1. Breddemann A, Schilbach L, Kunerl E, Witzmann M, Schuwerk T. [Gender Differences in Autism Diagnostics]. Psychiatr Prax;2023 (May 5)

Autism spectrum condition (ASC) is predominantly diagnosed in boys and men. There is evidence that this is also because girls and women with ASC don’t receive a diagnosis, or, if they do, only later in life. This study investigates gender differences in diagnosis, support needs, mental health, and life satisfaction among individuals with autism spectrum condition (ASC) in Germany. Data of an online questionnaire study with 659 persons with ASC from 3-67 years of age living in Bavaria, Germany, were analyzed (215 thereof were female). It was found that women with ASC are diagnosed 7-11 years later than men and are more likely to receive at least one misdiagnosis. They are more likely than men to have unmet educational support needs and comorbid internalizing psychiatric disorders. The results of this study point towards a strong gender bias in clinical diagnosis of ASC in Germany and need for improvements in the case of women.

Lien vers le texte intégral (Open Access ou abonnement)

2. Crawshaw D. Should We Continue to Tell Autistic People that Their Brains are Different?. Psychol Rep;2023 (May 5):332941231174391.

Autism is often considered to reflect categorically ‘different brains’. Neuropsychological research on autism spectrum disorder (ASD) however, has struggled to define this difference, or derive clear-cut boundaries between autism and non-autism. Consequently, restructuring or disbanding the ASD diagnosis is becoming increasingly advocated within research. Nonetheless, autism now exists as a salient social construction, of which ‘difference’ is a key facet. Clinical and educational professionals must influence this cautiously, as changes to autism’s social construction may counterproductively affect the quality of life of autistic people. This paper therefore reviews ASD’s value as both neuropsychological and social constructs. Although lacking neuropsychological validity, the autism label may be beneficial for autistic self-identity, reduction of stigma, and administering support. Whilst a shift away from case-control ASD research is warranted, lay notions of ‘different brains’ may be preserved.

Lien vers le texte intégral (Open Access ou abonnement)

3. Fiani D, Engler S, Fields S, Calarge CA. Iron Deficiency in Attention-Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Internalizing and Externalizing Disorders, and Movement Disorders. Child Adolesc Psychiatr Clin N Am;2023 (Apr);32(2):451-467.

This article reviews the role of iron in brain development and function, with a focus on the association between iron deficiency (ID) and neuropsychiatric conditions. First, we describe how ID is defined and diagnosed. Second, the role of iron in brain development and function is summarized. Third, we review current findings implicating ID in a number of neuropsychiatric conditions in children and adolescents, including attention deficit hyperactivity disorder and other disruptive behavior disorders, depressive and anxiety disorders, autism spectrum disorder, movement disorders, and other situations relevant to mental health providers. Last, we discuss the impact of psychotropic medication on iron homeostasis.

Lien vers le texte intégral (Open Access ou abonnement)

4. Karim JL, Solomon S, Abreu do Valle H, Zusman EZ, Nitschke AS, Meiri G, Dinstein I, Ip A, Lanphear N, Lanphear B, Hutchison S, Iarocci G, Psych R, Oberlander TF, Menashe I, Hanley GE. Exogenous oxytocin administration during labor and autism spectrum disorder. Am J Obstet Gynecol MFM;2023 (May 6):101010.

BACKGROUND: Oxytocin is a neuropeptide hormone that plays a key role in social behaviour, stress regulation, and mental health. Synthetic oxytocin administration is a common obstetrical practice, and importantly, previous research has suggested that intrapartum exposure may increase the risk of neurodevelopmental disorders, such as autism spectrum disorder (ASD). OBJECTIVE: To examine the association between synthetic oxytocin exposure during labor and ASD diagnosis in the child. STUDY DESIGN: This population-based retrospective cohort study compared two cohorts of children: 1) all children born in British Columbia (BC), Canada between April 1, 2000 and December 31, 2014 (n = 414,336 births), and 2) all children delivered at Soroka University Medical Center (SUMC) in Be’er Sheva, Israel between January 1, 2011 and December 31, 2019 (n = 82,892 births). Nine different exposure groups were examined. Cox proportional hazards models were used to estimate crude and adjusted hazard ratios of ASD in both cohorts based on induction and/or augmentation exposures status. To further control for confounding by indication, we conducted sensitivity analyses among a cohort of healthy, uncomplicated deliveries and among a group that was induced only for post-dates. Additionally, we stratified our analyses by infant sex to assess for potential sex differences. RESULTS: In the BC cohort, 170,013 of 414,336 deliveries (41.0%) were not induced or augmented, 107,543 (26.0%) were exposed to oxytocin, and 136,780 (33.0%) were induced or augmented but not exposed to oxytocin. In the Israel cohort, 51,790 of 82,892 deliveries (62.5%) were not induced or augmented, 28,852 (34.8%) were exposed to oxytocin, and 2,250 (2.7%) were induced or augmented but not exposed to oxytocin. Upon adjusting for covariates in the main analysis, significant associations were observed in the Israel cohort, including adjusted hazard ratios (aHRs) of 1.51 (95% CI 1.20, 1.90) for oxytocin augmented births and 2.18 (95% CI 1.32, 3.57) for those induced by means other than oxytocin and not augmented. However, oxytocin induction was not significantly associated with ASD in the Israel cohort. In the Canadian cohort, there were no statistically significant aHRs. Further, no significant sex differences were observed in the fully adjusted models. CONCLUSIONS: This study provides support that induction of labor through oxytocin administration does not increase the risk of ASD in the child. Our international comparison of two countries with differences in clinical practice regarding oxytocin administration for induction and/or augmentation suggests that previous studies reporting a significant association were likely confounded by the underlying indication for the induction.

