1. Brandwein AB, Foxe JJ, Butler JS, Frey HP, Bates JC, Shulman LH, Molholm S. {{Neurophysiological Indices of Atypical Auditory Processing and Multisensory Integration are Associated with Symptom Severity in Autism}}. {J Autism Dev Disord};2014 (Sep 23)
Atypical processing and integration of sensory inputs are hypothesized to play a role in unusual sensory reactions and social-cognitive deficits in autism spectrum disorder (ASD). Reports on the relationship between objective metrics of sensory processing and clinical symptoms, however, are surprisingly sparse. Here we examined the relationship between neurophysiological assays of sensory processing and (1) autism severity and (2) sensory sensitivities, in individuals with ASD aged 6-17. Multiple linear regression indicated significant associations between neural markers of auditory processing and multisensory integration, and autism severity. No such relationships were apparent for clinical measures of visual/auditory sensitivities. These data support that aberrant early sensory processing contributes to autism symptoms, and reveal the potential of electrophysiology to objectively subtype autism.
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2. Campbell DJ, Chang J, Chawarska K. {{Early generalized overgrowth in autism spectrum disorder: prevalence rates, gender effects, and clinical outcomes}}. {J Am Acad Child Adolesc Psychiatry};2014 (Oct);53(10):1063-1073 e1065.
OBJECTIVE: Although early head and body overgrowth have been well documented in autism spectrum disorder (ASD), their prevalence and significance remain unclear. It is also unclear whether overgrowth affects males and females differentially, and whether it is associated with clinical outcomes later in life. METHOD: To evaluate prevalence of somatic overgrowth, gender effects, and associations with clinical outcomes, head circumference, height, and weight measurements were collected retrospectively between birth and 2 years of age in toddlers with ASD (n = 200) and typically developing (TD; n = 147) community controls. Symptom severity, verbal, and nonverbal functioning were assessed at 4 years. RESULTS: Abnormalities in somatic growth in infants with ASD were consistent with early generalized overgrowth (EGO). Boys but not girls with ASD were larger and exhibited an increased rate of extreme EGO compared to community controls (18.0% versus 3.4%). Presence of a larger body at birth and postnatal overgrowth were associated independently with poorer social, verbal, and nonverbal skills at 4 years. CONCLUSION: Although early growth abnormalities in ASD are less common than previously thought, their presence is predictive of lower social, verbal, and nonverbal skills at 4 years, suggesting that they may constitute a biomarker for identifying toddlers with ASD at risk for less-optimal outcomes. The results highlight that the search for mechanisms underlying atypical brain development in ASD should consider factors responsible for both neural and nonneural tissue development during prenatal and early postnatal periods, and can be informed by the finding that early overgrowth may be more readily observed in males than in females with ASD.
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3. Chadman KK. {{Making progress in autism drug discovery}}. {Expert Opin Drug Discov};2014 (Sep 24):1-3.
Currently, there are still just two medications approved by the U.S. FDA to treat the irritability that is often found in children with autism spectrum disorder (ASD). Furthermore, there are no drugs approved that treat the core symptoms of ASD. And while many drugs have had good outcomes in preclinical animal models, they have been met with very little success in human clinical trials. There are several factors likely contributing to this problem starting with the heterogeneity within the ASD phenotype. It is therefore important that researchers develop their knowledge about the neurobiological basis of ASD as well as possible subgroups within the disorder, based on either specific behavioral profiles or biological pathways. Furthermore, the development of valid biological markers will allow researchers to use more than parent or teacher reports to determine if a treatment is effective. This author believes that there a good chance of finding effective pharmacological treatments for the core symptoms of ASD with this increased knowledge of the biology and etiology.
