1. Akobirshoev I, Mitra M, Parish SL, Moore Simas TA, Dembo R, Ncube CN. {{Racial and ethnic disparities in birth outcomes and labour and delivery-related charges among women with intellectual and developmental disabilities}}. {J Intellect Disabil Res};2018 (Dec 21)
BACKGROUND: Women with intellectual and developmental disabilities (IDD) in the USA are bearing children at increasing rates. However, very little is known whether racial and ethnic disparities in birth outcomes and labour and delivery-related charges exist in this population. This study investigated racial and ethnic disparities in birth outcomes and labour and delivery-related charges among women with IDD. METHODS: The study employed secondary analysis of the 2004-2011 Healthcare Cost and Utilization Project National Inpatient Sample, the largest all-payer, publicly available US inpatient healthcare database. Hierarchical mixed-effect logistic and linear regression models were used to compare the study outcomes. RESULTS: We identified 2110 delivery-associated hospitalisations among women with IDD including 1275 among non-Hispanic White women, 527 among non-Hispanic Black women and 308 among Hispanic women. We found significant disparities in stillbirth among non-Hispanic Black and Hispanic women with IDD compared with their non-Hispanic White peers [odds ratio = 2.50, 95% confidence interval (CI): 1.16-5.28, P < 0.01 and odds ratio = 2.53, 95% CI: 1.08-5.92, P < 0.01, respectively]. There were no racial and ethnic disparities in caesarean delivery, preterm birth and small-for-gestational-age neonates among women with IDD. The average labour and delivery-related charges for non-Hispanic Black and Hispanic Women with IDD ($18 889 and $22 481, respectively) exceeded those for non-Hispanic White women with IDD ($14 886) by $4003 and $7595 or by 27% and 51%, respectively. The significant racial and ethnic differences in charges persisted even after controlling for a range of individual-level and institutional-level characteristics and were 6% (ln(beta) = 0.06, 95% CI: 0.01-0.11, P < 0.05) and 9% (ln(beta) = 0.09, 95% CI: 0.03-0.14, P < 0.01) higher for non-Hispanic Black and Hispanic Women with IDD compared with non-Hispanic White women with IDD. CONCLUSIONS: Our findings highlight the need for an integrated approach to the delivery of comprehensive perinatal services for racial and ethnic minority women with IDD to reduce their risk of having a stillbirth. Additionally, further research is needed to examine the causes of racial and ethnic disparities in hospital charges for labour and delivery admission among women with IDD and ascertain whether price discrimination exists based on patients' racial or ethnic identities. Lien vers le texte intégral (Open Access ou abonnement)
2. Black J, Barzy M, Williams D, Ferguson H. {{Intact counterfactual emotion processing in autism spectrum disorder: Evidence from eye-tracking}}. {Autism Res};2018 (Dec 21)
Counterfactual emotions, such as regret and relief, require an awareness of how things could have been different. We report a preregistered experiment that examines how adults with and without ASD process counterfactual emotions in real-time, based on research showing that the developmental trajectory of counterfactual thinking may be disrupted in people with ASD. Participants were eye-tracked as they read narratives in which a character made an explicit decision then subsequently experienced either a mildly negative or positive outcome. The final sentence in each story included an explicit remark about the character’s mood that was either consistent or inconsistent with the character’s expected feelings of regret or relief (e.g., « … she feels happy/annoyed about her decision. »). Results showed that adults with ASD are unimpaired in processing emotions based on counterfactual reasoning, and in fact showed earlier sensitivity to inconsistencies within relief contexts compared to TD participants. This finding highlights a previously unknown strength in empathy and emotion processing in adults with ASD, which may have been masked in previous research that has typically relied on explicit, response-based measures to record emotional inferences, which are likely to be susceptible to demand characteristics and response biases. Therefore, this study highlights the value of employing implicit measures that provide insights on peoples’ immediate responses to emotional content without disrupting ongoing processing. Autism Res 2018. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Despite known difficulties with empathy and perspective-taking, we found that adults with autism are unimpaired at inferring complex emotions (regret and relief) in others. This finding extends existing evidence showing dysfunctional counterfactual thinking in children with autism. We highlight the value of using implicit measures to identify strengths and abilities in ASD that may be masked by explicit tasks that require participants to interact socially or report their own thoughts.
