1. Adachi M, Autry AE, Covington HE, 3rd, Monteggia LM. MeCP2-{{Mediated Transcription Repression in the Basolateral Amygdala May Underlie Heightened Anxiety in a Mouse Model of Rett Syndrome}}. {J Neurosci};2009 (Apr 1);29(13):4218-4227.
Rett syndrome (RTT) is an X-linked neurodevelopmental disorder that results from loss of function mutations in the methyl-CpG binding protein 2 (MECP2) gene. Using viral-mediated basolateral amygdala (BLA)-specific deletion of Mecp2 in mice, we show that intact Mecp2 function is required for normal anxiety behavior as well as some types of learning and memory. To examine whether these behavioral deficits are the result of impaired transcriptional repression, because Mecp2 is believed to act as a transcriptional repressor in complex with histone deacetylases (HDACs), we infused a HDAC inhibitor chronically into the BLA of wild-type mice. We found that HDAC inhibition produces behavioral deficits similar to those observed after the deletion of Mecp2 in the BLA. These results suggest a key role for Mecp2 as a transcriptional repressor in the BLA in mediating behavioral features of RTT.
2. Al-Salehi SM, Ghaziuddin M. {{G6PD deficiency in autism: a case-series from Saudi Arabia}}. {Eur Child Adolesc Psychiatry};2009 (Apr);18(4):227-230.
Autism is a neurodevelopmental disorder characterized by a pattern of social and communication deficits. Although it occurs in all cultures and countries, most of the published research has come from Western industrialized countries. In particular, relatively little is known about its clinical correlates and comorbidity in African and Middle Eastern countries. In this paper, we report two cases of G6PD deficiency with autism, recruited as part of a larger study on the occurrence of autism in Saudi Arabia. These findings suggest that a different set of medical conditions may be associated with autism in developing countries.
3. Annaz D, Karmiloff-Smith A, Johnson MH, Thomas MS. {{A cross-syndrome study of the development of holistic face recognition in children with autism, Down syndrome, and Williams syndrome}}. {J Exp Child Psychol};2009 (Apr);102(4):456-486.
We report a cross-syndrome comparison of the development of holistic processing in face recognition in school-aged children with developmental disorders: autism, Down syndrome, and Williams syndrome. The autism group was split into two groups: one with high-functioning children and one with low-functioning children. The latter group has rarely been studied in this context. The four disorder groups were compared with typically developing children. Cross-sectional trajectory analyses were used to compare development in a modified version of Tanaka and Farah’s part-whole task. Trajectories were constructed linking part-whole performance either to chronological age or to several measures of mental age (receptive vocabulary, visuospatial construction, and the Benton Facial Recognition Test). In addition to variable delays in onset and rate of development, we found an atypical profile in all disorder groups. These profiles were atypical in different ways, indicating multiple pathways to, and variable outcomes in, the development of face recognition. We discuss the implications for theories of face recognition in both atypical and typical development, including the idea that part-whole and rotation manipulations may tap different aspects of holistic and/or configural processing.
4. Bent S, Bertoglio K, Hendren RL. {{Omega-3 Fatty Acids for Autistic Spectrum Disorder: A Systematic Review}}. {J Autism Dev Disord};2009 (Mar 31)
We conducted a systematic review to determine the safety and efficacy of omega-3 fatty acids for autistic spectrum disorder (ASD). Articles were identified by a search of MEDLINE, EMBASE, and the Cochrane Database using the terms autism or autistic and omega-3 fatty acids. The search identified 143 potential articles and six satisfied all inclusion criteria. One small randomized controlled trial (n = 13) noted non-significant improvements in hyperactivity and stereotypy. The remaining five studies were small (n = 30, 22, 19, 9, and 1) with four reporting improvements in a wide range of outcomes including language and learning skills, parental observations of general health and behavior, a clinician-administered symptom scale, and clinical observations of anxiety. Due to the limitations of evidence from uncontrolled studies and the presence of only one small randomized controlled trial, there is currently insufficient scientific evidence to determine if omega-3 fatty acids are safe or effective for ASD.
5. Besag FM. {{The relationship between epilepsy and autism: a continuing debate}}. {Acta Paediatr};2009 (Apr);98(4):618-620.
6. Bolte S, Dziobek I, Poustka F. {{Brief report: the level and nature of autistic intelligence revisited}}. {J Autism Dev Disord};2009 (Apr);39(4):678-682.
Owing to higher performance on the Raven’s Progressive Matrices (RPM) than on the Wechsler Intelligence Scales (WIS), it has recently been argued that intelligence is underestimated in autism. This study examined RPM and WIS IQs in 48 individuals with autism, a mixed clinical (n = 28) and a neurotypical (n = 25) control group. Average RPM IQ was higher than WIS IQ only in the autism group, albeit to a much lesser degree than previously reported and only for individuals with WIS IQs <85. Consequently, and given the importance of reliable multidimensional IQ estimates in autism, the WIS are recommended as first choice IQ measure in high functioning individuals. Additional testing with the RPM might be required in the lower end of the spectrum.
7. Cans C. {{Pervasive developmental disorders in individuals with cerebral palsy}}. {Dev Med Child Neurol};2009 (Apr);51(4):254-255.
