Pubmed du 22/09/20

mardi 22 septembre 2020

1. Altakhaineh ARM, Zibin A, Alkhatib RN. On the Acquisition of the Arabic Grammatical Gender by Arabic-Speaking Children with ASD. J Psycholinguist Res ;2020 (Sep 22)

This study examines the ability of Arabic-speaking-children diagnosed with Autism Spectrum Disorder (ASD) to acquire the Arabic grammatical gender. It also explores whether the use of visual stimuli can be effective to acquire it. Using the experimental design of a pre- and post-test, 14 children with ASD were tested twice on the same items after a treatment period and their results were compared using a paired sample t-test. The results showed that the use of visual stimuli could be effective in the acquisition of grammatical gender evidenced by the higher accuracy rate on the post-test. The results also demonstrated that the visibility of the feminine suffix marked on the target noun and the participants’ familiarity with these nouns contributed to this rate on the post-test. Furthermore, it was shown that even if the noun belonged to a natural gender class, it had no effect on the participants’ answers unlike the results reported by previous studies on the acquisition of grammatical gender.

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2. Anderson MP, Quinton R, Kelly K, Falzon A, Halladay A, Schumann CM, Hof PR, Tamminga CA, Hare CK, Amaral DG. Autism BrainNet. Arch Pathol Lab Med ;2020 (Sep 22)

CONTEXT.— : Autism spectrum disorder is a neurodevelopmental condition that affects over 1% of the population worldwide. Developing effective preventions and treatments for autism will depend on understanding the neuropathology of the disorder. While evidence from magnetic resonance imaging indicates altered development of the autistic brain, it lacks the resolution needed to identify the cellular and molecular underpinnings of the disorder. Postmortem studies of human brain tissue currently represent the only viable option to pursuing these critical studies. Historically, the availability of autism brain tissue has been extremely limited. OBJECTIVE.— : To overcome this limitation, Autism BrainNet, funded by the Simons Foundation, was formed as a network of brain collection sites that work in a coordinated fashion to develop a library of human postmortem brain tissues for distribution to researchers worldwide. Autism BrainNet has collection sites (or Nodes) in California, Texas, and Massachusetts ; affiliated, international Nodes are located in Oxford, England and Montreal, Quebec, Canada. DATA SOURCES.— : Pubmed, Autism BrainNet. CONCLUSIONS.— : Because the death of autistic individuals is often because of an accident, drowning, suicide, or sudden unexpected death in epilepsy, they often are seen in a Medical Examiner’s or Coroner’s office. Yet, autism is rarely considered when evaluating the cause of death. Advances in our understanding of chronic traumatic encephalopathy have occurred because medical examiners and neuropathologists questioned whether a pathologic change might exist in individuals who played contact sports and later developed severe behavioral problems. This article highlights the potential for equally significant breakthroughs in autism arising from the proactive efforts of medical examiners, pathologists, and coroners in partnership with Autism BrainNet.

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3. Audrain SP, Urbain CM, Yuk V, Leung RC, Wong SM, Taylor MJ. Frequency-specific neural synchrony in autism during memory encoding, maintenance and recognition. Brain Commun ;2020 ;2(2):fcaa094.

Working memory impairment is associated with symptom severity and poor functional outcome in autistic individuals, and yet the neurobiology underlying such deficits is poorly understood. Neural oscillations are an area of investigation that can shed light on this issue. Theta and alpha oscillations have been found consistently to support working memory in typically developing individuals and have also been shown to be functionally altered in people with autism. While there is evidence, largely from functional magnetic resonance imaging studies, that neural processing underlying working memory is altered in autism, there remains a dearth of information concerning how sub-processes supporting working memory (namely encoding, maintenance and recognition) are impacted. In this study, we used magnetoencephalography to investigate inter-regional theta and alpha brain synchronization elicited during the widely used one-back task across encoding, maintenance and recognition in 24 adults with autism and 30 controls. While both groups performed comparably on the working-memory task, we found process- and frequency-specific differences in networks recruited between groups. In the theta frequency band, both groups used similar networks during encoding and recognition, but different networks specifically during maintenance. In comparison, the two groups recruited distinct networks across encoding, maintenance and recognition in alpha that showed little overlap. These differences may reflect a breakdown of coherent theta and alpha synchronization that supports mnemonic functioning, or in the case of alpha, impaired inhibition of task-irrelevant neural processing. Thus, these data provide evidence for specific theta and widespread alpha synchrony alterations in autism, and underscore that a detailed examination of the sub-processes that comprise working memory is warranted for a complete understanding of cognitive impairment in this population.

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4. Barros F, Figueiredo C, Costa A, Soares SC. Sensory Processing in the Autism Spectrum : The Role of Attention to Detail and Somatic Trait Anxiety in the Olfactory Perception of the General Population. J Autism Dev Disord ;2020 (Sep 22)

Autism Spectrum Disorders, as well as autism traits (AT), have been associated with altered sensory processing. However, the role of AT in olfactory processing is still unclear. We analyzed the impact of AT and trait anxiety (TANX), relevant in the context of autism and olfactory perception, in the olfactory abilities of a nonclinical adult sample. Participants (N = 116) completed the Autism-Spectrum Quotient (AQ), the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and the Sniffin’ Sticks Extended Test to measure AT, TANX and olfactory abilities, respectively. A hierarchical multiple regression analysis suggested that women and higher scores on the Attention to Detail subscale of AQ were associated with better odor discrimination, and higher somatic TANX was related to poorer odor discrimination.

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5. Bellalou L, Downes N, Cappe E. Development and preliminary validation of a depressive symptomatology detection scale among children and adolescents on the autism spectrum. Autism ;2020 (Sep 21):1362361320958209.

