1. Abel E, Kim SY, Kellerman AM, Brodhead MT. {{Recommendations for Identifying Sleep Problems and Treatment Resources for Children with Autism Spectrum Disorder}}. {Behav Anal Pract}. 2017; 10(3): 261-9.
Many young children experience sleep problems that may influence their daytime functioning. These sleep problems are especially prevalent in young children with autism spectrum disorder (ASD). Therefore, general recommendations for identifying and treating sleep problems in children with ASD are needed for behavior analysts to identify potential sleep problems and make empirically informed decisions regarding treatment options. The current paper seeks to provide behavior analysts, who work with children with ASD, with informative research on pediatric sleep problems, sleep measures, and options for behavioral sleep treatment.
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2. Amor DJ, Bijlsma EK. {{Letter regarding the article « Extending the phenotype of recurrent rearrangements of 16p11.2: Deletions in mentally retarded patients without autism and in normal individuals () » and the diagnosis of coexisting Mowat-Wilson syndrome in a patient with 16p11.2 deletion}}. {Eur J Med Genet}. 2017.
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3. DiGuiseppi C, Levy SE, Sabourin KR, Soke GN, Rosenberg S, Lee LC, Moody E, Schieve LA. {{Injuries in Children with Autism Spectrum Disorder: Study to Explore Early Development (SEED)}}. {J Autism Dev Disord}. 2017.
This study examined caregiver-reported medically-attended injuries among 30-68 month old children with autism spectrum disorder (ASD) compared to general population (POP) and non-ASD developmental disorders (DD) controls in the Study to Explore Early Development. Injuries were common in ASD cases (32.3%) as well as POP (30.2%) and DD (27.8%) controls; most resulted in an emergency visit or hospitalization. After accounting for sociodemographic, health, IQ and behavior differences, odds of injury in ASD cases were significantly higher than DD controls but similar to POP controls. Attention problems mediated the relationships. Clinicians caring for children with both ASD and attention problems should consider providing targeted safety advice. Differences in injury risk between children with ASD vs. other developmental disorders need further study.
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4. Dixon DR, Burns CO, Granpeesheh D, Amarasinghe R, Powell A, Linstead E. {{A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder}}. {Behav Anal Pract}. 2017; 10(3): 307-12.
The present study aimed to retrospectively compare the relative rates of mastery of exemplars for individuals with ASD (N = 313) who received home-based and center-based services. A between-group analysis found that participants mastered significantly more exemplars per hour when receiving center-based services than home-based services. Likewise, a paired-sample analysis found that participants who received both home and center-based services had mastered 100 % more per hour while at the center than at home. These analyses indicated that participants demonstrated higher rates of learning during treatment that was provided in a center setting than in the participant’s home.
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5. Grow LL, Kodak T, Clements A. {{An Evaluation of Instructive Feedback to Teach Play Behavior to a Child with Autism Spectrum Disorder}}. {Behav Anal Pract}. 2017; 10(3): 313-7.
Instructive feedback is used to expose learners to secondary targets during skill acquisition programs (Reichow & Wolery, in Journal of Applied Behavior Analysis, 44, 327-340, 2011; Werts, Wolery, Gast, & Holcombe, in Journal of Behavioral Education, 5, 55-75, 1995). Although unrelated feedback may have clinical utility in practice, very little research has evaluated unrelated instructive feedback, particularly for promoting play behavior (Colozzi, Ward, & Crotty, in Education and Training in Developmental Disabilities, 43, 226-248, 2008). The purpose of the study was to determine if play emerged after embedding instructive feedback during the consequence portion of discrete trial training to teach tacts. An adapted alternating treatments design was used to compare tact training with and without instructive feedback for play behaviors. Instructive feedback resulted in the emergence of play behaviors during tabletop instruction and a play area of a classroom. We discuss the results in terms of clinical practice and future research.
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6. Hume K, Dykstra Steinbrenner J, Sideris J, Smith L, Kucharczyk S, Szidon K. {{Multi-informant assessment of transition-related skills and skill importance in adolescents with autism spectrum disorder}}. {Autism}. 2017: 1362361317722029.