8. Cantor RM. {{Molecular genetics of autism}}. {Curr Psychiatry Rep};2009 (Apr);11(2):137-142.
The increasing autism incidence estimates are generating strong interest in identifying its salient risk factors. Recognition of the importance of genes in this and other disorders has promulgated the development of valuable research tools. As this review indicates, application of these tools paints a portrait of a disorder that is more complex than anticipated.
9. Chen YH, Rodgers J, McConachie H. {{Restricted and repetitive behaviours, sensory processing and cognitive style in children with autism spectrum disorders}}. {J Autism Dev Disord};2009 (Apr);39(4):635-642.
Many individuals with autism tend to focus on details. It has been suggested that this cognitive style may underlie the presence of stereotyped routines, repetitive interests and behaviours, and both relate in some way to sensory abnormalities. Twenty-nine children with diagnosis of high functioning autism or Asperger syndrome completed the Embedded Figures Test (EFT), and their parents the Short Sensory Profile and Childhood Routines Inventory. Significant correlations were found between degree of sensory abnormalities and amount of restricted and repetitive behaviours reported. Repetitive behaviours, age and IQ significantly predicted completion time on the EFT. The results suggest a cognitive link between an individual’s detail-focused cognitive style and their repetitiveness. No such relationship was found with sensory processing abnormalities, which may arise at a more peripheral level of functioning.
10. de Jonge M, Kemner C, Naber F, van Engeland H. {{Block design reconstruction skills: not a good candidate for an endophenotypic marker in autism research}}. {Eur Child Adolesc Psychiatry};2009 (Apr);18(4):197-205.
Superior performance on block design tasks is reported in autistic individuals, although it is not consistently found in high-functioning individuals or individuals with Asperger Syndrome. It is assumed to reflect weak central coherence: an underlying cognitive deficit, which might also be part of the genetic makeup of the disorder. We assessed block design reconstruction skills in high-functioning individuals with autism spectrum disorders (ASD) from multi-incidence families and in their parents. Performance was compared to relevant matched control groups. We used a task that was assumed to be highly sensitive to subtle performance differences. We did not find individuals with ASD to be significantly faster on this task than the matched control group, not even when the difference between reconstruction time of segmented and pre-segmented designs was compared. However, we found individuals with ASD to make fewer errors during the process of reconstruction which might indicate some dexterity in mental segmentation. However, parents of individuals with ASD did not perform better on the task than control parents. Therefore, based on our data, we conclude that mental segmentation ability as measured with a block design reconstruction task is not a neurocognitive marker or endophenotype useful in genetic studies.
11. de Krom M, Staal WG, Ophoff RA, Hendriks J, Buitelaar J, Franke B, de Jonge MV, Bolton P, Collier D, Curran S, van Engeland H, van Ree JM. {{A common variant in DRD3 receptor is associated with autism spectrum disorder}}. {Biol Psychiatry};2009 (Apr 1);65(7):625-630.
BACKGROUND: The presence of specific and common genetic etiologies for autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) was investigated for 132 candidate genes in a two-stage design-association study. METHODS: 1,536 single nucleotide polymorphisms (SNPs) covering these candidate genes were tested in ASD (n = 144) and ADHD (n = 110) patients and control subjects (n = 404) from The Netherlands. A second stage was performed with those SNPs from Stage I reaching a significance threshold for association of p < .01 in an independent sample of ASD patients (n = 128) and controls (n = 124) from the United Kingdom and a Dutch ADHD (n = 150) and control (n = 149) sample. RESULTS: No shared association was found between ASD and ADHD. However, in the first and second ASD samples and in a joint statistical analysis, a significant association between SNP rs167771 located in the DRD3 gene was found (joint analysis uncorrected: p = 3.11 x 10(-6); corrected for multiple testing and potential stratification: p = .00162). CONCLUSIONS: The DRD3 gene is related to stereotyped behavior, liability to side effects of antipsychotic medication, and movement disorders and may therefore have important clinical implications for ASD.
12. Eran A, Graham KR, Vatalaro K, McCarthy J, Collins C, Peters H, Brewster SJ, Hanson E, Hundley R, Rappaport L, Holm IA, Kohane IS, Kunkel LM. {{Comment on « Autistic-like phenotypes in Cadps2-knockout mice and aberrant CADPS2 splicing in autistic patients »}}. {J Clin Invest};2009 (Apr);119(4):679-681.
13. Green D, Charman T, Pickles A, Chandler S, Loucas T, Simonoff E, Baird G. {{Impairment in movement skills of children with autistic spectrum disorders}}. {Dev Med Child Neurol};2009 (Apr);51(4):311-316.
AIM: We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. METHOD: Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children (n=101: 89 males,12 females; mean age 11y 4mo, SD 10mo; range 10y-14y 3mo) with childhood autism and broader ASD and a wide range of IQ scores. Additionally, we tested whether a parent-completed questionnaire, the Developmental Coordination Disorder Questionnaire (DCDQ), was useful in identifying children who met criteria for movement impairments after assessment (n=97 with complete M-ABCs and DCDQs). RESULTS: Of the children with ASD, 79% had definite movement impairments on the M-ABC; a further 10% had borderline problems. Children with childhood autism were more impaired than children with broader ASD, and children with an IQ less than 70 were more impaired than those with IQ more than 70. This is consistent with the view that movement impairments may arise from a more severe neurological impairment that also contributes to intellectual disability and more severe autism. Movement impairment was not associated with everyday adaptive behaviour once the effect of IQ was controlled for. The DCDQ performed moderately well as a screen for possible motor difficulties. INTERPRETATION: Movement impairments are common in children with ASD. Systematic assessment of movement abilities should be considered a routine investigation.
