1. Bass MM, Duchowny CA, Llabre MM. {{The effect of therapeutic horseback riding on social functioning in children with autism}}. {J Autism Dev Disord};2009 (Sep);39(9):1261-1267.
This study evaluated the effects of therapeutic horseback riding on social functioning in children with autism. We hypothesized that participants in the experimental condition (n = 19), compared to those on the wait-list control (n = 15), would demonstrate significant improvement in social functioning following a 12-weeks horseback riding intervention. Autistic children exposed to therapeutic horseback riding exhibited greater sensory seeking, sensory sensitivity, social motivation, and less inattention, distractibility, and sedentary behaviors. The results provide evidence that therapeutic horseback riding may be a viable therapeutic option in treating children with autism spectrum disorders.
2. Campbell JM, Marino CA. {{Brief report: sociometric status and behavioral characteristics of peer nominated buddies for a child with autism}}. {J Autism Dev Disord};2009 (Sep);39(9):1359-1363.
We examined social and behavioral correlates of children selected by their peers to serve as peer buddies for an unfamiliar child with autism (CWA). Participants were 293 children from two public elementary schools who completed social status, behavioral, and peer buddy nomination measures. Peer buddy nominations for a CWA were related to: (a) perceived unpopularity; (b) being viewed as helpful and smart; and (c) lacking influence regarding popularity within the classroom. In contrast, peer buddy nominations for a typical boy were related to being viewed as popular, helpful, and self-confident. Students may select a social niche for CWA based on principles of peer homophily. Limitations and suggestions for future research are discussed.
3. Cheung C, Chua SE, Cheung V, Khong PL, Tai KS, Wong TK, Ho TP, McAlonan GM. {{White matter fractional anisotrophy differences and correlates of diagnostic symptoms in autism}}. {J Child Psychol Psychiatry};2009 (Sep);50(9):1102-1112.
BACKGROUND: Individuals with autism have impairments in 3 domains: communication, social interaction and repetitive behaviours. Our previous work suggested early structural and connectivity abnormalities in prefrontal-striato-temporal-cerebellar networks but it is not clear how these are linked to diagnostic indices. METHOD: Children with autism (IQ > 70) aged 6 to 14 years old and matched typically developing controls were studied using diffusion tensor imaging. Voxel-based methods were used to compare fractional anisotrophy (FA) measures in each group and to correlate FA measures in the autism group with the diagnostic phenotype described by the Autism Diagnostic Interview – Revised (ADI-R) algorithm for ICD-10. RESULTS: After controlling for the effects of age and white matter volume, we found that FA in the autism group was significantly lower than controls in bilateral prefrontal and temporal regions, especially in the right ventral temporal lobe adjacent to the fusiform gyrus. FA was greater in autism in the right inferior frontal gyrus and left occipital lobe. We observed a tight correlation between lower FA and higher ADI-R diagnostic algorithm scores across white matter tracts extending from these focal regions of group difference. Communication and social reciprocity impairments correlated with lower FA throughout fronto-striato-temporal pathways. Repetitive behaviours correlated with white matter indices in more posterior brain pathways, including splenium of the corpus callosum and cerebellum. CONCLUSIONS: Our data support the position that diagnostic symptoms of autism are associated with a core disruption of white matter development.
4. Cotugno AJ. {{Social competence and social skills training and intervention for children with Autism Spectrum Disorders}}. {J Autism Dev Disord};2009 (Sep);39(9):1268-1277.
This study examined the effectiveness of a 30 week social competence and social skills group intervention program with children, ages 7-11, diagnosed with Autism Spectrum Disorders (ASD). Eighteen children with ASD were assessed with pretreatment and posttreatment measures on the Walker-McConnell Scale (WMS) and the MGH YouthCare Social Competence Development Scale. Each received the 30-week intervention program. For comparison, a matched sample of ten non-ASD children was also assessed, but received no treatment. The findings indicated that each ASD intervention group demonstrated significant gains on the WMS and significant improvement in the areas of anxiety management, joint attention, and flexibility/transitions. Results suggest that this approach can be effective in improving core social deficits in individuals with ASD.
5. Dichter GS, Felder JN, Bodfish JW. {{Autism is characterized by dorsal anterior cingulate hyperactivation during social target detection}}.{ Soc Cogn Affect Neurosci};2009 (Sep);4(3):215-226.
Though the functional neural correlates of impaired cognitive control and social dysfunction in autism spectrum disorders (ASD) have been delineated, brain regions implicated in poor cognitive control of social information is a novel area of autism research. We recently reported in a non-clinical sample that detection of ‘social oddball’ targets activated a portion of the dorsal anterior cingulate gyrus and the supracalcarine cortex (Dichter, Felder, Bodfish, Sikich, and Belger, 2009). In the present investigation, we report functional magnetic resonance imaging results from individuals with ASD who completed the same social oddball task. Between-group comparisons revealed generally greater activation in the ASD group to both social and non-social targets. When responses to social and non-social targets were contrasted, the ASD group showed relatively greater activation in the right and middle inferior frontal gyri and a region in dorsomedial prefrontal cortex that abuts the dorsal anterior cingulate (Brodmann’s Area 32). Further, dorsal anterior cingulate activation to social targets predicted the severity of social impairments in a subset of the ASD sample. These data suggest that the dorsal anterior cingulate mediates social target detection in neurotypical individuals and is implicated in deficits of cognitive control of social information in ASD.
