1. Croteau C, Mottron L, Dorais M, Tarride JE, Perreault S. {{Use, costs, and predictors of psychiatric healthcare services following an autism spectrum diagnosis: Population-based cohort study}}. {Autism}. 2019: 1362361319840229.
A number of cross-sectional studies report extensive use of psychiatric services and high healthcare costs in autistic youths. However, little is known about how the use of these services evolves from the time of diagnosis, as children grow up. Our objectives were to investigate the use, costs, and predictors of psychiatric services following autism spectrum diagnosis. We built a cohort of 1227 newly diagnosed autism spectrum individuals identified in the Quebec (Canada) Regie de l’assurance maladie du Quebec administrative database (January 1998 to December 2010). Mean number and cost per individual of psychiatric healthcare use (hospitalizations, medical visits, psychoactive drug use) were calculated yearly for 5 years following autism spectrum diagnosis. Mean number of psychiatric visits decreased over time by more than threefold (7.5 vs 2.1 visits) from year 1 to year 5, whereas psychoactive drug use increased from 16.0 to 25.2 claims. Psychiatric hospitalizations decreased during follow-up, but still represented the greatest costs per individual (CAD9820 for year 1; CAD4628 for year 5). Antipsychotics represented over 50% of drug costs. Mixed-effect model with repeated measures showed that previous psychoactive drug use was the strongest predictor of greater psychiatric healthcare cost during follow-up (odds ratio: 9.96; 95% confidence interval: 7.58-13.10). These trends contrast with guidelines advocating cautious prescribing of antipsychotics with periodical re-assessment of their benefit.
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2. Dijkhuis RR, Ziermans T, van Rijn S, Staal W, Swaab H. {{Emotional Arousal During Social Stress in Young Adults With Autism: Insights From Heart Rate, Heart Rate Variability and Self-Report}}. {J Autism Dev Disord}. 2019.
In order to better understand which factors play a role in non-adaptive social behavior in autism spectrum disorder (ASD) we looked into physiological arousal and awareness of one’s own emotions. Heart rate (HR) and heart rate variability (HRV) were measured during a public speaking task in 51 young adults with ASD and 28 typically developing (TD) controls. The results showed no significant group differences in baseline HR/HRV, HR reactivity (change from baseline to the speaking task) or self-reported emotional awareness. However, adults with ASD showed significantly lower HRV reactivity (p = .023, d = 0.6) compared to TD adults. These results suggest a mismatch between arousal regulation and emotional awareness, which may be related to problems in social adaptation in ASD.
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3. Dovgan K, Mazurek MO. {{Impact of multiple co-occurring emotional and behavioural conditions on children with autism and their families}}. {J Appl Res Intellect Disabil}. 2019.
BACKGROUND: Comorbid conditions are very common in children and adults with autism spectrum disorder (ASD) and can affect school performance, adaptive skills and peer relationships. Comorbid conditions place strain on the family as well as the individual with ASD. This project aimed to determine the affect of comorbid conditions over and above child and family characteristics. METHODS: The present authors examined 3,055 cases of children with ASD who had varying numbers of comorbid conditions (i.e., ADHD, depression, anxiety or behaviour problems). RESULTS: Multiple comorbid conditions did have a unique impact on difficulties accessing services. A greater number of comorbid conditions impacted daily activity participation, but not a family’s receipt of mental health care or respite, work changes or number of weekly hours dedicated to caring for a child with ASD. CONCLUSIONS: Families, practitioners, paraprofessionals and educators of children with autism should address comorbid conditions to ensure both child and family well-being.
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4. Fernandez Sanchez H, Hernandez CBE, Sidani S, Osorio CH, Contreras EC, Mendoza JS. {{Dance Intervention for Mexican Family Caregivers of Children With Developmental Disability: A Pilot Study}}. {Journal of transcultural nursing : official journal of the Transcultural Nursing Society}. 2019: 1043659619838027.
