1. {{Every child with an autism spectrum condition has specific needs}}. {Emerg Nurse};2017 (Jul 13);25(4):5.
Autism is a lifelong developmental disability that affects perceptions of the world and interactions with other people. About 700,000 people, or one in 100, live with an autism spectrum condition (ASC) in the UK and there is greater prevalence among males.
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2. Beaudet AL. {{Brain carnitine deficiency causes nonsyndromic autism with an extreme male bias: A hypothesis}}. {Bioessays};2017 (Jul 13)
Could 10-20% of autism be prevented? We hypothesize that nonsyndromic or « essential » autism involves extreme male bias in infants who are genetically normal, but they develop deficiency of carnitine and perhaps other nutrients in the brain causing autism that may be amenable to early reversal and prevention. That brain carnitine deficiency might cause autism is suggested by reports of severe carnitine deficiency in autism and by evidence that TMLHE deficiency – a defect in carnitine biosynthesis – is a risk factor for autism. A gene on the X chromosome (SLC6A14) likely escapes random X-inactivation (a mixed epigenetic and genetic regulation) and could limit carnitine transport across the blood-brain barrier in boys compared to girls. A mixed, common gene variant-environment hypothesis is proposed with diet, minor illnesses, microbiome, and drugs as possible risk modifiers. The hypothesis can be tested using animal models and by a trial of carnitine supplementation in siblings of probands. Perhaps the lack of any Recommended Dietary Allowance for carnitine in infants should be reviewed. Also see the video abstract here: https://youtu.be/BuRH_jSjX5Y.
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3. Dalton JC, Crais ER, Velleman SL. {{Joint attention and oromotor abilities in young children with and without autism spectrum disorder}}. {J Commun Disord};2017 (Jul 01);69:27-43.
PURPOSE: This study examined the relationship between joint attention ability and oromotor imitation skill in three groups of young children with and without Autism Spectrum Disorder using both nonverbal oral and verbal motor imitation tasks. Research questions addressed a) differences among joint attention and oromotor imitation abilities; b) the relationship between independently measured joint attention and oromotor imitation, both nonverbal oral and verbal motor; c) the relationships between joint attention and verbal motor imitation during interpersonal interaction; and d) the relationship between the sensory input demands (auditory, visual, and tactile) and oromotor imitation, both nonverbal oral and verbal motor. METHOD: A descriptive, nonexperimental design was used to compare joint attention and oromotor skills of 10 preschool-aged children with ASD, with those of two control groups: 6 typically developing children (TD), and 6 children with suspected Childhood Apraxia of Speech (sCAS) or apraxic-like symptoms. All children had at least a 3.0 mean length utterance. RESULTS: Children with ASD had poorer joint attention skills overall than children with sCAS or typically developing children. Typically developing children demonstrated higher verbal motor imitation skills overall compared to children with sCAS. Correlational analyses revealed that nonverbal oral imitation and verbal motor imitation were positively related to joint attention abilities only in the children with ASD. Strong positive relationships between joint attention in a naturalistic context (e.g., shared story experience) and oromotor imitation skills, both nonverbal oral and verbal motor, were found only for children with ASD. These data suggest there is a strong positive relationship between joint attention skills and the ability to sequence nonverbal oral and verbal motor movements in children with ASD. The combined sensory input approach involving auditory, visual, and tactile modalities contributed to significantly higher nonverbal oral and verbal motor imitation performance for all groups of children. CONCLUSIONS: Verbal children with ASD in this study had difficulties with both the social and cognitive demands of oromotor imitation within a natural environment that demanded cross-modal processing of incoming stimuli within an interpersonal interaction. Further, joint attention and oral praxis may serve as components of an important coupling mechanism in the development of spoken communication and later developing socialcognitive skills.
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4. Duffy L, Baluch B, Welland S, Raman E. {{Effects of physical activity on debilitating behaviours in 13- to 20-year-old males with severe autism spectrum disorder}}. {J Exerc Rehabil};2017 (Jun);13(3):340-347.
