Pubmed du 12/02/20

mercredi 12 février 2020

1. Arakawa H. Somatosensorimotor and odor modification, along with serotonergic processes underlying the social deficits in BTBR T+ Itpr3(tf)/J and BALB/cJ mouse models of autism. Neuroscience ;2020 (Feb 12)

Autism is a complex spectrum of disorders characterized by core behavioral deficits in social communicative behavior, which are also required for comprehensive analysis of preclinical mouse models. As animal models of the core behavioral deficits in autism, two inbred mouse strains, BTBR T+ Itpr3(tf)/J (BTBR) and BALB/cJ (BALB), were compared with the standard social strain, C57BL/6J (B6), regarding a variety of behavioral factors underlying social communicative interactions, including olfactory and tactile sensory processes, social recognition abilities and behavioral expression strategies. Although both female BTBR and BALB mice can express social recognition and approach behavior depending on the stimuli they encounter, the available sensory modalities, along with modulation of the serotonergic system, differ between the two strains. BALB mice have deficits in using volatile olfactory cues and tactile information in a social context ; they fail to exhibit a social approach to volatile cues and seek nonvolatile cues by exhibiting substantial sniff/contact behavior when allowed direct contact with social opponents. Systemic injection of the serotonin (5-HT1A) agonist buspirone has little effect on these social deficits, suggesting a congenitally degraded serotonergic system in BALB mice. In contrast, BTBR mice exhibit impaired body coordination and social motivation-modified olfactory signals, which are relevant to a reduced social approach. A systemic injection of the 5-HT1A agonist restored these social deficits in BTBR mice, indicating that a downregulated serotonergic system is involved in the social deficits exhibited by BTBR mice. (233).

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2. Boukakiou R, Heritier AC, Royannez I, Kosel M, Prada P. Pour un accès facilité aux soins somatiques des adultes en situation de handicap mental sévère. Rev Med Suisse ;2020 (Feb 12) ;16(681):310-313.

For the purpose of improving the management of somatic disorders among patients suffering from severe intellectual development and autism spectrum disorders, a specific admissions mechanism has been implemented at Geneva University Hospitals (HUG). The Adult Psychiatric Hospital Unit (UPHA), a complex intervention unit, collaborates with HUG’s Disability Program. From May 2018 to May 2019, 29 requests for hospitalizations were accepted. These requests primarily originated from private practice physicians (42 %). In some cases, immediate admissions were urgently organized, and in others a 13-day waiting period was imposed. Hospitalizations were adapted to the patient : more often than not, these were short (48 %), with 6 hospitalizations extended for an average 103-day period. A clinical case illustrates the healthcare management provided.

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3. Conner CM, White SW, Scahill L, Mazefsky CA. The role of emotion regulation and core autism symptoms in the experience of anxiety in autism. Autism ;2020 (Feb 12):1362361320904217.

LAY ABSTRACT : Many children with autism spectrum disorder have problems with managing their emotions (emotion regulation) and anxiety. In this study, over 1000 parents completed an online survey which showed that emotion regulation and anxiety are closely linked. Although emotion regulation and anxiety are inter-connected, the results also show that autism symptoms play an important role in anxiety in autism spectrum disorder. Emotion regulation problems may be an important target for the treatment of anxiety in autism.

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4. Daniel E, Menashe I. Exploring the familial role of social responsiveness differences between savant and non-savant children with autism. Sci Rep ;2020 (Feb 10) ;10(1):2255.

Savant syndrome is a phenomenon whereby individuals with cognitive impairments have one or more outstanding abilities, inconsistent with their general intellectual functioning. Approximately 50% of savant individuals have autism spectrum disorder (ASD), and 10-30% of people with ASD have savant skills. To shed additional light on this considerable overlap, we compared autistic traits as measured by the Social-Responsiveness-Scale (SRS) between 712 children with at least one reported savant skill, as determined by designated questions from the ADI-R questionnaire (savant group), and 2,032 non-savant children from the Simons-Simplex-Collection (SSC) database. We also examined SRS scores of the parents of these children and compared parent-child differences in SRS scores between the savant and non-savant groups. Savant children had significantly lower SRS scores (less deficiencies) compared to non-savant children (P < 0.05), while no such differences were observed among their parents. Further intra-familial analyses revealed weak pairwise-correlations (r = -0.015-0.141) between SRS scores of parents and their children, and significantly larger parent-child differences in standardized SRS scores within savant families (P < 0.05). These findings suggest that the less severe autistic traits among savant children with ASD compared to other people with ASD is not likely to be a familial trait.

