1. Arikawa M, Goto H, Mineno K. {{Job support by occupational therapists for people with developmental disabilities: Two case studies}}. {Work};2013 (Mar 11)
The present report uses two cases to provide an overview of employment support by occupational therapists for people with developmental disabilities and investigates the roles occupational therapists should play and the support they should give. Case A was a man in his 30 s with Asperger disorder who used a trial employment program and received on-the-job training, leading to regular employment. Case B was a man in his 40 s with intellectual disability who used outreach supported employment and achieved financial stability through sheltered employment. These two cases suggest that occupational therapists can help people with developmental disabilities acquire stable employment by accelerating their adaptation to the workplace through the following steps: assessing the occupational performance of the individual and the work environment; understanding the characteristics of the job by experiencing the job first-hand; and adjusting or improving the work environment to match the capabilities of the individual.
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2. Baker E, Richdale A, Short M, Gradisar M. {{An investigation of sleep patterns in adolescents with high-functioning autism spectrum disorder compared with typically developing adolescents}}. {Dev Neurorehabil};2013 (Mar 11)
Objective: To investigate the sleep patterns and disturbances in a pure sample of adolescents with high-functioning autism spectrum disorder (HFASD). Method: Adolescents completed a sleep questionnaire battery and a 7 d sleep diary. Actigraphic data were collected from a sub-sample of participants (55%) with HFASD and all typically developing (TD) adolescents. Results: Adolescents with HFASD were three times more likely to report a sleep problem than their TD peers (46.2% vs. 14.8%). Adolescents with HFASD had decreased sleep efficiency (diary) (p = 0.04, eta2 = 0.10), and more fatigue (p = 0.002, eta2 = 0.18) compared with TD adolescents. While TD adolescents generally experienced one symptom of insomnia, adolescents with HFASD were likely to experience two or three symptoms of insomnia (p = 0.02, V = 0.36). Conclusion: The findings suggest that adolescents with HFASD show a continuation of the maladaptive sleep patterns as seen in children with an autism spectrum disorder and these sleep disturbances are associated with increased daytime sleepiness.
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3. Beighley JS, Matson JL, Rieske RD, Jang J, Cervantes PE, Goldin RL. {{Comparing challenging behavior in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5}}. {Dev Neurorehabil};2013 (Mar 11)
Objective: The aim of the current study is to investigate challenging behavior in children who may no longer meet criteria for an autism spectrum disorder (ASD) diagnosis according to the proposed fifth edition of the Diagnostic and Statistical Manual (DSM-5). Method: Children and adolescents (n = 459) were separated into three groups including those who met criteria for ASD according to the DSM-5 criteria (n = 219); those who will no longer qualify for an ASD diagnosis according to the DSM-5 but met criteria according to the DSM-IV-TR (n = 109); and a control group (n = 131). Scores on the Autism Spectrum Disorders – Problem Behaviors for Children (ASD-PB-C) were compared among groups. Results: The DSM-5 captured a slightly more impaired population in terms of problem behavior. Conclusion: Implications regarding access to treatment for those no longer meeting criteria need to be taken into consideration in the coming months.
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4. Bolte EE, Diehl JJ. {{Measurement Tools and Target Symptoms/Skills Used to Assess Treatment Response for Individuals with Autism Spectrum Disorder}}. {J Autism Dev Disord};2013 (Mar 12)
This study examined the measurement tools and target symptoms/skills used to assess treatment response during Autism Spectrum Disorder (ASD) intervention trials from 2001 through 2010. Data from 195 prospective trials were analyzed. There were 289 unique measurement tools, of which 61.6 % were used only once, and 20.8 % were investigator-designed. Only three tools were used in more than 2 % of the studies, and none were used in more than 7 % of studies. Studies investigated an average of 11.4 tool-symptom combinations per trial, with as many as 45 in one study. These results represent a lack of consistency in outcome measurements in ASD intervention trials. These findings highlight the need to set guidelines for appropriate outcome measurement in the ASD field.
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5. Butterly F, Percy C, Ward G. {{Brief Report: Do Service Dog Providers Placing Dogs with Children with Developmental Disabilities Use Outcome Measures and, If So, What Are they?}}. {J Autism Dev Disord};2013 (Mar 12)
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly Asperger’s syndrome, autism and communication disorders, completed the survey. All five participants reported that they expected to see positive changes as a consequence of the service dog placement, in both the recipient child and their family, including improvements in attention span and language skills, as well as increased familial cohesion. Survey responses indicated that not all desired outcomes were routinely assessed. The range of assessments used were interviews, intake conversations, pre-placement questionnaires, child social dairies filled in by parents, follow up surveys after placement, and child observation by parents. No specifically named valid and reliable clinical or research measures were referred to, showing an emphasis on assessments from parents and service dog providers. It is not clear whether pre-intervention assessments are repeated systematically at follow-up, which could show robust intervention effects. There is scope for professionals in developmental disability to work with service dog providers to improve the evidence base in this field.
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6. Egan AM, Dreyer ML, Odar CC, Beckwith M, Garrison CB. {{Obesity in Young Children with Autism Spectrum Disorders: Prevalence and Associated Factors}}. {Child Obes};2013 (Mar 13)
Abstract Background: The purpose of this study was to identify rates of overweight and obesity in young children with autism spectrum disorders (ASD) and factors related to overweight. Methods: Retrospective chart reviews were conducted for 273 children with ASD [i.e., autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified (PDD-NOS)] after receiving outpatient services with a developmental pediatrician or the developmental team at a children’s hospital. Information on child demographics, height and weight, medications prescribed, and adaptive functioning was collected from charts. Results: Rates of overweight and obesity in children with ASD were found to be above nationally representative prevalence estimates for children. Among children with autistic disorder, 17.16% had a body mass index (BMI) percentile in the overweight range and 21.89% had a BMI percentile in the obese range. For children with Asperger’s disorder/PDD-NOS, 12.50% were considered overweight and 10.58% were considered obese. Neither psychotropic medications prescribed nor adaptive functioning was found to be related to whether the child was overweight or obese. Conclusions: Children with ASD are at risk for overweight and obesity, and children with autistic disorder are at greater risk for weight problems than children with Asperger’s disorder/PDD-NOS. Further research is needed to identify factors related to overweight in children with ASD.
