Pubmed du 17/04/09

lundi 20 avril 2009

1. Bogte H, Flamma B, Van Der Meere J, Van Engeland H. Divided attention capacity in adults with autism spectrum disorders and without intellectual disability. Autism ;2009 (May) ;13(3):229-243.

Earlier research showed that divided attention, an aspect of executive function, is limited in both children and adults with autism spectrum disorders (ASDs). The current study explored divided attention capacity in adults with ASD and without intellectual disability (n = 36). Divided attention was tested using a computerized variant of a well-known memory recognition test, with two levels of cognitive load. The effect of cognitive load on reaction time performance is considered to be inversely proportional to divided attention capacity. The study failed to provide a relationship between divided attention and ASD, contrary to earlier research. Findings indicated that only the adults with ASD who used medication had a divided attention deficit, and that this group had specific difficulty reaching a binary decision in a memory search task. An additional finding was that the participants with ASD were overall slow. Possible causes and implications of these findings are discussed.

2. Bramham J, Ambery F, Young S, Morris R, Russell A, Xenitidis K, Asherson P, Murphy D. Executive functioning differences between adults with attention deficit hyperactivity disorder and autistic spectrum disorder in initiation, planning and strategy formation. Autism ;2009 (May) ;13(3):245-264.

Executive functioning deficits characterize the neuropsychological profiles of the childhood neurodevelopmental disorders of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD). This study sought to determine whether similar impairments exist in adults with ADHD (N = 53) and ASD (N = 45) in comparison with a healthy control group (N = 31), whether the two disorders can be distinguished on the basis of their executive functioning features, and whether these impairments are related to symptom severity. Both clinical groups were found to exhibit executive functioning deficits. The ADHD group had difficulty withholding a response, with relative preservation of initiation and planning abilities. In contrast, the ASD group exhibited significant impairments in initiation, planning and strategy formation. The specific executive functioning deficits were related to severity of response inhibition impairments in ADHD and stereotyped, repetitive behaviours in ASD. These findings suggest the pattern of executive functioning deficits follows a consistent trajectory into adulthood.

3. Causton-Theoharis J, Ashby C, Cosier M. Islands of loneliness : exploring social interaction through the autobiographies of individuals with autism. Intellect Dev Disabil ;2009 (Apr) ;47(2):84-96.

Assumptions of difficulties with social interaction, or lack of interest in social interaction, are central to many definitions and conventional understandings of autism. However, many individuals with autism describe a strong craving social interaction. This article uses autobiographical accounts written by individuals who identified as autistic as a source of qualitative research data and specifically explores the ways these texts address issues of social relationships. Using narrative inquiry, the authors explored how individuals with autism described their own notions of and experiences with social interaction. This article discusses the broad themes of (a) the desire to have connections and (b) navigation through the world of people. Last, implications for the education of individuals with autism are considered.

4. Cimera RE, Cowan RJ. The costs of services and employment outcomes achieved by adults with autism in the US. Autism ;2009 (May) ;13(3):285-302.

This article examines the cost of services and employment outcomes obtained by adults with autism within the United States vocational rehabilitation (VR) system. It found that the number of such individuals has increased by more than 121 percent from 2002 to 2006. Moreover, though adults with autism were employed at higher rates than most disability groups investigated, they tended to work far fewer hours and earn less in wages per week. The study also found that adults with autism were among the most costly individuals to serve.

5. Crane L, Goddard L, Pring L. Sensory processing in adults with autism spectrum disorders. Autism ;2009 (May) ;13(3):215-228.

Unusual sensory processing has been widely reported in autism spectrum disorders (ASDs) ; however, the majority of research in this area has focused on children. The present study assessed sensory processing in adults with ASD using the Adult/Adolescent Sensory Profile (AASP), a 60-item self-report questionnaire assessing levels of sensory processing in everyday life. Results demonstrated that sensory abnormalities were prevalent in ASD, with 94.4 percent of the ASD sample reporting extreme levels of sensory processing on at least one sensory quadrant of the AASP. Furthermore, analysis of the patterns of sensory processing impairments revealed striking within-group variability in the ASD group, suggesting that individuals with ASD could experience very different, yet similarly severe, sensory processing abnormalities. These results suggest that unusual sensory processing in ASD extends across the lifespan and have implications regarding both the treatment and the diagnosis of ASD in adulthood.

