Down Syndrome (DS) is a genetic disorder characterized by similar oxidative stress and transsulfuration pathway abnormalities. This hypothesis-testing longitudinal cohort study determined whether transsulfuration abnormalities and oxidative stress are important susceptibility factors in ASD etiology by evaluating the rate of ASD diagnoses in DS as compared to the general population. The Independent Healthcare Research Database (IHRD) was analyzed for healthcare records prospectively generated in Florida Medicaid. A cohort of 101,736 persons (born : 1990-1999) with >/= 10 outpatient office visits and continuously followed for 120-months after birth were examined. There were 942 children in the DS cohort (ICD-9 code : 758.0) and 100,749 children the undiagnosed cohort (no DS diagnosis). ASD diagnoses were defined as autistic disorder (ICD-9 code : 299.00) or Asperger’s disorder/pervasive developmental disorder - not otherwise specified (PDD-NOS) (ICD-9 code : 299.80). ASDs were diagnosed in 5.31% of the DS cohort and 1.34% in the undiagnosed cohort. The risk ratio of being diagnosed with an ASD in the DS cohort as compared to the undiagnosed cohort was 3.97-fold significantly increased with a risk difference of 3.97%. Among children diagnosed with DS, less than 6% were also diagnosed with an ASD. Among children diagnosed with an ASD, less than 5% were also diagnosed with DS. Children diagnosed with DS are apparently more susceptible to ASD diagnosis relative to the general population suggesting oxidative stress and transsulfuration pathway abnormalities are important susceptibility factors in ASD.

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6. Hahn LJ, Brady NC, Versaci T. Communicative Use of Triadic Eye Gaze in Children With Down Syndrome, Autism Spectrum Disorder, and Other Intellectual and Developmental Disabilities. Am J Speech Lang Pathol ;2019 (Nov 19) ;28(4):1509-1522.

Purpose This study examines differences in the communicative use of triadic eye gaze (TEG) during a communicative interaction in 2 neurodevelopmental disorders : Down syndrome (DS) and autism spectrum disorders (ASD), and a 3rd group of varying disabilities associated with intellectual and developmental disabilities (IDDs). Also, the relationship between TEG use and language abilities was explored. Method Participants were 45 children, 15 in each group. The frequency of TEG was coded during a scripted communication assessment when children were between 3 and 6 years of age (37-73 months). Receptive and expressive language was measured using raw scores from the Mullen Scales of Early Learning concurrently between 3 and 6 years and again 2 years later when children were between 5 and 8 years (59-92 months). Results Descriptively, children with DS had a higher frequency of TEG than children with ASD and IDD, but significant differences were only observed between children with DS and ASD. More TEG at Time 1 in children with DS was associated with higher receptive language at Time 1 and higher expressive language at Time 2. For children with ASD, a trend for a positive association between TEG at Time 1 and language abilities at Time 2 was observed. No significant associations were observed for children with IDD. Conclusion Children with DS used TEG significantly more than children with ASD in this sample. Identifying strengths and weaknesses in TEG use is important because providing caregiver training to facilitate TEG can result in increased opportunities to respond with language models and promote language development.

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7. Hof MV, Ester WA, Serdarevic F, van Berckelaer-Onnes I, Hillegers MHJ, Tiemeier H, Hoek HW, Jansen PW. The sex-specific association between autistic traits and eating behavior in childhood : An exploratory study in the general population. Appetite ;2019 (Nov 15):104519.

Children with Autism Spectrum Disorder (ASD) often exhibit problematic eating behaviors, an observation mostly based on male dominated, clinical ASD study samples. It is, however, important to evaluate both children with an ASD diagnosis and children with subclinical autistic traits as both often experience difficulties. Moreover, considering the suggestion of a possible girl-specific ASD phenotype, there is a need to determine whether autistic traits are related with problematic eating behaviors in girls as well. This study explores the sex-specific association between autism (both autistic traits and diagnosed ASD) and eating behavior in middle childhood in Generation R, a prospective population-based cohort from fetal life onwards. We collected parental reports of autistic traits at six years (Social Responsiveness Scale) and of eating behavior at ten years (Children’s Eating Behaviour Questionnaire). In this cohort of 3559 children, autistic traits at six years were associated with more Picky Eating, Emotional Eating and Food Responsiveness in later childhood (e.g. adjusted B for Picky Eating=0.07 ; 95% CI : 0.03, 0.11). Stratified analyses showed that in girls, autistic traits were associated with more Emotional Overeating and Emotional Undereating (e.g. adjusted B for Emotional Undereating=0.12 ; 95% CI : 0.04, 0.20), while no associations were found for boys. Results comparing children with and without an ASD diagnosis in the cohort largely confirm these associations (e.g. in girls, adjusted B for Emotional Undereating=0.72 ; 95% CI : 0.01, 1.42). Our results point to a sex-specific association between autism and eating behavior in middle childhood. Also, our study is the first study to show that autistic traits are associated with emotionally based eating problems in girls and possibly represent part of a girl-specific ASD phenotype.

