1. AlFaris NA, Alshwaiyat NM, JZ AL, Alagal RI, AlSalehi SM, Al Zarah RI, Alfaiz RF, Alhariqi AI, Alshamri DF, AlSouan NA, AlMousa LA. Nutritional Status and Dietary Behaviors of Children with Intellectual or Developmental Disabilities in Saudi Arabia: A Systematic Review. J Multidiscip Healthc;2024;17:3371-3399.

Children with intellectual or developmental disabilities are susceptible to malnutrition. This systematic review was conducted to assess the nutritional status and dietary behaviors of children with intellectual or developmental disabilities in Saudi Arabia. The target population was children from Saudi Arabia aged 18 years or younger and diagnosed with intellectual or developmental disabilities. Appropriate research studies that were published from inception up to December 2023 were obtained and reviewed. The outcomes of interest, including anthropometric data, laboratory data, dietary intake data, and dietary behaviors data, were collected and organized in relevant tables. The methodological quality and bias risk for the involved studies were evaluated. Out of 286 screened articles, 31 research articles were selected. The review results show that the rates of overweight and obesity were significantly higher among children with intellectual or developmental disabilities compared to typically developing children. The laboratory data revealed that they were more likely to have nutritional deficiencies. Low intake of energy, protein, and several micronutrients is frequently reported among them. Moreover, they are anticipated to have unhealthy dietary behavior. In conclusion, the findings suggested that children with intellectual or developmental disabilities were at higher risk of malnutrition including deploying obesity and nutritional deficiencies. Healthy and balanced nutrition that considers dietary requirements and food preferences is critical to maintaining the optimal development of these children. This review could invite researchers and policy-makers in Saudi Arabia to put more effort into integrating individuals with disability into the healthcare system and community. Further research is required to determine the types of intervention measures that can be taken to reduce the risk of malnutrition. Additional action is needed to monitor the implementation of national policies and programs that target this part of society.

Lien vers le texte intégral (Open Access ou abonnement)

2. Almog N, Keren EH, Gabai T, Kassel O. Autistic People’s Perspectives on Parental Diagnosis Disclosure: A Grounded Theory Study. J Autism Dev Disord;2024 (Jul 24)

Being diagnosed with autism has multiple implications for a person’s life and self-identity. Although learning about autism at a younger age is correlated with quality of life, only a few studies have addressed parental disclosure thereof. This study conceptualizes autistic adults’ perspectives on parental disclosure. The methods combine grounded theory with the emancipatory research paradigm, drawing on autistic people’s personal knowledge. Eighty-five autistic adults participated in six focus groups (51 male, 33 female, 3 non-binary; M(age) = 25); and 41 autistic adults were interviewed (22 male, 17 female, 2 non-binary; M(age) = 28). Both focus groups and individual interviews addressed the way participants learned about their diagnosis from their parents, and their recommendations to other parents on how to disclose. Based on these findings, we developed autistic-driven recommendations for parental disclosure process. The participants viewed the diagnosis as validating their experienced otherness, helping them overcome shame, and promoting their self-understanding and self-advocacy skills. They recommended disclosure as soon as possible after diagnosis and stressed the importance of gradual disclosure according to the child’s abilities. Furthermore, they suggested focusing on how autism manifested in the child’s own life, rather than « autism » in general. Finally, they recommended presenting autism as a neutral or positive quality, highlighting its strengths and networking the child with other autistic individuals. In conclusion, this study reveals that parental disclosure is an ongoing and spiral process. The proposed model contributes significantly to post-diagnostic support for parents, providing a framework for effective communication about autism with their children.

Lien vers le texte intégral (Open Access ou abonnement)

3. An M. « As Long as There’s a Glimmer of Hope, I’m Willing to Try »: The Moral Experiences of Parental Pursuit for Autism Therapy in Urban China. Med Anthropol;2024 (Jul 3);43(5):455-468.

