1. Delli K, Reichart PA, Bornstein MM, Livas C. {{Management of children with autism spectrum disorder in the dental setting: Concerns, behavioural approaches and recommendations}}. {Med Oral Patol Oral Cir Bucal}. 2013.
Objectives: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. Material and Methods: The MEDLINE database was searched using the terms ‘Autistic Disorder’, ‘Behaviour Control/methods’, ‘Child’, ‘Dental care for disabled’, ‘Education’, ‘Oral Health’, and ‘Pediatric Dentistry’ to locate related articles published up to January 2013. Results: Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.
2. Duffield TC, Trontel HG, Bigler ED, Froehlich A, Prigge MB, Travers B, Green RR, Cariello AN, Cooperrider J, Nielsen J, Alexander A, Anderson J, Fletcher PT, Lange N, Zielinski B, Lainhart J. {{Neuropsychological investigation of motor impairments in autism}}. {J Clin Exp Neuropsychol}. 2013.
It is unclear how standardized neuropsychological measures of motor function relate to brain volumes of motor regions in autism spectrum disorder (ASD). An all-male sample composed of 59 ASD and 30 controls (ages 5-33 years) completed three measures of motor function: strength of grip (SOG), finger tapping test (FTT), and grooved pegboard test (GPT). Likewise, all participants underwent magnetic resonance imaging with region of interest (ROI) volumes obtained to include the following regions: motor cortex (precentral gyrus), somatosensory cortex (postcentral gyrus), thalamus, basal ganglia, cerebellum, and caudal middle frontal gyrus. These traditional neuropsychological measures of motor function are assumed to differ in motor complexity, with GPT requiring the most followed by FTT and SOG. Performance by ASD participants on the GPT and FTT differed significantly from that of controls, with the largest effect size differences observed on the more complex GPT task. Differences on the SOG task between the two groups were nonsignificant. Since more complex motor tasks tap more complex networks, poorer GPT performance by those with ASD may reflect less efficient motor networks. There was no gross pathology observed in classic motor areas of the brain in ASD, as ROI volumes did not differ, but FTT was negatively related to motor cortex volume in ASD. The results suggest a hierarchical motor disruption in ASD, with difficulties evident only in more complex tasks as well as a potential anomalous size-function relation in motor cortex in ASD.
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3. Elwin M, Ek L, Kjellin L, Schroder A. {{Too much or too little: Hyper- and hypo-reactivity in high-functioning autism spectrum conditions}}. {J Intellect Dev Disabil}. 2013; 38(3): 232-41.
Abstract Background Sensory reactivity in people with autism spectrum conditions (ASC) has been found to differ in comparison to reactivity in people without ASC. In this study sensory experiences of high-functioning individuals with ASC were explored and described. Method Interview data from 15 participants with a diagnosis of ASC were analysed by content analysis. Results Seven aspects of sensory experiences were identified: Being hyper- and hypo-reactive, reacting to general overload, having strong stimuli preferences, managing attentiveness to stimuli, managing sensory/motor stimuli, and dealing with consequences of sensory reactions in daily life. Conclusions The categorisation of sensory reactivity in this study can guide clinicians on how to pose questions about sensory issues to individuals with ASC. The assessment of spectrum-specific sensory experiences in high-functioning ASC and their association with other social and nonsocial features of ASC are goals for further research.
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4. Foxe JJ, Molholm S, Del Bene VA, Frey HP, Russo NN, Blanco D, Saint-Amour D, Ross LA. {{Severe Multisensory Speech Integration Deficits in High-Functioning School-Aged Children with Autism Spectrum Disorder (ASD) and Their Resolution During Early Adolescence}}. {Cereb Cortex}. 2013.
Under noisy listening conditions, visualizing a speaker’s articulations substantially improves speech intelligibility. This multisensory speech integration ability is crucial to effective communication, and the appropriate development of this capacity greatly impacts a child’s ability to successfully navigate educational and social settings. Research shows that multisensory integration abilities continue developing late into childhood. The primary aim here was to track the development of these abilities in children with autism, since multisensory deficits are increasingly recognized as a component of the autism spectrum disorder (ASD) phenotype. The abilities of high-functioning ASD children (n = 84) to integrate seen and heard speech were assessed cross-sectionally, while environmental noise levels were systematically manipulated, comparing them with age-matched neurotypical children (n = 142). Severe integration deficits were uncovered in ASD, which were increasingly pronounced as background noise increased. These deficits were evident in school-aged ASD children (5-12 year olds), but were fully ameliorated in ASD children entering adolescence (13-15 year olds). The severity of multisensory deficits uncovered has important implications for educators and clinicians working in ASD. We consider the observation that the multisensory speech system recovers substantially in adolescence as an indication that it is likely amenable to intervention during earlier childhood, with potentially profound implications for the development of social communication abilities in ASD children.
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5. Gabard-Durnam L, Tierney AL, Vogel-Farley V, Tager-Flusberg H, Nelson CA. {{Alpha Asymmetry in Infants at Risk for Autism Spectrum Disorders}}. {J Autism Dev Disord}. 2013.
An emerging focus of research on autism spectrum disorder (ASD) targets the identification of early-developing ASD endophenotypes using infant siblings of affected children. One potential neural endophenotype is resting frontal electroencephalogram (EEG) alpha asymmetry, a metric of hemispheric organization. Here, we examined the development of frontal EEG alpha asymmetry in ASD high-risk and low-risk infant populations. Our findings demonstrate that low and high-risk infants show different patterns of alpha asymmetry at 6 months of age and opposite growth trajectories in asymmetry over the following 12 months. These results support the candidacy of alpha asymmetry as an early neural ASD endophenotype.
