1. Akobirshoev I, Mitra M, Parish SL, Valentine A, Simas TAM. {{Racial and Ethnic Disparities in Birth Outcomes and Labor and Delivery Charges Among Massachusetts Women With Intellectual and Developmental Disabilities}}. {Intellectual and developmental disabilities}. 2020; 58(2): 126-38.
Understanding the pregnancy experiences of racial and ethnic minority women with intellectual and developmental disabilities (IDD) is critical to ensuring that policies can effectively support these women. This research analyzed data from the 1998-2013 Massachusetts Pregnancy to Early Life Longitudinal (PELL) data system to examine the racial and ethnic disparities in birth outcomes and labor and delivery charges of U.S. women with IDD. There was significant preterm birth disparity among non-Hispanic Black women with IDD compared to their non-Hispanic White peers. There were also significant racial and ethnic differences in associated labor and delivery-related charges. Further research, examining potential mechanisms behind the observed racial and ethnic differences in labor and delivery-related charges in Massachusetts’ women with IDD is needed.
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2. Azim A, Rdesinski RE, Phelps R, Zuckerman KE. {{Nonclinical Factors in Autism Diagnosis: Results From a National Health Care Provider Survey}}. {J Dev Behav Pediatr}. 2020.
OBJECTIVE: The prevalence of autism spectrum disorder (ASD) has increased 10-fold in the past 40 years, and disparities have been noted by race/ethnicity and socioeconomic status, prompting concern about diagnostic accuracy. Provider perceptions of ASD diagnostic accuracy are not known. We conducted a survey of providers who diagnose ASD assessing how nonclinical factors might affect ASD diagnostic rates. METHODS: The mixed-mode survey was sent to the members of the Society of Developmental and Behavioral Pediatrics with clinical interest in ASD (n = 400). Respondents used a Likert-type scale to address how often they and their colleagues overdiagnosed or underdiagnosed ASD. They were also asked how families grouped by race/ethnicity, education, socioeconomic status, and urbanicity perceived an ASD diagnosis. RESULTS: Sixty-three percent of providers completed the survey. Eight point seven percent of providers self-reported that they overdiagnose ASD at least sometimes. However, 58% of providers reported that local colleagues overdiagnose ASD at least sometimes. Seven point eight percent of providers self-reported underdiagnosing ASD at least sometimes and cited parents not wanting a diagnosis as one of the most common reasons they may underdiagnose. Providers reported that non-white and rural families were more likely to think that ASD diagnosis was « a bad thing » than « a good thing » than white and urban and suburban families, respectively. CONCLUSION: Providers report moderate rates of ASD misdiagnosis and perceive differences in diagnostic preferences according to family characteristics. The study results may help explain the trends and disparities in ASD diagnosis.
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3. Dinora P, Bogenschutz M, Broda M. {{Identifying Predictors for Enhanced Outcomes for People With Intellectual and Developmental Disabilities}}. {Intellectual and developmental disabilities}. 2020; 58(2): 139-57.
People with intellectual and developmental disabilities (IDD) often rely on Medicaid-funded services and supports to facilitate their daily living. The financial investment for these services is significant, yet little work has been conducted to understand how these investments affect life outcomes. This pilot study used a novel data integration approach to offer initial insights about how Medicaid expenditures relate to outcomes using Medicaid claims data, results of the National Core Indicators consumer survey, and data from the Supports Intensity Scale (SIS). Findings suggested that subpopulations of people with IDD who also had high behavioral needs or high medical needs had significantly higher expenditures than individuals with more typical SIS-assessed support needs. Regression analyses suggested mixed outcomes based on the factors we considered, including a finding that people with IDD who lived in sponsored residential care homes were more likely to engage in inclusive activities in the community than those who lived in larger congregate settings, or those who lived in a family home. Results of this pilot, when brought to scale, will be useful in examining the performance of state IDD service systems over time.
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4. Gardner L, Campbell JM. {{Law Enforcement Officers’ Preparation for Calls Involving Autism: Prior Experiences and Response to Training}}. {J Autism Dev Disord}. 2020.
Highly publicized interactions between law enforcement officers (LEOs) and individuals with autism spectrum disorder (ASD) have raised questions about LEOs’ training related to ASD. In the present study, 157 LEOs participated in ASD-specific training and completed pretest and posttest surveys of autism knowledge, confidence, and self-monitoring. The majority of LEOs responded to calls involving someone with ASD in the last year, with 20% of these calls resulting in involuntary psychiatric hospitalization. LEO knowledge of ASD, self-confidence in responding to calls, and self-monitoring of performance increased from pretest to posttest. Compared to male counterparts, female officers were less likely to use force and handcuffs when responding to ASD-related calls. Female officers’ self-confidence increased significantly more than male officers.
