1. Chi DL, Momany ET, Mancl LA, Lindgren SD, Zinner SH, Steinman KJ. {{Dental Homes for Children With Autism: A Longitudinal Analysis of Iowa Medicaid’s I-Smile Program}}. {Am J Prev Med}. 2015.
INTRODUCTION: Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa’s I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile’s longitudinal influence on ASD-related dental use disparities. METHODS: Data from 2002-2011 were analyzed for newly Medicaid-enrolled children aged 3-17 years (N=30,059); identified each child’s ASD status; and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. RESULTS: In 2003-2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, p<0.001). Longitudinal trends in dental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). CONCLUSIONS: Among newly Medicaid-enrolled children in Iowa's I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. Lien vers le texte intégral (Open Access ou abonnement)
2. Corvey K, Menear KS, Preskitt J, Goldfarb S, Menachemi N. {{Obesity, Physical Activity and Sedentary Behaviors in Children with an Autism Spectrum Disorder}}. {Matern Child Health J}. 2015.
Background and Objectives Previous literature using small sample sizes and limited geographic areas report that overweight/obesity and physical inactivity occur at higher rates among children with autism spectrum disorder (ASD) compared to typically developing peers. The purpose of this study was to examine obesity, overweight, physical activity, and sedentary behavior among children and youth with and without ASD using nationally representative data and controlling for secondary conditions, including intellectual and learning disabilities, ADHD, developmental delay, and other mental, physical, and medical conditions, as well as medication use. Methods Data were collected from the 2011-2012 National Survey of Children’s Health, a cross-sectional survey of 65,680 (weighted N = 49,586,134) children aged 6-17 (1385 with ASD, weighted N = 986,352). Logistic regression was used to estimate odds ratios, adjusting for demographics and possible secondary conditions. Results Having a diagnosis of ASD was associated with higher odds of obesity (OR 1.76, CI 1.27-2.43; p = <0.001). However, after additional adjustment for possible secondary conditions, ASD diagnosis was no longer associated with obesity. Those with moderate ASD (OR 0.58, CI 0.36-0.93; p = <0.05) reported lower odds of sedentary behavior, but this association failed to achieve significance after adjustment for secondary conditions and medication use. No significant associations between ASD and overweight or physical activity were found. Conclusions These findings suggest that ASD diagnosis is not significantly associated with obesity status after adjustment for possible secondary conditions and medication use. Decision makers, clinicians, and researchers developing interventions for children with ASDs should consider how secondary conditions may impact obesity and related activities. Lien vers le texte intégral (Open Access ou abonnement)
3. Deavenport-Saman A, Lu Y, Smith K, Yin L. {{Do Children with Autism Overutilize the Emergency Department? Examining Visit Urgency and Subsequent Hospital Admissions}}. {Matern Child Health J}. 2015.
Background Children with autism spectrum disorders (ASD) are more likely to have difficulties accessing health care compared to other children with special health care needs. National data based on parent report indicate that children with ASD are overutilizing emergency department (ED) services, but data on actual ED use has been limited to children with psychiatric diagnoses. This study examined factors associated with ED utilization (rate, urgency, and hospital admissions) among children with ASD compared to those without ASD. Methods Data from an urban, tertiary children’s hospital level 1 trauma center were examined retrospectively 2006-2009. Anderson’s model of health services utilization served as the study framework. The NYU ED algorithm was used to predict nonurgent visits. Multivariate linear and logistic regression analyses were performed on the rate, urgency, and subsequent hospital admissions of these ED visits. Results There were 115,443 children 2-21 years old, accounting for a total of 157,902 visits. The top three reasons for visiting the ED for children with and without ASD were acute upper respiratory infections, viral infections and otitis media. Children with ASD had on average 0.26 more ED visits annually than children without ASD (p < 0.01) and were 2.6 % points more likely to have nonurgent visits; p < 0.01). Their visits were also less likely to result in hospital admissions (OR 0. 61; p < 0.01). Conclusions Examination of predisposing, enabling, and reinforcing factors suggest that children with ASD were more likely to visit the ED and for nonurgent reasons. Lien vers le texte intégral (Open Access ou abonnement)
4. Hare DJ, Gracey C, Wood C. {{Anxiety in high-functioning autism: A pilot study of experience sampling using a mobile platform}}. {Autism}. 2015.
