1. Ayaydın H, Kirmit A, Çelik H, Akaltun İ, Koyuncu İ, Bilgen Ulgar Ş. {{High Serum Levels of Serum 100 Beta Protein, Neuron-specific Enolase, Tau, Active Caspase-3, M30 and M65 in Children with Autism Spectrum Disorders}}. {Clin Psychopharmacol Neurosci};2020 (May 31);18(2):270-278.
OBJECTIVE: The purpose of this study was therefore to investigate whether neuronal, axonal, and glial cell markers (Neuron-specific enolase [NSE], tau, serum 100 beta protein [S100B], respectively) and apoptosis markers (active caspase 3, M30, M65) and whether these parameters can be used as diagnostic biomarkers in autism spectrum disorders (ASD). METHODS: This study measured the serum S100B, NSE, tau, active caspase 3, M30, and M65 levels in 43 patients with ASD (aged 3-12 years) and in 41 age- and sex-matched healthy controls. ASD severity was rated using the Childhood Autism Rating Scale. The serum levels were determined in the biochemistry laboratory using the ELISA technique. The receiver operator characteristics curve method was employed to evaluate the accuracy of the parameters in diagnosing ASD. RESULTS: Serum S100B, tau, NSE, active caspase-3, M30, and M65 levels were significantly higher in the patient group than in the control group (p ＜ 0.001, p = 0.002, p = 0.002, p = 0.005, p ＜ 0.001, and p = 0.004, respectively). The cut-off value of S100B was 48.085 pg/ml (sensitivity: 74.4%, specificity: 80.5%, areas under the curve: 0.879, p ＜ 0.001). CONCLUSION: Apoptosis increased in children with ASD, and neuronal, axonal, and glial cell injury was observed. In addition, S100B may be an important diagnostic biomarker in patients with ASD. Apoptosis, and neuronal, axonal and astrocyte pathologies may play a significant role in the pathogenesis of ASD, and further studies are now required to confirm this.
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2. Beck KB, Conner CM, Breitenfeldt KE, Northrup JB, White SW, Mazefsky CA. {{Assessment and Treatment of Emotion Regulation Impairment in Autism Spectrum Disorder Across the Life Span: Current State of the Science and Future Directions}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):527-542.
Emotion regulation (ER) is the ability to modify arousal and emotional reactivity to achieve goals and maintain adaptive behaviors. ER impairment in autism spectrum disorder (ASD) is thought to underlie many problem behaviors, co-occurring psychiatric symptoms, and social impairment, and yet is largely unaddressed both clinically and in research. There is a critical need to develop ER treatment and assessment options for individuals with ASD across the life span, given the multitude of downstream effects on functioning. This article summarizes the current state of science in ER assessment and treatment and identifies the most promising measurement options and treatments.
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3. Besag FMC, Vasey MJ. {{Seizures and Epilepsy in Autism Spectrum Disorder}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):483-500.
Epilepsy and autism frequently co-occur. Epilepsy confers an increased risk of autism and autism confers an increased risk of epilepsy. Specific epilepsy syndromes, intellectual disability, and female gender present a particular risk of autism in individuals with epilepsy. Epilepsy and autism are likely to share common etiologies, which predispose individuals to either or both conditions. Genetic factors, metabolic disorders, mitochondrial disorders, and immune dysfunction all can be implicated.
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4. Brinkert J, Remington A. {{Making sense of the perceptual capacities in autistic and non-autistic adults}}. {Autism};2020 (May 31):1362361320922640.
Perceptual capacity refers to the amount of information that we can pay attention to at any one time. Research has shown that autistic people have a higher perceptual capacity, which means they can take in more information than non-autistic people can. This can be useful in certain situations, for instance, hearing approaching cars or noticing small details. However, in other situations, a higher perceptual capacity may result in more distraction. This study looked at whether having this increased perceptual capacity is linked to being very sensitive to sensory information (lights, sounds, touch, taste and smell) – something that many autistic people experience on a daily basis. Being very sensitive to these things can make it hard to interact with the world around us, so it is important to know more about what causes the sensitivity. To explore this, 38 autistic and 66 non-autistic adults completed a computer task that measured perceptual capacity and filled in a questionnaire about how sensitive they were to sensory information. We found that perceptual capacity was related to sensory symptoms for both autistic and non-autistic participants; people who had a larger perceptual capacity showed more sensitivity, while people who had a lower perceptual capacity showed reduced sensory sensitivity. This information can hopefully be used to improve the way in which we can support people who experience unpleasant sensory sensitivity.
