1. Boso M, Emanuele E, P F, Politi P, Barale F, D’Angelo E. {{Autism and genius: is there a link? The involvement of central brain loops and hypotheses for functional testing}}. {Funct Neurol} (Jan/Mar);25(1):15-20.
Mental processing is the product of the huge number of synaptic interactions that occur in the brain. It is easier to understand how brain functions can deteriorate than how they might be boosted. Lying at the border between the humanities, cognitive science and neurophysiology, some mental diseases offer new angles on this problematic issue. Despite their social deficits, autistic subjects can display unexpected and extraordinary skills in numerous fields, including music, the arts, calculation and memory. The advanced skills found in a subgroup of people with autism may be explained by their special mental functioning, in particular by their weak central coherence, one of the pivotal characteristics of the disorder. As a result of the increasing interest in autistic talent, there has recently emerged a tendency to screen any eccentric artist or scientist for traits of the autistic spectrum. Following this trend, we analyze the eccentricity of the popular pianist Glenn Gould and briefly discuss the major functional hypotheses on autistic hyperfunctioning, advancing proposals for functional testing. In particular, the potential involvement of rhythm-entrained systems and cerebro-cerebellar loops opens up new perspectives for the investigation of autistic disorders and brain hyperfunctioning.
2. Cubala-Kucharska M. {{The review of most frequently occurring medical disorders related to aetiology of autism and the methods of treatment}}. {Acta Neurobiol Exp (Wars)};70(2):141-146.
The medical understanding of autism has changed since it was first defined by Kanner. Nowadays medicine identifies many medical abnormalities and diseases, which may underline or aggravate the cognitive aspect, behavioural issues and general health in autists. This includes chronic inflammation of gastrointestinal tract, dysbiosis, maldigestion, malabsorption, malnutrition, food intolerance, allergies, chronic viral, fungal and bacterial infections, impaired kidney function, impaired detoxification of endo- and exotoxins, disorders of metal ion transportation. Treatment of the above mentioned conditions combined with improving detoxification mechanisms, followed by a special diet and individually customized supplementation of nutritional deficiencies may lead to the improvement of the functioning of these patients, changing their level of functioning and self-dependence. The aim of this paper is to present medical problems of children with autism which may be identified and treated by general practitioners as a review of current medical papers related to Autism Spectrum Disorder, in the context of author’s professional experience, based on the medical cases from author’s practice.
3. Davis TN. {{Unsubstantiated treatments for individuals with autism}}. {Dev Neurorehabil};13(4):231-233.
4. Desoto MC, Hitlan RT. {{Sorting out the spinning of autism: heavy metals and the question of incidence}}. {Acta Neurobiol Exp (Wars)};70(2):165-176.
The reasons for the rise in autism prevalence are a subject of heated professional debate. Featuring a critical appraisal of some research used to question whether rising levels of autism are related to environmental exposure to toxins (Soden et al. 2007, Barbaresi et al. 2009, Thompson et al. 2007) we aim to evaluate the actual state of scientific knowledge. In addition, we surveyed the empirical research on the topic of autism and heavy metal toxins. In our opinion empirical investigations are finding support for a link with heavy metal toxins. The various causes that have led to the increase in autism diagnosis are likely multi-faceted, and understanding the causes is one of the most important health topics today. We argue that scientific research does not support rejecting the link between the neurodevelopmental disorder of autism and toxic exposures.
5. Fendri-Kriaa N, Mkaouar-Rebai E, Moalla D, Belguith N, Louhichi N, Zemni R, Slama F, Triki C, Fakhfakh F. {{Mutational Analysis of the MECP2 Gene in Tunisian Patients With Rett Syndrome: A Novel Double Mutation}}. {J Child Neurol} (Aug);25(8):1042-1046.
