1. Bonis SA, Sawin KJ. {{Risks and Protective Factors for Stress Self-Management in Parents of Children With Autism Spectrum Disorder: An Integrated Review of the Literature}}. {J Pediatr Nurs};2016 (Sep 13)
PROBLEM: Stress in parents of children with autism spectrum disorder (ASD) has been reported to be very high. However, little is known about what risk and protective factors influence parental stress self-management in this population. Accordingly, this manuscript is a synthesis of the risk and protective factors that impact self-management of stress in these parents. The concepts in the individual and family self-management theory context domain were used as a framework to guide data collection and analysis. ELIGIBILITY CRITERIA: Searches were conducted using CINAHL, MedLine and PsychInfo. Studies were included if they addressed context factors in parents of children with ASD and were written in English. SAMPLE: Ninety-eight studies met review criteria. RESULTS: This review highlighted risk factors to parental stress self-management within the context of condition-specific factors, physical and social environment, and individual and family. The most concerning of these findings is that parents struggle accessing a diagnosis and services for their child and are frustrated with health care providers’ knowledge of ASD and lack of communication. CONCLUSIONS: The risks parents experience as they care for their child with ASD far outweigh the protective factors for self-management of parental stress. IMPLICATIONS: Nurses who are aware of these issues can make important changes to their practice and have a significant impact on parental stress self-management and the care of children with ASD.
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2. Byars SG, Boomsma JJ. {{Opposite differential risks for autism and schizophrenia based on maternal age, paternal age, and parental age differences}}. {Evol Med Public Health};2016;2016(1):286-298.
BACKGROUND AND OBJECTIVES: Effects of maternal and paternal age on offspring autism and schizophrenia risks have been studied for over three decades, but inconsistent risks have often been found, precluding well-informed speculation on why these age-related risks might exist. METHODOLOGY: To help clarify this situation we analysed a massive single population sample from Denmark including the full spectrum of autistic and schizophrenic disorders (eliminating between-study confounding), used up to 30 follow-up years, controlled for over 20 potentially confounding factors and interpret the ultimate causation of the observed risk patterns using generally accepted principles of parent-offspring conflict and life-history theory. RESULTS: We evaluated the effects of paternal age, maternal age and parental age difference on offspring mental disorders and found consistently similar risk patterns for related disorders and markedly different patterns between autistic and schizophrenic disorders. Older fathers and mothers both conferred increased risk for autistic but not schizophrenic disorders, but autism risk was reduced in younger parents and offspring of younger mothers had increased risk for many schizophrenic disorders. Risk for most disorders also increased when parents were more dissimilarly aged. Monotonically increasing autism risk is consistent with mutation accumulation as fathers’ age, but this explanation is invalid for schizophrenic disorders, which were not related to paternal age and were negatively correlated with maternal age. CONCLUSIONS AND IMPLICATIONS: We propose that the observed maternally induced risk patterns ultimately reflect a shifting ancestral life-history trade-off between current and future reproduction, mediated by an initially high but subsequently decreasing tendency to constrain foetal provisioning as women proceed from first to final pregnancy.
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3. Caplan B, Feldman M, Eisenhower A, Blacher J. {{Student-Teacher Relationships for Young Children with Autism Spectrum Disorder: Risk and Protective Factors}}. {J Autism Dev Disord};2016 (Sep 16)
The quality of early student-teacher relationships (STRs) has been shown to predict children’s school adjustment, and children with autism spectrum disorder (ASD) are at risk for poor quality STRs. The present study examined 162 children with ASD (ages 4-7) and their teachers to evaluate student, teacher, and classroom characteristics that predicted concurrent and prospective STR quality across one school year. Child oppositional behavior, autism severity and teacher degree predicted changes in student-teacher conflict over a 1-year period, while child social skills and IQ positively predicted change in student-teacher closeness. Teacher preparedness, trainings in ASD, and classroom setting were unrelated to STR quality. Implications for intervention are discussed.