INTRODUCTION: There are 7.1 million people living with a disability in Mexico. Of these individuals, 7% are children and adolescents with developmental disabilities. Mexican women caring for children with a developmental disability are at risk of psychological stress, which may be prevented with physical activity such as dance. Therefore, the purpose of this pilot study was to examine (a) the feasibility of implementing the dance intervention, (b) the mothers’ satisfaction with the intervention, and (c) the changes in stress level experienced by the mothers on completion of the intervention. METHOD: A one-group pretest-posttest design was used. The Salsa dance intervention was given in nine 60-minute sessions, twice a week in Veracruz, Mexico. The sample included 14 mothers of children with disabilities. The outcome, stress level, was measured with the validated Questionnaire of Perceived Stress. Feasibility of intervention implementation was maintained by having the interventionist follow the interventionist manual. Satisfaction was assessed by the Satisfaction with Therapy and Therapist Scale. RESULTS: The intervention was feasible as all participants completed the intervention sessions. They reported high satisfaction (100%) with the intervention and interventionist. At posttest, participants showed reduced stress levels ( p = .028). DISCUSSION: The dance intervention is promising in reducing women’s stress levels and worth further development in order to benefit the Mexican women caring for children with developmental disability and experiencing stress. Nurses can implement the Salsa dance intervention with the Mexican population while improving the clients’ retention, outcomes, and overall satisfaction.
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5. Gillespie-Lynch K, Daou N, Sanchez-Ruiz MJ, Kapp SK, Obeid R, Brooks PJ, Someki F, Silton N, Abi-Habib R. {{Factors underlying cross-cultural differences in stigma toward autism among college students in Lebanon and the United States}}. {Autism}. 2019: 1362361318823550.
Although stigma negatively impacts autistic people globally, the degree of stigma varies across cultures. Prior research suggests that stigma may be higher in cultures with more collectivistic orientations. This study aimed to identify cultural values and other individual differences that contribute to cross-cultural differences in autism stigma (assessed with a social distance scale) between college students in Lebanon ( n = 556) and those in the United States ( n = 520). Replicating prior work, stigma was lower in women than men and in the United States relative to Lebanon. Heightened autism knowledge, quality of contact with autistic people, openness to experience, and reduced acceptance of inequality predicted lower stigma. Collectivism was not associated with heightened stigma. Findings highlight the need to address structural inequalities, combat harmful misconceptions, and foster positive contact to combat stigma.
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6. Hau J, Aljawad S, Baggett N, Fishman I, Carper RA, Muller RA. {{The cingulum and cingulate U-fibers in children and adolescents with autism spectrum disorders}}. {Hum Brain Mapp}. 2019.
The cingulum is the major fiber system connecting the cingulate and surrounding medial cortex and medial temporal lobe internally and with other brain areas. It is important for social and emotional functions related to core symptomatology in autism spectrum disorders (ASDs). While the cingulum has been examined in autism, the extensive system of cingulate U-fibers has not been studied. Using probabilistic tractography, we investigated white matter fibers of the cingulate cortex by distinguishing its deep intra-cingulate bundle (cingulum proper) and short rostral anterior, caudal anterior, posterior, and isthmus cingulate U-fibers in 61 ASD and 54 typically developing children and adolescents. Increased mean and radial diffusivity of the left cingulum proper was observed in the ASD group, replicating previous findings on the cingulum. For cingulate U-fibers, an atypical age-related decline in right posterior cingulate U-fiber volume was found in the ASD group, which appeared to be driven by an abnormally large volume in younger children. History of repetitive and restrictive behavior was negatively associated with right caudal anterior cingulate U-fiber volume, linking cingulate motor areas with neighboring gyri. Aberrant development in U-fiber volume of the right posterior cingulate gyrus may underlie functional abnormalities found in this region, such as in the default mode network.
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7. Nicolaidis C, Raymaker D, Kapp SK, Baggs A, Ashkenazy E, McDonald K, Weiner M, Maslak J, Hunter M, Joyce A. {{The AASPIRE practice-based guidelines for the inclusion of autistic adults in research as co-researchers and study participants}}. {Autism}. 2019: 1362361319830523.
As interest in autism in adulthood grows, so does the need for methods to promote the inclusion of autistic adults in research. Our objective was to create practice-based guidelines for the inclusion of autistic adults, both as research team members and as study participants. We conducted an institutional ethnography of three closely related research partnerships that used participatory methods with autistic adults over the years 2006-2018. We used an iterative approach which combined discussions with community and academic partners and artifact review. Guidelines to promote the inclusion of autistic adults as co-researchers focus on being transparent about partnership goals, clearly defining roles and choosing partners, creating processes for effective communication and power-sharing, building and maintaining trust, disseminating findings, encouraging community capacitation, and fairly compensating partners. Guidelines to promote the inclusion of autistic adults as study participants focus on maximizing autonomy and inclusion, creating an accessible consent process, offering multiple modes of participation, adapting survey instruments for use with autistic adults, creating accessible qualitative interview guides, and handling data from proxy reporters. Although these practice-based guidelines may not apply to all research teams, we hope that other researchers can capitalize on these practical lessons when including autistic adults in research.