Rett syndrome is a severe disorder characterized by loss of acquired skills after a period of normal development in infant girls. It is caused mainly by mutations in the MECP2 gene. In this study, we reported mutations in the MECP2 gene in 7 Tunisian patients with classic Rett syndrome. The results showed the presence of a double mutation in 1 patient: p.R306C and c.1461+98insA, which create a new hypothetical polyadenylation site in the 3(‘)UTR of the MECP2 gene. We also detected in another patient a new variant c.1461+92C>G in the 3(‘)UTR located previous to 34 bp from the polyadenylation site with a score of 4.085. This variation is located in a hypothetical splicing enhancer with a score of 1.96277 according to the ESE finder program. In the remaining 5 patients, we found 2 common mutations: p.T158M in 4 individuals and p.R168X in only 1 girl.
6. Geier DA, Audhya T, Kern JK, Geier MR. {{Blood mercury levels in autism spectrum disorder: is there a threshold level?}}. {Acta Neurobiol Exp (Wars)};70(2):177-186.
Mercury (Hg) may significantly impact the pathogenesis of autism spectrum disorders (ASDs). Lab results generated by Vitamin Diagnostics (CLIA-approved) from 2003-2007, were examined among subjects diagnosed with an ASD (n=83) in comparison to neurotypical controls (n=89). Blood Hg levels were determined by analyzing Hg content in red blood cells (RBC) using cold vapor analysis, and consistent Hg measurements were observed between Vitamin Diagnostics and the University of Rochester. Adjusted (age, gender, and date of collection) mean Hg levels were 1.9-fold significantly (P<.0001) increased among subjects diagnosed with an ASD (21.4 mmg/L) in comparison to controls (11.4 mmg/L). Further, an adjusted significant (P<.0005) threshold effect >15 mmg/L) was observed for Hg levels on the risk of a subject being diagnosed with an ASD in comparison to controls (odds ratio=6.4). The weight of scientific evidence supports Hg as a causal factor in subjects diagnosed with an ASD.
7. Geier DA, Kern JK, Geier MR. {{The biological basis of autism spectrum disorders: Understanding causation and treatment by clinical geneticists}}. {Acta Neurobiol Exp (Wars)};70(2):209-226.
Autism spectrum disorders (ASDs) also known as pervasive developmental disorders (PDD) are a behaviorally defined group of neurodevelopmental disorders that are usually diagnosed in early childhood. ASDs disproportionately affect male children. Mercury (Hg) a heavy metal, is widespread and persistent in the environment. Mercury is a ubiquitous source of danger in fish, drugs, fungicides/herbicides, dental fillings, thermometers, and many other products. Elevated Hg concentrations may remain in the brain from several years to decades following exposure. This is important because investigators have long recognized that Hg is a neurodevelopmental poison; it can cause problems in neuronal cell migration and division, and can ultimately cause cell degeneration and death. Case-reports of patients have described developmental regressions with ASD symptoms following fetal and/or early childhood Hg exposure, and epidemiological studies have linked exposure to Hg with an elevated risk of a patient being diagnosed with an ASD. Immune, sensory, neurological, motor, and behavioral dysfunctions similar to traits defining or associated with ASDs were reported following Hg intoxication with similarities extending to neuroanatomy, neurotransmitters, and biochemistry. The sexual dimorphism of ASDs may result from synergistic neurotoxicity caused by the interaction of testosterone and Hg; in contrast, estrogen is protective, mitigating the toxicity of Hg. Mercury exposure may significantly increase androgen levels, and as a result, patients diagnosed with an ASD may significantly benefit from anti-androgen therapy. Finally, the clinical geneticist has a wealth of biomarkers to evaluate and treat patients diagnosed with an ASD.
