1. Anwar A, Marini M, Abruzzo PM, Bolotta A, Ghezzo A, Visconti P, Thornalley PJ, Rabbani N. {{Quantitation of plasma thiamine, related metabolites and plasma protein oxidative damage markers in children with autism spectrum disorder and healthy controls}}. {Free Radic Res};2016 (Nov 2):1-6.
AIMS/HYPOTHESIS: To assess thiamine and related metabolite status by analysis of plasma and urine in autistic children and healthy controls, correlations to clinical characteristics and link to plasma protein markers of oxidative damage. METHODS: 27 children with autism (21 males and 6 females) and 21 (15 males and 6 females) age-matched healthy control children were recruited. The concentration of thiamine and related phosphorylated metabolites in plasma and urine and plasma protein content of dityrosine, N-formylkynurenine and 3-nitrotyrosine was determined. RESULTS: Plasma thiamine and thiamine monophosphate concentrations were similar in both study groups (median [lower-upper quartile]): autistic children – 6.60 nM (4.48-8.91) and 7.00 nM (5.51-8.55), and healthy controls – 6.82 nM (4.47-7.02) and 6.82 nM (5.84-8.91), respectively. Thiamine pyrophosphate (TPP) was decreased 24% in autistic children compared to healthy controls: 6.82 nM (5.81-8.52) versus 9.00 nM (8.41-10.71), p < .01. Urinary excretion of thiamine and fractional renal clearance of thiamine did not change between the groups. No correlation was observed between clinical markers and the plasma and urine thiamine concentration. Plasma protein dityrosine content was increased 88% in ASD. Other oxidative markers were unchanged. CONCLUSIONS/INTERPRETATION: Autistic children had normal plasma and urinary thiamine levels whereas plasma TPP concentration was decreased. The latter may be linked to abnormal tissue handling and/or absorption from gut microbiota of TPP which warrants further investigation. Increased plasma protein dityrosine may reflect increased dual oxidase activity in response to change in mucosal immunity and host-microbe homeostasis. Lien vers le texte intégral (Open Access ou abonnement)
2. Bjorkman B, Gimbler Berglund I, Enskar K, Faresjo M, Huus K. {{Peri-radiographic guidelines for children with autism spectrum disorder: a nationwide survey in Sweden}}. {Child Care Health Dev};2016 (Nov 2)
OBJECTIVE: This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process. METHOD: A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics. RESULTS: In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD. CONCLUSION: It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.
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3. Brucker DL, Nord D. {{Food Insecurity Among Young Adults With Intellectual and Developmental Disabilities in the United States: Evidence From the National Health Interview Survey}}. {Am J Intellect Dev Disabil};2016 (Nov);121(6):520-532.
People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may be particularly vulnerable. Using pooled data from the 2011-2014 National Health Interview Survey, we find that young adults with IDD have significantly higher levels of food insecurity than young adults without disabilities, even when controlling for poverty. Young adults with IDD who are living in low-income households are not significantly more likely to participate in the Supplemental Nutrition Assistance Program (SNAP) than young adults without disabilities who are also living in low-income households. Although our results suggest that SNAP is effectively reaching many young adults with IDD in need of nutrition assistance, further research is needed to determine the specific effects of food insecurity and SNAP participation on overall economic and health outcomes for this population.
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4. Engberg-Pedersen E, Christensen RV. {{Mental states and activities in Danish narratives: children with autism and children with language impairment}}. {J Child Lang};2016 (Nov 2):1-26.
This study focuses on the relationship between content elements and mental-state language in narratives from twenty-seven children with autism (ASD), twelve children with language impairment (LI), and thirty typically developing children (TD). The groups did not differ on chronological age (10;6-14;0) and non-verbal cognitive skills, and the groups with ASD and TD did not differ on language measures. The children with ASD and LI had fewer content elements of the storyline than the TD children. Compared with the TD children, the children with ASD used fewer subordinate clauses about the characters’ thoughts, and preferred talking about mental states as reported speech, especially in the form of direct speech. The children with LI did not differ from the TD children on these measures. The results are discussed in the context of difficulties with socio-cognition in children with ASD and of language difficulties in children with LI.
