1. Baghdadli A, Rattaz C, Michelon C, Pernon E, Munir K. {{Fifteen-Year Prospective Follow-Up Study of Adult Outcomes of Autism Spectrum Disorders Among Children Attending Centers in Five Regional Departments in France: The EpiTED Cohort}}. {J Autism Dev Disord}. 2019.
There is limited data on long-term outcome of ASD with co-occurring intellectual disabilities (ID) and challenging behaviours in France. The EpiTED period cohort is a 15 years longitudinal study of the developmental trajectories of 281 children initially recruited at mean age of 5 years. Two contrasted developmental trajectories were identified. Low cognitive level, absence of language, and higher ASD scores at baseline were predictive of low growth at follow-up. As adults the participants were predisposed to persistent co-occurring challenging behaviours as well as underlying ID impacting their ability to function independently. The results underscore the need for development of services and supports for adults with ASD in France who may also have already lacked access to adequate interventions and support services.
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2. Chester M, Richdale AL, McGillivray J. {{Group-Based Social Skills Training with Play for Children on the Autism Spectrum}}. {J Autism Dev Disord}. 2019.
Despite widespread clinical use of group-based social skills training (SST) for children with autism spectrum disorder (ASD), there remains a lack of follow-up data, generalisation effects, common definition of social skills, and teacher report data. This study evaluated the effectiveness of an 8-week SST intervention with a play component (unstructured versus semi-structured) for children with ASD across a range of social, behavioural and emotional measures. Forty-five children aged 8-12 years (M = 10.16, SD = 1.26) were assigned to one of three groups: (a) SST with unstructured play; (b) SST with semi-structured play; and (c) waitlist control. Compared to a waitlist control group, children who participated in the SST intervention showed significant gains in social skills and social competence over time.
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3. Contreras BP, Cooper AJ, Kahng S. {{Recent research on the relative efficiency of speaker and listener instruction for children with autism spectrum disorder}}. {Journal of applied behavior analysis}. 2019.
The traditional recommendation for sequencing speaker and listener instruction has been to teach listener skills prior to teaching speaker skills. In a review of the research literature prior to 2011, Petursdottir and Carr (2011) concluded that research did not support this recommendation. We reviewed the most recent research on the efficiency of skill acquisition during speaker and listener instruction and found similar results to Petursdottir and Carr. Recommendations for future research and practice are provided.
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4. Franck N, Bon L, Dekerle M, Plasse J, Massoubre C, Pommier R, Legros-Lafarge E, Jaafari N, Guillard-Bouhet N, Quiles C, Couhet G, Verdoux H, Gouache B, Martin B, Cervello S, Demily C, Dubreucq J. {{Satisfaction and Needs in Serious Mental Illness and Autism Spectrum Disorder: The REHABase Psychosocial Rehabilitation Project}}. {Psychiatr Serv}. 2019: appips201800420.
OBJECTIVE:: The REHABase project is a French observational, prospective, and multicenter cohort study of serious mental illness and autism spectrum disorder (ASD), launched in 2016 for a planned minimum duration of 15 years. The aim is to characterize the care and quality-of-life needs of participants. This article presents initial results from data collection. METHODS:: Psychosocial, cognitive, and functional data were collected at baseline, annually, and after rehabilitation care. Data from the baseline evaluation on diagnoses, medications, well-being, insight, life satisfaction, and care needs are presented. The clinical profiles of REHABase participants with serious mental illness or ASD were assessed in relation to their level of satisfaction with life and well-being in nine life dimensions and their needs, according to their stage of recovery in a five-stage model. RESULTS:: Baseline data were collected for 1,397 participants between January 2016 and August 2018. Main diagnoses were schizophrenia spectrum disorder (49%); ASD (13%); and personality (12%), bipolar (9%), and major depressive (6%) disorders. More than 50% of participants reported needs for care or interventions in four of nine dimensions: employment, cognitive functioning, symptom management, and interpersonal relationships. Nearly half of participants were not in the active stages of recovery (stages 4 and 5), and even those considered to have reached the final stage continued to require help in several areas. CONCLUSIONS:: Most participants had already received psychiatric care for several years, and most remained dissatisfied with their social and emotional life and their psychological well-being.