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4. Chen LS, Xu L, Dhar SU, Li M, Talwar D, Jung E. {{Autism Spectrum Disorders: A Qualitative Study of Attitudes toward Prenatal Genetic Testing and Termination Decisions of Affected Pregnancies}}. {Clin Genet};2014 (Sep 24)
In the United States, prenatal genetic testing (PGT) for Autism Spectrum Disorders (ASD) is currently available via clinical genetic services. Such testing may inform parents about their unborn child’s risk for ASD, prepare parents for the birth of an affected infant, and allow them to arrange for early interventions. Although PGT for autism has potential benefits, the associated ethical, legal, and social implications (ELSI) should be considered. This first qualitative study employed a hypothetical scenario to explore the attitudes toward PGT and termination decisions of 42 parents of children with ASD. Over half of the participants expressed willingness to undergo PGT for autism. Reasons included better preparation for birth, early and better treatment, termination of affected pregnancy, contribution to research, and curiosity. Of the 31 parents who were either willing or unsure about undergoing the PGT, approximately three-fourths would continue their hypothetical affected pregnancies. Explanations included preparation for birth of the child, bonding or acceptance of existing ASD children, apprehensions about test limitations, and religious concerns. Parents who reported they would terminate the affected pregnancy in this hypothetical situation were primarily Asians. This study contributes to the growing understanding of the ELSI aspects of PGT in clinical practice.
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5. Cheslack-Postava K, Suominen A, Jokiranta E, Lehti V, McKeague IW, Sourander A, Brown AS. {{Increased Risk of Autism Spectrum Disorders at Short and Long Interpregnancy Intervals in Finland}}. {J Am Acad Child Adolesc Psychiatry};2014 (Oct);53(10):1074-1081 e1074.
OBJECTIVE: Both short and long interpregnancy intervals (IPI) are believed to present possible adverse conditions for fetal development. Short IPI has recently been associated with increased risk of autism, but whether long IPI increases risk for autism spectrum disorders (ASD) has not been thoroughly investigated. We investigated the association between short and long IPI in a Finnish population-based study. METHOD: This study was conducted in the Finnish Prenatal Study of Autism, which is based in a national birth cohort. Children born in Finland in 1987 to 2005 and diagnosed with ASD by 2007 were identified through the Finnish Hospital Discharge Register. A total of 2,208 non-firstborn patients with ASD and 5,163 matched controls identified from the Finnish Medical Birth Register were included in the primary analysis. The association between IPI and ASD was determined using conditional logistic regression and adjusted for potential confounders. RESULTS: Relative to births with an IPI of 24 to 59 months, those with the shortest IPI (<12 months) had an increased risk of ASD (odds ratio [OR] = 1.50, 95% CI = 1.28, 1.74) in confounder-adjusted models, whereas the ORs for longer IPI births (60-119 months and >/=120 months) were 1.28 (95% CI = 1.08, 1.52) and 1.44 (95% CI = 1.12, 1.85), respectively. CONCLUSION: This study provides evidence that risk of ASD is increased at long as well as short IPI.
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6. de Jonge M, Parr J, Rutter M, Wallace S, Kemner C, Bailey A, van Engeland H, Pickles A. {{New Interview and Observation Measures of the Broader Autism Phenotype: Group Differentiation}}. {J Autism Dev Disord};2014 (Sep 23)
To identify the broader autism phenotype (BAP), the Family History Interview subject and informant versions and an observational tool (Impression of Interviewee), were developed. This study investigated whether the instruments differentiated between parents of children with autism, and parents of children with Down syndrome (DS). The BAP scores of parents of 28 multiplex autism families were compared with parents from, 32 DS families. The BAP measures provided good group differentiation but when considered together, the subject interview did not improve group differentiation. The differentiation was better for fathers than mothers. The measures do carry an important degree of validity; whether they can differentiate the BAP from other social disorders should be tested.
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7. DePape AM, Lindsay S. {{Parents’ Experiences of Caring for a Child With Autism Spectrum Disorder}}. {Qual Health Res};2014 (Sep 22)
Autism spectrum disorder (ASD) is a developmental disorder involving abnormal communication, repetitive and restrictive interests, and impaired social functioning. ASD can have a profound impact on family life, including the roles and responsibilities that parents assume. In this metasynthesis, we explore the experiences of parents who care for a child with ASD. We undertook a thematic synthesis to integrate qualitative evidence, searching 10 electronic databases and reviewing 4,148 abstracts. We selected 31 articles for inclusion (involving 160 fathers and 425 mothers) and examined the articles using a constant comparative approach. We identified six themes: prediagnosis, diagnosis, family life adjustment, navigating the system, parental empowerment, and moving forward. Our findings can inform the development of programs and services for families, provide insight for health care workers who advocate on behalf of parents, and provide valuable information to parents, particularly those of children newly diagnosed with ASD.