14. Grinter EJ, Van Beek PL, Maybery MT, Badcock DR. {{Brief report: visuospatial analysis and self-rated autistic-like traits}}. {J Autism Dev Disord};2009 (Apr);39(4):670-677.
Although there is good evidence that the behavioral traits of autism extend in lesser form to the general population, there has been limited investigation of whether cognitive features of the disorder also accompany these milder traits. This study investigated whether the superiority in visuospatial analysis established for individuals with autism also extends to individuals in the general population who self-report autistic-like traits. In an initial study, students scoring high on the Autism-spectrum Quotient (AQ) were faster and more accurate on the Embedded Figures Test (EFT) and the Block Design subscale of the Wechsler Intelligence Scale III compared to those scoring low on the AQ. A second study showed that high AQ scorers were faster to complete the EFT compared to low AQ scorers irrespective of IQ. Results are discussed with reference to weak central coherence theory and the autism spectrum.
15. Grossman RB, Schneps MH, Tager-Flusberg H. {{Slipped lips: onset asynchrony detection of auditory-visual language in autism}}. {J Child Psychol Psychiatry};2009 (Apr);50(4):491-497.
Background: It has frequently been suggested that individuals with autism spectrum disorder (ASD) have deficits in auditory-visual (AV) sensory integration. Studies of language integration have mostly used non-word syllables presented in congruent and incongruent AV combinations and demonstrated reduced influence of visual speech in individuals with ASD. The aim of our study was to test whether adolescents with high-functioning autism are able to integrate AV information of meaningful, phrase-length language in a task of onset asynchrony detection. Methods: Participants were 25 adolescents with ASD and 25 typically developing (TD) controls. The stimuli were video clips of complete phrases using simple, commonly occurring words. The clips were digitally manipulated to have the video precede the corresponding audio by 0, 4, 6, 8, 10, 12, or 14 video frames, a range of 0-500ms. Participants were shown the video clips in random order and asked to indicate whether each clip was in-synch or not. Results: There were no differences between adolescents with ASD and their TD peers in accuracy of onset asynchrony detection at any slip rate. Conclusion: These data indicate that adolescents with ASD are able to integrate auditory and visual components in a task of onset asynchrony detection using natural, phrase-length language stimuli. We propose that the meaningful nature of the language stimuli in combination with presentation in a non-distracting environment allowed adolescents with autism spectrum disorder to demonstrate preserved accuracy for bi-modal AV integration.
16. Jackman C, Horn ND, Molleston JP, Sokol DK. {{Gene associated with seizures, autism, and hepatomegaly in an amish girl}}. {Pediatr Neurol};2009 (Apr);40(4):310-313.
A genetic defect causing autism and epilepsy involving the contactin associated protein-like 2 gene (CNTNAP2) has been discovered in a selected cohort of Amish children. These children were found to have focal seizures and autistic regression. Surgical biopsy of the anterior temporal lobe of two such children revealed cortical dysplasia and a single nucleotide polymorphism mutation of this gene. The present case is that of a related but geographically distant proband with a similar phenotype but a single-base-pair deletion in the CNTNAP2 gene. This patient exhibited the additional features of periventricular leukomalacia and hepatomegaly.
17. Johnson S, Marlow N. {{Positive screening results on the modified checklist for autism in toddlers: implications for very preterm populations}}. {J Pediatr};2009 (Apr);154(4):478-480.
18. Kamp-Becker I, Ghahreman M, Smidt J, Remschmidt H. {{Dimensional structure of the autism phenotype: relations between early development and current presentation}}. {J Autism Dev Disord};2009 (Apr);39(4):557-571.
The dimensional structure of higher functioning autism phenotype was investigated by factor analysis. The goal of this study was to identify the degree to which early symptoms of autism (measured using the ADI-R) could be predictive of the current symptoms of autism as identified using the ADOS, the adaptive behavior scales, IQ scores and theory of mind scores. Participants included 140 subjects with Full Scale IQ > 70 (104 with autism spectrum diagnosis, 36 with non autism diagnosis, age range 6-24). For the early development as well as for the current presentation a multi-factor solution was found. In line with other studies we found that the social interaction and communication domains are closely related to one factor namely: Social communication. An additional factor implies anxious and compulsive behavior which is associated with current social communication functioning.
19. Katagiri J. {{The effect of background music and song texts on the emotional understanding of children with autism}}. {J Music Ther};2009 (Spring);46(1):15-31.
The purpose of this study was to examine the effect of background music and song texts to teach emotional understanding to children with autism. Participants were 12 students (mean age 11.5 years) with a primary diagnosis of autism who were attending schools in Japan. Each participant was taught four emotions to decode and encode: happiness, sadness, anger, and fear by the counterbalanced treatment-order. The treatment consisted of the four conditions: (a) no contact control (NCC)-no purposeful teaching of the selected emotion, (b) contact control (CC)-teaching the selected emotion using verbal instructions alone, (c) background music (BM)-teaching the selected emotion by verbal instructions with background music representing the emotion, and singing songs (SS)-teaching the selected emotion by singing specially composed songs about the emotion. Participants were given a pretest and a posttest and received 8 individual sessions between these tests. The results indicated that all participants improved significantly in their understanding of the four selected emotions. Background music was significantly more effective than the other three conditions in improving participants’ emotional understanding. The findings suggest that background music can be an effective tool to increase emotional understanding in children with autism, which is crucial to their social interactions.