6. Dworzynski K, Happe F, Bolton P, Ronald A. Relationship Between Symptom Domains in Autism Spectrum Disorders : A Population Based Twin Study. J Autism Dev Disord ;2009 (Apr 17)

Factor structure and relationship between core features of autism (social impairments, communication difficulties, and restricted, repetitive behaviours or interests (RRBIs)) were explored in 189 children from the Twins Early Development Study, diagnosed with autistic spectrum disorders (ASDs) using the Development and Wellbeing Assessment (DAWBA ; Goodman et al. in J Child Psychol Psyc 41:645-655, 2000). A bottom-up approach (analysis 1) used principal component factor analysis of DAWBA items indicating five factors, the first three mapping on the triad. In analysis 2, applying top-down DSM-IV criteria, correlations between domains were modest, strongest between social and communication difficulties. Cross-twin cross-trait correlations suggested small shared genetic effects between RRBIs and other symptoms. These findings from a clinical sample of twins indicate a fractionation of social/communicative and RRBI symptoms in ASD.

7. Knapp M, Romeo R, Beecham J. Economic cost of autism in the UK. Autism ;2009 (May) ;13(3):317-336.

Autism has lifetime consequences, with potentially a range of impacts on the health, wellbeing, social integration and quality of life of individuals and families. Many of those impacts are economic. This study estimated the costs of autism spectrum disorders (ASDs) in the UK. Data on prevalence, level of intellectual disability and place of residence were combined with average annual costs of services and support, together with the opportunity costs of lost productivity. The costs of supporting children with ASDs were estimated to be pound2.7 billion each year. For adults, these costs amount to pound25 billion each year. The lifetime cost, after discounting, for someone with ASD and intellectual disability is estimated at approximately pound1.23 million, and for someone with ASD without intellectual disability is approximately pound0.80 million.

8. Malone RP, Waheed A. The role of antipsychotics in the management of behavioural symptoms in children and adolescents with autism. Drugs ;2009 ;69(5):535-548.

Autistic disorder or autism is a serious childhood-onset disorder that affects all areas of development, particularly in the areas of language, communication and reciprocal social interaction. Patients with autistic disorder typically demonstrate repetitiveness and a restricted repertoire of behaviour. Additionally, they also have a number of disruptive symptoms that may be reduced by drug treatment, including severe tantrums, hyperactivity and lability. Antipsychotic drugs are the agents that are the most critically studied as treatments for reducing symptoms. Both first- and second-generation antipsychotics have shown safety and efficacy in short- and long-term studies in autism. The most studied antipsychotic drugs include haloperidol and risperidone, although studies of other antipsychotic drugs are underway. Safety concerns associated with treatment include the risk of drug-related dyskinesias, which is greater with the first-generation drugs, and the risk of weight gain and associated metabolic problems (i.e. increases in glucose and lipids), which is greater with second-generation agents. Prescription of antipsychotic drugs requires careful monitoring because of these safety risks and the likelihood of long-term use. Drug administration should be initiated at low dosages and subsequent dosage changes should be based on tolerability and clinical response.

9. Punshon C, Skirrow P, Murphy G. The ;not guilty verdict’ : Psychological reactions to a diagnosis of Asperger syndrome in adulthood. Autism ;2009 (May) ;13(3):265-283.

Asperger syndrome is a relatively new diagnostic classification. A number of factors make receiving a diagnosis of Asperger syndrome in adulthood a unique experience. This study used a phenomenological approach to examine the experiences of 10 adults receiving such a diagnosis. Results suggested that six major themes were associated with receiving a diagnosis of Asperger syndrome. Individuals discussed their negative life experiences and their experience of services prior to diagnosis, which led to individuals holding certain beliefs about the symptoms of Asperger syndrome. These beliefs had an effect on the formation of each individual’s perceived self-identity. Participants made links between how they felt when they received the diagnosis and their current beliefs about both their ;symptoms’ and themselves. Finally, participants highlighted the importance of the societal view of Asperger syndrome. The implications of these findings are reappraised in the context of previous research and the wider literature on identity formation.

