Pubmed du 20/06/20

samedi 20 juin 2020

1. Ames JL, Massolo ML, Davignon MN, Qian Y, Cerros HJ, Croen LA. Transitioning youth with autism spectrum disorders and other special health care needs into adult primary care : A provider survey. Autism ;2020 (Jun 18):1362361320926318.

The transition from pediatric to adult care is a critical inflection point for the long-term health of youth with autism spectrum disorders and other special health care needs. However, for many patients, their caregivers, and providers, the transition lacks coordination. This survey study demonstrates that pediatric and adult providers struggle to implement many components of transition best practices for youth with autism and other chronic conditions, highlighting the urgent need for enhanced medical coordination and additional transition training and resources.

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2. Barnoux M, Alexander R, Bhaumik S, Devapriam J, Duggan C, Shepstone L, Staufenberg E, Turner D, Tyler N, Viding E, Langdon PE. The face validity of an initial sub-typology of people with autism spectrum disorders detained in psychiatric hospitals. Autism ;2020 (Jun 20):1362361320929457.

Autistic adults who have a history of committing crimes pose challenges for the criminal justice system in terms of disposal and treatment. For this reason, we investigated the validity of a proposed sub-typology of autistic adults detained in secure psychiatric hospitals. Initially, we ran a focus group with psychiatrists, clinical psychologists, healthcare workers, family members and autistic adults who had been detained in hospital to consider a sub-typology of autistic adults who may come into contact with secure psychiatric hospitals. We asked 15 psychiatrists and clinical psychologists to rate 10 clinical vignettes based on our sub-typology with three rounds ; revisions to the vignettes to improve clarity were made following each round. The findings indicated that these subtypes possess face validity and raters were able to classify all 10 clinical case vignettes into the sub-typology and percentage of agreement ranged from 96% to 100% for overall subtype classification. The findings suggested that the further validity of the sub-typology should be investigated within a larger study using a clinical sample. These subtypes may help inform treatment and care pathways within hospital.

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3. Cascio MA, Weiss JA, Racine E. Person-oriented ethics for autism research : Creating best practices through engagement with autism and autistic communities. Autism ;2020 (Jun 18):1362361320918763.

Research ethics means issues that concern the welfare and wellbeing of people who take part in research. It is important in all scientific studies. Ethics helps people who do research treat people who take part in research fairly and with respect. This article is about day-to-day ethics when autistic people take part in research. We present tips for researchers who want to do this type of study. We used two methods to create these tips. First, we wanted to know what other people said about this topic. We used a literature review to find out. Second, we wanted to know what autistic people, parents, and professionals thought, and had a working group meet to discuss it. The working group provided advice that researchers could consider around day-to-day ethics in research. This article talks about these methods and advice. The advice fits into five big groups : Tailor the research process for the unique needs of each person. Think about the world in which people who take part in research live. Make it easier for people to make their own choices. Value what people who take part in research have to share and consider their needs and strengths. Think about how researchers and people who take part in research work together. This project shows why it is useful for researchers and communities to talk about research ethics together.

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4. Doernberg EA, Russ SW, Dimitropoulos A. Believing in Make-Believe : Efficacy of a Pretend Play Intervention for School-Aged Children with High-Functioning Autism Spectrum Disorder. J Autism Dev Disord ;2020 (Jun 16)

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder marked by socio-emotional deficits, and difficulties with pretend play skills. Play skills are related to processes of adaptive functioning and emotion understanding. The present pilot study implemented an in-person pretend play intervention to school-aged children (ages 6 to 9 years, intervention group = 18, control group = 7) diagnosed with high-functioning ASD (HF-ASD), to increase children’s cognitive and affective play skills, and emotional understanding abilities. The intervention consisted of 5 weekly sessions, 15-20 minutes each. The intervention group significantly increased in imagination and cognitive play skills, which generalized to increased skills in emotional understanding. Findings demonstrate the positive impact of a short, easily facilitated, accessible play intervention for school-aged children with HF-ASD.

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5. Hong SJ, Vogelstein JT, Gozzi A, Bernhardt BC, Yeo BTT, Milham MP, Di Martino A. Toward Neurosubtypes in Autism. Biol Psychiatry ;2020 (Jul 1) ;88(1):111-128.