6. Dichter GS, Lam KS, Turner-Brown LM, Holtzclaw TN, Bodfish JW. {{Generativity abilities predict communication deficits but not repetitive behaviors in Autism Spectrum Disorders}}. {J Autism Dev Disord};2009 (Sep);39(9):1298-1304.
Individuals with Autism Spectrum Disorders (ASD) often demonstrate impaired generativity that is thought to mediate repetitive behaviors in autism (Turner in J Child Psychol Psychiatry, 40(6):839-849, 1999a). The present study evaluated generativity in children with and without ASD via the use-of-objects task (Turner in J Child Psychol Psychiatry, 40(2):189-201, 1999b) and an Animals Fluency Task (Lezak in Neuropsychological assessment. Oxford University Press, Oxford, 1995). Groups differed significantly on two of four metrics from the Animals Fluency Task and two of seven metrics from the Use of Objects task. In the ASD sample, no significant relations were found between generativity and repetitive behaviors. Significant relations were found, however, between performance on the Animals Fluency Task and communication symptoms. Results replicate reports of generativity deficits in ASD and suggest that impaired generativity may reflect communication deficits that are characteristic of the disorder.
7. Dowell LR, Mahone EM, Mostofsky SH. {{Associations of postural knowledge and basic motor skill with dyspraxia in autism: Implication for abnormalities in distributed connectivity and motor learning}}. {Neuropsychology};2009 (Sep);23(5):563-570.
Children with autism often have difficulty performing skilled movements. Praxis performance requires basic motor skill, knowledge of representations of the movement (mediated by parietal regions), and transcoding of these representations into movement plans (mediated by premotor circuits). The goals of this study were (a) to determine whether dyspraxia in autism is associated with impaired representational (« postural ») knowledge and (b) to examine the contributions of postural knowledge and basic motor skill to dyspraxia in autism. Thirty-seven children with autism spectrum disorder (ASD) and 50 typically developing (TD) children, ages 8-13, completed (a) an examination of basic motor skills, (b) a postural knowledge test assessing praxis discrimination, and (c) a praxis examination. Children with ASD showed worse basic motor skill and postural knowledge than did controls. The ASD group continued to show significantly poorer praxis than did controls after accounting for age, IQ, basic motor skill, and postural knowledge. Dyspraxia in autism appears to be associated with impaired formation of spatial representations, as well as transcoding and execution. Distributed abnormality across parietal, premotor, and motor circuitry, as well as anomalous connectivity, may be implicated. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
8. Esbensen AJ, Greenberg JS, Seltzer MM, Aman MG. {{A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders}}. {J Autism Dev Disord};2009 (Sep);39(9):1339-1349.
Medication use was examined in 286 adolescents and adults with ASD over a 4.5 year period. A total of 70% were taking a psychotropic or non-psychotropic medication at the beginning of the study. Both the number of psychotropic and non-psychotropic medications taken, and the proportion of individuals taking these medications, increased significantly over the study period, with 81% taking at least one medication 4.5 years later. Our findings suggested a high likelihood of staying medicated over time. Thus, adolescents and adults with ASD are a highly and increasingly medicated population.
9. Francis P, Mellor D, Firth L. {{Techniques and recommendations for the inclusion of users with autism in the design of assistive technologies}}. {Assist Technol};2009 (Summer);21(2):57-68.
The increasing numbers of technology platforms offer opportunities to develop new visual assistive aids for people with autism. However, their involvement in the design of such aids is critical to their short-term uptake and longer term use. Using a three-round Delphi study involving seven Australian psychologists specializing in treating people with autism, the authors explored the utility of four techniques that might be implemented to involve users with autism in the design process. The authors found that individual users from the target group would be likely to respond differently to the techniques and that no technique was clearly better than any other. Recommendations for using these techniques to involve individuals with autism in the design of assistive technologies are suggested.
10. Grinter EJ, Maybery MT, Van Beek PL, Pellicano E, Badcock JC, Badcock DR. {{Global visual processing and self-rated autistic-like traits}}. {J Autism Dev Disord};2009 (Sep);39(9):1278-1290.
The current research investigated, firstly, whether individuals with high levels of mild autistic-like traits display a similar profile of embedded figures test (EFT) and global motion performance to that seen in autism. Secondly, whether differences in EFT performance are related to enhanced local processing or reduced global processing in the ventral visual stream was also examined. Results indicated that people who scored high on the Autism-spectrum Quotient (AQ) were faster to identify embedded figures, and had poorer global motion and global form thresholds than low AQ scorers. However, the two groups did not differ on a task assessing lower-level input to the ventral stream. Overall the results indicate that individuals with high levels of autistic-like traits have difficulties with global integration in the visual pathways, which may at least partly explain their superior EFT performance.
11. Hume K, Loftin R, Lantz J. {{Increasing independence in autism spectrum disorders: a review of three focused interventions}}. {J Autism Dev Disord};2009 (Sep);39(9):1329-1338.
