Pubmed du 19/12/19

jeudi 19 décembre 2019

1. Arazi A, Meiri G, Danan D, Michaelovski A, Flusser H, Menashe I, Tarasiuk A, Dinstein I. Reduced sleep pressure in young children with autism. Sleep ;2019 (Dec 18)

STUDY OBJECTIVES : Sleep disturbances and insomnia are highly prevalent in children with Autism Spectrum Disorder (ASD). Sleep homeostasis, a fundamental mechanism of sleep regulation that generates pressure to sleep as a function of wakefulness, has not been studied in children with ASD so far, and its potential contribution to their sleep disturbances remains unknown. Here, we examined whether slow wave activity (SWA), a measure that is indicative of sleep pressure, differs in children with ASD. METHODS : In this case-control study, we compared overnight electroencephalogram (EEG) recordings that were performed during Polysomnography (PSG) evaluations of 29 children with ASD and 23 typically developing children. RESULTS : Children with ASD exhibited significantly weaker SWA power, shallower SWA slopes, and a decreased proportion of slow wave sleep in comparison to controls. This difference was largest during the first two hours following sleep onset and decreased gradually thereafter. Furthermore, SWA power of children with ASD was significantly, negatively correlated with the time of their sleep onset in the lab and at home, as reported by parents. CONCLUSIONS : These results suggest that children with ASD may have a dysregulation of sleep homeostasis that is manifested in reduced sleep pressure. The extent of this dysregulation in individual children was apparent in the amplitude of their SWA power, which was indicative of the severity of their individual sleep disturbances. We, therefore, suggest that disrupted homeostatic sleep regulation may contribute to sleep disturbances in children with ASD.

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2. Bourque KS, Goldstein H. Expanding Communication Modalities and Functions for Preschoolers With Autism Spectrum Disorder : Secondary Analysis of a Peer Partner Speech-Generating Device Intervention. J Speech Lang Hear Res ;2019 (Dec 19):1-16.

Purpose This study reports a secondary analysis of the nature of communicative functions and modalities used in initiations and responses of minimally verbal preschoolers with severe autism spectrum disorder (ASD) from a previously published study (Thiemann-Bourque, Feldmiller, Hoffman, & Johner, 2018). This analysis focused on the final cohort (n = 6) from a group design study (N = 45) that examined a peer mediation and speech-generating device (SGD) intervention compared to an SGD-only condition. Method After teaching peers to use an iPad as an SGD within a modified stay-play-talk approach, school staff implemented SGD instruction in child-peer dyads during typical preschool activities. To investigate individual differences among children who demonstrated increased communication acts in the peer + SGD condition, changes in reciprocity, modalities used, and communicative functions were examined using a multiple-baseline design across children. Fidelity of implementation and social validity data were also collected. Results Six children with ASD and their peers demonstrated more balanced reciprocity, with individual differences in how and why children communicated during exchanges. That is, all children with ASD increased in SGD use as their primary communication mode ; 3 children used different modalities including more speech, and 3 children used primarily gestures and SGD. The most frequent function expressed was requests for objects. More modest increases were observed in comments and requests for actions, with negligible changes in gaining attention. Social validity reports by naive judges reflected clear improvements in communication interactions. Conclusion Findings are promising for a preschool SGD intervention that can expand children’s modalities and communicative functions to engage in balanced exchanges with peer partners. Supplemental Material https://doi.org/10.23641/asha.11374203.

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3. Downs SM, Bauer NS, Saha C, Ofner S, Carroll AE. Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics : A Cluster Randomized Clinical Trial. JAMA Netw Open ;2019 (Dec 2) ;2(12):e1917676.

