1. {{Communication tool improves cooperation in children with autism}}. {British dental journal}. 2014 Sep 12;217(5):212.
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2. Bershadsky J, Hiersteiner D, Fay ML, Bradley V. {{Race/Ethnicity and the Use of Preventive Health Care Among Adults With Intellectual and Developmental Disabilities}}. {Medical care}. 2014 Oct;52 Suppl 3, Healthcare at the Intersection of Disability, Race, and Ethnicity:S25-S31.
BACKGROUND:: Past research has been dedicated to documenting disparities in use of preventive health care faced by racial and ethnic minorities. In addition, studies have looked at the disparities in use of preventive health care experienced by individuals with intellectual and developmental disabilities (ID/DD). There is little known research that examines disparities in preventive health care use by individuals with ID/DD who identify as African American or Hispanic. OBJECTIVES:: This study aimed to determine whether National Core Indicators data demonstrate racial and/or ethnic disparities in the use of preventive health care. Further, this study examined whether those racial and/or ethnic disparities in the use of preventive health care persisted when the analysis controlled for other demographic factors. METHODS:: Data were derived from the 2011 to 2012 administration of the Adult Consumer Survey of the National Core Indicators Project. The association of race/ethnicity and preventive health care was assessed using binary logistic regression models. RESULTS:: There seem to be differences in receipt of preventive care by race/ethnicity. However, most of these differences were not significant after other person-level factors were accounted for. CONCLUSIONS:: Race/ethnicity may be less of a factor in accessing preventive care among adults with ID/DD receiving services than among the general population.
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3. Bogenschutz M. {{« We Find a Way »: Challenges and Facilitators for Health Care Access Among Immigrants and Refugees With Intellectual and Developmental Disabilities}}. {Medical care}. 2014 Oct;52 Suppl 3, Healthcare at the Intersection of Disability, Race, and Ethnicity:S64-S70.
BACKGROUND:: Immigrant and refugee populations and people with disabilities are known to have inequitable access to a range of health services. Very little study has been undertaken, however, about immigrants who have disabilities and their experience of the American health care system. RESEARCH DESIGN:: This qualitative study seeks to discover the particular challenges that immigrants with disabilities face when accessing health care, and the facilitating factors that assist them in this process. A complex multicase study design was utilized, and included purposively sampled individuals from 3 different immigrant communities, having an array of developmental disabilities. Interviews and participant observation provided the data that were analyzed in NVivo9 using a conventional content analysis approach. RESULTS:: Findings from this study suggest strong resilience among immigrant families with a member with a disability, as they continue to seek help despite experiencing confusion in navigating a complex health care system. Factors challenging access included difficulty finding accurate information on insurance and service providers, troubles with coordinating multiple specialist services, and a lack of cultural competence in all levels of health service provision. Access to health care services was facilitated by linguistically and culturally sensitive practitioners, favorable comparisons to the country or origin, and systems such as schools that helped to coordinate care. CONCLUSIONS:: Much can be done to integrate and improve health services to immigrants with developmental disabilities. Emerging models such as medical home may assist with coordination, and improvements in communication patterns could help to improve service access and outcomes.
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4. Connolly JJ, Hakonarson H. {{Etiology of autism spectrum disorder: a genomics perspective}}. {Current psychiatry reports}. 2014 Nov;16(11):501.
In recent years, considerable progress has been made in understanding the genomic basis of autism spectrum disorder (ASD). Hundreds of variants have been proposed as predisposing to ASD, and the challenge now is to validate candidates and to understand how gene networks interact to produce ASD phenotypes. Genome-wide association and second-generation sequencing studies in particular have provided important indications about how to understand ASD on a molecular level, and we are beginning to see these experimental approaches translate into novel treatments and diagnostic tests. We review key studies in the field over the past five years and discuss some of the remaining technological and methodological challenges that remain.
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5. Cusmano DM, Mong JA. {{In utero exposure to valproic Acid changes sleep in juvenile rats: a model for sleep disturbances in autism}}. {Sleep}. 2014;37(9):1489-99.