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3. Bolte S, Girdler S, Marschik PB. {{The contribution of environmental exposure to the etiology of autism spectrum disorder}}. {Cell Mol Life Sci};2018 (Dec 20)
Autism spectrum disorder (ASD) is a neurodevelopmental condition of heterogeneous etiology. While it is widely recognized that genetic and environmental factors and their interactions contribute to autism phenotypes, their precise causal mechanisms remain poorly understood. This article reviews our current understanding of environmental risk factors of ASD and their presumed adverse physiological mechanisms. It comprehensively maps the significance of parental age, teratogenic compounds, perinatal risks, medication, smoking and alcohol use, nutrition, vaccination, toxic exposures, as well as the role of extreme psychosocial factors. Further, we consider the role of potential protective factors such as folate and fatty acid intake. Evidence indicates an increased offspring vulnerability to ASD through advanced maternal and paternal age, valproate intake, toxic chemical exposure, maternal diabetes, enhanced steroidogenic activity, immune activation, and possibly altered zinc-copper cycles and treatment with selective serotonin reuptake inhibitors. Epidemiological studies demonstrate no evidence for vaccination posing an autism risk. It is concluded that future research needs to consider categorical autism, broader autism phenotypes, as well as autistic traits, and examine more homogenous autism variants by subgroup stratification. Our understanding of autism etiology could be advanced by research aimed at disentangling the causal and non-causal environmental effects, both founding and moderating, and gene-environment interplay using twin studies, longitudinal and experimental designs. The specificity of many environmental risks for ASD remains unknown and control of multiple confounders has been limited. Further understanding of the critical windows of neurodevelopmental vulnerability and investigating the fit of multiple hit and cumulative risk models are likely promising approaches in enhancing the understanding of role of environmental factors in the etiology of ASD.
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4. Bottema-Beutel K, Kim SY, Crowley S. {{A systematic review and meta-regression analysis of social functioning correlates in autism and typical development}}. {Autism Res};2018 (Dec 21)
Differences in social functioning are a hallmark feature of autism spectrum disorder (ASD), and much research has been devoted to locating cognitive and developmental explanations for this domain. To sort through this literature, we conducted a systematic review and meta-analysis that quantifies the extent to which several of these candidate constructs are associated with social functioning. We gathered 881 effect sizes calculated from 133 unique participant samples, and synthesized Pearson’s r correlations between social functioning and three cognitive constructs; (a) theory of mind (ToM), (b) executive function, and (c) central coherence, and five developmental constructs: (d) initiating joint attention, (e) responding to joint attention, (f) imitation, (g) pretend play, and (h) visual fixation to social stimuli. We synthesized effect sizes using robust variance estimation for each putative correlate, for populations with ASD and typical development (TD) separately. We also conducted a series of meta-regressions to determine if sample and study features moderated effect sizes. We found that, in the ASD group, effect size estimates were significant and small (<0.30) for ToM, executive function, and initiating joint attention. Effect size estimates were significant and moderate (0.30 < r < 0.50) for imitation and response to joint attention. In the TD group, effect size estimates for ToM, executive function, and initiating joint attention were significant and small. In a meta-regression collapsed across correlates, we found that effect sizes were significantly larger in the ASD group (P < 0.05) and decreased as mental age increased (P < 0.001). Autism Res 2018. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this meta-analysis, we found that correlations between social functioning and several constructs used to explain the developmental or cognitive origins of social functioning were quite low. This could mean that researchers will need to develop new theories about social functioning in ASD. Lien vers le texte intégral (Open Access ou abonnement)
5. Chouinard PA, Royals KA, Landry O, Sperandio I. {{The Shepard Illusion Is Reduced in Children With an Autism Spectrum Disorder Because of Perceptual Rather Than Attentional Mechanisms}}. {Front Psychol};2018;9:2452.
Earlier studies demonstrate reduced illusion strength in the Shepard illusion in adults and adolescents with an autism spectrum disorder (ASD) and in typically developing (TD) adults with high levels of autistic traits. We measured the strength of the Shepard illusion in ASD and TD children and tested if ten different eye-tracking measurements could predict group differences in illusion strength. The ASD children demonstrated reduced illusion strength relative to the TD group. Despite this, there were no mean differences on any of the eye-tracking measurements between groups. Even though none of the eye-tracking measurements revealed mean differences between the two groups, the degree to which spatial attention was directed toward the standard stimulus, as indexed by the number of saccades within and toward this stimulus, predicted the strength of the illusion in the overall sample. Furthermore, this active scanning of the standard stimulus was found to enhance illusion strength more strongly in the ASD than the TD group. Together, we conclude that scan patterns and the degree to which participants are able to shift between different locations in a visual scene did not account for group differences in illusion strength. Thus, the reduced strength of the Shepard illusion in ASD does not appear to be driven by how attention shifts or is spatially allocated. Rather, differences may relate instead to perceptual mechanisms that integrate visual information. Strategies that may aid ASD individuals to see this illusion more strongly could have them make even more eye movements within and between the stimuli presented in the illusion display.
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6. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith C, Kaminski JW, Kenney MK, Peacock G. {{Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders and Poverty Among Children Aged 2-8 Years – United States, 2016}}. {MMWR Morb Mortal Wkly Rep};2018 (Dec 21);67(50):1377-1383.
Childhood mental, behavioral, and developmental disorders (MBDDs) are associated with adverse outcomes that can persist into adulthood (1,2). Pediatric clinical settings are important for identifying and treating MBDDs (3). Early identification and treatment of MBDDs can promote healthy development for all children (4), especially those living in poverty who are at increased risk for MBDDs (3,5) but might have reduced access to care (6). CDC analyzed data from the 2016 National Survey of Children’s Health (NSCH) on MBDDs, risk factors, and use of federal assistance programs (e.g., Supplemental Nutrition Assistance Program [SNAP]) to identify points to reach children in poverty. In line with previous research (3,6), compared with children in higher-income households, those in lower-income households more often had ever received a diagnosis of an MBDD (22.1% versus 13.9%), and less often had seen a health care provider in the previous year (80.4% versus 93.8%). Among children living below 200% of the federal poverty level (FPL) who did not see a health care provider in the previous year, seven of 10 were in families receiving at least one public assistance benefit. Public assistance programs might offer collaboration opportunities to provide families living in poverty with information, co-located screening programs or services, or connection to care.