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5. Brown DM, Arbour-Nicitopoulos KP, Martin Ginis KA, Latimer-Cheung AE, Bassett-Gunter RL. {{Examining the relationship between parent physical activity support behaviour and physical activity among children and youth with autism spectrum disorder}}. {Autism};2020 (May 31):1362361320922658.
Children and youth with autism spectrum disorder engage in less physical activity than neurotypically developing peers. This may be due to factors associated with autism spectrum disorder at the individual and environmental level that can make physical activity participation more challenging. Parent support is a known determinant of physical activity among children and youth; however, limited research has explored the relationship between parent physical activity support behaviour and child physical activity behaviour within the autism spectrum disorder population. The purpose of this study was to examine the relationship between parent physical activity support behaviour and physical activity levels of children and youth with autism spectrum disorder. Parents (n = 201) of school-aged children and youth with autism spectrum disorder completed measures of parent physical activity support (intentions, behavioural regulation, support behaviour), as well as their child’s physical activity behaviour. The results showed that parent’s intentions to provide physical activity support were associated with their support behaviour for their child’s physical activity (e.g. encouragement, being active together). Parents who followed through with their intentions to provide support reported using behavioural regulation strategies such as goal setting and planning more often. Finally, the results showed parent physical activity support behaviour was positively associated with child physical activity behaviour. Findings suggest parents play an instrumental role in the physical activity behaviour of children and youth with autism spectrum disorder. Family-level interventions targeting parents’ behavioural regulation strategies to provide physical activity support may be an effective strategy to increase physical activity in children and youth with autism spectrum disorder.
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6. Cage E, Howes J. {{Dropping out and moving on: A qualitative study of autistic people’s experiences of university}}. {Autism};2020 (May 31):1362361320918750.
Many autistic people now go to university, but many of them also drop out of their studies. In fact, it is believed that autistic people are at higher risk of dropping out, but little research has been done to understand why this is happening. This research used interviews to take an in-depth look at 14 autistic people’s experiences of dropping out of university. All the things the participants talked about were examined closely by the researchers who identified common themes in what the participants discussed. The first set of themes captured some overarching issues faced by autistic people, such as difficulties with getting diagnosed, a lack of autism understanding, mental health challenges and feeling like an outsider. The next themes were organised within challenges faced at university, including a feeling of culture shock, becoming disengaged from one’s studies, a lack of proactive support from their university and a feeling that dropping out became inevitable. Finally, there were themes about life after dropping out, which involved a sense that the experience at university had been traumatic and shameful, but they believed people had to do what is right for them. All of these themes suggest that universities need to be better at supporting autistic people when they first come to university, and that they should actively offer clear support throughout and try and make the university environment more accessible for everyone, to ensure more autistic people have a positive university experience.
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7. Crucitti J, Hyde C, Enticott PG, Stokes MA. {{Head circumference trends in autism between 0 and 100 months}}. {Autism};2020 (May 31):1362361320921037.
Summaries of studies that have measured head size in those with autism, known as meta-analyses, currently exist. However, this approach does not adequately explain extreme cases (such as those with extremely small, or extremely large, head size). Because of this, we obtained all available published data measuring head size (12 studies). The data from each study were then combined to make a larger dataset. We found that females with autism aged 12-17 months had, on average, smaller head sizes. Otherwise, average head size was not atypical in autism. However, we found that males with autism were more likely to have extreme head sizes at birth and between 60 and 100 months, a small head between 6 and 11 months, and a large head between 12 and 17 months. Females with autism were more likely to have extreme head sizes between 36 and 59 months and were less likely at birth. Our approach was able to measure the influence of age and biological sex on head size in autism, as well as the frequency of extreme cases of head size in autism. These results add to what we already know about head size in autism.
