1. Annaz D, Remington A, Milne E, Coleman M, Campbell R, Thomas MS, Swettenham J. {{Development of motion processing in children with autism}}. {Dev Sci} (Nov);13(6):826-838.
2. Bakken TL, Helverschou SB, Eilertsen DE, Heggelund T, Myrbakk E, Martinsen H. {{Psychiatric disorders in adolescents and adults with autism and intellectual disability: a representative study in one county in Norway}}. {Res Dev Disabil} (Nov-Dec);31(6):1669-1677.
Few studies assess psychiatric disorders in representative samples of individuals with autism and ID. Symptoms of autism and psychiatric disorders have been confounded. PAC, a conceptually analysed and validated screening instrument, was used. AIMS: Assess prevalence of psychiatric disorders in individuals with intellectual disability only (ID-only) and with combination of autism and ID (autism). Sixty-two (autism) and 132 (ID-only) participants were screened for psychiatric disorders with the Psychopathology in Autism Checklist (PAC); included general adjustment problems (GAP), and severe adjustment problems (SGAP) in one county in Norway. Psychosis, depression, anxiety, and OCD were addressed. Both SGAP and a high psychiatric disorder score were required to screen a psychiatric disorder. « Diagnostic overlap » was defined as more than one psychiatric disorder concurrent with autism. Psychiatric disorders and SGAP were found to be high both in the autism (53.2%) and ID-only group (17.4%). More than 50% of the autism and approximately 20% of ID-only group had SGAP. The differences were significant. The autism-psychiatric disorder interaction was significant. The largest differences between the prevalence in the autism and the ID-only group were shown in individuals with anxiety. The majority of the individuals in both study groups were afflicted with more than one psychiatric disorder. About 60% were found to have more than one disorder. The individuals with more severe psychiatric symptoms had higher degrees of diagnostic overlap. Having an intellectual disability seem to imply high risk for developing adjustment problems, and it seems especially difficult for individuals with autism to master every-day challenges.
3. Bharti B, Bharti S. {{Clinical-statistical gap in evaluating outcome of stool patterns in young children with autistic spectrum disorder}}. {Arch Dis Child} (Nov);95(11):953-954.
4. Briegel W, Schimek M, Kamp-Becker I. {{Moebius sequence and autism spectrum disorders–less frequently associated than formerly thought}}. {Res Dev Disabil} (Nov-Dec);31(6):1462-1466.
Moebius sequence is a rare congenital disorder usually defined as a combination of facial weakness with impairment of ocular abduction. It is questionable, whether there is a strong association of the sequence with autism spectrum disorders (ASDs) as suggested in some earlier case reports and studies. Twenty-two participants with Mobius sequence aged 6-16 years followed a request of the German Moebius foundation to participate in a nationwide study. All patients had a physical examination and intelligence testing. Primary caregivers were asked to complete two screening measures of ASD (Behaviour and Communication Questionnaire, VSK; Marburger Asperger’s Syndrome Rating Scale, MBAS). For those who reached the cut-off for ASD and/or showed behavioural aspects indicative of ASDs during IQ testing and/or physical examination, well standardized diagnostic instruments (Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, and Kinder-DIPS) were administered. Minimal diagnostic criteria for Mobius sequence were congenital facial weakness (uni- or bilateral) and impairment of ocular abduction (uni- or bilateral). Three boys (one of them mentally retarded) out of 22 participants (12 males and 10 females) were found suspicious of ASD by screening, but none of them fulfilled diagnostic criteria of ASD on a clinical consensus conference. Therefore, ASDs seem to be not as frequent as reported in previous studies on patients with Mobius sequence.
5. Burke RV, Andersen MN, Bowen SL, Howard MR, Allen KD. {{Evaluation of two instruction methods to increase employment options for young adults with autism spectrum disorders}}. {Res Dev Disabil} (Nov-Dec);31(6):1223-1233.
