Pediatric clinics of North America : Autism Spectrum Disorders : Practical Overview for Pediatricians

mardi 31 janvier 2012

Le numéro de février 2012 de Pediatric clinics of North America est entièrement consacré à l’autisme :

Autism Spectrum Disorders : Practical Overview for Pediatricians

Ce numéro propose des articles actualisés pour les praticiens sur des thèmes assez variés comme le diagnostic, l’imagerie, les facteurs endocriniens, la pharmacologie, les habiletés sociales, etc.

1. Merrick J. Autism spectrum disorders : practical overview for pediatricians. Pediatric clinics of North America. 2012 Feb ;59(1):xv-xvii.

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2. Patel DR, Greydanus DE. Autism spectrum disorders : practical overview for pediatricians. Pediatric clinics of North America. 2012 Feb ;59(1):xix.

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3. Greydanus DE, Toledo-Pereyra LH. Historical perspectives on autism : its past record of discovery and its present state of solipsism, skepticism, and sorrowful suspicion. Pediatric clinics of North America. 2012 Feb ;59(1):1-11.

Concepts of autism have evolved over the twentieth century after Bleuler coined the term to refer to symptoms of self-absorption in those with schizophrenia. Autism nosology changed to the current sesquipedalian constellation of autism spectrum disorders with a confusing archipelago of 5 conditions that often serve as islands of confusion to both the general public and professionals. This article reviews historical links that have led to the current confusing and controversial situation that is encouraging some people to return to magic, mysticism, and mantics for health care, despite the amazing accumulation of progress in vaccinology over the past 2 centuries.

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4. Nazeer A, Ghaziuddin M. Autism spectrum disorders : clinical features and diagnosis. Pediatric clinics of North America. 2012 Feb ;59(1):19-25.

The last decade has seen an increase of interest in autism spectrum disorders (ASD). With the prevalence now approaching 1%, children with ASD are usually first evaluated by clinicians working in primary care, such as pediatricians and family practitioners. Although classic autism is easy to recognize, differentiating autism from other spectrum disorders and comorbid conditions is not always simple.

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5. Duchan E, Patel DR. Epidemiology of autism spectrum disorders. Pediatric clinics of North America. 2012 Feb ;59(1):27-43.

Epidemiologic data gathered over the last 40 years report that the conservative estimate of autistic spectrum disorder prevalence is 27.5 per 10,000 individuals ; however, the prevalence estimate based on newer surveys is 60 per 10,000 individuals. Several factors are considered in various epidemiologic surveys of autism, especially the evolution of the concept of autism and changing criteria for diagnosis. This article reviews the incidence, prevalence, and risk factors for autism.

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6. Silver WG, Rapin I. Neurobiological basis of autism. Pediatric clinics of North America. 2012 Feb ;59(1):45-61.

Autism (autism spectrum disorders) is a complex, strongly genetically influenced, behaviorally defined disorder of the immature brain associated with very uneven intellectual abilities. Among its most salient and potentially treatable neurologic features that this article focuses on are epilepsy, disorganized sleep patterns, and sensory and motor deficits. Its many causes and wide range of severity means that there is no symptom, no pathology, imaging, electroencephalography, or other biologic feature, and no biologic treatment that is universal or diagnostic of this developmental syndrome.

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7. Chugani DC. Neuroimaging and Neurochemistry of Autism. Pediatric clinics of North America. 2012 Feb ;59(1):63-73.

Positron emission tomography, single-photon emission tomography, and magnetic resonance spectroscopy (MRS) are powerful tools for the monitoring of diverse neurochemical functions. Neuroimaging studies targeting neurotransmitter systems in autism have provided clues about how differences in development of these systems might lead to new intervention approaches. Direct measurement of diverse neurochemicals with MRS provides unique probes of neuronal integrity in vivo. Future directions include the combination of imaging modalities made possible by advances in software and hardware. Many tracers have not been applied in autism, and new molecules and signaling pathways might be targeted as genes associated with autism are identified.

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8. Tareen RS, Kamboj MK. Role of endocrine factors in autistic spectrum disorders. Pediatric clinics of North America. 2012 Feb ;59(1):75-88.

It is possible that autism spectrum disorders (ASDs) have a multifactorial cause along with more than one predisposing and perpetuating factor, all of which culminate in expression of these disorders. Endocrine and neuropeptide factors are among the list of possible etiologic or predisposing contenders. The search for an endocrine model to explain the etiopathogenesis of ASD is a new endeavor. In this article, the authors look at some of the emerging literature that is available regarding any possible relationship between the endocrine hormones and factors and whether it can possibly be etiologic or merely coincidental with autism and ASDs.

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9. Soares NS, Patel DR. Office screening and early identification of children with autism. Pediatric clinics of North America. 2012 Feb ;59(1):89-102.

Autism spectrum disorders (ASDs), also called pervasive developmental disorders in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revised), constitute a group of neurodevelopmental disorders that coalesce around a common theme of impairments in social functioning, communication abilities, and repetitive or rigid behaviors. The ASDs considered here include autism/autistic disorder, Asperger disorder/Asperger syndrome (AS), and pervasive developmental disorder not otherwise specified. This article focuses on autism/autistic disorder screening and its early identification, with a brief mention for AS screening, as there are limited tools and no recommendation for universal screening for AS.

