Pubmed du 24/01/20

vendredi 24 janvier 2020

1. Adams D, Emerson LM. Family accommodation of anxiety in a community sample of children on the autism spectrum. J Anxiety Disord ;2020 (Jan 17) ;70:102192.

Anxiety is recognised as one of the most common co-occurring conditions for individuals with a diagnosis on the autism spectrum, with approximately 40 % of children on the spectrum receiving a clinical diagnosis of an anxiety disorder. To date, research has tended to focus upon understanding presentation and evaluating treatment, with little focus on assessing systemic factors, such as the way that family members accommodate the anxiety. This study aimed to investigate the relationship between parent and child anxiety levels and child autism characteristics on the four domains of family accommodation ; Participation, Modification, Distress, and Consequence. A community sample (n = 132) of parents of children on the spectrum completed questionnaires on their child’s autism characteristics and anxiety symptomatology as well as their own levels of anxiety and family accommodation behaviours. Regression models identified specific aspects of child anxiety as well as parent anxiety as predictive of family accommodation, with the child’s difficulties with uncertainty being a consistent predictor of all four domains. Clinical and research implications of this study, including the importance of understanding similarities or differences in the nature and consequence of family accommodation in children on the autism spectrum, are discussed.

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2. Bernaerts S, Boets B, Bosmans G, Steyaert J, Alaerts K. Behavioral effects of multiple-dose oxytocin treatment in autism : a randomized, placebo-controlled trial with long-term follow-up. Mol Autism ;2020 ;11:6.

Background : Intranasal administration of the "prosocial" neuropeptide oxytocin is increasingly explored as a potential treatment for targeting the core characteristics of autism spectrum disorder (ASD). However, long-term follow-up studies, evaluating the possibility of long-lasting retention effects, are currently lacking. Methods : Using a double-blind, randomized, placebo-controlled, parallel design, this pilot clinical trial explored the possibility of long-lasting behavioral effects of 4 weeks of intranasal oxytocin treatment (24 International Units once daily in the morning) in 40 adult men with ASD. To do so, self-report and informant-based questionnaires assessing core autism symptoms and characterizations of attachment were administered at baseline, immediately after 4 weeks of treatment (approximately 24 h after the last nasal spray administration), and at two follow-up sessions, 4 weeks and 1 year post-treatment. Results : No treatment-specific effects were identified in the primary outcome assessing social symptoms (Social Responsiveness Scale, self- and informant-rated). In particular, with respect to self-reported social responsiveness, improvements were evident both in the oxytocin and in the placebo group, yielding no significant between-group difference (p = .37). Also informant-rated improvements in social responsiveness were not significantly larger in the oxytocin, compared to the placebo group (between-group difference : p = .19). Among the secondary outcome measures, treatment-specific improvements were identified in the Repetitive Behavior Scale and State Adult Attachment Measure, indicating reductions in self-reported repetitive behaviors (p = .04) and reduced feelings of avoidance toward others (p = .03) in the oxytocin group compared to the placebo group, up to 1 month and even 1 year post-treatment. Treatment-specific effects were also revealed in screenings of mood states (Profile of Mood States), indicating higher reports of "vigor" (feeling energetic, active, lively) in the oxytocin, compared to the placebo group (p = .03). Conclusions : While no treatment-specific improvements were evident in terms of core social symptoms, the current observations of long-term beneficial effects on repetitive behaviors and feelings of avoidance are promising and suggestive of a therapeutic potential of oxytocin treatment for ASD. However, given the exploratory nature of this pilot study, future studies are warranted to evaluate the long-term effects of OT administration further. Trial registration : The trial was registered with the European Clinical Trial Registry (Eudract 2014-000586-45) on January 22, 2014 (

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3. Decroocq C, Soulas T, Lichtle J, Sankey C, Engelberg A, Cappe E. Facilitators’ perspectives on a psychoeducational program for parents of an autistic child. Autism ;2020 (Jan 22):1362361319899766.

