1. Abdullah MM, Neville RD, Donnelly JH, Lakes KD. Are parental depressive symptoms related to the sleep quality and physical activity of their children with developmental disabilities?. Research in developmental disabilities. 2021; 119: 104091.

BACKGROUND: Parenting young children with developmental disabilities presents unique opportunities and challenges. Parents can experience meaningful priority shifts in and appreciation for their lives, but they can also be at greater risk for diminished emotional health. Physiological child factors warrant further investigation as correlates for parent risk of or protection from depression. AIM: This study examined the relations between parental depressive symptoms and the (1) sleep quality and (2) physical activity in their children with developmental disabilities adjusting for parent- and child-level factors. METHODS AND PROCEDURES: Children and parents were recruited for participation in this study from a university-based neurodevelopmental clinic. Parents completed questionnaires about themselves including measures of depressive symptoms and about their children including measures of sleep quality and physical activity. Researchers administered developmental measures to the children and physicians completed children’s diagnostic evaluations. Participants were 147 children (32 ± 4 months old) mostly with autism spectrum disorder (ASD) and their parents (mostly mothers). Factors associated with parent-reported depressive symptoms were analyzed with a generalized linear model. OUTCOMES AND RESULTS: An R(2)(deviance) value of 43 % confirmed that there was a substantial, moderate-to-large sized, improvement in the proportion of variance explained by the final model when compared with a null, or intercept-only, model. Depressive symptoms were approximately two times higher for parents of children with above average sleep disturbances and one and half times higher for parents whose children engaged in above average physical activity. CONCLUSION AND IMPLICATIONS: Our study demonstrates the importance of considering children’s sleep and physical activity in supporting children’s developmental disabilities because they may offer pathways to enhanced family resilience and well-being.

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2. Barrea C, Jadot A, Debray FG, Vrancken G, Leroy P. [How I explore… autism spectrum disorder in a child]. Revue medicale de Liege. 2021; 76(10): 761-7.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental trouble characterized by deficits in communication and social interactions associated with restricted and repetitive behaviour, interests and activities. Given the heterogeneity of the disorder and the absence of biomarker, its diagnostic approach must be comprehensive and multidisciplinary, according to international classifications. The aetiology of ASDs remains mostly unknown and results from a multifactorial model. This document offers guidelines to standardize practices and optimize the exploration of children with autism.

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3. Bravo A, Schwartz I. Teaching Imitation to Young Children with Autism Spectrum Disorder Using Discrete Trial Training and Contingent Imitation. Journal of developmental and physical disabilities. 2021: 1-18.

Imitation is a pivotal skill for children with and without disabilities, serving both learning and social interaction functions for young children. Children with autism spectrum disorder (ASD) frequently experience delays in acquiring this skillset, demonstrating challenges in the ability and/or propensity to imitate the actions of others. Current intervention programs frequently use discrete trial teaching (DTT) or contingent imitation to support imitation development in young children with ASD. This study combined contingent imitation with DTT to teach imitation to individuals who had previously struggled with acquiring this skill. A multiple probe design across three preschool children with ASD was conducted within participants’ early learning classrooms. Response to intervention varied across participants, with participants with more advanced imitation skills at study onset demonstrating greater outcomes. Combining contingent imitation with DTT may facilitate the propensity to imitate for individuals who exhibit some appropriate object engagement and are inconsistently imitating others’ actions with objects. However, further research using stronger research design is needed to improve the teaching of imitation to young children with ASD who exhibit challenges with this skillset.

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4. Buro AW, Gray HL, Kirby RS, Marshall J, Strange M, Pang T, Hasan S, Holloway J. Feasibility of a virtual nutrition intervention for adolescents with autism spectrum disorder. Autism : the international journal of research and practice. 2021: 13623613211051150.

