Pubmed du 15/05/20

vendredi 15 mai 2020

1. On the occasion of World Autism Awareness Day 2020. Bulletin de l’Academie nationale de medecine. 2020.

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2. Achermann S, Nyström P, Bölte S, Falck-Ytter T. Motor atypicalities in infancy are associated with general developmental level at 2 years, but not autistic symptoms. Autism. 2020 : 1362361320918745.

Atypicalities in motor functioning are often observed in later born infant siblings of children with autism spectrum disorder. The goal of our study was to investigate motor functioning in infants with and without familial history of autism spectrum disorder. Specifically, we investigated how infants catch a ball that is rolling toward them following a non-straight path, a task that requires both efficient planning and execution. Their performance was measured using detailed three-dimensional motion capture technology. We found that several early motor functioning measures were different in infants with an older autistic sibling compared to controls. However, these early motor measures were not related to autistic symptoms at the age of 2 years. Instead, we found that some of the early motor measures were related to their subsequent non-social, general development. The findings of our study help us understand motor functioning early in life and how motor functioning is related to other aspects of development.

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3. Ambridge B, Bidgood A, Thomas K. Disentangling syntactic, semantic and pragmatic impairments in ASD : Elicited production of passives. J Child Lang. 2020 : 1-18.

Children with ASD and an IQ-matched control group of typically developing (TD) children completed an elicited-production task which encouraged the production of reversible passive sentences (e.g., "Bob was hit by Wendy"). Although the two groups showed similar levels of correct production, the ASD group produced a significantly greater number of "reversal" errors (e.g., "Wendy was hit by Bob", when, in fact Wendy hit Bob) than the TD group (who, when they did not produce correct passives, instead generally produced semantically appropriate actives ; e.g., "Wendy hit Bob"). These findings suggest that the more formal elements of syntax are spared relative to more semantic/pragmatic/narrative aspects (e.g., manipulating thematic roles) in at least high-functioning children with ASD.

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4. Ashitha SNM, Ramachandra NB. Integrated Functional Analysis Implicates Syndromic and Rare Copy Number Variation Genes as Prominent Molecular Players in Pathogenesis of Autism Spectrum Disorders. Neuroscience. 2020 ; 438 : 25-40.

Autism Spectrum Disorders (ASD) are caused by disrupted neurodevelopment leading to socio-communication and behavioural abnormalities. Although genetic anomalies like Copy Number Variations (CNV) have been implicated in ASD, their overall genomic landscape and pathogenicity remain elusive. Therefore, we created a CNV map for ASD using 9337 cases and 5650 controls from SFARI database, statistically marked genomic regions with high and low frequencies of CNVs (i.e., common and rare CNV regions respectively), performed gene function enrichment for CNV genes, built functional networks, pathways and examined their expression in brain tissues. Information thus obtained were cumulatively integrated using a weighted scoring strategy to rank CNV regions by their neuro-functional attributes. Subsequently, we mapped 105 genic CNV regions across 20 chromosomes. They encompassed 537 genes, of which only 59 (11%) genes were identified with Single Nucleotide Variations (SNV) in ASD subjects through sequencing and functional studies, which indicated that diverse sets of genes were affected by CNVs and SNVs in ASD. Overall, syndromic CNV regions displayed the most prominent neuronal functions. While common CNV regions were found in loci 15q11.2, 16p11.2, 22q11.21, 15q13.2-13.3, rare CNV regions in loci 4p16.3, 9q34.3, 7q11.23, 17p11.2 contributed significantly to protein interaction networks and were highly expressed in brain. Enriched CNV genes were clustered in six functional categories with either direct roles in neurodevelopment or auxiliary roles like cellular signalling via MAPK pathway, cytoskeletal organization and transport or immune regulation. Mechanisms through which these molecular systems could independently or in combination trigger an ASD phenotype were predicted.

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5. Banas K, Sawchuk B. Clonidine as a Treatment of Behavioural Disturbances in Autism Spectrum Disorder : A Systematic Literature Review. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent. 2020 ; 29(2) : 110-20.

