51
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Dovgan KN, Villanti KM. The Prevalence of Broad Autism Phenotype in Young Adults: The Roles of Genetic Relationship to Autism, Gender, and Academic Major. The Journal of Genetic Psychology 2021; 182:174-181. [PMID: 33794752 DOI: 10.1080/00221325.2021.1904817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Subclinical levels of autism traits are known as the Broad Autism Phenotype (BAP) and include a rigid personality, aloof personality, and pragmatic language difficulties. Genetic relatives of children with autism spectrum disorder (ASD), males, and those in math- or science-oriented careers may be more likely to exhibit BAP. This study examined the prevalence of BAP in young adults to assess the influence of genetic relationship to ASD, gender, and academic field. Online self-report data from 170 undergraduate college students included the Broad Autism Phenotype Questionnaire (BAPQ), information about genetic relationship to ASD, and demographic information. Results showed no relationship between BAP and level of shared ASD genes, gender, or academic major. However, 25.3% of our college-aged sample met BAP cutoffs, compared to previous estimates of only 5-9% of adult parents of neurotypical children and 14-23% of parents of children with ASD. These findings expand our understanding of subclinical autistic traits in young adults. This research highlights the need to investigate community-based samples of various age groups when estimating the prevalence of BAP to better-understand the extent to which these personality characteristics are present in the general population.
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52
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Tang CH, Chi MH, Hsieh YT, Lee TI, Tai YC, Lien YJ, Yang YK, Chen PS. Sex differences in the diagnosis of autism spectrum disorder and effects of comorbid mental retardation and attention-deficit hyperactivity disorder. J Formos Med Assoc 2021; 121:210-217. [PMID: 33820714 DOI: 10.1016/j.jfma.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/08/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/PURPOSE The association between sex and diagnostic behavior of autism spectrum disorder (ASD), and the effects of comorbid mental retardation (MR) and attention-deficit hyperactivity disorder (ADHD), were explored. METHODS Based on the Taiwan Longitudinal Health Insurance Database (LHID)-2000 and data from 1996 through 2008, the cumulative incidence of ASD over time was compared between the sexes (both cohorts n = 38,117) using the log-rank test. The effects of comorbid MR and ADHD on the incidence of ASD were evaluated using Cox proportional hazard regression analysis. The age at first diagnosis of ASD in the two sexes was compared using the independent-sample t-test. RESULTS The incidence was higher in males than in females (0.0007 vs. 0.0002) across ages. Comorbid MR or ADHD increased the incidence of ASD in both sexes; comorbid MR or ADHD also decreased the male to female hazard ratio of ASD, with no significant differences in the incidence density of ASD between sexes. ADHD delayed diagnosis in both sexes (males: 6.61 vs 5.10, p < 0.0001; females: 6.83 vs 4.69, p = 0.0037). CONCLUSIONS The general concept of a higher incidence of ASD among males was noted in this study of a Taiwanese population, but disappeared in those with comorbid MR or ADHD, indicating unique vulnerabilities to MR/ADHD or under-identification of high-functioning females with ASD in childhood. Increasing the diagnostic sensitivity of ASD in those with comorbid ADHD is important due to a delayed diagnostic age in this group.
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Affiliation(s)
- Chia Hung Tang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi Ting Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu I Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ying Chun Tai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yueh-Ju Lien
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
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53
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Dai YG, Porto KS, Skapek M, Barton ML, Dumont-Mathieu T, Fein DA, Robins DL. Comparison of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) Positive Predictive Value by Race. J Autism Dev Disord 2021; 51:855-867. [PMID: 32125566 PMCID: PMC7483574 DOI: 10.1007/s10803-020-04428-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) is the most widely used screener for ASD. Despite the comparable rate of ASD in Black and White children, the M-CHAT-R/F was validated on a primarily White, Non-Hispanic sample. Few studies have assessed whether the screener performs adequately with racial minorities. This study compared the M-CHAT-R/F Positive Predictive Value (PPV), for ASD, and for any developmental condition, in Black and White children. We also examined M-CHAT-R/F item-level PPV by race. The PPVs for ASD and other developmental disorders were similar in both racial groups for total score and individual items. Therefore, our findings support the use of the M-CHAT-R/F with Black and White children.
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Affiliation(s)
- Yael G Dai
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA.
| | - Katelynn S Porto
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Mary Skapek
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Marianne L Barton
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Thyde Dumont-Mathieu
- Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT, 06106, USA
| | - Deborah A Fein
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Diana L Robins
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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54
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Testing a Tailored Social-Ecological Model for Autism Spectrum Disorders. Matern Child Health J 2021; 25:956-966. [PMID: 33394274 DOI: 10.1007/s10995-020-03064-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To propose a tailored social ecological model for Autism Spectrum Disorders and explore relationships between variables in a large nationally-representative dataset. METHODS A tailored social-ecological model was developed and examined across variables in the 2016/2017 National Survey of Children's Health. A series of iterative multivariable logistic regressions were performed including individual, family, and community/neighborhood variables. A multivariable logistic regression using state-level fixed effects was performed to understand dynamics related to macro-level policies. RESULTS In the full model, gender, disability severity, certain types of insurance coverage and household income were significantly related to ASD diagnosis. Females had lower odds of a diagnosis compared to males (aOR: 0.27; CI:0.18-0.41). Children with at least one other moderate/severe disability had odds 7.61 higher (CI:5.36-10.82) of a diagnosis than children without moderate/severe disabilities. Children with public insurance only (aOR:1.66; CI:1.14-2.41) or both private and public insurance coverage (aOR: 2.62; CI:1.6-4.16) had higher odds of a diagnosis compared to children with private insurance only. For those who reported it was "somewhat" or "very often" hard to cover basics with their income, odds of a diagnosis were higher compared to those who reported it was "never" or "hardly ever" hard to cover basics (aOR: 1.676; CI:0.21-2.56). CONCLUSIONS FOR PRACTICE Patterns of ASD diagnosis are related to individual and family characteristics. There is some evidence that a child's environment has some relationship to reported ASD diagnosis. Professionals should be aware of an individual's environmental factors or context when assessing for ASD.
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55
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Siddiqua A, Duku E, Georgiades K, Mesterman R, Janus M. Association between neighbourhood socioeconomic status and developmental vulnerability of kindergarten children with Autism Spectrum Disorder: A population level study. SSM Popul Health 2020; 12:100662. [PMID: 33015307 PMCID: PMC7522116 DOI: 10.1016/j.ssmph.2020.100662] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/29/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
There is limited knowledge about the relationship between neighbourhood socioeconomic status (SES) and development of kindergarten children with ASD. The primary objective of this study was to determine the association between neighbourhood SES and developmental vulnerability of kindergarten children with ASD while controlling for family SES across 10 provinces and territories in Canada. This study used data from a population level database of child development in kindergarten, collected with the Early Development Instrument (EDI). The EDI covers five broad domains of developmental health: physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge. Neighbourhood SES was assessed with an SES index created using 10 variables from the 2011 Canadian Census and 2010 Taxfiler data. Family SES was assessed using 4 variables from the 2016 Canadian Census. Descriptive statistics and regression-based models were used in this study. Multilevel binary logistic regression analyses were used to examine the association between neighbourhood SES and child developmental vulnerability (yes/no), at the individual level, while controlling for family SES, demographic characteristics, and neighbourhood clustering. The association between neighbourhood SES and child developmental vulnerability at the individual level, while controlling for family SES and demographic characteristics was examined with binary single level logistic regression analyses. Multivariable linear regression analyses were used to examine the association between neighbourhood SES and developmental vulnerability at the neighbourhood level (% of kindergarten children with ASD demonstrating developmental vulnerability in a neighbourhood). In Ontario, British Columbia, Manitoba, and Newfoundland and Labrador, higher neighbourhood SES was associated with lower likelihood of developmental vulnerability. In Nova Scotia, higher neighbourhood SES was associated with higher likelihood of vulnerability in the social competence and communication skills and general knowledge domains. These findings emphasize the importance of addressing neighbourhood deprivation to support the development of children with ASD. Additionally, the inconsistency highlights the importance of examining the mechanisms through which neighbourhood SES impacts development of these children on a provincial basis.
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Affiliation(s)
- Ayesha Siddiqua
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West – MIP Suite 201A, Hamilton, ON L8S 4K1, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West – MIP Suite 201A, Hamilton, ON L8S 4K1, Canada
| | - Kathy Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West – MIP Suite 201A, Hamilton, ON L8S 4K1, Canada
| | - Ronit Mesterman
- Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West – MIP Suite 201A, Hamilton, ON L8S 4K1, Canada
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56
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School-Based Autism Rates by State: An Analysis of Demographics, Political Leanings, and Differential Identification. J Autism Dev Disord 2020; 51:2271-2283. [PMID: 32926306 DOI: 10.1007/s10803-020-04700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We reviewed federal special education data to determine school-identified prevalence of Autism Spectrum Disorder (ASD) and other disability categories by U.S. state. We also examined whether state-level policies, demographic factors, and rates of other eligibility categories are predictive of these state ASD rates. Results indicate that overall, 1 of 81 school-aged children are served under an ASD special education eligibility. State-level demographic factors, such as socioeconomic status and political leanings were highly predictive of rates of ASD. States with higher rates of ASD had lower rates of intellectual and learning disabilities, but higher rates of Other Health Impairment (OHI).
