1. Chamak B, Bonniau B, Oudaya L, Ehrenberg A. {{The autism diagnostic experiences of French parents}}. {Autism} (Sep 27)
This survey focused on French parents’ views of the diagnostic process relating to their child with autism. Data were collected on the age at diagnosis, the time taken to obtain a diagnosis and the difficulties encountered. Questionnaires filled in by the parents (n = 248) and in-depth interviews (n = 43) were analyzed in order to obtain quantitative and qualitative results. The ages of the children ranged from 4 to 45. This approach enabled us to compare the practices of professionals now and in the past. The mean age of diagnosis was 10 +/- 8 years from 1960 to 1990, 5 +/- 3 years from 1990 to 2005 (3 +/- 1 from 2003 to 2005). The results showed that the mean delays between first consultation and diagnosis were reduced. Regarding the way the diagnosis was announced, 63% of the parents of children with autism and 93% of the parents of adults with autism were dissatisfied. We discuss the parents’ reactions and the changes in the diagnostic process.
2. Corbett BA, Schupp CW, Simon D, Ryan N, Mendoza SP. {{Elevated cortisol during play is associated with age and social engagement in children with autism}}. {Mol Autism} (Sep 27);1(1):13.
ABSTRACT: BACKGROUND: The hallmark characteristic of autism is impaired reciprocal social interaction. While children find social interaction stress-reducing, many children with autism may find social interaction stress-inducing. The current study was designed to examine stress responsivity as measured by cortisol by comparing children with autism to neurotypical peers during an ecologically valid 20-minute playground paradigm. METHODS: The experiment involved sets of three children: a child with autism, a neurotypical child, and a confederate. Participants included 45 prepubescent males between 8 and 12 years of age (21 with autism and 24 neurotypical children). RESULTS: Children with autism showed fewer initiations (chi^2(1) = 4.03, P = 0.044), rejected initiations from others more (chi^2(1) = 7.10, P = 0.008) and spent less time interacting during motor (F(1,43) = 16.7, P = 0.0002) and cooperative (F(1,43) = 14.78, P = 0.0004) play. Repeated measures analysis of the cortisol values revealed a significant model (chi^2(4)=22.76, P < 0.0005) that included time of measurement, diagnosis and age as main effects and an interaction between diagnosis and age. Thus, as age increased among children with autism, they experienced enhanced cortisol levels while age did not modify expected cortisol levels for typical children. Stress responsivity was associated with more peripheral equipment play for motor (chi^2(3) = 12.3, P = 0.006) and cooperative (chi^2(3) = 8.24, P = 0.04) play as well as reduced nonverbal social skills during motor (chi^2(1) = 5.52, P = 0.018) and cooperative play (chi^2(1) = 4.53, P = 0.033). CONCLUSIONS: Overall, children with autism engaged in fewer social overtures and spent less time interacting than typically developing peers during play. The peer interaction paradigm resulted in significantly higher levels of cortisol in many children with autism. Distinct patterns emerged within the autism group based on developmental (older), biological (cortisol responder) and behavioral patterns (peripheral group interaction). The enhanced cortisol response was observed in children who voluntarily engaged in interaction; thus, it does not support the notion of a response to social threat. Rather, it appears to reflect attendant metabolic preparedness and enhanced arousal from engaging socially. The data suggest that many children with autism activate hypothalamic-pituitary-adrenal responses in relatively benign social situations, which appears to be a function of age and level of social engagement. The findings support the need to teach coping strategies in addition to fundamental social skills to youth with autism.
3. Luppanapornlarp S, Leelataweewud P, Putongkam P, Ketanont S. {{Periodontal status and orthodontic treatment need of autistic children}}. {World J Orthod} (Fall);11(3):256-261.
Aim: To evaluate the periodontal status and orthodontic treatment need of autistic children and compare these findings to nonaffected, same-age individuals. Method: The periodontal status and orthodontic treatment need were evaluated in 32 autistic and 48 nonautistic boys and girls age 8 years to 12 years (mean 9.7 +/- 1.2 years and 9.9 +/- 1.1 years, respectively). The periodontal status of all subjects was recorded using the Community Periodontal Index of Treatment Need (CPITN) with a slight modification. The orthodontic treatment need was determined using the Dental Aesthetic Index (DAI). Chi-square test and odds ratio were used for statistical analysis. Results: No significant sex differences were found in the autistic or nonautistic groups. The autistic children presented with a significantly poorer periodontal status than the nonautistic children (P < .05). No significant differences in terms of the various malocclusion categories were found between both groups (P > .05); however, children with autism showed missing teeth, spacing, diastemas, reverse overjets, open bites, and Class II molar relationship tendencies in a higher percentage than nonautistic individuals. In all, autistic children and nonautistic children frequently needed orthodontic treatment. Conclusion: This study suggests that children with autism require special dental management to improve their oral hygiene as well as their dental esthetics. More care from parents, general dentists, and pedodontists/orthodontists should be provided routinely to autistic children. World J Orthod 2010;11:256-261.
4. Mesibov G, Shea V. {{Evidence-Based Practices and Autism}}. {Autism} (Sep 27)
Interventions for autism are increasing being held to standards such as ‘evidence-based practice’ in psychology and ‘scientifically-based research’ in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special education has raised additional concerns. An analysis of the benefits and limitations of current approaches to empiricism in autism interventions is presented, and suggestions for future research are made.
