1. Chlebowski C, Green JA, Barton ML, Fein D. {{Using the Childhood Autism Rating Scale to Diagnose Autism Spectrum Disorders}}. {J Autism Dev Disord}. Jan 7.
This study investigated the childhood autism rating scale (CARS) as a tool for ASD diagnoses for 2-year-old (n = 376) and 4-year-old (n = 230) children referred for possible autism. The cut-off score to distinguish autistic disorder from PDD-NOS was 32 in the 2-year-old sample (consistent with Lord in J Child Psychol Psychiatry Allied Discipl, 36, 1365-1382, 1995), and 30 in the 4-year-old sample, with good sensitivity and specificity at both ages. The cut-off score to distinguish ASD from non-ASD at both ages was 25.5, with good sensitivity and specificity. Results confirm the utility of the CARS in distinguishing autistic disorder from PDD-NOS, and distinguishing ASD from other developmental disorders and typical development and suggest that an ASD cutoff around 25, which is in common clinical use, is valid.
2. Dias GG, Prado EF, Vadasz E, Siqueira JT. {{Evaluation of the Efficacy of a Dental Plaque Control Program in Autistic Patients}}. {J Autism Dev Disord}. Jan 6.
The aim of this study was to verify the efficacy of a programme for dental plaque control in autistics. Patients were evaluated on five occasions over a period of 180 days using the following instruments: OHI-S, DMF-T, the Fonnes brushing technique and diet questionnaire. Participants were divided into two groups according to level of co-operation on the programme: Group A (co-operative) and Group B (non-cooperative). A statistically significant improvement (p < 0.001) in Oral Hygiene was attained, with 84.2% showing regular or satisfactory hygiene at study end-point. Conclusion: Groups A and B both showed improvement in hygiene (p < 0.001 and p = 0.004), but improvement was significantly higher among co-operative patients (p < 0.001 at 180 days), who also had a higher mean age (p = 0.02).
3. Gold R, Faust M. {{Right Hemisphere Dysfunction and Metaphor Comprehension in Young Adults with Asperger Syndrome}}. {J Autism Dev Disord}. Jan 7.
This study examined whether the known difficulties in metaphor comprehension exhibited by persons with Asperger syndrome (AS) can be explained by a dysfunctional right hemisphere (RH). Using the divided visual field paradigm, 27 AS participants and 36 matched controls were presented with word pairs of four types (literal, conventional metaphors, novel metaphors, and unrelated word pairs), and were asked to perform a semantic judgment task. The main hypothesis was that whereas the control group participants will show RH superiority for novel metaphor processing, no RH superiority will be found in the AS group. Results indeed indicate much less RH contribution to novel metaphor comprehension in AS, and are discussed in light of linguistic models and the neurobiology of autism.
4. Kokina A, Kern L. {{Social Story Interventions for Students with Autism Spectrum Disorders: A Meta-Analysis}}. {J Autism Dev Disord}. Jan 7.
A meta-analysis of single-subject research was conducted, examining the use of Social Stories and the role of a comprehensive set of moderator variables (intervention and participant characteristics) on intervention outcomes. While Social Stories had low to questionable overall effectiveness, they were more effective when addressing inappropriate behaviors than when teaching social skills. Social Stories also seemed to be associated with improved outcomes when used in general education settings and with target children as their own intervention agents. The role of other variables of interest, such as participants’ age, diagnosis, and skill development, the format of Social Stories, the length of the intervention, and the use of assessment (e.g., comprehension checks) also was explored.
5. Larson T, Anckarsater H, Gillberg C, Stahlberg O, Carlstrom E, Kadesjo B, et al. {{Screening for autism and AD/HD. The A-TAC: further validation of a telephone interview in clinical and population samples}}. {BMC Psychiatry}. Jan 7;10(1):1.
ABSTRACT: BACKGROUND: Reliable, valid, and easy-to-administer instruments to identify possible caseness and to provide proxies for clinical diagnoses are needed in epidemiological research on child and adolescent mental health. The aim of this study is to provide further validity data for a parent telephone interview focused on Autism – Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC), for which reliability and preliminary validation data have been previously reported. METHODS: Parents of 91 children clinically diagnosed at a specialized Child Neuropsychiatric Clinic, 366 control children and 319 children for whom clinical diagnoses had been previously assigned were interviewed by the A-TAC over the phone. Interviewers were blind to clinical information. Different scores from the A-TAC were compared to the diagnostic outcome. RESULTS: Areas under ROC curves for interview scores as predictors of clinical diagnoses were around 0.95 for most disorders, including autism spectrum disorders (ASDs), attention deficit/hyperactivity disorder (AD/HD), tic disorders, developmental coordination disorders (DCD) and learning disorders, indicating excellent screening properties. Screening cut-off scores with sensitivities above 0.90 (0.95 for ASD and AD/HD) were established for most conditions, as well as cut-off scores to identify proxies to clinical diagnoses with specificities above 0.90 (0.95 for ASD and AD/HD). CONCLUSIONS: The previously reported validity of the A-TAC was supported by this larger replication study using broader scales from the A-TAC-items and a larger number of diagnostic categories. Short versions of algorithms worked as well as larger. Different cut-off levels for screening versus identifying proxies for clinical diagnoses are warranted. Data on the validity for mood problems and oppositional defiant/conduct problems are still lacking. Although the A-TAC is principally intended for epidemiological research and general investigations, the instrument may be useful as a tool to collect information in clinical practice as well.
6. Sen B, Surindro Singh A, Sinha S, Chatterjee A, Ahmed S, Ghosh S, et al. {{Family-based studies indicate association of Engrailed 2 gene with autism in an Indian population}}. {Genes Brain Behav}. 2009 Nov 24.
Engrailed 2 (EN2) is a homeobox transcription factor involved in the patterning of cerebellum during brain development. Linkage analysis and studies on knockout mice support EN2, located on chromosome 7q36.3, as a potential risk locus for autism. Candidate gene approach also suggested association of EN2 with autism spectrum disorder (ASD) in various populations. Here, we have investigated the association of five markers [rs3735653 (C/T) in exon 1; rs34808376 (GC/-) and rs6150410 (CGCATCCCC/-) in promoter region; rs1861972 (A/G) and rs1861973 (C/T) in the intron] of the gene with autism and ASD in Indian population using family-based approach. Probands have been recruited using Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) diagnostic criteria. Genotypic distributions conform to Hardy-Weinberg equilibrium. Genotyping analysis showed that the intronic single nucleotide polymorphisms (SNPs) are in complete linkage disequilibrium showing A-C and corresponding G-T allelic association. We observed significant preferential transmission of C allele of rs1861973 from the parents to affected offspring [transmission disequilibrium test (TDT): narrow diagnosis likelihood ratio statistics (LRS) = 6.63, P = 0.006; broad diagnosis LRS = 4.47, P = 0.05]. Interestingly, gender-based investigations showed significant transmission of C allele to the affected females [TDT: LRS = 7.36, P = 0.0025; haplotype-based haplotype relative risk (HHRR): LRS = 7.16, P = 0.02]. A maternal overtransmission for these alleles was also noted (TDT: LRS = 3.65, P = 0.036; HHRR: LRS = 2.81, P = 0.036). Bioinformatic analysis using TFSearch showed generation of Sp1 binding site in the presence of C allele. While Del-T haplotype formed from rs34808376-rs1861973 markers showed increased non-transmission, the Ins-C showed significant transmission suggesting protective effect and risk, respectively, conferred by these haplotypes in autism etiology. These results suggest positive genetic correlation of EN2 with autism in the Indian population.
