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Perfilyeva A, Bespalova K, Perfilyeva Y, Skvortsova L, Musralina L, Zhunussova G, Khussainova E, Iskakova U, Bekmanov B, Djansugurova L. Integrative Functional Genomic Analysis in Multiplex Autism Families from Kazakhstan. DISEASE MARKERS 2022; 2022:1509994. [PMID: 36199823 PMCID: PMC9529466 DOI: 10.1155/2022/1509994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
The study of extended pedigrees containing autism spectrum disorder- (ASD-) related broader autism phenotypes (BAP) offers a promising approach to the search for ASD candidate variants. Here, a total of 650,000 genetic markers were tested in four Kazakhstani multiplex families with ASD and BAP to obtain data on de novo mutations (DNMs), common, and rare inherited variants that may contribute to the genetic risk for developing autistic traits. The variants were analyzed in the context of gene networks and pathways. Several previously well-described enriched pathways were identified, including ion channel activity, regulation of synaptic function, and membrane depolarization. Perhaps these pathways are crucial not only for the development of ASD but also for ВАР. The results also point to several additional biological pathways (circadian entrainment, NCAM and BTN family interactions, and interaction between L1 and Ankyrins) and hub genes (CFTR, NOD2, PPP2R2B, and TTR). The obtained results suggest that further exploration of PPI networks combining ASD and BAP risk genes can be used to identify novel or overlooked ASD molecular mechanisms.
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Affiliation(s)
| | - Kira Bespalova
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
- Al-Farabi Kazakh National University, 71 Al-Farabi Ave., Almaty 050040, Kazakhstan
| | - Yuliya Perfilyeva
- M.A. Aitkhozhin's Institute of Molecular Biology and Biochemistry, 86 Dosmukhamedov St., Almaty 050012, Kazakhstan
- Branch of the National Center for Biotechnology, 14 Zhahanger St., Almaty 050054, Kazakhstan
| | - Liliya Skvortsova
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
| | - Lyazzat Musralina
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
| | - Gulnur Zhunussova
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
| | - Elmira Khussainova
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
| | - Ulzhan Iskakova
- Kazakh National Medical University, 94 Tole Bi St., Almaty 050000, Kazakhstan
| | - Bakhytzhan Bekmanov
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
| | - Leyla Djansugurova
- Institute of Genetics and Physiology, 93 Al-Farabi Ave., Almaty 050060, Kazakhstan
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Margiano SG, Sassu KA, Dale BA, Caemmerer JM, Bray MA, Peters E. School psychologists and autism identification: Present challenges and potential solutions. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Suzanne G. Margiano
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
| | - Kari A. Sassu
- Department of Counseling & School Psychology Southern Connecticut University New Haven Connecticut USA
| | - Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
| | | | - Melissa A. Bray
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
| | - Emily Peters
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
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Impact of Three Kinds of Early Interventions on Developmental Profile in Toddlers with Autism Spectrum Disorder. J Clin Med 2022; 11:jcm11185424. [PMID: 36143071 PMCID: PMC9506464 DOI: 10.3390/jcm11185424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Autism spectrum disorder is a neurodevelopmental disorder with a rising prevalence disorder. This high-cost/high-burden condition needs evidence-based behavioral treatments that are able to reduce the impact of symptoms on children’s functioning. This retrospective chart review study compared the impact of different types of early interventions on toddlers diagnosed with an autism spectrum disorder developmental profile. Analyses were conducted on 90 subjects (mean = 27.76 months, range 18−44 months; M:F = 4.29:1), of which 36 children underwent the usual treatment, 13 children underwent an intervention based on early intensive behavioral intervention (EIBI) and 41 children received the Early Start Denver Model, for one year, with the same weekly frequency of about 6 h a week. A significant decrease in the severity of autism symptoms was observed for all children when looking at the Ados-2 severity score (average difference = 3.05, SD = 0.71, p = < 0.001) and the Ados-2 social subscale (average difference = 2.87, SD = 0.59, p < 0.001). Otherwise, for most of the Griffiths subscales, we found a significant improvement only for those children who underwent the Early Start Denver Model intervention (General Quotient average difference = 14.47, SD = 3.22, corrected p < 0.001). Analyzing the influence of age on the investigated scores, we found a significant association with the Eye−hand Coordination Quotient (p = 0.003), Performance Quotient (p = 0.042) and General Quotient (p = 0.006). In all these domains, a mild negative correlation with age was observed, as measured by the Pearson’s correlation coefficient (r = −0.32, p = 0.002; r = −0.21, p = 0.044; r = −0.25, p = 0.019, respectively), suggesting less severe developmental skills at the start of treatment for older children. Our results are consistent with the literature that underlines the importance of early intervention, since prompt diagnosis can reduce the severity of autism symptoms; nevertheless, in toddlers, our study demonstrated that an intervention model based on naturalistic developmental behavioral principles such as the Early Start Denver Model is more effective on children’s developmental profile. Further studies are required to assess the extent of effectiveness of different early intervention models in community settings.
