1. Chiang CH, Chu CL, Lee TC. {{Efficacy of caregiver-mediated joint engagement intervention for young children with autism spectrum disorders}}. {Autism};2015 (Apr 20)
Joint attention intervention for children with autism spectrum disorders was focused on improving joint engagement and joint attention skills. The purpose of this study was to develop a caregiver-mediated joint engagement intervention program combined with body movement play to investigate the effects of joint engagement/joint attention skills in young children with autism spectrum disorders. A quasi-experimental research design was conducted. A total of 34 young children with autism spectrum disorders aged 2-4 years were separated into an intervention and a control group. The program consisted of 20 sessions, 60 min per session, twice a week, for the target child and his or her parent. The results indicated that child-initiated supportive and coordinated joint engagement was greater for the intervention group compared with the control group at 3-month follow-up. This demonstrated that our joint engagement intervention could enhance joint engagement, especially coordinated joint engagement for young children with autism spectrum disorders. The limitations of the study and future directions were discussed.
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2. Erbetta A, Bulgheroni S, Contarino VE, Chiapparini L, Esposito S, Annunziata S, Riva D. {{Low-Functioning Autism and Nonsyndromic Intellectual Disability: Magnetic Resonance Imaging (MRI) Findings}}. {J Child Neurol};2015 (Apr 20)
Previous neuroradiologic studies reported a high incidence of abnormalities in low-functioning autistic children. In this population, it is difficult to know which abnormality depends on autism itself and which is related to intellectual disability associated with autism. The aim of this study was to evaluate the frequency of neuroradiologic abnormalities in low-functioning autistic children compared to Intellectual Quotient and age-matched nonsyndromic children, using the same set of magnetic resonance imaging (MRI) sequences. MRI was rated as abnormal in 44% of autistic and 54% of children with intellectual disability. The main results were mega cisterna magna in autism and hypoplastic corpus callosum in intellectual disability. These abnormalities are morphologically visible signs of altered brain development. These findings, more frequent than expected, are not specific to the 2 conditions. Although MRI cannot be considered mandatory, it allows an in-depth clinical assessment in nonsyndromic intellectual-disabled and autistic children.
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3. Eshraghi AA, Nazarian R, Telischi FF, Martinez D, Hodges A, Velandia S, Cejas-Cruz I, Balkany TJ, Lo K, Lang D. {{Cochlear Implantation in Children With Autism Spectrum Disorder}}. {Otol Neurotol};2015 (Apr 20)
OBJECTIVE: To assess the outcome of cochlear implantation in children with autism spectrum disorder (ASD). STUDY DESIGN: Retrospective case review and survey. SETTING: Tertiary referral center. PATIENTS: Children who meet criteria for cochlear implantation and diagnosis of ASD. MAIN OUTCOME MEASURES: Receptive and expressive language scores and parental survey data. RESULTS: Fifteen patients with history of ASD and cochlear implantation were analyzed and compared with 15 patients who received cochlear implant and have no other disability. Postoperatively, more than 67% of children with ASD significantly improved their speech perception skills, and 60% significantly improved their speech expression skills, whereas all patients in the control group showed significant improvement in both aspects. The top 3 reported improvements after cochlear implantation were name recognition, response to verbal requests, and enjoyment of music. Of all behavioral aspects, the use of eye contact was the least improved. Survey results in regard to improvements in patient interaction were more subtle when compared with those related to sound and speech perception. The most improved aspects in the ASD patients’ lives after cochlear implantation seemed to be attending to other people’s requests and conforming to family routines. Of note, awareness of the child’s environment is the most highly ranked improvement attributed to the cochlear implant. CONCLUSION: Cochlear implants are effective and beneficial for hearing impaired members of the ASD population, although development of language may lag behind that of implanted children with no additional disabilities. Significant speech perception and overall behavior improvement are noted.
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4. Hara Y, Takuma K, Takano E, Katashiba K, Taruta A, Higashino K, Hashimoto H, Ago Y, Matsuda T. {{Reduced prefrontal dopaminergic activity in valproic acid-treated mouse autism model}}. {Behav Brain Res};2015 (Apr 20)
Previous studies suggest that dysfunction of neurotransmitter systems is associated with the pathology of autism in humans and the disease model rodents, but the precise mechanism is not known. Rodent offspring exposed prenatally to VPA shows autism-related behavioral abnormalities. The present study examined the effect of prenatal VPA exposure on brain monoamine neurotransmitter systems in male and female mice. The prenatal VPA exposure did not affect the levels of dopamine (DA), noradrenaline (NA), serotonin (5-HT) and their metabolites in the prefrontal cortex and striatum, while it significantly reduced methamphetamine (METH) (1.0mg/kg)-induced hyperlocomotion in male offspring. In vivo microdialysis study demonstrated that prenatal VPA exposure attenuated METH-induced increases in extracellular DA levels in the prefrontal cortex, while it did not affect those in extracellular NA and 5-HT levels. Prenatal VPA exposure also decreased METH-induced c-Fos expression in the prefrontal cortex and the mRNA levels of DA D1 and D2 receptors in the prefrontal cortex. These effects of VPA were not observed in the striatum. In contrast to male offspring, prenatal VPA exposure did not affect METH-induced increase in locomotor activity and prefrontal DA levels and the D1 and D2 receptor mRNA levels in the prefrontal cortex in female offspring. These findings suggest that prenatal VPA exposure causes hypofunction of prefrontal DA system in a sex-dependent way.