STUDY OBJECTIVES: To determine whether sleep disturbances are found in the valproic acid model of autism spectrum disorders (ASD). DESIGN: Comparative study for sleep behavior, sleep architecture, electroencephalogram (EEG) spectral analysis, and glutamic acid decarboxylase (GAD) 65/67 protein expression in juvenile rats exposed to valproic acid (VPA), sodium salt, or saline in utero. SETTING: N/A. PARTICIPANTS: Juvenile (postnatal day 32) male and female Sprague-Dawley rats. INTERVENTIONS: In utero exposure to either saline or 400 mg/kg VPA administered intraperitoneally to the dams on gestational day 12.5. On postnatal days 22-24, all rats were implanted with transmitters to record EEG and electromyogram (EMG) activity. MEASUREMENTS AND RESULTS: During the light phase, when nocturnal animals are typically quiescent, the VPA-exposed animals spent significantly more time in wake ( approximately 35 min) and significantly less time in non-rapid eye movement (NREM) sleep ( approximately 26 min) compared to the saline controls. Furthermore, spectral analysis of the EEG reveled that VPA-exposed animals exhibited increased high-frequency activity during wake and rapid eye movement (REM) sleep and reduced theta power across all vigilance states. Interestingly, the gamma-aminobutyric acid (GABA)-ergic system, which modulates the induction and maintenance of sleep states, was also disrupted, with reduced levels of both GAD 65 and GAD67 in the cortical tissue of VPA-exposed animals compared to saline controls. CONCLUSIONS: To date, the current animal models of ASD have been underutilized in the investigation of associated sleep disturbances. The VPA animal model recapitulates aspects of sleep disruptions reported clinically, providing a tool to investigate cellular and molecular dysregulation contributing to sleep disruptions in ASD. CITATION: Cusmano DM, Mong JA. In utero exposure to valproic acid changes sleep in juvenile rats: a model for sleep disturbances in autism. SLEEP 2014;37(9):1489-1499.
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6. Damiano CR, Mazefsky CA, White SW, Dichter GS. {{Future Directions for Research in Autism Spectrum Disorders}}. {Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53}. 2014 September-October;43(5):828-43.
This article suggests future directions for research aimed at improving our understanding of the etiology and pathophysiology of autism spectrum disorder (ASD) as well as pharmacologic and psychosocial interventions for ASD across the lifespan. The past few years have witnessed unprecedented transformations in the understanding of ASD neurobiology, genetics, early identification, and early intervention. However, recent increases in ASD prevalence estimates highlight the urgent need for continued efforts to translate novel ASD discoveries into effective interventions for all individuals with ASD. In this article we highlight promising areas for ongoing and new research expected to quicken the pace of scientific discovery and ultimately the translation of research findings into accessible and empirically supported interventions for those with ASD. We highlight emerging research in the following domains as particularly promising and pressing: (a) preclinical models, (b) experimental therapeutics, (c) early identification and intervention, (d) psychiatric comorbidities and the Research Domain Criteria initiative, (e) ecological momentary assessment, (f) neurotechnologies, and (g) the needs of adults with ASD. Increased research emphasis in these areas has the potential to hasten the translation of knowledge on the etiological mechanisms of ASD to psychosocial and biological interventions to reduce the burden of ASD on affected individuals and their families.
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7. Dewinter J, Vermeiren R, Vanwesenbeeck I, Lobbestael J, Van Nieuwenhuizen C. {{Sexuality in Adolescent Boys with Autism Spectrum Disorder: Self-reported Behaviours and Attitudes}}. {J Autism Dev Disord}. 2014 Sep 12.
Differences in sexual functioning of adolescents with and without autism spectrum disorder (ASD) are understudied. In the current study, self-reported sexual behaviours, interests and attitudes of 50 adolescent boys, aged 15-18, with at least average intelligence and diagnosed with ASD, were compared with a matched general population control group of 90 boys. Results demonstrated substantial similarity between the groups in terms of sexual behaviours. The only significant difference was that boys with ASD reacted more tolerant towards homosexuality compared to the control group. Results reveal that sexuality is a normative part of adolescent development in high-functioning boys with ASD. Hence, attention should be given to this topic in education and mental health care.
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8. Gentry T, Kriner R, Sima A, McDonough J, Wehman P. {{Reducing the Need for Personal Supports Among Workers with Autism Using an iPod Touch as an Assistive Technology: Delayed Randomized Control Trial}}. {J Autism Dev Disord}. 2014 Sep 12.
Personal digital assistants (PDAs) are versatile task organizers that hold promise as assistive technologies for people with cognitive-behavioral challenges. This delayed randomized controlled trial compared two groups of adult workers with autism spectrum disorder (ASD) to determine whether the use of an Apple iPod Touch PDA as a vocational support improves work performance and reduces personal support needs on the job. Baseline data were collected on 50 adults with ASD who were beginning a vocational placement supported by a job coach. Participants were randomized to receive training in the use of a PDA as a vocational aid upon starting their job or after working 12 weeks without PDA support. Workers who received PDA training at the beginning of their job placement required significantly less hours of job coaching support (p = 0.013) during their first 12 weeks on the job than those who had not yet received the intervention. Functional performance between the two groups was not significantly different. The significant difference in hours of job coaching support persisted during the subsequent 12 weeks, in which both groups used a PDA (p = 0.017).