Adolescents with autism spectrum disorder are at an increased risk of unhealthy eating behaviors and obesity compared to their typically developing peers. Many nutrition interventions for this population focus on improving autism spectrum disorder symptoms or managing weight rather than addressing participants’ healthy eating self-efficacy. The purpose of this study was to examine a virtual implementation of a new intervention for adolescents with autism spectrum disorder, Bringing Adolescent Learners with Autism Nutrition and Culinary Education. We used fidelity checklists, engagement records, and field notes to measure implementation. We also examined the feasibility of assessing outcome measures, including a food frequency questionnaire (FFQ), psychosocial survey, height, and weight. We recruited adolescents with autism spectrum disorder aged 12-21 years. Six groups of 2-7 adolescents (27 total) participated in the intervention and pre-/post-intervention measurements. Bringing Adolescent Learners with Autism Nutrition and Culinary Education consisted of eight weekly lessons: exploring taste, flavor, and texture; mealtimes and rules; food groups and nutrients; moderation; beverages; cooking; well-being; sustaining healthy eating habits. The virtual implementation was feasible based on lesson attendance, participation, homework completion, fidelity, and prevalence of technical difficulties. Evaluation was also feasible based on response rate, completion, and data quality for the food frequency questionnaire, psychosocial survey, and height and weight measurements. Bringing Adolescent Learners with Autism Nutrition and Culinary Education may be used in virtual settings to reach diverse populations of adolescents with autism spectrum disorder. Future research is needed to evaluate the impact of Bringing Adolescent Learners with Autism Nutrition and Culinary Education on dietary behavior and obesity outcomes.

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5. Dallman AR, Bailliard A, Harrop C. Correction to: Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study. Journal of autism and developmental disorders. 2022; 52(1): 304-5.

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6. Davis R, Fletcher-Watson S, Digard BG. Autistic People’s Access to Bilingualism and Additional Language Learning: Identifying the Barriers and Facilitators for Equal Opportunities. Frontiers in psychology. 2021; 12: 741182.

Bilingualism is a valuable tool that enriches and facilitates cultural, social and lived experiences for autistic and non-autistic people alike. Research consistently finds no negative effects of bilingualism and highlights the potential for positive effects across cognitive and socio-cultural domains for autistic and non-autistic children. Yet parents of autistic children remain concerned that bilingualism will cause delays in both cognitive and language development and are still frequently advised by practitioners to raise their child monolingually. Evidently, findings from research are not reflected in practice or subsequent advice, and it is essential to identify ways to ensure equal access to additional language learning. We briefly summarise the existing literature on bilingualism and autism, considering perspectives from the bilingual autistic community, and experimental research. We identify the most pertinent barriers to participation for autistic bilingual children in terms of familial, clinical and educational perspectives. We propose novel solutions to promote additional language learning and suggest changes to practice that will contribute to an evidence base for families and practitioners. This commentary makes innovative recommendations at both the individual and societal level to ensure that autistic bilingual people have equal rights and opportunities to language learning and are optimally supported in accessing them.

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7. Fanjul-Fernández M, Brown NJ, Hickey P, Diakumis P, Rafehi H, Bozaoglu K, Green CC, Rattray A, Young S, Alhuzaimi D, Mountford HS, Gillies G, Lukic V, Vick T, Finlay K, Coe BP, Eichler EE, Delatycki MB, Wilson SJ, Bahlo M, Scheffer IE, Lockhart PJ. A family study implicates GBE1 in the etiology of autism spectrum disorder. Human mutation. 2022; 43(1): 16-29.

Autism spectrum disorders (ASD) are neurodevelopmental disorders with an estimated heritability of >60%. Family-based genetic studies of ASD have generally focused on multiple small kindreds, searching for de novo variants of major effect. We hypothesized that molecular genetic analysis of large multiplex families would enable the identification of variants of milder effects. We studied a large multigenerational family of European ancestry with multiple family members affected with ASD or the broader autism phenotype (BAP). We identified a rare heterozygous variant in the gene encoding 1,4-ɑ-glucan branching enzyme 1 (GBE1) that was present in seven of seven individuals with ASD, nine of ten individuals with the BAP, and none of four tested unaffected individuals. We genotyped a community-acquired cohort of 389 individuals with ASD and identified three additional probands. Cascade analysis demonstrated that the variant was present in 11 of 13 individuals with familial ASD/BAP and neither of the two tested unaffected individuals in these three families, also of European ancestry. The variant was not enriched in the combined UK10K ASD cohorts of European ancestry but heterozygous GBE1 deletion was overrepresented in large ASD cohorts, collectively suggesting an association between GBE1 and ASD.