The presented study investigated the extent to which engaging in a therapeutic sporting programme in males with severe autism spectrum disorder (ASD) improves the debilitating behaviours commonly associated with ASD. Furthermore, the views of parents of the autistic participants were assessed concerning the effectiveness of the programme. Participants were eight 13- to 20-year-old males born in the United Kingdom from a school and sports college for pupils with severe learning difficulties. The selection was using volunteer sampling from the « Monday Club » initiative, run by Saracens Sports Foundation in partnership with a local school and specialist sports college. The Gilliam Autism Rating Scale, 3rd edition was administered to identify and measure the severity of ASD behaviours at four time periods namely: at programme entry as the baseline (Time 1, T1), a second time after 8 weeks (Time 2, T2), a third time after 16 weeks (Time 3, T3), and a fourth time post programme (Time 4, T4). The results showed that for the more severe cases of ASD (Autism Index >101) there was no positive change in subscale performance from T1 to T2. For milder cases (Autism Index, 71-100) there were subtle non-significant improvements on the subscale scores from T1 to T2. Of the 6 subscales at T2, emotional responses, cognitive style, and maladaptive speech approached significance at the P=0.05 level. At T3 and T4, there was also no statistically significant improvement in ASD behaviours compared to the baseline for either condition. Finally parents’ were « very satisfied » with their child’s participation in the physical activity programme.
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5. Eapen V, Nicholls L, Spagnol V, Mathew NE. {{Current status of biological treatment options in Autism Spectrum Disorder}}. {Asian J Psychiatr};2017 (Jul 06);30:1-10.
Autism Spectrum Disorders (ASDs) are characterised by deficits in social communication and restricted and repetitive behaviours. With an onset in early childhood, ASDs are thought to be heterogeneous, both genetically and clinically. This has led to the notion that « autism » is « autisms », however, there has been limited progress in understanding the different subgroups and the unique pathogenesis that would then allow targeted intervention. Although existing treatments are mainly symptom focussed, research is beginning to unravel the underlying genetic and molecular pathways, structural and functional neuronal circuitry involvement and the associated neurochemicals. This paper will review selected biological models with regard to pharmacological targets while also covering some of the non-pharmacological treatments such as neuro-stimulation.
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6. Fakhruddin KS, El Batawi HY. {{Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder}}. {Dent Res J (Isfahan)};2017 (May-Jun);14(3):177-182.
BACKGROUND: The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. MATERIALS AND METHODS: This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t-test was used to assess the significance of changes in pulse and O2 saturation levels during each visit. RESULTS: International Caries Detection and Assessment System-code 2 was found to be the most prevalent (n = 58; 52%). A significant difference (P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. CONCLUSION: Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures. Lien vers Pubmed
7. Harris A, Williams JM. {{The Impact of a Horse Riding Intervention on the Social Functioning of Children with Autism Spectrum Disorder}}. {Int J Environ Res Public Health};2017 (Jul 14);14(7)
This paper reports a case-control study of a horse riding intervention for children with autism spectrum disorder (ASD). A sample of 26 children, aged 6 to 9 years, were assigned to either the intervention (n = 12) or control group conditions (n = 14). Pre- and post-tests were carried out using the Childhood Autism Rating Scale, Second Edition (CARS2) and the Aberrant Behaviour Checklist-Community Edition (ABC-C). An observational measure of compliance and behaviour during the horse riding sessions was completed for the intervention group. There was a significant reduction in the severity of ASD symptoms and hyperactivity from pre- to post-test for the intervention group only. These results indicate that the intervention improves some aspects of social functioning for children with ASD.
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8. Ingersoll B, Shannon K, Berger N, Pickard K, Holtz B. {{Self-Directed Telehealth Parent-Mediated Intervention for Children With Autism Spectrum Disorder: Examination of the Potential Reach and Utilization in Community Settings}}. {J Med Internet Res};2017 (Jul 12);19(7):e248.
