1. Ang KQP, Loh PR. {{Mental Health and Coping in Parents of Children with Autism Spectrum Disorder (ASD) in Singapore: An Examination of Gender Role in Caring}}. {J Autism Dev Disord}. 2019.
Research has supported the notion that gender plays a significant role in coping and mental health outcome among parents of children with ASD. The current study aims to examine gender role in the relationship between mental health outcome and coping in parents of children with ASD in Singapore. This study involved 97 fathers and 106 mothers of children with ASD completing self-report questionnaires. MANOVA revealed mothers experienced significantly higher stress levels than fathers. Stress was a significant predictor of depression for fathers but not for mothers. Regression analyses found use of active avoidance coping moderated the relationship between stress and depression in both parents. Implications of these findings on intervention are discussed.
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2. Brisini KSC, Solomon DH. {{Relational Turbulence and Marital Communication When Children with Autism Start School: A Longitudinal Dyadic Diary Study}}. {Health Commun}. 2019: 1-11.
Autism spectrum disorder (ASD) is a pervasive and often difficult health condition, the consequences of which ripple through family relationships. This paper engages relational turbulence theory, which addresses communication in romantic relationships, and the experiencing life transitions model, from the field of nursing, to examine how communication between parents affects the marital relationship during a major transition in the life of a child with ASD. Transition processing communication (TPC) includes four forms of communication that can help married partners navigate difficult life events: increasing interaction, promoting connection, promoting feeling situated, and increasing confidence in the relationship. This study examines the effects of partners’ TPC on their own and their spouse’s experiences of relational uncertainty, changes in interdependence, and relational turbulence. A total of 33 couples and 60 married, female individuals, parents of a child with ASD who was starting school for the first time, completed a pre-test, 14 dairies, and a post-test; diaries were completed every three days over a 42-day period, beginning on the child’s first day of school. Findings suggest that partners’ engagement in TPC significantly affects some relationship qualities. In addition, an individual’s perceptions of his or her spouse’s communication were a stronger predictor of relational turbulence than the spouse’s self-reported communication. Results point to several implications for understanding the ways in which married partners can protect their marriage in the face of their child’s health-related transitions.
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3. Esler A, Hewitt A, Hall-Lande J, Pettingell SL, Houseworth J. {{Psychotropic Medication Use for Adults with Autism Spectrum Disorder who Receive Services and Supports Through Adult Developmental Disability Services in the United States}}. {J Autism Dev Disord}. 2019.
Individuals with autism spectrum disorder (ASD) have higher rates of co-occurring diagnoses and use of psychotropic medication prescriptions than people with other developmental disabilities. Few studies have examined these trends in samples of people with intellectual and developmental disabilities (IDD) with and without ASD. Using a random sample of 11,947 adult IDD service users from 25 states, co-occurring diagnoses and psychotropic medication use were compared for those with and without ASD. Regardless of diagnosis, individuals with ASD had higher percentages of psychotropic medication use. Controlling for co-occurring condition, age, gender, and ID level, a diagnosis of ASD predicted number of medications used. Further research is needed to understand why individuals with ASD are prescribed more medication, more often, than similarly functioning groups of individuals without ASD.
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4. Fallah MS, Shaikh MR, Neupane B, Rusiecki D, Bennett TA, Beyene J. {{Atypical Antipsychotics for Irritability in Pediatric Autism: A Systematic Review and Network Meta-analysis}}. {J Child Adolesc Psychopharmacol}. 2019.