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10. Huerta M, Lord C. Diagnostic evaluation of autism spectrum disorders. Pediatric clinics of North America. 2012 Feb ;59(1):103-11.

Research on the identification and evaluation of autism spectrum disorders is reviewed, and best practices for clinical work are discussed. The latest research on diagnostic tools, and their recommended use, is also reviewed. Recommendations include the use of instruments designed to assess multiple domains of functioning and behavior, the inclusion of parents and caregivers as active partners, and the consideration of developmental factors throughout the diagnostic process.

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11. Toriello HV. Approach to the genetic evaluation of the child with autism. Pediatric clinics of North America. 2012 Feb ;59(1):113-28.

Autism is a heterogeneous entity that clearly has a substantial genetic component to its cause. There is likely enough evidence to suggest that there are common genetic mechanisms that predispose to various psychiatric disorders. More recent studies have attempted to identify the specific genes involved in predisposition to autism. In general, such conditions can be subdivided into metabolic, mitochondrial, chromosomal, and monogenic (ie, caused by mutation in a single gene). This article examines what conditions should be considered in the child who does not appear to have a syndromic cause as the reason for the autistic phenotype.

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12. Prelock PJ, Nelson NW. Language and communication in autism : an integrated view. Pediatric clinics of North America. 2012 Feb ;59(1):129-45.

Children with autism spectrum disorders can have varying degrees of difficulty acquiring spoken and written language, but symptoms of communication impairment associated with social impairment are uniformly present, distinguishing autism spectrum disorders from other neurodevelopmental disabilities. Early diagnosis and early intervention involving parents can improve prognosis. Red flags for social communication problems can be observed early. This article summarizes findings from the National Standards Project of the National Autism Center, which identified 11 types of treatment, 8 of which address communication. Both contemporary behavioral approaches and naturalistic developmental approaches are included in this set.

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13. Leblanc LA, Gillis JM. Behavioral interventions for children with autism spectrum disorders. Pediatric clinics of North America. 2012 Feb ;59(1):147-64.

Early intensive behavioral intervention is the only well-established treatment for young children with autism spectrum disorders (ASDs). Less intensive behavioral interventions are also effective for targeted concerns with older children and adolescents. This article describes the core features of behavioral treatments, summarizes the evidence base for effectiveness, and provides recommendations to facilitate family understanding of these interventions and identification of qualified providers. Recommendations are also provided for collaboration between pediatric providers and behavior analysts who are serving families of individuals with ASDs.

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14. Bohlander AJ, Orlich F, Varley CK. Social skills training for children with autism. Pediatric clinics of North America. 2012 Feb ;59(1):165-74.

This article summarizes the current literature on social skills training for children and adolescents with autism spectrum disorders. The article describes several different methods of social skills training, along with a summary of research findings on effectiveness. Interventions described include social skills groups, peer mentoring/training, social stories, and video modeling. The article also describes information about accessing social skills training services, and concludes with future directions and recommendations for pediatricians.

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15. Kaplan G, McCracken JT. Psychopharmacology of autism spectrum disorders. Pediatric clinics of North America. 2012 Feb ;59(1):175-87.

At present, no evidence-based effective pharmacologic options are available for treating the core deficits of autism spectrum disorders (ASDs), which are best addressed by behavioral and educational interventions. However, such evidence exists for several of the frequently associated/comorbid symptoms such as aggression and severe irritability, hyperactivity, and repetitive behaviors, which can become a major source of additional distress and interference in functioning. This article offers information on the psychopharmacology of ASD that is current, relevant, and organized in a user-friendly manner, to form a concise but informative reference guide for primary pediatric clinicians.

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16. Schall C, Wehman P, McDonough JL. Transition from school to work for students with autism spectrum disorders : understanding the process and achieving better outcomes. Pediatric clinics of North America. 2012 Feb ;59(1):189-202.

Individuals and their parents frequently turn to pediatricians, adolescent medicine specialists, and psychologists to answer questions about the course and outcomes of their disorder. This article provides a description of the characteristics of autism spectrum disorders (ASD) in adolescence and early adulthood. It also describes essential elements of high school programs designed to increase positive outcomes for youth with ASD and provides detailed information about various employment support models. Finally, the implications of transition programming for medical specialists and psychologists are discussed.

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17. Suarez MA. Sensory processing in children with autism spectrum disorders and impact on functioning. Pediatric clinics of North America. 2012 Feb ;59(1):203-14.

Children with autism experience many challenges that affect their ability to function. Sensory processing disorder and, specifically, sensory modulation disorder can compound dysfunction and further inhibit participation in productive activities. Through detection of and referral for sensory modulation disorders, treatment can be accessed. Emerging treatment evidence points to functional gains for autism and sensory modulation disorder that can ease the burden that this combination of symptoms has on the everyday life of children with autism.

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