1. Aljunied M, Frederickson N. {{Does central coherence relate to the cognitive performance of children with autism in dynamic assessments?}}. {Autism};2011 (Jun 29)
Central coherence refers to an in-built propensity to form meaningful links over a wide range of stimuli and to generalize over as wide a range of contexts as possible. In children with autism this ability is diminished, and the impact of central coherence deficits in children with autism have previously been observed using static measures of learning, such as reading comprehension test performance. In this study, the relationship between central coherence and more dynamic indicators of learning are investigated. The responses of 52 children with autism (mean age 9:10 years) on a test of central coherence and a dynamic assessment task were analysed. All the children showed significant improvements in dynamic assessment test scores after mediation; however, among those with below average nonverbal intelligence scores, weak central coherence was significantly associated with smaller gains in performance after teaching. Implications for the validity of dynamic assessments for children with autism are discussed.
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2. Allanson JE, Hennekam RC, Moog U, Smeets EE. {{Rett syndrome: A study of the face}}. {Am J Med Genet A};2011 (Jul);155(7):1563-1567.
Rett syndrome is a unique disorder of neurodevelopment that is characterized by an evolving behavioral and developmental phenotype, which emerges after an apparently normal early infantile period. It almost exclusively affects females. The face of Rett syndrome is said to resemble that of Angelman syndrome, although there seems little objective support for this impression and it is not a concept with universal support. This observational and anthropometric study was carried out to define the key facial characteristics of females with Rett syndrome and to evaluate whether any changes of significance occur with age. Thirty-seven affected Caucasian females, from 2 to 20 years of age, were evaluated. Thirty-five of them had a documented mutation in MECP2 while the remaining two fulfilled the clinical criteria for Rett syndrome and had been diagnosed by an experienced clinician. Few unusual facial features were noted. Almost all facial measurements were within the normal range although head circumference tended to fall below the normal range with increasing age. The pattern of measurements was constant over time, with the exception of increased facial width in the under 3-year-old girls. The face of Rett syndrome does not demonstrate marked prognathism, wide mouth, spaced teeth or striking microcephaly, all features of Angelman syndrome. Thus, while Rett and Angelman syndromes have similar clinical, neurological, and behavioral phenotypes, they do not appear to share similar facial features. (c) 2011 Wiley-Liss, Inc.
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3. Antshel KM, Polacek C, McMahon M, Dygert K, Spenceley L, Dygert L, Miller L, Faisal F. {{Comorbid ADHD and anxiety affect social skills group intervention treatment efficacy in children with autism spectrum disorders}}. {J Dev Behav Pediatr};2011 (Jul-Aug);32(6):439-446.
OBJECTIVE: : To assess the influence of psychiatric comorbidity on social skill treatment outcomes for children with autism spectrum disorders (ASDs). METHODS: : A community sample of 83 children (74 males, 9 females) with an ASD (mean age = 9.5 yr; SD = 1.2) and common comorbid disorders participated in 10-week social skills training groups. The first 5 weeks of the group focused on conversation skills and the second 5 weeks focused on social problem solving skills. A concurrent parent group was also included in the treatment. Social skills were assessed using the Social Skills Rating System. Ratings were completed by parents at pre- and posttreatment time periods. RESULTS: : Children with ASD and children with an ASD and comorbid anxiety disorder improved in their parent reported social skills. Children with ASD and comorbid attention deficit/hyperactivity disorder failed to improve. CONCLUSION: : Psychiatric comorbidity affects social skill treatment gains in the ASD population.
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4. Ashwood P, Krakowiak P, Hertz-Picciotto I, Hansen R, Pessah IN, Van de Water J. {{Altered T cell responses in children with autism}}. {Brain Behav Immun};2011 (Jul);25(5):840-849.
Autism spectrum disorders (ASD) are characterized by impairment in social interactions, communication deficits, and restricted repetitive interests and behaviors. A potential etiologic role for immune dysfunction in ASD has been suggested. Dynamic adaptive cellular immune function was investigated in 66 children with a confirmed diagnosis of ASD and 73 confirmed typically developing (TD) controls 2-5years-of-age. In vitro stimulation of peripheral blood mononuclear cells with PHA and tetanus was used to compare group-associated cellular responses. The production of GM-CSF, TNFalpha, and IL-13 were significantly increased whereas IL-12p40 was decreased following PHA stimulation in ASD relative to TD controls. Induced cytokine production was associated with altered behaviors in ASD children such that increased pro-inflammatory or T(H)1 cytokines were associated with greater impairments in core features of ASD as well as aberrant behaviors. In contrast, production of GM-CSF and T(H)2 cytokines were associated with better cognitive and adaptive function. Following stimulation, the frequency of CD3(+), CD4(+) and CD8(+) T cells expressing activation markers CD134 and CD25 but not CD69, HLA-DR or CD137 were significantly reduced in ASD, and suggests an altered activation profile for T cells in ASD. Overall these data indicate significantly altered adaptive cellular immune function in children with ASD that may reflect dysfunctional immune activation, along with evidence that these perturbations may be linked to disturbances in behavior and developmental functioning. Further longitudinal analyzes of cellular immunity profiles would delineate the relationship between immune dysfunction and the progression of behavioral and developmental changes throughout the course of this disorder.
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5. Beard CM, Panser LA, Katusic SK. {{Is excess folic acid supplementation a risk factor for autism?}}. {Med Hypotheses};2011 (Jul);77(1):15-17.
BACKGROUND: The objective was to assess the association between increasing autism incidence rates and the increasing dose of folic acid in prescription prenatal and pediatric vitamins. METHODS: We used published autism incidence rates from the Rochester Epidemiological Project in Rochester, MN, for 1976-1997. Additionally, we used the percent of prescription prenatal vitamins containing 1mg folic acid and the percent of prescription pediatric vitamins with any folic acid from Physicians’ Desk References for roughly the same time period. RESULTS: The Pearson product moment correlation coefficient (r) for the association between the percentage of prescription prenatal vitamins containing 1mg folic acid and research-identified autism incidence in Olmsted County was 0.87 [95% confidence interval (CI)=0.19-0.99]. In contrast, there was a weak association between pediatric vitamins containing any folic acid and autism incidence using the same statistical method (r=0.62, 95% CI=-0.38-0.95). CONCLUSIONS: If it is true that too little folic acid results in nervous tissue damage, as is accepted by the scientific community in regard to neural tube defects (NTDs), then it seems plausible that too much folic acid may result in nervous tissue damage associated with autism. Although the correlations described here do not provide proof of causation, these data provide an impetus for further study. Children who develop autism may be receiving a massive dose of folic acid in utero, as well as, after birth. It would be of interest to carry out a case-control study using medical record data to document folic acid intake for pregnant women whose offspring were later diagnosed with autism and controls.
