Pubmed du 28/12/17

jeudi 28 décembre 2017

1. Argou-Cardozo I, Cano Martin JA, Zeidan-Chulia F. Dental amalgam fillings and the use of technological devices as an environmental factor : Updating the cumulative mercury exposure-based hypothesis of autism. Eur J Dent ;2017 (Oct-Dec) ;11(4):569-570.

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2. Bjork M, Riedel B, Spigset O, Veiby G, Kolstad E, Daltveit AK, Gilhus NE. Association of Folic Acid Supplementation During Pregnancy With the Risk of Autistic Traits in Children Exposed to Antiepileptic Drugs In Utero. JAMA Neurol ;2017 (Dec 26)

Importance : Strategies to prevent autism in children exposed to antiepileptic drugs (AEDs) during pregnancy are important. Objective : To explore whether folic acid supplementation and folate status in pregnancy are associated with reduced risk of autistic traits owing to in utero AED exposure. Design, Setting, and Participants : The population-based, prospective Norwegian Mother and Child Cohort Study approached Norwegian-speaking women attending routine ultrasonographic examinations from June 1999 through December 31, 2008 (163844 of 277702 women refused). No exclusion criteria were applied beyond language. Questionnaires during and after pregnancy, analysis of blood samples, and linkage to the Medical Birth Registry of Norway were performed. Children aged 18 to 36 months of women with available information on use of AEDs and of folic acid supplementation (n = 104946) were included in the analysis from March 1, 2016, through June 13, 2017. Exposures : Maternal folic acid supplementation 4 weeks before to 12 weeks after conception. Plasma folate concentration was analyzed at gestational weeks 17 to 19. Main Outcomes and Measures : Autistic traits were evaluated using the Modified Checklist for Autism in Toddlers and Social Communication Questionnaire. Odds ratios (ORs) for autistic traits in children by maternal use vs nonuse of folic acid supplements were adjusted for maternal health and socioeconomic factors. Folate concentrations and folic acid doses were associated with the degree of autistic traits. Results : The overall mean (SD) age of the 104946 mothers of participating children was 29.8 (4.6) years, with complete information available for analysis in 103 868. Mean (SD) age of women with epilepsy who received AED treatment was 29.4 (4.9) ; women with epilepsy who did not receive AED treatment, 29.1 (4.9) ; and without epilepsy, 29.8 (4.6) years. In the 335 children exposed to AEDs, the risk for autistic traits was significantly higher at 18 months of age (adjusted OR [AOR], 5.9 ; 95% CI, 2.2-15.8) and 36 months of age (AOR, 7.9 ; 95% CI, 2.5-24.9) when their mothers had not used folic acid supplements compared with children of mothers who had used supplements. Among women without epilepsy, the corresponding risks were lower at 18 months of age (AOR, 1.3 ; 95% CI, 1.2-1.4) and 36 months of age (AOR, 1.7 ; 95% CI, 1.5-1.9) ; among the 389 children of women with untreated epilepsy, the corresponding risks were not significant at 18 months of age (AOR, 1.0 ; 95% CI, 0.4-3.0) and 36 months of age (AOR, 2.5 ; 95% CI, 0.4-16.6). Degree of autistic traits was inversely associated with maternal plasma folate concentrations (beta = -0.3 ; P = .03) and folic acid doses (beta = -0.5 ; P < .001). Concentrations of AEDs were not associated with the degree of autistic traits. Conclusions and Relevance : Risk of autistic traits in children exposed to AEDs in utero may be mitigated by periconceptional folic acid supplementation and folate status. Fertile women using AEDs should take folic acid supplements continuously.

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3. Coret A, Boyd K, Hobbs K, Zazulak J, McConnell M. Patient Narratives as a Teaching Tool : A Pilot Study of First-Year Medical Students and Patient Educators Affected by Intellectual/Developmental Disabilities. Teach Learn Med ;2017 (Dec 28):1-11.

