1. Fraser R, Cotton S, Gentle E, Angus B, Allott K, Thompson A. {{Non-expert clinicians’ detection of autistic traits among attenders of a youth mental health service}}. {Early Interv Psychiatry}. 2011 Aug 30.
Aims: The aims of this study were to determine the point prevalence of autism spectrum disorders and to estimate the prevalence of autistic traits in a youth mental health service. Methods: Following three educational sessions on autism spectrum disorders, treating clinicians were interviewed to determine whether the clients on their caseloads had (i) a confirmed prior diagnosis of autism spectrum disorder; (ii) were felt to exhibit autistic traits; or (iii) were not felt to exhibit autistic traits. Results: Information on autism spectrum disorder status was obtained for 476 patients. Of the included patients, 3.4% (n = 16) had a confirmed diagnosis of autism spectrum disorder and 7.8% (n = 37) were reported by treating clinicians to exhibit autistic traits. Conclusions: The rate of autism spectrum disorder was higher in this population than that in community samples with twice as many again being identified as having autistic traits by their treating clinicians. This has implications for correct diagnosis and appropriate management in these settings.
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2. Geluk CA, Jansen LM, Vermeiren R, Doreleijers TA, van Domburgh L, de Bildt A, et al. {{Autistic symptoms in childhood arrestees: longitudinal association with delinquent behavior}}. {J Child Psychol Psychiatry}. 2011 Sep 2.
Background: To compare childhood arrestees with matched comparison groups on levels of autistic symptoms and to assess the unique predictive value of autistic symptoms for future delinquent behavior in childhood arrestees. Methods: Childhood first-time arrestees (n = 308, baseline age 10.7 +/- 1.5 years) were followed up for 2 years. Autistic symptoms, externalizing disorders and delinquent behavior were assessed yearly. Childhood arrestees were compared on autistic symptoms with matched (age, gender) general population and clinical autism spectrum disorder samples. The predictive value of autistic symptoms for delinquent behavior was analyzed using generalized estimating equations. Results: At each assessment, levels of autistic symptoms in childhood arrestees were in between levels found in the general population and autism spectrum disorder samples. Autistic symptoms were positively associated with delinquent behavior in childhood arrestees, even after adjustment for externalizing disorders: IRR (incidence rate ratio) 1.23; 95% CI 1.11-1.36 and IRR 1.29; 95% CI 1.15-1.45 for core autistic symptoms and total symptom score, respectively. Conclusions: Autistic symptoms are more prevalent in childhood arrestees compared to the general population and are uniquely associated with future delinquent behavior. Attention should, therefore, be given to the possible presence of autism related symptomatology in these children. Implications for diagnostic assessment and intervention need further investigation.
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3. Ji NY, Capone GT, Kaufmann WE. {{Autism spectrum disorder in Down syndrome: cluster analysis of Aberrant Behaviour Checklist data supports diagnosis}}. {J Intellect Disabil Res}. 2011 Aug 30.
Background The diagnostic validity of autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders (DSM) has been challenged in Down syndrome (DS), because of the high prevalence of cognitive impairments in this population. Therefore, we attempted to validate DSM-based diagnoses via an unbiased categorisation of participants with a DSM-independent behavioural instrument. Methods Based on scores on the Aberrant Behaviour Checklist – Community, we performed sequential factor (four DS-relevant factors: Autism-Like Behaviour, Disruptive Behaviour, Hyperactivity, Self-Injury) and cluster analyses on a 293-participant paediatric DS clinic cohort. The four resulting clusters were compared with DSM-delineated groups: DS + ASD, DS + None (no DSM diagnosis), DS + DBD (disruptive behaviour disorder) and DS + SMD (stereotypic movement disorder), the latter two as comparison groups. Results Two clusters were identified with DS + ASD: Cluster 1 (35.1%) with higher disruptive behaviour and Cluster 4 (48.2%) with more severe autistic behaviour and higher percentage of late onset ASD. The majority of participants in DS + None (71.9%) and DS + DBD (87.5%) were classified into Cluster 2 and 3, respectively, while participants in DS + SMD were relatively evenly distributed throughout the four clusters. Conclusions Our unbiased, DSM-independent analyses, using a rating scale specifically designed for individuals with severe intellectual disability, demonstrated that DSM-based criteria of ASD are applicable to DS individuals despite their cognitive impairments. Two DS + ASD clusters were identified and supported the existence of at least two subtypes of ASD in DS, which deserve further characterisation. Despite the prominence of stereotypic behaviour in DS, the SMD diagnosis was not identified by cluster analysis, suggesting that high-level stereotypy is distributed throughout DS. Further supporting DSM diagnoses, typically behaving DS participants were easily distinguished as a group from those with maladaptive behaviours.