Anxiety and stress are everyday issues for many people with high-functioning autism, and while cognitive-behavioural therapy is the treatment of choice for the management of anxiety, there are challenges in using it with people with high-functioning autism. This study used modified experience sampling techniques to examine everyday anxiety and stress in adults with high-functioning autism and to explore the feasibility of delivering real-time stress management techniques using a mobile platform. High levels of anxiety were found to be characterised by worry, confusing thoughts and being alone but was not associated with internal focus, imagery or rumination. Participants reported improved mood and less worry and anxious thinking in the active phase of the study. These results support previous studies indicating that people with high-functioning autism differ in their experience of anxiety and provided preliminary data on the feasibility of real-time stress management. The limitations of this approach are discussed together with considerations for future work in the area of developing clinical interventions on mobile platforms.
Lien vers le texte intégral (Open Access ou abonnement)
5. Hayakawa N, Okada T, Nomura K, Tsukada T, Nakamura M. {{Is high job control a risk factor for poor quality of life in workers with high autism spectrum tendencies? A cross-sectional survey at a factory in Japan}}. {J Occup Health}. 2015; 57(5): 419-26.
OBJECTIVES: To examine the effect of autism spectrum (AS) tendencies and psychosocial job characteristics on health-related quality of life (HRQOL) among factory workers. METHODS: A questionnaire survey was administered to 376 Japanese factory employees from the same company (response rate: 83.6%) in 2010. Psychosocial job characteristics, including job demand, job control, and social support, were evaluated using the Job Content Questionnaire (JCQ). AS tendencies was assessed using the Autism-Spectrum Quotient (AQ), and HRQOL was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-8). Associations were investigated using multiple logistic regression analysis adjusted for confounders. RESULTS: In the multivariate analysis, AQ was positively (odds ratio [OR]: 3.94; 95% confidence interval [CI]: 1.70-9.73) and social support in the workplace was inversely (OR: 0.25; 95% CI: 0.10-0.57) associated with poor mental HRQOL. No significant interaction was observed between AQ and JCQ subitems. Only social support was inversely associated with poor physical HRQOL (OR and 95% CI for medium social support: 0.45 and 0.21-0.94), and a significant interaction between AQ and job control was observed (p=0.02), suggesting that high job control was associated with poor physical HRQOL among workers with high AQ, whereas low job control tended to be associated with poor physical HRQOL among others. CONCLUSIONS: Our results suggest that AS tendencies have a negative effect on workers’ HRQOL and social support is a primary factor in maintaining HRQOL. Moreover, a structured work environment can maintain physical HRQOL in workers with high AS tendencies since higher job control will be stressful.(J Occup Health 2015; 57: 419-426).
Lien vers le texte intégral (Open Access ou abonnement)
6. Iourov IY, Vorsanova SG, Voinova VY, Yurov YB. {{3p22.1p21.31 microdeletion identifies CCK as Asperger syndrome candidate gene and shows the way for therapeutic strategies in chromosome imbalances}}. {Mol Cytogenet}. 2015; 8: 82.
BACKGROUND: In contrast to other autism spectrum disorders, chromosome abnormalities are rare in Asperger syndrome (AS) or high-functioning autism. Consequently, AS was occasionally subjected to classical positional cloning. Here, we report on a case of AS associated with a deletion of the short arm of chromosome 3. Further in silico analysis has identified a candidate gene for AS and has suggested a therapeutic strategy for manifestations of the chromosome rearrangement. RESULTS: Using array comparative genomic hybridization, an interstitial deletion of 3p22.1p21.31 (~2.5 Mb in size) in a child with Asperger’s syndrome, seborrheic dermatitis and chronic pancreatitis was detected. Original bioinformatic approach to the prioritization of candidate genes/processes identified CCK (cholecystokinin) as a candidate gene for AS. In addition to processes associated with deleted genes, bioinformatic analysis of CCK gene interactome indicated that zinc deficiency might be a pathogenic mechanism in this case. This suggestion was supported by plasma zinc concentration measurements. The increase of zinc intake produced a rise in zinc plasma concentration and the improvement in the patient’s condition. CONCLUSIONS: Our study supported previous linkage findings and had suggested a new candidate gene in AS. Moreover, bioinformatic analysis identified the pathogenic mechanism, which was used to propose a therapeutic strategy for manifestations of the deletion. The relative success of this strategy allows speculating that therapeutic or dietary normalization of metabolic processes altered by a chromosome imbalance or genomic copy number variations may be a way for treating at least a small proportion of cases of these presumably incurable genetic conditions.