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8. Howard PL, Zhang L, Benson V. What Can Eye Movements Tell Us about Subtle Cognitive Processing Differences in Autism ?. Vision (Basel) ;2019 (May 24) ;3(2)

Autism spectrum disorder (ASD) is neurodevelopmental condition principally characterised by impairments in social interaction and communication, and repetitive behaviours and interests. This article reviews the eye movement studies designed to investigate the underlying sampling or processing differences that might account for the principal characteristics of autism. Following a brief summary of a previous review chapter by one of the authors of the current paper, a detailed review of eye movement studies investigating various aspects of processing in autism over the last decade will be presented. The literature will be organised into sections covering different cognitive components, including language and social communication and interaction studies. The aim of the review will be to show how eye movement studies provide a very useful on-line processing measure, allowing us to account for observed differences in behavioural data (accuracy and reaction times). The subtle processing differences that eye movement data reveal in both language and social processing have the potential to impact in the everyday communication domain in autism.

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9. Ma X, Qiu S. Control of cortical synapse development and plasticity by MET receptor tyrosine kinase, a genetic risk factor for autism. J Neurosci Res ;2019 (Nov 19)

The key developmental milestone events of the human brain, such as neurogenesis, synapse formation, maturation, and plasticity, are determined by a myriad of molecular signaling events, including those mediated by a number of receptor tyrosine kinases (RTKs) and their cognate ligands. Aberrant or mistimed brain development and plasticity can lead to maladaptive changes, such as dysregulated synaptic connectivity and breakdown of circuit functions necessary for cognition and adaptive behaviors, which are hypothesized pathophysiologies of many neurodevelopmental and neuropsychiatric disorders. Here we review recent literature that supports autism spectrum disorder as a likely result of aberrant synapse development due to mistimed maturation and plasticity. We focus on MET RTK, a prominent genetic risk factor for autism, and discuss how a pleiotropic molecular signaling system engaged by MET exemplifies a genetic program that controls cortical circuit development and plasticity by modulating the anatomical and functional connectivity of cortical circuits, thus conferring genetic risk for neurodevelopmental disorders.

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10. Mahmoodifar E, Sotoodeh MS. Combined Transcranial Direct Current Stimulation and Selective Motor Training Enhances Balance in Children With Autism Spectrum Disorder. Percept Mot Skills ;2019 (Nov 19):31512519888072.

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11. Marquis SM, McGrail K, Hayes M. Mental health of parents of children with a developmental disability in British Columbia, Canada. J Epidemiol Community Health ;2019 (Nov 19)

BACKGROUND : There is evidence in the literature that parents of children who have a developmental disability experience an increased risk of mental health problems. METHODS : This study used population-level administrative data from the Ministry of Health, British Columbia, Canada, to assess the mental health of parents of children who have a developmental disability compared with the mental health of parents of children who do not have a developmental disability. Population-level and individual explanatory variables available in the data were included in the models. RESULTS : At a population level, the study found strong evidence that parents of children who have a developmental disability experience higher odds of depression or other mental health diagnoses compared with parents of children who do not have a developmental disability. Age of the parent at birth of the child, income and location of healthcare services were all associated with outcomes. CONCLUSION : Parents of children who have a developmental disability may be in need of programmes and services that support their mental health.

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12. Mhiri I, Rekik I. Joint functional brain network atlas estimation and feature selection for neurological disorder diagnosis with application to autism. Med Image Anal ;2019 (Nov 7) ;60:101596.