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6. Becker KG. {{Autism, immune dysfunction and Vitamin D}}. {Acta Psychiatr Scand};2011 (Jul);124(1):74.
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7. Boyd K, Woodbury-Smith M, Szatmari P. {{Managing anxiety and depressive symptoms in adults with autism-spectrum disorders}}. {J Psychiatry Neurosci};2011 (Jul);36(4):E35-36.
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8. Carter AS, Messinger DS, Stone WL, Celimli S, Nahmias AS, Yoder P. {{A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms}}. {J Child Psychol Psychiatry};2011 (Jul);52(7):741-752.
Background: This randomized controlled trial compared Hanen’s ‘More than Words’ (HMTW), a parent-implemented intervention, to a ‘business as usual’ control group. Methods: Sixty-two children (51 boys and 11 girls; M age = 20 months; SD = 2.6) who met criteria for autism spectrum disorders (ASD) and their parents participated in the study. The HMTW intervention was provided over 3.5 months. There were three measurement periods: prior to randomization (Time 1) and at 5 and 9 months post enrollment (Times 2 and 3). Children’s communication and parental responsivity were measured at each time point. Children’s object interest, a putative moderator, was measured at Time 1. Results: There were no main effects of the HMTW intervention on either parental responsivity or children’s communication. However, the effects on residualized gains in parental responsivity from Time 1 to both Times 2 and 3 yielded noteworthy effect sizes (Glass’s Delta = .71, .50 respectively). In contrast, there were treatment effects on child communication gains to Time 3 that were moderated by children’s Time 1 object interest. Children with lower levels of Time 1 object interest exhibited facilitated growth in communication; children with higher levels of object interest exhibited growth attenuation. Conclusions: The HMTW intervention showed differential effects on child communication depending on a baseline child factor. HMTW facilitated communication in children with lower levels of Time 1 object interest. Parents of children who evidence higher object interest may require greater support to implement the HMTW strategies, or may require different strategies than those provided by the HMTW curriculum.
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9. Chan LG, Saluja B. {{Sexual offending and improvement in autistic characteristics after acquired brain injury: a case report}}. {Aust N Z J Psychiatry};2011 (Jun 30)
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10. Chien IC, Lin CH, Chou YJ, Chou P. {{Prevalence and incidence of autism spectrum disorders among national health insurance enrollees in taiwan from 1996 to 2005}}. {J Child Neurol};2011 (Jul);26(7):830-834.
The authors used a national database to examine the prevalence and incidence of autism spectrum disorders. The National Health Research Institute provided a database of 1 000 000 random participants for study. A population-based sample of 372 642 aged younger than 18 was obtained as a dynamic cohort. Those study participants who had at least one service claim from 1996 to 2005 with a principal diagnosis of autism spectrum disorders were identified. The cumulative prevalence of autism spectrum disorders increased from 1.79 to 28.72 per 10 000 from 1996 to 2005. The annual incidence of autism spectrum disorders increased from 0.91 to 4.41 per 10 000 per year from 1997 to 2005. Higher incidence was detected in the 0 to 5 age group, in males, and in those who lived in northern, southern, and eastern regions and urban areas. Our findings suggest increases in the prevalence and incidence of treated autism spectrum disorders in Taiwan.
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11. Chien YL, Wu YY, Chen CH, Gau SS, Huang YS, Chien WH, Hu FC, Chao YL. {{Association of HLA-DRB1 alleles and neuropsychological function in autism}}. {Psychiatr Genet};2011 (Jun 28)
Evidence suggests an association between autism and immune dysfunction. The associations between human lymphocyte antigen (HLA)-A2, B44, DRbeta1*04 (DR4), C4B, and haplotype B44-SC30-DR4 and autism have been reported in western countries but there is a lack of such information in Asian population. This study aimed to assess the association between HLA-DRB1 allele frequencies and the clinical phenomenology of autism. The sample included 141 participants (male, 87.2%), who were diagnosed with autistic disorder based on clinical assessments and structured interviews using the Chinese version of the Autism Diagnostic Interview-Revised, and 156 healthy controls (male, 38.6%). The HLA-DRB1 alleles were determined by sequencing-based typing method. A subsample of patients (n=39) were assessed for intelligence and neuropsychological functions. The results showed that the pattern of DRB1 allele frequencies was significantly different between patients with autism and the controls (P=0.047). After adjusting for sex by haplotype regression, the frequencies of DR4, DR11, and DR14 were significantly different between patients with autism and healthy controls. In addition, patients with autism and DR4, DR11, or DR14 had different performance on intelligence and neuropsychology tests. Despite a relatively small sample size and a case-control association design, the findings suggest HLA-DRB1 gene might be associated with autism in Han Chinese. The true functional variants associated with autism in our samples remain to be further clarified. It warrants a replication study of a larger family sample and to validate the HLA genetic association with autism and its influence on neuropsychological function. (ClinicalTrials.gov ID: NCT00494754).
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12. Chonchaiya W, Nuntnarumit P, Pruksananonda C. {{Comparison of television viewing between children with autism spectrum disorder and controls}}. {Acta Paediatr};2011 (Jul);100(7):1033-1037.