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8. Cutri-French C, Armstrong D, Saby J, Gorman C, Lane J, Fu C, Peters SU, Percy A, Neul JL, Marsh ED. {{Comparison of core features in four Developmental Encephalopathies in the Rett Natural History Study}}. {Ann Neurol};2020 (May 30)
OBJECTIVE: Rett Syndrome, CDKL5-Deficiency Disorder, FOXG1 Disorder, and MECP2 Duplication Disorder are Developmental Encephalopathies with shared and distinct features. Though historically linked, no direct comparison has been performed. The first head-to-head comparison of clinical features in these conditions is presented. METHODS: Comprehensive clinical information was collected from 793 individuals enrolled in the Rett Syndrome and Related Disorders Natural History Study. Clinical features including clinical severity, regression, and seizures were cross-sectionally compared between diagnoses to test the hypothesis that these are 4 distinct disorders. RESULTS: Distinct patterns of clinical severity, seizure onset age, and regression were present. Individuals with CDKL5-Deficency Disorder were the most severely affected and had the youngest age of seizure onset (2 months) whereas children with MECP2-duplication syndrome had the oldest median age of seizure onset (64 months) and lowest severity scores. Rett syndrome and FOGX1 were intermediate in both features. Smaller head circumference correlates with increased severity in all disorders and earlier age of seizure onset in MECP2-duplication syndrome. Developmental regression occurred in all Rett syndrome participants (median 18 months) but only 23-34% of the other disorders. Seizure incidence prior to the baseline visit was highest for CDKL5-Deficency Disorder (96.2%) and lowest for Rett syndrome (47.5%). Other clinical features including seizure types and frequency differed amongst groups. INTERPRETATION: While these Developmental Encephalopathies share many clinical features, clear differences in severity, regression, and seizures warrant considering them as unique disorders. These results will aid in the development of disease specific severity scales, precise therapeutics, and future clinical trials. This article is protected by copyright. All rights reserved.
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9. Ghaziuddin M, Ghaziuddin N. {{Bipolar Disorder and Psychosis in Autism}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):433-441.
Autism seldom occurs in its pure form. Often labeled as behavioral disorders or psychological reactions, comorbid psychiatric disorders are common. Bipolar disorder is one of the most common psychiatric disorders that occur in persons with autism across their life spans. It can be comorbid with and mistaken for several other conditions. Similarly, psychosis occurs in several psychiatric disorders. Schizophrenia is the prototype psychotic disorder that has a close but controversial relationship with autism. Assessment and treatment of bipolar disorder and psychosis should be based on their individual characteristics, family dynamics, and community resources.
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10. Ghaziuddin N, Andersen L, Ghaziuddin M. {{Catatonia in Patients with Autism Spectrum Disorder}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):443-454.
Catatonia was first described by Karl Ludwig Kahlbaum in 1874, occurring in association with other psychiatric and medical disorders. However, in the nineteenth century the disorder was incorrectly classified as a subtype of schizophrenia. This misclassification persisted until the publication of DSM-5 in 2013 when important changes were incorporated. Although the etiology is unknown, disrupted gamma-aminobutyric acid has been proposed as the underlying pathophysiological mechanism. Key symptoms can be identified under 3 clinical domains: motor, speech, and behavioral. Benzodiazepines and electroconvulsive therapy are the only known effective treatments. Timely recognition and treatment have important outcome, and sometimes lifesaving, implications.
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11. Keating CT, Cook JL. {{Facial Expression Production and Recognition in Autism Spectrum Disorders: A Shifting Landscape}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):557-571.
Social « difficulties » associated with ASD may be a product of neurotypical-autistic differences in emotion expression and recognition. Research suggests that neurotypical and autistic individuals exhibit expressive differences, with autistic individuals displaying less frequent expressions that are rated lower in quality by non-autistic raters. Autistic individuals have difficulties recognizing neurotypical facial expressions; neurotypical individuals have difficulties recognizing autistic expressions. However, findings are mixed. Task-related factors (e.g., intensity of stimuli) and participant characteristics (e.g., age, IQ, comorbid diagnoses) may contribute to the mixed findings. The authors conclude by highlighting important areas for future research and the clinical implications of the discussed findings.