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4. Edgington L, Hill V, Pellicano E. {{The design and implementation of a CBT-based intervention for sensory processing difficulties in adolescents on the autism spectrum}}. {Res Dev Disabil};2016 (Sep 14);59:221-233.
BACKGROUND: Unusual reactions to sensory input now form part of the diagnostic criteria for autism. These features are common and can have an often-devastating impact on autistic individuals and their families. Yet there are few validated interventions that help to remediate or support autistic individuals’ adverse sensory experiences. To date, both measurement of sensory experiences and the resulting interventions have been based on assumptions of neurological sensitivities and largely ignored the role of cognition. This study therefore sought to assess the feasibility of a new 8-week CBT-based group intervention for self-regulation of sensory processing difficulties. METHOD: Seven cognitively able adolescents diagnosed with autism aged 11-16 years from one mainstream secondary school received the 8-week intervention. Measures of sensory reactivity, anxiety and repetitive behaviours were taken at baseline, post-intervention and follow-up, 8 weeks after the intervention had ceased. Semi-structured interviews and focus groups were also conducted with adolescents and their parents to examine further the acceptability of the intervention. RESULTS: The results showed that the intervention itself was feasible – both in its implementation and its acceptability to participants. Qualitative analysis clearly showed that the intervention was effective in raising meta-conscious awareness and self-regulation in these autistic adolescents. Analysis of outcome variables showed no significant change over the intervention period, although effect sizes were moderate-to-large. CONCLUSIONS: These preliminary results are encouraging and should inform the design of a future pilot randomized controlled trial to test its efficacy with a larger group of participants.
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5. Hreich EK, Messarra C, Roux S, Barthelemy C, Richa S. {{[Validation in Arabic of the Revised Autistic Behavior Summarized Evaluation Scale (BSE-R)]}}. {Encephale};2016 (Sep 13)
The Behavioral Summarized Evaluation is a rating scale specifically related to the assessment of autistic behaviors in children and young teenagers with Autism Spectrum Disorder, such as communication, social interaction and interests. It also facilitates progressive recording of the evolution of children with ASD involved in short-term therapeutical studies. In the absence of standardized tools to assess autistic behaviors and effects of therapeutics in Lebanon, the BSE-R validation is an urgent need. The purpose of this study is to validate the BSE-R to the Lebanese population. METHOD: Specialized translators and clinicians ensured forward and backward translation of the scale into Arabic. The participants consisted of 100 children with ASD, diagnosed upon DSMIV-TR criterion (age range: 35 to 153 months, DS: 28.0). Fifty-eight had intellectual disability (ID). Scores of autism severity as measured by CARS1 (Schopler et al., 1980) varied from 20-58.5. Trained raters on recorded individual and group situations performed BSE-R ratings. RESULTS: BSE-R for Lebanese was found to have excellent inter-rater reliability. The internal validity highlighted a main factor which describes the severity of core autistic behaviors related to social interactions and communication, and behavioral specificities and particular interests with an internal consistency of 0.91 in a one-to-one setting and 0.92 in group settings. External validity of the scale as measured by correlations with CARS and the age of the children showed that this main factor is essentially determined by ASD severity, not by the severity of ID. It was named « relational deficiency » according to the initial paper of Barthelemy et al. (1997). CONCLUSION: BSE-R in Arabic is a practical tool, useful to all team members working with ASD children in Lebanon and the Arab countries. It will also allow future research based on reliable tools at an international level.
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6. Kaartinen M, Puura K, Himanen SL, Nevalainen J, Hietanen JK. {{Autonomic Arousal Response Habituation to Social Stimuli Among Children with Asd}}. {J Autism Dev Disord};2016 (Sep 16)
Sustained autonomic arousal during eye contact could cause the impairments in eye contact behavior commonly seen in autism. The aim of the present study was to re-analyze the data from a study by Kaartinen et al. (J Autism Develop Disord 42(9):1917-1927, 2012) to investigate the habituation of autonomic arousal responses to repeated facial stimuli and the correlations between response habituation and social impairments among children with and without ASD. The results showed that among children with ASD, the smaller the habituation was, specifically in responses to a direct gaze, the more the child showed social impairments. The results imply that decreased autonomic arousal habituation to a direct gaze might play a role in the development of social impairments in autism.