Lien vers le texte intégral (Open Access ou abonnement)
7. Johnson NL, Burkett K, Reinhold J, Bultas MW. {{Translating Research to Practice for Children With Autism Spectrum Disorder: Part I: Definition, Associated Behaviors, Prevalence, Diagnostic Process, and Interventions}}. {J Pediatr Health Care}. 2015.
INTRODUCTION: The number of children with autism spectrum disorder (ASD) is rising, along with the potential for challenging behaviors during health care encounters. METHOD: We present an overview of the emerging science related to ASD diagnosis and interventions for children with ASD. RESULTS: Emerging science on ASD reveals common associated challenging behaviors, increasing prevalence, emphasis on early diagnosis at 18 to 24 months of age, changes in the diagnostic process with criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, and interventions with medication, education, and behavior management. DISCUSSION: Family and health care provider preparation strategies facilitate care of children with ASD and their families. Early diagnosis at 18 to 24 months of age and evidence-based interventions contribute to best outcomes for children and families. Health care providers must be aware of the state of the science for diagnosis and best practices to provide family-centered care for this growing population.
Lien vers le texte intégral (Open Access ou abonnement)
8. Kern Koegel L, Ashbaugh K, Navab A, Koegel RL. {{Improving Empathic Communication Skills in Adults with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2015.
The literature suggests that many individuals diagnosed with Autism Spectrum Disorder (ASD) experience challenges with recognizing and describing emotions in others, which may result in difficulties with the verbal expression of empathy during communication. Thus, there is a need for intervention techniques targeting this area. Using a multiple baseline across participants design, this study examined the effectiveness of a video-feedback intervention with a visual framework component to improve verbal empathetic statements and questions during conversation for adults with ASD. Following intervention, all participants improved in verbal expression of empathetic statements and empathetic questions during conversation with generalization and maintenance of gains. Furthermore, supplemental assessments indicated that each participant improved in their general level of empathy and confidence in communication skills.
Lien vers le texte intégral (Open Access ou abonnement)
9. Kirkovski M, Enticott PG, Hughes ME, Rossell SL, Fitzgerald PB. {{Atypical Neural Activity in Males But Not Females with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2015.
The medial prefrontal cortex (mPFC) and the right temporo-parietal junction (rTPj) are highly involved in social understanding, a core area of impairment in autism spectrum disorder (ASD). We used fMRI to investigate sex differences in the neural correlates of social understanding in 27 high-functioning adults with ASD and 23 matched controls. There were no differences in neural activity in the mPFC or rTPj between groups during social processing. Whole brain analysis revealed decreased activity in the posterior superior temporal sulcus in males with ASD compared to control males while processing social information. This pattern was not observed in the female sub-sample. The current study indicates that sex mediates the neurobiology of ASD, particularly with respect to processing social information.
Lien vers le texte intégral (Open Access ou abonnement)
10. Morett LM, O’Hearn K, Luna B, Ghuman AS. {{Altered Gesture and Speech Production in ASD Detract from In-Person Communicative Quality}}. {J Autism Dev Disord}. 2015.
This study disentangled the influences of language and social processing on communication in autism spectrum disorder (ASD) by examining whether gesture and speech production differs as a function of social context. The results indicate that, unlike other adolescents, adolescents with ASD did not increase their coherency and engagement in the presence of a visible listener, and that greater coherency and engagement were related to lesser social and communicative impairments. Additionally, the results indicated that adolescents with ASD produced sparser speech and fewer gestures conveying supplementary information, and that both of these effects increased in the presence of a visible listener. Together, these findings suggest that interpersonal communication deficits in ASD are driven more strongly by social processing than language processing.
Lien vers le texte intégral (Open Access ou abonnement)
11. Pacey LK, Guan S, Tharmalingam S, Thomsen C, Hampson DR. {{Persistent astrocyte activation in the fragile X mouse cerebellum}}. {Brain Behav}. 2015; 5(10): e00400.