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12. Kunreuther E. {{Autism Spectrum Disorder and Substance Use Disorder: A Dual Diagnosis Hiding in Plain Sight}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):467-481.
Individuals with autism spectrum disorder (ASD) have a significantly higher risk for developing a substance use disorder (SUD) than the general population yet literature addressing cooccurring ASD and SUD is scarce. This article explores connections between ASD and SUD and the impact on development, screening and treatment. The article proposes culturally constructed narratives associated with both diagnoses may be responsible for the dearth of research and literature. Constructed narratives of ASD and SUD do not naturally intersect and the resulting disconnect can create a cognitive dissonance that could allow the medical and general community to neglect this life-threatening dual diagnosis.
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13. Landa RK, Frampton SE, Shillingsburg MA. {{Teaching children with autism to mand for social information}}. {J Appl Behav Anal};2020 (May 31)
We replicated Shillingsburg et al. (2018) by teaching children with autism to mand for social information while analyzing the variables influencing the emission of mands. We presented questions about a social partner that were known and observable (e.g., « What is Robin doing? »), known but unobservable (i.e., questions for which an intraverbal response had previously been taught, such as, « Where does Robin work? »), or unknown (e.g., « What is Robin’s favorite food? »). Correct answers were reinforced across all conditions. During treatment, we prompted children to mand for information from the social partner following only unknown questions. All children acquired mands for social information and answered previously unknown questions correctly after manding for social information and 3 of 4 participants emitted mands to novel social partners, including a peer with autism.
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14. Lau WKW, Leung MK, Zhang R. {{Hypofunctional connectivity between the posterior cingulate cortex and ventromedial prefrontal cortex in autism: Evidence from coordinate-based imaging meta-analysis}}. {Prog Neuropsychopharmacol Biol Psychiatry};2020 (May 27):109986.
BACKGROUND: Underconnectivity in the posterior cingulate cortex (PCC) may be associated with a weakened ability to interpret social signals in autism spectrum disorder (ASD) and result in cognitive inflexibility – a hallmark feature of ASD. However, previous neuroimaging studies using resting-state functional magnetic resonance imaging in ASD reported inconsistent findings on functional connectivity of the PCC. This study investigated the aberrant resting-state functional connectivity of the PCC in ASD using multilevel kernel density analysis. METHODS: Online databases (MEDLINE/PubMed) were searched for PCC-based functional connectivity in ASD. Ten studies (501 subjects; 161 reported foci) met the inclusion criteria of this meta-analysis. RESULTS: We found one consistent and strong abnormal functional connectivity of ASD during the resting state, which was the hypoconnectivity between the PCC and ventromedial prefrontal cortex (VMPFC). Importantly, the Jackknife sensitivity analysis revealed that the VMPFC cluster was stably hypoconnected with the PCC in ASD (maximum spatial overlap rate: 100%). CONCLUSIONS: The reduced PCC-VMPFC functional coupling may provide an early insight into the effects of ASD on multiple dimensions of functioning, including higher-order cognitive and complex social functions.
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15. Lim J, Greenspoon D, Hunt A, McAdam L. {{Rehabilitation interventions in Rett syndrome: a scoping review}}. {Dev Med Child Neurol};2020 (May 30)
AIM: To summarize existing interventions and their outcomes in Rett syndrome (RTT) rehabilitation and identify gaps in the literature. METHOD: Five databases (Ovid MEDLINE, Ovid Embase Classic, Ovid PsycINFO, EBSCO CINAHL Plus, and ProQuest ERIC) were systematically searched up to 23rd July 2018 for studies describing rehabilitation interventions. Data on study participants, design, and outcomes were extracted. RESULTS: Sixty-two articles were included in the final review. Evidence consistently demonstrated that females with RTT can improve their gross motor, fine motor, and communicative skills with rehabilitation. All 11 interventions targeting gross motor function, namely ambulation, achieved functional improvements. Twenty of 24 articles describing fine motor rehabilitation studies succeeded in decreasing stereotypies, improving functional hand use, and/or reducing self-injurious behaviors. Twenty-one of 22 studies describing communication interventions succeeded in training choice-making, communicative language, or socialization behavior. Other key findings include the positive interplay between physical and communicative rehabilitation outcomes, and the ability of females with RTT to improve their cognitive abilities during intervention. INTERPRETATION: Rehabilitation can impact the daily lives of females with RTT and their caregivers in clinically meaningful ways.