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5. Frye RE, Vassall S, Kaur G, Lewis C, Karim M, Rossignol D. Emerging biomarkers in autism spectrum disorder : a systematic review. Ann Transl Med ;2019 (Dec) ;7(23):792.

Autism spectrum disorder (ASD) affects approximately 2% of children in the United States (US) yet its etiology is unclear and effective treatments are lacking. Therapeutic interventions are most effective if started early in life, yet diagnosis often remains delayed, partly because the diagnosis of ASD is based on identifying abnormal behaviors that may not emerge until the disorder is well established. Biomarkers that identify children at risk during the pre-symptomatic period, assist with early diagnosis, confirm behavioral observations, stratify patients into subgroups, and predict therapeutic response would be a great advance. Here we underwent a systematic review of the literature on ASD to identify promising biomarkers and rated the biomarkers in regards to a Level of Evidence and Grade of Recommendation using the Oxford Centre for Evidence-Based Medicine scale. Biomarkers identified by our review included physiological biomarkers that identify neuroimmune and metabolic abnormalities, neurological biomarkers including abnormalities in brain structure, function and neurophysiology, subtle behavioral biomarkers including atypical development of visual attention, genetic biomarkers and gastrointestinal biomarkers. Biomarkers of ASD may be found prior to birth and after diagnosis and some may predict response to specific treatments. Many promising biomarkers have been developed for ASD. However, many biomarkers are preliminary and need to be validated and their role in the diagnosis and treatment of ASD needs to be defined. It is likely that biomarkers will need to be combined to be effective to identify ASD early and guide treatment.

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6. Gil-Hernandez F, Gomez-Fernandez AR, la Torre-Aguilar MJ, Perez-Navero JL, Flores-Rojas K, Martin-Borreguero P, Gil-Campos M. Neurotoxicity by mercury is not associated with autism spectrum disorders in Spanish children. Ital J Pediatr ;2020 (Feb 12) ;46(1):19.

BACKGROUND : The pathophysiological etiologies related with the development of Autism Spectrum Disorders (ASD) remain controversial. Different authors have studied neurotoxins such as mercury (Hg) and their relationship with ADS. The objective of this study was to assess the levels of Hg in hair in a group of ASD children (chronic exposure) and in urinary excretion (acute exposure), in comparison to a healthy group. METHODS : A case-control study was conducted in Spanish children. We compared 54 ASD children (aged 2-6) with no other associated pathology to a normally-developing control group (54 subjects). RESULTS : There were no differences in urine (p:0.631) and hair (p:1.000) samples percentages below the limits of detection between the control and the ASD groups, and also between patients in the regression ASD subgroup (AMR) (p:0.08) and the non-regression ASD subgroup (ANMR) (p:0.705). When the analysis was adjusted for age and sex, the differences between Hg levels maintained not significant. There were no correlations between Hg concentrations in the ASD group as a whole (p : 0.739), or when they were subdivided into ASD-AMR (p : 0.739) and ASD-ANMR (p : 0.363). CONCLUSIONS : The present study shows no evidence in our geographical area to support an association between mercury neurotoxicity and the etiopathogenesis of ASD.

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7. Horwitz EH, Schoevers RA, Greaves-Lord K, de Bildt A, Hartman CA. Adult Manifestation of Milder Forms of Autism Spectrum Disorder ; Autistic and Non-autistic Psychopathology. J Autism Dev Disord ;2020 (Feb 12)

We compared the presence of autistic and comorbid psychopathology and functional impairments in young adults who received a clinical diagnosis of Pervasive Developmental Disorders Not Otherwise Specified or Asperger’s Disorder during childhood to that of a referred comparison group. While the Autism Spectrum Disorder group on average scored higher on a dimensional ASD self- and other-report measure than clinical controls, the majority did not exceed the ASD cutoff according to the Autism Diagnostic Observation Schedule. Part of the individuals with an ASD diagnosis in their youth no longer show behaviors that underscribe a clinical ASD diagnosis in adulthood, but have subtle difficulties in social functioning and a vulnerability for a range of other psychiatric disorders.