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5. Hepburn SL, Blakeley-Smith A, Wolff B, Reaven JA. {{Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study}}. {Autism};2015 (Apr 20)
Youth with autism spectrum disorders frequently experience significant symptoms of anxiety. Empirically supported psychosocial interventions exist, yet access is limited, especially for families in rural areas. Telehealth (i.e. videoconferencing) has potential to reduce barriers to access to care; however, little is known about the feasibility or efficacy of directly intervening with youth with autism spectrum disorders through this modality. This study details the pilot testing of a telehealth version of an empirically supported intervention targeting anxiety in youth with autism spectrum disorders. The primary focus of this study is on feasibility, with evaluation of outcomes as a starting point for future randomized trials. In all, 33 families of youth with autism spectrum disorders and significant anxiety symptoms participated in this study (Telehealth Facing Your Fears (FYF) Intervention: n = 17; Wait-list control: n = 16). Youth of all functioning levels were included. Acceptability was strong; however, the usability of the technology was problematic for some families and impeded some sessions significantly. Fidelity of the telehealth version to the critical elements of the original, in vivo version was excellent. More work is needed to improve delivery of exposure practices and parent coaching. Preliminary efficacy analyses are promising, with improvements observed in youth anxiety over time (relative to a comparison group waiting for live intervention) and parent sense of competence (within group). Clearly, stronger designs are necessary to evaluate efficacy sufficiently; however, this study does provide support for further investigation of clinic-to-home videoconferencing as a direct intervention tool for youth with autism spectrum disorders and their parents.
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6. Kocher CP, Howard MR, Fienup DM. {{The Effects of Work-Reinforcer Schedules on Skill Acquisition for Children With Autism}}. {Behav Modif};2015 (Apr 20)
This study evaluated the effects of continuous and discontinuous work-reinforcer schedule arrangements on skill acquisition for three students with autism. Participants were initially exposed to both schedules in an alternating schedules condition where they were taught different but equivalent skills for each schedule. In the discontinuous schedule condition, participants completed work in small increments to gain access to a reinforcer for short periods of time. In the continuous schedule condition, participants completed larger increments of work to gain longer access to a reinforcer. Results showed that two participants mastered the target responses with both schedules and the third participant only met mastery criterion with the continuous schedule. Preference for schedules varied across participants. Session duration was consistently shorter during the continuous work-reinforcer schedule, suggesting that continuous work-reinforcer schedules are more efficient. Participants engaged with the reinforcer less when provided longer access, suggesting that reinforcer access might be reduced with continuous schedules for further efficiency gains.
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7. Koufaris C, Sismani C. {{Modulation of the Genome and Epigenome of Individuals Susceptible to Autism by Environmental Risk Factors}}. {Int J Mol Sci};2015;16(4):8699-8718.
Diverse environmental factors have been implicated with the development of autism spectrum disorders (ASD). Genetic factors also underlie the differential vulnerability to environmental risk factors of susceptible individuals. Currently the way in which environmental risk factors interact with genetic factors to increase the incidence of ASD is not well understood. A greater understanding of the metabolic, cellular, and biochemical events involved in gene x environment interactions in ASD would have important implications for the prevention and possible treatment of the disorder. In this review we discuss various established and more alternative processes through which environmental factors implicated in ASD can modulate the genome and epigenome of genetically-susceptible individuals.
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8. Neul JL, Glaze DG, Percy AK, Feyma T, Beisang A, Dinh T, Suter B, Anagnostou E, Snape M, Horrigan J, Jones NE. {{Improving Treatment Trial Outcomes for Rett Syndrome: The Development of Rett-specific Anchors for the Clinical Global Impression Scale}}. {J Child Neurol};2015 (Apr 20)
Rett syndrome is a genetically based neurodevelopmental disorder. Although the clinical consequences of Rett syndrome are profound and lifelong, currently no approved drug treatments are available specifically targeted to Rett symptoms. High quality outcome measures, specific to the core symptoms of a disorder are a critical component of well-designed clinical trials for individuals with neurodevelopmental disorders. The Clinical Global Impression Scale is a measure of global clinical change with strong face validity that has been widely used as an outcome measure in clinical trials of central nervous system disorders. Despite its favorable assay sensitivity in clinical trials, as a global measure, the Clinical Global Impression Scale is not specific to the signs and symptoms of the disorder under study. Development of key anchors for the scale, specific to the disorder being assessed, holds promise for enhancing the validity and reliability of the measure for disorders such as Rett syndrome.