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16. Maddox BB, Lecavalier L, Miller JS, Pritchett J, Hollway J, White SW, Gillespie S, Evans AN, Schultz RT, Herrington JD, Bearss K, Scahill L. {{Reliability and validity of the Pediatric Anxiety Rating Scale modified for autism spectrum disorder}}. {Autism};2020 (May 31):1362361320922682.
Many youth with autism spectrum disorder have anxiety, but it can be difficult to assess anxiety with existing measures. We modified the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder and tested the new measure in a group of 116 youth (age: 5-17 years) with autism spectrum disorder. The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder is an interview that a clinician usually completes with the child and parent together. We modified the interview questions and scoring instructions based on feedback from parents of children with autism spectrum disorder and from a panel of experts in autism spectrum disorder and anxiety. Unlike many other anxiety measures, the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder relies less on a child’s verbal expression of anxiety and more on signs that a parent can easily observe. Training clinicians to administer and score the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder was uncomplicated, and raters showed excellent agreement on video-recorded interviews. Youth who were not currently in treatment for anxiety had stable Pediatric Anxiety Rating Scale for youth with autism spectrum disorder scores with repeat measurement over a 1-month period. The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder is a useful clinician-rated measure of anxiety in youth with autism spectrum disorder and fills a gap for assessing anxiety in this population.
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17. Madra M, Ringel R, Margolis KG. {{Gastrointestinal Issues and Autism Spectrum Disorder}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):501-513.
Gastrointestinal disorders are one of the most common medical conditions that are comorbid with autism spectrum disorders. These comorbidities can cause greater severity in autism spectrum disorder symptoms, other associated clinical manifestations, and lower quality of life if left untreated. Clinicians need to understand how these gastrointestinal issues present and apply effective therapies. Effective treatment of gastrointestinal problems in autism spectrum disorder may result in marked improvements in autism spectrum disorder behavioral outcomes. This article discusses the gastrointestinal disorders commonly associated with autism spectrum disorders, how they present, and studied risk factors.
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18. Neumeyer A, Thom RP, McDougle CJ. {{A rational pharmacologic approach toward a biologically meaningful subtype of autism spectrum disorder}}. {J Pediatr (Rio J)};2020 (May 27)
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19. Park SE, Grados M, Wachtel L, Kaji S. {{Use of Electroconvulsive Therapy in Autism}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):455-465.
The mechanism of action of electroconvulsive therapy (ECT) is not fully elucidated, with prevailing theories ranging from neuroendocrinological to neuroplasticity effects of ECT or epileptiform brain plasticity. Youth with autism can present with catatonia. ECT is a treatment that can safely and rapidly resolve catatonia in autism and should be considered promptly. The literature available for ECT use in youth with autism is consistently growing. Under-recognition of the catatonic syndrome and delayed diagnosis and implementation of the anticatatonic treatment paradigms, including ECT, as well as stigma and lack of knowledge of ECT remain clinical stumbling blocks.
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20. Pecora LA, Hooley M, Sperry L, Mesibov GB, Stokes MA. {{Sexuality and Gender Issues in Individuals with Autism Spectrum Disorder}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):543-556.
This article reviews relevant literature on sexuality in individuals with autism spectrum disorder (ASD). Findings reveal a growing awareness of desire for sexual and intimate relationships in individuals with ASD. However, core impairments of ASD lead to difficulties establishing requisite knowledge and skills necessary to attain a healthy sexuality and facilitate relationships. Consequently, individuals with ASD present with increased risk of engaging in inappropriate sexual behaviors and sexual victimization than their typically developing peers. The literature asserts the need to implement effective sexual education programs to assist in development of healthy sexual identity and relationships that meet each individual’s needs.
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21. Sarcia B. {{The Impact of Applied Behavior Analysis to Address Mealtime Behaviors of Concern Among Individuals with Autism Spectrum Disorder}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):515-525.
