Pubmed du 11/02/21
1. Alshatrat SM, Al-Bakri IA, Al-Omari WM, Al Mortadi NA. Oral health knowledge and dental behavior among individuals with autism in Jordan : a case-control study. BMC oral health. 2021 ; 21(1) : 62.
BACKGROUND : Oral care is acknowledged as an integral component of general health and plays an essential role in establishing the desired level of quality of life for individuals with autism spectrum disorder (ASD). PURPOSE : To investigate oral health knowledge and dental behaviors in individuals with ASD in comparison with individuals without ASD in Jordan. METHODS : A case-control study was carried out among 296 caregivers of individuals with ASD (n = 147) and control (n = 149) groups. A closed ended, validated self-designed questionnaire was distributed. The questionnaire included questions addressing participant’s oral health knowledge and behaviour. Data were analyzed using SPSS® software Version 22 with a 0.05 level of significance. A Chi-square test and contingency-table analysis were performed. RESULTS : Individuals with ASD in Jordan were significantly less knowledgeable about different oral health aspects than individuals without ASD (p < 0.05). Fewer individuals in the ASD group brushed their teeth once or twice daily (89%), compared to the control group (93%). Only 15% of the ASD participants could brush their teeth without help. The use of fluoridated toothpaste and the frequency of using mouth rinse demonstrated a significant difference between groups (p < 0.05). CONCLUSION : ASD individuals in Jordan suffer from a significant lack of oral knowledge comparing to their controls, leading to a misunderstanding of the basic and highly important dental health aspects. Indicating that the knowledge was not enough to influence their dental behaviors. Children with ASD and their families should receive appropriate education in special need oral health care given by oral health professionals to reduce the risk of having dental problems and oral disease and enhance their quality of life.
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2. Beverly J, Giannouchos T, Callaghan T. Examining frequent emergency department use among children and adolescents with autism spectrum disorder. Autism. 2021 : 1362361321990925.
This study used data for 5.9 million individuals with 9.1 million emergency department visits from all hospitals in the state of New York to explore frequent emergency department use between children and adolescents with autism spectrum disorders and those without autism spectrum disorders. We found that children and adolescents with autism spectrum disorders had larger shares of comorbidities and diagnoses related to attention-deficit/hyperactivity disorder, intellectual disability, and epilepsy. Children and adolescents with autism spectrum disorders were also more likely to utilize emergency departments and to exhibit frequent use. These results emphasize the need for using family-centered care to improve the care experiences of children and youth with autism spectrum disorders and their families. In addition, the education of emergency department staff of processes and practices as it relates to delivery of care and the care experience.
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3. Campbell K, Carbone PS, Liu D, Stipelman CH. Improving Autism Screening and Referrals With Electronic Support and Evaluations in Primary Care. Pediatrics. 2021.
BACKGROUND : Universal screening for autism promotes early evidence-based treatment. However, many children are not screened, and screened children are often not referred for autism evaluation. METHODS : We implemented process changes in 3 phases : phase 1, changing the screening instrument and adding decision support ; phase 2, adding automatic reminders ; and phase 3, adding a referral option for autism evaluations in primary care. We analyzed the proportion of visits with autism screening at 2 intervention clinics before and after implementation of process changes versus 27 community clinics (which received only automatic reminders in phase 2) with χ(2) test and interrupted time series. We evaluated changes in referral for autism evaluation by calculating the rate ratio for referral. RESULTS : In 12 233 visits over 2 years (baseline and phased improvements), autism screening increased by 52% in intervention clinics (58.6%-88.8% ; P < .001) and 21% in community clinics (43.4%-52.4% ; P < .001). In phase 1, interrupted time series trend for screening in intervention clinics increased by 2% per week (95% confidence interval [CI] : 1.1% to 2.9%) and did not increase in community clinics. In phase 2, screening in the community clinics increased by 0.46% per week (95% CI : 0.03% to 0.89%). In phase 3, the intervention clinic providers referred patients for diagnostic evaluation 3.4 times more frequently (95% CI : 2.0 to 5.8) than at baseline. CONCLUSIONS : We improved autism screening and referrals by changing the screening instrument, adding decision support, using automatic reminders, and offering autism evaluation in primary care in intervention clinics. Automatic reminders alone improved screening in community clinics.
