1. Allely CS, Cooper P. {{Jurors’ and Judges’ Evaluation of Defendants with Autism and the Impact on Sentencing: A Systematic Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Review of Autism Spectrum Disorder in the Courtroom}}. {Journal of law and medicine}. 2017; 25(1): 105-23.
Concern has been highlighted in the literature regarding how juries and judges handle cases which involve a defendant with autism spectrum disorder (ASD). The relatively little research on judicial perceptions or decision-making regarding individuals with ASD indicates that judges have limited understanding and familiarity with high-functioning ASD (hfASD) and ASD. The present systematic review will identify studies which investigate jurors’ (eg using mock jurors) and/or judges’ evaluations of defendants with ASD and studies which investigate whether the defendant diagnosis of ASD impacts on sentencing. Only four studies were identified which investigated jurors’ and/or judges’ evaluations of a defendant with an ASD or investigated whether the defendant diagnosis of ASD impacts on sentencing. Further research is recommended which should include an evaluation of cases involving a defendant with an hfASD or ASD diagnosis comparing charges, pleas entered, procedural adjustments at court, evidence adduced about the defendant’s condition, directions to juries, judicial remarks on the evidence (eg summing-up for the jury), verdicts and sentencing. This would enable the assessment of the specific offending behaviour and disorder of the defendant, and how these may be relevant to their mental capacity and culpability.
2. Cai RY, Richdale AL, Uljarevic M, Dissanayake C, Samson AC. {{Emotion regulation in autism spectrum disorder: Where we are and where we need to go}}. {Autism Res}. 2018.
Emotion dysregulation is a common issue experienced by individuals with autism spectrum disorder (ASD) and has been associated with a wide range of negative mental and physical health outcomes. This commentary highlights the role emotion dysregulation plays in ASD by first considering the literature on emotion regulation (ER) in the general population and then summarizing the ER research in ASD. Based on the evaluation of previous research findings, we conclude that individuals with ASD have more ER difficulties and consistently self-report or demonstrate a less adaptive pattern of ER strategy use. In addition, the higher prevalence of internalizing and externalizing issues seen in ASD are associated with the greater habitual use of some ER strategies and less habitual use of others. Conceptual and methodological limitations are discussed, including the use of coping measures and single-method approaches, and ASD gender distribution. We propose a set of new directions for investigating ER in ASD, incorporating knowledge from other literatures on the role of flexibility in healthy adaptation, overlaps between flexibility and executive function deficits, the adaptive value of up-regulation of positive emotions, and the importance of emotional self-awareness. Increasing our capacity for identifying the mechanisms underlying co-morbid affective disorders can ultimately inform the design of effective interventions to maximize the wellbeing of individuals with ASD. Autism Res 2018. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Research has shown that people diagnosed with autism tend to have difficulties with regulating their own emotions. This commentary article summarizes the main information from emotion regulation research conducted both in autism and in other populations. We make suggestions on how we can improve emotion regulation research in autism, with the ultimate goal being to use the learning gained from research to design effective interventions that can improve the wellbeing of people with autism.
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3. Derguy C, Roux S, Portex M, M’Bailara K. {{An ecological exploration of individual, family, and environmental contributions to parental quality of life in autism}}. {Psychiatry Res}. 2018; 268: 87-93.
The aim of this study was to assess the respective weight of individual and environmental factors on quality of life (Qol) of parents of children with autism spectrum disorders (ASD). Few studies have investigated both individual and environmental predictors of Qol but to our knowledge, none of them has considered the child’s and parents’ characteristics, family context and services available in the same design. Participants were 115 parents (73 mothers and 42 fathers) of children with ASD aged from 3 to 10 years. Hierarchical regression analyses were conducted to investigate predictors of parental Qol among child-related, parent-related and environmental factors. Findings indicate that a higher Qol is associated with a good quality of interaction in marital and parent-grandparents dyads, no family medical history and access to psycho-educational interventions for the child, regardless of child’s developmental quotient, comorbidity, parent sex and working time. This final model best fits the data and explains 31.5% of the variance of parents’ Qol. This study highlights that it is crucial to consider both individual and environmental variables as potential protective factors of parental adjustment. An ecological approach seems to be relevant to understand which parenting resources should be targeted in support programs.