The features of autism that inhibit the independent demonstration of skills, as well as three effective interventions for increasing independence, are explored in this review article. Independent performance may prove difficult for individuals with autism spectrum disorders (ASD) due to the core deficits of the disability, as well as executive function deficits that impact initiation and generalization. These difficulties, coupled with intervention strategies that encourage over-reliance on adult support, contribute to poor long term outcomes for adults with ASD in employment, housing, and relationship development. Self-monitoring, video modeling, and individual work systems each emphasize a shift in stimulus control from continuous adult management to an alternative stimulus and have proven successful in addressing executive function deficits and increasing independence.
12. Jeste SS, Friedman SL, Urion DK. {{Child neurology: autism as a model: considerations for advanced training in behavioral child neurology}}. {Neurology};2009 (Sep 1);73(9):733-735.
In this article, we advocate for advanced training for child neurologists in behavior and development in order to facilitate the investigation of childhood behavioral and neurodevelopmental disabilities, with autism serving as a model disorder. We explore the current training options and then propose alternative subspecialty training options that focus on behavior and development, with appreciation that most developmental disabilities are not static encephalopathies but, rather, dynamic processes representing the influence of genetics and environment on neural circuitry.
13. King MD, Fountain C, Dakhlallah D, Bearman PS. {{Estimated autism risk and older reproductive age}}. {Am J Public Health};2009 (Sep);99(9):1673-1679.
OBJECTIVES: We sought to estimate the risk for autism associated with maternal and paternal age across successive birth cohorts. METHODS: We linked birth records and autism diagnostic records from the California Department of Developmental Services for children born in California between 1992 and 2000 to calculate the risk associated with maternal and paternal age for each birth cohort as well as for the pooled data. RESULTS: The categorical risks associated with maternal age over 40 years ranged from a high of 1.84 (95% confidence interval [CI] = 1.37, 2.47) to a low of 1.27 (95% CI = 0.95, 1.69). The risk associated with paternal age ranged from 1.29 (95% CI = 1.03, 1.6) to 1.71 (95% CI = 1.41, 2.08). CONCLUSIONS: Pooling data across multiple birth cohorts inflates the risk associated with paternal age. Analyses that do not suffer from problems produced by pooling across birth cohorts demonstrated that advanced maternal age, rather than paternal age, may pose greater risk. Future research examining parental age as a risk factor must be careful to avoid the paradoxes that can arise from pooling data, particularly during periods of social demographic change.
14. Koegel RL, Vernon TW, Koegel LK. {{Improving social initiations in young children with autism using reinforcers with embedded social interactions}}. {J Autism Dev Disord};2009 (Sep);39(9):1240-1251.
Children with autism often exhibit low levels of social engagement, decreased levels of eye contact, and low social affect. However, both the literature and our direct clinical observations suggest that some components of intervention procedures may result in improvement in child-initiated social areas. Using an ABAB research design with three children with autism, this study systematically assessed whether embedding social interactions into reinforcers, delivered during language intervention, would lead to increased levels of child-initiated social behaviors. We compared this condition with a language intervention condition that did not embed social interactions into the reinforcers. Results indicated that embedding social interactions into the reinforcers resulted in increases in child-initiated social engagement during communication, improved nonverbal dyadic orienting, and improvements in general child affect. Theoretical and applied implications are discussed.
15. Kuczynski E, Bertola DR, Castro CI, Koiffmann CP, Kim CA.{{ Infantile autism and 47,XYY karyotype}}. {Arq Neuropsiquiatr};2009 (Sep);67(3A):717-718.
16. Lacroix A, Guidetti M, Roge B, Reilly J. {{Recognition of emotional and nonemotional facial expressions: a comparison between Williams syndrome and autism}}. {Res Dev Disabil};2009 (Sep-Oct);30(5):976-985.
The aim of our study was to compare two neurodevelopmental disorders (Williams syndrome and autism) in terms of the ability to recognize emotional and nonemotional facial expressions. The comparison of these two disorders is particularly relevant to the investigation of face processing and should contribute to a better understanding of social behaviour and social cognition. Twelve participants with WS (from 6;1 to 15 years) and twelve participants with autism (from 4;9 to 8 years) were matched on verbal mental age. Their performances were compared with those of twelve typically developing controls matched on verbal mental age (from 3;1 to 9;2). A set of five tasks assessing different dimensions of emotional and nonemotional facial recognition were administered. Results indicated that recognition of emotional facial expressions is more impaired in Williams syndrome than in autism. Our study comparing Williams syndrome and autism over a small age range highlighted two distinct profiles which call into question the relationships between social behaviour/cognition and emotion perception.
17. Lima FT, Brunoni D, Schwartzman JS, Pozzi MC, Kok F, Juliano Y, Pereira Lda V. {{Genotype-phenotype correlation in Brazillian Rett syndrome patients}}. {Arq Neuropsiquiatr};2009 (Sep);67(3A):577-584.
BACKGROUND: Rett syndrome (RS) is a severe neurodevelopmental X-linked dominant disorder caused by mutations in the MECP2 gene. PURPOSE: To search for point mutations on the MECP2 gene and to establish a correlation between the main point mutations found and the phenotype. METHOD: Clinical evaluation of 105 patients, following a standard protocol. Detection of point mutations on the MECP2 gene was performed on peripheral blood DNA by sequencing the coding region of the gene. RESULTS: Classical RS was seen in 68% of the patients. Pathogenic point mutations were found in 64.1% of all patients and in 70.42% of those with the classical phenotype. Four new sequence variations were found, and their nature suggests patogenicity. Genotype-phenotype correlations were performed. CONCLUSION: Detailed clinical descriptions and identification of the underlying genetic alterations of this Brazilian RS population add to our knowledge of genotype/phenotype correlations, guiding the implementation of mutation searching programs.
