1. Amirault M, Etchegoyhen K, Delord S, Mendizabal S, Kraushaar C, Hesling I, Allard M, Bouvard M, Mayo W. {{Alteration of attentional blink in high functioning autism: a pilot study}}. {J Autism Dev Disord};2009 (Nov);39(11):1522-1528.
Autism is characterized by deficits in attention. However, no study has investigated the dynamics of attentional processes in autistic patients yet. The attentional blink (AB) paradigm provides information about the temporal dynamics of attention in particular about the allocation and the duration of an attentional episode. We compared 11 high functioning autistic patients with 15 control participants on a classical AB task. Autistic patients exhibited a deficit in rapidly allocated attentional resources. Further investigations such as coupling AB evaluation with neuroimaging data and/or increasing the size of groups, would allow for investigating the neurobiological substrates of these AB alterations in autistic patients.
2. Atkinson AP. {{Impaired recognition of emotions from body movements is associated with elevated motion coherence thresholds in autism spectrum disorders}}. {Neuropsychologia};2009 (Nov);47(13):3023-3029.
Recent research has confirmed that individuals with autism spectrum disorder (ASD) have difficulties in recognizing emotions from body movements. Difficulties in perceiving coherent motion are also common in ASD. Yet it is unknown whether these two impairments are related. Thirteen adults with ASD and 16 age- and IQ-matched typically developing (TD) adults classified basic emotions from point-light and full-light displays of body movements and discriminated the direction of coherent motion in random-dot kinematograms. The ASD group was reliably less accurate in classifying emotions regardless of stimulus display type, and in perceiving coherent motion. As predicted, ASD individuals with higher motion coherence thresholds were less accurate in classifying emotions from body movements, especially in the point-light displays; this relationship was not evident for the TD group. The results are discussed in relation to recent models of biological motion processing and known abnormalities in the neural substrates of motion and social perception in ASD.
3. Auyeung B, Wheelwright S, Allison C, Atkinson M, Samarawickrema N, Baron-Cohen S. {{The children’s Empathy Quotient and Systemizing Quotient: sex differences in typical development and in Autism Spectrum Conditions}}. {J Autism Dev Disord};2009 (Nov);39(11):1509-1521.
Children’s versions of the Empathy Quotient (EQ-C) and Systemizing Quotient (SQ-C) were developed and administered to n = 1,256 parents of typically developing children, aged 4-11 years. Both measures showed good test-retest reliability and high internal consistency. As predicted, girls scored significantly higher on the EQ-C, and boys scored significantly higher on the SQ-C. A further sample of n = 265 children with Autism Spectrum Conditions (ASC) scored significantly lower on the EQ-C, and significantly higher on the SQ-C, compared to typical boys. Empathy and systemizing in children show similar patterns of sex differences to those observed in adults. Children with ASC tend towards a ‘hyper-masculinized’ profile, irrespective of sex.
4. Begeer S, Terwogt MM, Lunenburg P, Stegge H. {{Brief report: additive and subtractive counterfactual reasoning of children with high-functioning autism spectrum disorders}}. {J Autism Dev Disord};2009 (Nov);39(11):1593-1597.
The development of additive (‘If only I had done…’) and subtractive (‘If only I had not done….’) counterfactual reasoning was examined in children with High Functioning Autism Spectrum Disorders (HFASD) (n = 72) and typically developing controls (n = 71), aged 6-12 years. Children were presented four stories where they could generate counterfactuals based on a given consequent (e.g., ‘you left muddy footprints in the kitchen. How could that have been prevented?’). Children with HFASD increasingly used subtractive counterfactuals as they got older, but controls showed an increase in additive counterfactuals, which may be linked to their growing adaptive and flexible skills. Children with HFASD likely develop different strategies for their counterfactual reasoning. The role of IQ and ideational fluency will be discussed.
5. Beretich GR. {{Reversal of autistic symptoms by removal of low-relative tryptophan foods: case report}}. {Med Hypotheses};2009 (Nov);73(5):856-857.
6. Black DO, Wallace GL, Sokoloff JL, Kenworthy L. {{Brief report: IQ split predicts social symptoms and communication abilities in high-functioning children with autism spectrum disorders}}. {J Autism Dev Disord};2009 (Nov);39(11):1613-1619.
We investigated the relationship of discrepancies between VIQ and NVIQ (IQ split) to autism symptoms and adaptive behavior in a sample of high-functioning (mean FSIQ = 98.5) school-age children with autism spectrum disorders divided into three groups: discrepantly high VIQ (n = 18); discrepantly high NVIQ (n = 24); and equivalent VIQ and NVIQ (n = 36). Discrepantly high VIQ and NVIQ were associated with autism social symptoms but not communication symptoms or repetitive behaviors. Higher VIQ and NVIQ were associated with better adaptive communication but not socialization or Daily Living Skills. IQ discrepancy may be an important phenotypic marker in autism. Although better verbal abilities are associated with better functional outcomes in autism, discrepantly high VIQ in high-functioning children may also be associated with social difficulties.
7. Bourreau Y, Roux S, Gomot M, Bonnet-Brilhault F, Barthelemy C. {{Validation of the repetitive and restricted behaviour scale in autism spectrum disorders}}. {Eur Child Adolesc Psychiatry};2009 (Nov);18(11):675-682.
Repetitive and restricted behaviours represent a common problem for various psychiatric syndromes, especially in autistic spectrum disorders, and they include a wide range of heterogeneous behavioural manifestations. An accurate and standardized description of these behaviours is needed to advance the understanding of this complex and heterogeneous clinical dimension of autism. The present article reports the reliability and validity studies of a new assessment scale: the repetitive and restricted behaviour scale. 145 subjects with autism spectrum disorders were assessed using the RRB scale. The RRB scale has good interrater reliability, internal consistency and content validity. Factorial analysis produced four clinically meaningful factors, i.e. « sensorimotor stereotypies », « reaction to change », « restricted behaviours » and « modulation insufficiency ». The RRB scale has good psychometric qualities and constitutes a real breakthrough towards a neurofunctional approach to autistic disorders. It should be valuable for research and treatment, and in clinical practice.
8. Eigsti IM, Bennetto L. {{Grammaticality judgments in autism: deviance or delay}}. {J Child Lang};2009 (Nov);36(5):999-1021.