OBJECTIVE: Irritability is common in pediatric autism spectrum disorder (ASD) patients. This can have major implications in child development, receptivity to behavioral therapy, as well as child and caregiver well-being. A systematic review and network meta-analysis were conducted to assess the efficacy and safety of atypical antipsychotics in treating irritability in these patients. METHODS: Studies were identified from Medline, Embase, and PsycINFO from inception to March 2018. The clinical trials database was reviewed. Studies were included if they were a double-blind, randomized controlled trial utilizing the Aberrant Behavior Checklist Irritability (ABC-I) to measure the efficacy of atypical antipsychotic monotherapy. Data extraction was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses for network meta-analysis guidelines. The main outcome was the reduction in irritability score using the ABC-I subscale from baseline. RESULTS: Eight trials comparing four interventions-risperidone, aripiprazole, lurasidone, and placebo in 878 patients, were included. Both risperidone and aripiprazole had significantly reduced ABC-I scores than placebo. Estimates of mean differences (95% credible intervals) were risperidone, -6.89 (-11.14, -2.54); aripiprazole, -6.62 (-10.88, -2.22); and lurasidone, -1.61 (-9.50, 6.23). Both risperidone and aripiprazole had similar safety. There were only eight studies included in the analysis, however, sample sizes were not small. Variance in reporting of adverse effects limited the quality of safety analysis. CONCLUSION: Risperidone and aripiprazole were the two best drugs, with comparable efficacy and safety in pediatric ASD patients. These two medications could be beneficial in improving irritability in these patients.
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5. Fleischer AS. {{Support to students with Asperger syndrome in higher education – the perspectives of three relatives and three coordinators}}. {International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung Revue internationale de recherches de readaptation}. 2011.
An increasing number of students with disabilities attend institutes of higher education (HE). Among this group are persons with Asperger syndrome (AS). Persons with AS have a cognitive impairment that can interfere with their studies and the ability to describe their needs and ask for support. This study deals with an assessment of the support services for students with AS from the perspectives of the students’ relatives and the students’ service providers at the universities they attend. The aim of this study was to investigate (a) earlier experiences and events in relation to the transition of students with AS to higher education, according to the relatives’ perceptions of how these experiences and events affect university studies; and (b) the perceptions of both the relatives of students with AS and the coordinators for students with disabilities with respect to the study environment and support for students with AS. The approach is a case study methodology involving relatives and university coordinators for three students with AS. The coordinators’ way of working with students with disabilities is primarily based on the coordinators’ own ideas. No specific organizational routines exist for students with AS. The results reveal that the needs of students with AS have to be made explicit and must be incorporated into the support system. Relatives lack information about the situation and opportunities to engage in collaboration. Universities must adapt the support system to the cognitive impairments experienced by AS students and the difficulties of their everyday lives. The relatives of students with AS may play the central role in supporting the students and in understanding their impairment.Immer mehr behinderte Studenten schlagen einen zweiten Bildungsweg ein. Zu dieser Gruppe zahlen auch Studenten mit Asperger-Syndrom (AS). Personen mit AS sind oftmals kognitiv eingeschrankt, was Auswirkungen auf ihr Studium haben kann, aber auch auf ihre Fahigkeit, ihre Bedurfnisse zu formulieren und um Hilfe zu bitten. Die vorliegende Studie begutachtet die Hilfseinrichtungen fur Studenten mit AS aus der Perspektive der Angehorigen und der Leistungstrager der Studenten an den jeweiligen Universitaten. Ziel der vorliegenden Studie ist (a) die Untersuchung fruherer Erfahrungen und Ereignisse mit Bezug auf den Ubergang von Studenten mit AS zum zweiten Bildungsweg aus der Sicht der Angehorigen und der Auswirkung dieser Erfahrungen und Ereignisse auf das Studium und (b) die Untersuchung der Sichtweise der Angehorigen der Studenten mit AS sowie der Koordinatoren der behinderten Studenten hinsichtlich des Studienumfelds und der Betreuung von Studenten mit AS. Die Studie erfolgte als