1. Avirame K, Stehberg J, Todder D. {{Enhanced cognition and emotional recognition, and reduced obsessive compulsive symptoms in two adults with high-functioning autism as a result of deep Transcranial Magnetic Stimulation (dTMS): a case report}}. {Neurocase};2017 (Aug 08):1-6.
We report reduced repetitive behaviors similar to obsessive compulsive disorder and improved emotional recognition and cognitive abilities in two young patients diagnosed with high-functioning Autism as a result of deep transcranial magnetic stimulation (dTMS). The patients received daily high-frequency (5 Hz) dTMS with HAUT-coil over the medial prefrontal cortex for a period of 5-6 weeks. A computerized cognitive battery, tasks for testing emotional recognition, and clinical questionnaires were used to measure the effects of treatment. TMS might have modulated networks related to metalizing abilities and self-referential processes since both patients reported improved sociability and communication skills.
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2. Bieleninik L, Geretsegger M, Mossler K, Assmus J, Thompson G, Gattino G, Elefant C, Gottfried T, Igliozzi R, Muratori F, Suvini F, Kim J, Crawford MJ, Odell-Miller H, Oldfield A, Casey O, Finnemann J, Carpente J, Park AL, Grossi E, Gold C. {{Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder: The TIME-A Randomized Clinical Trial}}. {Jama};2017 (Aug 08);318(6):525-535.
Importance: Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. Objective: To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. Design, Setting, and Participants: Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. Interventions: Enhanced standard care (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents’ concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child’s focus of attention, to help children develop affect sharing and joint attention. Main Outcomes and Measures: The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. Results: Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, -0.70 to 0.81]; P = .88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. Conclusions and Relevance: Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. Trial Registration: isrctn.org Identifier: ISRCTN78923965.
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3. Bienkowski RS, Banerjee A, Rounds JC, Rha J, Omotade OF, Gross C, Morris KJ, Leung SW, Pak C, Jones SK, Santoro MR, Warren ST, Zheng JQ, Bassell GJ, Corbett AH, Moberg KH. {{The Conserved, Disease-Associated RNA Binding Protein dNab2 Interacts with the Fragile X Protein Ortholog in Drosophila Neurons}}. {Cell Rep};2017 (Aug 08);20(6):1372-1384.
The Drosophila dNab2 protein is an ortholog of human ZC3H14, a poly(A) RNA binding protein required for intellectual function. dNab2 supports memory and axon projection, but its molecular role in neurons is undefined. Here, we present a network of interactions that links dNab2 to cytoplasmic control of neuronal mRNAs in conjunction with the fragile X protein ortholog dFMRP. dNab2 and dfmr1 interact genetically in control of neurodevelopment and olfactory memory, and their encoded proteins co-localize in puncta within neuronal processes. dNab2 regulates CaMKII, but not futsch, implying a selective role in control of dFMRP-bound transcripts. Reciprocally, dFMRP and vertebrate FMRP restrict mRNA poly(A) tail length, similar to dNab2/ZC3H14. Parallel studies of murine hippocampal neurons indicate that ZC3H14 is also a cytoplasmic regulator of neuronal mRNAs. Altogether, these findings suggest that dNab2 represses expression of a subset of dFMRP-target mRNAs, which could underlie brain-specific defects in patients lacking ZC3H14.
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4. Broder-Fingert S, Feinberg E, Silverstein M. {{Music Therapy for Children With Autism Spectrum Disorder}}. {Jama};2017 (Aug 08);318(6):523-524.
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5. Fedor J, Lynn A, Foran W, DiCicco-Bloom J, Luna B, O’Hearn K. {{Patterns of fixation during face recognition: Differences in autism across age}}. {Autism};2017 (Aug 01):1362361317714989.
Difficulties with face recognition increase from adolescence to adulthood in autism, reflecting a lack of typical late development. We examined whether this reflects differences in the development of patterns of fixation to eyes and mouths during face recognition. Children, adolescents, and adults (aged 7-30) with and without autism completed the Cambridge Face Memory Test while gaze was recorded. Average duration and number of fixations were calculated for eyes and mouth regions of interest, defined individually for each face image in the task. All groups and age groups made more and longer fixations to eyes than mouths. However, during face memorization, typically developing children and adults, but not adolescents, made more fixations to eyes than did their peers with autism. During face recognition, typically developing children and adults made shorter fixations on mouths than did their peers with autism; this pattern was reversed in adolescence, with adolescents with autism making more fixations to mouths than typically developing adolescents. Results suggest that group differences in patterns of fixations to faces change with age. Furthermore, different relationships between patterns of fixations and face recognition performance in typical development and autism suggest that these differences contribute, at least in part, to difficulties in autism.