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5. Kato H, Ozaki N. {{[The considerations for diagnosis of autism spectrum disorders and its pathogenic mechanisms]}}. {Rinsho shinkeigaku = Clinical neurology}. 2019; 59(1): 13-20.
Autism spectrum disorder (ASD) is characterized by deficits in social interaction and social communication, along with restricted and repetitive sensory-motor behaviors. The diagnosis of ASD includes various phenotypes outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)-5. The comprehensive evaluation of each individual case with ASD is needed because many of them have comorbidity with number of neuropsychiatric disorders or somatic conditions. The growing number of genetic studies detected multiple rare variants with relatively large effect sizes. The results have revealed their common potential pathology including abnormal chromatin regulation, which induces epigenetic changes. More researches are expected to elucidate the pathogenesis of ASD and to develop therapeutic approaches.
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6. Kolesnik A, Begum Ali J, Gliga T, Guiraud J, Charman T, Johnson MH, Jones EJH. {{Increased cortical reactivity to repeated tones at 8 months in infants with later ASD}}. {Translational psychiatry}. 2019; 9(1): 46.
Dysregulation of cortical excitation/inhibition (E/I) has been proposed as a neuropathological mechanism underlying core symptoms of autism spectrum disorder (ASD). Determining whether dysregulated E/I could contribute to the emergence of behavioural symptoms of ASD requires evidence from human infants prior to diagnosis. In this prospective longitudinal study, we examine differences in neural responses to auditory repetition in infants later diagnosed with ASD. Eight-month-old infants with (high-risk: n = 116) and without (low-risk: n = 27) an older sibling with ASD were tested in a non-linguistic auditory oddball paradigm. Relative to high-risk infants with typical development (n = 44), infants with later ASD (n = 14) showed reduced repetition suppression of 40-60 Hz evoked gamma and significantly greater 10-20 Hz inter-trial coherence (ITC) for repeated tones. Reduced repetition suppression of cortical gamma and increased phase-locking to repeated tones are consistent with cortical hyper-reactivity, which could in turn reflect disturbed E/I balance. Across the whole high-risk sample, a combined index of cortical reactivity (cortical gamma amplitude and ITC) was dimensionally associated with reduced growth in language skills between 8 months and 3 years, as well as elevated levels of parent-rated social communication symptoms at 3 years. Our data show that cortical ‘hyper-reactivity’ may precede the onset of behavioural traits of ASD in development, potentially affecting experience-dependent specialisation of the developing brain.
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7. Pacheva I, Ivanov I, Yordanova R, Gaberova K, Galabova F, Panova M, Petkova A, Timova E, Sotkova I. {{Epilepsy in Children with Autistic Spectrum Disorder}}. {Children (Basel, Switzerland)}. 2019; 6(2).
The comorbidity of autistic spectrum disorder (ASD) and epilepsy has been widely discussed but many questions still remain unanswered. The aim of this study was to establish the occurrence of epilepsy among children with ASD to define the type of epileptic seizures and syndromes, the age of onset of epilepsy, EEG abnormalities, the used antiepileptic drugs and the therapeutic responses for seizures and autistic behavior, as well as to find some correlations between epilepsy and gender, etiology and intellectual disability (ID). A retrospective study of medical files of 59 patients (aged 1(-)18 years) with ASD during a 5-year period was performed. ASD diagnosis was based on the DSM-5 diagnostic criteria. The patients were examined with a detailed medical history, physical and neurological examination, as well as some additional functional, imaging, laboratory and genetic investigations ASD etiology was syndromic in 9, probable syndromic in 9, and idiopathic in 41 children. ID was established in 90% of ASD children, and epilepsy in 44.4%. The onset of epilepsy prevailed before 7 years of age. The most common seizure types were focal with or without secondary generalization (53.4%). Focal epileptiform EEG abnormalities prevailed. Therapeutic response to seizures was good: 58% were seizure-free, while 27% had >50% seizure reduction but no improvement in autistic behavior. There was no correlation between epilepsy and either occurrence or degree of ID. There was a correlation between the frequency of epileptic seizures and the degree of ID. There was no significant difference among epilepsy rates in different etiologic, gender, and ID groups, probably because of the high percentage of ID and because this was a hospital-based study. Our study showed a significant percentage of epilepsy in ASD population and more than 1/4 were of symptomatic etiology. Those could be managed with specific treatments based on the pathophysiology of the gene defect.
