1. Bontinck C, Warreyn P, Van der Paelt S, Demurie E, Roeyers H. {{The early development of infant siblings of children with autism spectrum disorder: Characteristics of sibling interactions}}. {PLoS One}. 2018; 13(3): e0193367.
Although sibling interactions play an important role in children’s early development, they are rarely studied in very young children with an older brother or sister with autism spectrum disorder (ASD). This study used a naturalistic, observational method to compare interactions between 18-month-old infants and their older sibling with ASD (n = 22) with a control group of 18-month-old infants and their typically developing (TD) older sibling (n = 29). In addition, role (a)symmetry and the influence of gender were evaluated. Sibling interactions in ASD-dyads were characterized by higher levels of negativity. Although somewhat less pronounced in ASD-dyads, role asymmetry was present in both groups, with the older child taking the dominant position. Finally, siblings pairs with an older sister were characterized by more positive behaviours. Since differences in sibling interactions may alter the developmental trajectories of both siblings, these early relationships should be taken into account in future ASD research and interventions.
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2. Christian MA, Samms-Vaughan M, Lee M, Bressler J, Hessabi M, Grove ML, Shakespeare-Pellington S, Coore Desai C, Reece JA, Loveland KA, Boerwinkle E, Rahbar MH. {{Maternal Exposures Associated with Autism Spectrum Disorder in Jamaican Children}}. {J Autism Dev Disord}. 2018.
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with poorly understood etiology. Many maternal exposures during pregnancy and breastfeeding potentially interfere with neurodevelopment. Using data from two age- and sex-matched case-control studies in Jamaica (n = 298 pairs), results of conditional logistic regression analyses suggest that maternal exposures to fever or infection (matched odds ratio (MOR) = 3.12, 95% CI 1.74-5.60), physical trauma (MOR 2.02, 95% CI 1.01-4.05), and oil-based paints (MOR 1.99, 95% CI 1.14-3.46) may be associated with ASD. Additionally, maternal exposure to oil-based paints may modify the relationship between maternal exposure to pesticides and ASD, which deepens our understanding of the association between pesticides and ASD.
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3. Floris DL, Lai MC, Nath T, Milham MP, Di Martino A. {{Network-specific sex differentiation of intrinsic brain function in males with autism}}. {Mol Autism}. 2018; 9: 17.
Background: The male predominance in the prevalence of autism spectrum disorder (ASD) has motivated research on sex differentiation in ASD. Multiple sources of evidence have suggested a neurophenotypic convergence of ASD-related characteristics and typical sex differences. Two existing, albeit competing, models provide predictions on such neurophenotypic convergence. These two models are testable with neuroimaging. Specifically, the Extreme Male Brain (EMB) model predicts that ASD is associated with enhanced brain maleness in both males and females with ASD (i.e., a shift-towards-maleness). In contrast, the Gender Incoherence (GI) model predicts a shift-towards-maleness in females, yet a shift-towards-femaleness in males with ASD. Methods: To clarify whether either model applies to the intrinsic functional properties of the brain in males with ASD, we measured the statistical overlap between typical sex differences and ASD-related atypicalities in resting-state fMRI (R-fMRI) datasets largely available in males. Main analyses focused on two large-scale R-fMRI samples: 357 neurotypical (NT) males and 471 NT females from the 1000 Functional Connectome Project and 360 males with ASD and 403 NT males from the Autism Brain Imaging Data Exchange. Results: Across all R-fMRI metrics, results revealed coexisting, but network-specific, shift-towards-maleness and shift-towards-femaleness in males with ASD. A shift-towards-maleness mostly involved the default network, while a shift-towards-femaleness mostly occurred in the somatomotor network. Explorations of the associated cognitive processes using available cognitive ontology maps indicated that higher-order social cognitive functions corresponded to the shift-towards-maleness, while lower-order sensory motor processes corresponded to the shift-towards-femaleness. Conclusions: The present findings suggest that atypical intrinsic brain properties in males with ASD partly reflect mechanisms involved in sexual differentiation. A model based on network-dependent atypical sex mosaicism can synthesize prior competing theories on factors involved in sex differentiation in ASD.
