1. Arnold LE, Ober N, Aman MG, Handen B, Smith T, Pan X, Hyman SL, Hollway J, Lecavalier L, Page K, Rice R, Jr. {{A 1.5-Year Follow-Up of Parent Training and Atomoxetine for Attention-Deficit/Hyperactivity Disorder Symptoms and Noncompliant/Disruptive Behavior in Autism}}. {J Child Adolesc Psychopharmacol};2018 (Apr 25)
OBJECTIVE: To examine status of children with autism spectrum disorder (ASD) 10 months after a 34-week clinical trial of atomoxetine (ATX) and parent training (PT). METHODS: In a 2 x 2 design, 128 children with ASD and attention-deficit/hyperactivity disorder (ADHD) were randomly assigned ATX, PT+placebo, PT+ATX, or placebo alone. PT was weekly for 10 weeks, and then monthly. ATX/placebo was titrated over 6 weeks [=1.8 mg/kg/d], and then maintained until week 10. Responders continued to week 34 or nonresponse. Placebo nonresponders had a 10-week ATX open trial; ATX nonresponders were treated clinically. All continued to week 34. With no further treatment from the study, all were invited to follow-up (FU) at 1.5 years postbaseline; 94 (73%) participated. Changes from Week 34 to FU and from baseline to FU were tested by one-way analysis of variance or chi-squared test. PT versus no PT was tested by chi-squared test, Fisher's exact test, Welch's t-test, Student's t-test, and Mann-Whitney's U test. RESULTS: For the whole sample, the primary outcomes (parent-rated ADHD on the Swanson, Nolan, and Pelham [SNAP] scale and noncompliance on the Home Situations Questionnaire [HSQ]) deteriorated mildly from week 34 to FU, but were still substantially better than baseline (SNAP: t = 12.177, df = 93, p < 0.001; HSQ: t = 8.999, df = 93, p < 0.001). On the SNAP, 61% improved >/=30% from baseline (67% did at week 34); on noncompliance, 56% improved >/=30% from baseline (77% did at week 34). Outcomes with PT were not significantly better than without PT (SNAP p = 0.30; HSQ p = 0.27). Originally assigned treatment groups did not differ significantly. Only 34% still took ATX; 27% were taking stimulants; and 25% took no medication. CONCLUSIONS: The majority retained their 34-week end-of-study improvement 10 months later, even though most participants stopped ATX. For some children, ATX continuation may not be necessary for continued benefit or other drugs may be necessary. Cautious individual clinical experimentation may be justified. Twelve sessions of PT made little long-term difference. ClinicalTrials.gov Identifier: Atomoxetine, Placebo and Parent Management Training in Autism (Strattera) (NCT00844753).
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2. Askari E, Setarehdan SK, Sheikhani A, Mohammadi MR, Teshnehlab M. {{Designing a model to detect the brain connections abnormalities in children with autism using 3D-cellular neural networks and wavelet transform}}. {J Integr Neurosci};2018 (Apr 20)
In neuropsychological disorders, the significant abnormalities in the brain connections in some regions are observed. This paper presents a novel model to demonstrate the connections between different regions in children with autism. The proposed model first conducts the wavelet decomposition of electroencephalography signals by wavelet transform then the features are extracted, such as relative energy and entropy. These features are fed to the 3D-cellular neural network model as inputs to indicate the brain connections. The results showed that there are significant differences and abnormalities in the left hemisphere, (p<0.05) at the electrodes AF3, F3, P7, T7 and O1 in alpha band, AF3, F7, T7 and O1 in beta band, T7 and P7 in gamma band for children with autism compared with the control children. Also, the evaluation of the obtained connections values between brain regions indicated that there are more abnormalities in the connectivity of frontal and parietal lobes and the relations of the neighboring regions in all three bands especially in gamma band for autistic children. Evaluation of the analysis demonstrated that alpha frequency band had the best distinction level of 96.6% based on the obtained values of the cellular neural network using support vector machine method. Lien vers le texte intégral (Open Access ou abonnement)
3. Ben-Sasson A, Robins DL, Yom-Tov E. {{Risk Assessment for Parents Who Suspect Their Child Has Autism Spectrum Disorder: Machine Learning Approach}}. {J Med Internet Res};2018 (Apr 24);20(4):e134.