Adolescents with autism spectrum disorder have limited participation in the transition planning process, despite the link between active participation and an improvement in postsecondary education and employment outcomes. The Secondary School Success Checklist was designed to support transition planning for adolescents with autism spectrum disorder by incorporating their own assessments of strengths, skill deficits, and prioritization for instruction along with those of their parents and teachers across multiple skill domains. Findings from more than 500 adolescents with autism spectrum disorder across the United States indicate discrepancies between adolescent, teacher, and parent ratings of skills highlighting the importance of the inclusion of multiple perspectives in transition planning. Although ratings varied, agreement between adolescents with autism spectrum disorder, parents, and teachers across the highest and lowest rated skills suggests the need to broaden the focus on critical transition skills to include problem-solving, planning for life after high school, and self-advocacy.
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7. Jackson SLJ, Hart L, Brown JT, Volkmar FR. {{Brief Report: Self-Reported Academic, Social, and Mental Health Experiences of Post-Secondary Students with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2017.
Increasing numbers of individuals with autism spectrum disorder (ASD) are enrolling in post-secondary academic institutions. However, research indicates that post-secondary students with ASD are struggling more than their typically developing peers, with high rates of loneliness, anxiety, depression, and an increased incidence of dropping-out before completion of their degrees. The current study utilized an online survey to gain insight into the self-reported academic, social, and mental health experiences of post-secondary students with ASD. Participants reported high levels of academic comfort, but struggled with issues of isolation/loneliness and high levels of stress, anxiety, and depression. Of greatest concern, were the nearly three-quarters of participants who reported lifetime suicidal behaviors. Further analysis on collected data and implications of findings are discussed.
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8. Kim OH, Cho HJ, Han E, Hong TI, Ariyasiri K, Choi JH, Hwang KS, Jeong YM, Yang SY, Yu K, Park DS, Oh HW, Davis EE, Schwartz CE, Lee JS, Kim HG, Kim CH. {{Zebrafish knockout of Down syndrome gene, DYRK1A, shows social impairments relevant to autism}}. {Mol Autism}. 2017; 8: 50.
BACKGROUND: DYRK1A maps to the Down syndrome critical region at 21q22. Mutations in this kinase-encoding gene have been reported to cause microcephaly associated with either intellectual disability or autism in humans. Intellectual disability accompanied by microcephaly was recapitulated in a murine model by overexpressing Dyrk1a which mimicked Down syndrome phenotypes. However, given embryonic lethality in homozygous knockout (KO) mice, no murine model studies could present sufficient evidence to link Dyrk1a dysfunction with autism. To understand the molecular mechanisms underlying microcephaly and autism spectrum disorders (ASD), we established an in vivo dyrk1aa KO model using zebrafish. METHODS: We identified a patient with a mutation in the DYRK1A gene using microarray analysis. Circumventing the barrier of murine model studies, we generated a dyrk1aa KO zebrafish using transcription activator-like effector nuclease (TALEN)-mediated genome editing. For social behavioral tests, we have established a social interaction test, shoaling assay, and group behavior assay. For molecular analysis, we examined the neuronal activity in specific brain regions of dyrk1aa KO zebrafish through in situ hybridization with various probes including c-fos and crh which are the molecular markers for stress response. RESULTS: Microarray detected an intragenic microdeletion of DYRK1A in an individual with microcephaly and autism. From behavioral tests of social interaction and group behavior, dyrk1aa KO zebrafish exhibited social impairments that reproduce human phenotypes of autism in a vertebrate animal model. Social impairment in dyrk1aa KO zebrafish was further confirmed by molecular analysis of c-fos and crh expression. Transcriptional expression of c-fos and crh was lower than that of wild type fish in specific hypothalamic regions, suggesting that KO fish brains are less activated by social context. CONCLUSIONS: In this study, we established a zebrafish model to validate a candidate gene for autism in a vertebrate animal. These results illustrate the functional deficiency of DYRK1A as an underlying disease mechanism for autism. We also propose simple social behavioral assays as a tool for the broader study of autism candidate genes.
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9. Lahvis GP. {{What California sea lions exposed to domoic acid might teach us about autism: lessons for predictive and preventive medicine}}. {EPMA J}. 2017; 8(3): 229-35.