We evaluated the efficacy of a vocational training program including behavioral skills training, and a « performance cue system » (i.e., a proprietary iPhone application adapted for the study) to teach targeted social-vocational skills to six young adults with an Autism Spectrum Disorder. In two separate studies, participants were employed to assist in the delivery of a fire safety education program. Participants were asked to wear an inflatable firefighter WalkAround(R) mascot costume and to perform 63 scripted behaviors in coordination with a fire prevention specialist who was the lead program presenter. In Study 1, three participants were initially exposed to established company training procedures comprised of behavioral skills training components to determine whether they met mastery of the skills. If necessary to reach criteria, participants were then exposed to a performance cue system. In Study 2, three additional participants were provided with the performance cue system alone, and then behavioral skills training if required. A single case, multiple-baseline design across subjects was used to evaluate efficacy of each intervention. Results indicate that 5 of 6 participants reached criterion only after introduction of the cue system while the sixth reached criterion with behavioral skills training alone. The program received high satisfaction ratings from participants, their parents, and consumers. Implications and potential use of the PCS in other employment settings are discussed.
6. Chang CH, Wade MG, Stoffregen TA, Hsu CY, Pan CY. {{Visual tasks and postural sway in children with and without autism spectrum disorders}}. {Res Dev Disabil} (Nov-Dec);31(6):1536-1542.
We investigated the influences of two different suprapostural visual tasks, visual searching and visual inspection, on the postural sway of children with and without autism spectrum disorder (ASD). Sixteen ASD children (age=8.75+/-1.34 years; height=130.34+/-11.03 cm) were recruited from a local support group. Individuals with an intellectual disability as a co-occurring condition and those with severe behavior problems that required formal intervention were excluded. Twenty-two sex- and age-matched typically developing (TD) children (age=8.93+/-1.39 years; height=133.47+/-8.21 cm) were recruited from a local public elementary school. Postural sway was recorded using a magnetic tracking system (Flock of Birds, Ascension Technologies, Inc., Burlington, VT). Results indicated that the ASD children exhibited greater sway than the TD children. Despite this difference, both TD and ASD children showed reduced sway during the search task, relative to sway during the inspection task. These findings replicate those of Stoffregen et al. (2000), Stoffregen, Giveans, et al. (2009), Stoffregen, Villard, et al. (2009) and Prado et al. (2007) and extend them to TD children as well as ASD children. Both TD and ASD children were able to functionally modulate postural sway to facilitate the performance of a task that required higher perceptual effort.
7. D’Auria JP. {{Autism on the web: « oh, the places you’ll go! »}}. {J Pediatr Health Care} (Nov-Dec);24(6):e11-15.
8. Falck-Ytter T, Fernell E, Gillberg C, Von Hofsten C. {{Face scanning distinguishes social from communication impairments in autism}}. {Dev Sci} (Nov);13(6):864-875.
9. Groen WB, Buitelaar JK, van der Gaag RJ, Zwiers MP. {{Pervasive microstructural abnormalities in autism: a DTI study}}. {J Psychiatry Neurosci} (Nov 1)
Background: Recent studies have reported abnormal functional connectivity patterns in the brains of people with autism that may be accompanied by decreases in white matter integrity. Since autism is a developmental disorder, we aim to investigate the nature and location of decreases in white and grey matter integrity in an adolescent sample while accounting for age. Methods: We used structural (T1) imaging to study brain volumetrics and diffusion tensor imaging (DTI) to investigate white and grey matter integrity in people with autism. We obtained magnetic resonance images for adolescents aged 12-18 years with high-functioning autism and from matched controls. Fractional anisotropy and mean diffusivity, as well as grey and white matter volumetrics were analyzed. Results: There were 17 participants with autism and 25 matched controls included in this study. Participants with autism had lower fractional anisotropy in the left and right superior and inferior longitudinal fasciculus, but this effect was not significant after adjusting for age and intelligence quotient (IQ). The kurtosis of the white matter fractional anisotropy probability distribution was higher in this participant group, with and without adjustment for age and IQ. Most notably, however, the mean diffusivity levels were markedly increased in the autism group throughout the brain, and the mean diffusivity probability distributions of both grey and white matter were shifted toward a higher value, particularly with age and IQ adjustment. No volumetric differences in grey and white matter were found. Limitations: We corrected for age and IQ using a linear model. The study was also limited by its sample size, investigated age range and cross-sectional design. Conclusion: The findings suggest that autism is characterized by a generalized reduction of white matter integrity that is associated with an increase of interstitial space. The generalized manifestation of the white matter abnormalities provides an important new perspective on autism as a connectivity disorder.