BACKGROUND: There is a significant need for strategies to increase access to evidence-based interventions for children with autism spectrum disorder (ASD). One novel approach is to train parents to use evidence-based interventions for their child with ASD via telehealth. Pilot work examining the efficacy of one such program, ImPACT Online, demonstrated a high rate of parent program engagement, low attrition, and associated gains in parent learning and child social communication. OBJECTIVE: The objective of this study was to conduct an open trial of ImPACT Online to better understand its dissemination potential. METHODS: We examined the reach and representativeness of families who registered (n=36) compared to families who were referred (n=139) to the open trial for one referral site. We then compared the demographics of all families who enrolled in the open trial (n=112) to families who enrolled in one of two controlled trials of the same program (n=50). We also examined metrics of program engagement for the open and controlled trials, the relationship between program engagement and changes in parents’ intervention knowledge, and program evaluation for the participants in the open trial. RESULTS: In total, 25.8% (36/139) of the parents who were given information about the program at their child’s diagnostic feedback session registered with the program. The parents who enrolled in the open (OT) and controlled trials (CT), respectively, were similar in gender (OT: 84.8% (95/112); CT: 88% (44/50), female), marital status (OT: 80.4% (90/112) ; CT: 69.6% (32/46), married), education (OT: 58.0% (65/112); CT: 54.0% (27/50), college degree or higher), and employment status (OT: 58.0% (65/112); CT: 65.3% (32/49), employed outside the home). The child participants were similar in terms of gender (OT: 83.0% (93/112); CT: 76.0% (38/50), male) and race and ethnicity (OT: 38.4% (43/112); CT: 24.0% (12/50), minority). However, the mean chronological age of the child participants in the open trial group was significantly higher (Mean=60.0 months) than in the controlled trial group (Mean=43.0 months), with t160=5.22, P<.001. Parents in the open trial engaged with the program at a significantly lower rate than the controlled trial, F3,81=21.14, P<.001. Program engagement was significantly associated with gains in parent intervention knowledge across both the groups, beta=.41, t=2.43, P=.02. Participants in the open access trial evaluated the program highly, but several barriers were noted. CONCLUSIONS: These data suggest that additional strategies may need to be developed to support families in using telehealth-based parent-mediated intervention in community settings. Lien vers le texte intégral (Open Access ou abonnement)
9. Kraper CK, Kenworthy L, Popal H, Martin A, Wallace GL. {{The Gap Between Adaptive Behavior and Intelligence in Autism Persists into Young Adulthood and is Linked to Psychiatric Co-morbidities}}. {J Autism Dev Disord};2017 (Jul 14)
For individuals with autism spectrum disorder (ASD), long-term outcomes have been troubling, and intact IQ has not been shown to be protective. Nevertheless, relatively little research into adaptive functioning among adults with ASD has been completed to date. Therefore, both adaptive functioning and comorbid psychopathology were assessed among 52 adults with ASD without intellectual disability (ID). Adaptive functioning was found to substantially lag behind IQ, and socialization was a particular weakness. Comorbid psychopathology was significantly correlated with the size of IQ-adaptive functioning discrepancy. These findings emphasize key intervention targets of both adaptive skill and psychopathology for transition-age youth and young adults with ASD, as well as the need for ongoing monitoring of anxiety and depression symptoms during this developmental window.
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10. Merritt J, Hart JC, LeGrow TL. {{Autism spectrum disorder in Say-Barber-Biesecker-Young-Simpson syndrome}}. {BMJ Case Rep};2017 (Jul 14);2017
Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS), also known as Ohdo syndrome SBBYS type, is a rare genetic disorder characterised by dysmorphic facial features and severe intellectual disability, as well as cardiac, dental and hearing abnormalities. There has been little psychiatric or psychological description of children with SBBYSS, although previous reports noted repetitive self-injurious behaviours, sensitivity to light and noise and severe deficits in communication. In this report, a 4-year-old male with SBBYSS is described with a focus on psychiatric and psychological assessment, including formal testing for autism spectrum disorder (ASD). Results of multiple behavioural assessment scales are reported. Testing revealed characteristic ASD features, and the patient met criteria for ASD diagnosis in the context of SBBYSS. His behaviours improved with Applied Behavioural Analysis therapy and communication skills training. This is the first documented case of ASD reported alongside SBBYSS. These results suggest ASD may be a clinical feature of SBBYSS.
