1. Bitsika V, Arnold WM, Sharpley CF. {{Cluster analysis of autism spectrum disorder symptomatology: Qualitatively distinct subtypes or quantitative degrees of severity of a single disorder?}}. {Res Dev Disabil}. 2018; 76: 65-75.
The decision to collapse several related disorders into a single diagnosis of Autism Spectrum Disorder (ASD) generated significant controversy and debate. There has been mixed evidence as to whether various ASD subtypes are qualitatively distinct or if they exist on a spectrum of symptom severity. The present study conducted a two-step cluster analysis of major ASD symptoms in a sample of 147 young males with ASD aged between 6yr and 18yr with IQ>70. Results indicated that a two-cluster solution (high and low severity of ASD symptomatology) was reliable and valid. Further, the construct of challenging behaviour was not a necessary component of the two-cluster solution, verifying the new conceptualisation of ASD. Further replication of these findings with other subsets of individuals with ASD is needed.
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2. El-Ansary A, Bacha AB, Bjorklund G, Al-Orf N, Bhat RS, Moubayed N, Abed K. {{Probiotic treatment reduces the autistic-like excitation/inhibition imbalance in juvenile hamsters induced by orally administered propionic acid and clindamycin}}. {Metabolic brain disease}. 2018.
Increasing evidence suggests that the gut microbiota plays a key role in the central nervous system (CNS), and alterations of the gut microbiota composition due to environmental factors can contribute to neurodevelopmental disorders. Animal modeling may help to identify drugs that can normalize the altered gut microbiota and thereby ameliorate abnormal brain signaling pathways. The purpose of the present study was to investigate the therapeutic potency of probiotics such as Bifidobacteria and Lactobacilli on glutamate excitotoxicity as a neurotoxic effect induced by clindamycin and propionic acid (PPA) in juvenile hamsters. Fifty young golden Syrian hamsters weighing between 60 and 70 g were enrolled in the study. The hamsters were randomly divided into five groups, each with ten hamsters. The hamsters in the control group only received phosphate-buffered saline orally. The PPA-treated group received a neurotoxic dose of 250 mg PPA/kg body weight (BW)/day for three days. The clindamycin-treated group received 30 mg clindamycin/kg BW as a single orogastric dose on the day the experiment started. The two therapeutic groups received the same doses of PPA and clindamycin followed by 0.2 g probiotic/kg BW for three weeks. Biochemical parameters related to glutamate excitotoxicity were investigated in brain homogenates from each group of hamsters. Additionally, the development of pathogenic bacteria was monitored in stool samples from all groups. The microbiology results of the present study revealed descriptive changes in the fecal microbiota and the appearance of Clostridium species in the hamsters treated with clindamycin and PPA. Additionally, the effectiveness of the probiotic in the restoration of the normal gut microbiota was demonstrated. Moreover, clindamycin and PPA were found to induce a significant depletion of Mg(2+) and gamma-aminobutyric acid (GABA) and a remarkable increase in the Na(+)/Mg(2+) and glutamate/GABA ratios but non-significant changes in the absolute levels of K(+), Na(+) and glutamate. The bacteria overgrowth induced by PPA and clindamycin in the present study effectively showed signs of neuronal toxicity. The study indicates that probiotics can be used safely to ameliorate glutamate excitotoxicity mostly through increasing depleted GABA and Mg(2+) and decreasing the excitatory neurotransmitter, glutamate.
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3. Foxe JJ, Molholm S, Baudouin SJ, Wallace MT. {{Explorations and perspectives on the neurobiological bases of autism spectrum disorder}}. {Eur J Neurosci}. 2018; 47(6): 488-96.
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4. Frank F, Jablotschkin M, Arthen T, Riedel A, Fangmeier T, Holzel LP, Tebartz van Elst L. {{Education and employment status of adults with autism spectrum disorders in Germany – a cross-sectional-survey}}. {BMC Psychiatry}. 2018; 18(1): 75.
