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Øien RA, Hart L, Schjølberg S, Wall CA, Kim ES, Nordahl-Hansen A, Eisemann MR, Chawarska K, Volkmar FR, Shic F. Parent-Endorsed Sex Differences in Toddlers with and Without ASD: Utilizing the M-CHAT. J Autism Dev Disord 2017; 47:126-134. [PMID: 27757737 PMCID: PMC5222910 DOI: 10.1007/s10803-016-2945-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sex differences in typical development can provide context for understanding ASD. Baron-Cohen (Trends Cogn Sci 6(6):248-254, 2002) suggested ASD could be considered an extreme expression of normal male, compared to female, phenotypic profiles. In this paper, sex-specific M-CHAT scores from N = 53,728 18-month-old toddlers, including n = 185 (32 females) with ASD, were examined. Results suggest a nuanced view of the "extreme male brain theory of autism". At an item level, almost every male versus female disadvantage in the broader population was consistent with M-CHAT vulnerabilities in ASD. However, controlling for total M-CHAT failures, this male disadvantage was more equivocal and many classically ASD-associated features were found more common in non-ASD. Within ASD, females showed relative strengths in joint attention, but impairments in imitation.
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Jou RJ, Reed HE, Kaiser MD, Voos AC, Volkmar FR, Pelphrey KA. White Matter Abnormalities in Autism and Unaffected Siblings. J Neuropsychiatry Clin Neurosci 2016; 28:49-55. [PMID: 26404174 DOI: 10.1176/appi.neuropsych.15050109] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study was conducted to identify a potential neuroendophenotype for autism using diffusion tensor imaging. Whole-brain, voxel-based analysis of fractional anisotropy was conducted in 50 children: 19 with autism, 20 unaffected siblings, and 11 controls. Relative to controls, participants with autism exhibited bilateral reductions in fractional anisotropy across association, commissure, and projection fibers. The most severely affected tracts included the uncinate fasciculus, forceps minor, and inferior fronto-occipital fasciculus. Unaffected siblings also exhibited reductions in fractional anisotropy, albeit less severe with fewer affected tracts, sparing the uncinate fasciculus and forceps minor. These results suggest the presence of a neuroendophenotype for autism.
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van Schalkwyk GI, Beyer C, Martin A, Volkmar FR. College students with autism spectrum disorders: A growing role for adult psychiatrists. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:575-579. [PMID: 27347704 DOI: 10.1080/07448481.2016.1205072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Adolescents with autism spectrum disorders (ASD) are increasingly attending college. This case report highlights the nature of the psychiatric difficulties these individuals may face and the potential role for college mental health practitioners. PARTICIPANTS A case of a female student with ASD presenting with significant inattentive symptoms. METHODS The authors describe the unique features of this patient's clinical presentation, discuss relevant diagnostic considerations, and make recommendations about how to best approach treatment. RESULTS This student presented with symptoms of attention-deficit/hyperactivity disorder (ADHD), which were first relevant during her time at college, owing to increased demands on planning and other executive functions. She was eventually responsive to treatment with a stimulant, but had more side effects early on. CONCLUSIONS As individuals with ASD attend college, their mental health needs will require treatment. However, such treatment draws on a comparatively limited evidence base, and providers need to be aware of potential challenges that may arise.
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Doehring P, Volkmar FR. Knowledge Gaps in ASD Research: Short and Long Term Implications for Policy. J Autism Dev Disord 2016; 46:733-6. [PMID: 26754478 DOI: 10.1007/s10803-015-2683-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Autism is a prevalent and strongly genetic brain-based disorder. Early focus in the field on the relevance of psychogenic factors led to the blaming of parents for the occurrence of the disorder, and as a result mainstream research on psychotherapeutic approaches has until recently been limited. Although psychoanalytic approaches continue to be considered of limited relevance for these individuals, dynamic theory is both informative and informed by conceptual approaches to the understanding of autism. Theory of mind in particular is a prominent model for understanding the core deficits of autism and bears strong resemblance to the concept of mentalization. Although cognitive-behavioral and social skills interventions may form the cornerstone of psychotherapy for individuals with autism, the formation of a treatment alliance remains crucial and may require a particular willingness for flexibility on the part of the therapist.
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Volkmar FR. Categorical Approaches to the Diagnosis of Autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016. [DOI: 10.1177/1362361398021005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although autism was first reported in 1943 nearly 40 years elapsed before the disorder was included as an official diagnosis in the American (DSM) classification system. In the last two decades guidelines for the diagnosis of this, and related, conditions have evolved based on a growing body of research. An important recent development has been the convergence of the American (DSM) and International (ICD) diagnostic systems. Although these two official systems differ somewhat in format and intended use, the advent of consistent approaches to the diagnosis of autism will facilitate both research and clinical service. Data that have informed the development of these systems are reviewed and areas of continuing controversy are noted.