18. Lind SE, Bowler DM. {{Recognition memory, self-other source memory, and theory-of-mind in children with autism spectrum disorder}}. {J Autism Dev Disord};2009 (Sep);39(9):1231-1239.
This study investigated semantic and episodic memory in autism spectrum disorder (ASD), using a task which assessed recognition and self-other source memory. Children with ASD showed undiminished recognition memory but significantly diminished source memory, relative to age- and verbal ability-matched comparison children. Both children with and without ASD showed an « enactment effect », demonstrating significantly better recognition and source memory for self-performed actions than other-person-performed actions. Within the comparison group, theory-of-mind (ToM) task performance was significantly correlated with source memory, specifically for other-person-performed actions (after statistically controlling for verbal ability). Within the ASD group, ToM task performance was not significantly correlated with source memory (after controlling for verbal ability). Possible explanations for these relations between source memory and ToM are considered.
19. Lindell AK, Notice K, Withers K. {{Reduced language processing asymmetry in non-autistic individuals with high levels of autism traits}}. {Laterality};2009 (Sep);14(5):457-472.
In the normal population the left hemisphere’s predominance for language processing is well established. However, in disorders such as autism atypical patterns of hemispheric lateralisation are common. Given increasing recognition of the idea that autism represents a continuum, we investigated whether the reduced/absent hemispheric asymmetry for language processing extended into the normal population at the upper end of the autism spectrum. A total of 51 participants completed the AQ questionnaire (Baron-Cohen et al., 2001), and a lateralised lexical decision task assessing identification of concrete and abstract words. Based on the clinical finding of decreased hemispheric asymmetry in people with autism, we anticipated reduced hemispheric lateralisation in non-autistic people with higher levels of autism traits. Consistent with prediction, whereas people with lower AQ scores showed a clear right visual field (left hemisphere) advantage for word/nonword discrimination, people with higher AQ scores showed equivalent performance for the left and right visual fields. Our data indicate reduced left hemisphere language dominance in people with higher levels of autism traits, just as people with a clinical diagnosis of autism show atypical lateralisation. Moreover, the data offer further support for the notion that autism is a continuum, rather than a categorical diagnosis, with atypical patterns of hemispheric asymmetry being characteristic of people at the upper end of the spectrum.
20. Luyster R, Gotham K, Guthrie W, Coffing M, Petrak R, Pierce K, Bishop S, Esler A, Hus V, Oti R, Richler J, Risi S, Lord C. {{The Autism Diagnostic Observation Schedule-toddler module: a new module of a standardized diagnostic measure for autism spectrum disorders}}. {J Autism Dev Disord};2009 (Sep);39(9):1305-1320.
The Autism Diagnostic Observation Schedule (ADOS; Lord et al., J Autism Dev Disord, 30(3):205-223, 2000) is widely accepted as a « gold standard » diagnostic instrument, but it is of restricted utility with very young children. The purpose of the current project was to modify the ADOS for use in children under 30 months of age. A modified ADOS, the ADOS Toddler Module (or Module T), was used in 360 evaluations. Participants included 182 children with best estimate diagnoses of ASD, non-spectrum developmental delay or typical development. A final set of protocol and algorithm items was selected based on their ability to discriminate the diagnostic groups. The traditional algorithm « cutoffs » approach yielded high sensitivity and specificity, and a new range of concern approach was proposed.
21. Makrythanasis P, Kapranov P, Bartoloni L, Reymond A, Deutsch S, Guigo R, Denoeud F, Drenkow J, Rossier C, Ariani F, Capra V, Excoffier L, Renieri A, Gingeras TR, Antonarakis SE. {{Variation in novel exons (RACEfrags) of the MECP2 gene in Rett syndrome patients and controls}}. {Hum Mutat};2009 (Sep);30(9):E866-879.
The study of transcription using genomic tiling arrays has lead to the identification of numerous additional exons. One example is the MECP2 gene on the X chromosome; using 5’RACE and RT-PCR in human tissues and cell lines, we have found more than 70 novel exons (RACEfrags) connecting to at least one annotated exon.. We sequenced all MECP2-connected exons and flanking sequences in 3 groups: 46 patients with the Rett syndrome and without mutations in the currently annotated exons of the MECP2 and CDKL5 genes; 32 patients with the Rett syndrome and identified mutations in the MECP2 gene; 100 control individuals from the same geoethnic group. Approximately 13 kb were sequenced per sample, (2.4 Mb of DNA resequencing). A total of 75 individuals had novel rare variants (mostly private variants) but no statistically significant difference was found among the 3 groups. These results suggest that variants in the newly discovered exons may not contribute to Rett syndrome. Interestingly however, there are about twice more variants in the novel exons than in the flanking sequences (44 vs. 21 for approximately 1.3 Mb sequenced for each class of sequences, p=0.0025). Thus the evolutionary forces that shape these novel exons may be different than those of neighboring sequences.