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8. Kinard JL, Mosner MG, Greene RK, Addicott M, Bizzell J, Petty C, Cernasov P, Walsh E, Eisenlohr-Moul T, Carter RM, McLamb M, Hopper A, Sukhu R, Dichter GS. Neural Mechanisms of Social and Nonsocial Reward Prediction Errors in Adolescents with Autism Spectrum Disorder. Autism Res ;2020 (Feb 11)

Autism spectrum disorder (ASD) is characterized by impaired predictive abilities ; however, the neural mechanisms subsuming reward prediction errors in ASD are poorly understood. In the current study, we investigated neural responses during social and nonsocial reward prediction errors in 22 adolescents with ASD (ages 12-17) and 20 typically developing control adolescents (ages 12-18). Participants performed a reward prediction error task using both social (i.e., faces) and nonsocial (i.e., objects) rewards during a functional magnetic resonance imaging scan. Reward prediction errors were defined in two ways : (a) the signed prediction error, the difference between the experienced and expected reward ; and (b) the thresholded unsigned prediction error, the difference between expected and unexpected outcomes regardless of magnitude. During social reward prediction errors, the ASD group demonstrated the following differences relative to the TD group : (a) signed prediction error : decreased activation in the right precentral gyrus and increased activation in the right frontal pole ; and (b) thresholded unsigned prediction error : increased activation in the right anterior cingulate gyrus and bilateral precentral gyrus. Groups did not differ in brain activation during nonsocial reward prediction errors. Within the ASD group, exploratory analyses revealed that reaction times and social-communication impairments were related to precentral gyrus activation during social prediction errors. These findings elucidate the neural mechanisms of social reward prediction errors in ASD and suggest that ASD is characterized by greater neural atypicalities during social, relative to nonsocial, reward prediction errors in ASD. LAY SUMMARY : We used brain imaging to evaluate differences in brain activation in adolescents with autism while they performed tasks that involved learning about social and nonsocial information. We found no differences in brain responses during the nonsocial condition, but differences during the social condition of the learning task. This study provides evidence that autism may involve different patterns of brain activation when learning about social information.

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9. Laratta JL, Glassman SD, Atanda AA, Dimar JR, Gum JL, Crawford CH, 3rd, Bratcher K, Carreon LY. The Berg balance scale for assessing dynamic stability and balance in the adult spinal deformity (ASD) population. J Spine Surg ;2019 (Dec) ;5(4):451-456.

Background : Adult spinal deformity (ASD) is a prevalent condition in individuals over the age of 65 ; leading to impaired standing balance and abnormal gait patterns. This functional impairment may be due to the fixed sagittal or coronal malalignment ; associated spinal stenosis or deconditioning. The Berg balance scale (BBS) was developed to measure balance by assessing the performance of functional tasks. The purpose of this study is to determine if BBS is a useful metric for evaluating functional status in ASD patients. Methods : ASD patients who required fusion from the thoracic spine to the pelvis from 2014 to 2016 were enrolled and asked to complete the BBS prior to and six months after surgery. BBS were obtained by a certified physical therapist. Standard demographic ; radiographic and surgical data were collected. The Oswestry disability index (ODI), EuroQOL-5D and numeric rating scales (0 to 10) for back and leg pain were assessed at baseline and post-intervention. Results : Of 21 patients enrolled ; 19 completed pre- and post-surgery BBS. The mean age was 59.8+/-13.3 years with 14 females. There was a statistically significant improvement in all outcome scores and radiographic parameters after surgery ; but no difference in BBS. Only one patient had a BBS score low enough to be considered a medium fall risk. There was no difference in the pre-op BBS scores in the four patients that had revision surgery compared to those that did not. Conclusions : In this small pilot study ; BBS did not appear to be associated with measures of clinical and radiographic improvement in ASD patients. The test was also potentially problematic in that it has a ceiling effect and required significant time with a trained physical therapist for administration. Continued effort to identify a viable measure of balance dysfunction in ASD patients is warranted.

