Pubmed du 07/09/17

jeudi 7 septembre 2017

1. Ameis SH. Heterogeneity Within and Between Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder : Challenge or Opportunity ?. JAMA Psychiatry ;2017 (Sep 06)

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2. Aoki Y, Yoncheva YN, Chen B, Nath T, Sharp D, Lazar M, Velasco P, Milham MP, Di Martino A. Association of White Matter Structure With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. JAMA Psychiatry ;2017 (Sep 06)

Importance : Clinical overlap between autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) is increasingly appreciated, but the underlying brain mechanisms remain unknown to date. Objective : To examine associations between white matter organization and 2 commonly co-occurring neurodevelopmental conditions, ASD and ADHD, through both categorical and dimensional approaches. Design, Setting, and Participants : This investigation was a cross-sectional diffusion tensor imaging (DTI) study at an outpatient academic clinical and research center, the Department of Child and Adolescent Psychiatry at New York University Langone Medical Center. Participants were children with ASD, children with ADHD, or typically developing children. Data collection was ongoing from December 2008 to October 2015. Main Outcomes and Measures : The primary measure was voxelwise fractional anisotropy (FA) analyzed via tract-based spatial statistics. Additional voxelwise DTI metrics included radial diffusivity (RD), mean diffusivity (MD), axial diffusivity (AD), and mode of anisotropy (MA). Results : This cross-sectional DTI study analyzed data from 174 children (age range, 6.0-12.9 years), selected from a larger sample after quality assurance to be group matched on age and sex. After quality control, the study analyzed data from 69 children with ASD (mean [SD] age, 8.9 [1.7] years ; 62 male), 55 children with ADHD (mean [SD] age, 9.5 [1.5] years ; 41 male), and 50 typically developing children (mean [SD] age, 9.4 [1.5] years ; 38 male). Categorical analyses revealed a significant influence of ASD diagnosis on several DTI metrics (FA, MD, RD, and AD), primarily in the corpus callosum. For example, FA analyses identified a cluster of 4179 voxels (TFCE FEW corrected P < .05) in posterior portions of the corpus callosum. Dimensional analyses revealed associations between ASD severity and FA, RD, and MD in more extended portions of the corpus callosum and beyond (eg, corona radiata and inferior longitudinal fasciculus) across all individuals, regardless of diagnosis. For example, FA analyses revealed clusters overall encompassing 12121 voxels (TFCE FWE corrected P < .05) with a significant association with parent ratings in the social responsiveness scale. Similar results were evident using an independent measure of ASD traits (ie, children communication checklist, second edition). Total severity of ADHD-traits was not significantly related to DTI metrics but inattention scores were related to AD in corpus callosum in a cluster sized 716 voxels. All these findings were robust to algorithmic correction of motion artifacts with the DTIPrep software. Conclusions and Relevance : Dimensional analyses provided a more complete picture of associations between ASD traits and inattention and indexes of white matter organization, particularly in the corpus callosum. This transdiagnostic approach can reveal dimensional relationships linking white matter structure to neurodevelopmental symptoms.

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3. Barta EA, Guzsvinecz T, Sik Lanyi C, Szucs V. Android-Based Daily Routine Organizing Application for Elementary School Students Living with ASD. Stud Health Technol Inform ;2017 ;242:283-290.

Today, more and more children with Autism Spectrum disorder are diagnosed, which means that around 1% of the population is concerned. Most of the concerned can acquire daily routine tasks by a bit of help and can fit in the society. As Besio et al. said, " is an instinctive need for both humans....In children with disabilities, depending on the type of functional limitations, the spontaneity of play is lost and the activity becomes problematic. Children with cognitive and intellectual impairments have a difficulties in communication, social interactions,....Since play is also a window for children’s cognitive development, children may be perceived as more developmentally delayed than they actually are, leading to reduce expectations on the part of adults." The aim of the authors was to create an Android based application which helps 6-9 year old children living with Autism Spectrum disorder to learn everyday tasks and acquire everyday routine.