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4. Kaale A, Smith L, Sponheim E. {{A randomized controlled trial of preschool-based joint attention intervention for children with autism}}. {J Child Psychol Psychiatry}. 2011 Aug 30.
Background: Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parent-mediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools. Aim: Assess the effects of a preschool-based JA-intervention. Methods: 61 children (48 males) with autistic disorder (29-60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and video taped preschool teacher-child and mother-child play at baseline and post-intervention. Clinical trials registration: Clinicaltrials.gov: NCT00378157. Results: Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers. Conclusions: This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention.
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5. Kaldy Z, Kraper C, Carter AS, Blaser E. {{Toddlers with Autism Spectrum Disorder are more successful at visual search than typically developing toddlers}}. {Dev Sci}. 2011 Sep;14(5):980-8.
Plaisted, O’Riordan and colleagues (Plaisted, O’Riordan & Baron-Cohen, 1998; O’Riordan, 2004) showed that school-age children and adults with Autism Spectrum Disorder (ASD) are faster at finding targets in certain types of visual search tasks than typical controls. Currently though, there is very little known about the visual search skills of very young children (1-3-year-olds) – either typically developing or with ASD. We used an eye-tracker to measure looking behavior, providing fine-grained measures of visual search in 2.5-year-old toddlers with and without ASD (this representing the age by which many children may first receive a diagnosis of ASD). Importantly, our paradigm required no verbal instructions or feedback, making the task appropriate for toddlers who are pre- or nonverbal. We found that toddlers with ASD were more successful at finding the target than typically developing, age-matched controls. Further, our paradigm allowed us to estimate the number of items scrutinized per trial, revealing that for large set size conjunctive search, toddlers with ASD scrutinized as many as twice the number of items as typically developing toddlers, in the same amount of time.
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6. Kim SH, Lord C. {{Combining information from multiple sources for the diagnosis of autism spectrum disorders for toddlers and young preschoolers from 12 to 47 months of age}}. {J Child Psychol Psychiatry}. 2011 Sep 1.
Background: Purpose of this study was to systematically examine combined use of the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) for children under age 4 using newly developed and revised diagnostic algorithms. Methods: Single and combined use of the ADI-R and ADOS algorithms were compared to clinical best estimate diagnoses for 435 children with autism spectrum disorders (ASD), 113 children with nonspectrum disorders, and 47 children with typical development from 12 to 47 months of age. Sequential strategies to reach a diagnostic decision by prioritizing administrations of instruments were also evaluated. Results: Well-balanced sensitivities and specificities above 80% were obtained for ASD diagnoses using both instruments. Specificities significantly improved when both instruments were used compared to one. Scores that can be used to systematically prioritize administrations of instruments were identified. Conclusions: The ADI-R and ADOS make independent, additive contributions to more accurate diagnostic decisions for clinicians evaluating toddlers and young preschoolers with ASD. Sequential assessment strategies using the scores identified may be appropriate for some children.
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7. Koldewyn K, Whitney D, Rivera SM. {{Neural correlates of coherent and biological motion perception in autism}}. {Dev Sci}. 2011 Sep;14(5):1075-88.