BACKGROUND : Agitation and aggression are commonly cited reasons for psychiatry consultation for individuals diagnosed with autism spectrum disorder (ASD). While risperidone and aripiprazole do not carry Health Canada approval for management of ASD-associated irritability, both are used for this indication but are not universally effective and carry substantial risk of adverse effects. This necessitates use of off-label medications to assist in management of behavioral dysregulation. Clonidine, an alpha-2 receptor agonist, is approved in Canada for treatment of hypertension. The evidence base also supports its use for attention deficit/hyperactivity disorder (ADHD) and for tics in Tourette’s disorder. This review focuses on examining the literature regarding clonidine as a treatment of challenging behaviours in the ASD population. METHOD : Systematic search of MEDLINE, EMBASE, and PsycINFO databases resulted in 540 unique records. Ten publications were relevant to this review. RESULTS : Two cross-over studies, one open-label case series, and seven case reports were identified. One of two controlled studies suggested benefit from clonidine versus placebo. Caregivers typically noted improvement in behaviour with clonidine versus baseline. Clonidine was generally well-tolerated. Sedation was the most consistently reported adverse effect. Despite being an anti-hypertensive medication, few discontinued clonidine due to hypotension or bradycardia. CONCLUSION : Clonidine has a limited evidence base for use in the management of behavioural problems in patients with ASD. Most evidence originates from case reports. Given the paucity of pharmacological options for addressing challenging behaviours in ASD patients, a clonidine trial may be an appropriate and cost-effective pharmaceutical option for this population.

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6. Caldani S, Atzori P, Peyre H, Delorme R, Bucci MP. Short rehabilitation training program may improve postural control in children with autism spectrum disorders : preliminary evidences. Sci Rep. 2020 ; 10(1) : 7917.

Autism Spectrum Disorders subjects (ASD) is characterized by postural control deficits. This study aimed to explore the effect of a short postural rehabilitation training program on postural capabilities in children with ASD. Two groups (G1 and G2) of twenty children with ASD of IQ-, sex- and age- matched (mean age 11.7 ± 2.4 years) were included in this study. Posture was recorded by using the Balance Quest from Framiral on unstable platform in three different viewing conditions. The rehabilitation program consisted in two distinct postural control training exercises. Postural recordings were performed twice at T1 and T2 for both groups of children. Between T1 and T2 a 6-minute postural training was performed by the G1 group only, while the G2 group had a 6-minute of rest. Children were allocated randomly to the G1 or G2 groups. At T1, postural instability was similar for both groups of ASD children (G1 and G2) desp+\ite viewing conditions. At T2, we observed an improvement of postural control related to a mixed effect of training rehabilitation but also of test-retest. Knowing the potential of new rehabilitation strategies, the impact of postural control deficit in ASD children needs to be reconsidered. Well design case-control studies are requested to ensure scientific validity of postural rehabilitation training program.

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7. Eggleston JD, Harry JR, Cereceres PA, Olivas AN, Chavez EA, Boyle JB, Dufek JS. Lesser magnitudes of lower extremity variability during terminal swing characterizes walking patterns in children with autism. Clinical biomechanics (Bristol, Avon). 2020 ; 76 : 105031.

BACKGROUND : Anecdotally, children with Autism Spectrum Disorder have highly variable lower extremity walking patterns, yet, this has not been sufficiently quantified. As such, the purpose of this study was to examine walking pattern variability by way of lower extremity coordination and spatio-temporal characteristics in children with autism compared with individuals with typical development during over-ground walking. METHODS : Bilateral continuous relative phase variability was computed for the thigh-leg, leg-foot, and thigh-foot segment couples for 11 children with autism and 9 children with typical development at each gait sub-phase. Furthermore, left and right stride lengths and stride width were computed and compared. The Model Statistic was utilized to test for statistical differences in variability between each child with autism to an aggregate group with typical development. Effect sizes were computed to determine the meaningfulness between responses for children with autism and typical development. Coefficient of variation and effect sizes were computed for stride lengths and stride width. FINDINGS : Analysis revealed that children with autism exhibited differences in variability in each gait sub-phase. Notably, all but two children with autism exhibited lesser variability in all segment couples during terminal swing. Differences in stride lengths were relatively minimal, however, greater coefficient of variation magnitudes in stride width were observed in children with autism. INTERPRETATION : This finding reveals that children with autism may have limited or a preferred movement strategy when preparing the foot for ground contact. The findings from this study suggest variability may be an identifiable characteristic during movement in children with autism.