Fallstudien-Methodik mit Angehorigen und Universitatskoordinatoren fur drei Studenten mit AS. Welche Gestalt die Zusammenarbeit der Koordinatoren mit behinderten Studenten annimmt, beruht primar auf den eigenen Ideen der Koordinatoren. Fur AS-Studenten existiert kein spezieller organisatorischer Ablauf. Die Ergebnisse gaben zu erkennen, dass die Bedurfnisse von AS-Studenten explizit formuliert und in das Betreuungsschema integriert werden mussen. Angehorigen mangelt es an ausfuhrlichen Informationen uber die Situation und an Gelegenheiten zur Eigenbeteiligung. Universitaten mussen ihre Betreuung den Einschrankungen der kognitiven Fahigkeiten der AS-Studenten sowie deren Schwierigkeiten im taglichen Leben anpassen. Den Angehorigen der Studenten mit AS kommt moglicherweise eine zentrale Rolle bei deren Unterstutzung und beim Verstandnis ihrer Behinderung zu.Cada vez es mayor el numero de estudiantes con discapacidades que pueden acceder a estudios de ensenanza superior, entre los cuales se encuentran las personas que padecen el sindrome de Asperger (SA). Las personas con SA presentan una discapacidad cognitiva que puede interferir en sus estudios y en la habilidad para expresar sus necesidades y pedir ayuda. Este estudio consiste en la evaluacion de los servicios de asistencia de los estudiantes con SA desde el punto de vista de sus familiares y del personal de apoyo de las universidades donde estos estudian. El objetivo del estudio fue investigar (a) las experiencias y acontecimientos previos relacionados con la transicion a la ensenanza superior de los estudiantes con SA, de acuerdo con la opinion de sus familiares sobre como dichas experiencias y acontecimientos influyen en los estudios universitarios; y (b) el punto de vista de los familiares de los estudiantes con SA y de los coordinadores de los estudiantes con discapacidades con respecto al entorno de estudio y los servicios de apoyo de los estudiantes con SA. La metodologia utilizada consistio en un estudio de caso donde participaron los familiares y los coordinadores de la universidad de tres estudiantes con SA. El modo en que los coordinadores trabajan con los estudiantes con discapacidades se basa principalmente en sus propios metodos, ya que no existen unos metodos de organizacion especificos para los estudiantes con SA. Los resultados mostraron que las necesidades de los estudiantes con SA deben ser mas explicitas y deben incorporarse en el sistema de los servicios de asistencia. Los familiares no poseen informacion sobre la situacion y las formas en que pueden colaborar. Las universidades deben adaptar el sistema de los servicios de asistencia a las discapacidades cognitivas que sufren los estudiantes con SA y a las dificultades que experimentan en su vida diaria. El papel que desempenan los familiares de los estudiantes con SA debe ser el de apoyo y comprension de la discapacidad que estos padecen.Un nombre croissant d’eleves handicapes frequentent des instituts d’enseignement superieur (ES). On denombre parmi ce groupe des personnes souffrant du syndrome d’Asperger (SA). Ces patients presentent une deficience cognitive qui peut interferer avec leurs etudes et leur capacite a decrire leurs besoins et a demander un soutien. La presente etude porte sur une evaluation des services de soutien a l’attention des etudiants souffrant du SA du point de vue des parents/proches des etudiants et des prestataires de services dans les universites qu’ils frequentent. L’etude avait pour objet d’examiner les experiences et les evenements anterieurs en relation avec la transition de ces eleves vers l’enseignement superieur, selon les perceptions des parents de la maniere dont ces experiences et ces evenements affectent les etudes universitaires, et (b) les perceptions des proches de ces eleves et de leurs coordonnateurs vis-a-vis de l’environnement d’etude et du soutien qui leur est propose. L’approche est une methodologie d’etude de cas impliquant les proches et les coordonnateurs universitaires de trois eleves souffrant du SA. La methode de travail des coordonnateurs avec les etudiants handicapes repose essentiellement sur leurs propres idees du soutien. Aucune routine organisationnelle specifique n’existe pour les etudiants souffrant du SA. Les resultats revelent que les besoins ces eleves doivent etre rendus explicites et etre incorpores dans le systeme de soutien. Les parents/proches manquent d’informations sur la situation et les possibilites d’engager un processus de collaboration. Les universites doivent adapter le systeme de soutien a la deficience cognitive vecue par les etudiants souffrant du SA et les difficultes de leur vie quotidienne. Les proches de ces etudiants peuvent jouer un role central dans le soutien qui leur est apporte et dans la comprehension de leur deficience.