PROBLEM : People with intellectual and developmental disabilities (IDD) face complex biopsychosocial challenges and are medically underserved. This is in part due to insufficient resources and supports but can also be attributed to a lack of adequate physician training in addressing the unique needs of this population. INTERVENTION : This study aimed to introduce 1st-year medical students to the IDD population using a blended educational experience that included video narratives of and direct interactions with people affected by IDD. The goal of this intervention was to promote person-centered attitudes and communication among early medical trainees. CONTEXT : The study recruited 27 first-year medical students and randomly assigned each to 1 of 2 groups. The control group received an introductory video lecture about IDD healthcare, followed by a quiz. The narrative group received the same lecture, followed by reflective discussion of videos featuring people living with IDD sharing their perspectives and stories. All students then participated in 4 simulated clinical encounters with patient educators (PEs) who have lived experiences of IDD. Focus groups were conducted with students following the simulated encounters to explore their experiences and perceptions of this blended learning activity. Moreover, secondary quantitative data were collected to assess students’ performance in the clinical encounters, along with self-reports of comfort, confidence, and competence of interacting with people with IDD (pre- and postparticipation). OUTCOME : All students thought that the blended educational experience was valuable and enjoyable, commenting on the importance of adaptable language and engagement of people with IDD, as well as the merits of reflecting on patient narratives. Students also discussed feelings of discomfort stemming from a lack of knowledge and previous exposure to IDD and how this discomfort might motivate them to learn more and develop their skills further. In addition, descriptive analyses revealed that students in the narrative group showed greater self-rated measures of comfort, confidence, and competence compared to control ; they also had higher mean performance scores across all PE interview stations. LESSONS LEARNED : PEs add a powerful real-life dimension to communication skills teaching and have been shown to be a valuable educational modality. Moreover, exposure to and reflection on video-based patient narratives are useful ways of teaching medical students about patients’ lived experiences and promoting person-centered communication, both within and beyond IDD.

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4. Dugas C, Simard MN, Fombonne E, Couture M. Comparison of Two Tools to Assess Sensory Features in Children With Autism Spectrum Disorder. Am J Occup Ther ;2018 (Jan/Feb) ;72(1):7201195010p7201195011-7201195010p7201195019.

OBJECTIVE : This article documents the convergent validity of the Sensory Profile (SP) and the Sensory Processing Measure (SPM)-Home Form for children with autism spectrum disorder (ASD). METHO : . Parents of 34 children with ASD between ages 5 and 8 yr filled out both measures. Through correlations, chi(2) tests, and levels of agreement between classifications, the results for the SP and the SPM-Home Form were compared. RESULTS : The raw scores were correlated for some sensory domains (hearing, vision, touch, and proprioception) and for social functioning. The classifications showed a significant level of agreement for most scales (kappas = .247-.589, p </= .05) and for the total scores (kappa = .324, p </= .01). CONCLUSION : This study provides further evidence of convergent validity between both tools. The SPM-Home Form identifies more children with ASD who present with sensory features for every domain measured by both tools.

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5. Flygare Wallen E, Ljunggren G, Carlsson AC, Pettersson D, Wandell P. High prevalence of diabetes mellitus, hypertension and obesity among persons with a recorded diagnosis of intellectual disability or autism spectrum disorder. J Intellect Disabil Res ;2017 (Dec 26)

BACKGROUND : Obesity and lack of physical activity are frequently reported in persons with intellectual disability (ID) or autism spectrum disorder (ASD). We hypothesised a higher prevalence of diabetes and hypertension in this population. METHOD : We used administrative data for all primary and specialist outpatient and inpatient healthcare consultations for people with at least one recorded diagnosis of diabetes mellitus, hypertension or obesity from 1998 to 2015. Data were drawn from the central administrative database for Stockholm County, Sweden. It was not possible to separate data for type 1 and type 2 diabetes. We stratified 26 988 individuals with IDs or ASD into three groups, with Down syndrome treated separately, and compared these groups with 1 996 140 people from the general population. RESULTS : Compared with the general population, men and women with ID/ASD had 1.6-3.4-fold higher age-adjusted odds of having a registered diagnosis of obesity or diabetes mellitus, with the exception of diabetes among men with Down syndrome. A registered diagnosis of hypertension was only more common among men with ID/ASD than in the general population. CONCLUSIONS : Diabetes and blood pressure health screening, along with efforts to prevent development of obesity already in childhood, are necessary for individuals with IDs and ASD. We believe that there is a need for adapted community-based health promotion programmes to ensure more equitable health for these populations.

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6. Griffin JW, Gavett BE. Third party observer effect : Application to autistic traits in the normal population. Dev Neuropsychol ;2017 (Dec 26):1-16.

This study examined how autistic traits relate to third-party observation during neuropsychological testing. Using a counterbalanced within-subjects design (N = 61), we manipulated the absence and presence of third-party observation when administering alternate forms of the Rey Auditory Verbal Learning Test and Paced Auditory Serial Addition Test to individuals with variable autistic traits. Bayesian linear mixed effects modeling was used to examine the interaction between autistic traits and third-party observation on test performance. With more autistic traits, susceptibility to a third-party observer decreased on the dependent variables. The third-party observer effect may therefore depend on the social awareness exhibited by the examinee.

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7. Harrop C, Tu N, Landa R, Kasier A, Kasari C. Sensory Behaviors in Minimally Verbal Children With Autism Spectrum Disorder : How and When Do Caregivers Respond ?. Am J Intellect Dev Disabil ;2018 (Jan) ;123(1):1-16.