Feeding difficulties among individuals with autism spectrum disorder are common. The science of applied behavior analysis (ABA) has been employed to address these difficulties. Ample publications exist that demonstrate that ABA is consistently effective in increasing the consumption of new foods and drinks, increasing chewing and swallowing behavior, decreasing problem behavior at mealtime, and improving skills such as self-feeding. This article details the application of the basic principles of ABA, reinforcement, extinction, and punishment to treat feeding difficulties.
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22. Schallmo MP, Kolodny T, Kale AM, Millin R, Flevaris AV, Edden RAE, Gerdts J, Bernier RA, Murray SO. {{Weaker neural suppression in autism}}. {Nat Commun};2020 (May 29);11(1):2675.
Abnormal sensory processing has been observed in autism, including superior visual motion discrimination, but the neural basis for these sensory changes remains unknown. Leveraging well-characterized suppressive neural circuits in the visual system, we used behavioral and fMRI tasks to demonstrate a significant reduction in neural suppression in young adults with autism spectrum disorder (ASD) compared to neurotypical controls. MR spectroscopy measurements revealed no group differences in neurotransmitter signals. We show how a computational model that incorporates divisive normalization, as well as narrower top-down gain (that could result, for example, from a narrower window of attention), can explain our observations and divergent previous findings. Thus, weaker neural suppression is reflected in visual task performance and fMRI measures in ASD, and may be attributable to differences in top-down processing.
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23. Song L, Luo X, Jiang Q, Chen Z, Zhou L, Wang D, Chen A. {{Vitamin D Supplementation is Beneficial for Children with Autism Spectrum Disorder: A Meta-analysis}}. {Clin Psychopharmacol Neurosci};2020 (May 31);18(2):203-213.
OBJECTIVE: We conducted a meta-analysis of randomized controlled trials to explore whether vitamin D supplementation is beneficial for symptom improvement in children with autism spectrum disorder. METHODS: We systematically searched the PubMed database, EMBASE, Cochrane Library, Web of Science, Sino-Med, Wanfang Data, and China National Knowledge Infrastructure mainly up to September 2019. Using a fixed effects model, we calculated the standard mean difference with 95% confidence interval. Furthermore, we analyzed baseline serum 25-hydroxyvitamin D levels and outcome scores including the Social Responsiveness Scale and Child Autism Rating Scale scores after vitamin D supplementation. RESULTS: There was no significant difference in baseline serum 25-hydroxyvitamin D levels among 203 children included from three studies in the meta-analysis. After vitamin D supplementation, the outcome scores in the experimental group were dramatically elevated compared with those in the control group (p = 0.03). CONCLUSION: Vitamin D supplementation improves the typical symptoms of autism spectrum disorder, as indicated by reduced Social Responsiveness Scale and Child Autism Rating Scale scores; thus, it is beneficial for children with autism spectrum disorder.
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24. Styles M, Alsharshani D, Samara M, Alsharshani M, Khattab A, Qoronfleh MW, Al-Dewik NI. {{Risk factors, diagnosis, prognosis and treatment of autism}}. {Front Biosci (Landmark Ed)};2020 (Jun 1);25:1682-1717.
The prevalence rate of Autism Spectrum Disorder (ASD) has reached over 1% world-wide prompting governments, health providers and schools to develop programs and policies to address this challenging disorder. Here, we review the cause(s), as well as environmental factors, genetic mutations, and neural pathways that are implicated in ASD. We also discuss the criteria that are commonly used for the diagnosis of ASD and future clinical genetic testing that can aid in the diagnosis of this disorder. Finally, we provide practical steps that can be used to reduce the incidence and severity of ASD, as well as prognosis and treatment of autism.
25. Tanet A, Hubert-Barthelemy A, Clément MN, Soumille F, Crespin GC, Pellerin H, Allaert FA, Cohen D, Saint-Georges C. {{Developmental and sequenced one-to-one educational intervention (DS1-EI) for autism spectrum disorder and intellectual disability: a two-year interim report of a randomized single-blind multicenter controlled trial}}. {BMC Pediatr};2020 (May 29);20(1):263.