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57
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Bowden N, Thabrew H, Kokaua J, Audas R, Milne B, Smiler K, Stace H, Taylor B, Gibb S. Autism spectrum disorder/Takiwātanga: An Integrated Data Infrastructure-based approach to autism spectrum disorder research in New Zealand. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2213-2227. [PMID: 32677449 PMCID: PMC7542998 DOI: 10.1177/1362361320939329] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
New Zealand has few estimates of the prevalence of autism spectrum disorder and no national registry. The use of administrative data sources is expanding and could be useful in autism spectrum disorder research. However, the extent to which autism spectrum disorder can be captured in these data sources is unknown. In this study, we utilised three linked administrative health data sources from the Integrated Data Infrastructure to identify cases of autism spectrum disorder among New Zealand children and young people. We then investigated the extent to which a range of mental health, neurodevelopmental and related problems co-occur with autism spectrum disorder. In total, 9555 unique individuals aged 0–24 with autism spectrum disorder were identified. The identification rate for 8-year-olds was 1 in 102. Co-occurring mental health or related problems were noted in 68% of the autism spectrum disorder group. The most common co-occurring conditions were intellectual disability, disruptive behaviours and emotional problems. Although data from the Integrated Data Infrastructure may currently undercount cases of autism spectrum disorder, they could be useful for monitoring service and treatment-related trends, types of co-occurring conditions and for examining social outcomes. With further refinement, the Integrated Data Infrastructure could prove valuable for informing the national incidence and prevalence of autism spectrum disorder and the long-term effectiveness of clinical guidelines and interventions for this group.
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Affiliation(s)
- Nicholas Bowden
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Hiran Thabrew
- A Better Start National Science Challenge, New Zealand.,The University of Auckland, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Richard Audas
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Barry Milne
- A Better Start National Science Challenge, New Zealand.,The University of Auckland, New Zealand
| | | | | | - Barry Taylor
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Sheree Gibb
- A Better Start National Science Challenge, New Zealand.,University of Otago, Wellington, New Zealand
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58
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Dimian AF, Symons FJ, Wolff JJ. Delay to Early Intensive Behavioral Intervention and Educational Outcomes for a Medicaid-Enrolled Cohort of Children with Autism. J Autism Dev Disord 2020; 51:1054-1066. [DOI: 10.1007/s10803-020-04586-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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59
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Pinto OY, Raz R. Employment Outcomes After a Birth of a Child with a Developmental Disability: A National Nested Case-Control Study. J Autism Dev Disord 2020; 51:697-703. [PMID: 32621096 DOI: 10.1007/s10803-020-04581-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Using records from the National Insurance Institute of Israel, we recognized all children with autism spectrum disorders (ASD, N = 8072) or hearing loss (HL, N = 2231) born in Israel between 2005 and 2010. Typical developed children were taken from a random 20% sample of children born during the same years (N = 227,492). Analyses were adjusted for year of birth, population group, parental ages, parental education, child birth order and peripherality. Working women, who gave birth to children with either ASD or HL, were at increased risk of not maintaining their working status over the 5 years after birth. There is a decreased ratio between household wage after and before birth, in families with children with either ASD or HL.
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Affiliation(s)
- Ofir Y Pinto
- National Insurance Institute of Israel, Jerusalem, Israel.,Employment Service, Jerusalem, Israel
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem - Hadassah, Jerusalem, Israel.
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60
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A High Prevalence of Autism Spectrum Disorder in Preschool Children in an Immigrant, Multiethnic Population in Sweden: Challenges for Health Care. J Autism Dev Disord 2020; 51:538-549. [PMID: 32533384 PMCID: PMC7835151 DOI: 10.1007/s10803-020-04563-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study examines the prevalence of autism spectrum disorder (ASD) in preschool children in an immigrant population. Possible risk factors for ASD and individual needs for the children and their families are described, as well as implications for health care. The estimated minimum prevalence for ASD in the area was 3.66% for children aged 2–5 years. Multiple risk factors and extensive individual needs for the children and their families were observed. The high prevalence of ASD and the plethora of needs in immigrant communities pose challenges for health care. A coordinated health care system is necessary to meet the many and individual needs.
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61
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Improving Service Access in ASD: A Systematic Review of Family Empowerment Interventions for Children with Special Healthcare Needs. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00208-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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62
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Leibson C, Weaver A, Myers S, Long K, Ransom J, Voigt R, Katusic S. Objective Estimates of Direct-Medical Costs Among Persons Aged 3 to 38 Years With and Without Research-Defined Autism Spectrum Disorder Ascertained During Childhood: A Population-Based Birth-Cohort Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:595-605. [PMID: 32389225 PMCID: PMC7224581 DOI: 10.1016/j.jval.2019.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/25/2019] [Accepted: 12/22/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Accurate estimates of autism spectrum disorder (ASD)-associated medical costs are essential for predicting future care needs, allocating resources, identifying best practices, and modeling cost-effectiveness. Most existing studies have either employed subjective cost data or ascertained ASD using self-reported or International Classification of Diseases-coded diagnoses. Such ascertainment is especially problematic for identifying milder ASD among older individuals never diagnosed with ASD. METHODS This 1976 through 2000 population-based birth-cohort study was set in Olmsted County, Minnesota. ASD cases and age- and sex-matched unaffected controls were identified by applying uniform operational research criteria for ASD (using the guidelines of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision) after rigorous review of provider-linked medical and public, private, or home school records available for all members from birth to a maximum age of 21 years. Medical cost estimates for the 901 case-control pairs used line-item provider-linked billing data (including all payers) from 2003 through 2014 (ages 3-38 years). Outpatient pharmaceutical costs were unavailable. Temporal changes in diagnostic criteria, clinical practice, public awareness, and access were addressed by separating analyses into 5-year age group and 4-year calendar period cells. Unadjusted and adjusted (age and age plus co-occurring conditions) cost estimates were provided for cases, controls, and case-control differences. Additional factors (co-occurring conditions, percentage hospitalized, intellectual disability) were investigated using unadjusted descriptive analyses. RESULTS Cell sample sizes ranged from 93 to 402 for age groups 3 through 19 years and from 45 to 395 for age groups 20 through 38 years. Unadjusted, age-adjusted, and fully adjusted medical costs were significantly higher for cases versus controls in 100% of cells for age groups 3 through 19 years and in 50% (unadjusted), 38% (age adjusted), and 12% (fully adjusted) of cells for age groups 20 through 38 years. CONCLUSIONS These unique estimates can help inform the construction of cost-effectiveness models; decisions by payers, providers, and policy makers; and predictions of lifetime costs.
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Affiliation(s)
- Cynthia Leibson
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
| | - Amy Weaver
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Scott Myers
- Geisinger Autism & Developmental Medicine Institute, Lewisburg, PA, USA
| | - Kirsten Long
- K Long Health Economics Consulting LLC, St Paul, MN, USA
| | - Jeanine Ransom
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Robert Voigt
- Meyer Center for Developmental Pediatrics, Baylor College, of Medicine, Houston, TX, USA
| | - Slavica Katusic
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
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63
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Nichols HM, Dababnah S, Troen B, Vezzoli J, Mahajan R, Mazefsky CA. Racial Disparities in a Sample of Inpatient Youth with ASD. Autism Res 2020; 13:532-538. [PMID: 31930779 DOI: 10.1002/aur.2262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/21/2019] [Accepted: 12/23/2019] [Indexed: 11/09/2022]
Abstract
Although more than one in 10 youth with Autism Spectrum Disorder (ASD) is admitted to a psychiatric facility before they reach adulthood, the inpatient population is underrepresented in research. Furthermore, Black youth are more likely to be psychiatrically hospitalized, compared to their White counterparts. Yet, prior research has been inconsistent in potential racial differences in ASD symptoms and severity. This study examined differences in the symptom presentation of psychiatrically hospitalized Black and White youth with ASD. Researchers collected data as part of a larger study of youth admitted to one of six US specialized inpatient psychiatric units between 2013 and 2017. We used bivariate and multivariate models to analyze the data. The study included 654 youth diagnosed with ASD, with an average age of 13 years. While bivariate analyses found that Black youth had lower written language and daily living skills and more impaired social affect and inappropriate speech, multivariate regression models suggested that overall ability level and age may be driving these differences. Specifically, the only variables that significantly predicted adaptive functioning (written language, daily living) and behavioral profiles (social affect, inappropriate speech) were verbal ability, IQ, and age. Race was not a significant predictor in any of the models. Cultural diversity and competency are vital to the identification and treatment of ASD clinical care. Thus, understanding the role race may play in early detection and accurate diagnosis is important to improving ASD identification, diagnosis, and treatment. Autism Res 2020, 13: 532-538. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study examined differences in autism symptoms between Black and White youth in psychiatric hospitals. We found that while it initially appeared that Black and White youth differed in written language and daily living skills, these racial differences were not significant once we accounted for differences in IQ, age, and verbal ability. Our findings suggest that providers should pay greater attention to other potential reasons for racial disparities in autism services.
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Affiliation(s)
- Helen M Nichols
- School of Social Work, University of Maryland, Baltimore, Maryland
| | - Sarah Dababnah
- School of Social Work, University of Maryland, Baltimore, Maryland
| | | | - Jessica Vezzoli
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rajneesh Mahajan
- Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Sheppard Pratt Health System, Baltimore, Maryland
| | - Carla A Mazefsky
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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64
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Tran KT, Le VS, Bui HTP, Do DH, Ly HTT, Nguyen HT, Dao LTM, Nguyen TH, Vu DM, Ha LT, Le HTT, Mukhopadhyay A, Nguyen LT. Genetic landscape of autism spectrum disorder in Vietnamese children. Sci Rep 2020; 10:5034. [PMID: 32193494 PMCID: PMC7081304 DOI: 10.1038/s41598-020-61695-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/18/2020] [Indexed: 12/19/2022] Open
Abstract
Autism spectrum disorder (ASD) is a complex disorder with an unclear aetiology and an estimated global prevalence of 1%. However, studies of ASD in the Vietnamese population are limited. Here, we first conducted whole exome sequencing (WES) of 100 children with ASD and their unaffected parents. Our stringent analysis pipeline was able to detect 18 unique variants (8 de novo and 10 ×-linked, all validated), including 12 newly discovered variants. Interestingly, a notable number of X-linked variants were detected (56%), and all of them were found in affected males but not in affected females. We uncovered 17 genes from our ASD cohort in which CHD8, DYRK1A, GRIN2B, SCN2A, OFD1 and MDB5 have been previously identified as ASD risk genes, suggesting the universal aetiology of ASD for these genes. In addition, we identified six genes that have not been previously reported in any autism database: CHM, ENPP1, IGF1, LAS1L, SYP and TBX22. Gene ontology and phenotype-genotype analysis suggested that variants in IGF1, SYP and LAS1L could plausibly confer risk for ASD. Taken together, this study adds to the genetic heterogeneity of ASD and is the first report elucidating the genetic landscape of ASD in Vietnamese children.
