1. Ely E, Chen-Lim ML, Carpenter KM, 2nd, Wallhauser E, Friedlaender E. {{Pain Assessment of Children with Autism Spectrum Disorders}}. {Journal of developmental and behavioral pediatrics : JDBP}. 2016 Jan;37(1):53-61.
OBJECTIVE: Pain assessment of individuals with autism spectrum disorder (ASD) is largely unexplored. The core deficits of ASD may interfere with this population’s ability to effectively use traditional pain assessment tools. Accurate pain assessment is essential to providing quality care. The objective was to illuminate barriers to pain assessment in children with an ASD, describe novel methods to communicate about their pain experience, and identify vocabularies that hold meaning with respect to pain to better understand pain from their context. METHODS: Qualitative descriptive study using semistructured interviews including interactive electronic technology to enhance communication. Subjects included children aged 6 to 17 years with ASD experiencing acute pain after a surgical procedure at a large urban tertiary children’s hospital. RESULTS: Based on the analysis of 40 interviews, participants consisted of 34 (85%) male, 29 (72.5%) non-Hispanic white with mean age 11.75 +/- 3.36 years (range: 6-17). All subjects were able to describe and locate their pain but required a variety of approaches. Assessment preferences included minimal time spent focusing on pain and simplistic language and actions using terms familiar to each subject. Notably, subjects were able to reliably demonstrate understanding of graded response and seriation. Parent involvement was essential, both in helping interpret the child’s needs and providing trusted support. CONCLUSIONS: Some children with ASD require an alternate interactive approach to pain assessment. Individualized consideration and estimation of pain assessment methods for use in this population may provide more meaningful interactions, ultimately guiding better pain management interventions.
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2. Guha T, Yang Z, Ramakrishna A, Grossman RB, Darren H, Lee S, Narayanan SS. {{On Quantifying Facial Expression-Related Atypicality of Children with Autism Spectrum Disorder}}. {Proceedings of the IEEE International Conference on Acoustics, Speech, and Signal Processing / sponsored by the Institute of Electrical and Electronics Engineers Signal Processing Society ICASSP (Conf}. 2015 Apr;2015:803-7.
Children with Autism Spectrum Disorder (ASD) are known to have difficulty in producing and perceiving emotional facial expressions. Their expressions are often perceived as atypical by adult observers. This paper focuses on data driven ways to analyze and quantify atypicality in facial expressions of children with ASD. Our objective is to uncover those characteristics of facial gestures that induce the sense of perceived atypicality in observers. Using a carefully collected motion capture database, facial expressions of children with and without ASD are compared within six basic emotion categories employing methods from information theory, time-series modeling and statistical analysis. Our experiments show that children with ASD usually have less complex expression producing mechanisms; the differences in facial dynamics between children with and without ASD primarily come from the eye region. Our study also notes that children with ASD exhibit lower symmetry between left and right regions, and lower variation in motion intensity across facial regions.
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3. Hirjak D, Wolf RC, Paternoga I, Kubera KM, Thomann AK, Stieltjes B, Maier-Hein KH, Thomann PA. {{Neuroanatomical Markers of Neurological Soft Signs in Recent-Onset Schizophrenia and Asperger-Syndrome}}. {Brain topography}. 2015 Dec 26.
Neurological soft signs (NSS) are frequently found in psychiatric disorders of significant neurodevelopmental origin. Previous MRI studies in schizophrenia have shown that NSS are associated with abnormal cortical, thalamic and cerebellar structure and function. So far, however, no neuroimaging studies investigated brain correlates of NSS in individuals with Asperger-Syndrome (AS) and the question whether the two disorders exhibit common or disease-specific cortical correlates of NSS remains unresolved. High-resolution MRI data at 3 T were obtained from 48 demographically matched individuals (16 schizophrenia patients, 16 subjects with AS and 16 healthy individuals). The surface-based analysis via Freesurfer enabled calculation of cortical thickness, area and folding (local gyrification index, LGI). NSS were examined on the Heidelberg Scale and related to cortical measures. In schizophrenia, higher NSS were associated with reduced cortical thickness and LGI in fronto-temporo-parietal brain areas. In AS, higher NSS were associated with increased frontotemporal cortical thickness. This study lends further support to the hypothesis that disorder-specific mechanisms contribute to NSS expression in schizophrenia and AS. Pointing towards dissociable neural patterns may help deconstruct the complex processes underlying NSS in these neurodevelopmental disorders.