Language in autism has been the subject of intense interest, because communication deficits are central to the disorder, and because autism serves as an arena for testing theories of language acquisition. High-functioning older children with autism are often considered to have intact grammatical abilities, despite pragmatic impairments. Given the heterogeneity in language skills at younger ages, this assumption merits further investigation. Participants with autism (n=21, aged nine to seventeen years), matched on chronological age, receptive vocabulary and IQ, to 22 typically developing individuals, completed a grammaticality judgment task. Participants with autism were significantly less sensitive than controls, specifically for third person singular and present progressive marking. Performance interacted with sentence length, with lower sensitivity to errors occurring at the end of the longest stimulus sentences. Performance sensitivity was associated with onset of single word and phrase speech, and with severity of autistic symptomatology. Implications of findings are discussed.
9. Elsen GE, Choi LY, Prince VE, Ho RK. {{The autism susceptibility gene met regulates zebrafish cerebellar development and facial motor neuron migration}}. {Dev Biol};2009 (Nov 1);335(1):78-92.
During development, Met signaling regulates a range of cellular processes including growth, differentiation, survival and migration. The Met gene encodes a tyrosine kinase receptor, which is activated by Hgf (hepatocyte growth factor) ligand. Altered regulation of human MET expression has been implicated in autism. In mouse, Met signaling has been shown to regulate cerebellum development. Since abnormalities in cerebellar structure have been reported in some autistic patients, we have used the zebrafish to address the role of Met signaling during cerebellar development and thus further our understanding of the molecular basis of autism. We find that zebrafish met is expressed in the cerebellar primordium, later localizing to the ventricular zone (VZ), with the hgf1 and hgf2 ligand genes expressed in surrounding tissues. Morpholino knockdown of either Met or its Hgf ligands leads to a significant reduction in the size of the cerebellum, primarily as a consequence of reduced proliferation. Met signaling knockdown disrupts specification of VZ-derived cell types, and also reduces granule cell numbers, due to an early effect on cerebellar proliferation and/or as an indirect consequence of loss of signals from VZ-derived cells later in development. These patterning defects preclude analysis of cerebellar neuronal migration, but we have found that Met signaling is necessary for migration of hindbrain facial motor neurons. In summary, we have described roles for Met signaling in coordinating growth and cell type specification within the developing cerebellum, and in migration of hindbrain neurons. These functions may underlie the correlation between altered MET regulation and autism spectrum disorders.
10. Embregts P, van Nieuwenhuijzen M. {{Social information processing in boys with autistic spectrum disorder and mild to borderline intellectual disabilities}}. {J Intellect Disabil Res};2009 (Nov);53(11):922-931.
BACKGROUND: Children with autistic spectrum disorders (ASD) and mild to borderline intellectual disability (ID) have less adaptive behaviour and more behaviour problems than children with mild to borderline ID. Social information processing appears to be an important mechanism in the explanation of the socially inadequate behaviour of children with mild to borderline ID; however, little is known about the social information processing skills of children with ASD and mild to borderline ID. METHOD: In the present study, a total of 136 boys in the age of 10-14 years participated; 26 with ASD (specifically Pervasive Developmental Disorder–Not Otherwise Specified) and mild to borderline ID, 54 with mild to borderline ID without ASD and 56 typically developing boys. They completed the Social Problem Solving Test to measure their social information processing. RESULTS: The research results show boys with PDD-NOS and mild to borderline ID to differ from typically developing boys in their encoding of information; they focus on negative and emotional information in the social situation. They differ from boys with mild to borderline ID in response generation, evaluation of inadequate solutions (aggressive and submissive responses) and assertive response decision. CONCLUSIONS: The present study extends our knowledge regarding social information processing of children with ASD (PDD-NOS) and mild to borderline ID. This knowledge may be helpful in designing and adapting programmes (e.g. social skills training, self-management training) for the management of behaviour problems and development of adaptive behaviour of children with ASD and mild to borderline ID.
11. Fan X, Miles JH, Takahashi N, Yao G. {{Abnormal transient pupillary light reflex in individuals with autism spectrum disorders}}. {J Autism Dev Disord};2009 (Nov);39(11):1499-1508.
Computerized binocular infrared pupillography was used to measure the transient pupillary light reflex (PLR) in both children with autism spectrum disorders (ASDs) and children with typical development. We found that participants with ASDs showed significantly longer PLR latency, smaller constriction amplitude and lower constriction velocity than children with typical development. The PLR latency alone can be used to discriminate the ASD group from the control group with a cross-validated success rate of 89.6%. By adding the constriction amplitude, the percentage of correct classification can be further improved to 92.5%. In addition, the right-lateralization of contraction anisocoria that was observed in participants with typical development was not observed in those with ASDs. Further studies are necessary to understand the origin and implications of these observations. It is anticipated that as potential biomarkers, these pupillary light reflex measurements will advance our understanding of neurodevelopmental differences in the autism brain.
12. Gadow KD, Roohi J, DeVincent CJ, Kirsch S, Hatchwell E. {{Association of COMT (Val158Met) and BDNF (Val66Met) gene polymorphisms with anxiety, ADHD and tics in children with autism spectrum disorder}}. {J Autism Dev Disord};2009 (Nov);39(11):1542-1551.
The aim of the study is to examine rs4680 (COMT) and rs6265 (BDNF) as genetic markers of anxiety, ADHD, and tics. Parents and teachers completed a DSM-IV-referenced rating scale for a total sample of 67 children with autism spectrum disorder (ASD). Both COMT (p = 0.06) and BDNF (p = 0.07) genotypes were marginally significant for teacher ratings of social phobia (etap (2) = 0.06). Analyses also indicated associations of BDNF genotype with parent-rated ADHD (p = 0.01, etap (2) = 0.10) and teacher-rated tics (p = 0.04; etap (2) = 0.07). There was also evidence of a possible interaction (p = 0.02, etap (2) = 0.09) of BDNF genotype with DAT1 3′ VNTR with tic severity. BDNF and COMT may be biomarkers for phenotypic variation in ASD, but these preliminary findings remain tentative pending replication with larger, independent samples.
13. Geurts HM, Begeer S, Stockmann L. {{Brief report: inhibitory control of socially relevant stimuli in children with high functioning autism}}. {J Autism Dev Disord};2009 (Nov);39(11):1603-1607.