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Affiliation(s)
- Kien Trung Tran
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai, Hai Ba Trung district, Hanoi, Vietnam
| | - Vinh Sy Le
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai, Hai Ba Trung district, Hanoi, Vietnam.
- University of Engineering and Technology, Vietnam National University Hanoi, 144 Xuan Thuy, Cau Giay ditrict, Hanoi, Vietnam.
| | - Hoa Thi Phuong Bui
- Department of Gene Technology, Hi-tech Center, Vinmec International Hospital, 458 Minh Khai, Hai Ba Trung district, Hanoi, Hanoi, Vietnam
| | - Duong Huy Do
- Department of Gene Technology, Hi-tech Center, Vinmec International Hospital, 458 Minh Khai, Hai Ba Trung district, Hanoi, Hanoi, Vietnam
| | - Ha Thi Thanh Ly
- Department of Gene Technology, Hi-tech Center, Vinmec International Hospital, 458 Minh Khai, Hai Ba Trung district, Hanoi, Hanoi, Vietnam
| | - Hieu Thi Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai, Hai Ba Trung district, Hanoi, Vietnam
| | - Lan Thi Mai Dao
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai, Hai Ba Trung district, Hanoi, Vietnam
| | - Thanh Hong Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai, Hai Ba Trung district, Hanoi, Vietnam
| | - Duc Minh Vu
- Department of Gene Technology, Hi-tech Center, Vinmec International Hospital, 458 Minh Khai, Hai Ba Trung district, Hanoi, Hanoi, Vietnam
| | - Lien Thi Ha
- Department of Gene Technology, Hi-tech Center, Vinmec International Hospital, 458 Minh Khai, Hai Ba Trung district, Hanoi, Hanoi, Vietnam
| | - Huong Thi Thanh Le
- Department of Gene Technology, Hi-tech Center, Vinmec International Hospital, 458 Minh Khai, Hai Ba Trung district, Hanoi, Hanoi, Vietnam
| | - Arijit Mukhopadhyay
- Translational Medicine Laboratory, Biomedical Research Centre, School of Science, Engineering and Environment, University of Salford, Manchester, M5 4WT, United Kingdom
| | - Liem Thanh Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai, Hai Ba Trung district, Hanoi, Vietnam.
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65
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Multi-stage Screening in Early Intervention: A Critical Strategy for Improving ASD Identification and Addressing Disparities. J Autism Dev Disord 2020; 51:868-883. [PMID: 32144605 DOI: 10.1007/s10803-020-04429-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Health disparities in ASD detection affect children's access to subsequent interventions. We examined potential disparities in implementation of a multi-stage ASD screening and diagnostic evaluation protocol in Part C Early Intervention with 4943 children ages 14-36 months (mean 22.0 months; 62.9% boys, 73.3% children of color, 34.9% non-English-primary language, 64.5% publicly-insured). Participation and follow-through were high (64.9% and 65.3% at first- and second-stage screening, respectively, 84.6% at diagnostic evaluation). Logistic regressions identified predictors of screening participation and outcomes at each stage; demographic differences (race, language, public insurance) were observed only at first-stage screening and reflected higher participation for children of color and higher positive screens for publicly-insured children. Results suggest the multi-stage screening protocol shows promise in addressing disparities in early diagnosis.
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66
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Son E, Magaña S, Pedraza FDM, Parish SL. Providers' Guidance to Parents and Service Use for Latino Children With Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:64-75. [PMID: 31877261 DOI: 10.1352/1944-7558-125.1.64] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
To better understand disparities between Latino and White children with autism or other developmental disabilities (ASD/DD), we examined whether Latino ethnicity predicted the number of specialty care services received by children with severe functional limitations depending on medical providers' responses to parents' initial concerns about their child's development. Through linkage of the Pathways and NS-CSHCN datasets, we found ethnic disparities in the receipt of specialty services associated with providers' responsiveness to parent-reported concerns among children with ASD/DD. Among children with significant functional limitations, Latino children whose parents received passive/reassuring responses from their providers were less likely to receive specialty services than White children with ASD/DD. Providers' guidance to parents may be a promising point of intervention for future disparity reduction efforts.
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Affiliation(s)
- Esther Son
- Esther Son, College of Staten Island, The City University of New York; Sandy Magaña, The University of Texas at Austin; Frances D. Martínez-Pedraza, Florida International University; and Susan L. Parish, The Virginia Commonwealth University
| | - Sandy Magaña
- Esther Son, College of Staten Island, The City University of New York; Sandy Magaña, The University of Texas at Austin; Frances D. Martínez-Pedraza, Florida International University; and Susan L. Parish, The Virginia Commonwealth University
| | - Frances D Martínez Pedraza
- Esther Son, College of Staten Island, The City University of New York; Sandy Magaña, The University of Texas at Austin; Frances D. Martínez-Pedraza, Florida International University; and Susan L. Parish, The Virginia Commonwealth University
| | - Susan L Parish
- Esther Son, College of Staten Island, The City University of New York; Sandy Magaña, The University of Texas at Austin; Frances D. Martínez-Pedraza, Florida International University; and Susan L. Parish, The Virginia Commonwealth University
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67
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Garfield T, Yudell M. Commentary 2: Participatory Justice and Ethics in Autism Research. J Empir Res Hum Res Ethics 2019; 14:455-457. [PMID: 31779547 DOI: 10.1177/1556264619858524b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tamara Garfield
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Michael Yudell
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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68
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Siddiqua A, Duku E, Georgiades K, Mesterman R, Janus M. Neighbourhood-level prevalence of teacher-reported Autism Spectrum Disorder among kindergarten children in Canada: A population level study. SSM Popul Health 2019; 10:100520. [PMID: 31872037 PMCID: PMC6909034 DOI: 10.1016/j.ssmph.2019.100520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/03/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022] Open
Abstract
Number of children with ASD per neighbourhood varies from none to as high as 21. Developmental vulnerabilities were not associated with levels of clustering. Highest level of clustering of children with ASD was found in Nova Scotia.
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Affiliation(s)
- Ayesha Siddiqua
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Kathy Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Ronit Mesterman
- Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
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69
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Bejarano-Martín Á, Canal-Bedia R, Magán-Maganto M, Fernández-Álvarez C, Cilleros-Martín MV, Sánchez-Gómez MC, García-Primo P, Rose-Sweeney M, Boilson A, Linertová R, Roeyers H, Van der Paelt S, Schendel D, Warberg C, Cramer S, Narzisi A, Muratori F, Scattoni ML, Moilanen I, Yliherva A, Saemundsen E, Loa Jónsdóttir S, Efrim-Budisteanu M, Arghir A, Papuc SM, Vicente A, Rasga C, Rogé B, Guillon Q, Baduel S, Kafka JX, Poustka L, Kothgassner OD, Kawa R, Pisula E, Sellers T, Posada de la Paz M. Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives. J Autism Dev Disord 2019; 50:3380-3394. [DOI: 10.1007/s10803-019-04253-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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70
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Autism in India: a case-control study to understand the association between socio-economic and environmental risk factors. Acta Neurol Belg 2019; 119:393-401. [PMID: 30554347 DOI: 10.1007/s13760-018-01057-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/02/2018] [Indexed: 10/27/2022]
Abstract
Autism spectrum disorder is a neurodevelopmental disorder and the cause of autism is still unclear. The aim of this study was to investigate the association of socioeconomic, environmental, pregnancy and newborn-related risk factors among children with autism spectrum disorders. This was a population-based case-control study. The study included 55 children with autism spectrum disorder and 55 age and sex matched typically developing normal children (TD) between 3 and 12 years. Several socio-economic factors, environmental factors, pregnancy related, natal, post-natal factors and the first noticed signs by the parents were analyzed. Chi-square test was used to compare nominal variables. For multivariate analysis, forward stepwise logistic regression model was employed to examine the association between autism and the chances that the child develops ASD to assess the odds ratios. Male predominance was observed in the study. Logistic regression model showed statistical significance of the following factors: paternal age greater than 40 years, family history of autism, nutrition during pregnancy, mode of labor, fetal hypoxia, NICU stay and history of breast feeding. In this epidemiological study of autism in Coimbatore city, we found correlation between several environmental factors during fetal development and can be transmitted to succeeding generations, causing atypical behavior phenotypes. The exact exposure magnitude, exposure time in relation to vital developmental periods need to be studied to understand the influence of socioeconomic and environmental factors, which can be improved to prevent ASD-related challenges.