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9. Harrop C, Shire S, Gulsrud A, Chang YC, Ishijima E, Lawton K, Kasari C. {{Does Gender Influence Core Deficits in ASD? An Investigation into Social-Communication and Play of Girls and Boys with ASD}}. {J Autism Dev Disord}. 2014 Sep 13.
Due to the predominance of boys diagnosed with autism spectrum disorders (ASD), girls are rarely studied independently. Research specifically focusing on play and social-communication in girls with ASD is extremely varied. We were interested in whether girls with ASD demonstrated equivalent social-communication and play skills in early childhood relative to boys, using two measures focused on the specific quantification of these variables. We also examined whether the associations between developmental variables and social-communication and play differed by gender. Forty girls with ASD were individually matched to 40 boys based on ASD severity. Our results suggest that girls and boys were more similar than different, however they also raise questions about the potential differential associations between development and requesting ability in girls and boys with ASD.
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10. Pugliese CE, Fritz MS, White SW. {{The role of anger rumination and autism spectrum disorder-linked perseveration in the experience of aggression in the general population}}. {Autism}. 2014 Sep 11.
This study (a) examined the role of anger rumination as a mediator of the relation between social anxiety and the experience of anger, hostility, and aggression, in the general population, and (b) evaluated the degree to which the presence of autism spectrum disorder characteristics moderates the indirect influence of anger rumination. We then explored whether social cognition and perseveration characteristic of autism spectrum disorder uniquely accounted for the predicted moderation. In this survey study of young adults (n = 948), anger rumination mediated the relation between social anxiety and hostility, as well as verbal and physical aggression, as predicted. Greater autism spectrum disorder characteristics augmented the effect of social anxiety on hostility and physical aggression by increasing the effect of anger rumination, but not by increasing the effect of social anxiety on anger rumination. Implications for developing treatment approaches that target hostility and aggression among young adults who may not be formally diagnosed but have characteristics of autism spectrum disorder are discussed.
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11. Rogers SJ, Vismara L, Wagner AL, McCormick C, Young G, Ozonoff S. {{Autism Treatment in the First Year of Life: A Pilot Study of Infant Start, a Parent-Implemented Intervention for Symptomatic Infants}}. {J Autism Dev Disord}. 2014 Sep 12.
The goal of early autism screening is earlier treatment. We pilot-tested a 12-week, low-intensity treatment with seven symptomatic infants ages 7-15 months. Parents mastered the intervention and maintained skills after treatment ended. Four comparison groups were matched from a study of infant siblings. The treated group of infants was significantly more symptomatic than most of the comparison groups at 9 months of age but was significantly less symptomatic than the two most affected groups between 18 and 36 months. At 36 months, the treated group had much lower rates of both ASD and DQs under 70 than a similarly symptomatic group who did not enroll in the treatment study. It appears feasible to identify and enroll symptomatic infants in parent-implemented intervention before 12 months, and the pilot study outcomes are promising, but testing the treatment’s efficacy awaits a randomized trial.
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12. Shebani SO, Skinner GJ, Duke C. {{ASD closure under pressure}}. {BMJ case reports}. 2014;2014.
Transcatheter atrial septal defect device implantation in elderly patients may cause acute pulmonary oedema when impaired left ventricular diastolic function causes an abrupt increase in left atrial pressure. Though left atrial pressure is often monitored during test occlusion of a defect, it is not clear at what cut-off value device implantation is contraindicated. We report successful closure of an atrial septal defect in a 73-year-old patient, even though the mean left atrial pressure increased from 18 to 25 mm Hg with device implantation. Although a fenestrated device was used, this did not prevent the rise in left atrial pressure. The patient was supported with mechanical ventilation, milrinone and intravenous diuretics following the procedure and did not develop pulmonary oedema. Her dyspnoea improved and her functional status increased from New York Heart Association (NYHA) III to NYHA II. In conclusion, successful device closure can be accomplished even with high left atrial pressure.
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13. Woodbury-Smith M. {{Editorial: ASD and Illegal Behaviors}}. {J Autism Dev Disord}. 2014 Sep 13.
The last decade has seen significant advances in our understanding of autism spectrum disorder, from both biological and clinical perspectives. Outcome runs the gamut from complete independence to relative dependence. Of particular interest, among those described with poor outcome are a small number of individuals, male and female, who have engaged in unlawful behavior. This special issue of the Journal of Autism and Developmental Disorders presents a number of papers providing further insight into this issue.