The current study explored whether inhibitory control deficits in high functioning autism (HFA) emerged when socially relevant stimuli were used and whether arousal level affected the performance. A Go/NoGo paradigm, with socially relevant stimuli and varying presentation rates, was applied in 18 children with HFA (including children with autism or Asperger syndrome) and 22 typically developing children (aged 8-13 years). Children with HFA did not show inhibitory control deficits compared to the control group, but their performance deteriorated in the slow presentation rate condition. Findings were unrelated to children’s abilities to recognize emotions. Hence, rather than a core deficit in inhibitory control, low arousal level in response to social stimuli might influence the responses given by children with HFA.
14. Grether JK, Anderson MC, Croen LA, Smith D, Windham GC. {{Risk of autism and increasing maternal and paternal age in a large north American population}}. {Am J Epidemiol};2009 (Nov 1);170(9):1118-1126.
Previous studies are inconsistent regarding whether there are independent effects of maternal and paternal age on the risk of autism. Different biologic mechanisms are suggested by maternal and paternal age effects. The study population included all California singletons born in 1989-2002 (n = 7,550,026). Children with autism (n = 23,311) were identified through the California Department of Developmental Services and compared with the remainder of the study population, with parental ages and covariates obtained from birth certificates. Adjusted odds ratios and 95% confidence intervals were used to evaluate the risk of autism associated with increasing maternal and paternal age. In adjusted models that included age of the other parent and demographic covariates, a 10-year increase in maternal age was associated with a 38% increase in the odds ratio for autism (odds ratio = 1.38, 95% confidence interval: 1.32, 1.44), and a 10-year increase in paternal age was associated with a 22% increase (odds ratio = 1.22, 95% confidence interval: 1.18, 1.26). Maternal and paternal age effects were seen in subgroups defined by race/ethnicity and other covariates and were of greater magnitude among first-born compared with later-born children. Further studies are needed to help clarify the biologic mechanisms involved in the independent association of autism risk with increasing maternal and paternal age.
15. Hinton VJ, Cyrulnik SE, Fee RJ, Batchelder A, Kiefel JM, Goldstein EM, Kaufmann P, De Vivo DC. {{Association of autistic spectrum disorders with dystrophinopathies}}. {Pediatr Neurol};2009 (Nov);41(5):339-346.
Parents of 85 boys with dystrophinopathies and 51 sibling controls completed the Social Communication Questionnaire, describing child behaviors associated with autism spectrum disorders and a rating of parental stress. Twenty-one boys with dystrophinopathies and no siblings received scores above the cut-point for possible autistic spectrum disorders. Mothers of identified children were given detailed interviews using the Autism Diagnostic Interview-Revised, and 16 boys (about 19% of the sample) met the criteria for autism spectrum disorders. Significant qualitative abnormalities in reciprocal social interactions and communication were evident in all, whereas restricted and repetitive behaviors were generally less pronounced in the group. Moreover, parents of boys with dystrophinopathy and autism spectrum disorders demonstrated significantly higher ratings of stress than parents of boys with dystrophinopathy alone. Increased attention to behavioral concerns associated with dystrophinopathies is necessary to ensure the well-being of the whole family.
16. Jones CR, Happe F, Baird G, Simonoff E, Marsden AJ, Tregay J, Phillips RJ, Goswami U, Thomson JM, Charman T. {{Auditory discrimination and auditory sensory behaviours in autism spectrum disorders}}. {Neuropsychologia};2009 (Nov);47(13):2850-2858.
It has been hypothesised that auditory processing may be enhanced in autism spectrum disorders (ASD). We tested auditory discrimination ability in 72 adolescents with ASD (39 childhood autism; 33 other ASD) and 57 IQ and age-matched controls, assessing their capacity for successful discrimination of the frequency, intensity and duration differences in pairs of sounds. At the group level, auditory discrimination ability did not differ between the adolescents with and without ASD. However, we found a subgroup of 20% of individuals in the ASD group who showed ‘exceptional’ frequency discrimination skills (defined as 1.65 SDs above the control mean) and who were characterised by average intellectual ability and delayed language onset. Auditory sensory behaviours (i.e. behaviours in response to auditory sensory input) are common in ASD and we hypothesised that these would relate to auditory discrimination ability. For the ASD group, poor performers on the intensity discrimination task reported more auditory sensory behaviours associated with coping with loudness levels. Conversely, those who performed well on the duration discrimination task reported more auditory sensory behaviours across the full range measured. Frequency discrimination ability did not associate with auditory sensory behaviours. We therefore conclude that (i) enhanced frequency discrimination is present in around 1 in 5 individuals with ASD and may represent a specific phenotype; and (ii) individual differences in auditory discrimination ability in ASD may influence the expression of auditory sensory behaviours by modulating the degree to which sounds are detected or missed in the environment.
17. Joseph RM, Keehn B, Connolly C, Wolfe JM, Horowitz TS. {{Why is visual search superior in autism spectrum disorder?}} {Dev Sci};2009 (Nov);12(6):1083-1096.
This study investigated the possibility that enhanced memory for rejected distractor locations underlies the superior visual search skills exhibited by individuals with autism spectrum disorder (ASD). We compared the performance of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children in a standard static search task and a dynamic search task, in which targets and distractors randomly changed locations every 500 ms, precluding the use of memory in search. Children with ASD exhibited overall faster reaction time (RT) relative to TD children, and showed no disruption in search efficiency in the dynamic condition, discounting the possibility that memory for rejected distractors augments their visual search abilities. Analyses of RT x set size functions showed no group differences in slopes but lower intercepts for the ASD group in both static and dynamic search, suggesting that the ASD advantage derived from non-search processes, such as an enhanced ability to discriminate between targets and distractors at the locus of attention. Eye-movement analyses revealed that the ASD and TD groups were similar in the number and spatial distribution of fixations across the search array, but that fixation duration was significantly shorter among children with ASD. Lower intercepts in static search were related to increased symptom severity in children with ASD. In summary, ASD search superiority did not derive from differences in the manner in which individuals with ASD deployed their attention while searching, but from anomalously enhanced perception of stimulus features, which was in turn positively associated with autism symptom severity.
