1. Friedman C. Moving home: Community transition supports for people with intellectual and developmental disabilities. Disability and health journal. 2022: 101419.

BACKGROUND: In recognition of the important role housing plays in people’s health and quality of life, Medicaid Home- and Community-Based Services (HCBS) programs are more frequently working to promote the housing security of Medicaid beneficiaries. One mechanism states use to promote housing security of people with intellectual and developmental disabilities (IDD) is to offer community transition services in their HCBS programs. Community transition services help with transition by assisting with securing housing and leases, obtaining basic furnishings, paying for utility setup, funding moving expenses, and making accessibility adaptations. OBJECTIVE: The aim of this study was to examine if and how states provided community transition services in their HCBS waiver programs for people with IDD. METHODS: We analyzed 107 fiscal year (FY) 2021 HCBS 1915(c) waivers for people with IDD from across the United States. We analyzed the service expenditures and utilization data for community transition services, including projected spending, projected number of users served, reimbursement rates, projected spending per participant, and annual service provision per participant. RESULTS: In FY2021, 49 waivers (45.8%) from 28 states provided community transition services to people with IDD. A total of $7.21 million of spending was projected for community transition services for 2405 people with IDD, with an average spending per person of $2303. CONCLUSIONS: While community transition services can help promote the housing insecurity of people with IDD, there was wide variance in how these services were allocated to people with IDD in FY2021.

Lien vers le texte intégral (Open Access ou abonnement)

2. Lee J, Clark PC, Spratling R. Transitioning a Research Protocol for Videosomnography to Assess Sleep and Nighttime Caregiving Activities in School-Aged Children With Developmental Disabilities During the COVID-19 Pandemic. Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners. 2022.

INTRODUCTION: The COVID-19 pandemic significantly affected children with developmental disabilities (DDs)’ sleep. Videosomnography is a noninvasive, portable time-lapse video recording system to objectively obtain a child’s sleep-wake behaviors and parents’ caregiving activities in a natural environment. METHOD: From September 2020 to February 2021, we conducted a feasibility study using actigraphy (in mothers) and videosomnography in children with DDs for seven consecutive nights to assess sleep and nighttime caregiving activities. Because of the pandemic, we developed and implemented alternative data collection strategies, such as delivering a « study package » with easy-to-follow written instructions and emailed video-recorded instructions on recording a child’s sleep. RESULTS: We aimed to enroll 10 mothers and 10 school-aged children with DDs and achieved this goal. Nine out of 10 mothers completed video recordings of their child’s sleep, with only 10% missing data for videosomnography. DISCUSSION: This paper shared adaptations to our videosomnography protocol and lessons learned.

Lien vers le texte intégral (Open Access ou abonnement)

3. Li F, Ke H, Wang S, Mao W, Fu C, Chen X, Fu Q, Qin X, Huang Y, Li B, Li S, Xing J, Wang M, Deng W. Leaky Gut Plays a Critical Role in the Pathophysiology of Autism in Mice by Activating the Lipopolysaccharide-Mediated Toll-Like Receptor 4-Myeloid Differentiation Factor 88-Nuclear Factor Kappa B Signaling Pathway. Neuroscience bulletin. 2022.

Increased intestinal barrier permeability, leaky gut, has been reported in patients with autism. However, its contribution to the development of autism has not been determined. We selected dextran sulfate sodium (DSS) to disrupt and metformin to repair the intestinal barrier in BTBR T(+)tf/J autistic mice to test this hypothesis. DSS treatment resulted in a decreased affinity for social proximity; however, autistic behaviors in mice were improved after the administration of metformin. We found an increased affinity for social proximity/social memory and decreased repetitive and anxiety-related behaviors. The concentration of lipopolysaccharides in blood decreased after the administration of metformin. The expression levels of the key molecules in the toll-like receptor 4 (TLR4)-myeloid differentiation factor 88 (MyD88)-nuclear factor kappa B (NF-κB) pathway and their downstream inflammatory cytokines in the cerebral cortex were both repressed. Thus, « leaky gut » could be a trigger for the development of autism via activation of the lipopolysaccharide-mediated TLR4-MyD88-NF-κB pathway.