Image-based brain maps, generally coined as ’intensity or image atlases’, have led the field of brain mapping in health and disease for decades, while investigating a wide spectrum of neurological disorders. Estimating representative brain atlases constitute a fundamental step in several MRI-based neurological disorder mapping, diagnosis, and prognosis. However, these are strikingly lacking in the field of brain connectomics, where connectional brain atlases derived from functional MRI (fRMI) or diffusion MRI (dMRI) are almost absent. On the other hand, conventional connectomic-based classification methods traditionally resort to feature selection methods to decrease the high-dimensionality of connectomic data for learning how to diagnose new patients. However, these are generally limited by high computational cost and a large variability in performance across different datasets, which might hinder the identification of reproducible biomarkers. To address both limitations, we unprecedentedly propose a brain network atlas-guided feature selection (NAG-FS) method to disentangle the healthy from the disordered connectome. To this aim, given a population of brain connectomes, we propose to learn how estimate a centered and representative functional brain network atlas (i.e., a population center) to reliably map the functional connectome and its variability across training individuals, thereby capturing their shared traits (i.e., connectional fingerprint of a population). Essentially, we first learn the pairwise similarities between connectomes in the population to map them into different subspaces. Next, we non-linearly diffuse and fuse connectomes living in each subspace, respectively. By integrating the produced subspace-specific network atlases we ultimately estimate the population network atlas. Last, we compute the difference between healthy and disordered network atlases to identify the most discriminative features, which are then used to train a predictive learner. Our method boosted the classification performance by 6% in comparison to state-of-the-art FS methods when classifying autistic and healthy subjects.

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13. Morgan B, Nageye F, Masi G, Cortese S. Sleep in adults with Autism Spectrum Disorder : a systematic review and meta-analysis of subjective and objective studies. Sleep Med ;2019 (Aug 2) ;65:113-120.

BACKGROUND/OBJECTIVE : Sleep problems are commonly reported by individuals with Autism Spectrum Disorder (ASD). However, to date, no quantitative evidence synthesis of available studies has been performed to quantify sleep alterations in adults with ASD. We performed a systematic review and meta-analysis of objective (ie, based on actigraphy or polysomnography [PSG]) and subjective (ie, based on sleep diaries/questionnaires) studies comparing sleep parameters in adults with ASD and in a typically developing (TD) control group. METHODS : PubMed, OVID databases and Web of Knowledge were systematically searched up to February 2019 with no language restrictions. Original studies including adults with a diagnosis of ASD according to DSM, ICD, or based on standard diagnostic tools (eg, ADOS), and a TD control group were included. Random-effects models were used. Study quality was evaluated with the Newcastle Ottawa Scale (NOS). Analyses were conducted using Comprehensive Meta-Analysis. RESULTS : From initial pool of 1948 references, 14 publications including 8 datasets, (194 ASD and 277 controls) met the inclusion criteria. Compared to controls, individuals with ASD were significantly more impaired in six out of 11 subjective parameters, including lower sleep efficiency (SE, SMD = -0.87, CI = -1.14 - 0.60) and in 10 out of 17 objective outcomes, including longer sleep onset latency (PSG) (SMD = 0.86, CI = 0.29-1.07) and wake after sleep onset (WASO, actigraphy) (SMD = 0.57, CI = 0.28-0.87). The mean NOS score was 4.88/6. CONCLUSIONS : Individuals with ASD demonstrated impaired sleep compared to controls in most subjective and objective measures.

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14. Naito M, Hotta C, Toichi M. Development of Episodic Memory and Foresight in High-Functioning Preschoolers with ASD. J Autism Dev Disord ;2019 (Nov 19)

To investigate the early development of episodic memory and future thinking in autism spectrum disorder (ASD), we selected 94 participants each from a group of ASD and typically developing (TD) preschoolers. They were required to remember newly-acquired knowledge sources and anticipate action timings necessary for future events. Five-year-old children with ASD remembered their knowledge sources similar to TD children ; however, the 6-year-old children performed more poorly than their TD counterparts. ASD children failed to anticipate future action timings in comparison with TD children. Although source memory and future thinking were related in TD children, they were unrelated in children with ASD. The results suggest that episodic memory and foresight are deficient and unintegrated in ASD children during the preschool years.

