1. Cheung G, Trembath D, Arciuli J, Togher L. {{The impact of workplace factors on evidence-based speech-language pathology practice for children with autism spectrum disorders}}. {Int J Speech Lang Pathol}. 2012.
Although researchers have examined barriers to implementing evidence-based practice (EBP) at the level of the individual, little is known about the effects workplaces have on speech-language pathologists’ implementation of EBP. The aim of this study was to examine the impact of workplace factors on the use of EBP amongst speech-language pathologists who work with children with Autism Spectrum Disorder (ASD). This study sought to (a) explore views about EBP amongst speech-language pathologists who work with children with ASD, (b) identify workplace factors which, in the participants’ opinions, acted as barriers or enablers to their provision of evidence-based speech-language pathology services, and (c) examine whether or not speech-language pathologists’ responses to workplace factors differed based on the type of workplace or their years of experience. A total of 105 speech-language pathologists from across Australia completed an anonymous online questionnaire. The results indicate that, although the majority of speech-language pathologists agreed that EBP is necessary, they experienced barriers to their implementation of EBP including workplace culture and support, lack of time, cost of EBP, and the availability and accessibility of EBP resources. The barriers reported by speech-language pathologists were similar, regardless of their workplace (private practice vs organization) and years of experience.
Lien vers le texte intégral (Open Access ou abonnement)
2. Drahota A, Aarons GA, Stahmer AC. {{Developing the Autism Model of Implementation for Autism spectrum disorder community providers: study protocol}}. {Implement Sci}. 2012; 7(1): 85.
ABSTRACT: BACKGROUND: Currently, 1 out of 88 children are diagnosed with an autism spectrum disorder (ASD), and the estimated cost for treatment services is $126 billion annually. Typically, ASD community providers (ASD-CPs) provide services to children with any severity of ASD symptoms using a combination of various treatment paradigms, some with an evidence-base and some without. When evidence-based practices (EBPs) are successfully implemented by ASD-CPs, they can result in positive outcomes. Despite this promise, EBPs are often implemented unsuccessfully and other treatments used by ASD-CPs lack supportive evidence, especially for school-age children with ASD. While it is not well understood why ASD-CPs are not implementing EBPs, organizational and individual characteristics likely play a role. As a response to this need and to improve the lives of children with ASD and their families, this study aims to develop and test the feasibility and acceptability of the Autism Model of Implementation (AMI) to support the implementation of EBPs by ASD-CPs. Methods/design An academic-community collaboration developed to partner with ASD-CPs will facilitate the development of the AMI, a process specifically for use by ASD community-based agencies. Using a mixed methods approach, the project will assess agency and individual factors likely to facilitate or hinder implementing EBPs in this context; develop the AMI to address identified barriers and facilitators; and pilot test the AMI to examine its feasibility and acceptability using a specific EBP to treat anxiety disorders in school-age children with ASD. DISCUSSION: The AMI will represent a data-informed approach to facilitate implementation of EBPs by ASD-CPs by providing an implementation model specifically developed for this context. This study is designed to address the real-world implications of EBP implementation in ASD community-based agencies. In doing so, the AMI will help to provide children with ASD the best and most effective services in their own community. Moreover, the proposed study will positively impact the field of implementation science by providing an empirically supported and tested model of implementation to facilitate the identification, adoption, and use of EBPs.
Lien vers le texte intégral (Open Access ou abonnement)
3. Goods KS, Ishijima E, Chang YC, Kasari C. {{Preschool Based JASPER Intervention in Minimally Verbal Children with Autism: Pilot RCT}}. {J Autism Dev Disord}. 2012.
In this pilot study, we tested the effects of a novel intervention (JASPER, Joint Attention Symbolic Play Engagement and Regulation) on 3 to 5 year old, minimally verbal children with autism who were attending a non-public preschool. Participants were randomized to a control group (treatment as usual, 30 h of ABA-based therapy per week) or a treatment group (substitution of 30 min of JASPER treatment, twice weekly during their regular program). A baseline of 12 weeks in which no changes were noted in core deficits was followed by 12 weeks of intervention for children randomized to the JASPER treatment. Participants in the treatment group demonstrated greater play diversity on a standardized assessment. Effects also generalized to the classroom, where participants in the treatment group initiated more gestures and spent less time unengaged. These results provide further support that even brief, targeted interventions on joint attention and play can improve core deficits in minimally verbal children with ASD.
Lien vers le texte intégral (Open Access ou abonnement)
4. Kotagal S, Broomall E. {{Sleep in children with autism spectrum disorder}}. {Pediatr Neurol}. 2012; 47(4): 242-51.
Children with autism spectrum disorder demonstrate an increased prevalence of difficulties with sleep initiation and maintenance. The consequences may include alterations in daytime behavior, memory, and learning in patients, and significant stress in caretakers. The dysregulation of melatonin synthesis, sensitization to environmental stimuli, behavioral insomnia syndromes, delayed sleep phase syndrome, rapid eye movement sleep behavior disorder, and comorbid anxiety, depression, and epilepsy comprise common etiologic factors. The clinical assessment of sleep problems in this population and a management algorithm are presented.