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4. Cannon J, O’Brien AM, Bungert L, Sinha P. Prediction in Autism Spectrum Disorder : A Systematic Review of Empirical Evidence. Autism Res. 2021.
According to a recent influential proposal, several phenotypic features of autism spectrum disorder (ASD) may be accounted for by differences in predictive skills between individuals with ASD and neurotypical individuals. In this systematic review, we describe results from 47 studies that have empirically tested this hypothesis. We assess the results based on two observable aspects of prediction : learning a pairing between an antecedent and a consequence and responding to an antecedent in a predictive manner. Taken together, these studies suggest distinct differences in both predictive learning and predictive response. Studies documenting differences in learning predictive pairings indicate challenges in detecting such relationships especially when predictive features of an antecedent have low salience or consistency, and studies showing differences in habituation and perceptual adaptation suggest low-level predictive processing differences in ASD. These challenges may account for the observed differences in the influence of predictive priors, in spontaneous predictive movement or gaze, and in social prediction. An important goal for future research will be to better define and constrain the broad domain-general hypothesis by testing multiple types of prediction within the same individuals. Additional promising avenues include studying prediction within naturalistic contexts and assessing the effect of prediction-based intervention on supporting functional outcomes for individuals with ASD. LAY SUMMARY : Researchers have suggested that many features of autism spectrum disorder (ASD) may be explained by differences in the prediction skills of people with ASD. We review results from 47 studies. These studies suggest that ASD may be associated with differences in the learning of predictive pairings (e.g., learning cause and effect) and in low-level predictive processing in the brain (e.g., processing repeated sounds). These findings lay the groundwork for research that can improve our understanding of ASD and inform interventions.
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5. Haratizadeh S, Parvan M, Mohammadi S, Shabani M, Nozari M. An overview of modeling and behavioral assessment of autism in the rodent. Int J Dev Neurosci. 2021.
Autism Spectrum Disorders (ASDs) are common neurodevelopmental disorders with a growing incidence that generally present in the first 3 years of life. Behavioral symptoms, including impaired social interaction and increased repetitive or stereotypic movements, are hallmark characteristics of autism. Animal models are research tools used to study the biology of the disease and to develop new therapeutic approaches. The complexity of the etiology of autism makes it challenging to develop a comprehensive animal model that accurately mimics different clinical aspects of autism. Here, we reviewed the literature on modeling and behavioral assessment of autism in the rodent, and focused on ASD behavioral phenotypes that can be modeled in rodents. These animal models can be effective in gaining a better understanding of the pathophysiology of the disease.
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6. Lee SHF, Aziz SA, Hamid M, Lim YC, Koh D, Chaw LL. 2D:4D Ratio and Autism Spectrum Disorder in Brunei Darussalam. J Autism Dev Disord. 2021.
BACKGROUND : Despite the global increase in the prevalence of autism spectrum disorders (ASD), relevant research studies are lacking in Brunei Darussalam. Various studies have shown a significant association between a lowered 2D:4D ratio (ratio of second digit/index finger to the fourth digit/ring finger) and ASD, making it one of the potential phenotypic biomarkers for early detection of autism, which is important for early intervention and management. OBJECTIVE : The objective of this study is to explore the association between 2D:4D ratio and ASD in Brunei Darussalam, as a potential tool to complement early ASD diagnosis. METHODS : We conducted a case-control study comprising 28 ASD and 62 typically developing (TD) children in the case and control group, respectively (age range : 3-11 years old ; median age : 6 years old). Median 2D:4D ratios were measured, compared and analysed between the two groups. Logistic regression models were used to explore potential associations between the median 2D:4D ratio and ASD in respective gender, for both left and right hands, independently. RESULTS : Our study shows that the median 2D:4D ratio of left hand in ASD males is significantly lower than those in TD males, after adjusting for ethnicity and age [Odds Ratio (OR) = 0.57 (95% Confidence Interval (CI) : 0.31-0.96) ; p = 0.044]. For females, there is no association of ASD with the median left hand 2D:4D ratio [OR = 3.09 (95% CI : 0.98-19.86) ; p = 0.144] or the median right hand 2D:4D ratio [OR = 1.23 (95% CI : 0.42-3.88) ; p = 0.702]. Our study also shows a significant positive correlation and/or a reduced asymmetry between the average 2D:4D ratio of left hands and right hands in ASD males (Pearson’s correlation (r) = 0.48 ; 95% CI : 0.076-0.75, p = 0.023). CONCLUSIONS : There is significant association between a lowered median 2D:4D ratio of the left hand (in males only) and ASD diagnosis. Once validated in a larger sample size, a lowered median 2D:4D ratio on the left hand may be a potential tool to complement ASD diagnosis for males in our study population. There is no association between the median 2D:4D ratio (left or right hands) and ASD in females, which could be due to the small female sample size and/or the possibility of different aetiology for ASD in females. Reduced asymmetry between the average 2D:4D ratio of left and right hands observed in ASD males only (not in ASD females) also suggests the importance of considering gender-specific biomarkers for ASD diagnosis.
