1. Drmic IE, Aljunied M, Reaven J. {{Feasibility, Acceptability and Preliminary Treatment Outcomes in a School-Based CBT Intervention Program for Adolescents with ASD and Anxiety in Singapore}}. {J Autism Dev Disord};2017 (Jan 18)
Adolescents with autism spectrum disorder (ASD) are at high risk for anxiety difficulties and disorders. Clinic-based cognitive behavioral therapy (CBT) is effective; however, few published school-based CBT programs for youth with ASD exist. In this study, the Facing Your Fears CBT protocol was adapted for delivery and piloted within a school setting by non-clinicians, with culturally appropriate adaptations. 44 13-15 aged youth with ASD from 22 mainstream schools in Singapore participated. Feasibility, acceptability and preliminary treatment outcomes were examined. Decreases in youth and parent reported anxiety symptoms were reported. Staff and parents found the program useful. Stakeholder support was important for implementation. Initial findings reflect the importance of carefully bridging research-to-practice for youth with ASD and anxiety.
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2. Fluegge K. {{Re: « Worsening Psychosis After Fever of Unknown Origin in an Adolescent Boy with Autism » by Huynh et al. (J Child Adolesc Psychopharmacol 2013; 23:224-227)}}. {J Child Adolesc Psychopharmacol};2017 (Jan 19)
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3. Hull JV, Jacokes ZJ, Torgerson CM, Irimia A, Van Horn JD. {{Resting-State Functional Connectivity in Autism Spectrum Disorders: A Review}}. {Front Psychiatry};2016;7:205.
Ongoing debate exists within the resting-state functional MRI (fMRI) literature over how intrinsic connectivity is altered in the autistic brain, with reports of general over-connectivity, under-connectivity, and/or a combination of both. Classifying autism using brain connectivity is complicated by the heterogeneous nature of the condition, allowing for the possibility of widely variable connectivity patterns among individuals with the disorder. Further differences in reported results may be attributable to the age and sex of participants included, designs of the resting-state scan, and to the analysis technique used to evaluate the data. This review systematically examines the resting-state fMRI autism literature to date and compares studies in an attempt to draw overall conclusions that are presently challenging. We also propose future direction for rs-fMRI use to categorize individuals with autism spectrum disorder, serve as a possible diagnostic tool, and best utilize data-sharing initiatives.
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4. Jack A, Pelphrey KA. {{Annual Research Review: Understudied populations within the autism spectrum – current trends and future directions in neuroimaging research}}. {J Child Psychol Psychiatry};2017 (Jan 19)
BACKGROUND: Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions that vary in both etiology and phenotypic expression. Expressions of ASD characterized by a more severe phenotype, including autism with intellectual disability (ASD + ID), autism with a history of developmental regression (ASD + R), and minimally verbal autism (ASD + MV) are understudied generally, and especially in the domain of neuroimaging. However, neuroimaging methods are a potentially powerful tool for understanding the etiology of these ASD subtypes. SCOPE AND METHODOLOGY: This review evaluates existing neuroimaging research on ASD + MV, ASD + ID, and ASD + R, identified by a search of the literature using the PubMed database, and discusses methodological, theoretical, and practical considerations for future research involving neuroimaging assessment of these populations. FINDINGS: There is a paucity of neuroimaging research on ASD + ID, ASD + MV, and ASD + R, and what findings do exist are often contradictory, or so sparse as to be ungeneralizable. We suggest that while greater sample sizes and more studies are necessary, more important would be a paradigm shift toward multimodal (e.g. imaging genetics) approaches that allow for the characterization of heterogeneity within etiologically diverse samples.
