1. Almirall D, DiStefano C, Chang YC, Shire S, Kaiser A, Lu X, Nahum-Shani I, Landa R, Mathy P, Kasari C. {{Longitudinal Effects of Adaptive Interventions With a Speech-Generating Device in Minimally Verbal Children With ASD}}. {J Clin Child Adolesc Psychol};2016 (Mar 8):1-15.
There are limited data on the effects of adaptive social communication interventions with a speech-generating device in autism. This study is the first to compare growth in communications outcomes among three adaptive interventions in school-age children with autism spectrum disorder (ASD) who are minimally verbal. Sixty-one children, ages 5-8 years, participated in a sequential, multiple-assignment randomized trial (SMART). All children received a developmental behavioral communication intervention: joint attention, symbolic play, engagement and regulation (JASP) with enhanced milieu teaching (EMT). The SMART included three 2-stage, 24-week adaptive interventions with different provisions of a speech-generating device (SGD) in the context of JASP+EMT. The first adaptive intervention, with no SGD, initially assigned JASP+EMT alone, then intensified JASP+EMT for slow responders. In the second adaptive intervention, slow responders to JASP+EMT were assigned JASP+EMT+SGD. The third adaptive intervention initially assigned JASP+EMT+SGD; then intensified JASP+EMT+SGD for slow responders. Analyses examined between-group differences in change in outcomes from baseline to Week 36. Verbal outcomes included spontaneous communicative utterances and novel words. Nonlinguistic communication outcomes included initiating joint attention and behavior regulation, and play. The adaptive intervention beginning with JASP+EMT+SGD was estimated as superior. There were significant (p < .05) between-group differences in change in spontaneous communicative utterances and initiating joint attention. School-age children with ASD who are minimally verbal make significant gains in communication outcomes with an adaptive intervention beginning with JASP+EMT+SGD. Future research should explore mediators and moderators of the adaptive intervention effects and second-stage intervention options that further capitalize on early gains in treatment. Lien vers le texte intégral (Open Access ou abonnement)
2. Ashburner J, Ziviani J, Rodger S, Hinder EA, Cartmill L, White J, Vickerstaff S. {{Improving Transfer of Learning: An Innovative Comentoring Program to Enhance Workplace Implementation After an Occupational Therapy Course on Autism Spectrum Disorders}}. {J Contin Educ Health Prof};2015 (Fall);35(4):270-277.
INTRODUCTION: Research suggests that learning gained through training is infrequently implemented in the workplace. A short-term postcourse comentoring program was developed with the aim of facilitating workplace implementation of learning after a 3-day course for occupational therapists. The program was evaluated for usefulness, successes, challenges, recommended improvements, and associations with changes in self-rated knowledge and confidence. METHOD: Two months after the course, 42 participants completed an evaluation of the comentoring program with closed- and open-ended questions addressing usefulness, successes, challenges, pairing preferences, and recommendations. They also completed a record on whether or not they had worked on goals nominated in their comentoring contract. Before and 2 months after the course, they completed a self-rated questionnaire on knowledge and confidence. RESULTS: The comentoring program was recommended by 80% of participants. Benefits included opportunities for information and resource sharing, debriefing, problem solving, reassurance, and implementation of ideas. Ninety-five percent of participants worked on some or all their comentoring goals. Although there were significant improvements in knowledge (P < 0.001) and confidence (P < 0.001), the total comentoring evaluation score was not significantly associated with these changes. It is therefore possible that these improvements related to the course itself rather than the comentoring program. Challenges related to time, scheduling, distance, and pairing of comentors. CONCLUSION: Reported benefits of the program included enhanced psychosocial support and prompting to trial newly learned strategies. Effectiveness may be improved by setting aside time for comentoring in the workplace and better matching of comentors. Lien vers le texte intégral (Open Access ou abonnement)
3. Bottema-Beutel K, Turiel E, DeWitt MN, Wolfberg PJ. {{To include or not to include: Evaluations and reasoning about the failure to include peers with autism spectrum disorder in elementary students}}. {Autism};2016 (Mar 7)
Given the significant role that typically developing children play in the social lives of children with autism spectrum disorder, it is important to understand how they evaluate and reason about the inclusion/exclusion of children with autism spectrum disorder in social situations. The objective of this study is to determine elementary students’ evaluations, reasoning patterns, and reasoning complexity regarding the failure to include children with autism spectrum disorder in social activities. Forty-four elementary-aged students participated in interviews, which included vignettes describing four contexts in which a child with autism spectrum disorder is not invited to a social event. Responses were analyzed according to social domain theory, an approach emphasizing that children identify and coordinate different domains of social knowledge, including the moral, personal, societal, and prudential. Results showed that regardless of grade and context, most children judge that failure to include on the basis of disability status is not acceptable. However, the complexity of children’s reasoning (i.e. the extent to which they drew upon and coordinated multiple domains) was higher in older children. Mean complexity scores were also higher in a birthday party context as compared to a playdate context. We offer implications for future research and practice regarding the social inclusion of children with autism spectrum disorder.
