Pubmed du 09/09/20

mercredi 9 septembre 2020

1. Alizadeh R, Bahmanpoor Z, Jalali-Qomi S, Amiri M, Afkhami H, Khaledi M, Moosavi R, Akouchekian M. MicroRNA-targeted signaling pathways in the Autism spectrum disorder : implications for early detection and targeted therapy. CNS Neurol Disord Drug Targets ;2020 (Sep 7)

BACKGROUND & OBJECTIVE : Autism Spectrum Disorders (ASD) known as a neurodevelopmental disorder showing communication impairments and unusual patterns of behavior .It seems that ASD frequency is on the increase. Therefore, diagnostic tools that help detect the disease in the early stages can be very useful in better management of the disease. Recent studies represent that miRNAs as novel biomarkers can be used to find out the process and etiology of ASD by regulating various genes of multiple pathways. However, ASD associated pathway targeted by miRNA is still in infancy. METHODS : In this in-silico study taking into consideration the importance of miRNAs, we reviewed bioinformatics databases for finding possible pathways and potential miRNAs related to selected pathways. RESULTS : The results displayed some prominent pathways involved in ASD, as well as some experimental and predicted miRNAs that may regulate targets associated with these pathways such as neuroactive ligand-receptor interaction, serotonergic synapse, calcium signaling pathway, cAMP Signaling Pathway, PI3K-Akt signaling pathway. CONCLUSION : This study showed that the identified miRNAs may be involved in ASD-related pathways and may be considered as a new diagnostic tool and provide potential targets for the treatment of ASD.

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2. Barokova MD, La Valle C, Hassan S, Lee C, Xu M, McKechnie R, Johnston E, Krol MA, Leano J, Tager-Flusberg H. Eliciting Language Samples for Analysis (ELSA) : A New Protocol for Assessing Expressive Language and Communication in Autism. Autism Res ;2020 (Sep 9)

Expressive language and communication are among the key targets of interventions for individuals with autism spectrum disorder (ASD), and natural language samples provide an optimal approach for their assessment. Currently, there are no protocols for collecting such samples that cover a wide range of ages or language abilities, particularly for children/adolescents who have very limited spoken language. We introduce a new protocol for collecting language samples, eliciting language samples for analysis (ELSA), and a novel approach for deriving basic measures of verbal communicative competence from it that bypasses the need for time-consuming transcription. Study 1 presents ELSA-adolescents (ELSA-A), designed for minimally and low-verbal older children/adolescents with ASD. The protocol successfully engaged and elicited speech from 46 participants across a wide range of ages (6 ;6-19 ;7) with samples averaging 20-25 min. The collected samples were segmented into speaker utterances (examiner and participant) using real-time coding as one is listening to the audio recording and two measures were derived : frequency of utterances and conversational turns per minute. These measures were shown to be reliable and valid. For Study 2, ELSA was adapted for younger children (ELSA-Toddler [ELSA-T]) with samples averaging 29 min from 19 toddlers (2 ;8-4 ;10 years) with ASD. Again, measures of frequency of utterances and conversational turns derived from ELSA-T were shown to have strong psychometric properties. In Study 3, we found that ELSA-A and ELSA-T were equivalent in eliciting language from 17 children with ASD (ages : 4 ;0-6 ;8), demonstrating their suitability for deriving robust objective assessments of expressive language that could be used to track change in ability over time. We introduce a new protocol for collecting expressive language samples, ELSA, that can be used with a wide age range, from toddlers (ELSA-T) to older adolescents (ELSA-A) with ASD who have minimal or low-verbal abilities. The measures of language and communication derived from them, frequency of utterances, and conversational turns per minute, using real-time coding methods, can be used to characterize ability and chart change in intervention research. LAY SUMMARY : We introduce a new protocol for collecting expressive language samples, ELSA, that can be used with a wide age range, from toddlers (ELSA-T) to older adolescents (ELSA-A) with autism spectrum disorder who have minimal or low-verbal abilities. The measures of language and communication derived from them, frequency of utterances and conversational turns per minute, using real-time coding methods, can be used to characterize ability and chart change in intervention research.