22. Marcu I, Oppenheim D, Koren-Karie N, Dolev S, Yirmiya N. {{Attachment and symbolic play in preschoolers with autism spectrum disorders}}. {J Autism Dev Disord};2009 (Sep);39(9):1321-1328.
The association between attachment and symbolic play was examined in a sample of 45 preschool age boys with autism spectrum disorders. Attachment was assessed using the strange situation procedure, and the frequency, duration, diversity and complexity of child-initiated symbolic play was assessed from observations of mother-child interactions during free play and doll play. We hypothesized that children with secure attachments will score higher on measures of symbolic play compared to children with insecure attachments, and that children with organized attachments will also score higher on measures of symbolic play compared to children with disorganized attachments. Only the second hypothesis received support, and the reasons for this, as well as the implications of the findings for attachment theory, are discussed.
23. Mosconi MW, Kay M, D’Cruz AM, Seidenfeld A, Guter S, Stanford LD, Sweeney JA. {{Impaired inhibitory control is associated with higher-order repetitive behaviors in autism spectrum disorders}}. {Psychol Med};2009 (Sep);39(9):1559-1566.
BACKGROUND: Impairments in executive cognitive control, including a reduced ability to inhibit prepotent responses, have been reported in autism spectrum disorders (ASD). These deficits may underlie patterns of repetitive behaviors associated with the disorder. METHOD: Eighteen individuals with ASD and 15 age- and IQ-matched healthy individuals performed an antisaccade task and a visually guided saccade control task, each with gap and overlap conditions. Measures of repetitive behaviors were obtained using the Autism Diagnostic Inventory-Revised (ADI-R) and examined in relation to neurocognitive task performance. RESULTS: Individuals with an ASD showed increased rates of prosaccade errors (failures to inhibit prepotent responses) on the antisaccade task regardless of task condition (gap/overlap). Prosaccade error rates were associated with the level of higher-order (e.g. compulsions, preoccupations) but not sensorimotor repetitive behaviors in ASD. CONCLUSIONS: Neurocognitive disturbances in voluntary behavioral control suggest that alterations in frontostriatal systems contribute to higher-order repetitive behaviors in ASD.
24. Mostofsky SH, Powell SK, Simmonds DJ, Goldberg MC, Caffo B, Pekar JJ. {{Decreased connectivity and cerebellar activity in autism during motor task performance}}. {Brain};2009 (Sep);132(Pt 9):2413-2425.
Although motor deficits are common in autism, the neural correlates underlying the disruption of even basic motor execution are unknown. Motor deficits may be some of the earliest identifiable signs of abnormal development and increased understanding of their neural underpinnings may provide insight into autism-associated differences in parallel systems critical for control of more complex behaviour necessary for social and communicative development. Functional magnetic resonance imaging was used to examine neural activation and connectivity during sequential, appositional finger tapping in 13 children, ages 8-12 years, with high-functioning autism (HFA) and 13 typically developing (TD), age- and sex-matched peers. Both groups showed expected primary activations in cortical and subcortical regions associated with motor execution [contralateral primary sensorimotor cortex, contralateral thalamus, ipsilateral cerebellum, supplementary motor area (SMA)]; however, the TD group showed greater activation in the ipsilateral anterior cerebellum, while the HFA group showed greater activation in the SMA. Although activation differences were limited to a subset of regions, children with HFA demonstrated diffusely decreased connectivity across the motor execution network relative to control children. The between-group dissociation of cerebral and cerebellar motor activation represents the first neuroimaging data of motor dysfunction in children with autism, providing insight into potentially abnormal circuits impacting development. Decreased cerebellar activation in the HFA group may reflect difficulty shifting motor execution from cortical regions associated with effortful control to regions associated with habitual execution. Additionally, diffusely decreased connectivity may reflect poor coordination within the circuit necessary for automating patterned motor behaviour. The findings might explain impairments in motor development in autism, as well as abnormal and delayed acquisition of gestures important for socialization and communication.
25. Mouridsen SE, Hauschild KM. {{A longitudinal study of autism spectrum disorders in individuals diagnosed with a developmental language disorder as children}}. {Child Care Health Dev};2009 (Sep);35(5):691-697.
BACKGROUND: A number of studies have shown that the diagnosis of developmental language disorder (DLD) can be unstable over time, such that young children with a diagnosis of DLD may show symptoms more characteristics of autism spectrum disorder (ASD) at a later date. METHOD: To estimate the types and prevalence of ASD 469 individuals with a DLD, consecutively assessed in the same clinic during a period of 10 years, and 2345 controls from the general population were screened for ASD through the nationwide Danish Psychiatric Central Register (DPCR). The mean length of observation was 34.7 years, and the mean age at follow-up 35.8 (range: 28.3-46.7) years. RESULTS: At follow-up, 10 (2.1%) in the DLD group and two (0.09%) in the comparison group were known in the DPCR with a diagnosis of any ASD (P < 0.0001; odds ratio = 25.5; 95% confidence interval 5.5-116.9). CONCLUSION: Our results provide additional support to the notion that DLD is a marker of increased vulnerability to the development of ASD.
