Pubmed du 30/06/20

mardi 30 juin 2020

1. Bordini D, Paula CS, Cunha GR, Caetano SC, Bagaiolo LF, Ribeiro TC, Martone MCC, Portolese J, Moya AC, Brunoni D, Bosa C, Brentani H, Cogo-Moreira H, de Jesus Mari J. A randomised clinical pilot trial to test the effectiveness of parent training with video modelling to improve functioning and symptoms in children with autism spectrum disorders and intellectual disability. J Intellect Disabil Res ;2020 (Jun 30)

BACKGROUND : Poor eye contact and joint attention are early signs of autism spectrum disorder (ASD) and important prerequisites for developing other socio-communicative skills. Teaching parents evidence-based techniques to improve these skills can impact the overall functioning of children with ASD. We aimed to analyse the impact of conducting a group parent-training intervention with video modelling to improve the intelligent quotient (IQ), social and communication functioning and to minimise symptoms in children with ASD and intellectual disability (ID). METHODS : Study design : A multicentre, single-blinded, randomised clinical pilot trial of parent training using video modelling was conducted. SAMPLE : Sixty-seven parents of children with ASD, aged between 3 and 6 years and with IQs between 50 and 70, were randomised : 34 to the intervention group and 33 to the control group. Intervention program : The intervention group received parent training over 22 sessions, and the control group received the standard community treatment. INSTRUMENTS : Pre-evaluation and post-evaluation (week 28), the following were used : Autism Diagnostic Interview, Vineland Adaptive Behaviour Scale I, Snijders-Oomen Nonverbal Intelligence Test, Autism Behaviour Checklist and Hamilton Depression Rating Scale. DATA ANALYSIS : Intention to treat and complier-average causal effect (CACE) were used to estimate the effects of the intervention. RESULTS : There was a statistically significant improvement in the Vineland standardized communication scores in CACE (Cohen’s d = 0.260). There was a non-statistically significant decrease in autism symptomatology (Autism Behaviour Checklist total scores) and a significant increase in the non-verbal IQ in the intervention group. After the false discovery rate correction was applied, IQ remained statistically significant under both paradigms. The effect size for this adjusted outcome under the intention-to-treat paradigm was close to 0.4, and when considering adherence (CACE), the effect sizes were more robust (IQ’s Cohen’s d = 0.433). CONCLUSIONS : Parent training delivered by video modelling can be a useful technique for improving the care given to children with ASD and ID, particularly in countries that lack specialists.

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2. Cooper R, Cooper K, Russell AJ, Smith LGE. "I’m Proud to be a Little Bit Different" : The Effects of Autistic Individuals’ Perceptions of Autism and Autism Social Identity on Their Collective Self-esteem. J Autism Dev Disord ;2020 (Jun 30)

This study aimed to identify the attributes that autistic people perceive as positively and negatively impacting on their identity and wellbeing. In Study 1, we recruited 140 autistic participants for an online survey. Participants completed autism social identification and collective self-esteem measures and listed attributes they associated with autism. In Study 2, we conducted focus groups with 15 autistic people to explore how positively they perceived the attributes of autism. Participants then discussed the autism attributes in relation to their own experiences and identity. We found a positive relationship between the number of positive attributes participants associated with autism, and their collective self-esteem, to the extent that they identified with other autistic people.

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3. Doherty AJ, Atherton H, Boland P, Hastings R, Hives L, Hood K, James-Jenkinson L, Leavey R, Randell E, Reed J, Taggart L, Wilson N, Chauhan U. Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism : an integrative review. BJGP Open ;2020 (Jun 30)