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5. Fluegge K. {{In Regard to « Autism in the Son of a Woman with Mitochondrial Myopathy and Dysautonomia: A Case Report »}}. {Innov Clin Neurosci};2016 (May-Jun);13(5-6):13-14.
6. Gaigg SB, Cornell AS, Bird G. {{The psychophysiological mechanisms of alexithymia in autism spectrum disorder}}. {Autism};2016 (Nov 2)
Accumulating evidence indicates that co-occurring alexithymia underlies several facets of the social-emotional difficulties common in individuals with autism spectrum disorder. The mechanisms involved, however, remain poorly understood because measuring alexithymia relies heavily on self-report. To address this issue, carefully matched groups of individuals with autism spectrum disorder and comparison participants rated 70 emotion-inducing pictures on subjectively experienced arousal while skin conductance responses were monitored objectively. The results demonstrated reliable correlations between these subjective and objective measures, and in both groups, around 25% of individual differences in this correlation (i.e. in emotion-relevant interoception) were accounted for by self-reported alexithymia. In the context of the wider literature, this suggests that alexithymia involves a disruption in how physiological arousal modulates the subjective experience of feelings in those with and without a diagnosis of autism spectrum disorder. Since mindfulness-based therapies foster greater awareness of thoughts, feelings and bodily sensations, the findings also have implications for how the symptoms and consequences of alexithymia (e.g. anxiety) might be ameliorated.
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7. Grove R, Hoekstra RA, Wierda M, Begeer S. {{Exploring sex differences in autistic traits: A factor analytic study of adults with autism}}. {Autism};2016 (Nov 2)
Research has highlighted potential differences in the phenotypic and clinical presentation of autism spectrum conditions across sex. Furthermore, the measures utilised to evaluate autism spectrum conditions may be biased towards the male autism phenotype. It is important to determine whether these instruments measure the autism phenotype consistently in autistic men and women. This study evaluated the factor structure of the Autism Spectrum Quotient Short Form in a large sample of autistic adults. It also systematically explored specific sex differences at the item level, to determine whether the scale assesses the autism phenotype equivalently across males and females. Factor analyses were conducted among 265 males and 285 females. A two-factor structure consisting of a social behaviour and numbers and patterns factor was consistent across groups, indicating that the latent autism phenotype is similar among both autistic men and women. Subtle differences were observed on two social behaviour item thresholds of the Autism Spectrum Quotient Short Form, with women reporting scores more in line with the scores expected in autism on these items than men. However, these differences were not substantial. This study showed that the Autism Spectrum Quotient Short Form detects autistic traits equivalently in males and females and is not biased towards the male autism phenotype.
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8. Hui Shyuan Ng A, Schulze K, Rudrud E, Leaf JB. {{Using the Teaching Interactions Procedure to Teach Social Skills to Children With Autism and Intellectual Disability}}. {Am J Intellect Dev Disabil};2016 (Nov);121(6):501-519.
This study implemented a modified teaching interaction procedure to teach social skills to 4 children diagnosed with autism spectrum disorder with an intellectual disability. A multiple baseline design across social skills and replicated across participants was utilized to evaluate the effects of the modified teaching interaction procedure. The results demonstrated that the teaching interaction procedure resulted in all participants acquiring targeted social skills, maintaining the targeted social skills, and generalizing the targeted social skills.
