1. Ames CS, White SJ. {{Brief Report: Are ADHD Traits Dissociable from the Autistic Profile? Links Between Cognition and Behaviour}}. {J Autism Dev Disord} (Jun 29)
Reports of co-morbid symptoms of ADHD in children with ASD have increased. This research sought to identify ADHD-related behaviours in a sample of children with ASD, and their relationship with the ASD triad of impairments and related cognitive impairments. Children with ASD (n = 55) completed a comprehensive cognitive assessment whilst a semi-structured parental interview (3Di) provided information on ASD and ADHD symptoms. Co-morbid presentation of ADHD traits in these participants was associated with reports of more ASD related behaviours. Inhibitory control performance was directly related only to the ADHD symptom of impulsive behaviour. In contrast, while there was a relationship between social difficulties associated with ASD and theory of mind ability, there was no such relationship with behaviours relating to ADHD.
2. Baharav E, Reiser C. {{Using Telepractice in Parent Training in Early Autism}}. {Telemed J E Health} (Jun 29)
Abstract There is a growing body of literature indicating that intense early intervention is current best practice for treating children with autism spectrum disorders (ASD). Several studies demonstrate the effectiveness of parents as agents of intervention in the child’s home environment. However, this approach requires intense one-on-one supervision by highly trained professionals. Consequently, there is a significant gap between the intensive service requirements for children with ASD and the available resources to provide these services. In the current pilot study, the use of remote technology, telepractice, is evaluated as a tool for coaching parents of two children found to have ASD. Two clinical models of intervention are compared: a traditional model of twice-weekly speech and language therapy sessions (traditional clinical model) and a model where a once-a-week clinical session is followed by a home-based session administered by the parents and remotely supervised and coached by the clinician (clinic/telepractice model). Results suggest that gains obtained in traditional therapy can be maintained and even exceeded in a treatment model that uses telepractice. Parents reported that they perceived telepractice sessions to be as valuable as those delivered directly by the clinician, felt comfortable using the technology, and were willing to continue intervention with their children at home. These preliminary results suggest that use of telepractice holds promise for reducing the demands on available resources of service for this population. A study with a larger population is currently underway including cost-benefit analyses to examine the implications for such a treatment model to its users and to the healthcare system.
3. Biederman J, Petty CR, Fried R, Wozniak J, Micco JA, Henin A, Doyle R, Joshi G, Galdo M, Kotarski M, Caruso J, Yorks D, Faraone SV. {{Child Behavior Checklist Clinical Scales Discriminate Referred Youth With Autism Spectrum Disorder: A Preliminary Study}}. {J Dev Behav Pediatr} (Jun 25)
OBJECTIVE:: To evaluate the properties of clinical scales of the Child Behavior Checklist in discriminating referred children with autism spectrum disorders (ASDs) (autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified) from psychiatrically referred children without ASDs. METHOD:: Comparisons were made between children with ASDs (n = 65) with intelligence quotient >70 and children without ASDs (N = 83) on the clinical scales of the Child Behavior Checklist. Stepwise logistic regression was used to identify those scales that best predicted ASDs when compared with the non-ASD comparison group. Receiver operating characteristic curves examined the ability of the significant predictor T-scores to identify ASDs versus the non-ASD subjects. RESULTS:: Withdrawn, Social Problems, and Thought Problems T-scores were the best independent predictors of ASD status. The Withdrawn + Social + Thought Problems T-scores yielded an area under the curve of 0.86, indicating an 86% chance that a randomly selected sample of ASD subject will have abnormal scores on these scales than a randomly selected sample of non-ASD subjects. CONCLUSION:: These findings suggest that a new Child Behavior Checklist-ASD profile consisting of the Child Behavior Checklist-Withdrawn, Social, and Thought Problems scales could serve as a rapid and cost-effective screening instrument to help identify cases likely to meet clinical criteria for ASDs in the clinical setting.
4. Hvidtjorn D, Grove J, Schendel D, Schieve LA, Svaerke C, Ernst E, Thorsen P. {{Risk of autism spectrum disorders in children born after assisted conception: a population-based follow-up study}}. {J Epidemiol Community Health} (Jun 27)
Objectives To assess the risk of autism spectrum disorders (ASD) in children born after assisted conception compared with children born after natural conception. Design Population-based follow-up study. Setting All children born alive in Denmark 1995-2003. Participants 588 967 children born in Denmark from January 1995 to December 2003. Assisted conception was defined as in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection and ovulation induction (OI) with or without subsequent insemination. Children exposed to IVF or OI were identified in the IVF Register and in the Danish Drug Prescription Register. Main outcome measures A diagnosis of ASD in the Danish Psychiatric Central Register. Results 33 139 (5.6%) of all children born in Denmark in 1995-2003 resulted from assisted conception, 225 of whom (0.68%) had a diagnosis of ASD. Of the 555 828 children born in this period after natural conception, 3394 (0.61%) had a diagnosis of ASD. The follow-up time was 4-13 years (median 9 years). In crude analyses, children born after assisted conception had an increased risk of a diagnosis of ASD: crude hazard rate ratio (HRR) 1.25 (95% CI 1.09 to 1.43). In analyses adjusting for maternal age, educational level, parity, smoking, birth weight and multiplicity, the risk disappeared: adjusted HRR 1.13. (95% CI 0.97 to 1.31). However, subgroup analyses that suggest possible associations in women who received follicle stimulating hormone indicate the need for further study. Discussion This population-based follow-up study found no risk of ASD in children born after assisted conception.
