1. Aman MG, Kasper W, Manos G, Mathew S, Marcus R, Owen R, Mankoski R. {{Line-item analysis of the Aberrant Behavior Checklist: results from two studies of aripiprazole in the treatment of irritability associated with autistic disorder}}. {J Child Adolesc Psychopharmacol} (Oct);20(5):415-422.
OBJECTIVES: The aim of this study was to evaluate the efficacy of aripiprazole in the treatment of discrete symptoms of irritability associated with autistic disorder, as well as other symptoms captured on the Aberrant Behavior Checklist (ABC). METHODS: This was a post hoc analysis of data from two 8-week, randomized, double-blind, multicenter trials to evaluate the efficacy of aripiprazole dosed flexibly (2-15 mg/day, n=47) or fixed (5, 10, or 15 mg/day, n = 166) versus placebo (flexibly dosed, n = 51; fixed dose, n = 52). The effects of treatment on the 58 ABC items were evaluated. RESULTS: Statistically significantly greater improvement was seen with aripiprazole versus placebo (p < 0.05) for all arms in both trials on the ABC-Irritability total subscale score and on the following individual ABC-Irritability items: Mood changes quickly, cries/screams inappropriately, and stamps feet/bangs objects. Several additional items measuring tantrum-like behaviors improved in the flexibly dosed trial and at least one arm of the fixed-dose trial (p < 0.05). Measures of self-injurious behavior, which had low baseline values, demonstrated numerical, but not statistically significant, improvement in both trials. Statistically significantly greater improvement in ABC Stereotypic Behavior and Hyperactivity total subscale scores was also consistent across all arms in both trials. In particular, there was a cluster of items related to hyperkinesis that were consistently sensitive to treatment. Conclusions: Aripiprazole is efficacious in the treatment of irritability in children and adolescents with autistic disorder, particularly with respect to symptoms associated with tantrum behavior.
2. Begeer S, Gevers C, Clifford P, Verhoeve M, Kat K, Hoddenbach E, Boer F. {{Theory of Mind Training in Children with Autism: A Randomized Controlled Trial}}. {J Autism Dev Disord} (Oct 26)
Many children with Autism Spectrum Disorders (ASD) participate in social skills or Theory of Mind (ToM) treatments. However, few studies have shown evidence for their effectiveness. The current study used a randomized controlled design to test the effectiveness of a 16-week ToM treatment in 8-13 year old children with ASD and normal IQs (n = 40). The results showed that, compared to controls, the treated children with ASD improved in their conceptual ToM skills, but their elementary understanding, self reported empathic skills or parent reported social behaviour did not improve. Despite the effects on conceptual understanding, the current study does not indicate strong evidence for the effectiveness of a ToM treatment on the daily life mindreading skills.
3. Fountain C, King MD, Bearman PS. {{Age of diagnosis for autism: individual and community factors across 10 birth cohorts}}. {J Epidemiol Community Health} (Oct 25)
Background The incidence of autism rose dramatically between 1992 and 2001, while the age at which children were first diagnosed declined. During this period the size and composition of the autism caseload has changed, but little is known about whether the factors associated with the timing of diagnosis may also have shifted. Using a multilevel analysis strategy, the individual and community-level factors associated with age of diagnosis were modelled across 10 birth cohorts of California children. Methods Linked birth and administrative records on 17 185 children with diagnoses of autistic disorder born in California between 1992 and 2001 and enrolled with the California Department of Developmental Services (DDS) were analysed. Information on cases, their parents and their residential location were extracted from birth and DDS records. Zip codes of residence were matched to census data to create community-level measures. Multilevel linear models were estimated for each birth cohort, with individual-level effects for sex, race, parental characteristics, poverty status, birth order and symptom expression. At the community level measures of educational and economic composition, local autism prevalence and the presence of a child psychiatrist were included. Results Children with highly educated parents are diagnosed earlier, and this effect has strengthened over time. There is a persistent gap in the age of diagnosis between high and low socioeconomic status (SES) children that has shrunk but not disappeared over time. Conclusion Routine screening for autism in early childhood for all children, particularly those of low SES, is necessary to eliminate disparities in early intervention.
4. Harrington JW. {{The Actual Prevalence of Autism: Are We There Yet?}}. {Pediatrics} (Oct 25)
5. Janson S, Blennow M. {{[Mass screening for autism can be a reality in the 2,5-year check ups. Child health services have a key position in early diagnosis–if the studies are correct]}}. {Lakartidningen} (Sep 29-Oct 5);107(39):2308-2309.