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8. Fisher MH, Sung C, Kammes RR, Okyere C, Park J. Social support as a mediator of stress and life satisfaction for people with intellectual or developmental disabilities during the COVID-19 pandemic. Journal of applied research in intellectual disabilities : JARID. 2022; 35(1): 243-51.

INTRODUCTION: This study examined factors that predict stress level and life satisfaction among adults with intellectual or developmental disabilities during the COVID-19 pandemic and the role of social support. METHOD: From a larger study about the experiences during the pandemic of 2028 individuals with and without disabilities, 181 adults with intellectual or developmental disabilities (or proxy) responded. RESULTS: Most respondents with intellectual or developmental disabilities (92.8%) reported negative impacts from the pandemic, with 55.2% of the 96 employed pre-pandemic reporting impacted employment, including job loss. The negative impact of the pandemic was a significant predictor of stress level; social support was related to reduced stress. Stress level and the negative impact of the pandemic were inversely related to life satisfaction; social support was positively related to life satisfaction. Social support partially mediated the association between stress level and life satisfaction. DISCUSSION: Comprehensive services and social support systems are needed to combat the impact of the pandemic.

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9. Hampton LH, Rodriguez EM. Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis. Autism : the international journal of research and practice. 2021: 13623613211050433.

Interventions to address core symptoms for young children on the autism spectrum have a strong and growing evidence base. Adapting and delivering evidence-based interventions to infants and toddlers with a high likelihood for autism is a logical next step. This systematic review and meta-analysis summarize the association between infant and toddler interventions and developmental and family outcomes. Results indicate that these early interventions are effective for improving parent implementation of core strategies, yet the effects do not readily translate to child outcomes. However, key studies demonstrate conditional results that indicate that parent implementation is associated with child outcome. Implications for research and practice toward building adaptive interventions that respond to parent implementation and changing child characteristics are discussed.

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10. Hanley A, Nguyen QC, Badawi DG, Chen J, Ma T, Slopen N. The diagnostic odyssey of autism: a cross-sectional study of 3 age cohorts of children from the 2016-2018 National Survey of Children’s Health. Child and adolescent psychiatry and mental health. 2021; 15(1): 58.

BACKGROUND: Autism prevalence has increased rapidly in recent years, however, nationally representative estimates on the ages of first identification and intervention are out of date. Objectives: (1) To estimate the ages at which children with autism receive their first diagnosis, intervention plan, and developmental services; and (2) To evaluate differences in ages at events by birth cohort and sociodemographic characteristics. METHODS: Using cross-sectional data from the 2016-2018 National Survey of Children’s Health (NSCH), we examined associations via linear regression among a sample of 2303 children aged 2-17 years old, who had ever been diagnosed with autism and either (1) ever had a plan for special education or early intervention, or (2) ever received special services to meet developmental needs. Exposures included age cohort, child, household and healthcare provider characteristics. RESULTS: Most children in the study sample (n = 2303) were over age 6 years, male, of non-Hispanic white race/ethnicity and had mild/moderate autism. Mean ages (years) at first diagnosis was 4.56 (SE = 0.13); first plan was 4.43 (SE = 0.11); and first services was 4.10 (SE = 0.11). After adjustment for exposures and survey year, the middle childhood cohort was 18 months older at first intervention (β = 1.49, 95% CI, 1.18-1.81), and adolescents were 38 months older at first diagnosis (β = 3.16, 95% CI, 2.72-3.60) compared to those in early childhood. Younger ages at events were observed among: Hispanic/Latinx as compared to white children, those with moderate or severe symptoms as compared to mild symptoms, and children who received their diagnosis from a specialist as compared to psychologists or psychiatrists. CONCLUSIONS: Children with autism receive their first diagnosis, intervention plans and developmental services at younger ages than they had in the past. Future research is needed to identify the mechanisms for these improvements in early identification and intervention to accelerate additional progress.