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9. Kushak RI, Winter HS, Buie TM, Cox SB, Phillips CD, Ward NL. {{Analysis of the Duodenal Microbiome in Autistic Individuals: Association with Carbohydrate Digestion}}. {J Pediatr Gastroenterol Nutr};2016 (Nov 2)
OBJECTIVES: There is evidence that symptoms of maldigestion or malabsorption in autistic individuals are related to changes in the indigenous microbiota. Analysis of colonic bacteria has revealed microbial dysbiosis in children with autism; however, characteristics of the duodenal microbiome are not well described. In this study the microbiome of the duodenal mucosa of subjects with autism was evaluated for dysbiosis, bacteria overgrowth and microbiota associated with carbohydrate digestion. The relationship between the duodenal microbiome and disaccharidase activity was analyzed in biopsies from 21 autistic subjects and 19 children without autism. METHODS: Microbiota composition was determined by 16S ribosomal RNA gene sequencing, and disaccharidase activity via biochemical assays. RESULTS: Although subjects with autism had a higher frequency of constipation (p < 0.005), there was no difference in disaccharidase activity between groups. Additionally, no differences in microbiome diversity (species richness and evenness) were observed. Bacteria belonging to the genus Burkholderia were more abundant in subjects with autism, while members of the genus Neisseria were less abundant. At the species level, a relative decrease in abundance of two Bacteroides species and Escherichia coli was found in autistic individuals. There was a positive correlation between the abundance of Clostridium species, and disaccharidase activity, in autistic individuals. CONCLUSION: There are a variety of changes at the genus and species level in duodenal microbiota in children with autism that could be influenced by carbohydrate malabsorption. These observations could be impacted by variations in individual diets, but also may represent a more pervasive dysbiosis that results in metabolites that impact the behavior of autistic children. Lien vers le texte intégral (Open Access ou abonnement)
10. Leaf JB, Leaf JA, Milne C, Taubman M, Oppenheim-Leaf M, Torres N, Townley-Cochran D, Leaf R, McEachin J, Yoder P. {{An Evaluation of a Behaviorally Based Social Skills Group for Individuals Diagnosed with Autism Spectrum Disorder}}. {J Autism Dev Disord};2016 (Nov 2)
In this study we evaluated a social skills group which employed a progressive applied behavior analysis model for individuals diagnosed with autism spectrum disorder. A randomized control trial was utilized; eight participants were randomly assigned to a treatment group and seven participants were randomly assigned to a waitlist control group. The social skills group consisted of 32, 2 h sessions. Teachers implemented a variety of behaviorally based procedures. A blind evaluator measured participants’ behavior immediately prior to intervention, immediately following intervention, and during 16 and 32-week maintenance probes. Results of the study demonstrated that participants made significant improvements with their social behavior (p < .001) following intervention, and the results were maintained up to 32 weeks after intervention had concluded. Lien vers le texte intégral (Open Access ou abonnement)
11. Lindly OJ, Chavez AE, Zuckerman KE. {{Unmet Health Services Needs Among US Children with Developmental Disabilities: Associations with Family Impact and Child Functioning}}. {J Dev Behav Pediatr};2016 (Nov/Dec);37(9):712-723.
OBJECTIVE: To determine associations of unmet needs for child or family health services with (1) adverse family financial and employment impacts and (2) child behavioral functioning problems among US children with autism spectrum disorder (ASD), developmental delay (DD), and/or intellectual disability (ID). METHOD: This was a secondary analysis of parent-reported data from the 2009 to 2010 National Survey of Children with Special Health Care Needs linked to the 2011 Survey of Pathways to Diagnosis and Services. The study sample (n = 3,518) represented an estimated 1,803,112 US children aged 6 to 17 years with current ASD, DD, and/or ID (developmental disabilities). Dependent variables included adverse family financial and employment impacts, as well as child behavioral functioning problems. The independent variables of interest were unmet need for (1) child health services and (2) family health services. Multivariable logistic regression models were fit to examine associations. RESULTS: Unmet need for child and family health services, adverse family financial and employment impacts, and child behavioral functioning problems were prevalent among US children with developmental disabilities. Unmet needs were associated with an increased likelihood of adverse family employment and financial impacts. Unmet needs were associated with an increased likelihood of child behavioral functioning problems the following year; however, this association was not statistically significant. CONCLUSION: Unmet needs are associated with adverse impacts for children with developmental disabilities and their families. Increased access to and coordination of needed health services following ASD, DD, and/or ID diagnosis may improve outcomes for children with developmental disabilities and their families.