In today’s China, countless parents embark on a journey of moral peril in search of treatment for their children with autism, navigating a bustling yet chaotic market of therapies. Based on 13 months of fieldwork in the Pearl River Delta, this study examines how the boom of China’s autism therapy industry has plunged parents, who are relentlessly striving for their children’s futures, into deeper vulnerability. I view the « ethics of trying » as parental enactment of their moral agency in seeking therapy and reveal how it serves as a moral engine for the industry’s growth in the early 21st century, as well as how it leads to moral tragedies for parents as new norms of therapeutic choice emerge with government and professional guidance compelling them to make optimal therapeutic choices within a critical developmental window. Although parental efforts to avoid « agent-regret » can paradoxically lead to significant remorse, the moral tragedy they encounter can also prompt reflection and reevaluation of their approach to their child’s condition.

Lien vers le texte intégral (Open Access ou abonnement)

4. Bennewith C, Bellali J, Watkins L, Tromans S, Bhui K, Shankar R. Sublime and extended reality experiences to enhance emotional wellbeing for autistic people: A state of the art review and narrative synthesis. Int J Soc Psychiatry;2024 (Jul 24):207640241261172.

BACKGROUND: Sublime is a centuries old concept of emergent experience arising from immense and threatening awareness provoked by overwhelming fear and dread when faced with an incomprehensible situation as is common to autistic people. Extended Reality (XR) technologies have been used since the mid-1990s, in regulating emotions, behaviour and supporting social skill development for autistic people. AIMS: To understand utility of XR technologies in creating immersive experiences for autistic people to alleviate anxiety and the relationship to the sublime. METHOD: A State of the Art literature review and narrative synthesis was conducted. PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with terms Autism AND Technology. In addition, fields of digital technologies and wellbeing, digital art and mental health, generative arts and the sublime were explored through web searches of grey literature, conversations with digital designers and explorations of extended reality platforms. No time limits were placed. Searches were done in English. Papers were screened and shortlisted using the inclusion criteria applied by two reviewers. RESULTS: Fifty-eight papers/articles met the preliminary inclusion criteria for in-depth review of which 31 were found suitable for the narrative synthesis related to XR technologies and sublime experiences as related to autistic people. Narrative synthesis lent itself to four themes that is current utility of XR Technologies in autism, the impact of immersive experiences on Behavioural, phenomenological and biological markers of autistic people, the Benefits of increased sensory stimulation using XR on autism and an inquiry into the potential of the sublime for autism. CONCLUSIONS: Mixed reality environments that experiment with a broad range of XR technologies including incorporating notions of the sublime, might be beneficial in reducing emotional dysregulation and improving social development in autistic people especially if co-designed with them.

Lien vers le texte intégral (Open Access ou abonnement)

5. David A, Stolar O, Berkovitch M, Kohn E, Hazan A, Waissengreen D, Gal E. Effects of Medical Cannabis Treatment for Autistic Children on Anxiety and Restricted and Repetitive Behaviors and Interests: An Open-Label Study. Cannabis Cannabinoid Res;2024 (Jul 24)