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8. Pan Z, Granger DA, Guerin NA, Shoffner A, Gabriels RL. {{Replication Pilot Trial of Therapeutic Horseback Riding and Cortisol Collection With Children on the Autism Spectrum}}. {Frontiers in veterinary science}. 2018; 5: 312.
We aimed to determine whether results of our prior randomized control trial [RCT; NCT02301195, (1)] of Therapeutic Horseback Riding (THR) for children and adolescents with autism spectrum disorder (ASD) could be replicated at a different riding center and if treatment effects also included differences in the expression of associations between problem behavior and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Participants with ASD (N = 16) ages 6-16 years were randomized by nonverbal intelligence quotient to either a 10-week THR group (n = 8) or no horse interaction barn activity (BA) control group (n = 8). Outcome measures were a standard speech-language sample and caregiver-report of aberrant and social behaviors. Participants’ saliva was sampled weekly at a consistent afternoon time immediately pre- and 20 min’ post-condition (later assayed for cortisol). Intent-to-treat analysis revealed that compared to controls, THR participants had significant improvements in hyperactivity, and social awareness, and significant improvements at the 0.1 significance level in irritability and social communication behaviors. There were no significant improvements in number of words or new words spoken during the standard language sample. Linear mixed effects model analysis indicated that greater weekly pre-lesson irritability levels were associated with smaller post-lesson reduction in salivary cortisol levels, and greater weekly pre-lesson hyperactivity levels were associated with smaller cortisol reduction in the THR group, but not in the BA control group. The findings represent a partial replication of prior results (1), extend prior observations to include THR effects on biobehavioral relationships and suggest that cortisol could be a target mediator for THR effects on irritability and hyperactivity behaviors in youth with ASD. Clinical Trial Registration: Trial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov, identifier: NCT02301195.
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9. Paynter J, Luskin-Saxby S, Keen D, Fordyce K, Frost G, Imms C, Miller S, Trembath D, Tucker M, Ecker U. {{Evaluation of a template for countering misinformation-Real-world Autism treatment myth debunking}}. {PLoS One}. 2019; 14(1): e0210746.
Misinformation poses significant challenges to evidence-based practice. In the public health domain specifically, treatment misinformation can lead to opportunity costs or direct harm. Alas, attempts to debunk misinformation have proven sub-optimal, and have even been shown to « backfire », including increasing misperceptions. Thus, optimized debunking strategies have been developed to more effectively combat misinformation. The aim of this study was to test these strategies in a real-world setting, targeting misinformation about autism interventions. In the context of professional development training, we randomly assigned participants to an « optimized-debunking » or a « treatment-as-usual » training condition and compared support for non-empirically-supported treatments before, after, and six weeks following completion of online training. Results demonstrated greater benefits of optimized debunking immediately after training; thus, the implemented strategies can serve as a general and flexible debunking template. However, the effect was not sustained at follow-up, highlighting the need for further research into strategies for sustained change.
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10. Raza S, Zwaigenbaum L, Sacrey LR, Bryson S, Brian J, Smith IM, Reid K, Roberts W, Szatmari P, Vaillancourt T, Roncadin C, Garon N. {{Brief Report: Evaluation of the Short Quantitative Checklist for Autism in Toddlers (Q-CHAT-10) as a Brief Screen for Autism Spectrum Disorder in a High-Risk Sibling Cohort}}. {J Autism Dev Disord}. 2019.
