1. Chang YC, Chen CH, Huang PC, Lin LY. {{Understanding the characteristics of friendship quality, activity participation, and emotional well-being in Taiwanese adolescents with autism spectrum disorder}}. {Scandinavian journal of occupational therapy}. 2018: 1-11.
BACKGROUND: Autism spectrum disorder (ASD) is a lifelong developmental disability characterized by deficits in social communication and social interaction across multiple contexts. Existing literature on social relationships and well-being among adolescents with ASD in Asian countries is scant. AIMS: This study compared the perceptions of adolescents with ASD with those of their neurotypical peers toward their friendship quality, activity participation, and emotional well-being, and examined the relationships between friendship quality, activity participation, and emotional well-being. METHODS: The study participants-101 adolescents with ASD and 101 neurotypical peers, aged 10-19 years-completed the following self-administered questionnaires: the Friendship Quality Questionnaire, the Child and Adolescent Scale of Participation, the Beck Anxiety Inventory, and the short-form UCLA loneliness scale. RESULTS: Adolescents with ASD reported lower friendship quality, lower school participation, and higher levels of anxiety and loneliness compared to their neurotypical peers. Loneliness correlated negatively with friendship quality and school participation and positively with anxiety. Adolescents with ASD experienced increased levels of anxiety when low friendship quality was accompanied by greater loneliness. CONCLUSIONS AND SIGNIFICANCE: These findings reveal that friendship quality, school participation, and loneliness have a considerable effect on the emotional well-being of adolescents with ASD, thus indicating the need for therapeutic interventions that address interpersonal relationships and emotional well-being.
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2. Francis K, Dougali A, Sideri K, Kroupis C, Vasdekis V, Dima K, Douzenis A. {{Brain-derived neurotrophic factor (BDNF) in children with ASD and their parents: a 3-year follow-up}}. {Acta Psychiatr Scand}. 2018.
OBJECTIVE: Several lines of evidence point to a probable relationship between brain-derived neurotrophic factor (BDNF) and autism spectrum disorder (ASD), but studies have yielded inconsistent findings on the BDNF serum level in ASD. The study aimed to assess those levels in children with ASD and their families. METHOD: BDNF serum levels were measured in 45 ASD children without intellectual disability (ID) and allergies, age 30-42 months and age-matched normal controls. BDNF serum levels in the parents of the ASD subjects were compared to normal controls. BDNF serum levels in the ASD subjects were followed up for 3 years and correlated with adaptive functioning changes. RESULTS: BDNF serum levels were measured to be lower in children with ASD and independent of all the major baseline characteristics of the subjects. Having a child with ASD raises the BDNF levels in parents comparing to controls. Prospectively, no correlation between the change of BDNF variables in time and the change of the Vineland scores was found. CONCLUSIONS: Our results contradict those from recent published meta-analyses with the age, the presence of ID and allergies being possible contributing factors. The parents’ data indeed point to a role of BDNF in the pathophysiology of ASD.
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3. Galdino MP, Pegoraro LFL, Saad LO, Grodberg D, Celeri E. {{Evidence of Validity of the Autism Mental Status Examination (AMSE) in a Brazilian Sample}}. {J Autism Dev Disord}. 2018.
This study investigated the psychometric properties of the Autism Mental Status Examination (AMSE) in a Brazilian sample of children and adolescents with autism spectrum disorder (ASD). A sample of 260 children and adolescents, comprising 56 (21.5%) females and 204 (78.5%) males, was assessed. The participants were submitted to both the childhood autism rating scale (CARS-BR) and the AMSE. The CARS-BR was used to estimate ASD severity and the cutoff point on the AMSE. Spearman’s correlation test was employed to determine the correlation between the AMSE and CARS-BR scales. The cutoff values were calculated using the ROC (receiver operating characteristic) curve, identifying the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The homogeneity of the items of the AMSE was determined using Cronbach s alpha. The AMSE exhibited good internal consistency (0.74), sensitivity (0.91) and specificity (0.98); and high correlation with the CARS-BR (rho = 0.91, p < 0.01). Preliminary results showed that the AMSE is a tool with good psychometric properties for ASD screening. Lien vers le texte intégral (Open Access ou abonnement)
4. Hisle-Gorman E, Susi A, Stokes T, Gorman G, Erdie-Lalena C, Nylund CM. {{Prenatal, perinatal, and neonatal risk factors of autism spectrum disorder}}. {Pediatr Res}. 2018.