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5. Johnson KA, Vladescu JC, Kodak T, Sidener TM. {{An assessment of differential reinforment procedures for learners with autism spectrum disorder}}. {J Appl Behav Anal};2017 (Jan 19)
Differential reinforcement procedures may promote unprompted correct responding, resulting in a quicker transfer of stimulus control than nondifferential reinforcement. Recent studies that have compared reinforcement arrangements have found that the most effective arrangement may differ across participants. The current study conducted an assessment of differential reinforcement arrangements (i.e., quality, schedule, and magnitude) and nondifferential reinforcement to identify the most effective arrangement for each participant. The assessment phase showed that the quality arrangement was the most efficient for all participants during auditory-visual matching. Next, a validation phase was conducted to evaluate whether the assessment would predict the most effective arrangement across multiple skills. The results from the assessment phase were validated for all participants for the same skill. However, the results were only validated for one participant during the other skills (i.e., tact and intraverbal). The results are discussed in light of previous research and future areas of research.
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6. Melogno S, Pinto MA, Orsolini M. {{Novel Metaphors Comprehension in a Child with High-Functioning Autism Spectrum Disorder: A Study on Assessment and Treatment}}. {Front Psychol};2016;7:2004.
Until the first decade of the current millennium, the literature on metaphor comprehension highlighted typical difficulties in children with high-functioning Autism Spectrum Disorder (ASD). More recently, some scholars have devised special programs for enhancing the capability of understanding metaphors in these children. This article presents a case study based on a treatment aiming at enhancing novel metaphor comprehension in a high-functioning child with ASD. M.M., a pseudoacronym for an 8;10 year-old boy, diagnosed with high-functioning ASD, was first assessed with a metaphor comprehension test. This testing (at time T0) highlighted a rigid refusal of metaphors and a marked tendency toward literal interpretation. A baseline treatment (8 sessions of 45-60 min each, twice a week) was implemented, based on a series of recognition, denomination and emotion comprehension activities. M.M.’s metaphor comprehension was assessed a second time (T1), followed by the experimental treatment (same duration and frequency as the first one), specifically focused on metaphor comprehension. Finally, a third assessment of metaphor comprehension took place (T2), followed by a last assessment 4 months later (follow-up, T3). The comparison between the performances at the metaphor comprehension test across the four assessments, from T0 to T3, showed that the baseline treatment produced no effect at all, whereas a significant improvement appeared at T2, just after the experimental treatment, later confirmed at the follow up. Both quantitative and qualitative results showed an evident improvement in the way M.M. handled the semantic issues posed by the metaphors of the test, in line with the strategies he was taught during the treatment.
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7. Mukherjee SB. {{Autism Spectrum Disorders – Diagnosis and Management}}. {Indian J Pediatr};2017 (Jan 19)
Autism Spectrum Disorder (ASD) is a neuro-developmental disorder commonly seen in children. It is characterized by age inappropriate, impaired social communication and the presence of stereotypic behavior. This disorder is hypothesized to result from cerebral dysfunction arising from a complex interaction between genetic, epigenetic and environmental factors. ASD should be suspected in children failing ASD specific screening tests, in the presence of red flags in social, language and/or play domains, in children with developmental or language delay, abnormal behavior, poor school performance or in those who are at high risk. Comprehensive assessment comprises of a step-wise approach that includes taking a detailed history, performing a holistic examination and observing the child closely in relation to play, social interaction and behavior. Diagnosis is established by application of the diagnostic criteria for ASD of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM V). The degree of severity, intellectual and language impairment and presence of other illnesses should be specified. Functional assessment identifies an individual’s strengths and weaknesses. All these are important to formulate a customized intervention plan along with the family. The goal is to build up skills enabling optimal and as far as possible normal functioning while simultaneously reducing maladaptive behavior. This is achieved by a multi-disciplinary team comprising of various personnel experienced in tackling issues in ASD related to their respective areas of expertise. Intervention is primarily non-pharmacological, based on behavioral modification strategies. Drugs are only indicated in the reduction of target symptoms refractory to behavioral intervention. Although there is no cure, timely and appropriate intervention can improve the quality of life significantly.
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8. Ng M, de Montigny JG, Ofner M, Do MT. {{Environmental factors associated with autism spectrum disorder: a scoping review for the years 2003-2013}}. {Health Promot Chronic Dis Prev Can};2017 (Jan);37(1):1-23.