5. Nah YH, Poon KK. {{The perception of social situations by children with autism spectrum disorders}}. {Autism} (Sep 27)
This study investigated how children with autism spectrum disorders (ASD) make social judgments of social situations and provide justifications for their responses. Fifteen children with ASD and 15 typically developing children (ages from 9 to 13 years old) were presented with eight vignettes, based on the Dewey Story Test (Dewey, 1991) and developed for the purposes of this study. The participants rated the appropriateness (on a 4-point Likert scale) of the socially inappropriate event (test item) and non-social appropriate event (control item) in each vignette. Justifications for each rating were also elicited at the end of each vignette. The children with ASD rated socially inappropriate behaviors in vignettes no differently from their typically developing peers but rated control items as stranger. They also had a higher tendency to provide inappropriate/bizarre and don’t know/no response justifications instead of appropriate/social justifications (that reflect social awareness). The impact of the method of eliciting social judgments of social situations and its impact on findings are discussed.
6. Reaven J. {{The treatment of anxiety symptoms in youth with high-functioning autism spectrum disorders: Developmental considerations for parents}}. {Brain Res} (Sep 25)
7. Sacco R, Curatolo P, Manzi B, Militerni R, Bravaccio C, Frolli A, Lenti C, Saccani M, Elia M, Reichelt KL, Pascucci T, Puglisi-Allegra S, Persico AM. {{Principal pathogenetic components and biological endophenotypes in autism spectrum disorders}}. {Autism Res} (Sep 27)
Autism is a complex neurodevelopmental disorder, likely encompassing multiple pathogenetic components. The aim of this study is to begin identifying at least some of these components and to assess their association with biological endophenotypes. To address this issue, we recruited 245 Italian patients with idiopathic autism spectrum disorders and their first-degree relatives. Using a stepwise approach, patient and family history variables were analyzed using principal component analysis (« exploratory phase »), followed by intra- and inter-component cross-correlation analyses (« follow-up phase »), and by testing for association between each component and biological endophenotypes, namely head circumference, serotonin blood levels, and global urinary peptide excretion rates (« biological correlation phase »). Four independent components were identified, namely « circadian & sensory dysfunction, » « immune dysfunction, » « neurodevelopmental delay, » and « stereotypic behavior, » together representing 74.5% of phenotypic variance in our sample. Marker variables in the latter three components are positively associated with macrocephaly, global peptiduria, and serotonin blood levels, respectively. These four components point toward at least four processes associated with autism, namely (I) a disruption of the circadian cycle associated with behavioral and sensory abnormalities, (II) dysreactive immune processes, surprisingly linked both to prenatal obstetric complications and to excessive postnatal body growth rates, (III) a generalized developmental delay, and (IV) an abnormal neural circuitry underlying stereotypies and early social behaviors.
8. Voituron N, Menuet C, Dutschmann M, Hilaire G. {{Physiological definition of upper airway obstructions in mouse model for Rett syndrome}}. {Respir Physiol Neurobiol} (Sep 30);173(2):146-156.
Rett syndrome is a neuro-developmental disease accompanied by breathing symptoms including breath-hold events, and is caused by mutation of the transcriptional repressor methyl-CpG-binding protein 2 (MeCP2). Males of Mecp2-deficient mice (Mecp2(-/y)) also develop breathing symptoms, with erratic rhythm and life-threatening apnoeas from postnatal day 30 (P30), leading to respiratory distress and premature death at around P60. We investigated the respiratory function of conscious Mecp2(-/y) mice at P40-P60 using conventional whole-body plethysmography, double-chamber plethysmography and chest EMG recordings. Double-chamber plethysmography revealed a persistent increase in respiratory work-load with enlarged chest movements, but no subsequent increase of tidal volume thus revealing a mismatch between airflow and muscle work-load. Apnoeas occurred with cessation of both chest movements and ventilation, but some (40%) developed with persisting rhythmic chest EMG discharges or chest movements without respiratory airflow, suggesting respiratory efforts against obstructed airways. Airway obstruction was maintained even when the respiratory drive increased significantly, triggering large chest EMG discharges and movements. Whole-body plethysmography of Mecp2(-/y) mice revealed significant increases of spirograms, reflecting forced chest movements against partially obstructed airways. The persisting chest EMG discharges and rhythmic chest movements without respiratory airflow suggest that Mecp2 inactivation alters neural circuits controlling the upper airway dilator muscles. The observed breath-hold events in Mecp2(-/y) mice might imply disturbance of neural circuits attached to voluntary control of breathing.
9. Wilson CE, Freeman P, Brock J, Burton AM, Palermo R. {{Facial identity recognition in the broader autism phenotype}}. {PLoS One};5(9)
BACKGROUND: The ‘broader autism phenotype’ (BAP) refers to the mild expression of autistic-like traits in the relatives of individuals with autism spectrum disorder (ASD). Establishing the presence of ASD traits provides insight into which traits are heritable in ASD. Here, the ability to recognise facial identity was tested in 33 parents of ASD children. METHODOLOGY AND RESULTS: In experiment 1, parents of ASD children completed the Cambridge Face Memory Test (CFMT), and a questionnaire assessing the presence of autistic personality traits. The parents, particularly the fathers, were impaired on the CFMT, but there were no associations between face recognition ability and autistic personality traits. In experiment 2, parents and probands completed equivalent versions of a simple test of face matching. On this task, the parents were not impaired relative to typically developing controls, however the proband group was impaired. Crucially, the mothers’ face matching scores correlated with the probands’, even when performance on an equivalent test of matching non-face stimuli was controlled for. CONCLUSIONS AND SIGNIFICANCE: Components of face recognition ability are impaired in some relatives of ASD individuals. Results suggest that face recognition skills are heritable in ASD, and genetic and environmental factors accounting for the pattern of heritability are discussed. In general, results demonstrate the importance of assessing the skill level in the proband when investigating particular characteristics of the BAP.