Aim: To examine the pattern and extent of television viewing in children with autism spectrum disorder (ASD) compared with typically developing controls and those with delayed language development (DLD). Methods: Fifty-four individuals with ASD (mean age 2.56 +/- 0.66 years) and 84 controls (mean age 2.43 +/- 0.81 years) were enrolled. Fifty-six individuals with DLD, who had language developmental levels similar to those with ASD, were enrolled in our previous study. Main outcome measures included onset and frequency of television viewing, in addition to the type of programme and whether a caregiver cowatched television. Results: Those with ASD began to watch television significantly earlier than controls (6.44 +/- 6.35 vs. 12.41 +/- 6.00 months of age, p </= 0.0001*) and spent more time watching television than those with DLD (4.60 +/- 1.91 vs. 3.05 +/- 1.90 h/day, p </= 0.0001*) and controls (4.60 +/- 1.91 vs. 2.06 +/- 1.21 h/day, p </= 0.0001*). Those with ASD appeared to watch more adult programmes than normal controls, and they were less likely to watch television with caregivers than both control groups. Conclusion: There is an earlier onset and higher frequency of television viewing in autistic children compared with children with typical development.
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13. Cubo E, Saez Velasco S, Delgado Benito V, Ausin Villaverde V, Garcia Soto XR, Trejo Gabriel YGJM, Martin Santidrian A, Macarron JV, Cordero Guevara J, Benito-Leon J, Louis ED. {{[Psychometric attributes of the spanish version of A-TAC screening scale for autism spectrum disorders.]}}. {An Pediatr (Barc)};2011 (Jul);75(1):40-50.
BACKGROUND: As there are no biological markers for Autism Spectrum Disorders (ASD), screening must focus on behaviour and the presence of a markedly abnormal development or a deficiency in verbal and non-verbal social interaction and communication. OBJECTIVE: To evaluate the psychometric attributes of a Spanish version of the autism domain of the Autism-Tics, AD/HD and other Comorbidities Inventory (A-TAC) scale for ASD screening. MATERIAL AND METHODS: A total of 140 subjects (43% male, 57% female) aged 6-16, with ASD (n=15), Mental Retardation (n=40), Psychiatric Illness (n=22), Tics (n=12) and controls (n=51), were included for ASD screening. The predictive validity, acceptability, scale assumptions, internal consistency, and precision were analysed. RESULTS: The internal consistency was high (alpha=0.93), and the standard error was adequate (1.13 [95% CI, -1.08 a 3.34]). The mean scores of the Autism module were higher in patients diagnosed with ASD and mental disability compared to the rest of the patients (P<.001). The area under the curve was 0.96 for the ASD group. CONCLUSION: The autism domain of the A-TAC scale seems to be a reliable, valid and precise tool for ASD screening in the Spanish school population.
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14. Dittlinger LH, Lerman DC. {{Further analysis of picture interference when teaching word recognition to children with autism}}. {J Appl Behav Anal};2011 (Summer);44(2):341-349.
Previous research indicates that pairing pictures with associated words when teaching sight-word reading may hinder acquisition (e.g., Didden, Prinsen, & Sigafoos, 2000; Singh & Solman, 1990; Solman & Singh, 1992). The purpose of the current study was to determine whether this phenomenon was due to a previously learned association between the spoken word and picture (i.e., blocking) or due to the mere presence of a picture as an extrastimulus prompt (i.e., overshadowing). Three participants were taught to recognize words that were presented alone or paired with pictures that the participants either could or could not identify prior to training. All participants learned the words more quickly when they were presented alone rather than with pictures, regardless of their prior learning history with respect to pictures representing the words. This finding is consistent with the phenomenon of overshadowing. Nonetheless, consistent with blocking, all participants also acquired the words presented alone more quickly if they could not identify the associated pictures prior to training. Together, these findings have important implications for using prompts when teaching skills to individuals with developmental disabilities.
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15. Dodds L, Fell DB, Shea S, Armson BA, Allen AC, Bryson S. {{The role of prenatal, obstetric and neonatal factors in the development of autism}}. {J Autism Dev Disord};2011 (Jul);41(7):891-902.
We conducted a linked database cohort study of infants born between 1990 and 2002 in Nova Scotia, Canada. Diagnoses of autism were identified from administrative databases with relevant diagnostic information to 2005. A factor representing genetic susceptibility was defined as having an affected sibling or a mother with a history of a psychiatric or neurologic condition. Among 129,733 children, there were 924 children with an autism diagnosis. The results suggest that among those with low genetic susceptibility, some maternal and obstetric factors may have an independent role in autism etiology whereas among genetically susceptible children, these factors appear to play a lesser role. The role of pre-pregnancy obesity and excessive weight gain during pregnancy on autism risk require further investigation.
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16. Ebisch SJ, Gallese V, Willems RM, Mantini D, Groen WB, Romani GL, Buitelaar JK, Bekkering H. {{Altered intrinsic functional connectivity of anterior and posterior insula regions in high-functioning participants with autism spectrum disorder}}. {Hum Brain Mapp};2011 (Jul);32(7):1013-1028.
Impaired understanding of others’ sensations and emotions as well as abnormal experience of their own emotions and sensations is frequently reported in individuals with Autism Spectrum Disorder (ASD). It is hypothesized that these abnormalities are based on altered connectivity within « shared » neural networks involved in emotional awareness of self and others. The insula is considered a central brain region in a network underlying these functions, being located at the transition of information about bodily arousal and the physiological state of the body to subjective feelings. The present study investigated the intrinsic functional connectivity properties of the insula in 14 high-functioning participants with ASD (HF-ASD) and 15 typically developing (TD) participants in the age range between 12 and 20 years by means of « resting state » or « nontask » functional magnetic resonance imaging. Essentially, a distinction was made between anterior and posterior regions of the insular cortex. The results show a reduced functional connectivity in the HF-ASD group, compared with the TD group, between anterior as well as posterior insula and specific brain regions involved in emotional and sensory processing. It is suggested that functional abnormalities in a network involved in emotional and interoceptive awareness might be at the basis of altered emotional experiences and impaired social abilities in ASD, and that these abnormalities are partly based on the intrinsic functional connectivity properties of such a network. Hum Brain Mapp, 2011. (c) 2010 Wiley-Liss, Inc.
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17. Engel SM, Daniels JL. {{On the complex relationship between genes and environment in the etiology of autism}}. {Epidemiology};2011 (Jul);22(4):486-488.
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18. Erickson CA, Stigler KA, Wink LK, Mullett JE, Kohn A, Posey DJ, McDougle CJ. {{A prospective open-label study of aripiprazole in fragile X syndrome}}. {Psychopharmacology (Berl)};2011 (Jul);216(1):85-90.
