Pubmed du 18/04/20

samedi 18 avril 2020

1. Beauchamp MLH, Rezzonico S, MacLeod AAN. Bilingualism in School-Aged Children with ASD : A Pilot Study. J Autism Dev Disord. 2020.

Preschool-aged bilingual children with autism spectrum disorder (ASD) can keep pace with their monolingual peers with ASD. However, can older children with ASD continue to do so as language demands become greater ? Also, can they reach language levels similar to those of neurotypically developing (ND) bilingual children ? The current study compares the language abilities of 3 school-aged bilingual children with ASD to those of 2 monolingual peers, and 19 ND bilingual and 12 ND monolingual peers. Using cluster analyses, we found that bilingual children with ASD had similar language to those of monolingual children with ASD and neurotypically developing bilingual and monolingual children. Results suggest that bilingual children with ASD can keep pace with their peers with similar intellectual abilities.

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2. Bullen JC, Swain Lerro L, Zajic M, McIntyre N, Mundy P. A Developmental Study of Mathematics in Children with Autism Spectrum Disorder, Symptoms of Attention Deficit Hyperactivity Disorder, or Typical Development. J Autism Dev Disord. 2020.

This study examined mathematics achievement in school-aged children with autism spectrum disorder (ASD), symptoms of attention-deficit/hyperactivity disorder (ADHD), or typical development (TD) over a 30-month period and the associations between cognitive and reading abilities with mathematics achievement in children with ASD. Seventy-seven children with ASD without intellectual disability (ASD-WoID), 39 children with ADHD, and 43 children with TD participated in this study. The results revealed that the ASD-WoID and ADHD samples displayed significant and comparable delays in problem solving and calculation abilities. Lower VIQ was related to lower math achievement across all subgroups. The ASD-WoID sample differed from comparison samples in terms of their pattern of mathematical achievement and the role of cognitive abilities in the development of mathematics competence.

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3. D’Alo GL, De Crescenzo F, Minozzi S, Morgano GP, Mitrova Z, Scattoni ML, Amato L, Davoli M, Schunemann HJ. Equity, acceptability and feasibility of using polyunsaturated fatty acids in children and adolescents with autism spectrum disorder : a rapid systematic review. Health and quality of life outcomes. 2020 ; 18(1) : 101.

INTRODUCTION : Some recent randomized controlled trials (RCTs) assessed the efficacy and safety of polyunsaturated fatty acids (PUFAs) for the treatment of autism spectrum disorder (ASD). To optimally inform the Italian guideline for the management of ASD in children and adolescents, we reviewed the impact on equity, acceptability and feasibility for developing a pilot recommendation for PUFAs. METHODS : We performed a rapid systematic review of observational and experimental studies on PUFAs for children and adolescents with ASD, extracting data on resources required, equity, acceptability, and feasibility of PUFAs. We followed the framework provided by the grading of recommendations assessment, development and evaluation (GRADE) methodology, and we assessed risk of bias and methodological quality of included studies. Results were synthesized both narratively and quantitatively to address clinically relevant questions on equity, acceptability, and feasibility. RESULTS : We found 14 papers related to equity. PUFAs did not seem to impact equity importantly. We did not find variation in effectiveness across subgroups and in a base case scenario, the cost of a 12 weeks cycle of therapy with 1.155 g/day of PUFAs was euro65.51 euro. The acceptability of PUFAs was evaluated in 17 studies, 9 of which were RCTs. PUFAs were widely used among children and adolescents with ASD (18 to 51%), and 50% of parents considered nutritional supplementation as useful. Difficulty in swallowing capsules and bad taste were identified as possible causes of poor compliance, but treatment adherence, when measured in included RCTs, was judged to be good to excellent. Discontinuation due to any cause for PUFAs could not differ from placebo (low certainty of evidence). The feasibility of using PUFAs was assessed in 12 studies. PUFAs were probably sustainable, and no particular critical issue emerged from the feasibility assessment. However, the evidence appeared scarce and indirect. CONCLUSIONS : We found the administration of PUFAs in children and adolescents with ASD to be potentially equitable, acceptable and feasible. These results are limited by the limited number and quality of retrieved documents, and need to be viewed in light of efficacy and safety data to formulate clinical recommendations.