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3. Benson L, Axiotis N, Harvey A. Hannah Grace is an art therapist. BMJ ;2020 (Sep 7) ;370:m2318.

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4. Bostwick A, Snyder NW, Windham GC, Whitman C, Pearl M, Robinson L, Newschaffer CJ, Lyall K. Polyunsaturated Fatty Acids in Newborn Bloodspots : Associations With Autism Spectrum Disorder and Correlation With Maternal Serum Levels. Autism Res ;2020 (Sep 8)

We conducted a population-based case-control study to examine newborn polyunsaturated fatty acid (PUFA) levels in association with autism spectrum disorder (ASD) and assess PUFA correlation across two time points. ASD cases (n = 200) were identified through the Department of Developmental Services and matched to live-birth population controls (n = 200) on birth month, year (2010-2011), and sex. Nonesterified PUFAs were measured by isotope dilution liquid chromatography-high resolution mass spectrometry from archived newborn dried blood spots and maternal mid-pregnancy serum samples. Crude and adjusted conditional logistic regression models were used to examine the association between neonatal PUFA levels, categorized in quartiles and according to distributional extremes, and ASD. Cubic splines were utilized to examine nonlinear relationships between continuous neonatal PUFAs and ASD. The correlation between neonatal and maternal levels was examined using Pearson correlation coefficients. In adjusted analyses of neonatal PUFA levels, no clear trends emerged, though there was an elevated odds ratio of ASD for the third quartile of linoleic acid, relative to the first (adjusted odds ratio = 2.49, 95% confidence interval : 1.31, 4.70). Cubic spline analysis suggested a nonlinear association between linoleic acid and ASD, though this was not robust to sensitivity analyses. While individual PUFAs were significantly correlated with one another within a given time point, aside from docohexaseanoic acid, PUFAs were not correlated across maternal and neonatal samples. Overall, our findings do not support an association between neonatal PUFA levels and ASD. Future work should confirm and expand these findings by examining associations with phenotypic subgroups and considering PUFAs in other time points. LAY SUMMARY : In this study, we examined whether levels of fats known as polyunsaturated fatty acids, measured in newborns, were related to later child diagnosis of autism spectrum disorder (ASD). Overall, we did not find strong evidence for hypothesized reduction in risk of ASD based on newborn levels of these fats. Future studies in larger samples and considering other time points may be useful to explain whether these fats are important in brain development related to ASD.

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5. Chang MY, Doppee D, Yu F, Perez C, Coleman AL, Pineles SL. Prevalence of ophthalmologic diagnoses in children with autism spectrum disorder using the Optum dataset : a population-based study. Am J Ophthalmol ;2020 (Sep 4)

PURPOSE : Autism spectrum disorder (ASD) affects an estimated 1.85% of children in the United States and is increasing in prevalence. Any relation between ophthalmologic disorders and ASD is poorly understood. The purpose of this study was to calculate the prevalence of ophthalmologic disorders in children with ASD. DESIGN : Population-based retrospective cohort study. SETTING : Claims data from OptumLabs® Data Warehouse, a longitudinal real-world data asset with de-identified administrative claims and electronic health records data. STUDY POPULATION : Children less than or equal to 18 years of age at the time of first claim between 2007 to 2013. OBSERVATION : Diagnosis of pervasive developmental disorder (PDD) or autistic disorder (AD) by International Classification of Disease-9 (ICD-9) codes. MAIN OUTCOME MEASURES : Prevalence of an ophthalmologic diagnosis (amblyopia, strabismus, optic neuropathy, nystagmus, or retinopathy of prematurity) by ICD-9 codes in typically developing (TD) controls and children with PDD and AD. Adjusted odds ratios (OR) for each diagnosis were calculated using multivariable logistic regression models. RESULTS : Claims from over 10 million children were included. The prevalence of any ophthalmologic diagnosis considered in this study was 3.5% in TD controls, 12.5% in children with PDD (adjusted OR 3.22, 95% CI 3.16-3.29, p<0.001), and 13.5% in children with AD (adjusted OR 3.23, 95% CI 3.15-3.31, p<0.001). CONCLUSIONS : Population-based data suggest an increased risk of ophthalmologic diagnoses in children with ASD. Future research is necessary to further clarify the relation between ophthalmologic disorders and autistic symptoms and severity.