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4. Cholemkery H, Medda J, Lempp T, Freitag CM. {{Classifying Autism Spectrum Disorders by ADI-R: Subtypes or Severity Gradient?}}. {J Autism Dev Disord};2016 (Mar 8)
To reduce phenotypic heterogeneity of Autism spectrum disorders (ASD) and add to the current diagnostic discussion this study aimed at identifying clinically meaningful ASD subgroups. Cluster analyses were used to describe empirically derived groups based on the Autism Diagnostic Interview-revised (ADI-R) in a large sample of n = 463 individuals with ASD aged 3-21. Three clusters were observed. Most severely affected individuals regarding all core symptoms were allocated to cluster 2. Cluster 3 comprised moderate symptom severity of social communication impairments (SCI) and less stereotyped repetitive behavior (RRB). Minor SCI and relatively more RRB characterized cluster 1. This study offers support for both, a symptom profile, and a gradient model of ASD within the spectrum due to the sample included.
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5. Dewinter J, Van Parys H, Vermeiren R, van Nieuwenhuizen C. {{Adolescent boys with an autism spectrum disorder and their experience of sexuality: An interpretative phenomenological analysis}}. {Autism};2016 (Mar 7)
This qualitative study explored how adolescent boys with autism spectrum disorder experience their sexuality. Previous research has demonstrated that sexuality is a developmental task for boys with autism spectrum disorder, as it is for their peers. Case studies have suggested a relation between autism spectrum disorder and atypical sexual development; empirical studies on this subject, however, are scant and inconsistent. This study is based on interviews with eight boys, aged 16-20 years, with Asperger’s disorder or autistic disorder. Interpretative phenomenological analysis of the data revealed three major themes relating to (a) how they experience sexual feelings, think about sexuality and think about themselves as sexual beings; (b) how they perceive messages relating to sexuality in their surroundings; and (c) how they experience finding and having a partner and partnered sex. We believe that attention to these themes is needed in assessment, education and further research.
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6. Lim BO, O’Sullivan D, Choi BG, Kim MY. {{Comparative gait analysis between children with autism and age-matched controls: analysis with temporal-spatial and foot pressure variables}}. {J Phys Ther Sci};2016 (Jan);28(1):286-292.
[Purpose] The purpose of this study was to investigate the gait pattern of children with autism by using a gait analysis system. [Subjects] Thirty children were selected for this study: 15 with autism (age, 11.2 +/- 2.8 years; weight, 48.1 +/- 14.1 kg; height, 1.51 +/- 0.11 m) and 15 healthy age-matched controls (age, 11.0 +/- 2.9 years; weight, 43.6 +/- 10 kg; height, 1.51 +/- 0.011 m). [Methods] All participants walked three times on the GAITRite((R)) system while their plantar pressure was being recorded. [Results] The results showed a reduction in cadence, gait velocity, and step length, and an increase in step width in children with autism. Plantar pressure variables highlight the differences between the active pressure areas, especially in the hindfoot of children with autism. [Conclusion] The results suggest that children with autism have an abnormal gait compared with that of age-matched controls, and thus they need extra attention to correct these abnormal gait patterns.