Importance : Universal early screening for autism spectrum disorder (ASD) is recommended but not routinely performed. Objective : To determine whether computer-automated screening and clinical decision support can improve ASD screening rates in pediatric primary care practices. Design, Setting, and Participants : This cluster randomized clinical trial, conducted between November 16, 2010, and November 21, 2012, compared ASD screening rates among a random sample of 274 children aged 18 to 24 months in urban pediatric clinics of an inner-city county hospital system with or without an ASD screening module built into an existing decision support software system. Statistical analyses were conducted from February 6, 2017, to June 1, 2018. Interventions : Four clinics were matched in pairs based on patient volume and race/ethnicity, then randomized within pairs. Decision support with the Child Health Improvement Through Computer Automation system (CHICA) was integrated with workflow and with the electronic health record in intervention clinics. Main Outcomes and Measures : The main outcome was screening rates among children aged 18 to 24 months. Because the intervention was discontinued among children aged 18 months at the request of the participating clinics, only results for those aged 24 months were collected and analyzed. Rates of positive screening results, clinicians’ response rates to screening results in the computer system, and new cases of ASD identified were also measured. Main results were controlled for race/ethnicity and intracluster correlation. Results : Two clinics were randomized to receive the intervention, and 2 served as controls. Records from 274 children (101 girls, 162 boys, and 11 missing information on sex ; age range, 23-30 months) were reviewed (138 in the intervention clinics and 136 in the control clinics). Of 263 children, 242 (92.0%) were enrolled in Medicaid, 138 (52.5%) were African American, and 96 (36.5%) were Hispanic. Screening rates in the intervention clinics increased from 0% (95% CI, 0%-5.5%) at baseline to 68.4% (13 of 19) (95% CI, 43.4%-87.4%) in 6 months and to 100% (18 of 18) (95% CI, 81.5%-100%) in 24 months. Control clinics had no significant increase in screening rates (baseline, 7 of 64 children [10.9%] ; 6-24 months after the intervention, 11 of 72 children [15.3%] ; P = .46). Screening results were positive for 265 of 980 children (27.0%) screened by CHICA during the study period. Among the 265 patients with positive screening results, physicians indicated any response in CHICA in 151 (57.0%). Two children in the intervention group received a new diagnosis of ASD within the time frame of the study. Conclusions and Relevance : The findings suggest that computer automation, when integrated with clinical workflow and the electronic health record, increases screening of children for ASD, but follow-up by physicians is still flawed. Automation of the subsequent workup is still needed. Trial Registration : ClinicalTrials.gov identifier : NCT01612897.

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4. Gao X, Zheng R, Ma X, Gong Z, Xia D, Zhou Q. Elevated Level of PKMzeta Underlies the Excessive Anxiety in an Autism Model. Front Mol Neurosci ;2019 ;12:291.

Anxiety affects the life quality of a significant percentage of autism patients. To understand the possible biological basis of this high anxiety level, we used a valproic acid (VPA) model of autism. Anxiety level is significantly higher in VPA-injected mice, at both P35 and P70. In addition, protein kinase Mzeta (PKMzeta) level in the basolateral amygdala (BLA) is significantly higher in VPA mice at both ages. Consistent with this finding, infusion of a PKMzeta-blocking peptide z-pseudosubstrate inhibitory peptide (ZIP) into BLA significantly reduced anxiety levels in VPA mice. Furthermore, viral overexpression of PKMzeta in the BLA led to elevated anxiety level in Wild Type (WT) mice, with concomitant higher intrinsic excitability of BLA excitatory neurons. Altogether, our results indicate a key contribution of BLA PKMzeta level to anxiety, especially in autism ; and this finding may provide a further understanding of the pathogenesis as well as treatment of anxiety symptoms in autism patients.

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5. Garcia JM, Leahy N, Rivera P, Renziehausen J, Samuels J, Fukuda DH, Stout JR. Brief Report : Preliminary Efficacy of a Judo Program to Promote Participation in Physical Activity in Youth with Autism Spectrum Disorder. J Autism Dev Disord ;2019 (Dec 17)

To examine the preliminary efficacy of an 8-week judo program to promote moderate-to-vigorous physical activity (MVPA) and reduce sedentary behavior (SB) in youth with Autism Spectrum Disorder (ASD). Fourteen children diagnosed with ASD participated in a weekly judo program over a period of 8 weeks. Participants wore an Actigraph accelerometer to measure activity levels at baseline and post-judo. All 14 children attended at least 75% of the 8 judo classes. Percentage of time spent in daily MVPA (8% vs 4%, p = .05) increased following the intervention. A high rate of participation and an increase in time spent in MVPA was observed following the 8-week program. Further research to examine causal mechanisms is warranted.