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6. Hoirisch-Clapauch S, Nardi AE. {{Autism spectrum disorders: let’s talk about glucose?}}. {Translational psychiatry}. 2019; 9(1): 51.
Autism spectrum disorders (ASD) are characterized by disconnectivity due to disordered neuronal migration, and by neuronal mitochondrial dysfunction. Different pathways involved in neuronal migration are affected by intrauterine hyperglycemia and hyperinsulinemia, while prolonged neonatal hypoglycemia may cause mitochondrial dysfunction. Our hypothesis was that conditions leading to intrauterine hyperglycemia or neonatal hypoglycemia would influence ASD pathogenesis. In this study, we identified risk factors for ASD by searching PubMed with the MeSH terms « autism spectrum disorder » and « risk factors ». We then analyzed the relationship between the risk factors and glucose abnormalities in the mother and the offspring. The relationship between glucose abnormalities and risk factors such as obesity, excessive maternal weight gain, or diabetes mellitus is evident. For risk factors such as malformations or exposure to selective serotonin reuptake inhibitors, the relationship is speculative. In rodents, for example, intrauterine hyperglycemia is associated with malformations, independent of maternal diabetes. In their turn, selective serotonin reuptake inhibitors reduce the signs of neonatal hypoglycemia. Going undetected, prolonged hypoglycemia may harm the neonatal brain. Importantly, our group demonstrated that either high-carbohydrate diets or physical inactivity the day before delivery may influence neonatal glycemia. In that study, of 158 neonates selected to be screened according to maternal lifestyle risk factors, 48 had hypoglycemia. Of note, five of them had not been identified with current screening programs. Controlled studies are needed to clarify whether maternal interventions aiming at maintaining glycemic control, together with screening programs for neonatal hypoglycemia based on maternal lifestyle risk factors and on exposure to specific prenatal medications can reduce the prevalence of ASD.
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7. Kissine M, Geelhand P. {{Brief Report: Acoustic Evidence for Increased Articulatory Stability in the Speech of Adults with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2019.
Subjective impressions of speech delivery in Autism Spectrum Disorder (ASD) as monotonic or over-precise are widespread but still lack robust acoustic evidence. This study provides a detailed acoustic characterization of the specificities of speech in individuals with ASD using an extensive sample of speech data, from the production of narratives and from spontaneous conversation. Syllable-level analyses (30,843 tokens in total) were performed on audio recordings from two sub-tasks of the Autism Diagnostic Observation Schedule from 20 adults with ASD and 20 pairwise matched neuro-typical adults, providing acoustic measures of fundamental frequency, jitter, shimmer and the first three formants. The results suggest that participants with ASD display a greater articulatory stability in vowel production than neuro-typical participants, both in phonation and articulatory gestures.
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8. Marlow M, Servili C, Tomlinson M. {{A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries}}. {Autism Res}. 2019.
Without intervention, developmental delay (DD) and autism spectrum disorders (ASDs) severely restrict children from reaching their developmental potential. Monitoring child development through the use of screening tools can help identify children who need further assessment or intervention. Screening has been widely encouraged to identify children with ASD or DD, and a large variety of screening instruments are suggested in the literature. There is a lack of consensus around which screening tools are most effective, especially where tools are used in cultures other than those in which they were created. We conducted a review of the literature for screening tools for DD and autism to make recommendations for tool selection and use in low- and middle-income countries (LMIC). We included 99 screening tools in the review and created profiles for each tool to evaluate their properties and determine which tools could be effectively used in various LMIC. Our review identified a substantial number (35 for DD and 6 for ASD) of screening tools from LMIC. We identified 10 tools which show promise for use across settings; these tools are brief, low-cost and can be implemented by paraprofessionals or lay community health workers. Routine screening is an important first step toward addressing the need for services in LMIC, but high-quality tools take time to be conceptualized, developed, piloted, and validated, before implementation can happen. A focus on improving the scientific rigor of early detection approaches and on enhancing the reach to underserved populations should be prioritized. Autism Research 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Screening tools are short questionnaires or brief assessments used to identify children at risk of a developmental disability such as autism. Many screening tools exist, but there is uncertainty about which tools work best in non-Western cultures or low-resource settings. We reviewed over 90 screening tools to identify which tools can be easily used in these settings. Selecting tools that are affordable and easy to use will make it easier to identify and support children with developmental difficulties.