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7. Lindsay G, Ricketts J, Peacey LV, Dockrell JE, Charman T. {{Meeting the educational and social needs of children with language impairment or autism spectrum disorder: the parents’ perspectives}}. {Int J Lang Commun Disord};2016 (Mar 8)
BACKGROUND: There is increasing interest in examining the perspectives of parents of children with special educational needs (SEN). Exploring the view of parents of a child with language impairment (LI) or autism spectrum disorder (ASD) is particularly important because of their high prevalence, at over 30% of children with SEN in England, and the increasing evidence of overlapping profiles of their needs. AIMS: To examine the similarities and differences between the perspectives of parents of children with LI or ASD on three issues: (1) their child’s educational progress, and their behavioural, emotional and social development; (2) the provision made to support their child’s education and meet their SEN; and (3) their own involvement in decision-making about provision for their child. METHODS & PROCEDURES: The parents of 129 children with LI (n = 76) or ASD (n = 53) were interviewed using a semi-structured protocol that gathered both quantitative data (parent ratings) and qualitative, in-depth explorations of their perspectives. OUTCOMES & RESULTS: There were no significant differences between the perspectives of parents of children with LI and parents of children with ASD with respect to their child’s educational progress; the provision made to meet their child’s educational needs; or their involvement in decision-making during the statutory assessment procedure, including the determination of a statement of SEN, and the current provision made by their child’s school. Both parent groups were generally positive about these but parents of children with ASD were more concerned about their child’s peer relationships. Parents whose child attended a mainstream school with a specialist resource tended to be more positive about the provision made than parents whose child was included individually into a mainstream school. CONCLUSIONS & IMPLICATIONS: Although previous research indicates that parents of children with ASD are overrepresented among those who express dissatisfaction with the provision made to meet their child’s needs, this study indicates high levels of satisfaction and overlap between the perspectives of parents of children with LI or ASD regarding their child’s educational progress and their own involvement in decision-making about the child’s provision. The findings indicate the importance for policy and practice of focusing on identified needs rather than diagnostic category; and the importance of practitioners and administrators engaging meaningfully with parents in collaborative decision-making.
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8. Michaelsen-Preusse K, Zessin S, Grigoryan G, Scharkowski F, Feuge J, Remus A, Korte M. {{Neuronal profilins in health and disease: Relevance for spine plasticity and Fragile X syndrome}}. {Proc Natl Acad Sci U S A};2016 (Mar 7)
Learning and memory, to a large extent, depend on functional changes at synapses. Actin dynamics orchestrate the formation of synapses, as well as their stabilization, and the ability to undergo plastic changes. Hence, profilins are of key interest as they bind to G-actin and enhance actin polymerization. However, profilins also compete with actin nucleators, thereby restricting filament formation. Here, we provide evidence that the two brain isoforms, profilin1 (PFN1) and PFN2a, regulate spine actin dynamics in an opposing fashion, and that whereas both profilins are needed during synaptogenesis, only PFN2a is crucial for adult spine plasticity. This finding suggests that PFN1 is the juvenile isoform important during development, whereas PFN2a is mandatory for spine stability and plasticity in mature neurons. In line with this finding, only PFN1 levels are altered in the mouse model of the developmental neurological disorder Fragile X syndrome. This finding is of high relevance because Fragile X syndrome is the most common monogenetic cause for autism spectrum disorder. Indeed, the expression of recombinant profilins rescued the impairment in spinogenesis, a hallmark in Fragile X syndrome, thereby linking the regulation of actin dynamics to synapse development and possible dysfunction.
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9. Molenhuis RT, Bruining H, Remmelink E, de Visser L, Loos M, Burbach JP, Kas MJ. {{Limited impact of Cntn4 mutation on autism-related traits in developing and adult C57BL/6J mice}}. {J Neurodev Disord};2016;8:6.