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15. Nisar S, Hashem S, Bhat AA, Syed N, Yadav S, Azeem MW, Uddin S, Bagga P, Reddy R, Haris M. Association of genes with phenotype in autism spectrum disorder. Aging (Albany NY) ;2019 (Nov 19) ;11

Autism spectrum disorder (ASD) is a genetic heterogeneous neurodevelopmental disorder that is characterized by impairments in social interaction and speech development and is accompanied by stereotypical behaviors such as body rocking, hand flapping, spinning objects, sniffing and restricted behaviors. The considerable significance of the genetics associated with autism has led to the identification of many risk genes for ASD used for the probing of ASD specificity and shared cognitive features over the past few decades. Identification of ASD risk genes helps to unravel various genetic variants and signaling pathways which are involved in ASD. This review highlights the role of ASD risk genes in gene transcription and translation regulation processes, as well as neuronal activity modulation, synaptic plasticity, disrupted key biological signaling pathways, and the novel candidate genes that play a significant role in the pathophysiology of ASD. The current emphasis on autism spectrum disorders has generated new opportunities in the field of neuroscience, and further advancements in the identification of different biomarkers, risk genes, and genetic pathways can help in the early diagnosis and development of new clinical and pharmacological treatments for ASD.

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16. Papadopoulos N, Sciberras E, Hiscock H, Williams K, McGillivray J, Mihalopoulos C, Engel L, Fuller-Tyszkiewicz M, Bellows ST, Marks D, Howlin P, Rinehart N. Sleeping sound with autism spectrum disorder (ASD) : study protocol for an efficacy randomised controlled trial of a tailored brief behavioural sleep intervention for ASD. BMJ Open ;2019 (Nov 19) ;9(11):e029767.

INTRODUCTION : Sleep problems are a characteristic feature of children with autism spectrum disorder (ASD) with 40% to 80% of children experiencing sleep difficulties. Sleep problems have been found to have a pervasive impact on a child’s socio-emotional functioning, as well as on parents’ psychological functioning. The Sleeping Sound ASD project aims to evaluate the efficacy of a brief behavioural sleep intervention in reducing ASD children’s sleep problems in a fully powered randomised controlled trial (RCT). Intervention impact on child and family functioning is also assessed. METHODS AND ANALYSIS : The RCT aims to recruit 234 children with a diagnosis of ASD, aged 5-13 years, who experience moderate to severe sleep problems. Participants are recruited from paediatrician clinics in Victoria, Australia, and via social media. Families interested in the study are screened for eligibility via phone, and then asked to complete a baseline survey online, assessing child sleep problems, and child and family functioning. Participants are then randomised to the intervention group or treatment as usual comparator group. Families in the intervention group attend two face-to-face sessions and a follow-up phone call with a trained clinician, where families are provided with individually tailored behavioural sleep strategies to help manage the child’s sleep problems. Teacher reports of sleep, behavioural and social functioning are collected, and cognitive ability assessed to provide measures blind to treatment group. The primary outcome is children’s sleep problems as measured by the Children’s Sleep Habits Questionnaire at 3 months post-randomisation. Secondary outcomes include parent and child quality of life ; child social, emotional, behavioural and cognitive functioning ; and parenting stress and parent mental health. Cost-effectiveness of the intervention is also evaluated. ETHICS AND DISSEMINATION : Findings from this study will be published in peer-reviewed journals and disseminated at national and international conferences, local networks and online. TRIAL REGISTRATION NUMBER : ISRCTN14077107 (ISRCTN registry dated on 3 March 2017).

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17. Qiu S, Lu Y, Li Y, Shi J, Cui H, Gu Y, Li Y, Zhong W, Zhu X, Liu Y, Cheng Y, Liu Y, Qiao Y. Prevalence of autism spectrum disorder in Asia : A systematic review and meta-analysis. Psychiatry Res ;2019 (Nov 5):112679.