There is a consensus that substantial heterogeneity underlies the neurobiology of autism spectrum disorder (ASD). As such, it has become increasingly clear that a dissection of variation at the molecular, cellular, and brain network domains is a prerequisite for identifying biomarkers. Neuroimaging has been widely used to characterize atypical brain patterns in ASD, although findings have varied across studies. This is due, at least in part, to a failure to account for neurobiological heterogeneity. Here, we summarize emerging data-driven efforts to delineate more homogeneous ASD subgroups at the level of brain structure and function-that is, neurosubtyping. We break this pursuit into key methodological steps : the selection of diagnostic samples, neuroimaging features, algorithms, and validation approaches. Although preliminary and methodologically diverse, current studies generally agree that at least 2 to 4 distinct ASD neurosubtypes may exist. Their identification improved symptom prediction and diagnostic label accuracy above and beyond group average comparisons. Yet, this nascent literature has shed light onto challenges and gaps. These include 1) the need for wider and more deeply transdiagnostic samples collected while minimizing artifacts (e.g., head motion), 2) quantitative and unbiased methods for feature selection and multimodal fusion, 3) greater emphasis on algorithms’ ability to capture hybrid dimensional and categorical models of ASD, and 4) systematic independent replications and validations that integrate different units of analyses across multiple scales. Solutions aimed to address these challenges and gaps are discussed for future avenues leading toward a comprehensive understanding of the mechanisms underlying ASD heterogeneity.

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6. Hwang IT, Kramer JM, Cohn ES, Barnes LL. Asian Immigrant Parents’ Role Enactment While Accessing and Using Services for Their Child With Developmental Disabilities in the United States : A Meta-Synthesis Study. Qual Health Res ;2020 (Jun 20):1049732320926138.

We conducted a meta-synthesis to explore how Asian immigrant parents in the United States enact their perceived parental role while using health and educational services for their child with developmental disabilities. We identified 11 qualitative studies for analysis, and examined these studies using a constant comparative approach and thematic analysis informed by role theory and acculturation theory. Based on our analysis, five themes related to parents’ role enactment emerged : (a) parents perceive a multifaceted parental role ; (b) parents’ individual factors influence their role enactment ; (c) system factors influence parents’ role enactment ; (d) parents use coping strategies to address role dissatisfaction ; and (e) parental role enactment is a continuously evolving process influenced by acculturation, which spirals them toward their ultimate goal of helping their child thrive. Findings can inform practitioners’ and researchers’ understanding of how to create a culturally safe environment to support Asian immigrant parents in realizing their parental role.

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7. Kawabe K, Hosokawa R, Nakachi K, Yoshino A, Horiuchi F, Ueno SI. Making brochure of Coronavirus disease (COVID-19) for children with autism spectrum disorder and their family members. Psychiatry Clin Neurosci ;2020 (Jun 20)

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8. McAuliffe T, Cordier R, Chen YW, Vaz S, Thomas Y, Falkmer T. In-the-moment experiences of mothers of children with autism spectrum disorder : a comparison by household status and region of residence. Disabil Rehabil ;2020 (Jun 18):1-15.

Purpose : This study compared the in-the-moment experiences among mothers of children with Autism Spectrum Disorders (ASD) by their household status (i.e., single versus coupled) and region of residence (i.e., regional versus major city area).Methods : An experience sampling method was employed to collect data, and a total of 40 mothers used an iOS device to record activity types and in-the-moment experiences for one week during school term. Mann-Whitney U test and multilevel analysis were conducted to compare the experiences of these mothers.Results : The analyses found the following results : 1) mothers spent most time in childcare and least time in self-care activities ; 2) coupled mothers were more likely to feel supported ; 3) coupled mothers were less likely to feel supported in domestic tasks ; 4) mothers from major city were more likely to feel challenged in self-care activities ; and 5) mothers from major city were more likely to feel supported in productivity tasks.Conclusion : Limited but significant differences between single and coupled mothers, as well as mothers from regional and major city areas, were found. Future research direction and service provisions were suggested.Implications for rehabilitationThis study shows that all mothers spent the most time on childcare and the least amount of time on self-care activities.In-the-moment experiences between single and coupled mothers, as well as mothers from major cities and mothers from regional areas, differ somewhat ; however, this study builds evidence to support that these mothers’ experiences are similar.The result of the study indicates that single mothers require extra support as they carry similar levels of responsibilities as coupled mothers, but without the support of a partner.Promoting a sense of control may assist all mothers to fully engage in parenting activities.

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9. McLeod JD, Hawbaker A, Meanwell E. The health of college students on the autism spectrum as compared to their neurotypical peers. Autism ;2020 (Jun 18):1362361320926070.