10. Hudry K, Leadbitter K, Temple K, Slonims V, McConachie H, Aldred C, Howlin P, Charman T. {{Preschoolers with autism show greater impairment in receptive compared with expressive language abilities}}. {Int J Lang Commun Disord} (Nov);45(6):681-690.
BACKGROUND: In early typical language development, children understand words before they are able to use them in speech. Children with autism spectrum disorders (ASD) generally show impairments in both the comprehension and the production of language. However, the relative degree of delay or impairment in each of these sub-domains may also be atypical and remains less well-understood. AIMS: Relative delay in receptive and expressive language skills was examined within a large sample of preschoolers with autism. Children’s language abilities varied from pre-verbal to fluent speech. METHOD & PROCEDURES: Scores on one direct clinician assessment and two parent-report measures of language were obtained for 152 preschoolers with core autism. OUTCOMES & RESULTS: As expected, on average, the language ability of the children with autism was lower than typical age norms, albeit with substantial individual variability. On all three language measures, receptive ability was relatively more impaired than expressive ability. Higher non-verbal ability was associated with such an atypical language profile. CONCLUSIONS & IMPLICATIONS: Recognition of the marked receptive language impairment relative to expressive language, found to affect at least one-third of preschoolers with autism in this sample, has important implications for interacting with these children and for informing appropriate targets in language and communication intervention.
11. Johnson SB, Whitney G, McAuliffe M, Wang H, McCreedy E, Rozenblit L, Evans CC. {{Using global unique identifiers to link autism collections}}. {J Am Med Inform Assoc} (Nov 1);17(6):689-695.
OBJECTIVE: To propose a centralized method for generating global unique identifiers to link collections of research data and specimens. DESIGN: The work is a collaboration between the Simons Foundation Autism Research Initiative and the National Database for Autism Research. The system is implemented as a web service: an investigator inputs identifying information about a participant into a client application and sends encrypted information to a server application, which returns a generated global unique identifier. The authors evaluated the system using a volume test of one million simulated individuals and a field test on 2000 families (over 8000 individual participants) in an autism study. MEASUREMENTS: Inverse probability of hash codes; rate of false identity of two individuals; rate of false split of single individual; percentage of subjects for which identifying information could be collected; percentage of hash codes generated successfully. RESULTS: Large-volume simulation generated no false splits or false identity. Field testing in the Simons Foundation Autism Research Initiative Simplex Collection produced identifiers for 96% of children in the study and 77% of parents. On average, four out of five hash codes per subject were generated perfectly (only one perfect hash is required for subsequent matching). DISCUSSION: The system must achieve balance among the competing goals of distinguishing individuals, collecting accurate information for matching, and protecting confidentiality. Considerable effort is required to obtain approval from institutional review boards, obtain consent from participants, and to achieve compliance from sites during a multicenter study. CONCLUSION: Generic unique identifiers have the potential to link collections of research data, augment the amount and types of data available for individuals, support detection of overlap between collections, and facilitate replication of research findings.
12. Keil A, Daniels JL, Forssen U, Hultman C, Cnattingius S, Soderberg KC, Feychting M, Sparen P. {{Parental autoimmune diseases associated with autism spectrum disorders in offspring}}. {Epidemiology} (Nov);21(6):805-808.