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11. Hnoonual A, Kor-Anantakul P, Charalsawadi C, Worachotekamjorn J, Limprasert P. Case Report: An Atypical Angelman Syndrome Case With Obesity and Fulfilled Autism Spectrum Disorder Identified by Microarray. Frontiers in genetics. 2021; 12: 755605.

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders which are etiologically heterogeneous. Chromosomal microarray is now recommended as the first-tier clinical diagnostic test for ASD. We performed chromosomal microarray in 16 Thai patients with ASD using an Illumina HumanCytoSNP-12 v2.1 array and found one case with uniparental disomy (UPD) of chromosome 15. Methylation-specific PCR showed abnormal methylation of the maternal SNRPN allele. Haplotype analysis revealed that the patient had received both chromosomes 15 from his father. These results were consistent with Angelman syndrome. However, his clinical features had no clinical significance for classic Angelman syndrome. He had first presented at the pediatric clinic with no speech, poor social interaction skills and repetitive behaviors consistent with ASD based on the DSM-IV criteria at 2 years of age and later confirmed by ADOS at 5 years of age. He was strikingly overweight but had no dysmorphic facies, seizures nor ataxia and was diagnosed as non-syndromic ASD, a diagnosis which was believed until at 10 years of age, his DNA was included for analysis in this current cohort study. Our findings suggest that ASD patients with unknown etiology should be considered for methylation-specific PCR testing for Angelman syndrome where chromosomal microarray is not available. In the study, we also review the clinical features of Angelman syndrome caused by UPD and the frequency of ASD in individuals with Angelman syndrome.

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12. Huang Q, Cao S, Zhou S, Punia D, Zhu X, Luo Y, Wu H. How anxiety predicts interpersonal curiosity during the COVID-19 pandemic: The mediation effect of interpersonal distancing and autistic tendency. Personality and individual differences. 2021; 180: 110973.

With the worldwide implementation of quarantine regulations to suppress the spread of the COVID-19, anxiety, interpersonal distancing and autistic tendency may decrease individuals’ desire to seek interpersonal information and thus might have negative effects on their interpersonal curiosity. Through behavioral paradigms and scales, two studies were conducted (Study 1: n = 570; Study 2: n = 501). We explored the predictive effect of anxiety on interpersonal curiosity in situations when mandatory isolation measures have led to dramatic changes in interpersonal distancing and autistic tendency. We found that interpersonal distancing and autistic tendency negatively predicted interpersonal curiosity, and these predictive effects suppressed the positive prediction of state anxiety to interpersonal curiosity. Our research provides insights into the relationships among anxiety, curiosity, interpersonal distancing, and autistic tendency during the COVID-19 pandemic.

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13. Iroegbu JD, Ijomone OK, Femi-Akinlosotu OM, Ijomone OM. ERK/MAPK signalling in the developing brain: Perturbations and consequences. Neuroscience and biobehavioral reviews. 2021; 131: 792-805.

The extracellular regulated kinase/microtubule-associated protein kinase (ERK/MAPK) signalling pathway transduces signals that cause an alteration in the ongoing metabolic pathways and modifies gene expression patterns; thus, influencing cellular behaviour. ERK/MAPK signalling is essential for the proper development of the nervous system from neural progenitor cells derived from the embryonic mesoderm. Several signalling molecules that regulate the well-coordinated process of neurodevelopment transduce developmental information through the ERK/MAPK signalling pathway. The ERK/MAPK is a potential novel therapeutic target in several neurodevelopmental disorders, however, despite years of study, there is still significant uncertainty about the exact mechanism by which the ERK/MAPK signalling pathway elicits specific responses in neurodevelopment. Here, we will review the evidence highlighting the role of ERK/MAPK signalling in neurodevelopment. We will also discuss the structural implication and behavioural deficits associated with perturbed ERK/MAPK signalling pathway in cortical development, whilst examining its contribution to the neuropathology of several neurodevelopmental disorders, such as Autism Spectrum Disorder, Schizophrenia, Fragile X, and Attention Deficit Hyperactive Disorder.