8. Huang HS, Cheung I, Akbarian S. {{RPP25 is developmentally regulated in prefrontal cortex and expressed at decreased levels in autism spectrum disorder}}. {Autism Res} (Jul 14)
Dysfunction of cerebral cortex in autism is thought to involve alterations in inhibitory neurotransmission. Here, we screened, in prefrontal cortex (PFC) of 15 subjects diagnosed with autism and 15 matched controls the expression of 44 transcripts that are either preferentially expressed in gamma-aminobutyric acidergic interneurons of the mature cortex or important for the development of inhibitory circuitry. Significant alterations in the autism cohort included decreased expression (-45%) of RPP25 (15q24.1), which is located within the autism susceptibility locus, 15q22-26. RPP25, which encodes the 25 kDa subunit of ribonuclease P involved in tRNA and pre-ribosomal RNA processing, was developmentally regulated in cerebral cortex with peak levels of expression during late fetal development (human) or around birth (mouse). In the PFC, RPP25 chromatin showed high levels of histone H3-lysine 4 trimethylation, an epigenetic mark associated with transcriptional regulation. Unexpectedly, and in contrast to peripheral tissues, levels of RPP25 protein remained undetectable in fetal and adult cerebral cortex. Taken together, these findings suggest a potential role for the RPP25 gene transcript in the neurobiology of developmental brain disorders.
9. Ingersoll B, Lalonde K. {{The impact of object and gesture imitation training on language use in children with autism}}. {J Speech Lang Hear Res} (Jul 14)
PURPOSE: Reciprocal Imitation Training (RIT) is a naturalistic behavioral intervention that teaches imitation to children with autism within a social-communicative context. RIT has been shown to be effective at teaching spontaneous, generalized object and gesture imitation. In addition, improvements in imitation were associated with increases in verbal imitation and spontaneous language. METHOD: This study used a modified multiple-baseline design across four children to examine whether adding gesture imitation training improves the overall rate of appropriate language use in children with ASD who have already been participating in object imitation training. RESULTS: Three of the four children showed greater improvements in their use of appropriate language after gesture imitation was begun. Further, the children were more likely to use verbal imitation during gesture than object imitation training. CONCLUSIONS: These findings suggest adding gestural imitation training to object imitation training can lead to greater gains in rate of language use than object imitation alone. Implications for both language development and early intervention are discussed.
10. Kallstrand J, Olsson O, Nehlstedt SF, Skold ML, Nielzen S. {{Abnormal auditory forward masking pattern in the brainstem response of individuals with Asperger syndrome}}. {Neuropsychiatr Dis Treat};6:289-296.
Abnormal auditory information processing has been reported in individuals with autism spectrum disorders (ASD). In the present study auditory processing was investigated by recording auditory brainstem responses (ABRs) elicited by forward masking in adults diagnosed with Asperger syndrome (AS). Sixteen AS subjects were included in the forward masking experiment and compared to three control groups consisting of healthy individuals (n = 16), schizophrenic patients (n = 16) and attention deficit hyperactivity disorder patients (n = 16), respectively, of matching age and gender. The results showed that the AS subjects exhibited abnormally low activity in the early part of their ABRs that distinctly separated them from the three control groups. Specifically, wave III amplitudes were significantly lower in the AS group than for all the control groups in the forward masking condition (P < 0.005), which was not the case in the baseline condition. Thus, electrophysiological measurements of ABRs to complex sound stimuli (eg, forward masking) may lead to a better understanding of the underlying neurophysiology of AS. Future studies may further point to specific ABR characteristics in AS individuals that separate them from individuals diagnosed with other neurodevelopmental diseases.
11. Kawa R, Pisula E. {{Locomotor activity, object exploration and space preference in children with autism and Down syndrome}}. {Acta Neurobiol Exp (Wars)};70(2):131-140.