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71
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Hao Z, Wu Q, Li Z, Li Y, Li Q, Lai X, Liu H, Zhang M, Yang T, Chen J, Tang Y, Miao J, Xu H, Li T, Hu R. Maternal exposure to triclosan constitutes a yet unrecognized risk factor for autism spectrum disorders. Cell Res 2019; 29:866-869. [PMID: 31462724 PMCID: PMC6796921 DOI: 10.1038/s41422-019-0220-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/01/2019] [Indexed: 01/20/2023] Open
Affiliation(s)
- Zijian Hao
- University of Chinese Academy of Sciences; State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Qionghui Wu
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China
| | - Zhengwei Li
- University of Chinese Academy of Sciences; State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yali Li
- University of Chinese Academy of Sciences; State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Qiu Li
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China
| | - Xi Lai
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China
| | - Huan Liu
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China
| | - Menghuan Zhang
- University of Chinese Academy of Sciences; State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Ting Yang
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China
| | - Jie Chen
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China
| | - Yaping Tang
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, 510623, China
| | - Jingkun Miao
- Neonatal Screening Center, Chongqing Women and Children's Medical Center, Chongqing, 401174, China
| | - Huatai Xu
- Shanghai Institute of Neurosciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Tingyu Li
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, 400014, China.
| | - Ronggui Hu
- University of Chinese Academy of Sciences; State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, 200031, China.
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72
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Stahmer AC, Vejnoska S, Iadarola S, Straiton D, Segovia FR, Luelmo P, Morgan EH, Lee HS, Javed A, Bronstein B, Hochheimer S, Cho E, Aranbarri A, Mandell D, Hassrick EM, Smith T, Kasari C. Caregiver Voices: Cross-Cultural Input on Improving Access to Autism Services. J Racial Ethn Health Disparities 2019; 6:752-773. [PMID: 30859514 PMCID: PMC6936957 DOI: 10.1007/s40615-019-00575-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/17/2019] [Accepted: 02/12/2019] [Indexed: 01/16/2023]
Abstract
Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.
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Affiliation(s)
- Aubyn C Stahmer
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA.
| | - Sarah Vejnoska
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
| | - Suzannah Iadarola
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Diondra Straiton
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
- Department of Psychology, Michigan State University, 316 Physics, Rd., East Lansing, MI, 48824, USA
| | - Francisco Reinosa Segovia
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
| | - Paul Luelmo
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
- Department of Special Education, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Elizabeth H Morgan
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
| | - Hyon Soo Lee
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
| | - Asim Javed
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Briana Bronstein
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
| | - Samantha Hochheimer
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - EunMi Cho
- College of Education, California State University, Sacramento, 6000 J St., Sacramento, CA, 95819, USA
| | - Aritz Aranbarri
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
- Mental Health Department, Sant Juan de Deu Barcelona Children's Hospital, Itaka Building 1st floor, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Catalonia, Spain
| | - David Mandell
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
| | - Elizabeth McGhee Hassrick
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street | Suite 560, Philadelphia, PA, 19104, USA
| | - Tristram Smith
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Connie Kasari
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
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73
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Segev A, Weisskopf MG, Levine H, Pinto O, Raz R. Incidence time trends and socioeconomic factors in the observed incidence of autism spectrum disorder in israel: A nationwide nested case-control study. Autism Res 2019; 12:1870-1879. [PMID: 31365189 DOI: 10.1002/aur.2185] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 07/16/2019] [Indexed: 12/23/2022]
Abstract
Autism spectrum disorder (ASD) trends have been gaining a great deal of focus in recent decades, as many studies worldwide show a continued rise in incidence rates. Many researchers have begun analyzing socioeconomic data in relation to ASD in an effort to understand the source of these changing rates and the role of awareness and access to resources. In this study, we aim to contribute to this body of knowledge by examining incidence time trends of ASD in Israel according to socioeconomic factors. While similar studies have been conducted in Israel, this study is the first of its kind to include the total population. Individual-level data from the Israeli National Insurance Institute were used to determine cumulative incidence of ASD, first for the total population, and then stratified by population group and income categories. Multivariable logistic regression models were fit to analyze associations between income category and both risk of ASD and risk of ASD diagnosis in later age. A total of 431,348 children were examined in this study, with 13,841 cases of ASD. The cumulative incidence of all children aged 8 in 2015 was 0.64%, marking an increase compared to previous literature from Israel. Within our study period, ASD incidence followed this increase until the 2009 birth cohort, where it began to stabilize. Our initial findings from regression models showed strong positive associations between household income and ASD incidence, as expected. After factoring in population group, however, the elevated ASD incidence rates in the highest income bracket decreased. Autism Res 2019, 12: 1870-1879. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study contributes comprehensive and current data on ASD trends overtime in Israel and introduces crucial insights regarding the impact of socioeconomic factors on ASD diagnoses. We found a rise in ASD that began leveling off in 2009. We identified more ASD diagnoses occurring in families with higher incomes and in the General Population, pointing to the important role of sociodemographic factors on ASD diagnoses.
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Affiliation(s)
- Avital Segev
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Ofir Pinto
- Israeli National Insurance Institute, Jerusalem, Israel
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
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74
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Weksler-Derri D, Shwed U, Davidovitch N. Ethical Challenges in Participatory Research With Autistic Adults in Israel. J Empir Res Hum Res Ethics 2019; 14:447-451. [PMID: 31303130 DOI: 10.1177/1556264619858524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Contemporary calls for participatory research raise unique ethical questions. Our semi-participatory mixed-methodology study of the needs of autistic adults in Israel utilized an advisory committee of autistic persons. This article discusses three fundamental ethical issues that emerged in the study. First, employing formal diagnosis and legal guardian approval as inclusion criteria may result in the unjust exclusion of self-diagnosed autistics and those who are cognitively able to consent and participate. Second, adopting a participatory research approach does not in itself guarantee participatory justice; the representation of diverse groups from the community must be ensured. Finally, regarding autism spectrum disorder (ASD) as a medical diagnosis requires indisputable confidentiality which may conflict with the personal choice to waive anonymity and be recognized by name. Researchers and ethical committees should take these ethical challenges into account when conducting and reviewing studies with and about autistic adults.
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Affiliation(s)
- Dan Weksler-Derri
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uri Shwed
- Department of Sociology and Anthropology, Faculty of Humanities and Social Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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75
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Abstract
Early diagnosis of autism spectrum disorder (ASD) in children enables earlier access to services and better ability to predict subsequent development. A vast body of literature consistently shows discrepancies in the age of diagnosis between children from varying socio-economic levels, cultural and ethnic backgrounds. The present study examines the effect of sociodemographic factors on age of ASD diagnosis among the three primary ethnic sectors in Jerusalem region: secular and modern religious Jews, ultra-Orthodox Jews and Arabs. Findings indicate minimal differences in age of diagnosis prior to the age of six, although Arab children of this age were largely minimally verbal. After age six, no Arab children were referred for an evaluation.
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76
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Mire SS, McQuillin S, Racine M, Goin-Kochel RP. Using latent class analysis to identify treatment-use subgroups among parents of children with autism spectrum disorder. Autism Res 2019; 12:843-854. [PMID: 30990248 DOI: 10.1002/aur.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/22/2019] [Indexed: 11/09/2022]
Abstract
Among parents of 2,582 children (ages 4-17 years old) with autism spectrum disorder (ASD), we used latent class analysis to identify subgroups and profiles of treatment users and included annual household income in the specification of the models, then described characteristics of each subgroup. Based on three indicators of fit (Akaike's Information Criterion, Bayesian Information Criterion, and Lo-Mendell-Rubin), six latent classes of treatment users emerged. Subgroups included users of: (a) mostly private and school speech and occupational therapies; (b) nearly all treatment types; (c) mostly speech and occupational therapies, plus intensive behavioral and "other" treatments, but little medication use; (d) private therapies almost exclusively; (e) primarily psychotropic medications; and (f) mostly school-based therapies. Income significantly predicted class differences for all but one latent class. Probabilities of families' lifetime use of nine treatment types varied depending on latent classification. Proportions of families reporting having observed children's developmental regression were largest in those with the highest overall treatment use, and these children also had the lowest cognitive and adaptive-functioning scores and the highest ASD symptom scores. Understanding patterns of treatment use among families of children with ASD is an important first step in enhancing treatment-related selection and implementation. Autism Research 2019, 12: 843-854. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We identified six different groups of treatment users to help explain patterns in treatment implementation among parents of children and adolescents with autism. These included families who used: (a) mostly used private and school speech and occupational therapies; (b) nearly all treatment types (private and school therapies, intensive behavioral, biomedical, psychotropic medications, and other treatments); (c) mostly speech and occupational therapies, plus intensive behavioral and "other" treatments, but little medication use; (d) private therapies almost exclusively; (e) primarily psychotropic medications; and (f) mostly school-based therapies.
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Affiliation(s)
- Sarah S Mire
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas
| | - Samuel McQuillin
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Madeline Racine
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas
| | - Robin P Goin-Kochel
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Autism Center, Texas Children's Hospital, Houston, Texas
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77
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Issarraras A, Matson JL, Matheis M, Burns CO. Differences in Developmental Concerns of Young Children with Autism Spectrum Disorder Across Racial/Ethnic Groups. Dev Neurorehabil 2019; 22:174-179. [PMID: 30081703 DOI: 10.1080/17518423.2018.1504828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Parents/caregivers of children with autism spectrum disorder (ASD) have varying types of initial concerns regarding their child's development, which may be culturally bound to parents' perceptions of their child's development. This study investigated differences in the types of initial developmental concerns reported by parents or caregivers of different racial/ethnic groups with children in an early intervention program. METHOD This study examined the frequency of endorsement of different types of concerns in African American, Caucasian, and Hispanic families. RESULTS No significant differences between racial/ethnic groups were found in the endorsement of concerns related to communication, language/speech, motor, problem behavior, sensory, feeding, prematurity, attention, adaptive functioning, and medical conditions. Racial/ethnic groups differed significantly in their endorsement for social concerns. CONCLUSION Racial/ethnic group differences were confirmed regarding initial developmental concerns related to social behavior, which may be due to cultural beliefs. The implications of these findings on early identification are discussed.