RATIONALE: Fragile X syndrome (FXS) is the most common inherited form of developmental disability and most common single gene cause of autism. Persons with FXS frequently exhibit irritable behavior marked by aggression, self-injury, and severe tantrums. Despite frequent clinical use of atypical antipsychotic drugs to target this behavioral cluster, no systematic trials to date have assessed the efficacy and safety of these drugs in persons with FXS. METHODS: We conducted a prospective open-label 12-week trial of aripiprazole in 12 persons aged 6-25 years (mean age, 14.3 years) with FXS who were free of concomitant psychoactive drugs. RESULTS: Aripiprazole use (mean dose, 9.8 mg/day) was associated with treatment response (defined by a Clinical Global Impressions-Improvement scale score of much improved or very much improved and a >/=25% improvement on the Aberrant Behavior Checklist-Irritability subscale) in 10 of 12 (87%) persons. Two individuals (13%) discontinued aripiprazole prior to study completion due to adverse events. One discontinuation was due to akathisia, mild drooling, and mild tiredness and the other due to moderate tiredness and moderate drooling. No significant changes in vital signs including weight or laboratory measures occurred during treatment with aripiprazole. CONCLUSIONS: Aripiprazole was generally safe and well tolerated and was associated with significant improvement in irritable behavior. Given these findings, a double-blind, placebo-controlled study of aripiprazole in FXS is warranted.
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19. Freilinger M, Dunkler D, Lanator I, Item CB, Muhl A, Fowler B, Bodamer OA. {{Effects of creatine supplementation in rett syndrome: a randomized, placebo-controlled trial}}. {J Dev Behav Pediatr};2011 (Jul-Aug);32(6):454-460.
OBJECTIVE: : To evaluate the effects of creatine monohydrate (CMH) supplementation on global DNA methylation and disease-specific clinical symptoms in female patients with Rett syndrome (RTT). METHODS: : Double-blind, randomized, placebo-controlled crossover trial of female patients with RTT. Participants received 200 mg/kg of either CMH or placebo daily for 6 months and switched following a 4-week washout period. Primary endpoints were change in global DNA methylation and in a RTT-specific symptom score as defined by medical history and clinical evaluation with Rett Syndrome Motor and Behavioral Assessment. Secondary endpoints were changes in biochemical markers of methionine metabolism. RESULTS: : Eighteen female patients aged 3 to 25 years with clinically diagnosed typical RTT and MECP2 mutation at clinical Stages III or IV were studied. CMH supplementation resulted in a statistically significant increase of global methylation by 0.11 (95% confidence interval 0.03-0.19, p = .009) compared with placebo. Total and subscores of Rett Syndrome Motor and Behavioral Assessment tended to improve but without statistical significance. CONCLUSION: : CMH supplementation increases global DNA methylation statistically significantly. Scores were lower for creatine than for placebo reflecting clinical improvement but not reaching statistical significance. Biochemical variables of methionine-homocysteine remethylation are unaffected. Multicenter studies are urgently warranted to evaluate the long-term effects of CMH supplementation in an optimally homogenous RTT population over a prolonged period.
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20. Gray L, Ansell P, Baird G, Parr JR. {{The continuing challenge of diagnosing autism spectrum disorder in children with Down syndrome}}. {Child Care Health Dev};2011 (Jul);37(4):459-461.
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21. Guenole F, Baleyte JM. {{Effectiveness of melatonin for sleep problems in autism spectrum disorders: evidence grows but research is still needed}}. {J Autism Dev Disord};2011 (Jul);41(7):974-975.
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22. Haltigan JD, Ekas NV, Seifer R, Messinger DS. {{Brief report: attachment security in infants at-risk for autism spectrum disorders}}. {J Autism Dev Disord};2011 (Jul);41(7):962-967.
Little is known about attachment security and disorganization in children who are at genetic risk for an Autism Spectrum Disorder (ASD) prior to a possible diagnosis. The present study examined distributions of attachment security and disorganization at 15-months of age in a sample of infant siblings of older children with (ASD-sibs; n = 51) or without (COMP-sibs; n = 34) an ASD. ASD-sibs were not more or less likely to evince attachment insecurity or disorganization than COMP-sibs. However, relative to COMP-sibs, the rate of B1-B2 secure subclassifications was disproportionately larger in the ASD-sib group. Results suggest that ASD-sibs are not less likely to form secure affectional bonds with their caregivers than COMP-sibs, but may differ from COMP-sibs in their expression of attachment security.
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23. Hus V, Taylor A, Lord C. {{Telescoping of caregiver report on the Autism Diagnostic Interview – Revised}}. {J Child Psychol Psychiatry};2011 (Jul);52(7):753-760.
Background: Delays in development are a fundamental feature in diagnosing autism spectrum disorders (ASD). Age of language acquisition, usually obtained through retrospective caregiver report, is currently used to distinguish between categories within ASD. Research has shown that caregivers often report children as having acquired developmental milestones earlier or later than they were actually achieved. The current study examines the extent to which this phenomenon, referred to as ‘telescoping,’ impacts retrospective reports provided by caregivers of children with ASD. Methods: Participants were 127 caregivers of children referred for possible ASD or non-spectrum developmental delay. Caregivers were interviewed when children were 2, 3, 5, and 9 years of age. Caregiver-reported ages of first concern, language and non-diagnostic developmental milestones and interviewer-estimated age of onset were compared over time using linear models. Results: Significant telescoping of language milestones resulted in more children meeting language delay criteria as they grew older, in spite of original reports that their language was not delayed. There was little evidence of consistent telescoping of caregiver-reported ages of first concern, daytime bladder control, and independent walking. With time, the interviewers’ judged ages of symptom onset increased, but remained prior to age three. Conclusions: Telescoping of caregiver-reported ages of language acquisition has implications for both clinical diagnosis and genetic studies using these milestones to increase homogeneity of samples. Results support proposals to remove specific age-based criteria in the diagnosis of ASD. Telescoping should be considered when working with any clinical population in which retrospectively recalled events are used in diagnosis.