26. Perez Velazquez JL, Barcelo F, Hung Y, Leshchenko Y, Nenadovic V, Belkas J, Raghavan V, Brian J, Garcia Dominguez L. {{Decreased brain coordinated activity in autism spectrum disorders during executive tasks: reduced long-range synchronization in the fronto-parietal networks}}. {Int J Psychophysiol};2009 (Sep);73(3):341-349.
Current theories of brain function propose that the coordinated integration of transient activity patterns in distinct brain regions is the essence of brain information processing. The behavioural manifestations of individuals with autism spectrum disorders (ASD) suggest that their brains have a different style of information processing. Specifically, a current trend is to invoke functional disconnection in the brains of individuals with ASD as a possible explanation for some atypicalities in the behaviour of these individuals. Our observations indicate that the coordinated activity in brains of children with autism is lower than that found in control participants. Disruption of long-range phase synchronization among frontal, parietal and occipital areas was found, derived from magnetoencephalographic (MEG) recordings, in high-functioning children with ASD during the performance of executive function tasks and was associated with impaired execution, while enhanced long-range brain synchronization was observed in control children. Specifically, a more significant prefrontal synchronization was found in control participants during task performance. In addition, a robust enhancement in synchrony was observed in the parietal cortex of children with ASD relative to controls, which may be related to parietal lobe abnormalities detected in these individuals. These results, using synchronization analysis of brain electrical signals, provide support for the contention that brains of individuals with autism may not be as functionally connected as that of the controls, and may suggest some therapeutic interventions to improve information processing in specific brain areas, particularly prefrontal cortices.
27. Rickards AL, Walstab JE, Wright-Rossi RA, Simpson J, Reddihough DS. {{One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families}}. {Child Care Health Dev};2009 (Sep);35(5):593-602.
INTRODUCTION: There is debate about the type and intensity of early childhood intervention that is most helpful for children with developmental problems. The aim of the study was to determine whether a home-based programme provided over 12 months resulted in sustained improvement in development and behaviour 12 months after the intervention ceased. The characteristics of the children and families who benefited most from the intervention were also studied. METHOD: Randomized controlled trial. Participants A total of 59 children, aged 3-5 years, attending two early childhood intervention centres in Melbourne, Australia. Intervention Half of the subjects received an additional home-based programme consisting of 40 weekly visits. MAIN OUTCOME MEASURES: Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence Revised, Preschool Behaviour Checklist, Bayley Behaviour Rating Scale and Behaviour Screening Questionnaire. All tests administered pre-intervention, following the intervention and 12 months later. Secondary outcome measures Family stress, support and empowerment. RESULTS: Fifty-four children completed the assessments 12 months after conclusion of the intervention. Compared with the control group, improvement in aspects of cognitive development in the children who received the extra intervention was sustained 1 year later (P= 0.007) while significant behavioural differences post intervention were not. Analyses of the data by the Reliable Change Index indicated improvement of clinical significance occurred in non-verbal areas. In contrast to the control group who deteriorated, language skills in the intervention group remained stable. Improvements were significantly associated with higher stress in the families. CONCLUSION: Improvements following the provision of a home-based programme to preschool children with developmental disabilities were sustained 1 year later. Children from highly stressed families appeared to benefit most, reinforcing the importance of involving families in early childhood intervention programmes.
28. Rowlandson PH, Smith C. {{An interagency service delivery model for autistic spectrum disorders and attention deficit hyperactivity disorder}}. Child Care Health Dev;2009 (Sep);35(5):681-690.
BACKGROUND: A multiplicity of government initiatives advocate increasing shared working between services to ensure that holistic and co-ordinated assessment of need and related shared intervention is available to children and families. Concurrently, there is an increasing demand upon services to provide a wide range of support for children with complex difficulties. METHODS: On the Isle of Wight, joint services have been developing shared practice. The inter-agency service was initiated in 2001 through a 3-year project funded jointly between all services on the Island and the government through the ‘Invest to Save’ initiative. The project initially focused upon developing a combined process of diagnosis of autistic spectrum disorders (ASD) and the co-ordination of intervention at schools, within families and in the child’s community. Gradually, the service extended to include children with a much wider range of difficulties, including those of attention deficit hyperactivity disorder (ADHD), developmental co-ordination disorder and co-morbid diagnoses. RESULTS: There are 19 000 school-aged children on the Isle of Wight. A total of 1101 referrals have been accepted between June 2001 and May 2007. In total, 201 children have been given a diagnosis of ASD. Overall, 392 children have been given a diagnosis of ADHD or ADHD/Co-morbid. Seventy were co-morbid for ASD and ADHD. The current service is rated as 85% satisfactory by its users, in contrast to the high level of complaint which resulted in the bid for the project initially. CONCLUSION: Following the successful conclusion of the 3-year government-funded project Education Services, Social Care and The Health Authority shared the ongoing funding of the current service. This has been operating effectively for over 6 years and has highlighted a wide variety of issues around this style of service delivery.
29. Sadakata T, Furuichi T. {{Developmentally regulated Ca2+-dependent activator protein for secretion 2 (CAPS2) is involved in BDNF secretion and is associated with autism susceptibility}}. {Cerebellum};2009 (Sep);8(3):312-322.