BACKGROUND : Globally, people with intellectual disabilities and/or autism experience health inequalities. Death occurs at a younger age and the prevalence of long-term morbidities is higher than in the general population. Despite this, their primary healthcare access rates are lower than the general population, their health needs are often unmet, and their views and experiences are frequently overlooked in research, policy, and practice. AIM : To investigate the barriers and facilitators reported by individuals with intellectual disabilities, autism, or both, and/or their carers, to accessing and utilising primary health care for their physical and mental health needs. DESIGN & SETTING : An integrative review was undertaken, which used systematic review methodology. METHOD : Electronic databases MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane were searched for relevant studies (all languages) using a search strategy. Two researchers independently screened the results and assessed the quality of the studies. RESULTS : Sixty-three international studies were identified. Six main themes relating to barriers and facilitators emerged from an analysis of these studies. The main themes were : training ; knowledge and awareness ; communication ; fear and embarrassment ; involvement in healthcare decision-making ; and time. All the themes were underpinned by the need for greater care, dignity, respect, collaborative relationships, and reasonable adjustments. Opposing barriers and facilitators were identified within each of the main themes. CONCLUSION : Adolescents and adults with intellectual disabilities and/or autism experience several barriers to accessing and utilising primary health care. The findings highlight the reasonable adjustments and facilitators that can be implemented to ensure that these individuals are not excluded from primary health care.

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4. Khalil M, Azouz HG, Ahmed SA, Gad HA, Omar OM. Sensory Processing and Gastrointestinal Manifestations in Autism Spectrum Disorders : No Relation to Clostridium difficile. J Mol Neurosci ;2020 (Jun 30)

The role of the gut microbiota in triggering autism is a rapidly emerging field of research. Gut microbiota have been incriminated because autistic children often have gastrointestinal symptoms. Pathogenic gut bacteria in children with autism spectrum disorders (ASD) have been reported. The present study aimed to assess Clostridium difficile in the stool of children with ASD and its relation to gastrointestinal (GI) comorbidities, autism severity, and sensory impairment. The study included 58 ASD patients, 45 of their neurotypical siblings, and 45 unrelated controls. Childhood Autism Rating Scale (CARS) was used to assess the severity of autism. Sensory problems were evaluated using the Short Sensory Profile (SSP). GI symptoms were assessed with a modified six-item GI Severity Index (6-GSI) questionnaire. Quantitative real-time PCR was done for the detection and quantitation of C. difficile and its toxins A and B. C. difficile was detected in 25.9%, 40%, and 15.6% of ASD cases, siblings, and unrelated control respectively. Regarding toxin A and B production, 73.3%, 77.8%, and 71.4% of C. difficile in positive ASD, siblings, and unrelated control cases respectively were toxigenic. There was no statistically significant difference between the three groups as regards C. difficile qualitative, quantitative, and toxin production results. In conclusion,C. difficile is not specifically prevalent in the gut of children with ASD. Although most of the strains are toxigenic, there were no GI symptoms in the control groups and no statistically significant association with GI Severity Index in autistic cases. Gastrointestinal dysfunction and sensory impairment are common comorbidities in ASD.

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5. Li Y, Cheng Y, Liu Y. Reply to Comment on "Association Between DCC Polymorphisms and Susceptibility to Autism Spectrum Disorder". J Autism Dev Disord ;2020 (Jun 30)

The comments from Dr. Meisami about our article "Association between DCC polymorphisms and Susceptibility to Autism Spectrum Disorder", and we wish to respond to several points. First, 100% of detection rate for each SNP genotype cannot be obtained. Second, we listed the detection rates in Supplemental Table 1. Last, Dr. Meisami referred an article focused on two SNPs ; however, our article focused on seven SNPs. If we marked the number of detected cases, we had to make a table for each result, occupying a large part of the layout. Moreover, if the number of detected cases was marked respectively, it was not in accordance with academic norms. For these reasons, we provided the actual number of cases in Table 3.

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6. Patra S, Kar SK. Autism spectrum disorder in India : a scoping review. Int Rev Psychiatry ;2020 (Jun 30):1-32.