INTRODUCTION: The number of children diagnosed with autism spectrum disorder (ASD) has been rapidly rising in the past decade. The etiology of this disorder, however, is largely unknown, although the environmental relative to the genetic contribution is substantial. We conducted a scoping review to comprehensively assess the current state of knowledge of the environmental factors present from preconception to early life associated with ASD, and to identify research gaps. METHODS: We searched electronic databases MEDLINE, PsycINFO and ERIC for articles on potential risk factors or protective factors from the physical and social environments associated with ASD and its subclassifications published between 1 January, 2003, and 12 July, 2013. We categorized articles into broad themes: chemical, physiological, nutritional and social factors, based on environmental exposure. RESULTS: We identified over 50 000 publications, but after ineligible studies were screened out, 315 articles remained. Most of these studies examined physiological factors, followed closely by chemical factors, and to a much lesser extent, nutritional and social factors, associated with ASD. Despite a vast literature and many heterogeneous studies, several risk factors emerged consistently: chemical factors such as traffic-related air pollutants; physiological factors including advanced parental age, preterm birth, low birth weight, hyperbilirubinemia and clustering of pregnancy complications; and maternal immigrant status. Despite extensive research on vaccines, findings overwhelmingly demonstrate no support for an association with ASD. CONCLUSION: The lack of consistency, temporality and specificity of associations between environmental factors and ASD remains the largest barrier to establishing causal relationships. More robust research is required to resolve inconsistencies in the literature. Future research should explore underlying mechanisms of associations between the risk factors that we identified and ASD.
Publisher: INTRODUCTION: Le nombre d’enfants chez lesquels on diagnostique un trouble du spectre de l’autisme (TSA) grimpe rapidement depuis une decennie. L’etiologie de ce trouble est toutefois en grande partie inconnue, meme si la contribution de l’environnement est importante par rapport a celle de la genetique. Nous avons procede a une etude de delimitation pour evaluer en detail l’etat actuel des connaissances sur les facteurs environnementaux presents depuis le stade de la preconception jusqu’au debut de la vie que l’on associe au TSA et pour degager les lacunes de la recherche. METHODOLOGIE: Nous avons cherche dans les bases de donnees electroniques MEDLINE, PsycINFO et ERIC des articles portant sur des facteurs de risque potentiels ou des facteurs de protection des environnements physiques et sociaux associes au TSA et a ses sous-categories entre le 1er janvier 2003 et le 12 juillet 2013. Nous avons regroupe les articles en themes generaux en fonction de l’exposition environnementale : facteurs chimiques, physiologiques, nutritionnels et sociaux. RESULTATS: Nous avons trouve plus de 50 000 publications, mais apres elimination des etudes inadmissibles il est reste 315 articles. La plupart de ces etudes portaient sur les facteurs psychologiques, suivis de pres par les facteurs chimiques et, a un degre beaucoup moindre, les facteurs nutritionnels et sociaux associes au TSA. En depit d’une masse importante de publications et de nombreuses etudes heterogenes, quelques facteurs de risque se sont demarques regulierement : facteurs chimiques comme les polluants atmospheriques causes par la circulation; facteurs physiologiques, dont l’age avance des parents, les naissances prematurees, l’insuffisance de poids a la naissance, l’hyperbilirubinemie et les grappes de complications de la grossesse et enfin le statut de la mere vis-a-vis de l’immigration. En depit de recherches poussees sur les vaccins, les faits revelent de facon ecrasante que rien n’appuie l’existence d’un lien avec le TSA. CONCLUSION: Le manque d’uniformite, de temporalite et de specificite des liens entre les facteurs environnementaux et le TSA demeure l’obstacle le plus important dans l’etablissement de liens de cause a effet. Une recherche plus robuste s’impose pour supprimer le manque d’uniformite dans les publications. Les recherches futures devraient porter sur des mecanismes sous-jacents des liens entre facteurs de risque que nous avons identifies et le TSA.
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9. Stancliffe RJ, Anderson LL. {{Factors associated with meeting physical activity guidelines by adults with intellectual and developmental disabilities}}. {Res Dev Disabil};2017 (Jan 16);62:1-14.