Background: The literature supports the benefits of medical cannabis for core and comorbid symptoms in autistic individuals and anxiety-related symptoms in individuals without autism. However, no study has specifically investigated how cannabidiol (CBD)-rich cannabis affects anxiety subtypes in autistic children or its relationship with restricted and repetitive behaviors and interests (RRBI). Understanding the effects of CBD-rich cannabis treatment on anxiety subtypes and RRBI could offer more precise treatment approaches to managing anxiety symptoms and reducing RRBI frequency in autistic children. Objectives: To examine (1) the impact of CBD-rich cannabis treatment on autistic children’s (1a) anxiety levels and subtypes and (1 b) RRBI and subtypes and (2) whether changes in anxiety explain changes in RRBI following cannabis treatment. Method: In this open-label study, we analyzed data from 65 autistic children (5-12 years) who had participated in research on the effects of CBD-rich cannabis on children with autism. Their parents completed the Repetitive Behavior Scale-revised to assess the frequency and severity of six subgroups of their children’s recurrent behaviors and the Screen for Child Anxiety-Related Emotional Disorders for symptoms related to five types of anxiety disorders. They completed these assessments at three time points: (T1) before treatment, (T2) after 3 months, and (T3) after 6 months of treatment. Results: The results indicated reduced RRBI and symptoms related to various anxiety subtypes in autistic children following 6 months of CBD-rich cannabis treatment. Specifically, we observed significant differences in the autistic children’s overall anxiety and in some anxiety subtypes (i.e., general, social, panic, and separation anxieties). Significant improvements were observed in RRBI, including the total score, and specifically in compulsive, ritualistic, and sameness behaviors. Our findings revealed that reduced anxiety, particularly within the panic- and separation-related subtypes, predicted a subsequent decrease in RRBI, specifically sameness behaviors, following cannabis treatment. Conclusions: The findings of the cannabis treatment’s potential benefits for alleviating anxiety symptoms, leading to reduced RRBI, may provide evidence for the meaningful relationship between these variables and for the potential benefits of cannabis treatment for autistic children. We strongly recommend further double-blind, placebo-controlled studies using standardized assessments to validate these findings.

Lien vers le texte intégral (Open Access ou abonnement)

6. De Marzio M, Lasky-Su J, Chu SH, Prince N, Litonjua AA, Weiss ST, Kelly RS, Glass KR. The metabolic role of vitamin D in children’s neurodevelopment: a network study. Sci Rep;2024 (Jul 23);14(1):16929.

Neurodevelopmental disorders are rapidly increasing in prevalence and have been linked to various environmental risk factors. Mounting evidence suggests a potential role of vitamin D in child neurodevelopment, though the causal mechanisms remain largely unknown. Here, we investigate how vitamin D deficiency affects children’s communication development, particularly in relation to Autism Spectrum Disorder (ASD). We do so by developing an integrative network approach that combines metabolomic profiles, clinical traits, and neurodevelopmental data from a pediatric cohort. Our results show that low levels of vitamin D are associated with changes in the metabolic networks of tryptophan, linoleic, and fatty acid metabolism. These changes correlate with distinct ASD-related phenotypes, including delayed communication skills and respiratory dysfunctions. Additionally, our analysis suggests the kynurenine and serotonin sub-pathways may mediate the effect of vitamin D on early life communication development. Altogether, our findings provide metabolome-wide insights into the potential of vitamin D as a therapeutic option for ASD and other communication disorders.

Lien vers le texte intégral (Open Access ou abonnement)

7. Flaifl Y, Hassona Y, Altoum D, Flaifl N, Taimeh D. Online information about oral health in autism spectrum disorder: Is it good enough?. Spec Care Dentist;2024 (Jul 23)

INTRODUCTION: The use of the internet has surged significantly over the years. Patients and caregivers of patients with autism spectrum disorder (ASD) might consult the internet for oral health-related information. Hence, this study aimed to assess the quality and readability of online information available in the English language regarding oral health in ASD. METHODS: Online search using Google.com was conducted using the terms « Autism and dental care, » « Autism and oral health, » and « Autism and dentistry ». The first 100 websites for each term were screened. Quality of information was assessed using the Patient Education Materials Assessment Tool for printed material (PEMAT-P) and the Journal of American Medical Association (JAMA) benchmarks. A PEMAT score higher than 70% is considered acceptable for readability and actionability. The JAMA benchmarks are authorship, attribution, disclosure, and currency. Readability was evaluated using the Flesch reading ease score and Simple Measure of Gobbledygook (SMOG) readability formula. RESULTS: Out of the 300 screened websites, 66 were eventually included. The mean PEMAT understandability and actionability scores were 77.13%, and 42.12%, respectively. Only 12.1% of the websites displayed all four JAMA benchmarks. The mean Flesch score was 10th-12th grade level, and the mean SMOG score was 10th grade level. CONCLUSION: While the understandability of the information was acceptable, the readability and actionability were too challenging for lay people. Health care professionals and organizations involved in patient education should place more efforts in promoting the quality of online information targeting patients with ASD.

