1. Barrett B, Byford S, Sharac J, Hudry K, Leadbitter K, Temple K, Aldred C, Slonims V, Green J. {{Service and Wider Societal Costs of Very Young Children with Autism in the UK}}. {J Autism Dev Disord};2011 (Nov 17)
Autism spectrum disorders (ASD) are associated with a substantial economic burden, but there is little evidence of the costs in the early years; the period in which children are increasingly likely to be diagnosed. We describe the services used by 152 children aged 24-60 months with autism, report family out-of-pocket expenses and productivity losses, and explore the relationship between family characteristics and costs. Children received a wide range of hospital and community services including relatively high levels of contact with speech and language therapists and paediatricians. Total service costs varied greatly (mean pound430 per month; range pound53 to pound1,116), with some families receiving little statutory support. Higher costs were associated with increasing age and symptom severity.
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2. Dannemiller L, Hymes L. {{Commentary on « predictors of standardized walking obstacle course outcome measures in children with and without developmental disabilities »}}. {Pediatr Phys Ther};2011 (Winter);23(4):374.
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3. Huang YP, St John W, Tsai SW, Chen HJ. {{Taiwanese fathers’ experiences of having their child diagnosed with a developmental disability}}. {J Nurs Res};2011 (Dec);19(4):239-249.
BACKGROUND: : Receiving a diagnosis of a developmental disability in a child can be a crisis event for parents. Gender differences in parental roles are worth considering when exploring the impact of having a child with a disability. However, most studies on this topic have focused on the mother’s experience, and little is known about what the father goes through as the parent of a child diagnosed with a disability. Even less is known regarding this experience in the context of the Chinese culture. PURPOSE: : The goal of this study was to explore fathers’ experiences of having a child diagnosed with a developmental disability in a Chinese cultural context. METHODS: : This study used a hermeneutic phenomenological approach informed by the philosophical world views of Heidegger. The 16 fathers who participated in the study were purposively sampled from a teaching hospital in central Taiwan. Data were collected using in-depth and semistructured interviews and were analyzed using hermeneutic analysis. RESULTS: : Data analysis revealed four shared meanings: losing hope, feelings of failure, being frustrated with family conflicts, and searching for positive coping strategies. CONCLUSIONS/IMPLICATIONS FOR PRACTICE:: Fathers feel shock and despair as well as personally devalued when learning that their child has been diagnosed with a developmental disability. Chinese cultural beliefs and values can elicit different experiences for fathers while helping them make sense of their experiences and accept their child in meaningful ways. Nurses can actively engage fathers as well as mothers to understand their feelings and thoughts about their child’s disability to provide appropriate emotional and informational support. Providing support or referral is necessary particularly when fathers encounter issues with the child’s grandparents. Nurses can assist fathers to find a way to make sense of having a child with a disability within their cultural frame of reference by adapting cultural beliefs and values to their situation and to make meaning of their child’s life.
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4. Kataoka S, Takuma K, Hara Y, Maeda Y, Ago Y, Matsuda T. {{Autism-like behaviours with transient histone hyperacetylation in mice treated prenatally with valproic acid}}. {Int J Neuropsychopharmacol};2011 (Nov 18):1-13.
Maternal use of valproic acid (VPA) during pregnancy has been implicated in the aetiology of autism spectrum disorders in children, and rodents prenatally exposed to VPA showed behavioural alterations similar to those observed in humans with autism. However, the exact mechanism for VPA-induced behavioural alterations is not known. To study this point, we examined the effects of prenatal exposure to VPA and valpromide, a VPA analog lacking histone deacetylase inhibition activity, on behaviours, cortical pathology and histone acetylation levels in mice. Mice exposed to VPA at embryonic day 12.5 (E12.5), but not at E9 and E14.5, displayed social interaction deficits, anxiety-like behaviour and memory deficits at age 4-8 wk. In contrast to male mice, the social interaction deficits (a decrease in sniffing behaviour) were not observed in female mice at age 8 wk. The exposure to VPA at E12.5 decreased the number of Nissl-positive cells in the middle and lower layers of the prefrontal cortex and in the lower layers of the somatosensory cortex at age 8 wk. Furthermore, VPA exposure caused a transient increase in acetylated histone levels in the embryonic brain, followed by an increase in apoptotic cell death in the neocortex and a decrease in cell proliferation in the ganglionic eminence. In contrast, prenatal exposure to valpromide at E12.5 did not affect the behavioural, biochemical and histological parameters. Furthermore, these findings suggest that VPA-induced histone hyperacetylation plays a key role in cortical pathology and abnormal autism-like behaviours in mice.
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5. Kott KM, Held SL, Giles EF, Franjoine MR. {{Predictors of standardized walking obstacle course outcome measures in children with and without developmental disabilities}}. {Pediatr Phys Ther};2011 (Winter);23(4):365-373.
PURPOSE: : This study was designed to determine which characteristics of children predict measures on the Standardized Walking Obstacle Course (SWOC). METHODS: : SWOC testing was performed under 3 conditions: (1) walk, (2) walk with a tray, and (3) walk wearing shaded glasses. Trials consisted of standing up, walking the course in 1 direction, and sitting down. Children (n = 440) completed 2 trials per condition. Trial measures included time, and numbers of steps, stumbles, and steps off the path. Relationships were evaluated using Chi-square analyses and significant predictors were determined by multiple logistic regression analyses. Sensitivity and specificity were calculated to determine the accuracy of disability as a predictor. RESULTS: : Age, weight, and disability were the strongest predictors (P < .05). Increased age and weight predicted shorter time and fewest steps. Disability predicts longer time and most steps. CONCLUSION: : The SWOC is appropriate to screen children for disabilities in functional ambulation.
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6. McGrew SG, Peters BR, Crittendon JA, Veenstra-Vanderweele J. {{Diagnostic Yield of Chromosomal Microarray Analysis in an Autism Primary Care Practice: Which Guidelines to Implement?}}. {J Autism Dev Disord};2011 (Nov 17)
Genetic testing is recommended for patients with ASD; however specific recommendations vary by specialty. American Academy of Pediatrics and American Academy of Neurology guidelines recommend G-banded karyotype and Fragile X DNA. The American College of Medical Genetics recommends Chromosomal Microarray Analysis (CMA). We determined the yield of CMA (N = 85), karyotype (N = 119), and fragile X (N = 174) testing in a primary pediatrics autism practice. We found twenty (24%) patients with abnormal CMA results (eight were clinically significant), three abnormal karyotypes and one Fragile X syndrome. There was no relationship between CMA result and cognitive level, seizures, dysmorphology, congenital malformations or behavior. We conclude that CMA should be the clinical standard in all specialties for first tier genetic testing in ASD.