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4. Feinberg E, Kuhn J, Eilenberg JS, Levinson J, Patts G, Cabral H, Broder-Fingert S. Improving Family Navigation for Children with Autism : A Comparison of Two Pilot Randomized Controlled Trials. Academic pediatrics. 2020.

OBJECTIVES : Family Navigation (FN), a care management strategy, helps families overcome systems and person-level barriers to care. We previously demonstrated FN’s feasibility, acceptability, and potential efficacy for increasing access and reducing time to autism-related diagnostic services among low-income, minority children. In this paper, we describe modifications to FN in response to concerns raised in our first pilot randomized controlled trial (RCT), and then assess these modifications in a second pilot RCT. METHODS : An advisory group recommended modifications to recruitment procedures and study conditions. 40 parent-child dyad participants with autism-related concerns were randomized to receive modified usual care (UC) or modified FN. We compared whether the first and second pilot RCTs differed in : participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment. RESULTS : Recruitment improved under the modified protocol with significantly fewer potentially eligible families refusing (19.5% vs. 4.8%, p < .05) or being excluded from study enrollment (43.6% vs. 0%, p < 0.01). Comparing the first and second pilot RCTs, regardless of study arm, families in the second pilot were more likely to complete diagnostic assessment (UC : HR 3.41, 95% CI [1.20, 9.68] ; FN : HR 2.64, 95% CI [1.31, 5.30]) and report greater satisfaction with clinical care. In the second pilot, compared to UC, FN continued increase the likelihood of completing the diagnostic assessment (HR : 2.57 ; 95% CI [1.22, 5.40]). CONCLUSIONS : Easy-to-implement system-level enhancements improved study recruitment, satisfaction with care, and completion of a diagnostic assessment. With enhancement, FN continued to confer benefits to families.

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5. Gordon A, Geschwind DH. Human in vitro models for understanding mechanisms of autism spectrum disorder. Mol Autism. 2020 ; 11(1) : 26.

Early brain development is a critical epoch for the development of autism spectrum disorder (ASD). In vivo animal models have, until recently, been the principal tool used to study early brain development and the changes occurring in neurodevelopmental disorders such as ASD. In vitro models of brain development represent a significant advance in the field. Here, we review the main methods available to study human brain development in vitro and the applications of these models for studying ASD and other psychiatric disorders. We discuss the main findings from stem cell models to date focusing on cell cycle and proliferation, cell death, cell differentiation and maturation, and neuronal signaling and synaptic stimuli. To be able to generalize the results from these studies, we propose a framework of experimental design and power considerations for using in vitro models to study ASD. These include both technical issues such as reproducibility and power analysis and conceptual issues such as the brain region and cell types being modeled.

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6. Juliano AC, Alexander AO, DeLuca J, Genova H. Feasibility of a school-based mindfulness program for improving inhibitory skills in children with autism spectrum disorder. Res Dev Disabil. 2020 ; 101 : 103641.

BACKGROUND : Executive dysfunction is prevalent in children with autism spectrum disorder (ASD), including prominent difficulties in the two facets of inhibition, as well as with selective attention. School-based mindfulness has been used in typically-developing children to improve executive functioning, though this has not been investigated in children with ASD. Therefore, the purpose of this study was to examine the efficacy of a school-based mindfulness program for improving inhibition (prepotent response inhibition and interference control) and selective attention in children with ASD. METHOD : Using a quasi-experimental, pre-post design, an eight week school-based mindfulness program (Mindful Schools ;, was administered to students with ASD (n = 27) at a private, not-for-profit school for children with special needs. The Walk/Don’t Walk test and the Color-Word Interference test were used to evaluate prepotent response inhibition and interference control, respectively. Selective attention was measured using a cancellation test. RESULTS : Significant improvements followed the intervention for prepotent response inhibition and interference control (medium effect sizes), as well as for overall selective attention (large effect size). CONCLUSIONS : The study’s findings demonstrate that school-based mindfulness holds promise for increasing specific executive functioning abilities in children with ASD.