BACKGROUND: Fragile X Syndrome, the most common single gene cause of autism, results from loss of the RNA-binding protein FMRP. Although FMRP is highly expressed in neurons, it has also recently been identified in glia. It has been postulated that in the absence of FMRP, abnormal function of non-neuronal cells may contribute to the pathogenesis of the disorder. We previously demonstrated reduced numbers of oligodendrocyte precursor cells and delayed myelination in the cerebellum of fragile X (Fmr1) knockout mice. METHODS: We used quantitative western blotting and immunocytochemistry to examine the status of astrocytes and microglia in the cerebellum of Fmr1 mice during development and in adulthood. RESULTS: We report increased expression of the astrocyte marker GFAP in the cerebellum of Fmr1 mice starting in the second postnatal week and persisting in to adulthood. At 2 weeks postnatal, expression of Tumor Necrosis Factor Receptor 2 (TNFR2) and Leukemia Inhibitory Factor (LIF) were elevated in the Fmr1 KO cerebellum. In adults, expression of TNFR2 and the glial marker S100beta were also elevated in Fmr1 knockouts, but LIF expression was not different from wild-type mice. We found no evidence of microglial activation or neuroinflammation at any age examined. CONCLUSIONS: These findings demonstrate an atypical pattern of astrogliosis in the absence of microglial activation in Fmr1 knockout mouse cerebellum. Enhanced TNFR2 and LIF expression in young mice suggests that changes in the expression of astrocytic proteins may be an attempt to compensate for delayed myelination in the developing cerebellum of Fmr1 mice.
Lien vers le texte intégral (Open Access ou abonnement)
12. Rysstad AL, Pedersen AV. {{Brief Report: Non-right-Handedness Within the Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2015.
A larger distribution of left-handedness in the population of Autism Spectrum Disorder has been repeatedly reported. Despite of this, the sample sizes in the individual study’s are too small for any generalization to be made. Using both description-based and citation-based searches, the present review combines the individual results in order to examine whether non-right-handedness is a general trait of the autism spectrum disorder. With a relatively large combined sample size (N = 497), it can be concluded that the distribution of non-right-handedness is significantly greater within the autism spectrum disorder population, compared with the population in general.
Lien vers le texte intégral (Open Access ou abonnement)
13. Stephenson KG, Quintin EM, South M. {{Age-Related Differences in Response to Music-Evoked Emotion Among Children and Adolescents with Autism Spectrum Disorders}}. {J Autism Dev Disord}. 2015.
While research regarding emotion recognition in ASD has focused primarily on social cues, musical stimuli also elicit strong emotional responses. This study extends and expands the few previous studies of response to music in ASD, measuring both psychophysiological and behavioral responses in younger children (ages 8-11) as well as older adolescents (ages 16-18). Compared to controls, the ASD group demonstrated reduced skin conductance response to music-evoked emotion. Younger groups, regardless of diagnosis, showed greater physiological reactivity to scary stimuli than to other emotions. There was a significant interaction of age group and diagnostic group in identifying scary music stimuli, possibly evidencing disrupted developmental trajectories in ASD for integrating physiological and cognitive cues that may underlie symptoms of anxiety.
Lien vers le texte intégral (Open Access ou abonnement)
14. Wang T, Shan L, Du L, Feng J, Xu Z, Staal WG, Jia F. {{Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis}}. {Eur Child Adolesc Psychiatry}. 2015.
Vitamin D may play an important role in the etiology of Autism Spectrum Disorders (ASD). Vitamin D is regarded as a neuroactive steroid affecting brain development and function. It plays an essential role in myelination, which is important for connectivity in the brain. Studies have shown that decreased vitamin D levels in patients, decreased maternal vitamin D levels during pregnancy, and decreased exposure to solar UVB might increase the risk for ASD. In addition, autism symptoms and global functioning may improve after vitamin D supplementation. Here, we sought to aggregate information from previous publications on vitamin D levels and ASD, in order to achieve a higher statistical power and thereby to determine the validity of vitamin D deficiency as a risk factor for ASD. For this meta-analysis, 11 studies met the inclusion and exclusion criteria, accounting for a total of 870 ASD patients and 782 healthy controls. Levels of serum 25(OH) D in participants with ASD were significantly lower than controls, suggesting that lower vitamin D level might be a risk factor for ASD.