20. Kelly VB, Salt A. {{Question 2. Should fragile X be tested for in boys with a diagnosis of autistic spectrum disorder?}} {Arch Dis Child};2009 (Apr);94(4):323-324.
21. Kilincaslan A, Mukaddes NM. {{Pervasive developmental disorders in individuals with cerebral palsy}}. {Dev Med Child Neurol};2009 (Apr);51(4):289-294.
The aim of the present study was to describe the prevalence and associated factors of pervasive developmental disorders (PDD), including autistic disorder and PDD not otherwise specified (NOS), in a clinical sample of 126 children and adolescents (75 males, 51 females; age range 4-18y, mean 8y 8mo, SD 3y 8mo) with tetraplegic, hemiplegic, diplegic, dyskinetic, or mixed types of cerebral palsy (CP); 28% could not crawl or walk even with support, 29% could move with support, and 43% walked independently. Participants were examined for PDD in two stages. In the first stage, probable participants were determined by direct observation, Autism Behavior Checklist score, and medical reports. In the second stage, those with ‘probable’ symptoms underwent psychiatric examination and their autistic symptoms were scored on the Childhood Autism Rating Scale. The final diagnosis of autistic disorder or PDD-NOS was given according to DSM-IV criteria. Fourteen (11%) and five (4%) of the participants met the criteria for autistic disorder and PDD-NOS respectively. Children with CP and PDD differed from those without PDD in terms of type of CP (p=0.02), presence of epilepsy (p<0.001), intellectual level (p<0.001), and level of speech (p<0.001). PDD was more common in children with tetraplegic, mixed, and hemiplegic CP, and in children with epilepsy, learning disability, and low level of speech. The findings corroborate the notion that CP is a complex disorder, often associated with additional impairments. PDD is not rare in CP and should be considered in patients with comorbid conditions such as epilepsy, learning disability, and language delay and in the presence of tetraplegic, mixed, and hemiplegic CP types.
22. Kleinhans NM, Johnson LC, Richards T, Mahurin R, Greenson J, Dawson G, Aylward E. {{Reduced neural habituation in the amygdala and social impairments in autism spectrum disorders}}. {Am J Psychiatry};2009 (Apr);166(4):467-475.
OBJECTIVE: Amygdala dysfunction has been proposed as a critical component in social impairment in autism spectrum disorders. This study was designed to investigate whether abnormal habituation characterizes amygdala dysfunction in autism spectrum disorders and whether the rate of amygdala habituation is related to social impairment. METHOD: Using functional MRI, the authors measured change over time in activation of the amygdala and fusiform gyrus to neutral facial stimuli in adults with autism spectrum disorders and healthy comparison adults. RESULTS: The comparison group evidenced significantly greater amygdala habituation bilaterally than the autism spectrum group. There were no group differences in overall fusiform habituation. For the autism spectrum group, lower levels of habituation of the amygdala to the face stimuli were associated with more severe social impairment. CONCLUSIONS: These results suggest amygdala hyperarousal in autism spectrum disorders in response to socially relevant stimuli. Further, sustained amygdala arousal may contribute to the social deficits observed in autism spectrum disorders.
23. Koyama T, Osada H, Tsujii H, Kurita H. {{Utility of the Kyoto Scale of Psychological Development in cognitive assessment of children with pervasive developmental disorders}}. {Psychiatry Clin Neurosci};2009 (Apr);63(2):241-243.
Based on the clinical records of 74 children with pervasive developmental disorders (PDD; mean age, 45.2 months; 62 boys), the utility of the Kyoto Scale of Psychological Development in cognitive assessment of young and/or mentally retarded PDD children was investigated. Because the overall developmental quotient (DQ) had the highest correlation with the IQ (Pearson’s r, 0.88) and the Cognitive-Adaptive DQ showed a non-significant difference in mean (65.8) from the IQ (66.4), they both seem useful as an equivalent to an IQ. The test would enable clinicians to carry out continual developmental assessments and to develop appropriate remedial programs for those children from infancy.
24. Krysko KM, Rutherford MD. {{A threat-detection advantage in those with autism spectrum disorders}}. {Brain Cogn};2009 (Apr);69(3):472-480.
Identifying threatening expressions is a significant social perceptual skill. Individuals with autism spectrum disorders (ASD) are impaired in social interaction, show deficits in face and emotion processing, show amygdala abnormalities and display a disadvantage in the perception of social threat. According to the anger superiority hypothesis, angry faces capture attention faster than happy faces in individuals with a history of typical development [Hansen, C. H., & Hansen, R. D. (1988). Finding the face in the crowd: An anger superiority effect. Journal of Personality and Social Psychology, 54(6), 917-924]. We tested threat detection abilities in ASD using a facial visual search paradigm. Participants were asked to detect an angry or happy face image in an array of distracter faces. A threat-detection advantage was apparent in both groups: participants showed faster and more accurate detection of threatening over friendly faces. Participants with ASD showed similar reaction time, but decreased overall accuracy compared to controls. This provides evidence for less robust, but intact or learned implicit processing of basic emotions in ASD.