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12. Loesch DZ, Annesley SJ, Trost N, Bui MQ, Lay ST, Storey E, De Piazza SW, Sanislav O, Francione LM, Hammersley EM, Tassone F, Francis D, Fisher PR. {{Novel Blood Biomarkers Are Associated with White Matter Lesions in Fragile X- Associated Tremor/Ataxia Syndrome}}. {Neurodegener Dis};2017;17(1):22-30.
BACKGROUND: The need for accessible cellular biomarkers of neurodegeneration in carriers of the fragile X mental retardation 1 (FMR1) premutation (PM) alleles. OBJECTIVE: To assess the mitochondrial status and respiration in blood lymphoblasts from PM carriers manifesting the fragile X-associated tremor/ataxia syndrome (FXTAS) and non-FXTAS carriers, and their relationship with the brain white matter lesions. METHODS: Oxygen consumption rates (OCR) and ATP synthesis using a Seahorse XFe24 Extracellular Flux Analyser, and steady-state parameters of mitochondrial function were assessed in cultured lymphoblasts from 16 PM males (including 11 FXTAS patients) and 9 matched controls. The regional white matter hyperintensity (WMH) scores were obtained from MRI. RESULTS: Mitochondrial respiratory activity was significantly elevated in lymphoblasts from PM carriers compared with controls, with a 2- to 3-fold increase in basal and maximum OCR attributable to complex I activity, and ATP synthesis, accompanied by unaltered mitochondrial mass and membrane potential. The changes, which were more advanced in FXTAS patients, were significantly associated with the WMH scores in the supratentorial regions. CONCLUSION: The dramatic increase in mitochondrial activity in lymphoblasts from PM carriers may represent either the early stages of disease (specific alterations in short-lived blood cells) or an activation of the lymphocytes under pathological situations. These changes may provide early, convenient blood biomarkers of clinical involvements.
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13. Moss J, Nelson L, Powis L, Waite J, Richards C, Oliver C. {{A Comparative Study of Sociability in Angelman, Cornelia de Lange, Fragile X, Down and Rubinstein Taybi Syndromes and Autism Spectrum Disorder}}. {Am J Intellect Dev Disabil};2016 (Nov);121(6):465-486.
Few comparative studies have evaluated the heterogeneity of sociability across a range of neurodevelopmental disorders. The Sociability Questionnaire for People with Intellectual Disability (SQID) was completed by caregivers of individuals with Cornelia de Lange (n = 98), Angelman (n = 66), Fragile X (n = 142), Down (n = 117) and Rubinstein Taybi (n = 88) syndromes and autism spectrum disorder (ASD; n = 107). Between groups and age-band (<12yrs; 12-18yrs; >18yrs) comparisons of SQID scores were conducted. Rates of behaviors indicative of selective mutism were also examined. Fragile X syndrome achieved the lowest SQID scores. Cornelia de Lange, ASD, and Fragile X groups scored significantly lower than Angelman, Down and Rubinstein Taybi groups. Selective mutism characteristics were highest in Cornelia de Lange (40%) followed by Fragile X (17.8%) and ASD (18.2%). Age-band differences were identified in Cornelia de Lange and Down syndrome.
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14. Nolan R, Walker T, Hanson JL, Friedman S. {{Developmental Behavioral Pediatrician Support of the Medical Home for Children with Autism Spectrum Disorders}}. {J Dev Behav Pediatr};2016 (Nov/Dec);37(9):687-693.
