1. Bhat AN, Galloway JC, Landa RJ. {{Social and non-social visual attention patterns and associative learning in infants at risk for autism}}. {J Child Psychol Psychiatry} (Sep);51(9):989-997.
BACKGROUND: Social inattention is common in children with autism whereas associative learning capabilities are considered a relative strength. Identifying early precursors of impairment associated with autism could lead to earlier identification of this disorder. The present study compared social and non-social visual attention patterns as well as associative learning in infant siblings of children with autism (AU sibs) and low-risk (LR) infants at 6 months of age. METHODS: Twenty-five AU sibs and 25 LR infants were observed in a novel social-object learning task, within which attention to social and non-social cues was contrasted. Video recorded data were coded for percent duration of gaze to objects or caregiver. Movement rates to activate the toy within the associative learning task were also quantified. RESULTS: Both groups learned the association between moving a switch and activating a cause-effect toy. AU sibs spent less time looking at caregivers and more time looking at the toy or joystick when their caregivers made no attempts to engage their attention. However, response to caregiver-initiated social bids was comparable for both groups. CONCLUSIONS: Infrequent self-initiated socially directed gaze may be an early marker of later social and communication delays.
2. Bishop DV. {{Overlaps between autism and language impairment: phenomimicry or shared etiology?}}. {Behav Genet} (Sep);40(5):618-629.
Traditionally, autistic spectrum disorder (ASD) and specific language impairment (SLI) are regarded as distinct conditions with separate etiologies. Yet these disorders co-occur at above chance levels, suggesting shared etiology. Simulations, however, show that additive pleiotropic genes cannot account for observed rates of language impairment in relatives, which are higher for probands with SLI than for those with ASD + language impairment. An alternative account is in terms of ‘phenomimicry’, i.e., language impairment in comorbid cases may be a consequence of ASD risk factors, and different from that seen in SLI. However, this cannot explain why molecular genetic studies have found a common risk genotype for ASD and SLI. This paper explores whether nonadditive genetic influences could account for both family and molecular findings. A modified simulation involving G x G interactions obtained levels of comorbidity and rates of impairment in relatives more consistent with observed values. The simulations further suggest that the shape of distributions of phenotypic trait scores for different genotypes may provide evidence of whether a gene is involved in epistasis.
3. Brownlow C. {{Re-presenting autism: the construction of ‘NT syndrome’}}. {J Med Humanit} (Sep);31(3):243-255.
Autism is a widely researched area and much emphasis has been placed in research on the differences between the autistic and non-autistic populations. Such research commonly draws on proposed deficits within people with autism in order to explain differences. This paper seeks to present an alternative understanding of differences and draws on writings of people with autism in such a discussion. The construction of ‘Neurologically Typical syndrome’ (NT) will be presented as an inverted construction of diagnosis, which serves to challenge the dominant position of ‘NTs’ and ‘NT traits’ over autistic traits. It will be argued that such an alternative representation of people with and without autism has important implications for our construction of and understanding of autism.
4. Chevallier C, Wilson D, Happe F, Noveck I. {{Scalar inferences in Autism Spectrum Disorders}}. {J Autism Dev Disord} (Sep);40(9):1104-1117.
On being told « John or Mary will come », one might infer that not both of them will come. Yet the semantics of « or » is compatible with a situation where both John and Mary come. Inferences of this type, which enrich the semantics of « or » from an ‘inclusive’ to an ‘exclusive’ interpretation, have been extensively studied in linguistic pragmatics. However, the phenomenon has not been much explored in Autism Spectrum Disorders (ASDs), where pragmatic deficits are commonly reported. Here, we present an experiment investigating these inferences. We predicted that, as a result of the reported pragmatic deficits, participants with ASD would produce fewer inferential enrichments of « or » than matched controls. However, contrary to expectations, but in line with recent findings by Pijnacker et al. (Journal of Autism and Developmental Disorders, 39, 607-618, 2009), performances did not differ across groups. This unexpected finding is discussed in light of the literature on pragmatic abilities in autism.
5. Christ SE, Kanne SM, Reiersen AM. {{Executive function in individuals with subthreshold autism traits}}. {Neuropsychology} (Sep);24(5):590-598.
Objective: Recent research has documented increased psychosocial difficulties in individuals who report higher-than-typical autistic traits but without an Autism Spectrum Disorder (ASD) diagnosis. Less is known, however, regarding the cognitive profile of individuals with subthreshold autism symptomatology. The objective of the present study was to provide additional insight into this issue and examine whether young adults who report higher degrees of autism traits also report experiencing increased difficulties with executive control. Method: The Behavior Rating Inventory of Executive Function was utilized to evaluate behavioral aspects of executive functioning in 66 and 28 individuals who endorsed high and low subthreshold levels of autism symptomatology, respectively. Results: After accounting for Attention Deficit/Hyperactivity Disorder (ADHD) symptomatology at both the group and individual participant levels, we found that autism traits continued to explain a significant amount of variance in participants’ overall level of executive function (Global Executive Composite) as well as within most individual executive domains. Interestingly, the high and low trait groups did not differ on the inhibitory control and organization of materials scales, areas of functioning that appears to be largely spared in individuals with ASD as well. Conclusions: Findings from the present study are consistent with past research linking ASD and executive control impairment. In addition, ASD and ADHD traits were associated with unique contributions to the executive control profile of individuals with subthreshold autism symptomatology. This finding underscores the importance of accounting for ADHD symptomatology in studying ASD. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
6. Devillard F, Guinchat V, Moreno-De-Luca D, Tabet AC, Gruchy N, Guillem P, Nguyen Morel MA, Leporrier N, Leboyer M, Jouk PS, Lespinasse J, Betancur C. {{Paracentric inversion of chromosome 2 associated with cryptic duplication of 2q14 and deletion of 2q37 in a patient with autism}}. {Am J Med Genet A} (Sep);152A(9):2346-2354.
We describe a patient with autism and a paracentric inversion of chromosome 2q14.2q37.3, with a concurrent duplication of the proximal breakpoint at 2q14.1q14.2 and a deletion of the distal breakpoint at 2q37.3. The abnormality was derived from his mother with a balanced paracentric inversion. The inversion in the child appeared to be cytogenetically balanced but subtelomere FISH revealed a cryptic deletion at the 2q37.3 breakpoint. High-resolution single nucleotide polymorphism array confirmed the presence of a 3.5 Mb deletion that extended to the telomere, and showed a 4.2 Mb duplication at 2q14.1q14.2. FISH studies using a 2q14.2 probe showed that the duplicated segment was located at the telomeric end of chromosome 2q. This recombinant probably resulted from breakage of a dicentric chromosome. The child had autism, mental retardation, speech and language delay, hyperactivity, growth retardation with growth hormone deficiency, insulin-dependent diabetes, and mild facial dysmorphism. Most of these features have been previously described in individuals with simple terminal deletion of 2q37. Pure duplications of the proximal chromosome 2q are rare and no specific syndrome has been defined yet, so the contribution of the 2q14.1q14.2 duplication to the phenotype of the patient is unknown. These findings underscore the need to explore apparently balanced chromosomal rearrangements inherited from a phenotypically normal parent in subjects with autism and/or developmental delay. In addition, they provide further evidence indicating that chromosome 2q terminal deletions are among the most frequently reported cytogenetic abnormalities in individuals with autism. (c) 2010 Wiley-Liss, Inc.