18. Kawai T. {{Union and separation in the therapy of pervasive developmental disorders and ADHD}}. {J Anal Psychol};2009 (Nov);54(5):659-675.
This paper discusses the characteristics of psychotherapy for pervasive developmental disorders (PDD) in the context of the curative effects of the movement of images. The ‘autistic spectrum’ is widened here and includes not only PDD, but also ADHD. The main common characteristic in these two sets of disorders seems to be the lack of a subject, which manifests itself as the absence of awareness of otherness and difficulties with boundaries and language. In these cases a normal psychotherapy is ineffective as it presupposes an established subject. However a psychotherapeutic approach with these patients can contribute to the emergence of a subject. In severe cases the process of union and separation which is enacted either in the therapeutic relationship or in symbolic play leads to the birth of a subject, and of language. In milder cases, such as ADHD, the moments of separation and confrontation with the therapist suffice. I will discuss a case of my own with Asperger’s syndrome in which union and separation in the play therapy occurred simultaneously. This indicates that union and separation are not a consecutive process, but are simultaneous and lead to dialectical movement. However, in neurotic cases with an established subjectivity the symbolic meaning of image plays a central role. This corresponds to Jung’s understanding of image in alchemy.
19. Koegel RL, Shirotova L, Koegel LK. {{Brief report: using individualized orienting cues to facilitate first-word acquisition in non-responders with autism}}. {J Autism Dev Disord};2009 (Nov);39(11):1587-1592.
Though considerable progress has been made in developing techniques for improving the acquisition of expressive verbal communication in children with autism, research has documented that 10-25% still fail to develop speech. One possible technique that could be significant in facilitating responding for this nonverbal subgroup of children is the use of orienting cues. Using a multiple baseline design, this study examined whether individualized orienting cues could be identified, and whether their presentation would result in verbal expressive words. The results suggest that using individualized orienting cues can increase correct responding to verbal models as well as subsequent word use. Theoretical and applied implications of orienting cues as they relate to individualized programming for children with autism are discussed.
20. Loo CY, Graham RM, Hughes CV. {{Behaviour guidance in dental treatment of patients with autism spectrum disorder}}. {Int J Paediatr Dent};2009 (Nov);19(6):390-398.
BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder categorized into autism, pervasive developmental disorder – not otherwise specified (PDD-NOS) and Asperger syndrome. AIMS: To identify factors associated with the behaviour of patients with ASD in a dental setting, use of general anaesthesia (GA), and protective stabilization. DESIGN: The dental charts of 395 patients with ASD patients and 386 unaffected patients were reviewed. The following data were analysed: ASD diagnosis, age, gender, residence, seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behaviour or pica), medications, caries prevalence and severity, dental treatment history, behaviour, and behaviour guidance technique(s) used. RESULTS: Within both groups, younger patients were more uncooperative. ASD patients with autism were more uncooperative than patients with PDD-NOS; patients with an additional diagnosis were also more uncooperative. ASD patients with higher caries severity, who were uncooperative or female, were more likely to require GA. Use of protective stabilization was associated with lower caries severity, presence of seizure disorder, uncooperative behaviour, male gender, or residency in a group home/institution. CONCLUSIONS: Autism spectrum disorder patients with autism, younger age and an additional diagnosis were more uncooperative. Factors associated with the use of GA and protective stabilization in patients with ASD were also identified.
21. LoVullo SV, Matson JL. {{Comorbid psychopathology in adults with Autism Spectrum Disorders and intellectual disabilities}}. {Res Dev Disabil};2009 (Nov-Dec);30(6):1288-1296.
There is an abundance of research investigating Autism Spectrum Disorders (ASD) in children; however, little emphasis has been placed on ASD in adults, especially in regards to comorbid psychopathology. Although scales are available that measure comorbidity in adults with ID, what is needed are scales that measure comorbidity in adults with ID and ASD. One such scale is the newly developed Autism Spectrum Disorders-Comorbidity for Adults (ASD-CA). There are two purposes of this study. The first is to further develop the ASD-CA by calculating cutoff scores for its subscales. The second is to compare the frequency of symptom endorsements on the ASD-CA among three groups: individuals with ID; individuals with ID and ASD; and individuals with ID, ASD, and additional psychopathology.
22. Marcus RN, Owen R, Kamen L, Manos G, McQuade RD, Carson WH, Aman MG. {{A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder}}. {J Am Acad Child Adolesc Psychiatry};2009 (Nov);48(11):1110-1119.
OBJECTIVE: To evaluate the short-term efficacy and safety of aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. METHOD: Two hundred eighteen children and adolescents (aged 6-17 years) with a diagnosis of autistic disorder, and with behaviors such as tantrums, aggression, self-injurious behavior, or a combination of these symptoms, were randomized 1:1:1:1 to aripiprazole (5, 10, or 15 mg/day) or placebo in this 8-week double-blind, randomized, placebo-controlled, parallel-group study. Efficacy was evaluated using the caregiver-rated Aberrant Behavior Checklist Irritability subscale (primary efficacy measure) and the clinician-rated Clinical Global Impressions-Improvement score. Safety and tolerability were also assessed. RESULTS: At week 8, all aripiprazole doses produced significantly greater improvement than placebo in mean Aberrant Behavior Checklist Irritability subscale scores (5 mg/day, -12.4; 10 mg/day, -13.2; 15 mg/day, -14.4; versus placebo, -8.4; all p < .05). All aripiprazole doses demonstrated significantly greater improvements in mean Clinical Global Impressions-Improvement score than placebo at week 8. Discontinuation rates due to adverse events were as follows: placebo 7.7%, aripiprazole 5 mg/day 9.4%, 10 mg/day 13.6%, and 15 mg/day 7.4%. The most common adverse event leading to discontinuation was sedation. There were two serious adverse events: presyncope (5 mg/day) and aggression (10 mg/day). At week 8, mean weight change (last observation carried forward) was as follows: placebo +0.3 kg, aripiprazole 5 mg/day +1.3 kg, 10 mg/day +1.3 kg, and 15 mg/day +1.5 kg; all p < .05 versus placebo. CONCLUSIONS: Aripiprazole was efficacious and generally safe and well tolerated in the treatment of children and adolescents with irritability associated with autistic disorder.