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24. Johnston K, Madden AK, Bramham J, Russell AJ. {{Response inhibition in adults with autism spectrum disorder compared to attention deficit/hyperactivity disorder}}. {J Autism Dev Disord};2011 (Jul);41(7):903-912.
Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are hypothesised to involve core deficits in executive function. Previous studies have found evidence of a double dissociation between the disorders on specific executive functions (planning and response inhibition). To date most research has been conducted with children. No studies have directly compared the stable cognitive profile of adults. It was hypothesised that adults with ASD would show generally intact response inhibition whereas those with ADHD would show more global impairment. Participants were 24 adults aged 18-55 with high functioning ASD, 24 with ADHD, and 14 age and IQ matched controls. Participants completed three standardised measures of response inhibition. Participants with ASD had generally intact response inhibition but slow response latencies, possibly due to deficits in response initiation. Adults with ADHD did not show the more global impairments hypothesised. There were some significant differences between the clinical groups across measures of inhibition. In terms of performance style, adults with ASD were slow and accurate whilst those with ADHD showed an impulsive style.
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25. Judson MC, Amaral DG, Levitt P. {{Conserved Subcortical and Divergent Cortical Expression of Proteins Encoded by Orthologs of the Autism Risk Gene MET}}. {Cereb Cortex};2011 (Jul);21(7):1613-1626.
Met receptor tyrosine kinase signaling regulates the growth and development of axons and may contribute to the wiring of cortical and limbic circuits in the rodent forebrain. Whether the orthologous MET receptor functions similarly in the developing primate forebrain is not known but is of considerable interest considering the association of variant MET alleles with social and communication phenotypes in autism. To begin addressing this question, we compared Met/MET protein expression in the developing mouse and rhesus macaque forebrain. There was a strong temporal conservation of expression during the time of rapid axon development and the onset of robust synapse formation. Expression patterns of Met/MET in limbic-related structures were almost identical between species. In marked contrast, there was highly divergent expression in the neocortex. In mouse, Met was broadly distributed throughout neocortex. In the macaque, robust MET expression was largely restricted to the posterior cingulate, inferior temporal, posterior parietal, and visual cortices, including face processing regions. The pattern is consistent with the importance of vision in the social repertoire of the primate. Collectively, these data suggest a conserved developmental function of the MET receptor in wiring together limbic and neocortical circuits that facilitate species-appropriate responses, including social behavior.
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26. Juraska JM. {{From environmental enrichment to Fragile X: The retirement of William Greenough introduction to a special issue}}. {Dev Psychobiol};2011 (Jul);53(5):425-427.
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27. Karsten AM, Carr JE, Lepper TL. {{Description of a practitioner model for identifying preferred stimuli with individuals with autism spectrum disorders}}. {Behav Modif};2011 (Jul);35(4):347-369.
The rich technology of stimulus preference assessment (SPA) is a product of 40 years of experimental research. Basic principles of reinforcement and a modest empirical literature suggest that high-preference stimuli identified via SPA may enhance treatment efficacy and decrease problem behavior more effectively than less-preferred stimuli. SPAs can be conducted using one of several methods associated with different time requirements and outcomes. Despite the broad applicability of preference assessments, we are unaware of widely available practitioner guidelines that prescribe when to use SPAs, how to select and modify specific SPA procedures, and how to supplement SPAs with other procedures for maximizing performance. The purpose of the current article is to describe a model for practitioners to select and conduct preference assessments based on practical considerations and research findings. Data are also reported from the application of the proposed model to preference assessments for 20 individuals diagnosed with autism spectrum disorders.
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28. Khanna R, Madhavan SS, Smith MJ, Tworek C, Patrick JH, Becker-Cottrill B. {{Psychometric properties of the Caregiver Strain Questionnaire (CGSQ) among caregivers of children with autism}}. {Autism};2011 (Jun 29)
The purpose of this study was to test the psychometric properties of the Caregiver Strain Questionnaire (CGSQ) among caregivers of children with autism. The CGSQ was originally developed to assess burden experienced by parents of children and adolescents with serious emotional and behavioral disorders. Study data was collected from 304 primary caregivers ofchildren with autism using a cross-sectional survey design. We tested the one-, two-, and three-factor CGSQ model. Though the three-factor CGSQ model fit better than the one- and two-factor model, it was still short of an acceptable fit. Minor modifications were made to the three-factor model by correlating error terms. The modified three-factor CGSQ model with correlated error indicated reasonable fit with the data. The 21-item CGSQ had good convergent validity, as indicated by the correlation of its three subscales with constructs including mental health-related quality of life, maladaptive coping, social support, family functioning, and care recipient level of functional impairment and extent of behavioral problems, respectively. The internal consistency reliability of the instrument was also good, and there were no floor and ceiling effects. The CGSQ was found to be a reliable and valid instrument to assess burden among caregivers of children with autism.
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29. Kim HS, Lee JJ, Cho AR, Kim DH, Choi CW. {{Squamous Cell Carcinoma of the Lung in an Autistic Child Who has Never Smoked}}. {J Pediatr Hematol Oncol};2011 (Jul);33(5):e216-219.
Primary bronchogenic carcinoma of the lung is extremely rare in childhood, particularly the squamous cell type. Only 13 cases have been reported in the literature. We report a case of squamous cell carcinoma in an autistic, 16-year-old boy who presented with a productive cough. Interestingly, he was a never-smoker, but had been exposed to environmental tobacco smoking by his father for 13 years. The diagnosis was delayed by approximately 1 month due to his young age. He was diagnosed with squamous cell carcinoma of the lung by video-assisted thoracoscopic surgery, and chemotherapy was arranged. Considering his age, autism, and good performance status, a combined chemotherapeutic regimen with gemcitabine plus carboplatin was planned. After the second cycle of chemotherapy, the cough resolved and a computed tomography scan showed a partial response of the central conglomerated mass with the absence of the malignant pleural effusion.
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30. Koop SE. {{Scoliosis and Rett syndrome}}. {Dev Med Child Neurol};2011 (Jul);53(7):582-583.
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31. Leekam SR, Prior MR, Uljarevic M. {{Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade}}. {Psychol Bull};2011 (Jul);137(4):562-593.