7. Downs J, Bebbington A, Jacoby P, Williams AM, Ghosh S, Kaufmann WE, Leonard H. {{Level of purposeful hand function as a marker of clinical severity in Rett syndrome}}. {Dev Med Child Neurol} (Sep);52(9):817-823.
AIM: We investigated relationships between hand function and genotype and aspects of phenotype in Rett syndrome. METHOD: Video assessment in naturalistic settings was supplemented by parent-reported data in a cross-sectional study of 144 females with a mean age of 14 years 10 months (SD 7 y 10 mo; range 2 y-31 y 10 mo), 110 of whom had a mutation of the methyl CpG binding protein 2 (MECP2) gene. Ordinal logistic regression was used to assess relationships between hand function and MECP2 mutation, age, a modified Kerr score, Functional Independence Measure for Children (WeeFIM), ambulation level, and frequency of hand stereotypies. RESULTS: Approximately two-thirds of participants demonstrated purposeful hand function, ranging from simple grasping skills to picking up and manipulating small objects. In participants with a confirmed MECP2 mutation, those with the p.R168X mutation had the poorest hand function on multivariate analysis with C-terminal deletion as the baseline (odds ratio [OR] 0.19; 95% confidence interval [CI] 0.04-0.95), whereas those with the p.R133C or p.R294X mutation had better hand function. Participants aged 19 years or older had lower hand function than those aged less than 8 years (OR 0.36; 95% CI 0.14-0.92). Factors that were associated with better hand function were lower Kerr scores for a 1-point increase in score (OR 0.77; 95% CI 0.69-0.86), higher WeeFIM scores for a 1-point increase in score (OR 1.08; 95% CI 1.04-1.12), and greater ambulation than those completely dependent on carers for mobility (OR 22.64; 95% CI 7.02-73.08). The results for participants with a confirmed pathogenic mutation were similar to results obtained when participants without a mutation were also included. INTERPRETATION: Our novel assessment of hand function in Rett syndrome correlated well with known profiles of common MECP2 mutations and overall clinical severity. This promising assessment could measure clinical responses to therapy.
8. Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. {{Using participant data to extend the evidence base for intensive behavioral intervention for children with autism}}. {Am J Intellect Dev Disabil} (Sep);115(5):381-405.
Abstract We gathered individual participant data from 16 group design studies on behavioral intervention for children with autism. In these studies, 309 children received behavioral intervention, 39 received comparison interventions, and 105 were in a control group. More children who underwent behavioral intervention achieved reliable change in IQ (29.8%) compared with 2.6% and 8.7% for comparison and control groups, respectively, and reliable change in adaptive behavior was achieved for 20.6% versus 5.7% and 5.1%, respectively. These results equated to a number needed to treat of 5 for IQ and 7 for adaptive behavior and absolute risk reduction of 23% and 16%, respectively. Within the behavioral intervention sample, IQ and adaptive behavior at intake predicted gains in adaptive behavior. Intensity of intervention predicted gains in both IQ and adaptive behavior.
9. Fan YT, Decety J, Yang CY, Liu JL, Cheng Y. {{Unbroken mirror neurons in autism spectrum disorders}}. {J Child Psychol Psychiatry} (Sep);51(9):981-988.
BACKGROUND: The ‘broken mirror’ theory of autism, which proposes that a dysfunction of the human mirror neuron system (MNS) is responsible for the core social and cognitive deficits in individuals with autism spectrum disorders (ASD), has received considerable attention despite weak empirical evidence. METHODS: In this electroencephalographic study, we examined mu suppression, as an indicator of sensorimotor resonance, concurrent with oculomotor performance while individuals (n = 20) with ASD and control participants (n = 20) either executed hand actions or observed hand actions or a moving dot. No difference in visual attention between groups was found as indicated by fixation duration and normalized fixation number on the presented stimuli. RESULTS: The mu suppression over the sensorimotor cortex was significantly affected by experimental conditions, but not by group membership, nor by the interaction between groups and conditions. Individuals with ASD, similar to the controls, exhibited stronger mu suppression when watching hand actions relative to a moving dot. Notably, participants with ASD failed to imitate the observed actions while their mu suppression indicating the MNS activity was intact. In addition, the mu suppression during the observation of hand actions was positively associated with the communication competence of individuals with ASD. CONCLUSION: Our study clearly challenges the broken mirror theory of autism. The functioning of the mirror neuron system might be preserved in individuals with ASD to a certain degree. Less mu suppression to action observation coupled with more communicational severity can reflect the symptom heterogeneity of ASD. Additional research needs to be done, and more caution should be used when reaching out to the media.
10. Frazier TW, Youngstrom EA, Sinclair L, Kubu CS, Law P, Rezai A, Constantino JN, Eng C. {{Autism spectrum disorders as a qualitatively distinct category from typical behavior in a large, clinically ascertained sample}}. {Assessment} (Sep);17(3):308-320.
The present study evaluated the hypothesis that autism spectrum disorders (ASDs) are best represented as a discrete category distinct from typical behavior within autism-affected families. The latent structure, categorical versus dimensional, of ASDs informs future diagnostic revisions, clinical assessment, and the design of future research. Data were obtained from Interactive Autism Network, a registry that preferentially recruits families with at least one ASD-affected child. Caregivers reported autism symptoms for affected and unaffected children using the Social Responsiveness Scale and Social Communication Questionnaire. Taxometric and latent variable models examined whether dimensional or categorical models best fit the data. Taxometric and latent variable model comparisons consistently indicated two-group mixtures for all indicator sets, even in participants designated as unaffected by caregivers. The identified category was associated with external indicators of disability, supporting its validity. Results indicated that ASD is best characterized as a category, distinct from typical behavior within ASD-affected families.
11. Gadow KD, Roohi J, DeVincent CJ, Kirsch S, Hatchwell E. {{Brief report: glutamate transporter gene (SLC1A1) single nucleotide polymorphism (rs301430) and repetitive behaviors and anxiety in children with autism spectrum disorder}}. {J Autism Dev Disord} (Sep);40(9):1139-1145.