10. Raznahan A, Pugliese L, Barker GJ, Daly E, Powell J, Bolton PF, Murphy DG. Serotonin transporter genotype and neuroanatomy in autism spectrum disorders. Psychiatr Genet ;2009 (Apr 14)

There is increasing evidence that people with autism spectrum disorders (ASDs) have abnormalities in the serotonergic system. For example, a functional polymorphism of the serotonin transporter gene promoter region (5HTTLPR long/short polymorphism) has been reported to confer risk for ASDs, and to affect cortical grey matter volume in young children. However, the persistence of this association later in development is unknown. Hence, we investigated whether variation in the 5HTTLPR long/short polymorphism modulates brain anatomy in older people with ASD. We related 5HTTLPR long/short polymorphism in 43 adolescents and adults with ASD to brain anatomy using structural magnetic resonance imaging and voxel-based morphometry. There were no significant associations between brain anatomy and genotype. When considered alongside evidence of a relationship between 5HTTLPR genotype and brain volume amongst children with autism, our findings raise the possibility that the relationship between 5HTTLPR polymorphism and brain anatomy in ASDs anatomy may differ as a function of age and/or ASD subdiagnosis.

11. Saldana D, Alvarez RM, Lobaton S, Lopez AM, Moreno M, Rojano M. Objective and subjective quality of life in adults with autism spectrum disorders in southern Spain. Autism ;2009 (May) ;13(3):303-316.

Subjective and objective measures of quality of life (QoL) were obtained for adults with autism spectrum disorders (ASDs) living in Andalusia (Spain). Seventy-four families responded to questionnaires about objective QoL indicators such as employment, health, adaptive behaviour and social network, and were asked to act as proxies for subjective QoL measures. Outcome on objective QoL was extremely poor. Social networks were most frequently composed of family members. Community-oriented resources were absent in most cases. For two-thirds of the families, the ability to act as proxies for subjective QoL was seriously limited by the participants’ poor social and communicative abilities. The results are indicative of the need for additional support to families of adults with ASD and increased community-based resources. Further conceptualization of indicators and measurement of subjective QoL in individuals with severe disabilities and ASD is also needed in order to include their own perspective in the evaluation of service provision.

12. Vatta F, Mininel S, Colafati SG, D’Errico L, Malena S, Di Salle F. A novel tool for the morphometric analysis of corpus callosum : applications to the diagnosis of autism - biomed 2009. Biomed Sci Instrum ;2009 ;45:442-448.

Autism is a developmental disorder characterized by social deficits, impaired communication, and restricted and repetitive patterns of behaviour. Emerging theories indicate interregional functional and anatomical brain connectivity as a likely key feature in autism pathophysiology. Corpus callosum (CC) represents a natural target of autism connectivity research, being the expression of interhemispheric communication. In this paper, a novel method for a robust morphometric analysis of CC data is presented. The standard morphometric approach is based on the analysis of the size and shape of the CC midsagittal cross-section. As there are no gross anatomical landmarks that clearly delimit anatomically or functionally distinct CC regions, several geometric partitioning schemes have been proposed in the literature for morphometric analysis, subdividing CC into subregions whose fiber topography is expected to target different hemispheric cortical regions. A novel tool of morphometric analysis, based on the automated subdivision of a high number of partitions from a CC centroid and on the consequent determination of the CC anatomical landmarks is presented, allowing an automated analysis of CC volumes, shapes and curvatures, suitable for an automated application in clinical environment. Moreover the proposed tool can be used for original post-processing and visualization techniques that may help in the analysis of possible alterations of CC and in the correlations with autism-related diseases. The proposed morphometric tool has been validated and applied for clinical investigation on brain morphometry in children (age 3-11 years) with autism or with other autism spectrum disorders (DSA) and on healthy control subjects who underwent volumetric MRI T1 weighted acquisitions.

13. Woodcock A, Woolner A, Benedyk R. Applying the Hexagon-Spindle Model to the design of school environments for children with Autistic spectrum disorders. Work ;2009 ;32(3):249-259.

Schools and other educational environments beyond serving as the primary work places of children provide the backdrop against which formative emotional, psychological, cognitive and physical development takes place. However, ergonomists have paid little attention to the design of these environments, the interactions within them or their organization from a child’s perspective. Children with special education needs, such as those with hearing or visual difficulties, cognitive or social disabilities, or even those with different learning styles may be placed in mainstream schools ill-equipped to suit their needs. Rather than retrofitting classrooms as children with different requirements enter the school, a ground-up approach could be taken to create effective educational environments based on an understanding of the learning tasks to be supported, the learner characteristics and the facilities and interactions needed to effect task completion. The application of an holistic ergonomic model, such as the Hexagon-Spindle model [1,2] provides a means of systematically considering the variables which need to be included in the design and evaluation of such environments. This paper presents a case study of the application of this model to the design of low sensory classrooms and interactive learning experiences for children with an autistic spectrum disorder.


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