25. Kuban KC, O’Shea TM, Allred EN, Tager-Flusberg H, Goldstein DJ, Leviton A. {{Positive screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age newborns}}. {J Pediatr};2009 (Apr);154(4):535-540 e531.
OBJECTIVE: To test the hypothesis that children born preterm are more likely to screen positive on the M-CHAT for an autism spectrum disorder. STUDY DESIGN: We compared the M-CHAT positive rate of those with cerebral palsy, cognitive impairment, and vision and hearing impairments to those without such deficits. RESULTS: Relative to children who could walk, the odds for screening positive on the M-CHAT were increased 23-fold for those unable to sit or stand independently and more than 7-fold for those requiring assistance to walk. Compared with children without a diagnosis of cerebral palsy, those with quadriparesis were 13 times more likely to screen positive, and those with hemiparesis were 4 times more likely to screen positive. Children with major vision or hearing impairments were 8 times more likely to screen positive than those without such impairments. Relative to those with a Mental Development Index (MDI) of >70, the odds for screening positive were increased 13-fold for those with an MDI of <55 and more than 4-fold for those with an MDI of 55 to 69. CONCLUSIONS: Major motor, cognitive, visual, and hearing impairments appear to account for more than half of the positive M-CHAT screens in extremely low gestational age newborns. Even after those with such impairments were eliminated, 10% of children–nearly double the expected rate–screened positive.
26. Larsson EL, Aaro S, Ahlinder P, Normelli H, Tropp H, Oberg B. {{Long-term follow-up of functioning after spinal surgery in patients with Rett syndrome}}. {Eur Spine J};2009 (Apr);18(4):506-511.
In a prospective study, 23 consecutive girls with Rett syndrome and neuromuscular scoliosis were evaluated for functioning at a long-term follow-up. The patients had mostly improved, which was confirmed by their parents. Rett syndrome is associated with neuromuscular scoliosis and has a typically long C-shaped thoracolumbar kyphoscoliosis. Prospective long-term follow-up studies related to these patients’ total situation are sparse. Most studies focus on the Cobb angle of the scoliosis, whereas parents are mainly concerned about the girls’ continued functioning. Twenty-three patients with Rett syndrome and neuromuscular scoliosis were evaluated preoperatively from 1993 to 2002. At follow-up, 19 patients remained in the study. Three patients died (not due to surgery), and one patient could not participate because it was too far to travel. Mean follow-up time was 74 months (range 49-99 months). The assessments comprised the sitting balance, seating supports in wheelchair, weight distribution, time used for rest, care given, and angle of scoliosis. Follow-up questionnaires and two-open-ended questions about the positive and negative effects of surgery were sent to parents. Sitting balance, number of seating supports in wheelchair, weight distribution, time used for rest, and the Cobb angle had all improved after surgery. The parents assessed improvement in seating position, daily activities, time used for rest, and cosmetic appearance. We can conclude that the stabilized spine resulted in sufficient strength to keep the body upright with the possibility of looking around at the surroundings more easily. The girls got better seating position with less need for seating adaptations in the wheelchair and with reduced time needed for resting during the day. Finally we can conclude that the indication for surgery is to get a better posture which lead to less risk of pressure sores, and that un upright position lead to better possibility to easily breath with fewer episodes of pneumonia and a better general health as result. The evidence of positive surgical effects for girls with Rett syndrome is of great importance in indication for surgery in the decision-making process.
27. Laugeson EA, Frankel F, Mogil C, Dillon AR. {{Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders}}. {J Autism Dev Disord};2009 (Apr);39(4):596-606.
This study examines the efficacy of a manualized parent-assisted social skills intervention in comparison with a matched Delayed Treatment Control group to improve friendship quality and social skills among teens 13-17 years of age with autism spectrum disorders. Targeted skills included conversational skills, peer entry and exiting skills, developing friendship networks, good sportsmanship, good host behavior during get-togethers, changing bad reputations, and handling teasing, bullying, and arguments. Results revealed, in comparison with the control group, that the treatment group significantly improved their knowledge of social skills, increased frequency of hosted get-togethers, and improved overall social skills as reported by parents. Possibly due to poor return rate of questionnaires, social skills improvement reported by teachers was not significant. Future research should provide follow-up data to test the durability of treatment.
28. Levitt P, Campbell DB. {{The genetic and neurobiologic compass points toward common signaling dysfunctions in autism spectrum disorders}}.{ J Clin Invest};2009 (Apr);119(4):747-754.
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with high heritability. Here, we discuss data supporting the view that there are at least two distinct genetic etiologies for ASD: rare, private (de novo) single gene mutations that may have a large effect in causing ASD; and inherited, common functional variants of a combination of genes, each having a small to moderate effect in increasing ASD risk. It also is possible that a combination of the two mechanisms may occur in some individuals with ASD. We further discuss evidence from individuals with a number of different neurodevelopmental syndromes, in which there is a high prevalence of ASD, that some private mutations and common variants converge on dysfunctional ERK and PI3K signaling, which negatively impacts neurodevelopmental events regulated by some receptor tyrosine kinases.
29. Li J, Vestergaard M, Obel C, Christensen J, Precht DH, Lu M, Olsen J. {{A nationwide study on the risk of autism after prenatal stress exposure to maternal bereavement}}. {Pediatrics};2009 (Apr);123(4):1102-1107.