Investigated association of single nucleotide polymorphism (SNP) rs301430 in glutamate transporter gene (SLC1A1) with severity of repetitive behaviors (obsessive-compulsive behaviors, tics) and anxiety in children with autism spectrum disorder (ASD). Mothers and/or teachers completed a validated DSM-IV-referenced rating scale for 67 children with autism spectrum disorder. Although analyses were not significant for repetitive behaviors, youths homozygous for the high expressing C allele had more severe anxiety than carriers of the T allele. Allelic variation in SLC1A1 may be a biomarker for or modifier of anxiety symptom severity in children with ASD, but study findings are best conceptualized as tentative pending replication with larger independent samples.
12. Ghaziuddin M. {{Brief report: should the DSM V drop Asperger syndrome?}}. {J Autism Dev Disord} (Sep);40(9):1146-1148.
The DSM IV defines Asperger syndrome (AS) as a pervasive developmental (autistic spectrum) disorder characterized by social deficits and rigid focused interests in the absence of language impairment and cognitive delay. Since its inclusion in the DSM-IV, there has been a dramatic increase in its recognition both in children and adults. However, because studies have generally failed to demonstrate a clear distinction between AS and autism, some researchers have called for its elimination from the forthcoming DSM V. This report argues for a modification of its diagnostic criteria and its continued retention in the diagnostic manual.
13. Hall SS, Lightbody AA, Hirt M, Rezvani A, Reiss AL. {{Autism in fragile X syndrome: a category mistake?}}. {J Am Acad Child Adolesc Psychiatry} (Sep);49(9):921-933.
OBJECTIVE: Many investigators now routinely classify children with fragile X syndrome (FXS) according to whether or not they also meet diagnostic criteria for autism. To determine whether this classification is appropriate, we examined the profiles of autistic behaviors shown by boys and girls with FXS. METHOD: Individuals with FXS, aged 5 to 25 years, were assessed on two established measures of autism, the Social Communication Questionnaire (SCQ) and the Autism Diagnostic Observation Schedule (ADOS). RESULTS: We found that 35.1% of boys and 4.3% of girls with FXS scored in the « autism » category on both instruments. Analysis of the symptom profile indicated that both boys and girls with FXS showed lower rates of impairment on communication and reciprocal social interaction items than the reference autism samples on the measures. Furthermore, a regression model showed that IQ was significantly negatively associated with the SCQ total score in both boys and girls with FXS, when controlling for age, medication use, and FMRP levels. CONCLUSIONS: These data suggest that there are significant differences in the profile of social and communicative symptomatology in FXS compared with individuals diagnosed with idiopathic autism. Given these differences, the implementation of standard autism interventions for individuals with FXS may not be optimal. Maintaining the conceptual distinction between FXS (an established biological disease) and idiopathic autism (a phenomenologically defined behavioral disorder) may also facilitate the development of more targeted and thus effective interventions for individuals with FXS in the future.
14. Hofstaetter JG, Roetzer KM, Krepler P, Nawrot-Wawrzyniak K, Schwarzbraun T, Klaushofer K, Roschger P. {{Altered bone matrix mineralization in a patient with Rett syndrome}}. {Bone} (Sep);47(3):701-705.
Rett syndrome (RTT) is a common X-linked neurodevelopmental disorder caused by mutations in the coding region of methyl-CpG-binding 2 (MECP2) gene. Patients with RTT have a low bone mineral density and increased risk of fracture. However, very little is known if bone matrix mineralization is altered in RTT. A 17-year-old girl with a classical form of RTT with a heterozygous nonsense mutation in exon 3 in the MECP2-gene was treated in our hospital. Her femoral neck BMD is 43.3% below the 3rd percentile when compared to age and sex-matched controls. She underwent surgery for correction of her scoliosis, which provided a unique opportunity to obtain bone tissue to study bone matrix mineralization (Bone Mineralization Density Distribution-BMDD) using quantitative backscattered electron imaging (qBEI) and histomorphometry. BMDD outcomes were compared to recently published normative reference data for young individuals. qBEI analysis showed a significant shift to lower matrix mineralization despite histomorphometric indices indicate a low bone turnover. There was a reduction in CaMean (-7.92%) and CaPeak (-3.97%), which describe the degree of mineralization. Furthermore the fraction of low mineralized matrix (CaLow: +261.84%) was dramatically increased, which was accompanied with an increase in the heterogeneity of mineralization (CaWidth: +86.34%). Our findings show a significantly altered bone matrix mineralization of a typical patient with RTT. This may partly explain the low bone density seen in these patients. These results also warrant further studies on the molecular role of MECP2 in bone matrix mineralization.
15. Holt R, Barnby G, Maestrini E, Bacchelli E, Brocklebank D, Sousa I, Mulder EJ, Kantojarvi K, Jarvela I, Klauck SM, Poustka F, Bailey AJ, Monaco AP. {{Linkage and candidate gene studies of autism spectrum disorders in European populations}}. {Eur J Hum Genet} (Sep);18(9):1013-1019.
Over the past decade, research on the genetic variants underlying susceptibility to autism and autism spectrum disorders (ASDs) has focused on linkage and candidate gene studies. This research has implicated various chromosomal loci and genes. Candidate gene studies have proven to be particularly intractable, with many studies failing to replicate previously reported associations. In this paper, we investigate previously implicated genomic regions for a role in ASD susceptibility, using four cohorts of European ancestry. Initially, a 384 SNP Illumina GoldenGate array was used to examine linkage at six previously implicated loci. We identify linkage approaching genome-wide suggestive levels on chromosome 2 (rs2885116, MLOD=1.89). Association analysis showed significant associations in MKL2 with ASD (rs756472, P=4.31 x 10(-5)) and between SND1 and strict autism (rs1881084, P=7.76 x 10(-5)) in the Finnish and Northern Dutch populations, respectively. Subsequently, we used a second 384 SNP Illumina GoldenGate array to examine the association in seven candidate genes, and evidence for association was found in RELN (rs362780, P=0.00165). Further increasing the sample size strengthened the association with RELN (rs362780, P=0.001) and produced a second significant result in GRIK2 (rs2518261, P=0.008). Our results strengthen the case for a more detailed study of the role of RELN and GRIK2 in autism susceptibility, as well as identifying two new potential candidate genes, MKL2 and SND1.
16. Hutman T, Rozga A, DeLaurentis AD, Barnwell JM, Sugar CA, Sigman M. {{Response to distress in infants at risk for autism: a prospective longitudinal study}}. {J Child Psychol Psychiatry} (Sep);51(9):1010-1020.