5. Peter Hobson R, Lee A. {{Reversible autism among congenitally blind children? A controlled follow-up study}}. {J Child Psychol Psychiatry} (Jun 24)
Background: Atypical forms of autism may yield insights into the development and nature of the syndrome. Methods: We conducted a follow-up study of nine congenitally blind and seven sighted children who, eight years earlier, had satisfied formal diagnostic criteria for autism and had been included in groups matched for chronological age and verbal ability. In keeping with the original study, we met with teachers to discuss a DSM-based checklist of clinical features of autism, and conducted direct observations of the children to complete assessments on the Childhood Autism Rating Scale (CARS; Schopler, Reichler, and Renner, 1986) and the Behavior Checklist for Disordered Preschoolers (BCDP; Sherman, Shapiro, & Glassman, 1983). Results: As predicted, a substantially higher proportion of blind (eight out of nine) than sighted (none out of seven) children now failed to meet formal DSM criteria for autism, and in keeping with BCDP ratings, they had significantly lower CARS scores. Conclusions: Follow-up of nine congenitally blind children with autism revealed that, in adolescence, only one still satisfied diagnostic criteria for the syndrome. We consider the implications for theoretical perspectives on the development of autism.
6. Sharda M, Subhadra TP, Sahay S, Nagaraja C, Singh L, Mishra R, Sen A, Singhal N, Erickson D, Singh NC. {{Sounds of melody–pitch patterns of speech in autism}}. {Neurosci Lett} (Jun 30);478(1):42-45.
The objective of this study was to find a pattern in vocalizations of children with Autism Spectrum Disorder (ASD). We compared the intonational features of 15 children with ASD who showed speech, aged 4-10 years, with 10 age-matched typically developing controls. Exaggerated pitch, pitch range, pitch excursion and pitch contours were observed in speech of children with autism, but absent in age-matched controls. These exaggerated features, which are distinctive characteristics of motherese, were also seen in interactions of an independent group of 8 mothers of typical infants using child-directed speech. Our findings provide the first evidence of a distinct pattern in vocal output from children with autism. They also demonstrate that speech patterns might follow a delayed developmental trajectory in these children.
7. Wise MD, Little AA, Holliman JB, Wise PH, Wang CJ. {{Can State Early Intervention Programs Meet the Increased Demand of Children Suspected of Having Autism Spectrum Disorders?}}. {J Dev Behav Pediatr} (Jun 25)
OBJECTIVE:: To determine whether Early Intervention programs have the capacity to accommodate the expected increase in referrals following the American Academy of Pediatrics’ 2007 recommendation for universal screening of 18- and 24-month-old children for Autism Spectrum Disorders (ASD). METHOD:: We conducted a telephone survey of all state and territory early. Intervention coordinators about the demand for ASD evaluations, services, and program capacity. We used multivariate models to examine state-level factors associated with the capacity to serve children with ASD. RESULTS:: Fifty-two of the 57 coordinators (91%) responded to the survey. Most states reported an increase in demand for ASD-related evaluations (65%) and services (58%) since 2007. In addition, 46% reported that their current capacity poses a challenge to meeting the 45-day time limit for creating the Individualized Family Service Plan. Many states reported that they have shortages of ASD-related personnel, including behavioral therapists (89%), speech-language pathologists (82%), and occupational therapists (79%). Among states that reported the number of service hours (n = 34) 44% indicated that children with ASD receive 5 or fewer weekly service hours. Multivariate models showed that states with a higher percentage of African-American and Latino children were more likely to have provider shortages whereas states with higher population densities were more likely to offer a greater number of service hours. CONCLUSION:: Many Early Intervention programs may not have the capability to address the expected increase in demand for ASD services. Early Intervention programs will likely need enhanced resources to provide all children with suspected ASD with appropriate evaluations and services.
8. Yoshida W, Dziobek I, Kliemann D, Heekeren HR, Friston KJ, Dolan RJ. {{Cooperation and heterogeneity of the autistic mind}}. {J Neurosci} (Jun 30);30(26):8815-8818.
Individuals with autism spectrum conditions (ASCs) have a core difficulty in recursively inferring the intentions of others. The precise cognitive dysfunctions that determine the heterogeneity at the heart of this spectrum, however, remains unclear. Furthermore, it remains possible that impairment in social interaction is not a fundamental deficit but a reflection of deficits in distinct cognitive processes. To better understand heterogeneity within ASCs, we employed a game-theoretic approach to characterize unobservable computational processes implicit in social interactions. Using a social hunting game with autistic adults, we found that a selective difficulty representing the level of strategic sophistication of others, namely inferring others’ mindreading strategy, specifically predicts symptom severity. In contrast, a reduced ability in iterative planning was predicted by overall intellectual level. Our findings provide the first quantitative approach that can reveal the underlying computational dysfunctions that generate the autistic « spectrum. »