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9. Pallathra AA, Cordero L, Wong K, Brodkin ES. {{Psychosocial Interventions Targeting Social Functioning in Adults on the Autism Spectrum: a Literature Review}}. {Curr Psychiatry Rep}. 2019; 21(1): 5.
PURPOSE OF REVIEW: There is a perceived shortage of evidence-based treatment programs for adults on the autism spectrum. This article reviews the recent research literature on psychosocial/behavioral interventions targeting social functioning in autistic adults without intellectual disability. RECENT FINDINGS: We identified only 41 peer-reviewed studies published from 1980 to 2017 that tested intervention programs focused on one or more of the behavioral components of social functioning (i.e., social motivation, social anxiety, social cognition, and social skills) in more than one adult with autism spectrum disorder (ASD). The studies demonstrated substantial variability in treatment objectives, intervention procedures, assessment methods, and methodologic quality. The results indicate a strong need for additional research to develop and rigorously test interventions for autistic adults that target the many behavioral components of social functioning and that include procedures to promote generalization of knowledge and skills to community settings.
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10. Rodgers RA, Travers BG, Mason AH. {{Bimanual Reach to Grasp Movements in Youth With and Without Autism Spectrum Disorder}}. {Front Psychol}. 2018; 9: 2720.
Reaching and grasping (prehension) is one of the earliest developing motor skills in humans, but continued prehension development in childhood and adolescence enables the performance of increasingly complex manual tasks. In individuals with autism spectrum disorder (ASD) atypical unimanual reaching and grasping has been reported, but to date, no studies have investigated discrete bimanual movements. We examined unimanual and bimanual reach to grasp tasks in youth with ASD to better understand how motor performance might change with increasing complexity. Twenty youth with ASD (10.1 +/- 2.4 years) and 17 youth with typical development (TD) (9.6 +/- 2.6 years) were instructed to reach and grasp cubes that became illuminated. Participants were asked to reach out with the right and/or left hands to grasp and lift targets located at near (18 cm) and/or far (28 cm) distances. For the unimanual (simplest) condition, participants grasped one illuminated cube (with either the left or right hand). For the bimanual conditions, participants grasped two illuminated cubes located at the same distance from the start position (bimanual symmetric condition) or two illuminated cubes located at different distances (bimanual asymmetric condition). Significant interactions among diagnostic group, task complexity, and age were found for initiation time (IT) and movement time (MT). Specifically, the older children in both groups initiated and performed their movements faster in the unimanual condition than in the bimanual conditions, although the older children with ASD produced slower ITs and MTs compared to typically developing peers across all three conditions. Surprisingly, the younger children with ASD had similar ITs and MTs as their peers for the unimanual condition but did not considerably slow these times to adjust for the complexity of the bimanual tasks. We hypothesize that they chose to re-use the motor plans that were generated for the unimanual trials rather than generate more appropriate motor plans for the bimanual tasks. An atypical spatiotemporal relationship between MT and peak aperture (PA) was also found in the ASD group. Together, our results suggest deficits in motor planning that result in subtle effects on performance in younger children with ASD that become more pronounced with age.
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11. Rosina E, Battan B, Siracusano M, Di Criscio L, Hollis F, Pacini L, Curatolo P, Bagni C. {{Disruption of mTOR and MAPK pathways correlates with severity in idiopathic autism}}. {Translational psychiatry}. 2019; 9(1): 50.