Lien vers le texte intégral (Open Access ou abonnement)

5. Khoodoruth MAS, Khoodoruth WNC, Ramadan AAM, Johnson B, Gulistan S, Deluvio RBC, Alamri MN, Al-Abdulla M, Ouanes S, Khan YS. Evaluating COVID-19 vaccination intentions and vaccine hesitancy among parents of children with autism spectrum disorder. Sci Rep;2023 (May 5);13(1):7353.

As the global vaccination mass campaign against COVID-19 extended to children aged 5 to 11 years, some parents remained hesitant about their children being administered the vaccine despite data supporting its safety. Parent vaccine hesitancy (PVH) may have predisposed certain groups of children, particularly those with autism spectrum disorder (ASD), to COVID-19 when other neurotypical children would have been vaccinated. We investigated the current PVH in 243 parents of children with ASD and 245 controls using the Parent Attitudes about Childhood Vaccines (PACV) scale. The study was conducted in Qatar from May to October 2022. Overall, 15.0% [95% CI 11.7%; 18.3%] of parents were vaccine-hesitant, with no difference (p = 0.054) between groups (ASD children [18.2%] vs. controls [11.7%]). The only sociodemographic factor associated with higher vaccine hesitancy was being a mother (as compared to being a father). The COVID-19 vaccine receipt rate at the time of the study did not differ between ASD (24.3%) and non-ASD groups (27.8%). Around two-thirds of parents of children with ASD refused or were unsure about vaccinating their children against COVID-19. We found that the intent to vaccinate against COVID-19 was higher in parents who were married and in those with a lower PACV total score. Continued public health efforts are needed to address vaccine hesitancy among parents.

Lien vers le texte intégral (Open Access ou abonnement)

6. Opoku MP, Anwahi N, Belbase S, Shah H, Alkateri T, Moustafa A. Accessibility of nutritional services for children with autism spectrum disorder in the United Arab Emirates: Insights from special education teachers and parents. Res Dev Disabil;2023 (May 4);138:104521.

BACKGROUND: Goal 2 of United Nation’s Sustainable Development Goals exhorts countries to provide guidelines on better nutrition for all children. In response, the United Arab Emirates (UAE) government designed a national nutrition framework to encourage better eating habits. However, large body of literature has reported that children with ASD are at high risks of malnutrition and poor eating habits. Yet, in the UAE and other contexts, there is limited research on accessibility of nutritional services to adults in the lives of children with ASD. AIMS: As parents and teachers spend the most time with children with ASD, this study sought to understand their perceptions of the availability of nutritional services for such children in the UAE. METHOD AND PROCEDURES: Penchansky and Thomas’ (1981) health access theory served as the theoretical framework; its five tenets (geography, finance, accommodation, resources and acceptability) informed the design of a semi-structured interview guide. Data were collected from 21 participants, comprising 6 parents and 15 teachers of children with ASD. OUTCOMES AND RESULTS: Thematic analysis revealed that participants perceived accommodation, acceptability, and human resource availability as barriers to accessibility. However, geographical and financial accessibility were not identified as challenges. CONCLUSIONS AND IMPLICATIONS: The study calls for health policymakers to formalise nutritional services as an integrated part of the UAE health system, while also extending services to children with ASD. CONTRIBUTION: This study makes a substantial contribution to the literature. First, it addresses the needs for nutritional services for children with ASD. There is a limited body of knowledge on whether children with ASD have access to the requisite nutrition for development This study sheds light on an area that has received limited scholarly insight. Second, it adds to the usage of health access theory in studies on nutritional services for children with ASD.

Lien vers le texte intégral (Open Access ou abonnement)

7. Paasch V, Doucoure A, Bifano M, Smith-Hicks CL. An exploratory study of sleep quality and quantity in children with causal variants in SYNGAP1, an autism risk gene. Sleep Med;2023 (Apr 20);107:101-107.