23. Marriage S, Wolverton A, Marriage K. {{Autism spectrum disorder grown up: a chart review of adult functioning}}. {J Can Acad Child Adolesc Psychiatry};2009 (Nov);18(4):322-328.
OBJECTIVE: To survey the adult functioning of patients with Autism Spectrum Disorder (ASD), and to compare the outcomes for those diagnosed in childhood with those diagnosed as adults. METHODS: Using a chart review, we evaluated the adult outcomes for 45 individuals diagnosed with ASD prior to age 18, and compared this with the functioning of 35 patients whose ASD was identified after 18 years. Concurrent mental illnesses were noted for both groups. RESULTS: Adult outcome was poorest for those with the combination of ASD and Intellectual Disability (ID). The sub- group of individuals with Autism identified in adulthood whose functioning was assessed after 25 years of age had achieved more in the areas of education and independent living. All three groups had a high frequency of psychiatric co-morbidity. CONCLUSION: While co-morbid ID and ASD generally imply a poor outcome, for children and youth with ASD and normal range IQ, adult functioning is more variable and difficult to predict. Because of delays in ongoing social development, some of these individuals may attain educational, independent living and relationship goals, but reach them a decade or more later than typical for the general population.
24. Matson JL, Dempsey T, Fodstad JC. {{The effect of Autism Spectrum Disorders on adaptive independent living skills in adults with severe intellectual disability}}. {Res Dev Disabil};2009 (Nov-Dec);30(6):1203-1211.
Autism Spectrum Disorders are a class of conditions categorized by communication problems, ritualistic behaviors, and deficits in social behaviors. While evidence supporting a genetic component of Autism Spectrum Disorders (ASDs) is strong, no specific genetic marker has been identified. Thus, professionals have had to utilize intelligence tests and measures of adaptive functioning to aid in the diagnosis of individuals with ASD. The present study aimed to isolate specific differences in adaptive functioning in adults with ASD. Two hundred and thirty-four adults with ASD (Autism Spectrum Disorder) or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and intellectual disabilities (IDs) were evaluated with respect to the nature and extent of their independent living skill functioning. The implications of these data for more fully describing and diagnosing autism and PDD-NOS in adults are discussed.
25. Matson JL, Fodstad JC, Mahan S. {{Cutoffs, norms, and patterns of comorbid difficulties in children with developmental disabilities on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 2)}}. {Res Dev Disabil};2009 (Nov-Dec);30(6):1221-1228.
Behavioral symptoms of comorbid psychopathology of 651 children 17-37 months of age who were at risk for developmental disabilities were studied using the BISCUIT-Part 2. In Study 1, norms and cutoff scores were established for this new scale on this sample. In Study 2, frequency of response on the 52 items measured was reported. Problems in eating and sleep were the most common with just over 15% of the sample experiencing these difficulties of either a moderate or severe nature. For severe problems, the most commonly reported difficulties were inattention/impulsivity, and tantrums/conduct behavior problems. Implications of this scale and these data for early identification of behavior disorders in atypically developing children are discussed.
26. Matson JL, Rivet TT, Fodstad JC, Dempsey T, Boisjoli JA. {{Examination of adaptive behavior differences in adults with autism spectrum disorders and intellectual disability}}. {Res Dev Disabil};2009 (Nov-Dec);30(6):1317-1325.
Autism spectrum disorders (ASD) and intellectual disabilities (ID) are high prevalence developmental disabilities that co-occur at high rates. Furthermore, Axis I psychopathology is known to occur more frequently in individuals with ID than the general population. The problems are lifelong and can be major impediments to independent living. Despite this, little research with adults is available to determine the effects of these disabilities on specific adaptive skills. In this study, 337 adults were evaluated using the Vineland Adaptive Behavior Scale to assess the effects of these disabilities on looking at an ID, ID plus ASD, and ID and ASD plus Axis I psychopathology group. Adaptive skills were greatest for the ID group followed by the ID plus ASD, and ID and ASD plus psychopathology. Thus, the more handicapping conditions, the greater the skills deficits observed, particularly where psychopathology was concerned. As such, accurately identifying the causes of adaptive skill deficits will likely result in more precise and effective treatment.
27. Matson JL, Shoemaker M. {{Intellectual disability and its relationship to autism spectrum disorders}}. {Res Dev Disabil};2009 (Nov-Dec);30(6):1107-1114.
Intellectual disability (ID) and autism spectrum disorders (ASDs) covary at very high rates. Similarly, greater severity of one of these two disorders appears to have effects on the other disorder on a host of factors. A good deal of research has appeared on the topic with respect to nosology, prevalence, adaptive functioning, challenging behaviors, and comorbid psychopathology. The purpose of this paper was to provide a critical review and status report on the research published on these topics. Current status and future directions for better understanding these two covarying disorders was reviewed along with a discussion of relevant strengths and weaknesses of the current body of research.
28. McAlonan GM, Cheung C, Cheung V, Wong N, Suckling J, Chua SE. {{Differential effects on white-matter systems in high-functioning autism and Asperger’s syndrome}}. {Psychol Med};2009 (Nov);39(11):1885-1893.
BACKGROUND: Whether autism spectrum maps onto a spectrum of brain abnormalities and whether Asperger’s syndrome (ASP) is distinct from high-functioning autism (HFA) are debated. White-matter maldevelopment is associated with autism and disconnectivity theories of autism are compelling. However, it is unknown whether children with ASP and HFA have distinct white-matter abnormalities. METHOD: Voxel-based morphometry mapped white-matter volumes across the whole brain in 91 children. Thirty-six had autism spectrum disorder. A history of delay in phrase speech defined half with HFA; those without delay formed the ASP group. The rest were typically developing children, balanced for age, IQ, gender, maternal language and ethnicity. White-matter volumes in HFA and ASP were compared and each contrasted with controls. RESULTS: White-matter volumes around the basal ganglia were higher in the HFA group than ASP and higher in both autism groups than controls. Compared with controls, children with HFA had less frontal and corpus callosal white matter in the left hemisphere; those with ASP had less frontal and corpus callosal white matter in the right hemisphere with more white matter in the left parietal lobe. CONCLUSIONS: HFA involved mainly left hemisphere white-matter systems; ASP affected predominantly right hemisphere white-matter systems. The impact of HFA on basal ganglia white matter was greater than ASP. This implies that aetiological factors and management options for autism spectrum disorders may be distinct. History of language acquisition is a potentially valuable marker to refine our search for causes and treatments in autism spectrum.