BACKGROUND: Parents are likely to seek Web-based communities to verify their suspicions of autism spectrum disorder markers in their child. Automated tools support human decisions in many domains and could therefore potentially support concerned parents. OBJECTIVE: The objective of this study was to test the feasibility of assessing autism spectrum disorder risk in parental concerns from Web-based sources, using automated text analysis tools and minimal standard questioning. METHODS: Participants were 115 parents with concerns regarding their child’s social-communication development. Children were 16- to 30-months old, and 57.4% (66/115) had a family history of autism spectrum disorder. Parents reported their concerns online, and completed an autism spectrum disorder-specific screener, the Modified Checklist for Autism in Toddlers-Revised, with Follow-up (M-CHAT-R/F), and a broad developmental screener, the Ages and Stages Questionnaire (ASQ). An algorithm predicted autism spectrum disorder risk using a combination of the parent’s text and a single screening question, selected by the algorithm to enhance prediction accuracy. RESULTS: Screening measures identified 58% (67/115) to 88% (101/115) of children at risk for autism spectrum disorder. Children with a family history of autism spectrum disorder were 3 times more likely to show autism spectrum disorder risk on screening measures. The prediction of a child’s risk on the ASQ or M-CHAT-R was significantly more accurate when predicted from text combined with an M-CHAT-R question selected (automatically) than from the text alone. The frequently automatically selected M-CHAT-R questions that predicted risk were: following a point, make-believe play, and concern about deafness. CONCLUSIONS: The internet can be harnessed to prescreen for autism spectrum disorder using parental concerns by administering a few standardized screening questions to augment this process.
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4. Boyd BA, Watson LR, Reszka SS, Sideris J, Alessandri M, Baranek GT, Crais ER, Donaldson A, Gutierrez A, Johnson L, Belardi K. {{Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial}}. {J Autism Dev Disord};2018 (Apr 24)
The advancing social-communication and play (ASAP) intervention was designed as a classroom-based intervention, in which the educational teams serving preschool-aged children with autism spectrum disorder are trained to implement the intervention in order to improve these children’s social-communication and play skills. In this 4-year, multi-site efficacy trial, classrooms were randomly assigned to ASAP or a business-as-usual control condition. A total of 78 classrooms, including 161 children, enrolled in this study. No significant group differences were found for the primary outcomes of children’s social-communication and play. However, children in the ASAP group showed increased classroom engagement. Additionally, participation in ASAP seemed to have a protective effect for one indicator of teacher burnout. Implications for future research are discussed.
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5. Bryn V, Verkerk R, Skjeldal OH, Saugstad OD, Ormstad H. {{Kynurenine Pathway in Autism Spectrum Disorders in Children}}. {Neuropsychobiology};2018 (Apr 25):1-7.
BACKGROUND: There is increasing evidence that altered immune responses play a role in the pathogenesis of autism spectrum disorders (ASD), together with dysfunction of the serotonergic and glutamatergic systems. Since the kynurenine (KYN) pathway that degrades tryptophan (TRP) is activated in various neuroinflammatory states, we aimed to determine whether this pathway is activated in ASD. METHODS: Sixty-five pediatric ASD patients (including 52 boys) were enrolled from an epidemiological survey covering 2 counties in Norway; 30 (46.5%) of these patients were diagnosed with childhood autism, 16 (24.6%) with Asperger syndrome, 12 (18.5%) with atypical autism, 1 (1.5%) with Rett syndrome, and 6 (9.2%) with other ASD. The serum levels of the following markers were measured in the children with ASD and compared to those in 30 healthy children: TRP, KYN, kynurenic acid (KA), 3-hydroxykynurenine, and quinolinic acid. RESULTS: The mean serum level of KA was significantly lower in the ASD group than in the healthy controls (28.97 vs. 34.44 nM, p = 0.040), while the KYN/KA ratio was significantly higher in the ASD group (61.12 vs. 50.39, p = 0.006). The same relative values were found when comparing the childhood autism subgroup with the controls. Also, the mean serum level of TRP was significantly lower in children with a subdiagnosis of childhood autism than in those with Asperger syndrome (67.26 vs. 77.79 muM, p = 0.020). CONCLUSION: Our study indicates that there is an increased neurotoxic potential and also a possible lower KYN aminotransferase activity in ASD.
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6. Chen KL, Lin CH, Yu TY, Huang CY, Chen YD. {{Differences Between the Childhood Autism Rating Scale and the Social Responsiveness Scale in Assessing Symptoms of Children with Autistic Spectrum Disorder}}. {J Autism Dev Disord};2018 (Apr 25)
This study aimed to compare symptoms of autism spectrum disorder using the Childhood Autism Rating Scale (CARS) and the Social Responsiveness Scale (SRS-2) and to investigate their influencing factors. The diagnostic agreement was 92.7%, but with a fair Kappa value (0.247). Children’s verbal comprehension was related to the CARS scores, and no variables were related to the SRS-2 scores. Generally, significant small correlations were found between the two measures in children with normal or borderline to below average verbal comprehension (rs = 0.32 ~ 0.49, p < .005), but not in those with impaired verbal comprehension. The CARS and the SRS-2 may contain different explicit behaviors and collect different perspectives (i.e., those of caregivers and professionals). Therefore, they appear to complement each other. Lien vers le texte intégral (Open Access ou abonnement)
7. Dickinson A, DiStefano C, Lin YY, Scheffler AW, Senturk D, Jeste SS. {{Interhemispheric alpha-band hypoconnectivity in children with autism spectrum disorder}}. {Behav Brain Res};2018 (Apr 21)
Diverse genetic and environmental etiologies converge onto circuit level brain dysfunction in autism spectrum disorder (ASD), manifesting at a macroscopic level as aberrant neural connectivity. Previous studies have described atypical patterns of decreased short range and increased long range connectivity in ASD [1]. However, it remains unclear whether group level features of circuit dysfunction are consistently present across the range of cognitive function seen in the autism spectrum. The dynamics of neural oscillations in the alpha range (6-12Hz) are exquisitely sensitive to healthy development of functional and structural connectivity. Alpha-band coherence, measured with high temporal-precision electroencephalography (EEG) therefore represents an ideal tool for studying neural connectivity in developmental populations. Here we examined spontaneous alpha phase coherence in a heterogeneous sample of 59 children with ASD and 39 age matched typically developing children. Using a data driven approach, we conducted an unbiased examination of all possible atypical connectivity patterns across all cortical regions. Long-range hypoconnectivity was present in children with ASD compared to typically developing children, with temporal interhemispheric connectivity showing the largest difference between the two groups. Decreased long range alpha coherence distinguishes a heterogeneous group of ASD children from typically developing children. Interhemispheric temporal hypoconnectivity represents a fundamental functional difference in children with ASD across a wide cognitive and age range that may reflect white matter disturbances or increased signal variability at temporal sites in ASD.
