1. Akhter M, Ashraf M, Ali A, Rizwan I, Rehman R. {{Integration of therapies in autistic children; a survey based in Karachi, Pakistan}}. {JPMA The Journal of the Pakistan Medical Association}. 2018; 68(10): 1508-12.
A cross-sectional study was conducted from January to June 2016 on autistic children at the Autism Unit of Dow University of Health Sciences to compare speech therapy, occupational therapy and combination of both for rehabilitation of autistic children in the selected population. A total of 55 children with autism age range from 1-12 years of both gender and all ethnic groups were recruited. All data was analysed in IBM-SPSS version 23.0. Pearson chi-square test was used to determine association of type of therapy with the diagnosed age of child, gender, mode of delivery, history of vaccination and parent’s education. Educated parenthood and a normal behaviour especially by other siblings played a significant role in early detection and referral of autistic child to rehabilitation centre. Moreover, it was observed that a combination of therapies helped in enhancement of social, learning and behavioural skills required for rehabilitation of autistic children.
2. Del Valle Rubido M, McCracken JT, Hollander E, Shic F, Noeldeke J, Boak L, Khwaja O, Sadikhov S, Fontoura P, Umbricht D. {{In Search of Biomarkers for Autism Spectrum Disorder}}. {Autism research : official journal of the International Society for Autism Research}. 2018.
Autism Spectrum Disorder (ASD) lacks validated measures of core social functions across development stages suitable for clinical trials. We assessed the concurrent validity between ASD clinical measures and putative biomarkers of core deficits, and their feasibility of implementation in human studies. Datasets from two adult ASD studies were combined (observational study [n = 19] and interventional study baseline data [n = 19]). Potential biomarkers included eye-tracking, olfaction, and auditory and visual emotion recognition assessed via the Affective Speech Recognition test (ASR) and Reading-the-Mind-in-the-Eyes Test (RMET). Current functioning was assessed with intelligence quotient (IQ), adaptive skill testing, and behavioral ratings. Autism severity was determined by the Autism Diagnostic Observation Scale-2 and Social Communication Interaction Test (SCIT). Exploratory measures showed varying significant associations across ASD severity, adaptive skills, and behavior. Eye tracking endpoints showed little relationship to adaptive ability but correlated with severity and behavior. ASR scores significantly correlated with most adaptive behavior domains, as well as severity. Olfaction predicted visual and auditory emotion recognition. SCIT scores related moderately to multiple severity domains, and was the only measure not related with IQ. RMET accuracy was less related to ASD features. Eye tracking, SCIT, and ASR showed high test-retest reliability. We documented associations of proximal biomarkers of social functioning with multiple ASD dimensions. With the exception of SCIT, most correlations were modest, limiting utility as proxy measures of social communication. Feasibility and reliability were high for eye-tracking, ASR, and SCIT. Overall, several novel experimental paradigms showed potential as social biomarkers or surrogate markers in ASD. Autism Research 2018. (c) 2018 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY: More accurate measurements of treatment effects are needed to help the development of new drug treatments for autism spectrum disorders (ASD). This study evaluates the relationship between assessments designed to measure behaviors associated with social communication and cognition in ASD with clinical and diagnostic assessments of symptom severity as well as their implementation. The assessments including eye-tracking, auditory and visual social stimuli recognition, and olfaction identification showed potential for use in the evaluation of treatments for social difficulties in ASD.
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3. Hulbert SW, Bey AL, Jiang YH. {{Environmental enrichment has minimal effects on behavior in the Shank3 complete knockout model of autism spectrum disorder}}. {Brain and behavior}. 2018: e01107.