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Affiliation(s)
- Abigail Issarraras
- a Department of Psychology, Louisiana State University , Baton Rouge , LA , USA
| | - Johnny L Matson
- a Department of Psychology, Louisiana State University , Baton Rouge , LA , USA
| | - Maya Matheis
- a Department of Psychology, Louisiana State University , Baton Rouge , LA , USA
| | - Claire O Burns
- a Department of Psychology, Louisiana State University , Baton Rouge , LA , USA
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78
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Zablotsky B, Maenner MJ, Blumberg SJ. Geographic Disparities in Treatment for Children with Autism Spectrum Disorder. Acad Pediatr 2019; 19:740-747. [PMID: 30858082 PMCID: PMC6732019 DOI: 10.1016/j.acap.2019.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/08/2019] [Accepted: 02/10/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Geographic differences may provide insight into what factors influence the likelihood that a child is diagnosed with autism spectrum disorder (ASD) in the United States; yet, there have been few nationally representative surveys that have explored this topic. The current study expands the limited literature by analyzing regional differences in ASD prevalence, service utilization, and the presence of unmet needs within a nationally representative sample of children. METHODS Data were drawn from the 2014-2016 National Health Interview Survey (NHIS), a nationally representative household survey of the noninstitutionalized US population. Children 3 to 17 years of age were included in the analytic sample. Prevalence estimates accounted for the complex survey design of the NHIS, and differences between geographic regions were compared using logistic/linear regressions with and without adjustment for child/family characteristics. RESULTS The prevalence of ASD was highest in the Northeast (3.0%), followed by the Midwest (2.4%), South (2.4%), and West (2.3%). A significant difference was found between the Northeast and West (P < .05); however, after accounting for child and family characteristics, this difference was no longer significant. Children with ASD in the Northeast were the most likely to have seen a specialist in the past year. Approximately 1 in 8 children with ASD experienced at least 1 unmet need, but there were no differences found by geographic region. CONCLUSIONS Although differences in prevalence were not significant after adjustment, service utilization differences remained. It appears that children with ASD in the Northeast utilize the greatest number of specialty services when compared to children with ASD from other parts of the country.
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Affiliation(s)
- Benjamin Zablotsky
- National Center for Health Statistics (B Zablotsky and SJ Blumberg), Hyattsville, Md.
| | - Matthew J. Maenner
- National Center on Birth Defects and Developmental Disabilities, 1600 Clifton Road, Atlanta, GA, 30329
| | - Stephen J. Blumberg
- National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD, 20782
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79
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Caramaschi D, Taylor AE, Richmond RC, Havdahl KA, Golding J, Relton CL, Munafò MR, Davey Smith G, Rai D. Maternal smoking during pregnancy and autism: using causal inference methods in a birth cohort study. Transl Psychiatry 2018; 8:262. [PMID: 30498225 PMCID: PMC6265272 DOI: 10.1038/s41398-018-0313-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 11/22/2022] Open
Abstract
An association between maternal smoking in pregnancy and autism may be biologically plausible, but the evidence to date is inconsistent. We aimed to investigate the causal relationship between maternal smoking during pregnancy and offspring autism using conventional analysis and causal inference methods. In the Avon Longitudinal Study of Parents and Children we investigated the association of maternal smoking during pregnancy (exposure) with offspring autism spectrum disorder (ASD) or possible ASD diagnosis (n = 11,946) and high scores on four autism-related traits (outcomes) (n = 7402-9152). Maternal smoking was self-reported and also measured using an epigenetic score (n = 866-964). Partner's smoking was used as a negative control for intrauterine exposure (n = 6616-10,995). Mendelian randomisation (n = 1002-2037) was carried out using a genetic variant at the CHRNA3 locus in maternal DNA as a proxy for heaviness of smoking. In observational analysis, we observed an association between smoking during pregnancy and impairments in social communication [OR = 1.56, 95% CI = 1.29, 1.87] and repetitive behaviours, but multivariable adjustment suggested evidence for confounding. There was weaker evidence of such association for the other traits or a diagnosis of autism. The magnitude of association for partner's smoking with impairments in social communication was similar [OR = 1.56, 95% CI = 1.30, 1.87] suggesting potential for shared confounding. There was weak evidence for an association of the epigenetic score or genetic variation at CHRNA3 with ASD or any of the autism-related traits. In conclusion, using several analytic methods, we did not find enough evidence to support a causal association between maternal smoking during pregnancy and offspring autism or related traits.
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Affiliation(s)
- Doretta Caramaschi
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Amy E Taylor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca C Richmond
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jean Golding
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Caroline L Relton
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Experimental Psychology, University of Bristol, Bristol, UK
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Dheeraj Rai
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
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80
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Social Function and Autism Spectrum Disorder in Children and Adults with Neurofibromatosis Type 1: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2018; 28:317-340. [DOI: 10.1007/s11065-018-9380-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/10/2018] [Indexed: 12/27/2022]
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81
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Moseley RL, Hitchiner R, Kirkby JA. Self-reported sex differences in high-functioning adults with autism: a meta-analysis. Mol Autism 2018; 9:33. [PMID: 29796237 PMCID: PMC5960195 DOI: 10.1186/s13229-018-0216-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/30/2018] [Indexed: 12/21/2022] Open
Abstract
Background Sex differences in autistic symptomatology are believed to contribute to the mis- and missed diagnosis of many girls and women with an autism spectrum condition (ASC). Whilst recent years have seen the emergence of clinical and empirical reports delineating the profile of young autistic girls, recognition of sex differences in symptomatology in adulthood is far more limited. Methods We chose here to focus on symptomatology as reported using a screening instrument, the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R). In a meta-analysis, we pooled and analysed RAADS-R data from a number of experimental groups. Analysis of variance (ANOVA) searched for the presence of main effects of Sex and Diagnosis and for interactions between these factors in our sample of autistic and non-autistic adults. Results In social relatedness and circumscribed interests, main effects of Diagnosis revealed that as expected, autistic adults reported significantly greater lifetime prevalence of symptoms in these domains; an effect of Sex, in circumscribed interests, also suggested that males generally reported more prevalent symptoms than females. An interaction of Sex and Diagnosis in language symptomatology revealed that a normative sex difference in language difficulties was attenuated in autism. An interaction of Sex and Diagnosis in the sensorimotor domain revealed the opposite picture: a lack of sex differences between typically developing men and women and a greater prevalence of sensorimotor symptoms in autistic women than autistic men. Conclusions We discuss the literature on childhood sex differences in relation to those which emerged in our adult sample. Where childhood sex differences fail to persist in adulthood, several interpretations exist, and we discuss, for example, an inherent sampling bias that may mean that only autistic women most similar to the male presentation are diagnosed. The finding that sensorimotor symptomatology is more highly reported by autistic women is a finding requiring objective confirmation, given its potential importance in diagnosis. Electronic supplementary material The online version of this article (10.1186/s13229-018-0216-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R L Moseley
- Department of Psychology, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - R Hitchiner
- Department of Psychology, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - J A Kirkby
- Department of Psychology, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB UK
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82
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Escher J. Bugs in the program: can pregnancy drugs and smoking disturb molecular reprogramming of the fetal germline, increasing heritable risk for autism and neurodevelopmental disorders? ENVIRONMENTAL EPIGENETICS 2018; 4:dvy001. [PMID: 29732167 PMCID: PMC5920304 DOI: 10.1093/eep/dvy001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 01/04/2018] [Accepted: 02/11/2018] [Indexed: 05/24/2023]
Abstract
In a seeming paradox, the prevalence of autism spectrum disorder (ASD) has surged, while at the same time research has pointed to the strong heritability of this neurodevelopmental pathology. Here an autism research philanthropist suggests a biological phenomenon of exogenously induced 'gamete disruption' that could reconcile these seemingly contradictory observations. Mining information from her own family history and that of her fellow autism parents, while also engaging with the scientific community, she proposes that a subset of the autisms may be rooted in a variety of molecular glitches in parental gametes induced by certain acute exposures during the parents' own fetal or neonatal development. These exposures include but are not limited to synthetic hormone drugs, tobacco, and general anesthesia. Consistent with this hypothesis, animal models have demonstrated adverse neurobehavioral outcomes in grandoffspring of gestating dams exposed to hormone-disrupting compounds, tobacco components, and general anesthesia. A recent epidemiological study showed a link between grandmaternal smoking and risk for ASD in grandoffspring through the maternal line. Given the urgency of the autism crisis, combined with the biological plausibility of this mostly unexplored paradigm, the writer contends that questions of nongenetic inheritance should be a priority in autism research.
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Affiliation(s)
- Jill Escher
- Correspondence address. 1590 Calaveras Avenue, San Jose, CA 95126, USA. E-mail:
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83
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Bröring T, Oostrom KJ, van Dijk-Lokkart EM, Lafeber HN, Brugman A, Oosterlaan J. Attention deficit hyperactivity disorder and autism spectrum disorder symptoms in school-age children born very preterm. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 74:103-112. [PMID: 29413425 DOI: 10.1016/j.ridd.2018.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 11/21/2017] [Accepted: 01/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Very preterm (VP) children face a broad range of neurodevelopmental sequelae, including behavioral problems. AIM To investigate prevalence, pervasiveness and co-occurrence of symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in school-age children born very preterm. METHODS Using questionnaire and diagnostic interview data, parent and teacher reported symptoms of ADHD and ASD of 57 VP-children (mean age = 9.2 years) were compared with 57 gender and age matched full-term children using t-tests. Intra-class correlation coefficients quantified parent-teacher agreement. Correlation analysis investigated co-occurrence of ADHD/ASD symptoms. ADHD/ASD measures were aggregated using principal component analysis. Regression analyses investigated the contribution of perinatal risk factors, sex and SES to ADHD/ASD symptoms. RESULTS VP-children showed higher levels of parent and teacher reported attention problems, social impairment and compromised communication skills. Fair to strong agreement was found between parent and teacher reported ADHD and ASD symptoms, indicating pervasiveness of observed difficulties. Co-occurrence of ADHD and ASD symptoms in VP-children was found. Lower gestational age was associated with higher ADHD and ASD symptom levels, male sex with higher ADHD symptom levels and lower SES with higher ASD symptom levels. CONCLUSION School-age VP-children show higher levels of ADHD and ASD symptoms, and attention, socialization and communication difficulties in particular. Routinely screening for these problems is recommended in follow-up care.