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6. Chen P, Li Z, Li Y, Ahmad SS, Kamal MA, Huo X. The language development via FOXP2 in autism spectrum disorder : A Review. Curr Pharm Des ;2020 (Sep 9)

BACKGROUND : An increasing number of newborn children in numerous nations are enrolled in early childhood education programs, and instructors, in this way, assume a focal job in invigorating language improvement in these youthful kids. Kids with language issues are found to have a higher risk for future scholarly challenges and learning inabilities. Language advancement among kids is an intricate procedure and vital for correspondence. The shortcomings in the utilization of grammatical structures may lessen the useful utilization of language for verbally expressive kids with autism spectrum disorder and exacerbate troubles with academic and social expertise advancement. RESULTS : FOXP2, the single principal gene connected to a speech and language issue, is significant for the right execution of complex motor behaviors used for speech. In any case, changes in FOXP2 lead to a speech/language issue portrayed by childhood apraxia of speech. These days, language learning is fundamentally required for kids who need to move to different nations to pursue the instructive frameworks and be helpful individuals or residents of those nations. CONCLUSION : The purpose of this study is to explore the role of FOXP2 in language disorder and its management for children’s language and communication development.

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7. Gilmore D, Harris L, Longo A, Hand BN. Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability : An analysis of inpatient and institutional outpatient medical claims. Autism ;2020 (Sep 9):1362361320955109.

Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. Our study is the first, to our knowledge, to use US national data to compare physical and mental health conditions among autistic older adults with and without intellectual disability. The data analyzed in this study consisted of records from inpatient hospitalizations as well as "institutional outpatient" healthcare visits, which include visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers. Autistic older adults with intellectual disability were significantly more likely to have thyroid disorders, epilepsy, respiratory infections, gastrointestinal conditions, osteoporosis, cognitive disorders, and schizophrenia/psychotic disorders. In contrast, autistic older adults without intellectual disability were significantly more likely to have obesity, diabetes, high blood pressure, cerebrovascular disease, chronic obstructive pulmonary disease, arthritis, back conditions, attention deficit disorders, substance use disorders, and suicidal ideation or intentional self-injury. These findings highlight the importance of developing distinct, tailored health management strategies for the autistic older adults with and without intellectual disability.

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8. Gonçalves Campos L, Hass Massena JR, Ávila Duarte J. Case of Eosinophilic Meningitis in an Autistic Child. Int J Infect Dis ;2020 (Sep 4)

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9. Hancock B, Chauhan H. Special topic cluster of articles on "Advancement in the Formulation, Characterization and Performance of Amorphous Solid Dispersions (ASDs)". J Pharm Sci ;2020 (Sep 5)

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10. Hand BN, Coury DL, White S, Darragh AR, Moffatt-Bruce S, Harris L, Longo A, Garvin JH. Specialized primary care medical home : A positive impact on continuity of care among autistic adults. Autism ;2020 (Sep 9):1362361320953967.

There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the "medical home". The medical home is not a residential home, but a system where a patient’s healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults.

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11. Howes A, Richards G, Galvin J. A Preliminary Investigation Into the Relationship Between Autistic Traits and Self-Compassion. Psychol Rep ;2020 (Sep 9):33294120957244.

Self-compassion refers to the extension of kindness to oneself when faced with feelings of inadequacies, shortcomings or failures. It is possible that individuals high in autistic traits may encounter difficulties with self-compassion, and this could be particularly pronounced due to the social challenges they might face. To explore this potential relationship, we recruited university students and members of the general population to an online survey (n = 176). Participants completed measures on demographics, autistic traits, and self-compassion. We found that autistic traits were indeed negatively correlated with self-compassion in both males and females. Interestingly, a comparison of the slopes showed significantly stronger relationships in males compared to females for the negative (but not the positive) subscales of the self-compassion scale. Although speculative at this point, it is possible that self-compassion acts as a mediator between autistic traits and psychopathology. With this in mind, further work is warranted to determine whether self-compassion could be a target for therapeutic intervention.