INTRODUCTION: Several studies have supported the use of enriched environments to prevent the manifestation of ASD-like phenotypes in laboratory rodents. While the translational value of such experiments is unknown, the findings have been relatively consistent across many different models. METHODS: In the current study, we tested the effects of early environmental enrichment on a mouse model of ASD with high construct validity, the Shank3 e4-22 mice our laboratory previously generated and characterized. RESULTS: Contrary to previous reports, we found no benefits of enriched rearing, including no change in repetitive self-grooming or hole-board exploration. Instead, we found that early environmental enrichment increased anxiety-like behavior in all mice regardless of genotype and decreased motor performance specifically in wild-type mice. CONCLUSIONS: Although using a different enrichment protocol may have rescued the phenotypes in our mouse model, these results suggest that a « one-size fits all » approach may not be the best when it comes to behavioral intervention for ASD and underscores the need for effective pharmaceutical development in certain genetic syndromes with severe symptom presentation.
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4. Luckhardt C, Kroger A, Elsuni L, Cholemkery H, Bender S, Freitag CM. {{Facilitation of biological motion processing by group-based autism specific social skills training}}. {Autism research : official journal of the International Society for Autism Research}. 2018.
Abnormalities in neurophysiological correlates of social perception are a well-known feature of autism spectrum disorder (ASD). However, little is known if and how ASD specific behavioral interventions may affect neural processing in ASD. The aim of the current study was to investigate for the first time, whether the group-based social skills training SOSTA-FRA would elicit changes in neurophysiological correlates of social perception in high-functioning ASD individuals aged 8-17 years. Event-related potentials (ERPs) of a facial emotion recognition (FER) and a biological motion perception task were examined. ERPs were compared between a randomized intervention and a treatment as usual group at three time points (baseline, post-intervention, and at 3 months follow-up). A reduction of P100 amplitude in the right hemisphere and a trend toward reduced N200 latency in the biological motion task were found after the training only in the intervention group, whereas behavioral performance remained stable. Change in N200 latencies and parent-rated social responsiveness showed small but statistically nonsignificant correlations. No changes were observed regarding FER. Results indicate that the intervention changed neural correlates of social perception in ASD. Especially neural correlates of biological motion perception, which is an important prerequisite for successful social interaction, were sensitive to change. ERPs of social perception tasks that are impaired in ASD can well be used to objectively measure neural processing improvement by behavioral intervention. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: It is well known that people with autism spectrum disorder (ASD) process social information differently than other people and that these differences can also be seen in their brain activity. We also know that behavioral therapies, such as group-based social skills trainings can help people with ASD improve their behavior. But it is unclear how therapy changes social processing in the brain. The aim of our study was therefore to examine how neural processing of social stimuli changed after behavioral intervention. Comparing a group of children and adolescents that received the group-based social skills training SOSTA-FRA to a control group we found that the neural processing of human motion became faster and involved less brain resources after the intervention, while behavioral performance remained stable. No changes were seen for the processing of emotional facial expressions. We recommend that future studies should also analyze changes in brain function as well as behavioral changes as a secondary therapy outcome parameter.
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5. McGuinty EF, Bird BM, Nelson J, McGuinty JL, Cashin A. {{Novel four-session treatment intervention for anxiety and high-functioning autism: A single case report for Externalizing Metaphors Therapy}}. {Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc}. 2018.
TOPIC: The Brief Services psychotherapy paradigm has evolved to produce cost-effective and clinically significant outcomes in children’s mental health. Though its clinical evaluation is still in its infancy, it has been utilized to a much lesser degree with autism spectrum disorders, which typically require a longer-term approach to psychotherapy treatment. PURPOSE: The current paper introduces a novel, four-session intervention that aims to decrease anxiety experienced by clients presenting with high-functioning autism. Externalizing Metaphors Therapy is based upon the externalization of problems, transformation of metaphoric imagery, shifting of maladaptive emotional schemas, and the generalization of problems. A case study is utilized to visually aid in the understanding of this new treatment intervention. SOURCE: A composite literature review was conducted with regards to significant works in Narrative Therapy, treatment interventions for anxiety and high functioning autism, evidence-based treatments for anxiety, and practice based approaches in psychotherapy. Works were selected based on their relevance to the research filed of anxiety and autism. CONCLUSIONS: This clinical research challenges the children’s mental health field in addressing anxiety and high-functioning autism from a brief framework. Further clinical research is needed to clinically evaluate the current model.