Lien vers le texte intégral (Open Access ou abonnement)

8. Fontanals J, McCleery JP, Schatz P. Neurocognitive Concussion Test Performance for Student Athletes on the Autism Spectrum. Arch Clin Neuropsychol;2024 (Jul 24);39(5):618-625.

OBJECTIVE: To examine baseline neurocognitive functioning among adolescent athletes on the autism spectrum based on self-reported level of academic performance. METHOD: Participants in this cross-sectional, observational study were 6,441 adolescent athletes with a self-reported diagnosis of autism who completed pre-season neurocognitive testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT); 4,742 reported a co-occurring learning disorder (LD), and 6,612 individuals without autism or LD were included as a control group. The majority (57%) self-reported Average Academic Performance, 39% Above Average, and 4% Below Average performance. RESULTS: Athletes with self-reported autism (with or without LD; 12.2%) were 2.74x (95% CI: 2.17-2.82) more likely to fall below cutoffs for ImPACT Embedded Invalidity Indicators (EVIs), with a significant interaction between self-reported Diagnosis and Academic Performance; individuals with co-occurring autism and LD who reported Below Average Academic Performance had the greatest likelihood of scoring below cutoffs (22%), followed by ASD without LD (14.8%) and Controls (14.6%) with Below Average Academic Performance. Analyses of variance (ANOVAs) revealed main effects of Diagnosis and Academic Performance on neurocognitive performance, with interactions on all ImPACT Composite Scores except Processing Speed. CONCLUSION: Athletes with self-reported ASD are more likely to fall below ImPACT EVIs and score worse on ImPACT, with greater likelihood/worse performance related to level of academic functioning. Academic performance should be considered when interpreting neurocognitive testing data, to best index neuropsychological functioning associated with concussion in this population. The current findings highlight the importance of individual participant baseline neuropsychological testing for individuals on the autism spectrum.

Lien vers le texte intégral (Open Access ou abonnement)

9. Giua G, Pereira-Silva J, Caceres-Rodriguez A, Lassalle O, Chavis P, Manzoni OJ. Cell- and Pathway-Specific Disruptions in the Accumbens of Fragile X Mouse. J Neurosci;2024 (Jul 24);44(30)

Fragile X syndrome (FXS) is a genetic cause of intellectual disability and autism spectrum disorder. The mesocorticolimbic system, which includes the prefrontal cortex (PFC), basolateral amygdala (BLA), and nucleus accumbens core (NAcC), is essential for regulating socioemotional behaviors. We employed optogenetics to compare the functional properties of the BLA→NAcC, PFC→NAcC, and reciprocal PFC↔BLA pathways in Fmr1-/y::Drd1a-tdTomato male mice. In FXS mice, the PFC↔BLA reciprocal pathway was unaffected, while significant synaptic modifications occurred in the BLA/PFC→NAcC pathways. We observed distinct changes in D1 striatal projection neurons (SPNs) and separate modifications in D2 SPNs. In FXS mice, the BLA/PFC→NAcC-D2 SPN pathways demonstrated heightened synaptic strength. Focusing on the BLA→NAcC pathway, linked to autistic symptoms, we found increased AMPAR and NMDAR currents and elevated spine density in D2 SPNs. Conversely, the amplified firing probability of BLA→NAcC-D1 SPNs was not accompanied by increased synaptic strength, AMPAR and NMDAR currents, or spine density. These pathway-specific alterations resulted in an overall enhancement of excitatory-to-spike coupling, a physiologically relevant index of how efficiently excitatory inputs drive neuronal firing, in both BLA→NAcC-D1 and BLA→NAcC-D2 pathways. Finally, the absence of fragile X messenger ribonucleoprotein 1 (FMRP) led to impaired long-term depression specifically in BLA→D1 SPNs. These distinct alterations in synaptic transmission and plasticity within circuits targeting the NAcC highlight the potential role of postsynaptic mechanisms in selected SPNs in the observed circuit-level changes. This research underscores the heightened vulnerability of the NAcC in the context of FMRP deficiency, emphasizing its pivotal role in the pathophysiology of FXS.