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12. Kopec J, Hagmann C, Shea N, Prawl A, Batkin D, Russo N. Examining the Temporal Limits of Enhanced Visual Feature Detection in Children With Autism. Autism Res ;2020 (Sep 8)

The enhanced perceptual processing of visual features in children with autism spectrum disorder (ASD) is supported by an abundance of evidence in the spatial domain, with less robust evidence regarding whether this extends to information presented across time. The current study aimed to replicate and extend previous work finding that children with an ASD demonstrated enhanced perceptual accuracy in detecting feature-based (but not categorically defined) targets in time, when these were presented quickly, at a stimulus onset asynchrony (SOA) of 50 ms per item. Specifically, we extend the range of SOAs to examine the temporal boundaries of this enhanced accuracy and examine whether there is a relationship between ASD-related traits and detection accuracy on temporal visual search tasks. Individuals with autism perceived feature-based targets with statistically higher accuracy than their typically developing peers between SOAs of 39 and 65 ms and were numerically faster at all SOAs. No group differences were noted for category-based task accuracy. Our results also demonstrated that ASD-related traits measured by the autism spectrum quotient were positively correlated with accuracy on the feature-based task. Overall, results suggest that accurate visual perception of features (particularly color) is enhanced in children with ASD across time. LAY SUMMARY : Our results suggest that children with autism are able to process visual features, such as color, more accurately than typically developing children, even when these are presented very rapidly. Accuracy was higher in children with higher levels of autism-related traits and symptoms. Our findings suggest that more accurate visual perception exists not only across space in children with autism, as much of the existing literature demonstrates, but also over time.

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13. Levinson S, Neuspiel J, Eisenhower A, Blacher J. Parent-Teacher Disagreement on Ratings of Behavior Problems in Children with ASD : Associations with Parental School Involvement Over Time. J Autism Dev Disord ;2020 (Sep 9)

ASD symptomology and behavioral problems pose challenges for children with ASD in school. Disagreement between parents and teachers in ratings of children’s behavior problems may provide clinically relevant information. We examined parent-teacher disagreement on ratings of behavior problems among children with ASD during the fall and spring of the school year. When child, teacher, and class characteristics were considered simultaneously, only ASD symptom severity predicted informant disagreement on internalizing and externalizing behavior problems. We also examined associations between informant disagreement and parent school involvement. Cross-lagged panel analyses revealed that higher informant disagreement on children’s behavior problems in the fall predicted lower parent school involvement in the spring, suggesting that greater informant agreement may foster parental school involvement over time.

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14. Nguyen Thanh L, Nguyen HP, Ngo MD, Bui VA, Dam PTM, Bui HTP, Ngo DV, Tran KT, Dang TTT, Duong BD, Nguyen PAT, Forsyth N, Heke M. Outcomes of bone marrow mononuclear cell transplantation combined with interventional education for autism spectrum disorder. Stem Cells Transl Med ;2020 (Sep 9)

The aim of this study was to evaluate the safety and efficacy of autologous bone marrow mononuclear cell transplantation combined with educational intervention for children with autism spectrum disorder. An open-label clinical trial was performed from July 2017 to August 2019 at Vinmec International Hospital, Hanoi, Vietnam. Thirty children who fulfilled the autism criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and had Childhood Autism Rating Scale (CARS) scores >37 were selected. Bone marrow was harvested by anterior iliac crest puncture under general anesthesia. The volume collected was as follows : 8 mL/kg for patients under 10 kg (80 mL + [body weight in kg - 10] × 7 mL) for patients above 10 kg. Mononuclear cells were isolated with a Ficoll gradient and then infused intrathecally. The same procedure was repeated 6 months later. After the first transplantation, all patients underwent 8 weeks of educational intervention based on the Early Start Denver Model. There were no severe adverse events associated with transplantation. The severity of autism spectrum disorder (ASD) was significantly reduced, with the median CARS score decreasing from 50 (range 40-55.5) to 46.5 (range 33.5-53.5) (P < .05). Adaptive capacity increased, with the median Vineland Adaptive Behavior Scales score rising from 53.5 to 60.5. Social communication, language, and daily skills improved markedly within 18 months after transplantation. Conversely, repetitive behaviors and hyperactivity decreased remarkably. Autologous bone marrow mononuclear cell transplantation in combination with behavioral intervention was safe and well tolerated in children with ASD (Trial registration : ClinicalTrials.gov identifier : NCT03225651).