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8. Goel R, Hong JS, Findling RL, Ji NY. {{An update on pharmacotherapy of autism spectrum disorder in children and adolescents}}. {Int Rev Psychiatry};2018 (Apr 25):1-18.
To date, no medication is proven to be effective in treating core symptoms of autism spectrum disorder (ASD). Psychotropic medications are widely used to target emotional and behavioural symptoms in ASD. This article reviewed evidence for pharmacotherapy, novel therapeutic agents, and Complementary and Alternative Medicine (CAM) in children and adolescents with ASD. Currently, only risperidone and aripiprazole have been approved by the US Food and Drug Administration (FDA) for treatment of irritability associated with ASD in children and adolescents. However, associated metabolic side-effects are concerning. Evidence supports use of methylphenidate and atomoxetine for attention deficit hyperactivity disorder (ADHD) symptoms and clonidine and guanfacine ER appear to be helpful. SSRIs are poorly tolerated and lack evidence in reducing restricted repetitive behaviours (RRB), anxiety, and depression. Buspirone shows promise in the treatment of RRB. The evidence is inconsistent for the effectiveness of anti-epileptic medications. Recent studies of glutamatergic, Gamma-aminobutyric acid (GABA)ergic, and cholinergic agents and oxytocin show inconsistent results. Despite wide use of CAM agents, the evidence is inconclusive. Melatonin can be helpful in reducing sleep problems. Overall, the evidence is limited for pharmacotherapy in children with ASD, and side-effects with long-term use can be burdensome.
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9. Gulsrud A, Lin CE, Park MN, Hellemann G, McCracken J. {{Self-injurious behaviours in children and adults with autism spectrum disorder (ASD)}}. {J Intellect Disabil Res};2018 (Apr 25)
BACKGROUND: Self-injurious behaviours (SIB) are concerning, maladaptive behaviours that commonly occur in people with neurodevelopmental conditions and delays but seem to be particularly prevalent in children and adults with autism spectrum disorder (ASD). There has been increasing research examining the risk markers associated with the presence of SIB in people with ASD. Some of the factors associated with SIB have included cognitive abilities, adaptive functioning deficits and behaviour regulation impairments (e.g. impulsivity and repetitive behaviours). However, many of the findings in the literature are mixed and only explain a small proportion of the variance contributing to SIB. Limitations in the previous literature have centred on lack of availability of large and diverse samples, restricted age ranges and constraints of measurement. METHOD: This study characterises a clinic-referred sample of children and adults currently presenting with and without SIB using a range of standardised and parent-report measures. The sample includes 144 individuals with ASD between the ages of 2.5 and 60.1 years. RESULTS: After adjusting for multiple tests, none of the variables maintained statistical significance between the group of individuals with and without SIB, but medium to large effect sizes were noted. These variables include parent-reported early motor and toileting delays and perinatal risk, and current cognitive and social impairment. The remaining variables, including current autism severity levels, early ASD symptomatology, impulsivity, executive functioning impairments, adaptive functioning, mood and anxiety, did not differ between those with and without current engagement in SIB. CONCLUSIONS: Utilising a diverse clinic-referred sample and standardised diagnostic tools, this study explored retrospective and current correlate risk markers of SIB in individuals with ASD. In addition to impairments in current functioning, specific early developmental delays and perinatal risk factors were preliminarily associated with the presence of SIB in individuals with ASD. Together these findings suggest that a set of specific characteristics may be related to both early risk and concurrent manifestation of SIB. Identifying this set of characteristics in early development may lead to faster identification and better intervention services, but future work utilising longitudinal design and multivariate analysis is warranted.