Lien vers le texte intégral (Open Access ou abonnement)

10. Gülbetekin E, Kardaş Özdemir F, Aşut G. The mediator role of parenting stress in the effect of stigmatization on burnout in parents of children with autism: A structural equality model. J Pediatr Nurs;2024 (Jul 24)

PURPOSE: The purpose of this study was to report on the mediator role of parenting stress in the effect of stigmatization on burnout in parents of children with autism. DESIGN AND METHODS: A descriptive and correlational research design was used in this study. The sample consisted of 146 parents who had children diagnosed with autism spectrum disorder and volunteered to participate in the study. A « Personal Information Form », the « Parents’ Internalized Stigma of Mental Illness Scale », the « Parenting Stress Scale », and the « Parental Burnout Assessment » were used for data collection. RESULTS: In the study, it was observed that the feeling of stigmatization increased as the education level increased and that variables such as the ages of the parent and the child and an increase in the number of children requiring care also affected the feeling of stigmatization. Parenting stress was found to have a « partial mediator » role in the effect of stigmatization on parental burnout. CONCLUSION: Our findings emphasized the heterogeneous correlation between stigmatization, burnout, and stress levels of parents of children with autism. PRACTICE IMPLICATIONS: This study has key implications for pediatric nursing practices. Pediatric nurses can educate the community about autism, what issues should be considered, and how to support parents. Furthermore, nurses can introduce parents who have children with autism to each other and direct them to parent-child activities that can regulate their moods.

Lien vers le texte intégral (Open Access ou abonnement)

11. Jacinto M, Rodrigues F, Monteiro D, Diz S, Morquecho Sánchez R, Morales-Sánchez V, Matos R, Amaro N, Antunes R. Effects of combined training in individual with Intellectual and Developmental Disabilities: a systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil;2024 (Jul 24):1-16.

PURPOSE OF THE ARTICLE: This study aims to evaluate the literature, peer-reviewed clinical trials investigating the effects of combined exercise interventions on individuals with Intellectual and Developmental Disabilities. MATERIALS AND METHODS: Various databases, using various descriptors and Boolean operators were utilized. RESULTS: Eight studies meet the eligibility criteria. Regarding the anthropometric measures/body composition variable, the meta-analysis revealed that combined physical exercise did not have a significant effect (standard mean difference (SMD) = -0.16; 95% CI, -0.34 to 0.03; Z = 1.68; p = 0.09). For the lipid profile variable, the combined exercise interventions did not show a significant effect (SMD = -0.07; 95% CI, -0.43 to 0.29; Z = 0.38; p = 0.71). Combined exercise training had a significant effect on increasing functional capacity (SMD = 0.28; 95% CI, 0.01 to 0.54; Z = 2.03; p = 0.04), cardiorespiratory function (SMD = 0.80; 95% CI, 0.34 to 1.26; Z = 3.41; p ≤ 0.001), and strength (SMD = 0.77; 95% CI, 0.45 to 1.08; Z = 4.78; p ≤ 0.001). CONCLUSIONS: Participants from the intervention group that took part in combined exercise training showed a higher probability of improving their functional, cardiorespiratory, and strength capacity compared to the control group. This study synthesises the literature, peer-reviewed clinical trials investigating the effects of combined exercise interventions on individuals with Intellectual and Developmental Disabilities.Participants who performed combined physical exercise were more likely to improve their functional, cardiorespiratory and strength capacity compared to the control group.Professionals (e.g., rehabilitation technician, exercise technician) responsible for planning interventions for people with IDD should consider the results of this study when planning their interventions, particularly regarding the prescription of physical exercise, as well as monitoring training and several important variables that can be enhanced by regular physical exercise.Organisations that provide support to people with IDD (support or social solidarity institutions) should also consider the results of this study, to provide the necessary conditions (materials, spaces or human resources) so that professionals could plan this type of intervention in the most appropriate and adapted way possible for the individual. eng

Lien vers le texte intégral (Open Access ou abonnement)

12. Parenti M, Slupsky CM. Disrupted Prenatal Metabolism May Explain the Etiology of Suboptimal Neurodevelopment: A Focus on Phthalates and Micronutrients and their Relationship to Autism Spectrum Disorder. Adv Nutr;2024 (Jul 24):100279.