OBJECTIVE: Prenatal stress has been linked to several adverse neurobehavioral outcomes, which may share a common pathophysiology with autism. We aimed to examine whether prenatal stress exposure after maternal bereavement is associated with an increased risk of autism later in life. METHODS: We conducted a nationwide population-based cohort study of all 1492709 singletons in Denmark born from 1978 to 2003. A total of 37275 children were born to women who lost a close relative during pregnancy or up to 1 year before pregnancy. These children were included in the exposed group, and the remaining children were in the unexposed group. All children were followed up from birth until their death, migration, onset of autism, or the end of 2006. Information on autism was obtained from the Danish Psychiatric Central Register. We used Cox regression models to estimate hazard ratios in the exposed group compared with those in the unexposed group. RESULTS: Maternal bereavement during the prenatal period was not associated with an increased risk of autism in the offspring. The hazard ratios did not differ by the nature of the exposure (maternal relationship to the deceased or cause of death). The hazard ratios were comparable between the 5 prenatal exposure periods under study (7-12 months before pregnancy, 0-6 months before pregnancy, first trimester, second trimester, and third trimester). CONCLUSIONS: This is the first population-based cohort study to examine the effect of prenatal stress on autism in childhood. Our data do not support any strong association between prenatal stress after maternal bereavement and the risk of autism.
30. Lind SE, Bowler DM. {{Delayed self-recognition in children with autism spectrum disorder}}. {J Autism Dev Disord};2009 (Apr);39(4):643-650.
This study aimed to investigate temporally extended self-awareness (awareness of one’s place in and continued existence through time) in autism spectrum disorder (ASD), using the delayed self-recognition (DSR) paradigm (Povinelli et al., Child Development 67:1540-1554, 1996). Relative to age and verbal ability matched comparison children, children with ASD showed unattenuated performance on the DSR task, despite showing significant impairments in theory-of-mind task performance, and a reduced propensity to use personal pronouns to refer to themselves. The results may indicate intact temporally extended self-awareness in ASD. However, it may be that the DSR task is not an unambiguous measure of temporally extended self-awareness and it can be passed through strategies which do not require the possession of a temporally extended self-concept.
31. Lombardo MV, Chakrabarti B, Baron-Cohen S. {{The amygdala in autism: not adapting to faces?}} {Am J Psychiatry};2009 (Apr);166(4):395-397.
32. Moore TR, Symons FJ. {{Adherence to Behavioral and Medical Treatment Recommendations by Parents of Children with Autism Spectrum Disorders}}. {J Autism Dev Disord};2009 (Mar 31)
The extent to which parents of children with intellectual or developmental disabilities are adherent to prescribed treatments has not been investigated. In this treatment adherence study, parents (n = 220) of children with autism spectrum disorders were surveyed regarding implementation of recommended treatments to manage problem behavior of their children living at home. Overall adherence to medical treatment recommendations was significantly greater than adherence to behavioral treatment recommendations (p < .002). Of the behavioral treatment recommendations, parents reported greater adherence to reinforcement (81.7%) than punishment (68.9%). Child diagnosis (p < .002) and the diagnosis x marital status interaction (p < .05) were significantly associated with reported adherence to behavioral and medical treatment, respectively. Results are discussed in light of the need to address adherence enhancement and measurement methods.
33. Murray DS, Ruble LA, Willis H, Molloy CA. {{Parent and teacher report of social skills in children with autism spectrum disorders}}. {Lang Speech Hear Serv Sch};2009 (Apr);40(2):109-115.
PURPOSE: The purpose of this study was to examine the agreement between parent and teacher perceptions of specific social behaviors in children with autism spectrum disorders (ASD). METHOD: Informant ratings were generated concerning 45 children with ASD between the ages of 5 and 14 years who were enrolled in social skills groups at 2 Midwestern outpatient autism treatment centers. RESULTS: Moderate agreement was observed between parents and teachers for the overall social skills rating scores (r = 0.34; p < 0.05), but there was little agreement on specific social items. Distinct patterns of skill profiles emerged. Parents consistently provided relatively higher ratings on items that pertained to initiating interactions. Teachers, on the other hand, consistently provided higher ratings on items related to responding to and maintaining interactions. Parents and teachers agreed most often on items of affective understanding and perspective taking. CONCLUSION: These findings suggest that specific social behaviors may be context dependent, indicating the need for a multi-informant approach to provide a more complete profile of a child’s social abilities, which is necessary for generating a more effective treatment plan.
34. Nag N, Ward B, Berger-Sweeney JE. {{Nutritional factors in a mouse model of Rett syndrome}}. {Neurosci Biobehav Rev};2009 (Apr);33(4):586-592.
Environmental factors such as nutrition and housing can influence behavioral and anatomical characteristics of several neurological disorders, including Rett syndrome (RTT). RTT is associated with mutations in the X-linked gene encoding MeCP2, a transcriptional repressor that binds methylated DNA. While direct genetic intervention in humans is impossible at this time, motor and cognitive deficits in RTT may be ameliorated through manipulations of epigenetic/environmental factors. For example, studies in rodents suggest that choline nutrient supplementation during critical periods of brain development enhances cholinergic neurotransmission, alters neuronal size and distribution, and facilitates performance of memory and motoric tasks. Recent work in a mouse model of RTT shows that enhancing maternal nutrition through choline supplementation improves both anatomical and behavioral symptoms in the mutant offspring. We describe here cellular and molecular mechanisms that may underlie this specific enhancement and may provide more general insights into mechanisms underlying gene-environment interactions in neurological disorders.