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15. Pan PY, Bölte S, Kaur P, Jamil S, Jonsson U. Neurological disorders in autism : A systematic review and meta-analysis. Autism ;2020 (Sep 9):1362361320951370.

Neurological disorders, such as epilepsy and cerebral palsy, have been reported to occur among individuals with autism beyond chance and may have an impact on daily living across the lifespan. Although there has been research investigating neurological disorders in autism, the findings are not always conclusive. Previous summaries of existing studies have not evaluated the full range of neurological disorders. This study aimed to comprehensively explore the neurological problems appearing in autism to provide updated information that is needed for better healthcare and support in this population. We looked at already published studies focusing on risk or frequency of neurological disorders in autism. Our results suggest that individuals with autism are more likely than the general population to have a range of neurological disorders, including epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headache, and inborn abnormalities of the nervous system. In order to provide individualized healthcare and support of high quality to individuals diagnosed with autism, health care professionals and other support providers need to be attentive to neurological complications. To further improve our understanding about the link between autism and neurological disorders, future research should follow the neurological health of children who are diagnosed with or are at increased likelihood of autism.

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16. Park BY, Yao R, Tierney E, Brucato M, Hong X, Wang G, Ji Y, Pearson C, Fallin MD, Wang X, Volk H. The association between maternal lipid profile after birth and offspring risk of Autism Spectrum Disorder. Ann Epidemiol ;2020 (Sep 9)

BACKGROUND : Maternal obesity has been consistently associated with offspring risk for ASD as well as lipid metabolism derangements. However, few ASD studies have examined maternal lipids in conjunction with maternal prepregnancy body mass index (BMI). METHODS : This nested case-control study was based on the Boston Birth Cohort, a prospective cohort study of mother-child dyads recruited at the Boston Medical Center. Maternal blood samples were collected shortly after delivery and analyzed for total plasma cholesterol, HDL, and triglyceride (TG) concentrations. Low-density lipoprotein (LDL) was subsequently calculated by the Friedewald equation. Cases were identified using ASD diagnoses in children’s medical records. The odds of ASD were estimated with continuous lipid levels for a linear relationship, and we further explored the non-linear relationship using the tertile of each lipid analyte with the highest tertile as the reference group. Logistic regression was used to estimate the risk of ASD adjusting for potential confounders. The analyses were performed separately for mothers with normal weight and overweight/obese based on maternal prepregnancy BMI. RESULTS : One standard deviation decrease in postpartum maternal LDL was associated with increased odds of ASD aOR 1.33 [1.03 - 1.75]. There were no association between postpartum maternal HDL and TG levels and ASD risk. Decreasing levels of LDL were not associated with ASD risk in normal weight mothers (aOR 1.18 [0.83 - 1.69]), but the ASD risk was more pronounced in overweight and obese mothers (aOR 1.54 [1.04 - 2.27]). Follow-up analysis of non-linear association models showed that, when compared to the highest tertile, lower maternal LDL concentrations were associated with approximately two times increased risk of ASD (first tertile : aOR 2.34 [1.22 - 4.49] and second tertile : aOR 2.63 [1.37 - 5.08]). A similar pattern was observed with overweight/obese mothers but not in normal weight mothers CONCLUSION : Lower maternal postpartum plasma LDL concentration was associated with increased odds of ASD in offspring among children born to overweight and obese mothers. Our findings suggest that both maternal BMI and lipids should be considered in assessing their role in offspring ASD risk ; and additional longitudinal studies are needed to better understand maternal lipid dynamics during pregnancy among normal weight and overweight/obese mothers.