BACKGROUND: Infants and preschoolers with ASD show impairment in their responses to other people’s distress relative to children with other developmental delays and typically developing children. This deficit is expected to disrupt social interactions, social learning, and the formation of close relationships. Response to distress has not been evaluated previously in infants with ASD earlier than 18 months of age. METHODS: Participants were 103 infant siblings of children with autism and 55 low-risk controls. All children were screened for ASD at 36 months and 14 were diagnosed with ASD. Infants’ responsiveness to distress was evaluated at 12, 18, 24, and 36 months. An examiner pretended to hit her finger with a toy mallet and infants’ responses were video-recorded. Attention to the examiner and congruent changes in affect were coded on four-point Likert scales. RESULTS: Cross-sectional and longitudinal analyses confirm that the ASD group paid less attention and demonstrated less change in affect in response to the examiner’s distress relative to the high-risk and low-risk participants who were not subsequently diagnosed with ASD. Group differences remained when verbal skills and general social responsiveness were included in the analytic models. CONCLUSIONS: Diagnostic groups differ on distress response from 12 to 36 months of age. Distress-response measures are predictive of later ASD diagnosis above and beyond verbal impairments. Distress response is a worthwhile target for early intervention programs.
17. Iizuka C, Yamashita Y, Nagamitsu S, Yamashita T, Araki Y, Ohya T, Hara M, Shibuya I, Kakuma T, Matsuishi T. {{Comparison of the strengths and difficulties questionnaire (SDQ) scores between children with high-functioning autism spectrum disorder (HFASD) and attention-deficit/hyperactivity disorder (AD/HD)}}. {Brain Dev} (Sep);32(8):609-612.
The aim of this research was to compare the Strengths and Difficulties Questionnaire (SDQ) scores and subscale scores in children with high-functioning autism spectrum disorder (HFASD) and attention-deficit/hyperactivity disorder (AD/HD), and also to clarify the differences between parent- and teacher-assessed SDQ scores/subscores in HFASD and AD/HD children. These patients’ total difficulties scores were significantly high compared to the community sample. In the parent rating, HFASD children had significantly higher scores in the subscales of emotional symptoms and peer problems. In the teacher rating, AD/HD children showed significantly higher scores in the subscales of hyperactivity/inattention and conduct problems, whereas peer problems were significantly higher in HFASD. The teacher rating showed significantly greater difficulties than the parent rating on the subscale of prosocial behavior in both the AD/HD and HFASD groups. These results suggest that each subscale may reflect behavioral, emotional, and social characteristics of HFASD and AD/HD.
18. Ingersoll B. {{Brief report: pilot randomized controlled trial of Reciprocal Imitation Training for teaching elicited and spontaneous imitation to children with autism}}. {J Autism Dev Disord} (Sep);40(9):1154-1160.
Children with autism exhibit significant deficits in imitation skills. Reciprocal Imitation Training (RIT), a naturalistic imitation intervention, was developed to teach young children with autism to imitate during play. This study used a randomized controlled trial to evaluate the efficacy of RIT on elicited and spontaneous imitation skills in 21 young children with autism. Results found that children in the treatment group made significantly more gains in elicited and spontaneous imitation, replicating previous single-subject design studies. Number of spontaneous play acts at pre-treatment was related to improvements in imitation during the intervention, suggesting that children with a greater play repertoire make greater gains during RIT.
19. James SJ, Melnyk S, Jernigan S, Pavliv O, Trusty T, Lehman S, Seidel L, Gaylor DW, Cleves MA. {{A functional polymorphism in the reduced folate carrier gene and DNA hypomethylation in mothers of children with autism}}. {Am J Med Genet B Neuropsychiatr Genet} (Sep);153B(6):1209-1220.
The biologic basis of autism is complex and is thought to involve multiple and variable gene-environment interactions. While the logical focus has been on the affected child, the impact of maternal genetics on intrauterine microenvironment during pivotal developmental windows could be substantial. Folate-dependent one carbon metabolism is a highly polymorphic pathway that regulates the distribution of one-carbon derivatives between DNA synthesis (proliferation) and DNA methylation (cell-specific gene expression and differentiation). These pathways are essential to support the programmed shifts between proliferation and differentiation during embryogenesis and organogenesis. Maternal genetic variants that compromise intrauterine availability of folate derivatives could alter fetal cell trajectories and disrupt normal neurodevelopment. In this investigation, the frequency of common functional polymorphisms in the folate pathway was investigated in a large population-based sample of autism case-parent triads. In case-control analysis, a significant increase in the reduced folate carrier (RFC1) G allele frequency was found among case mothers, but not among fathers or affected children. Subsequent log linear analysis of the RFC1 A80G genotype within family trios revealed that the maternal G allele was associated with a significant increase in risk of autism whereas the inherited genotype of the child was not. Further, maternal DNA from the autism mothers was found to be significantly hypomethylated relative to reference control DNA. Metabolic profiling indicated that plasma homocysteine, adenosine, and S-adenosylhomocyteine were significantly elevated among autism mothers consistent with reduced methylation capacity and DNA hypomethylation. Together, these results suggest that the maternal genetics/epigenetics may influence fetal predisposition to autism.
20. Jones AP, Frederickson N. {{Multi-informant predictors of social inclusion for students with autism spectrum disorders attending mainstream school}}. {J Autism Dev Disord} (Sep);40(9):1094-1103.
This study examined differential profiles of behavioural characteristics predictive of successful inclusion in mainstream education for children with autism spectrum disorders (ASD) and comparison students. Multiple regression analyses using behavioural ratings from parents, teachers and peers found some evidence for differential profiles predicting peer acceptance and rejection. High levels of peer-rated shyness significantly predicted social rejection in comparison students only. Parent-rated prosocial behaviour also differentially predicted social acceptance; high-levels of prosocial behaviour predicted acceptance in comparison students, but low-levels were predictive for students with ASD. These findings suggest that schools may seek to augment traditional social skills programmes with awareness raising about ASD among mainstream pupils to utilise peers’ apparent willingness to discount characteristics such as ‘shyness’.
21. Kalkbrenner AE, Daniels JL, Chen JC, Poole C, Emch M, Morrissey J. {{Perinatal exposure to hazardous air pollutants and autism spectrum disorders at age 8}}. {Epidemiology} (Sep);21(5):631-641.
BACKGROUND: Hazardous air pollutants are plausible candidate exposures for autism spectrum disorders. They have been explored in recent studies for their role in the development of these disorders. METHODS: We used a prevalent case-control design to screen perinatal exposure to 35 hazardous air pollutants for further investigation in autism etiology. We included 383 children with autism spectrum disorders and, as controls, 2,829 children with speech and language impairment. All participants were identified from the records-based surveillance of 8-year-old children conducted by the Autism and Developmental Disabilities Monitoring Network in North Carolina (for children born in 1994 and 1996) and West Virginia (born in 1992 and 1994). Exposures to ambient concentrations of metal, particulate, and volatile organic air pollutants in the census tract of the child’s birth residence were assigned from the 1996 National Air Toxics Assessment annual-average model. We estimated odds ratios (ORs) for autism spectrum disorders and corresponding 95% confidence intervals (CIs), comparing across the 20th and 80th percentiles of log-transformed hazardous air pollutant concentration among the selected controls, using semi-Bayes logistic models and adjusting for sampling variables (surveillance year and state), a priori demographic confounders from the birth certificate and census, and covarying air pollutants. RESULTS: We estimated many near-null ORs, including those for metals, established human neurodevelopmental toxicants, and several pollutants that were elevated in a similar study in California. Hazardous air pollutants with more precise and elevated OR estimates included methylene chloride, 1.4 (95% CI = 0.7-2.5), quinoline, 1.4 (1.0-2.2), and styrene, 1.8 (1.0-3.1). CONCLUSIONS: Our screening design was limited by exposure misclassification of air pollutants and the use of an alternate developmental disorder as the control group, both of which may have biased results toward the null. Despite these limitations, methylene chloride, quinoline, and styrene emerged (based on this analysis and prior epidemiologic evidence) as candidates that warrant further investigation for a possible role in autism etiology.