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6. Miller EK, Lenke LG, Neuman BJ, Sciubba DM, Kebaish KM, Smith JS, Qiu Y, Dahl BT, Pellise F, Matsuyama Y, Carreon LY, Fehlings MG, Cheung KM, Lewis S, Dekutoski MB, Schwab FJ, Boachie-Adjei O, Mehdian H, Bess S, Shaffrey CI, Ames CP. {{External Validation of the Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) in the Scoli-RISK-1 Patient Database}}. {Spine}. 2018; 43(20): 1426-31.
STUDY DESIGN: Analysis of a prospective multicenter database. OBJECTIVE: To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive ASD surgery compared with patients in the database used to create the index. SUMMARY OF BACKGROUND DATA: Accurate preoperative estimates of risk are necessary given the high complication rates currently associated with ASD surgery. METHODS: Patients were enrolled by participating institutions in Europe, Asia, and North America from 2009 to 2011. ASD-FI scores were used to classify 267 patients as not frail (NF) (<0.3), frail (0.3-0. 5), or severely frail (SF) (>0.5). Multivariable logistic regression, adjusted for preoperative and surgical covariates such as operative time and blood loss, was performed to determine the relationship between ASD-FI category and incidence of major complications, overall incidence of complications, and length of hospital stay. RESULTS: The mean ASD-FI score was 0.3 (range, 0-0.7). We categorized 105 patients as NF, 103 as frail, and 59 as SF. The adjusted odds of developing a major complication were higher for SF patients (odds ratio = 4.4; 95% CI 2.0, 9.9) compared with NF patients. After adjusting for covariates, length of hospital stay for SF patients increased by 19% (95% CI 1.4%, 39%) compared with NF patients. The odds of developing a major complication or having increased length of stay were similar between frail and NF patients. CONCLUSION: Greater patient frailty, as measured by the ASD-FI, is associated with a longer hospital stay and greater risk of major complications among patients who have severe preoperative deformity and undergo invasive surgical procedures. LEVEL OF EVIDENCE: 2.
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7. Nahar A, Thippeswamy H, Shanker Reddy MS, Kishore MT, Chaturvedi SK. {{Psychiatric comorbidity in persons with high-functioning autism spectrum disorders: Findings from a tertiary care neuropsychiatric hospital}}. {Asian journal of psychiatry}. 2018.
BACKGROUND: The literature on co-morbid psychiatric illnesses in adults with high-functioning autism (HFA) spectrum disorder is sparse. PURPOSE: To examine the nature of psychiatric comorbidity and treatment response in adults with HFA spectrum disorder. MATERIALS AND METHODS: Case records of subjects (age >/=17 years) who presented over a period of 16 years with primary psychiatric symptoms and further detected to have an HFA spectrum disorder, were analyzed. Autism spectrum disorders (ASD) along with near normal to normal verbal communication and general intelligence were considered as HFA spectrum disorders. RESULTS: 33 subjects met the study criteria. Nine subjects (27%) were diagnosed to have an underlying Asperger’s syndrome and the rest 24 (73%) had pervasive developmental disorders unspecified (PDD NOS). None of the subjects were diagnosed to be suffering from ASD prior to the visit to our hospital. Mean age at the time of psychiatric consultation was 22.7 (s.d=4.8) years and mean age at the onset of psychiatric comorbidity was 16.48 (s.d=4.4) years. Nearly half of the sample had more than one type of psychiatric illness. Most common lifetime psychiatric diagnosis was obsessive-compulsive disorder (OCD) (n=16, 48.4%). Bipolar disorder (BD) was the second most common type of psychiatric manifestation (n=13, 39.3%) followed by psychotic spectrum disorders (n=9, 27.2%). Overall response to treatment was minimal. CONCLUSIONS: Individuals with HFA spectrum disorders suffer from multiple psychiatric comorbidities. OCD is the most common type of psychiatric comorbidity followed by BD and psychotic spectrum disorders. Comorbid psychiatric illnesses in individuals with HFA show poor response to treatment.