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4. Hoofs V, Princen MM, Poljac E, Stolk A, Poljac E. {{Task switching in autism: An EEG study on intentions and actions}}. {Neuropsychologia}. 2018; 117: 398-407.
One of the main symptoms of Autism Spectrum Conditions (ASC) is experiencing cognitive inflexibility when adjustments of behaviour are required. While this so-called behavioural rigidity is broadly recognised in ASC, finding evidence for the underlying neurocognitive mechanisms remains challenging. In this electroencephalographic (EEG) study, participants with ASC and matched controls were instructed to choose between two cognitive tasks in each trial, and to respond to the subsequently presented target stimulus according to their task choice. While doing so, we tracked the frontally distributed contingent negative variation (CNV) during the task preparation interval as a measure of intentional control, and the posteriorly measured P3 during the task execution interval to monitor the translation of intentions into actions. The results support the notion of intentional control difficulties in ASC, where the CNV was attenuated in the ASC group compared to the control group. Furthermore, the CNV was differentiated between the tasks and transition types in the control group only, suggesting that the ASC group was less fine-tuning the required amount of intentional control to contextual circumstances. In contrast, the P3 showed no significant differences between the groups. Together, these findings highlight the importance of intentional control mechanisms as a crucial future route for a better understanding of cognitive flexibility and behavioural rigidity in ASC.
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5. Locke J, Anderson A, Frederick L, Kasari C. {{Understanding Friendship Sex Heterophily and Relational Characteristics to Optimize the Selection of Peer Models for Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2018.
This study used social network analysis to evaluate whether sex heterophily, the degree to which peers are different in sex, between 126 children with autism (ages 5-12 years) and their peers affected social network connectivity. Results indicate that: (1) the quantity and sex of friends were more important in predicting social network connectivity than the relational characteristics of the friends (friendship nominations and social network salience/popularity); and (2) sex heterophily is an important factor in predicting social network connectivity. For males with autism, having friends of the same sex was associated with better social network connectivity; this was not true for females with autism. These findings have important implications for the selection of peer models for elementary-aged children with autism.
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6. McChesney G, Toseeb U. {{Happiness, self-esteem, and prosociality in children with and without autism spectrum disorder: Evidence from a UK population cohort study}}. {Autism Res}. 2018.
High levels of childhood happiness, self-esteem, and prosociality are associated with positive social and emotional outcomes. Little is known about whether these constructs co-occur and how levels of co-occurrence are different in children with or without Autism Spectrum Disorder (ASD). Data was obtained from 13,285 11-year olds (408 with ASD) from a UK based prospective cohort study. Latent class analysis revealed five distinct classes: The « very low prosociality class » (with ASD 32% vs. without ASD 7%) was characterized by children who were happy and had high self-esteem but they were not prosocial. The « low happiness class » (with ASD 3% vs. without ASD 3%), included those children who had moderate self-esteem and were prosocial but were the least happy. Children in the « low to moderate positive functioning class » (with ASD 16% vs. without ASD 6%) were moderately happy and had the lowest self-esteem but were prosocial. The « moderate to high positive functioning class » (with ASD 17% vs. without ASD 23%) was characterized by children who were happy, had moderate self-esteem, and were very prosocial. The majority of children were in the « optimum class » (with ASD 31% vs. without ASD 62%), and were very happy, very prosocial with high self-esteem. Our findings demonstrate that for the majority of children in our sample, happiness, self-esteem, and prosociality co-occur. Furthermore, although as a group children with ASD have lower levels of positive functioning, our multivariable latent class approach suggests that nearly half of children with ASD are happy, have good levels self-esteem, and are prosocial. Autism Res 2018. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: High levels of childhood happiness, self-esteem, and prosociality are associated with positive social and emotional outcomes. In this study, we investigated whether happiness, self-esteem and prosociality co-occur in children, and how possible co-occurrence differs between those with and without Autism Spectrum Disorder. We found that for the majority of children happiness, self-esteem, and prosociality co-occur. Furthermore, although as a group children with ASD have lower levels of positive functioning, our findings suggest that nearly half of children with ASD are happy, have good levels of self-esteem, and are prosocial.
