1. Albert N, Daniels J, Schwartz J, Du M, Wall DP. {{GapMap: Enabling Comprehensive Autism Resource Epidemiology}}. {JMIR Public Health Surveill};2017 (May 04);3(2):e27.
BACKGROUND: For individuals with autism spectrum disorder (ASD), finding resources can be a lengthy and difficult process. The difficulty in obtaining global, fine-grained autism epidemiological data hinders researchers from quickly and efficiently studying large-scale correlations among ASD, environmental factors, and geographical and cultural factors. OBJECTIVE: The objective of this study was to define resource load and resource availability for families affected by autism and subsequently create a platform to enable a more accurate representation of prevalence rates and resource epidemiology. METHODS: We created a mobile application, GapMap, to collect locational, diagnostic, and resource use information from individuals with autism to compute accurate prevalence rates and better understand autism resource epidemiology. GapMap is hosted on AWS S3, running on a React and Redux front-end framework. The backend framework is comprised of an AWS API Gateway and Lambda Function setup, with secure and scalable end points for retrieving prevalence and resource data, and for submitting participant data. Measures of autism resource scarcity, including resource load, resource availability, and resource gaps were defined and preliminarily computed using simulated or scraped data. RESULTS: The average distance from an individual in the United States to the nearest diagnostic center is approximately 182 km (50 miles), with a standard deviation of 235 km (146 miles). The average distance from an individual with ASD to the nearest diagnostic center, however, is only 32 km (20 miles), suggesting that individuals who live closer to diagnostic services are more likely to be diagnosed. CONCLUSIONS: This study confirmed that individuals closer to diagnostic services are more likely to be diagnosed and proposes GapMap, a means to measure and enable the alleviation of increasingly overburdened diagnostic centers and resource-poor areas where parents are unable to diagnose their children as quickly and easily as needed. GapMap will collect information that will provide more accurate data for computing resource loads and availability, uncovering the impact of resource epidemiology on age and likelihood of diagnosis, and gathering localized autism prevalence rates.
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2. Antezana L, Scarpa A, Valdespino A, Albright J, Richey JA. {{Rural Trends in Diagnosis and Services for Autism Spectrum Disorder}}. {Front Psychol};2017;8:590.
Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.
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3. Brosnan M, Ashwin C, Lewton M. {{Brief Report: Intuitive and Reflective Reasoning in Autism Spectrum Disorder}}. {J Autism Dev Disord};2017 (May 04)
Dual Process Theory has recently been applied to Autism spectrum disorder (ASD) to suggest that reasoning by people with ASD and people with higher levels of ASD-like traits can be characterised by reduced intuitive and greater reflective processing. 26 adolescents and adults with ASD and 22 adolescent and adult controls completed an assessment of ASD-like traits, the cognitive reflections test (CRT) to measure intuitive and reflective reasoning and an index of general cognitive ability. The ASD group produced less intuitive responses, and the degree of ASD-like traits showed a negative correlation with intuitive responses and positive correlation with reflective responses on the CRT. Together, these results are consistent with ASD being associated with reduced intuitive reasoning and greater deductive reasoning.
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4. Ferrarelli LK. {{Finding drugs for fragile X syndrome}}. {Science};2017 (May 05);356(6337):497-498.