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4. Borsos Z, Gyori M. Can Automated Facial Expression Analysis Show Differences Between Autism and Typical Functioning ?. Stud Health Technol Inform ;2017 ;242:797-804.

Exploratory analyses of emotional expressions using a commercially available facial expression recognition software are reported, from the context of a serious game for screening purposes. Our results are based on a comparative analysis of two matched groups of kindergarten-age children (high-functioning children with autism spectrum condition : n=13 ; typically developing children : n=13). Results indicate that this technology has the potential to identify autism-specific emotion expression features, and may play a role in affective diagnostic and assistive technologies.

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5. Budimirovic DB. Can a Neurosteroid Ameliorate Fragile X-Associated Tremor/Ataxia Syndrome ?. Neurotherapeutics ;2017 (Sep 07)

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6. Chyung E, LeBlanc HF, Fallon JR, Akins MR. Fragile X granules are a family of axonal ribonucleoprotein particles with circuit-dependent protein composition and mRNA cargos. J Comp Neurol ;2017 (Sep 07)

Local axonal protein synthesis plays a crucial role in the formation and function of neuronal circuits. Understanding the role of this mechanism in specific circuits requires identifying the protein composition and mRNA cargos of the ribonucleoprotein particles (RNPs) that form the substrate for axonal translation. FXGs (Fragile X granules) are axonal RNPs present in a stereotyped subset of mature axons in the intact brain that contain one or more of the Fragile X related (FXR) proteins (FMRP, FXR2P, and FXR1P) along with mRNA and ribosomes. Here we performed a systematic survey of the FXR protein composition and mRNA association of FXGs in the brain. We have identified four FXG types that can be categorized based on their FXR protein complement. All FXGs contain FXR2P, with FMRP and/or FXR1P present in circuit-selective subsets. Individual neuronal cell types predominantly express a single FXG type, with FMRP-containing FXGs the most prevalent in forebrain neurons. All FXG types associate with ribosomes and mRNA, but the specific mRNA cargos are a function of FXG type, brain region and neuron class. Transcripts for beta-catenin and its regulator APC associate with a subset of forebrain FXGs. Moreover, both these transcripts can colocalize within individual FXGs, suggesting that the axonal translation of functionally related proteins may be coordinately regulated with high spatiotemporal resolution. Cell type-dependent expression of specific RNP types with distinct mRNA cargos, such as FXGs, presents a potential mechanism for regulating local translation and its output in a circuit-dependent manner. This article is protected by copyright. All rights reserved.

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7. Desideri L, Negrini M, Cutrone MC, Rouame A, Malavasi M, Hoogerwerf EJ, Bonifacci P, Di Sarro R. Exploring the Use of a Humanoid Robot to Engage Children with Autism Spectrum Disorder (ASD). Stud Health Technol Inform ;2017 ;242:501-509.

We present a study aimed at exploring whether a humanoid robot may improve the effectiveness of educational interventions targeting children with autism spectrum disorders (ASD). Preliminary results with three preschool children with ASD indicate that interacting with a humanoid robot may facilitate engagement and goal achievement in educational activities.

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8. Douglas MD, Benevides TW, Carretta H. Analyzing State Autism Private Insurance Mandates for Allied Health Services : A Pilot Study. OTJR (Thorofare N J) ;2017 (Sep 01):1539449217730355.

Due to the prevalence, severity, and costs associated with autism spectrum disorders (ASDs), it has become a public health issue. In response, state governments have adopted ASD-specific private insurance mandates requiring coverage of ASD screening, diagnosis, and treatment. Despite rapid uptake of these laws, differences exist in the type and levels of coverage, especially for allied health services including occupational therapy. We piloted a structured legal research methodology to code ASD insurance mandates that impact allied health service provisions. State private insurance mandates were obtained from WestlawNext. A coding methodology was piloted on 14 states and included variables for age and service limits, treatments covered, and medical necessity. Coding methods were feasible and highly reliable among raters. Ten of 12 states had a coverage mandate, many with specific provisions for allied health providers. A full analysis of all 50 states is warranted to identify provisions affecting allied health providers serving individuals with ASD.