OBJECTIVE: To identify challenges primary care providers (PCPs) experience providing a Medical Home for children with autism spectrum disorders (ASDs) and to describe the role developmental behavioral pediatricians (DBPs) play in the Medical Home Neighborhood. METHODS: The authors used purposeful sampling to recruit 25 PCPs from around Colorado to participate in 4 focus groups. Member checking was performed at the end of each group. Sampling continued until themes repeated and saturation was achieved. Focus groups were transcribed verbatim, and transcripts were analyzed using content analysis; an outside reviewer audited the data. RESULTS: Qualitative analysis yielded 30 codes that fell into 7 themes: provider education, shared model of care, initial diagnostic evaluation by the DBP, communication, office factors, cost and coverage, and access. PCPs identified knowledge gaps that led to decreased comfort and desired ongoing education and a centralized resource for providers. They envisioned a shared care model with ongoing specialist collaboration and improved communication within the care team. A specific role desired of the DBP was to provide the initial diagnostic evaluation and treatment plan with specific resources. Office factors, high cost and variable coverage, and poor access to services were barriers to providing a Medical Home for children with ASD. CONCLUSION: Working to remove barriers to shared care as well as providing continued educational opportunities will help improve access to a Medical Home Neighborhood for children with ASD. Advocacy is needed to help remove barriers related to cost, coverage, and access to services.
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15. O’Dwyer L, Tanner C, van Dongen EV, Greven CU, Bralten J, Zwiers MP, Franke B, Heslenfeld D, Oosterlaan J, Hoekstra PJ, Hartman CA, Groen W, Rommelse N, Buitelaar JK. {{Decreased Left Caudate Volume Is Associated with Increased Severity of Autistic-Like Symptoms in a Cohort of ADHD Patients and Their Unaffected Siblings}}. {PLoS One};2016;11(11):e0165620.
Autism spectrum disorder (ASD) symptoms frequently occur in individuals with attention-deficit/hyperactivity disorder (ADHD). While there is evidence that both ADHD and ASD have differential structural brain correlates, knowledge of the structural brain profile of individuals with ADHD with raised ASD symptoms is limited. The presence of ASD-like symptoms was measured by the Children’s Social Behavior Questionnaire (CSBQ) in a sample of typically developing controls (n = 154), participants with ADHD (n = 239), and their unaffected siblings (n = 144) between the ages of 8 and 29. Structural magnetic resonance imaging (MRI) correlates of ASD ratings were analysed by studying the relationship between ASD ratings and grey matter volumes using mixed effects models which controlled for ADHD symptom count and total brain volume. ASD ratings were significantly elevated in participants with ADHD relative to controls and unaffected siblings. For the entire group (participants with ADHD, unaffected siblings and TD controls), mixed effect models revealed that the left caudate nucleus volume was negatively correlated with ASD ratings (t = 2.83; P = 0.005). The current findings are consistent with the role of the caudate nucleus in executive function, including the selection of goals based on the evaluation of action outcomes and the use of social reward to update reward representations. There is a specific volumetric profile associated with subclinical ASD-like symptoms in participants with ADHD, unaffected siblings and controls with the caudate nucleus and globus pallidus being of critical importance in predicting the level of ASD-like symptoms in all three groups.
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16. Powell EM. {{Is the Wrong Environment Enough to Cause Autism and Epilepsy? Interplay Between Seizures and Aberrant Behaviors Due to Gestational Factors}}. {Epilepsy Curr};2016 (Sep-Oct);16(5):322-324.
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17. Rigles B. {{The Relationship Between Adverse Childhood Events, Resiliency and Health Among Children with Autism}}. {J Autism Dev Disord};2016 (Nov 2)
Previous research has shown a negative relationship between adverse childhood events (ACEs) and health and resiliency among the general population, but has not examined these associations among children with autism. Purpose To determine the prevalence of ACEs among children with autism and how ACEs are associated with resiliency and health. Methods A quantitative analysis was conducted using data from the 2011-2012 National Survey of Children’s Health. Results Children with autism experience significantly more ACEs than their peers, which is negatively associated with their health. However, resiliency is not significantly associated with ACEs in this population. ACEs disproportionately affect children with autism, which is negatively associated with health, but not resiliency. Further investigation into why children with autism experience more ACEs but maintain resiliency is warranted.