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8. Gumusoglu SB, Hing BWQ, Chilukuri ASS, Dewitt JJ, Scroggins SM, Stevens HE. Correction : Chronic maternal interleukin-17 and autism-related cortical gene expression, neurobiology, and behavior. Neuropsychopharmacology. 2020.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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9. Hallett V, Mueller J, Breese L, Hollett M, Beresford B, Irvine A, Pickles A, Slonims V, Scott S, Charman T, Simonoff E. Introducing ’Predictive Parenting’ : A Feasibility Study of a New Group Parenting Intervention Targeting Emotional and Behavioral Difficulties in Children with Autism Spectrum Disorder. J Autism Dev Disord. 2020.

Parent-mediated interventions can reduce behavioral and emotional problems in children with ASD. This report discusses the development of the first group parent intervention targeting behaviors and anxiety in children with ASD, across the spectrum of cognitive and language ability. ’Predictive Parenting’ was developed from the clinical observation (and emerging evidence base) that children with ASD struggle with ’prediction’ and anticipating change. It integrates well-established parenting strategies within an ASD-specific framework. The concept was co-created with patient and public involvement panels of parents and adults with ASD. A feasibility study found the programme is acceptable and accessible. Qualitative feedback from participants was largely positive, and critiques were used to inform a larger, pilot randomized controlled trial of the intervention.

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10. Howard J, Copeland JN, Gifford EJ, Lawson J, Bai Y, Heilbron N, Maslow G. Brief Report : Classifying Rates of Students with Autism and Intellectual Disability in North Carolina : Roles of Race and Economic Disadvantage. J Autism Dev Disord. 2020.

We examined special education classifications among students aged 3-21 in North Carolina public schools, highlighting autism spectrum disorder (ASD) and intellectual disability (ID). Results revealed variability by county in ASD and ID prevalence, and in county-level ratios of ID vs. ASD classifications. Sociodemographic characteristics predicted proportion of ASD or ID within a county ; correlations showed an association between race and ID, but not ASD. County’s median household income predicted proportion of students classified as ASD and ID (opposite directions), controlling for number of students and gender. Variability was unlikely related to biological incidence, and more likely related to district/school practices, or differences in resources. Disparities warrant further examination to ensure that North Carolina’s youth with disabilities access necessary, appropriate resources.

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11. Ishola IO, Balogun AO, Adeyemi OO. Novel potential of metformin on valproic acid-induced autism spectrum disorder in rats : involvement of antioxidant defense system. Fundamental & clinical pharmacology. 2020.

Prenatal exposure to valproic acid (VPA) has been shown to increase the risk of autism in children. This study examined the effect of metformin on VPA-induced autism spectrum disorders in rats. Pregnant albino rats administered VPA (500 mg/kg, i.p.) or normal saline (10 ml/kg, i.p. ; vehicle-control) on gestational day 12.5. The pups were given metformin (5, 50 or 500 mg/kg, p.o.) or vehicle (10 ml/kg, p.o.) daily from postnatal day (PND) 21 to 50. Social behaviour, spatial learning/ reference memory, repetitive behaviour and anxiety were assessed using the three-chamber social assay, Morris water maze (MWM), Y-maze and elevated plus maze tests (EPM), respectively. PND 51, the animals were euthanized and brains removed for biochemical assay. In-utero VPA exposure caused significant reduction in sociability index, social novelty preference index in three chambered apparatus and spatial learning and reference memory deficits in the MWM task as well as increase in repetitive/anxiety-like behaviour in Y-maze and EPM tests, respectively, which were ameliorated by post-treatment with metformin in a dose-dependent manner. Moreover, prenatal VPA increased malondialdehyde (MDA) and nitrite levels as well as deficits in antioxidant enzymes activities in the hippocampus and prefrontal cortex (PFC) which were attenuated by metformin administration. Similarly, VPA-induced increase in acetylcholinesterase activity in the hippocampus and PFC were attenuated by post-natal treatment with metformin. Findings from this study showed that postnatal administration of metformin prevented valproic acid-induced autistic-like behaviour. Hence, metformin could be a potential adjunct in the management of autism spectrum disorders.

