1. Abdallah MW, Mortensen EL, Greaves-Lord K, Larsen N, Bonefeld-Jorgensen EC, Norgaard-Pedersen B, Hougaard DM, Grove J. {{Neonatal levels of neurotrophic factors and risk of autism spectrum disorders}}. {Acta Psychiatr Scand};2012 (Oct 5)
OBJECTIVE: To examine levels of 3 neurotrophic factors (NTFs): Brain derived neurotrophic factor (BDNF), Neurotrophin-4 (NT-4), and transforming growth factor-beta (TGF-beta) in dried blood spot samples of neonates diagnosed with autism spectrum disorders (ASD) later in life and frequency-matched controls. METHOD: Biologic samples were retrieved from the Danish Newborn Screening Biobank. NTFs for 414 ASD cases and 820 controls were measured using Luminex technology. Associations were analyzed with continuous measures (Tobit regression) as well as dichotomized at the lower and upper 10th percentiles cutoff points derived from the controls’ distributions (logistic regression). RESULTS: ASD cases were more likely to have BDNF levels falling in the lower 10th percentile (odds ratios [OR], 1.53 [95% confidence intervals (CI), 1.04-2.24], P-value = 0.03). Similar pattern was seen for TGF-beta in females with ASD (OR, 2.36 [95% CI, 1.05-5.33], P-value = 0.04). For NT-4, however, ASD cases diagnosed with ICD-10 only were less likely to have levels in upper 10th percentile compared with controls (OR, 0.22 [95% CI, 0.05-0.98], P-value = 0.05). CONCLUSION: Results cautiously indicate decreased NTFs levels during neonatal period in ASD. This may contribute to the pathophysiology of ASD through impairments of neuroplasticity. Further research is required to confirm our results and to examine the potential therapeutic effects of NTFs in ASD.
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2. Cheshire WP. {{Highlights in clinical autonomic neuroscience: New insights into autonomic dysfunction in autism}}. {Auton Neurosci};2012 (Oct 3)
Investigations of autonomic nervous system biomarkers in autism have been sparse relative to its prevalence. Recent studies of children with autism spectrum disorders (ASD) have increasingly drawn correlations between autonomic findings and psychosocial behavior. Studies of heart rate variability, pupil size, salivary alpha-amylase, and electrodermal responsiveness have shown that children with ASD differ from normally developing children in their autonomic responsiveness to visualizing human faces and other mental tasks. While some results have conflicted, much of the data appears to support the theory of a hypersympathetic state in autism insufficiently attenuated by vagal parasympathetic influences. To what degree these differences in autonomic physiology might influence cognitive processing and behavior rather than simply being epiphenomena of a pervasive disorder of brain development is as yet unclear.
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3. Memari AH, Ghaheri B, Ziaee V, Kordi R, Hafizi S, Moshayedi P. {{Physical activity in children and adolescents with autism assessed by triaxial accelerometry}}. {Pediatr Obes};2012 (Oct 8)
What is already known about this subject Individuals with disabilities are more likely to be sedentary compared to the general population. Individuals with ASD show several impairments in motor and physical functioning. Lack of opportunity is the primary factor that brings minimal physical activity to children with ASD. What this study adds There was a substantial reduction in level of PA across the adolescent years in ASD. A decline in PA level and opportunities at school can contribute to a reduction in individual’s total PA in ASD. Household structure, sedentary activities, comorbidities and obesity are associated with PA level in children and adolescents with ASD. OBJECTIVE: This study aimed to examine physical activity (PA) patterns in children with autism spectrum disorder (ASD) as well as to address PA determinant factors by employing triaxial accelerometry. METHODS: In a school-based cross-sectional study of 80 children and adolescents with ASD (mean = 9.6, standard deviation = 1.8), we investigated demographics, children’s behavioural and clinical profile, and their PA data as objectively measured using an Actigraph GT3X on the right hip for seven consecutive days. All activity measures were expressed as counts per minute (c.p.m.). RESULTS: There was a substantial reduction in activity across the adolescent years in ASD. Girls were significantly less active than boys with ASD. Participants were remarkably less active in school compared to after-school, and there was a PA decline during weekdays compared to weekends, which was not significant. Household structure, sedentary pursuits, comorbidities and obesity were identified as other determinants of PA in children with ASD. CONCLUSIONS: Given the limited objective assessment of PA in children with ASD, our findings stressed the need for improving PA programmes, particularly for girls and older children with ASD. This study also provided important information for counselling clinicians, families and school policy-makers about health issues in ASD.