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14. Jones DR, Morrison KE, DeBrabander KM, Ackerman RA, Pinkham AE, Sasson NJ. Greater Social Interest Between Autistic and Non-autistic Conversation Partners Following Autism Acceptance Training for Non-autistic People. Frontiers in psychology. 2021; 12: 739147.

Bi-directional differences in social communication and behavior can contribute to poor interactions between autistic and non-autistic (NA) people, which in turn may reduce social opportunities for autistic adults and contribute to poor outcomes. Historically, interventions to improve social interaction in autism have focused on altering the behaviors of autistic people and have ignored the role of NA people. Recent efforts to improve autism understanding among NA adults via training have resulted in more favorable views toward autistic people, yet it remains unknown whether these benefits extend to real-world interactions between autistic and NA people. The current study explores whether a brief autism acceptance training (AAT) program can improve social interactions between autistic and NA adults. Thirty-nine NA males were randomly assigned to complete AAT or a no-training control condition, then participated in a 5-min unstructured conversation with an unfamiliar autistic male (n = 39). Following the conversation, participants rated their perceptions of interaction quality, first impressions of their partner, and their interest in future interactions with their partner. In dyads where the NA individual completed AAT, both the autistic and NA person endorsed greater future interest in hanging out with their partner relative to dyads in which the NA adult did not complete AAT. However, other social interaction outcomes, including ratings of interaction quality and first impressions of autistic partners, largely did not differ between training and no-training conditions, and assessments of the interaction were largely unrelated for autistic and NA partners within dyads. Results also indicated that NA participants, but not autistic participants, demonstrated substantial correspondence between evaluations of their partner and the interaction, suggesting that autistic adults may place less weight on trait judgments when assessing the quality of an interaction. These findings suggest that the brief AAT for NA adults used in this study may increase mutual social interest in real-world interactions between NA and autistic adults, but more systematic changes are likely needed to bridge divides between these individuals. Future work with larger, more diverse samples is recommended to further explore whether interventions targeting NA adults are beneficial for improving autistic experiences within NA social environments.

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15. Kong XJ, Clairmont C, Wang B. Case Report: Off-Label Use of Omalizumab in a 6-Year-Old Boy With ASD Ameliorated Severe Allergic Rhinitis and Subsequently Improved Behavioral Symptoms. Frontiers in pediatrics. 2021; 9: 714111.

Children with ASD have elevated risk for developing allergic symptoms. The severity of allergic symptoms can exacerbate behavioral problems in children with ASD. Omalizumab, an anti-IgE antibody, has previously shown efficacy in treating allergic rhinitis and behavioral problems in a 12-year-old child with ASD. The present case report provides robust characterization of behavioral improvement in a 6-year-old child with ASD, allergic rhinitis, and autoimmune disorder. A 6-year-old boy with ASD and Hashimoto’s disease presented to the clinic with severe allergic rhinitis, irritability, and language delay. After other treatments failed to improve symptoms, our patient was treated with omalizumab at 300 mg/month via subcutaneous injection for a total of 6 months. Marked improvement in allergic symptoms were observed at 2 months into treatment and were maintained through the treatment period. At the conclusion of the treatment period, results from multiple behavioral questionnaires, including the SRS-2, ABC, RBS-R, and PSQI, demonstrated substantial improvement in ASD-related behavioral symptoms. In this case, omalizumab markedly improved ASD-related and sleep behavior in a 6-year-old with ASD, allergic rhinitis, and autoimmune disorder. Future studies with larger patient populations are warranted to investigate the efficacy of omalizumab in patients with ASD and allergy symptoms.