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10. Livingston LA, Shah P, Milner V, Happe F. Quantifying compensatory strategies in adults with and without diagnosed autism. Mol Autism ;2020 (Feb 12) ;11(1):15.

BACKGROUND : There is growing recognition that some autistic people engage in ’compensation’, showing few behavioural symptoms (e.g. neurotypical social skills), despite continuing to experience autism-related cognitive difficulties (e.g. difficulties in social cognition). One way this might be achieved is by individuals consciously employing ’compensatory strategies’ during everyday social interaction. However, very little is currently known about the broad range of these strategies, their mechanisms and consequences for clinical presentation and diagnosis. METHODS : We aimed to measure compensatory strategies in autism for the first time. Using a novel checklist, we quantified self-reported social compensatory strategies in 117 adults (58 with autism, 59 without autism) and explored the relationships between compensation scores and autism diagnostic status, autistic traits, education level, sex and age at diagnosis. RESULTS : Higher compensation scores-representing a greater repertoire of compensatory strategies-were associated with having an autism diagnosis, more autistic traits and a higher education level. The link between autism diagnostic status and compensation scores was, however, explained by autistic traits and education level. Compensation scores were unrelated to sex or age at diagnosis. LIMITATIONS : Our sample was self-selected and predominantly comprised of intellectually able females ; therefore, our findings may not generalise to the wider autistic population. CONCLUSIONS : Together, our findings suggest that many intellectually able adults, with and without a clinical diagnosis of autism, report using compensatory strategies to modify their social behaviour. We discuss the clinical utility of measuring self-reported compensation (e.g., using our checklist), with important implications for the accurate diagnosis and management of autism and related conditions.

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11. Lu L, Chen T, Chen Y, Yuan M, Gerstein M, Li T, Liang H, Froehlich T. Towards developing a practical artificial intelligence tool for diagnosing and evaluating autism spectrum disorder : A study using multicenter ABIDE II datasets. JMIR Med Inform ;2020 (Feb 9)

BACKGROUND : Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with unknown etiology. Early diagnosis and intervention are the keys to improving outcomes for patients with ASD. Structural MRI (sMRI) has been widely used in clinic to facilitate the diagnosis of brain diseases such as brain tumors. However, sMRI is less frequently investigated in neurological and psychiatric disorders such as ASD due to subtle, if any, anatomical changes of the brain. In recent years, more and more evidence has suggested that ASD is associated with anatomical changes of the brain. OBJECTIVE : The aim of this study was to investigate the possibility of identifying structural patterns in the ASD patients’ brain as potential biomarkers in the diagnosis and evaluation of ASD in clinic. METHODS : We developed a novel two-level histogram-based morphometry (HBM) classification framework in which an algorithm based on a 3D version of histogram of oriented gradients (HOG) was used to extract features from sMRI data. We applied this framework to distinguish ASD patients from healthy controls using four datasets from the second edition of the Autism Brain Imaging Data Exchange (ABIDE II) including sites ETH Zurich (ETH), NYU Langone Medical Center : Sample 1 (NYU), Oregon Health and Science University (OHSU), and Stanford University (SU). We used stratified 10-fold cross-validation method to evaluate the model performance, and optimized the parameters for 3D HOG and selected the best algorithms for each level of the HBM framework. We applied the Naive Bayes approach to identify the predictive ASD-related brain regions based on classification contributions of each HOG feature. RESULTS : Based on the 3D HOG feature extraction method, our proposed HBM framework achieved >0.75 AUC on each dataset, with the best AUC of 0.849 on the ETH site. We compared the 3D HOG algorithm with the original 2D HOG algorithm and improved >4% AUC on each dataset, with the best improvement of 10% on the SU site. Comparison of the 3D HOG algorithm with the scale-invariant feature transform (SIFT) algorithm showed >14% AUC improvement on each dataset. Furthermore, we identified ASD-related brain regions based on the sMRI images. Some of these regions (e.g., frontal gyrus, temporal gyrus, ingulate gyrus, postcentral gyrus, precuneus, caudate and hippocampus) are known to be implicated in ASD in prior neuroimaging literatures. We also identified less well-known regions that may play unrecognized roles in ASD and be worth further investigation. CONCLUSIONS : Our research suggested it was possible to identify neuroimaging biomarkers that can distinguish ASD patients from healthy controls based on sMRI brain images. As a cost-effective and non-invasive tool for investigating brain structural changes, sMRI is also more amenable to populations for whom compliance is a challenge as it can be completed under sedation. Therefore, our tool could be useful in the diagnosis and evaluation of ASD in clinic. We also demonstrated the potentials of applying data-driven artificial intelligence technology in the clinical settings of neurological and psychiatric disorders that usually harbor in the brain subtle anatomical changes often invisible to human eyes.