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5. Gomez-Perez MM, Mata S, Serrano F, Calero MD. {{Wisconsin Card Sorting Test-Learning Potential: Usefulness for Assessing Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2020.
This study analyzes the Wisconsin Card Sorting Test-Learning Potential (WCST-LP) in children with Autism Spectrum Disorder (ASD) versus children with typical development (TD). Its main aim was to assess: the test’s construct validity; the effect of IQ on its pretest and LP scores; and whether the WCST-LP held any relationship to cognitive/EF and social abilities. Participants were 105 children (43 with ASD/62 with TD). Results showed evidence of construct validity in an ASD population (improvements from pretest to posttest), that full IQ influenced pretest performance but did not affect LP, and that a relationship between LP and verbal and social abilities existed only in children with ASD. Conclusions indicate the appropriateness of the WCST-LP in ASD prognosis assessment.
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6. Haine-Schlagel R, Rieth S, Dickson KS, Brookman-Frazee L, Stahmer A. {{Adapting parent engagement strategies for an evidence-based parent-mediated intervention for young children at risk for autism spectrum disorder}}. {Journal of community psychology}. 2020.
AIMS: Aims included (a) characterizing provider feedback on parent engagement strategies integrated into a parent-mediated intervention for toddlers at risk for autism spectrum disorder (ASD) and (b) identifying provider characteristics that predict attitudes about parent engagement strategies. METHODS: A mixed method approach was utilized, including gathering quantitative data via survey (breadth) and collecting qualitative data via interview (depth). Acceptability, utility, appropriateness, sustainment, generalizability, and perceived effectiveness were examined. Fourteen agency leaders and 24 therapists provided input. RESULTS: Providers perceived the integration of parent engagement strategies as having a positive impact on implementation. Providers considered the strategies to be acceptable, appropriate, and effective, though barriers of time and complexity were noted. Provider characteristics did not consistently predict attitudes about the engagement strategies. CONCLUSIONS: Incorporating parent engagement strategies into parent-mediated interventions for ASD is well-received by providers and may improve quality of service delivery for families served in early intervention for ASD.
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7. Haruvi-Lamdan N, Horesh D, Zohar S, Kraus M, Golan O. {{Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions}}. {Autism}. 2020: 1362361320912143.
People with Autism Spectrum Disorder show an increased risk of experiencing potentially traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to potentially traumatic life events and PTSD symptoms in adults with Autism Spectrum Disorder vs typical adults. Twenty-five adults with Autism Spectrum Disorder and 25 typical adults were comparable on age and gender. Participants self-reported on potentially traumatic life events of social and non-social nature, and on PTSD symptoms related to their most distressing event. Results showed higher rates of probable-Post-Traumatic Stress Disorder in the Autism Spectrum Disorder group (32%) compared with the typical adults group (4%). Individuals with Autism Spectrum Disorder reported more PTSD symptoms, particularly re-experiencing and hyper-arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical adults, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder and probable-Post-Traumatic Stress Disorder co-occurrence presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate increased vulnerability of individuals with Autism Spectrum Disorder to trauma and Post-Traumatic Stress Disorder, especially due to social stressors. Females with Autism Spectrum Disorder may be particularly vulnerable to Post-Traumatic Stress Disorder.
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8. Jager-Hyman S, Maddox BB, Crabbe SR, Mandell DS. {{Mental Health Clinicians’ Screening and Intervention Practices to Reduce Suicide Risk in Autistic Adolescents and Adults}}. {J Autism Dev Disord}. 2020.
Autistic individuals experience elevated risk for suicide ideation, attempts, and deaths. Little is known about how clinicians assess risk or intervene with suicidal autistic individuals. We surveyed 121 clinicians about use of suicide prevention practices with autistic and non-autistic clients. Clinicians reported greater self-efficacy in screening for suicide risk among non-autistic clients (p = 0.01). There were no statistically significant differences in whether they used standardized screening measures or in their reported normative pressure or attitudes towards screening. Clinicians reported similar rates of use of Safety Planning, an evidence-based suicide-prevention strategy, across groups, but greater acceptability for non-autistic clients (p < 0.001). These findings have implications for strategies to increase clinicians' adoption of these tools for autistic individuals. Lien vers le texte intégral (Open Access ou abonnement)
9. Kalantarian H, Jedoui K, Dunlap K, Schwartz J, Washington P, Husic A, Tariq Q, Ning M, Kline A, Wall DP. {{The Performance of Emotion Classifiers for Children With Parent-Reported Autism: Quantitative Feasibility Study}}. {JMIR mental health}. 2020; 7(4): e13174.