There have been ambiguous accounts of exploration in children with intellectual disabilities with respect to the course of that exploration, and in particular the relationship between the features of explored objects and exploratory behaviour. It is unclear whether reduced exploratory activity seen with object exploration but not with locomotor activity is autism-specific or if it is also present in children with other disabilities. The purpose of the present study was to compare preschool children with autism with their peers with Down syndrome and typical development in terms of locomotor activity and object exploration and to determine whether the complexity of explored objects affects the course of exploration activity in children with autism. In total there were 27 children in the study. The experimental room was divided into three zones equipped with experimental objects providing visual stimulation of varying levels of complexity. Our results indicate that children with autism and Down syndrome differ from children with typical development in terms of some measures of object exploration (i.e. looking at objects) and time spent in the zone with the most visually complex objects.
12. Kazek B, Huzarska M, Grzybowska-Chlebowczyk U, Kajor M, Ciupinska-Kajor M, Wos H, Marszal E. {{Platelet and intestinal 5-HT2A receptor mRNA in autistic spectrum disorders – results of a pilot study}}. {Acta Neurobiol Exp (Wars)};70(2):232-238.
The etiology and pathogenesis of autistic spectrum disorders (ASD) are still unknown. Platelet hyperserotonemia has been detected in 25-60% of autistic children. Higher incidence of gastrointestinal problems in people with autism is observed. The aim was compare the expression of platelet 5-HT2Ar mRNA in autistic and non autistic groups. In a subgroup of patients with gastrointestinal problems an upper gastrointestinal tract endoscopy was performed and additionally the expression of 5-HT2A receptor mRNA in the duodenum was assessed. The examination was conducted in 79 children – 51 with ASD and 28 without autistic traits. Statistically significant differences between the study and control groups were proven in gastrointestinal problems. The analyses reveal a significantly higher level of 5-HT2Ar mRNA in platelets of the study group patients, which could suggest serotonin system dysregulation.
13. Kern JK, Geier DA, Adams JB, Mehta JA, Grannemann BD, Geier MR. {{Toxicity Biomarkers in Autism Spectrum Disorder: A Blinded Study of Urinary Porphyrins}}. {Pediatr Int} (Jul 4)
Abstract Background: Recent studies suggest children diagnosed with an autism spectrum disorder (ASD) have significantly increased levels of urinary porphyrins associated with mercury (Hg) toxicity, including pentacarboxyporphyrin (5cxP), precoproporphyrin (prcP), and coproporphyrin (cP), compared to typically developing controls. However, these initial studies were criticized because the controls were not age- and gender-matched to the children diagnosed with an ASD. Methods: Urinary porphyrin biomarkers in a group of children (2-13 years of age) diagnosed with an ASD (n=20) were compared to matched (age, gender, race, location, and year tested) group of typically developing controls (n = 20). Results: Participants diagnosed with an ASD had significantly increased levels of 5cxP, prcP, and cP in comparison to controls. No significant differences were found in non-Hg associated urinary porphyrins (uroporphyrins, hexacarboxyporphyrin, and heptacarboxyporphyrin). There was a significantly increased odds ratio for an ASD diagnosis relative to controls among study participants with precoproporphyrin (odds ratio = 15.5, p < 0.01) and coproporphyrin (odds ratio = 15.5, p < 0.01) levels in the second through fourth quartiles in comparison to the first quartile. Conclusion: These results suggest that the levels of Hg-toxicity-associated porphyrins are higher in children with an ASD diagnosis than controls. Although the pattern seen (increased 5cxP, prcP, and cP) is characteristic of Hg toxicity, the influence of other factors, such as genetics and other metals cannot be completely ruled-out.
14. Majewska MD, Urbanowicz E, Rok-Bujko P, Namyslowska I, Mierzejewski P. {{Age-dependent lower or higher levels of hair mercury in autistic children than in healthy controls}}. {Acta Neurobiol Exp (Wars)};70(2):196-208.