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11. Reilly J, Gallagher L, Chen JL, Leader G, Shen S. {{Bio-collections in autism research}}. {Mol Autism};2017;8:34.
Autism spectrum disorder (ASD) is a group of complex neurodevelopmental disorders with diverse clinical manifestations and symptoms. In the last 10 years, there have been significant advances in understanding the genetic basis for ASD, critically supported through the establishment of ASD bio-collections and application in research. Here, we summarise a selection of major ASD bio-collections and their associated findings. Collectively, these include mapping ASD candidate genes, assessing the nature and frequency of gene mutations and their association with ASD clinical subgroups, insights into related molecular pathways such as the synapses, chromatin remodelling, transcription and ASD-related brain regions. We also briefly review emerging studies on the use of induced pluripotent stem cells (iPSCs) to potentially model ASD in culture. These provide deeper insight into ASD progression during development and could generate human cell models for drug screening. Finally, we provide perspectives concerning the utilities of ASD bio-collections and limitations, and highlight considerations in setting up a new bio-collection for ASD research.
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12. Richards B. {{Caring for children with autism spectrum condition in paediatric emergency departments}}. {Emerg Nurse};2017 (Jul 13);25(4):30-34.
The needs of children with autism spectrum condition (ASC) in paediatric emergency departments (EDs) can often be overlooked. EDs are high-stress environments for children with ASC, which can result in meltdowns, making the diagnostic process challenging. There should be provision for children with ASC, who can have sensory, behavioural and communication needs, in the same way that analgesia is provided for children in pain. This article promotes a multi-strategy approach to making reasonable adjustments to help meet the needs of these children and provide them with a positive hospital experience.
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13. Saghazadeh A, Rezaei N. {{Systematic review and meta-analysis links autism and toxic metals and highlights the impact of country development status: Higher blood and erythrocyte levels for mercury and lead, and higher hair antimony, cadmium, lead, and mercury}}. {Prog Neuropsychopharmacol Biol Psychiatry};2017 (Jul 14)
BACKGROUND: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder that affects cognitive and higher cognitive functions. Increasing prevalence of ASD and high rates of related comorbidities has caused serious health loss and placed an onerous burden on the supporting families, caregivers, and health care services. Heavy metals are among environmental factors that may contribute to ASD. However, due to inconsistencies across studies, it is still hard to explain the association between ASD and toxic metals. Therefore the objective of this study was to investigate the difference in heavy metal measures between patients with ASD and control subjects. METHODS: We included observational studies that measured levels of toxic metals (antimony, arsenic, cadmium, lead, manganese, mercury, nickel, silver, and thallium) in different specimens (whole blood, plasma, serum, red cells, hair and urine) for patients with ASD and for controls. The main electronic medical database (PubMed and Scopus) were searched from inception through October 2016. RESULTS: 52 studies were eligible to be included in the present systematic review, of which 48 studies were included in the meta-analyses. The hair concentrations of antimony (standardized mean difference (SMD)=0.24; 95% confidence interval (CI): 0.03 to 0.45) and lead (SMD=0.60; 95% confidence interval (CI): 0.17 to 1.03) in ASD patients were significantly higher than those of control subjects. ASD patients had higher erythrocyte levels of lead (SMD=1.55, CI: 0.2 to 2.89) and mercury (SMD=1.56, CI: 0.42 to 2.70). There were significantly higher blood lead levels in ASD patients (SMD=0.43, CI: 0.02 to 0.85). Sensitivity analyses showed that ASD patients in developed but not in developing countries have lower hair concentrations of cadmium (SMD=-0.29, CI: -0.46 to -0.12). Also, such analyses indicated that ASD patients in developing but not in developed lands have higher hair concentrations of lead (SMD=1.58, CI: 0.80 to 2.36) and mercury (SMD=0.77, CI: 0.31 to 1.23). These findings were confirmed by meta-regression analyses indicating that development status of countries significantly influences the overall effect size of mean difference for hair arsenic, cadmium, lead, and mercury between patients with ASD and controls. CONCLUSION: The findings help highlighting the role of toxic metals as environmental factors in the etiology of ASD, especially in developing lands. While there are environmental factors other than toxic metals that greatly contribute to the etiology of ASD in developed lands. It would be, thus, expected that classification of ASD includes etiological entities of ASD on the basis of implication of industrial pollutants (developed vs. developing ASD).