BACKGROUND: Adults with autism spectrum disorders (ASD) experience challenges in participating in the labour market and struggle to achieve and maintain appropriate professional positions, possibly due to impairments of communication and social interaction. Studies have shown high rates of unemployment as well as evidence of inadequate employment. As knowledge on the participation in the German labour market is scarce, the aim of our study was to examine employment status, type of occupation and inadequate employment in a sample of clinically mostly late-diagnosed and most likely not intellectually disabled adults with ASD in Germany. METHODS: We conducted a cross-sectional-survey in clinically mostly late-diagnosed adults with ASD. Employment status, type of occupation, and the level of formal education and training were examined through a postal questionnaire. Inadequate employment regarding participants’ current and longest practised occupation was assessed by transforming participants’ information into skill levels of the « Classification of Occupations 2010 » of the German Federal Employment Agency, and comparing these with participants’ level of formal education and training. RESULTS: The response rate was 43.2% (N = 185 of N = 428 potential participants). 94.6% were first-time diagnosed when being 18 years of age or older. 56.8% held a general university entrance-level qualification and 24.9% had obtained a Masters’ or diploma degree as their highest vocational qualification. 94.1% had been employed at some time. Of these, 68.4% reported being currently employed, 13.5% being currently unemployed and 17.0% being retired for health reasons. Regarding the longest-practised and the current occupation, the highest proportion of participants was found in the occupational area « health and social sector, teaching and education » (22.4% and 23.3%, respectively). With respect to inadequate employment, 22.1% were found to be overeducated in relation to their longest-practised occupation and 31.3% in relation to their current occupation. This is significantly higher than the percentage of overeducation in the general population. CONCLUSIONS: Despite largely high formal qualifications, the clinically mostly late-diagnosed adults with ASD represented in our sample are disadvantaged regarding their participation in the German labour market, especially with respect to rates of unemployment, early retirement and overeducation. Employment support programs should be developed to improve employment outcomes.
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5. Green J, Garg S. {{Annual Research Review: The state of autism intervention science: progress, target psychological and biological mechanisms and future prospects}}. {J Child Psychol Psychiatry}. 2018; 59(4): 424-43.
BACKGROUND: There has been recent systematic review of key evidence in psychosocial intervention in autism but little review of biological treatments. METHODS: We analyse the current literature from the perspective of intervention and mechanism targets across social and biological development. RESULTS: The overall quality of trials evidence in autism intervention remains relatively low, despite some recent progress. Many treatments in common use have little or no evidence base. This is very concerning in such an important disorder. A variety of psychosocial interventions can show effect to improve some short-term effects on children’s immediate dyadic social interactions, for instance with caregivers. But showing true effectiveness in this developmental disorder requires generalisation of such effects into wider social contexts, on autism symptoms and in long-term progress in development. Only a few interventions so far have begun to show this. A number of early phase interventions on biological targets have shown real promise, but none has yet progressed to larger scale effectiveness trials on behavioural or symptom outcomes. CONCLUSIONS: There has been enough progress in psychosocial intervention research now to be able to begin to identify some evidence-based practice in autism treatment. To consolidate and improve outcomes, the next phase of intervention research needs improved trial design, and an iterative approach building on success. It may also include the testing of potential synergies between promising biological and psychosocial interventions.
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6. Hens K, Noens I, Peeters H, Steyaert J. {{The ethics of patenting autism genes}}. {Nature reviews Genetics}. 2018.
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7. Hill TL, Gray SAO, Baker CN, Boggs K, Carey E, Johnson C, Kamps JL, Varela RE. {{A Pilot Study Examining the Effectiveness of the PEERS Program on Social Skills and Anxiety in Adolescents with Autism Spectrum Disorder}}. {Journal of developmental and physical disabilities}. 2017; 29(5): 797-808.