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12. Jones MK, Kraus N, Bonacina S, Nicol T, Otto-Meyer S, Roberts MY. Auditory Processing Differences in Toddlers With Autism Spectrum Disorder. Journal of speech, language, and hearing research : JSLHR. 2020 ; 63(5) : 1608-17.

Purpose Auditory processing measures have been used in an attempt to understand the relationship between neurological mechanisms and autism spectrum disorder (ASD) symptomatology in school-age children. The focus of the current study was to understand neural auditory processing in 2- to 3-year-olds with ASD. Method Auditory processing measures (click auditory brainstem responses and speech-evoked frequency-following responses) were hypothesized to differ between typically developing children (n = 18) and children with ASD (n = 18). Auditory processing measures were hypothesized to relate to language development in children with ASD. Results The current study found limited differences in auditory processing measures between the two groups. No relationships were found between auditory processing measures and language development measures. Conclusions Future research is necessary to characterize auditory processing in toddlers with ASD. Longitudinal approaches should be considered when studying auditory processing in children with ASD in order to explore its developmental relationship with ASD symptomatology.

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13. Kim Y, An JY. Spatio-Temporal Roles of ASD-Associated Variants in Human Brain Development. Genes. 2020 ; 11(5).

Transcriptional regulation of the genome arguably provides the basis for the anatomical elaboration and dynamic operation of the human brain. It logically follows that genetic variations affecting gene transcription contribute to mental health disorders, including autism spectrum disorder (ASD). A number of recent studies have shown the role of de novo variants (DNVs) in disrupting early neurodevelopment. However, there is limited knowledge concerning the role of inherited variants during the early brain development of ASD. In this study, we investigate the role of rare inherited variations in neurodevelopment. We conducted co-expression network analyses using an anatomically comprehensive atlas of the developing human brain and examined whether rare coding and regulatory variants, identified from our genetic screening of Australian families with ASD, work in different spatio-temporal functions.

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14. Krug MK, Elliott MV, Gordon A, Hogeveen J, Solomon M. Proactive control in adolescents and young adults with autism spectrum disorder : Unimpaired but associated with symptoms of depression. Journal of abnormal psychology. 2020.

Although autism spectrum disorder (ASD) is characterized by deficits in cognitive control, our previous work has shown that preparatory, goal-directed cognitive processing (proactive control) may be preserved in children with ASD. We investigated whether proactive control is intact in adolescents and young adults with ASD, as well as how symptoms of ASD (repetitive behaviors) and psychopathology (Depressive, Anxiety, and Attention-Deficit/Hyperactivity Problems) are related to proactive control. Participants were adolescents and young adults with ASD (N = 44) and typical development (TD ; N = 44). Proactive control was assessed using a picture-word Stroop paradigm where participants named animals depicted in drawings while ignoring a superimposed written animal word. Interference effects (reaction time (RT) differences between more difficult incongruent trials, where animal pictures and words prompted different responses, and simpler congruent trials, where animal pictures and words prompted the same response) were calculated for two versions of the Stroop Task : a mostly congruent (MC) block, where the majority of trials were congruent, and a mostly incongruent (MI) block, where most trials were incongruent. Proactive control was calculated as the reduction in interference in the MI block in comparison to the MC block. Proactive control did not differ between groups, indicating that proactive control is not impaired in adolescents and young adults with ASD. In ASD, depression symptoms were associated with reduced proactive control. Future research should investigate the effects of interventions targeting depression as well as interventions targeting proactive control processes in individuals with ASD and comorbid depression. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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15. Lombardo MV. Ribosomal protein genes in post-mortem cortical tissue and iPSC-derived neural progenitor cells are commonly upregulated in expression in autism. Mol Psychiatry. 2020.

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16. Matsuo K, Yabuki Y, Fukunaga K. 5-aminolevulinic acid inhibits oxidative stress and ameliorates autistic-like behaviors in prenatal valproic acid-exposed rats. Neuropharmacology. 2020 ; 168 : 107975.