Recent evidence suggests those with autism may be generally impaired in visual motion perception. To examine this, we investigated both coherent and biological motion processing in adolescents with autism employing both psychophysical and fMRI methods. Those with autism performed as well as matched controls during coherent motion perception but had significantly higher thresholds for biological motion perception. The autism group showed reduced posterior Superior Temporal Sulcus (pSTS), parietal and frontal activity during a biological motion task while showing similar levels of activity in MT+/V5 during both coherent and biological motion trials. Activity in MT+/V5 was predictive of individual coherent motion thresholds in both groups. Activity in dorsolateral prefrontal cortex (DLPFC) and pSTS was predictive of biological motion thresholds in control participants but not in those with autism. Notably, however, activity in DLPFC was negatively related to autism symptom severity. These results suggest that impairments in higher-order social or attentional networks may underlie visual motion deficits observed in autism.
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8. Lou HC. {{Paradigm shift in consciousness research: The child’s self-awareness and abnormalities in autism, ADHD, and schizophrenia}}. {Acta Paediatr}. 2011 Aug 29.
Self-awareness is a pivotal component of any conscious experience and conscious self-regulation of behavior. A paralimbic network is active, specific, and causal in self-awareness. Its regions interact by gamma synchrony. Gamma synchrony develops throughout infancy, childhood, and adolescence into adulthood and is regulated by dopamine and other neurotransmitters via GABA interneurons. Major derailments of this network and self-awareness occur in developmental disorders of conscious self-regulation like autism, ADHD, and schizophrenia. Conclusion: Recent research on conscious experience is no longer limited to the study of neural « correlations » but is increasingly lending itself to the study of causality. This paradigm shift opens new perspectives for understanding the neural mechanisms of the developing self, and the causal effects of their disturbance in developmental disorders.
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9. Magnee MJ, de Gelder B, van Engeland H, Kemner C. {{Multisensory integration and attention in autism spectrum disorder: evidence from event-related potentials}}. {PLoS One}. 2011;6(8):e24196.
Successful integration of various simultaneously perceived perceptual signals is crucial for social behavior. Recent findings indicate that this multisensory integration (MSI) can be modulated by attention. Theories of Autism Spectrum Disorders (ASDs) suggest that MSI is affected in this population while it remains unclear to what extent this is related to impairments in attentional capacity. In the present study Event-related potentials (ERPs) following emotionally congruent and incongruent face-voice pairs were measured in 23 high-functioning, adult ASD individuals and 24 age- and IQ-matched controls. MSI was studied while the attention of the participants was manipulated. ERPs were measured at typical auditory and visual processing peaks, namely, P2 and N170. While controls showed MSI during divided attention and easy selective attention tasks, individuals with ASD showed MSI during easy selective attention tasks only. It was concluded that individuals with ASD are able to process multisensory emotional stimuli, but this is differently modulated by attention mechanisms in these participants, especially those associated with divided attention. This atypical interaction between attention and MSI is also relevant to treatment strategies, with training of multisensory attentional control possibly being more beneficial than conventional sensory integration therapy.
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10. Montgomery J, Storey K, Post M, Lemley J. {{The use of auditory prompting systems for increasing independent performance of students with autism in employment training}}. {Int J Rehabil Res}. 2011 Aug 31.