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8. Nuber S, Jacob H, Kreifelts B, Martinelli A, Wildgruber D. {{Attenuated impression of irony created by the mismatch of verbal and nonverbal cues in patients with autism spectrum disorder}}. {PloS one}. 2018; 13(10): e0205750.
Perception of irony has been observed to be impaired in adults with autism spectrum disorder. In typically developed adults, the mismatch of verbal and nonverbal emotional cues can be perceived as an expression of irony even in the absence of any further contextual information. In this study, we evaluate to what extent high functioning autists perceive this incongruence as expressing irony. Our results show that incongruent verbal and nonverbal signals create an impression of irony significantly less often in participants with high-functioning autism than in typically developed control subjects. The extent of overall autistic symptomatology as measured with the autism-spectrum questionnaire (AQ), however, does not correlate with the reduced tendency to attribute incongruent stimuli as expressing irony. Therefore, the attenuation in irony attribution might rather be related to specific subdomains of autistic traits, such as a reduced tendency to interpret communicative signals in terms of complex intentional mental states. The observed differences in irony attribution support the assumption that a less pronounced tendency to engage in higher order mentalization processes might underlie the impairment of pragmatic language understanding in high functioning autism.
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9. Pu S, Nakagome K, Satake T, Ohtachi H, Itakura M, Yamanashi T, Miura A, Yokoyama K, Matsumura H, Iwata M, Nagata I, Kaneko K. {{Comparison of prefrontal hemodynamic responses and cognitive deficits between adult patients with autism spectrum disorder and schizophrenia}}. {Schizophrenia research}. 2018.
Autism spectrum disorder (ASD) and schizophrenia share many phenotypic characteristics, but their association with prefrontal function have not been directly compared. The aim of this study is to compare cognitive profiles and their association with the prefrontal function between the two groups. We explored prefrontal dysfunction among adult individuals with ASD (n=32), schizophrenia (n=87), and healthy controls (HCs; n=50). We assessed cognitive function in all participants using the Brief Assessment of Cognition in Schizophrenia (BACS). The BACS data of patients with schizophrenia were entered into hierarchical cluster analyses to assign subjects to a specific subgroup based on individual profiles. Using near-infrared spectroscopy, we measured hemodynamic responses in the fronto-temporal regions during a working memory task. Among the patients with schizophrenia, we defined 4 neurocognitive subgroups, including a global impairment, a mild impairment, and 2 selective impairment groups. Compared to the HCs, the ASD and schizophrenia groups had much weaker hemodynamic responses in the left DLPFC, left frontopolar cortex (FPC), and left inferior frontal gyrus. The ASD group showed a similar level of cognitive impairment with the mild level subgroup of schizophrenia. Additionally, the two groups shared reduced activity in the left DLPFC and left FPC during the task compared to HCs. Moreover, the BACS composite scores correlated positively with hemodynamic responses in a broad area involving fronto-temporal regions in the total patient sample. This research indicates considerable similarity in the left PFC dysfunction and its association with cognitive deficits between the disorders. These findings may guide future studies that investigate pathophysiological similarities between ASD and schizophrenia.
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10. Sungur AO, Schwarting RKW, Wohr M. {{Behavioral phenotypes and neurobiological mechanisms in the Shank1 mouse model for autism spectrum disorder: A translational perspective}}. {Behavioural brain research}. 2018; 352: 46-61.