Autism spectrum disorders (ASDs) constitute a neurodevelopmental disorder characterized by social deficits, repetitive behaviors, and learning disability. Oxidative stress and mitochondrial dysfunction are associated with ASD brain pathology. Here, we used oxidative stress in prenatal valproic acid (VPA)-exposed rats as an ASD model. After maternal VPA exposure (600 mg/kg, p.o.) on embryonic day (E) 12.5, temporal analyses of oxidative stress in the brain using an anti-4-hydroxy-2-nonenal antibody revealed that oxidative stress was increased in the hippocampus after birth. This was accompanied by aberrant enzymatic activity in the mitochondrial electron transport chain and reduced adenosine triphosphate (ATP) levels in the hippocampus. VPA-exposed rats exhibited impaired spatial reference and object recognition memory alongside impaired social behaviors and repetitive behaviors. ASD-like behaviors including learning and memory were rescued by chronic oral administration of 5-aminolevulinic acid (5-ALA ; 30 mg/kg/day) and intranasal administration of oxytocin (OXT ; 12 μg/kg/day), a neuropeptide that improves social behavior in ASD patients. 5-ALA but not OXT treatment ameliorated oxidative stress and mitochondrial dysfunction in the hippocampus of VPA-exposed rats. Fewer parvalbumin-positive interneurons were observed in VPA-exposed rats. Both 5-ALA and OXT treatments augmented the number of parvalbumin-positive interneurons. Collectively, our results indicate that oral 5-ALA administration ameliorated oxidative stress and mitochondrial dysfunction, suggesting that 5-ALA administration improves ASD-like neuropathology and behaviors via mechanisms different to those of OXT.

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17. Morotti H, Mastel S, Keller K, Barnard RA, Hall T, O’Roak BJ, Fombonne E. Autism and attention-deficit/hyperactivity disorders and symptoms in children with neurofibromatosis type 1. Dev Med Child Neurol. 2020.

AIM : To evaluate if autism symptoms and diagnoses are more common in children with neurofibromatosis type 1 (NF1) than in typically developing children, to which levels, and to determine if co-occurring attention-deficit/hyperactivity disorder (ADHD) symptomatology accounts for this increase. METHOD : We searched hospital electronic medical records (EMR) for International Classification of Diseases, 10th Revision NF1 and co-occurring diagnoses codes. We recruited a subsample of 45 children (mean age 9y 2mo ; SD 2y 7mo ; range 5-12y ; 22 males, 23 females) and collected parental reports of autism symptomatology, adaptive behavior, and behavioral problems that were compared to those of 360 age- and sex-matched controls from the Simons Simplex Collection (SSC) with autism spectrum disorder (ASD ; SSC-ASD) or typically developing (SSC-TD). RESULTS : The EMR search identified 968 children with NF1 ; 8.8% had ADHD and 2.1% had ASD co-occurring diagnoses. In the subsample, the mean autism scale score for participants with NF1 was below cut-off for significant autism symptoms. Participants with NF1 had significantly more autism and behavioral symptoms than SSC-TD participants, and significantly less than SSC-ASD participants, with one exception : ADHD symptom levels were similar to those of SSC-ASD participants. In analyses that controlled for internalizing, ADHD, and communication scores, the difference in autism symptom levels between participants with NF1 and typically developing controls disappeared almost entirely. INTERPRETATION : Our results do not support an association between NF1 and autism, both at the symptom and disorder levels.

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18. Morrissette M, Boman J. Assessment of Aggressive Behaviour in a Patient with Autism Spectrum Disorder Requiring General Anesthesia. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent. 2020 ; 29(2) : 106-9.

OBJECTIVE : To consider the utility of general anesthesia in the assessment of aggressive behaviour associated with autism spectrum disorder (ASD). METHODS : We describe the case of an adolescent male exhibiting violent behaviour with a previous diagnosis of ASD and review medical literature relevant to the assessment of aggression in the context of ASD. RESULTS : A 16-year-old male with a prior diagnosis of ASD, who was non-verbal, was admitted to an inpatient psychiatry ward with the presenting issue of violent behaviour. The patient had not received routine medical or dental care for several years due to agitation and aggression when attempts to physically examine him were made. General anesthesia was necessary to assess for medical conditions that may be contributory to his behavioural changes. While under general anesthesia, he was physically examined by several consulting services, received brain imaging, and laboratory specimens were drawn. CONCLUSIONS : Aggressive behaviour is a common issue for patients with ASD. When a patient’s behaviour precludes examination and investigations, general anesthesia may be beneficial to facilitate the assessment process. This case illustrates the importance of a multidisciplinary approach in the assessment and management of a minimally verbal patient presenting with behavioural changes. To the knowledge of the authors, this represents the first published case report of a patient with ASD requiring general anesthesia for the assessment of aggressive behaviour.