Restricted and repetitive behaviors (RRBs) are a core feature of autism spectrum disorders. They constitute a major barrier to learning and social adaptation, but research on their definition, cause, and capacity for change has been relatively neglected. The last decade of research has brought new measurement techniques that have improved the description of RRBs. Research has also identified distinctive subtypes of RRBs in autism spectrum disorders. Research on potential causal origins and immediate triggers for RRBs is still at an early stage. However, promising new ideas and evidence are emerging from neurobiology and developmental psychology that identify neural adaptation, lack of environmental stimulation, arousal, and adaptive functions as key factors for the onset and maintenance of RRBs. Further research is needed to understand how these factors interact with each other to create and sustain atypical levels of RRB. The literature indicates that RRBs have the potential to spontaneously reduce across time, and this is enhanced for those with increased age and cognitive and language ability. Research on interventions is sparse. Pharmacological treatments can be helpful in some children but have adverse side effects. Behavioral intervention methods provide the better intervention option with positive effects, but a more systematic and targeted approach is urgently needed. Evidence suggests that we will learn best from the last decade of research by taking a developmental perspective, by directing future research toward subtypes of RRBs, and by implementing early intervention targeted to improve RRBs before these behaviors become entrenched. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
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32. Leonard HC, Annaz D, Karmiloff-Smith A, Johnson MH. {{Brief report: developing spatial frequency biases for face recognition in autism and williams syndrome}}. {J Autism Dev Disord};2011 (Jul);41(7):968-973.
The current study investigated whether contrasting face recognition abilities in autism and Williams syndrome could be explained by different spatial frequency biases over developmental time. Typically-developing children and groups with Williams syndrome and autism were asked to recognise faces in which low, middle and high spatial frequency bands were masked. All three groups demonstrated a gradual specialisation toward the mid-band. However, while the use of high spatial frequencies decreased in control and autism groups over development, the Williams syndrome group did not display a bias toward this band at any point. These data demonstrate that typical outcomes can be achieved through atypical developmental processes, and confirm the importance of cross-syndrome studies in the investigation of developmental disorders.
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33. Li BM, Liu XR, Yi YH, Deng YH, Su T, Zou X, Liao WP. {{Autism in Dravet syndrome: Prevalence, features, and relationship to the clinical characteristics of epilepsy and mental retardation}}. {Epilepsy Behav};2011 (Jul);21(3):291-295.
Autism is a pervasive developmental disorder that frequently co-occurs with epilepsy. Dravet syndrome is a severe epileptic encephalopathy associated with psychomotor developmental delay. Autism in Dravet syndrome, however, has rarely been studied. In this study, the prevalence and features of autism in patients with Dravet syndrome, their potential association with mental retardation, and the clinical characteristics of epilepsy were investigated. Clinical data of 37 patients with Dravet syndrome were collected, and evaluations of autism and mental retardation were performed. Nine patients (24.3%) met the criteria for autism. All patients with autism showed speech delay, no emotional reciprocity, and narrow interests, whereas 89.3, 46.4, and 39.9% of patients without autism had speech delay, short temper, and narrow interests, respectively. Mental retardation was observed in 94.6% of patients with Dravet syndrome, with more frequent severe or profound mental retardation in those with autism. The clinical features of epilepsy did not statistically differ between the patients with autism and the patients without autism.
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34. Lickenbrock DM, Ekas NV, Whitman TL. {{Feeling Good, Feeling Bad: Influences of Maternal Perceptions of the Child and Marital Adjustment on Well-being in Mothers of Children with an Autism Spectrum Disorder}}. {J Autism Dev Disord};2011 (Jul);41(7):848-858.
Mothers of children with an autism spectrum disorder (n = 49) participated in a 30-day diary study which examined associations between mothers’ positive and negative perceptions of their children, marital adjustment, and maternal well-being. Hierarchical linear modeling results revealed that marital adjustment mediated associations between positive perceptions and maternal well-being. Mothers who reported higher levels of positive perceptions of the child were higher in marital adjustment and well-being. Results also revealed that marital adjustment moderated the relation between negative perceptions and negative maternal affect. Mothers low in marital adjustment had a positive association between negative maternal perceptions of the child and negative maternal affect. These findings highlight the dynamic roles that mothers’ perceptions and marital adjustment play in determining maternal psychological outcomes.
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35. Limeres JR, Feijoo JF, Diz P. {{Children with autism}}. {J Am Dent Assoc};2011 (Jul);142(7):793-794.
36. Liu X, Solehdin F, Cohen IL, Gonzalez MG, Jenkins EC, Lewis ME, Holden JJ. {{Population- and Family-Based Studies Associate the MTHFR Gene with Idiopathic Autism in Simplex Families}}. {J Autism Dev Disord};2011 (Jul);41(7):938-944.
Two methylenetetrahydrofolate reductase gene (MTHFR) functional polymorphisms were studied in 205 North American simplex (SPX) and 307 multiplex (MPX) families having one or more children with an autism spectrum disorder. Case-control comparisons revealed a significantly higher frequency of the low-activity 677T allele, higher prevalence of the 677TT genotype and higher frequencies of the 677T-1298A haplotype and double homozygous 677TT/1298AA genotype in affected individuals relative to controls. Family-based association testing demonstrated significant preferential transmission of the 677T and 1298A alleles and the 677T-1298A haplotype to affected offspring. The results were not replicated in MPX families. The results associate the MTHFR gene with autism in SPX families only, suggesting that reduced MTHFR activity is a risk factor for autism in these families.
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37. Liu XQ, Georgiades S, Duku E, Thompson A, Devlin B, Cook EH, Wijsman EM, Paterson AD, Szatmari P. {{Identification of genetic Loci underlying the phenotypic constructs of autism spectrum disorders}}. {J Am Acad Child Adolesc Psychiatry};2011 (Jul);50(7):687-696 e613.