Autism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental disorders, characterized by early-onset deficits in social behavior and communication across multiple contexts, together with restricted, repetitive patterns of behavior, interests, or activities. ASD is among the most heritable neuropsychiatric conditions with heritability estimates higher than 80%, and while available evidence points to a complex set of genetic factors, the SHANK (also known as ProSAP) gene family has emerged as one of the most promising candidates. Several genetic Shank mouse models for ASD were generated, including Shank1 knockout mice. Behavioral studies focusing on the Shank1 knockout mouse model for ASD included assays for detecting ASD-relevant behavioral phenotypes in the following domains: (I) social behavior, (II) communication, and (III) repetitive and stereotyped patterns of behavior. In addition, assays for detecting behavioral phenotypes with relevance to comorbidities in ASD were performed, including but not limited to (IV) cognitive functioning. Here, we summarize and discuss behavioral and neuronal findings obtained in the Shank1 knockout mouse model for ASD. We identify open research questions by comparing such findings with the symptoms present in humans diagnosed with ASD and carrying SHANK1 deletions. We conclude by discussing the implications of the behavioral and neuronal phenotypes displayed by the Shank1 knockout mouse model for the development of future pharmacological interventions in ASD.
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11. Vivanti G, Dissanayake C, Fanning PAJ, Hocking DR. {{Reduced Motor Interference in Preschoolers with Autism Spectrum Disorder and Williams Syndrome}}. {Developmental neuropsychology}. 2018; 43(8): 751-63.
Motor interference occurs when action execution is hindered by the observation of an incongruent action. The present study used a novel eye-tracking paradigm to test the motor interference effect in 22 preschoolers with autism spectrum disorder (ASD), 14 preschoolers with Williams syndrome (WS), and 18 typically developing (TD) peers. In TD children, performance of a pre-determined action was slower after the observation of an incongruent motor action and faster following observation of a congruent motor action, indicating a motor interference effect. In both the ASD and WS groups, performance was unaffected by the congruent versus incongruent nature of the observed motor action.
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12. White SW, Abbott L, Wieckowski AT, Capriola-Hall NN, Aly S, Youssef A. {{Feasibility of Automated Training for Facial Emotion Expression and Recognition in Autism}}. {Behavior therapy}. 2018; 49(6): 881-8.
Impairment in facial emotion recognition (FER) and facial emotion expression (FEE), often documented in autism spectrum disorder (ASD), are believed to contribute to the observed core social-communication disability that characterizes this disorder. Moreover, impaired FER and FEE are frequently seen in other disorders and problem behaviors. We describe the development of a novel system to detect and give real-time feedback on these processes, termed facial emotion expression training (FEET), an automated, gamelike system that is based on 3-dimensional sensing (Kinect) technology. A sample of 40 children (n = 20 ASD, n = 20 typically developing) interacted with our prototype system, which presented audiovisual stimuli and assessed responses of participants. Overall, consumer satisfaction ratings were high, and youth with ASD reported enjoying interacting with the system more than did the typical youth. Results suggest that new technology-based interventions are acceptable to consumers and viable for use in remediation of transdiagnostic processes, such as FER and FEE. Implications for future technology-based intervention to target transdiagnostic processes are discussed.
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13. Will MN, Currans K, Smith J, Weber S, Duncan A, Burton J, Kroeger-Geoppinger K, Miller V, Stone M, Mays L, Luebrecht A, Heeman A, Erickson C, Anixt J. {{Evidenced-Based Interventions for Children With Autism Spectrum Disorder}}. {Current problems in pediatric and adolescent health care}. 2018.
This paper reviews evidenced-based interventions for children with autism spectrum disorders (ASD) across the disciplines of psychology, speech-language pathology, occupational therapy, and developmental pediatrics. BACKGROUND: rates of ASD diagnoses have been steadily rising over the past 2 decades. There are a wide range of therapies and interventions, of varying levels of evidence, across disciplines that are now available to treat children with ASD. The field has moved toward a greater emphasis on the identification and utilization of evidenced-based treatments. METHODS: a review and summary of recent literature was conducted by professionals in an interdisciplinary autism center. An emphasis was placed on results of the National Autism Center’s National Standards Project. RESULTS AND CONCLUSIONS: within each discipline, interventions exist that vary in level of evidenced-based support. Although disciplines may differ in their definitions of evidence-based treatments, it is important for each discipline to strive to offer and promote practices with the best evidenced-based support according to each field’s standards.