29. Medrihan L, Rohlmann A, Fairless R, Andrae J, Doring M, Missler M, Zhang W, Kilimann MW. {{Neurobeachin, a protein implicated in membrane protein traffic and autism, is required for the formation and functioning of central synapses}}. {J Physiol};2009 (Nov 1);587(Pt 21):5095-5106.
The development of neuronal networks in the brain requires the differentiation of functional synapses. Neurobeachin (Nbea) was identified as a putative regulator of membrane protein trafficking associated with tubulovesicular endomembranes and postsynaptic plasma membranes. Nbea is essential for evoked transmission at neuromuscular junctions, but its role in the central nervous system has not been characterized. Here, we have studied central synapses of a newly generated gene-trap knockout (KO) mouse line at embryonic day 18, because null-mutant mice are paralysed and die perinatally. Although the overall brain architecture was normal, we identified major abnormalities of synaptic function in mutant animals. In acute slices from the brainstem, both spontaneous excitatory and inhibitory postsynaptic currents were clearly reduced and failure rates of evoked inhibitory responses were markedly increased. In addition, the frequency of miniature excitatory and both the frequency and amplitudes of miniature inhibitory postsynaptic currents were severely diminished in KO mice, indicating a perturbation of both action potential-dependent and -independent transmitter release. Moreover, Nbea appears to be important for the formation and composition of central synapses because the area density of mature asymmetric contacts in the fetal brainstem was reduced to 30% of wild-type levels, and the expression levels of a subset of synaptic marker proteins were smaller than in littermate controls. Our data demonstrate for the first time a function of Nbea at central synapses that may be based on its presumed role in targeting membrane proteins to synaptic contacts, and are consistent with the ‘excitatory-inhibitory imbalance’ model of autism where Nbea gene rearrangements have been detected in some patients.
30. Neves-Pereira M, Muller B, Massie D, Williams JH, O’Brien PC, Hughes A, Shen SB, Clair DS, Miedzybrodzka Z. {{Deregulation of EIF4E: a novel mechanism for autism}}. {J Med Genet};2009 (Nov);46(11):759-765.
BACKGROUND: Autism is a common childhood onset neurodevelopmental disorder, characterised by severe and sustained impairment of social interaction and social communication, as well as a notably restricted repertoire of activities and interests. Its aetiology is multifactorial with a strong genetic basis. EIF4E is the rate limiting component of eukaryotic translation initiation, and plays a key role in learning and memory through its control of translation within the synapse. EIF4E mediated translation is the final common process modulated by the mammalian target of rapamycin (mTOR), PTEN and fragile X mental retardation protein (FMRP) pathways, which are implicated in autism. Linkage of autism to the EIF4E region on chromosome 4q has been found in genome wide linkage studies. METHODS AND RESULTS: The authors present evidence that directly implicates EIF4E in autism. In a boy with classic autism, the authors observed a de novo chromosome translocation between 4q and 5q and mapped the breakpoint site to within a proposed alternative transcript of EIF4E. They then screened 120 autism families for mutations and found two unrelated families where in each case both autistic siblings and one of the parents harboured the same single nucleotide insertion at position -25 in the basal element of the EIF4E promoter. Electrophoretic mobility shift assays and reporter gene studies show that this mutation enhances binding of a nuclear factor and EIF4E promoter activity. CONCLUSIONS: These observations implicate EIF4E, and more specifically control of EIF4E activity, directly in autism. The findings raise the exciting possibility that pharmacological manipulation of EIF4E may provide therapeutic benefit for those with autism caused by disturbance of the converging pathways controlling EIF4E activity.
31. Nicholas JS, Carpenter LA, King LB, Jenner W, Charles JM. {{Autism spectrum disorders in preschool-aged children: prevalence and comparison to a school-aged population}}. {Ann Epidemiol};2009 (Nov);19(11):808-814.
PURPOSE: The purpose of this study was to determine the prevalence and case characteristics of children with autism spectrum disorders (ASDs) among 4-year-olds and to compare findings to previous prevalence estimates for 8-year-olds in the same geographic area. METHODS: South Carolina (SC) has been a participant in the Centers for Disease Control and Prevention’s active, population-based, multiple-site ASD surveillance network for 8-year-olds since 2000. The 8-year-old methodology, designed to identify children both with and without prior diagnosis, was applied in SC with modification to include information sources for younger children. RESULTS: The ASD prevalence among 4-year-olds in 2006 was 8.0 per 1000 (95% confidence interval [CI], 6.1-9.9), or 1 in 125. In comparison, ASD prevalence among 8-year-olds in the same geographic area was 7.6 (95% CI, 5.7-9.5) in 2000 and 7.0 (95% CI 5.1-8.9) in 2002. Developmental concerns were documented at earlier ages across time, and while most cases received services, only 20% to 29% received services specific to ASD. CONCLUSIONS: Findings should provide useful information for the planning of health/education policies and early intervention strategies for ASD.
32. Niederhofer H. {{First preliminary results of an observation of Ginkgo Biloba treating patients with autistic disorder}}. {Phytother Res};2009 (Nov);23(11):1645-1646.
Deficits in reciprocal social interaction, verbal and nonverbal communication, and imaginative activity are the main characteristics of autism. From the psychopharmacological point of view, clonidine, metylphenidate and neuroleptics may improve some of these aspects, but with a remarkable risk of adverse side effects. In our observational study, three patients received 2 x 100 mg Ginkgo Biloba EGb 761 for 4 weeks and showed some improvement on the Aberrant Behavior and Symptom Checklist. These results suggest, that Ginkgo Biloba might be effective at least as an add-on therapy.
33. Niederhofer H. St John’s {{Wort treating patients with autistic disorder}}. {Phytother Res};2009 (Nov);23(11):1521-1523.