OBJECTIVE: To investigate the underlying phenotypic constructs in autism spectrum disorders (ASD) and to identify genetic loci that are linked to these empirically derived factors. METHOD: Exploratory factor analysis was applied to two datasets with 28 selected Autism Diagnostic Interview-Revised (ADI-R) algorithm items. The first dataset was from the Autism Genome Project (AGP) phase I (1,236 ASD subjects from 618 families); the second was from the AGP phase II (804 unrelated ASD subjects). Variables derived from the factor analysis were then used as quantitative traits in genome-wide variance components linkage analyses. RESULTS: Six factors, namely, joint attention, social interaction and communication, nonverbal communication, repetitive sensory-motor behavior, peer interaction, and compulsion/restricted interests, were retained for both datasets. There was good agreement between the factor loading patterns from the two datasets. All factors showed familial aggregation. Suggestive evidence for linkage was obtained for the joint attention factor on 11q23. Genome-wide significant evidence for linkage was obtained for the repetitive sensory-motor behavior factor on 19q13.3. CONCLUSIONS: This study demonstrates that the underlying phenotypic constructs based on the ADI-R algorithm items are replicable in independent datasets, and that the empirically derived factors are suitable and informative in genetic studies of ASD.
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38. Loth E, Gomez JC, Happe F. {{Do high-functioning people with autism spectrum disorder spontaneously use event knowledge to selectively attend to and remember context-relevant aspects in scenes?}}. {J Autism Dev Disord};2011 (Jul);41(7):945-961.
This study combined an event schema approach with top-down processing perspectives to investigate whether high-functioning children and adults with autism spectrum disorder (ASD) spontaneously attend to and remember context-relevant aspects of scenes. Participants read one story of story-pairs (e.g., burglary or tea party). They then inspected a scene (living room) of which some objects were relevant in that context, irrelevant (related to the non-emphasized event) or neutral (scene-schema related). During immediate and delayed recall, only the (TD) groups selectively recalled context-relevant objects, and significantly more context-relevant objects than the ASD groups. Gaze-tracking suggests that one factor in these memory differences may be diminished top-down effects of event schemas on initial attention (first ten fixations) to relevant items in ASD.
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39. Luyster RJ, Kuban KC, O’Shea TM, Paneth N, Allred EN, Leviton A. {{The Modified Checklist for Autism in Toddlers in extremely low gestational age newborns: individual items associated with motor, cognitive, vision and hearing limitations}}. {Paediatr Perinat Epidemiol};2011 (Jul);25(4):366-376.
Luyster RJ, Kuban KCK, O’Shea TM, Paneth N, Allred EN, Leviton A for ELGAN Study investigators. The Modified Checklist for Autism in Toddlers in extremely low gestational age newborns: Individual items associated with motor, cognitive, vision and hearing limitations. Paediatric and Perinatal Epidemiology 2011; 25: 366-376. The Modified Checklist for Autism in Toddlers (M-CHAT) has yielded elevated rates of screening failure for children born preterm or with low birthweight. We extended these findings with a detailed examination of M-CHAT items in a large sample of children born at extremely low gestational age. The sample was grouped according to children’s current limitations and degree of impairment. The aim was to better understand how disabilities might influence M-CHAT scores. Fourteen participating institutions of the Extremely Low Gestational Age Newborns (ELGAN) Study prospectively collected information about 1086 infants who were born before the 28th week of gestation and had an assessment at age 24-months. The 24-month visit included a neurological assessment, the Bayley Scales of Infant Development, Second edition (BSID-II), M-CHAT and a medical history form. Outcome measures included the distribution of failed M-CHAT items among groups classified according to cerebral palsy diagnosis, gross motor function, BSID-II scores and vision or hearing impairments. M-CHAT items were failed more frequently by children with concurrently identified impairments (motor, cognitive, vision and hearing). In addition, the frequency of item failure increased with the severity of impairment. The failed M-CHAT items were often, but not consistently, related to children’s specific impairments. Importantly, four of the six M-CHAT ‘critical items’ were commonly affected by presence and severity of concurrent impairments. The strong association between impaired sensory or motor function and M-CHAT results among extremely low gestational age children suggests that such impairments might give rise to false positive M-CHAT screening.
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40. M DEJ, Punt M, E DEG, Minderaa RB, Hadders-Algra M. {{Minor neurological dysfunction in children with autism spectrum disorder}}. {Dev Med Child Neurol};2011 (Jul);53(7):641-646.
Aim The aim of this study was to improve the understanding of brain function in children with autism spectrum disorder (ASD) in relation to minor neurological dysfunctions (MNDs). Method We studied MNDs in 122 children (93 males, 29 females; mean age 8y 1mo, SD 2y 6mo) who, among a total cohort of 705 children (513 males, 192 females; mean age 9y, SD 2y 0.5mo) referred to a regional outpatient non-academic psychiatric centre in the Netherlands, were diagnosed with ASD after an extensive multidisciplinary psychiatric assessment. Children with clear neurological abnormalities (e.g. cerebral palsy or spina bifida) were excluded from the study. MNDs were assessed in all 705 children using the Touwen examination method. Special attention was paid to the severity and type of MND. Data of the children with ASD were compared with neurological morbidity data of children with other psychiatric disorders and with children in the general population, who were born at Groningen University Hospital between 1975 and 1978. Results Seventy-four percent of the children with ASD showed complex MNDs compared with 52% of the children with other psychiatric disorders and 6% of the reference group (chi(2) =18.0, p<0.001; chi(2) =937.5, p<0.001 respectively). Specific dysfunctions frequently encountered in ASD were dysfunctional posture and muscle tone, fine manipulative disability, dyscoordination, and excessive associated movements. Conclusion These findings suggest a contribution of dysfunctional supraspinal networks involving multiple parts of the brain in the pathogenesis of ASD. This is consistent with findings from neuroimaging studies, and highlights the importance of neurological examinations in paediatric psychiatric assessments.
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41. Malhotra S, Rajender G, Bhatia MS, Singh TB. {{Effects of picture exchange communication system on communication and behavioral anomalies in autism}}. {Indian J Psychol Med};2010 (Jul);32(2):141-143.