BACKGROUND: Autism spectrum disorders are often idiopathic. Studies have suggested associations between immune response and these disorders. We explored associations between parental autoimmune disorders and children’s diagnosis of autism by linking Swedish registries. METHODS: Data for each participant were linked across 3 Swedish registries. The study includes 1227 cases and 25 matched controls for each case (30,693 controls with parental linkage). Parental diagnoses comprised 19 autoimmune disorders. We estimated odds ratios (ORs) using multivariable conditional logistic regression. RESULTS: Parental autoimmune disorder was weakly associated with autism spectrum disorders in offspring (maternal OR = 1.6 [95% confidence interval = 1.1-2.2]; paternal OR = 1.4 [1.0-2.0]). Several maternal autoimmune diseases were correlated with autism. For both parents, rheumatic fever was associated with autism spectrum disorders. CONCLUSIONS: These data support previously reported associations between parental autoimmune disorders and autism spectrum disorders. Parental autoimmune disorders may represent a critical pathway that warrants more detailed investigation.
13. Kuhaneck HM, Burroughs T, Wright J, Lemanczyk T, Darragh AR. {{A qualitative study of coping in mothers of children with an autism spectrum disorder}}. {Phys Occup Ther Pediatr} (Nov);30(4):340-350.
A significant body of research exists that explores the stressors of raising a child with an autism spectrum disorder (ASD). There are fewer studies, however, that examine specific effective coping strategies of mothers of children with an ASD. This qualitative study explored mothers’ perceptions of effective coping strategies for their parenting stressors. In-depth interviews were conducted with 11 mothers to inquire about their personal coping methods. Interviews were coded and emergent themes identified that included coping strategies such as « me time, » planning, knowledge is power, sharing the load, lifting the restraints of labels, and recognizing the joys. The information from this study may benefit mothers of children with ASD and inform pediatric therapists providing services to children with ASD and their families.
14. Lazar AS, Lazar ZI, Biro A, Gyori M, Tarnok Z, Prekop C, Keszei A, Stefanik K, Gadoros J, Halasz P, Bodizs R. {{Reduced fronto-cortical brain connectivity during NREM sleep in Asperger syndrome: an EEG spectral and phase coherence study}}. {Clin Neurophysiol} (Nov);121(11):1844-1854.
OBJECTIVE: To investigate whether sleep macrostructure and EEG power spectral density and coherence during NREM sleep are different in Asperger syndrome (AS) compared to typically developing children and adolescents. METHODS: Standard all night EEG sleep parameters were obtained from 18 un-medicated subjects with AS and 14 controls (age range: 7.5-21.5years) after one adaptation night. Spectral, and phase coherence measures were computed for multiple frequency bands during NREM sleep. RESULTS: Sleep latency and wake after sleep onset were increased in AS. Absolute power spectrum density (PSD) was significantly reduced in AS in the alpha, sigma, beta and gamma bands and in all 10 EEG derivations. Relative PSD showed a significant increase in delta and a decrease in the sigma band for frontal, and in beta for centro-temporal derivations. Intrahemispheric coherence measures were markedly lower in AS in the frontal areas, and the right hemisphere over all EEG channels. The most prominent reduction in intrahemispheric coherence was observed over the fronto-central areas in delta, theta, alpha and sigma EEG frequency bands. CONCLUSION: EEG power spectra and coherence during NREM sleep, in particular in fronto-cortical derivations are different in AS compared to typically developing children and adolescents. SIGNIFICANCE: Quantitative analysis of the EEG during NREM sleep supports the hypothesis of frontal dysfunction in AS.
15. Mayoral M, Merchan-Naranjo J, Rapado M, Leiva M, Moreno C, Giraldez M, Arango C, Parellada M. {{Neurological soft signs in juvenile patients with Asperger syndrome, early-onset psychosis, and healthy controls}}. {Early Interv Psychiatry} (Nov);4(4):283-290.
16. Monnerat LS, Moreira Ados S, Alves MC, Bonvicino CR, Vargas FR. {{Identification and characterization of novel sequence variations in MECP2 gene in Rett syndrome patients}}. {Brain Dev} (Nov);32(10):843-848.