BACKGROUND: Many individuals with intellectual and developmental disabilities (IDD) have sedentary lifestyles. AIMS: (a) compare adults with IDD with the general adult population on adherence to U.S. physical activity (PA) guidelines, and (b) determine what factors predict adherence to PA guidelines by adults with IDD. METHODS: We compared adults with IDD from the 2011-2012 National Core Indicators Adult Consumer Survey (NCI-ACS) with the general U.S. population on meeting PA guidelines. We examined the association of demographic, diagnostic, mobility, health and community participation variables with meeting PA guidelines by adults with IDD. RESULTS: The rate for adults with IDD meeting PA guidelines (13.5%) was less than half that of the general population (30.8%). Among adults with IDD, at-risk groups included those with more severe disability, Down syndrome, mobility impairments, obesity, poor health, mental illness, no independent access to community exercise, and less frequent participation in community exercise. Going out for exercise was the only form of community participation associated with meeting PA guidelines. People who accessed the community for exercise independently (i.e., alone) were more likely to meet PA guidelines. CONCLUSIONS: Interventions aimed at increasing PA for people with IDD should consider these factors in their design.
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10. Wang Y, Zhang YB, Liu LL, Cui JF, Wang J, Shum DH, van Amelsvoort T, Chan RC. {{A Meta-Analysis of Working Memory Impairments in Autism Spectrum Disorders}}. {Neuropsychol Rev};2017 (Jan 19)
Autism spectrum disorders (ASD) are characterized by executive dysfunction, and working memory (WM) comprises one core component of executive function. Many studies have investigated WM impairments in individuals with ASD, however, a conclusive agreement has not been reached. The present study provided a meta-analytic review of WM impairments in individuals with ASD and evaluated potential moderating variables of this problem. Twenty-eight studies were included in this study, and the participants comprised 819 individuals with ASD and 875 healthy controls. A significant WM impairment (Cohen’s d = -0.61) was identified in the individuals with ASD, however, this impairment was not associated with age. Results of moderation analyses showed that (a) spatial WM was more severely impaired than verbal WM and (b) the component of cognitive processing (maintenance vs. maintenance plus manipulation) did not affect the severity of WM impairments. These findings suggest that WM is impaired in individuals with ASD and may have implications for interventions related to WM impairments in these individuals.
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11. Whitehouse AJ, Cooper MN, Bebbington K, Alvares G, Lin A, Wray J, Glasson EJ. {{Evidence of a reduction over time in the behavioral severity of autistic disorder diagnoses}}. {Autism Res};2017 (Jan 19)
The increasing prevalence of Autism Spectrum Disorders (ASD) may in part be due to a shift in the diagnostic threshold that has led to individuals with a less severe behavioral phenotype receiving a clinical diagnosis. This study examined whether there were changes over time in the qualitative and quantitative phenotype of individuals who received the diagnosis of Autistic Disorder. Data were from a prospective register of new diagnoses in Western Australia (n = 1252). From 2000 to 2006, we examined differences in both the percentage of newly diagnosed cases that met each criterion as well as severity ratings of the behaviors observed (not met, partially met, mild/moderate and extreme). Linear regression determined there was a statistically significant reduction from 2000 to 2006 in the percentage of new diagnoses meeting two of 12 criteria. There was also a reduction across the study period in the proportion of new cases rated as having extreme severity on six criteria. There was a reduction in the proportion of individuals with three or more criteria rated as extreme from 2000 (16.0%) to 2006 (1.6%), while percentage of new cases with no « extreme » rating on any criteria increased from 58.5% to 86.6% across the same period. This study provides the first clear evidence of a reduction over time in the behavioral severity of individuals diagnosed with Autistic Disorder during a period of stability in diagnostic criteria. A shift toward diagnosing individuals with less severe behavioral symptoms may have contributed to the increasing prevalence of Autistic Disorder diagnoses. Autism Res 2017. (c) 2016 International Society for Autism Research, Wiley Periodicals, Inc.