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10. Hall SS, Hustyi KM, Barnett RP. {{Examining the influence of social-environmental variables on self-injurious behaviour in adolescent boys with fragile X syndrome}}. {J Intellect Disabil Res};2018 (Apr 25)
BACKGROUND: Individuals with fragile X syndrome (FXS), the most common known inherited form of intellectual disability, are at increased risk for showing specific forms of self-injurious behaviour (SIB) such as hand biting and head hitting, suggesting that biological factors associated with the syndrome confers increased risk for SIB. Few studies, however, have examined the extent to which social-environmental variables can influence the occurrence of these behaviours in this population. METHOD: Twenty-two adolescent boys with FXS, aged 10 to 18 years were systematically exposed to seven environmental conditions in functional analyses of SIB conducted over 2 days at our research centre. RESULTS: Fourteen (63.6%) boys with FXS engaged in SIB during the functional analyses. Ten (45.5%) boys engaged in SIB that was maintained by social-environmental variables, that is, gaining access to attention/tangibles and/or escaping from social interaction, task demands and/or transition demands. For two boys, SIB was undifferentiated across conditions, and for two boys, SIB appeared to be maintained by automatic reinforcement. CONCLUSIONS: Social-environmental variables appeared to maintain SIB in a significant proportion of boys with FXS. Given that pharmacological treatments for SIB have limited efficacy in this population, the potential role of social-environmental factors on SIB should be examined before pharmacological treatments are implemented for these behaviours.
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11. Healy S, Nacario A, Braithwaite RE, Hopper C. {{The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis}}. {Autism Res};2018 (Apr 25)
The purpose of this meta-analysis was to examine the effect of physical activity interventions on youth diagnosed with autism spectrum disorder. Standard meta-analytical procedures determining inclusion criteria, literature searches in electronic databases, coding procedures, and statistical methods were used to identify and synthesize articles retained for analysis. Hedge’s g (1988) was utilized to interpret effect sizes and quantify research findings. Moderator and outcome variables were assessed using coding procedures. A total of 29 studies with 30 independent samples (N = 1009) were utilized in this analysis. Results from meta-analyses indicated an overall moderate effect (g = 0.62). Several outcomes indicated moderate-to-large effects (g >/= 0.5); specifically, moderate to large positive effects were revealed for participants exposed to interventions targeting the development of manipulative skills, locomotor skills, skill-related fitness, social functioning, and muscular strength and endurance. Moderator analyses were conducted to explain variance between groups; environment was the only subgrouping variable (intervention characteristics) to produce a significant difference (QB = 5.67, P < 0.05) between moderators. While no significant differences were found between other moderators, several trends were apparent within groups in which experimental groups outperformed control groups. Autism Res 2018, 0: 000-000. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Results of the meta-analysis-a method for synthesizing research-showed physical activity interventions to have a moderate or large effect on a variety of outcomes, including for the development of manipulative skills, locomotor skills, skill-related fitness, social functioning, and muscular strength and endurance. The authors conclude that physical activity's standing as an evidence-based strategy for youth with ASD is reinforced. Lien vers le texte intégral (Open Access ou abonnement)
12. Ilias K, Cornish K, Kummar AS, Park MS, Golden KJ. {{Parenting Stress and Resilience in Parents of Children With Autism Spectrum Disorder (ASD) in Southeast Asia: A Systematic Review}}. {Front Psychol};2018;9:280.
Background: This paper aimed to review the literature on the factors associated with parenting stress and resilience among parents of children with autism spectrum disorder (ASD) in the South East Asia (SEA) region. Methods: An extensive search of articles in multiple online databases (PsycNET, ProQuest, PudMed, EMBASE, CINAHL, Web of Science, and Google Scholar) resulted in 28 papers that met the inclusion criteria (i.e., conducted in the SEA region, specific to ASD only, published in a peer-reviewed journal, full text in English). Studies found were conducted in the following countries: Brunei, n = 1; Indonesia, n = 2; Malaysia, n = 12; Philippines, n = 5; Singapore, n = 5, Thailand, n = 2; and Vietnam, n = 1, but none from Cambodia, East Timor, Laos, and Myanmar were identified. Results: Across the studies, six main factors were found to be associated with parenting stress: social support, severity of autism symptoms, financial difficulty, parents’ perception and understanding toward ASD, parents’ anxiety and worries about their child’s future, and religious beliefs. These six factors could also be categorized as either a source of parenting stress or a coping strategy/resilience mechanism that may attenuate parenting stress. Conclusion: The findings suggest that greater support services in Western countries may underlie the cultural differences observed in the SEA region. Limitations in the current review were identified. The limited number of studies yielded from the search suggests a need for expanded research on ASD and parenting stress, coping, and resilience in the SEA region especially in Cambodia, East Timor, Laos, and Myanmar. The identified stress and resilience factors may serve as sociocultural markers for clinicians, psychologists, and other professionals to consider when supporting parents of children with ASD.
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13. Ismael N, Lawson LM, Hartwell J. {{Relationship Between Sensory Processing and Participation in Daily Occupations for Children With Autism Spectrum Disorder: A Systematic Review of Studies That Used Dunn’s Sensory Processing Framework}}. {Am J Occup Ther};2018 (May/Jun);72(3):7203205030p7203205031-7203205030p7203205039.