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8. Pelch KE, Bolden AL, Kwiatkowski CF. {{Environmental Chemicals and Autism: A Scoping Review of the Human and Animal Research}}. {Environmental health perspectives}. 2019; 127(4): 46001.
BACKGROUND: Estimates of autism prevalence have increased dramatically over the past two decades. Evidence suggests environmental factors may contribute to the etiology of the disorder. OBJECTIVES: This scoping review aimed to identify and categorize primary research and reviews on the association between prenatal and early postnatal exposure to environmental chemicals and the development of autism in epidemiological studies and rodent models of autism. METHODS: PubMed was searched through 8 February 2018. Included studies assessed exposure to environmental chemicals prior to 2 months of age in humans or 14 d in rodents. Rodent studies were considered relevant if they included at least one measurement of reciprocal social communicative behavior or repetitive and stereotyped behavior. Study details are presented in interactive displays using Tableau Public. RESULTS: The search returned 21,603 unique studies, of which 54 epidemiological studies, 46 experimental rodent studies, and 50 reviews were deemed relevant, covering 152 chemical exposures. The most frequently studied exposures in humans were particulate matter ([Formula: see text]), mercury ([Formula: see text]), nonspecific air pollution ([Formula: see text]), and lead ([Formula: see text]). In rodent studies, the most frequently studied exposures were chlorpyrifos ([Formula: see text]), mercury ([Formula: see text]), and lead ([Formula: see text]). DISCUSSION: Although research is growing rapidly, wide variability exists in study design and conduct, exposures investigated, and outcomes assessed. Conclusions focus on recommendations to guide development of best practices in epidemiology and toxicology, including greater harmonization across these fields of research to more quickly and efficiently identify chemicals of concern. In particular, we recommend chlorpyrifos, lead, and polychlorinated biphenyls (PCBs) be systematically reviewed in order to assess their relationship with the development of autism. There is a pressing need to move forward quickly and efficiently to understand environmental influences on autism in order to answer current regulatory questions and inform treatment and prevention efforts. https://doi.org/10.1289/EHP4386.
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9. Peter B, Dinu V, Liu L, Huentelman M, Naymik M, Lancaster H, Vose C, Schrauwen I. {{Exome Sequencing of Two Siblings with Sporadic Autism Spectrum Disorder and Severe Speech Sound Disorder Suggests Pleiotropic and Complex Effects}}. {Behavior genetics}. 2019.
Recent studies of autism spectrum disorder (ASD) and childhood apraxia of speech (CAS) have resulted in conflicting conclusions regarding the comorbidity of these disorders on phenotypic grounds. In a nuclear family with two dually affected and one unaffected offspring, whole-exome sequences were evaluated for single nucleotide and indel variants and CNVs. The affected siblings but not the unaffected sibling share a rare deleterious compound heterozygous mutation in WWOX, implicated both in ASD and motor control. In addition, one of the affected children carries a rare deleterious de novo mutation in the ASD candidate gene RIMS1. The two affected children but not their unaffected sibling inherited deleterious variants with relevance for ASD and/or CAS. WWOX, RIMS1, and several of the genes harboring the inherited variants are expressed in the brain during prenatal and early postnatal development. Results suggest compound heterozygosity as a cause of ASD and CAS, pleiotropic gene effects, and potentially additional, complex genetic effects.
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10. Roux AM, Rast JE, Shattuck PT. {{Correction to: State-Level Variation in Vocational Rehabilitation Service Use and Related Outcomes Among Transition-Age Youth on the Autism Spectrum}}. {J Autism Dev Disord}. 2019.
The original version of this article unfortunately contained mistakes in Table 1 values. Some of the values in « TAY-ASD who received services » were incorrect. The corrected Table 1 is given below.
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11. Saisanen L, Maatta S, Julkunen P, Niskanen E, Kallioniemi E, Grohn H, Kemppainen S, Lakka TA, Lintu N, Eloranta AM, Vanninen R, Makkonen I, Kononen M. {{Functional and structural asymmetry in primary motor cortex in Asperger syndrome: a navigated TMS and imaging study}}. {Brain topography}. 2019.