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6. Garg P, Haynes N, De Lima J, Collins JJ. {{Profile of children with developmental disabilities attending a complex pain clinic of a children’s hospital in Australia}}. {J Paediatr Child Health};2017 (Aug 08)
AIM: To document the profile and management of children with developmental disabilities (DD) attending an outpatient complex pain clinic at a Children’s Hospital in Sydney, Australia. METHODS: Children with DD from 2011 to 2014 were identified from a clinic database, and pain relevant data was collected. RESULTS: A total of 107 (19.6%) of 544 children were identified with DD, and accounted for one-third of clinic attendances. The median age was 14 years (interquartile range: 11-16) and females were slightly over-represented (62, 57.9%). About one-third of children had cerebral palsy (CP) from a variety of prenatal, natal and post-neonatal causes. The lower limb was the most common site for pain in children with CP, while back pain was more frequent in children with other disabilities. Comorbid emotional disorders were significantly associated with the non-CP disabilities. Children who required more than four clinic attendances were more likely to have comorbid anxiety/depression and to be reviewed by multiple specialists. CONCLUSIONS: Long-term persistent pain in children with DD forms a significant cohort of children requiring tertiary level paediatric pain services. Multisystem comorbidities and emotional disorders predict greater service utilisation. Further research into the effectiveness of multidisciplinary pain teams and interventions in this cohort of children is required.
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7. Kuhfeld M, Sturm A. {{An Examination of the Precision of the Autism Diagnostic Observation Schedule Using Item Response Theory}}. {Psychol Assess};2017 (Aug 07)
The current study examined the reliability of the Autism Diagnostic Observation Schedule (ADOS) across the continuum of severity of autism spectrum disorder (ASD) core deficits. Modules 3 and 4 of the ADOS assess the deficits of ASD in 2 core domains (Social Affect and Restrictive and Repetitive Behaviors [RRB]) among verbally fluent children, adolescents, and adults, and ADOS diagnostic classification of ASD is based on a total score that combines the 2 domains. Currently, the total and domain scores are calculated using only a subset of the administered items. This study used an item response theory (IRT) approach to examine whether scores from the ADOS Modules 3 and 4 item sets under the revised scoring algorithm provide adequate reliability around the diagnostic threshold of the total score, as well as across the hypothesized continuum of the Social Affect and RRB domains. Furthermore, the present study examined whether the reliability of the ASD domains measured by the ADOS is improved by incorporating items that are collected but not included in the current diagnostic algorithm. Measurement precision was estimated using IRT models, which allow for an examination of reliability across a continuum of ASD domain severity. Results suggest that although the ADOS Modules 3 and 4 are reliable at the diagnostic threshold using only the scoring algorithm items, adding additional items can improve the reliability of scores at moderately low and moderately high levels of ASD severity. However, even with additional items, the ADOS Modules 3 and 4 do not allow for adequately reliable measurement of restrictive and repetitive behaviors. (PsycINFO Database Record
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8. Moore M, Evans V, Hanvey G, Johnson C. {{Assessment of Sleep in Children with Autism Spectrum Disorder}}. {Children (Basel)};2017 (Aug 08);4(8)
Sleep disturbances in children with autism spectrum disorder (ASD) are significantly more prevalent than found in typically developing (TD) children. Given the detrimental impact of poor sleep on cognitive, emotional, and behavioral functioning, it is imperative to screen and assess for sleep disturbances in this population. In this paper, we describe the screening and assessment process, as well as specific measures commonly used for assessing sleep in children with ASD. Advantages and limitations for use in children with ASD are discussed. While subjective measures, such as parent-report questionnaires and sleep diaries, are the most widely used, more objective measures such as actigraphy, polysomnography, and videosomnography provide additional valuable information for both diagnostic purposes and treatment planning. These objective measures, nonetheless, are limited by cost, availability, and feasibility of use with children with ASD. The current review provides an argument for the complementary uses of both subjective and objective measures of sleep specifically for use in children with ASD.