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9. Nguyen CT, Fairclough DL, Noll RB. {{Problem-solving skills training for mothers of children recently diagnosed with autism spectrum disorder: A pilot feasibility study}}. {Autism};2015 (Apr 20)
Problem-solving skills training is an intervention designed to teach coping skills that has shown to decrease negative affectivity (depressive symptoms, negative mood, and post-traumatic stress symptoms) in mothers of children with cancer. The objective of this study was to see whether mothers of children recently diagnosed with autism spectrum disorder would be receptive to receiving problem-solving skills training (feasibility trial). Participants were recruited from a local outpatient developmental clinic that is part of a university department of pediatrics. Participants were to receive eight 1-h sessions of problem-solving skills training and were asked to complete assessments prior to beginning problem-solving skills training (T1), immediately after intervention (T2), and 3 months after T2 (T3). Outcome measures assessed problem-solving skills and negative affectivity (i.e. distress). In total, 30 mothers were approached and 24 agreed to participate (80.0%). Of them, 17 mothers completed problem-solving skills training (retention rate: 70.8%). Mothers of children with autism spectrum disorder who completed problem-solving skills training had significant decreases in negative affectivity and increases in problem-solving skills. A comparison to mothers of children with cancer shows that mothers of children with autism spectrum disorder displayed similar levels of depressive symptoms but less negative mood and fewer symptoms of post-traumatic stress. Data suggest that problem-solving skills training may be an effective way to alleviate distress in mothers of children recently diagnosed with autism spectrum disorder. Data also suggest that mothers of children with autism spectrum disorder were moderately receptive to receiving problem-solving skills training. Implications are that problem-solving skills training may be beneficial to parents of children with autism spectrum disorder; modifications to improve retention rates are suggested.
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10. Swineford LB, Guthrie W, Thurm A. {{Convergent and Divergent Validity of the Mullen Scales of Early Learning in Young Children With and Without Autism Spectrum Disorder}}. {Psychol Assess};2015 (Apr 20)
The purpose of this study was to report on the construct, convergent, and divergent validity of the Mullen Scales of Early Learning (MSEL), a widely used test of development for young children. The sample consisted of 399 children with a mean age of 3.38 years (SD = 1.14) divided into a group of children with autism spectrum disorder (ASD) and a group of children not on the autism spectrum, with and without developmental delays. The study used the MSEL and several other measures assessing constructs relevant to the age range-including developmental skills, autism symptoms, and psychopathology symptoms-across multiple methods of assessment. Multiple-group confirmatory factor analyses revealed good overall fit and equal form of the MSEL 1-factor model across the ASD and nonspectrum groups, supporting the construct validity of the MSEL. However, neither full nor partial invariance of factor loadings was established because of the lower loadings in the ASD group compared with the nonspectrum group. Exploratory structural equation modeling revealed that other measures of developmental skills loaded together with the MSEL domain scores on a Developmental Functioning factor, supporting convergent validity of the MSEL. Divergent validity was supported by the lack of loading of MSEL domain scores on Autism Symptoms or Emotion/Behavior Problems factors. Although factor structure and loadings varied across groups, convergent and divergent validity findings were similar in the ASD and nonspectrum samples. Together, these results demonstrate evidence for the construct, convergent, and divergent validity of the MSEL using powerful data-analytic techniques. (PsycINFO Database Record
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11. van Steensel FJ, Bogels SM. {{CBT for Anxiety Disorders in Children With and Without Autism Spectrum Disorders}}. {J Consult Clin Psychol};2015 (Apr 20)
OBJECTIVE: The effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders in children with autism spectrum disorders (ASD) was examined, and compared with children without ASD. METHOD: Children with ASD and comorbid anxiety disorders (n = 79, 58 boys; Mage = 11.76) and children with anxiety disorders (n = 95, 46 boys; Mage = 12.85), and their parents, participated. All families were referred to 1 of 7 mental health care centers and received the same CBT. Anxiety, quality of life, ASD-like behaviors, and emotional-behavioral problems were measured at waitlist (ASD-group only, n = 17), pretest, posttest, and 3 months, 1 year, and 2 years after CBT. RESULTS: CBT was more effective than waitlist for treating anxiety disorders (d = -1.45) and anxiety symptoms (d = -0.48) in children with ASD. At 2 years follow-up, 61% of the children with and 64% without ASD were free of their primary anxiety disorder (percentages not significantly different). The decrease in severity of anxiety disorders after CBT (d values ranging between -1.05 and -1.46) was not different for children with and without ASD. Improvements were less in children with ASD for (only) 2 out of 7 continuous outcomes measures: anxiety symptoms (d values ranging between -0.68 and -0.94 vs. d values ranging between -0.98 and -1.25) and quality of life (d values ranging between 0.39 and 0.56 vs. d values ranging between 0.77 and 0.98). CONCLUSIONS: CBT for anxiety disorders is effective for children with ASD, also in the long-term. Treatment gains may be somewhat less compared with children without ASD. (PsycINFO Database Record