There has been an increased prevalence of the diagnosis of Autism Spectrum Disorder (ASD) globally during the last decade. An updated and overall estimate of ASD prevalence in Asia would assist health professionals to develop relevant public health strategies. We performed a systematic review by searching English databases (Medline, Embase, Web of Science, and Cochran Library) from inception date to August 6, 2018. Subgroup, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using Egger’s test. A total of 2,195,497 subjects in Asia from 12 eligible studies were included in this meta-analysis. The pooled estimate of ASD prevalence among the included subjects was 0.36% (95% CI : 0.16-0.79%). The pooled ASD prevalence in males (0.45%, 95% CI : 0.19-1.04%) was higher than that in females (0.18%, 95% CI : 0.079-0.49%). ASD prevalence in East Asia, South Asia, and West Asia was 0.51% (95% CI : 0.06-4.22%), 0.31% (95% CI : 0.14-0.65%), and 0.35% (95% CI : 0.07-1.80%) respectively. The prevalence of ASD is increasing in Asia. Universal and standardized diagnostic processes for ASD should be adopted for the prevention and control programs of ASD in future.

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18. Rasmussen PS, Pedersen IK, Pagsberg AK. Biographical disruption or cohesion ? : How parents deal with their child’s autism diagnosis. Soc Sci Med ;2019 (Nov 11):112673.

Currently, we are witnessing a precipitous rise in autism diagnoses among children, and several bodies of sociological research are attempting to explain this development. However, the experiences within parental contexts have been inadequately examined ; that is, how parents feel about and act upon the awareness of their child’s autism diagnosis. Drawing upon a qualitative study among Danish parents of 20 children recently diagnosed with autism, this paper contributes with situated insights into parents’ experiences. We identify a spectrum of feelings towards the autism diagnosis, including both relief and grief. In the absence of theoretical notions drawing attention to how a child’s diagnosis influences parents’ self-conceptions and understandings of their child, we develop the concept of ’parent-biographical disruption’ : the parents’ rethinking of themselves and their child that might be caused by a chronic condition such as autism. Based on the variety of findings, we discuss what we call ’parent-biographical cohesion’ as a counterpart to ’disruption’. By ’cohesion’ we refer to the diagnostic awareness potentially creating clarification for parents about the past, present and future parenting of their child instead of disrupting their self-understandings as parents. In this way, through the notion of a parental-biographical spectrum of disruption and cohesion, we emphasize the diversity in how parents deal with a child’s autism diagnosis and the variety of needs for rethinking parental biographies in the wake of a diagnosis.

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19. Stanislaw H, Howard J, Martin C. Helping parents choose treatments for young children with autism : A comparison of applied behavior analysis and eclectic treatments. J Am Assoc Nurse Pract ;2019 (Nov 13)

BACKGROUND : Nurse practitioners (NPs) increasingly meet with families of young children who have been recently diagnosed with autism spectrum disorder (ASD). These families face a bewildering variety of treatment options and can benefit from working with NPs who can help them better understand those options and the likely outcomes for their children. PURPOSE : This study describes outcomes for young children with autism, who were treated with either applied behavior analysis (ABA) or eclectic treatment. Nurse practitioners can use this information to help families choose treatments for their children. METHODS : Children diagnosed with autism received ABA (n = 50) or eclectic treatment (n = 32). Age-appropriate assessments in a variety of domains were made before and after up to 7 years of treatment. RESULTS : Initial scores were below normal in every domain except motor skills. Sixty percent of children had normal cognitive scores after ABA, compared with only 25% of children after eclectic treatment. Other domains also showed better outcomes after ABA than eclectic treatment. IMPLICATIONS FOR PRACTICE : Nurse practitioners should be prepared to help families understand treatment options and their likely outcomes. The present study suggests that young children diagnosed with ASD can achieve normal levels of functioning in a variety of domains. These outcomes are much more likely after ABA than eclectic treatment.

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20. Teague SJ, Newman LK, Tonge BJ, Gray KM. Attachment and child behaviour and emotional problems in autism spectrum disorder with intellectual disability. J Appl Res Intellect Disabil ;2019 (Nov 19)

BACKGROUND : Behaviour and emotional problems are highly prevalent in children with autism spectrum disorder (ASD). In typically developing children, attachment quality acts as a risk/protective factor for behavioural outcomes and adjustment, warranting investigation in children with ASD. METHOD : We investigated the relationship between attachment and child behaviour and emotional problems in children with ASD and comorbid intellectual disability. Data were collected from parent-child dyads where children were diagnosed with ASD and ID (n = 28) or other developmental disabilities (n = 20). RESULTS : Children with ASD had higher levels of behaviour and emotional problems and more attachment difficulties than children with other developmental disabilities. Poorer attachment quality contributed uniquely to the variance in child behaviour and emotional problems. CONCLUSIONS : Interventions targeting behaviour and emotional problems in children with ASD may benefit from an attachment model which addresses the child’s difficulty in using caregivers as a coregulatory agent of emotions.