The Program for the Evaluation of the Enrichment of Relational Skills (PEERS), a social skills intervention for high functioning adolescents with autism spectrum disorder (ASD), has been proven efficacious in randomized control trials. However, the effectiveness of the PEERS program in community settings has not been studied. The present small-scale pilot study examined the effectiveness of the PEERS program in a community setting. Five adolescents and their caregivers participated in the PEERS intervention. Results indicated that the adolescents showed significant improvement in their social engagement, social cognition, social communication, social motivation, and knowledge of PEERS skills and concepts from pre- to post-intervention. Furthermore, adolescents showed significant reductions in their internalizing and autistic symptoms from pre- to post-intervention. The findings from this small-scale pilot study support the effectiveness of the PEERS program in community-based settings.
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8. Kouklari EC, Tsermentseli S, Monks CP. {{Developmental trends of hot and cool executive function in school-aged children with and without autism spectrum disorder: Links with theory of mind}}. {Development and psychopathology}. 2018: 1-16.
The development of executive function (EF) in autism spectrum disorder (ASD) has been investigated using only « cool »-cognitive EF tasks while there is limited knowledge regarding the development of « hot »-affective EF. Although cool EF development and its links to theory of mind (ToM) have been widely examined, understanding of the influence of hot EF to ToM mechanisms is minimal. The present study introduced a longitudinal design to examine the developmental changes in cool and hot EF of children with ASD (n = 45) and matched (to age and IQ) controls (n = 37) as well as the impact of EF on ToM development over a school year. For children with ASD, although selective cool (working memory and inhibition) and hot (affective decision making) EF domains presented age-related improvements, they never reached the performance level of the control group. Early cool working memory predicted later ToM in both groups but early hot delay discounting predicted later ToM only in the ASD group. No evidence was found for the reverse pattern (early ToM predicting later EF). These findings suggest that improvements in some EF aspects are evident in school age in ASD and highlight the crucial role that both cool and hot EF play in ToM development.
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9. Li SJ, Wang Y, Qian L, Liu G, Liu SF, Zou LP, Zhang JS, Hu N, Chen XQ, Yu SY, Guo SL, Li K, He MW, Wu HT, Qiu JX, Zhang L, Wang YL, Lou X, Ma L. {{Alterations of White Matter Connectivity in Preschool Children with Autism Spectrum Disorder}}. {Radiology}. 2018: 170059.
Purpose To investigate the topologic architecture of white matter connectivity networks in preschool-aged children with a diagnosis of autism spectrum disorder (ASD) versus typical development (TD). Materials and Methods Forty-two participants were enrolled, including 21 preschool children with ASD (14 male children and seven female children; mean age, 4.56 years +/- 0.97 [standard deviation]) and 21 children with TD (11 males and 10 females; mean age, 5.13 years +/- 0.82). The diagnosis of ASD was determined according to the Diagnostic and Statistical Manual of Mental Disorders Global Assessment of Functioning scores (mean score, 8.00 +/- 0.50). All participants underwent diffusion-tensor imaging (DTI) and T2-weighted imaging on a 3-T magnetic resonance system. A graph theoretical analysis was applied to investigate the topologic organization of the brain network including global and local topologic parameters. Statistical analysis was then performed for the comparison between the groups. Results Compared with the TD group, children with ASD demonstrated shortened characteristic path length (t1 = 0.536, t2 = 0.534, t3 = 0.523, t4 = 0.510, and t5 = 0.501; P < .05) and increased global efficiency (t1 = 0.499, t2 = 0.497, t3 = 0.486, t4 = 0.473, and t5 = 0.465; P < .05) and clustering coefficient (t1 = 0.673, t2 = 0.750, t3 = 0.757, t4 = 0.738, and t5 = 0.741; P < .05). Significant increases in nodal efficiency were mainly found in left pallidum (0.037 vs 0.032, respectively; P < .01) and right caudate nucleus (0.037 vs 0.032, respectively; P < .01) of the basal ganglia network. Conclusion Significantly altered patterns of global and local brain network topography may underlie the abnormal brain development in preschool children with ASD compared with those who have TD. The identification of altered structural connectivity in basal ganglia and paralimbic-limbic networks may point toward potential imaging biomarkers for preschool-age patients with ASD. ((c)) RSNA, 2018. Lien vers le texte intégral (Open Access ou abonnement)
10. Loukusa S, Makinen L, Kuusikko-Gauffin S, Ebeling H, Leinonen E. {{Assessing social-pragmatic inferencing skills in children with autism spectrum disorder}}. {J Commun Disord}. 2018.