Rett syndrome (RS) is a neurodevelopmental disorder caused by mutations in MECP2 gene. Exons 2, 3, and 4, in addition to intronic and 3’UTR adjacent regions, were sequenced in 80 patients with RS. Twenty-nine sequence variations were detected in 49 patients, 34 (69.4%) patients with the classic form of RS, and 15 (30.6%) patients with atypical forms of RS. Thirteen of the 29 detected mutations represent novel sequence variations. Missense mutation T158M was the most commonly observed mutation, detected in nine patients (11.2%). Six hotspot pathogenic mutations (R133C, T158M, R168X, R255X, R270X, and R294X) were responsible for the phenotype in 26/80 patients (32.5%).
17. Niemi J, Otsa L, Evtyukova A, Lehtoaro L, Niemi J. {{Linguistic reflections of social engagement in Asperger discourse and narratives: A quantitative analysis of two cases}}. {Clin Linguist Phon} (Nov);24(11):928-940.
The present linguistic analyses of two children (aged 8 and 10) with Asperger Syndrome (AS) and their two matched controls are based on dyadic therapist-child conversations and on picture description tasks. The circa 100 analysis features covering aspects of (i) lexicon (e.g. prominalization), (ii) structural characteristics of turns, (iii) co-operation features (e.g. shared/non-shared elaboration of themes), (iv) prosody, (v) cognitive aspects (e.g. involvement/commitment, world of discourse) and (vi) affect features, show that the AS speakers describe, rather than narrate their conceptualizations, whether (practically) self-initiated (dyadic discourse) or prompted through pictures (narratives). In previous experimental studies of spatially deictic expressions and spatial orientation, it has been shown that the spatial and low-level social cognition of these AS subjects was unimpaired. However, in the present study AS discourse carries features of impaired inter-personal and inter-subjective performance, manifest, for example, in linguistic deixis, atypical power-oriented features and lack of joint activity.
18. Nomura Y, Nagao Y, Kimura K, Hachimori K, Segawa M. {{Epilepsy in autism: A pathophysiological consideration}}. {Brain Dev} (Nov);32(10):799-804.
Eighty cases of idiopathic autism with epilepsy and 97 cases without epilepsy were studied to evaluate the pathophysiology of epilepsy in autism. The initial visit to this clinic ranged 8months-30years 3months of age, and the current ages are 5years 8months-42years 3months, 60% reaching to over 30years of age. The average follow up duration is 22.2years+/-9.4years. The ages of onset of epilepsy were from 7months to 30years of age, with the two peaks at 3.2years and 16.7years. EEG central focus appeared earlier than frontal focus. Abnormality of locomotion and atonic NREM were observed more frequently in epileptic group. These suggest the neuronal system related to abnormality of locomotion and atonic NREM, which are the hypofunction of the brainstem monoaminergic system, is the pathomechanism underling the epilepsy in autism. By showing the abnormal sleep-wake rhythm and locomotion being the very initial symptoms in autism, we had shown the hypofunction of the brainstem monoaminergic system is the initial pathomechanism of autism. Thus, epilepsy in autism is not the secondary manifestation, but one of the pathognomonic symptoms of autism. The brainstem monoaminergic system project to the wider cortical area, and the initial monoaminergic hypofunction may lead to the central focus which appears earlier. The failure of the monoaminergic (serotonergic) system causes dysfunction of the pedunculo-pontine nucleus (PPN) and induces dysfunction of the dopamine (DA) system, and with development of the DA receptor supersensitivity consequently disinhibits the thalamo-frontal pathway, which after maturation of this pathway in teens cause the epileptogenesis in the frontal cortex.
19. Nyden A, Niklasson L, Stahlberg O, Anckarsater H, Wentz E, Rastam M, Gillberg C. {{Adults with autism spectrum disorders and ADHD neuropsychological aspects}}. {Res Dev Disabil} (Nov-Dec);31(6):1659-1668.
The purpose of the present study was to assess which types of neuropsychological deficits appear to be most commonly associated with autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) in adults. The effect of the combination of ASD with ADHD (ASD/ADHD) was also studied. One hundred and sixty-one adult individuals (>/=18 years of age) were included in the study. None had full scale IQ less than 71. The neuropsychological investigations included measures of intellectual ability, learning and memory, attention/executive function and theory of mind. The three diagnostic groups showed reduced performance in most cognitive domains. However, within these domains differentiating distinct features could be seen. The dysfunctions of the ASD/ADHD group cannot be seen as a summary of the dysfunctions found in the ASD and ADHD groups. The ADHD seemed to have the most severe neuropsychological impairments of the three groups. No domain-specific deficit typical of any of the diagnostic groups was found.