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14. Sahoo S, Padhy SK, Singla N, Singh A. {{Effectiveness of clozapine for the treatment of psychosis and disruptive behaviour in a child with Atypical Autism: A case report and a brief review of the evidence}}. {Asian J Psychiatr};2017 (Jul 04);29:194-195.
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15. Sato W, Kochiyama T, Uono S, Yoshimura S, Toichi M. {{Neural Mechanisms Underlying Conscious and Unconscious Gaze-Triggered Attentional Orienting in Autism Spectrum Disorder}}. {Front Hum Neurosci};2017;11:339.
Impaired joint attention represents the core clinical feature of autism spectrum disorder (ASD). Behavioral studies have suggested that gaze-triggered attentional orienting is intact in response to supraliminally presented eyes but impaired in response to subliminally presented eyes in individuals with ASD. However, the neural mechanisms underlying conscious and unconscious gaze-triggered attentional orienting remain unclear. We investigated this issue in ASD and typically developing (TD) individuals using event-related functional magnetic resonance imaging. The participants viewed cue stimuli of averted or straight eye gaze direction presented either supraliminally or subliminally and then localized a target. Reaction times were shorter when eye-gaze cues were directionally valid compared with when they were neutral under the supraliminal condition in both groups; the same pattern was found in the TD group but not the ASD group under the subliminal condition. The temporo-parieto-frontal regions showed stronger activation in response to averted eyes than to straight eyes in both groups under the supraliminal condition. The left amygdala was more activated while viewing averted vs. straight eyes in the TD group than in the ASD group under the subliminal condition. These findings provide an explanation for the neural mechanisms underlying the impairment in unconscious but not conscious gaze-triggered attentional orienting in individuals with ASD and suggest possible neurological and behavioral interventions to facilitate their joint attention behaviors.
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16. Siew CT, Mazzucchelli TG, Rooney R, Girdler S. {{A specialist peer mentoring program for university students on the autism spectrum: A pilot study}}. {PLoS One};2017;12(7):e0180854.
INTRODUCTION: The provision of peer mentoring may improve tertiary education outcomes of students with autism spectrum disorder (ASD). This study evaluated the pilot year of the Curtin Specialist Mentoring Program (CSMP), a specialised peer mentoring program for university students with ASD aimed at improving self-reported well-being, academic success and retention in university studies. METHODS: A single group pre-test, post-test design was employed. Quantitative and qualitative evaluations were undertaken with 10 young adults with ASD to explore the effectiveness and acceptability of the CSMP program. Students completed a battery of questionnaires focused on general anxiety, state communication apprehension, perceived communication competence, and communication apprehension both prior to, and five months after commencing enrolment in the CSMP. Information regarding academic success and retention was also obtained. Interviews with participants provided further insight into their experience of the program. RESULTS: Students enrolled in the CSMP showed significant improvement in social support and general communication apprehension assessment scores. Interviews revealed key features of the CSMP that may have contributed to these positive outcomes. CONCLUSIONS: The current study provides preliminary evidence that a specialised peer mentoring program can improve the well-being of students with ASD, and highlights the importance of interventions which are individualised, flexible, based on a social model, and target environmental factors such as social support.