Many individuals on the autism spectrum experience depressive symptoms. These symptoms contribute to poor quality of life and may have a more negative impact than core autistic features. However, identifying depressive symptoms among individuals on the spectrum is a real challenge. In this study, we investigate the psychometric qualities of a French scale for evaluating depressive symptoms among youth on the autism spectrum. Participants were 153 autistic children and adolescents aged between 3 and 17 years. The majority of the sample was male (73.86%). One of their parents completed the scale for evaluating depressive symptoms among youth on the autism spectrum during an interview with a psychologist. Overall, the findings indicate the scale may be reliably used with children and adolescents on the autism spectrum. Experts deemed the items as being representative of depressive symptoms. The scale is composed of two factors : behavioral changes on one hand and cognitive and emotional changes on the other. The results are encouraging and show the scale is a promising instrument for assessing Major Depressive Disorder symptomatology among youth on the spectrum. Future studies should focus on testing this scale among adults and developing an auto-evaluative section.

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6. Chakraborty A, Jenjaroenpun P, Li J, El Hilali S, McCulley A, Haarer B, Hoffman EA, Belak A, Thorland A, Hehnly H, Schildkraut C, Chen CL, Kuznetsov VA, Feng W. Replication Stress Induces Global Chromosome Breakage in the Fragile X Genome. Cell Rep ;2020 (Sep 22) ;32(12):108179.

Fragile X syndrome (FXS) is a neurodevelopmental disorder caused by mutations in the FMR1 gene and deficiency of a functional FMRP protein. FMRP is known as a translation repressor whose nuclear function is not understood. We investigated the global impact on genome stability due to FMRP loss. Using Break-seq, we map spontaneous and replication stress-induced DNA double-strand breaks (DSBs) in an FXS patient-derived cell line. We report that the genomes of FXS cells are inherently unstable and accumulate twice as many DSBs as those from an unaffected control. We demonstrate that replication stress-induced DSBs in FXS cells colocalize with R-loop forming sequences. Exogenously expressed FMRP in FXS fibroblasts ameliorates DSB formation. FMRP, not the I304N mutant, abates R-loop-induced DSBs during programmed replication-transcription conflict. These results suggest that FMRP is a genome maintenance protein that prevents R-loop accumulation. Our study provides insights into the etiological basis for FXS.

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7. Clark RJ, Wilder DA, Kelley ME, Ryan V. Evaluation of Instructions and Video Modeling to Train Parents to Implement a Structured Meal Procedure for Food Selectivity Among Children With Autism. Behav Anal Pract ;2020 (Sep) ;13(3):674-678.

We evaluated written instructions plus video modeling-and when necessary, in vivo prompting and feedback-to teach 3 parents to implement a structured meal procedure to decrease food selectivity among their children with autism. In addition to data on correct parent implementation, we also collected data on child bite acceptance. Results showed that instructions and video modeling were effective to achieve the mastery criteria for 1 parent ; the other 2 parents required in vivo prompts and feedback. Two of the children exhibited an increase in bite acceptance during the structured meal procedure.

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8. Diener ML, Wright CA, Taylor C, D’Astous V, Lasrich L. Dual perspectives in autism spectrum disorders and employment : Toward a better fit in the workplace. Work ;2020 (Sep 17)

BACKGROUND : Compared with people with other disabilities, individuals with autism spectrum disorder (ASD) have the lowest rates of employment and switch jobs at a higher frequency. Thus, understanding how to support workplace success for people with ASD is important. OBJECTIVE : Grounded in an ecological conceptual model, this study explores the dual employment perspectives of adults with ASD and supervisors who worked with individuals with ASD. METHODS : Using participatory research methods, a purposive sample of ten adults with ASD (all verbal with high school diplomas) and ten supervisors participated in semi-structured interviews on employment experiences. Qualitative analyses were used to identify themes. RESULTS : Four major themes emerged from an ecological framework to create a strong person-environment fit in the workplace : 1) building on interest/experiences/strengths/skills, 2) reducing social demands, 3) clear communication and expectations, and 4) ASD awareness for work environment. Comparisons between the two groups of participants showed substantive differences in expectations and accommodations. CONCLUSIONS : Supervisors, although eager to employ individuals with ASD, could benefit by employing an ecological model to successful employment. Results indicate that multiple lenses on the process of employment for those with ASD can lead to better outcomes in the workplace.

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9. Dixon DR, Miyake CJ, Nohelty K, Novack MN, Granpeesheh D. Evaluation of an Immersive Virtual Reality Safety Training Used to Teach Pedestrian Skills to Children With Autism Spectrum Disorder. Behav Anal Pract ;2020 (Sep) ;13(3):631-640.

Children with autism spectrum disorder (ASD) are at an increased risk of injury, making safety skills training essential. Whether such training is conducted in the natural environment or in contrived settings is an important consideration for generalization and safety purposes. Immersive virtual reality (VR) environments may offer the advantages of both contrived and natural environment training settings, providing structure to create repeated learning opportunities in a safe and realistic analogue of the natural environment. The current study evaluated the effectiveness of an immersive VR safety skills training environment in teaching 3 children with ASD to identify whether it is safe to cross the street. After modifications to the VR training environment, all 3 participants reached mastery criteria in both VR and natural environment settings. Findings suggest that immersive VR is a promising medium for the delivery of safety skills training to individuals with ASD.

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10. Espinosa L, Lundin Kleberg J, Hofvander B, Berggren S, Bölte S, Olsson A. Enhanced social learning of threat in adults with autism. Mol Autism ;2020 (Sep 22) ;11(1):71.