Pregnancy is a time of high metabolic coordination, as maternal metabolism adapts to support the growing fetus. Many of these changes are coordinated by the placenta, a critical fetal endocrine organ and the site of maternal-fetal crosstalk. Dysregulation in maternal and placental metabolism during pregnancy has been linked to adverse outcomes, including altered neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder linked to metabolic alterations in both children and their mothers. Prenatal environmental exposures have been linked to risk of ASD through dysregulated maternal, placental, and fetal metabolism. In this review, we focus on recent studies investigating the associations between prenatal metabolism in the maternal-placental-fetal unit and the impact of prenatal environmental exposures to phthalates and micronutrients on ASD risk. By identifying the mechanisms through which phthalates and other ubiquitous endocrine disrupting chemicals influence development, and how nutritional interventions can impact those mechanisms, we can identify promising ways to prevent suboptimal neurodevelopment.

Lien vers le texte intégral (Open Access ou abonnement)

13. Pickard K, S RE, Wedderburn Q, Wikel K, Buster J, Maye M. We Must Consider Infrastructure when Attempting to Scale up Autism EBIs: A Case Example from Early Intervention Systems. Adm Policy Ment Health;2024 (Jul 24)

In the autism field, there is increasing interest in translating evidence-based interventions (EBIs) into systems that serve young autistic children and their families. Public Early Intervention systems have been a focal point of research-based implementation efforts given that these systems are federally mandated to provide services to children birth to three years of age with developmental delays under Part C of the Individuals with Disabilities Education Act. Although a growing number of research studies are now training Early Intervention providers to deliver autism EBIs, this work has been conducted on a relatively small scale and has only just begun to consider the alignment of these models with Early Intervention systems and whether sufficient infrastructure exists to scale up these training efforts and to sustain their public health impact. This commentary aims to address this gap by reviewing factors that have been found to uniformly impact the scale-up of EBIs across diverse public systems (Fagan 20, 1147-1168, 2019), and to extend this framework to the implementation of EBIs within public Early Intervention systems. These factors include developer and funder capacity, the public’s awareness of and support for EBIs, the system’s leadership support for EBI use, the capacity for community engagement in implementation efforts, the availability of a skilled workforce capable of delivering EBIs, and the capacity for data monitoring and quality improvement. This commentary discusses how these factors may specifically impact the scale-up of autism EBIs within EI systems to support toddlers and young, autistic children, and implications for autism researchers.

Lien vers le texte intégral (Open Access ou abonnement)

14. Qian H, Shao M, Wei Z, Zhang Y, Liu S, Chen L, Meng J. Intact painful sensation but enhanced non-painful sensation in individuals with autistic traits. Front Psychiatry;2024;15:1432149.

Somatosensory abnormalities are commonly recognized as diagnostic criteria in autism spectrum disorder (ASD), and may also exist in individuals with autistic traits. The present research included two studies to explore the painful and non-painful sensation and their cognitive-neurological mechanisms of individuals with autistic traits. Study 1 included 358 participants to assess the relationship between autistic traits and pain/non-pain sensitivities using questionnaires: the Autism Spectrum Quotient (AQ), the Pain Sensitivity Questionnaire, and the Highly Sensitive Person Scale, respectively. Study 1 found that autistic traits were positively correlated with non-pain sensitivity, but not associated with pain sensitivity. Study 2 recruited 1,167 participants whose autistic traits were assessed using the AQ. Subsequently, thirty-three participants who scored within the top 10% and bottom 10% on the AQ were selected into High-AQ and Low-AQ groups, respectively, to explore the cognitive-neural responses of individuals with autistic traits to both painful and non-painful stimuli with event-related potential (ERP) technology. Results of Study 2 showed that the High-AQ group showed higher intensity ratings, more negative emotional reactions, and larger N1 amplitudes than the Low-AQ group to the non-painful stimuli, but no difference of response to the painful stimuli was found between High-AQ and Low-AQ groups. These findings suggest that individuals with autistic traits may experience enhanced non-painful sensation but intact painful sensation.