Lien vers le texte intégral (Open Access ou abonnement)
5. O’Hearn K, Franconeri S, Wright C, Minshew N, Luna B. {{The Development of Individuation in Autism}}. {J Exp Psychol Hum Percept Perform}. 2012.
Evidence suggests that people with autism rely less on holistic visual information than typical adults. The current studies examine this by investigating core visual processes that contribute to holistic processing-namely, individuation and element grouping-and how they develop in participants with autism and typically developing (TD) participants matched for age, IQ, and gender. Individuation refers to the ability to « see » approximately four elements simultaneously; grouping elements can modify how many elements can be individuated. We examined these processes using two well-established paradigms, rapid enumeration and multiple object tracking (MOT). In both tasks, a performance limit of four elements in typical adults is thought to reflect individuation capacity. Participants with autism displayed a smaller individuation capacity than TD controls, regardless of whether they were enumerating static elements or tracking moving ones. To manipulate the holistic information available via element grouping, elements were arranged into a design in rapid enumeration, or moved together in MOT. Performance in participants with autism was affected to a similar degree as TD participants by element grouping, whether the manipulation helped or hurt performance, consistent with evidence that some types of gestalt/grouping information are processed typically in autism. There was substantial development from childhood to adolescence in the speed of individuation in those with autism, but not from adolescence to adulthood, a pattern distinct from TD participants. These results reveal how core visual processes function in autism, and provide insight into the architecture of vision (i.e., individuation appears distinct from visual strengths in autism, such as visual search). (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Lien vers le texte intégral (Open Access ou abonnement)
6. Schroer RJ, Beaudet AL, Shinawi M, Sahoo T, Patel A, Sun Q, Skinner C, Stevenson RE. {{Duplication of OCRL and adjacent genes associated with autism but not Lowe syndrome}}. {Am J Med Genet A}. 2012.
Disturbances in the form of microduplications and microdeletions have been found throughout the genome and have been associated with autism, intellectual disability, and recognizable malformation syndromes. In our study of 187 probands with autism, we have identified a duplication in Xq25 including full gene duplication of OCRL and six flanking genes. Activity of the enzyme gene product in fibroblasts was elevated to over twice the level in control fibroblasts. The boy had no somatic or neurological findings reminiscent of Lowe syndrome. (c) 2012 Wiley Periodicals, Inc.
Lien vers le texte intégral (Open Access ou abonnement)
7. Senju A. {{Atypical development of spontaneous social cognition in autism spectrum disorders}}. {Brain Dev}. 2012.
Individuals with autism spectrum disorders (ASD) have profound impairment in the development of social interaction and communication. However, it is also known that some ‘high-functioning’ individuals with ASD show apparently typical capacity to process social information in a controlled experimental settings, despite their difficulties in daily life. The current paper overviews the spontaneous social cognition, spontaneous processing of social information in the absence of explicit instruction or task demand, in individuals with ASD. Three areas of the researches, false belief attribution, imitation/mimicry, and eye gaze processing, have been reviewed. The literatures suggest that high-functioning individuals with ASD (a) do not spontaneously attribute false belief to others, even though they can easily do so when explicitly instructed, (b) can imitate others’ goal-directed actions under explicit instruction and show spontaneous mimicry of others’ actions when they attend to the action, but are less likely to show spontaneous mimicry without the task structure to navigate attention to others’ action and (c) can process others’ gaze direction and shift attention to others’ gaze directions, but fail to spontaneously attend to another person’s eyes in social and communicative context, and less likely to be prompted to respond in response to perceived eye contact. These results are consistent with the claim that individuals with ASD do not spontaneously attend to socially relevant information, even though they can easily process the same information when their attention is navigated towards it.
Lien vers le texte intégral (Open Access ou abonnement)
8. Skafidas E, Testa R, Zantomio D, Chana G, Everall IP, Pantelis C. {{Predicting the diagnosis of autism spectrum disorder using gene pathway analysis}}. {Mol Psychiatry}. 2012.
Autism spectrum disorder (ASD) depends on a clinical interview with no biomarkers to aid diagnosis. The current investigation interrogated single-nucleotide polymorphisms (SNPs) of individuals with ASD from the Autism Genetic Resource Exchange (AGRE) database. SNPs were mapped to Kyoto Encyclopedia of Genes and Genomes (KEGG)-derived pathways to identify affected cellular processes and develop a diagnostic test. This test was then applied to two independent samples from the Simons Foundation Autism Research Initiative (SFARI) and Wellcome Trust 1958 normal birth cohort (WTBC) for validation. Using AGRE SNP data from a Central European (CEU) cohort, we created a genetic diagnostic classifier consisting of 237 SNPs in 146 genes that correctly predicted ASD diagnosis in 85.6% of CEU cases. This classifier also predicted 84.3% of cases in an ethnically related Tuscan cohort; however, prediction was less accurate (56.4%) in a genetically dissimilar Han Chinese cohort (HAN). Eight SNPs in three genes (KCNMB4, GNAO1, GRM5) had the largest effect in the classifier with some acting as vulnerability SNPs, whereas others were protective. Prediction accuracy diminished as the number of SNPs analyzed in the model was decreased. Our diagnostic classifier correctly predicted ASD diagnosis with an accuracy of 71.7% in CEU individuals from the SFARI (ASD) and WTBC (controls) validation data sets. In conclusion, we have developed an accurate diagnostic test for a genetically homogeneous group to aid in early detection of ASD. While SNPs differ across ethnic groups, our pathway approach identified cellular processes common to ASD across ethnicities. Our results have wide implications for detection, intervention and prevention of ASD.Molecular Psychiatry advance online publication, 11 September 2012; doi:10.1038/mp.2012.126.
