Pubmed du 09/01/21
1. Buono S, Zingale M, Città S, Mongelli V, Trubia G, Mascali G, Occhipinti P, Pettinato E, Ferri R, Gagliano C, Greco D. Clinical management of individuals with Intellectual Disability : The outbreak of Covid-19 pandemic as experienced in a clinical and research center Research in Developmental Disabilities. Res Dev Disabil ;2021 (Jan 9) ;110:103856.
During the COVID-19 pandemic, the Oasi Research Institute of Troina (Italy) became an important hotbed for infection ; in fact, 109 patients with different levels of Intellectual Disability (ID) tested positive for COVID-19. The procedures and interventions put in place at the Oasi Research Institute due to the COVID-19 pandemic are exhaustively reported in this paper. The description of the clinical procedures as well as remote/in person psychological support services provided to people with ID and their families are here divided into three different sections : Phase I (or Acute phase), Phase II (or Activity planning), and Phase III (or Activity consolidation). In each section, the main psycho-pathological characteristics of patients, the reactions of family members and the multidisciplinary interventions put in place are also described.
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2. Choueiri R, Lindenbaum A, Ravi M, Robsky W, Flahive J, Garrison W. Improving Early Identification and Access to Diagnosis of Autism Spectrum Disorder in Toddlers in a Culturally Diverse Community with the Rapid Interactive screening Test for Autism in Toddlers. J Autism Dev Disord ;2021 (Jan 9)
The objective of this study was to test a screening model that employs the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T), in an underserved community to improve ASD detection. We collaborated with a large Early Intervention (EI) program and trained 4 providers reliably on the RITA-T. Toddlers received the Modified Checklist for Autism in Toddlers (MCHAT-R/F), the RITA-T, developmental and autism testing, and a best-estimate clinical diagnosis. Eighty-One toddlers were enrolled : 57 with ASD and 24 with Developmental Delay (DD) non-ASD. Wait-time for diagnosis was on average 6 weeks. The RITA-T correlated highly with autism measures and EI staff integrated this model easily. The RITA-T significantly improved the identification and wait time for ASD in this underserved community.
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3. Crutel V, Lambert E, Penelaud PF, Albarrán Severo C, Fuentes J, Rosier A, Hervás A, Marret S, Oliveira G, Parellada M, Kyaga S, Gouttefangeas S, Bertrand M, Ravel D, Falissard B. Correction to : Bumetanide Oral Liquid Formulation for the Treatment of Children and Adolescents with Autism Spectrum Disorder : Design of Two Phase III Studies (SIGN Trials). J Autism Dev Disord ;2021 (Jan 9)
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4. da Silveira Cruz-Machado S, Guissoni Campos LM, Fadini CC, Anderson G, Markus RP, Pinato L. Disrupted nocturnal melatonin in autism : Association with tumor necrosis factor and sleep disturbances. J Pineal Res ;2021 (Jan 9):e12715.
Sleep disturbances, abnormal melatonin secretion, and increased inflammation are aspects of autism spectrum disorder (ASD) pathophysiology. The present study evaluated the daily urinary 6-sulfatoxymelatonin (aMT6s) excretion profile and the salivary levels of tumor necrosis factor (TNF) and interleukin-6 (IL-6) in 20 controls and 20 ASD participants, as well as correlating these measures with sleep disturbances. Although 60% of ASD participants showed a significant night-time rise in aMT6s excretion, this rise was significantly attenuated, compared to controls (P < .05). The remaining 40% of ASD individuals showed no significant increase in nocturnal aMT6s. ASD individuals showed higher nocturnal levels of saliva TNF, but not IL-6. Dysfunction in the initiation and maintenance of sleep, as indicated by the Sleep Disturbance Scale for Children, correlated with night-time aMT6s excretion (r = -.28, P < .05). Dysfunction in sleep breathing was inversely correlated with aMT6s (r = -.31, P < .05) and positively associated with TNF level (r = .42, P < .01). Overall such data indicate immune-pineal axis activation, with elevated TNF but not IL-6 levels associated with disrupted pineal melatonin release and sleep dysfunction in ASD. It is proposed that circadian dysregulation in ASD is intimately linked to heightened immune-inflammatory activity. Such two-way interactions of the immune-pineal axis may underpin many aspects of ASD pathophysiology, including sleep disturbances, as well as cognitive and behavioral alterations.