Sensory behaviors are widely reported in autism spectrum disorder (ASD). However, the impact of these behaviors on families remains largely unknown. This study explored how caregivers of minimally verbal children with ASD responded to their child’s sensory behaviors. Using a mixed-methods approach, we examined two variables for each endorsed child behavior : (1) Did the caregiver respond/try to change the behavior ? and (2) What response did they employ ? Caregivers did not differ in the frequency of responses to hypo- or hyper-responsive behaviors but employed different responses. Caregivers responded to more social sensory behaviors and predominately changed their own behavior in response to their child’s. Our findings demonstrate how extensively caregivers adapt to their child’s behaviors and vary their response dependent on behavior exhibited.

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8. Meador KJ. Periconceptional Folate Supplementation and the Risk of Autism Following Antiepileptic Drug Exposure. JAMA Neurol ;2017 (Dec 26)

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9. Olsen DL. Later Life Impacts of Social Participation on Parents of Adult Offspring With and Without Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil ;2018 (Jan) ;123(1):50-60.

Social participation is an important resource for parents in old age, and may be particularly important for parents living with adult offspring with intellectual and developmental disabilities. To evaluate whether socializing with friends and family and participating in social organizations protects against depression in old age, this study examined parents of adult offspring with disabilities ( n = 164) and without disabilities ( n = 820). As expected, more socializing with friends and more participating in organizations were associated with fewer depressive symptoms for all parents. However, socializing with family members predicted fewer depressive symptoms only for parents co-residing with their adult offspring with disabilities, suggesting that socializing with family is particularly important for parents providing direct care to adults with disabilities.

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10. Riccio MP, Franco C, Negri R, Ferrentino RI, Maresca R, D’Alterio E, Greco L, Bravaccio C. Is food refusal in autistic children related to TAS2R38 genotype ?. Autism Res ;2017 (Dec 28)

Several studies suggest that atypical eating behaviors, in particular food selectivity, are more frequent in children with autism spectrum disorder (ASD). A link between bitter taste perception, namely PROP/PTC sensitivity and food preferences is known in healthy children. The aim of this study is to investigate whether genetic variants of the TAS2R38 taste receptor responsible for different bitter sensitivity could affect foods preferences and consequently food refusal in ASD children. We recruited 43 children with ASD and 41 with normotypic development (TD) with or without food selectivity, aged between 2 and 11 years. Children were characterized for bitter sensitivity by means of PROP strips and FACS analysis and genotyped for TAS2R38 polymorphisms. Food selectivity was assessed by a validated food preference questionnaire filled by parents. A statistically significant correlation between PROP sensitivity and food refusal was observed. Furthermore, a prevalence of the PAV-sensitive haplotype compared to the AVI-insensitive one was seen in ASD children with food selectivity. In agreement with the initial hypothesis the results show that food refusal in ASD children is mediated by bitter taste sensitivity thus suggesting that the bitter sensitivity test may be used as a device to orientate tailored food proposals for the practical management of food selectivity in ASD. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : A variation of the gene TAS2R38, associated with bitter taste sensitivity, can cause a different perception of some foods. In particular, some children are hypersensitive to bitterness and show a more restricted repertoire of accepted foods. We evaluate bitter sensitivity in ASD children with or without food selectivity, through a simple bitter taste test with edible strips. The results show that food refusal in ASD children can be mediated by bitter taste sensitivity thus suggesting that the bitter sensitivity test may be used as a device to orientate tailored food proposals for the practical management of food selectivity in ASD.

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11. Twomey C, O’Connell H, Lillis M, Tarpey SL, O’Reilly G. Utility of an abbreviated version of the stanford-binet intelligence scales (5(th) ed.) in estimating ’full scale’ IQ for young children with autism spectrum disorder. Autism Res ;2017 (Dec 28)

The fifth edition of the Stanford-Binet Intelligence scales allows ’full scale’ IQ (FSIQ) to be estimated using an abridged version of the test-the abbreviated battery IQ (ABIQ). Set within a public early intervention team service, the current cross-sectional study investigated the utility of the ABIQ in estimating FSIQ for 40 children with autism spectrum disorder (ASD) aged 3-5 years. A strong ABIQ-FSIQ association was yielded (r = 0.89 ; r(2) = 0.808) and the ABIQ did not over-estimate mean FSIQ above a clinically-relevant threshold ; however, clinically significant over-estimation occurred in 17.5% of individual cases. While the findings provide support for the utility of the ABIQ in estimating FSIQ for young children with ASD, caution relating to the over-estimation of FSIQ is warranted. Careful clinical judgment-ideally based on examination of previous cognitive assessment results (if available), thorough interactional observations, and close multi-disciplinary consultation-is necessary to determine the applicability of the ABIQ to individual cases. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : We investigated the utility of a shortened version of the Stanford-Binet Intelligence Scales in estimating IQ for 40 young children with autism spectrum disorder (ASD). The findings provide qualified support for the instrument : acceptably accurate IQ estimation was achieved for most cases ; but not so for a sizeable minority (17.5%). Careful clinical judgment is necessary to determine the applicability of the ABIQ to individual cases.

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