BACKGROUND : Recent theories have linked autism to challenges in prediction learning and social cognition. It is unknown, however, how autism affects learning about threats from others "demonstrators" through observation, which contains predictive learning based on social information. The aims of this study are therefore to investigate social fear learning in individual with autism spectrum disorder (ASD) and to examine whether typically developing social cognition is necessary for successful observational learning. METHODS : Adults with ASD (n = 23) and neurotypical controls (n = 25) completed a social fear learning (SFL) procedure in which participants watched a "demonstrator" receiving electrical shocks in conjunction with a previously neutral conditioned stimulus (CS+), but never with a safe control stimulus (CS-). Skin conductance was used to measure autonomic responses of learned threat responses to the CS+ versus CS-. Visual attention was measured during learning using eye tracking. To establish a non-social learning baseline, each participant also underwent a test of Pavlovian conditioning. RESULTS : During learning, individuals with ASD attended less to the demonstrator’s face, and when later tested, displayed stronger observational, but not Pavlovian, autonomic indices of learning (skin conductance) compared to controls. In controls, both higher levels of attention to the demonstrator’s face and trait empathy predicted diminished expressions of learning during test. LIMITATIONS : The relatively small sample size of this study and the typical IQ range of the ASD group limit the generalizability of our findings to individuals with ASD in the average intellectual ability range. CONCLUSIONS : The enhanced social threat learning in individuals with ASD may be linked to difficulties using visual attention and mental state attributions to downregulate their emotion.

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11. Frampton SE, Shillingsburg MA, Simeone PJ. Feasibility and Preliminary Efficacy of Direct Instruction for Individuals With Autism Utilizing Speech-Generating Devices. Behav Anal Pract ;2020 (Sep) ;13(3):648-658.

Direct instruction (DI) is an evidence-based approach to education that has been shown to be effective across a wide variety of student populations. Growing evidence suggests that DI may be an efficacious strategy for individuals with autism spectrum disorder (ASD). The current study aimed to evaluate the feasibility of using DI with students with ASD who utilize speech-generating devices (SGDs) ; 3 students with ASD whose primary mode of communication was an SGD were exposed to the Language for Learning Curriculum, Lessons 1-10. Student performance on pre- and posttests was measured, as well as student performance on exercises within each lesson. The average time to complete an exercise, number of repetitions, number of terminated sessions, and student affect were also evaluated. Results indicated that all 3 students could participate and complete exercises with some modifications to support SGD use. The students demonstrated improved performance, positive affect, and overall timely completion of exercises. Taken together, these findings suggest that DI may be feasible for some students with ASD who utilize SGDs.

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12. Frye RE, Cakir J, Rose S, Delhey L, Bennuri SC, Tippett M, Melnyk S, James SJ, Palmer RF, Austin C, Curtin P, Arora M. Prenatal air pollution influences neurodevelopment and behavior in autism spectrum disorder by modulating mitochondrial physiology. Mol Psychiatry ;2020 (Sep 22)

We investigate the role of the mitochondrion, an organelle highly sensitive to environmental agents, in the influence of prenatal air pollution exposure on neurodevelopment and behavior in 96 children with autism spectrum disorder (ASD) [45 with neurodevelopmental regression (NDR) ; 76% Male ; mean (SD) age 10 y 9 m (3 y 9 m)]. Mitochondrial function was assessed using the Seahorse XFe96 in fresh peripheral blood mononuclear cells. Second and third trimester average and maximal daily exposure to fine air particulate matter of diameter ≤2.5 µm (PM(2.5)) was obtained from the Environmental Protection Agency’s Air Quality System. Neurodevelopment was measured using the Vineland Adaptive Behavior Scale 2nd edition and behavior was assessed using the Aberrant Behavior Checklist and Social Responsiveness Scale. Prenatal PM(2.5) exposure influenced mitochondrial respiration during childhood, but this relationship was different for those with (r = 0.25-0.40) and without (r = -0.07 to -0.19) NDR. Mediation analysis found that mitochondrial respiration linked to energy production accounted for 25% (SD = 2%) and 10% (SD = 2%) of the effect of average prenatal PM(2.5) exposure on neurodevelopment and behavioral symptoms, respectively. Structural equation models estimated that PM(2.5) and mitochondrial respiration accounted for 34% (SD = 4%) and 36% (SD = 3%) of the effect on neurodevelopment, respectively, and that behavior was indirectly influenced by mitochondrial respiration through neurodevelopment but directly influenced by prenatal PM(2.5). Our results suggest that prenatal exposure to PM(2.5) disrupts neurodevelopment and behavior through complex mechanisms, including long-term changes in mitochondrial respiration and that patterns of early development need to be considered when studying the influence of environmental agents on neurodevelopmental outcomes.

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13. Green RR, Bigler ED, Froehlich A, Prigge MBD, Zielinski BA, Travers BG, Anderson JS, Alexander A, Lange N, Lainhart JE. Beery VMI and Brain Volumetric Relations in Autism Spectrum Disorder. J Pediatr Neuropsychol ;2019 (Sep) ;5(3):77-84.

Although diminished proficiency on tasks that require visual-motor integration (VMI) has been reported in individuals with autism spectrum disorder (ASD), very few studies have examined the association between VMI performance and neuroanatomical regions of interest (ROI) involved in motor and perceptual functioning. To address these issues, the current study included an all-male sample of 41 ASD (ages 3-23 years) and 27 typically developing (TD) participants (ages 5-26 years) who completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) as part of a comprehensive neuropsychological battery. All participants underwent 3.0 T magnetic resonance imaging (MRI) with image quantification (FreeSurfer software v5.3). The groups were statistically matched on age, handedness, and intracranial volume (ICV). ASD participants performed significantly lower on VMI and IQ measures compared with the TD group. VMI performance was significantly correlated with FSIQ and PIQ in the TD group only. No pre-defined neuroanatomical ROIs were significantly different between groups. Significant correlations were observed in the TD group between VMI and total precentral gyrus gray matter volume (r = .51, p = .006) and total frontal lobe gray matter volume (r = .46, p = .017). There were no significant ROI correlations with Beery VMI performance in ASD participants. At the group level, despite ASD participants exhibiting reduced visuomotor abilities, no systematic relation with motor or sensory-perceptual ROIs was observed. In the TD group, results were consistent with the putative role of the precentral gyrus in motor control along with frontal involvement in planning, organization, and execution monitoring, all essential for VMI performance. Given that similar associations between VMI and ROIs were not observed in those with ASD, neurodevelopment in ASD group participants may not follow homogenous patterns making correlations in these brain regions unlikely to be observed.