Lien vers le texte intégral (Open Access ou abonnement)

15. Roy MA, Kinlin C, Estes M, MacEachern SJ. Improving patient-centred care in the emergency department: Implementation of a Sensory Toolkit for children with autism. Paediatr Child Health;2024 (Jul);29(4):199-204.

Emergency department (ED) visits for children with autism can present challenges due to the unique sensory needs of this population. This Quality Improvement (QI) project executed two Plan-Do-Study-Act (PDSA) cycles to create and implement a Sensory Toolkit in the ED for children with autism. Most caregivers (94%; n = 31/33) and healthcare providers (HCPs; 86%; n = 37/44) identified the need for sensory items in the ED. In PDSA Cycle 1, 100% of caregivers (n = 21) and HCPs (n = 3) agreed/strongly agreed that the ED Sensory Toolkit was helpful. In PDSA Cycle 2, 92% of caregivers (n = 12/13) and 100% of HCPs (n = 3) agreed/strongly agreed that they were helpful. The Sensory Toolkit was positively evaluated by caregivers of children with autism and HCPs during the child’s visit to the ED. There is an opportunity to adapt the Sensory Toolkit for other EDs and areas of the hospital.

Lien vers le texte intégral (Open Access ou abonnement)

16. Rubenstein E, Toth M, Tewolde S. Autism Among Adults with Down Syndrome: Prevalence, Medicaid Usage, and Co-Occurring Conditions. J Autism Dev Disord;2024 (Jul 24)

Our objective was to examine occurrence of both conditions in Medicaid; and compare Medicaid service use and cost, and chronic conditions among adults with Down syndrome and autism to those with Down syndrome alone and those with autism alone. We used ICD9 and ICD10 codes in Medicaid claims and encounters from 2011 to 2019 to identify autism and Down syndrome in adults > 18 years. We then calculated costs, claims, hospitalizations, long term care days, and chronic conditions, and compared by group- autism alone, Down syndrome alone, Down syndrome + autism. Between 2011 and 2019, there were 519,450 adult Medicaid enrollees who met our criteria for autism (N = 396,426), Down syndrome (N = 116,422), or both Down syndrome and autism (N = 6,602). In 2011, 4.1% of enrollees with Down syndrome had co-occurring autism; by 2011 it was 6.6%. The autism group had the fewest claims and inpatient hospitalizations, followed by the Down syndrome group, then the Down syndrome + autism group. After age adjustment, those with Down syndrome alone and Down syndrome + autism had elevated prevalence of atrial fibrillation, dementia, heart failure, kidney disease, and obesity compared to the autism alone group. Both groups also had decreased occurrence of depression and hypertension compared to the autism alone group. Prevalence of autism is higher among people with Down syndrome than in peers. The increased costs and service use for those with both conditions highlight the extent to which this population need health care and signal the need for more effective preventative care and therapies.

Lien vers le texte intégral (Open Access ou abonnement)

17. Scharko AM, Mireski SJ. A 16-Year-Old Male with Autism Spectrum Disorder, Psychosis, and Refusal to Accept Any Oral Medication: A Case Report and Use of Long-Acting Injectable Aripiprazole Lauroxil. J Child Adolesc Psychopharmacol;2024 (Jul 24)

Lien vers le texte intégral (Open Access ou abonnement)

18. Tanaka Y, Kurasawa S, Ouchi K, Oi N. Structural associations between self-perception of support and knowledge of disability characteristics of autism spectrum disorder among staff in facilities providing after-school day services. Fukushima J Med Sci;2024 (Jul 24);70(3):153-162.

