1. Gray L, Ansell P, Baird G, Parr JR. {{The continuing challenge of diagnosing autism spectrum disorder in children with Down syndrome}}. {Child Care Health Dev};2011 (Mar 23)
2. Hagebeuk EE, Koelman JH, Duran M, Abeling NG, Vyth A, Poll-The BT. {{Clinical and Electroencephalographic Effects of Folinic Acid Treatment in Rett Syndrome Patients}}. {J Child Neurol};2011 (Mar 22)
Rett syndrome is characterized by the development of stereotypic hand movements and seizures, which are often difficult to treat. Previous studies have shown conflicting results during add-on folinic acid. Here, the authors reevaluate the response to folinic acid in terms of epilepsy control and electroencephalography features. They performed a randomized, placebo-controlled, double-blind crossover trial, with a follow-up of more than 2 years. Twelve girls with Rett syndrome participated, comparable in clinical stage and disease severity. The Rett syndrome patients were given either folinic acid or placebo, for 1 year each. Only 3 girls benefited to some extent: 2 had a reduction and/or decrease in seizures, and all 3 showed some decreased epileptiform activity on electroencephalography during the addition of folinic acid. Despite this, antiepileptic drugs were adjusted. Because the effect of added folinic acid was limited and did not prevent antiepileptic drug increase, the authors do not recommend adding on folinic acid in Rett syndrome girls with epilepsy.
3. Kamen BA, Chukoskie L. {{Autism Speaks: Meeting on Folate Metabolism and Autism Spectrum Disorders, March 19-20, 2009, Washington, DC}}. {J Pediatr Hematol Oncol};2011 (Apr);33(3):208-215.
4. Lundstrom S, Chang Z, Kerekes N, Gumpert CH, Rastam M, Gillberg C, Lichtenstein P, Anckarsater H. {{Autistic-like traits and their association with mental health problems in two nationwide twin cohorts of children and adults}}. {Psychol Med};2011 (Mar 22):1-11.
BACKGROUND: Autistic-like traits (ALTs), that is restrictions in intuitive social interaction, communication and flexibility of interests and behaviors, were studied in two population-based Swedish twin studies, one in children and one in adults: (1) to examine whether the variability in ALTs is a meaningful risk factor for concomitant attention deficit hyperactivity disorder (ADHD), anxiety, conduct problems, depression and substance abuse, and (2) to assess whether common genetic and environmental susceptibilities can help to explain co-existence of ALTs and traits associated with such concomitant problems.MethodTwo nationwide twin cohorts from Sweden (consisting of 11 222 children and 18 349 adults) were assessed by DSM-based symptom algorithms for autism. The twins were divided into six groups based on their degree of ALTs and the risk for concomitant mental health problems was calculated for each group. Genetic and environmental susceptibilities common to ALTs and the other problem types were examined using bivariate twin modeling. RESULTS: In both cohorts, even the lowest degree of ALTs increased the risk for all other types of mental health problems, and these risk estimates increased monotonically with the number of ALTs. For all conditions, common genetic and environmental factors could be discerned. Overall, the phenotypic correlation between ALTs and the traits examined were less pronounced in adulthood than in childhood and less affected by genetic compared with environmental factors. CONCLUSIONS: Even low-grade ALTs are relevant to clinical psychiatry as they increase the risk for several heterotypical mental health problems. The association is influenced partly by common genetic and environmental susceptibilities. Attention to co-existing ALTs is warranted in research on a wide range of mental disorders.
5. Van Adel JM, Dunn Geier J, Perry A, Reitzel JA. {{Credible Knowledge: A pilot evaluation of a modified GRADE method using parent-implemented interventions for children with autism}}. {BMC Health Serv Res};2011 (Mar 22);11(1):60.
ABSTRACT: BACKGROUND: Decision-making in child and youth mental health (CYMH) care requires recommendations that are developed through an efficient and effective method and are based on credible knowledge. Credible knowledge is informed by two sources: scientific evidence, and practice-based evidence, that reflects the « real world » experience of service providers. Current approaches to developing these recommendations in relation to CYMH will typically include evidence from one source or the other but do not have an objective method to combine the two. To this end, a modified version of the Grading Recommendations Assessment, Development and Evaluation (GRADE) approach, a novel method for the CYMH field, was pilot-tested. METHODS: GRADE has an explicit methodology that relies on input from scientific evidence as well as a panel of experts. The panel established the quality of evidence and derived detailed recommendations regarding the organization and delivery of mental health care for children and youth or their caregivers. In this study a modified GRADE method was used to provide precise recommendations based on a specific CYMH question (i.e. What is the current credible knowledge concerning the effects of parent-implemented, early intervention with their autistic children?). RESULTS: Overall, it appeared that early, parent-implemented interventions for autism result in positive effects that outweigh any undesirable effects. However, as opposed to overall recommendations, the heterogeneity of the evidence required that recommendations be specific to particular interventions, based on the questions of whether the benefits of a particular intervention outweighs its harms. CONCLUSIONS: This pilot project provided evidence that a modified GRADE method may be an effective and practical approach to making recommendations in CYMH, based on credible knowledge. Key strengths of the process included separating the assessments of the quality of the evidence and the strength of recommendations, transparency in decision-making, and the objectivity of the methods. Most importantly, this method combined the evidence and clinical experience in a more timely, explicit and simple process as compared to previous approaches. The strengths, limitations and modifications of the approach as they pertain to CYMH, are discussed.
6. Wei BY, Huang F, Qin XT, Liang QQ. {{[Treatment of behavioral disorders by risperidone in children with autism.]}}. {Zhongguo Dang Dai Er Ke Za Zhi};2011 (Mar);13(3):216-218.
OBJECTIVE: To study the effect of risperidone treatment on behavioral disorders in children with autism. METHODS: Forty children with behavioral disorders (aged from 5 to 12 years) were treated with risperidone for 8 weeks. The behavioral symptoms were evaluated by the Clinical Global Impression (CGI) and the Autism Treatment Evaluation Checklist (ATEC) before and after the treatment. The adverse events related to risperidone treatment were observed. RESULTS: The score of severity of illness and the ATEC total scores were significantly reduced 8 weeks after risperidone treatment. Besides the social intercourse ability, great improvements have been shown on the verbal communication, apperception and behavioural symptoms by the ATEC. No severe adverse events related to risperidone treatment were observed. CONCLUSIONS: Risperidone can significantly improve the behavioral disorders in children with autism and is well-tolerated.