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5. Flor J, Bellando J, Lopez M, Shui A. {{Developmental functioning and medical Co-morbidity profile of children with complex and essential autism}}. {Autism Res};2017 (May 05)
Children with Autism Spectrum Disorders (ASD) may be characterized as « complex » (those with microcephaly and/or dysmorphology) or « essential » (those with neither of these two). Previous studies found subjects in the complex group exhibited lower IQ scores, poorer response to behavioral intervention, more seizures and more abnormal EEGs and brain MRIs compared to the essential group. The objective of this study was to determine if there are differences in complex versus essential subjects based on several developmental/psychological measures as well as certain medical comorbidities. This study utilized data from 1,347 individuals (2-17 years old) well-characterized subjects enrolled in Autism Treatment Network (ATN) Registry. Head circumference measurement and the Autism Dysmorphology Measure (ADM) were used by trained physicians to classify subjects as complex or essential. Significantly lower scores were seen for complex subjects in cognitive level, adaptive behavior and quality of life. Complex subjects showed significantly increased physician-documented GI symptoms and were on a higher number of medications. No significant differences in autism severity scores, behavioral ratings and parent-reported sleep problems were found. After adjusting for multiple comparisons made, adaptive scores remained significantly lower for the complex group, and the complex group used a significantly higher number of medications and had increased GI symptoms. Complex and essential autism subtypes may have distinct developmental and medical correlates and thus underlines the importance of looking for microcephaly and dysmorphology, when evaluating a child with autism. Determining this distinction in autism may have implications in prognosis, identifying medical co-morbidities, directing diagnostic evaluations and treatment interventions. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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6. Hadad BS, Goldstein EK, Russo NN. {{Atypical perception in autism: A Failure of Perceptual Specialization?}}. {Autism Res};2017 (May 05)
We examined whether reduced perceptual specialization underlies atypical perception in autism spectrum disorder (ASD) testing classifications of stimuli that differ either along integral dimensions (prototypical integral dimensions of value and chroma), or along separable dimensions (prototypical separable dimensions of value and size). Current models of the perception of individuals with an ASD would suggest that on these tasks, individuals with ASD would be as, or more, likely to process dimensions as separable, regardless of whether they represented separable or integrated dimensions. In contrast, reduced specialization would propose that individuals with ASD would respond in a more integral manner to stimuli that differ along separable dimensions, and at the same time, respond in a more separable manner to stimuli that differ along integral dimensions. A group of nineteen adults diagnosed with high functioning ASD and seventeen typically developing participants of similar age and IQ, were tested on speeded and restricted classifications tasks. Consistent with the reduced specialization account, results show that individuals with ASD do not always respond more analytically than typically developed (TD) observers: Dimensions identified as integral for TD individuals evoke less integral responding in individuals with ASD, while those identified as separable evoke less analytic responding. These results suggest that perceptual representations are more broadly tuned and more flexibly represented in ASD. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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7. Haigh SM. {{Variable Sensory Perception in Autism}}. {Eur J Neurosci};2017 (May 05)
Autism is associated with sensory and cognitive abnormalities. Individuals with autism generally show normal or superior early sensory processing abilities compared to healthy controls, but deficits in complex sensory processing. In the current opinion paper, it will be argued that sensory abnormalities impact cognition by limiting the amount of signal that can be used to interpret and interact with environment. There is a growing body of literature showing that individuals with autism exhibit greater trial-to-trial variability in behavioural and cortical sensory responses. If multiple sensory signals that are highly variable are added together to process more complex sensory stimuli, then this might destabilize later perception and impair cognition. Methods to improve sensory processing have shown improvements in more general cognition. Studies that specifically investigate differences in sensory trial-to-trial variability in autism, and the potential changes in variability before and after treatment, could ascertain if trial-to-trial variability is a good mechanism to target for treatment in autism. This article is protected by copyright. All rights reserved.
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8. Kim SJ, Shonka S, French WP, Strickland J, Miller L, Stein MA. {{Dose-Response Effects of Long-Acting Liquid Methylphenidate in Children with Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD): A Pilot Study}}. {J Autism Dev Disord};2017 (May 05)
Attention deficit/hyperactivity disorder (ADHD) symptoms are common in youth with autism spectrum disorders (ASD) and are frequently treated with stimulant medications. Twenty-seven children were randomized to different dose titration schedules, and ADHD symptoms, tolerability, and aberrant behaviors were assessed weekly during a 6-week trial with long-acting liquid methylphenidate (MPH). MPH at low to moderate doses was effective in reducing ADHD symptoms and was well tolerated in young children with ASD and ADHD. Future studies are needed to assess generalization and maintenance of efficacy.
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9. Lee SY, Lo YY, Lo Y. {{Teaching Functional Play Skills to a Young Child with Autism Spectrum Disorder through Video Self-Modeling}}. {J Autism Dev Disord};2017 (May 04)
The researchers used a single-case, multiple probe design across three sets of toys (i.e., farm toy, doctor’s clinic toy, and rescue toy) to examine the effects of video self-modeling (VSM) on the functional play skills of a 5-year-old child with autism spectrum disorder. The findings showed a functional relation between VSM and increased percentages of functional play actions across the toy sets. The participant’s percentages of the targeted functional play skills for the intervention toys remained high 1 week and 2 weeks after the intervention ceased. Additionally, preliminary generalization results showed slight improvement in the percentages of functional play actions with the generalization toys that were not directly taught. Limitations, practical implications, and directions for future research are discussed.