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7. Dempsey EE, Smith IM, Flanagan HE, Duku E, Lawrence MA, Szatmari P, Zwaigenbaum L, Vaillancourt T, Volden J, Mirenda P, Wadell C, Georgiades S, Elsabbagh M, Ungar WJ, Bennett T. {{Psychometric Properties of the Merrill-Palmer-Revised Scales of Development in Preschool Children With Autism Spectrum Disorder}}. {Assessment};2018 (Dec 20):1073191118818754.
Psychometrically sound tests of intellectual ability are indispensable for research and assessment of children with autism spectrum disorder (ASD), yet few tests have been validated for use with this population. The Merrill-Palmer-Revised Scales of Development (M-P-R) is a standardized test of intellectual ability that was validated for use with typically developing preschoolers. The current study’s aim was to investigate the criterion validity of the M-P-R for assessing cognitive skills in preschoolers with ASD ( N = 180). Good concurrent validity was demonstrated, with a large positive correlation between the M-P-R Receptive Language domain and the PLS-4 Auditory Comprehension subscale. The Cognitive domain of the M-P-R showed a medium positive correlation with later WISC-4 scores, showing acceptable predictive validity. Cognitive strengths and weaknesses assessed using the M-P-R mirrored those described for other measures, with most children obtaining higher standard scores on the Cognitive than the Receptive Language domain. An exploratory factor analysis suggested that one factor accounted for the majority of variability in M-P-R domains.
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8. Diaz-Caneja CM, Schnack H, Martinez K, Santonja J, Aleman-Gomez Y, Pina-Camacho L, Moreno C, Fraguas D, Arango C, Parellada M, Janssen J. {{Neuroanatomical deficits shared by youth with autism spectrum disorders and psychotic disorders}}. {Hum Brain Mapp};2018 (Dec 19)
Autism spectrum disorders (ASD) and early-onset psychosis (EOP) are neurodevelopmental disorders that share genetic, clinical and cognitive facets; it is unclear if these disorders also share spatially overlapping cortical thickness (CT) and surface area (SA) abnormalities. MRI scans of 30 ASD, 29 patients with early-onset first-episode psychosis (EO-FEP) and 26 typically developing controls (TD) (age range 10-18 years) were analyzed by the FreeSurfer suite to calculate vertex-wise estimates of CT, SA, and cortical volume. Two publicly available datasets of ASD and EOP (age range 7-18 years and 5-17 years, respectively) were used for replication analysis. ASD and EO-FEP had spatially overlapping areas of cortical thinning and reduced SA in the bilateral insula (all p’s < .00002); 37% of all left insular vertices presenting with significant cortical thinning and 20% (left insula) and 61% (right insula) of insular vertices displaying decreased SA overlapped across both disorders. In both disorders, SA deficits contributed more to cortical volume decreases than reductions in CT did. This finding, as well as the novel finding of an absence of spatial overlap (for ASD) or marginal overlap (for EOP) of deficits in CT and SA, was replicated in the two nonoverlapping independent samples. The insula appears to be a region with transdiagnostic vulnerability for deficits in CT and SA. The finding of nonexistent or small spatial overlap between CT and SA deficits in young people with ASD and psychosis may point to the involvement of common aberrant early neurodevelopmental mechanisms in their pathophysiology. Lien vers le texte intégral (Open Access ou abonnement)
9. Edey R, Cook J, Brewer R, Bird G, Press C. {{Adults with autism spectrum disorder are sensitive to the kinematic features defining natural human motion}}. {Autism Res};2018 (Dec 21)
It has been hypothesized that individuals with Autism Spectrum Disorder (hereafter « autism ») have problems perceiving biological motion, which contributes to their social difficulties. However, the ability to perceive the kinematic profile characteristic of biological motion has not been systematically examined in autism. To examine this basic perceptual ability we conducted two experiments comparing adults with autism with matched typical adults. In Experiment 1, participants indicated whether two movements-which differed in the quantity of formula-generated biological motion-were the same or different. In Experiment 2, they judged which of two movements was « less natural, » where the stimuli varied in the degree to which they were a product of real movement data produced by autistic and typical models. There were no group differences in perceptual sensitivity in either experiment, with null effects supported by Bayesian analyses. The findings from these two experiments demonstrate that adults with autism are sensitive to the kinematic information defining biological motion to a typical degree-they are both able to detect the perceptual information in a same-different judgment, and as inclined to categorize biological motion derived from real models as natural. These findings therefore provide evidence against the hypothesis that individuals with autism exhibit low-level difficulties in perceiving the kinematics of others’ actions, suggesting that atypicalities arise either when integrating this kinematic information with other perceptual input, or in the interpretation of kinematic information. Autism Research 2018. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: It has previously been suggested that autistic children and adults have problems perceiving the detailed manner in which others move-that is, the subtle changes in speed as we move from point to point-which may impact on their ability to learn from, and about, others in a typical fashion. However, the results from the present two studies demonstrate that adults with autism can perceive this information, suggesting that atypicalities in processing others’ movement may arise mainly as a consequence of atypical interpretation rather than perception.