OBJECTIVE: We explored the association of 29 previously reported neonatal, perinatal and prenatal conditions and exposures with later diagnosis of ASD in a large sample of children followed over multiple years. STUDY DESIGN: A retrospective case-cohort study was formed using the Military Health System database. Cases were identified by International Classification of Diseases, Ninth Revision (ICD-9) codes for ASD between 2000 and 2013 and were matched 3:1 with controls on sex, date of birth, and enrollment time-frame. Exposures included 29 conditions previously associated with ASD; 17 prenatal conditions and their pharmaceutical treatment, 5 perinatal conditions, and 6 neonatal conditions. RESULTS: 8,760 children diagnosed with ASD between age 2-18 years were matched with 26, 280 controls. ASD is associated with maternal mental illness, epilepsy, obesity, hypertension, diabetes, polycystic ovary syndrome, infection, asthma, assisted fertility, hyperemesis, younger maternal age, labor complications, low birth weight, infant infection, epilepsy, birth asphyxia and newborn complications. Greatest increased risk was associated with infant epilepsy (OR 7.57 [5.68-10.07]), and maternal mental health (OR 1.80 [1.65-1.96]), and epilepsy (OR 1.60 [1.02-2.50]) medications. CONCLUSION: ASD is associated with a range of prenatal, perinatal, and neonatal factors, with the highest magnitude associations with maternal medication use and neonatal seizure.Pediatric Research accepted article preview online, 14 March 2018. doi:10.1038/pr.2018.23.
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5. Johnson CR, Smith T, DeMand A, Lecavalier L, Evans V, Gurka M, Swiezy N, Bearss K, Scahill L. {{Exploring sleep quality of young children with autism spectrum disorder and disruptive behaviors}}. {Sleep medicine}. 2018; 44: 61-6.
BACKGROUND AND PURPOSE: Sleep disturbances in autism spectrum disorder (ASD) are common and may impair daytime functioning as well as add to parental burden. In this well characterized sample of young children with ASD and disruptive behaviors, we examine the association of age and IQ in sleep disturbances using the Child Sleep Habits Questionnaire modified for ASD (CSHQ-ASD). We also test whether children with poor sleep have greater daytime behavioral problems than those with better sleep. Finally, we examine whether parental stress is higher in children with greater disruptive behaviors and sleep disturbances. PARTICIPANTS AND METHODS: One hundred and seventy-seven children with complete data out of 180 (mean age 4.7) with ASD participated in a randomized clinical trial. Parents completed the CSHQ-ASD and several other measures at study enrollment. The sample was divided into « poor sleepers » (upper quartile on the total score of the CSHQ-ASD) and « good sleepers » (lower quartile) for comparisons. Analyses were conducted to evaluate group differences on age, IQ, daytime disruptive behavior, social disability and parental stress. RESULTS: The two groups of young children with ASD, good sleepers versus poor sleepers, were not different on age or cognitive level. Children in the poor sleeping group had significantly higher daytime behavioral problems including irritability, hyperactivity, social withdrawal and stereotypical behaviors. Parents in this group reported significantly higher levels of stress. CONCLUSIONS: The finding of no age difference between good and poor sleepers in young children with ASD and disruptive behaviors suggests that sleep problems are unlikely to resolve as might be expected in typically developing children. Likewise, the good and poor sleepers did not significantly differ in IQ. These findings add strong support for the need to screen for sleep disturbances in all children with ASD, regardless of age and cognitive level. Poor sleepers exhibited significantly greater daytime behavioral problems and parents of children in this group reported significantly higher levels of stress. Above and beyond the co-occurring disruptive behavior, poor sleep quality appears to pose substantial additive burden on child and parents.
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6. Keefer A, White SW, Vasa RA, Reaven J. {{Psychosocial interventions for internalizing disorders in youth and adults with ASD}}. {International review of psychiatry (Abingdon, England)}. 2018: 1-16.