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12. Nerli E, Roggero OM, Baj G, Tongiorgi E. In vitro modeling of dendritic atrophy in Rett syndrome : determinants for phenotypic drug screening in neurodevelopmental disorders. Sci Rep ;2020 (Feb 12) ;10(1):2491.

Dendritic atrophy, defined as the reduction in complexity of the neuronal arborization, is a hallmark of several neurodevelopmental disorders, including Rett Syndrome (RTT). RTT, affecting 1:10,000 girls worldwide, is mainly caused by mutations in the MECP2 gene and has no cure. We describe here an in vitro model of dendritic atrophy in Mecp2(-/y) mouse hippocampal primary cultures, suitable for phenotypic drug-screening. Using High-Content Imaging techniques, we systematically investigated the impact of culturing determinants on several parameters such as neuronal survival, total dendritic length, dendritic endpoints, soma size, cell clusterization, spontaneous activity. Determinants included cell-seeding density, glass or polystyrene substrates, coating with poly-Ornithine with/without Matrigel and miniaturization from 24 to 96-half surface multiwell plates. We show that in all plate-sizes at densities below 320 cells/mm(2), morphological parameters remained constant while spontaneous network activity decreased according to the cell-density. Mecp2(-/y) neurons cultured at 160 cells/mm(2) density in 96 multiwell plates, displayed significant dendritic atrophy and showed a marked increase in dendritic length following treatment with Brain-derived neurotrophic factor (BDNF) or Mirtazapine. In conclusion, we have established a phenotypic assay suitable for fast screening of hundreds of compounds, which may be extended to other neurodevelopmental diseases with dendritic atrophy.

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13. Rashid M, Thompson-Hodgetts S, Nicholas D. Tensions experienced by employment support professionals when seeking meaningful employment for persons with developmental disabilities. Res Dev Disabil ;2020 (Feb 8) ;99:103603.

PURPOSE : Current research suggests that supported employment for people with developmental disabilities offers significantly higher rates of employment, personal satisfaction, and employer satisfaction. This study focuses on tensions experienced by employment support professionals while working with employers regarding employment for persons with developmental disabilities. These tensions experienced by employment support professionals is an area that is currently under researched and needs further exploration. METHOD : In-depth interviews and focus group sessions were conducted with employment support professionals (n=34) from a variety of organizations in two Canadian provinces. Theoretical sampling was used to recruit study participants. Data were thematically analysed, informed by a grounded theory approach. RESULTS : Four main themes emerged : (i) Hire for capabilities, not pity, (ii) The bottom line : profit versus moral code, (iii) Education and concerns about accommodations and costs, and (iv) Pros and cons of incentives. CONCLUSIONS : Our study highlights some of the tensions experienced by employment support professionals when they work with employers considering employing persons with developmental disabilities. This information can be used to help employment support professionals, and others, target approaches and supports aimed at building employers’ capacity to support meaningful employment for people with developmental disabilities.

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14. Rimmer A. Health secretary is threatened with legal action over treatment of people with learning disabilities and autism. Bmj ;2020 (Feb 12) ;368:m578.