Communication skills deficits and stereotyped behaviors are frequently found among people with pervasive developmental disabilities like autism. These communication and behavioral oddities of autism are often considered to be difficult to treat and are challenging. Picture exchange communication system (PECS) is a six-phase picture system based on applied behavior analysis and is specially designed to overcome these communication difficulties in children with autism by encouraging the child to be the communication initiator. The present paper throws light on the process of using PECS along with other traditional behavioral approaches in managing communication deficits and behavioral stereotypies in a seven-year-old male child diagnosed as having childhood autism. The identified target behaviors of repeated head turning, flapping his hands, poor communication skills were assessed using various rating scales including visual analogue scale as per clinician observation and parental reports and managed using PECS as an adjunct to traditional behavioral techniques of contingency management, differential reinforcement, task direction and reprimand. Outcome was assessed using same tools after thirty-two sessions of interventions spread over three months. Significant improvements of around 60% were observed in the target behaviors.
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42. Marzullo-Kerth D, Reeve SA, Reeve KF, Townsend DB. {{Using multiple-exemplar training to teach a generalized repertoire of sharing to children with autism}}. {J Appl Behav Anal};2011 (Summer);44(2):279-294.
The current study examined the utility of multiple-exemplar training to teach children with autism to share. Stimuli from 3 of 4 categories were trained using a treatment package of video modeling, prompting, and reinforcement. Offers to share increased for all 3 children following the introduction of treatment, with evidence of skill maintenance. In addition, within-stimulus-category generalization of sharing was evident for all participants, although only 1 participant demonstrated across-category generalization of sharing. Offers to share occurred in a novel setting, with familiar and novel stimuli, and in the presence of novel adults and peers for all participants during posttreatment probes.
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43. Matson JL, Sipes M, Fodstad JC, Fitzgerald ME. {{Issues in the management of challenging behaviours of adults with autism spectrum disorder}}. {CNS Drugs};2011 (Jul 1);25(7):597-606.
Autism spectrum disorder (ASD) is a particularly important risk factor for challenging behaviours such as aggression, tantrums, self-injury and pica. Adults with ASD have rarely been studied with respect to these problems. This is particularly disconcerting since there are far more adults than children with ASD. In addition, because of adults’ increased physical size and longer history of these problems, treating these behaviours effectively is important. Psychological methods, particularly applied behaviour analysis, and pharmacotherapy have been the most frequently addressed treatments for challenging behaviours associated with ASD in the research literature. In many cases, challenging behaviours have clear environmental antecedents. In these cases, behavioural interventions, such as applied behaviour analysis, should be used to reduce the behaviours. When environmental factors cannot be identified or when challenging behaviours are very severe, pharmacological treatments may be necessary in combination with behavioural interventions. Newer antipsychotics are the most researched medications for use with this population. Currently, risperidone and aripiprazole are the only medications that have US FDA approval for the treatment of behaviours associated with ASD, specifically irritability; however, they are indicated for use in children not adults. It is important not to use medications unnecessarily, due to possible side effects associated with their use. Based on available research, some recommendations for the treatment of challenging behaviours of adults (and children) with ASD include the use of functional assessment, side-effect monitoring of medications and behavioural methods whenever possible. Additionally, future research in this area needs to focus more on adults, as most current research has used child samples.
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44. Mavropoulou S, Papadopoulou E, Kakana D. {{Effects of task organization on the independent play of students with autism spectrum disorders}}. {J Autism Dev Disord};2011 (Jul);41(7):913-925.
The purpose of the study was to examine the impact of task organization, a component of Structured Teaching developed by Division TEACCH, on the independent play of children with autism spectrum disorders (ASD). On-task behavior, task accuracy, task performance and teacher prompting were measured across independent play sessions in the classroom. An ABAB design was implemented to evaluate the effects of task organization on the independent play skills of two young children with ASD. Results regarding on-task behavior, task accuracy and independence were variable and are discussed. The implications of findings on the use of task organization for increasing independence in children with ASD are discussed.
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45. May T, Brewer WJ, Rinehart NJ, Enticott PG, Brereton AV, Tonge BJ. {{Differential Olfactory Identification in Children with Autism and Asperger’s Disorder: A Comparative and Longitudinal Study}}. {J Autism Dev Disord};2011 (Jul);41(7):837-847.
Key theories of autism implicate orbitofrontal cortex (OFC) compromise, while olfactory identification (OI) deficits are associated with OFC dysfunction. This study aimed to complete a 5-year follow-up of children with high-functioning autism (HFA) who previously lacked the normal age-OI association; and compare unirhinal-OI in children with HFA, Asperger’s disorder (ASP), and controls. While both HFA and controls had improved birhinal-OI at follow-up, reduced OI in some HFA participants suggested OFC deterioration and heterogeneous OFC development. Unirhinal-OI was impaired in HFA but not ASP relative to controls, suggesting orbitofrontal compromise in HFA but integrity in ASP. Differing IQ-OI relationships existed between HFA and ASP. Findings support the hypothesis of separate neurobiological underpinnings in ASP and HFA, specifically differential orbitofrontal functioning.
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46. Mieres AC, Smallwood V, Nicholson SK. {{Retrospective case report: evaluation of pain in a child with pervasive developmental disorder}}. {Pediatr Phys Ther};2011 (Summer);23(2):194-200.
PURPOSE: To describe how a nurse and a physical therapist in an interprofessional (IP) school-based clinic collaborated to meet the needs of a child with pervasive developmental disorder-not otherwise specified, with atypical classroom behaviors and declining student performance. SUMMARY: The IP team sought answers for atypical classroom behaviors with declining student performance. Student sensory perceptions masked and delayed the ability to recognize infection. OBSERVATIONS: Cumulative observations by the team generated serial referrals until a diagnosis of dental abscess was identified. CONCLUSIONS: An IP team in this school setting generated a positive outcome for a student demonstrating absence of clear indicators of pain or infection, with additional positive outcomes for the clinic. RECOMMENDATIONS FOR CLINICAL PRACTICE: Further studies are needed to recognize illness earlier in the absence of pain or pain perception in children with a form of autism spectrum disorder and to develop reliable and valid metrics for pain identification.
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47. Milne E. {{Increased intra-participant variability in children with autistic spectrum disorders: evidence from single-trial analysis of evoked EEG}}. {Front Psychol};2011;2:51.
Intra-participant variability in clinical conditions such as autistic spectrum disorder (ASD) is an important indicator of pathophysiological processing. The data reported here illustrate that trial-by-trial variability can be reliably measured from EEG, and that intra-participant EEG variability is significantly greater in those with ASD than in neuro-typical ma