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Asgharian P, Quispe C, Herrera-Bravo J, Sabernavaei M, Hosseini K, Forouhandeh H, Ebrahimi T, Sharafi-Badr P, Tarhriz V, Soofiyani SR, Helon P, Rajkovic J, Durna Daştan S, Docea AO, Sharifi-Rad J, Calina D, Koch W, Cho WC. Pharmacological effects and therapeutic potential of natural compounds in neuropsychiatric disorders: An update. Front Pharmacol 2022; 13:926607. [PMID: 36188551 PMCID: PMC9521271 DOI: 10.3389/fphar.2022.926607] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Neuropsychiatric diseases are a group of disorders that cause significant morbidity and disability. The symptoms of psychiatric disorders include anxiety, depression, eating disorders, autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder, and conduct disorder. Various medicinal plants are frequently used as therapeutics in traditional medicine in different parts of the world. Nowadays, using medicinal plants as an alternative medication has been considered due to their biological safety. Despite the wide range of medications, many patients are unable to tolerate the side effects and eventually lose their response. By considering the therapeutic advantages of medicinal plants in the case of side effects, patients may prefer to use them instead of chemical drugs. Today, the use of medicinal plants in traditional medicine is diverse and increasing, and these plants are a precious heritage for humanity. Investigation about traditional medicine continues, and several studies have indicated the basic pharmacology and clinical efficacy of herbal medicine. In this article, we discuss five of the most important and common psychiatric illnesses investigated in various studies along with conventional therapies and their pharmacological therapies. For this comprehensive review, data were obtained from electronic databases such as MedLine/PubMed, Science Direct, Web of Science, EMBASE, DynaMed Plus, ScienceDirect, and TRIP database. Preclinical pharmacology studies have confirmed that some bioactive compounds may have beneficial therapeutic effects in some common psychiatric disorders. The mechanisms of action of the analyzed biocompounds are presented in detail. The bioactive compounds analyzed in this review are promising phytochemicals for adjuvant and complementary drug candidates in the pharmacotherapy of neuropsychiatric diseases. Although comparative studies have been carefully reviewed in the preclinical pharmacology field, no clinical studies have been found to confirm the efficacy of herbal medicines compared to FDA-approved medicines for the treatment of mental disorders. Therefore, future clinical studies are needed to accelerate the potential use of natural compounds in the management of these diseases.
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Affiliation(s)
- Parina Asgharian
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Cristina Quispe
- Facultad de Ciencias de la Salud, Universidad Arturo Prat, Iquique, Chile
| | - Jesús Herrera-Bravo
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Santo Tomas, Chile
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco, Chile
| | - Mahsa Sabernavaei
- Department of Pharmacognosy and Pharmaceutical Biotechnology, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Hosseini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Forouhandeh
- Infectious and Tropical Diseases Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahereh Ebrahimi
- Infectious and Tropical Diseases Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Paria Sharafi-Badr
- Department of Pharmacognosy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahideh Tarhriz
- Infectious and Tropical Diseases Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saiedeh Razi Soofiyani
- Infectious and Tropical Diseases Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Clinical Research Development Unit of Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Paweł Helon
- Branch in Sandomierz, Jan Kochanowski University of Kielce, Sandomierz, Poland
| | - Jovana Rajkovic
- Medical Faculty, Institute of Pharmacology, Clinical Pharmacology and Toxicology, University of Belgrade, Belgrade, Serbia
| | - Sevgi Durna Daştan
- Department of Biology, Faculty of Science, Sivas Cumhuriyet University, Sivas, Turkey
- Beekeeping Development Application and Research Center, Sivas Cumhuriyet University, Sivas, Turkey
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | | | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Wojciech Koch
- Department of Food and Nutrition, Medical University of Lublin, Lublin, Poland
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China
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105