Autism spectrum disorder (ASD) shares many biological and behavioral similarities with the deleterious effects of domoic acid (DA) exposure. DA is produced by marine algae and most commonly by species of Pseudo-nitzschia. Humans and marine mammals can be exposed to DA when they consume whole fish or shellfish. The mammalian fetus is highly sensitive to the deleterious effects of DA exposure. Both ASD and exposures to toxic levels of DA feature repetitive behaviors, challenges with social interaction, and seizures. They can also share a commonality in brain anatomy and function, particularly the balance between excitatory and inhibitory mechanisms. The current article is relevant to predictive, preventive, and personalized medicine for three reasons. First, shellfish consumption may be a risk factor for ASD and the regulatory limit for DA should be adjusted to prevent this possibility. Human contributions to increased algal production of DA in coastal waters should be identified and reduced. Second, evaluations of sentinel species wild and free-roaming in the environment, though typically outside the purview of biomedical research, should be much more fully employed to gain insights to risk factors for human disease. To better identify and prevent disease, biomedical researchers should study wild populations. Third, studies of DA exposure highlight the possibility that glutamate additives to processed foods may also have deleterious impacts on human brain development and behavior.
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10. Lecavalier L, Pan X, Smith T, Handen BL, Arnold LE, Silverman L, Tumuluru RV, Hollway J, Aman MG. {{Parent Stress in a Randomized Clinical Trial of Atomoxetine and Parent Training for Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2017.
We previously reported a 2 x 2 randomized clinical trial of atomoxetine (ATX) and parent training (PT) for attention deficit hyperactivity disorder (ADHD) symptoms and behavioral noncompliance in 128 children with autism spectrum disorder, ages 5-14 years. Children were randomized to one of four conditions: ATX alone, placebo alone, ATX + PT, or PT + placebo. Both ATX and PT improved some indices of ADHD and behavioral compliance. In this report, we describe parent stress over time and across conditions. All four treatments improved parent self-rated stress from baseline to week 10. However, there were no statistically significant differences between treatment groups. Significantly more improvement in parent stress scores was observed for clinical responders than non-responders. ClinicalTrials.gov Title: Atomoxetine, Placebo and Parent Management Training in Autism (Strattera) ClinicalTrials.gov Identifier: NCT00844753.
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11. Mademtzi M, Singh P, Shic F, Koenig K. {{Challenges of Females with Autism: A Parental Perspective}}. {J Autism Dev Disord}. 2017.
Most studies investigating the experiences and needs of individuals with ASD have largely focused on males. Hence, this study investigates parents’ perspectives on the challenges that their daughters with ASD face. In total, 40 parents of 40 females with autism (age range = 4-29 years; mean = 15.9) participated in the study. Five separate, 2-h long focus groups were conducted, with 7-10 participants in each group. Field notes were analyzed using thematic analysis. Some of the issues parents discussed were similar to those experienced by males with ASD, such as challenges in social interactions. However, other issues discussed were of particular relevance to girls with ASD, including difficulties socializing with other girls, sex-specific puberty issues, barriers in accessing intervention and sexual vulnerability.
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12. McKeel A, Matas J. {{Utilizing PEAK Relational Training System to Teach Visual, Gustatory, and Auditory Relations to Adults with Developmental Disabilities}}. {Behav Anal Pract}. 2017; 10(3): 252-60.
Two multiple baseline designs were conducted across participants to determine if the promoting the emergence of advanced knowledge (PEAK) equivalence module was an effective tool in teaching adults with autism relationships between stimuli. More specifically, a transitivity program utilizing the gustatory sensory modality was implemented. Stimuli were selected and probed initially preceding the training. First, gustatory stimuli to a visual picture were trained. Then, a visual picture to a spoken word was trained. Finally, once mastery criterion was reached, each participant’s responding was tested to determine whether there were derived relations following training. Results showed that all three participants reached mastery criterion in training sessions and were able to derive new relations without direct training.
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13. Mills C, Chapparo C. {{Listening to teachers: Views on delivery of a classroom based sensory intervention for students with autism}}. {Aust Occup Ther J}. 2017.