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7. Kalmbach D, Wood W, Peters BC. Parental Perspectives of Occupational Therapy in an Equine Environment for Children with Autism Spectrum Disorder. Occupational therapy in health care. 2020 : 1-23.

This paper reports on the qualitative phase of a mixed methods study of occupational therapy in an equine environment for children with autism spectrum disorder (ASD). The study’s quantitative phase found that this intervention improved the occupational performance, social motivation, social communication, and self-regulation of some children with ASD. The study’s qualitative phase, reported herein, subsequently aimed to describe parental perspectives on children’s experiences of the intervention and its influences on everyday life. Using a qualitative descriptive research approach, five parents participated in two rounds of semi-structured interviews. Interview data were analyzed using theoretical thematic analysis. Although parents expressed some concerns about the intervention, overall they found the intervention to be appropriate and acceptable. Next research steps include creation of a manual for the intervention and assessment of feasibility across a broader range of practice sites, occupational therapists, children with ASD, and their parents.

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8. Leming M, Gorriz JM, Suckling J. Ensemble Deep Learning on Large, Mixed-Site fMRI Datasets in Autism and Other Tasks. International journal of neural systems. 2020 : 2050012.

Deep learning models for MRI classification face two recurring problems : they are typically limited by low sample size, and are abstracted by their own complexity (the "black box problem"). In this paper, we train a convolutional neural network (CNN) with the largest multi-source, functional MRI (fMRI) connectomic dataset ever compiled, consisting of 43,858 datapoints. We apply this model to a cross-sectional comparison of autism spectrum disorder (ASD) versus typically developing (TD) controls that has proved difficult to characterize with inferential statistics. To contextualize these findings, we additionally perform classifications of gender and task versus rest. Employing class-balancing to build a training set, we trained 3 x 300 modified CNNs in an ensemble model to classify fMRI connectivity matrices with overall AUROCs of 0.6774, 0.7680, and 0.9222 for ASD versus TD, gender, and task versus rest, respectively. Additionally, we aim to address the black box problem in this context using two visualization methods. First, class activation maps show which functional connections of the brain our models focus on when performing classification. Second, by analyzing maximal activations of the hidden layers, we were also able to explore how the model organizes a large and mixed-center dataset, finding that it dedicates specific areas of its hidden layers to processing different covariates of data (depending on the independent variable analyzed), and other areas to mix data from different sources. Our study finds that deep learning models that distinguish ASD from TD controls focus broadly on temporal and cerebellar connections, with a particularly high focus on the right caudate nucleus and paracentral sulcus.

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9. Lindgren S, Wacker D, Schieltz K, Suess A, Pelzel K, Kopelman T, Lee J, Romani P, O’Brien M. A Randomized Controlled Trial of Functional Communication Training via Telehealth for Young Children with Autism Spectrum Disorder. J Autism Dev Disord. 2020.

Many children with autism spectrum disorder (ASD) have problem behaviors that interfere with learning and social interaction. This randomized controlled trial compared treatment with functional communication training (FCT) to "treatment as usual" for young children with ASD (n = 38, ages 21-84 months). FCT was conducted by parents with training and real-time coaching provided by behavioral consultants using telehealth. FCT treatment via telehealth achieved a mean reduction in problem behavior of 98% compared to limited behavioral improvement in children receiving "treatment as usual" during a 12-week period. Social communication and task completion also improved. For children with ASD and moderate to severe behavior problems, parent-implemented FCT using telehealth significantly reduced problem behavior while ongoing interventions typically did not.