Lien vers le texte intégral (Open Access ou abonnement)

4. McNally Keehn R, Enneking B, Ryan T, James C, Tang Q, Blewitt A, Tomlin A, Corona L, Wagner L. Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome. Autism : the international journal of research and practice. 2022: 13623613221138642.

The diagnosis of autism spectrum disorder (ASD) has traditionally been made through in-person evaluation. While the COVID-19 pandemic disrupted access to ASD services, there has been remarkable growth in research focused on novel ASD diagnostic practices, including the use of telemedicine. We implemented a standard ASD tele-assessment evaluation procedure, including use of a novel remote clinician-coached, caregiver-delivered ASD assessment tool (TELE-ASD-PEDS; TAP), with the goal of continuing to provide diagnostic services to young children and their families during the pandemic. We examined the relationship between child characteristics and diagnostic outcome for 335 children, ages 14-78 months, who received ASD tele-assessment conducted by psychologists and pediatricians in an outpatient clinic of a Midwestern academic medical center. We found that clinicians could make a determination about ASD diagnosis for most children (85%) evaluated using tele-assessment. Child clinical characteristics, including TAP scores and clinician ratings of ASD symptoms, were related to diagnostic outcome (i.e. diagnosis of ASD, no ASD, and Unsure about ASD). When all clinical characteristics were examined together, the presence of specific repetitive behaviors predicted ASD diagnosis. We also found that the TAP is effective for making an ASD diagnosis when used as part of comprehensive tele-assessment evaluation in children ⩾ 36 months of age with delayed language. Our study adds to an increasing body of research supporting use of tele-assessment for diagnosis of ASD. Although further research is needed, telemedicine may help families from different backgrounds and geographic locations to access high-quality diagnostic services.

Lien vers le texte intégral (Open Access ou abonnement)

5. Randeniya R, Vilares I, Mattingley JB, Garrido MI. Increased functional activity, bottom-up and intrinsic effective connectivity in autism. NeuroImage Clinical. 2022; 37: 103293.

Sensory perceptual alterations such as sensory sensitivities in autism have been proposed to be caused by differences in sensory observation (Likelihood) or in forming models of the environment (Prior), which result in an increase in bottom-up information flow relative to top-down control. To investigate this conjecture, we had autistic individuals (AS) and neurotypicals (NT) perform a decision-under-uncertainty paradigm while undergoing functional magnetic resonance imaging (fMRI). There were no group differences in task performance and in Prior and Likelihood representations in brain activity. However, there were significant group differences in overall task activity, with the AS group showing significantly greater activation in the bilateral precuneus, mid-occipital gyrus, cuneus, superior frontal gyrus (SFG) and left putamen relative to the NT group. Further, when pooling the data across both groups, we found that those with higher AQ scores showed greater activity in the left cuneus and precuneus. Effective connectivity analysis using dynamic causal modelling (DCM) revealed that group differences in BOLD signals were underpinned by increased activity within sensory regions and a net increase in bottom-up connectivity from the occipital region to the precuneus and the left SFG. These findings support the hypothesis of increased bottom-up information flow in autism during sensory learning tasks.

Lien vers le texte intégral (Open Access ou abonnement)

6. Smith JR, Hopkins CE, Xiong J, Luccarelli J, Shultz E, Vandekar S. Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis. Journal of autism and developmental disorders. 2022.

Autism spectrum disorder (ASD) and intellectual disability (ID) are heterogenous and prevalent conditions which may occur in isolation or as a co-morbidity. Psychiatric co-morbidity is common with limited treatment options. Preliminary research into electroconvulsive therapy (ECT) for these conditions has been encouraging. Thus, further research in this patient population is warranted. We conducted a 10-year retrospective review of the electronic medical record and identified intellectually capable individuals with ASD (IC-ASD), and those with ASD+ID or ID who received at least three ECT treatments. 32 patients were identified of which 30 (94%) experienced positive clinical response, defined as a clinical global impression-improvement (CGI-I) score of 3 or less. The average retrospective CGI-I score across all groups was 1.97, and results of a t-test performed on CGI-I scores indicated improvement across all groups [t = - 16.54, df = 31, p < 0.001, 95% CI = (1.72, 2.22)]. No significant adverse events were identified based on clinical documentation. Our findings further support previous ECT research in this patient population.