BACKGROUND: Mouse models offer an essential tool to unravel the impact of genetic mutations on autism-related phenotypes. The behavioral impact of some important candidate gene models for autism spectrum disorder (ASD) has not yet been studied, and existing characterizations mostly describe behavioral phenotypes at adult ages, disregarding the developmental nature of the disorder. In this context, the behavioral influence of CNTN4, one of the strongest suggested ASD candidate genes, is unknown. Here, we used our recently established developmental test battery to characterize the consequences of disruption of contactin 4 (Cntn4) on neurological, sensory, cognitive, and behavioral phenotypes across different developmental stages. METHODS: C57BL/6J mice with heterozygous and homozygous disruption of Cntn4 were studied through an extensive, partially longitudinal, test battery at various developmental stages, including various paradigms testing social and restricted repetitive behaviors. RESULTS: Developmental neurological and cognitive screenings revealed no significant differences between genotypes, and ASD-related behavioral domains were also unchanged in Cntn4-deficient versus wild-type mice. The impact of Cntn4-deficiency was found to be limited to increased startle responsiveness following auditory stimuli of different high amplitudes in heterozygous and homozygous Cntn4-deficient mice and enhanced acquisition in a spatial learning task in homozygous mice. CONCLUSIONS: Disruption of Cntn4 in the C57BL/6J background does not affect specific autism-related phenotypes in developing or adult mice but causes subtle non-disorder specific changes in sensory behavioral responses and cognitive performance.
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10. Murza KA, Schwartz JB, Hahs-Vaughn DL, Nye C. {{Joint attention interventions for children with autism spectrum disorder: a systematic review and meta-analysis}}. {Int J Lang Commun Disord};2016 (Mar 8)
BACKGROUND: A core social-communication deficit in children with autism spectrum disorder (ASD) is limited joint attention behaviours-important in the diagnosis of ASD and shown to be a powerful predictor of later language ability. Various interventions have been used to train joint attention skills in children with ASD. However, it is unclear which participant, intervention and interventionist factors yield more positive results. AIMS: The purpose of this systematic review and meta-analysis was to provide a quantitative assessment of the effectiveness of joint attention interventions aimed at improving joint attention abilities in children with ASD. METHODS & PROCEDURES: The researchers searched six databases for studies meeting the inclusion criteria at two levels: title/abstract and full-text stages. Two independent coders completed data extraction using a coding manual and form developed specifically for this research study. Meta-analysis procedures were used to determine the overall effects of several comparisons including treatment type, treatment administrator, intervention characteristics and follow-up. MAIN CONTRIBUTION: Fifteen randomized experimental studies met inclusion criteria. All comparisons resulted in statistically significant effects, though overlapping confidence intervals suggest that none of the comparisons were statistically different from each other. Specifically, treatment administrator, dosage and design (control or comparison, etc.) characteristics of the studies do not appear to produce significantly different effects. CONCLUSIONS & IMPLICATIONS: The results of this meta-analysis provide strong support for explicit joint attention interventions for young children with ASD; however, it remains unclear which children with ASD respond to which type of intervention.
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11. Rai V. {{Association of methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with autism: evidence of genetic susceptibility}}. {Metab Brain Dis};2016 (Mar 8)
Autism (MIM 209850) is a heterogeneous neurodevelopmental disease that manifests within the first 3 years of life. Numerous articles reported that dysfunctional folate-methionine pathway enzymes may play an important role in the pathophysiology of autism. Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme of this pathway and MTHFR C677T polymorphism reported as risk factor for autism in several case control studies. However, controversial reports were also published. Hence the present meta-analysis was designed to investigate the relationship of the MTHFR C677T polymorphism with the risk of autism. Electronic databases were searched for case control studies with following search terms – ‘MTHFR’, ‘C677T’, in combination with ‘Autism’. Pooled OR with its corresponding 95 % CI was calculated and used as association measure to investigate the association between MTHFR C677T polymorphism and risk of autism. Total of thirteen studies were found suitable for the inclusion in the present meta-analysis, which comprises 1978 cases and 7257 controls. Meta-analysis using all four genetic models showed significant association between C677T polymorphism and autism (ORTvs.C = 1.48; 95 % CI: 1.18-1.86; P = 0.0007; ORTT + CT vs. CC = 1.70, 95 % CI = 0.96-2.9, p = 0.05; ORTT vs. CC = 1.84, 95 % CI = 1.12-3.02, p = 0.02; ORCT vs.CC = 1.60, 95 % CI = 1.2-2.1, p = 0.003; ORTT vs.CT+CC = 1.5, 95 % CI = 1.02-2.2, p = 0.03). In total 13 studies, 9 studies were from Caucasian population and 4 studies were from Asian population. The association between C677T polymorphism and autism was significant in Caucasian (ORTvs.C = 1.43; 95 % CI = 1.1-1.87; p = 0.009) and Asian population (ORTvs.C = 1.68; 95 % CI = 1.02-2.77; p = 0.04) using allele contrast model. In conclusion, present meta-analysis strongly suggested a significant association of the MTHFR C677T polymorphism with autism.