Lien vers le texte intégral (Open Access ou abonnement)
9. Spek AA, van Ham NC, Nyklicek I. {{Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial}}. {Res Dev Disabil}. 2012; 34(1): 246-53.
Research shows that depression and anxiety disorders are the most common psychiatric concern in autism spectrum disorders (ASD). Mindfulness-based therapy (MBT) has been found effective in reducing anxiety and depression symptoms, however research in autism is limited. Therefore, we examined the effects of a modified MBT protocol (MBT-AS) in high-functioning adults with ASD. 42 participants were randomized into a 9-week MBT-AS training or a wait-list control group. Results showed a significant reduction in depression, anxiety and rumination in the intervention group, as opposed to the control group. Furthermore, positive affect increased in the intervention group, but not in the control group. Concluding, the present study is the first controlled trial to demonstrate that adults with ASD can benefit from MBT-AS.
Lien vers le texte intégral (Open Access ou abonnement)
10. Sunita, Bilszta JL. {{Early identification of autism: A comparison of the Checklist for Autism in Toddlers and the Modified Checklist for Autism in Toddlers}}. {J Paediatr Child Health}. 2012.
There is still debate as to what is the most effective strategy for identifying the early signs of autism in very young children. Two levels of screening having been advocated: broad-based developmental surveillance and targeted screening. Two popular tools for use in developmental surveillance are the Checklist for Autism in Toddlers (CHAT) and the Modified Checklist for Autism in Toddlers (M-CHAT). The purpose of this article is to summarise the current evidence for screening for autistic symptoms in very young children using CHAT and M-CHAT. A systematic search was carried out of electronic database and other sources for original studies which evaluated the use of CHAT and M-CHAT in screening for autism in children younger than 5 years of age. Studies were included for review if they evaluated the sensitivity and/or specificity of CHAT or M-CHAT, or described the best age to administer these instruments. The available evidence suggests that characteristic behaviours in autism should be evident in simple forms before the age of 18 months, while screening at 24 months should be conducted to identify those who regress. Administering a screening tool during 18- to 24-month well-child visits improves early identification of autism, while the stability of diagnosis at the ages of 18 months and 24 months is confirmed. M-CHAT has slightly better sensitivity and specificity compared to CHAT, and is preferable to use as a developmental surveillance screening instrument.
Lien vers le texte intégral (Open Access ou abonnement)
11. Wang J, Hu Y, Wang Y, Qin X, Xia W, Sun C, Wu L. {{Parenting stress in Chinese mothers of children with autism spectrum disorders}}. {Soc Psychiatry Psychiatr Epidemiol}. 2012.
OBJECTIVE: Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China. METHODS: In this cross-sectional study, data about participants’ demographic characteristics, parenting stress, anxiety, depression, child’s behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home. RESULTS: The participants reported elevated parenting stress. Mothers’ parenting stress was associated with levels of depression and anxiety, and child’s behavioral symptoms. Child’s behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress. CONCLUSIONS: Government support may play an important role in reducing parenting stress in this population.
Lien vers le texte intégral (Open Access ou abonnement)
12. Wang L, Mandell DS, Lawer L, Cidav Z, Leslie DL. {{Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison Between Medicaid and Private Insurance}}. {J Autism Dev Disord}. 2012.
Healthcare costs and service use for autism spectrum disorder (ASD) were compared between Medicaid and private insurance, using 2003 insurance claims data in 24 states. In terms of costs and service use per child with ASD, Medicaid had higher total healthcare costs ($22,653 vs. $5,254), higher ASD-specific costs ($7,438 vs. $928), higher psychotropic medication costs($1,468 vs. $875), more speech therapy visits (13.0 vs. 3.6 visits), more occupational/physical therapy visits (6.4 vs. 0.9 visits), and more behavior modification/social skills visits (3.8 vs. 1.1 visits) than private insurance (all p < 0.0001). In multivariate analysis, being enrolled in Medicaid had the largest effect on costs, after controlling for other variables. The findings emphasize the need for continued efforts to improve private insurance coverage of autism.
Lien vers le texte intégral (Open Access ou abonnement)
13. Webb SAPD. {{Unraveling autism one de novo mutation at a time}}. {Biotechniques}. 2012; 53(3): 133-6.
Lien vers le texte intégral (Open Access ou abonnement)
14. Zwaigenbaum L. {{What’s in a name: changing the terminology of autism diagnosis}}. {Dev Med Child Neurol}. 2012; 54(10): 871-2.