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8. Harrison AJ, Zimak EH, Sheinkopf SJ, Manji KP, Morrow EM. {{Observation-centered Approach to ASD Assessment in Tanzania}}. {Intellect Dev Disabil};2014 (Oct);52(5):330-347.
Abstract In many lower-income countries, there is a paucity of assessment services for autism spectrum disorders (ASD)., Guidelines will be provided for conducting cross-cultural assessments in the context of limited validated resources in Tanzania. By examining behavioral, social, and adaptive differences we were able to provide differential diagnostic evaluations aligning with best practice standards for 41 children in Tanzania age 2-21 years. We describe the utility of a flexible, behavioral observation instrument, the Childhood Autism Rating Scales, Second Edition (CARS2), to gather diagnostic information in a culturally sensitive manner. We observed that the ASD group was characterized by significantly higher scores on the CARS2, F = 21.09, p < .001, eta(2) = .37, than the general delay comparison group. Additional recommendations are provided for making cultural adaptations to current assessment instruments for use in a country without normed instruments, such as Tanzania.
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9. Hovik KT, Egeland J, Isquith PK, Gioia G, Skogli EW, Andersen PN, Oie M. {{Distinct Patterns of Everyday Executive Function Problems Distinguish Children With Tourette Syndrome From Children With ADHD or Autism Spectrum Disorders}}. {J Atten Disord};2014 (Sep 24)
OBJECTIVE: The aim is to investigate the everyday executive function (EF) in children with Tourette syndrome (TS), Inattentive or Combined presentations of ADHD (ADHD-I/ADHD-C), autism spectrum disorders (ASD), and typically developing children (TDC). METHOD: Nineteen TS, 33 ADHD-C, 43 ADHD-I, 34 ASD, and 50 TDC participated (8-17 years). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: TS, ADHD-C, ADHD-I, or ASD were rated with significantly more regulation problems on all scales compared with TDC. Considerable overlap of symptoms between clinical groups made differentiation difficult on individual scales. Scale configurations showed children with TS to have more problems with emotional control (EC) than cognitive flexibility in relation to children with ASD, more problems with EC than inhibitory control in relation to ADHD-C, and more problems with EC than planning/organizing in relation to ADHD-I. CONCLUSION: Paired BRIEF scales dissociated EF problems in children with TS from children with ADHD-C, ADHD-I, or ASD. Clinical relevance is discussed.
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10. Liu EX, Carter EW, Boehm TL, Annandale NH, Taylor CE. {{In their own words: the place of faith in the lives of young people with autism and intellectual disability}}. {Intellect Dev Disabil};2014 (Oct);52(5):388-404.
Abstract Although the prominence of spirituality and religious connections among the people of the United States is well documented, little is known about the place of faith in the lives of youth with developmental disabilities. In this qualitative interview study, we examined the perspectives of 20 young people with intellectual disability or autism on their faith, spiritual expressions, and disability. Participants identified key spiritual expressions and themes reflecting the importance of faith in their lives. They also shared perceptions of their disability in the context of their faith, highlighting affirmation and acceptance of their disability. We offer recommendations to families, faith communities, and service systems for supporting the spiritual formation, expression, and connections of young people with disabilities.
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11. Raznahan A. {{Sizing Up the Search for Autism Spectrum Disorder (ASD) Risk Markers During Prenatal and Early Postnatal Life}}. {J Am Acad Child Adolesc Psychiatry};2014 (Oct);53(10):1045-1047.
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12. Tufan E. {{The Relationship Between Social Communication Disorder (SCD) and Broad Autism Phenotype (BAP)}}. {J Am Acad Child Adolesc Psychiatry};2014 (Oct);53(10):1130.