The postnatal development of the cerebellum is accomplished via a series of cytogenetic and morphogenetic events encoded in the genome. To decipher the underlying genetic basis of these events we have systematized the spatio-temporal gene expression profiles during mouse cerebellar development in the Cerebellar Development Transcriptome Database (CDT-DB). Using the CDT-DB, Ca(2+)-dependent activator protein for secretion 2 (CAPS2 or CADPS2) was identified as a developmentally regulated gene that is predominantly expressed in cerebellar granule cells (GCs) with an expression peak around the first or second postnatal week. CAPS2 protein is concentrated in parallel fiber (PF) terminals and is associated with secretory vesicles containing brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3). CAPS2 enhances release of BDNF and NT-3, both of which are essential for normal cerebellar development. CAPS2-deficient (CAPS2(-/-)) mice show reduced secretion of BDNF and NT-3; consequently, the cerebella of these mice exhibit developmental deficits, such as delayed development and increased cell death in GCs, fewer branched dendrites on Purkinje cells (PCs), and loss of the intercrural fissure. The PF-PC synapses have aberrant cytoarchitectures and electrophysiological properties. These abnormal cellular and morphological phenotypes are more severe around the cerebellar vermis, in which hypoplasia has been reported in autism patients. Moreover, CAPS2(-/-) mice had fewer cortical and hippocampal parvalbumin-positive interneurons and some autistic-like behavioral phenotypes. In the CAPS2 genes of some autistic patients an aberrant splicing variant and non-synonymous SNPs have been identified. These recent studies implicate CAPS2 in autism susceptibility. Therefore, CAPS2(-/-) mice will be a useful model animal in which to study aspects of the neuropathology and behaviors characteristic of developmental disorders.
30. Sajdel-Sulkowska EM, Xu M, Koibuchi N. {{Increase in cerebellar neurotrophin-3 and oxidative stress markers in autism}}. {Cerebellum};2009 (Sep);8(3):366-372.
Autism is a neurodevelopmental disorder characterized by social and language deficits, ritualistic-repetitive behaviors and disturbance in motor functions. Data of imaging, head circumference studies, and Purkinje cell analysis suggest impaired brain growth and development. Both genetic predisposition and environmental triggers have been implicated in the etiology of autism, but the underlying cause remains unknown. Recently, we have reported an increase in 3-nitrotyrosine (3-NT), a marker of oxidative stress damage to proteins in autistic cerebella. In the present study, we further explored oxidative damage in the autistic cerebellum by measuring 8-hydroxydeoxyguanosine (8-OH-dG), a marker of DNA modification, in a subset of cases analyzed for 3-NT. We also explored the hypothesis that oxidative damage in autism is associated with altered expression of brain neurotrophins critical for normal brain growth and differentiation. The content of 8-OH-dG in cerebellar DNA isolated by the proteinase K method was measured using an enzyme-linked immunosorbent assay (ELISA); neurotrophin-3 (NT-3) levels in cerebellar homogenates were measured using NT-3 ELISA. Cerebellar 8-OH-dG showed trend towards higher levels with the increase of 63.4% observed in autism. Analysis of cerebellar NT-3 showed a significant (p = 0.034) increase (40.3%) in autism. Furthermore, there was a significant positive correlation between cerebellar NT-3 and 3-NT (r = 0.83; p = 0.0408). These data provide the first quantitative measure of brain NT-3 and show its increase in the autistic brain. Altered levels of brain NT-3 are likely to contribute to autistic pathology not only by affecting brain axonal targeting and synapse formation but also by further exacerbating oxidative stress and possibly contributing to Purkinje cell abnormalities.
31. Sasayama D, Masutani S, Imai J, Harada Y, Washizuka S, Amano N. {{High prevalence of pervasive developmental disorders in depressed children and adolescents}}. {Child Care Health Dev};2009 (Sep);35(5):746-747.
32. Sinzig J, Walter D, Doepfner M. {{Attention deficit/hyperactivity disorder in children and adolescents with autism spectrum disorder: symptom or syndrome?}} {J Atten Disord};2009 (Sep);13(2):117-126.
Objective: This study aims to evaluate ADHD-like symptoms in children with autism spectrum disorder (ASD) based on single-item analysis, as well as the comparison of two ASD subsamples of children with ADHD (ASD+) and without ADHD (ASD-). Methods: Participants are 83 children with ASD. Dimensional and categorical aspects of ADHD are evaluated using a diagnostic symptom checklist according to DSM-IV. Results: Of the sample, 53% fulfill DSM-IV criteria for ADHD. The comparison of the ASD+ and the ASD- samples reveals differences in age and IQ. Correlations of ADHD and PDD show significant results for symptoms of hyperactivity with impairment in communication and for inattention with stereotyped behavior. Item profiles of ADHD symptoms in the ASD+ sample are similar to those in a pure ADHD sample. Conclusion: The results of our study reveal a high phenotypical overlap between ASD and ADHD. The two identified subtypes, inattentive-stereotyped and hyperactive-communication impaired, reflect the DSM classification and may theoretically be a sign of two different neurochemical pathways, a dopaminergic and a serotonergic. (J. of Att. Dis. 2009; 13(2) 117-126).
33. Sizoo BB, van den Brink W, Gorissen-van Eenige M, Koeter MW, van Wijngaarden-Cremers PJ, van der Gaag RJ. {{Using the Autism-spectrum quotient to discriminate Autism Spectrum Disorder from ADHD in adult patients with and without comorbid Substance Use Disorder}}. {J Autism Dev Disord};2009 (Sep);39(9):1291-1297.