This study examined the potential of the short form of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10) to identify autism spectrum disorder (ASD) in a high-risk sibling cohort. High-risk (HR; siblings of children diagnosed with ASD) and low-risk (LR; no family history of ASD) toddlers were assessed prospectively at 18 and 24 months of age using the Q-CHAT-10 and underwent blind diagnostic assessment for ASD at 36 months of age. The results indicated that at 18 and 24 months, total score differentiated between HR toddlers subsequently diagnosed with ASD from other HR and LR toddlers. The sensitivity at both time points was acceptable; however, the specificity was below the level recommended for clinical application.
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11. Shrestha R, Dissanayake C, Barbaro J. {{Age of Diagnosis of Autism Spectrum Disorder in Nepal}}. {J Autism Dev Disord}. 2019.
The current study investigated the age of diagnosis (AoD) of autism spectrum disorder (ASD) in Nepal by using de-identified data on 246 children with a diagnosis of ASD registered at AutismCare Nepal Society from 2010 to 2015. The mean AoD in children was 58 months (range 14-187 months). Majority of children were male (76%), lived in the Kathmandu valley (75%), and were from upper caste groups (62%). The mean diagnostic age of ASD in Nepal is much later than the age at which a reliable diagnosis is possible, indicating the need to reduce the gap between the age at which it is possible to diagnose ASD, and the average age at which ASD is currently diagnosed.
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12. Silva S, Teixeira A. {{Design and Development for Individuals with ASD: Fostering Multidisciplinary Approaches Through Personas}}. {J Autism Dev Disord}. 2019.
Developing technologies to support individuals with ASD is a growing field of research facing numerous challenges. First, while the individual with ASD is central, the motivations of others, such as parents, are often taken as the motivations of the individual. Second, the desirable cross-disciplinary pollination for improved intervention can often face difficulties due to a lack of a common language among disciplines. Thirdly, the literature often lacks enough information to allow a clear understanding of the targeted contexts and goals not enabling an assessment of outcomes and building on past advances. To tackle these challenges, we propose that families of Personas and scenarios are used throughout the design and development process, and as dissemination resources, and provide illustrative examples.
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13. Thabtah F, Peebles D. {{A new machine learning model based on induction of rules for autism detection}}. {Health informatics journal}. 2019: 1460458218824711.
Autism spectrum disorder is a developmental disorder that describes certain challenges associated with communication (verbal and non-verbal), social skills, and repetitive behaviors. Typically, autism spectrum disorder is diagnosed in a clinical environment by licensed specialists using procedures which can be lengthy and cost-ineffective. Therefore, scholars in the medical, psychology, and applied behavioral science fields have in recent decades developed screening methods such as the Autism Spectrum Quotient and Modified Checklist for Autism in Toddlers for diagnosing autism and other pervasive developmental disorders. The accuracy and efficiency of these screening methods rely primarily on the experience and knowledge of the user, as well as the items designed in the screening method. One promising direction to improve the accuracy and efficiency of autism spectrum disorder detection is to build classification systems using intelligent technologies such as machine learning. Machine learning offers advanced techniques that construct automated classifiers that can be exploited by users and clinicians to significantly improve sensitivity, specificity, accuracy, and efficiency in diagnostic discovery. This article proposes a new machine learning method called Rules-Machine Learning that not only detects autistic traits of cases and controls but also offers users knowledge bases (rules) that can be utilized by domain experts in understanding the reasons behind the classification. Empirical results on three data sets related to children, adolescents, and adults show that Rules-Machine Learning offers classifiers with higher predictive accuracy, sensitivity, harmonic mean, and specificity than those of other machine learning approaches such as Boosting, Bagging, decision trees, and rule induction.