LAY ABSTRACT : The recent increase of diagnosed cases of autism spectrum disorders has led to a considerable rise in the demands for autism-related services and interventions. Caring for an autistic child can be perceived as an enrichment, which coexists with stress in parents. Parents express the need to access relevant information about their child’s difference, and parent support interventions appear to respond effectively to this demand, as they are knowledge-focused and offer indirect support to the child. The aim of this study was to capture the subjective experience of facilitators who implemented a psychoeducational program called Beyond PDD : Parental Skills within My Reach. This program is based on the acknowledged fact that parents of autistic children play a central role in their child’s development. Its main goal is to help parents of autistic children under the age of 8 to identify, develop, and update their parenting competences. This program broaches different topics : (1) specific features of an autistic child, (2) post-diagnostic parental adjustment, (3) communication and social relationships, (4) importance of providing the child with a structured environment, and (5) parental emotions and perceptions that impact everyday life. Structured interviews of the facilitators provided insight on institutional support, issues related to the program itself, required and/or recommended professional background, personal experience and competences, and difficulties linked to recruitment and research criteria. Recommendations aiming to enhance program implementation and delivery were then created using facilitators’ feedback on these aspects.

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4. Kerns CM, Winder-Patel B, Iosif AM, Nordahl CW, Heath B, Solomon M, Amaral DG. Clinically Significant Anxiety in Children with Autism Spectrum Disorder and Varied Intellectual Functioning. J Clin Child Adolesc Psychol ;2020 (Jan 23):1-16.

Objective : To evaluate how distinct presentations of anxiety symptoms and intellectual impairment influence the measurement and estimated rate of clinically significant anxiety in autism spectrum disorder (ASD).Method : The sample included 75 children (ages 9-13 years) with ASD and varied IQ and 52 typically developing (TD) controls and parents. Parents completed anxiety symptom scales and a diagnostic interview, designed to (1) differentiate anxiety and ASD and (2) examine DSM-specified and unspecified ("distinct") anxiety presentations in each child, including fears of change, special interests, idiosyncratic stimuli and social confusion rather than evaluation. Children completed standard intellectual and ASD diagnostic assessments.Results : 69% of those with ASD had clinically-significant anxiety, including 21% DSM-specified anxiety disorders, 17% distinct anxiety, and 31% both. Only 8% of TD children had clinically-significant anxiety, all DSM-specified. DSM-specified anxiety disorders in children with ASD and intellectual impairment (IQ<70) were predominantly specific phobias. DSM-specified anxiety other than specific phobia was significantly less common in children with, versus without, intellectual impairment ; this was not the case for distinct anxiety. The sensitivities of anxiety scales were moderate to poor, particularly in cases with intellectual impairment.Conclusions : ASD is associated with more frequent and varied presentations of clinical anxiety, which may align with and differ from the specified anxiety disorders of the DSM. Standard parent report anxiety scales have reduced sensitivity to detect clinical anxiety in ASD, particularly in children with intellectual impairment.

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5. Lam GYH, Holden E, Fitzpatrick M, Raffaele Mendez L, Berkman K. "Different but connected" : Participatory action research using Photovoice to explore well-being in autistic young adults. Autism ;2020 (Jan 22):1362361319898961.

LAY ABSTRACT : Past research has mainly focused on autistic people’s deficits and poor outcomes compared to other groups of people. Little is known about their positive life experiences, and how to support them to achieve a higher quality of life. It is important to include autistic individuals in research so that they can influence how their voices are represented in a meaningful way and how the research results will be useful to them. In this study, a university researcher collaborated with 14 autistic young adults in a post-school transition program to design and run the research, collect and analyze the data, and use the results to create a presentation to the community. Specifically, the participants took photos in daily life and discussed their ideas about what a good life means to them. Results showed that these young adults described themselves as uniquely and different, but they were eager to learn and adapt. They also valued their relationships with their families, friends, and animals around them, as well as the community at large. This research shows that autistic individuals have important perspectives to share and knowledge to contribute when they are given the opportunities to participate in different aspects of research. The findings will be useful in developing services and influencing policies that promote well-being among autistic adults.