In this study a self-operated auditory prompting system is introduced to determine if it can increase the on-task behavior for two students with autism participating in an employment training program. In addition, the amount of prompts provided by support staff is measured. The self-operated auditory prompting system consisted of tape recordings of music interspersed with prompts of self-evaluation and encouragement related to the job tasks being performed in the employment setting. The results of the study indicated a potential positive relationship between the self-operated auditory prompting system and the on-task behavior of the participants as well as a positive relationship between the decreased amounts of prompts used by support staff.Im Rahmen der vorliegenden Studie wird ein selbsttatig bedienbares System mit akustischen Impulsen vorgestellt, das Aufschluss daruber geben soll, ob es das On-task-Verhalten von zwei autistischen Teilnehmern an einem Berufsbildungsprogramm verbessern kann. Ausserdem erfolgt eine Messung der Anzahl der von Betreuern gesendeten Impulse. Das selbsttatig bedienbare System mit akustischen Impulsen bestand aus Bandaufnahmen mit abwechselnd Musik und Impulsen zur Selbsteinschatzung und Anregung bzgl. der am Arbeitsplatz auszuubenden Aufgaben. Die Studienergebnisse deuteten auf eine potenzielle positive Beziehung zwischen dem selbsttatig bedienbaren System mit akustischen Impulsen und dem On-task-Verhalten der Teilnehmer hin aber auch auf eine positive Beziehung zwischen der geringeren Anzahl der von den Betreuern gesendeten Impulse.Este estudio presenta un sistema automatico de senales auditivas que tiene como objetivo mejorar la disciplina de trabajo de dos estudiantes con autismo que participan en un programa de formacion profesional. Asimismo, el estudio tambien evalua la cantidad de ayuda proporcionada por el personal de apoyo. El sistema automatico de senales auditivas consistia en grabaciones de musica combinadas con directrices de autoevaluacion y estimulo en relacion con tareas aplicadas al contexto laboral. Los resultados del estudio indicaron una posible relacion positiva entre el sistema automatico de senales auditivas y la disciplina de trabajo de los participantes, asi como una relacion positiva con la disminucion del numero de pautas necesarias por parte del personal de apoyo.Dans cette etude, un systeme auditif d’invite auto-gere est introduit pour determiner s’il peut augmenter le comportement d’execution des taches de deux eleves autistes participant a un programme de formation a l’emploi. En outre, la quantite d’invites communiquees par le personnel d’encadrement est mesuree. Le systeme auditif d’invite auto-gere se compose d’enregistrements de musique entrecoupes d’invites d’auto-evaluation et d’encouragement associees aux taches executees dans un cadre d’emploi. Les resultats de l’etude ont indique une eventuelle relation positive entre le systeme auditif d’invite auto-gere et le comportement des participants lors de l’execution des taches ainsi qu’une relation positive entre la diminution du nombre d’invites utilisees par le personnel d’encadrement.
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11. Moore TR, Symons FJ. {{Adherence to Treatment in a Behavioral Intervention Curriculum for Parents of Children With Autism Spectrum Disorder}}. {Behav Modif}. 2011 Sep 1.
Parents (N = 21) of children with autism spectrum disorders responded to a survey on adherence to skills instruction and problem behavior management strategies they had previously been observed to master in a standardized training curriculum based on the principles of applied behavior analysis. Survey items were guided by existing models of and research in treatment adherence. Parents reported adherence below observed mastery criteria in five of six skill areas. Three independent variables indexing caregiver perception were significantly correlated with reported adherence: perceived effectiveness as a behavior change agent, confidence in the intervention to produce meaningful change, and acceptance of child in family and community. Perceived confidence significantly predicted adherence in a regression model (p < .05). Implications of caregiver perception in explanatory frameworks for adherence are discussed, and next steps in the measurement and study of treatment adherence in behavior analysis are proposed.
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12. Onaivi ES, Benno R, Halpern T, Mehanovic M, Schanz N, Sanders C, et al. {{Consequences of cannabinoid and monoaminergic system disruption in a mouse model of autism spectrum disorders}}. {Curr Neuropharmacol}. 2011 Mar;9(1):209-14.
Autism spectrum disorders (ASDs) are heterogenous neurodevelopmental disorders characterized by impairment in social, communication skills and stereotype behaviors. While autism may be uniquely human, there are behavioral characteristics in ASDs that can be mimicked using animal models. We used the BTBR T+tf/J mice that have been shown to exhibit autism-like behavioral phenotypes to 1). Evaluate cannabinoid-induced behavioral changes using forced swim test (FST) and spontaneous wheel running (SWR) activity and 2). Determine the behavioral and neurochemical changes after the administration of MDMA (20 mg/kg), methamphetamine (10 mg/kg) or MPTP (20 mg/kg). We found that the BTBR mice exhibited an enhanced basal spontaneous locomotor behavior in the SWR test and a reduced depressogenic profile. These responses appeared to be enhanced by the prototypic cannabinoid, Delta(9)-THC. MDMA and MPTP at the doses used did not modify SWR behavior in the BTBR mice whereas MPTP reduced SWR activity in the control CB57BL/6J mice. In the hippocampus, striatum and frontal cortex, the levels of DA and 5-HT and their metabolites were differentially altered in the BTBR and C57BL/6J mice. Our data provides a basis for further studies in evaluating the role of the cannabinoid and monoaminergic systems in the etiology of ASDs.