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7. Lei J, Jones L, Brosnan M. Exploring an e-learning community’s response to the language and terminology use in autism from two massive open online courses on autism education and technology use. Autism. 2021 : 1362361320987963.
Within the neurodiversity movement, one recent divergence is in the semantic choice of language when describing autism, as members of the autism and autistic community preferred to use identity-first language (autistic person), whereas professionals were more likely to use person-first language (person with autism). This study explored 803 e-learners’ responses from their comments across two massive open online courses on autism education held between 2017 and 2019. Learners agreed that autistic individuals should guide others on which terminology to use when describing autism, and although identity-first language acknowledges autism as part of an individual’s identity, it can also conjure up negative stereotypes and be stigmatising. Although family, friends and professionals highlighted that the diagnostic label is a way to facilitate understanding across stakeholder groups and help autistic individuals gain access to support, autistic self-advocates found the process of disclosing autism as a form of disability to conflict with their sense of identity, and broader terms such as ‘autism spectrum’ failed to capture individual strengths and weaknesses. Semantic language choices may matter less as long as the person’s difficulties are clearly acknowledged, with adaptations made to meet their specific needs. Adding to a growing body of literature on terminology use in autism research and practice, we highlight that language used when describing autism should follow the autistic individual’s lead, with the primary focus on communicating an individual’s strengths and difficulties, to foster a sense of positive autism identity and inclusivity, and enable access to appropriate support.
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8. Lopez-Espejo MA, Nuñez AC, Moscoso OC, Escobar RG. Brief Report : Health-Related Quality of Life in Preschoolers with Autism Spectrum Disorder is Related to Diagnostic Age and Autistic Symptom Severity. J Autism Dev Disord. 2021.
We conducted a cross-sectional study to explore whether clinical characteristics and autism diagnostic-traits severity are associated with caregiver-reported impairment of health-related quality of life (Pediatric Quality of Life Inventory Generic Core Scales, Fourth Edition) in 93 Chilean toddlers (age : 2-4 years) with autism spectrum disorder. Median total scale, physical health, and psychosocial health scores were 76 (IQR 70-81), 88 (IQR 81-94), and 71 (IQR 62-79), respectively. In multiple-regression analysis, diagnostic age (β = 0.219 ; p 0.021) and Calibrated Severity Score of Autism Diagnostic Observation Schedule, second edition (β = – 0.434 ; p < 0.001) were independently correlated to the total scale score. Lower age and higher autistic traits severity at diagnosis are correlated with worse well-being perception by caregivers.
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9. Matthias C, LaVelle JM, Johnson DR, Wu YC, Thurlow ML. Exploring Predictors of Bullying and Victimization of Students with Autism Spectrum Disorder (ASD) : Findings from NLTS 2012. J Autism Dev Disord. 2021.
Research suggests that bullying victimization occurs at higher rates among students with autism spectrum disorder (ASD) than among their typically-developing peers. This study used data from the National Longitudinal Transition Study 2012 to explore differences in student and family characteristics between students with ASD and students with all other special education disability categories. The study also examined characteristics serve as predictors of bullying and victimization. Students with ASD were found to have greater difficulties with communication and social skills, as well as less-robust sense of themselves and their abilities than students with all other disabilities. Race, household income, social and communication skills, and self-concept were found to be associated with higher rates of bullying and victimization.