BACKGROUND: Autism spectrum disorder (ASD) is a developmental disorder characterized by deficits in social communication and interaction, and restricted and repetitive behaviors and interests. The incidence of ASD has increased in recent years; it is now estimated that approximately 1 in 40 children in the United States are affected. Due in part to increasing prevalence, access to treatment has become constrained. Hope lies in mobile solutions that provide therapy through artificial intelligence (AI) approaches, including facial and emotion detection AI models developed by mainstream cloud providers, available directly to consumers. However, these solutions may not be sufficiently trained for use in pediatric populations. OBJECTIVE: Emotion classifiers available off-the-shelf to the general public through Microsoft, Amazon, Google, and Sighthound are well-suited to the pediatric population, and could be used for developing mobile therapies targeting aspects of social communication and interaction, perhaps accelerating innovation in this space. This study aimed to test these classifiers directly with image data from children with parent-reported ASD recruited through crowdsourcing. METHODS: We used a mobile game called Guess What? that challenges a child to act out a series of prompts displayed on the screen of the smartphone held on the forehead of his or her care provider. The game is intended to be a fun and engaging way for the child and parent to interact socially, for example, the parent attempting to guess what emotion the child is acting out (eg, surprised, scared, or disgusted). During a 90-second game session, as many as 50 prompts are shown while the child acts, and the video records the actions and expressions of the child. Due in part to the fun nature of the game, it is a viable way to remotely engage pediatric populations, including the autism population through crowdsourcing. We recruited 21 children with ASD to play the game and gathered 2602 emotive frames following their game sessions. These data were used to evaluate the accuracy and performance of four state-of-the-art facial emotion classifiers to develop an understanding of the feasibility of these platforms for pediatric research. RESULTS: All classifiers performed poorly for every evaluated emotion except happy. None of the classifiers correctly labeled over 60.18% (1566/2602) of the evaluated frames. Moreover, none of the classifiers correctly identified more than 11% (6/51) of the angry frames and 14% (10/69) of the disgust frames. CONCLUSIONS: The findings suggest that commercial emotion classifiers may be insufficiently trained for use in digital approaches to autism treatment and treatment tracking. Secure, privacy-preserving methods to increase labeled training data are needed to boost the models’ performance before they can be used in AI-enabled approaches to social therapy of the kind that is common in autism treatments.
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10. Kallitsounaki A, Williams D. {{Mentalising Moderates the Link between Autism Traits and Current Gender Dysphoric Features in Primarily Non-autistic, Cisgender Individuals}}. {J Autism Dev Disord}. 2020.
The co-occurrence between autism and gender dysphoria has received much attention recently. We found that, among 101 adults from the general population number of autism traits, as measured using the autism-spectrum quotient was associated significantly with recalled and current gender dysphoric traits. Furthermore, performance on an objective measure of mentalising, such as the « Reading the Mind in the Eyes » test was associated with current gender dysphoric traits, but most importantly it moderated the relation between number of autism traits and number of current gender dysphoric traits, such that the association was significant only when mentalising ability was relatively low. Results suggest mentalising may represent a contributing factor to the relation between autism and gender dysphoric traits in the general population.
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11. Kerr-Gaffney J, Harrison A, Tchanturia K. {{The social responsiveness scale is an efficient screening tool for autism spectrum disorder traits in adults with anorexia nervosa}}. {European eating disorders review : the journal of the Eating Disorders Association}. 2020.
OBJECTIVE: A significant proportion of individuals with anorexia nervosa (AN) show high levels of autism spectrum disorder (ASD) traits, a factor associated with poorer treatment outcomes. An important question for both researchers and clinicians relates to how ASD traits should be assessed in individuals with AN. This study aimed to examine scores on the Social Responsiveness Scale adult self-report version (SRS-2) in individuals in the acute (AN) and recovered stages (REC) of illness compared to healthy controls (HCs). We also aimed to examine associations between the SRS-2 and an observational diagnostic measure, the Autism Diagnostic Observation Schedule – second edition (ADOS-2). METHOD: The SRS-2 and ADOS-2 were administered to 142 adults with AN, REC, and HCs. Eating disorder (ED) psychopathology and functional impairment were also assessed. RESULTS: AN and REC scored significantly higher than HCs on the SRS-2. SRS-2 scores significantly predicted ADOS-2 classification and were positively associated with ED psychopathology and functional impairment. SRS-2 scores were not associated with BMI or illness duration. CONCLUSIONS: The SRS-2 may be a useful tool in screening for ASD traits in individuals with AN. Although cross-sectional, the results also suggest ASD symptoms are independent of BMI and persist in individuals recovered from AN.