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Affiliation(s)
- Tinka Bröring
- Department of Medical Psychology, VU University Medical Center, de Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
| | - Kim J Oostrom
- Department of Medical Psychology, VU University Medical Center, de Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands; Psychosocial Department, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Elisabeth M van Dijk-Lokkart
- Department of Medical Psychology, VU University Medical Center, de Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
| | - Harrie N Lafeber
- Department of Pediatrics, VU University Medical Center, Amsterdam, de Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
| | - Anniek Brugman
- Department of Medical Psychology, VU University Medical Center, de Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
| | - Jaap Oosterlaan
- Department of Pediatrics, VU University Medical Center, Amsterdam, de Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands; Department of Pediatrics, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands; Clinical Neuropsychology section, Vrije Universiteit Amsterdam, van der Boechorstraat 1, 1081 BT, Amsterdam, The Netherlands.
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84
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Characterizing Health Disparities in the Age of Autism Diagnosis in a Study of 8-Year-Old Children. J Autism Dev Disord 2018; 48:2396-2407. [DOI: 10.1007/s10803-018-3500-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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85
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Advanced Maternal Age and Maternal Education Disparity in Children with Autism Spectrum Disorder. Matern Child Health J 2018; 22:941-949. [DOI: 10.1007/s10995-018-2470-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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86
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Lyall K, Yau VM, Hansen R, Kharrazi M, Yoshida CK, Calafat AM, Windham G, Croen LA. Prenatal Maternal Serum Concentrations of Per- and Polyfluoroalkyl Substances in Association with Autism Spectrum Disorder and Intellectual Disability. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:017001. [PMID: 29298162 PMCID: PMC6014693 DOI: 10.1289/ehp1830] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 11/22/2017] [Accepted: 11/24/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Emerging work has examined neurodevelopmental outcomes following prenatal exposure to per- and polyfluoroalkyl substances (PFAS), but few studies have assessed associations with autism spectrum disorder (ASD). OBJECTIVES Our objective was to estimate associations of maternal prenatal PFAS concentrations with ASD and intellectual disability (ID) in children. METHODS Participants were from a population-based nested case-control study of children born from 2000 to 2003 in southern California, including children diagnosed with ASD (n=553), ID without autism (n=189), and general population (GP) controls (n=433). Concentrations of eight PFAS from stored maternal sera collected at 15-19 wk gestational age were quantified and compared among study groups. We used logistic regression to obtain adjusted odds ratios for the association between prenatal PFAS concentrations (parameterized continuously and as quartiles) and ASD versus GP controls, and separately for ID versus GP controls. RESULTS Geometric mean concentrations of most PFAS were lower in ASD and ID groups relative to GP controls. ASD was not significantly associated with prenatal concentrations of most PFAS, though significant inverse associations were found for perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) [adjusted ORs for the highest vs. lowest quartiles 0.62 (95% CI: 0.41, 0.93) and 0.64 (95% CI: 0.43, 0.97), respectively]. Results for ID were similar. CONCLUSIONS Results from this large case-control study with prospectively collected prenatal measurements do not support the hypothesis that prenatal exposure to PFAS is positively associated with ASD or ID. https://doi.org/10.1289/EHP1830.
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Affiliation(s)
- Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Vincent M Yau
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Robin Hansen
- MIND Institute and the Department of Pediatrics, University of California, Davis, Davis, California, USA
| | - Martin Kharrazi
- Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California, USA
| | | | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gayle Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente, Oakland, California, USA
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87
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Kelly B, Williams S, Collins S, Mushtaq F, Mon-Williams M, Wright B, Mason D, Wright J. The association between socioeconomic status and autism diagnosis in the United Kingdom for children aged 5–8 years of age: Findings from the Born in Bradford cohort. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:131-140. [DOI: 10.1177/1362361317733182] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There has been recent interest in the relationship between socioeconomic status and the diagnosis of autism in children. Studies in the United States have found lower rates of autism diagnosis associated with lower socioeconomic status, while studies in other countries report no association, or the opposite. This article aims to contribute to the understanding of this relationship in the United Kingdom. Using data from the Born in Bradford cohort, comprising 13,857 children born between 2007 and 2011, it was found that children of mothers educated to A-level or above had twice the rate of autism diagnosis, 1.5% of children (95% confidence interval: 1.1%, 1.9%) compared to children of mothers with lower levels of education status 0.7% (95% confidence interval: 0.5%, 0.9%). No statistically significant relationship between income status or neighbourhood material deprivation was found after controlling for mothers education status. The results suggest a substantial level of underdiagnosis for children of lower education status mothers, though further research is required to determine the extent to which this is replicated across the United Kingdom. Tackling inequalities in autism diagnosis will require action, which could include increased education, awareness, further exploration of the usefulness of screening programmes and the provision of more accessible support services.
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Affiliation(s)
- Brian Kelly
- Bradford Teaching Hospitals NHS Foundation Trust, UK
| | | | | | | | | | | | - Dan Mason
- Bradford Teaching Hospitals NHS Foundation Trust, UK
| | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust, UK
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88
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Factors Associated with Self-Injurious Behaviors in Children with Autism Spectrum Disorder: Findings from Two Large National Samples. J Autism Dev Disord 2017; 47:285-296. [PMID: 27830427 DOI: 10.1007/s10803-016-2951-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In this study, we explored potential associations among self-injurious behaviors (SIB) and a diverse group of protective and risk factors in children with autism spectrum disorder from two databases: Autism and Developmental Disabilities Monitoring (ADDM) Network and the Autism Speaks-Autism Treatment Network (AS-ATN). The presence of SIB was determined from children's records in ADDM and a parent questionnaire in AS-ATN. We used multiple imputation to account for missing data and a non-linear mixed model with site as a random effect to test for associations. Despite differences between the two databases, similar associations were found; SIB were associated with developmental, behavioral, and somatic factors. Implications of these findings are discussed in relation to possible etiology, future longitudinal studies, and clinical practice.
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89
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Lung FW, Chiang TL, Lin SJ, Lee MC, Shu BC. Assisted reproductive technology has no association with autism spectrum disorders: The Taiwan Birth Cohort Study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:377-384. [DOI: 10.1177/1362361317690492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The use of assisted reproduction technology has increased over the last two decades. Autism spectrum disorders and assisted reproduction technology share many risk factors. However, previous studies on the association between autism spectrum disorders and assisted reproduction technology have shown inconsistent results. The purpose of this study was to investigate the association between assisted reproduction technology and autism spectrum disorder diagnosis in a national birth cohort database. Furthermore, the results from the assisted reproduction technology and autism spectrum disorder propensity score matching exact matched datasets were compared. For this study, the 6- and 66-month Taiwan Birth Cohort Study datasets were used (N = 20,095). In all, 744 families were propensity score matching exact matched and selected as the assisted reproduction technology sample (ratio of assisted reproduction technology to controls: 1:2) and 415 families as the autism spectrum disorder sample (ratio of autism spectrum disorder to controls: 1:4). Using a national birth cohort dataset, controlling for the confounding factors of assisted reproduction technology conception and autism spectrum disorder diagnosis, both assisted reproduction technology and autism spectrum disorder propensity score matching matched datasets showed the same results of no association between assisted reproduction technology and autism spectrum disorder. Further study on the detailed information regarding the processes and methods of assisted reproduction technology may provide us with more information on the association between assisted reproduction technology and autism spectrum disorder.
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Affiliation(s)
- For-Wey Lung
- Calo Psychiatric Center, Taiwan
- National Defense Medical Center, Taiwan
- Kaohsiung Medical University, Taiwan
| | | | | | - Meng-Chih Lee
- Taichung Hospital, Taiwan
- National Health Research Institutes, Taiwan
- Chung Shan Medical University, Taiwan
- National Taichung University of Science and Technology, Taiwan
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90
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Pulcini CD, Zima BT, Kelleher KJ, Houtrow AJ. Poverty and Trends in Three Common Chronic Disorders. Pediatrics 2017; 139:peds.2016-2539. [PMID: 28193790 DOI: 10.1542/peds.2016-2539] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES For asthma, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), the objectives were to (1) describe the percent increases in prevalence and comorbidity and how these vary by poverty status, and (2) examine the extent to which poverty status is a predictor of higher than average comorbid conditions. METHODS Secondary analyses of the National Survey of Children's Health for years 2003, 2007, and 2011-2012 were conducted to identify trends in parent reported lifetime prevalence and comorbidity among children with asthma, ADHD, and ASD and examine variation by sociodemographic characteristics, poverty status, and insurance coverage. Using 2011-2012 data, multivariable regression was used to examine whether poverty status predicted higher than average comorbid conditions after adjusting for other sociodemographic characteristics. RESULTS Parent-reported lifetime prevalence of asthma and ADHD rose 18% and 44%, respectively, whereas the lifetime prevalence of ASD rose almost 400% (from 0.5% to 2%). For asthma, the rise was most prominent among the poor at 25.8%. For ADHD, the percent change by poverty status was similar (<100% federal poverty level [FPL]: 43.20%, 100% to 199% FPL: 52.38%, 200% to 399% FPL: 43.67%), although rise in ASD was associated with being nonpoor (200% to 399% FPL: 43.6%, ≥400% FPL: 36.0%). Publicly insured children with asthma, ADHD, and ASD also had significantly higher odds (1.9×, 1.6×, 3.0×, respectively) of having higher than average comorbidities. CONCLUSIONS Poverty status differentially influenced parent-reported lifetime prevalence and comorbidities of these target disorders. Future research is needed to examine parent and system-level characteristics that may further explain poverty's variable impact.