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6. Joshi G, DiSalvo M, Wozniak J, Ceranoglu TA, Yule A, Surman C, Fried R, Galdo M, Hoskova B, Belser A, Biederman J. A prospective open-label trial of long-acting liquid methylphenidate for the treatment of attention deficit/hyperactivity disorder in intellectually capable adults with autism spectrum disorder. World J Biol Psychiatry ;2019 (Dec 19):1-17.

Objectives : This treatment trial is aimed at assessing the short-term tolerability and efficacy of liquid-formulation extended-release methylphenidate (MPH-ER) for the treatment of attention deficit/hyperactivity disorder (ADHD) in adults with high-functioning autism spectrum disorder (HF-ASD).Methods : A 6-week open-label trial (ClinicalTrials.gov : NCT02096952) was conducted in 15 HF-ASD adults (mean age 24.9 +/- 4.6 ; male, 12 (80%)) suffering from moderate-severe ADHD. MPH-ER was administered based on a flexible titration schedule. Efficacy was assessed on clinician- and self-rated measures. Tolerability was assessed by documenting treatment-emergent adverse events (AEs) and other safety measures.Results : Short-term MPH-ER treatment was associated with significant improvement in ADHD severity (Adult ADHD Investigator Symptom Report Scale (AISRS) mean change (MC), -22.8 +/- 8.8, P < 0.001 ; Adult ADHD Self-Report Scale (ASRS) MC, -8.2 +/- 15.3, P < 0.001). Twelve (80%) participants were deemed responders, based on >/=30% reduction in AISRS score and an ADHD Clinical Global Impression-Improvement score </=2. MPH-ER was well-tolerated (treatment-limiting AEs, 1/15 ; severe AEs, 1/15) at mean dose of 48.7 +/- 15 mg/day. AEs were transient and experienced by 13/15 (87%) participants at mild to moderate severity. Frequently reported AEs were as typically expected (headache (53%), insomnia (33%), anxiety (33%), decreased appetite (27%)).Conclusions : Our findings suggest that MPH-ER is effective and well-tolerated in the treatment of ADHD in HF-ASD adults.

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7. Lau BY, Leong R, Uljarevic M, Lerh JW, Rodgers J, Hollocks MJ, South M, McConachie H, Ozsivadjian A, Van Hecke A, Libove R, Hardan A, Leekam S, Simonoff E, Magiati I. Anxiety in young people with autism spectrum disorder : Common and autism-related anxiety experiences and their associations with individual characteristics. Autism ;2019 (Dec 19):1362361319886246.

Anxiety is common in autism spectrum disorder. Many anxiety symptoms in autism spectrum disorder are consistent with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) anxiety disorders (termed "common" anxieties), but others may be qualitatively different, likely relating to autism spectrum disorder traits (herein termed "autism-related" anxieties). To date, few studies have examined both "common" and "autism-related" anxiety experiences in autism spectrum disorder. We explored caregiver-reported Spence Children’s Anxiety Scale-Parent version data from a multi-site (United Kingdom, Singapore, and United States) pooled database of 870 6- to 18-year-old participants with autism spectrum disorder, of whom 287 provided at least one written response to the optional open-ended Spence Children’s Anxiety Scale-Parent item 39 ("Is there anything else your child is afraid of ?"). Responses were thematically coded to explore (a) common and autism-related anxiety presentations and (b) their relationship with young people’s characteristics. Nearly half of the responses were autism-related anxieties (mostly sensory, uncommon, or idiosyncratic specific phobias and worries about change and unpredictability). The other half described additional common anxieties not covered in the original measure (mostly social, weather and environmental disasters, and animals). Caregivers of participants who were more severely affected by autism spectrum disorder symptoms reported more autism-related, as compared to common, additional anxieties. Implications for the assessment and understanding of anxiety in autism are discussed.

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8. Lei J, Ashwin C, Brosnan M, Russell A. Differences in anxieties and social networks in a group-matched sample of autistic and typically developing students transitioning to university. Autism ;2019 (Dec 19):1362361319894830.