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5. Ketcheson LR, Pitchford EA, Wentz CF. The Relationship Between Developmental Coordination Disorder and Concurrent Deficits in Social Communication and Repetitive Behaviors Among Children with Autism Spectrum Disorder. Autism Res ;2021 (Jan 9)
Children with Autism Spectrum Disorder (ASD), characterized by core deficits in social communication and restrictive behaviors, can exhibit concurrent motor incoordination and/or intellectual disability (ID). While pervasive delays in motor behavior are common, formal diagnosis of Development Coordination Disorder (DCD) is uncommon. It is not clear how DCD and ID impact core deficits in ASD. This study utilized the Simons Foundation SPARK cohort to describe the scope of motor incoordination among children with ASD and examine the interrelationships between DCD risk, ID, and ASD core deficits. 10,234 children with ASD, between the ages of 5 and 15 years, were included in the analysis. Parents completed online versions of the DCD Questionnaire (DCD-Q), Social Communication Questionnaire (SCQ) and Restrictive Behavior Scale (RBS-R). 85% of children with ASD had DCD-Q scores consistent with being at-risk for DCD, but only 14% reported a formal diagnosis. Children with ID exhibited significantly greater motor incoordination compared to children without ID (P < 0.001). Significantly, greater core deficits were identified in both children at-risk for DCD (P < 0.001) and with ID (P < 0.001). However, the effects of DCD risk were independent of ID and exhibited a medium effect size for SCQ (η(2) (p) = 0.063) and a small effect size for RBS-R (η(2) (p) = 0.04) scores. Collectively, study outcomes reinforce the pervasiveness of motor incoordination among children with ASD, both with and without concurrent ID, and provide further justification for the inclusion of motor behavior in the early intervention and prescription for children with ASD. LAY SUMMARY : This secondary data analysis of the Simons Foundation SPARK cohort found high rates (85%) of DCD risk among children with ASD. Deficits in motor coordination were greater among children with ASD with concurrent ID diagnoses. Meaningful differences in ASD core deficits (social communication and repetitive behaviors) were independently found in children at risk for DCD, both with and without ID.
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6. Konicar L, Radev S, Prillinger K, Klöbl M, Diehm R, Birbaumer N, Lanzenberger R, Plener PL, Poustka L. Volitional modification of brain activity in adolescents with Autism Spectrum Disorder : A Bayesian analysis of Slow Cortical Potential neurofeedback. Neuroimage Clin ;2021 (Jan 9) ;29:102557.
Autism spectrum disorder is (ASD) characterized by a persisting triad of impairments of social interaction, language as well as inflexible, stereotyped and ritualistic behaviors. Increasingly, scientific evidence suggests a neurobiological basis of these emotional, social and cognitive deficits in individuals with ASD. The aim of this randomized controlled brain self-regulation intervention study was to investigate whether the core symptomatology of ASD could be reduced via an electroencephalography (EEG) based brain self-regulation training of Slow Cortical Potentials (SCP). 41 male adolescents with ASD were recruited and allocated to a) an experimental group undergoing 24 sessions of EEG-based brain training (n(1) = 21), or to b) an active control group undergoing conventional treatment (n(2) = 20), that is, clinical counseling during a 3-months intervention period. We employed real-time neurofeedback training recorded from a fronto-central electrode intended to enable participants to volitionally regulate their brain activity. Core autistic symptomatology was measured at six time points during the intervention and analyzed with Bayesian multilevel approach to characterize changes in core symptomatology. Additional Bayesian models were formulated to describe the neural dynamics of the training process as indexed by SCP (time-domain) and power density (PSD, frequency-domain) measures. The analysis revealed a substantial improvement in the core symptomatology of ASD in the experimental group (reduction of 21.38 points on the Social Responsiveness Scale, SD = 5.29), which was slightly superior to that observed in the control group (evidence Ratio = 5.79). Changes in SCP manifested themselves as different trajectories depending on the different feedback conditions and tasks. Further, the model of PSD revealed a continuous decrease in delta power, parallel to an increase in alpha power. Most notably, a non-linear (quadratic) model turned out to be better at predicting the data than a linear model across all analyses. Taken together, our analyses suggest that behavioral and neural processes of change related to neurofeedback training are complex and non-linear. Moreover, they have implications for the design of future trials and training protocols.
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7. Lunsky Y, Albaum C, Baskin A, Hastings RP, Hutton S, Steel L, Wang W, Weiss J. Group Virtual Mindfulness-Based Intervention for Parents of Autistic Adolescents and Adults. J Autism Dev Disord ;2021 (Jan 9):1-11.
