1. Bohlander AJ, Orlich F, Varley CK. {{Social skills training for children with autism}}. {Pediatric clinics of North America}. 2012 Feb;59(1):165-74.
This article summarizes the current literature on social skills training for children and adolescents with autism spectrum disorders. The article describes several different methods of social skills training, along with a summary of research findings on effectiveness. Interventions described include social skills groups, peer mentoring/training, social stories, and video modeling. The article also describes information about accessing social skills training services, and concludes with future directions and recommendations for pediatricians.
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2. Chugani DC. {{Neuroimaging and Neurochemistry of Autism}}. {Pediatric clinics of North America}. 2012 Feb;59(1):63-73.
Positron emission tomography, single-photon emission tomography, and magnetic resonance spectroscopy (MRS) are powerful tools for the monitoring of diverse neurochemical functions. Neuroimaging studies targeting neurotransmitter systems in autism have provided clues about how differences in development of these systems might lead to new intervention approaches. Direct measurement of diverse neurochemicals with MRS provides unique probes of neuronal integrity in vivo. Future directions include the combination of imaging modalities made possible by advances in software and hardware. Many tracers have not been applied in autism, and new molecules and signaling pathways might be targeted as genes associated with autism are identified.
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3. Duchan E, Patel DR. {{Epidemiology of autism spectrum disorders}}. {Pediatric clinics of North America}. 2012 Feb;59(1):27-43.
Epidemiologic data gathered over the last 40 years report that the conservative estimate of autistic spectrum disorder prevalence is 27.5 per 10,000 individuals; however, the prevalence estimate based on newer surveys is 60 per 10,000 individuals. Several factors are considered in various epidemiologic surveys of autism, especially the evolution of the concept of autism and changing criteria for diagnosis. This article reviews the incidence, prevalence, and risk factors for autism.
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4. Elsabbagh M, Mercure E, Hudry K, Chandler S, Pasco G, Charman T, Pickles A, Baron-Cohen S, Bolton P, Johnson MH, the BT. {{Infant Neural Sensitivity to Dynamic Eye Gaze Is Associated with Later Emerging Autism}}. {Curr Biol}. 2012 Jan 24.
Autism spectrum disorders (henceforth autism) are diagnosed in around 1% of the population [1]. Familial liability confers risk for a broad spectrum of difficulties including the broader autism phenotype (BAP) [2, 3]. There are currently no reliable predictors of autism in infancy, but characteristic behaviors emerge during the second year, enabling diagnosis after this age [4, 5]. Because indicators of brain functioning may be sensitive predictors, and atypical eye contact is characteristic of the syndrome [6-9] and the BAP [10, 11], we examined whether neural sensitivity to eye gaze during infancy is associated with later autism outcomes [12, 13]. We undertook a prospective longitudinal study of infants with and without familial risk for autism. At 6-10 months, we recorded infants’ event-related potentials (ERPs) in response to viewing faces with eye gaze directed toward versus away from the infant [14]. Longitudinal analyses showed that characteristics of ERP components evoked in response to dynamic eye gaze shifts during infancy were associated with autism diagnosed at 36 months. ERP responses to eye gaze may help characterize developmental processes that lead to later emerging autism. Findings also elucidate the mechanisms driving the development of the social brain in infancy.
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5. Farmer C. {{Demystifying moderators and mediators in intellectual and developmental disabilities research: a primer and review of the literature}}. {J Intellect Disabil Res}. 2012 Jan 29.
Background Intellectual and developmental disability (IDD) researchers have been relatively slow to adopt the search for moderators and mediators, although these variables are key in understanding how and why relationships exist between variables. Although the traditional method of causal steps is useful for describing and understanding moderators and mediators, it is not sufficient for statistical analysis. Methods The theoretical and statistical processes of evaluating moderators and mediators are explained in terms familiar to IDD psychologists, using examples from IDD literature. Moderator and mediator analyses in five leading IDD journals are assessed for patterns of usage. Results Although the number of publications in the past decade exceeds previous years, the field is still behind others in both the quantity and quality of the use of moderators and mediators. Conclusion The field as a whole will advance if the recent theoretical and technical advances outlined in this paper are employed.
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6. Greydanus DE, Toledo-Pereyra LH. {{Historical perspectives on autism: its past record of discovery and its present state of solipsism, skepticism, and sorrowful suspicion}}. {Pediatric clinics of North America}. 2012 Feb;59(1):1-11.