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10. Smith MJ, Sherwood K, Ross B, Smith JD, DaWalt L, Bishop L, Humm L, Elkins J, Steacy C. Virtual interview training for autistic transition age youth : A randomized controlled feasibility and effectiveness trial. Autism. 2021 : 1362361321989928.
Autistic transition age youth struggle with obtaining employment, and interviewing is a critical barrier to getting a job. We adapted an efficacious virtual reality job interview intervention to meet the needs of autistic transition age youth, called the Virtual Interview Training for Transition Age Youth. This study evaluated whether Virtual Interview Training for Transition Age Youth can be feasibly delivered in high school special education settings and whether Virtual Interview Training for Transition Age Youth improves job interview skills, job interview self-efficacy, job interview anxiety, and access to employment. Forty-eight autistic transition age youth received school-based pre-employment services as usual with Virtual Interview Training for Transition Age Youth, while 23 autistic transition age youth received services as usual only. Local teachers trained and supervised autistic transition age youth using Virtual Interview Training for Transition Age Youth. Participants reported Virtual Interview Training for Transition Age Youth was highly acceptable. Participants receiving services as usual and Virtual Interview Training for Transition Age Youth, compared to participants receiving services as usual only, had better job interview skills and lower job interview anxiety as well as greater access to jobs. Overall, Virtual Interview Training for Transition Age Youth appears to be effective at teaching job interview skills that are associated with accessing competitive jobs. Moreover, youth enjoyed Virtual Interview Training for Transition Age Youth and teachers feasibly implemented the tool within special education pre-employment transition services. Future research needs to better understand how autistic transition age youth from culturally diverse backgrounds and different social, behavioral, or mental health challenges may respond to Virtual Interview Training for Transition Age Youth.
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11. Stevenson RA, Ruppel J, Sun SZ, Segers M, Zapparoli BL, Bebko JM, Barense MD, Ferber S. Visual working memory and sensory processing in autistic children. Sci Rep. 2021 ; 11(1) : 3648.
While atypical sensory processing is one of the more ubiquitous symptoms in autism spectrum disorder, the exact nature of these sensory issues remains unclear, with different studies showing either enhanced or deficient sensory processing. Using a well-established continuous cued-recall task that assesses visual working memory, the current study provides novel evidence reconciling these apparently discrepant findings. Autistic children exhibited perceptual advantages in both likelihood of recall and recall precision relative to their typically-developed peers. When autistic children did make errors, however, they showed a higher probability of erroneously binding a given colour with the incorrect spatial location. These data align with neural-architecture models for feature binding in visual working memory, suggesting that atypical population-level neural noise in the report dimension (colour) and cue dimension (spatial location) may drive both the increase in probability of recall and precision of colour recall as well as the increase in proportion of binding errors when making an error, respectively. These changes are likely to impact core symptomatology associated with autism, as perceptual binding and working memory play significant roles in higher-order tasks, such as communication.
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12. Yap CX, Alvares GA, Henders AK, Lin T, Wallace L, Farrelly A, McLaren T, Berry J, Vinkhuyzen AAE, Trzaskowski M, Zeng J, Yang Y, Cleary D, Grove R, Hafekost C, Harun A, Holdsworth H, Jellett R, Khan F, Lawson L, Leslie J, Levis Frenk M, Masi A, Mathew NE, Muniandy M, Nothard M, Visscher PM, Dawson PA, Dissanayake C, Eapen V, Heussler HS, Whitehouse AJO, Wray NR, Gratten J. Analysis of common genetic variation and rare CNVs in the Australian Autism Biobank. Mol Autism. 2021 ; 12(1) : 12.
