1. Bearss K, Johnson C, Handen B, Smith T, Scahill L. {{A Pilot Study of Parent Training in Young Children with Autism Spectrum Disorders and Disruptive Behavior}}. {J Autism Dev Disord}. 2012.
Guidance on effective interventions for disruptive behavior in young children with autism spectrum disorders (ASDs) is limited. We present feasibility and initial efficacy data on a structured parent training program for 16 children (ages 3-6) with ASD and disruptive behavior. The 6-month intervention included 11 Core and up to 2 Optional sessions. The program was acceptable to parents as evidenced by an attendance rate of 84 % for Core sessions. Fourteen of 16 families completed the treatment. An independent clinician rated 14 of 16 subjects as much improved or very much improved at Week 24. Using last observation carried forward, the parent-rated Aberrant Behavior Checklist-Irritability subscale decreased 54 % from 16.00 (SD = 9.21) to 7.38 (SD = 6.15).
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2. Cidav Z, Lawer L, Marcus SC, Mandell DS. {{Age-Related Variation in Health Service Use and Associated Expenditures Among Children with Autism}}. {J Autism Dev Disord}. 2012.
This study examined differences by age in service use and associated expenditures during 2005 for Medicaid-enrolled children with autism spectrum disorders. Aging was associated with significantly higher use and costs for restrictive, institution-based care and lower use and costs for community-based therapeutic services. Total expenditures increased by 5 % with each year of age; by 23 % between 3-5 and 6-11 year olds, 23 % between 6-11 and 12-16, and 14 % between 12-16 and 17-20 year olds. Use of and expenditures for long-term care, psychiatric medications, case management, medication management, day treatment/partial hospitalization, and respite services increased with age; use of and expenditures for occupational/physical therapy, speech therapy, mental health services, diagnostic/assessment services, and family therapy declined.
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3. Clarke RA, Lee S, Eapen V. {{Pathogenetic model for Tourette syndrome delineates overlap with related neurodevelopmental disorders including Autism}}. {Transl Psychiatry}. 2012; 2: e158.
Tourette syndrome (TS) is a highly heritable neuropsychiatric disorder characterised by motor and vocal tics. Despite decades of research, the aetiology of TS has remained elusive. Recent successes in gene discovery backed by rapidly advancing genomic technologies have given us new insights into the genetic basis of the disorder, but the growing collection of rare and disparate findings have added confusion and complexity to the attempts to translate these findings into neurobiological mechanisms resulting in symptom genesis. In this review, we explore a previously unrecognised genetic link between TS and a competing series of trans-synaptic complexes (neurexins (NRXNs), neuroligins (NLGNs), leucine-rich repeat transmembrane proteins (LRRTMs), leucine rich repeat neuronals (LRRNs) and cerebellin precursor 2 (CBLN2)) that links it with autism spectrum disorder through neurodevelopmental pathways. The emergent neuropathogenetic model integrates all five genes so far found to be uniquely disrupted in TS into a single pathogenetic chain of events described in context with clinical and research implications.
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4. Kelly A, Barnes-Holmes D. {{Implicit attitudes towards children with autism versus normally developing children as predictors of professional burnout and psychopathology}}. {Res Dev Disabil}. 2012; 34(1): 17-28.
Tutors trained in applied behaviour analysis (n=16) and mainstream school teachers (n=16) were exposed to an Implicit Relational Assessment Procedure (IRAP) designed to assess implicit attitudes towards individuals with autism versus normally developing individuals. Participants also completed a range of explicit measures, including measures of professional burnout and psychopathology. All participants produced more negative biases towards children with autism compared to children who were normally developing. Increased negativity towards autism on the IRAP predicted similar attitudes on some of the explicit measures and also correlated with increased levels of self-reported psychopathology and professional burnout for the tutors working with children with autism. Results suggest that implicit measures of attitudes may provide a marker for professional burnout.
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5. Lerna A, Esposito D, Conson M, Russo L, Massagli A. {{Social-communicative effects of the Picture Exchange Communication System (PECS) in Autism Spectrum Disorders}}. {Int J Lang Commun Disord}. 2012; 47(5): 609-17.
Background: The Picture Exchange Communication System (PECS) is a common treatment choice for non-verbal children with autism. However, little empirical evidence is available on the usefulness of PECS in treating social-communication impairments in autism. Aims: To test the effects of PECS on social-communicative skills in children with autism, concurrently taking into account standardized psychometric data, standardized functional assessment of adaptive behaviour, and information on social-communicative variables coded in an unstructured setting. Methods & Procedures: Eighteen preschool children (mean age = 38.78 months) were assigned to two intervention approaches, i.e. PECS and Conventional Language Therapy (CLT). Both PECS (Phases I-IV) and CLT were delivered three times per week, in 30-min sessions, for 6 months. Outcome measures were the following: Autism Diagnostic Observation Schedule (ADOS) domain scores for Communication and Reciprocal Social Interaction; Language and Personal-Social subscales of the Griffiths’ Mental Developmental Scales (GMDS); Communication and Social Abilities domains of the Vineland Adaptive Behavior Scales (VABS); and several social-communicative variables coded in an unstructured setting. Outcomes & Results: Results demonstrated that the two groups did not differ at Time 1 (pre-treatment assessment), whereas at Time 2 (post-test) the PECS group showed a significant improvement with respect to the CLT group on the VABS social domain score and on almost all the social-communicative abilities coded in the unstructured setting (i.e. joint attention, request, initiation, cooperative play, but not eye contact). Conclusions & Implications: These findings showed that PECS intervention (Phases I-IV) can improve social-communicative skills in children with autism. This improvement is especially evident in standardized measures of adaptive behaviour and measures derived from the observation of children in an unstructured setting.