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15. Sharp WG, Berry RC, Burrell L, Scahill L, McElhanon BO. Scurvy as a Sequela of Avoidant-Restrictive Food Intake Disorder in Autism : A Systematic Review. J Dev Behav Pediatr ;2020 (Feb 10)

OBJECTIVE : To document the clinical presentation of scurvy in children with autism spectrum disorder (ASD) and summarize the contemporary approaches to assessment and management in this population. Scurvy is a disease caused by vitamin C deficiency most often detected in populations at high risk for nutrition insufficiency (e.g., extreme poverty). Children with ASD and severe food selectivity consistent with avoidant-restrictive food intake disorder may also be at risk for scurvy. METHOD : We searched MEDLINE, CINAHL, and PsycINFO databases (1990-2018) in peer-reviewed journals for studies of children with ASD and scurvy. Inclusion criteria required confirmed diagnosis of ASD and scurvy in children (birth to 18 years) with a clear description of restrictive dietary patterns. Cases of scurvy due to other causes were excluded. We used a standardized protocol to independently code information ; agreement between coders was high. RESULTS : The systematic search identified 20 case reports involving 24 children (mean age = 9 +/- 3.5 ; 22 boys/2 girls). The eventual diagnosis of scurvy followed a wide range of negative diagnostic testing ; treatment with ascorbic acid and/or a multivitamin resulted in rapid improvement. CONCLUSIONS : Symptoms of scurvy mimic other pediatric conditions (e.g., cancer). The range of diagnostic testing increased costs and healthcare risks (radiation, sedation) and delayed the diagnosis of scurvy. In children with ASD and severe food selectivity, a nutrition evaluation and laboratory testing are warranted before a more elaborate testing.

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16. Sheppard E, Mitchell P, Alkhaldi RS. How are Autistic People Perceived ? A Reply to Chown, Hughes and Baker-Rogers (2019). J Autism Dev Disord ;2020 (Feb 12)

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17. Stewart GR, Corbett A, Ballard C, Creese B, Aarsland D, Hampshire A, Charlton RA, Happe F. The Mental and Physical Health of Older Adults With a Genetic Predisposition for Autism. Autism Res ;2020 (Feb 11)

Autism commonly aggregates in families, with twin studies estimating heritability to be around 80%. Subclinical autism-like characteristics have also been found at elevated rates in relatives of autistic probands. Physical and psychiatric conditions have been reported at elevated rates in autistic children and adults, and also in their relatives. However, to date, there has been no exploration of how aging may affect this pattern. This study examined cross-sectional data from the ongoing online PROTECT study. A total of 20,220 adults aged 50 years and older reported whether they have an autistic first-degree relative. In total, 739 older adults reported having an autistic first-degree relative (AFDR group) and 11,666 were identified as having no family history of any neurodevelopmental disorder (NFD group). The AFDR group demonstrated significantly higher frequencies of self-reported psychiatric diagnoses and a greater total number of co-occurring psychiatric diagnoses than the NFD group. Furthermore, the AFDR group reported elevated current self-report symptoms of depression, anxiety, traumatic experience, and post-traumatic stress than the NFD group. By contrast, few differences between AFDR and NFD groups were observed in physical health conditions, and no differences were observed in the total number of co-occurring physical health diagnoses. These findings suggest that adults who have an AFDR may be at greater risk of poor mental, but not physical, health in later life. Older adults with autistic relatives may benefit from close monitoring to mitigate this susceptibility and to provide timely intervention. Autism Res 2020. (c) 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Children and adults with an autistic relative have been found to experience more psychiatric difficulties than those with no family links to autism. However, a few studies have explored what happens when these individuals get older. Examining over 20,000 adults age 50+, we found that older adults with an autistic relative experienced elevated rates of most psychiatric conditions but not physical conditions. Older adults with autistic relatives may benefit from close monitoring to mitigate this susceptibility and to provide timely intervention.