STUDY OBJECTIVES: Sleep disturbances are reported in 62% of children with SYNGAP1-Intellectual Disability (SYNGAP1-ID), a rare neurodevelopmental disorder characterized by intellectual disability, epilepsy, autism spectrum disorder (ASD), sensory and behavioral challenges. Although Children’s Sleep Habits Questionnaire (CSHQ) scores are elevated in children with SYNGAP1-ID factors that predict sleep disturbance are not well understood. The goal of this study is to identify predictors of sleep problems. METHODS: Parents of 21 children with SYNGAP1-ID completed questionnaires, and 6 children wore the Actiwatch2 for 14 continuous days. Non-parametric analysis of psychometric scales and actigraphy data were performed. Actigraphy derived sleep parameters were compared to controls and rest activity rhythms were assessed using arctools an open-source R package. RESULTS: CSHQ total sleep scores in children with SYNGAP1-ID and ASD were not different from children with SYNGAP1 without ASD (p = 0.61). Sleep anxiety (β 1.646, 95% CI 0.9566 to 2.336) and parasomnias (β 0.6294, 95% CI 0.06423 to 1.195) were strong predictors of bedtime resistance (R(2) = 0.767, p < 0.001). The sedentary to active transition probability during the 12-18 h epoch (β = 0.004, p = 0.008, R(2) = 0.85) and the duration of the active bout during the 18-24 h epoch (β = 0.166, p = 0.029, R(2) = 0.74) were strong predictors of total sleep disturbance. CONCLUSION: The CSHQ may be a reliable measure of sleep difficulties in children with SYNGAP1-ID. Sleep anxiety, parasomnias and difficulty winding-down are significant contributors to sleep disturbances.

Lien vers le texte intégral (Open Access ou abonnement)

8. Vandana P, Simkin DR, Hendren RL, Arnold LE. Autism Spectrum Disorder and Complementary-Integrative Medicine. Child Adolesc Psychiatr Clin N Am;2023 (Apr);32(2):469-494.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects 0.6%-1.7% of children. The etiology of autism is hypothesized to include both biological and environmental factors (Watts, 2008). In addition to the core symptoms of social-communication delay and restricted, repetitive interests, co-occurring irritability/aggression, hyperactivity, and insomnia negatively impact adaptive functioning and quality of life of patients and families. Despite years of effort, no pharmacologic agent has been found that targets the core symptoms of ASD. The only FDA-approved agents are risperidone and aripiprazole for agitation and irritability in ASD, not for core symptoms. Though they effectively reduce irritability/violence, they do so at the expense of problematic side effects: metabolic syndrome, elevated liver enzymes, and extrapyramidal side effects. Thus, it is not surprising that many families of children with ASD turn to nonallopathic treatment, including dietary interventions, vitamins, and immunomodulatory agents subsumed under complementary-integrative medicine (CIM). Per recent studies, 27% to 88% of families report using a CIM treatment. In an extensive population-based survey of CIM, families of children with more severe ASD, comorbid irritability, GI symptoms, food allergies, seizures, and higher parental education tend to use CIM at higher rates. The perceived safety of CIM treatments as « natural treatment » over allopathic medication increases parental comfort in using these agents. The most frequently used CIM treatments include multivitamins, an elimination diet, and Methyl B12 injections. Those perceived most effective are sensory integration, melatonin, and antifungals. Practitioners working with these families should improve their knowledge about CIM as parents currently perceive little interest in and poor knowledge of CIM by physicians. This article reviews the most popular complementary treatments preferred by families with children with autism. With many of them having limited or poor quality data, clinical recommendations about the efficacy and safety of each treatment are discussed using the SECS versus RUDE criteria.

Lien vers le texte intégral (Open Access ou abonnement)

9. Zhang J, Fang S, Yao Y, Li F, Luo Q. Parsing the heterogeneity of brain-symptom associations in autism spectrum disorder via random forest with homogeneous canonical correlation. J Affect Disord;2023 (May 6)

BACKGROUND: Autism spectrum disorder (ASD) is a highly heterogeneous developmental disorder, but the neuroimaging substrates of its heterogeneity remain unknown. The difficulty lies mainly on the significant individual variability in the brain-symptom association. METHODS: T1-weighted magnetic resonance imaging data from the Autism Brain Imaging Database Exchange (ABIDE) (N(TDC) = 1146) were used to generate a normative model to map brain structure deviations of cases (N(ASD) = 571). Voxel-based morphometry (VBM) was used to compute gray matter volume (GMV). Singular Value Decomposition (SVD) was employed to perform dimensionality reduction. A tree-based algorithm was proposed to identify the ASD subtypes according to the pattern of brain-symptom association as assessed by a homogeneous canonical correlation. RESULTS: We identified 4 ASD subtypes with distinct association patterns between residual volumes and a social symptom score. More severe the social symptom was associated with greater GMVs in both the frontoparietal regions for the subtype1 (r = 0.29-0.44) and the ventral visual pathway for the subtype3 (r = 0.19-0.23), but lower GMVs in both the right anterior cingulate cortex for the subtype4 (r = -0.25) and a few subcortical regions for the subtype2 (r = -0.31-0.20). The subtyping significantly improved the classification accuracy between cases and controls from 0.64 to 0.75 (p < 0.05, permutation test), which was also better than the accuracy of 0.68 achieved by the k-means-based subtyping (p < 0.01). LIMITATIONS: Sample size limited the study due to the missing data. CONCLUSIONS: These findings suggest that the heterogeneity of ASD might reflect changes in different subsystems of the social brain, especially including social attention, motivation, perceiving and evaluation.

Lien vers le texte intégral (Open Access ou abonnement)