BACKGROUND: We constructed a hypothetical model of the knowledge of autism spectrum disorder (ASD) and self-perception of support of staff working in after-school day services to clarify structural relationships. METHODS: A questionnaire survey was conducted at 194 facilities providing after-school day services in Fukushima Prefecture (October 2020), including a basic attributes questionnaire, the Literacy Scale of Characteristics of Autistic Spectrum Disorder (LS-ASD), and a staff questionnaire. We developed a hypothetical model of the relationship between self-perception and LS-ASD total scores of after-school service staff. To obtain latent variables for structural equation modeling (SEM) to confirm factor extraction and the interrelationships among variables, exploratory factor analysis was performed. SEM was used to examine the fit of the hypothetical model to the data and the relationships among variables. RESULTS: The study included 302 staff members from 58 of 194 facilities. Four factors (Factor 1, motivation; 2, self-perception of knowledge; 3, information sharing; 4, self-confidence) were extracted. The final model showed that Factor 2 had a positive direct effect (path coefficient = 0.64) and Factor 4 had a negative direct effect (path coefficient = -0.22) on LS-ASD scores. The model goodness of fit was acceptable (Goodness-of-Fit Index = 0.890; Comparative Fit Index = 0.912; Root Mean Square Error of Approximation = 0.086; Akaike’s Information Criterion = 392.7). CONCLUSION: Self-perception of knowledge contributes greatly to knowledge acquisition, while excessive confidence may hinder knowledge retention.

Lien vers le texte intégral (Open Access ou abonnement)

19. Thom-Jones S, Melgaard I, Gordon CS. Correction: Autistic Women’s Experience of Motherhood: A Qualitative Analysis of Reddit. J Autism Dev Disord;2024 (Jul 24)

Lien vers le texte intégral (Open Access ou abonnement)

20. Tuckerman J, Mohamed Y, Justice F, Andersson T, Wyatt K, Broun K, Bastable A, Overmars I, Kaufman J, Danchin M. Stakeholder perspectives of immunisation delivery for adolescents with disability in specialist schools in Victoria, Australia: ‘we need a vaccination pathway’. BMC Public Health;2024 (Jul 23);24(1):1973.

BACKGROUND: Adolescents with disability have lower vaccination rates than the general population, including HPV vaccination. Understanding the multi-level influences on vaccination in specialist schools is crucial to achieve optimal vaccination coverage and vaccination experiences for adolescents living with disability. OBJECTIVE: To identify and improve understanding of the facilitators and barriers of HPV vaccination among adolescents with intellectual disabilities or autism in Victorian specialist schools to inform strategies to increase vaccination acceptance and uptake. METHODS: Qualitative interviews with key stakeholders (adolescents with disabilities, parents, school and council immunisation staff) from six specialist schools in Victoria, Australia. Data were analysed thematically. Inductively derived themes were then deductively mapped across the UNICEF ‘Journey to Immunization’ model. RESULTS: 32 interviews were conducted with stakeholders (2 adolescents, 7 parents, 13 school staff, 10 council staff). Trust in vaccines was high, but knowledge of the HPV vaccine was limited. Barriers included lack of accessible information for parents, the consent process, behavioural challenges and vaccine-related anxiety among students. The immunisation program in special schools was perceived as convenient, however preparing students for vaccination day and catering to individual student needs were key. Participants expressed a need for more parent information about options and additional support for vaccination outside of the school program. CONCLUSIONS: Our study identified a range of facilitators and barriers to the school immunisation program for students with disabilities in specialist schools. The next phase of this work will use co-design workshops to build on the suggestions for improvement and opportunities that could be leveraged to improve vaccination uptake.

Lien vers le texte intégral (Open Access ou abonnement)