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7. Rogozin IB, Gertz EM, Baranov P, Poliakov E, Schaffer AA. {{Genome-wide changes in protein translation efficiency are associated with autism}}. {Genome biology and evolution}. 2018.
We previously proposed that changes in the efficiency of protein translation are associated with autism spectrum disorders (ASDs). This hypothesis connects environmental factors and genetic factors because each can alter translation efficiency. For genetic factors, we previously tested our hypothesis using a small set of ASD-associated genes, a small set of ASD-associated variants, and a statistic to quantify by how much a single nucleotide variant (SNV) in a protein coding region changes translation speed. In this study, we confirm and extend our hypothesis using a published set of 1800 autism quartets (parents, one affected child and one unaffected child) and genome-wide variants. Then, we extend the test statistic to combine translation efficiency with other possibly relevant variables: ribosome profiling data, presence/absence of CpG dinucleotides, and phylogenetic conservation. The inclusion of ribosome profiling abundances strengthens our results for male-male sibling pairs. The inclusion of CpG information strengthens our results for female-female pairs, giving an insight into the significant gender differences in autism incidence. By combining the single-variant test statistic for all variants in a gene, we obtain a single gene score to evaluate how well a gene distinguishes between affected and unaffected siblings. Using statistical methods, we compute gene sets that have some power to distinguish between affected and unaffected siblings by translation efficiency of gene variants. Pathway and enrichment analysis of those gene sets suggest the importance of Wnt signaling pathways, some other pathways related to cancer, ATP binding, and ATP-ase pathways in the etiology of ASDs.
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8. Steward R, Crane L, Mairi Roy E, Remington A, Pellicano E. {{« Life is Much More Difficult to Manage During Periods »: Autistic Experiences of Menstruation}}. {J Autism Dev Disord}. 2018.
Although menarche and menstruation are perceived to be overwhelmingly negative events for developmentally-disabled women, women’s health issues remain under-researched in autism. Here, we conducted a preliminary investigation of the experiences of post-menarcheal autistic (n = 123) and non-autistic (n = 114) respondents to a brief online survey. Although autistic respondents reported many overlapping issues and experiences with non-autistic respondents, they also highlighted distinct-and sometimes-distressing-issues relating to menstruation, especially a cyclical amplification of autistic-related challenges, including sensory differences and difficulties with regulating emotion and behavior, which had a significant, negative impact on their lives. These initial findings call for systematic research on the potential causes, correlates and consequences of menstrual-related problems in autistic individuals-across the spectrum and the lifespan.
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9. Tian Y, Bai B, Zhang J, Li H. {{[Difference in Perioperative Management for Patients with and without Autism Spectrum Disorders undergoing General Anesthesia]}}. {Zhongguo yi xue ke xue yuan xue bao Acta Academiae Medicinae Sinicae}. 2018; 40(3): 365-72.
Objective To compare the difference in perioperative management for patients with or without autism spectrum disorders(ASD) undergoing general anesthesia. Methods We retrospectively analyzed the clinical data of 10 ASD patients(case group) and 10 non-ASD patients(control group) undergoing general anesthesia from January 2013 to February 2018. Both groups were matched by age,gender,and surgical procedures. The induction mode,premedication patterns,narcotic drugs,time to wake up,post-anesthesia care unit(PACU) stay,and perioperative vital signs were compared. Results The main induction mode was combined intravenous and inhaled anesthesia(CIIA) in case group(6/10) and total intravenous anesthesia(TIVA) in control group(10/10)(chi(2)=8.571,P=0.003). The wake-up time are significantly longer in case group[(36.0+/-10.7) min] than in control group [(22.7+/-6.6)min] (t=18.000,P=0.005). Case group [(12.7+/-6.7)min] needed more time to obtain first vital sign than control group[(6.7+/-3.3)min](t=23.000,P=0.038). There were also significant differences in first systolic blood pressure (SBP)(t=15.500,P=0.007),preinductive SBP(t=24.000,P=0.048),and heart rate(t=22.000,P=0.033) between two groups. Conclusion Compared with non-ASD patients,ASD patients tend to use CIIA as the induction mode,have longer wake up time and later vital sign record,and are more likely to have peri-inductive vital signs.