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16. Kouakou MR, Cameron D, Hannon E, Dempster EL, Mill J, Hill MJ, Bray NJ. Sites of active gene regulation in the prenatal frontal cortex and their role in neuropsychiatric disorders. American journal of medical genetics Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2021; 186(6): 376-88.

Common genetic variation appears to largely influence risk for neuropsychiatric disorders through effects on gene regulation. It is therefore possible to shed light on the biology of these conditions by testing for enrichment of associated genetic variation within regulatory genomic regions operating in specific tissues or cell types. Here, we have used the assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-Seq) to map open chromatin (an index of active regulatory genomic regions) in bulk tissue, NeuN+ and NeuN- nuclei from the prenatal human frontal cortex, and tested enrichment of single-nucleotide polymorphism (SNP) heritability for five neuropsychiatric disorders (autism spectrum disorder, attention deficit hyperactivity disorder [ADHD], bipolar disorder, major depressive disorder, and schizophrenia) within these regions. We observed significant enrichment of SNP heritability for ADHD, major depressive disorder, and schizophrenia within open chromatin regions (OCRs) mapped in bulk fetal frontal cortex, and for all five tested neuropsychiatric conditions when we restricted these sites to those overlapping histone modifications indicative of enhancers (H3K4me1) or promoters (H3K4me3) in fetal brain. SNP heritability for neuropsychiatric disorders was significantly enriched in OCRs identified in fetal frontal cortex NeuN- as well as NeuN+ nuclei overlapping fetal brain H3K4me1 or H3K4me3 sites. We additionally demonstrate the utility of our mapped OCRs for prioritizing potentially functional SNPs at genome-wide significant risk loci for neuropsychiatric disorders. Our data provide evidence for an early neurodevelopmental component to a range of neuropsychiatric conditions and highlight an important role for regulatory genomic regions active within both NeuN+ and NeuN- cells of the prenatal brain.

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17. Krigsman A, Walker SJ. Gastrointestinal disease in children with autism spectrum disorders: Etiology or consequence?. World journal of psychiatry. 2021; 11(9): 605-18.

Chronic gastrointestinal (GI) symptoms and disorders are common in children with autism spectrum disorder and have been shown to be significantly correlated with the degree of behavioral and cognitive impairment. In this unique population, GI symptoms often arise very early in development, during infancy or toddlerhood, and may be misdiagnosed – or not diagnosed at all – due in part to the challenges associated with recognition of symptoms in a minimally or non-communicative child. Evidence demonstrating that the gut-brain-axis can communicate gut dysbiosis and systemic immune dysregulation in a bidirectional manner raises the question as to whether an untreated gastrointestinal disorder can directly impact neurodevelopment or, conversely, whether having a neurodevelopmental disorder predisposes a child to chronic GI issues. From the data presented in this mini review, we conclude that the preponderance of available evidence would suggest the former scenario is more strongly supported.

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18. Lemay JF, Langenberger S, McLeod S. Parental evaluation of a revised autism spectrum disorder diagnostic process for children under 36 months of age. Paediatrics & child health. 2021; 26(6): e246-e51.

