1. Fletcher FE, Foster-Owens MD, Conduit R, Rinehart NJ, Riby DM, Cornish KM. {{The development trajectory of parent-report and objective sleep profiles in autism spectrum disorder: Associations with anxiety and bedtime routines}}. {Autism}. 2016.
The present study compared the course of parent-report and actigraphy-derived sleep profiles over a 1-year period, in school-age children with autism spectrum disorder and typically developing children. The Children’s Sleep Habits Questionnaire and 14 nights of actigraphy were used to assess sleep profiles. Parents also completed the Spence Children’s Anxiety Scale, the Social Worries Questionnaire and the Bedtime Routines Questionnaire. Between-group differences in parent-reported sleep problems were less pronounced at follow-up compared to baseline. The course of objective sleep was comparable between groups, with a significant reduction in sleep duration over time in both groups. Children with autism spectrum disorder were further characterised by significantly more night-to-night variability in sleep quality, across both time points. Reductions over time in parent-reported sleep problems were significantly associated with reduced anxiety. Reductions in actigraphy-derived sleep efficiency were associated with an increased frequency of maladaptive activities in the hour before bedtime, in both children with and without autism spectrum disorder.
Lien vers le texte intégral (Open Access ou abonnement)
2. Hirsch LE, Pringsheim T. {{Aripiprazole for autism spectrum disorders (ASD)}}. {Cochrane Database Syst Rev}. 2016; 6: CD009043.
BACKGROUND: Autism spectrum disorders (ASD) include autistic disorder, Asperger’s disorder and pervasive developmental disorder – not otherwise specified (PDD-NOS). Antipsychotics have been used as a medication intervention for irritability related to ASD. Aripiprazole, a third-generation, atypical antipsychotic, is a relatively new drug that has a unique mechanism of action different from that of other antipsychotics. This review updates a previous Cochrane review on the safety and efficacy of aripiprazole for individuals with ASD, published in 2011 (Ching 2011). OBJECTIVES: To assess the safety and efficacy of aripiprazole as medication treatment for individuals with ASD. SEARCH METHODS: In October 2015, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and seven other databases as well as two trial registers. We searched for records published in 1990 or later, as this was the year aripiprazole became available. SELECTION CRITERIA: Randomised controlled trials (RCTs) of aripiprazole (administered orally and at any dosage) versus placebo for treatment of individuals with a diagnosis of ASD. DATA COLLECTION AND ANALYSIS: Two review authors independently collected, evaluated and analysed data. We performed meta-analysis for primary and secondary outcomes, when possible. We used the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach to rate the overall quality of the evidence. MAIN RESULTS: We included three trials in this review. Two were included in the previous published review, and the results of one, placebo-controlled discontinuation study were added to this review. Although we searched for studies across age groups, we found only studies conducted in children and youth. Included trials had low risk of bias across most domains. High risk of bias was seen in only one trial with incomplete outcome data. We judged the overall quality of the evidence for most outcomes to be moderate.Two RCTs with similar methods evaluated use of aripiprazole for a duration of eight weeks in 316 children/adolescents with ASD. Meta-analysis of study results revealed a mean improvement of -6.17 points on the Aberrant Behavior Checklist (ABC) – Irritability subscale (95% confidence intervals (CIs) -9.07 to -3.26, two studies, 308 children/adolescents, moderate-quality evidence), -7.93 points on the ABC – Hyperactivity subscale (95% CI -10.98 to -4.88, two studies, 308 children/adolescents, moderate-quality evidence) and -2.66 points on the ABC – Stereotypy subscale (95% CI -3.55 to -1.77, two studies, 308 children/adolescents, moderate-quality evidence) in children/adolescents taking aripiprazole relative to children/adolescents taking placebo. In terms of side effects, children/adolescents taking aripiprazole had a greater increase in weight, with a mean increase of 1.13 kg relative to placebo (95% CI 0.71 to 1.54, two studies, 308 children/adolescents, moderate-quality evidence), and had a higher risk ratio (RR) for sedation (RR 4.28, 95% CI 1.58 to 11.60, two studies, 313 children/adolescents, moderate-quality evidence) and tremor (RR 10.26, 95% CI 1.37 to 76.63, two studies, 313 children/adolescents, moderate-quality evidence). A randomised, placebo-controlled discontinuation study found that 35% of children/adolescents randomised to continue intervention with aripiprazole relapsed with respect to their symptoms of irritability, compared with 52% of children/adolescents randomised to placebo, for a hazard ratio of 0.57 (95% CI 0.28 to 1.12, 85 children/adolescents, low-quality evidence).All three included trials were supported by Bristol-Myers Squibb (Princeton, NJ) and Otsuka Pharmaceutical Company, Ltd. (Tokyo, Japan), with editorial support provided by Ogilvy Healthworld Medical Education and Bristol-Myers Squibb. AUTHORS’ CONCLUSIONS: Evidence from two RCTs suggests that aripiprazole can be effective as a short-term medication intervention for some behavioural aspects of ASD in children/adolescents. After a short-term medication intervention with aripiprazole, children/adolescents showed less irritability and hyperactivity and fewer stereotypies (repetitive, purposeless actions). However, notable side effects, such as weight gain, sedation, drooling and tremor, must be considered. One long-term, placebo discontinuation study found that relapse rates did not differ between children/adolescents randomised to continue aripiprazole versus children/adolescents randomised to receive placebo, suggesting that re-evaluation of aripiprazole use after a period of stabilisation in irritability symptoms is warranted. Studies included in this review used criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (APA 2000) for ASD diagnosis; however, the diagnostic criteria for ASD changed significantly with release of the fifth edition of the DSM (DSM-5) in 2013 (APA 2013).