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6. Nordahl CW, Iosif AM, Young GS, Hechtman A, Heath B, Lee JK, Libero L, Reinhardt VP, Winder-Patel B, Amaral DG, Rogers S, Solomon M, Ozonoff S. High Psychopathology Subgroup in Young Children With Autism : Associations With Biological Sex and Amygdala Volume. J Am Acad Child Adolesc Psychiatry ;2020 (Jan 20)

OBJECTIVE : 1) To identify a subset of children with autism spectrum disorder (ASD) and co-occurring symptoms of psychopathology. 2) To evaluate associations between this subgroup and biological sex and amygdala volume. METHOD : Participants included 420 children (ASD : 91 girls, 209 boys ; typically developing controls : 57 girls, 63 boys). Latent profile analysis was used to identify ASD subgroups based on symptoms of psychopathology, adaptive functioning, cognitive development, and autism severity. Sex differences in the proportion of girls and boys in each subgroup were evaluated. MRI scans were acquired (346 children) ; amygdala volumes were evaluated in relation to subgroups and problem behavior scores. RESULTS : Three ASD subgroups were identified ; one was characterized by high levels of psychopathology and moderate impairment on other measures (High Psychopathology Moderate Impairments [HPMI], comprising 27% of the sample). The other two subgroups had lower symptoms of psychopathology but were differentiated by high and low levels of impairment on other measures. A higher proportion of girls were classified into the HPMI subgroup (40% of girls vs. 22% of boys). Relative to controls, amygdala volumes were enlarged only in the HPMI subgroup, other subgroups did not differ. There was a positive association between right amygdala volume and internalizing behaviors in girls but not boys with ASD. CONCLUSION : A higher proportion of girls with ASD faced greater challenges with psychopathology, suggesting a need for closer evaluation and potentially earlier intervention to help improve outcomes. Amygdala enlargement was associated with co-occurring symptoms of psychopathology and sex-specific correlations with symptoms were observed.

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7. Oti-Boadi M, Dankyi E, Kwakye-Nuako CO. Stigma and Forgiveness in Ghanaian Mothers of Children with Autism Spectrum Disorders (ASD). J Autism Dev Disord ;2020 (Jan 22)

This study explored stigma experiences of mothers of children with ASD and forgiveness as their coping response. Semi-structured interviews were conducted with 6 mothers of children with ASD. Results of this study found several noteworthy themes including, feelings of mother, family/societal reactions, forgiveness factors, and impact of forgiveness. Mothers reported significant stigmatization from families and society. Some expressed their feelings towards themselves, others and God, and finally recounted the use of forgiveness as a coping resource which contributed significantly to their well-being. Findings from this study contribute to the emerging literature on forgiveness as a coping resource for persons who are offended. Implications for clinical practice, intervention and policy are discussed.

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8. Sarmukadam K, Bitsika V, Sharpley CF, McMillan MME, Agnew LL. Comparing Different EEG Connectivity Methods in Young Males with ASD. Behav Brain Res ;2020 (Jan 20):112482.

Although EEG connectivity data are often used to build models of the association between overt behavioural signs of Autism Spectrum Disorder (ASD) and underlying brain connectivity indices, use of a large number of possible connectivity methods across studies has produced a fairly inconsistent set of results regarding this association. To explore the level of agreement between results from five commonly-used EEG connectivity models (i.e., Coherence, Weighted Phased Lag Index- Debiased, Phase Locking Value, Phase Slope Index, Granger Causality), a sample of 41 young males with ASD provided EEG data under eyes-opened and eyes-closed conditions. There were relatively few statistically significant and/or meaningful correlations between the results obtained from the five connectivity methods, arguing for a re-estimation of the methodology used in such studies so that specific connectivity methods may be matched to particular research questions regarding the links between neural connectivity and overt behaviour within this population.

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9. Schertz HH, Lester JN, Erden E, Safran S, Githens P. Challenges and contributors to self-efficacy for caregivers of toddlers with autism. Autism ;2020 (Jan 22):1362361319899761.