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10. Friedman C, Rizzolo MC, Spassiani NA. {{Self-management of health by people with intellectual and developmental disabilities}}. {J Appl Res Intellect Disabil};2018 (Dec 21)
BACKGROUND: Self-management of health includes people with intellectual and developmental disabilities (IDD) playing a key role in health management in collaborating with healthcare professionals. METHODS: This study analysed data from Personal Outcome Measures((R)) surveys (n = 1,341) to explore self-management of health. We had the following research questions: Who is most likely to be supported to self-manage their health? How does being supported to self-manage impact different areas of health? and How does being supported to self-manage impact other health-related organizational supports? RESULTS: Findings revealed the impact of self-management of health can be wide-ranging, regardless of impairment severity. When supported to self-manage their health, healthcare professionals were more likely to address healthcare issues, and interventions were more likely to be effective. CONCLUSIONS: Self-management represents a paradigm shift for people with IDD because it transforms people from passive recipients to active directors of their health.
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11. Guo M, Li L, Zhang Q, Chen L, Dai Y, Liu L, Feng J, Cai X, Cheng Q, Chen J, Wei H, Li T. {{Vitamin and mineral status of children with autism spectrum disorder in Hainan Province of China: associations with symptoms}}. {Nutr Neurosci};2018 (Dec 20):1-8.
OBJECTIVE: This study was designed to compare the vitamin and mineral levels of children with autism spectrum disorders (ASDs) with those of age-matched typically developing (TD) children and to investigate their effects on the symptoms of autistic children. METHODS: The Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS) and Gesell Developmental Scale (GDS) were completed for 274 children diagnosed with ASD. Vitamins and minerals were compared for all ASD children and 97 age-matched TD children. Serum levels of vitamin A (VA) were detected with high-performance liquid chromatography (HPLC); those of vitamin D (VD), folate, vitamin B12 (VB12), and ferritin were measured with immunoassay methods; and those of minerals were detected using atomic absorption spectrophotometry in two groups. RESULTS: The VD and folate levels of children with ASD were significantly lower than those of TD children. The levels of calcium (Ca), magnesium (Mg), iron (Fe), and zinc (Zn) in children with ASD were significantly lower than those in TD children, and no significant difference was found in copper (Cu) levels. Correlation analysis showed that VA and Ca levels were negatively correlated with ASD symptoms. Folate, Ca, Fe and Zn were positively correlated with the GDS scores of autistic children. There were no significant interactions among VD, VB12 and ferritin and symptoms. CONCLUSION: We found that children with autism had more vitamin and mineral insufficiencies than TD children, and their levels were related to ASD symptoms. Therefore, it is essential to formulate a detailed nutritional evaluation for ASD children and provide timely and intensive interventions.
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12. Hooyman A, Kayekjian D, Xiao R, Jiang C, Vanderbilt DL, Smith BA. {{Relationships between variance in electroencephalography relative power and developmental status in infants with typical development and at risk for developmental disability: An observational study}}. {Gates Open Res};2018 (Nov 15);2:47.
Background: Electroencephalography (EEG) is a non-invasive tool that has the potential to identify and quantify atypical brain development. We introduce a new measure here, variance of relative power of resting-state EEG. We sought to assess whether variance of relative power of resting-state EEG could predict i) classification of infants as typical development (TD) or at risk (AR) for developmental disability, and ii) Bayley developmental scores at the same visit or future visits. Methods: A total of 22 infants with TD participated, aged between 38 and 203 days. In addition, 11 infants broadly at risk participated (6 high-risk pre-term, 4 low-risk pre-term, 1 high-risk full-term), aged between 40 and 225 days of age (adjusted for prematurity). We used EEG to measure resting-state brain function across months. We calculated variance of relative power as the standard deviation of the relative power across each of the 32 EEG electrodes. The Bayley Scales of Infant Development (3 edition) was used to measure developmental level. Infants were measured 1-6 times each, with 1 month between measurements. Results: Our main findings were: i) variance of relative power of resting state EEG can predict classification of infants as TD or AR, and ii) variance of relative power of resting state EEG can predict Bayley developmental scores at the same visit (Bayley raw fine motor, Bayley raw cognitive, Bayley total raw score, Bayley motor composite score) and at a future visit (Bayley raw fine motor). Conclusions: This was a preliminary, exploratory, small study. Our results support variance of relative power of resting state EEG as an area of interest for future study as a biomarker of neurodevelopmental status and as a potential outcome measure for early intervention.