Concepts of autism have evolved over the twentieth century after Bleuler coined the term to refer to symptoms of self-absorption in those with schizophrenia. Autism nosology changed to the current sesquipedalian constellation of autism spectrum disorders with a confusing archipelago of 5 conditions that often serve as islands of confusion to both the general public and professionals. This article reviews historical links that have led to the current confusing and controversial situation that is encouraging some people to return to magic, mysticism, and mantics for health care, despite the amazing accumulation of progress in vaccinology over the past 2 centuries.
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7. Heulens I, D’Hulst C, Van Dam D, De Deyn PP, Kooy RF. {{Pharmacological treatment of fragile X syndrome with GABAergic drugs in a knockout mouse model}}. {Behavioural brain research}. 2012 Jan 21.
Molecular and electrophysiological studies have provided evidence for a general downregulation of the GABAergic system in the Fmr1 knockout mouse. GABA(A) receptors are the main inhibitory receptors in the brain and the GABA(A) receptor was proposed as a novel target for treatment of the fragile X syndrome, the most frequent form of intellectual disability. This study examined the functionality of the GABA(A) receptor in rotarod and elevated plus maze tests with fragile X mice treated with GABA(A) receptor agonists, the benzodiazepine diazepam and the neuroactive steroid alphaxalone. In addition, the effect of GABA(A) receptor activation on the audiogenic seizure activity was determined. We proved that the GABA(A) receptor is still sensitive to GABAergic drugs as the sedative effect of diazepam resulted in a decreased latency time on the rotarod and alphaxalone had a clear anxiolytic effect in the elevated plus maze, decreasing the frequency of entries, the total time spent and the path length in the closed arms. We also observed that treatment with ganaxolone could rescue audiogenic seizures in Fmr1 knockout mice. These findings support the hypothesis that the GABA(A) receptor is a potential therapeutic target for fragile X syndrome.
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8. Huerta M, Lord C. {{Diagnostic evaluation of autism spectrum disorders}}. {Pediatric clinics of North America}. 2012 Feb;59(1):103-11.
Research on the identification and evaluation of autism spectrum disorders is reviewed, and best practices for clinical work are discussed. The latest research on diagnostic tools, and their recommended use, is also reviewed. Recommendations include the use of instruments designed to assess multiple domains of functioning and behavior, the inclusion of parents and caregivers as active partners, and the consideration of developmental factors throughout the diagnostic process.
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9. Iidaka T, Miyakoshi M, Harada T, Nakai T. {{White matter connectivity between superior temporal sulcus and amygdala is associated with autistic trait in healthy humans}}. {Neuroscience letters}. 2012 Jan 25.
Growing evidence suggests that autistic traits, such as reduced social and communication skills, exist along a continuum between healthy and pathological conditions. Thus, functional and structural investigations of neuroanatomical substrates that significantly correlate with autistic tendency in healthy human subjects are critical for understanding this disorder. To accomplish this goal, we performed functional magnetic resonance imaging (fMRI) in combination with diffusion tensor imaging (DTI) in 30 healthy young subjects. The subjects were evaluated using the Autistic-Spectrum Quotient (AQ), which was designed to measure autistic traits in healthy and autistic spectrum disorder (ASD) subjects. Face-specific brain activation in the superior temporal sulcus (STS) and amygdala (AMG) was identified using fMRI and passive viewing of faces. In addition, probabilistic tractography performed in each subject by using DTI showed a white matter pathway between the face-specific regions of interest in the STS and AMG. The volume of connectivity between the STS and AMG correlated positively with the total AQ score (Spearman’s rho=0.38, p<0.05); however, among the AQ subscales, only imagination was significantly associated with the connectivity volume. These results suggest that healthy subjects with high autistic traits may show an increase in the white matter pathway that connects key regions involved in face processing.
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10. Kaplan G, McCracken JT. {{Psychopharmacology of autism spectrum disorders}}. {Pediatric clinics of North America}. 2012 Feb;59(1):175-87.
At present, no evidence-based effective pharmacologic options are available for treating the core deficits of autism spectrum disorders (ASDs), which are best addressed by behavioral and educational interventions. However, such evidence exists for several of the frequently associated/comorbid symptoms such as aggression and severe irritability, hyperactivity, and repetitive behaviors, which can become a major source of additional distress and interference in functioning. This article offers information on the psychopharmacology of ASD that is current, relevant, and organized in a user-friendly manner, to form a concise but informative reference guide for primary pediatric clinicians.