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14. Johnson N, Sangasy P, Robinson K. "No one could calm him down" : Mothers’ experience of autism diagnosis and obtainment of resources in an urban public school district. Fam Syst Health ;2020 (Sep) ;38(3):255-264.

Introduction : The purpose of this study was to explore the experience of accessing autism diagnosis and resources in a Midwest urban public school district for diverse mothers of children with autism spectrum disorder. Method : We employed thematic analysis using narrative inquiry methodology to analyze the data from 9 mothers (n = 5 African American, n = 2 Hispanic, and n = 2 White) who participated in a focus group. Results : Three themes were identified by the researchers : (a) late medical diagnosis (subthemes : problems that parents didn’t perceive as signs of autism spectrum disorder, making comparisons to other siblings or children), (b) negative communication experiences (subthemes : husband and wife, parent and educational professionals), and (c) coping strategies (subthemes : resources, prayer). Discussion : The mothers’ narratives indicated a strong need for advocacy and parent-school partnership. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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15. Karni-Visel Y, Hershkowitz I, Hershkowitz F, Flaisher M, Schertz M. Increased risk for child maltreatment in those with developmental disability : A primary health care perspective from Israel. Res Dev Disabil ;2020 (Sep 18) ;106:103763.

BACKGROUND : Child Maltreatment (CM) is a worldwide phenomenon. Literature suggests that children with disabilities are at increased risk for CM. However, limited information exists regarding if such increased risk is noted in community primary care clinics. AIM : To report on the incidence of CM in children with and without disabilities attending community primary care clinics. METHOD : This was a cohort study of children belonging to a Health Maintenance Organization (HMO) in Israel. The study group consisted of children with disabilities and the control group consisted of children without disabilities. Formal reports to child protection services, medical and sociodemographic data were extracted from designated documentation and medical records. RESULTS : The odds to be identified as suspected CM, after adjusting for sociodemographic variables, was 6.2 times higher among children with disabilities compared to children without disabilities and 5.0 times higher among children with severe vs. mild disability. CONCLUSIONS : Developmental disability is a risk factor for CM, and is noted even more seriously in community primary care clinics. CM positively correlated with the severity of disability. The presented data marks higher figures than previously reported, enhancing understanding of the scope of the problem and its relation to the type of organization being examined.

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16. Khundrakpam B, Vainik U, Gong J, Al-Sharif N, Bhutani N, Kiar G, Zeighami Y, Kirschner M, Luo C, Dagher A, Evans A. Neural correlates of polygenic risk score for autism spectrum disorders in general population. Brain Commun ;2020 ;2(2):fcaa092.

Autism spectrum disorder is a highly prevalent and highly heritable neurodevelopmental condition, but studies have mostly taken traditional categorical diagnosis approach (yes/no for autism spectrum disorder). In contrast, an emerging notion suggests a continuum model of autism spectrum disorder with a normal distribution of autistic tendencies in the general population, where a full diagnosis is at the severe tail of the distribution. We set out to investigate such a viewpoint by investigating the interaction of polygenic risk scores for autism spectrum disorder and Age(2) on neuroimaging measures (cortical thickness and white matter connectivity) in a general population (n = 391, with age ranging from 3 to 21 years from the Pediatric Imaging, Neurocognition and Genetics study). We observed that children with higher polygenic risk for autism spectrum disorder exhibited greater cortical thickness for a large age span starting from 3 years up to ∼14 years in several cortical regions localized in bilateral precentral gyri and the left hemispheric postcentral gyrus and precuneus. In an independent case-control dataset from the Autism Brain Imaging Data Exchange (n = 560), we observed a similar pattern : children with autism spectrum disorder exhibited greater cortical thickness starting from 6 years onwards till ∼14 years in wide-spread cortical regions including (the ones identified using the general population). We also observed statistically significant regional overlap between the two maps, suggesting that some of the cortical abnormalities associated with autism spectrum disorder overlapped with brain changes associated with genetic vulnerability for autism spectrum disorder in healthy individuals. Lastly, we observed that white matter connectivity between the frontal and parietal regions showed significant association with polygenic risk for autism spectrum disorder, indicating that not only the brain structure, but the white matter connectivity might also show a predisposition for the risk of autism spectrum disorder. Our findings showed that the fronto-parietal thickness and connectivity are dimensionally related to genetic risk for autism spectrum disorder in general population and are also part of the cortical abnormalities associated with autism spectrum disorder. This highlights the necessity of considering continuum models in studying the aetiology of autism spectrum disorder using polygenic risk scores and multimodal neuroimaging.

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17. LaRue RH, Maraventano JC, Budge JL, Frischmann T. Matching Vocational Aptitude and Employment Choice for Adolescents and Adults with ASD. Behav Anal Pract ;2020 (Sep) ;13(3):618-630.