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19. Obeid R, Bisson JB, Cosenza A, Harrison AJ, James F, Saade S, Gillespie-Lynch K. Do Implicit and Explicit Racial Biases Influence Autism Identification and Stigma ? An Implicit Association Test Study. J Autism Dev Disord. 2020.

Are implicit and explicit biases related to ASD identification and/or stigma ? College students (N = 493) completed two IATs assessing implicit stigma and racial biases. They evaluated vignettes depicting a child with ASD or conduct disorder (CD) paired with a photo of a Black or White child. CD was more implicitly and explicitly stigmatized than ASD. Accurately identifying ASD was associated with reduced explicit stigma ; identifying CD led to more stigma. Participants who identified as White implicitly associated the White child with ASD and the Black child with CD. A trend in the reverse direction was observed among Black participants. Implicit and explicit biases were unrelated. Findings highlight a need for trainings to ameliorate biases favoring one’s in-group.

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20. Ota T, Iida J, Okazaki K, Ishida R, Takahashi M, Okamura K, Yamamuro K, Kishimoto N, Kimoto S, Yasuda Y, Hashimoto R, Makinodan M, Kishimoto T. Delayed prefrontal hemodynamic response associated with suicide risk in autism spectrum disorder. Psychiatry Res. 2020 ; 289 : 112971.

Adults diagnosed with Autism spectrum disorder (ASD) are at high risk of experiencing suicidality compared with other clinical groups. Recently, near-infrared spectroscopy (NIRS) studies have investigated the association between frontotemporal functional abnormalities and suicidality in patients with mood disorders. However, whether these prefrontal hemodynamic responses are associated with suicide vulnerability in individuals with ASD remains unclear. Here, we used 24-channel NIRS to examine the characteristics of prefrontal hemodynamic responses during a verbal fluency task in 20 adults with ASD and in age-, sex-, and intelligence quotient-matched healthy controls. In addition, we used Spearman’s correlation analysis to identify the relationship between the time-course of prefrontal hemodynamic activation and the current suicide risk in patients with ASD. We found no significant differences between the verbal fluency task-induced prefrontal hemodynamic responses in the ASD vs. control group. However, we found a significant positive correlation between the current suicide risk score and the time-course of prefrontal hemodynamic activation in the ASD group. Thus, the 24-channel NIRS system appears to be useful in assessing suicide risk in individuals with ASD.

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21. Patton SR, Odar Stough C, Pan TY, Holcomb LO, Dreyer Gillette ML. Associations between autism symptom severity and mealtime behaviors in young children presented with an unfamiliar food. Res Dev Disabil. 2020 ; 103 : 103676.

BACKGROUND : Feeding problems are common in children with Autism Spectrum Disorder (ASD), and there are associations between parent reports of child ASD symptom severity and feeding problems. The current study further explores this association between ASD severity and family mealtime behaviors using directly observed naturalistic mealtime interactions. METHODS AND PROCEDURES : Seventy-three children (M(age) = 5.42 years) were presented an unfamiliar food during a videotaped but otherwise typical home meal. Mealtime behavior was assessed through coding of the videotaped meal using the Dyadic Interaction Nomenclature for Eating (DINE) and parent report (Brief ASD Mealtime Behavior Inventory ; BAMBI). ASD severity was assessed with the clinician-completed Childhood Autism Rating Scale-Second Edition (CARS-2). OUTCOMES AND RESULTS : Greater ASD severity was associated with fewer bites of the unfamiliar food, greater disruptive behavior during meals, and greater parental commands to take bites during meals. We found negative associations between limited food variety and food refusal (BAMBI subscales) and child bites of the unfamiliar food, with higher levels of limited food variety and food refusal associated with fewer bites of the unfamiliar food. CONCLUSIONS AND IMPLICATIONS : Children with more severe ASD may eat less and be more disruptive during meals, despite parent redirection. We also found associations between the BAMBI and DINE which suggest the BAMBI may be a sensitive measure of mealtime behaviors such as food flexibility and food refusal.