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9. Fujita R, Zismanov V, Jacob JM, Jamet S, Asiev K, Crist C. Fragile X mental retardation protein regulates skeletal muscle stem cell activity by regulating the stability of Myf5 mRNA. Skelet Muscle ;2017 (Sep 07) ;7(1):18.

BACKGROUND : Regeneration of adult tissues relies on adult stem cells that are primed to enter a differentiation program, while typically remaining quiescent. In mouse skeletal muscle, these features are reconciled by multiple translational control mechanisms that ensure primed muscle stem cells (MuSCs) are not activated. In quiescent MuSCs, this concept is illustrated by reversible microRNA silencing of Myf5 translation, mediated by microRNA-31 and fragile X mental retardation protein (FMRP). METHODS : In this work, we take advantage of FMRP knockout (Fmr1 -/- ) mice to support the role for FMRP in maintaining stem cell properties of the MuSC. We compare the activity of MuSCs in vivo after acute injury and engraftment, as well as ex vivo during culture. We use RNA immunoprecipitation and 3’UTR poly-adenine (poly(A)) length assays to assess the impact of FMRP on the stability of transcripts for myogenic regulatory factors. RESULTS : We show that RNA-binding FMRP is required to maintain the MuSC pool. More specifically, FMRP is required for stem cell properties of muscle stem cells, which include MuSC capacity to prime the myogenic program, their self-renewal, and their capacity to efficiently regenerate muscle. We provide evidence that FMRP regulation of MuSC activity occurs in part by the capacity of FMRP to directly bind Myf5 transcripts and impact rates of Myf5 deadenylation. CONCLUSIONS : Our results provide further evidence supporting a role for post-transcriptional silencing platforms by RNA-binding proteins in maintaining stemness properties of adult stem cells. In addition, deregulated MuSC activity in the absence of Fmr1 may have implications for fragile X syndrome, which is associated with muscle hypotonia during infancy.

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10. Genik LM, McMurtry CM, Breau LM, Lewis SP, Freedman-Kalchman T. Pain in Children with Developmental Disabilities : Development and Preliminary Effectiveness of a Pain Training Workshop for Respite Workers. Clin J Pain ;2017 (Sep 01)

INTRODUCTION : Pain in children with intellectual disabilities (ID) is common and complex, yet there is no standard pain training for their secondary caregivers. OBJECTIVES : Determine perceived pain training needs/preferences of children’s respite staff (Phase One) and, use this information combined with extant research and guidelines to develop and pilot a training (Phase Two). METHODS : In Phase One, 22 participants responded to questionnaires and engaged in individual interviews/focus groups about their experiences with pain in children with ID, and perceived training needs/preferences. In Phase Two, 50 participants completed knowledge measures and rated the feasibility of, and their own confidence and skill in, pain assessment and management for children with ID immediately before and after completing a pain training. They also completed a training evaluation. RESULTS : Participants viewed a pain training as beneficial. Their ideal training involved a half-day, multifaceted in person program with a relatively small group of trainees incorporating a variety of learning activities, and an emphasis on active learning. Phase Two results suggested that completion of the 3-3.5 hour pain training significantly increased respite workers’ pain-related knowledge (large effect sizes : r=0.81-0.88), as well as their ratings of the feasibility of, and their own confidence and skill in, pain assessment and management in children with ID (moderate to large effect sizes : r=0.41-0.70). The training was rated favorably. DISCUSSION : Training can positively impact respite workers’ knowledge and perceptions about pain assessment and management. As such, they may be better equipped to care for children with ID in this area.

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11. Hong M, Lee SY, Han J, Park JC, Lee YJ, Hwangbo R, Chang H, Cho SW, Bhang SY, Kim B, Hwang JW, Bahn GH. Prescription Trends of Psychotropics in Children and Adolescents with Autism Based on Nationwide Health Insurance Data. J Korean Med Sci ;2017 (Oct) ;32(10):1687-1693.