As individuals age out of the public school system, they encounter what is colloquially referred to as the "services cliff." Although supports and services are readily available during school-age years, the lack of available resources for adults with autism spectrum disorder (ASD) is striking. Although schools are charged with preparing students for life after graduation, individuals with ASD are often woefully unprepared for integration into the workforce. Employment rates for adults with autism are lower than those reported for any other population of adults with disabilities (Burke, Andersen, Bowen, Howard, & Allen, 2010 ; Bush & Tassé, 2017 ; Newman, Wagner, Cameto, Knokey, & Shaver, 2010). In the present investigation, a skill-based vocational assessment was developed and implemented with 6 individuals diagnosed with ASD. The results of the assessment were used to design matched and unmatched jobs to determine if performance varied as a function of the assessment’s results. The assessment resulted in varied job profiles across the participants. All the participants performed better (i.e., more on-task, less disruptive behavior) while completing jobs matched to their assessment results. In addition, when participants were allowed to choose between matched and unmatched jobs, they consistently chose to complete jobs that matched their profile results. Results from the current investigation suggest that a brief, skill-based vocational assessment may be a viable tool for improving employment outcomes for adolescents and adults with ASD.

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18. Lee D, Frey GC, Min A, Kim B, Cothran DJ, Bellini S, Han K, Shih PC. Usability inquiry of a gamified behavior change app for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder. Health Informatics J ;2020 (Sep 19):1460458220952909.

The purpose of this study was to conduct the first usability inquiry of a gamified, behavior change theory-guided mobile app PuzzleWalk for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder (ASD). Eighteen adults with and without ASD participated in a mixed-methods study that consisted of cognitive walkthrough, system usability assessment, and qualitative interviews. The results of the system usability testing indicated satisfactory quality of the PuzzleWalk system that can be readily applicable to both adults with and without ASD. Several notable issues were identified from the qualitative interviews that address critical insights into unique health and social needs in adults with ASD. Future work is warranted to examine the long-term effects of the PuzzleWalk system on increasing physical activity and reducing sedentary behavior in adults with and without ASD in real-world settings.

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19. Li S, Hu J, Chang R, Li Q, Wan P, Liu S. Eye Movements of Spatial Working Memory Encoding in Children with and without Autism : Chunking Processing and Reference Preference. Autism Res ;2020 (Sep 22)

Individuals with autism spectrum disorder (ASD) experience spatial working memory deficits and show different encoding mechanisms from typical developing (TD) peers. To effectively describe the encoding strategies of those with ASD and highlight their characteristics in cognitive processing, we adopted improved change detection tasks and added eye-movement indicators to investigate the chunking function and reference preference of children with and without ASD. The current study included 20 participants with ASD aged 8-16 and 20 TD children matched for age, gender, and intelligence. Experiment 1 used high/low-structured change detection tasks, and eye-movement indexes were recorded as they memorized the locations of the items to investigate spatial chunking strategies. In Experiment 2, changes in eye movement patterns were observed by adding a frame of reference. The results suggested different encoding strategies in ASD and TD individuals. The ASD group showed local processing bias and had difficulty adopting chunking strategies in spatial working memory. Eye-movement analysis suggested that they rarely showed integrated information processing tendency observed in TD children. Moreover, as a compensatory processing, they were more likely to use the frame of reference. In this study, we compared the spatial chunking strategies and reference preference of children with and without ASD, and eye-movement analysis was used to investigate the processing mechanism. These findings are significant for research on cognitive characteristics of ASD and provide a new focus for working memory training in children with ASD. LAY SUMMARY : The current study suggests that children with autism spectrum disorder are poorer at organizing items into chunks in spatial working memory, but rely more on reference frames. If the purpose of location memory is to strengthen the adaptability of children with autism, it should provide them with more clues or references. If it is for the purpose of intervention such as cognitive training, it should guide them to integrate information to improve the basic cognitive processing efficiency.

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20. Li T, Li Y, Hu Y, Wang Y, Lam CM, Ni W, Wang X, Yi L. Heterogeneity of Visual Preferences for Biological and Repetitive Movements in Children With Autism Spectrum Disorder. Autism Res ;2020 (Sep 21)

Previous studies have repeatedly reported atypical visual preferences to repetitive movements and deficient perception of biological movements in individuals with autism spectrum disorder (ASD). However, limited research has investigated the heterogeneity of the visual preferences in individuals with ASD. In the current study, we explored the visual preferences to different movement types (repetitive, biological, and random) in children with ASD using a paired preferential looking paradigm. Thirty-nine children with ASD and 37 typically developing (TD) children participated in our study, with their eye movements recorded as the index of visual preferences. We examined the differences of visual preferences between the ASD and TD group, and the heterogeneity of visual preferences within the ASD group. We found group differences between children with ASD and TD children : Overall, the ASD group preferred repetitive movements while the TD group preferred biological movements. We also detected heterogeneity of visual preferences within the ASD group : Although the majority of children with ASD preferred repetitive movements as previous studies reported, 9 out of 39 children with ASD preferred biological movements similarly as their TD peers. Moreover, the visual preference patterns were correlated with autistic symptoms, especially the socio-communicative impairments. Our study provided evidence of heterogeneity of visual attention and main visual preference to repetitive movements in children with ASD. The findings add to the body of literature of the heterogeneous behavioral symptoms and the atypical visual preferences in individuals with ASD. LAY SUMMARY : The current study examined visual preferences to biological, repetitive, and random movements in children with Autism Spectrum Disorder (ASD). We showed a pair of two videos representing two types of movements (random, repetitive, or biological movements) to children with ASD and typically developing children. We found the main visual preferences for repetitive movements and heterogeneity of visual attention within the ASD group. Our findings provide theoretical and methodological implications for future study of the heterogeneity in the ASD population.

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21. Lopez AR, Wiskow KM. Teaching Children With Autism to Initiate Social Interactions Using Textual Prompts Delivered via Apple Watches®. Behav Anal Pract ;2020 (Sep) ;13(3):641-647.