Transitioning to university can be anxiety-provoking for all students. The relationship between social anxiety, autistic traits and students’ social network structure, and perceived support is poorly understood. This study used a group-matched design where autistic students (n = 28) and typically developing students (n = 28) were matched on sex, age (17-19 years), ethnicity, pre-university academic performance and degree subject at university. Autistic students reported greater transition to university worries, and a smaller social network size compared to typically developing students, though perceived similar levels of support from their social networks. Autistic and typically developing students showed differential patterns of association with both autistic traits and social anxiety. Broader clinical and practical implications of findings are discussed.

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9. Liu TL, Wang PW, Yang YC, Shyi GC, Yen CF. Association between Facial Emotion Recognition and Bullying Involvement among Adolescents with High-Functioning Autism Spectrum Disorder. Int J Environ Res Public Health ;2019 (Dec 15) ;16(24)

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is characterized by impaired social interaction, communication and restricted and repetitive behavior. Few studies have focused on the effect of facial emotion recognition on bullying involvement among individuals with ASD. The aim of this study was to examine the association between facial emotion recognition and different types of bullying involvement in adolescents with high-functioning ASD. We recruited 138 adolescents aged 11 to 18 years with high-functioning ASD. The adolescents’ experiences of bullying involvement were measured using the Chinese version of the School Bullying Experience Questionnaire. Their facial emotion recognition was measured using the Facial Emotion Recognition Task (which measures six emotional expressions and four degrees of emotional intensity). Logistic regression analysis was used to examine the association between facial emotion recognition and different types of bullying involvement. After controlling for the effects of age, gender, depression, anxiety, inattention, hyperactivity/impulsivity and opposition, we observed that bullying perpetrators performed significantly better on rating the intensity of emotion in the Facial Emotion Recognition Task ; bullying victims performed significantly worse on ranking the intensity of facial emotion. The results of this study support the different deficits of facial emotion recognition in various types of bullying involvement among adolescents with high-functioning ASD. The different directions of association between bully involvement and facial emotion recognition must be considered when developing prevention and intervention programs.

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10. Lopata C, Donnelly JP, Rodgers JD, Thomeer ML, Booth AJ. Reliability and validity of teacher ratings on the Adapted Skillstreaming Checklist for children with autism spectrum disorder. Autism ;2019 (Dec 19):1362361319894824.

This study assessed the reliability and criterion-related validity of teacher ratings on the Adapted Skillstreaming Checklist for a sample of 133 children, aged 6-11 years, with autism spectrum disorder (without intellectual disability). Internal consistency for the total sample was 0.93. For a subsample, test-retest reliability was very good (r = 0.74 ; intraclass correlation coefficient = 0.85) at a 9-month interval. Child age, intelligence quotient, language abilities, and sex were not associated with the Adapted Skillstreaming Checklist total score. The Adapted Skillstreaming Checklist total score was inversely and strongly related to teacher ratings of autism spectrum disorder symptom severity. Significant positive correlations (moderate-to-high) were found between the Adapted Skillstreaming Checklist and prosocial skills scales and significant negative correlations (low-to-moderate) with problem behavior scales on a broad measure of child functioning. Implications and suggestions for future study are discussed.

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11. Marsack-Topolewski CN. A Snapshot of Social Support Networks Among Parental Caregivers of Adults with Autism. J Autism Dev Disord ;2019 (Dec 18)

This study provided a description of types and dimensions of informal and formal social support among aging parental caregivers of adult children diagnosed with autism spectrum disorder (ASD). Parents participated in a web-based survey regarding use of and satisfaction with social support services for parents or their adult children. Results indicated that many parents participated in autism support groups (27.5%), with psychiatric services (48.8%), counseling (40.6%), and financial assistance (39.7%) the most commonly used formal social supports. Emotional support (88.8%) and informational support (67.5%) were the most common informal social supports used. Professionals who are working with parental caregivers and their adult children diagnosed with ASD should be aware of available social support services to help them find needed services.