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11. Leblanc LA, Gillis JM. {{Behavioral interventions for children with autism spectrum disorders}}. {Pediatric clinics of North America}. 2012 Feb;59(1):147-64.
Early intensive behavioral intervention is the only well-established treatment for young children with autism spectrum disorders (ASDs). Less intensive behavioral interventions are also effective for targeted concerns with older children and adolescents. This article describes the core features of behavioral treatments, summarizes the evidence base for effectiveness, and provides recommendations to facilitate family understanding of these interventions and identification of qualified providers. Recommendations are also provided for collaboration between pediatric providers and behavior analysts who are serving families of individuals with ASDs.
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12. Merrick J. {{Autism spectrum disorders: practical overview for pediatricians}}. {Pediatric clinics of North America}. 2012 Feb;59(1):xv-xvii.
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13. Nazeer A, Ghaziuddin M. {{Autism spectrum disorders: clinical features and diagnosis}}. {Pediatric clinics of North America}. 2012 Feb;59(1):19-25.
The last decade has seen an increase of interest in autism spectrum disorders (ASD). With the prevalence now approaching 1%, children with ASD are usually first evaluated by clinicians working in primary care, such as pediatricians and family practitioners. Although classic autism is easy to recognize, differentiating autism from other spectrum disorders and comorbid conditions is not always simple.
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14. Patel DR, Greydanus DE. {{Autism spectrum disorders: practical overview for pediatricians}}. {Pediatric clinics of North America}. 2012 Feb;59(1):xix.
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15. Prelock PJ, Nelson NW. {{Language and communication in autism: an integrated view}}. {Pediatric clinics of North America}. 2012 Feb;59(1):129-45.
Children with autism spectrum disorders can have varying degrees of difficulty acquiring spoken and written language, but symptoms of communication impairment associated with social impairment are uniformly present, distinguishing autism spectrum disorders from other neurodevelopmental disabilities. Early diagnosis and early intervention involving parents can improve prognosis. Red flags for social communication problems can be observed early. This article summarizes findings from the National Standards Project of the National Autism Center, which identified 11 types of treatment, 8 of which address communication. Both contemporary behavioral approaches and naturalistic developmental approaches are included in this set.
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16. Rinald K, Mirenda P. {{Effectiveness of a modified rapid toilet training workshop for parents of children with developmental disabilities}}. {Res Dev Disabil}. 2012 Jan 25;33(3):933-43.
Individuals with developmental disabilities often experience challenges in acquiring toileting skills, which highlights a need for effective toilet training strategies that can be readily disseminated to caregivers. The purpose of this multiple baseline study was to evaluate the effectiveness of a modified rapid toilet training workshop provided to the parents of six children with developmental disabilities. In the workshop, parents were taught to implement an instructional protocol that included increased fluid intake, positive reinforcement for correct toileting, scheduled toilet sittings, scheduled chair sittings to teach initiation, neutral redirection for accidents, and procedures to enhance maintenance and generalization. Following the workshop, parents implemented the toilet training protocol at home with their children for 5-8 days, with telephone support from a researcher. Results indicate that the workshop resulted in increased in-toilet urination and defecation and decreased accidents for the five children who completed the study. The results are discussed in relation to previous and future research and implications for practice.
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17. Schall C, Wehman P, McDonough JL. {{Transition from school to work for students with autism spectrum disorders: understanding the process and achieving better outcomes}}. {Pediatric clinics of North America}. 2012 Feb;59(1):189-202.
Individuals and their parents frequently turn to pediatricians, adolescent medicine specialists, and psychologists to answer questions about the course and outcomes of their disorder. This article provides a description of the characteristics of autism spectrum disorders (ASD) in adolescence and early adulthood. It also describes essential elements of high school programs designed to increase positive outcomes for youth with ASD and provides detailed information about various employment support models. Finally, the implications of transition programming for medical specialists and psychologists are discussed.
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18. Senova S, Jarraya B, Iwamuro H, Tani N, Ouerchefani N, Lepetit H, Gurruchaga JM, Brugieres P, Apartis E, de Broucker T, Palfi S. {{Unilateral thalamic stimulation safely improved fragile X-associated tremor ataxia: A case report}}. {Movement disorders : official journal of the Movement Disorder Society}. 2012 Jan 27.