Children diagnosed with autism spectrum disorder (ASD) often engage in low levels of peer social interactions ; therefore, we often need to explicitly teach these skills. In the current study, we implemented a combined tactile and textual prompt, delivered via a text message sent to an Apple Watch®, to prompt social initiations from children with ASD to peers during free play. Results showed that the text message prompts increased the frequency of independent social initiations for both participants. Furthermore, 1 participant continued to emit high levels of independent social initiations during a 1-month follow-up with no prompts.

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22. McGhee Hassrick E, Sosnowy C, Graham Holmes L, Walton J, Shattuck PT. Social Capital and Autism in Young Adulthood : Applying Social Network Methods to Measure the Social Capital of Autistic Young Adults. Autism Adulthood ;2020 (Sep 1) ;2(3):243-254.

Social isolation is a core challenge associated with autism. Interpersonal relationships and the resources and support embedded in the social networks of autistic young adults could impact key adult outcomes, including quality of life, mental health, employment, and independence. However, little research systematically measures the networks of autistic young adults and network impact on key adult outcomes. This article demonstrates how social network analysis can be adapted for the field of autism to measure young adult networks. We provide examples as to how this approach could be implemented to yield key insights into the amount and quality of interpersonal relationships and the types of resources embedded in the networks of autistic young adults. The network protocol was feasibility tested with autistic adults during the posthigh school transition period (n = 17, 19-27 years). The parents of three of the recruited young adults also successfully completed a complementary network survey, allowing for the inclusion of the parent-reported network using duocentric network analysis, never before applied to parent-child networks. The implementation data collected from the study suggest feasibility of egocentric and duocentric approaches, with several important modifications to adapt the measure for the field of autism. The future potential of social network research for understanding autism in adulthood is discussed.

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23. Mohammadi MH, Shahramian I, Bazi A, Delaramnasab M. Seizure Induced by Defecation in a 15-Year Old Autistic Patient : A Case Report and Literature Review. Iran J Child Neurol ;2020 (Summer) ;14(3):83-88.

Epilepsy in autism is a relatively common phenomenon. However, reflex seizures provoked by multifactorial stimuli are rare in these patients. We here reported the first case of defecation-induced seizure in a 15-year old autistic girl. The patient had been diagnosed with epilepsy within the first year after birth ; however, seizures induced by bowel movements were observed at the age of 15. Reflex seizures showed a myoclonic pattern represented with one-sided neck deflection. EEG showed an abnormal polyspike and wave pattern during defecation while the patterns were normal between the attacks. The patient was partially responsive to adrenocorticotropic hormone therapy with a reduced frequency of both reflexes and generalized seizures. Phenobarbital therapy was effective to manage recurrent seizure attacks. Although seizure is commonly encountered in autism, reflex seizures induced by defecation have not been previously reported in this condition.

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24. Mooney LN, Nordahl CW, Solomon M, Ghetti S. Children with ASD Show Impaired Item-Space Recollection, But Preserved Item-Color Recollection. Autism Res ;2020 (Sep 21)

Although individuals with autism spectrum disorder (ASD) have been often shown to display similar memory performance on semantic memory tasks compared to typically developing (TD) children, there is ongoing debate about whether and how their ability to remember specific past events (i.e., episodic memory) is impaired. We assessed a sample of 62 children with ASD and 72 TD children, ranging in age between 8 and 12 years on 2 memory tasks. Participants encoded a series of images and their association with either where they appeared on the screen (item-space association task) or with the color of an image’s border (item-color association task). Children with ASD showed worse memory in the item-space association task compared to their TD peers, but comparable memory for the item-color association task. These differences persisted when age, intellectual quotient, and general item recognition memory were accounted for statistically. We interpret these results in light of evidence for specific deficits along the dorsal stream affecting processing of spatiotemporal information in ASD. LAY SUMMARY : Episodic memory requires the ability to bind contextual details (such as color, location, etc.) to an item or event in order to remember the past with specific detail. Here, we compared children with autism spectrum disorder (ASD) and typically developing (TD) children on tasks examining episodic memory. Children with ASD recalled more poorly previously seen items and their associated space-related details, but they performed comparably to TD children on color details. We discuss the possible mechanisms that contribute to worse spatial processing/recall in ASD.

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25. Oberman LM, Downs J, Cianfaglione R, Leonard H, Kaufmann WE. Assessment of a Clinical Trial Metric for Rett Syndrome : Critical Analysis of the Rett Syndrome Behaviour Questionnaire. Pediatr Neurol ;2020 (Oct) ;111:4.

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26. Pelton MK, Crawford H, Robertson AE, Rodgers J, Baron-Cohen S, Cassidy S. A Measurement Invariance Analysis of the Interpersonal Needs Questionnaire and Acquired Capability for Suicide Scale in Autistic and Non-Autistic Adults. Autism Adulthood ;2020 (Sep 1) ;2(3):193-203.

Background : Autistic adults are more likely to engage in suicidal thoughts and behaviors, but there is little research to explore the underlying reasons. It is unclear whether self-report suicide scales that have been designed for non-autistic people accurately measure suicide risk constructs in autistic people. Therefore, this study explored, for the first time, whether the measurement properties of the self-report scales of the Interpersonal Theory of Suicide are equivalent in autistic and non-autistic adults. Methods : In this study, responses from 342 autistic and 353 non-autistic people on the Interpersonal Needs Questionnaire-10 (INQ-10) and Acquired Capability for Suicide Scale-Fearlessness about Death (ACSS-FAD) were compared by using measurement invariance analysis. Data were gathered through an online cross-sectional survey of the self-report measures. Results : Results suggest that measurement properties of the INQ-10 were different in autistic people. Autistic characteristics, such as different theory of mind and preference for concrete language, may have led the scale items to load differently on the factors in the autistic group than in the non-autistic group. The measurement properties of the ACSS-FAD were invariant between autistic and non-autistic people. Conclusions : Scores on the INQ-10 cannot be meaningfully compared between autistic and non-autistic people due to different measurement properties. Future research could explore how autistic people experience the concepts of burdensomeness and belonging, to consider how measures could accurately capture this. This would allow researchers to explore the role of these constructs in the development of suicidal thoughts and behaviors in autistic people. Clinicians should be aware that suicide risk factors may present differently in autistic people. Scores on the ACSS-FAD can be meaningfully compared, but the negatively worded scale items may pose similar response difficulties to autistic and non-autistic people.