Studies have shown that children and older adults on the autism spectrum experience more physical and mental health problems than their neurotypical peers. Less is known about the physical and mental health of college students on the spectrum. Studying college students is important because young adults on the spectrum are enrolling in college at increasing rates and because health problems can be a barrier to succeeding in college. We collected data from 2820 students at 14 colleges and universities using an online survey, some of whom had registered for accommodations based on autism and others of whom had not. We used the data to compare the physical and mental health of students on the spectrum to their neurotypical peers. Because students with autism often report other disabilities that also affect health, we accounted for whether they experienced a learning disability, attention deficit hyperactivity disorder, sensory impairment, mobility impairment, mental health disorder, or any other disabilities. We assessed health using self-reports of how healthy they were physically and mentally, and reports of depressive symptoms, symptoms of anxiety, sleep deprivation, and binge drinking. We found that students with autism reported poorer physical and mental health, more depressive symptoms, and more symptoms of anxiety even after taking into account other disabilities they may have experienced. They were also less likely to report sleep deprivation and binge drinking. Our results argue for developing specialized services to address the physical and mental health challenges of college students on the spectrum.

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10. Ratto AB. Commentary : What’s so special about girls on the autism spectrum ? - a commentary on Kaat et al. (2020). J Child Psychol Psychiatry ;2020 (Jun 19)

This commentary on the multisite integrative analysis of sex differences on gold standard measures of autism by Kaat and colleagues (2020) provides perspective on its contributions to the debate surrounding sex differences in autism. While this study reports important findings regarding sex differences using currently available tools and samples, innovative research approaches are needed to develop new tools and methodologies to improve our understanding of how autism manifests across the gender spectrum. This includes developing meaningful research partnerships with autistic colleagues, actively recruiting more diverse samples, and augmenting conventional tools and methodologies with new, and equally rigorous, approaches.

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11. Smith AM, Natowicz MR, Braas D, Ludwig MA, Ney DM, Donley ELR, Burrier RE, Amaral DG. A Metabolomics Approach to Screening for Autism Risk in the Children’s Autism Metabolome Project. Autism Res ;2020 (Jun 18)

Autism spectrum disorder (ASD) is biologically and behaviorally heterogeneous. Delayed diagnosis of ASD is common and problematic. The complexity of ASD and the low sensitivity of available screening tools are key factors in delayed diagnosis. Identification of biomarkers that reduce complexity through stratification into reliable subpopulations can assist in earlier diagnosis, provide insight into the biology of ASD, and potentially suggest targeted interventions. Quantitative metabolomic analysis was performed on plasma samples from 708 fasting children, aged 18 to 48 months, enrolled in the Children’s Autism Metabolome Project (CAMP). The primary goal was to identify alterations in metabolism helpful in stratifying ASD subjects into subpopulations with shared metabolic phenotypes (i.e., metabotypes). Metabotypes associated with ASD were identified in a discovery set of 357 subjects. The reproducibility of the metabotypes was validated in an independent replication set of 351 CAMP subjects. Thirty-four candidate metabotypes that differentiated subsets of ASD from typically developing participants were identified with sensitivity of at least 5% and specificity greater than 95%. The 34 metabotypes formed six metabolic clusters based on ratios of either lactate or pyruvate, succinate, glycine, ornithine, 4-hydroxyproline, or α-ketoglutarate with other metabolites. Optimization of a subset of new and previously defined metabotypes into a screening battery resulted in 53% sensitivity (95% confidence interval [CI], 48%-57%) and 91% specificity (95% CI, 86%-94%). Thus, our metabolomic screening tool detects more than 50% of the autistic participants in the CAMP study. Further development of this metabolomic screening approach may facilitate earlier referral and diagnosis of ASD and, ultimately, more targeted treatments. LAY SUMMARY : Analysis of a selected set of metabolites in blood samples from children with autism and typically developing children identified reproducible differences in the metabolism of about half of the children with autism. Testing for these differences in blood samples can be used to help screen children as young as 18 months for risk of autism that, in turn, can facilitate earlier diagnoses. In addition, differences may lead to biological insights that produce more precise treatment options. We are exploring other blood-based molecules to determine if still a higher percentage of children with autism can be detected using this strategy.