An association between autism and early life exposure to mercury is a hotly debated issue. In this study, 91 autistic Polish children, male and female, 3-4 and 7-9 years old, were compared to 75 age- and sex-matched healthy children with respect to: demographic, perinatal, clinical and developmental measures, parental age, birth order, morphometric measures, vaccination history, and hair mercury content. In demographic and perinatal measures there were no consistent differences between the autistic and control groups. Autistic children had a significantly greater prevalence of adverse reactions after vaccinations and abnormal development than controls. Between 45 and 80% of autistic children experienced developmental regress. Autistic children significantly differed from healthy peers in the concentrations of mercury in hair: younger autistics had lower levels, while older – higher levels than their respective controls. The results suggest that autistic children differ from healthy children in metabolism of mercury, which seems to change with age.
15. Matson JL, Mahan S, Kozlowski AM, Shoemaker M. {{Developmental milestones in toddlers with autistic disorder, pervasive developmental disorder-not otherwise specified and atypical development}}. {Dev Neurorehabil};13(4):239-247.
Objective: To investigate age differences in developmental milestone attainment among toddlers with Autistic Disorder, PDD-NOS and atypical development. Methods: A questionnaire was administered to caregivers of toddlers to obtain ages of onset of developmental milestones. The study included 1044 participants with 442, 112, 498 and 497 participants in first word, first phrase, crawling and walking analyses, respectively. Results: Significant differences were found between groups on the attainment of milestones within normal limits, delayed or not yet attained. Significant differences were also found between groups in age of saying first word and onset of crawling. There were no significant differences between groups for walking or first phrase. Conclusion: Increased severity of autism has been noted to be related to greater deficits in a multitude of areas. With basic human motor behaviours also appearing to follow that trend, motor and speech skills should be targeted in early intervention programmes.
16. Moon EC, Corkum P, Smith IM. {{Case Study: A Case-Series Evaluation of a Behavioral Sleep Intervention for Three Children with Autism and Primary Insomnia}}. {J Pediatr Psychol} (Jul 14)
OBJECTIVE: To assess the effectiveness of a manualized multi-component behavioral sleep intervention for children with autism spectrum disorder (ASD) and primary insomnia. METHODS: Three children (2 males and 1 female, aged 8-9 years) participated. The intervention consisted of a treatment handbook for parents; a distance treatment approach was used in which parents had weekly telephone contact with a therapist. The main behavioral strategies employed were Faded Bedtime with Response Cost and positive reinforcement. Within a case-series design, both subjective (parent-report questionnaires and sleep diaries) and objective (actigraphy) measures were used to record changes in children’s sleep and daytime behavior. RESULTS: For all 3 children, mean sleep onset latency was reduced following the intervention. These improvements were generally maintained at follow-up 12 weeks later. CONCLUSIONS: The current study provides preliminary evidence for the effectiveness of a manualized behavioral sleep intervention program for improving insomnia in children with ASD.
17. Oosterling I, Rommelse N, de Jonge M, van der Gaag RJ, Swinkels S, Roos S, Visser J, Buitelaar J. {{How useful is the Social Communication Questionnaire in toddlers at risk of autism spectrum disorder?}}. {J Child Psychol Psychiatry} (Jul 7)
Background: The Social Communication Questionnaire (SCQ) is a screening instrument with established validity against the Autism Diagnostic Interview-Revised (ADI-R) in children aged 4 years and older. Indices of diagnostic accuracy have been shown to be strong in school-aged samples; however, relatively little is known about the performance of the SCQ in toddlers at risk of autism spectrum disorder (ASD). Methods: This study replicates and extends previous research by Corsello et al. (2007) in a comparatively large (N = 208), substantially younger (20-40 months) sample of children at high risk of ASD. The usefulness of the SCQ as a second-level screening instrument with different cut-off scores was evaluated in relation to IQ, age, and type of ASD diagnosis. The use of the SCQ as compared to the ADI-R was evaluated against clinical diagnosis, both alone and in combination with the ADOS. Results: The SCQ with different cut-offs consistently showed an unsatisfactory balance between sensitivity and specificity in screening for ASD in high-risk toddlers, with only a few exceptions for specific age, IQ, or diagnostic groups. Even though the SCQ and ADI-R were highly correlated, diagnostic agreement with the best evidence clinical diagnosis was poor for both measures. The ADOS used alone consistently had the highest predictive value. For autism versus not-autism, the combined SCQ and ADOS performed as well as the ADOS alone and notably better than the combination ADI-R and ADOS. Conclusions: The SCQ is likely to result in a number of false-positive findings, particularly in children with autism symptomatology, and the balance between sensitivity and specificity is poor. The ADOS should be considered the most valid and reliable diagnostic instrument in these very young at-risk children.