BACKGROUND/AIM: Occupational therapists consider the impact of autism spectrum disorder on occupational performance at school. Occupational therapists work with teachers to support student participation. Atypical sensory processing is common in children with autism. Therefore, collaborating with teachers to enable students with autism to appropriately process sensory information within classrooms may be necessary. This qualitative pilot study aimed to capture teachers’ perceptions of using a Sensory Activity Schedule, a sensory based intervention, in the classroom. METHODS: A qualitative descriptive approach was used to analyse semi-structured interview responses from 19 qualified teachers who taught children with autism from seven different autism specific special schools in NSW. Teachers were asked about their motivation to complete the intervention as well as helpful and difficult aspects of the intervention. FINDINGS: Three main categories and eight sub-categories were identified from the 19 respondents who reported that helping their students was an important motivation for using a Sensory Activity Schedule as well as the opportunity to evaluate whether sensory based intervention was beneficial. Teachers reported that learning new ideas, working with an occupational therapist and seeing an increase in concentration and a reduction in undesired behaviours were positive aspects of utilising the intervention. Timing, staffing and fidelity of the intervention were areas of concern. CONCLUSION: Collaboration with classroom teachers is an essential part of school-based occupational therapy. Insights from teachers who implemented a sensory based intervention in the classroom assist occupational therapists to better support students with autism spectrum disorder in schools.
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14. Parish-Morris J, Liberman MY, Cieri C, Herrington JD, Yerys BE, Bateman L, Donaher J, Ferguson E, Pandey J, Schultz RT. {{Linguistic camouflage in girls with autism spectrum disorder}}. {Mol Autism}. 2017; 8: 48.
BACKGROUND: Autism spectrum disorder (ASD) is diagnosed more frequently in boys than girls, even when girls are equally symptomatic. Cutting-edge behavioral imaging has detected « camouflaging » in girls with ASD, wherein social behaviors appear superficially typical, complicating diagnosis. The present study explores a new kind of camouflage based on language differences. Pauses during conversation can be filled with words like UM or UH, but research suggests that these two words are pragmatically distinct (e.g., UM is used to signal longer pauses, and may correlate with greater social communicative sophistication than UH). Large-scale research suggests that women and younger people produce higher rates of UM during conversational pauses than do men and older people, who produce relatively more UH. Although it has been argued that children and adolescents with ASD use UM less often than typical peers, prior research has not included sufficient numbers of girls to examine whether sex explains this effect. Here, we explore UM vs. UH in school-aged boys and girls with ASD, and ask whether filled pauses relate to dimensional measures of autism symptom severity. METHODS: Sixty-five verbal school-aged participants with ASD (49 boys, 16 girls, IQ estimates in the average range) participated, along with a small comparison group of typically developing children (8 boys, 9 girls). Speech samples from the Autism Diagnostic Observation Schedule were orthographically transcribed and time-aligned, with filled pauses marked. Parents completed the Social Communication Questionnaire and the Vineland Adaptive Behavior Scales. RESULTS: Girls used UH less often than boys across both diagnostic groups. UH suppression resulted in higher UM ratios for girls than boys, and overall filled pause rates were higher for typical children than for children with ASD. Higher UM ratios correlated with better socialization in boys with ASD, but this effect was driven by increased use of UH by boys with greater symptoms. CONCLUSIONS: Pragmatic language markers distinguish girls and boys with ASD, mirroring sex differences in the general population. One implication of this finding is that typical-sounding disfluency patterns (i.e., reduced relative UH production leading to higher UM ratios) may normalize the way girls with ASD sound relative to other children, serving as « linguistic camouflage » for a naive listener and distinguishing them from boys with ASD. This first-of-its-kind study highlights the importance of continued commitment to understanding how sex and gender change the way that ASD manifests, and illustrates the potential of natural language to contribute to objective « behavioral imaging » diagnostics for ASD.
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15. Sosnowy C, Silverman C, Shattuck P. {{Parents’ and young adults’ perspectives on transition outcomes for young adults with autism}}. {Autism}. 2017: 1362361317699585.
Existing research shows that young adults with autism spectrum disorder have poorer outcomes than their peers with other developmental disabilities in the key areas of independent living, postsecondary education, and employment. However, we understand little about how young adults with autism and their families understand and value outcomes and whether these indicators match their goals and aspirations. We interviewed parents (n = 21) and young adults with autism spectrum disorder (n = 20) about their experiences with the transition to adulthood to understand what they consider to be desirable outcomes and how they seek to achieve them. Understanding these perspectives will help identify areas of need as well as disconnections between service objectives and the goals of young adults and their families. Participants described outcomes as more complex and nuanced than current conceptions and measures account for. They defined and evaluated outcomes in relation to their or their child’s individual abilities, needs, and desires. These findings provide important insight into challenges to and facilitators of desired outcomes, which has implications for programming, service delivery, and policy.