Motor functions are frequently impaired in Asperger syndrome (AS). In this study, we examined the motor cortex structure and function using navigated transcranial magnetic stimulation (nTMS) and voxel-based morphometry (VBM) and correlated the results with the box and block test (BBT) of manual dexterity and physical activity in eight boys with AS, aged 8-11 years, and their matched controls. With nTMS, we found less focused cortical representation areas of distinct hand muscles in AS. There was hemispheric asymmetry in the motor maps, silent period duration and active MEP latency in the AS group, but not in controls. Exploratory VBM analysis revealed less gray matter in the left postcentral gyrus, especially in the face area, and less white matter in the precentral area in AS as compared to controls. On the contrary, in the right leg area, subjects with AS displayed an increased density of gray matter. The structural findings of the left hemisphere correlated negatively with BBT score in controls, whereas the structure of the right hemisphere in the AS group correlated positively with motor function as assessed by BBT. These preliminary functional (neurophysiological and behavioral) findings are indicative of asymmetry, and co-existing structural alterations may reflect the motor impairments causing the deteriorations in manual dexterity and other motor functions commonly encountered in children with AS.
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12. Shen L, Feng C, Zhang K, Chen Y, Gao Y, Ke J, Chen X, Lin J, Li C, Iqbal J, Zhao Y, Wang W. {{Proteomics Study of Peripheral Blood Mononuclear Cells (PBMCs) in Autistic Children}}. {Frontiers in cellular neuroscience}. 2019; 13: 105.
Autism is one of the most common neurological developmental disorder associated with social isolation and restricted interests in children. The etiology of this disorder is still unknown. There is neither any confirmed laboratory test nor any effective therapeutic strategy to diagnose or cure it. To search for biomarkers for early detection and exploration of the disease mechanisms, here, we investigated the protein expression signatures of peripheral blood mononuclear cells (PBMCs) in autistic children compared with healthy controls by using isobaric tags for relative and absolute quantitation (iTRAQ) proteomics approach. The results showed a total of 41 proteins as differentially expressed in autistic group as compared to control. These proteins are found associated with metabolic pathways, endoplasmic reticulum (ER) stress and protein folding, endocytosis, immune and inflammatory response, plasma lipoprotein particle organization, and cell adhesion. Among these, 17 proteins (13 up-regulated and four down-regulated) are found to be linked with mitochondria. Eight proteins including three already reported proteins in our previous studies were selected to be verified. Five already reported autism associated pro-inflammatory cytokines [interferon-gamma (IFN-gamma), interleukin-1beta (IL-1beta), IL-6, IL-12, and tumor necrosis factor-alpha (TNF-alpha)] were detected in plasma by enzyme-linked immunosorbent assay (ELISA) analysis. The results were consistent with proteomic results and reports from previous literature. These results proposed that PBMCs from autistic children might be activated, and ER stress, unfolded protein response (UPR), acute-phase response (APR), inflammatory response, and endocytosis may be involved in autism occurrence. These reported proteins may serve as potential biomarkers for early diagnosis of autism. More specifically, simultaneous detection of three proteins [complement C3 (C3), calreticulin (CALR), and SERPINA1] in the plasma and PBMCs could increase the authenticity of detection.
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13. Stahmer AC, Vejnoska S, Iadarola S, Straiton D, Segovia FR, Luelmo P, Morgan EH, Lee HS, Javed A, Bronstein B, Hochheimer S, Cho E, Aranbarri A, Mandell D, Hassrick EM, Smith T, Kasari C. {{Correction to: Caregiver Voices: Cross-Cultural Input on Improving Access to Autism Services}}. {Journal of racial and ethnic health disparities}. 2019.
Please note that the middle name of coauthor Francisco Reinosa Segovia was misspelled (as « Rienosa ») is this article as originally published.
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14. Tonello L, Giacobbi L, Pettenon A, Scuotto A, Cocchi M, Gabrielli F, Cappello G. {{Problem behavior in autism spectrum disorders: A paradigmatic self-organized perspective of network structures}}. {The Behavioral and brain sciences}. 2019; 42: e28.
Autism spectrum disorder (ASD) subjects can present temporary behaviors of acute agitation and aggressiveness, named problem behaviors. They have been shown to be consistent with the self-organized criticality (SOC), a model wherein occasionally occurring « catastrophic events » are necessary in order to maintain a self-organized « critical equilibrium. » The SOC can represent the psychopathology network structures and additionally suggests that they can be considered as self-organized systems.