18. Peters-Scheffer N, Didden R, Mulders M, Korzilius H. {{Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability}}. {Res Dev Disabil} (Jun 3)
This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers) and a discrete trial teaching approach was used. Twelve children in the treatment group were compared to 22 children receiving regular intervention. At pre-treatment, both groups did not differ on chronological age, developmental age, diagnosis and level of adaptive skills. Eight months into treatment, children receiving behavioral treatment displayed significantly higher developmental ages and made more gains in adaptive skills than children from the control group. No significant differences between groups were found on autistic symptom severity and emotional and behavioral problems.
19. Pisula E. {{The autistic mind in the light of neuropsychological studies}}. {Acta Neurobiol Exp (Wars)};70(2):119-130.
The underlying causes of autism spectrum disorders have not yet been identified. There is a group of theories which attempt to explain the source of difficulties experienced by people with these disorders through neurocognitive deficits. The most popular among them refer to deficits in theory of mind, executive dysfunction and weak central coherence. The results of over 20 years of research show that although these deficits may at least partially explain variations in the course of social development, communication difficulties and the formation of rigid patterns of behavior and interests in individuals with autism, none of them is sufficient on its own to comprehensively explain the complex picture of autistic disorders. Information about the neurobiological correlates of these deficits complement our knowledge about their mutual relationships by showing that multiple neural networks are involved in the emergence of autism’s signs and symptoms. Further investigation of various aspects of these cognitive deficits and the relationships between them may significantly improve our understanding of processes involved in the development of autism.
20. Rahbar MH, Ibrahim K, Assassi P. {{Knowledge and Attitude of General Practitioners Regarding Autism in Karachi, Pakistan}}. {J Autism Dev Disord} (Jul 15)
General practitioners (GPs) could have an important role in early diagnosis of autism. There have been no studies evaluating the knowledge of GPs regarding autism in Pakistan. We aimed to fill that gap by assessing knowledge and attitude of GPs in Karachi regarding autism. We conducted a cross-sectional survey of 348 GPs; only 148 (44.6%) had heard of « autism. » Our results show that GPs less than 30 years of age and those who obtained their Medical Degree in the last 5 years are more likely to report knowledge about autism: OR = 3.0; 95% CI: 1.71, 5.31, and OR = 2.56; 95% CI: 1.48, 4.42, respectively. In addition, among those reporting knowledge about autism, many held misconceptions regarding the signs and symptoms and etiology.
21. Scherf KS, Luna B, Minshew N, Behrmann M. {{Location, Location, Location: Alterations in the Functional Topography of Face- but not Object- or Place-Related Cortex in Adolescents with Autism}}. {Front Hum Neurosci};4:26.
In autism, impairments in face processing are a relatively recent discovery, but have quickly become a widely accepted aspect of the behavioral profile. Only a handful of studies have investigated potential atypicalities in autism in the development of the neural substrates mediating face processing. High-functioning individuals with autism (HFA) and matched typically developing (TD) controls watched dynamic movie vignettes of faces, common objects, buildings, and scenes of navigation while undergoing an fMRI scan. With these data, we mapped the functional topography of category-selective activation for faces bilaterally in the fusiform gyrus, occipital face area, and posterior superior temporal sulcus. Additionally, we mapped category-selective activation for objects in the lateral occipital area and for places in the parahippocampal place area in the two groups. Our findings do not indicate a generalized disruption in the development of the entire ventral visual pathway in autism. Instead, our results suggest that the functional topography of face-related cortex is selectively disrupted in autism and that this alteration is present in early adolescence. Furthermore, for those HFA adolescents who do exhibit face-selective activation, this activation tends to be located in traditionally object-related regions, which supports the hypothesis that perceptual processing of faces in autism may be more akin to the perceptual processing of common objects in TD individuals.