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27. Persson M, Opdahl S, Risnes K, Gross R, Kajantie E, Reichenberg A, Gissler M, Sandin S. Gestational age and the risk of autism spectrum disorder in Sweden, Finland, and Norway : A cohort study. PLoS Med ;2020 (Sep) ;17(9):e1003207.

INTRODUCTION : The complex etiology of autism spectrum disorder (ASD) is still unresolved. Preterm birth (<37 weeks of gestation) and its complications are the leading cause of death of babies in the world, and those who survive often have long-term health problems. Length of gestation, including preterm birth, has been linked to ASD risk, but robust estimates for the whole range of gestational ages (GAs) are lacking. The primary objective of this study was to provide a detailed and robust description of ASD risk across the entire range of GAs while adjusting for sex and size for GA. METHODS AND FINDINGS : Our study had a multinational cohort design, using population-based data from medical registries in three Nordic countries : Sweden, Finland, and Norway. GA was estimated in whole weeks based on ultrasound. Children were prospectively followed from birth for clinical diagnosis of ASD. Relative risk (RR) of ASD was estimated using log-binomial regression. Analyses were also stratified by sex and by size for GA. The study included 3,526,174 singletons born 1995 to 2015, including 50,816 (1.44%) individuals with ASD. In the whole cohort, 165,845 (4.7%) were born preterm. RR of ASD increased by GA, from 40 to 24 weeks and from 40 to 44 weeks of gestation. The RR of ASD in children born in weeks 22-31, 32-36, and 43-44 compared to weeks 37-42 were estimated at 2.31 (95% confidence interval [CI] 2.15-2.48 ; 1.67% vs 0.83% ; p-value < 0.001), 1.35 (95% CI 1.30-1.40 ; 1.08% vs 0.83% ; p-value < 0.001), and 1.37 (95% CI 1.21-1.54 ; 1.74% vs 0.83% ; p-value < 0.001), respectively. The main limitation of this study is the lack of data on potential causes of pre- or postterm birth. Also, the possibility of residual confounding should be considered. CONCLUSION : In the current study, we observed that the RR of ASD increased weekly as the date of delivery diverged from 40 weeks, both pre- and postterm, independently of sex and size for GA. Given the unknown etiology of ASD and the lifelong consequences of the disorder, identifying groups of increased risk associated with a potentially modifiable risk factor is important.

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28. Ponton JA, Smyth K, Soumbasis E, Llanos SA, Lewis M, Meerholz WA, Tanguay RL. A pediatric patient with autism spectrum disorder and epilepsy using cannabinoid extracts as complementary therapy : a case report. J Med Case Rep ;2020 (Sep 22) ;14(1):162.

BACKGROUND : The pharmacological treatment for autism spectrum disorders is often poorly tolerated and has traditionally targeted associated conditions, with limited benefit for the core social deficits. We describe the novel use of a cannabidiol-based extract that incidentally improved core social deficits and overall functioning in a patient with autism spectrum disorder, at a lower dose than has been previously reported in autism spectrum disorder. CASE PRESENTATION : The parents of a 15-year-old boy, of South African descent, with autism spectrum disorder, selective mutism, anxiety, and controlled epilepsy, consulted a medical cannabis physician to trial cannabis extract to replace seizure medications. Incidentally, at a very low cannabidiol-based extract dose, he experienced unanticipated positive effects on behavioral symptoms and core social deficits. CONCLUSION : This case report provides evidence that a lower than previously reported dose of a phytocannabinoid in the form of a cannabidiol-based extract may be capable of aiding in autism spectrum disorder-related behavioral symptoms, core social communication abilities, and comorbid anxiety, sleep difficulties, and weight control. Further research is needed to elucidate the clinical role and underlying biological mechanisms of action of cannabidiol-based extract in patients with autism spectrum disorder.

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29. Pua EPK, Thomson P, Yang JY, Craig JM, Ball G, Seal M. Individual Differences in Intrinsic Brain Networks Predict Symptom Severity in Autism Spectrum Disorders. Cereb Cortex ;2020 (Sep 22)

The neurobiology of heterogeneous neurodevelopmental disorders such as Autism Spectrum Disorders (ASD) is still unknown. We hypothesized that differences in subject-level properties of intrinsic brain networks were important features that could predict individual variation in ASD symptom severity. We matched cases and controls from a large multicohort ASD dataset (ABIDE-II) on age, sex, IQ, and image acquisition site. Subjects were matched at the individual level (rather than at group level) to improve homogeneity within matched case-control pairs (ASD : n = 100, mean age = 11.43 years, IQ = 110.58 ; controls : n = 100, mean age = 11.43 years, IQ = 110.70). Using task-free functional magnetic resonance imaging, we extracted intrinsic functional brain networks using projective non-negative matrix factorization. Intrapair differences in strength in subnetworks related to the salience network (SN) and the occipital-temporal face perception network were robustly associated with individual differences in social impairment severity (T = 2.206, P = 0.0301). Findings were further replicated and validated in an independent validation cohort of monozygotic twins (n = 12 ; 3 pairs concordant and 3 pairs discordant for ASD). Individual differences in the SN and face-perception network are centrally implicated in the neural mechanisms of social deficits related to ASD.