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Reichow B, George-Puskar A, Lutz T, Smith IC, Volkmar FR. Brief report: systematic review of Rett syndrome in males. J Autism Dev Disord 2016; 45:3377-83. [PMID: 26254891 DOI: 10.1007/s10803-015-2519-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Rett syndrome (RTT) is a neurogenetic disorder in which a period of typical development is followed by loss of previously acquired skills. Once thought to occur exclusively in females, increasing numbers of male cases of RTT have been reported. This systematic review included 36 articles describing 57 cases of RTT in males. Mutations of the MECP2 gene were present in 56 % of cases, and 68 % of cases reported other genetic abnormalities. This is the first review of published reports of RTT in male patients.
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Smith IC, Reichow B, Volkmar FR. The Effects of DSM-5 Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2016; 45:2541-52. [PMID: 25796195 DOI: 10.1007/s10803-015-2423-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and DSM-5 ASD criteria. Consistent with previous reviews, the majority of included studies indicated between 50 and 75% of individuals will maintain diagnoses. We conducted visual analyses of subgroups using harvest plots and found the greatest decreases among high-functioning populations with IQs over 70 and/or previous diagnoses of PDD-NOS or Asperger's disorder. We discuss the potential research and clinical implications of reduced numbers of individuals diagnosed with ASD.
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Volkmar FR, McPartland JC. Moving beyond a categorical diagnosis of autism. Lancet Neurol 2015; 15:237-8. [PMID: 26497770 DOI: 10.1016/s1474-4422(15)00299-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
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van Schalkwyk GI, Klingensmith K, Volkmar FR. Gender identity and autism spectrum disorders. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2015; 88:81-3. [PMID: 25744543 PMCID: PMC4345542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this review, we briefly summarize much of the existing literature on gender-related concerns and autism spectrum disorders (ASD), drawing attention to critical shortcomings in our current understanding and potential clinical implications. Some authors have concluded that gender identity disorder (GID), or gender dysphoria (GD), is more common in individuals with ASD, providing a range of potential explanations. However, existing literature is quantitatively limited, and our capacity to draw conclusions is further complicated by conceptual challenges regarding how gender identity is best understood. Discourses that emphasize gender as a component of identity formation are gaining prominence and seem particularly salient when applied to ASD. Individuals with ASD should enjoy equal rights with regard to treatment for gender dysphoria. Clinicians may be able to assist individuals in understanding this aspect of their identity by broadening the social frame and facilitating an exploration of gender roles.
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Grapel JN, Cicchetti DV, Volkmar FR. Sensory features as diagnostic criteria for autism: sensory features in autism. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2015; 88:69-71. [PMID: 25745375 PMCID: PMC4345540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study, we examined the frequency of sensory-related issues as reported by parents in a large sample of school-age adolescents and adults with autism/autism spectrum disorder (ASD) [1] as compared to a group of individuals receiving similar clinical evaluations for developmental/behavioral difficulties but whose final diagnoses were not on the autism spectrum. In no comparison were the features examined predictive of autism or autism spectrum in comparison to the non-ASD sample. Only failure to respond to noises had sensitivity above .75 in the comparison of the broader autism spectrum group, but specificity was poor. While sensory issues are relatively common in autism/ASD, they are also frequent in other disorders. These results question the rationale for including sensory items as a diagnostic criterion for autism.
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Volkmar FR. Editorial: 2014 in review. J Autism Dev Disord 2015; 45:613-25. [PMID: 25672259 DOI: 10.1007/s10803-015-2382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Volkmar FR, Grigorenko E. Special issue: in honor of Sara S. Sparrow, Ph.D. J Autism Dev Disord 2014; 44:249. [PMID: 24390591 DOI: 10.1007/s10803-013-2026-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Volkmar FR. The Puberty Video for Boys with Asperger Syndrome (and Autism Spectrum Disorder: Level 1) DVD $25.00, 48 Minutes and Managing Puberty, Social Challenges, and (Almost) Everything: A Video Guide for Girls: DVD, $25.00, 80 Minutes; Coulter Video (http://coultervideo.com). J Autism Dev Disord 2014; 45:1497. [PMID: 25432100 DOI: 10.1007/s10803-014-2285-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cicchetti DV, Lord C, Koenig K, Klin A, Volkmar FR. Erratum to: Reliability of the ADI-R for the Single Case-Part II: Clinical Versus Statistical Significance. J Autism Dev Disord 2014; 45:274. [PMID: 25425245 DOI: 10.1007/s10803-014-2322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Volkmar FR, McPartland JC. From Kanner to DSM-5: Autism as an Evolving Diagnostic Concept. Annu Rev Clin Psychol 2014; 10:193-212. [DOI: 10.1146/annurev-clinpsy-032813-153710] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Volkmar FR, Reichow B. Infants and toddlers with autism: the promise and the challenges. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:11-14. [PMID: 24345000 DOI: 10.3109/17549507.2013.862859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There has been a marked increase in interest in early identification of young children with and at risk for autism. This interest has reflected advances in research as well as an awareness of the potential for major changes in long-term outcome as a result of intervention. Several issues have complicated these efforts. There continue to be challenges to implementation of effective screening and diagnostic approaches in young children. Although the body of evidence-based research on treatment has increased, it remains limited. Despite these issues, important findings have emerged that may assist in fostering better approaches to screening, diagnosis, and documenting treatment impact.