22. Kasari C, Gulsrud AC, Wong C, Kwon S, Locke J. {{Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism}}. {J Autism Dev Disord} (Sep);40(9):1045-1056.
This study aimed to determine if a joint attention intervention would result in greater joint engagement between caregivers and toddlers with autism. The intervention consisted of 24 caregiver-mediated sessions with follow-up 1 year later. Compared to caregivers and toddlers randomized to the waitlist control group the immediate treatment (IT) group made significant improvements in targeted areas of joint engagement. The IT group demonstrated significant improvements with medium to large effect sizes in their responsiveness to joint attention and their diversity of functional play acts after the intervention with maintenance of these skills 1 year post-intervention. These are among the first randomized controlled data to suggest that short-term parent-mediated interventions can have important effects on core impairments in toddlers with autism. Clinical Trials #: NCT00065910.
23. Koegel LK, Singh AK, Koegel RL. {{Improving motivation for academics in children with autism}}. {J Autism Dev Disord} (Sep);40(9):1057-1066.
Many children with autism show very little interest in academic assignments and exhibit disruptive behavior when assignments are presented. Research indicates that incorporating specific motivational variables such as choice, interspersal of maintenance tasks, and natural reinforcers during intervention leads to improvements in core symptoms of autism and may possibly be effective in academic areas. Using a multiple baseline across children and behaviors design with four pre- and elementary school children with autism, we assessed whether the above variables could be incorporated into academic tasks to improve performance and interest. Results indicated that the intervention decreased the children’s latency to begin academic tasks, improved their rate of performance and interest, and decreased their disruptive behavior. Theoretical and applied implications are discussed.
24. Kujala T, Kuuluvainen S, Saalasti S, Jansson-Verkasalo E, von Wendt L, Lepisto T. {{Speech-feature discrimination in children with Asperger syndrome as determined with the multi-feature mismatch negativity paradigm}}. {Clin Neurophysiol} (Sep);121(9):1410-1419.
OBJECTIVE: Asperger syndrome, belonging to the autistic spectrum of disorders, involves deficits in social interaction and prosodic use of language but normal development of formal language abilities. Auditory processing involves both hyper- and hypoactive reactivity to acoustic changes. METHODS: Responses composed of mismatch negativity (MMN) and obligatory components were recorded for five types of deviations in syllables (vowel, vowel duration, consonant, syllable frequency, syllable intensity) with the multi-feature paradigm from 8-12-year old children with Asperger syndrome. RESULTS: Children with Asperger syndrome had larger MMNs for intensity and smaller MMNs for frequency changes than typically developing children, whereas no MMN group differences were found for the other deviant stimuli. Furthermore, children with Asperger syndrome performed more poorly than controls in Comprehension of Instructions subtest of a language test battery. CONCLUSIONS: Cortical speech-sound discrimination is aberrant in children with Asperger syndrome. This is evident both as hypersensitive and depressed neural reactions to speech-sound changes, and is associated with features (frequency, intensity) which are relevant for prosodic processing. SIGNIFICANCE: The multi-feature MMN paradigm, which includes variation and thereby resembles natural speech hearing circumstances, suggests abnormal pattern of speech discrimination in Asperger syndrome, including both hypo- and hypersensitive responses for speech features.
25. Kumar A, Sundaram SK, Sivaswamy L, Behen ME, Makki MI, Ager J, Janisse J, Chugani HT, Chugani DC. {{Alterations in frontal lobe tracts and corpus callosum in young children with autism spectrum disorder}}. {Cereb Cortex} (Sep);20(9):2103-2113.
Major frontal lobe tracts and corpus callosum (CC) were investigated in 32 children with autism spectrum disorder (ASD, mean age: 5 years), 12 nonautistic developmentally impaired children (DI, mean age: 4.6 years), and 16 typically developing children (TD, mean age: 5.5 years) using diffusion tensor imaging tractography and tract-based spatial statistics. Various diffusion and geometric properties were calculated for uncinate fasciculus (UF), inferior fronto-occipital fasciculus (IFO), arcuate fasciculus (AF), cingulum (Cg), CC, and corticospinal tract. Fractional anisotropy was lower in the right UF, right Cg and CC in ASD and DI children; in right AF in ASD children; and in bilateral IFO in DI children, compared with TD children. Apparent diffusion coefficient was increased in right AF in both ASD and DI children. The ASD group showed shorter length of left UF and increased length, volume, and density of right UF; increased length and density of CC; and higher density of left Cg, compared with the TD group. Compared with DI group, ASD group had increased length, volume, and density of right UF; higher volume of left UF; and increased length of right AF and CC. Volume of bilateral UF and right AF and fiber density of left UF were positively associated with autistic features.
26. Lake JK, Cardy S, Humphreys KR. {{Brief report: animacy and word order in individuals with autism spectrum disorders}}. {J Autism Dev Disord} (Sep);40(9):1161-1164.
Individuals with autism or autism spectrum disorders (ASDs) are known to have difficulties discriminating animacy and are less likely to attend to animate stimuli, which may underlie the social deficits of autism. For individuals without ASD, animacy also affects word order choices: speakers choose syntactic structures (active vs. passive) that place animate entities as the grammatical subject, as a result of their conceptual salience. This study tested whether highly verbal adults with ASD would show sensitivity to animacy in a picture description task. Results showed that individuals with ASD were as sensitive to animacy as controls, and overwhelmingly placed animate entities as the grammatical subject. One stimulus proved an exception, where only individuals with ASD placed an inanimate entity (a clock) in subject position in preference to an animate one (a boy), which coincides with previous observations that individuals with autism find clocks highly salient. This study provides converging evidence of the role of conceptual salience in word order choices, and furthermore shows animate entities to be highly salient for individuals with ASD, at least as it pertains to these word order choices.
27. Lee H, Marvin AR, Watson T, Piggot J, Law JK, Law PA, Constantino JN, Nelson SF. {{Accuracy of phenotyping of autistic children based on Internet implemented parent report}}. {Am J Med Genet B Neuropsychiatr Genet} (Sep);153B(6):1119-1126.