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12. Leaf JB, Cihon JH, Ferguson JL, Milne CM, Leaf R, McEachin J. {{Advances in Our Understanding of Behavioral Intervention: 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2020.
There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.
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13. Lombardo SD, Battaglia G, Petralia MC, Mangano K, Basile MS, Bruno V, Fagone P, Bella R, Nicoletti F, Cavalli E. {{Transcriptomic Analysis Reveals Abnormal Expression of Prion Disease Gene Pathway in Brains from Patients with Autism Spectrum Disorders}}. {Brain Sci}. 2020; 10(4).
The role of infections in the pathogenesis of autism spectrum disorder (ASD) is still controversial. In this study, we aimed to evaluate markers of infections and immune activation in ASD by performing a meta-analysis of publicly available whole-genome transcriptomic datasets of brain samples from autistic patients and otherwise normal people. Among the differentially expressed genes, no significant enrichment was observed for infectious diseases previously associated with ASD, including herpes simplex virus-1 (HSV-1), cytomegalovirus and Epstein-Barr virus in brain samples, nor was it found in peripheral blood from ASD patients. Interestingly, a significant number of genes belonging to the « prion diseases » pathway were found to be modulated in our ASD brain meta-analysis. Overall, our data do not support an association between infection and ASD. However, the data do provide support for the involvement of pathways related to other neurodegenerative diseases and give input to uncover novel pathogenetic mechanisms underlying ASD.
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14. McCulloch E, Cuckler A, Valdes E, Hughes MC. {{Effectiveness of Online Training and Supervisor Feedback on Safe Eating and Drinking Practices for Individuals With Developmental Disabilities}}. {Intellectual and developmental disabilities}. 2020; 58(2): 111-25.
Dysphagia is common in individuals with developmental disabilities. Little research exists on the impact of trainings aimed at improving Direct Care Staff’s (DCS) use of safe eating and drinking practices. This article presents two studies using pre-and postexperimental design, evaluating online training to improve DCSs’ knowledge and ability to identify nonadherence to diet orders. A pilot study (n = 18) informed improvements to the intervention. The follow-up study (n = 64) compared those receiving training with those receiving training plus supervisor feedback. There was no significant difference between groups after training. Both groups increased in knowledge and identification of nonadherence to diet orders. Online training may be an effective tool for training DCS in safe eating and drinking practices.
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15. Orji CS, Sharkey L. {{Self-Injurious Behaviours in Children and Adolescents with Intellectual Disability and Autism Spectrum Disorder}}. {Irish medical journal}. 2020; 113(4): 63.
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16. Pham D, Silver S, Haq S, Hashmi SS, Eissa M. {{Obesity and Severe Obesity in Children with Autism Spectrum Disorder: Prevalence and Risk Factors}}. {Southern medical journal}. 2020; 113(4): 168-75.
OBJECTIVE: Research suggests a high prevalence of obesity in children with autism spectrum disorders (ASDs), but the prevalence of severe obesity and its association with risk factors unique to this population remain undetermined. This study sought to compare the prevalence of severe obesity in children with ASDs to that of the general population and investigated associated risk factors for obesity in this population. METHODS: A chart review was done on 592 patients with ASDs seen between 2013 and 2017 at a center in Houston, Texas. The prevalence of obesity in the study population was compared with 2013-2016 national data. Univariable, multivariable, and stratified analyses were performed to determine the association between risk factors and body mass index. RESULTS: The prevalence of obesity and severe obesity in our study population was similar to those reported in the general population. When stratified by age, children with ASDs ages 6 to 11 years had a significantly higher prevalence of severe obesity than the general population. CONCLUSIONS: The prevalence of severe obesity in children with ASDs was higher with increasing age, and in the 6- to 11-year-old age group, was significantly higher than in the general population. Healthcare providers should address diet and exercise early as part of a comprehensive management plan for children with ASDs.
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17. Sanchez MJ, Constantino JN. {{Expediting clinician assessment in the diagnosis of autism spectrum disorder}}. {Dev Med Child Neurol}. 2020.