20. Peters-Scheffer N, Didden R, Mulders M, Korzilius H. {{Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability}}. {Res Dev Disabil} (Nov-Dec);31(6):1678-1684.
This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers) and a discrete trial teaching approach was used. Twelve children in the treatment group were compared to 22 children receiving regular intervention. At pre-treatment, both groups did not differ on chronological age, developmental age, diagnosis and level of adaptive skills. Eight months into treatment, children receiving behavioral treatment displayed significantly higher developmental ages and made more gains in adaptive skills than children from the control group. No significant differences between groups were found on autistic symptom severity and emotional and behavioral problems.
21. Philip RC, Whalley HC, Stanfield AC, Sprengelmeyer R, Santos IM, Young AW, Atkinson AP, Calder AJ, Johnstone EC, Lawrie SM, Hall J. {{Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders}}. {Psychol Med} (Nov);40(11):1919-1929.
BACKGROUND: Previous behavioural and neuroimaging studies of emotion processing in autistic spectrum disorder (ASD) have focused on the use of facial stimuli. To date, however, no studies have examined emotion processing in autism across a broad range of social signals. METHOD: This study addressed this issue by investigating emotion processing in a group of 23 adults with ASD and 23 age- and gender-matched controls. Recognition of basic emotions (‘happiness’, ‘sadness’, ‘anger’, disgust’ and ‘fear’) was assessed from facial, body movement and vocal stimuli. The ability to make social judgements (such as approachability) from facial stimuli was also investigated. RESULTS: Significant deficits in emotion recognition were found in the ASD group relative to the control group across all stimulus domains (faces, body movements and voices). These deficits were seen across a range of emotions. The ASD group were also impaired in making social judgements compared to the control group and this correlated with impairments in basic emotion recognition. CONCLUSIONS: This study demonstrates that there are significant and broad-ranging deficits in emotion processing in ASD present across a range of stimulus domains and in the auditory and visual modality; they cannot therefore be accounted for simply in terms of impairments in face processing or in the visual modality alone. These results identify a core deficit affecting the processing of a wide range of emotional information in ASD, which contributes to the impairments in social function seen in people with this condition.
22. Rodger S, Vishram A. {{Mastering social and organization goals: strategy use by two children with Asperger syndrome during cognitive orientation to daily occupational performance}}. {Phys Occup Ther Pediatr} (Nov);30(4):264-276.
Preliminary data supports the effectiveness of Cognitive Orientation to (daily) Occupational Performance (CO-OP) for children with Asperger syndrome (AS). Children with AS often experience social and organizational difficulties spanning daily occupations. This case study explored the pattern of Global Strategies and Domain-Specific Strategies (DSS) use, the type of guidance, and dimensions of time on task used by two children with AS (aged 10 and 12 years) in addressing social and organizational goals during the CO-OP intervention. Coding of the videotaped CO-OP sessions suggested that both children (a) utilized all the Global strategies, particularly « understanding the context » and « plan »; (b) used six common DSS, namely transitional supports, affective supports, attending, task-specification, task modification, and supplementing task knowledge, with task-specification being most prominent; (c) required minimal guidance while « doing »; and (d) engaged in considerable time « talking about the task. » The results provide initial insights into strategies that may enable children with AS to achieve social and organizational goals.
23. Shapiro JR, Bibat G, Hiremath G, Blue ME, Hundalani S, Yablonski T, Kantipuly A, Rohde C, Johnston M, Naidu S. {{Bone mass in Rett syndrome: association with clinical parameters and MECP2 mutations}}. {Pediatr Res} (Nov);68(5):446-451.