Research measuring sensory processing in children with autism spectrum disorder (ASD) has shown variability in terms of measures used and participant ages, contributing to difficulty in interpreting and summarizing the findings of these studies. In an attempt to clarify the status of the literature, we conducted a systematic review of studies that focused on participation in daily occupations and evaluated sensory processing in children with ASD aged 5-13 yr using Dunn’s sensory processing framework. Evidence from 7 studies shows that sensory processing has a significant impact on participation in daily life of children with ASD. Included studies demonstrated medium and low levels of evidence. Additional research using more robust scientific methods is needed.
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14. Kim HW, Park EJ, Kim JH, Boon-Yasidhi V, Tarugsa J, Reyes A, Manalo S, Joung YS. {{Aripiprazole for Irritability in Asian Children and Adolescents with Autistic Disorder: A 12-Week, Multinational, Multicenter, Prospective Open-Label Study}}. {J Child Adolesc Psychopharmacol};2018 (Apr 24)
OBJECTIVES: We investigated the effectiveness and tolerability of aripiprazole in the treatment of irritability in Asian children and adolescents (6-17 years) with autistic disorder in a 12-week, multinational, multicenter, open-label study. METHODS: Sixty-seven subjects (10.0 +/- 3.1 years old, 52 boys) were enrolled and treated with flexibly dosed aripiprazole for 12 weeks (mean dose, 5.1 +/- 2.5 mg; range 2-15 mg). RESULTS: Aripiprazole significantly reduced the mean caregiver-rated scores for the Irritability, Lethargy/Social Withdrawal, Stereotypy, Hyperactivity, and Inappropriate Speech subscales of the Aberrant Behavior Checklist from baseline to week 12 (p < 0.001 for all subscales). Clinician-rated Clinical Global Impression Severity of Illness scale score also improved from baseline through week 12 (p < 0.001). The most common adverse event was weight gain and no serious adverse event related to aripiprazole treatment was noted. CONCLUSION: Our results suggest that aripiprazole is effective and generally tolerable in the treatment of irritability in Asian children and adolescents with autistic disorder. Further studies with larger sample sizes and longer treatment durations are required. Lien vers le texte intégral (Open Access ou abonnement)
15. Masarwa R, Levine H, Gorelik E, Reif S, Perlman A, Matok I. {{Prenatal Exposure to Acetaminophen and Risk for Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorder: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Cohort Studies}}. {Am J Epidemiol};2018 (Apr 24)
Acetaminophen is the most commonly used analgesic and antipyretic during pregnancy. Evidence of neuro-disruptive properties is accumulating. Therefore, we sought to evaluate the risk for attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) in the offspring of women exposed to acetaminophen during pregnancy. We searched MEDLINE, EMBASE, and Cochrane up to January 2017. Data were independently extracted and assessed by two researchers. Seven eligible retrospective cohorts included 132,738 mother and child pairs and with a follow-up period of 3-11 years. Pooled risk ratio (RR) for ADHD was (RR=1.32, 95% CI 1.18,1.45, I2=61%), for ASD (RR=1.23, 95% CI1.13,1.32, I2=17%), and for hyperactivity symptoms (RR=1.23, 95% CI 1.01,1.49, I2=94%). In meta-regression analysis, the association between exposure and ADHD increased with childs’ age upon follow-up and with the mean duration of exposure (beta=0.0354, 95% CI 0.001,0.07), (beta=0.006, 95% CI 0.009,0.01). The available data is of observational nature only. Studies differed gravely in exposure and outcome assessment. Acetaminophen use during pregnancy is associated with an increased risk for ADHD, ASD and hyperactivity symptoms. These findings are concerning, however, results should be interpreted with caution as the available evidence consists of observational studies and susceptible to several potential sources of bias.
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16. Morales-Hidalgo P, Roige-Castellvi J, Hernandez-Martinez C, Voltas N, Canals J. {{Prevalence and Characteristics of Autism Spectrum Disorder Among Spanish School-Age Children}}. {J Autism Dev Disord};2018 (Apr 25)
The present study aims to assess the prevalence of autism spectrum disorder (ASD) in preschool and school-age children following a two-phase procedure. The screening phase was performed on a sample of 5555 children taking into account parent and teacher information. The individual assessment included the ADI-R, ADOS-2 and Wechsler scales. The estimated prevalence was 1.55% in preschoolers and 1.00% in school-age children. Between 1.84 and 2.59% of the children exhibited subclinical diagnosis. The male-to-female ratio was around 4:1. Most of the children exhibited mild and moderate nuclear symptoms, and the girls showed less severe communication problems. Previous diagnosis was found in 62-71% of the children. Prevalence estimates are close to the 1% international ratings and much higher than previous national reports suggested.