6. Johnson S, Hollis C, Hennessy E, Kochhar P, Wolke D, Marlow N. {{Screening for autism in preterm children: diagnostic utility of the Social Communication Questionnaire}}. {Arch Dis Child} (Oct 27)
Objective Preterm survivors are at high risk for autism spectrum disorders (ASD). The diagnostic utility of the Social Communication Questionnaire (SCQ) in screening for ASD was assessed in extremely preterm children at 11 years of age. Design All babies born at <26 weeks gestation in UK and Ireland from March through December 1995 were recruited to the EPICure Study. Of 307 survivors, 219 (71%) were assessed at 11 years. Parents of 173 children completed the SCQ to screen for autistic features and the Development and Well Being Assessment (DAWBA) psychiatric interview. A consensus diagnosis of ASD was assigned by two child psychiatrists following review of the DAWBA parental interview and corresponding DAWBA teacher questionnaire. Setting Community-based follow-up. Results Using the established SCQ cut-off (scores >/=15), 28 (16%) extremely preterm children screened positive for ASD. Eleven (6%) were assigned a diagnosis of ASD. Using this cut-off, the SCQ had 82% sensitivity and 88% specificity for identifying ASD in this population. Using a receiver operating characteristic curve, SCQ scores >/=14 had optimal diagnostic utility (area under curve: 0.94; sensitivity: 91%; specificity: 86%). Positive predictive value was relatively low (31%) resulting in numerous over-referrals. However, children with false positive screens had significantly worse neuro-developmental, cognitive and behavioural outcomes than those with true negative screens. Conclusion The SCQ has good diagnostic utility for identifying ASD in extremely preterm children and is a useful screening tool in this population. Children with false positive screens represent a high-risk group in whom further diagnostic assessment would be beneficial.
7. Kana RK, Wadsworth HM, Travers BG. {{A Systems Level Analysis of the Mirror Neuron Hypothesis and Imitation Impairments in Autism Spectrum Disorders}}. {Neurosci Biobehav Rev} (Oct 22)
Although several studies suggest an imitation deficit as a key feature of autism, questions have been raised about the consistency of this finding and about the component skills involved in imitation. The primary aim of this review is to examine the uneven profile of imitation deficits found in autism in the context of the mirror neuron system (MNS) dysfunction hypothesis. We use the cortical underconnectivity framework (Just et al., 2004) to examine the coordination of brain areas that orchestrate the communication between the component skills underlying imitation. A comprehensive account of imitation deficit in autism should take into account the regions that are at the core of the MNS (e.g., IFG and IPL) and related regions that feed into the MNS (e.g., STS, Cerebellum) in their functioning and in their coordination. Our findings suggest that the MNS may be associated with mediating familiarity, attention, self-other matching, and social relevance, which may be vital in characterizing the imitation deficits in autism. Such an analysis may have greater clinical and therapeutic value.
8. Mack H, Fullana MA, Russell AJ, Mataix-Cols D, Nakatani E, Heyman I. {{Obsessions and compulsions in children with Asperger’s syndrome or high-functioning autism: a case-control study}}. {Aust N Z J Psychiatry} (Oct 25)
Objective: To compare the clinical characteristics and symptom severity of children with obsessive disorder (OCD) plus autism spectrum disorders (ASD) with those of children with OCD plus Tourette’s syndrome (TS) or OCD alone. Method: Children with OCD and ASD (OCD/ASD) (n = 12, mean age = 14.33, range: 12-18) were compared to children with OCD and TS (OCD/TS) (n = 12, mean age = 13.92, range: 9-17) and children with OCD-alone (OCD) (n = 12, mean age = 12.92, range: 9-17) on measures of obsessive-compulsive (OC) symptom frequency, severity, interference and other clinical variables. Results: Patients from the OCD/ASD group rated their OC symptoms as equally distressing, time consuming and contributing to a similar level of interference in functioning as patients in the OCD/TS and OCD groups. The types of symptoms were similar across groups but patients with OCD/TS reported greater frequency of ordering and arranging compulsions, and a trend towards more sexual obsessions. Patients with OCD/ASD reported more peer relationship problems compared with the other two groups. Conclusions: Children with ASD may experience a similar level of impairment from OC symptoms as children with TS plus OCD and children with OCD only. It is suggested that it is useful to establish both diagnoses given that obsessions and compulsions may respond to treatment, and their alleviation may improve functioning in children on the autism spectrum.
9. Maenner MJ, Durkin MS. {{Trends in the Prevalence of Autism on the Basis of Special Education Data}}. {Pediatrics} (Oct 25)
Objective: The goal was to determine whether the increasing prevalence of autism, on the basis of educational data, in Wisconsin between 2002 and 2008 was uniform in all school districts or was greatest in districts with lower baseline (2002) prevalence. Methods: Special education counts were obtained for all Wisconsin elementary school districts from 2002 through 2008. The annual prevalence of children being served under the autism category was calculated for each district, districts were grouped into 8 categories (octiles) according to their baseline prevalence, and prevalence trends were plotted according to octile. Results: The overall prevalence of use of the autism category in Wisconsin elementary schools increased from 4.9 to 9.0 cases per 1000 children between 2002 and 2008. The magnitude of this increase was not uniform across districts and was inversely associated with baseline prevalence. Prevalence in the lowest octile increased from 0.5 cases per 1000 students in 2002 to 7.0 cases per 1000 students in 2008 (P < .0001), whereas no significant trend was seen for the octile with the highest baseline prevalence (range: 11.2-12.3 cases per 1000 students; P = .11). The highest-octile/lowest-octile prevalence ratio decreased from 24.6 (95% confidence interval: 16.2-37.3) in 2002 to 1.8 (95% confidence interval: 1.6-2.1) in 2008. Conclusions: The prevalence of use of the autism special education category in Wisconsin seems to be leveling off in the school districts with the highest prevalence rates, at approximately 12 cases per 1000 students, whereas the gap in prevalence between districts overall has narrowed.