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14. Tremblay MW, Jiang YH. {{DNA Methylation and Susceptibility to Autism Spectrum Disorder}}. {Annual review of medicine}. 2019; 70: 151-66.
The prevalence of autism spectrum disorder (ASD) has been increasing steadily over the last 20 years; however, the molecular basis for the majority of ASD cases remains unknown. Recent advances in next-generation sequencing and detection of DNA modifications have made methylation-dependent regulation of transcription an attractive hypothesis for being a causative factor in ASD etiology. Evidence for abnormal DNA methylation in ASD can be seen on multiple levels, from genetic mutations in epigenetic machinery to loci-specific and genome-wide changes in DNA methylation. Epimutations in DNA methylation can be acquired throughout life, as global DNA methylation reprogramming is dynamic during embryonic development and the early postnatal period that corresponds to the peak time of synaptogenesis. However, technical advances and causative evidence still need to be established before abnormal DNA methylation and ASD can be confidently associated.
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15. Vidyashree HM, Maheshkumar K, Sundareswaran L, Sakthivel G, Partheeban PK, Rajan R. {{Effect of Yoga Intervention on Short-Term Heart Rate Variability in Children with Autism Spectrum Disorder}}. {International journal of yoga}. 2019; 12(1): 73-7.
Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social interactions, communication, restricted, and repetitive behaviors. Evidence-based treatment options for ASD are limited. Yoga is practiced by over 20 million people worldwide, and multiple studies have investigated yoga as a possible effective intervention for children with ASD. Aim: The aim of this study is to investigate the effect of yoga intervention on short-term heart rate variability (HRV) in children with ASD. Methodology: In this study, 50 children (38 boys and 12 girls) with ASD were recruited from Swabhimaan Trust, Palavakkam, Chennai. They were randomly grouped into ASD with yoga intervention group (n = 25) and ASD without yoga intervention group (n = 25) by simple lottery method. Yoga group children underwent yoga training for 3 months, and the control group did not receive any such training. For short-term HRV, 15 min electrocardiogram recording in sitting posture was recorded in lead II using a simple analog amplifier. Results: In HRV, time domain parameters such as mean RR interval (0.72 [0.74] to 0.94 [0.92]), standard deviation of the NN intervals (52.04 [54.23] to 74.48 [72.80]), and root of the mean squared differences of successive NN interval (32.60 [34.40] to 40.83 [42.90]) significantly increased in ASD children after yoga intervention. In frequency-domain parameters, high frequency (HF) in n. u (48.08 [47.24] to 58.37 [59.22]) shows a significant increase and low frequency (LF) in n. u (52.4 [51.82] to 40.51 [40.12]), and LF/HF ratio (1.29 [1.31] to 0.78 [0.79]) shows a significant decrease in ASD with yoga intervention group children after 3 months of yoga training. Conclusion: Yoga interventions have been successful in bringing parasympathetic dominance in ASD children, and the greater advantage is being a noninvasive way of intervention to support children with ASD and help them to achieve physiological as well as psychological balance.
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16. Yingling ME, Bell BA, Hock RM. {{Treatment Utilization Trajectories among Children with Autism Spectrum Disorder: Differences by Race-Ethnicity and Neighborhood}}. {J Autism Dev Disord}. 2019.
Health coverage of early intensive behavioral intervention (EIBI) for children with autism spectrum disorder is expanding. Yet there is no longitudinal research on patterns of or inequities in utilization of EIBI. We integrated state administrative records with Medicaid and Census data for children enrolled in an EIBI Medicaid waiver (N = 730) to identify and describe the type and prevalence of treatment utilization trajectories, and to examine the association between trajectory types and (a) child race-ethnicity and (b) neighborhood racial composition, poverty, affluence, and urbanicity. We identified four utilization trajectories (Low, Low-Moderate, Moderate, and High users). Race-ethnicity and neighborhood affluence were associated with trajectory membership. As coverage expands, policy makers should consider strategies to improve overall treatment utilization and enhance equity.