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17. Ohja K, Gozal E, Fahnestock M, Cai L, Cai J, Freedman JH, Switala A, El-Baz A, Barnes GN. {{Neuroimmunologic and Neurotrophic Interactions in Autism Spectrum Disorders: Relationship to Neuroinflammation}}. {Neuromolecular Med};2018 (Apr 24)
Autism spectrum disorders (ASD) are the most prevalent set of pediatric neurobiological disorders. The etiology of ASD has both genetic and environmental components including possible dysfunction of the immune system. The relationship of the immune system to aberrant neural circuitry output in the form of altered behaviors and communication characterized by ASD is unknown. Dysregulation of neurotrophins such as BDNF and their signaling pathways have been implicated in ASD. While abnormal cortical formation and autistic behaviors in mouse models of immune activation have been described, no one theory has been described to link activation of the immune system to specific brain signaling pathways aberrant in ASD. In this paper we explore the relationship between neurotrophin signaling, the immune system and ASD. To this effect we hypothesize that an interplay of dysregulated immune system, synaptogenic growth factors and their signaling pathways contribute to the development of ASD phenotypes.
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18. Okyere C, Aldersey HM, Lysaght R, Sulaiman SK. {{Implementation of inclusive education for children with intellectual and developmental disabilities in African countries: a scoping review}}. {Disabil Rehabil};2018 (Apr 25):1-18.
PURPOSE: To advance understanding of practices that support inclusion of children with intellectual and developmental disabilities in inclusive education classrooms in Africa by conducting a review of the extant literature. METHODS: Five academic databases were searched supplemented by a hand search of key journals and references of included studies. Two authors independently screened studies via a reference manager (Covidence) which allowed for blinding. A third author was consulted in cases of conflict. RESULTS: Thirty articles that provided empirical evidence of inclusive education implementation were included. Eight articles highlighted practices that support inclusion of children with intellectual and developmental disabilities. Using Bronfenbrenner’s bioecological framework, findings revealed that inclusive education implementation is influenced by factors on the bio level, micro level, meso level, and macro level. Recommendations for promoting inclusive education implementation are provided. CONCLUSIONS: Inclusion goes beyond teachers and requires strong commitment of other stakeholders such as families and governments. To guarantee the smooth inclusion of children with special education needs and particularly with intellectual and developmental disabilities, a set of practices validated through rigorous research as supportive and unique and that can be universal to Africa is wise. Implications for rehabilitation A number of strategies were identified that can improve the classroom inclusion of children with intellectual and developmental disabilities. Development of policies that support such strategies could improve implementation. Inclusion goes beyond teachers. Rehabilitation professionals (i.e. occupational therapists) and educational professionals should partner to identify practical solutions to the challenges of creating inclusive environments for children with special education needs. Committing more resources and time towards the development and implementation of special education policies can advance the successful inclusion of children with special education needs.
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19. Park MTM, Raznahan A, Shaw P, Gogtay N, Lerch JP, Chakravarty MM. {{Neuroanatomical phenotypes in mental illness: identifying convergent and divergent cortical phenotypes across autism, ADHD and schizophrenia}}. {J Psychiatry Neurosci};2018 (May);43(3):201-212.
BACKGROUND: There is evidence suggesting neuropsychiatric disorders share genomic, cognitive and clinical features. Here, we ask if autism-spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and schizophrenia share neuroanatomical variations. METHODS: First, we used measures of cortical anatomy to estimate spatial overlap of neuroanatomical variation using univariate methods. Next, we developed a novel methodology to determine whether cortical deficits specifically target or are « enriched » within functional resting-state networks. RESULTS: We found cortical anomalies were preferentially enriched across functional networks rather than clustering spatially. Specifically, cortical thickness showed significant enrichment between patients with ASD and those with ADHD in the default mode network, between patients with ASD and those with schizophrenia in the frontoparietal and limbic networks, and between patients with ADHD and those with schizophrenia in the ventral attention network. Networks enriched in cortical thickness anomalies were also strongly represented in functional MRI results (Neurosynth; r = 0.64, p = 0.032). LIMITATIONS: We did not account for variable symptom dimensions and severity in patient populations, and our cross-sectional design prevented longitudinal analyses of developmental trajectories. CONCLUSION: These findings suggest that common deficits across neuropsychiatric disorders cannot simply be characterized as arising out of local changes in cortical grey matter, but rather as entities of both local and systemic alterations targeting brain networks.
20. Saeliw T, Tangsuwansri C, Thongkorn S, Chonchaiya W, Suphapeetiporn K, Mutirangura A, Tencomnao T, Hu VW, Sarachana T. {{Integrated genome-wide Alu methylation and transcriptome profiling analyses reveal novel epigenetic regulatory networks associated with autism spectrum disorder}}. {Mol Autism};2018;9:27.