AIM: To investigate a novel observational rating protocol designed to expedite clinical diagnosis of autism spectrum disorder (ASD). METHOD: Two hundred and forty patients referred to a tertiary autism center (median age 8y 9mo, 2y 6mo-34y 8mo; 188 males, 52 females) were rated using an adaptation of the Childhood Autism Rating Scale, Second Edition (CARS-2) based exclusively on patient observation (CARS-2(obs) ). Scores were compared to expert diagnosis of ASD, parent-reported Social Responsiveness Scale, Second Edition (SRS-2) and, in a selected subset of patients, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). RESULTS: CARS-2(obs) distinguished patients with a clinical diagnosis of ASD from those with non-ASD neuropsychiatric disorders (mean score=18 vs 11.7, p<0.001). Severity ratings on the CARS-2(obs) correlated with the ADOS-2 (r=0.68, rho=0.64) and SRS-2 (r=0.31, rho=0.32). A CARS-2(obs) cutoff point equal to or greater than 16 demonstrated 95.8% specificity and 62.3% sensitivity in discriminating individuals with ASD from individuals without ASD. INTERPRETATION: The CARS-2(obs) allows the rapid acquisition of quantitative ratings of autistic severity by direct observation. Coupled with parent/teacher-reported symptoms and developmental history, the measure may contribute to a low-cost diagnostic paradigm in clinical and public health settings, where positive results might help reduce delays in diagnosis, and negative results could prompt further specialty assessment. What this paper adds The Childhood Autism Rating Scale, Second Edition based on patient observation distinguished individuals with versus without autism spectrum disorder (ASD). A score equal to or greater than 16 on this assessment showed high specificity for a diagnosis of ASD. Lien vers le texte intégral (Open Access ou abonnement)
18. Shah S, Molinaro G, Liu B, Wang R, Huber KM, Richter JD. {{FMRP Control of Ribosome Translocation Promotes Chromatin Modifications and Alternative Splicing of Neuronal Genes Linked to Autism}}. {Cell reports}. 2020; 30(13): 4459-72.e6.
Silencing of FMR1 and loss of its gene product, FMRP, results in fragile X syndrome (FXS). FMRP binds brain mRNAs and inhibits polypeptide elongation. Using ribosome profiling of the hippocampus, we find that ribosome footprint levels in Fmr1-deficient tissue mostly reflect changes in RNA abundance. Profiling over a time course of ribosome runoff in wild-type tissue reveals a wide range of ribosome translocation rates; on many mRNAs, the ribosomes are stalled. Sucrose gradient ultracentrifugation of hippocampal slices after ribosome runoff reveals that FMRP co-sediments with stalled ribosomes, and its loss results in decline of ribosome stalling on specific mRNAs. One such mRNA encodes SETD2, a lysine methyltransferase that catalyzes H3K36me3. Chromatin immunoprecipitation sequencing (ChIP-seq) demonstrates that loss of FMRP alters the deployment of this histone mark. H3K36me3 is associated with alternative pre-RNA processing, which we find occurs in an FMRP-dependent manner on transcripts linked to neural function and autism spectrum disorders.
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19. Tajik-Parvinchi DJ, Farmus L, Cribbie R, Albaum C, Weiss JA. {{Clinical and parental predictors of emotion regulation following cognitive behaviour therapy in children with autism}}. {Autism}. 2020: 1362361320909178.
LAY ABSTRACT: Children with autism commonly experience difficulty controlling their emotions. Although existing treatments are successful in teaching critical emotion regulation skills, not all children improve. It is important to identify the factors that influence treatment response to be able to reach more children. This study aimed to identify child and parent characteristics that predict treatment response in a 10-week cognitive behaviour therapy treatment for children with autism, 8-12 years of age, and their parents. We found that youth who started the treatment with higher verbal abilities, who were more anxious in social situations, and had parents who were more anxious, were more likely to improve in learning new emotion regulation skills. We also found that children who had more physical discomforts or complaints before starting the treatment were less likely to improve in their negative expressions of emotion. Our study suggests that it is important for clinicians to promote active involvement and learning by avoiding complex language and to use more visual materials to supplement the learning process, and make sure that sessions are sensitive to the individual needs of participants.
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20. Waddington H, McLay L, Woods L, Whitehouse AJO. {{Child and Family Characteristics Associated with Sleep Disturbance in Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2020.
Little is known about the role of family characteristics in sleep disturbance for children with autism spectrum disorder (ASD). This study involved an exploratory analysis of the association between 17 child, parent, and socioeconomic characteristics and sleep disturbance using data from 203, 2-18-year-old children with ASD whose families participated in the Western Australian Autism Biological Registry. Results suggest that greater ASD symptom severity; child seizures; maternal autism traits, anxiety, and depression; lower paternal education; and lower family income were related to increased sleep disturbance. All these characteristics, aside from maternal depression, were significant predictors within a regression model, which accounted for 33% of the total variance. Thus, child characteristics alone may not adequately explain sleep disturbance in children with ASD.