BACKGROUND: Children with autism spectrum disorder (ASD) and moderate to severe intellectual disability (ID) face many challenges. There is little evidence-based research into educational settings for children with ID and ASD and in France. Little is known about how this unserved population could benefit from intervention and education. This study assessed the feasibility and efficacy of a new intervention model using an individualized educational approach. METHODS: We conducted a randomized, single-blind controlled trial to assess a novel intervention: the « Developmental and Sequenced One-to-One Intervention (DS1-EI) ». In DS1-EI, trained teachers worked one-to-one with each child in a small classroom setting, offering 10 h per week of the intervention. The focus was on encouraging spontaneous communication, promoting skills through play with peers, supporting positive interactions, and developmental and sequenced learning. We enrolled 5- to 9-year-old children with ASD and ID across 11 French child care institutions for children with co-occurring ASD and ID. Participants were matched in dyads by developmental quotient and randomized to the treatment-as-usual (TAU) group or the DS1-EI group. Independent raters blindly assessed the primary variables: The Childhood Autism Rating scale (CARS) and the Psychoeducational Profile, third edition (PEP-3). The secondary variables included the Vineland Adaptive Behavior Scale II (VABS-II) and the Clinical Global Assessment Scale (CGAS). Here we perform interim analyses at 24 months. RESULTS: At baseline, 72 participants were randomized. Nine patients (5 in the DS1-EI group and 4 in the TAU group) dropped out of the study. Using linear mixed models, both intent-to-treat (ITT) and per-protocol (PP) analyses at the 12-, 18- and 24-month outcomes showed no significant group nor group-by-time interaction effects. However, we found significant improvements in most primary and secondary variables over time in both groups. CONCLUSIONS: The study did not show that DS1-EI was superior to TAU in treating children with ASD and ID over 24 months. However, the low dropout rate shows that DS1-EI is feasible, and well accepted. As the study is still ongoing, we need to wait for data at 36 months to ensure whether DS1-EI could be recommended. TRIAL REGISTRATION: ANSM130282B-31 (April 16, 2013) and ACTRN12616000592448. Registered 6 May 2016, retrospectively registered, http://www.anzctr.org.au/.
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26. Wisner-Carlson RW, Pekrul SR, Flis T, Schloesser R. {{Acts of Medical Kindness for People with Autism}}. {Child Adolesc Psychiatr Clin N Am};2020 (Jul);29(3):xi-xiv.
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27. Yildiz GY, Vilsten JS, Millard AS, Chouinard PA. {{Grey-Matter Thickness of the Left But Not the Right Primary Visual Area Correlates with Autism Traits in Typically Developing Adults}}. {J Autism Dev Disord};2020 (May 29)
We examined whether functional and structural variability in the primary visual area (V1) correlated with autism traits. Twenty-nine participants (16 males; M(Age) = 26.4 years, SD(Age) = 4.0 years) completed the autism-spectrum quotient (AQ) questionnaire prior to a magnetic resonance imaging session. The total AQ scores was used to assess the degree of self-reported autism traits. The average functional activation in V1 to visual stimulation and its average grey-matter thickness were calculated. There were no correlations between functional activation in V1 and autism traits. Conversely, grey-matter thickness of the left but not the right V1 correlated with autism traits. We conclude that structural changes in the left V1 could be a marker for the presence of autism traits.
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28. Zwaigenbaum L, Warren Z. {{Commentary: Embracing innovation is necessary to improve assessment and care for individuals with ASD: a reflection on Kanne and Bishop (2020)}}. {J Child Psychol Psychiatry};2020 (May 30)
This commentary is offered in response to Kanne and Bishop (2020) who urge caution in adopting new devices and processes for ASD assessment and advocate that that comprehensive, expert-driven, diagnostic models for ASD remain essential to maintain quality standards. While we agree that there is a critical shortage in current care, we propose that developing suites of tools and innovative approaches for screening, risk-classification, formal diagnosis, and rich assessment of abilities and challenges may be of great value to families and necessary to improve current systems of care. As well, the evaluation of ‘assessment quality’ should take into consideration both content and process, with a focus on achieving meaningful outcomes and optimizing family experience.