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4. Hong J, Bishop-Fitzpatrick L, Smith LE, Greenberg JS, Mailick MR. {{Factors Associated with Subjective Quality of Life of Adults with Autism Spectrum Disorder: Self-Report Versus Maternal Reports}}. {Journal of autism and developmental disorders}. 2015 Dec 26.
We examined factors related to subjective quality of life (QoL) of adults with autism spectrum disorder (ASD) aged 25-55 (n = 60), using the World Health Organization Quality of Life measure (WHOQOL-BREF). We used three different assessment methods: adult self-report, maternal proxy-report, and maternal report. Reliability analysis showed that adults with ASD rated their own QoL reliably. QoL scores derived from adult self-reports were more closely related to those from maternal proxy-report than from maternal report. Subjective factors such as perceived stress and having been bullied frequently were associated with QoL based on adult self-reports. In contrast, level of independence in daily activities and physical health were significant predictors of maternal reports of their son or daughter’s QoL.
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5. Hubner LM, Feldman HM, Huffman LC. {{Parent-Reported Shared Decision Making: Autism Spectrum Disorder and Other Neurodevelopmental Disorders}}. {Journal of developmental and behavioral pediatrics : JDBP}. 2016 Jan;37(1):20-32.
OBJECTIVES: Assess differences in parent-reported shared decision making (SDM) based on diagnostic group in a national sample of children with neurodevelopmental disorders (autism spectrum disorder [ASD], cerebral palsy [CP], or Down syndrome [DS]). Assess contribution of medical home and child functional impairment. METHODS: Secondary analysis of 2009 to 2010 National Survey of Children with Special Health Care Needs explored reports of 3966 children with ASD, CP, or DS. SDM was defined categorically (SDMcat, present or absent) and continuously (SDMcont, score range 0-12). Regression models were adjusted for child/family characteristics, medical home, functional impairment, and diagnostic group. RESULTS: SDMcat and SDMcont were significantly lower in the ASD group (56.7% [95% confidence interval = CI, 53.4-59.9] and mean 8.7 [95% CI, 8.5-9.0]), compared with the CP group (70.5% [95% CI, 63.4-76.7] and mean 9.7 [95% CI, 9.3-10.1]), or the DS group (70.8% [95% CI, 61.2-78.8] and mean 10.0 [95% CI, 9.5-10.4]). In adjusted analyses of SDMcat and SDMcont, SDM was more likely among children with a medical home (adjusted odds ratio 6.6, p < .001, mean = 11.9, and p < .001), and less likely for children with greatest functional impairment (adjusted odds ratio 0.4, p = .002, mean = 10.1, and p = .001). Adjusted analysis of SDMcont also showed differences based on diagnostic group with lower SDMcont scores in the ASD group (mean = 10.1 and p = .005) compared with the DS group. CONCLUSION: A medical home was associated with higher SDM, whereas greater functional impairment and ASD diagnosis were associated with lower SDM. Lien vers le texte intégral (Open Access ou abonnement)
6. Rahman A, Divan G, Hamdani SU, Vajaratkar V, Taylor C, Leadbitter K, Aldred C, Minhas A, Cardozo P, Emsley R, Patel V, Green J. {{Effectiveness of the parent-mediated intervention for children with autism spectrum disorder in south Asia in India and Pakistan (PASS): a randomised controlled trial}}. {The lancet Psychiatry}. 2015 Dec 15.