Lien vers le texte intégral (Open Access ou abonnement)

7. Viana CE, Bortolotto VC, Araujo SM, Dahleh MMM, Machado FR, de Souza Pereira A, Moreira de Oliveira BP, Leimann FV, Gonçalves OH, Prigol M, Guerra GP. Lutein-loaded nanoparticles reverse oxidative stress, apoptosis, and autism spectrum disorder-like behaviors induced by prenatal valproic acid exposure in female rats. Neurotoxicology. 2022; 94: 223-34.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction and repetitive behaviors. In this study, we assessed the effect of lutein-loaded nanoparticles on ASD-like behaviors induced by prenatal valproic acid (VPA) exposure in female offspring rats and the possible involvement of oxidative stress and apoptosis. Pregnant female Wistar rats received a single intraperitoneal injection of VPA (600 mg/kg), on the gestational day 12.5. The VPA-exposed female offspring rats were divided into two subgroups and received either lutein-loaded nanoparticles (5 mg/kg) or saline by oral gavage, for 14 days. The animals were submitted to the three-chamber test and open field to evaluate ASD-like behaviors. The hippocampus was removed for the determination of oxidative stress indicators (ROS; TBARS; SOD and Nrf2) and apoptosis biomarkers (Hsp-70; p38-MAPK; Bax and Bcl-2). The exposure to lutein-loaded nanoparticles reversed sociability deficit, social memory deficit, and anxiety-like and repetitive behaviors induced by VPA, and restored the oxidative stress indicators and apoptosis biomarkers in the hippocampus. This neurochemical effect must be associated with the reversal of ASD-like behaviors. These results provide evidence that lutein-loaded nanoparticles are an alternative treatment for VPA-induced behavioral damage in female rats and suggest the involvement of oxidative stress.

Lien vers le texte intégral (Open Access ou abonnement)

8. Yu R, Zhang M, Ahmed T, Wu Z, Lv L, Zhou G, Li B. Metabolic and Proteomic Profiles Reveal the Response of the ASD-Associated Resistant Strain 6-1 of Lactobacillus plantarum to Propionic Acid. International journal of environmental research and public health. 2022; 19(24).

Autism spectrum disorder (ASD) seriously affects children’s health. In our previous study, we isolated and identified a bacterium (Lactobacillus plantarum strain 6-1) that is resistant to propionic acid (PA), which has been reported to play a significant role in the formation of ASD. In order to elucidate the mechanism of the resistance to PA, this study investigated the change in the metabolic and proteomic profile of L. plantarum strain 6-1 in the presence and absence of PA. The results show that 967 and 1078 proteins were specifically identified in the absence and the presence of PA, respectively, while 616 proteins were found under both conditions. Gene ontology enrichment analysis of 130 differentially expressed proteins accumulated in the presence and absence of PA indicated that most of the proteins belong to biological processes, cellular components, and molecular functions. Pathway enrichment analysis showed a great reduction in the metabolic pathway-related proteins when this resistant bacterium was exposed to PA compared to the control. Furthermore, there was an obvious difference in protein-protein interaction networks in the presence and the absence of propionic acid. In addition, there was a change in the metabolic profile of L. plantarum strain 6-1 when this bacterium was exposed to PA compared to the control, while six peaks at 696.46, 1543.022, 1905.241, 2004.277, 2037.374, and 2069.348 m/z disappeared. Overall, the results could help us to understand the mechanism of the resistance of gut bacteria to PA, which will provide a new insight for us to use PA-resistant bacteria to prevent the development of ASD in children.

Lien vers le texte intégral (Open Access ou abonnement)