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Shenouda J, Barrett E, Davidow AL, Sidwell K, Halperin W, Silenzio VMB, Zahorodny W. Disparities in Early Intervention Program Participation by Children With Autism Spectrum Disorder in a US Metropolitan Area, 2006 to 2016. JAMA Pediatr 2022; 176:906-914. [PMID: 35849409 PMCID: PMC9295023 DOI: 10.1001/jamapediatrics.2022.2366] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Multiple studies have shown the value of early interventions for autism spectrum disorder (ASD). In the US, the Early Intervention Program (EIP) is mandated by law (Part C of the Individuals With Disabilities Education Act [IDEA]) to provide services to all young children with delays or disabilities. However, the extent to which children with ASD participate in this key service system is unknown. OBJECTIVES To evaluate EIP use by children with ASD from 2006 to 2016 and to describe the factors associated with EIP participation. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used repeated data collected from 2006 to 2016 by active ASD surveillance of the New York-New Jersey metropolitan area as reported in the New Jersey Autism Study. The New Jersey Autism Study identified 4050 children aged 8 years with ASD from 2006 to 2016. Demographic and clinical data were collected and participation in an EIP was assessed through active surveillance. Data were analyzed from June to December 2021. EXPOSURE Sociodemographic factors associated with the outcome of EIP participation. MAIN OUTCOMES AND MEASURES Participation in an EIP assessed at age 8 years. Demographic, ecological, and clinical factors, as well as temporal patterns, were examined by using standard and multilevel logistic regression models. RESULTS Among 4050 children aged 8 years with ASD by active surveillance, 1887 (46.6%) received EIP services. Of these children, 3303 (81.6%) were boys; 1105 (27.3%) were Hispanic, 801 (19.8%) were non-Hispanic Black, 1816 (44.8%) were non-Hispanic White, and 328 (8.1%) were non-Hispanic other (included Alaska Native or American Indian and Asian or Pacific Islander). In adjusted regression models, non-Hispanic Black children with ASD had lower odds of EIP participation (adjusted odds ratio [AOR], 0.67; 95% CI, 0.54-0.84) compared with their non-Hispanic White peers, and children residing in affluent areas had higher odds of receiving EIP services (AOR, 1.71; 95% CI, 1.36-2.15) compared with children residing in underserved areas. Children with ASD born in 2008 had higher odds of EIP participation than children born in 1998 (AOR, 2.64; 95% CI, 2.07-3.36). CONCLUSIONS AND RELEVANCE Early identification of ASD is an important public health priority and receipt of EIP services may improve ASD outcomes. Approximately half of the population of children aged 8 years with ASD received EIP services between 2006 and 2016, and EIP participation by children with ASD increased during the 10-year period. However, receipt of EIP services was marked by strong socioeconomic status- and race and ethnicity-based disparities. Universal ASD screening and additional strategies are needed to address disparities and to increase access to EIP services.
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Affiliation(s)
- Josephine Shenouda
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, Piscataway, New Jersey,Department of Pediatrics, Rutgers New Jersey Medical School, Newark
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, Piscataway, New Jersey
| | - Amy L. Davidow
- Department of Biostatistics, New York University School of Global Public Health, New York
| | - Kate Sidwell
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark
| | - William Halperin
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, Piscataway, New Jersey
| | - Vincent M. B. Silenzio
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, Piscataway, New Jersey
| | - Walter Zahorodny
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark
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106
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Fong A, Friedlander R, Richardson A, Allen K, Zhang Q. Characteristics of children with autism and unspecified intellectual developmental disorder (intellectual disability) presenting with severe self-injurious behaviours. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:518-529. [PMID: 38699500 PMCID: PMC11062266 DOI: 10.1080/20473869.2022.2113321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 08/10/2022] [Indexed: 05/05/2024]
Abstract
Objective: This study aims to delineate the characteristics of severe self-injurious behaviors (SIB) in a cohort of children with autism and unspecified intellectual developmental disorder (UIDD) (intellectual disability) and examine potential risk factors for developing SIB. Methods: A retrospective chart review studied characteristics of severe SIB in 30 children with autism spectrum disorder (ASD) and UIDD referred to a tertiary care center. Characteristics examined include genetic syndromes, brain MRI abnormalities, verbal ability, adaptive functioning, SIB frequency and severity, age of onset, number of psychopharmacological agents, irritability, hyperactivity, stereotypy, psychiatric and physical comorbidities, among others. Descriptive and bivariate analysis were applied to explore potential relationships between factors. Results: Children with severe SIB exhibit this behaviour with high frequency, inflicting moderate to severe injury. Most children in the study sample are non-verbal and have ASD (93.3%; n = 28) with psychiatric (96.7%; n = 29) and physical (90%; n = 27) comorbidities. Overall SIB improvement using the Clinical Global Impression, Improvement Score (CGI-I) was 3.0 (minimally improved). A minority were much or very much improved following appropriate intervention. Conclusions: The severity of SIB is much higher in this sample than previously noted in the literature. Severe SIB is associated with ADHD, early onset mood disorders, tics, avoidant restrictive food intake disorder and Obsessive-Compulsive Disorder.