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18. Tasse MJ, Wagner JB, Kim M. Using technology and remote support services to promote independent living of adults with intellectual disability and related developmental disabilities. J Appl Res Intellect Disabil ;2020 (Feb 12)

BACKGROUND : The use of remote support technologies is a newer form of service that can contribute to increased independence while giving adults with intellectual and developmental disabilities a sense of home safety. This research reviewed the use of remote support services, which is a waiver service that includes smart home technologies and remote support staff that can be called upon, when needed. METHOD : Using focus groups and telephone interviews, the present authors asked users of remote support services about their experience, including what they liked most and least about their experience with these technologies. RESULTS : Overall, increased independence and a sense of security and home safety were identified as the two principal benefits. Remote support technologies may be a part of the solution to addressing the lack of direct support professionals available to provide in-home care. CONCLUSIONS : The present authors discuss the benefits of remote support technologies and offer recommendations for future research regarding remote support technologies and the potential benefits of this newer form of support service.

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19. Wicks R, Paynter J, Westerveld MF. Looking or talking : Visual attention and verbal engagement during shared book reading of preschool children on the autism spectrum. Autism ;2020 (Feb 12):1362361319900594.

LAY ABSTRACT : Children who have an autism diagnosis often have trouble learning to talk and read. These difficulties become noticeable before children start school and may be linked to lower attention and engagement in literacy-related activities such as sharing storybooks with their parents. To date, few researchers have looked at possible ways to measure how children on the autism spectrum engage during shared storybook reading, for example, where children look or how much they talk, and how this may be related to their letter-name knowledge and their vocabulary knowledge. In this study, we analyzed videos of 40 preschoolers on the spectrum and their parents sharing an unfamiliar storybook. We wanted to see whether where children looked (i.e. toward the storybook, their parent, or elsewhere) and how much they talked were related to what their parents did (e.g. ask questions or provide prompts) and/or children’s letter-name knowledge and vocabulary. The videos were coded for different child and parent behaviors. We found that where children looked and how much they talked were strongly related to each other and what parents did during the shared book reading interaction, particularly asking questions and using prompts. In contrast to what we expected, where children looked was not related to children’s letter or vocabulary knowledge. Overall, results of the study draw attention to the connection between what parents do and what preschoolers on the spectrum do when sharing storybooks and provide directions for future research.

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20. Williams Buckley A, Hirtz D, Oskoui M, Armstrong MJ, Batra A, Bridgemohan C, Coury D, Dawson G, Donley D, Findling RL, Gaughan T, Gloss D, Gronseth G, Kessler R, Merillat S, Michelson D, Owens J, Pringsheim T, Sikich L, Stahmer A, Thurm A, Tuchman R, Warren Z, Wetherby A, Wiznitzer M, Ashwal S. Practice guideline : Treatment for insomnia and disrupted sleep behavior in children and adolescents with autism spectrum disorder : Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology ;2020 (Feb 12)

OBJECTIVE : To review pharmacologic and nonpharmacologic strategies for treating sleep disturbances in children and adolescents with autism spectrum disorder (ASD) and to develop recommendations for addressing sleep disturbance in this population. METHODS : The guideline panel followed the American Academy of Neurology 2011 guideline development process, as amended. The systematic review included studies through December 2017. Recommendations were based on evidence, related evidence, principles of care, and inferences. MAJOR RECOMMENDATIONS LEVEL B : For children and adolescents with ASD and sleep disturbance, clinicians should assess for medications and coexisting conditions that could contribute to the sleep disturbance and should address identified issues. Clinicians should counsel parents regarding strategies for improved sleep habits with behavioral strategies as a first-line treatment approach for sleep disturbance either alone or in combination with pharmacologic or nutraceutical approaches. Clinicians should offer melatonin if behavioral strategies have not been helpful and contributing coexisting conditions and use of concomitant medications have been addressed, starting with a low dose. Clinicians should recommend using pharmaceutical-grade melatonin if available. Clinicians should counsel children, adolescents, and parents regarding potential adverse effects of melatonin use and the lack of long-term safety data. Clinicians should counsel that there is currently no evidence to support the routine use of weighted blankets or specialized mattress technology for improving disrupted sleep. If asked about weighted blankets, clinicians should counsel that the trial reported no serious adverse events with blanket use and that blankets could be a reasonable nonpharmacologic approach for some individuals.