Internalizing disorders are common in individuals with ASD. Psychosocial interventions targeting these disorders in the ASD population have burgeoned in the last decade. Cognitive-behavioural therapy, modified for ASD, is the most frequently investigated model, although other interventions, including behaviour therapy, third-wave interventions, models targeting transdiagnostic constructs, and alternative interventions and treatment delivery methods are now emerging. This review provides a summary of the efficacy of these interventions in treating internalizing disorders in youth and adults with ASD. The barriers to accessing these treatments, which are experienced by many individuals with ASD and their families, as well as future research directions, are also discussed.
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7. Landa RJ. {{Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders}}. {International review of psychiatry (Abingdon, England)}. 2018: 1-15.
With advances in the field’s ability to identify autism spectrum disorders (ASD) at younger ages, the need for information about the evidence-base for early intervention continues to rise. This review of the ASD early intervention (EI) literature focuses on efficacy studies published within the past 15 years. The neurodevelopmental context for early intervention, timing of initiating intervention, primary intervention approaches, and predictors of treatment outcomes are discussed. The evidence indicates that young children with ASD benefit from EI, and their parents learn to implement child-responsive engagement strategies when a parent-coaching intervention is provided. Evidence supports combining parent-mediated and direct clinician-implemented intervention to maximize child developmental gains. Clinical practice recommendations are presented, based on the literature reviewed.
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8. Lim N, O’Reilly MF, Sigafoos J, Lancioni GE. {{Understanding the Linguistic Needs of Diverse Individuals with Autism Spectrum Disorder: Some Comments on the Research Literature and Suggestions for Clinicians}}. {J Autism Dev Disord}. 2018.
The practice of advising bilingual parents of children with autism spectrum disorder (ASD) to speak in a single language, often the majority language of the region, with their child with ASD seems to be common. Such advice, however, is not grounded on empirical evidence but appears to be based more on logical arguments and assumptions. In this commentary, fears surrounding dual language exposure and empirical evidence supporting bilingualism in children with ASD are discussed. Suggestions for future research and three key steps that clinicians can consider taking to better address the needs of diverse learners are provided.
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9. MacKay J, Leonard H, Wong K, Wilson A, Downs J. {{Respiratory morbidity in Rett syndrome: an observational study}}. {Dev Med Child Neurol}. 2018.
AIM: Respiratory illness is a major cause of morbidity and mortality in Rett syndrome. This study investigated respiratory morbidity and relationships with age, mutation type, feeding, and walking status. METHOD: Families registered with the InterRett database (n=399) provided data on the health of their child with Rett syndrome (age 2-57y). Hospital admissions because of lower respiratory tract infection (LRTI) over a 5-year exposure period were investigated by age, mutation type, enteral feeding, and walking status. RESULTS: A hospital admission for LRTI over the previous 5 years was reported for slightly more than one-fifth (21.4%) of individuals. Age and mutation groups did not seem to influence hospital admissions for LRTI but there was nearly twice the risk of an admission with enteral feeding (adjusted relative risk 1.79, 95% confidence interval [CI] 1.21-2.65). Compared with independent walking, being unable to walk was associated with a sixfold increased risk (adjusted relative risk 6.73, 95% CI 3.42-13.25), with assisted walking associated with an intermediate risk. INTERPRETATION: Beyond the influence of mutation type, walking seems to have protective effects on respiratory health. Further studies of exercise physiology in Rett syndrome and how this can be influenced by increasing activity levels are indicated. WHAT THIS PAPER ADDS: Rett syndrome is associated with increased vulnerability to lower respiratory tract infection (LRTI) requiring hospitalization. Enteral feeding is associated with a higher risk of hospital admission for LRTI. Assisted walking mitigates the risk of hospital admission for LRTI for those unable to walk independently.
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10. McGuire K, Siegel M. {{Psychiatric hospital treatment of youth with autism spectrum disorder in the United States: needs, outcomes, and policy}}. {International review of psychiatry (Abingdon, England)}. 2018: 1-6.
Children with Autism Spectrum Disorder (ASD) are admitted to inpatient psychiatric units at markedly high rates. As health insurance companies and government healthcare systems and regulators seek more evidence for healthcare outcomes, it is important to learn more about the effectiveness of psychiatric inpatient admissions for children with ASD to best inform decisions on provision and access to this level of care. Evidence for models of inpatient treatment for youth with ASD is presented, and key characteristics and consensus recommendations for care are discussed.