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13. Qian N, Lipkin RM. {{A learning-style theory for understanding autistic behaviors}}. {Front Hum Neurosci}. 2011;5:77.
Understanding autism’s ever-expanding array of behaviors, from sensation to cognition, is a major challenge. We posit that autistic and typically developing brains implement different algorithms that are better suited to learn, represent, and process different tasks; consequently, they develop different interests and behaviors. Computationally, a continuum of algorithms exists, from lookup table (LUT) learning, which aims to store experiences precisely, to interpolation (INT) learning, which focuses on extracting underlying statistical structure (regularities) from experiences. We hypothesize that autistic and typical brains, respectively, are biased toward LUT and INT learning, in low- and high-dimensional feature spaces, possibly because of their narrow and broad tuning functions. The LUT style is good at learning relationships that are local, precise, rigid, and contain little regularity for generalization (e.g., the name-number association in a phonebook). However, it is poor at learning relationships that are context dependent, noisy, flexible, and do contain regularities for generalization (e.g., associations between gaze direction and intention, language and meaning, sensory input and interpretation, motor-control signal and movement, and social situation and proper response). The LUT style poorly compresses information, resulting in inefficiency, sensory overload (overwhelm), restricted interests, and resistance to change. It also leads to poor prediction and anticipation, frequent surprises and over-reaction (hyper-sensitivity), impaired attentional selection and switching, concreteness, strong local focus, weak adaptation, and superior and inferior performances on simple and complex tasks. The spectrum nature of autism can be explained by different degrees of LUT learning among different individuals, and in different systems of the same individual. Our theory suggests that therapy should focus on training autistic LUT algorithm to learn regularities.
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14. Rillotta F, Kirby N, Shearer J, Nettelbeck T. {{Family quality of life of Australian families with a member with an intellectual/developmental disability}}. {J Intellect Disabil Res}. 2011 Aug 30.
Background Family quality of life (FQOL) is a recent concept in intellectual/developmental disability research. Outcomes for the family are important to the provision of services because families, rather than institutions, are increasingly considered the primary support unit. This article presents Australian findings using the international Family Quality of Life Survey: Main Caregivers of People with Intellectual or Developmental Disabilities (FQOLS-2006). Method Forty-two South Australian main caregivers of people with an intellectual/developmental disability were interviewed using the FQOLS-2006. The FQOL domains assessed were Health of the Family, Financial Well-being, Family Relationships, Support from Other People, Support from Disability-Related Services, Influence of Values, Careers, Leisure and Recreation, and Community Interaction. Domains were measured in terms of Importance, Opportunities, Attainment, Initiative, Stability and Satisfaction. The FQOLS-2006 asked about the family’s practical and emotional Support from Other People together, whereas the current study separated the constructs of practical and emotional support. Questions pertaining to FQOL in the past were also added, in order to gain a broader picture of present FQOL. Results Results indicated that families considered all the FQOL domains to be important. However, Health, Family Relationships and Financial Well-being were regarded as slightly more important than Practical and Emotional Support from Others. The attainment of Family Relationships, Health, Values, and Leisure and Recreation were rated as quite a bit, but Practical Support from Other People was only rated as a little. Families were generally satisfied with all FQOL domains, but they were satisfied with their Family Relationships and they were neither satisfied or dissatisfied with their Financial Well-being. Results also indicated that there was a need to distinguish between the provision of practical and emotional support from others, because the attainment of emotional support was rated at a slightly higher level than practical support. Conclusions The FQOLS-2006 provided a comprehensive measure of FQOL, which, with some additional modifications, could be used to better inform service provisions and ultimately enhance the quality of life of people with intellectual/developmental disabilities and their families.