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22. Shaughnessy AF. Autism Screening with Follow-Up Overidentifies Autism Spectrum Disorder. American family physician. 2020 ; 101(10) : 630.

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23. Simmons DH, Titley HK, Hansel C, Mason P. Behavioral Tests for Mouse Models of Autism : An Argument for the Inclusion of Cerebellum-controlled Motor Behaviors. Neuroscience. 2020.

Mouse models of Autism Spectrum Disorder (ASD) have been interrogated using a variety of behavioral tests in order to understand the symptoms of ASD. However, the hallmark behaviors that are classically affected in ASD - deficits in social interaction and communication as well as the occurrence of repetitive behaviors - do not have direct murine equivalents. Thus, it is critical to identify the caveats that come with modeling a human disorder in mice. The most commonly used behavioral tests represent complex cognitive processes based on largely unknown brain circuitry. Motor impairments provide an alternative, scientifically rigorous approach to understanding ASD symptoms. Difficulties with motor coordination and learning - seen in both patients and mice - point to an involvement of the cerebellum in ASD pathology. This brain area supports types of motor learning that are conserved throughout vertebrate evolution, allowing for direct comparisons of functional abnormalities between humans with autism and ASD mouse models. Studying simple motor behaviors provides researchers with clearly interpretable results. We describe and evaluate methods used on mouse behavioral assays designed to test for social, communicative, perseverative, anxious, nociceptive, and motor learning abnormalities. We comment on the effectiveness and validity of each test based on how much information its results give, as well as its relevance to ASD, and will argue for an inclusion of cerebellum-supported motor behaviors in the phenotypic description of ASD mouse models. LAY SUMMARY : Mouse models of Autism Spectrum Disorder help us gain insight about ASD symptoms in human patients. However, there are many differences between mice and humans, which makes interpreting their behaviors challenging. Here, we discuss a battery of behavioral tests for specific mouse behaviors to explore whether each test does indeed evaluate the intended measure, and whether these tests are useful in learning about ASD.

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24. Solish A, Klemencic N, Ritzema A, Nolan V, Pilkington M, Anagnostou E, Brian J. Effectiveness of a modified group cognitive behavioral therapy program for anxiety in children with ASD delivered in a community context. Mol Autism. 2020 ; 11(1) : 34.

BACKGROUND : Youth with autism spectrum disorder (ASD) experience high rates (approximately 50-79%) of comorbid anxiety problems. Given the significant interference and distress that excessive anxiety can cause, evidence-based intervention is necessary in order to reduce long-term negative effects. Cognitive behavioral therapy (CBT) has demonstrated efficacy for treating anxiety disorders across the lifespan, both in individual and group formats. Recently, modified CBT programs for youth with ASD have been developed, showing positive outcomes. To date, these modified CBT programs have primarily been evaluated in controlled research settings. METHODS : The current community effectiveness study investigated the effectiveness of a modified group CBT program (Facing Your Fears) delivered in a tertiary care hospital and across six community-based agencies providing services for youth with ASD. Data were collected over six years (N = 105 youth with ASD ; ages 6-15 years). RESULTS : Hospital and community samples did not differ significantly, except in terms of age (hospital M = 10.08 years ; community M = 10.87 years). Results indicated significant improvements in anxiety levels from baseline to post-treatment across measures, with medium effect sizes. An attempt to uncover individual characteristics that predict response to treatment was unsuccessful. CONCLUSIONS : Overall, this study demonstrated that community implementation of a modified group CBT program for youth with ASD is feasible and effective for treating elevated anxiety.

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25. Solomon C. Autism and Employment : Implications for Employers and Adults with ASD. J Autism Dev Disord. 2020.

A small but growing body of research has been conducted on vocational outcomes for adults with Autism Spectrum Disorder (ASD) ; however, limited resources have been directed towards understanding outcomes for competitive employers. While ASD does present with a range of social communication and adaptive behavior deficits, adults on the spectrum may be extremely efficient, trustworthy, reliable, and cost-effective employees. Nevertheless, fewer than half of young adults with ASD maintain a job. Many businesses are unwilling to hire these capable candidates, concerned among other things about an increase in supervision costs and a decrease in productivity. This is a bias based on misperceptions ; the financial and social benefits of hiring adults with ASD, for businesses and the individual, often outweigh the costs.