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13. Kratz HE, Stahmer A, Xie M, Marcus SC, Pellecchia M, Locke J, Beidas R, Mandell DS. {{The effect of implementation climate on program fidelity and student outcomes in autism support classrooms}}. {J Consult Clin Psychol};2018 (Dec 20)
OBJECTIVE: An organization’s implementation climate, or the extent to which use of an intervention is expected, supported, and rewarded by colleagues and supervisors, has been identified as critical to successful intervention implementation and outcomes. The effect of implementation climate has not been well studied in special education settings. The present study examines the association between teachers’ perceptions of implementation climate, teacher fidelity to a school-based program for students with autism, and student outcomes (measured as changes in IQ) over time. METHOD: Participants included 158 students from 45 classrooms and their teachers. Teachers provided a measure of implementation climate at the beginning of the academic year; program fidelity was measured monthly throughout the year. The main and interaction effects of perceived implementation climate and fidelity on student outcomes were examined using longitudinal nested linear models with random effects for classroom and student, controlling for important covariates. RESULTS: On average, IQ scores improved 2.2 points (SD = 8.7). There were no main effects of perceived implementation climate or fidelity on student outcomes; however, the interaction between perceived implementation climate and fidelity was associated with student outcomes (p < .05, d = 0.54). Among classrooms with a strong perceived implementation climate, higher fidelity was associated with better student outcomes. CONCLUSIONS: While preliminary and requiring replication, these findings suggest that perceived implementation climate and program fidelity each may be important but not sufficient for optimizing outcomes for students with autism. (PsycINFO Database Record (c) 2018 APA, all rights reserved). Lien vers le texte intégral (Open Access ou abonnement)
14. Lee GK, Shivers CM. {{Factors that affect the physical and mental health of caregivers of school-age children and transitioning young adults with autism spectrum disorder}}. {J Appl Res Intellect Disabil};2018 (Dec 21)
BACKGROUND: Although studies have examined quality of life (QOL) among family caregivers of individuals with autism spectrum disorder (ASD), little is known about potential differences in QOL based on the age of the individual with ASD, particularly in relation to caregivers’ needs, beliefs and coping mechanisms. METHOD: This study investigated 132 caregivers of school-age children and 61 caregivers of transitioning young adults with ASD on measures of caregiving, strain, coping, family needs and QOL. RESULTS: The results indicated that there were no significant differences in QOL based on the age of the individuals with ASD, although parents of children reported significantly more caregiving behaviours, with coping, internalized strain and health information needs predicted mental health QOL. DISCUSSION: Age of the individual with ASD was not significantly related to caregivers’ QOL. More research is needed to determine independent predictors of caregiver QOL across the lifespan.
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15. Li J, Xu L, Zheng X, Fu M, Zhou F, Xu X, Ma X, Li K, Kendrick KM, Becker B. {{Common and Dissociable Contributions of Alexithymia and Autism to Domain-Specific Interoceptive Dysregulations: A Dimensional Neuroimaging Approach}}. {Psychother Psychosom};2018 (Dec 21):1-3.
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16. Li N, Li L, Li G, Gai Z. {{The association of auditory integration training in children with autism spectrum disorders among Chinese: a meta-analysis}}. {Biosci Rep};2018 (Dec 21);38(6)
Randomized controlled trials (RCTs) have reported an inconsistent relationship about the auditory integration training (AIT) in children with autism spectrum disorders (ASD) among Chinese. The current study was to investigate the efficacy of AIT for children with ASD compared with those in control group by using meta-analysis. Relevant trials published were identified by an electronic search of PubMed, CENTRAL, EMBASE, WanFang, CNKI, and SinoMed databases up to December 31, 2017. Outcome of interest included childhood autism rating scale (CARS), autism behavior checklist (ABC), intelligence quotient (IQ), and autism treatment evaluation checklist (ATEC). Standardized mean difference (SMD) with 95% confidence intervals (CIs) was calculated using a random-effect model. Thirteen RCTs with 976 children with ASD were included for analysis. The pooled SMD showed that children with ASD had significantly lower ABC scores [summary SMD = -0.58, 95%CI = -0.79 to -0.38] and ATEC scores [summary SMD = -0.75, 95%CI = -1.05 to -0.45] in AIT group compared with that in control group. The analysis of pooled statistics put forward AIT could increase the IQ score when compared with that in control group [summary SMD = 0.59, 95%CI = 0.41-0.77]. A negative association was found about CARS scores between AIT group and control group. No publication bias was found and no single study had essential effect on the pooled results. In conclusions, AIT can reduce the score of ABC and ATEC and can increase the IQ score among children with ASD in Chinese. Therefore, it is recommended for Chinese children with ASD to receive AIT.
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17. Mellado-Cairet P, Harte C, Sejourne E, Robel L. {{Behavioural training and mirroring techniques to prepare elective anaesthesia in severe autistic spectrum disorder patients: an illustrative case and review}}. {Paediatr Anaesth};2018 (Dec 21)
Children with autistic spectrum disorder are more likely to become distressed during induction of anaesthesia. Inhalational induction is almost always the preferred route with acceptance of the face mask often presenting a considerable challenge. Tempering measures to facilitate gas induction such as forced premedication and physical restraint are no longer viable options except in extenuating circumstances. Recent research interest has focused on the need for advanced planning in collaboration with the caregiver to tailor an individualised perioperative plan. This plan may include both pharmacological and non pharmacological interventions. Applied behaviour analysis strategies have a well documented efficacy in this unique population to systematically change an individual’s usual behaviour. These can be used, as a non pharmacological strategy, to ensure a smooth perioperative course. We present a successful case of preoperative desensitisation of a child with severe autistic spectrum disorder using a mirror demonstration technique associated with positive reinforcement to prepare him for general anaesthesia. We discuss the potential application of applied behaviour analysis strategies for anaesthesia in this unique population. From a practical point of view, early communication with carers is required to establish who may benefit from this behavioural training. Planned individual preparation for general anaesthesia must be provided by trained multidisciplinary staff. This article is protected by copyright. All rights reserved.