By utilizing the Pragma test this study investigated how sixteen five- to ten-year-old children with autism spectrum disorder (ASD) and sixteen typically developing (TD) children comprehended contextually challenging scenarios demanding 1) contextual inference with theory of mind (ToM), 2) contextual inference without ToM, 3) relevant use of language, 4) recognition of feelings, and 5) understanding false beliefs. The study also compared children’s ability to explain their own correct answers. In addition, this study evaluated the sensitivity of three different methods for discriminating the children with ASD from the TD children: 1) the Pragma test, 2) the Social Interaction Deviance Composite (SIDC) of Children’s Communication Checklist-2 (CCC-2), and 3) the Theory of Mind subtest of the Developmental Neuropsychological Assessment, Second edition (NEPSY-II). The results showed that children with ASD differed from TD children in questions demanding context utilization. However, the demand of mind-reading in utterance interpretation increased the difference between groups. Compared to TD children, children with ASD had more difficulties in explaining how they had used context to arrive at the correct answer. The discrimination power for detecting children with ASD from TD children was excellent in the Pragma test, good in the SIDC CCC-2 and fair in the Theory of Mind subtest of NEPSY-II. This study showed that by using contextually sensitive materials, such as the Pragma test, it is possible to detect the social-pragmatic inferencing difficulties of high-functioning children with ASD in structured test situations and not only in real-life situations or by using parental reports.
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11. Noel JP, Stevenson RA, Wallace MT. {{Atypical Audiovisual Temporal Function in Autism and Schizophrenia: Similar Phenotype, Different Cause}}. {Eur J Neurosci}. 2018.
Binding across sensory modalities yields substantial perceptual benefits, including enhanced speech intelligibility. The coincidence of sensory inputs across time is a fundamental cue for this integration process. Recent work has suggested that individuals with diagnoses of Schizophrenia (SZ) and Autism Spectrum Disorder (ASD) will characterize auditory and visual events as synchronous over larger temporal disparities than their neurotypical counterparts. Namely, these clinical populations possess an enlarged temporal binding window (TBW). Although SZ and ASD patients share aspects of their symptomatology, phenotypic similarities may result from distinctly etiologies. To examine similarities and variances in audiovisual temporal function in these two populations, individuals diagnosed with ASD (n=46; controls n=40) and SZ (n=16, controls=16) completed an audiovisual simultaneity judgment task. In addition to standard psychometric analyses, synchrony judgments were assessed using Bayesian causal inference modeling. This approach permits distinguishing between distinct causes of an enlarged TBW: an a priori bias to bind sensory information and poor fidelity in the sensory representation. Findings indicate that both ASD and SZ populations show deficits in multisensory temporal acuity. Importantly, results suggest that while the wider TBWs in ASD most prominently results from atypical priors, the wider TBWs in SZ results from a trend toward changes in prior and weaknesses in the sensory representations. Results are discussed in light of current ASD and SZ theories and highlight that different perceptual training paradigms focused on improving multisensory integration may be most effective in these two clinical populations and emphasize that similar phenotypes may emanate from distinct mechanistic causes. This article is protected by copyright. All rights reserved.
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12. Sabatino DiCriscio A, Troiani V. {{The Broader Autism Phenotype and Visual Perception in Children}}. {J Autism Dev Disord}. 2018.