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17. Rein B, Ma K, Yan Z. A standardized social preference protocol for measuring social deficits in mouse models of autism. Nat Protoc ;2020 (Sep 7)

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and other behavioral abnormalities. The three-chamber social preference test is often used to assess social deficits in mouse models of ASD. However, varying and often contradicting phenotypic descriptions of ASD mouse models can be found in the scientific literature, and the substantial variability in the methods used by researchers to assess social deficits in mice could be a contributing factor. Here we describe a standardized three-chamber social preference protocol, which is sensitive and reliable at detecting social preference deficits in several mouse models of ASD. This protocol comprises three phases that can all be completed within 1 d. The test mouse is first habituated to the apparatus containing two empty cups in the side chambers, followed by the pre-test phase in which the mouse can interact with two identical inanimate objects placed in the cups. During the test phase, the mouse is allowed to interact with a social stimulus (an unfamiliar wild-type (WT) mouse) contained in one cup and a novel non-social stimulus contained in the other cup. The protocol is thus designed to assess preference between social and non-social stimuli under conditions of equal salience. The broad implementation of the three-chamber social preference protocol presented here should improve the accuracy and consistency of assessments for social preference deficits associated with ASD and other psychiatric disorders.

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18. Shah R, Klumpp L, Negron-Diaz J, Carmain T, Jordan J. Transverse colon volvulus in a patient with autism. J Surg Case Rep ;2020 (Sep) ;2020(9):rjaa284.

Transverse colon volvulus is an extremely rare cause of bowel obstruction with approximately 100 cases reported in literature. Transverse colon volvulus presents with signs and symptoms of large bowel obstruction, but it can become a surgical emergency due to bowel infarction or peritonitis. We present a rare case of transverse colon volvulus in a 36-year-old male patient with severe autism. We hope this case report will raise awareness of this disease.

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19. Vernetti A, Shic F, Boccanfuso L, Macari S, Kane-Grade F, Milgramm A, Hilton E, Heymann P, Goodwin MS, Chawarska K. Atypical Emotional Electrodermal Activity in Toddlers with Autism Spectrum Disorder. Autism Res ;2020 (Sep 8)

Past studies in autism spectrum disorder (ASD) indicate atypical peripheral physiological arousal. However, the conditions under which these atypicalities arise and their link with behavioral emotional expressions and core ASD symptoms remain uncertain. Given the importance of physiological arousal in affective, learning, and cognitive processes, the current study examined changes in skin conductance level (ΔSCL) in 41 toddlers with ASD (mean age : 22.7 months, SD : 2.9) and 32 age-matched toddlers with typical development (TD) (mean age : 21.6 months, SD : 3.6) in response to probes designed to induce anger, joy, and fear emotions. The magnitude of ΔSCL was comparable during anger (P = 0.206, d = 0.30) and joy (P = 0.996, d = 0.01) conditions, but significantly lower during the fear condition (P = 0.001, d = 0.83) in toddlers with ASD compared to TD peers. In the combined samples, ΔSCL positively correlated with intensity of behavioral emotional expressivity during the anger (r[71] = 0.36, P = 0.002) and fear (r[68] = 0.32, P = 0.007) conditions, but not in the joy (r[69] = -0.15, P = 0.226) condition. Finally, ΔSCL did not associate with autism symptom severity in any emotion-eliciting condition in the ASD group. Toddlers with ASD displayed attenuated ΔSCL to situations aimed at eliciting fear, which may forecast the emergence of highly prevalent internalizing and externalizing problems in this population. The study putatively identifies ΔSCL as a dimension not associated with severity of autism but with behavioral responses in negatively emotionally challenging events and provides support for the feasibility, validity, and incipient utility of examining ΔSCL in response to emotional challenges in very young children. LAY SUMMARY : Physiological arousal was measured in toddlers with autism exposed to frustrating, pleasant, and threatening tasks. Compared to typically developing peers, toddlers with autism showed comparable arousal responses to frustrating and pleasant events, but lower responses to threatening events. Importantly, physiological arousal and behavioral expressions were aligned during frustrating and threatening events, inviting exploration of physiological arousal to measure responses to emotional challenges. Furthermore, this study advances the understanding of precursors to emotional and behavioral problems common in older children with autism.

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20. Weir E, Allison C, Warrier V, Baron-Cohen S. Increased prevalence of non-communicable physical health conditions among autistic adults. Autism ;2020 (Sep 9):1362361320953652.