Background: Alu elements are a group of repetitive elements that can influence gene expression through CpG residues and transcription factor binding. Altered gene expression and methylation profiles have been reported in various tissues and cell lines from individuals with autism spectrum disorder (ASD). However, the role of Alu elements in ASD remains unclear. We thus investigated whether Alu elements are associated with altered gene expression profiles in ASD. Methods: We obtained five blood-based gene expression profiles from the Gene Expression Omnibus database and human Alu-inserted gene lists from the TranspoGene database. Differentially expressed genes (DEGs) in ASD were identified from each study and overlapped with the human Alu-inserted genes. The biological functions and networks of Alu-inserted DEGs were then predicted by Ingenuity Pathway Analysis (IPA). A combined bisulfite restriction analysis of lymphoblastoid cell lines (LCLs) derived from 36 ASD and 20 sex- and age-matched unaffected individuals was performed to assess the global DNA methylation levels within Alu elements, and the Alu expression levels were determined by quantitative RT-PCR. Results: In ASD blood or blood-derived cells, 320 Alu-inserted genes were reproducibly differentially expressed. Biological function and pathway analysis showed that these genes were significantly associated with neurodevelopmental disorders and neurological functions involved in ASD etiology. Interestingly, estrogen receptor and androgen signaling pathways implicated in the sex bias of ASD, as well as IL-6 signaling and neuroinflammation signaling pathways, were also highlighted. Alu methylation was not significantly different between the ASD and sex- and age-matched control groups. However, significantly altered Alu methylation patterns were observed in ASD cases sub-grouped based on Autism Diagnostic Interview-Revised scores compared with matched controls. Quantitative RT-PCR analysis of Alu expression also showed significant differences between ASD subgroups. Interestingly, Alu expression was correlated with methylation status in one phenotypic ASD subgroup. Conclusion: Alu methylation and expression were altered in LCLs from ASD subgroups. Our findings highlight the association of Alu elements with gene dysregulation in ASD blood samples and warrant further investigation. Moreover, the classification of ASD individuals into subgroups based on phenotypes may be beneficial and could provide insights into the still unknown etiology and the underlying mechanisms of ASD.
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21. Sato K. {{Why is vitamin B6 effective in alleviating the symptoms of autism?}}. {Med Hypotheses};2018 (Jun);115:103-106.
Many factors are reported to be involved in the complex pathophysiological processes of autism, suggesting that there is considerable variability in the manifestations of this disease. Several interventions are used to treat this disorder. Among them, vitamin B6 is widely used to treat the symptoms observed in autism. Vitamin B6 is beneficial for about half of autistic individuals in decreasing behavioral problems. However, until now, it remains unknown why vitamin B6 is effective for this disease. Although the exact pathogenesis is not defined, it is evident that certain neurotransmitter systems are impaired in the brains of autistic patients, causing the symptoms observed in the disease. In fact, impairment of many neurotransmitter systems has been reported, including GABA, serotonin, dopamine, and noradrenalin. Furthermore, vitamin B6 is important for the synthesis of many neurotransmitters, including GABA, serotonin, dopamine, noradrenalin, histamine, glycine, and d-serine, indicating that vitamin B6 supplementation may enhance many neurotransmitter systems. Thus, vitamin B6 supplementation can treat the impaired neurotransmitter systems in a given patient, even if the actual impaired neurotransmitter systems are not defined in that patient.
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22. Sato S. {{Apathy and fatigue in autistic spectrum disorder improved by Japanese herbal medicine; TSUMURA Ninjin’yoeito Extract}}. {Psychiatry Clin Neurosci};2018 (Apr 24)
The Japanese herbal medicine Ninjin’yoeito (NYT) improves fatigue, loss of appetite, and anemia.(1,2,4) Here we report its efficacy for fatigue and apathy in four cases of autistic spectrum disorder (ASD). All the patients were given informed consent and were their anonymity preserved.
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23. Thompson B, Winsler A. {{Parent-Teacher Agreement on Social Skills and Behavior Problems Among Ethnically Diverse Preschoolers with Autism Spectrum Disorder}}. {J Autism Dev Disord};2018 (Apr 25)
Parents and teachers provide complimentary information in the assessment of preschoolers so it is important to understand parent-teacher agreement, especially for children with autism. Parents and teachers rated an ethnically diverse sample of preschoolers with autism (N = 257; 67% Latino) on the Devereux Early Childhood Assessment (LeBuffe and Naglieri in Devereux Early Childhood Assessment: User’s guide, Kaplan Press, Lewisville, 1999). Correlations between parent and teacher ratings were moderate and significant for social skills (r = 0.20-0.37) but near zero for behavioral concerns. Parents rated children as having stronger social skills and fewer behavioral concerns than teachers, unlike prior research with typically developing preschoolers. Both informants rated White/other children more positively than minority children on several subscales, although agreement was similar across groups. Implications for practice are discussed.
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24. Thompson-Hodgetts S, Magill-Evans J. {{Sensory-Based Approaches in Intervention for Children With Autism Spectrum Disorder: Influences on Occupational Therapists’ Recommendations and Perceived Benefits}}. {Am J Occup Ther};2018 (May/Jun);72(3):7203205020p7203205021-7203205020p7203205028.