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11. Newcomb ET, Hagopian LP. {{Treatment of severe problem behaviour in children with autism spectrum disorder and intellectual disabilities}}. {International review of psychiatry (Abingdon, England)}. 2018: 1-14.
Children with autism spectrum disorder (ASD) and intellectual disabilities (ID) present with problem behaviour at rates disproportionately higher than their typically-developing peers. Problem behaviour, such as self-injury, aggression, pica, disruption, and elopement result in a diminished quality-of-life for the individual and family. Applied behaviour analysis has a well-established research base, detailing a number of assessment and treatment methods designed to address behaviour problems in children with ASD and ID. Although the variables that lead to the emergence of problem behaviour are not precisely known, those that are currently responsible for the maintenance of these problems can be identified via functional behaviour assessment, which is designed to identify events that occasion problem behaviour, consequences that maintain it, as well as other environmental factors that exert influence on the behaviour. Corresponding function-based treatment is implemented when environmental determinants are identified, with the aim of decreasing or eliminating problem behaviour, as well as teaching the individual to engage in more appropriate, alternative behaviour. In some cases, when problem behaviour is under the control of both environmental and biological variables, including psychiatric conditions, combining behavioural and pharmacological interventions is viewed as optimal, although there is limited empirical support for integrating these approaches.
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12. Qin L, Ma K, Wang ZJ, Hu Z, Matas E, Wei J, Yan Z. {{Social deficits in Shank3-deficient mouse models of autism are rescued by histone deacetylase (HDAC) inhibition}}. {Nat Neurosci}. 2018.
Haploinsufficiency of the SHANK3 gene is causally linked to autism spectrum disorder (ASD), and ASD-associated genes are also enriched for chromatin remodelers. Here we found that brief treatment with romidepsin, a highly potent class I histone deacetylase (HDAC) inhibitor, alleviated social deficits in Shank3-deficient mice, which persisted for ~3 weeks. HDAC2 transcription was upregulated in these mice, and knockdown of HDAC2 in prefrontal cortex also rescued their social deficits. Nuclear localization of beta-catenin, a Shank3-binding protein that regulates cell adhesion and transcription, was increased in Shank3-deficient mice, which induced HDAC2 upregulation and social deficits. At the downstream molecular level, romidepsin treatment elevated the expression and histone acetylation of Grin2a and actin-regulatory genes and restored NMDA-receptor function and actin filaments in Shank3-deficient mice. Taken together, these findings highlight an epigenetic mechanism underlying social deficits linked to Shank3 deficiency, which may suggest potential therapeutic strategies for ASD patients bearing SHANK3 mutations.
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13. Sheppard DP, Bruineberg JP, Kretschmer-Trendowicz A, Altgassen M. {{Prospective memory in autism: theory and literature review}}. {The Clinical neuropsychologist}. 2018: 1-35.
OBJECTIVE: The current article set out to review all research conducted to date investigating prospective memory (PM) in autism. METHOD: All studies on PM in autism are first described, followed by a critical review and discussion of experimental findings within the multiprocess framework. PM in autism is then considered through an embodied predictive-coding account of autism. RESULTS: Overall, despite somewhat inconsistent methodologies, a general deficit in PM in autism is observed, with evidence mostly in line with the multiprocess framework. That is, for tasks that are high in cognitive and attentional demand (e.g. time-based tasks; event-based cues of non-focality or low salience) PM performance of autistic participants is impaired. Building upon previous work in predictive-coding, and the way in which expected precision modulates attention, we postulate mechanisms that underpin PM and the potential deficits seen in autism. Furthermore, a unifying predictive-coding account of autism is extended under embodied predictive-coding models, to show how a predictive-coding impairment accounts not only for characteristic autistic difficulties, but also for commonly found differences in autistic movement. CONCLUSIONS: We show how differences in perception and action, core to the development of autism, lead directly to problems seen in PM. Using this link between movement and PM, we then put forward a number of holistic, embodied interventions to support PM in autism.