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10. Munshi K, Pawlowski K, Gonzalez-Heydrich J, Picker JD. {{Review of Salient Investigational Drugs for the Treatment of Fragile X Syndrome}}. {J Child Adolesc Psychopharmacol};2017 (May 05)
OBJECTIVES: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability, in addition to being the commonest diagnosable cause of autism. The identification of the biochemical mechanism underlying this disorder has provided amenable targets for therapy. This review aims to provide an overview of investigational drug therapies for FXS. METHODS: The authors carried out a search of clinical and preclinical trials for FXS in PubMed and on the U.S. National Institutes of Health index of clinical trials ( www.clinicaltrials.gov ). We limited our review to Phase II trials or more preliminary and reviewed the associated publications for these studies, complemented by a review of the literature on PubMed. RESULTS: The review of the preclinical, Phase I, and Phase II trials of agents with therapeutic potential in FXS revolves around an understanding of the putative pathways in the pathogenesis of FXS. While there is significant overlap between some of these pathways, the agents can be categorized as modulators of the metabotropic glutamate receptor system, GABAergic agents, and miscellaneous modulators affecting other pathways. CONCLUSION: As trials involving agents targeting different aspects of the molecular biology proceed, common themes have emerged. With the great hope came great disappointment as the initial trials failed to demonstrate sufficient significance. In particular, the differences in outcome between the animal models and humans have highlighted the unique challenges of carrying out trials in these cognitively and behaviorally challenged individuals, as well as a dearth of clinically relevant outcome measures for use in medication trials. However, in reviewing and reframing the studies of the last decade, many important lessons have been learned, which will ultimately have a greater impact on therapeutic research in the field of developmental delay as a whole.
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11. So R, Makino K, Fujiwara M, Hirota T, Ohcho K, Ikeda S, Tsubouchi S, Inagaki M. {{The Prevalence of Internet Addiction Among a Japanese Adolescent Psychiatric Clinic Sample With Autism Spectrum Disorder and/or Attention-Deficit Hyperactivity Disorder: A Cross-Sectional Study}}. {J Autism Dev Disord};2017 (May 04)
Extant literature suggests that autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are risk factors for internet addiction (IA). The present cross-sectional study explored the prevalence of IA among 132 adolescents with ASD and/or ADHD in a Japanese psychiatric clinic using Young’s Internet Addiction Test. The prevalence of IA among adolescents with ASD alone, with ADHD alone and with comorbid ASD and ADHD were 10.8, 12.5, and 20.0%, respectively. Our results emphasize the clinical importance of screening and intervention for IA when mental health professionals see adolescents with ASD and/or ADHD in psychiatric services.
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12. Tint A, Weiss JA, Lunsky Y. {{Identifying the clinical needs and patterns of health service use of adolescent girls and women with autism spectrum disorder}}. {Autism Res};2017 (May 05)
Girls and women in the general population present with a distinct profile of clinical needs and use more associated health services compared to boys and men; however, research focused on health service use patterns among girls and women with Autism Spectrum Disorder (ASD) is limited. In the current study, caregivers of 61 adolescent girls and women with ASD and 223 boys and men with ASD completed an online survey. Descriptive analyses were conducted to better understand the clinical needs and associated service use patterns of girls and women with ASD. Sex/gender comparisons were made of individuals’ clinical needs and service use. Adolescent girls and women with ASD had prevalent co-occurring mental and physical conditions and parents reported elevated levels of caregiver strain. Multiple service use was common across age groups, particularly among adolescent girls and women with intellectual disability. Overall, few sex/gender differences emerged, although a significantly greater proportion of girls and women accessed psychiatry and emergency department services as compared to boys and men. Though the current study is limited by its use of parent report and small sample size, it suggests that girls and women with ASD may share many of the same high clinical needs and patterns of services use as boys and men with ASD. Areas for future research are discussed to help ensure appropriate support is provided to this understudied population. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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13. Ye BS, Leung AOW, Wong MH. {{The association of environmental toxicants and autism spectrum disorders in children}}. {Environ Pollut};2017 (May 02);227:234-242.
Autism spectrum disorders (ASDs) is a set of complex neurodevelopment disorders that is prevalent in children and is increasing at a steady rate in recent years. However, the etiology of autism is still poorly understood. Humans are at higher risk of chemical exposure than in the past as a result of the increasing usage of chemicals in various fields, including food preservation, agriculture, industrial production, etc. A number of environmental agents have been suggested as contributing factors to ASD pathogenesis, which includes heavy metals (Hg and Pb), persistent organic pollutants (DDT, PBDEs and PCBs) and emerging chemicals of concern (phthalates and BPA). These three main categories of toxicants could be the cause of ASD in children. Recent research into the causes of ASD that have been linked to environment factors are reviewed in this paper. There are evidence supporting the etiological link between exposure to environmental toxicants and the development of ASD. Children exposed to these toxicants in the environment exhibit signature traits of ASD and have been reported with high body burdens of these chemicals and/or their metabolites, which may provide an explanation for the observed relation, yet comprehensive evidence in humans is limited, highlighting the need for further research.