Lien vers le texte intégral (Open Access ou abonnement)
3. Ketcheson L, Hauck J, Ulrich D. {{The effects of an early motor skill intervention on motor skills, levels of physical activity, and socialization in young children with autism spectrum disorder: A pilot study}}. {Autism}. 2016.
Despite evidence suggesting one of the earliest indicators of an eventual autism spectrum disorder diagnoses is an early motor delay, there remain very few interventions targeting motor behavior as the primary outcome for young children with autism spectrum disorder. The aim of this pilot study was to measure the efficacy of an intensive motor skill intervention on motor skills (Test of Gross Motor Development-2), physical activity (accelerometers), and socialization (Playground Observation of Peer Engagement) in young children with autism spectrum disorder. A total of 20 children with autism spectrum disorder aged 4-6 years participated. The experimental group (n = 11) participated in an 8-week intervention consisting of motor skill instruction for 4 h/day, 5 days/week. The control group (n = 9) did not receive the intervention. A repeated-measures analysis of covariance revealed statistically significant differences between groups in all three motor outcomes, locomotor (F(1, 14) = 10.07, p < 0.001, partial eta2 = 0.42), object control (F(1, 14) = 12.90, p < 0.001, partial eta2 = 0.48), and gross quotient (F(1, 14) = 15.61, p < 0.01, partial eta2 = 0.53). Findings shed light on the importance of including motor programming as part of the early intervention services delivered to young children with autism spectrum disorder. Lien vers le texte intégral (Open Access ou abonnement)
4. Merrick AD, Grieve A, Cogan N. {{Psychological impacts of challenging behaviour and motivational orientation in staff supporting individuals with autistic spectrum conditions}}. {Autism}. 2016.
Despite increased risk of experiencing challenging behaviour, psychological impacts on community and residential staff supporting adults with autistic spectrum conditions are under-explored. Studies examining related roles indicate protective psychological factors may help maintain staff well-being. This study investigated relationships between motivational orientation (eudaimonic or hedonic), challenging behaviour frequency and type (physical, verbal or self-injurious) and psychological impacts (anxiety, depression and life satisfaction). Participants (N = 99) were recruited from six organisations providing autism-specific adult services within Scotland. A series of binary logistic regressions demonstrated weekly challenging behaviour exposure (compared to monthly or daily) significantly increased the likelihood of anxiety caseness. Increased eudaimonic motivation significantly reduced the likelihood of anxiety caseness while also predicting higher life satisfaction. Furthermore, having high levels of eudaimonic motivation appeared to moderate the impact of weekly challenging behaviour exposure on anxiety. No motivational orientation or challenging behaviour factor significantly predicted depression. This sample also demonstrated higher anxiety, lower depression and equivalent life satisfaction levels compared with general population norms. The results highlight the need for considering staff’s motivational orientations, their frequency of exposure to challenging behaviour, and both positive and negative psychological outcomes, if seeking to accurately quantify or improve well-being in this staff population.
Lien vers le texte intégral (Open Access ou abonnement)
5. Tager-Flusberg H, Plesa Skwerer D, Joseph RM, Brukilacchio B, Decker J, Eggleston B, Meyer S, Yoder A. {{Conducting research with minimally verbal participants with autism spectrum disorder}}. {Autism}. 2016.
A growing number of research groups are now including older minimally verbal individuals with autism spectrum disorder in their studies to encompass the full range of heterogeneity in the population. There are numerous barriers that prevent researchers from collecting high-quality data from these individuals, in part because of the challenging behaviors with which they present alongside their very limited means for communication. In this article, we summarize the practices that we have developed, based on applied behavioral analysis techniques, and have used in our ongoing research on behavioral, eye-tracking, and electrophysiological studies of minimally verbal children and adolescents with autism spectrum disorder. Our goal is to provide the field with useful guidelines that will promote the inclusion of the entire spectrum of individuals with autism spectrum disorder in future research investigations.
Lien vers le texte intégral (Open Access ou abonnement)
6. Taylor CE, Bush K. {{Unintended consequences of inhibiting dihydrofolate reductase through folic acid supplementation: inattentive-type attention deficit hyperactivity disorder and ASD connections}}. {Int J Food Sci Nutr}. 2016: 1-2.
Lien vers le texte intégral (Open Access ou abonnement)
7. Vanwong N, Prommas S, Puangpetch A, Hongkaew Y, Nuntamool N, Nakorn CN, Ngamsamut N, Limsila P, Sukasem C. {{Development and Validation of Liquid Chromatography/Tandem Mass Spectrometry Analysis for Therapeutic Drug Monitoring of Risperidone and 9-Hydroxyrisperidone in Pediatric Patients with Autism Spectrum Disorders}}. {J Clin Lab Anal}. 2016.
BACKGROUND: Risperidone (RIS) is a widely used atypical antipsychotic drug. We developed and validated a sensitive and accurate LC-MS/MS method, which requires a small-volume of plasma and small-volume injection for measurement of RIS levels in ASD pediatric patients. We also investigated the relationship between RIS levels and RIS dosages, including prolactin levels. METHOD: Blood samples were processed by protein precipitation extraction. Only 1 mul of sample was injected. Plasma samples were separated on a C18 column (4.6 cm x 50 mm; 1.8 mum particle size). Detection was by MS-MS with an analytical run time of 6 min. RESULTS: The inter-day accuracy of RIS was 101.33-107.68% and 95.24-103.67% for 9-OH-RIS. The inter-day precision of RIS was Lien vers le texte intégral (Open Access ou abonnement)