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21. Wang X, Lu J, Xie W, Lu X, Liang Y, Li M, Wang Z, Huang X, Tang M, Pfaff DW, Tang YP, Yao P. Maternal diabetes induces autism-like behavior by hyperglycemia-mediated persistent oxidative stress and suppression of superoxide dismutase 2. Proc Natl Acad Sci U S A ;2019 (Nov 19) ;116(47):23743-23752.

Epidemiological studies show that maternal diabetes is associated with an increased risk of autism spectrum disorders (ASDs), although the detailed mechanisms remain unclear. The present study aims to investigate the potential effect of maternal diabetes on autism-like behavior in offspring. The results of in vitro study showed that transient hyperglycemia induces persistent reactive oxygen species (ROS) generation with suppressed superoxide dismutase 2 (SOD2) expression. Additionally, we found that SOD2 suppression is due to oxidative stress-mediated histone methylation and the subsequent dissociation of early growth response 1 (Egr1) on the SOD2 promoter. Furthermore, in vivo rat experiments showed that maternal diabetes induces SOD2 suppression in the amygdala, resulting in autism-like behavior in offspring. SOD2 overexpression restores, while SOD2 knockdown mimics, this effect, indicating that oxidative stress and SOD2 expression play important roles in maternal diabetes-induced autism-like behavior in offspring, while prenatal and postnatal treatment using antioxidants permeable to the blood-brain barrier partly ameliorated this effect. We conclude that maternal diabetes induces autism-like behavior through hyperglycemia-mediated persistent oxidative stress and SOD2 suppression. Here we report a potential mechanism for maternal diabetes-induced ASD.

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22. Westphal A, Allely C. The Need for a Structured Approach to Violence Risk Assessment in Autism. J Am Acad Psychiatry Law ;2019 (Nov 19)

The relationship between autism spectrum disorder (ASD) and violence is poorly understood. Several violence risk factors are either modified by or are unique to ASD ; clinicians conducting violence risk assessment of people with ASD must consider these factors. An ASD-specific risk assessment tool is clearly needed. In the absence of this, clinicians often use risk assessment tools designed for other populations, highlighting the importance of establishing their predictive validity in people with ASD. Girardi and colleagues have taken a very important step in this process in their paper, "Assessing the Risk of Inpatient Violence in Autism Spectrum Disorder," by examining whether the Historical Clinical Risk Management-20, Version 3, can predict violence in male patients with ASD in a forensic setting. Further research is needed to design a risk assessment tool specific to ASD and its unique features.

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23. Wilkinson KM, Madel M. Eye Tracking Measures Reveal How Changes in the Design of Displays for Augmentative and Alternative Communication Influence Visual Search in Individuals With Down Syndrome or Autism Spectrum Disorder. Am J Speech Lang Pathol ;2019 (Nov 19) ;28(4):1649-1658.

Purpose This research note reports on how small changes to the organization of a simulated display for augmentative and alternative communication influence the visual search patterns of individuals with Down syndrome or autism, as measured through eye tracking technologies. Prior research had demonstrated that clustering symbols by their internal color facilitates search and reduces attention to distracters, in children with typical development. This research systematically replicated the procedures with individuals with Down syndrome or autism spectrum disorder. Method Participants engaged in a visual search task on a monitor with embedded automated eye tracking technology. Patterns of gaze during search were measured via this technology. Results Participants were significantly faster to fixate on the target and to select it with the mouse when the like-colored symbols were clustered together. In addition, participants were significantly less likely to fixate on distracters in the clustered condition. No group differences were found. Conclusions Small changes to the organization of the simulated augmentative and alternative communication display resulted in substantial differences in eye gaze and speed to find a target. Of greatest clinical import is the finding that clustering symbols reduced attention to distracters, given that individuals with disabilities may be prone to distraction.

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