Autism is a grand challenge in global mental health to be dealt with on a priority basis. Phenotypic knowledge, biological understanding, and evidence-based intervention studies are all from western countries. We know very little about autism in the low- and middle-income countries (LMIC). Lack of infrastructure and difficulties in operationalizing research has widened the knowledge gap. We performed a comprehensive scoping review of research in Autism Spectrum Disorder in India to have an overall impression, identify gaps, and formulate evidence-based recommendations for further study. We searched PubMed, SCOPUS, and Cochrane Library to identify relevant Indian studies. A hundred and fifty-nine publications met the inclusion criteria. Most of the research contribution in autism is from few tertiary care medical centres, technological institutes, and not-for-profit organizations. We identified various themes of research like clinical profile, interventions, biomarkers, psychological, social, epidemiological, and risk factors. Evidence-based intervention studies, translation and adaptation of standard diagnostic instruments, and qualitative research on the experience of autism appeared to be state of the art. However, epidemiological studies, biomarkers identification, risk assessment studies were of low quality. There is a need for nationwide studies with representative sampling on epidemiology, biomarkers, and risk factors for a complete evaluation of the actual burden and biology of autism in India. Also, there is a need to design implementation research to evaluate the effectiveness of evidence-based interventions in routine healthcare settings. We recommend that future research should fill these gaps in understanding autism and improving its outcome in India.

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7. Riedel A, Maier S, Wenzler K, Feige B, Tebartz van Elst L, Bölte S, Neufeld J. A case of co-occuring synesthesia, autism, prodigious talent and strong structural brain connectivity. BMC Psychiatry ;2020 (Jun 30) ;20(1):342.

BACKGROUND : Synesthesia is a sensory phenomenon where certain domain-specific stimuli trigger additional sensations of e.g. color or texture. The condition occurs in about 4% of the general population, but is overrepresented in individuals with Autism Spectrum Disorder (ASD), where it might also be associated with the presence of prodigious talents. CASE PRESENTATION : Here we describe the case of a young transsexual man with Asperger Syndrome, synesthesia and a prodigious talent for foreign language acquisition. In our case, not only letters, numbers, spoken words, music, noises, weekdays and months lead to highly consistent, vivid color sensations but also his own and others’ emotions, geometric shapes, any mathematical symbol, and letters from an unfamiliar alphabet (Hebrew). These color associations seem to aid categorization, differentiation and storage of information and might thereby contribute to the young man’s language acquisition ability. We investigated the young man’s structural brain connectivity in comparison to adults with or without ASD, applying global fiber tracking to diffusion-weighted Magnetic Resonance Imaging (MRI) data. The case presented with increased connectivity, especially between regions involved in visual and emotion processing, memory, and higher order associative binding regions. An electroencephalography experiment investigating synesthetic color and shape sensations while listening to music showed a negligible occipital alpha suppression, indicating that these internally generated synesthetic sensations derive from a different brain mechanism than when processing external visual information. CONCLUSIONS : Taken together, this case study endorses the notion of a link between synesthesia, prodigious talent and autism, adding to the currently still sparse literature in this field. It provides new insights into the possible manifestations of synesthesia in individuals with ASD and its potential contribution to prodigious talents in people with an otherwise unexceptional cognitive profile. Additionally, this case impressively illustrates how synesthesia can be a key element not only of sensory perception but also social and emotional processing and contributes to existing evidence of increased brain connectivity in association with synesthesia.

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8. Tepest R. The Meaning of Diagnosis for Different Designations in Talking About Autism. J Autism Dev Disord ;2020 (Jun 30)

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9. Zhou H, Xu X, Yan W, Zou X, Wu L, Luo X, Li T, Huang Y, Guan H, Chen X, Mao M, Xia K, Zhang L, Li E, Ge X, Zhang L, Li C, Zhang X, Zhou Y, Ding D, Shih A, Fombonne E, Zheng Y, Han J, Sun Z, Jiang YH, Wang Y. Prevalence of Autism Spectrum Disorder in China : A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years. Neurosci Bull ;2020 (Jun 30)

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI : 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI : 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95% ; 95% CI : 0.87%-1.02% versus 0.30% ; 95% CI : 0.26%-0.34% ; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

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