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18. Molinaro ML, Rollo LE, Fletcher PC, Schneider MA. {{Having a Sibling with ASD: Perspectives of Siblings and Their Parents}}. {Compr Child Adolesc Nurs};2018 (Dec 21):1-13.
The overall purpose of this research was to explore the experiences of families living with a child with autism spectrum disorder (ASD). This paper reports the experiences of siblings of children with ASD, from the perspective of both siblings and parents. Using a phenomenological case study design, participants completed face sheets to provide context for one-on-one, semi-structured interviews, which were transcribed verbatim, and verified via member checks. Van Manen’s (1990) selective approach was used for data analysis. Siblings and parents described that the children with ASD made their siblings the targets of their aggression, and siblings spent less time with parents the children with ASD required more attention. It was also acknowledged that the siblings were more mature as a result of having a sibling with ASD. Families acknowledged that the relationship between children with ASD and their siblings would not differ if their children did not have ASD. This work highlights the importance of examining the family as a unit to provide a multifaceted perspective of how having a child with ASD affects their siblings.
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19. Papadopoulos C, Lodder A, Constantinou G, Randhawa G. {{Systematic Review of the Relationship Between Autism Stigma and Informal Caregiver Mental Health}}. {J Autism Dev Disord};2018 (Dec 19)
Families play a crucial role in determining the mental health of the autistic individual(s) they are caring for. However, the stigma associated with autism can impair caregiver health. To investigate this, empirical evidence pertaining to stigma’s impact on informal caregivers’ mental health was systematically reviewed. All twelve included studies (n = 1442 informal caregivers) consistently reported the impact of autism related stigma upon caregiver mental health to be significant, meaningful and complex. A new theoretical framework describing the relationship between stigma and caregiver mental health is constructed. Moderating variables include those both changeable through intervention (e.g. hopelessness, self-esteem, self-compassion) and not changeable (gender, culture, financial burden and time since diagnosis). Implications and recommendations for professionals, interventions and future research are proposed.
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20. Phillips KG, Houtenville AJ, Reichard A. {{Using all-payer claims data for health surveillance of people with intellectual and developmental disabilities}}. {J Intellect Disabil Res};2018 (Dec 21)
BACKGROUND: To address limitations and challenges associated with current health surveillance of people with intellectual and developmental disabilities (IDD), this study investigates the use of all-payer claims data to identify and characterise this population. METHOD: All-payer claims data from 2010 to 2014 were used to study people with IDD in New Hampshire. Starting with the Centers for Medicare and Medicaid Services’ algorithm, IDD was defined using ICD-9 diagnosis codes. Additional ICD-9 codes for developmental disabilities were included to build the knowledge base begun by recent research conducted on Medicaid claimants in five other states. RESULTS: Findings showed the enhanced algorithm offers a replicable and feasible way to conduct health surveillance of people with IDD at the state level. CONCLUSION: Substantive and significant differences between Medicaid and commercial claimants suggest that using all-payer claims provides a richer and more complete method for health surveillance of people with IDD.
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21. Safra L, Ioannou C, Amsellem F, Delorme R, Chevallier C. {{Author Correction: Distinct effects of social motivation on face evaluations in adolescents with and without autism}}. {Sci Rep};2018 (Dec 21);8(1):18077.
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
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22. Salehi P, Herzig L, Capone G, Lu A, Oron AP, Kim SJ. {{Comparison of Aberrant Behavior Checklist profiles across Prader-Willi syndrome, Down syndrome, and autism spectrum disorder}}. {Am J Med Genet A};2018 (Dec 21)
Prader-Willi syndrome (PWS, OMIM # 176270) and Down syndrome (DS, OMIM #190685) are neurodevelopmental genetic disorders with higher rates of autism spectrum disorder (ASD). The Aberrant Behavior Checklist (ABC) is a caregiver rating scale that assesses maladaptive behaviors. Overlapping symptoms exist between PWS, DS, and ASD, including maladaptive behaviors. We aimed to evaluate ABC profiles between PWS, DS, and ASD alone (without known genetic syndrome). In addition, we hypothesized PWS and DS with a comorbid ASD positive screen or diagnosis would have similar ABC profiles to ASD alone. ABC data from the following cohorts were analyzed: PWS (Seattle Children’s Hospital, n = 28, mean age = 12.8 +/- 4.9 years; University of Florida, n = 35, mean age = 9.3 +/- 7.1 years), DS (Johns Hopkins, n = 406, mean age = 8.1 +/- 2.4 years), and ASD (University of Florida, n = 102, mean age = 10.8 +/- 3.5 years). ASD alone had significantly higher ABC scores. Subgroups of PWS and DS with a comorbid ASD positive screen or diagnosis had similarities in scores with the ASD only group, with subscale patterns unique to each syndrome. The ABC indicated worse maladaptive behaviors in children with ASD, including those with genetic syndromes. Although more studies are needed to evaluate the utility and the accuracy of the ABC as a tool to screen for ASD in special populations, it may be a useful adjunct in screening those children with PWS or DS who need more in depth ASD evaluation.