Previous research indicates autistic individuals die at a younger age than others and that this is possibly due in part to chronic physical health conditions. The present study used an anonymous, online survey to determine how common certain physical health conditions are among autistic adults, compared with non-autistic adults. We found autistic adults are more likely to develop heart conditions, lung conditions, and diabetes than non-autistic adults. Autistic females may be at higher risk of developing certain conditions (including respiratory conditions, asthma, and prediabetes) than autistic males. Finally, autistic individuals have increased health risks even when considering lifestyle factors (such as smoking, alcohol, and body mass index). This is still a relatively small study, and future research needs to confirm these findings and identify why these risks exist.

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21. Weiss JA, Lai JKY, Lee V, Lunsky Y. Predictors of Changes in Daily Activity in Transition-Age Autistic Youth. Autism Res ;2020 (Sep 9)

Transitioning into adulthood is fraught with challenges for autistic youth. A greater understanding of the facilitators of community involvement in school and employment during this period is warranted. The current study examines changes in service need and receipt, and the stability of accessing daily structured activities, for autistic young adults over their transition period compared to adolescents and adults that did not enter the transition period. Baseline caregiver survey data were taken from the Canadian Autism Spectrum Disorders Alliance National Autism Needs Assessment Survey in 2014, and caregivers (n = 304) completed the same set of questions in 2017 about sociodemographic factors, clinical need, service receipt and typical weekday activities. Three cohorts were compared : (1) pretransition age youth, (2) transition-age youth, and (3) young adults who were past transition age. Results suggest that transition-age youth were found to have a unique set of priority service needs compared to pre transition-age adolescent and to adult groups, and both transition-age and adult groups had lower levels of priority service receipt compared to pretransition-age adolescents. The transition-age group experienced the greatest loss of structured weekday activity between time points, and were more likely than pretransition-age adolescents to not have structured weekday activities at Time 2. A recovery of structured daily activity was not observed in young adults. Our results highlight the tumultuous nature of the transition period for autistic youth, which continues into adulthood, and the urgent need for supports during this time. LAY SUMMARY : This research highlights that autistic young people who are transitioning to adulthood are at greatest risk of losing structured weekday activities, and that once in adulthood, many continue to struggle to obtain meaningful community engagement. These results can help guide the design of adolescent and young adult transition programs.

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22. Wu XR, Xia B, Ge LH, Qin M, Li RZ, Wang B, Ge FQ, Wang XJ, Chen X, Song GT, Shao LQ, Wang J, Zou J, Lin JJ, Zhao YM, Mei YF, Huang H, Zeng SJ. [Analysis of caries experience and the dental treatments under general anesthesia in 103 cases of children with autism spectrum disorders]. Zhonghua Kou Qiang Yi Xue Za Zhi ;2020 (Sep 9) ;55(9):639-646.

Objective : To compare the caries experience and the kinds of dental treatment between children with autism spectrum disorders (ASD) and children without systemic disease who were all treated under general anesthesia. Methods : Totally 103 children with ASD who received dental treatments under general anesthesia in 13 professional dental hospitals around China from April to November 2016 were included in the present study. A group of 97 children without systemic disease, according to the age, gender and application propensity score matching method, were chosen as controls, who received dental treatments under general anesthesia between January 2015 to November 2018 in the same hospitals as the children with ASD. Decay missing filling tooth (DMFT/dmft, DMFT for permanent teeth and dmft for primary teeth) indices of two groups of children and the contents of the dental treatments under general anesthesia were analyzed. Results : No significant difference of DMFT/dmft index [M (Q (25), Q (75))] was found between children with ASD group [0 (0, 3)/11(8, 14)] and control group [0 (0, 3)/9(7, 13)] (P>0.05). The average number of dental treatments under general anesthesia and the average number of endodontic treatment in children with ASD were 13 (11, 15) and 3 (2, 6) teeth respectively, while those in the control group were 12 (9, 14) and 2 (1, 4) teeth respectively, the differences were statistically significant (P<0.01, P<0.05). Conclusions : No significant difference was found between children with ASD and the normal controls who receive dental treatments under general anesthesia in DMFT/dmft index, but the treatment needs of children with ASD is relatively higher, and their tooth decay is relatively severer.

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