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30. Rosenblau G, Korn CW, Dutton A, Lee D, Pelphrey KA. Neurocognitive Mechanisms of Social Inferences in Typical and Autistic Adolescents. Biol Psychiatry Cogn Neurosci Neuroimaging ;2020 (Jul 15)

BACKGROUND : Many of our efforts in social interactions are dedicated to learning about others. Adolescents with autism have core deficits in social learning, but a mechanistic understanding of these deficits and how they relate to neural development is lacking. The present study aimed to specify how adolescents with and without autism represent and acquire social knowledge and how these processes are implemented in neural activity. METHODS : Typically developing adolescents (n = 26) and adolescents with autism spectrum disorder (ASD) (n = 20) rated in the magnetic resonance scanner how much 3 peers liked a variety of items and received trial-by-trial feedback about the peers’ actual preference ratings. In a separate study, we established the preferences of a new sample of adolescents (N = 99), used to examine population preference structures. Using computational models, we tested whether participants in the magnetic resonance study relied on preference structures during learning and how model predictions were implemented in brain activity. RESULTS : Typically developing adolescents relied on average population preferences and prediction error updating. Importantly, prediction error updating was scaled by the similarity between items. In contrast, preferences of adolescents with ASD were best described by a No-Learning model that relied only on the participant’s own preferences for each item. Model predictions were encoded in neural activity. Typically developing adolescents encoded prediction errors in the putamen, and adolescents with ASD showed greater encoding of own preferences in the angular gyrus. CONCLUSIONS : We specified how adolescents represent and update social knowledge during learning. Our findings indicate that adolescents with ASD rely only on their own preferences when making social inferences.

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31. Salleh NS, Abdullah KL, Yoong TL, Jayanath S, Husain M. Parents’ experiences of affiliate stigma when caring for a child with autism spectrum disorder (ASD) : A meta-synthesis of qualitative studies. J Pediatr Nurs ;2020 (Sep 18) ;55:174-183.

PROBLEM : Stigma affects not only children diagnosed with autism spectrum disorder (ASD) themselves, but also people connected with them (i.e., parents, siblings). The capacity of parents to provide care is affected by the stigma they perceive. This meta-synthesis encompasses the experiences of affiliate stigma among parents of children with ASD. ELIGIBILITY CRITERIA : Articles were limited to the English language, those reported on stigma experienced by parents of children with ASD aged 2-18 years, published between 1940 and 2019. SAMPLE : PubMed, CINAHL, PsycINFO, EMBASE, Scopus and The Cochrane Library databases were searched for eligible studies. Titles and abstracts were reviewed, and twelve articles fitted the selection criteria. The texts of the selected research papers were reviewed by two independent reviewers. RESULTS : Four common themes across parental experiences included felt stigma, enacted stigma, variations in stigma, and contributors to stigmatizing experiences. CONCLUSIONS : Highlighting the differences in parents’ views on affiliate stigma is necessary to create awareness about ASD and the stigma linked with this disorder. IMPLICATIONS : The findings asserted that healthcare professionals, especially those in pediatric settings, and society need to have a greater awareness of the stigma and challenges that these parents encounter as this has implications on their mental and physical health. This awareness will lead to more compassionate health care delivery which will support them and create a better environment for families and children with ASD.

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32. Scott M, Falkmer M, Kuzminski R, Falkmer T, Girdler S. Process evaluation of an autism-specific workplace tool for employers. Scand J Occup Ther ;2020 (Sep 21):1-13.

BACKGROUND : Limited studies exist exploring employers’ capacity in hiring and supporting employees on the autism spectrum, and even fewer have considered interventions targeting employers’ skills and knowledge in enhancing employment opportunities. In response to this need, the Integrated Employment Success Tool (IEST(TM)) was developed and its effectiveness established in a randomized controlled trial (RCT). Furthermore, a process evaluation was conducted to determine the usability and implementation of the IEST(TM). AIMS/OBJECTIVES : The process evaluation was conducted to determine employers’ perceived usability, implementation, and perceived barriers and facilitators in using the IEST(TM). MATERIAL AND METHODS : Employers (N = 29) provided their feedback via an online questionnaire. Of these, 11 participants were interviewed, further exploring their experiences. Data were analysed via descriptive statistics and thematic analysis. RESULTS : While employers’ frequency and usage of the IEST(TM) varied across workplaces, it was predominantly used to increase employers’ knowledge of autism and implement workplace strategies. A major barrier was the paper-based format of the intervention, with more than 60% of employers indicating the need for an online version. CONCLUSIONS AND SIGNIFICANCE : The process evaluation was a critical step in understanding why the IEST(TM) was effective, and how it could be further optimized for prospective employers.

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33. Shillingsburg MA, Frampton SE, Schenk YA, Bartlett BL, Thompson TM, Hansen B. Evaluation of a Treatment Package to Increase Mean Length of Utterances for Children with Autism. Behav Anal Pract ;2020 (Sep) ;13(3):659-673.

Skinner’s (1957) classification of mand responses has spawned decades of research related to teaching individuals with developmental disabilities. However, few studies have evaluated how to teach individuals with autism to progress from simple to more complex mands for desired items and activities. The present study used a treatment package consisting of errorless teaching, differential reinforcement, and systematic decision rules to increase the number of words per mand utterance used by 6 children with autism. Daily probes were conducted in the absence of prompting and differential reinforcement throughout every stage of the treatment. Results showed that all children showed significant developmental gains in the mean length of utterances. Increased rates of manding, increased emission of mand frames, and decreased instances of indicating responses (i.e., pointing, reaching) in the absence of mands were also observed. Implications regarding the feasibility of intensive mand training in practice are discussed.

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