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6. Gadgil M, Peterson E, Tregellas J, Hepburn S, Rojas DC. {{Differences in global and local level information processing in autism: an fMRI investigation}}. {Psychiatry Res}. 2013; 213(2): 115-21.
People with autism spectrum disorders (ASD) have atypical visual perception of global and local information. Previous neuroimaging studies have examined the functional anatomy of locally directed attention during visual processing in ASD, but few have examined differences in both globally and locally directed attention. We performed functional magnetic resonance imaging (fMRI) in 17 adults with ASD and 16 typically developing (TD) subjects to examine the neurobiology of both global- and local-level information processing in ASD using an abstract hierarchical design task. TD subjects showed no regions of increased brain activation relative to subjects with ASD as assessed using whole brain analysis. Subjects with ASD exhibited greater activation in right superior frontal gyrus during locally directed attention. During globally directed attention, the ASD group showed greater right lateral occipital activation. Additionally, subjects with ASD showed less deactivation in medial prefrontal cortex (part of the default mode network) in the globally directed attention condition. Our findings help elucidate networks of brain activation related to atyipcal global and local feature processing in ASD.
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7. Kendall T, Megnin-Viggars O, Gould N, Taylor C, Burt LR, Baird G. {{Management of autism in children and young people: summary of NICE and SCIE guidance}}. {BMJ}. 2013; 347: f4865.
8. Nagy G, Ackerman SL. {{Cholesterol metabolism and Rett syndrome pathogenesis}}. {Nat Genet}. 2013; 45(9): 965-7.
Rett syndrome is caused by mutations in the gene encoding the transcriptional regulator MECP2. A new study demonstrates that cholesterol homeostasis is disrupted in Mecp2 mutant mice and suggests new therapeutic options for this disease.
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9. Rodriguez NM, Thompson RH, Stocco CS, Schlichenmeyer K. {{Arranging and ordering in autism spectrum disorder: Characteristics, severity, and environmental correlates}}. {J Intellect Dev Disabil}. 2013; 38(3): 242-55.
Abstract Background There is a need for a more accurate characterisation of higher level restricted and repetitive behaviour (RRB) in autism spectrum disorder (ASD), including why it might be considered problematic and events associated with its occurrence. Method We selected one form of higher level RRB-arranging and ordering-that was rated as severe for a large percentage of the population sampled. We interviewed 20 students’ teachers and conducted naturalistic observations for 15 of those students. Results The characteristics of arranging and ordering varied across, and sometimes within, individuals. Problems associated with compulsive-like (1) behaviour also varied, with several unanticipated reported problems. With the exception of attention, social consequences were relatively infrequent. Conclusions These data highlight the need for research on the assessment and treatment of arranging and ordering and clinical attention to compulsive-like behaviour in ASD. Interviews and naturalistic observations are useful for structuring additional observations and analyses.
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10. Van Wijngaarden-Cremers PJ, van Eeten E, Groen WB, Van Deurzen PA, Oosterling IJ, Van der Gaag RJ. {{Gender and Age Differences in the Core Triad of Impairments in Autism Spectrum Disorders: A Systematic Review and Meta-analysis}}. {J Autism Dev Disord}. 2013.
Autism is an extensively studied disorder in which the gender disparity in prevalence has received much attention. In contrast, only a few studies examine gender differences in symptomatology. This systematic review and meta-analysis of 22 peer reviewed original publications examines gender differences in the core triad of impairments in autism. Gender differences were transformed and concatenated using standardized mean differences, and analyses were stratified in five age categories (toddlerhood, preschool children, childhood, adolescence, young adulthood). Boys showed more repetitive and stereotyped behavior as from the age of six, but not below the age of six. Males and females did not differ in the domain of social behavior and communication. There is an underrepresentation of females with ASD an average to high intelligence. Females could present another autistic phenotype than males. As ASD is now defined according to the male phenotype this could imply that there is an ascertainment bias. More research is needed into the female phenotype of ASD with development of appropriate instruments to detect and ascertain them.
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11. You X, Norr M, Murphy E, Kuschner ES, Bal E, Gaillard WD, Kenworthy L, Vaidya CJ. {{Atypical modulation of distant functional connectivity by cognitive state in children with Autism Spectrum Disorders}}. {Front Hum Neurosci}. 2013; 7: 482.
We examined whether modulation of functional connectivity by cognitive state differed between pre-adolescent children with Autism Spectrum Disorders (ASD) and age and IQ-matched control children. Children underwent functional magnetic resonance imaging (fMRI) during two states, a resting state followed by a sustained attention task. A voxel-wise method was used to characterize functional connectivity at two levels, local (within a voxel’s 14 mm neighborhood) and distant (outside of the voxel’s 14 mm neighborhood to the rest of the brain) and regions exhibiting Group x State interaction were identified for both types of connectivity maps. Distant functional connectivity of regions in the left frontal lobe (dorsolateral [BA 11, 10]; supplementary motor area extending into dorsal anterior cingulate [BA 32/8]; and premotor [BA 6, 8, 9]), right parietal lobe (paracentral lobule [BA 6]; angular gyrus [BA 39/40]), and left posterior middle temporal cortex (BA 19/39) showed a Group x State interaction such that relative to the resting state, connectivity reduced (i.e., became focal) in control children but increased (i.e., became diffuse) in ASD children during the task state. Higher state-related increase in distant connectivity of left frontal and right angular gyrus predicted worse inattention in ASD children. Two graph theory measures (global efficiency and modularity) were also sensitive to Group x State differences, with the magnitude of state-related change predicting inattention in the ASD children. Our results indicate that as ASD children transition from an unconstrained to a sustained attentional state, functional connectivity of frontal and parietal regions with the rest of the brain becomes more widespread in a manner that may be maladaptive as it was associated with attention problems in everyday life.