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12. Moon SJ, Hwang J, Hill HS, Kervin R, Birtwell KB, Torous J, McDougle CJ, Kim JW. Mobile device applications and treatment of autism spectrum disorder : a systematic review and meta-analysis of effectiveness. Arch Dis Child ;2019 (Dec 17)

OBJECTIVE : The current study was performed to assess the evidence for effects of therapeutic intervention with mobile device applications (apps) for individuals with autism spectrum disorder (ASD). DESIGN : The main methodology of the current study was systematic review with meta-analysis. SETTING : Only randomised controlled trials (RCTs) for mobile device apps for individuals with ASD were considered for review in the current study. PATIENTS : The target population was individuals clinically diagnosed with ASD. INTERVENTIONS : Applications that are operable on a smart (mobile) device and interactive with users. MAIN OUTCOME MEASURES : The main outcomes were based on standardised mean differences in pretrial and post-trial scales in each control and intervention group. RESULTS : Out of a total of 1100 studies (after duplicate removal), 7 RCTs were selected for final analysis. Of the seven studies, two RCTs were further analysed for effects based on the visual and fine motor subscales of the Mullen Scales of Early Learning, which favoured the intervention groups (standardised mean difference (SMD)=0.41, 95% CI 0.03 to 0.80 ; SMD=0.41, 95% CI 0.03 to 0.80), without either having any heterogeneity (p>0.1) or publication bias. CONCLUSIONS : Although it is still early to draw a conclusion, available studies are showing promise for use of mobile device apps for treatment of individuals with ASD. More well-designed and large-scale studies focused on improving behavioural symptoms of ASD are warranted. PROSPERO REGISTRATION NUMBER : CRD42019128362.

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13. Shvarts S, Jimenez-Gomez C, Bai JYH, Thomas RR, Oskam JJ, Podlesnik CA. Examining stimuli paired with alternative reinforcement to mitigate resurgence in children diagnosed with autism spectrum disorder and pigeons. J Exp Anal Behav ;2019 (Dec 19)

In two laboratory experiments, we examined whether stimuli paired with alternative reinforcers could mitigate resurgence of a previously reinforced target response with pigeons (Experiment 1) and children diagnosed with Autism Spectrum Disorder (Experiment 2). In Phase 1, we arranged food reinforcement according to a variable-ratio schedule for engaging in a target response. In Phase 2, we arranged extinction for target responding and differentially reinforced alternative responding according to a fixed-ratio schedule, with every alternative-reinforcer delivery paired with a change in keylight color (Experiment 1) or automated verbal (praise) statement (Experiment 2). In Phase 3, we assessed resurgence during extinction of target and alternative responding in the presence versus absence of continued presentation of the paired stimulus. Despite variation across sessions, resurgence on average was lower when continuing to present the paired stimuli in all pigeons and children while maintenance of alternative responding did not differ between assessments. These findings indicate that stimuli paired with alternative reinforcement can modestly decrease resurgence, but further examination of their efficacy and a better understanding of the underlying processes are necessary before they can be recommended for clinical use in reducing resurgence of clinically relevant problem behavior.

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14. Trifonova EA, Klimenko AI, Mustafin ZS, Lashin SA, Kochetov AV. The mTOR Signaling Pathway Activity and Vitamin D Availability Control the Expression of Most Autism Predisposition Genes. Int J Mol Sci ;2019 (Dec 15) ;20(24)

Autism spectrum disorder (ASD) has a strong and complex genetic component with an estimate of more than 1000 genes implicated cataloged in SFARI (Simon’s Foundation Autism Research Initiative) gene database. A significant part of both syndromic and idiopathic autism cases can be attributed to disorders caused by the mechanistic target of rapamycin (mTOR)-dependent translation deregulation. We conducted gene-set analyses and revealed that 606 out of 1053 genes (58%) included in the SFARI Gene database and 179 out of 281 genes (64%) included in the first three categories of the database ("high confidence", "strong candidate", and "suggestive evidence") could be attributed to one of the four groups : 1. FMRP (fragile X mental retardation protein) target genes, 2. mTOR signaling network genes, 3. mTOR-modulated genes, 4. vitamin D3 sensitive genes. The additional gene network analysis revealed 43 new genes and 127 new interactions, so in the whole 222 out of 281 (79%) high scored genes from SFARI Gene database were connected with mTOR signaling activity and/or dependent on vitamin D3 availability directly or indirectly. We hypothesized that genetic and/or environment mTOR hyperactivation, including provocation by vitamin D deficiency, might be a common mechanism controlling the expressivity of most autism predisposition genes and even core symptoms of autism.