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19. Silver WG, Rapin I. {{Neurobiological basis of autism}}. {Pediatric clinics of North America}. 2012 Feb;59(1):45-61.
Autism (autism spectrum disorders) is a complex, strongly genetically influenced, behaviorally defined disorder of the immature brain associated with very uneven intellectual abilities. Among its most salient and potentially treatable neurologic features that this article focuses on are epilepsy, disorganized sleep patterns, and sensory and motor deficits. Its many causes and wide range of severity means that there is no symptom, no pathology, imaging, electroencephalography, or other biologic feature, and no biologic treatment that is universal or diagnostic of this developmental syndrome.
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20. Soares NS, Patel DR. {{Office screening and early identification of children with autism}}. {Pediatric clinics of North America}. 2012 Feb;59(1):89-102.
Autism spectrum disorders (ASDs), also called pervasive developmental disorders in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revised), constitute a group of neurodevelopmental disorders that coalesce around a common theme of impairments in social functioning, communication abilities, and repetitive or rigid behaviors. The ASDs considered here include autism/autistic disorder, Asperger disorder/Asperger syndrome (AS), and pervasive developmental disorder not otherwise specified. This article focuses on autism/autistic disorder screening and its early identification, with a brief mention for AS screening, as there are limited tools and no recommendation for universal screening for AS.
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21. Suarez MA. {{Sensory processing in children with autism spectrum disorders and impact on functioning}}. {Pediatric clinics of North America}. 2012 Feb;59(1):203-14.
Children with autism experience many challenges that affect their ability to function. Sensory processing disorder and, specifically, sensory modulation disorder can compound dysfunction and further inhibit participation in productive activities. Through detection of and referral for sensory modulation disorders, treatment can be accessed. Emerging treatment evidence points to functional gains for autism and sensory modulation disorder that can ease the burden that this combination of symptoms has on the everyday life of children with autism.
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22. Tareen RS, Kamboj MK. {{Role of endocrine factors in autistic spectrum disorders}}. {Pediatric clinics of North America}. 2012 Feb;59(1):75-88.
It is possible that autism spectrum disorders (ASDs) have a multifactorial cause along with more than one predisposing and perpetuating factor, all of which culminate in expression of these disorders. Endocrine and neuropeptide factors are among the list of possible etiologic or predisposing contenders. The search for an endocrine model to explain the etiopathogenesis of ASD is a new endeavor. In this article, the authors look at some of the emerging literature that is available regarding any possible relationship between the endocrine hormones and factors and whether it can possibly be etiologic or merely coincidental with autism and ASDs.
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23. Toriello HV. {{Approach to the genetic evaluation of the child with autism}}. {Pediatric clinics of North America}. 2012 Feb;59(1):113-28.
Autism is a heterogeneous entity that clearly has a substantial genetic component to its cause. There is likely enough evidence to suggest that there are common genetic mechanisms that predispose to various psychiatric disorders. More recent studies have attempted to identify the specific genes involved in predisposition to autism. In general, such conditions can be subdivided into metabolic, mitochondrial, chromosomal, and monogenic (ie, caused by mutation in a single gene). This article examines what conditions should be considered in the child who does not appear to have a syndromic cause as the reason for the autistic phenotype.
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24. Waldman HB, Perlman SP. {{Ensuring oral health for older individuals with intellectual and developmental disabilities}}. {Journal of clinical nursing}. 2012 Jan 27.
Aims and objectives. To emphasise the oral health needs of older individuals with intellectual and developmental disabilities, the impact on the individual’s general health and the role that can be played by nurses. Background. All too often an examination and consideration of the oral health condition of this patient population by nurses/physicians is cursory at best. The increasing retention of the dentition into later years of life provides both the favourable abilities for eating, speech and self esteem, but also the potential for local and general health concerns. Design. Discursive paper. Method. Based on the findings from dental examination of thousands of international athletes in the Special Olympic Games and clinical experiences in academic and private practice settings for care of individuals with intellectual and developmental disabilities, a discursive listing was developed for use in a preliminary examination of the oral cavity. Conclusion. A nurse can play a critical role in the examination, preventive services and referrals for dental care for older individuals with intellectual and developmental disabilities. Relevance to clinical practice. The specific oral health needs of older individuals with intellectual and developmental disabilities should be an integral component of the preventive and general health care provided by nurses.