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21. Yasuno F, Makinodan M, Takahashi M, Matsuoka K, Yoshikawa H, Kitamura S, Ishida R, Kishimoto N, Miyasaka T, Kichikawa K, Kishimoto T. Microstructural Anomalies Evaluated by Neurite Orientation Dispersion and Density Imaging Are Related to Deficits in Facial Emotional Recognition via Perceptual-Binding Difficulties in Autism Spectrum Disorder. Autism Res ;2020 (Feb 12)

The integration of visual features is important for recognizing objects as a coherent whole, a key domain of difficulty in autism spectrum disorder (ASD). We tested the hypothesis that ASD patients exhibit difficulties in facial emotional recognition via perceptual binding difficulties due to weak coherence. We assessed 18 ASD and 27 typically developing individuals for their ability to identify emotional expressions from faces in pictures moving behind a narrow vertical and horizontal slit. In this task, only a single local piece of facial information was provided at any one time through the slit. Using a voxel-based analysis of neurite-orientation dispersion and density imaging (NODDI), we examined the relationship between NODDI index values at each voxel and the behavioral performance of ASD patients in the slit-viewing paradigm. ASD patients demonstrated impaired recognition of facial emotional expression only in horizontal slit-viewing. This deficit was associated with deficits in communication ability. Voxel-based analysis revealed significant negative correlations between behavioral deficits in horizontal slit-viewing and NODDI index values in clusters including the ventral occipital complex region, superior temporal/parietal association areas, and forceps major of the corpus callosum. Our results indicated deficits for the first time in perceptual integration of facial expression across hemispheres in ASD patients due to microstructural disturbances in the corpus callosum and areas related to viewing of the human face. This may underscore the difficulties faced by ASD patients in understanding the emotions of other people, contributing to impairments in communication ability in ASD patients. Autism Res 2019, 00 : 1-10. (c) 2019 International Society for Autism Research,Wiley Periodicals, Inc. LAY SUMMARY : We assessed ASD and typically developing individuals for their ability to identify emotional expressions from faces in pictures moving behind a narrow vertical and horizontal slit. ASD patients demonstrated impaired recognition of facial emotional expression only in horizontal slit-viewing. Voxel-based analysis revealed significant negative correlations between behavioral deficits and NODDI index values in clusters including the corpus callosum. Our results indicated deficits in perceptual integration of facial expression across hemispheres in ASD patients potentially resulting from microstructural disturbances.

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22. Zhang L, Huang CC, Dai Y, Luo Q, Ji Y, Wang K, Deng S, Yu J, Xu M, Du X, Tang Y, Shen C, Feng J, Sahakian BJ, Lin CP, Li F. Correction : Symptom improvement in children with autism spectrum disorder following bumetanide administration is associated with decreased GABA/glutamate ratios. Transl Psychiatry ;2020 (Feb 12) ;10(1):63.

An important detail was omitted in the Method of the original Article, I.E, The CARS and other evaluations were conducted ’blind’ to condition (Bumetanide or no treatment) by experienced clinicians. This has now been updated in the HTML and PDF versions of this Article.

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Formations pour les Familles et les Proches

le détail des programmes de formation à l’attention des familles et des proches de personnes avec TSA est disponible en cliquant sur l’image ci-dessous.

Formation pour les Aidants Familiaux {JPEG}

Sensibilisation à l’usage des tablettes au CRA !

Toutes les informations concernant les sensibilisations du CRA aux tablettes numériques en cliquant sur l’image ci-dessous :

1-Formation à l’état des connaissances de l’autisme

Plus d’information sur la formation gratuite que dispense le CRA en cliquant sur l’image ci-dessous :

Formation à l'état des connaissances de l'autisme {JPEG}

4-Accéder au Livret Autisme Auvergne Rhône-Alpes (LAARA)

Prenez connaissance du Livret Autisme Auvergne Rhône-Alpes, projet de répertoire régional des structures médico-sociales. En cliquant sur l’image ci-dessous :

Cliquer pour accéder au LAARA