Children with autism are often medicated to manage emotional and behavioral symptoms ; yet, data on such pharmacotherapy is insufficient. In this study, we investigated the Korean National Health Insurance Claims Database (NHICD) information related to autism incidence and psychotropic medication use. From the 2010-2012 NHICD, we selected a total of 31,919,732 subjects under 19 years old. To examine the diagnostic incidence, we selected patients who had at least one medical claim containing an 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for pervasive developmental disorder, F84, not diagnosed in the previous 360 days. Psychotropics were categorized into seven classes. Then, we analyzed the data to determine the mean annual diagnostic incidence and psychotropic prescription trends. Diagnostic incidence was 17,606 for the 3 years, with a mean annual incidence per 10,000 population of 5.52. Among them, 5,348 patients were prescribed psychotropics. Atypical antipsychotics were the most commonly used, followed by antidepressants. An older age, male sex, and the availability of medical aid were associated with a higher rate of prescription than observed for a younger age, female sex, and the availability of health insurance. Psychotropic drugs were used for less than one-third of patients newly diagnosed with autism, and prescription differed by sex and age. Increased diagnostic incidence is associated with an increased prescription of psychotropic drugs. Therefore, medication-related safety data and policies for psychotropic drugs in autism should be prepared.

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12. Keim SA, Sheppard KW. Long-standing Challenges to Exposure Measurement and Outcome Definitions : the Case of Alcohol and Autism Spectrum Disorder. Paediatr Perinat Epidemiol ;2017 (Sep 07)

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13. Korb E, Herre M, Zucker-Scharff I, Gresack J, Allis CD, Darnell RB. Excess Translation of Epigenetic Regulators Contributes to Fragile X Syndrome and Is Alleviated by Brd4 Inhibition. Cell ;2017 (Sep 07) ;170(6):1209-1223.e1220.

Fragile X syndrome (FXS) is a leading genetic cause of intellectual disability and autism. FXS results from the loss of function of fragile X mental retardation protein (FMRP), which represses translation of target transcripts. Most of the well-characterized target transcripts of FMRP are synaptic proteins, yet targeting these proteins has not provided effective treatments. We examined a group of FMRP targets that encode transcriptional regulators, particularly chromatin-associated proteins. Loss of FMRP in mice results in widespread changes in chromatin regulation and aberrant gene expression. To determine if targeting epigenetic factors could reverse phenotypes associated with the disorder, we focused on Brd4, a BET protein and chromatin reader targeted by FMRP. Inhibition of Brd4 function alleviated many of the phenotypes associated with FXS. We conclude that loss of FMRP results in significant epigenetic misregulation and that targeting transcription via epigenetic regulators like Brd4 may provide new treatments for FXS.

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14. Krupp DR, Barnard RA, Duffourd Y, Evans SA, Mulqueen RM, Bernier R, Riviere JB, Fombonne E, O’Roak BJ. Exonic Mosaic Mutations Contribute Risk for Autism Spectrum Disorder. Am J Hum Genet ;2017 (Sep 07) ;101(3):369-390.

Genetic risk factors for autism spectrum disorder (ASD) have yet to be fully elucidated. Postzygotic mosaic mutations (PMMs) have been implicated in several neurodevelopmental disorders and overgrowth syndromes. By leveraging whole-exome sequencing data on a large family-based ASD cohort, the Simons Simplex Collection, we systematically evaluated the potential role of PMMs in autism risk. Initial re-evaluation of published single-nucleotide variant (SNV) de novo mutations showed evidence consistent with putative PMMs for 11% of mutations. We developed a robust and sensitive SNV PMM calling approach integrating complementary callers, logistic regression modeling, and additional heuristics. In our high-confidence call set, we identified 470 PMMs in children, increasing the proportion of mosaic SNVs to 22%. Probands have a significant burden of synonymous PMMs and these mutations are enriched for computationally predicted impacts on splicing. Evidence of increased missense PMM burden was not seen in the full cohort. However, missense burden signal increased in subcohorts of families where probands lacked nonsynonymous germline mutations, especially in genes intolerant to mutations. Parental mosaic mutations that were transmitted account for 6.8% of the presumed de novo mutations in the children. PMMs were identified in previously implicated high-confidence neurodevelopmental disorder risk genes, such as CHD2, CTNNB1, SCN2A, and SYNGAP1, as well as candidate risk genes with predicted functions in chromatin remodeling or neurodevelopment, including ACTL6B, BAZ2B, COL5A3, SSRP1, and UNC79. We estimate that PMMs potentially contribute risk to 3%-4% of simplex ASD case subjects and future studies of PMMs in ASD and related disorders are warranted.