35. Pijnacker J, Hagoort P, Buitelaar J, Teunisse JP, Geurts B. {{Pragmatic inferences in high-functioning adults with autism and Asperger syndrome}}. {J Autism Dev Disord};2009 (Apr);39(4):607-618.
Although people with autism spectrum disorders (ASD) often have severe problems with pragmatic aspects of language, little is known about their pragmatic reasoning. We carried out a behavioral study on high-functioning adults with autistic disorder (n = 11) and Asperger syndrome (n = 17) and matched controls (n = 28) to investigate whether they are capable of deriving scalar implicatures, which are generally considered to be pragmatic inferences. Participants were presented with underinformative sentences like « Some sparrows are birds ». This sentence is logically true, but pragmatically inappropriate if the scalar implicature « Not all sparrows are birds » is derived. The present findings indicate that the combined ASD group was just as likely as controls to derive scalar implicatures, yet there was a difference between participants with autistic disorder and Asperger syndrome, suggesting a potential differentiation between these disorders in pragmatic reasoning. Moreover, our results suggest that verbal intelligence is a constraint for task performance in autistic disorder but not in Asperger syndrome.
36. Riby DM, Doherty-Sneddon G, Bruce V. {{Exploring face perception in disorders of development: evidence from Williams syndrome and autism}}. {J Neuropsychol};2008 (Mar);2(Pt 1):47-64.
Individuals with Williams syndrome (WS) and autism are characterized by different social phenotypes but have been said to show similar atypicalities of face-processing style. Although the structural encoding of faces may be similarly atypical in these two developmental disorders, there are clear differences in overall face skills. The inclusion of both populations in the same study can address how the profile of face skills varies across disorders. The current paper explored the processing of identity, eye-gaze, lipreading, and expressions of emotion using the same participants across face domains. The tasks had previously been used to make claims of a modular structure to face perception in typical development. Participants with WS (N=15) and autism (N=20) could be dissociated from each other, and from individuals with general developmental delay, in the domains of eye-gaze and expression processing. Individuals with WS were stronger at these skills than individuals with autism. Even if the structural encoding of faces appears similarly atypical in these groups, the overall profile of face skills, as well as the underlying architecture of face perception, varies greatly. The research provides insights into typical and atypical models of face perception in WS and autism.
37. Shattuck PT, Grosse S, Parish S, Bier D. {{Utilization of a medicaid-funded intervention for children with autism}}. {Psychiatr Serv};2009 (Apr);60(4):549-552.
OBJECTIVE: The study examined utilization of Wisconsin’s Medicaid funding for autism intervention before and after a major shift in program administration. METHODS: Medicaid enrollment data were analyzed for 1,822 children with autism from 2000 through 2006, as were geocoded demographic data and decennial census data. Enrollees’ data were compared with demographic data for Wisconsin’s general population. RESULTS: Compared with averages for all Wisconsin families, new Medicaid enrollees in 2000 were more likely to be from census tracts with a high proportion of white families with high socioeconomic status. These disparities decreased by 2006, two years after a change from a Medicaid fee-for-service structure to a Medicaid home- and community-based services waiver. CONCLUSIONS: As more states consider carve-out benefits for children with autism, close attention needs to be paid to the potential for disparities and the influence of mode of administration on utilization.
38. Sokhadze EM, El-Baz A, Baruth J, Mathai G, Sears L, Casanova MF. {{Effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on gamma frequency oscillations and event-related potentials during processing of illusory figures in autism}}. {J Autism Dev Disord};2009 (Apr);39(4):619-634.
Previous studies by our group suggest that the neuropathology of autism is characterized by a disturbance of cortical modularity. In this model a decrease in the peripheral neuropil space of affected minicolumns provides for an inhibitory deficit and a readjustment in their signal to noise bias during information processing. In this study we proposed using low frequency transcranial magnetic stimulation (rTMS) as a way increasing the surround inhibition of minicolumns in autism. Thirteen patients (ADOS and ADI-R diagnized) and equal number of controls participated in the study. Repetitive TMS was delivered at 0.5 Hz, 2 times per week for 3 weeks. Outcome measures based on event-related potentials (ERP), induced gamma activity, and behavioral measures showed significant post-TMS improvement. The results suggest that rTMS offers a potential therapeutic intervention for autism.
39. Tsuji H, Miyawaki D, Kawaguchi T, Matsushima N, Horino A, Takahashi K, Suzuki F, Kiriike N. {{Relationship of hypersensitivity to anxiety and depression in children with high-functioning pervasive developmental disorders}}. {Psychiatry Clin Neurosci};2009 (Apr);63(2):195-201.
AIMS: Sensory-perceptual abnormalities, which include hyper- and hyposensitivity, have been identified by numerous researchers as prevalent in individuals with pervasive developmental disorders (PDD). Hypersensitivity has a greater impact on PDD patients’ daily lives than hyposensitivity. The purpose of the present study was to clarify the relationship of hypersensitivity to anxiety, depression and other psychopathology in children with PDD. METHODS: Sixty-four children were divided into a hypersensitivity group (HG; n = 43) and a non-hypersensitivity group (non-HG; n = 21), and compared for anxiety, depression and other psychopathology on the Child Behavior Checklist (CBCL), State-Trait Anxiety Inventory for Children (STAIC) and Children’s Depression Inventory (CDI). RESULTS: The HG group had significantly higher scores than the non-HG group in Total, Internalizing, and Somatic complaints on the CBCL. On STAIC, the mean sore of Total Score, State Score and Trait Score in the HG group tended to be higher than in the non-HG group, but the difference was not significant. The score on the CDI in the HG group was significantly higher than that in the non-HG group. CONCLUSION: PDD children with hypersensitivity have more serious psychopathologies, especially internalizing symptoms including depression.