Mindfulness-based approaches have been shown to be effective in improving the mental health of parents of youth and adults with autism and other developmental disabilities, but prior work suggests that geography and caregiving demands can make in-person attendance challenging. The purpose of this study was to evaluate the feasibility, acceptability and preliminary outcomes of a mindfulness-based group intervention delivered to parents virtually. It was feasible to deliver this manualized intervention. Twenty-one of 39 parents completed the intervention and completers reported high satisfaction ratings. Parents reported reduced levels of distress, maintained at 3-month follow-up, and increased mindfulness. Changes reported following intervention were similar to changes reported in a prior study of parents competing an in person mindfulness group.
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8. Muscatello RA, Vandekar SN, Corbett BA. Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder : a case-control study. J Neurodev Disord ;2021 (Jan 9) ;13(1):6.
BACKGROUND : Individuals with autism spectrum disorder (ASD) often experience elevated stress during social interactions and may have difficulty forming and maintaining peer relationships. The autonomic nervous system (ANS) directs physiological changes in the body in response to a number of environmental stimuli, including social encounters. Evidence suggests the flexibility of the ANS response is an important driving factor in shaping social behavior. For youth with ASD, increased stress response and/or atypical ANS regulation to benign social encounters may therefore influence social behaviors, and, along with developmental and experiential factors, shape psychological outcomes. METHODS : The current study measured ANS response to a peer-based social interaction paradigm in 50 typically developing (TD) children and 50 children with ASD (ages 10-13). Respiratory sinus arrhythmia (RSA), a cardiac measure of parasympathetic influence on the heart, and pre-ejection period (PEP), a sympathetic indicator, were collected. Participants engaged in a friendly, face-to-face conversation with a novel, same-aged peer, and physiological data were collected continuously before and during the interaction. Participants also reported on state anxiety following the interaction, while parents reported on the child’s social functioning and number of social difficulties. RESULTS : Linear mixed models revealed that, while there were no diagnostic effects for RSA or PEP, older youth with ASD appeared to demonstrate a blunted parasympathetic (RSA) response. Further, increased severity of parent-reported social symptoms was associated with lower RSA. Youth with ASD reported more anxiety following the interaction ; however, symptoms were not related to RSA or PEP response based on linear mixed modeling. CONCLUSIONS : Physiological regulation, age, and social functioning likely influence stress responses to peer interactions for youth with ASD. Parasympathetic functioning, as opposed to sympathetic arousal, may be especially important in behavioral regulation, as older youth with ASD demonstrated atypical regulation and response to the social interaction paradigm. Future studies should help to further elucidate the developmental factors contributing to stress responses in ASD, the impact of physiological response on observable social behavior, and potential long-term consequences of chronic social stress in youth with ASD.
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9. Rivard M, Mello C, Mestari Z, Terroux A, Morin D, Forget J, Lefebvre C, Argumedes M. Using Prevent Teach Reinforce for Young Children to Manage Challenging Behaviors in Public Specialized Early Intervention Services for Autism. J Autism Dev Disord ;2021 (Jan 9)
This proof-of-concept study assessed the feasibility of implementing Prevent-Teach-Reinforce-for-Young-Children (PTR-YC) program to address challenging behaviors in children with autism within the context of public, specialized early intensive behavioral intervention (EIBI) services offered in community settings. Following a 2-day training and with brief weekly supervision meetings, children’s EIBI educators acted as facilitators in 35 families’ home environments. Small and moderate effect sizes were observed for children’s behavioral outcomes and parenting stress. Recruitment and retention rates, implementation fidelity, as well as treatment acceptability from the perspective of participating parents and the organization attested to the feasibility and relevance of implementing and evaluating this program on a larger scale as part of a multi-center randomized controlled trial.
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10. Shea L, Nonnemacher S. Embedded research approaches to address the needs of the increasing, aging autistic population. Healthc (Amst) ;2021 (Jan 9):100517.
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11. van ‘t Hof M, van Nieuwenhuyzen ADY, van Berckelaer-Onnes I, Deen M, Hoek HW, Ester WA. Autism Spectrum Disorder Alertness in Dutch Youth and Family Center Physicians : Effects of a Live Online Educational Program. J Autism Dev Disord ;2021 (Jan 9)
We investigated the effect of a live online educational program in 93 Dutch Youth and Family Center (YFC) physicians who were screening for Autism Spectrum Disorder (ASD) in the general child population. The educational program raised the physicians’ level of specific ASD knowledge and it remained higher at six months follow-up (p < .01). Their self-confidence in detecting ASD was also higher and maintained at follow-up (p < .01). The educational program had no effect on the physicians' stigmatizing attitudes toward mental illness nor on the number of potential ASD referrals in children of 4-6 years of age. In conclusion, the online educational program on early detection of ASD has a six month long effect on YFC physicians' level of ASD knowledge and self-confidence.