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23. Sayad A, Akbari MT, Noroozi R, Omrani MD, Inoko H, Taheri M, Ghafouri-Fard S. {{Association of HLA alleles with autism}}. {Neuropsychiatr Dis Treat};2018;14:3259-3265.
Background: Autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders known by impaired social interaction and activities and abnormal repetitive behavior. As a multifactorial disorder, several genetic and immunological factors have been shown to be implicated in its pathogenesis. Methods: Among them are certain human leukocyte antigen (HLA) alleles. In the current study, we genotyped HLA-A, -B & DRB alleles in 103 Iranian ASD patients and 180 age, gender, and ethnic-matched healthy controls. Results: After Boferroni correction no allele or haplotype was associated with genetic susceptibility to ASD in Iranian population. Conclusion: Future studies are needed to assess contribution of immunological factors such as HLA alleles in ASD pathogenesis.
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24. Shankar R, Wilcock M, Oak K, McGowan P, Sheehan R. {{Stopping, rationalising or optimising antipsychotic drug treatment in people with intellectual disability and/or autism}}. {Drug Ther Bull};2019 (Jan);57(1):10-13.
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25. Sritharan B, Koola MM. {{Barriers faced by immigrant families of children with autism: A program to address the challenges}}. {Asian J Psychiatr};2018 (Dec 8);39:53-57.
Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by social, communication, and behavioral deficits. Fortunately, early intervention has proved to be of significant benefit in the lives of children with ASD. However, timely access to health services and support requires equitable access, which is often a challenge for immigrant families. Barriers to equal access and support for immigrant families of children with ASD include cultural beliefs about child development and ASD, delayed diagnosis, access to services, and negative perceptions of services. There is a shortage of studies that explore how to increase understanding and collaboration among the immigrant population and health care practitioners to address these barriers. The barriers can indeed be appropriately addressed with structured programs and cultural models. The objectives of this article are to shed light on how barriers impact outcomes of immigrant children with ASD and to describe a culturally sensitive program model to address the barriers and provide awareness, education, and interventions for these immigrant families. The South Asian Autism Awareness Center in Toronto, Canada is presented as an example of such a model.
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26. Vatsa N, Jana NR. {{UBE3A and Its Link With Autism}}. {Front Mol Neurosci};2018;11:448.
UBE3A is a dual function protein consisting of ubiquitin ligase as well as transcriptional co-activator function. UBE3A gene is imprinted in the brain with preferential maternal-specific expression particularly in the neuron and loss of activity of the maternally inherited UBE3A causes Angelman syndrome (AS), characterized by severe mental retardation, lack of speech, seizures and autistic features. Interestingly, duplication, triplication, or gain-of-function mutations in the UBE3A gene are also linked with autism clinically distinguished by social impairments and stereotyped behaviors. These findings indicate that the expression and activity of UBE3A must be tightly regulated during brain development and UBE3A might be playing a crucial role in controlling synaptic function and plasticity through proteasome-mediated degradation as well as transcriptional regulation of its target proteins. In fact, several recent reports demonstrated the role of UBE3A in the modulation of synaptic function and plasticity. This review focuses on the critical role of UBE3A in regulating the synaptic function and how its altered activity is associated with autism.
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27. Wegiel J, Kaczmarski W, Flory M, Martinez-Cerdeno V, Wisniewski T, Nowicki K, Kuchna I, Wegiel J. {{Deficit of corpus callosum axons, reduced axon diameter and decreased area are markers of abnormal development of interhemispheric connections in autistic subjects}}. {Acta Neuropathol Commun};2018 (Dec 19);6(1):143.
INTRODUCTION: In autism spectrum disorder, lack of coherence and of complex information processing, and narrowly focused interests and repetitive behaviors are considered a sign of long-range underconnectivity and short-range overconnectivity. The goal of this morphometric study of five anatomically and functionally different segments of the corpus callosum (CC) was to establish patterns of differences between long-range interhemispheric connections in nine neurotypical and nine autistic subjects. RESULTS: Electron microscopy revealed a significant reduction in average axon diameter and axon cross-sectional area in autistic subjects, and reduction in CC segment-specific diversification of connections of functionally different cortical regions. The study shows an increase in the percentage of small diameter axons (< 0.651 mum) and a decrease in the percentage of axons with large diameter (> 1.051 mum). The total number of small-diameter axons is reduced in segment I and III by 43% on average. The number of medium- and large-diameter axons is reduced in all five CC segments by an average of 49 and 72%, respectively. CONCLUSIONS: The detected pattern of pathology suggests a failure of mechanisms controlling guidance of axons during development leading to axonal deficit, and failure of mechanisms controlling axon structure. A reduction in axon diameter may affect the velocity and volume of signal transmission, and distort functional specialization of CC segments. Significant deficits in axon number and reduction in axon size in all five CC segments appear to be substantial components of brain connectome integrity distortion which may contribute to the autism phenotype.