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6. Lundervold AJ, Stickert M, Hysing M, Sorensen L, Gillberg C, Posserud MB. {{Attention Deficits in Children With Combined Autism and ADHD: A CPT Study}}. {J Atten Disord}. 2012.
Objective: To investigate characteristics of attention in children with the combination of autism spectrum disorder (ASD) and ADHD. Method: Four groups of 8- to 10-year-old children were compared on the Conners’ Continuous Performance Test-Second Edition (CCPT-II): (a) ASD + ADHD (n = 11), (b) ASD only (n = 9), (c) ADHD only (n = 38), and (d) no diagnosis (n = 134). Results: There was an overall effect of group on the Continuous Performance Test (CPT) index and measures of hit reaction time, accuracy, response style, variability, and consistency. The ASD + ADHD group, much like the ADHD only group, had a more risky response style, a higher variability, and a lower consistency than the ASD only group. The impact of intellectual function on CCPT-II performance was considerable in children within the ASD subgroups. Conclusion: The findings underscore the importance of including measures of attention and intellectual function when assessing children with the combination of ASD and ADHD. (J. of Att. Dis. 2012; XX(X) 1-XX).
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7. Masino SA, Kawamura M, Jr., Cote JL, Williams RB, Ruskin DN. {{Adenosine and autism: A spectrum of opportunities}}. {Neuropharmacology}. 2012.
In rodents, insufficient adenosine produces behavioral and physiological symptoms consistent with several comorbidities of autism. In rodents and humans, stimuli postulated to increase adenosine can ameliorate these comorbidities. Because adenosine is a broad homeostatic regulator of cell function and nervous system activity, increasing adenosine’s influence might be a new therapeutic target for autism with multiple beneficial effects. This article is part of a Special Issue entitled ‘Neurodevelopment Disorder’.
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8. Moilanen I, Mattila ML, Loukusa S, Kielinen M. {{[Autism spectrum disorders in children and adolescents]}}. {Duodecim}. 2012; 128(14): 1453-62.
Childhood autism, Asperger’s syndrome and atypical autism together make up autism spectrum disorders (ASDs) with a prevalence of 0.6-0.7%. These disorders are defined by qualitative impairments in social interaction, qualitative abnormalities in communication, and by restricted, stereotyped, repetitive patterns of behaviour, interests and activities. Many children or adolescents with ASDs have sensory abnormalities, neurological disorders and additional disabilities of vision, hearing or ambulation. Psychiatric co-morbidity is common. Diagnostics and rehabilitation are implemented in multi-professional collaboration. Early recognition makes up the basis for early intervention that improves the prognosis. Screening of these disorders in well-baby clinics is being developed.
9. Smith T. {{Evolution of Research on Interventions for Individuals with Autism Spectrum Disorder: Implications for Behavior Analysts}}. {Behav Anal}. 2012; 35(1): 101-13.
The extraordinary success of behavior-analytic interventions for individuals with autism spectrum disorder (ASD) has fueled the rapid growth of behavior analysis as a profession. One reason for this success is that for many years behavior analysts were virtually alone in conducting programmatic ASD intervention research. However, that era has ended. Many investigators from other disciplines are now carrying out large-scale intervention studies and beginning to report successes of their own. The increasing number and range of studies has the potential to improve services for individuals with ASD, and it challenges behavior analysts to intensify their research efforts.
10. Wei H, Mori S, Hua K, Li X. {{Alteration of brain volume in IL-6 overexpressing mice related to autism}}. {Int J Dev Neurosci}. 2012.
Abnormal neuroimmune responses have been reported to be associated with autism and could be appropriate targets for pharmacologic intervention. Our previous studies showed that neuroimmune factor, interleukin (IL)-6, was significantly elevated in the fontal cortex and cerebellum of autistic subjects. The IL-6 overexpressing mice displayed several autism-like features as well as an abnormal dendritic spine morphology and synaptic function. The purpose of this study was to examine the volumetric differences in the brain of IL-6 overexpressing mice and compare with corresponding control mice using magnetic resonance imaging. Here we show that IL-6 overexpressing mice display an increase in the total brain volume. In addition, the lateral ventricle is also enlarged in the IL-6 overexpressing mice. The brain structures surrounding the lateral ventricle were squeezed and deformed from the normal location. These results indicate that IL-6 elevation in the brain could mediate neuroanatomical abnormalities. Taking together with our previous findings, a mechanism by which IL-6 may be involved in the pathogenesis of autism is proposed.