BACKGROUND: The Alberta Children’s Hospital-Autism Spectrum Disorder Diagnostic Clinic (ACH-ASDC) was restructured due to long wait times and unsustainable clinic workflow. Major changes included the initiation of pre- and post-ASD parent education sessions and distinct ASD screening appointments before the ASD diagnostic appointment. METHODS: We conducted a parental program evaluation in summer 2018 of the ACH-ASDC. We used a cross-sectional survey to evaluate key outcomes including parental satisfaction, and the percentage of families obtaining access to government supports and early intervention programs. RESULTS: For the 101 eligible patients diagnosed with ASD under 36 months of age 70 (69.3%) parents agreed to participate. The mean diagnostic age of the children diagnosed with ASD was 30.6 months (SD=4.1 months). There were no statistically significant age differences between biological sexes. Ninety-three per cent of parents felt that ASD educational sessions were useful, and 92% of parents were satisfied to very satisfied with the overall ASD diagnostic process. Ninety per cent of parents had access to at least one of the key resources available for ASD early intervention in our province following diagnosis. Parents reported a positive impact on intervention provided to their child in the areas of communication, social interaction, and behaviour. CONCLUSION: Parents of children diagnosed with ASD expressed a high level of satisfaction with the restructured ACH-ASDC process. Implementing parent education sessions was well received and met parents’ needs. Parents were able to access intervention services following diagnosis and reported positive impacts for their child. Re-envisioning program approaches to incorporate novel strategies to support families should be encouraged.

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19. Lotan M, P LW. Improving Balance in Adults With Intellectual Developmental Disorder via Virtual Environments. Perceptual and motor skills. 2021; 128(6): 2638-53.

Balance problems have been found among 57% of adults with Intellectual Developmental Disorder (IDD). Moreover, these adults have only partially participated in conventional activity programs. There is a clear need for new interventions that will enhance these individuals’ interest and motivation toward improving their balance skills. Virtual gaming training experiences are a promising prospect in that regard. The purpose of this study was to examine the effect of virtual reality games on improving balance for adults with IDD. We recruited 31 individuals with mild-moderate IDD who had fallen at least twice in the year prior to initiating this intervention, and we evaluated these participants using the Timed Up and Go (TUG) test. The participants were randomly assigned to control and experimental groups, and only the latter group took part in a series of twelve 30-minute bi-weekly virtual game sessions, designed to improve balance using the SeeMe virtual game system. We found significant (p < .001) pre-post improvements in balance abilities in the experimental group and no significant pre-post change in the control group (p < .77). These data suggest that virtual game technology is a viable tool for improving balance among adults with IDD.

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20. Mason LL, Andrews A. Referent-Based Instruction to Strengthen the Verbal Behavior of Early Learners with Autism and Related Language Disorders. Behavior analysis in practice. 2021; 14(3): 660-72.

The current study evaluated the use of precision teaching to address the verbal behavior deficits of children with autism and other language disorders. From 2013 to 2018, a high-research-activity doctoral university in the south-central United States operated a free clinic that provided applied behavior anlaysis services to early learners in the local community. Participants received referent-based verbal behavior instruction to strengthen their functional language skills by systematically transferring stimulus control across 4 primary verbal operants: mands, echoics, tacts, and sequelics. Referent-based instruction is premised on the notion that proportionate levels of strength among these 4 operants provide the relational flexibility of naturalistic speaking observed in typical language development. This article details the language gains made by 49 participants who received 13 weeks of intervention for 90 min a day, 4 days a week. Relative strengths and weaknesses were identified in the verbal repertoire of each participant, and individualized fluency aims were subsequently developed. Results of pretest and posttest comparisons show that there was a large effect size within the verbal behavior gains of participants who received precision teaching. Implications for implementing referent-based instruction, as well as future areas of research, are discussed.

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21. Odom JD, Sutton VR. Metabolomics in Clinical Practice: Improving Diagnosis and Informing Management. Clinical chemistry. 2021; 67(12): 1606-17.