Atypical visual perception has increasingly been described in individuals with autism spectrum disorders (ASD) and linked to quantitative, autism-like features that are present in children and adults without ASD. We investigated whether individual differences in visual processing skills were related to quantitative measures of autism traits in a pediatric sample with a range of clinical features. Visual processing was comprehensively characterized using the test of visual perceptual skills (TVPS), a standardized test of visual perception with seven subtests that capture a range of visual processing abilities. The TVPS Figure Ground (TVPS-FG) subtest requires an individual to disembed a smaller figure from a larger scene. TVPS-FG subtest scores were positively correlated with children’s autism features as measured by a parental report of the Broader Autism Phenotype Questionnaire (BAP-Q). The correlation with BAP-Q was specific to the TVPS-FG subtest, as the other TVPS subtest scores were not significantly related to the BAP-Q. This adds to the growing body of research documenting that atypical visual processing is associated with the autism phenotype and highlights the importance of capturing quantitative traits in heterogeneous developmental brain disorders.
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13. Simonoff E. {{Commentary: Randomized controlled trials in autism spectrum disorder: state of the field and challenges for the future}}. {J Child Psychol Psychiatry}. 2018; 59(4): 457-9.
This issue of the Journal includes two articles summarizing the evidence from clinical trials aimed at improving symptoms of autism. French and Kennedy (Journal of Child Psychology and Psychiatry, 2018, xx, xxxx) systematically review randomized controlled trials (RCTs) aimed at an « early intervention » and focus on trials including children with or at risk of autism under age 6 years. Although no type of intervention were excluded from their review, none of the included 48 RCTs employed pharmacological modalities and the overwhelming majority tested psychological/behavioural interventions aimed at modifying aspects of observed behaviours that are abnormal in children with autism. Using the standard Cochrane tool for evaluating risk of bias, French and Kennedy conclude that many RCTs are of low quality, which throws into question the reliance that should be placed on the findings.
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14. Stuker EW, Eskander JP, Gennuso SA. {{Third time’s a charm: Oral midazolam vs intranasal dexmedetomidine for preoperative anxiolysis in an autistic pediatric patient}}. {Paediatric anaesthesia}. 2018; 28(4): 370-1.
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15. Thompson C, Bolte S, Falkmer T, Girdler S. {{To be understood: Transitioning to adult life for people with Autism Spectrum Disorder}}. {PLoS One}. 2018; 13(3): e0194758.
INTRODUCTION: The purpose of this study was to explore the viewpoints of parents of young people with Autism Spectrum Disorder (ASD) in relation to their child’s transition to adulthood. METHODS: Data were collected during four structured focus groups with 19 parents of young people with ASD with average to high intellectual capacities. Condensed meaning units were identified and checked during focus groups, and were subsequently linked to the International Classification of Functioning, Disability and Health (ICF). RESULTS: Three major themes emerged: to be understood, to understand the world and to succeed. The ICF domains of activity and participation and environmental factors emerged as having the greatest potential to influence transition outcomes. CONCLUSIONS: Policies and services should focus on strengths to maximise participation in higher education, employment and independent living amongst young people with ASD. Interventions targeting environmental factors could be effective in improving participation in adult life. Person-centred and individualised approaches could further complement this approach supporting the transition to adulthood for people with ASD, ultimately improving outcomes in adulthood.
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16. Wayment HA, Al-Kire R, Brookshire K. {{Challenged and changed: Quiet ego and posttraumatic growth in mothers raising children with autism spectrum disorder}}. {Autism}. 2018: 1362361318763971.
Posttraumatic growth theory posits that when life circumstances are perceived as stressful, secondary appraisal processes can be recruited in ways to facilitate both coping efforts and personal growth. Using a mixed-methods approach, we found mothers’ most challenging experiences involved child behavior (e.g. aggression, communication, and social issues) and psychosocial impacts (e.g. lack of social support, perceived judgment of others, perceived loss, and personal distress). Descriptions of most rewarding experiences reflect posttraumatic growth frameworks including constructive perceptions about themselves, life, and their relationships as well as evidence for what Maercker and Zoellner call illusory types of posttraumatic growth. Quantitative data were subjected to a hierarchical regression analysis for self-reported posttraumatic growth and included mothers’ demographics, child functioning, and psychosocial measures. As predicted, posttraumatic growth was positively associated with social support from mothers’ most important network member and quiet ego characteristics, a type of eudaimonic motivation. Contrary to expectation, neither autism spectrum disorder-related rumination nor time since diagnosis (or their interaction) was associated with posttraumatic growth. Discussion focuses on the practical implications of our findings that posttraumatic growth-related coping includes both constructive and illusory forms and the importance of social support and eudaimonic motivation in facilitating positive forms of secondary coping.