LAY ABSTRACT : Parent-participatory early intervention practices are linked to parents’ positive views of their own and their children’s capabilities, beliefs that are associated with a range of parent and child outcomes. A qualitative study was conducted with 11 mothers of toddlers with autism who had experience with both professionally directed and parent-mediated early intervention. Participants were interviewed to explore their perspectives on their roles in relation to professionals and on how they viewed their ability to support their toddlers’ social learning. An in-depth analysis of the transcribed interviews resulted in four themes. First, in the early stages, participants experienced challenges to their self-efficacy as they adjusted to the diagnosis and reached to connect with their child when social challenges emerged. Second, participants’ views of their capability were stronger when they were provided with background knowledge enabling them to take the lead in guiding their children’s learning than when professionals modeled predetermined intervention strategies for them to copy. Third, participants provided specific examples of their expertise to support their toddlers’ social learning and viewed their close parent-child relationship and intimate knowledge of their children as valuable to the intervention. Fourth, participants voiced respect for their toddlers’ natures and preferences, positioning them to build on their toddlers’ strengths in everyday interactions. The results support the need for early intervention providers to promote and leverage family capacity for facilitating toddler learning as social challenges begin to appear for toddlers with autism.

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10. Torres EB, Caballero C, Mistry S. Aging with Autism Departs Greatly from Typical Aging. Sensors (Basel) ;2020 (Jan 20) ;20(2)

Autism has been largely portrayed as a psychiatric and childhood disorder. However, autism is a lifelong neurological condition that evolves over time through highly heterogeneous trajectories. These trends have not been studied in relation to normative aging trajectories, so we know very little about aging with autism. One aspect that seems to develop differently is the sense of movement, inclusive of sensory kinesthetic-reafference emerging from continuously sensed self-generated motions. These include involuntary micro-motions eluding observation, yet routinely obtainable in fMRI studies to rid images of motor artifacts. Open-access repositories offer thousands of imaging records, covering 5-65 years of age for both neurotypical and autistic individuals to ascertain the trajectories of involuntary motions. Here we introduce new computational techniques that automatically stratify different age groups in autism according to probability distance in different representational spaces. Further, we show that autistic cross-sectional population trajectories in probability space fundamentally differ from those of neurotypical controls and that after 40 years of age, there is an inflection point in autism, signaling a monotonically increasing difference away from age-matched normative involuntary motion signatures. Our work offers new age-appropriate stochastic analyses amenable to redefine basic research and provide dynamic diagnoses as the person’s nervous systems age.

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11. Vagnetti R, Pino MC, Masedu F, Peretti S, Le Donne I, Rossi R, Valenti M, Mazza M. Exploring the social cognition network in young adults with autism spectrum disorder using graph analysis. Brain Behav ;2020 (Jan 23):e01524.

BACKGROUND : Autism spectrum disorder (ASD) is characterized by an impairment in social cognition (SC). SC is a cognitive construct that refers to the capacity to process information about social situations. It is a complex network that includes distinct components. Exploring how SC components work together leads to a better understanding of how their interactions promote adequate social functioning. Our main goal was to use a novel statistical method, graph theory, to analyze SC relationships in ASD and Typically Developing (TD) individuals. METHODS : We applied graph theory to SC measures to verify how the SC components interact and to establish which of them are important within the interacting SC network for TD and ASD groups. RESULTS : The results showed that, in the TD group, the SC nodes are connected ; their network showed increased betweenness among nodes, especially for the Theory of Mind. By contrast, in the SC network in the ASD group the nodes are highly disconnected, and the efficient connection among the components is absent. CONCLUSION : ASD adults do not show SC competencies and functional communication among these skills. Under this regard, specific components are crucial, suggesting they could represent critical domains for ASD SC.

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12. Wu CC, Chu CL, Stewart L, Chiang CH, Hou YM, Liu JH. The Utility of the Screening Tool for Autism in 2-Year-Olds in Detecting Autism in Taiwanese Toddlers Who are Less than 24 Months of Age : A Longitudinal Study. J Autism Dev Disord ;2020 (Jan 22)

The present longitudinal study examined the utility of the screening tool for autism in 2-year-olds (STAT) in detecting autism spectrum disorder (ASD) in toddlers who are less than 24 months of age. The study sample, which consisted of 119 toddlers with developmental problems, were assessed when they were between 16 and 24 months of age (Time 1) and after a period of 18 months to finalize the diagnosis (Time 2) ; 57 children had ASD and 62 children had developmental delays. A cutoff score of 2.5 on the STAT yielded an optimal combination of high sensitivity and specificity. The STAT demonstrated adequate predictive validity in detecting ASD in Taiwanese toddlers who are less than 24 months of age.

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