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18. Tonnsen BL, Boan AD, Bradley CC, Charles J, Cohen A, Carpenter LA. {{Prevalence of Autism Spectrum Disorders Among Children With Intellectual Disability}}. {Am J Intellect Dev Disabil};2016 (Nov);121(6):487-500.
Autism spectrum disorders (ASD) often co-occur with intellectual disability (ID) and are associated with poorer psychosocial and family-related outcomes than ID alone. The present study examined the prevalence, stability, and characteristics of ASD estimates in 2,208 children with ASD and ID identified through the South Carolina Autism and Developmental Disabilities Network. The prevalence of ASD in ID was 18.04%, relative to ASD rates of 0.60%-1.11% reported in the general South Carolina population. Compared to children with ASD alone, those with comorbid ID exhibited increased symptom severity and distinct DSM-IV-TR profiles. Further work is needed to determine whether current screening, diagnostic, and treatment practices adequately address the unique needs of children and families affected by comorbid ASD and ID diagnoses.
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19. Toomey M, Schwartz J, Laverdiere M, Tucker CA, Bevans K, Forrest CB, Blum NJ. {{Preliminary Validation of the PROMIS Parent-Proxy Peer Relationships Measure in Children with Autism Spectrum Disorder: A DBPNet Study}}. {J Dev Behav Pediatr};2016 (Nov/Dec);37(9):724-729.
OBJECTIVE: To evaluate the content and construct validity of the existing PROMIS Pediatric Parent-Proxy Peer Relationships Measure in 5- to 12-year-old children with autism spectrum disorder (ASD). METHOD: Parents of 121 children aged 5 to 12 years who met DSM-IV criteria for ASD completed the Peer Relationships Measure using computerized adaptive testing (CAT). Parents also completed the Social Responsiveness Scale, Second Edition (SRS-2) and a demographic form. Intelligence quotient test results were extracted from clinical or research records. Five parents participated in semi-structured interviews about their child’s peer relationships and the item content on the Peer Relationships Measure. RESULTS: The children in the sample were primarily male (87%). The sample was racially and ethnically diverse, and parents were predominantly highly educated. The mean T-score (SD) on the Peer Relationships Measure was 36 (8), with a range from 15 to 62. For 98% of subjects, the CAT required administration of 5 items to reach a standard error of measurement of less than 4 T-score units. The Peer Relationships Measure demonstrated a large correlation with the SRS-2 (r = -0.60, p < .0001). In semi-structured interviews, parents reported that the items on the Peer Relationships Measure were relevant to the peer relationships of their child with ASD, but they reported a few challenges related to variability in their children's peer relationships over time and to somewhat limited knowledge of relationships in school. CONCLUSION: The PROMIS Pediatric Parent-Proxy Peer Relationships Measure may be an efficient, precise, and valid measure of peer relationships for 5- to 12-year-old children with ASD. Lien vers le texte intégral (Open Access ou abonnement)
20. Van Eylen L, Boets B, Cosemans N, Peeters H, Steyaert J, Wagemans J, Noens I. {{Executive functioning and local-global visual processing: candidate endophenotypes for autism spectrum disorder?}}. {J Child Psychol Psychiatry};2016 (Nov 2)
BACKGROUND: Heterogeneity within autism spectrum disorder (ASD) hampers insight in the etiology and stimulates the search for endophenotypes. Endophenotypes should meet several criteria, the most important being the association with ASD and the higher occurrence rate in unaffected ASD relatives than in the general population. We evaluated these criteria for executive functioning (EF) and local-global (L-G) visual processing. METHODS: By administering an extensive cognitive battery which increases the validity of the measures, we examined which of the cognitive anomalies shown by ASD probands also occur in their unaffected relatives (n = 113) compared to typically developing (TD) controls (n = 100). Microarrays were performed, so we could exclude relatives from probands with a de novo mutation in a known ASD susceptibility copy number variant, thus increasing the probability that genetic risk variants are shared by the ASD relatives. An overview of studies investigating EF and L-G processing in ASD relatives was also provided. RESULTS: For EF, ASD relatives – like ASD probands – showed impairments in response inhibition, cognitive flexibility and generativity (specifically, ideational fluency), and EF impairments in daily life. For L-G visual processing, the ASD relatives showed no anomalies on the tasks, but they reported more attention to detail in daily life. Group differences were similar for siblings and for parents of ASD probands, and yielded larger effect sizes in a multiplex subsample. The group effect sizes for the comparison between ASD probands and TD individuals were generally larger than those of the ASD relatives compared to TD individuals. CONCLUSIONS: Impaired cognitive flexibility, ideational fluency and response inhibition are strong candidate endophenotypes for ASD. They could help to delineate etiologically more homogeneous subgroups, which is clinically important to allow assigning ASD probands to different, more targeted, interventions.