Problems of eye contact and expressive language limit the effectiveness of educational and behavioral interventions in patients suffering from pervasive developmental disorders. For that reason, additive psychopharmacological interventions are sometimes needed to improve symptomatology. In our preliminary open trial, three male patients with autistic disorder, diagnosed by ICD-10 criteria, completed an open trial of St John’s Wort. Subjects were included in the study if their eye contact and expressive language was inadaequate for their developmental level and if they had not tolerated or responded to other psychopharmacologic treatments (methylphenidate, clonidine or desipramine). Parent and mentor ratings on the Aberrant Behavior Checklist, irritability, stereotypy, and inappropriate speech factors improved slightly during treatment with St John’s Wort. Clinician ratings (Psychiatric Rating Scale Autism, Anger and Speech Deviance factors; Global Assessment Scale; Clinical Global Impressions efficacy) did not improve significantly. St John’s Wort was only modestly effective in the short-term treatment of irritability in some patients with autistic disorder.
34. Pardini M, Garaci FG, Bonzano L, Roccatagliata L, Palmieri MG, Pompili E, Coniglione F, Krueger F, Ludovici A, Floris R, Benassi F, Emberti Gialloreti L. {{White matter reduced streamline coherence in young men with autism and mental retardation}}. {Eur J Neurol};2009 (Nov);16(11):1185-1190.
BACKGROUND AND PURPOSE: It has been proposed that white matter alterations might play a role in autistic disorders; however, published data are mainly limited to high-functioning autism. The goal of this study was to apply diffusion tensor imaging (DTI) and fiber tractography (FT) to study white matter in low-functioning autism and the relationship between white matter and cognitive impairment. METHODS: Ten low-functioning males with autism (mean age: 19.7 +/- 2.83 years) and 10 age-matched healthy males (mean age: 19.9 +/- 2.64 years) underwent DTI-MRI scanning. fractional anisotropy (FA) maps were analyzed with whole brain voxel-wise and tract-of-interest statistics. Using FT algorithms, white matter tracts connecting the orbitofrontal cortex (OFC) with other brain regions were identified and compared between the two groups. FA mean values of the autistic group were correlated with intelligence quotient (IQ) scores. RESULTS: Low-functioning autistic subjects showed a reduced tract volume and lower mean FA values in the left OFC network compared with controls. In the autistic group, lower FA values were associated with lower IQ scores. CONCLUSIONS: We showed evidence of OFC white matter network abnormalities in low-functioning autistic individuals. Our results point to a relationship between the severity of the intellectual impairment and the extent of white matter alterations.
35. Robel L. {{[Clinical features in autism]}}. {Arch Pediatr};2009 (Nov);16(11):1507-1512.{{Donnees actuelles sur la clinique de l’autisme}}.
Autism is a neurodevelopmental disorder diagnosed on the basis of three behaviorally altered domains: social deficits, impaired language and communication, and stereotyped and repetitive behaviors. The early recognition of the disorder, as early as 2 years, is an important challenge, because early treatments are more efficient in helping children to develop their adaptation skills, allowing their better integration in the society, with less suffering and a lower level of handicap. Therefore, we describe the symptoms that may lead first degree practitioners to suspect autistic disorders as early as possible, and how they can help the children and their parents to be directed to the appropriate services for diagnostic and treatment.
36. Sanders JL. {{Qualitative or quantitative differences between Asperger’s disorder and autism? Historical considerations}}.{ J Autism Dev Disord};2009 (Nov);39(11):1560-1567.
The histories of autism and Asperger’s Disorder (AD), based on original contributions by Kanner and Asperger, are reviewed in relation to DSM-IV diagnostic criteria. Their original articles appear to have influenced the distinction between AD and autism made in the DSM-IV. Based on up-to-date empirical research, however, it appears that AD and autism are not qualitatively distinct disorders, but are different quantitative manifestations of the same disorder. The differences between AD and autism may be a function of individual variability in these areas, not the manifestation of qualitatively distinct disorders. The DSM-IV criteria for AD and autism need to be considered with their historical developments, and based on empirical evidence, the DSM-IV diagnostic criteria may be subject to critical review.
37. Senju A, Kikuchi Y, Akechi H, Hasegawa T, Tojo Y, Osanai H. {{Brief report: does eye contact induce contagious yawning in children with autism spectrum disorder?}} {J Autism Dev Disord};2009 (Nov);39(11):1598-1602.
Individuals with autism spectrum disorder (ASD) reportedly fail to show contagious yawning, but the mechanism underlying the lack of contagious yawning is still unclear. The current study examined whether instructed fixation on the eyes modulates contagious yawning in ASD. Thirty-one children with ASD, as well as 31 age-matched typically developing (TD) children, observed video clips of either yawning or control mouth movements. Participants were instructed to fixate to the eyes of the face stimuli. Following instructed fixation on the eyes, both TD children and children with ASD yawned equally frequently in response to yawning stimuli. Current results suggest that contagious yawning could occur in ASD under an experimental condition in which they are instructed to fixate on the yawning eyes.
38. Simmons DR, Robertson AE, McKay LS, Toal E, McAleer P, Pollick FE. {{Vision in autism spectrum disorders}}. {Vision Res};2009 (Nov);49(22):2705-2739.
Autism spectrum disorders (ASDs) are developmental disorders which are thought primarily to affect social functioning. However, there is now a growing body of evidence that unusual sensory processing is at least a concomitant and possibly the cause of many of the behavioural signs and symptoms of ASD. A comprehensive and critical review of the phenomenological, empirical, neuroscientific and theoretical literature pertaining to visual processing in ASD is presented, along with a brief justification of a new theory which may help to explain some of the data, and link it with other current hypotheses about the genetic and neural aetiologies of this enigmatic condition.
39. Simms ML, Kemper TL, Timbie CM, Bauman ML, Blatt GJ. {{The anterior cingulate cortex in autism: heterogeneity of qualitative and quantitative cytoarchitectonic features suggests possible subgroups}}. {Acta Neuropathol};2009 (Nov);118(5):673-684.