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12. Trembath D, Sutherland R, Caithness T, Dissanayake C, Eapen V, Fordyce K, Frost G, Iacono T, Mahler N, Masi A, Paynter J, Pye K, Reilly S, Rose V, Sievers S, Thirumanickam A, Westerveld M, Tucker M. Clinician Proposed Predictors of Spoken Language Outcomes for Minimally Verbal Children with Autism Spectrum Disorder. J Autism Dev Disord ;2020 (Jun 17)

Our aim was to explore insights from clinical practice that may inform efforts to understand and account for factors that predict spoken language outcomes for children with Autism Spectrum Disorder who use minimal verbal language. We used a qualitative design involving three focus groups with 14 speech pathologists to explore their views and experiences. Using the Framework Method of analysis, we identified 9 themes accounting for 183 different participant references to potential factors. Participants highlighted the relevance of clusters of fine-grained social, communication, and learning behaviours, including novel insights into prelinguistic vocal behaviours. The participants suggested the potential value of dynamic assessment in predicting spoken language outcomes. The findings can inform efforts to developing clinically relevant methods for predicting children’s communication outcomes.

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13. Wieckowski AT, Flynn LT, Richey JA, Gracanin D, White SW. Measuring change in facial emotion recognition in individuals with autism spectrum disorder : A systematic review. Autism ;2020 (Jun 18):1362361320925334.

Children and adults with autism spectrum disorder show difficulty recognizing facial emotions in others, which makes social interaction challenging. While there are many treatments developed to improve facial emotion recognition, there is no agreement on the best way to measure such abilities in individuals with autism spectrum disorder. The purpose of this review is to examine studies that were published between January 1998 and November 2019 and have measured change in facial emotion recognition to evaluate the effectiveness of different treatments. Our search yielded 65 studies, and within these studies, 36 different measures were used to evaluate facial emotion recognition in individuals with autism spectrum disorder. Only six of these measures, however, were used in different studies and by different investigators. In this review, we summarize the different measures and outcomes of the studies, in order to identify promising assessment tools and inform future research.

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14. Yankowitz LD, Herrington JD, Yerys BE, Pereira JA, Pandey J, Schultz RT. Evidence against the "normalization" prediction of the early brain overgrowth hypothesis of autism. Mol Autism ;2020 (Jun 18) ;11(1):51.

BACKGROUND : The frequently cited Early Overgrowth Hypothesis of autism spectrum disorder (ASD) postulates that there is overgrowth of the brain in the first 2 years of life, which is followed by a period of arrested growth leading to normalized brain volume in late childhood and beyond. While there is consistent evidence for early brain overgrowth, there is mixed evidence for normalization of brain volume by middle childhood. The outcome of this debate is important to understanding the etiology and neurodevelopmental trajectories of ASD. METHODS : Brain volume was examined in two very large single-site samples of children, adolescents, and adults. The primary sample comprised 456 6-25-year-olds (ASD n = 240, typically developing controls (TDC) n = 216), including a large number of females (n = 102) and spanning a wide IQ range (47-158). The replication sample included 175 males. High-resolution T1-weighted anatomical MRI images were examined for group differences in total brain, cerebellar, ventricular, gray, and white matter volumes. RESULTS : The ASD group had significantly larger total brain, cerebellar, gray matter, white matter, and lateral ventricular volumes in both samples, indicating that brain volume remains enlarged through young adulthood, rather than normalizing. There were no significant age or sex interactions with diagnosis in these measures. However, a significant diagnosis-by-IQ interaction was detected in the larger sample, such that increased brain volume was related to higher IQ in the TDCs, but not in the ASD group. Regions-of-significance analysis indicated that total brain volume was larger in ASD than TDC for individuals with IQ less than 115, providing a potential explanation for prior inconsistent brain size results. No relationships were found between brain volume and measures of autism symptom severity within the ASD group. LIMITATIONS : Our cross-sectional sample may not reflect individual changes over time in brain volume and cannot quantify potential changes in volume prior to age 6. CONCLUSIONS : These findings challenge the "normalization" prediction of the brain overgrowth hypothesis by demonstrating that brain enlargement persists across childhood into early adulthood. The findings raise questions about the clinical implications of brain enlargement, since we find that it neither confers cognitive benefits nor predicts increased symptom severity in ASD.

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15. Zeng S, Strain A, Sung C. Health Care Transition Services and Adaptive and Social-Emotional Functioning of Youth with Autism Spectrum Disorder. J Autism Dev Disord ;2020 (Jun 15)

To promote health care transition services (HCTS) among youth with autism spectrum disorder (ASD), it is important to understand their access to HCTS and the association with functioning. We conducted weighted descriptive statistics and regressions. Findings suggested that HCTS were inconsistently provided to youth with ASD. Access to two or more HCTS was associated with positive social-emotional functioning. Helping youth with ASD understand health care changes and working with them to gain skills in managing health needs were found to be significant determinants of positive social-emotional functioning. The present study sheds light on HCTS that are essential for youth with ASD and highlights the necessity of health care system changes to promote service access and optimal functioning for youth with ASD.

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