40. Turk J, Bax M, Williams C, Amin P, Eriksson M, Gillberg C. Autism {{spectrum disorder in children with and without epilepsy: impact on social functioning and communication}}. {Acta Paediatr};2009 (Apr);98(4):675-681.
AIM: To compare developmental and psychological functioning in two groups of children with autism spectrum disorder (asd), one with epilepsy and one without. METHODS: Sixty 7-17-year-old children in each group were recruited through a range of services in order to screen as representative a sample as possible. Parents were interviewed using the diagnostic interview for social and communication disorders (DISCO-11), and children were clinically examined and their medical histories assessed. RESULTS: The asd and epilepsy (asd+e) group demonstrated a substantially more even gender ratio, with a greater proportion of girls. They were more likely to have received later asd diagnoses and additional medical diagnoses. They also showed more motor difficulties, developmental delays and challenging behaviours, but were no more likely to be aloof and passive. The asd-only group experienced more abnormal fascinations with objects and used brief glances as a means of eye contact more than the asd+e group. CONCLUSION: Results support important between-group differences with diagnostic and therapeutic implications. asds often present atypically in children with seizures. However, both groups showed widely varying social and linguistic presentations.
41. White SW, Oswald D, Ollendick T, Scahill L. {{Anxiety in children and adolescents with autism spectrum disorders}}. {Clin Psychol Rev};2009 (Apr);29(3):216-229.
Anxiety and poor stress management are common concerns in clinical samples of children with autism spectrum disorders (ASD). Anxiety may worsen during adolescence, as young people face an increasingly complex social milieu and often become more aware of their differences and interpersonal difficulties. This review summarizes the state of research on the prevalence, phenomenology, and treatment of anxiety in youth with autism and related conditions such as Asperger’s Disorder. Using search words autism, asperger(s), or pervasive developmental disorder and anxiety or anxious to find reports published between 1990 and 2008, this review identified 40 papers. The results of the review suggest that anxiety, whether measured categorically or dimensionally, is indeed common in children and adolescents with autism spectrum disorders and may be a source of additional morbidity. The assessment of anxiety disorders in ASD should be conducted using multiple informants and modalities, as children with ASD often do not display age-typical symptoms of anxiety. To date, relatively few controlled intervention studies using well-characterized samples have been conducted despite preliminary evidence for efficacy of select pharmacological and psychosocial approaches. Recommendations for future applied research are presented and clinical implications are explored.
42. Williams ME, Atkins M, Soles T. {{Assessment of autism in community settings: discrepancies in classification}}. {J Autism Dev Disord};2009 (Apr);39(4):660-669.
Review of 78 evaluations for 29 young children examined practices used in assessment of autism spectrum disorders in three settings: public schools, developmental disabilities eligibility determinations, and our hospital-based early childhood mental health program. While similar rates of classification of autism spectrum disorders were found across sites, the rate of agreement by different evaluators for individual children was only 45%. Further, most community evaluators did not follow best practice guidelines nor use autism diagnostic tools with established psychometric properties. In this sample of primarily Latino, Spanish-speaking children, most community evaluators did not document assessment of the child in their native language, nor address the impact of language in their assessments.
43. Yamasue H, Kuwabara H, Kawakubo Y, Kasai K. {{Oxytocin, sexually dimorphic features of the social brain, and autism}}. {Psychiatry Clin Neurosci};2009 (Apr);63(2):129-140.
The common features of autism spectrum disorder, a highly heritable representative pervasive developmental disorder with significant heterogeneity and multiple-genetic factors, are severe dysfunction in social reciprocity, abnormalities in social brain regions, and disproportionately low probability in the female gender. Concomitantly, certain domains of mental function, such as emotional memory and social reciprocity, show a significant sex difference. In addition, recent neuroimaging studies have shown significant sexual dimorphisms in neuroanatomical correlates of social cognition. Recently, some sexually dimorphic factors, including oxytocin, vasopressin, and genes linked with the x-chromosome, have received attention because of their possible contribution to mental development especially in the social cognitive domain. Taking this evidence together, it is hypothesized that a sexually dimorphic factor associated with social reciprocity could affect characteristics of autism spectrum disorder including dysfunction in social reciprocity, abnormalities in social brain regions, and disproportionately low probability in female gender. This review article overviews sexual dimorphisms in clinical features of autism spectrum disorder, in normal social cognition, and in social brain function and structure. The association of oxytocin with sexual dimorphisms, social reciprocity, neural correlates of social cognition, and the pathogenesis of autism spectrum disorder were further summarized. Recent studies have suggested that oxytocin plays a role in social attachment in experimental animals, in enhancing social interactive ability in human adults, and in the pathogenesis of autism spectrum disorder. Thus, the ongoing accumulated evidence suggests that oxytocin deserves to be examined as a candidate that causes the sexually dimorphic aspect of human social reciprocity, social brain development and the pathogenesis of autism spectrum disorder.