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28. Windham GC, Anderson M, Lyall K, Daniels JL, Kral TVE, Croen LA, Levy SE, Bradley CB, Cordero C, Young L, Schieve LA. {{Maternal Pre-pregnancy Body Mass Index and Gestational Weight Gain in Relation to Autism Spectrum Disorder and other Developmental Disorders in Offspring}}. {Autism Res};2018 (Dec 21)
Most prior studies examining maternal pre-pregnancy body mass index (BMI) in relation to offspring autism spectrum disorders (ASD) have reported an association, though findings are not uniform and few have also examined gestational weight gain (GWG). Therefore, we examined both in the Study to Explore Early Development, a multi-site case-control study of children born in 2003-2006. Children identified from clinics, schools, and birth certificates were enrolled at ages 2-5 year and using standardized developmental evaluations, classified as: ASD, other developmental delays (DD), or population-based controls. Maternal height, weight, and GWG were self-reported during the telephone interview. Three primary weight risk factors were examined: (a) Pre-pregnancy BMI, classified as underweight to obese, (b) GWG continuous and categorized as quintiles, and (c) Institute of Medicine clinical weight-gain recommendations. Odds ratios adjusted (AOR) for sociodemographic and prenatal factors were calculated among term singletons, comparing the ASD (n = 540) or DD (n = 720) groups to the control group (n = 776). The AOR of ASD and maternal obesity was 1.37 (95%CI 0.98-1.92). Associations with higher GWG were stronger (Quintile5 vs. Quintile3 AOR = 1.58, 95%CI 1.08-2.31), and particularly so among overweight/obese women (AOR = 1.90, 95%CI 0.98-3.68). DD was associated with maternal overweight and obesity (obesity AOR = 1.48, 95%CI 1.08-2.02), but not with total GWG or clinical recommendations. High maternal BMI and GWG are risk factors for other pregnancy and child outcomes, and our results suggest they may also represent modifiable risk factors for neurodevelopmental outcomes. Autism Res 2018. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In a large, national study, we found that children with autism were more likely than unaffected children to have mothers with higher weight gain during pregnancy; risk of autism may be even stronger if mothers were also overweight before pregnancy. Children with other developmental delays were more likely to have mothers who were overweight or obese before pregnancy, but not who gained more weight during pregnancy. Overweight and weight gain may represent factors that could be modified.
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29. Yerys BE, Bertollo JR, Kenworthy L, Dawson G, Marco EJ, Schultz RT, Sikich L. {{Brief Report: Pilot Study of a Novel Interactive Digital Treatment to Improve Cognitive Control in Children with Autism Spectrum Disorder and Co-occurring ADHD Symptoms}}. {J Autism Dev Disord};2018 (Dec 19)
The presence of attention deficit/hyperactivity disorder (ADHD) symptoms in children with autism spectrum disorder (ASD) is associated with worse cognitive control. Children with ASD and ADHD often respond poorly to medications, thus we need alternative treatments. We examined the feasibility, acceptability, and preliminary efficacy of Project Evo-a digital treatment. Nineteen children with ASD and co-occurring ADHD symptoms completed this app-based treatment that targets multi-tasking through gameplay versus a comparison educational treatment. Children had a high engagement with both treatments, and parents and children reported high acceptability. Within-group analyses suggest the multi-tasking but not the educational treatment may improve cognitive control. This multi-tasking treatment is feasible, acceptable, and possibly efficacious for cognitive control impairments in children with ASD and ADHD.
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30. Yoon JA, Yoo Y, Lee JS, Kim YM, Shin YB. {{An early seizure variant type of a male Rett syndrome patient with a MECP2 p.Arg133His missense mutation}}. {Mol Genet Genomic Med};2018 (Dec 19)
BACKGROUND: The clinical spectrum of Rett syndrome (RTT; Mendelian Inheritance in Man [MIM] #312750) in males is considered to be wider than previously expected. Therefore, the existence of RTT with a normal male karyotype is still controversial. Here, we report the first case of a male patient presenting with an early seizure type of Rett-like phenotypes with a missense variant of MECP2. METHOD: An 8-month-old male was admitted to the pediatric department due to an initial seizure event following aspiration pneumonia and was referred to our clinic for the evaluation of unexplained neuroregression. Genomic DNA was prepared from venous blood by standard procedures and was processed at the Yale Center for Genome Analysis (YCGA) for whole exome sequencing (WES). Processing of sequence data, variant calling, and the identification of de novo mutations were then performed. Direct Sanger sequencing was performed following PCR amplification. RESULT: In this patient with a normal karyotype, WES analysis led to the identification of a novel, de novo missense variant of MECP2 (p.Arg133His) that is not observed in the normal population. CONCLUSION: This rare case of an p.Arg133His hemizygous MECP2 missense mutation could guide future treatment and follow-up plans for RETT-like phenotypes.