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12. Richardson D. {{Toilet training for children with autism}}. {Nurs Child Young People};2016 (Mar 8);28(2):16-22.
Toilet training is one of the key developmental milestones of early childhood and there is growing evidence that it is now being initiated later than it was 50 years ago. This article explores the reasons why this is happening and considers the effect on children with autism and related conditions. It also examines the literature to discover the approaches to toilet training for this group. Research into this area has generally focused on small numbers of children and incorporated modified versions of Azrin and Foxx’s ( 1971 ) rapid toilet training method. Suggestions are offered about the most appropriate advice to give parents and carers of children with autism and related disorders, and the importance of addressing toilet training at an early stage.
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13. Rosso EG. {{Brief Report: Coaching Adolescents with Autism Spectrum Disorder in a School-Based Multi-Sport Program}}. {J Autism Dev Disord};2016 (Mar 8)
While physical activity (PA) is often overwhelming for people with ASD, appropriate engagement strategies can result in increased motivation to participate and associated physical and psychosocial benefits. In this framework, the multi-sport Supporting Success program aims to inform good-practice coaching strategies for community coaches to engage with adolescents with ASD in order to foster socialisation. The project employs a community development approach and a Participatory Action Research (PAR) design. Methods include ongoing consultation, focus groups, briefing/debriefing sessions and questionnaire surveys. Preliminary findings indicate that coaching strategies and program design are fundamental variables in the use of sport/PA to help adolescents with ASD to develop social skills and share positive experiences with peers, coaches, educators and local community members.
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14. Shenaar-Golan V. {{The Subjective Well-Being of Parents of Children with Developmental Disabilities: The Role of Hope as Predictor and Fosterer of Well-Being}}. {J Soc Work Disabil Rehabil};2016 (Mar 9)
The purpose of this study was to identify factors that can improve the subjective well-being (SWB) of parents of children with a developmental disability, expand the knowledge relating to the role of hope in their lives, and the extent to which parent appraisals of the influence of the disability (upon the couple’s relationship, family functioning, and personal development) moderate this association. The results revealed that parental SWB was below the societal average; however, it differed significantly across levels of parent appraisals of their child’s disability. Findings from this study point to the importance of hope to improve parental SWB.
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15. Varcin KJ, Nelson CA, 3rd. {{A developmental neuroscience approach to the search for biomarkers in autism spectrum disorder}}. {Curr Opin Neurol};2016 (Apr);29(2):123-129.
PURPOSE OF REVIEW: The delineation of biomarkers in autism spectrum disorder (ASD) offers a promising approach to inform precision-medicine-based approaches to ASD diagnosis and treatment and to move toward a mechanistic description of the disorder. However, biomarkers with sufficient sensitivity or specificity for clinical application in ASD are yet to be realized. Here, we review recent evidence for early, low-level alterations in brain and behavior development that may offer promising avenues for biomarker development in ASD. RECENT FINDINGS: Accumulating evidence suggests that signs associated with ASD may unfold in a manner that maps onto the hierarchical organization of brain development. Genetic and neuroimaging evidence points towards perturbations in brain development early in life, and emerging evidence indicates that sensorimotor development may be among the earliest emerging signs associated with ASD, preceding social and cognitive impairment. SUMMARY: The search for biomarkers of risk, prediction and stratification in ASD may be advanced through a developmental neuroscience approach that looks outside of the core signs of ASD and considers the bottom-up nature of brain development alongside the dynamic nature of development over time. We provide examples of assays that could be incorporated in studies to target low-level circuits.