Rett syndrome (RTT) is an X-linked neurodevelopmental disorder caused by mutations in the MECP2 gene. In 49 female RTT children, aged 1.9-17 y, bone mass was assessed and correlated with clinical parameters and mutations involving the MECP2 gene. We also studied five adult females, aged 20-33 y, and one male child, aged 6 y. Lumbar spine bone mineral content (BMC) and bone mineral density (BMD) were correlated with weight, height, BMI, clinical severity, degree of scoliosis, use of anticonvulsants, and ambulatory status. L1-L4 BMD and BMC showed that 48.9% of them had BMD values >2 SD below age-related norms. BMD values were in the osteoporotic range in the five adult females with RTT. Eleven percent of the children and adults with RTT experienced fractures. Low bone mass was correlated with marginal significance to clinical severity and ambulation but not to scoliosis or anticonvulsant use. Lowest bone mass occurred in patients with T158M or R270X mutations but without statistical significance. Studies in a murine model of RTT confirmed low bone mass as an inherent component of this syndrome. MECP2 mutations and clinical parameters impact bone mass in RTT, but an association with a specific mutation was not demonstrable.
24. Smith IM, Koegel RL, Koegel LK, Openden DA, Fossum KL, Bryson SE. {{Effectiveness of a novel community-based early intervention model for children with autistic spectrum disorder}}. {Am J Intellect Dev Disabil} (Nov);115(6):504-523.
Abstract The Nova Scotia early intensive behavior intervention model—NS EIBI ( Bryson et al., 2007 ) for children with autistic spectrum disorders was designed to be feasible and sustainable in community settings. It combines parent training and naturalistic one-to-one behavior intervention employing Pivotal Response Treatment—PRT (R. Koegel & Koegel, 2006 ). We followed 45 children (33 males, mean baseline age  =  50 months) for 12 months. Mean gains of 14.9 and 19.5 months were observed on expressive and receptive language measures, respectively, for children with an IQ of 50 or more at baseline versus 6.1 and 8.4 months for children with IQs less than 50. Behavior problems decreased significantly over the 1-year treatment for both groups, but autism symptoms decreased only for those with an IQ of 50 or more.
25. Smith KR, Matson JL. {{Social skills: differences among adults with intellectual disabilities, co-morbid autism spectrum disorders and epilepsy}}. {Res Dev Disabil} (Nov-Dec);31(6):1366-1372.
Assessing social skills is one of the most complex and challenging areas to study because behavioral repertoires vary depending on an individual’s culture and context. However, researchers have conclusively demonstrated that individuals with intellectual disabilities (ID) have impaired social skills as well as those with co-morbid autism spectrum disorders (ASD) and epilepsy. However, it is unknown how these groups differ. Assessment of social skills was made with the Matson Evaluation of Social Skills for Individuals with Severe Retardation. 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 on the MESSIER, Wilks’s Lambda=.58, F(18, 257)=3.05, p<.01. The multivariate eta(2) based on Wilks’s Lambda was .17. Significant differences were found on the Positive Verbal subscale, F(3, 96)=3.70, p<.01, eta(2)=.10, Positive Non-verbal subscale, F(3, 96)=8.95, p<.01, eta(2)=.22, General Positive subscale, F(3, 96)=7.30, p<.01, eta(2)=.19, Negative Non-verbal subscale, F(3, 96)=5.30, p<.01, eta(2)=.14, and General Negative subscale, F(3, 96)=3.16, p<.05, eta(2)=.09. Based on these results, individuals with ID expressing combined co-morbid ASD and epilepsy had significantly more impaired social skills than the ID only or groups containing only a single co-morbid factor with ID (ASD or epilepsy only). Implications of these findings are discussed.
26. Tolstoy N, Campbell AE. {{Invertebrate insights into autism}}. {Dis Model Mech} (Nov-Dec);3(11-12):665-666.
27. Wang L, Leslie DL. {{Health care expenditures for children with autism spectrum disorders in Medicaid}}. {J Am Acad Child Adolesc Psychiatry} (Nov);49(11):1165-1171.