10. Nygren G, Sandberg E, Arvidsson T, Gillberg C. {{[The unique role of child health services–early recognition of autism. Experiences with new routines in child health care in Gothenburg]}}. {Lakartidningen} (Sep 29-Oct 5);107(39):2314-2318.
11. Pivac N, Knezevic A, Gornik O, Pucic M, Igl W, Peeters H, Crepel A, Steyaert J, Novokmet M, Redzic I, Nikolac M, Novkovic Hercigonja V, Dodig-Curkovic K, Cacute Urkovic M, Nedic G, Muck-Seler D, Borovecki F, Rudan I, Lauc G. {{Human plasma glycome in attention-deficit hyperactivity disorder and autism spectrum disorders}}. {Mol Cell Proteomics} (Oct 25)
Over a half of all proteins are glycosylated, and their proper glycosylation is essential for normal function. Unfortunately, due to structural complexity of nonlinear branched glycans and the absence of genetic template for their synthesis, the knowledge about glycans is lagging significantly behind the knowledge about proteins or DNA. Using a recently developed quantitative high throughput glycan analysis methods we quantified components of the plasma N-glycome in 99 children with attention-deficit hyperactivity disorder (ADHD), 81 child and 5 adults with autism spectrum disorder (ASD) and total of 340 matching healthy controls. No changes in plasma glycome were found to associate with ASD, but several highly significant associations were observed with ADHD. Further structural analysis of plasma glycans revealed that ADHD is associated with increased antennary fucosylation of biantennary glycans and decreased levels of some complex glycans with three or four antennas. The design of this study prevented any functional conclusions about the observed associations, but specific differences in glycosylation appears to be strongly associated with ADHD what warrants further studies into this direction.
12. Salamanca AA. {{Psychotherapy treatment program in a group of adults with high-functioning autism spectrum disorder}}. {Actas Esp Psiquiatr} (Mar);38(2):94-100.
INTRODUCTION: An increasing number of adults diagnosed with a high-functioning autism spectrum disorder are diagnosed as being adult, so much the treatment applicable conditions, and possibly the clinical outcome. As a complement to medication and individual psychotherapy, group psychotherapy treatment is a clinical tool that offers significant advantages in the treatment of this syndrome. METHODOLOGY: This paper describes the sequence of group treatment we have been doing in our workplace, in the light of what the medical literature contains the subject, and according to the basic needs of this group of patients in adulthood. CONCLUSION: Group psychotherapeutic treatment in adult patients with a high-functioning autism spectrum disorder is a treatment option to consider, and whose clinical effectiveness must be evaluated in future studies.
13. Saygin AP, Cook J, Blakemore SJ. {{Unaffected perceptual thresholds for biological and non-biological form-from-motion perception in autism spectrum conditions}}. {PLoS One};5(10):e13491.
BACKGROUND: Perception of biological motion is linked to the action perception system in the human brain, abnormalities within which have been suggested to underlie impairments in social domains observed in autism spectrum conditions (ASC). However, the literature on biological motion perception in ASC is heterogeneous and it is unclear whether deficits are specific to biological motion, or might generalize to form-from-motion perception. METHODOLOGY AND PRINCIPAL FINDINGS: We compared psychophysical thresholds for both biological and non-biological form-from-motion perception in adults with ASC and controls. Participants viewed point-light displays depicting a walking person (Biological Motion), a translating rectangle (Structured Object) or a translating unfamiliar shape (Unstructured Object). The figures were embedded in noise dots that moved similarly and the task was to determine direction of movement. The number of noise dots varied on each trial and perceptual thresholds were estimated adaptively. We found no evidence for an impairment in biological or non-biological object motion perception in individuals with ASC. Perceptual thresholds in the three conditions were almost identical between the ASC and control groups. DISCUSSION AND CONCLUSIONS: Impairments in biological motion and non-biological form-from-motion perception are not across the board in ASC, and are only found for some stimuli and tasks. We discuss our results in relation to other findings in the literature, the heterogeneity of which likely relates to the different tasks performed. It appears that individuals with ASC are unaffected in perceptual processing of form-from-motion, but may exhibit impairments in higher order judgments such as emotion processing. It is important to identify more specifically which processes of motion perception are impacted in ASC before a link can be made between perceptual deficits and the higher-level features of the disorder.