OBJECTIVE: We investigated factors that influenced occupational therapists’ beliefs about and use of sensory-based approaches for children with autism spectrum disorder (ASD). METHOD: Occupational therapists working with children with ASD (N = 211 from 16 countries) completed an online survey addressing their work experience, training, use of sensory-based approaches, and beliefs and perceptions about the effects of the approaches. Linear regression was used to determine predictors of use of and beliefs about sensory-based approaches. RESULTS: Most respondents (98%) used sensory-based approaches for children with ASD and would recommend the approaches for 57% of the children they treated. Having a mentor who promoted sensory-based approaches and practicing outside North America and Australia predicted greater use and perceived effectiveness of these approaches. Less than 5 yr of occupational therapy experience predicted less use of the approaches. CONCLUSION: Respondents selectively used sensory-based approaches for children with ASD and were influenced by country of residence, clinical experience, and mentorship.
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25. Valayi S, Eftekharian MM, Taheri M, Alikhani MY. {{Evaluation of antibodies to cytomegalovirus and epstein-barr virus in patients with autism spectrum disorder}}. {Hum Antibodies};2018 (Apr 10)
Autism is a neurodevelopmental disease that manifested by a wide range of behavioral disorders. Although the etiology of autism is remained unknown but it is suggested that ASD have a complex etiology, including genetic and environmental factors, which may explain the observed different behavioral disorders in these patients. One of the proposed reasons for autism is viral infection in the early stages of development. The mechanism by which viral infection could lead to autism is still unclear.Previous studiesemphasized on the role of family membersof Herpesviruses in autism susceptibility. In this study, anti-Cytomegalovirus (CMV) and anti-Epstein-Barr virus (EBV) antibodies in the serum of 45 children with autism and 45 healthy individuals were evaluated. Serum samples were isolated from 5 ml blood of the patients and controls. Sandwich ELISA was used to quantitatively measure antibodies against the mentioned viruses. Results analyzed by SPSS software showed an increased amount of anti-CMV IgG and IgM antibodies in the blood of patients with Autism but not statistically significant (P< 0.05). The anti-EBV IgM antibody in the blood of patients with Autism was not only increased but also statistically significant (P< 0.05), however, the IgG level against EBV in the serum of ASD patients showed no significant difference in comparison to healthy controls. So it can be said that although the mechanisms of viral infection in autism is unknown, but probably EBV infection is associated with an increased risk of autism. Lien vers le texte intégral (Open Access ou abonnement)
26. Weiss JA, Thomson K, Burnham Riosa P, Albaum C, Chan V, Maughan A, Tablon P, Black K. {{A randomized waitlist-controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism}}. {J Child Psychol Psychiatry};2018 (Apr 23)
BACKGROUND: Mental health problems are common among individuals with autism spectrum disorder (ASD), and difficulties with emotion regulation processes may underlie these issues. Cognitive behavior therapy (CBT) is considered an efficacious treatment for anxiety in children with ASD. Additional research is needed to examine the efficacy of a transdiagnostic treatment approach, whereby the same treatment can be applied to multiple emotional problems, beyond solely anxiety. The purpose of the present study was to examine the efficacy of a manualized and individually delivered 10-session, transdiagnostic CBT intervention, aimed at improving emotion regulation and mental health difficulties in children with ASD. METHODS: Sixty-eight children (M age = 9.75, SD = 1.27) and their parents participated in the study, randomly allocated to either a treatment immediate (n = 35) or waitlist control condition (n = 33) (ISRCTN #67079741). Parent-, child-, and clinician-reported measures of emotion regulation and mental health were administered at baseline, postintervention/postwaitlist, and at 10-week follow-up. RESULTS: Children in the treatment immediate condition demonstrated significant improvements on measures of emotion regulation (i.e., emotionality, emotion regulation abilities with social skills) and aspects of psychopathology (i.e., a composite measure of internalizing and externalizing symptoms, adaptive behaviors) compared to those in the waitlist control condition. Treatment gains were maintained at follow-up. CONCLUSIONS: This study is the first transdiagnostic CBT efficacy trial for children with ASD. Additional investigations are needed to further establish its relative efficacy compared to more traditional models of CBT for children with ASD and other neurodevelopmental conditions.
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27. Zhang Y, Han VZ. {{[Neurobiological mechanisms of autistic savant and acquired savant]}}. {Sheng Li Xue Bao};2018 (Apr 25);70(2):201-210.
The autism spectrum is a pervasive developmental disorder characterized by profound social and verbal communication deficits, stereotypical motor behaviors, restricted interests, and cognitive abnormalities. It affects approximately 1% of children in most of the reported nations and regions. One of the most fascinating and mysterious features of autism, however, is the remarkable talent frequently found in people affected by it, namely autistic savant. A parallel and equally mysterious phenomenon is that some otherwise normal and ordinary individuals develop similarly remarkable talent after brain injuries, a disorder known as acquired savant. After decades of intensive investigation, significant progress has been made in these fields. Current studies indicate that autistic savant and acquired savant are neuropathologically related, and these disorders share many neurobiological mechanisms. This review summarizes current knowledge of autism and both two savant types, and how it may aid our understanding of higher brain functionalities.