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13. Ung D, Selles R, Small BJ, Storch EA. {{A Systematic Review and Meta-Analysis of Cognitive-Behavioral Therapy for Anxiety in Youth with High-Functioning Autism Spectrum Disorders}}. {Child Psychiatry Hum Dev};2014 (Sep 23)
Cognitive-behavioral therapy (CBT) has been developed and modified to treat anxiety symptoms in youth with high-functioning autism spectrum disorders (ASD) but has yielded varying findings. The present report is a systematic review and meta-analysis examining the efficacy of CBT for anxiety among youth with ASD. A systematic search identified 14 studies involving 511 youth with high-functioning ASD. A random effects meta-analysis yielded a statistically significant pooled treatment effect size (g) estimate for CBT (g = -0.71, p < .001) with significant heterogeneity [Q (13) = 102.27, p < .001]. Removal of a study outlier yielded a statistically significant pooled treatment effect size, (g = -0.47, p < .001). Anxiety informant and treatment modality were not statistically significant moderators of treatment response. Findings suggest that CBT demonstrates robust efficacy in reducing anxiety symptoms in youth with high-functioning ASD.
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14. Wandin H, Lindberg P, Sonnander K. {{Communication intervention in Rett syndrome: a survey of speech language pathologists in Swedish health services}}. {Disabil Rehabil};2014 (Sep 24):1-10.
Abstract Purpose: To investigate communication intervention that speech language pathologists (SLPs) provide to people with Rett syndrome. Methods: A web-based survey targeting all Swedish SLPs working with people currently receiving support from habilitation services. Results: The SLPs reportedly followed recommended practice in the following aspects: (1) Information on communicative function was collected from several sources, including observation in well-known settings and reports from the client s social network, (2) Multimodal communication was promoted and, (3) Responsive partner strategies were largely targeted in the intervention. However, few instruments or standard procedures were used and partner instruction was given informally. Most SLPs used communication aids in the intervention and their general impression of using communication aids was positive. Further, augmentative and alternative communication (AAC) was estimated to increase and clarify communicative contributions from the person. Conclusions: Communication aids were reported to have a positive influence on communicative functions. Swedish SLP services followed best practice in several aspects, but there are areas with potential for development. Tools and best practice guidelines are needed to support SLPs in the AAC process for clients with Rett syndrome. [Box: see text].
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15. Zwaigenbaum L, Young GS, Stone WL, Dobkins K, Ozonoff S, Brian J, Bryson SE, Carver LJ, Hutman T, Iverson JM, Landa RJ, Messinger D. {{Early Head Growth in Infants at Risk of Autism: A Baby Siblings Research Consortium Study}}. {J Am Acad Child Adolesc Psychiatry};2014 (Oct);53(10):1053-1062.
OBJECTIVE: Although early brain overgrowth is frequently reported in autism spectrum disorder (ASD), the relationship between ASD and head circumference (HC) is less clear, with inconsistent findings from longitudinal studies that include community controls. Our aim was to examine whether head growth in the first 3 years differed between children with ASD from a high-risk (HR) sample of infant siblings of children with ASD (by definition, multiplex), HR siblings not diagnosed with ASD, and low-risk (LR) controls. METHOD: Participants included 442 HR and 253 LR infants from 12 sites of the international Baby Siblings Research Consortium. Longitudinal HC data were obtained prospectively, supplemented by growth records. Random effects nonlinear growth models were used to compare HC in HR infants and LR infants. Additional comparisons were conducted with the HR group stratified by diagnostic status at age 3: ASD (n = 77), developmental delay (DD; n = 32), and typical development (TD; n = 333). Nonlinear growth models were also developed for height to assess general overgrowth associated with ASD. RESULTS: There was no overall difference in head circumference growth over the first 3 years between HR and LR infants, although secondary analyses suggested possible increased total growth in HR infants, reflected by the model asymptote. Analyses stratifying the HR group by 3-year outcomes did not detect differences in head growth or height between HR infants who developed ASD and those who did not, nor between infants with ASD and LR controls. CONCLUSION: Head growth was uninformative as an ASD risk marker within this HR cohort.