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Hazen EP, McDougle CJ, Volkmar FR. Changes in the diagnostic criteria for autism in DSM-5: controversies and concerns. J Clin Psychiatry 2013; 74:739-40. [PMID: 23945452 DOI: 10.4088/jcp.13ac08550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Voos AC, Pelphrey KA, Tirrell J, Bolling DZ, Vander Wyk B, Kaiser MD, McPartland JC, Volkmar FR, Ventola P. Neural mechanisms of improvements in social motivation after pivotal response treatment: two case studies. J Autism Dev Disord 2013; 43:1-10. [PMID: 23104615 DOI: 10.1007/s10803-012-1683-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pivotal response treatment (PRT) is an empirically validated behavioral treatment that has widespread positive effects on communication, behavior, and social skills in young children with autism spectrum disorder (ASD). For the first time, functional magnetic resonance imaging was used to identify the neural correlates of successful response to PRT in two young children with ASD. Baseline measures of social communication, adaptive behavior, eye tracking and neural response to social stimuli were taken prior to treatment and after 4 months of PRT. Both children showed striking gains on behavioral measures and also showed increased activation to social stimuli in brain regions utilized by typically developing children. These results suggest that neural systems supporting social perception are malleable through implementation of PRT.
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Volkmar FR, Reichow B. Autism in DSM-5: progress and challenges. Mol Autism 2013; 4:13. [PMID: 23675688 PMCID: PMC3716827 DOI: 10.1186/2040-2392-4-13] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/18/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Since Kanner's first description of autism there have been a number of changes in approaches to diagnosis with certain key continuities . Since the Fourth edition of the Diagnostic and Statistical Manual (DSM-IV) appeared in 1994 there has been an explosion in research publications. The advent of changes in DSM-5 presents some important moves forward as well as some potential challenges. METHODS The various relevant studies are summarized. RESULTS If research diagnostic instruments are available, many (but not all) cases with a DSM-IV diagnosis of autism continue to have this diagnosis. The overall efficiency of this system falls if only one source of information is available and, particularly, if the criteria are used outside the research context. The impact is probably greatest among the most cognitively able cases and those with less classic autism presentations. CONCLUSIONS Significant discontinuities in diagnostic practice raise significant problems for both research and clinical services. For DSM-5, the impact of these changes remains unclear.
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Volkmar FR. Editorial: 2012 in Review. J Autism Dev Disord 2013; 43:753-60. [DOI: 10.1007/s10803-013-1788-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reichow B, Halpern JI, Steinhoff TB, Letsinger N, Naples A, Volkmar FR. Characteristics and quality of autism websites. J Autism Dev Disord 2012; 42:1263-74. [PMID: 21822761 DOI: 10.1007/s10803-011-1342-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The World Wide Web is a common method for obtaining information on autism spectrum disorders, however, there are no guidelines for finding websites with high quality. We conducted two studies examining the characteristics and/or quality of autism websites in 2009 and 2010. We found websites with a .gov top-level domain had a statistically significant association with high quality websites and websites offering a product or service and websites promoting a non-evidence-based practice had a statistically significant association with poor quality websites. Based on our work we concluded that online information should not replace the information consumers obtain from professionals. Further implications for practice, overview of study limitations and future directions are provided.
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Reichow B, Naples A, Steinhoff T, Halpern J, Volkmar FR. Brief report: consistency of search engine rankings for autism websites. J Autism Dev Disord 2012; 42:1275-9. [PMID: 22350454 DOI: 10.1007/s10803-012-1480-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The World Wide Web is one of the most common methods used by parents to find information on autism spectrum disorders and most consumers find information through search engines such as Google or Bing. However, little is known about how the search engines operate or the consistency of the results that are returned over time. This study presents the results of analyses of searches from 2009, 2010, and 2011 for information on autism. We found that over time, consumers are likely to have different search experiences yielding different results, and we urge consumers to use caution when using the World Wide Web to obtain information on autism.
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Volkmar FR, Reichow B, McPartland J. Classification of autism and related conditions: progress, challenges, and opportunities. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 23226949 PMCID: PMC3513678 DOI: 10.31887/dcns.2012.14.3/fvolkmar] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since Kanner's classic description of the syndrome of early infantile autism in 1943, conceptions of the disorder have evolved while retaining important continuity with what Kanner viewed as the hallmarks of the condition—social impairment (autism) and difficulties in dealing with change in the nonsocial world (insistence on sameness). This paper reviews the history of this evolution and the important potential advantages and disadvantages of changes being contemplated for DSM-5. The convergence of diagnostic approach in DSM-IV and ICD-10 provided a shared system that fostered a tremendous body of research. The changes proposed in DSM-5 may impact both research comparability and service eligibility.
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