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4. Moreno-De-Luca D, Sanders SJ, Willsey AJ, Mulle JG, Lowe JK, Geschwind DH, State MW, Martin CL, Ledbetter DH. {{Using large clinical data sets to infer pathogenicity for rare copy number variants in autism cohorts}}. {Mol Psychiatry};2012 (Oct 9)
Copy number variants (CNVs) have a major role in the etiology of autism spectrum disorders (ASD), and several of these have reached statistical significance in case-control analyses. Nevertheless, current ASD cohorts are not large enough to detect very rare CNVs that may be causative or contributory (that is, risk alleles). Here, we use a tiered approach, in which clinically significant CNVs are first identified in large clinical cohorts of neurodevelopmental disorders (including but not specific to ASD), after which these CNVs are then systematically identified within well-characterized ASD cohorts. We focused our initial analysis on 48 recurrent CNVs (segmental duplication-mediated ‘hotspots’) from 24 loci in 31 516 published clinical cases with neurodevelopmental disorders and 13 696 published controls, which yielded a total of 19 deletion CNVs and 11 duplication CNVs that reached statistical significance. We then investigated the overlap of these 30 CNVs in a combined sample of 3955 well-characterized ASD cases from three published studies. We identified 73 deleterious recurrent CNVs, including 36 deletions from 11 loci and 37 duplications from seven loci, for a frequency of 1 in 54; had we considered the ASD cohorts alone, only 58 CNVs from eight loci (24 deletions from three loci and 34 duplications from five loci) would have reached statistical significance. In conclusion, until there are sufficiently large ASD research cohorts with enough power to detect very rare causative or contributory CNVs, data from larger clinical cohorts can be used to infer the likely clinical significance of CNVs in ASD.Molecular Psychiatry advance online publication, 9 October 2012; doi:10.1038/mp.2012.138.
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5. Nosik MR, Williams WL, Garrido N, Lee S. {{Comparison of computer based instruction to behavior skills training for teaching staff implementation of discrete-trial instruction with an adult with autism}}. {Res Dev Disabil};2012 (Oct 3);34(1):461-468.
In the current study, behavior skills training (BST) is compared to a computer based training package for teaching discrete trial instruction to staff, teaching an adult with autism. The computer based training package consisted of instructions, video modeling and feedback. BST consisted of instructions, modeling, rehearsal and feedback. Following training, participants were evaluated in terms of their accuracy on completing critical skills for running a discrete trial program. Six participants completed training; three received behavior skills training and three received the computer based training. Participants in the BST group performed better overall after training and during six week probes than those in the computer based training group. There were differences across both groups between research assistant and natural environment competency levels.
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6. Siegel M. {{Psychopharmacology of autism spectrum disorder: evidence and practice}}. {Child Adolesc Psychiatr Clin N Am};2012 (Oct);21(4):957-973.
Children with autism spectrum disorder present with a high rate of maladaptive behaviors and comorbid psychopathology. Psychopharmacologic treatment is frequently used in this population and is particularly associated with comorbid mental illness and increasing age. Successful treatment of presenting problems, however, is most likely achieved through consideration of multiple potential etiologic factors, only some of which may respond to pharmacologic intervention. The evidence base for targeting specific symptoms and disorders with psychopharmacology in children with autism spectrum disorder is expanding rapidly and offers guidance for practicing clinicians. The current evidence for symptom-specific treatment is presented.
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7. Sun X, Allison C, Auyeung B, Matthews FE, Murray S, Baron-Cohen S, Brayne C. {{Service provision for autism in mainland China: A service providers’ perspective}}. {Res Dev Disabil};2012 (Oct 3);34(1):440-451.
Qualitative semi-structured interviews were conducted with service providers regarding the current healthcare provision and education services for children with Autism Spectrum Conditions (ASC) and their families in mainland China. 10 service providers described the current policy and identified unmet needs within current practice. Providers perceived that children with ASC were an important but under-served group in mainland China. Two levels of service provision related to ASC were identified: (1) healthcare services mainly provided by government authorities; (2) education services mainly provided by the parents of children with ASC. Little cooperation was reported between the two types of providers. The structure of service provision for ASC is under-developed. There is an important need to establish coherent healthcare and education policies to support children with ASC and their families.