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15. Lassalle A, Asberg Johnels J, Zurcher NR, Hippolyte L, Billstedt E, Ward N, Lemonnier E, Gillberg C, Hadjikhani N. Hypersensitivity to low intensity fearful faces in autism when fixation is constrained to the eyes. Hum Brain Mapp ;2017 (Sep 07)

Previous studies that showed decreased brain activation in people with autism spectrum disorder (ASD) viewing expressive faces did not control that participants looked in the eyes. This is problematic because ASD is characterized by abnormal attention to the eyes. Here, we collected fMRI data from 48 participants (27 ASD) viewing pictures of neutral faces and faces expressing anger, happiness, and fear at low and high intensity, with a fixation cross between the eyes. Group differences in whole brain activity were examined for expressive faces at high and low intensity versus neutral faces. Group differences in neural activity were also investigated in regions of interest within the social brain, including the amygdala and the ventromedial prefrontal cortex (vmPFC). In response to low intensity fearful faces, ASD participants showed increased activation in the social brain regions, and decreased functional coupling between the amygdala and the vmPFC. This oversensitivity to low intensity fear coupled with a lack of emotional regulation capacity could indicate an excitatory/inhibitory imbalance in their socio-affective processing system. This may result in social disengagement and avoidance of eye-contact to handle feelings of strong emotional reaction. Our results also demonstrate the importance of careful control of gaze when investigating emotional processing in ASD. Hum Brain Mapp, 2017. (c) 2017 Wiley Periodicals, Inc.

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16. Li YJ, Li YM, Xiang DX. Supplement intervention associated with nutritional deficiencies in autism spectrum disorders : a systematic review. Eur J Nutr ;2017 (Sep 07)

PURPOSE : Nutritional supplements have been used for correction of deficiencies that may occur in patient with autism spectrum disorder (ASD) and to improve core symptoms. We aim to provide current best evidence about supplements for nutritional deficiencies and core symptoms in children with ASD and to evaluate the effectiveness and safety. METHODS : A systematic literature search of scientific databases was performed to retrieve relevant randomized controlled trials. Risk of bias was assessed for each study. RESULTS : 18 randomized controlled trials of five supplements were included. B6/Mg was not helpful for improving ASD symptoms (seven RCTs). Two RCTs of methyl B12 reported some improvement in ASD severity but the effects on the correction of deficiencies were inconclusive. Two RCTs of vitamin D3 both reported increased levels of mean 25(OH)D in serum but inconsistent results in behavioral outcomes. Omega-3 fatty acid supplementation did not affect ASD behaviors but may correct deficiencies (six RCTs). One RCT of folinic acid reported positive results in improving ASD symptoms measured by various behavioral scales. CONCLUSIONS : Current evidence for the use of supplements for correcting nutritional deficiencies in children with ASD and to improve the symptoms is little. More studies are needed.

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17. Morrier MJ, Ousley OY, Caceres-Gamundi GA, Segall MJ, Cubells JF, Young LJ, Andari E. Brief Report : Relationship Between ADOS-2, Module 4 Calibrated Severity Scores (CSS) and Social and Non-Social Standardized Assessment Measures in Adult Males with Autism Spectrum Disorder (ASD). J Autism Dev Disord ;2017 (Sep 05)

The ADOS-2 Modules 1-3 now include a standardized calibrated severity score (CSS) from 1 to 10 based on the overall total raw score. Subsequent research published CSS for Module 4 (Hus, Lord, Journal of Autism and Developmental Disorders 44(8):1996-2012, 2014) ; however more research is needed to examine the psychometric properties of this CSS. Forty males with ASD completed an assessment battery consisting of ADOS-2 Module 4 and other clinical measures assessing core ASD symptomology and comorbidity. Pearson correlation analyses found that CSS did not correlate with measures that assessed core social deficits of ASD or general psychiatric co-morbidity, but CSS did correlate negatively with intellectual quotient. These findings provide information on the limitations and relevance of CSS to be taken into account in future clinical evaluations of ASD.