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17. Soghomonian JJ, Zhang K, Reprakash S, Blatt GJ. {{Decreased parvalbumin mRNA levels in cerebellar Purkinje cells in autism}}. {Autism Res};2017 (Jul 14)
Recent neuropathology studies in human brains indicate that several areas of the prefrontal cortex have decreased numbers of parvalbumin interneurons or decreased parvalbumin expression in Autism Spectrum disorders (ASD) [Hashemi, Ariza, Rogers, Noctor, & Martinez-Cerdeno, 2017; Zikopoulos & Barbas, ]. These data suggest that a deficit in parvalbumin may be a key neuropathology of ASD and contribute to altered GABAergic inhibition. However, it is unclear if a deficit in parvalbumin is a phenomenon that occurs in regions other than the cerebral cortex. The cerebellum is a major region where neuropathology was first detected in ASD over three decades ago [Bauman & Kemper, ]. In view of the documented association between parvalbumin-expressing neurons and autism, the objective of the present study was to determine if parvalbumin gene expression is also altered in Purkinje neurons of the cerebellum. Radioisotopic in situ hybridization histochemistry was used on human tissue sections from control and ASD brains in order to detect and measure parvalbumin mRNA levels at the single cell level in Purkinje cells of Crus II of the lateral cerebellar hemispheres. Results indicate that parvalbumin mRNA levels are significantly lower in Purkinje cells in ASD compared to control brains. This decrease was not influenced by post-mortem interval or age at death. This result indicates that decreased parvalbumin expression is a more widespread feature of ASD. We discuss how this decrease may be implicated in altered cerebellar output to the cerebral cortex and in key ASD symptoms. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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18. Umbricht D, Del Valle Rubido M, Hollander E, McCracken JT, Shic F, Scahill L, Noeldeke J, Boak L, Khwaja O, Squassante L, Grundschober C, Kletzl H, Fontoura P. {{A Single Dose, Randomized, Controlled Proof-Of-Mechanism Study of a Novel Vasopressin 1a Receptor Antagonist (RG7713) in High-Functioning Adults with Autism Spectrum Disorder}}. {Neuropsychopharmacology};2017 (Aug);42(9):1924.
This corrects the article DOI: 10.1038/npp.2016.232.
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19. Wikramanayake M, Mandy W, Shahper S, Kaur S, Kolli S, Osman S, Reid J, Jefferies Sewell K, Fineberg N. {{Autism Spectrum Disorders in Adult Outpatients with Obsessive Compulsive Disorder in the UK}}. {Int J Psychiatry Clin Pract};2017 (Jul 14):1-22.
BACKGROUND: Patients with obsessive compulsive disorder (OCD) frequently show traits of autism spectrum disorders (ASD). This is one of the first studies to explore the clinical impact of the overlap between OCD and ASD as a categorical diagnosis. METHODS: A cross-sectional survey in 73 adult outpatients with DSM-IV OCD. Autistic traits were measured using the Autism-Spectrum Quotient (AQ). A clinical estimate ASD diagnosis was made by interview using DSM-IV-TR criteria. OCD patients with and without autistic traits or ASD were compared on demographic and clinical parameters and level of OCD treatment-resistance based on treatment history. RESULTS: Thirty-four (47%) patients scored above the clinical threshold on the AQ (> =26) and 21 (27.8%) met diagnostic criteria for ASD. These diagnoses had not been made before. Patients with autistic traits showed a borderline significant increase in OCD symptom-severity (Yale-Brown Obsessive Compulsive Scale (Y-BOCS); p=.054) and significantly increased impairment of insight (Brown Assessment of Beliefs Scale; p=.01). There was a positive correlation between AQ and Y-BOCS scores (p =.04), but not with OCD treatment resistance. CONCLUSION: There is a high prevalence of previously undiagnosed ASD in patients with OCD. ASD traits are associated with greater OCD symptom-severity and poor insight.
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20. Williamson HJ, Contreras GM, Rodriguez ES, Smith JM, Perkins EA. {{Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review}}. {OTJR (Thorofare N J)};2017 (Jul 01):1539449217714148.
Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study’s purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.