BACKGROUND : Autism spectrum disorder (ASD) is a complex neurodevelopmental condition whose biological basis is yet to be elucidated. The Australian Autism Biobank (AAB) is an initiative of the Cooperative Research Centre for Living with Autism (Autism CRC) to establish an Australian resource of biospecimens, phenotypes and genomic data for research on autism. METHODS : Genome-wide single-nucleotide polymorphism genotypes were available for 2,477 individuals (after quality control) from 546 families (436 complete), including 886 participants aged 2 to 17 years with diagnosed (n = 871) or suspected (n = 15) ASD, 218 siblings without ASD, 1,256 parents, and 117 unrelated children without an ASD diagnosis. The genetic data were used to confirm familial relationships and assign ancestry, which was majority European (n = 1,964 European individuals). We generated polygenic scores (PGS) for ASD, IQ, chronotype and height in the subset of Europeans, and in 3,490 unrelated ancestry-matched participants from the UK Biobank. We tested for group differences for each PGS, and performed prediction analyses for related phenotypes in the AAB. We called copy-number variants (CNVs) in all participants, and intersected these with high-confidence ASD- and intellectual disability (ID)-associated CNVs and genes from the public domain. RESULTS : The ASD (p = 6.1e-13), sibling (p = 4.9e-3) and unrelated (p = 3.0e-3) groups had significantly higher ASD PGS than UK Biobank controls, whereas this was not the case for height-a control trait. The IQ PGS was a significant predictor of measured IQ in undiagnosed children (r = 0.24, p = 2.1e-3) and parents (r = 0.17, p = 8.0e-7 ; 4.0% of variance), but not the ASD group. Chronotype PGS predicted sleep disturbances within the ASD group (r = 0.13, p = 1.9e-3 ; 1.3% of variance). In the CNV analysis, we identified 13 individuals with CNVs overlapping ASD/ID-associated CNVs, and 12 with CNVs overlapping ASD/ID/developmental delay-associated genes identified on the basis of de novo variants. LIMITATIONS : This dataset is modest in size, and the publicly-available genome-wide-association-study (GWAS) summary statistics used to calculate PGS for ASD and other traits are relatively underpowered. CONCLUSIONS : We report on common genetic variation and rare CNVs within the AAB. Prediction analyses using currently available GWAS summary statistics are largely consistent with expected relationships based on published studies. As the size of publicly-available GWAS summary statistics grows, the phenotypic depth of the AAB dataset will provide many opportunities for analyses of autism profiles and co-occurring conditions, including when integrated with other omics datasets generated from AAB biospecimens (blood, urine, stool, hair).
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13. Ydedahl-Jensen E, Jensen SL, Vilmar JW. [Autism spectrum disorders in neurofibromatosis type 1]. Ugeskrift for laeger. 2021 ; 183(5).
This case report describes a 12-year-old girl with neurofibromatosis type 1 (NF1), infantile autism, attention deficit hyperactivity disorder, executive difficulties and an IQ of 88. Her symptoms of autism being primarily of social communicative character seemed to be characteristic for patients with NF1 and autism spectrum disorders (ASD) compared to non-syndrome patients with ASD. Furthermore, her cognitive difficulties, including executive difficulties, attentional problems and an IQ-point reduction of ten, were very characteristic for NF1. There is a risk of overlapping symptoms, and the need for a thorough psychiatric examination is of great importance.
14. Yurkovic JR, Lisandrelli G, Shaffer RC, Dominick KC, Pedapati EV, Erickson CA, Kennedy DP, Yu C. Using head-mounted eye tracking to examine visual and manual exploration during naturalistic toy play in children with and without autism spectrum disorder. Sci Rep. 2021 ; 11(1) : 3578.
Multimodal exploration of objects during toy play is important for a child’s development and is suggested to be abnormal in children with autism spectrum disorder (ASD) due to either atypical attention or atypical action. However, little is known about how children with ASD coordinate their visual attention and manual actions during toy play. The current study aims to understand if and in what ways children with ASD generate exploratory behaviors to toys in natural, unconstrained contexts by utilizing head-mounted eye tracking to quantify moment-by-moment attention. We found no differences in how 24- to 48-mo children with and without ASD distribute their visual attention, generate manual action, or coordinate their visual and manual behaviors during toy play with a parent. Our findings suggest an intact ability and willingness of children with ASD to explore toys and suggest that context is important when studying child behavior.
