Le numéro de décembre de Current Opinion in Pediatrics propose quels articles sur l’autisme et la neurologie (comorbidités neurologiques, interventions comportementales, psychopharmacologie, bases neurales).

Les articles sont consultables sur le site de l’éditeur.

1. Dawson G, Burner K. Behavioral interventions in children and adolescents with autism spectrum disorder : a review of recent findings. Curr Opin Pediatr ;2011 (Dec) ;23(6):616-620.

PURPOSE OF REVIEW : The study provides an overview of recent studies on behavioral interventions for children and adolescents with autism spectrum disorder (ASD). RECENT FINDINGS : Recent reviews of the effectiveness of early intensive behavioral intervention (EIBI) conclude that EIBI can improve language and cognitive skills. The first randomized controlled trial (RCT) of a comprehensive early intervention for toddlers with ASD demonstrated gains in language, cognitive abilities, and adaptive behavior. Targeted, brief behavioral interventions are efficacious for improving social communication in young children with ASD. Parents can be taught to deliver behavioral interventions, which are associated with improvements in parent-child interaction ; effects on child outcome, however, have been mixed. Several studies show that social skills interventions are efficacious for improving peer relationships and social competence. Behavioral interventions are also effective for reducing anxiety symptoms and aggression. Medication combined with behavioral intervention was found to be more effective for reducing aggression than medication alone. SUMMARY : Behavioral interventions are effective for improving language, cognitive abilities, adaptive behavior, and social skills, and reducing anxiety and aggression. Medication combined with behavioral intervention appears to be more effective for reducing aggressive behavior than medication alone.

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2. Maski KP, Jeste SS, Spence SJ. Common neurological co-morbidities in autism spectrum disorders. Curr Opin Pediatr ;2011 (Dec) ;23(6):609-615.

PURPOSE OF REVIEW : Autism spectrum disorders (ASDs) are heterogeneous neurodevelopmental disorders associated with various co-morbidities. Neurological co-morbidities include motor impairments, epilepsy, and sleep dysfunction. These impairments have been receiving more attention recently, perhaps because of their significant impact on the behavior and cognitive function of children with ASDs. Here, we review the epidemiology, etiology, and clinical approach to these neurological co-morbidities and highlight future research directions. RECENT FINDINGS : Motor impairments include stereotypies, motor delays, and deficits, such as dyspraxia, incoordination, and gait problems. Sleep dysfunction typically presents as difficulty with sleep onset and prolonged awakenings during the night. Recent data suggest that abnormalities in melatonin may affect sleep and may be a potential treatment target. There is no classic epilepsy syndrome associated with ASDs. Intellectual disability, syndromic autism, and female sex are specific risk factors. Recent research has focused on identifying the overlapping pathways between these neurological co-morbidities and the core deficits in ASDs, which may have direct and powerful implications for treatment and prognosis. SUMMARY : Motor impairment, epilepsy, and sleep dysfunction are common neurological co-morbidities in ASDs. Clinicians should be aware that recognition and treatment of these issues may improve the function and outcome of children with ASDs.

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3. McPartland JC, Coffman M, Pelphrey KA. Recent advances in understanding the neural bases of autism spectrum disorder. Curr Opin Pediatr ;2011 (Dec) ;23(6):628-632.

PURPOSE OF REVIEW : This article reviews current work investigating the neural bases of autism spectrum disorder (ASD) within the discipline of electrophysiological brain research. The manuscript focuses primarily on advances in understanding related to social information processing and interconnectivity among brain systems in ASD. RECENT FINDINGS : Recent research indicates anomalous function of social brain regions in ASD and highlights the specificity of processing problems to these systems. Atypical activity in this circuitry may reflect genetic susceptibility for ASD, with increased activity in compensatory areas marking the distinction between developing and not developing the disorder. Advances in understanding connectivity in ASD are highlighted by novel work providing initial evidence of atypical interconnectivity in infancy. SUMMARY : Emerging understanding of neural dysfunction in ASD indicates consistent but heterogeneous dysfunction across brain systems in ASD. Key objectives for the immediate future include the use of multimethod approaches that encompass temporal and spatial imaging ; behavioral phenotyping carried out in developmental context to reveal subgroups defined uniquely by trajectories ; and individual-specific profiles of behavioral performance and brain function.

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4. Spence SJ, Tasker RC, Pomeroy SL. Recent advances in autism spectrum disorders. Curr Opin Pediatr ;2011 (Dec) ;23(6):607-608.

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