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4. Hawks ZW, Marrus N, Glowinski AL, Constantino JN. {{Early Origins of Autism Comorbidity: Neuropsychiatric Traits Correlated in Childhood Are Independent in Infancy}}. {Journal of abnormal child psychology}. 2018.
Previous research has suggested that behavioral comorbidity is the rule rather than the exception in autism. The present study aimed to trace the respective origins of autistic and general psychopathologic traits-and their association-to infancy. Measurements of autistic traits and early liability for general psychopathology were assessed in 314 twins at 18 months, ascertained from the general population using birth records. 222 twins were re-evaluated at 36 months. Standardized ratings of variation in social communication at 18 months were highly heritable and strongly predicted autistic trait scores at 36 months. These early indices of autistic liability were independent from contemporaneous ratings of behavior problems on the Brief Infant-Toddler Social and Emotional Assessment (which were substantially environmentally-influenced), and did not meaningfully predict internalizing or externalizing scores on the Achenbach Scales of Empirically Based Assessment at 36 months. In this general population infant twin study, variation in social communication was independent from variation in other domains of general psychopathology, and exhibited a distinct genetic structure. The commonly-observed comorbidity of specific psychiatric syndromes with autism may arise from subsequent interactions between autistic liability and independent susceptibilities to other psychopathologic traits, suggesting opportunities for preventive amelioration of outcomes of these interactions over the course of development.
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5. Lewis GJ, Shakeshaft NG, Plomin R. {{Face Identity Recognition and the Social Difficulties Component of the Autism-Like Phenotype: Evidence for Phenotypic and Genetic Links}}. {J Autism Dev Disord}. 2018.
Autism spectrum disorder (ASD) and autism-like traits are associated with deficits in face memory ability, although it is not yet clear whether this deficit reflects a specific aspect of the ASD/autism-like phenotype. We addressed this issue using a neurotypical sample of adolescent twins (Ncomplete pairs = 782) drawn from the Twins Early Development Study who were assessed on face and object memory performance alongside two core aspects of autism-like traits: (i) difficulties with social behavior/interactions, and (ii) attention to detail. We observed a negative association between face memory ability and difficulties with social behavior/interactions. This association reflected an overlapping genetic etiology: heritable influences acting on face memory ability are associated with the social difficulties aspects of autism-like traits.
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6. Manohar H, Kuppili PP, Kandasamy P, Chandrasekaran V, Rajkumar RP. {{Implications of comorbid ADHD in ASD interventions and outcome: Results from a naturalistic follow up study from south India}}. {Asian J Psychiatr}. 2018; 33: 68-73.
BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder commonly associated with Attention Deficit Hyperactivity Disorder (ADHD), the prevalence ranging from 14-70%. The current study attempted to assess the impact of comorbid ADHD in children with ASD, in terms of challenges in diagnosis, treatment, intervention outcomes and parental stress and coping through a naturalistic design. METHODS: Fifty children aged 2-6 years with ASD were recruited, assessed and followed up for six months. Twenty children were found to have comorbid ADHD. Severity of ASD and ADHD was assessed by Childhood Autism rating scale and Connor’s abbreviated rating scale respectively. Parental stress and coping was assessed by Family Interview for stress and coping. RESULTS: The diagnosis of ASD was apparently obscured by ADHD symptoms in about 22% of cases, as only diagnosis of ADHD was made at the time of referral to our centre. ADHD was the most common comorbidity followed by intellectual disability and seizure disorder. About 66% of children received combination of pharmacological and behavioral interventions. Clonidine was the most common medication to be used and was well tolerated. The improvement in ADHD symptomatology showed positive correlation with improvement with ASD-specific interventions as reflected by change in severity scores. Severity of ADHD significantly also predicted parental stress and coping, and thereby engagement in ASD-specific interventions. CONCLUSION: The current study highlights the need for screening and early diagnosis of comorbid ADHD in children with ASD and vice versa considering the management challenges. In case of multiple comorbid neurodevelopmental disorders, early interventions for one disorder can improve the outcome of the other.