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26. van den Berk-Smeekens I, van Dongen-Boomsma M, De Korte MWP, Den Boer JC, Oosterling IJ, Peters-Scheffer NC, Buitelaar JK, Barakova EI, Lourens T, Staal WG, Glennon JC. Adherence and acceptability of a robot-assisted Pivotal Response Treatment protocol for children with autism spectrum disorder. Sci Rep. 2020 ; 10(1) : 8110.

The aim of this study is to present a robot-assisted therapy protocol for children with ASD based on the current state-of-the-art in both ASD intervention research and robotics research, and critically evaluate its adherence and acceptability based on child as well as parent ratings. The robot-assisted therapy was designed based on motivational components of Pivotal Response Treatment (PRT), a highly promising and feasible intervention focused at training "pivotal" (key) areas such as motivation for social interaction and self-initiations, with the goal of establishing collateral gains in untargeted areas of functioning and development, affected by autism spectrum disorders. Overall, children (3-8 y) could adhere to the robot-assisted therapy protocol (Mean percentage of treatment adherence 85.5%), showed positive affect ratings after therapy sessions (positive in 86.6% of sessions) and high robot likability scores (high in 79.4% of sessions). Positive likability ratings were mainly given by school-aged children (H(1) = 7.91, p = .005) and related to the movements, speech and game scenarios of the robot. Parent ratings on the added value of the robot were mainly positive (Mean of 84.8 on 0-100 scale), while lower parent ratings were related to inflexibility of robot behaviour.

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27. Walsh MJM, Baxter LC, Smith CJ, Braden BB. Age Group Differences in Executive Network Functional Connectivity and Relationships with Social Behavior in Men with Autism Spectrum Disorder. Res Autism Spectr Disord. 2019 ; 63 : 63-77.

BACKGROUND : Research suggests adults with autism spectrum disorder (ASD) may use executive functions to compensate for social difficulties. Given hallmark age-related declines in executive functioning and the executive brain network in normal aging, there is concern that older adults with ASD may experience further declines in social functioning as they age. In a male-only sample, we hypothesized : 1) older adults with ASD would demonstrate greater ASD-related social behavior than young adults with ASD, 2) adults with ASD would demonstrate a greater age group reduction in connectivity of the executive brain network than neurotypical (NT) adults, and 3) that behavioral and neural mechanisms of executive functioning would predict ASD-related social difficulties in adults with ASD. METHODS : Participants were a cross-sectional sample of non-intellectually disabled young (ages 18-25) and middle-aged (ages 40-70) adult men with ASD and NT development (young adult ASD : n=24 ; middle-age ASD : n=25 ; young adult NT : n=15 ; middle-age NT : n=21). We assessed ASD-related social behavior via the self-report Social Responsiveness Scale-2 (SRS-2) Total Score, with exploratory analyses of the Social Cognition Subscale. We assessed neural executive function via connectivity of the resting-state executive network (EN) as measured by independent component analysis. Correlations were investigated between SRS-2 Total Scores (with exploratory analyses of the Social Cognition Subscale), EN functional connectivity of the dorsolateral prefrontal cortex (dlPFC), and a behavioral measure of executive function, Tower of London (ToL) Total Moves. RESULTS : We did not confirm a significant age group difference for adults with ASD on the SRS-2 Total Score ; however, exploratory analysis revealed middle-age men with ASD had higher scores on the SRS-2 Social Cognition Subscale than young adult men with ASD. Exacerbated age group reductions in EN functional connectivity were confirmed (left dlPFC) in men with ASD compared to NT, such that older adults with ASD demonstrated the greatest levels of hypoconnectivity. A significant correlation was confirmed between dlPFC connectivity and the SRS-2 Total Score in middle-age men with ASD, but not young adult men with ASD. Furthermore, exploratory analysis revealed a significant correlation with the SRS-2 Social Cognition Subscale for young and middle-aged ASD groups and ToL Total Moves. CONCLUSIONS : Our findings suggest that ASD-related difficulties in social cognition and EN hypoconnectivity may get worse with age in men with ASD and is related to executive functioning. Further, exacerbated EN hypoconnectivity associated with older age in ASD may be a mechanism of increased ASD-related social cognition difficulties in older adults with ASD. Given the cross-sectional nature of this sample, longitudinal replication is needed.

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