BACKGROUND: Autism spectrum disorder affects more than 5 million children in south Asia. Although early interventions have been used for the treatment of children in high-income countries, no substantive trials have been done of the interventions adapted for use in low-income and middle-income countries (LMICs). We therefore assessed the feasibility and acceptability of the parent-mediated intervention for autism spectrum disorder in south Asia (PASS) in India and Pakistan. METHODS: A single-blind randomised trial of the comparison of 12 sessions of PASS (plus treatment as usual) with treatment as usual alone delivered by non-specialist health workers was done at two centres in Goa, India, and Rawalpindi, Pakistan. Children aged 2-9 years with autism spectrum disorder were randomly assigned (1:1) by use of probabilistic minimisation, controlling for treatment centre (Goa or Rawalpindi), age (<6 years or >/=6 years), and functional impairment (Vineland Adaptive Behaviour Scale Composite score <65 or >/=65). The primary outcome was quality of parent-child interaction on the Dyadic Communication Measure for Autism at 8 months. Analysis was by intention to treat. The study is registered with ISRCTN, number ISRCTN79675498. FINDINGS: From Jan 1 to July 30, 2013, 65 children were randomly allocated, 32 to the PASS group (15 in Goa and 17 in Rawalpindi) and 33 to the treatment-as-usual group (15 in Goa and 18 in Rawalpindi). 26 (81%) of 32 participants completed the intervention. After adjustment for minimisation factors and baseline outcome, the primary outcome showed a treatment effect in favour of PASS in parental synchrony (adjusted mean difference 0.25 [95% CI 0.14 to 0.36]; effect size 1.61 [95% CI 0.90 to 2.32]) and initiation of communication by the child with the parent (0.15 [0.04 to 0.26]; effect size 0.99 [0.29 to 1.68]), but time in mutual shared attention was reduced (-0.16 [-0.26 to -0.05]; effect size -0.70 [-1.16 to -0.23]). INTERPRETATION: Our results show the feasibility of adapting and task-shifting an intervention used in a high-income context to LMICs. The findings also replicate the positive primary outcome treatment effects of a parent-mediated communication-focused intervention in the original UK Preschool Autism Communication Trial, with one negative effect not reported previously. FUNDING: Autism Speaks, USA.
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7. Shtayermman O. {{Angela Scarpa, Susan Williams White, Tony Attwood: CBT for Children and Adolescents with High Functioning Autism Spectrum Disorders : The Guilford Press, London and New York, 2013, 329 pp, ISBN: 978-1-4625-1048-1, $39.95 (hardcover)}}. {Journal of autism and developmental disorders}. 2015 Dec 26.
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8. Srinath S, Jacob P. {{Challenges in parent-mediated training in autism spectrum disorder}}. {The lancet Psychiatry}. 2015 Dec 15.
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9. Weiser MJ, Mucha B, Denheyer H, Atkinson D, Schanz N, Vassiliou E, Benno RH. {{Dietary docosahexaenoic acid alleviates autistic-like behaviors resulting from maternal immune activation in mice}}. {Prostaglandins, leukotrienes, and essential fatty acids}. 2015 Dec 2.
The prevalence of autism spectrum disorders over the last several decades has risen at an alarming rate. Factors such as broadened clinical definitions and increased parental age only partially account for this precipitous increase, suggesting that recent changes in environmental factors may also be responsible. One such factor could be the dramatic decrease in consumption of anti-inflammatory dietary omega-3 (n-3) polyunsaturated fatty acids (PUFAs) relative to the amount of pro-inflammatory omega-6 (n-3) PUFAs and saturated fats in the Western diet. Docosahexaenoic acid (DHA) is the principle n-3 PUFA found in neural tissue and is important for optimal brain development, especially during late gestation when DHA rapidly and preferentially accumulates in the brain. In this study, we tested whether supplementation of a low n-3 PUFA diet with DHA throughout development could improve measures related to autism in a mouse model of maternal immune activation. We found that dietary DHA protected offspring from the deleterious effects of gestational exposure to the viral mimetic polyriboinosinic-polyribocytidilic acid on behavioral measures of autism and subsequent adulthood immune system reactivity. These data suggest that elevated dietary levels of DHA, especially during pregnancy and nursing, may help protect normal neurodevelopment from the potentially adverse consequences of environmental insults like maternal infection.