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7. Miyasaka M, Kajimura S, Nomura M. {{Biases in Understanding Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Japan}}. {Front Psychol}. 2018; 9: 244.
Recent research has shown high rates of comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and difficulties regarding differential diagnosis. Unlike those in Western countries, the Japanese ADHD prevalence rate is lower relative to that of ASD. This inconsistency could have occurred because of cultural diversities among professionals such as physicians. However, little is known about attitudes toward ADHD and ASD in non-Western cultural contexts. We conducted two experiments to identify biases in ASD and ADHD assessment. In Study 1, we examined attitudes toward these disorders in medical doctors and mental health professionals, using a web-based questionnaire. In Study 2, medical doctors and clinical psychologists assessed four fictional cases based on criteria for ADHD, ASD, oppositional defiant disorder, and disinhibited social engagement disorder (DSED). Diagnosis of ASD was considered more difficult relative to that of ADHD. Most participants assessed the fictional DSED case as ASD, rather than DSED or ADHD. The results provide evidence that Japanese professionals are more likely to attribute children’s behavioral problems to ASD, relative to other disorders. Therefore, Japanese therapists could be more sensitive to and likely to diagnose ASD, relative to therapists in other countries. These findings suggest that cultural biases could influence clinicians’ diagnosis of ADHD and ASD.
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8. Penner M, Anagnostou E, Ungar WJ. {{Practice patterns and determinants of wait time for autism spectrum disorder diagnosis in Canada}}. {Mol Autism}. 2018; 9: 16.
Background: Inefficient diagnostic practices for autism spectrum disorder (ASD) may contribute to longer wait times, delaying access to intervention. The objectives were to describe the diagnostic practices of Canadian pediatricians and to identify determinants of longer wait time for ASD diagnosis. Methods: An online survey was conducted through the Canadian Paediatric Society’s developmental pediatrics, community pediatrics, and mental health sections. Participants were asked for demographic information, whether they diagnosed ASD, and elements of their diagnostic assessment. A multiple linear regression of total wait time (time from referral to communication of the diagnosis to the family) as a function of practice characteristics was conducted. Results: A total of 90 participants completed the survey, of whom 57 diagnosed ASD in their practices (63.3%). Respondents reported varied use of multi-disciplinary teams, with 53% reporting participation in a team. No two identically composed teams were reported. Respondents also had varied use of diagnostic tools, with 21% reporting no use of tools. The median reported total wait for ASD diagnosis time was 7 months (interquartile range 4-12 months). Longer time spent on assessment was the only variable that remained significantly associated with longer wait time in multiple regression (p = 0.002). Use of diagnostic tools did not significantly affect wait time. Conclusion: Canadian ASD diagnostic practices vary widely and wait times for these assessments are substantial-7 months from referral to receipt of diagnosis. Time spent on the assessment is a significant determinant of wait time, highlighting the need for efficient assessment practices.
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9. Politte LC, Scahill L, Figueroa J, McCracken JT, King B, McDougle CJ. {{A randomized, placebo-controlled trial of extended-release guanfacine in children with autism spectrum disorder and ADHD symptoms: an analysis of secondary outcome measures}}. {Neuropsychopharmacology}. 2018.