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7. Kim JW, Seung H, Chan Kim K, Gonzales EL, Oh HA, Yang SM, Ko MJ, Han SH, Banerjee S, Ko CY. {{Agmatine rescues autistic behaviors in the valproic acid-induced animal model of autism}}. {Neuropharmacology};2016 (Sep 13)
Autism spectrum disorder (ASD) is an immensely challenging developmental disorder characterized primarily by two core behavioral symptoms of social communication deficits and restricted/repetitive behaviors. Investigating the etiological process and identifying an appropriate therapeutic target remain as formidable challenges to overcome ASD due to numerous risk factors and complex symptoms associated with the disorder. Among the various mechanisms that contribute to ASD, the maintenance of excitation and inhibition balance emerged as a key factor to regulate proper functioning of neuronal circuitry. Interestingly, our previous study involving the valproic acid animal model of autism (VPA animal model) has demonstrated excitatory-inhibitory imbalance (E/I imbalance) due to enhanced differentiation of glutamatergic neurons and reduced GABAergic neurons. Here, we investigated the potential of agmatine, an endogenous NMDA receptor antagonist, as a novel therapeutic candidate in ameliorating ASD symptoms by modulating E/I imbalance using the VPA animal model. We observed that a single treatment of agmatine rescued the impaired social behaviors as well as hyperactive and repetitive behaviors in the VPA animal model. We also observed that agmatine treatment rescued the overly activated ERK1/2 signaling in the prefrontal cortex and hippocampus of VPA animal models, possibly, by modulating over-excitability due to enhanced excitatory neural circuit. Taken together, our results have provided experimental evidence suggesting a possible therapeutic role of agmatine in ameliorating ASD-like symptoms in the VPA animal model of ASD.
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8. Wang L, Almeida LE, Nettleton M, Khaibullina A, Albani S, Kamimura S, Nouraie M, Quezado ZM. {{Altered nocifensive behavior in animal models of autism spectrum disorder: The role of the nicotinic cholinergic system}}. {Neuropharmacology};2016 (Sep 13)
Caretakers and clinicians alike have long recognized that individuals with autism spectrum disorder (ASD) can have altered sensory processing, which can contribute to its core symptoms. However, the pathobiology of sensory alterations in ASD is poorly understood. Here we examined nocifensive behavior in ASD mouse models, the BTBR T+Itpr3tf/J (BTBR) and the fragile-X mental retardation-1 knockout (Fmr1-KO) mice. We also examined the effects of nicotine on nocifensive behavior given that nicotine, a nicotinic cholinergic receptor (nAChR) agonist that has antinociceptive effects and was shown to improve social deficits and decrease repetitive behaviors in BTBR mice. Compared to respective controls, both BTBR and Fmr1-KO had hyporesponsiveness to noxious thermal stimuli and electrical stimulation of C-sensory fibers, normal responsiveness to electrical stimulation of Abeta- and Adelta-fiber, and hyperresponsiveness to visceral pain after acetic acid intraperitoneal injection. In BTBR, nicotine at lower doses increased, whereas at higher doses, it decreased hotplate latency compared to vehicle. In a significantly different effect pattern, in control mice, nicotine had antinociceptive effects to noxious heat only at the high dose. Interestingly, these nocifensive behavior alterations and differential responses to nicotine antinociceptive effects in BTBR mice were associated with significant downregulation of alpha3, alpha4, alpha5, alpha7, beta2, beta3, and beta4 nAChR subunits in several cerebral regions both, during embryonic development and adulthood. Taken together, these findings further implicate nAChRs in behaviors alterations in the BTBR model and lend support to the hypothesis that nAChRs may be a target for treatment of behavior deficits and sensory dysfunction in ASD.