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21. Walton KM. {{Risk Factors for Behavioral and Emotional Difficulties in Siblings of Children With Autism Spectrum Disorder}}. {Am J Intellect Dev Disabil};2016 (Nov);121(6):533-549.
This study examined risk factors for behavioral and emotional problems in 1973 siblings of children with autism spectrum disorders (ASD). Results revealed six correlates of sibling internalizing and externalizing problems: male gender, smaller family size, older age of the child with ASD, lower family income, child with ASD behavior problems, and sibling Broader Autism Phenotype. Siblings with few risk factors were at low risk for behavioral and emotional problems. However, siblings with many risk factors were at increased risk for both internalizing and externalizing problems. These results highlight the need to assess risk for individual siblings to best identify a sub-population of siblings who may be in need of additional support.
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22. Xiong T, Chen H, Luo R, Mu D. {{Hyperbaric oxygen therapy for people with autism spectrum disorder (ASD)}}. {Cochrane Database Syst Rev};2016 (Oct 13);10:CD010922.
The rising prevalence of autism spectrum disorder (ASD) has increased the need for evidence-based treatments to lessen the impact of symptoms. Presently, no therapies are available to effectively treat individuals with all of the symptoms of this disorder. It has been suggested that hyperbaric oxygen therapy may alleviate the biochemical dysfunction and clinical symptoms of ASD. To determine whether treatment with hyperbaric oxygen:1. improves core symptoms of ASD, including social communication problems and stereotypical and repetitive behaviors;2. improves noncore symptoms of ASD, such as challenging behaviors;3. improves comorbid states, such as depression and anxiety; and4. causes adverse effects. On 10 December 2015, we searched CENTRAL, Ovid MEDLINE, Embase, and 15 other databases, four of which were Chinese language databases. We also searched multiple trial and research registers. We selected randomized controlled trials (RCTs) and quasi-RCTs of any dose, duration, and frequency for hyperbaric oxygen therapy compared with no treatment or sham treatment for children and adults with ASD. We used standard methodological procedures expected by The Cochrane Collaboration, in that three review authors independently selected studies, assessed them for risk of bias, and extracted relevant data. We also assessed the quality of the evidence by using the GRADE approach. We included one trial with a total of 60 children with a diagnosis of ASD who randomly received hyperbaric oxygen therapy or a sham treatment. Using GRADE criteria, we rated the quality of the evidence as low because of the small sample size and wide confidence intervals (CIs). Other problems included selection bias and short duration or follow-up.Overall, study authors reported no improvement in social interaction and communication, behavioral problems, communication and linguistic abilities, or cognitive function. With regard to the safety of hyperbaric oxygen therapy (adverse events), they reported minor-grade ear barotrauma events. Investigators found significant differences between groups in total number of side effect events (Peto odds ratio (OR) 3.87, 95% CI 1.53 to 9.82) and in the number of children who experienced side effects (Peto OR 4.40, 95% CI 1.33 to 14.48). To date, there is no evidence that hyperbaric oxygen therapy improves core symptoms and associated symptoms of ASD. It is important to note that adverse effects (minor-grade ear barotrauma events) can occur. Given the absence of evidence of effectiveness and the limited biological plausibility and possible adverse effects, the need for future RCTs of hyperbaric oxygen therapy must be carefully considered.