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18. O’Brolchain F, Gordijn B. Risks of Stigmatisation Resulting from Assistive Technologies for People with Autism Spectrum Disorder. Stud Health Technol Inform ;2017 ;242:265-268.

This short paper presents a philosophical analysis of the ways in which assistive technologies (ATs) can result in the stigmatisation of users with ASD. It frames the discussion in the context of the medical and social models of disability and outlines a number of ethical risks that might arise from the project of developing ATs.

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19. Singer AB, Aylsworth AS, Cordero C, Croen LA, DiGuiseppi C, Fallin MD, Herring AH, Hooper SR, Pretzel RE, Schieve LA, Windham GC, Daniels JL. Prenatal Alcohol Exposure in Relation to Autism Spectrum Disorder : Findings from the Study to Explore Early Development (SEED). Paediatr Perinat Epidemiol ;2017 (Sep 07)

BACKGROUND : Prenatal alcohol exposure can affect neurodevelopment, but few studies have examined associations with autism spectrum disorder (ASD). METHODS : We assessed the association between maternal alcohol use and ASD in the Study to Explore Early Development, a multi-site case-control study of children born between September 2003 and August 2006 in the US Regression analyses included 684 children with research clinician-confirmed ASD, 869 children with non-ASD developmental delays or disorders (DDs), and 962 controls ascertained from the general population (POP). Maternal alcohol exposure during each month from 3 months prior to conception until delivery was assessed by self-report. RESULTS : Mothers of POP children were more likely to report any prenatal alcohol use than mothers of children with ASD or DD. In trimester one, 21.2% of mothers of POP children reported alcohol use compared with 18.1% and 18.2% of mothers of children with ASD or DD, respectively (adjusted OR for ASD vs. POP 0.8, 95% confidence interval 0.6, 1.1). During preconception and the first month of pregnancy, one to two drinks on average per week was inversely associated with ASD risk. CONCLUSIONS : These results do not support an adverse association between low-level alcohol exposure and ASD, although these findings were based on retrospective self-reported alcohol use. Unmeasured confounding or exposure misclassification may explain inverse associations with one to two drinks per week. Pregnant or potentially pregnant women should continue to follow recommendations to avoid alcohol use because of other known effects on infant health and neurodevelopment.

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20. Swedish Council on Health Technology A. SBU Systematic Review Summaries. Autism Spectrum Disorders : Diagnosis and Interventions, Organization of Care and Patient Involvement. Stockholm : Swedish Council on Health Technology Assessment (SBU)
Copyright (c) 2013 by the Swedish Council on Health Technology Assessment., 2013.

Conclusions : Autism spectrum disorders in many cases involve major disabilities, and the instruments for diagnostic assessment should be better researched. There is scientific support for 2 of the 14 instruments evaluated. These instruments are Autism Diagnostic Interview-Revised (ADI-R) and Social Communication Questionnaire (SCQ) for autism spectrum disorders. For details of the diagnostic sensitivity and reliability of the two methods see the section "Evidence graded results". There is insufficient scientific evidence to draw any conclusions regarding other diagnostic instruments and assessment forms. As the instruments have not been adequately evaluated, the diagnostic process should remain within the sphere of specialised care. It is also important to follow up the use of diagnostic instruments and assessment forms. Many different interventions and treatments, apart from drugs, are currently used but knowledge of their benefits, risks and costs must be improved. We have identified 25 different interventions and treatment methods that are used with autism spectrum disorders. The scientific evidence for assessing the effectiveness of these is insufficient. Training which involves a combination of several methods is normal in Sweden, but its effectiveness has not been studied. Drug treatment with risperidone reduces severe behavioural disturbances such as aggression and self-destructive behaviour in individuals with autism spectrum disorders. In children with autistic disorder short term treatment (2 months) with risperidone produces a slightly better effect than placebo in cases of severe behavioural disturbances such as social withdrawal, hyperactivity and stereotypical behaviour. A common side effect is weight gain. Studies are needed into how care and community-based interventions should best be organised and coordinated for individuals with autism spectrum disorders. The involvement of people with autism spectrum disorders and their families need to be improved. They should be asked more about their own ideas on care and schooling. At present people with autism spectrum disorders and their families experience stigmatisation, social isolation, a lack of knowledge amongst healthcare and school personnel, a lack of resources and a sense of powerlessness. Early diagnosis can reduce stigmatisation. It is also important that a lack of involvement does not impede the efforts of the care system and schools to achieve good communication and contact. It is also important to pay particular attention to siblings, who might otherwise experience problems with social relationships and sometimes might even be exposed to intimidating and violent behaviour. The scientific knowledge concerning the importance of involvement in autism spectrum disorders can be improved substantially.