BACKGROUND: Metabolomics is the study of small molecules to simultaneously identify multiple low molecular weight molecules in a system. Broadly speaking, metabolomics can be subdivided into targeted and untargeted types of analysis, each type having advantages and drawbacks. Targeted metabolomics can quantify analytes but only looks for known or expected analytes related to particular disease(s), whereas untargeted metabolomics is typically nonquantitative but can detect thousands of analytes from an agnostic or nonhypothesis driven perspective, allowing for novel discoveries. CONTENT: One application of metabolomics is the study of inborn errors of metabolism (IEM). The biochemical hallmark of IEMs is decreased concentrations of analytes distal to the enzymatic defect and buildup of analytes proximal to the defect. Metabolomics can detect these changes with one test and is effective in screening for and diagnosis of IEMs. Metabolomics has also been used to study many nonmetabolic diseases such as autism spectrum disorder, various cancers, and multiple congenital anomalies syndromes. Metabolomics has led to the discovery of many novel biomarkers of disease. Recent publications demonstrate how metabolomics can be useful clinically in the diagnosis and management of patients, as well as for research and clinical discovery. SUMMARY: Metabolomics has proved to be a useful tool clinically for screening and diagnostic purposes and from a research perspective for the detection of novel biomarkers. In the future, metabolomics will likely become a routine part of the evaluation for many diseases as either a supplementary test or it may simply replace historical analyses that require several individual tests and sample types.

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22. Opoku MP, Nketsia W, J F, Mprah WK, Agyei-Okyere E, Safi M. The Interaction Between Typically Developing Students and Peers With Autism Spectrum Disorder in Regular Schools in Ghana: An Exploration Using the Theory of Planned Behaviour. Frontiers in psychology. 2021; 12: 752569.

The purpose of this study is to assess the intention of typically developing peers towards learning in the classroom with students with Autism Spectrum Disorder (ASD). In developing countries, such as Ghana, the body of literature on the relationship between students with disabilities and typically developing peers has been sparsely studied. Using Ajzen’s theory of planned behaviour as a theoretical framework for this study, 516 typically developing students completed four scales representing belief constructs, attitudes, subjective norms, and perceived behavioural controls (self-efficacy), hypothesised to predict behavioural intention. The data were subjected to a t-test, analysis of variance, and structural equation modelling. The modelling confirmed the combining ability of attitude, subjective norms, and perceived behavioural controls to predict intention. We conclude by revealing the need for policymakers to consider designing programmes aimed towards promoting social relationships between students with ASD and typically developing peers.

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23. Shea L, Tao S, Marcus SC, Mandell D, Epstein AJ. Medicaid Disruption Among Transition-Age Youth on the Autism Spectrum. Medical care research and review : MCRR. 2021: 10775587211051185.

Enrollment in Medicaid facilitates access to needed services among transition-age youth on the autism spectrum and youth with intellectual disability (ID). There are long-standing programs to ensure that individuals with ID remain enrolled as they age; similar programs for autistic youth are newer, not as widespread, and may not be as effective. We compared Medicaid disenrollment and re-enrollment between transition-age youth on the autism spectrum, youth with ID, and youth with both diagnoses using a national claims-based prospective cohort study from 2008 through 2012. Autistic youth were most likely to disenroll and least likely to re-enroll. Disenrollment peaked for all three groups at ages 19 and 21. Transition-age youth on the autism spectrum experience more disruptions in access to Medicaid-reimbursed services than youth with ID. More equitable Medicaid enrollment options for autistic individuals are needed to ensure their access to critical health care as they age.

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24. Valicenti-McDermott M, O’Neil M, Morales-Lara A, Seijo R, Fried T, Shulman L. Remote Learning Experience for Children With Developmental Disabilities During COVID-19 Pandemic in an Ethnically Diverse Community. Journal of child neurology. 2022; 37(1): 50-5.

Owing to the COVID-19 pandemic, K-12 education in New York City quickly transitioned to remote learning. We performed a structured interview with 50 consecutive families of children with developmental disabilities about their experience with remote learning 2 months after COVID-19 lockdown. We observed that setting up the remote learning system was challenging for families who were born outside of the United States, spoke limited English, or had a lower level of education. Though some special education supports were in place, remote learning for children with developmental disabilities led to gaps in their therapeutic services. Children with more severe developmental disabilities joined less than 2 hours of remote learning per day and had a decrease in their therapeutic services. Most children (80%) relied on their parents for education. Additionally, for low-income communities, with families who spoke languages other than English, remote learning revealed a new barrier to access: technology.

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