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10. Van Cleave J, Holifield C, Neumeyer AM, Perrin JM, Powers E, Van L, Kuhlthau KA. {{Expanding the Capacity of Primary Care to Treat Co-morbidities in Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2018.
We examined barriers and facilitators to expanding primary care’s capacity to manage conditions associated with autism spectrum disorder (ASD). We conducted semi-structured interviews with specialists, primary care providers (PCPs), primary care staff, and parents of children with ASD, discussing health/behavior problems encountered, co-management, and patient/family experience. Participants endorsed primary care as the right place for ASD-associated conditions. Specialists advising PCPs, in lieu of referrals, efficiently uses their expertise. PCPs’ ability to manage ASD-associated conditions hinged on how behavioral aspects of ASD affected care delivery. Practices lacked ASD-specific policies but made individual-level accommodations and broader improvements benefitting children with ASD. Enhancing access to specialty expertise, particularly around ASD-associated behaviors, and building on current quality improvements appear important to expanding primary care.
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11. Vats P, Juneja M, Mishra D. {{Diagnostic Accuracy of International Epidemiology Network (INCLEN) Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD) in Comparison with Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)}}. {Indian pediatrics}. 2018; 55(6): 482-4.
OBJECTIVE: To compare the diagnostic accuracy of INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD) against Diagnostic and Statistical Manual of Mental Disorders – 5 (DSM-5) for the diagnosis of Autism Spectrum Disorder (ASD). METHODS: 118 children aged 2-9 years with symptoms suggestive of ASD were assessed by INDT-ASD and DSM-V by trained personnel. ASD diagnosis by INDT-ASD was compared against the expert’s DSM-5 diagnosis. RESULTS: INDT-ASD had a sensitivity and specificity of 100% and 75%, respectively against DSM-5 for the diagnosis of ASD; specificity for Autistic Disorder was 87%. CONCLUSION: The INDT-ASD has a good sensitivity and specificity against DSM-5, and can continue to be used for the diagnosis of ASD even after the adoption of DSM-5 criteria.
12. Wannenburg N, van Niekerk R. {{Early diagnosis and intervention for autism spectrum disorder in Africa: insights from a case study}}. {African health sciences}. 2018; 18(1): 137-46.
Background: Globally the prevalence of autism spectrum disorder (ASD) has become more apparent. Prevalence on the African continent remains unknown. There is a call for further research into ASD in Africa as well as means to make early diagnosis and intervention possible. Objectives: The study aimed to raise awareness about ASD in Africa and encourage dialogue on possible intervention strategies for ASD in low resource settings. Methods: This was a qualitative mixed method case study. Literature regarding ASD in Africa was reviewed in order to provide context for the research and facilitate data reduction of the case study of Temple Grandin. The case study was conducted through a psychobiographical approach using Erikson’s (1950/1973) theory of psychosocial development to interpret the life of Temple Grandin. The findings underwent further data reduction in order to focus on possible interventions for ASD. Results: Four primary interventions were found to be useful in facilitating development in an individual with ASD. Namely; speech therapy, creative endeavours, animals (human-animal interaction), and being mentored. Conclusion: Undiagnosed and untreated cases of ASD place undue psychosocial and economic burden on families and communities. Government support, by including ASD in health policies, is essential. Through creative adaptation of knowledge, communities may provide a valuable resource to ASD intervention strategies.
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13. Wei HT, Hsu JW, Huang KL, Bai YM, Su TP, Li CT, Lin WC, Tsai SJ, Pan TL, Chen TJ, Chen MH. {{Timing of the Diagnoses of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Taiwan}}. {J Autism Dev Disord}. 2018.
ADHD comorbidity has been associated with delayed diagnosis of ASD, but no study has investigated this association in an Asian country. Children with ASD were included and divided into three groups: ADHD before ASD, ADHD same/after ASD, and ASD only. Timing of ASD and ADHD diagnoses were assessed. The logistic regression model was performed to investigate the likelihood of being diagnosed with ASD after 6 years of age between three groups. ADHD before ASD (OR 10.93) group was more likely to being diagnosed with ASD after 6 years of age compared with ADHD same/after ASD (OR: 1.37) and ASD only groups. ADHD comorbidity would delay the diagnosis of ASD in the general clinical settings in Taiwan.