Autism is a behaviorally defined disorder with deficits in social interaction, communication, atypical behaviors, and restricted areas of interest. Postmortem studies of the brain in autism have shown a broad spectrum of abnormalities in the cerebellum and neocortex, involving limbic regions such as anterior cingulate cortex (ACC, Brodmann’s area 24). Using stereological techniques, we analyzed quantitatively cytoarchitectonic subdomains of the ACC (areas 24a, b, c) with regard to cell packing density and cell size. Microscopic examination of the ACC was also done to identify any neuropathologies. Results showed a significant decrease in cell size in layers I-III and layers V-VI of area 24b and in cell packing density in layers V-VI of area 24c. Direct comparisons revealed irregular lamination in three of nine autism brains and increased density of neurons in the subcortical white matter in the remaining cases. Because previous studies have suggested that von Economo neurons (VENs) may be altered in autism, a preliminary study of their density and size was undertaken. VEN density did not differ between autism and control brains overall. However, among the nine autism cases, there were two subsets; three brains with significantly increased VEN density and the remaining six cases with reduced VEN density compared to controls. Collectively, the findings of this pilot study may reflect the known heterogeneity in individuals with autism and variations in clinical symptomotology. Further neuroanatomic analyses of the ACC, from carefully documented subjects with autism, could substantially expand our understanding of ACC functions and its role in autism.
40. Towgood KJ, Meuwese JD, Gilbert SJ, Turner MS, Burgess PW. {{Advantages of the multiple case series approach to the study of cognitive deficits in autism spectrum disorder}}. {Neuropsychologia};2009 (Nov);47(13):2981-2988.
In the neuropsychological case series approach, tasks are administered that tap different cognitive domains, and differences within rather than across individuals are the basis for theorising; each individual is effectively their own control. This approach is a mainstay of cognitive neuropsychology, and is particularly suited to the study of populations with heterogeneous deficits. However it has very rarely been applied to the study of cognitive differences in autism spectrum disorder (ASD). Here, we investigate whether this approach can yield information beyond that given by the typical group study method, when applied to an ASD population. Twenty-one high-functioning adult ASD participants and 22 IQ, age, and gender-matched control participants were administered a large battery of neuropsychological tests that would represent a typical neuropsychological assessment for neurological patients in the United Kingdom. The data were analysed using both group and single-case study methods. The group analysis revealed a limited number of deficits, principally on tests with a large executive function component, with no impairment in more routine abilities such as basic attending, language and perception. Single-case study analysis proved more fruitful revealing evidence of considerable variation in abilities both between and within ASD participants. Both sub-normal and supra-normal performance were observed, with the most defining feature of the ASD group being this variability. We conclude that the use of group-level analysis alone in the study of cognitive deficits in ASD risks missing cognitive characteristics that may be vitally important both theoretically and clinically, and even may be misleading because of averaging artifact.
41. van Daalen E, Kemner C, Dietz C, Swinkels SH, Buitelaar JK, van Engeland H. {{Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age}}. {Eur Child Adolesc Psychiatry};2009 (Nov);18(11):663-674.
To examine the inter-rater reliability and stability of autism spectrum disorder (ASD) diagnoses made at a very early age in children identified through a screening procedure around 14 months of age. In a prospective design, preschoolers were recruited from a screening study for ASD. The inter-rater reliability of the diagnosis of ASD was measured through an independent assessment of a randomly selected subsample of 38 patients by two other psychiatrists. The diagnoses at 23 months and 42 months of 131 patients, based on the clinical assessment and the diagnostic classifications of standardised instruments, were compared to evaluate stability of the diagnosis of ASD. Inter-rater reliability on a diagnosis of ASD versus non-ASD at 23 months was 87% with a weighted kappa of 0.74 (SE 0.11). The stability of the different diagnoses in the autism spectrum was 63% for autistic disorder, 54% for pervasive developmental disorder, not otherwise specified (PDD-NOS), and 91% for the whole category of ASD. Most diagnostic changes at 42 months were within the autism spectrum from autistic disorder to PDD-NOS and were mainly due to diminished symptom severity. Children who moved outside the ASD category at 42 months made significantly larger gains in cognitive and language skills than children with a stable ASD diagnosis. In conclusion, the inter-rater reliability and stability of the diagnoses of ASD established at 23 months in this population-based sample of very young children are good.
42. Wood JJ, Drahota A, Sze K, Van Dyke M, Decker K, Fujii C, Bahng C, Renno P, Hwang WC, Spiker M. {{Brief report: effects of cognitive behavioral therapy on parent-reported autism symptoms in school-age children with high-functioning autism}}.{ J Autism Dev Disord};2009 (Nov);39(11):1608-1612.
This pilot study tested the effect of cognitive behavioral therapy (CBT) on parent-reported autism symptoms. Nineteen children with autism spectrum disorders and an anxiety disorder (7-11 years old) were randomly assigned to 16 sessions of CBT or a waitlist condition. The CBT program emphasized in vivo exposure supported by parent training and school consultation to promote social communication and emotion regulation skills. Parents completed a standardized autism symptom checklist at baseline and posttreatment/postwaitlist and 3-month follow-up assessments. CBT outperformed the waitlist condition at posttreatment/postwaitlist on total parent-reported autism symptoms (Cohen’s d effect size = .77). Treatment gains were maintained at 3-month follow-up. Further investigation of this intervention modality with larger samples and broader outcome measures appears to be indicated.
43. Zeegers M, Pol HH, Durston S, Nederveen H, Schnack H, van Daalen E, Dietz C, van Engeland H, Buitelaar J. {{No differences in MR-based volumetry between 2- and 7-year-old children with autism spectrum disorder and developmental delay}}. {Brain Dev};2009 (Nov);31(10):725-730.
OBJECTIVE: To study brain volumes in children with ASD as compared to children with a mental retardation or a language delay (developmentally delayed). In addition, to study the association of intellectual functioning on brain volumes in children with ASD or developmental delay. METHODS: Thirty-four children with ASD and 13 developmentally delayed children without ASD, between 2 and 7 years old, matched on age and developmental level, participated in a MRI study. Volumes of cranium, total brain, cerebellum, grey and white matter, ventricles, hippocampus and amygdala were measured. RESULTS: No significant differences in volumes of intracranium, total brain, ventricles, cerebellum, grey or white matter or amygdala and hippocampus between the ASD group and the developmentally delayed group were found. In the developmentally delayed group, a significant correlation (0.73) was found between intellectual functioning and total brain volume after partialling out intracranial volume. In the ASD group, the correlation between intellectual functioning and brain volume corrected for intracranial volume was not significant. CONCLUSION: No evidence was found for overall differences in brain volumes in children with ASD compared to developmentally delayed children between 2 and 7 years. The finding that higher intellectual functioning was not associated with a relative larger brain volume in children with ASD may suggest that a relative enlargement of the brain may not be beneficial to patients with autism.