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Affiliation(s)
- Christian D Pulcini
- Department of Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Bonnie T Zima
- UCLA-Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - Kelly J Kelleher
- Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio; and
| | - Amy J Houtrow
- Department of Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; .,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania
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91
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Gong T, Dalman C, Wicks S, Dal H, Magnusson C, Lundholm C, Almqvist C, Pershagen G. Perinatal Exposure to Traffic-Related Air Pollution and Autism Spectrum Disorders. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:119-126. [PMID: 27494442 PMCID: PMC5226686 DOI: 10.1289/ehp118] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/23/2016] [Accepted: 07/12/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND Studies from the United States indicate that exposure to air pollution in early life is associated with autism spectrum disorders (ASD) in children, but the evidence is not consistent with European data. OBJECTIVE We aimed to investigate the association between exposure to air pollution from road traffic and the risk of ASD in children, with careful adjustment for socioeconomic and other confounders. METHOD Children born and residing in Stockholm, Sweden, during 1993-2007 with an ASD diagnosis were identified through multiple health registers and classified as cases (n = 5,136). A randomly selected sample of 18,237 children from the same study base constituted controls. Levels of nitrogen oxides (NOx) and particulate matter with diameter ≤ 10 μm (PM10) from road traffic were estimated at residential addresses during mother's pregnancy and the child's first year of life by dispersion models. Odds ratios (OR) and 95% confidence intervals (CI) for ASD with or without intellectual disability (ID) were estimated using logistic regression models after conditioning on municipality and calendar year of birth as well as adjustment for potential confounders. RESULT Air pollution exposure during the prenatal period was not associated with ASD overall (OR = 1.00; 95% CI: 0.86, 1.15 per 10-μg/m3 increase in PM10 and OR = 1.02; 95% CI: 0.94, 1.10 per 20-μg/m3 increase in NOx during mother's pregnancy). Similar results were seen for exposure during the first year of life, and for ASD in combination with ID. An inverse association between air pollution exposure and ASD risk was observed among children of mothers who moved to a new residence during pregnancy. CONCLUSION Early-life exposure to low levels of NOx and PM10 from road traffic does not appear to increase the risk of ASD. Citation: Gong T, Dalman C, Wicks S, Dal H, Magnusson C, Lundholm C, Almqvist C, Pershagen G. 2017. Perinatal exposure to traffic-related air pollution and autism spectrum disorders. Environ Health Perspect 125:119-126; http://dx.doi.org/10.1289/EHP118.
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Affiliation(s)
- Tong Gong
- Department of Medical Epidemiology and Biostatistics, and
| | - Christina Dalman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Susanne Wicks
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Henrik Dal
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Cecilia Magnusson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, and
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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92
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Sandhu KV, Sherwin E, Schellekens H, Stanton C, Dinan TG, Cryan JF. Feeding the microbiota-gut-brain axis: diet, microbiome, and neuropsychiatry. Transl Res 2017; 179:223-244. [PMID: 27832936 DOI: 10.1016/j.trsl.2016.10.002] [Citation(s) in RCA: 310] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/08/2016] [Accepted: 10/06/2016] [Indexed: 02/07/2023]
Abstract
The microbial population residing within the human gut represents one of the most densely populated microbial niche in the human body with growing evidence showing it playing a key role in the regulation of behavior and brain function. The bidirectional communication between the gut microbiota and the brain, the microbiota-gut-brain axis, occurs through various pathways including the vagus nerve, the immune system, neuroendocrine pathways, and bacteria-derived metabolites. This axis has been shown to influence neurotransmission and the behavior that are often associated with neuropsychiatric conditions. Therefore, research targeting the modulation of this gut microbiota as a novel therapy for the treatment of various neuropsychiatric conditions is gaining interest. Numerous factors have been highlighted to influence gut microbiota composition, including genetics, health status, mode of birth, and environment. However, it is diet composition and nutritional status that has repeatedly been shown to be one of the most critical modifiable factors regulating the gut microbiota at different time points across the lifespan and under various health conditions. Thus the microbiota is poised to play a key role in nutritional interventions for maintaining brain health.
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Affiliation(s)
- Kiran V Sandhu
- APC Microbiome institute, University College Cork, Cork, Ireland
| | - Eoin Sherwin
- APC Microbiome institute, University College Cork, Cork, Ireland
| | - Harriët Schellekens
- APC Microbiome institute, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Catherine Stanton
- APC Microbiome institute, University College Cork, Cork, Ireland; Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Co, Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome institute, University College Cork, Cork, Ireland; Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome institute, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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93
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Chinawa JM, Manyike PC, Aniwada EC, Chinawa AT, Obu HA, Odetunde OI, Nwokocha AR, Ibekwe RR. Prevalence and socioeconomic correlates of autism among children attending primary and secondary schools in south east Nigeria. Afr Health Sci 2016; 16:936-942. [PMID: 28479884 PMCID: PMC5398438 DOI: 10.4314/ahs.v16i4.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES The objectives of the study were to determine the prevalence and socio-economic determinants of autism among children attending primary and secondary schools in South East, Nigeria. METHODS This was a cross-sectional study that assessed the prevalence and socio-economic pattern of childhood autism among children attending primary and secondary schools in Enugu and Ebonyi states, South East Nigeria. The questionnaire was adapted from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000). The study was carried out between June and October, 2014. The schools were selected by listing all the mixed schools in the urban and semi- urban areas by simple random sampling. RESULTS A total of 721 subjects completed the questionnaire. The age of respondents ranged between 3 and 18 years, with mean age of 12.71 and standard deviation of 3.03 years. Twenty one children fulfilled the criteria for autism giving a prevalence of 2.9%. There is a significant association between age in categories (fishers exact test, p = 0.013) and social class (p=0.033). CONCLUSION The prevalence of autism was 2.9%; and the socio-economic characteristics of childhood autism in South East Nigeria are similar to those in other parts of the world.
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Affiliation(s)
- Josephat M Chinawa
- College of Medicine, Department of pediatrics, University of Nigeria/ University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | | | - Elias C Aniwada
- College of Medicine, Department of pediatrics, University of Nigeria/ University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Awoere T Chinawa
- (Epid& Med Stat), FWACP, FMCPH Lecturer, College of Community medicine, University of Nigeria/University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Herbert A Obu
- Department of Paediatrics, University of Nigeria/ University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Odutola I Odetunde
- College of Medicine,Department of pediatrics, University of Nigeria/ University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Ada Rc Nwokocha
- College of Medicine, Department of pediatrics, University of Nigeria/ University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Roland R Ibekwe
- Department of pediatrics, Enugu State University Teaching Hospital, Enugu
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94
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Webb SJ, Garrison MM, Bernier R, McClintic AM, King BH, Mourad PD. Severity of ASD symptoms and their correlation with the presence of copy number variations and exposure to first trimester ultrasound. Autism Res 2016; 10:472-484. [PMID: 27582229 DOI: 10.1002/aur.1690] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/07/2016] [Accepted: 07/21/2016] [Indexed: 01/13/2023]
Abstract
Current research suggests that incidence and heterogeneity of autism spectrum disorder (ASD) symptoms may arise through a variety of exogenous and/or endogenous factors. While subject to routine clinical practice and generally considered safe, there exists speculation, though no human data, that diagnostic ultrasound may also contribute to ASD severity, supported by experimental evidence that exposure to ultrasound early in gestation could perturb brain development and alter behavior. Here we explored a modified triple hit hypothesis [Williams & Casanova, ] to assay for a possible relationship between the severity of ASD symptoms and (1) ultrasound exposure (2) during the first trimester of pregnancy in fetuses with a (3) genetic predisposition to ASD. We did so using retrospective analysis of data from the SSC (Simon's Simplex Collection) autism genetic repository funded by the Simons Foundation Autism Research Initiative. We found that male children with ASD, copy number variations (CNVs), and exposure to first trimester ultrasound had significantly decreased non-verbal IQ and increased repetitive behaviors relative to male children with ASD, with CNVs, and no ultrasound. These data suggest that heterogeneity in ASD symptoms may result, at least in part, from exposure to diagnostic ultrasound during early prenatal development of children with specific genetic vulnerabilities. These results also add weight to on-going concerns expressed by the FDA about non-medical use of diagnostic ultrasound during pregnancy. Autism Res 2017, 10: 472-484. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Sara Jane Webb
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Departments of Psychiatry & Behavioral Science, Neurological Surgery, Seattle, Washington
| | - Michelle M Garrison
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Departments of Psychiatry & Behavioral Science, Neurological Surgery, Seattle, Washington
| | - Raphael Bernier
- Departments of Psychiatry & Behavioral Science, Neurological Surgery, Seattle, Washington
| | - Abbi M McClintic
- Departments of Psychiatry & Behavioral Science, Neurological Surgery, Seattle, Washington
| | - Bryan H King
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Pierre D Mourad
- Departments of Psychiatry & Behavioral Science, Neurological Surgery, Seattle, Washington.,Division of Engineering and Mathematics, University of Washington, Seattle, Washington
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95
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Dickerson AS, Rahbar MH, Bakian AV, Bilder DA, Harrington RA, Pettygrove S, Kirby RS, Durkin MS, Han I, Moyé LA, Pearson DA, Wingate MS, Zahorodny WM. Autism spectrum disorder prevalence and associations with air concentrations of lead, mercury, and arsenic. ENVIRONMENTAL MONITORING AND ASSESSMENT 2016; 188:407. [PMID: 27301968 DOI: 10.1007/s10661-016-5405-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/02/2016] [Indexed: 06/06/2023]
Abstract
Lead, mercury, and arsenic are neurotoxicants with known effects on neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder apparent by early childhood. Using data on 4486 children with ASD residing in 2489 census tracts in five sites of the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, we used multi-level negative binomial models to investigate if ambient lead, mercury, and arsenic concentrations, as measured by the US Environmental Protection Agency National-Scale Air Toxics Assessment (EPA-NATA), were associated with ASD prevalence. In unadjusted analyses, ambient metal concentrations were negatively associated with ASD prevalence. After adjusting for confounding factors, tracts with air concentrations of lead in the highest quartile had significantly higher ASD prevalence than tracts with lead concentrations in the lowest quartile (prevalence ratio (PR) = 1.36; 95 '% CI: 1.18, 1.57). In addition, tracts with mercury concentrations above the 75th percentile (>1.7 ng/m(3)) and arsenic concentrations below the 75th percentile (≤0.13 ng/m(3)) had a significantly higher ASD prevalence (adjusted RR = 1.20; 95 % CI: 1.03, 1.40) compared to tracts with arsenic, lead, and mercury concentrations below the 75th percentile. Our results suggest a possible association between ambient lead concentrations and ASD prevalence and demonstrate that exposure to multiple metals may have synergistic effects on ASD prevalence.