22. Schultz ST. {{Can autism be triggered by acetaminophen activation of the endocannabinoid system?}}. {Acta Neurobiol Exp (Wars)};70(2):227-231.
Acetaminophen use in children has been associated with increased autism risk. Recent evidence suggests that acetaminophen’s analgesic actions result from activation of the endocannabinoid system, and activation of this system can have neuromodulatory consequences during development. This investigation was performed to determine if there is evidence to support the hypothesis that acetaminophen use can trigger autism by activation of the endocannabinoid system.
23. Schultz ST. {{Does thimerosal or other mercury exposure increase the risk for autism? A review of current literature}}. {Acta Neurobiol Exp (Wars)};70(2):187-195.
This report reviews current literature regarding the association of the pharmaceutical preservative thimerosal and other mercury exposures with the risk for autism. The evidence presented here does not support a causal association between autism and mercury exposure from the preservative thimerosal. The risk for autism from other mercury exposures such as from dental amalgam restorations or environmental mercury release into the atmosphere is ambiguous. Since mercury is a known neurotoxin, more research should be done to ensure that mercury exposure from any source does not contribute to autism.
24. van der Meer LA, Rispoli M. {{Communication interventions involving speech-generating devices for children with autism: A review of the literature}}. {Dev Neurorehabil};13(4):294-306.
Objective: The current review synthesizes communication intervention studies that involved the use of speech-generating devices (SGD) for children with autism. Methods: Twenty-three studies were identified that met the inclusion criteria following systematic searches of electronic databases, journals and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) mode of communication, (d) communication skill(s) taught to the participant, (e) intervention procedures, (f) outcomes, (g) follow-up and generalization, (h) reliability and treatment integrity and (i) design and certainty of evidence. Results: Intervention, most commonly targeting requesting skills, was provided to a total of 51 children aged 3-16 years. Intervention strategies followed two main approaches: operant/behavioural techniques and naturalistic teaching procedures. Positive outcomes were reported for 86% of the studies and 78% of the studies were categorized as providing conclusive evidence. Conclusion: The literature base suggests that SGDs are viable communication options for children with autism. However, several areas warrant future research.
25. Watson LR, Baranek GT, Roberts JE, David FJ, Perryman TY. {{Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children with Autism Spectrum Disorders}}. {J Speech Lang Hear Res} (Jul 14)
PURPOSE: To determine the extent to which behavioral and physiological responses during child-directed speech (CDS) correlate concurrently and predictively with communication skills in young children with autism spectrum disorders (ASD). METHOD: Twenty-two boys with ASD (initial mean age of 35 months) participated in a longitudinal study. At entry, behavioral (i.e., percent looking) and physiological (i.e., vagal activity) measures were collected during CDS stimuli. A battery of standardized communication measures was administered at entry, and re-administered 12 months later. RESULTS: Percent looking during CDS was strongly correlated with all entry and follow-up communication scores; vagal activity during CDS was moderately to strongly correlated with entry Receptive Language, and follow-up Expressive Language and Social-Communicative Adaptive Skills. After controlling for entry communication skills, vagal activity during CDS accounted for significant variance in follow-up communication skills, but percent looking during CDS did not. CONCLUSIONS: Behavioral and physiological responses to CDS are significantly related to concurrent and later communication skills of children with ASD. Further, higher vagal activity during CDS predicts better communication outcomes 12 months later, after accounting for initial communication skills. Further research is needed to better understand the physiological mechanisms underlying variable responses to CDS among children with ASD.