In a prior report, we showed that extended-release guanfacine (GEXR) is safe and effective for children with autism spectrum disorder (ASD) accompanied by ADHD symptoms. Here, we examine the impact of GEXR on oppositional behavior, anxiety, repetitive behavior, and sleep disturbance. Sixty-two subjects with ASD (53 boys, 9 girls; ages 5-14 years) were randomly assigned to GEXR (n = 30) or placebo (n = 32) for 8 weeks. Outcomes include the Home Situation Questionnaire-Modified for ASD (HSQ-ASD), Anxiety scale of the Child and Adolescent Symptom Inventory (CASI), Children’s Yale-Brown Obsessive-Compulsive Scale-Modified for ASD (CYBOCS-ASD), and Children’s Sleep Habits Questionnaire (CSHQ). A repeated measures linear mixed model was used to determine the effects of treatment group and time on HSQ scores. For other measures, change from baseline was evaluated with Analysis of Covariance (ANCOVA).After 8 weeks of treatment, parent ratings of oppositional behavior on the HSQ declined by 44% (per item mean from 3.4 to 1.9) in the GEXR group compared to 12% (from 3.3 to 2.9) for placebo (p = 0.004). Repetitive behavior on the CYBOCS-ASD showed a significantly greater decline in GEXR-treated participants compared to placebo (24% vs. <1%, p = 0.01). No group differences were observed on CASI Anxiety or CSHQ (p = 0.64 and 0.75, respectively). GEXR was effective in reducing oppositional behavior and, more modestly, repetitive behavior. GEXR was not superior to placebo for anxiety, though baseline anxiety ratings were low. GEXR did not significantly improve sleep habits. Future studies could focus on repetitive behavior or anxiety, symptoms with limited treatment options. Lien vers le texte intégral (Open Access ou abonnement)
10. Robinson A, Elliott R. {{Correction to: Brief Report: An Observational Measure of Empathy for Autism Spectrum: A Preliminary Study of the Development and Reliability of the Client Emotional Processing Scale}}. {J Autism Dev Disord}. 2018.
The original version of this article unfortunately contained a mistake. There was an omission to the original acknowledgement. The acknowledgement should have read: We would also like to express our gratitude to the rater, Mary Hamilton for her expertise and time commitment given freely to this project.
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11. Sterling A. {{Grammar in Boys With Idiopathic Autism Spectrum Disorder and Boys With Fragile X Syndrome Plus Autism Spectrum Disorder}}. {Journal of speech, language, and hearing research : JSLHR}. 2018: 1-13.
Purpose: Some boys with autism spectrum disorder (ASD) and boys with fragile X syndrome and a codiagnosis of ASD (FXS+ASD) have impairments in expressive grammatical abilities. The current study compared grammatical performance in these 2 groups of school-age boys. Method: Thirty-seven boys similar on mean length of utterance participated in the current study (FXS: n = 19, ASD: n = 18). Participants completed an ASD assessment, nonverbal IQ testing, and conversation language samples. Convergent validity of a sentence imitation task with a norm-referenced assessment of grammar was examined in addition to divergent validity of the measures with nonverbal IQ and vocabulary comprehension and production. Results: The boys with ASD outperformed the boys with FXS+ASD on the norm-referenced assessment of « be, » and effect sizes indicate that the boys with ASD had better performance on past tense probes on the sentence imitation task and « do » on the norm-referenced assessment. The two measures of grammar had good convergent validity except for copula and auxiliary « be » and « do. » Grammatical performance was not correlated with nonverbal IQ, and trends indicate a relationship between vocabulary and grammar. Conclusions: Despite being similar on mean length of utterance, there were group differences on grammatical performance. The sentence imitation task had good convergent validity with a norm-referenced assessment of grammar for the third-person singular and past tense probes and therefore could be an inexpensive and valid tool to use clinically for these populations. Future research should continue to refine this task, particularly for the probes with high rates of unscorable responses (i.e., « be » and « do »).
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12. Stoodley CJ, D’Mello AM, Ellegood J, Jakkamsetti V, Liu P, Nebel MB, Gibson JM, Kelly E, Meng F, Cano CA, Pascual JM, Mostofsky SH, Lerch JP, Tsai PT. {{Author Correction: Altered cerebellar connectivity in autism and cerebellar-mediated rescue of autism-related behaviors in mice}}. {Nat Neurosci}. 2018.