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7. Lampi KM, Hinkka-Yli-Salomaki S, Lehti V, Helenius H, Gissler M, Brown AS, Sourander A. {{Parental Age and Risk of Autism Spectrum Disorders in a Finnish National Birth Cohort}}. {J Autism Dev Disord};2013 (Mar 12)
Aim of the study was to examine the associations between parental age and autism spectrum disorders (ASD). Data were based on the FIPS-A (Finnish Prenatal Study of Autism and Autism Spectrum Disorders), a case-control study with a total of 4,713 cases with childhood autism (n = 1,132), Asperger’s syndrome (n = 1,785) or other pervasive developmental disorder (PDD) (n = 1,796), which were ascertained from the Finnish Hospital Discharge Register. Controls were selected from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses. Advanced paternal age (35-49 years) was associated with childhood autism in offspring, whereas advanced maternal age was associated with both Asperger’s syndrome and PDD in offspring (35 years or more and 40 years or more, respectively). Teenage motherhood (19 years or less) was associated with PDD in offspring. The main finding was that maternal and paternal ages were differentially associated with ASD subtypes. In addition to advanced parental age, teenage pregnancy seems to incur a risk for PDD in offspring.
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8. Lloyd-Fox S, Blasi A, Elwell CE, Charman T, Murphy D, Johnson MH. {{Reduced neural sensitivity to social stimuli in infants at risk for autism}}. {Proc Biol Sci};2013;280(1758):20123026.
In the hope of discovering early markers of autism, attention has recently turned to the study of infants at risk owing to being the younger siblings of children with autism. Because the condition is highly heritable, later-born siblings of diagnosed children are at substantially higher risk for developing autism or the broader autism phenotype than the general population. Currently, there are no strong predictors of autism in early infancy and diagnosis is not reliable until around 3 years of age. Because indicators of brain functioning may be sensitive predictors, and atypical social interactions are characteristic of the syndrome, we examined whether temporal lobe specialization for processing visual and auditory social stimuli during infancy differs in infants at risk. In a functional near-infrared spectroscopy study, infants aged 4-6 months at risk for autism showed less selective neural responses to social stimuli (auditory and visual) than low-risk controls. These group differences could not be attributed to overall levels of attention, developmental stage or chronological age. Our results provide the first demonstration of specific differences in localizable brain function within the first 6 months of life in a group of infants at risk for autism. Further, these differences closely resemble known patterns of neural atypicality in children and adults with autism. Future work will determine whether these differences in infant neural responses to social stimuli predict either later autism or the broader autism phenotype frequently seen in unaffected family members.
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9. Preslar J, Kushner HI, Marino L, Pearce B. {{Autism, lateralisation, and handedness: A review of the literature and meta-analysis}}. {Laterality};2013 (Mar 12)
A number of recent investigators have hypothesised a link between autism, left-handedness, and brain laterality. Their findings have varied widely, in part because these studies have relied on different methodologies and definitions. We conducted a systematic review and meta-analysis to assess the literature, with the hypothesis that there would be an association between autism and laterality that would be moderated by handedness, sex, age, brain region studied, and level of autism. From a broad search resulting in 259 papers, 54 were identified for inclusion in the literature review. This list was narrowed further to include only studies reporting results in the inferior frontal gyrus for meta-analysis, resulting in four papers. The meta-analysis found a moderate but non-significant effect size of group on lateralisation, suggesting a decrease in strength of lateralisation in the autistic group, a trend supported by the literature review. A subgroup analysis of sex and a meta-regression of handedness showed that these moderating variables did not have a significant effect on this relationship. Although the results are not conclusive, there appears to be a trend towards a relationship between autism and lateralisation. However, more rigorous studies with better controls and clearer reporting of definitions and results are needed.
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10. Sellier C, Freyermuth F, Tabet R, Tran T, He F, Ruffenach F, Alunni V, Moine H, Thibault C, Page A, Tassone F, Willemsen R, Disney MD, Hagerman PJ, Todd PK, Charlet-Berguerand N. {{Sequestration of DROSHA and DGCR8 by Expanded CGG RNA Repeats Alters MicroRNA Processing in Fragile X-Associated Tremor/Ataxia Syndrome}}. {Cell Rep};2013 (Mar 5)
Fragile X-associated tremor/ataxia syndrome (FXTAS) is an inherited neurodegenerative disorder caused by the expansion of 55-200 CGG repeats in the 5′ UTR of FMR1. These expanded CGG repeats are transcribed and accumulate in nuclear RNA aggregates that sequester one or more RNA-binding proteins, thus impairing their functions. Here, we have identified that the double-stranded RNA-binding protein DGCR8 binds to expanded CGG repeats, resulting in the partial sequestration of DGCR8 and its partner, DROSHA, within CGG RNA aggregates. Consequently, the processing of microRNAs (miRNAs) is reduced, resulting in decreased levels of mature miRNAs in neuronal cells expressing expanded CGG repeats and in brain tissue from patients with FXTAS. Finally, overexpression of DGCR8 rescues the neuronal cell death induced by expression of expanded CGG repeats. These results support a model in which a human neurodegenerative disease originates from the alteration, in trans, of the miRNA-processing machinery.