While strong familial evidence supports a substantial genetic contribution to the etiology of autism spectrum disorders (ASD), specific genetic abnormalities have been identified in only a small minority of all cases. In order to comprehensively delineate the genetic components of autism including the identification of rare and common variants, overall sample sizes an order of magnitude larger than those currently under study are critically needed. This will require rapid and scalable subject assessment paradigms that obviate clinic-based time-intensive behavioral phenotyping, which is a rate-limiting step. Here, we test the accuracy of a web-based approach to autism phenotyping implemented within the Interactive Autism Network (IAN). Families who were registered with the IAN and resided near one of the three study sites were eligible for the study. One hundred seven children ascertained from this pool who were verbal, age 4-17 years, and had Social Communication Questionnaire (SCQ) scores > or =12 (a profile that characterizes a majority of ASD-affected children in IAN) underwent a clinical confirmation battery. One hundred five of the 107 children were ASD positive (98%) by clinician’s best estimate. One hundred four of these individuals (99%) were ASD positive by developmental history using the Autism Diagnostic Interview-Revised (ADI-R) and 97 (93%) were positive for ASD by developmental history and direct observational assessment (Autism Diagnostic Observational Schedule or expert clinician observation). These data support the reliability and feasibility of the IAN-implemented parent-report paradigms for the ascertainment of clinical ASD for large-scale genetic research.
28. Mattila ML, Hurtig T, Haapsamo H, Jussila K, Kuusikko-Gauffin S, Kielinen M, Linna SL, Ebeling H, Bloigu R, Joskitt L, Pauls DL, Moilanen I. {{Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: a community- and clinic-based study}}. {J Autism Dev Disord} (Sep);40(9):1080-1093.
The present study identifies the prevalence and types of comorbid psychiatric disorders associated with Asperger syndrome (AS)/high-functioning autism (HFA) in a combined community- and clinic-based sample of fifty 9- to 16-year-old subjects using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version. The level of functioning was estimated using the Children’s Global Assessment Scale. The results support common (prevalence 74%) and often multiple comorbid psychiatric disorders in AS/HFA; behavioral disorders were shown in 44%, anxiety disorders in 42% and tic disorders in 26%. Oppositional defiant disorder, major depressive disorder and anxiety disorders as comorbid conditions indicated significantly lower levels of functioning. To target interventions, routine evaluation of psychiatric comorbidity in subjects with AS/HFA is emphasized.
29. Miniscalco C, Dahlgren Sandberg A. {{Basic reading skills in Swedish children with late developing language and with or without autism spectrum disorder or ADHD}}. {Res Dev Disabil} (Sep-Oct);31(5):1054-1061.
Reading skills at age 7-8 years were examined in a community-representative sample of 21 screened and clinically examined children with language delay (LD) followed prospectively from 2.5 years of age. The present study aimed to (1) determine whether these children with a history of LD had deficits in basic reading skills, i.e. decoding and comprehension, compared to the age norms of standardized tests, (2) analyze if there was a relationship between reading outcome and neuropsychiatric diagnosis by comparing three subgroups of children, LD pure, LD+ASD (autism spectrum disorder) and LD+ADHD, and, (3) determine what language measures at age 6 years were associated with the 7-8-year reading outcome. Both decoding and comprehension of single word reading were significantly below the norm for the whole LD group, where children with LD+ASD scored lowest, and children with LD highest. However, the differences between the three groups did not reach significance. Two reader groups were identified according to the results of word decoding and comprehension, respectively, resulting in the same 7 children. ANOVA revealed that the only differences on the 6-year language tests between the two groups were found on color naming and word memory. This study has shown that children with LD and subsequently identified neurodevelopmental problems such as ASD and ADHD experience continued deficits, demonstrated also in reading skills and that the picture of the reading problems seemed to resemble those of typically developing children.
30. Munasinghe SA, Oliff C, Finn J, Wray JA. {{Digestive enzyme supplementation for Autism Spectrum Disorders: a double-blind randomized controlled trial}}. {J Autism Dev Disord} (Sep);40(9):1131-1138.
To examine the effects of a digestive enzyme supplement in improving expressive language, behaviour and other symptoms in children with Autism Spectrum Disorder. Randomized, double-blind placebo-controlled trial using crossover design over 6 months for 43 children, aged 3-8 years. Outcome measurement tools included monthly Global Behaviour Rating Scales, Additional Rating Scales of other symptoms by parents and therapists, and monthly completion of the Rescorla Language Development Survey. Compared with placebo, treatment with enzyme was not associated with clinically significant improvement in behaviour, food variety, gastrointestinal symptoms, sleep quality, engagement with therapist, or the Language Development Survey Vocabulary or Sentence Complexity Scores. A small statistically significant improvement on enzyme therapy was seen for the food variety scores. No clinically significant effect improvement of autism symptoms with enzyme use was shown with this trial, however, possible effects on improvement in food variety warrants further detailed investigation.
31. Oblak AL, Gibbs TT, Blatt GJ. {{Decreased GABA(B) receptors in the cingulate cortex and fusiform gyrus in autism}}. {J Neurochem} (Sep 1);114(5):1414-1423.
Autism is a behaviorally defined neurodevelopmental disorder and among its symptoms are disturbances in face and emotional processing. Emerging evidence demonstrates abnormalities in the GABAergic (gamma-aminobutyric acid) system in autism, which likely contributes to these deficits. GABA(B) receptors play an important role in modulating synapses and maintaining the balance of excitation-inhibition in the brain. The density of GABA(B) receptors in subjects with autism and matched controls was quantified in the anterior and posterior cingulate cortex, important for socio-emotional and cognitive processing, and the fusiform gyrus, important for identification of faces and facial expressions. Significant reductions in GABA(B) receptor density were demonstrated in all three regions examined suggesting that alterations in this key inhibitory receptor subtype may contribute to the functional deficits in individuals with autism. Interestingly, the presence of seizure in a subset of autism cases did not have a significant effect on the density of GABA(B) receptors in any of the three regions.
32. Oi M. {{Do Japanese children with high-functioning autism spectrum disorder respond differently to Wh-questions and Yes/No-questions?}}. {Clin Linguist Phon} (Sep);24(9):691-705.
The present study compared 12 Japanese children with high-functioning autism spectrum disorder (HFASD), ranging in age from 7.3-14.8 years, with 12 typically developing (TD) children matched for age, gender, and vocabulary. The means of full-scale IQ and verbal-IQ of the children with HFASD were 95.92 (SD = 15.30) and 98.00 (SD = 18.44), respectively. Children responded to questions from their mothers in conversations collected under a semi-structured setting, and the responses of both groups were examined from the viewpoint of adequacy. Compared to TD children, HFASD children produced more inadequate responses to Wh-questions than to Yes/No questions. To both types of questions, HFASD children produced more inappropriate responses than TD children. The findings suggest that parents of HFASD children should consider the influence of the question format on these children’s response inadequacies.