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10. Strang JF, van der Miesen AI, Caplan R, Hughes C, daVanport S, Lai MC. Both sex- and gender-related factors should be considered in autism research and clinical practice. Autism. 2020 ; 24(3) : 539-43.

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11. West KL, Roemer EJ, Northrup JB, Iverson JM. Profiles of Early Actions and Gestures in Infants With an Older Sibling With Autism Spectrum Disorder. Journal of speech, language, and hearing research : JSLHR. 2020 : 1-17.

Purpose Infants with autism spectrum disorder (ASD) produce fewer play actions and gestures than neurotypical infants (e.g., Mastrogiuseppe et al., 2015 ; Veness et al., 2012 ; Zwaigenbaum et al., 2005). The purpose of this study was to investigate whether different "types" of actions and gestures are more or less likely to develop atypically in ASD. Method We examined eight types of actions and gestures longitudinally from ages 8 to 14 months in 80 infants with a heightened risk for developing ASD by virtue of having an affected older sibling (high risk [HR] ; e.g., Ozonoff et al., 2011) and 25 infants with no such familial risk (low risk). Data were collected using the MacArthur-Bates Communicative Development Inventories (Fenson et al., 1994, 1993). Results HR infants later diagnosed with ASD showed less growth across nearly all types of actions and gestures compared to the low-risk comparison group. Importantly, these HR infants who were later diagnosed with ASD also exhibited reduced growth in frequent deictic gestures and in actions that involve object manipulation relative to HR infants with non-ASD language delay. Conclusions During infancy, it is challenging for clinicians to distinguish ASD from other early communicative delays (e.g., Camarata, 2014). Our results indicate that deictic gestures, as well as actions and gestures involving object manipulation, may be useful targets of surveillance strategies for HR infants and could support early detection efforts for ASD.

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12. Yoshihara Y, Lisi G, Yahata N, Fujino J, Matsumoto Y, Miyata J, Sugihara GI, Urayama SI, Kubota M, Yamashita M, Hashimoto R, Ichikawa N, Cahn W, van Haren NEM, Mori S, Okamoto Y, Kasai K, Kato N, Imamizu H, Kahn RS, Sawa A, Kawato M, Murai T, Morimoto J, Takahashi H. Overlapping but Asymmetrical Relationships Between Schizophrenia and Autism Revealed by Brain Connectivity. Schizophr Bull. 2020.

Although the relationship between schizophrenia spectrum disorder (SSD) and autism spectrum disorder (ASD) has long been debated, it has not yet been fully elucidated. The authors quantified and visualized the relationship between ASD and SSD using dual classifiers that discriminate patients from healthy controls (HCs) based on resting-state functional connectivity magnetic resonance imaging. To develop a reliable SSD classifier, sophisticated machine-learning algorithms that automatically selected SSD-specific functional connections were applied to Japanese datasets from Kyoto University Hospital (N = 170) including patients with chronic-stage SSD. The generalizability of the SSD classifier was tested by 2 independent validation cohorts, and 1 cohort including first-episode schizophrenia. The specificity of the SSD classifier was tested by 2 Japanese cohorts of ASD and major depressive disorder. The weighted linear summation of the classifier’s functional connections constituted the biological dimensions representing neural classification certainty for the disorders. Our previously developed ASD classifier was used as ASD dimension. Distributions of individuals with SSD, ASD, and HCs s were examined on the SSD and ASD biological dimensions. We found that the SSD and ASD populations exhibited overlapping but asymmetrical patterns in the 2 biological dimensions. That is, the SSD population showed increased classification certainty for the ASD dimension but not vice versa. Furthermore, the 2 dimensions were correlated within the ASD population but not the SSD population. In conclusion, using the 2 biological dimensions based on resting-state functional connectivity enabled us to discover the quantified relationships between SSD and ASD.

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