OBJECTIVE: To study trends in health care expenditures associated with autism spectrum disorders (ASDs) in state Medicaid programs. METHOD: Using Medicaid data from 42 states from 2000 to 2003, patients aged 17 years and under who were continuously enrolled in fee-for-service Medicaid were studied. Patients with claims related to autistic disorder (autism) were identified, as were patients with claims for any ASD other than autism. Total expenditures per treated patient consisted of Medicaid reimbursements from inpatient, outpatient, and long-term care and prescription drugs. Inflation-adjusted expenditures were compared over time and with expenditures associated with other mental health disorders. RESULTS: A total of 2,184,677 children were diagnosed with some type of mental disorder during the study period. Of these children, 69,542 had an ASD, with 49,921 having autism and the rest having another ASD. Mean total health care expenditures per child with ASD were $22,079 in 2000 (in 2003 US dollars), and rose by 3.1% to $22,772 in 2003. The treated prevalence of autism per 10,000 covered lives rose by 32.2% from 40.6 to 53.6, the highest rate of increase among all mental disorders. Total health care expenditures for ASDs per 10,000 covered lives grew by 32.8% from $1,270,435 in 2000 (in 2003 dollars) to $1,686,938 in 2003. CONCLUSIONS: Medicaid-reimbursed health care expenditures for ASD were quite substantial. Although the per patient expenditures grew slightly over time, the large increase in treated prevalence caused a considerable rise in total ASD-associated health care expenditures.
28. Yasuhara A. {{Correlation between EEG abnormalities and symptoms of autism spectrum disorder (ASD)}}. {Brain Dev} (Nov);32(10):791-798.
Children with ASD often suffer from epilepsy and paroxysmal EEG abnormality. Purposes of this study are the confirmation of incidence of epileptic seizures and EEG abnormalities in children with autism using a high performance digital EEG, to examine the nature of EEG abnormalities such as locus or modality, and to determine if the development of children with ASD, who have experienced developmental delay, improves when their epilepsy has been treated and maintained under control. A total of 1014 autistic children that have been treated and followed-up for more than 3 years at Yasuhara Children’s Clinic in Osaka, Japan, were included in this study. Each participant’s EEG had been recorded approximately every 6 months under sleep conditions. Epilepsy was diagnosed in 37% (375/1014) of the study participants. Almost all patients diagnosed with epilepsy presented with symptomatic epilepsy. The data showed that the participants with lower IQ had a higher incidence of epileptic seizures. Epileptic EEG discharges occurred in 85.8% (870/1014) of the patients. There was also a very high incidence of spike discharges in participants whose intellectual quotient was very low or low. Epileptic seizure waves most frequently developed from the frontal lobe (65.6%), including the front pole (Fp1 and Fp2), frontal part (F3, F4, F7 and F8) and central part (C3, Cz and C4). The occurrence rate of spike discharges in other locations, including temporal lobe (T3, T4, T5, T6), parietal lobe (P3, Pz, P4), occipital lobe (O1, O2) and multifocal spikes was less than 10%. These results support the notion that there is a relationship between ASD and dysfunction of the mirror neuron system. The management of seizure waves in children diagnosed with ASD may result in improves function and reduction of autistic symptoms.
29. Zinke K, Fries E, Kliegel M, Kirschbaum C, Dettenborn L. {{Children with high-functioning autism show a normal cortisol awakening response (CAR)}}. {Psychoneuroendocrinology} (Nov);35(10):1578-1582.
Individuals with high-functioning autism spectrum disorders (HFA) show difficulties in the ability to react to change. A recent study suggested that variations in the functioning of the hypothalamus-pituitary-adrenal axis, especially in one of its markers–the cortisol awakening response (CAR)–may be related to those difficulties in adolescents with Asperger’s syndrome. The current study investigated the CAR in a younger sample with diagnoses from the whole autism spectrum: A group of children with HFA (N=15) was compared to a group of typically developing children (N=25). Findings suggest that the frequency of a CAR as well as the increase in cortisol levels from awakening to 30 min later were similar between groups, indicating that variations in the CAR in HFA may not be present early in life but only develop later in adolescence or may only occur in some diagnoses from the autism spectrum.