21. Turner D, Briken P, Schottle D. Autism-spectrum disorders in adolescence and adulthood : focus on sexuality. Curr Opin Psychiatry ;2017 (Sep 04)

PURPOSE OF REVIEW : The combination of the core symptoms, characterizing individuals with autism-spectrum disorder (ASD), can lead to problems in romantic relationships and sexual functioning. The purpose of this article is to review studies on sexuality in individuals with ASD published since January 2016. RECENT FINDINGS : Individuals with ASD and especially women show a higher diversity in sexual orientation in comparison with the non-ASD population. Furthermore, ASD women are more frequently in a relationship and usually report more previous sexual experiences. Up to now, sexual education programs specifically addressing the needs of the ASD population were scarce, which was criticized by patients, their parents, and caregivers. With the development of the Tackling Teenage Training program, a psychoeducational intervention designed specifically for ASD individuals was introduced, leading to significant improvements in psychosexual functioning and knowledge. Such programs are needed because a considerable rate of problematic sexual behaviors, including public masturbation and paraphilic sexual interests were found in the ASD population. SUMMARY : Just like their typically developing counterparts, individuals with ASD show the whole range of normal-to-problematic sexual behaviors. Improving sexual knowledge could lead to less inappropriate sexual behaviors and could improve sexual health as part of a healthy and satisfying life.

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22. Yakkundi A, Dillenburger K, Goodman L, Dounavi K. User Centered Reading Intervention for Individuals with Autism and Intellectual Disability. Stud Health Technol Inform ;2017 ;242:249-256.

Individuals with autism and intellectual disability (ID) have complex learning needs and often have difficulty in acquiring reading comprehension skills using conventional teaching tools. Evidence based reading interventions for these learners and the use of assistive technology and application of behaviour analysis to develop user-centered teaching is discussed in this paper.

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23. Zamberletti E, Gabaglio M, Parolaro D. The Endocannabinoid System and Autism Spectrum Disorders : Insights from Animal Models. Int J Mol Sci ;2017 (Sep 07) ;18(9)

Autism spectrum disorder (ASD) defines a group of neurodevelopmental disorders whose symptoms include impaired communication and social interaction with restricted or repetitive motor movements, frequently associated with general cognitive deficits. Although it is among the most severe chronic childhood disorders in terms of prevalence, morbidity, and impact to the society, no effective treatment for ASD is yet available, possibly because its neurobiological basis is not clearly understood hence specific drugs have not yet been developed. The endocannabinoid (EC) system represents a major neuromodulatory system involved in the regulation of emotional responses, behavioral reactivity to context, and social interaction. Furthermore, the EC system is also affected in conditions often present in subsets of patients diagnosed with ASD, such as seizures, anxiety, intellectual disabilities, and sleep pattern disturbances. Despite the indirect evidence suggestive of an involvement of the EC system in ASD, only a few studies have specifically addressed the role of the EC system in the context of ASD. This review describes the available data on the investigation of the presence of alterations of the EC system as well as the effects of its pharmacological manipulations in animal models of ASD-like behaviors.

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