The molecular signature underlying autism spectrum disorder remains largely unknown. This study identifies differential expression of mTOR and MAPK pathways in patients affected by mild and severe idiopathic autism. A total of 55 subjects were enrolled, of which 22 were typically developing individuals and 33 were patients aged between 3 and 11 years, with autism spectrum disorder. A detailed history, including physical examination, developmental evaluation, mental health history and autism diagnostic observation schedule were performed for each patient. Components of the mTOR and MAPK signalling pathways were analysed from peripheral blood at the protein level. Patients were then stratified according to their clinical phenotypes, and the molecular profiling was analysed in relation to the degree of autism severity. In this cohort of patients, we identified increased activity of mTOR and the MAPK pathways, key regulators of synaptogenesis and protein synthesis. Specifically, rpS6, p-eIF4E, TSC1 and p-MNK1 expression discriminated patients according to their clinical diagnosis, suggesting that components of protein synthesis signalling pathways might constitute a molecular signature of clinical severity in autism spectrum disorder.
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12. Stanley JT, Morrison LB, Webster BA, Turner JR, Richards CJ. {{An Age-Friendly University (AFU) Assists with Technology Learning and Social Engagement among Older Adults and Individuals with Developmental Disabilities}}. {Gerontology & geriatrics education}. 2019: 1-15.
As an Age-Friendly University (AFU), University of Akron is striving to support lifelong learning. A collaborative research effort developed between aging researchers at the university and a government-sponsored pilot program aimed to provide learning opportunities for older adults (OA) and engagement for individuals with developmental disabilities (IDD). The present study assessed the success of a pilot program to increase comfort with technology and community engagement. OA and IDD participants met twice a month for 9 months to discuss how to use technology (e.g., an IPad). We assessed satisfaction, perceived changes in comfort with technology, perceived changes in connection with others, and motivations for participating with questionnaires and a structured interview. On average, participants reported very high satisfaction with the group, and moderate increases in comfort with technology and how connected they feel to others as a result of participating in the group. The most common motivations for participation were related to values, strengthening social ties, seeking to learn, and bringing joy to others. These findings suggest that the pilot was successful at improving community engagement. The involvement of the university in the assessment of this pilot program situates the university as an age-friendly partner for community efforts to support lifelong learning.
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13. Yau SY, Bettio L, Chiu J, Chiu C, Christie BR. {{Fragile-X Syndrome Is Associated With NMDA Receptor Hypofunction and Reduced Dendritic Complexity in Mature Dentate Granule Cells}}. {Front Mol Neurosci}. 2018; 11: 495.
Fragile X syndrome (FXS) is the most common form of inherited intellectual disability. It is caused by the overexpansion of cytosine-guanine-guanine (CGG) trinucleotide in Fmr1 gene, resulting in complete loss of the fragile X mental retardation protein (FMRP). Previous studies using Fmr1 knockout (Fmr1 KO) mice have suggested that a N-methyl-D-aspartate receptors (NMDAR) hypofunction in the hippocampal dentate gyrus may partly contribute to cognitive impairments in FXS. Since activation of NMDAR plays an important role in dendritic arborization during neuronal development, we examined whether deficits in NMDAR function are associated with alterations in dendritic complexity in the hippocampal dentate region. The dentate granule cell layer (GCL) presents active postnatal neurogenesis, and consists of a heterogenous neuronal population with gradient ages from the superficial to its deep layer. Here, we show that neurons with multiple primary dendrites that reside in the outer GCL of Fmr1 KO mice display significantly smaller NMDAR excitatory post-synaptic currents (EPSCs) and a higher alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) to NMDA ratio in comparison to their wild-type counterparts. These deficits were associated with a significant decrease in dendritic complexity, with both dendritic length and number of intersections being significantly reduced. In contrast, although neurons with a single primary dendrite resided in the inner GCL of Fmr1 KO mice had a trend toward a reduction in NMDAR EPSCs and a higher AMPA/NMDA ratio, no alterations were found in dendritic complexity at this developmental stage. Our data indicate that the loss of FMRP causes NMDAR deficits and reduced dendritic complexity in granule neurons with multiple primary dendrites which are thought to be more mature in the GCL.