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Affiliation(s)
- Aisha S Dickerson
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA.
| | - Mohammad H Rahbar
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
- Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Amanda V Bakian
- Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Deborah A Bilder
- Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Rebecca A Harrington
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Sydney Pettygrove
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA
| | - Russell S Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Maureen S Durkin
- Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Inkyu Han
- Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Lemuel A Moyé
- Division of Biostatistics, University of Texas School of Public Health at Houston, Houston, TX, 77030, USA
| | - Deborah A Pearson
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, TX, 77054, USA
| | - Martha Slay Wingate
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35205, USA
| | - Walter M Zahorodny
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
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96
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Abstract
A suite of recent studies has reported positive genetic correlations between autism risk and measures of mental ability. These findings indicate that alleles for autism overlap broadly with alleles for high intelligence, which appears paradoxical given that autism is characterized, overall, by below-average IQ. This paradox can be resolved under the hypothesis that autism etiology commonly involves enhanced, but imbalanced, components of intelligence. This hypothesis is supported by convergent evidence showing that autism and high IQ share a diverse set of convergent correlates, including large brain size, fast brain growth, increased sensory and visual-spatial abilities, enhanced synaptic functions, increased attentional focus, high socioeconomic status, more deliberative decision-making, profession and occupational interests in engineering and physical sciences, and high levels of positive assortative mating. These findings help to provide an evolutionary basis to understanding autism risk as underlain in part by dysregulation of intelligence, a core human-specific adaptation. In turn, integration of studies on intelligence with studies of autism should provide novel insights into the neurological and genetic causes of high mental abilities, with important implications for cognitive enhancement, artificial intelligence, the relationship of autism with schizophrenia, and the treatment of both autism and intellectual disability.
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Affiliation(s)
- Bernard J Crespi
- Department of Biological Sciences and Human Evolutionary Studies Program, Simon Fraser University Burnaby, BC, Canada
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97
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Burkett K, Morris E, Manning-Courtney P, Anthony J, Shambley-Ebron D. African American families on autism diagnosis and treatment: the influence of culture. J Autism Dev Disord 2016; 45:3244-54. [PMID: 26055985 DOI: 10.1007/s10803-015-2482-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cultural factors such as health care access and autism spectrum disorder (ASD) symptom interpretations have been proposed as impacting delayed diagnosis and treatment for African American children with ASD. A qualitative study of urban African American families caring for their child with autism was conducted with 24 family members and 28 ASD professionals. Cultural caring meant families protected their child from harm including potential or actual distrustful encounters, and took action for their child and community to optimize their child's health and address the knowledge deficits of ASD within their community. Families and professionals believed cultural influences delayed families' receiving and seeking appropriate health care for the African American child with ASD affecting timely autism diagnosis and treatment.
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Affiliation(s)
- Karen Burkett
- Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML4002, Cincinnati, OH, 45229, USA.
| | - Edith Morris
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA.,Nursing Research in Patient Services, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Patricia Manning-Courtney
- Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML4002, Cincinnati, OH, 45229, USA
| | - Jean Anthony
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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98
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Rosa M, Puig O, Lázaro L, Calvo R. Socioeconomic status and intelligence quotient as predictors of psychiatric disorders in children and adolescents with high-functioning autism spectrum disorder and in their siblings. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 20:963-972. [PMID: 26851231 DOI: 10.1177/1362361315617881] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Previous studies have shown high rates of comorbid disorders in children and adolescents with autism spectrum disorder, but failed to compare them with general population and few of them have identified predictors of comorbidity. This study compared the rates of psychiatric disorders in 50 children and adolescents with autism spectrum disorder, 24 of their siblings, 32 controls from general population and 22 of their siblings. Children and adolescent with autism spectrum disorder and their siblings had higher rates of attention deficit and hyperactivity disorder compared to controls. Lower socioeconomic status and intelligence quotient were the main risk factors. The contribution of socioeconomic status and intelligence quotient to increase the risk of developing comorbidity in autism spectrum disorder and psychopathology in their siblings deserves further study.
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Affiliation(s)
| | - Olga Puig
- Hospital Clínic de Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Luisa Lázaro
- Hospital Clínic de Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain Universitat de Barcelona, Spain
| | - Rosa Calvo
- Hospital Clínic de Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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99
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Hrdlicka M, Vacova M, Oslejskova H, Gondzova V, Vadlejchova I, Kocourkova J, Koutek J, Dudova I. Age at diagnosis of autism spectrum disorders: is there an association with socioeconomic status and family self-education about autism? Neuropsychiatr Dis Treat 2016; 12:1639-44. [PMID: 27462156 PMCID: PMC4940008 DOI: 10.2147/ndt.s107239] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The marked increase in autism spectrum disorders (ASD) prevalence has stimulated worldwide interest in exploring broader circumstances of care of autistic children, including the role of socioeconomic status (SES) and family information on autism. METHODS Our sample comprised of 160 children who participated in a diagnostic examination focused on autism, and their parents who completed a simple descriptive questionnaire focusing on the family situation as well as family self-education about autism. The diagnosis of ASD was confirmed in 120 children (75% of the sample; 94 boys, 26 girls) with mean age 6.2±2.7 years (median 5.3, range 2.2-17.2 years). In 71 autistic patients (59.2%), a diagnosis of mental retardation was also established. RESULTS The age at diagnosis of ASD correlated negatively with maternal (P=0.014) and paternal (P=0.002) ages at the time of birth of the ASD child as well as with paternal (P=0.002) and maternal (P=0.050) education. The age at diagnosis of ASD did not correlate with family SES. Mothers were significantly more active in seeking information on autism than fathers or both parents equally (80 vs 9 vs 28 cases, respectively; P<0.001). The mean number of information sources on autism was 3.5±1.8 with a range 0-9. The mean number of resources did not differ among the three SES groups (3.50 vs 3.49 vs 4.25, respectively; P=0.704). The mean number of sources did not correlate with the age at diagnosis of ASD. The most often used sources were the Internet (81.7%), followed by psychologists (48.3%), books (46.7%), and child and adolescent psychiatrists (43.3%). CONCLUSION An earlier diagnosis of ASD is associated with higher parental age at birth and higher parental education but not with family SES or number of family information sources.
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Affiliation(s)
- Michal Hrdlicka
- Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague
| | - Maria Vacova
- Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague
| | - Hana Oslejskova
- Department of Child Neurology, Masaryk University Faculty of Medicine and University Hospital, Brno
| | - Veronika Gondzova
- Department of Child Neurology, Masaryk University Faculty of Medicine and University Hospital, Brno
| | | | - Jana Kocourkova
- Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague
| | - Jiri Koutek
- Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague
| | - Iva Dudova
- Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague
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100
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Socioeconomic Disparities and Prevalence of Autism Spectrum Disorders and Intellectual Disability. PLoS One 2015; 10:e0141964. [PMID: 26540408 PMCID: PMC4635003 DOI: 10.1371/journal.pone.0141964] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 10/15/2015] [Indexed: 12/17/2022] Open
Abstract
Background and Objectives Study of the impact of socioeconomic status on autism spectrum disorders (ASD) and severe intellectual disabilities (ID) has yielded conflicting results. Recent European studies suggested that, unlike reports from the United States, low socioeconomic status is associated with an increased risk of ASD. For intellectual disabilities, the links with socioeconomic status vary according to the severity. We wished to clarify the links between socioeconomic status and the prevalence of ASD (with or without ID) and isolated severe ID. Methods 500 children with ASD and 245 children with severe ID (IQ <50) aged 8 years, born 1995 to 2004, were recruited from a French population-based registry. Inclusions were based on clinical diagnoses reported in medical records according to the International Classification of Diseases, 10th Revision. Socioeconomic status was measured by indicators available at block census level which characterize the population of the child’s area of residence. Measures of deprivation, employment, occupation, education, immigration and family structure were used. Prevalences were compared between groups of census units defined by the tertiles of socioeconomic level in the general population. Results Prevalence of ASD with associated ID was higher in areas with the highest level of deprivation and the highest percentage of unemployed adults, persons with no diploma, immigrants and single-parent families. No association was found when using occupational class. Regarding ASD without associated ID, a higher prevalence was found in areas with the highest percentage of immigrants. No association was found for other socioeconomic indicators. The prevalence of isolated severe ID was likely to be higher in the most disadvantaged groups defined by all indicators. Conclusion The prevalence of ASD with associated ID and of severe isolated ID is more likely to be higher in areas with the highest level of deprivation.
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