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17. Whyte EM, Scherf KS. {{Gaze Following is Related to the Broader Autism Phenotype in a Sex-Specific Way: Building the Case for Distinct Male and Female Autism Phenotypes}}. {Clinical psychological science : a journal of the Association for Psychological Science}. 2018; 6(2): 280-7.
The search for a female autism phenotype is difficult, given the low diagnostic rates in females. Here, we studied potential sex differences in a core feature of autism, difficulty with eye gaze processing, among typically developing individuals who vary in the broad autism phenotype, which includes autistic-like traits that are common, continuously distributed, and similarly heritable in males and females. Participants viewed complex images of an actor in a naturalistic scene looking at one of many possible objects and had to identify the target gazed-at object. Among males, those high in autistic-like traits exhibited worse eye gaze following performance than did those low in these traits. Among females, eye gaze following behavior did not vary with autistic-like traits. These results suggest that deficient eye gaze following behavior is part of the broader autism phenotype for males, but may not be a part of the female autism phenotype.
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18. Woodbury-Smith M, Scherer SW. {{Progress in the genetics of autism spectrum disorder}}. {Dev Med Child Neurol}. 2018.
A genetic basis for autism spectrum disorder (ASD) is now well established, and with the availability of high-throughput microarray and sequencing platforms, major advances have been made in our understanding of genetic risk factors. Rare, often de novo, copy number and single nucleotide variants are both implicated, with many ASD-implicated genes showing pleiotropy and variable penetrance. Additionally, common variants are also known to play a role in ASD’s genetic etiology. These new insights into the architecture of ASD’s genetic etiology offer opportunities for the identification of molecular targets for novel interventions, and provide new insight for families seeking genetic counselling. WHAT THE PAPER ADDS: A number of rare genetic variants are implicated in autism spectrum disorder (ASD), with some showing recurrence. Common genetic variants are also important and a number of loci are now being uncovered. Genetic testing for individuals with ASD offers the opportunity to identify relevant genetic etiology.
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19. Young O, Perati S, Weiss LA, Rauen KA. {{Age and ASD symptoms in Costello syndrome}}. {Am J Med Genet A}. 2018; 176(4): 1027-8.
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20. Zhou J, Liu A, He F, Jin Y, Zhou S, Xu R, Guo H, Zhou W, Wang M, Wei Q. {{High prevalence of serum folate receptor autoantibodies in children with autism spectrum disorders}}. {Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals}. 2018: 1-9.
BACKGROUND: Supplementation of folic acid by pregnant mothers is thought to lower the risk of autism spectrum disorders (ASDs) in the offspring. Folic acid is taken up by cells via receptors with high affinity for folate and reduced folic acid derivatives. However, this is blocked by the presence of folate receptor autoantibodies (FRAA). Cerebral FRAA have been detected with high frequency in children with ASDs, suggesting the existence of a link between folic acid uptake and disease etiology. METHODS: We investigated the frequency of FRAA in serum samples from 40 children with ASDs and 42 gender- and age-matched children with typical development (TD). Serum FRAA concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: We found a significant difference in the frequency of serum FRAA in the two study cohorts. Serum FRAA were present in 77.5% (31/40) of children with ASDs compared with 54.8% (23/42) of TD children (P = 003746, Fischer’s exact test). Thus, serum FRAA are more prevalent in children with ASDs than in TD children. CONCLUSIONS: Our data suggest that children with ASDs may have defects in folic acid absorption that play a role in the onset of ASDs.