In the version of this article initially published, the Simons Foundation was missing from the list of sources of support to P.T.T. in the Acknowledgments. The error has been corrected in the HTML and PDF versions of the article.
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13. Tan T, Wang W, Xu H, Huang Z, Wang YT, Dong Z. {{Low-Frequency rTMS Ameliorates Autistic-Like Behaviors in Rats Induced by Neonatal Isolation Through Regulating the Synaptic GABA Transmission}}. {Frontiers in cellular neuroscience}. 2018; 12: 46.
Patients with autism spectrum disorder (ASD) display abnormalities in neuronal development, synaptic function and neural circuits. The imbalance of excitatory and inhibitory (E/I) synaptic transmission has been proposed to cause the main behavioral characteristics of ASD. Repetitive transcranial magnetic stimulation (rTMS) can directly or indirectly induce excitability and synaptic plasticity changes in the brain noninvasively. However, whether rTMS can ameliorate autistic-like behaviors in animal model via regulating the balance of E/I synaptic transmission is unknown. By using our recent reported animal model with autistic-like behaviors induced by neonatal isolation (postnatal days 1-9), we found that low-frequency rTMS (LF-rTMS, 1 Hz) treatment for 2 weeks effectively alleviated the acquired autistic-like symptoms, as reflected by an increase in social interaction and decrease in self-grooming, anxiety- and depressive-like behaviors in young adult rats compared to those in untreated animals. Furthermore, the amelioration in autistic-like behavior was accompanied by a restoration of the balance between E/I activity, especially at the level of synaptic transmission and receptors in synaptosomes. These findings indicated that LF-rTMS may alleviate the symptoms of ASD-like behaviors caused by neonatal isolation through regulating the synaptic GABA transmission, suggesting that LF-rTMS may be a potential therapeutic technique to treat ASD.
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14. Tseng PT, Cheng YS, Chen YW, Stubbs B, Whiteley P, Carvalho AF, Li DJ, Chen TY, Yang WC, Tang CH, Chu CS, Yang WC, Liang HY, Wu CK, Yen CF, Lin PY. {{Peripheral iron levels in children with autism spectrum disorders vs controls: a systematic review and meta-analysis}}. {Nutrition research (New York, NY)}. 2018; 50: 44-52.
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder, and nutritional deficiency may play a role in the development of ASD. A relationship between ASD and iron levels/iron deficiency (ID) has been reported; however, the results have been inconsistent. Therefore, we conducted this meta-analysis to examine the relationship between ASD and ID following the Meta-Analysis of Observational Studies in Epidemiology guidelines. We performed a systematic search of PubMed, ScienceDirect, Embase, ProQuest, ClinicalTrials.gov, and Cochrane CENTRAL databases up to September 22, 2017. Studies providing data on peripheral iron levels and/or the prevalence of ID in children with ASD vs those without ASD (non-ASD) were included. Primary outcomes included the difference in peripheral iron levels in children with ASD compared with those without ASD, and the odds ratio of ASD in children with ID compared with those without ID. Twenty-five articles met the inclusion criteria. We found that peripheral iron levels were not significantly different between the ASD and non-ASD groups, including serum ferritin (k = 4, Hedges g = 0.016, 95% confidence interval [CI] = -0.482 to 0.515, P = .949) or hair iron (k = 12; Hedges g = -0.219, 95% CI = -0.551 to 0.113, P = .196). There was no significant difference in the amount of iron in food content between the ASD and non-ASD groups (k = 6; Hedges g = -0.458, 95% CI = -1.246 to 0.330, P = .254). However, the reciprocal comorbidity of ASD and ID was significantly higher than in the children without these disorders. Our analysis showed that the available evidence is inconsistent with regard to whether children with ASD have lower iron levels. Future longitudinal studies are required to confirm or refute these associations and elucidate potential mechanisms.