33. Paul LK, Corsello C, Tranel D, Adolphs R. {{Does bilateral damage to the human amygdala produce autistic symptoms?}}. {J Neurodev Disord} (Sep);2(3):165-173.
A leading neurological hypothesis for autism postulates amygdala dysfunction. This hypothesis has considerable support from anatomical and neuroimaging studies. Individuals with bilateral amygdala lesions show impairments in some aspects of social cognition. These impairments bear intriguing similarity to those reported in people with autism, such as impaired recognition of emotion in faces, impaired theory of mind abilities, failure to fixate eyes in faces, and difficulties in regulating personal space distance to others. Yet such neurological cases have never before been assessed directly to see if they meet criteria for autism spectrum disorders (ASD). Here we undertook such an investigation in two rare participants with developmental-onset bilateral amygdala lesions. We administered a comprehensive clinical examination, as well as the Autism Diagnostic Observation Schedule (ADOS), the Social Responsiveness Scale (SRS), together with several other standardized questionnaires. Results from the two individuals with amygdala lesions were compared with published norms from both healthy populations as well as from people with ASD. Neither participant with amygdala lesions showed any evidence of autism across the array of different measures. The findings demonstrate that amygdala lesions in isolation are not sufficient for producing autistic symptoms. We suggest instead that it may be abnormal connectivity between the amygdala and other structures that contributes to autistic symptoms at a network level.
34. Press C, Richardson D, Bird G. {{Intact imitation of emotional facial actions in autism spectrum conditions}}. {Neuropsychologia} (Sep);48(11):3291-3297.
It has been proposed that there is a core impairment in autism spectrum conditions (ASC) to the mirror neuron system (MNS): If observed actions cannot be mapped onto the motor commands required for performance, higher order sociocognitive functions that involve understanding another person’s perspective, such as theory of mind, may be impaired. However, evidence of MNS impairment in ASC is mixed. The present study used an ‘automatic imitation’ paradigm to assess MNS functioning in adults with ASC and matched controls, when observing emotional facial actions. Participants performed a pre-specified angry or surprised facial action in response to observed angry or surprised facial actions, and the speed of their action was measured with motion tracking equipment. Both the ASC and control groups demonstrated automatic imitation of the facial actions, such that responding was faster when they acted with the same emotional expression that they had observed. There was no difference between the two groups in the magnitude of the effect. These findings suggest that previous apparent demonstrations of impairments to the MNS in ASC may be driven by a lack of visual attention to the stimuli or motor sequencing impairments, and therefore that there is, in fact, no MNS impairment in ASC. We discuss these findings with reference to the literature on MNS functioning and imitation in ASC, as well as theories of the role of the MNS in sociocognitive functioning in typical development.
35. Ryan S. {{‘Meltdowns’, surveillance and managing emotions; going out with children with autism}}. {Health Place} (Sep);16(5):868-875.
The qualitative study from which the data reported here are taken, explored the experiences, support and information needs of parents of children diagnosed with autism spectrum disorders. 46 parents were interviewed either individually or in couples. Thematic analysis of the data revealed the complexity involved for the parents in taking their children out in public places. The emotion work parents conduct in public places both to make their children more acceptable within the space and to reduce the discomfort that others experience, helps to preserve the orderliness of public places. However, the special competence that parents developed over time also masks their turbulent feelings in public encounters.
36. Schwichtenberg AJ, Young GS, Sigman M, Hutman T, Ozonoff S. {{Can family affectedness inform infant sibling outcomes of autism spectrum disorders?}}. {J Child Psychol Psychiatry} (Sep);51(9):1021-1030.
BACKGROUND: Difficulties in communication and reciprocal social behavior are core features of autism spectrum disorders (ASD) and are often present, to varying degrees, in other family members. This prospective longitudinal infant sibling study examines whether social-communicative features of family members may inform which infants are at increased risk for ASD and other developmental concerns. METHOD: Two hundred and seventeen families participated in this study. Infant siblings were recruited from families with at least one older child diagnosed with an ASD (n = 135) or at least one typically developing older child (n = 82). Families completed the Social Responsiveness Scale to assess social and communication features of the broader autism phenotype (BAP), sometimes called quantitative autistic traits (QAT). Family affectedness was assessed in two ways: categorically, based on number of affected older siblings (i.e., typical, simplex, multiplex risk groups) and dimensionally, by assessing varying degrees of QAT in all family members. Infant siblings were assessed at 36 months of age and completed the Autism Diagnostic Observation Schedule and the Mullen Scales of Early Learning. RESULTS: In structural equation models, comparisons between multiplex, simplex and typical groups revealed the highest rates of QAT in the multiplex group followed by the simplex and typical groups. Infant sibling outcomes were predicted by gender, family risk group, proband QAT, and additional sibling QAT. CONCLUSIONS: Replicating previous cross-sectional and family history findings, the present study found elevated social and communication features of the BAP in siblings and fathers of ASD families, but not in mothers. While social and communication features of the BAP in mothers, fathers, and undiagnosed siblings did not predict infant sibling outcomes, having more than one affected older sibling did. Infant siblings from multiplex families were at significantly higher risk for ASD than infant siblings from simplex families in this sample.
37. Semrud-Clikeman M, Walkowiak J, Wilkinson A, Christopher G. {{Neuropsychological differences among children with Asperger syndrome, nonverbal learning disabilities, attention deficit disorder, and controls}}. {Dev Neuropsychol} (Sep);35(5):582-600.
Confusion is present as to possible diagnostic differences between Asperger syndrome (AS) and Nonverbal learning disabilities (NLD) and the relation of these disorders to attentional difficulties. Three-hundred and forty-five children participated in this study in 5 groups; NLD, AS, attention deficit hyperactivity disorder (ADHD): Combined type, ADHD: Inattentive type, and controls. The NLD group showed particular difficulty on visual-spatial, visual-motor, and fluid reasoning measures compared to the other groups. There was also a significant verbal-performance IQ split in this group related to difficulty in social functioning. This study extends the findings from previous studies and extends these findings to differences between AS and NLD groups.
38. Sevlever M, Gillis JM. {{An examination of the state of imitation research in children with autism: Issues of definition and methodology}}. {Res Dev Disabil} (Sep-Oct);31(5):976-984.
Several authors have suggested that children with autism are impaired in their ability to imitate others. However, diverse methodologies, contradictory findings, and varying theoretical explanations continue to exist in the literature despite decades of research. A comprehensive account of imitation in children with autism is hampered by the lack of a consistent and operational definition of imitation and other more simplistic forms of copying behavior. Failure to adopt specific definitions of imitative behavior and tasks capable of distinguishing between various types of copying behavior may be at the root of contradictions across studies of imitation and the lack of a unified theoretical account of the « imitation deficit » in autism. The current state of imitation research in children with autism is discussed, and specific recommendations are suggested regarding the adoption of a comparative taxonomy of imitation, a standardized methodology across researchers, and a standardized imitation battery for children with autism.