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15. Wang J, Pan J, Chen H, Li Y, Amakye WK, Liang J, Ma B, Chu X, Mao L, Zhang Z. Fecal Short-Chain Fatty Acids Levels Were Not Associated With Autism Spectrum Disorders in Chinese Children : A Case-Control Study. Front Neurosci ;2019 ;13:1216.

Evidence from animal models supports a link between short-chain fatty acids (SCFAs), a key subset of gut microbial metabolites, and autism spectrum disorders (ASD). However, findings from human studies on this topic are unclear. We aimed to investigate whether fecal SCFAs are associated with ASD in Chinese children aged 6-9 years old. A total of 45 ASD children aged 6-9 years and 90 sex- and age-matched neurotypical controls were enrolled. High-performance liquid chromatography was applied to quantify 10 SCFA subtypes in feces. Dietary and other socio-demographic information were obtained via face-to-face interview using questionnaires. After adjustment for multiple comparisons, paired t-test analysis indicated that the fecal total and subtype SCFA concentrations were comparable in autistic children and the controls. Conditional logistic regression analysis showed that there was no significant relationship between the fecal concentration of SCFAs and the risk of ASD after adjustment for age, sex, BMI, breastfeeding, mode of delivery, parental education level, and daily energy, protein, fat, and fiber intake. In conclusion, our results did not support the hypothesis that fecal SCFA levels might be associated with the presence of ASD. However, SCFA measurement was based on a single stool sample test, so this conclusion should be treated with caution. Further studies with measurement of long-term bodily SCFA concentrations are needed to examine this relationship.

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16. Wu H, Lu F, Yu B, Liu Q. Phonological acquisition and development in Putonghua-speaking children with Autism Spectrum Disorders. Clin Linguist Phon ;2019 (Dec 18):1-17.

Poor phonological development adversely affects language development and interpersonal communication abilities in children with Autism Spectrum Disorders (ASD). However, the characteristics of phonological development in children with ASD who speak Putonghua (the official standard spoken form of modern Mandarin Chinese) remain largely unknown. This study aims to investigate phonological acquisition and development among Putonghua-speaking children with ASD. Data were collected from participants recruited in Shanghai, China. Two experiments were conducted. In experiment I, phonological acquisition was compared between 16 children with ASD aged 3-6 years and 16 age-matched typically developing (TD) children. In experiment II, phonological acquisition was compared between 26 children with ASD over 6 years old and 26 receptive-language-age-matched TD children. Picture naming was applied to measure participants’ phonology - the 21 initials, 36 finals and four tones of Putonghua. Paired-samples t-tests and Fisher’s exact tests were applied. In experiment I, scores on initials, finals, tones and total phonology of children with ASD aged 3-6 years were significantly lower than those of age-matched TD children. The pronunciation accuracy rates for initials such as/x, t(h), l/, finals such as/ja, jo, wo/ and Tone 3 (the low-rising tone) in the ASD group were significantly lower than in the TD group. In experiment II, there was no significant difference in overall phonological developmental level between children with ASD over 6 years old and receptive-language-age-matched TD children. Phonological development of Putonghua-speaking children with ASD was significantly lower than that of age-matched TD children but closer to that of receptive-language-age-matched TD children. Further, participants with ASD showed atypical development sequences in both initials and finals.

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17. Yamamoto S, Isawa S. Effects of textual prompts and feedback on social niceties of adolescents with autism spectrum disorder in a simulated workplace. J Appl Behav Anal ;2019 (Dec 19)

Previous research demonstrates the efficacy of behavioral skills training with a textual prompt to establish greetings and conversational skills. This study examined the efficacy of a brief intervention of textual prompts with performance feedback for increasing social niceties of adolescents and young adults with autism spectrum disorder in a simulated workplace. Target social niceties included "Do you have a minute ?" when a participant initiated an interaction and "Thank you for your time" when a participant ended the interaction. Results revealed this intervention was effective for 7 of 9 participants. This study expands upon previous studies by showing the efficacy of a resource-efficient training on acquisition and generalization of social niceties by people with autism spectrum disorder.

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