It is unknown whether the Autism-spectrum quotient (AQ) can discriminate between Autism Spectrum Disorder (ASD) and Attention Deficit and Hyperactivity Disorder (ADHD) with or without comorbid Substance Use Disorder (SUD). ANOVA’s were used to analyse the mean AQ (sub)scores of 129 adults with ASD or ADHD. We applied receiver operating characteristic (ROC) computations to assess discriminant power. All but one of the mean AQ (sub)scores were significantly higher for adults with ASD compared to those with ADHD. The SUD status in general was not significantly associated with AQ (sub)scores. On the Social Skills subscale patients with ASD and comorbid SUD showed less impairment than those without SUD. The cut-off score 26 yielded 73% correct classifications. The clinical use of the AQ in differentiating between ASD and ADHD is limited.
34. Theoharides TC, Kempuraj D, Redwood L. {{Autism: an emerging ‘neuroimmune disorder’ in search of therapy}}. {Expert Opin Pharmacother};2009 (Sep);10(13):2127-2143.
BACKGROUND: Autism spectrum disorders (ASDs) are neurodevelopmental disorders characterized by difficulties in communication and by repetitive and stereotypic behaviors, as well as by social impairment, attention, cognitive, and learning defects. ASDs present in early childhood and their prevalence has increased significantly to 1/150 children. Despite a number of theories, the actual reasons for this increase are still not clear. There is no reliable screening test, and no definite pathogenesis or curative therapy. Consequently, there is a major gap hampering development of effective treatments. OBJECTIVE: To review recent publications on ASDs pathogenesis and treatment with emphasis on neuroimmune processes and new therapeutic approaches. METHODS: Mostly original papers (450) on epidemiology, possible pathogenesis or treatment of ASDs in Medline from 1990 to May 2009 were reviewed. All authors contributed to this review. RESULTS/CONCLUSION: Increased oxidative stress and immune dysregulation are present in ASDs. Mast-cell activation may contribute to gut-blood-brain barrier disruption and brain inflammation. No effective treatments have emerged. Well-designed clinical trials with nonpsychotropic drugs were few and ASD characteristics varied considerably, making conclusions difficult. Psychotropic drugs are often used for stereotypic and aggressive behaviors. Unique combinations with antioxidant and anti-inflammatory flavonoids hold promise. New potential translational research areas and possible treatments are suggested.
35. Vital PM, Ronald A, Wallace GL, Happe F. {{Relationship between special abilities and autistic-like traits in a large population-based sample of 8-year-olds}}. {J Child Psychol Psychiatry};2009 (Sep);50(9):1093-1101.
BACKGROUND: The raised incidence of special abilities or ‘savant skills’ among individuals with autism spectrum disorders (ASD) relative to other developmental disorders suggests an association between the traits characteristic of ASD and special abilities. The purpose of this study was to investigate the association between special abilities and ASD-like traits. METHODS: This study compared the scores of 6,426 8-year-olds with and without parent-reported special abilities on a screening questionnaire for ASD-like traits in three areas: social interaction, communication, and restricted and repetitive behaviours and interests. Measures of IQ, sex, and socioeconomic status (SES) were also compared. RESULTS: From parent report, children with special abilities showed significantly more ASD-like traits than those without such abilities. General intelligence did not mediate this relationship: IQ was found to be positively associated with ability, but negatively associated with ASD-like traits. Special abilities were more strongly associated with restricted/repetitive characteristics than with social or communication traits. CONCLUSIONS: Results support the association between special abilities and ASD-like traits, and expand it to traits in the general population. The type of nonsocial traits most strongly associated with parental reports of special abilities suggests a link to a feature information processing style, or ‘weak central coherence’.
36. Young GS, Merin N, Rogers SJ, Ozonoff S. {{Gaze behavior and affect at 6 months: predicting clinical outcomes and language development in typically developing infants and infants at risk for autism}}. {Dev Sci};2009 (Sep);12(5):798-814.
This paper presents follow-up longitudinal data to research that previously suggested the possibility of abnormal gaze behavior marked by decreased eye contact in a subgroup of 6-month-old infants at risk for autism (Merin, Young, Ozonoff & Rogers, 2007). Using eye-tracking data and behavioral data recorded during a live mother-infant interaction involving the still-face procedure, the predictive utility of gaze behavior and affective behaviors at 6 months was examined using diagnostic outcome data obtained longitudinally over the following 18 months. Results revealed that none of the infants previously identified as showing lower rates of eye contact had any signs of autism at outcome. In contrast, three infants who were diagnosed with autism demonstrated consistent gaze to the eye region and typical affective responses at 6 months. Individual differences in face scanning and affective responsivity during the live interaction were not related to any continuous measures of symptom frequency or symptom severity. In contrast, results of growth curve models for language development revealed significant relationships between face scanning and expressive language. Greater amounts of fixation to the mother’s mouth during live interaction predicted higher levels of expressive language at outcome and greater rates of growth. These findings suggest that although gaze behavior at 6 months may not provide early markers for autism as initially conceived, gaze to the mouth in particular may be useful in predicting individual differences in language development.