39. Sheikh AM, Malik M, Wen G, Chauhan A, Chauhan V, Gong CX, Liu F, Brown WT, Li X. {{BDNF-Akt-Bcl2 antiapoptotic signaling pathway is compromised in the brain of autistic subjects}}. {J Neurosci Res} (Sep);88(12):2641-2647.
Although the pathogenesis of autism is not understood, emerging evidence points to apoptotic mechanisms being involved in this disorder. However, it is not known whether apoptosis signaling is deregulated in the brain of autistic subjects. This study investigates how the apoptosis-related proteins are regulated in the autistic brain. Our studies show that Bcl2 is significantly decreased, whereas the expression of p53 is increased, in the brain of autistic subjects in comparison with age-matched controls. We also found that the expression and phosphorylation/activation of Akt kinase that regulates Bcl2 are significantly decreased in the autistic brain. The down-regulation of Akt may result from a decreased concentration of brain-derived neurotrophic factor (BDNF), the growth factor that modulates Akt activities. These results suggest that down-regulation of the BDNF-Akt-Bcl2 antiapoptotic signaling pathway in the autistic brain could be one of the underlying mechanisms responsible for the pathogenesis of autism.
40. Smith KR, Matson JL. {{Behavior problems: differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy}}. {Res Dev Disabil} (Sep-Oct);31(5):1062-1069.
Behavior problems such as aggression, property destruction, stereotypy, self-injurious behavior, and other disruptive behavior are commonly observed among adults with intellectual disabilities (ID), autism spectrum disorders (ASD), and epilepsy residing at state-run facilities. However, it is unknown how these populations differ on behavior problem indicies. Assessment of behavior problems were made with the ASD-behavior problems-adult version battery. One hundred participants with ID were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, significant differences were found among the four groups, Wilks’s Lambda=.79, F(12, 246)=1.93, p<.05. The multivariate eta2 based on Wilks’s Lambda was .08. A one-way ANOVA was conducted for each of the four subscales of the ASD-BPA as follow-up tests to the MANOVA. Groups differed on the aggression/destruction subscale, F(3, 96)=.79, p>.05, eta2=.03, and stereotypy subscale, F(3, 96)=2.62, p>.05, eta2=.08. No significant differences were found on the self-injury subscale and disruptive behavior subscale. Trend analysis demonstrated that individuals with ID expressing combined co-morbid ASD and epilepsy were significantly more impaired than the control group (ID only) or groups containing only a single co-morbid factor with ID (ASD or epilepsy only) on these four subscales. Implications of these findings in the context of known issues in ID, epilepsy, and ASD, current assessment practices among these populations and associated challenges are discussed.
41. Stichter JP, Herzog MJ, Visovsky K, Schmidt C, Randolph J, Schultz T, Gage N. {{Social competence intervention for youth with Asperger Syndrome and high-functioning autism: an initial investigation}}. {J Autism Dev Disord} (Sep);40(9):1067-1079.
Individuals with high functioning autism (HFA) or Asperger Syndrome (AS) exhibit difficulties in the knowledge or correct performance of social skills. This subgroup’s social difficulties appear to be associated with deficits in three social cognition processes: theory of mind, emotion recognition and executive functioning. The current study outlines the development and initial administration of the group-based Social Competence Intervention (SCI), which targeted these deficits using cognitive behavioral principles. Across 27 students age 11-14 with a HFA/AS diagnosis, results indicated significant improvement on parent reports of social skills and executive functioning. Participants evidenced significant growth on direct assessments measuring facial expression recognition, theory of mind and problem solving. SCI appears promising, however, larger samples and application in naturalistic settings are warranted.
42. Underwood L, McCarthy J, Tsakanikos E. {{Mental health of adults with autism spectrum disorders and intellectual disability}}. {Curr Opin Psychiatry} (Sep);23(5):421-426.
PURPOSE OF REVIEW: The literature has often suggested that individuals with intellectual disability who have an autism spectrum disorder (ASD) experience higher rates of mental health problems than those without ASD. This finding has been challenged in recent years and so the purpose of this article was to critically review relevant studies since March 2009. The review focuses on studies specifically about the mental health of adults with intellectual disability who have ASD. RECENT FINDINGS: Recent studies do not support the hypothesis that adults with intellectual disability and ASD are more vulnerable to psychiatric disorders than those without ASD. Factors found to be associated with poorer mental health include severity of intellectual disability, adaptive behaviour skills and social skills. SUMMARY: The evidence base on the mental health of adults with intellectual disability and ASD is small but rapidly increasing. Studies tend to have relatively small sample sizes and there remain difficulties in accurately assessing ASD and psychopathology in adults with intellectual disability.
43. Valentine K. {{A consideration of medicalisation: choice, engagement and other responsibilities of parents of children with autism spectrum disorder}}. {Soc Sci Med} (Sep);71(5):950-957.
Classic studies of medicalisation point to the ‘rise of the experts’ as disempowering patients and refusing to acknowledge their expertise in their own lives. More recently, medicalisation scholarship has taken a different turn, arguing that patient choice is both a responsibility imposed on patients, and a driver of medicalisation. To what extent does autism, a childhood developmental disorder in which parents are invited to take a close role, instantiate these different manifestations of medicalisation? This paper reports on a qualitative study of parents’ experience of diagnosis and treatment, conducted in four states in Australia in 2008-2009. It draws on 49 interviews with parents of young children with autism, and with early intervention service providers and clinicians. Our study shows that the importance of choice in decisions around treatment cannot be subsumed under the single category of disenfranchisement or engagement. The diverse responses of parents to the diffuse, complex field of autism treatment illustrate an admixture of consumption, advocacy and education driving contemporary medicalisation.
44. Viau R, Arsenault-Lapierre G, Fecteau S, Champagne N, Walker CD, Lupien S. {{Effect of service dogs on salivary cortisol secretion in autistic children}}. {Psychoneuroendocrinology} (Sep);35(8):1187-1193.
Children with Autism Syndrome Disorders (ASDs) exhibit social, communicative, and behavioral deficits. We know that human interaction with dogs, which is thought to serve as a social catalyst, results in a decrease of cortisol levels in healthy adults. Introducing service dogs to children with ASD is an attractive idea that has received growing attention in recent decades. However, no study has measured the physiological impact of service dogs on these children. Therefore, the goal of our study was to assess the effects of service dogs on the basal salivary cortisol secretion of children with ASD. We measured the salivary cortisol levels of 42 children with ASD in three experimental conditions; prior to and during the introduction of a service dog to their family, and after a short period during which the dog was removed from their family. We compared average cortisol levels and Cortisol Awakening Response (CAR) before and during the introduction of the dog to the family and after its withdrawal. We found that the introduction of service dogs translated into a statistically significant diminished CAR. Before the introduction of service dogs, we measured a 58% increase