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Affiliation(s)
- Alison Fong
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | | | - Katie Allen
- British Columbia Children’s Hospital, Vancouver, Canada
| | - Qian Zhang
- British Columbia Children’s Hospital Research Institute Clinical Research Support Unit, Vancouver, Canada
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107
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Matson JL, Callahan MM, Montrenes JJ. Development and initial testing of the BABY-BISCUIT in an at-risk population. Dev Neurorehabil 2022; 25:361-369. [PMID: 34962445 DOI: 10.1080/17518423.2021.2018736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Early identification of autism spectrum disorder (ASD) via screeners for diagnostic measures are a high priority. At present, there is no consensus on one screener due to the need for better sensitivity and specificity. In this study, we report on the development and utility of the BABY-BISCUIT, a six-item screener based on a modified subset of items from the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). METHODS A sample of 504 children between 17-3 9months of age, who consisted of toddlers identified as at-risk for neurodevelopmental and other health disorders, were tested during an annual screening through the Louisiana EarlySteps program. RESULTS An exploratory factor analysis yielded a one-factor solution (X2 = 48.62, df = 9, p = <.001). High sensitivity (i.e., 100.0%) at the cost of reduced specificity (i.e., 33.3%, AUC = 0.957) was found for an optimal screening cutoff score of 1. CONCLUSIONS Findings from this study suggest that the BABY-BISCUIT has the potential to be a short and easily administered screener for ASD to inform whether further ASD assessment is necessary. Further investigation of convergent validity with established ASD measures is recommended.
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108
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Verma A, Priyank H, Viswanath B, Bhagat JK, Purbay S, V M, Shivakumar S. Assessment of Parental Perceptions of Socio-Psychological Factors, Unmet Dental Needs, and Barriers to Utilise Oral Health Care in Autistic Children. Cureus 2022; 14:e27950. [PMID: 36120282 PMCID: PMC9467495 DOI: 10.7759/cureus.27950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Parents' participation is crucial in the dental health intervention of children with autism spectrum disorder (ASD). Parenting children with ASD is extremely stressful and challenging. Parents and other caregivers have a responsibility to care for and raise children with ASD. Parental perception of the condition, situational adaptation, and attitude towards the issue are significant indicators of how they will respond and eventually adapt to it. METHODOLOGY A comparative, descriptive study was done on parents of 154 autistic children and 235 normal children. An 11-variable questionnaire eliciting various details of socio-psychological factors affecting the utilisation of oral health care was designed and validated. The questionnaire also included parameters regarding barriers to accessing dental services. The dental caries and oral hygiene status of all children were examined using the Basic Oral Health Survey 2013 proforma. Chi-square and independent t-tests were applied to find significant differences between the groups. RESULTS A greater number of male children (61.0%) were observed among autistic children. Parental perception regarding socio-psychological concerns with raising an autistic child showed significant differences for all variables between the groups except for assistance in the child's task with 90.2% as against 55% of the parents with non-autistic children. Parents of autistic children were more receptive to the idea of focus group discussion. Decayed teeth were significantly found to be higher in autistic cohorts (2.554 ± 1.616 versus 1.779 ± 1.841). Oral hygiene status was also statistically significant amongst autism-affected children than those who were not at p =0.000. CONCLUSION The present study explored various socio-psychological factors of parental perception of autistic children. A better outcome can be suggested when parents gained awareness regarding various strategies and treatment options available for their child's oral health. Furthermore, dental health can be improved by bringing in certain environmental modifications in which the autistic child is groomed.
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Affiliation(s)
- Ankita Verma
- Department of Pedodontics and Preventive Dentistry, Hazaribagh College of Dental Sciences and Hospital, Hazaribagh, IND
| | - Harsh Priyank
- Department of Conservative, Endodontics & Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Butta Viswanath
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Jaimesh Kumar Bhagat
- Department of Conservative Dentistry and Endodontics, Mithila Minority Dental College and Hospital, Darbhanga, IND
| | - Saurav Purbay
- Department of Conservative Dentistry and Endodontics, Hazaribagh College of Dental Sciences and Hospital, Hazaribagh, IND
| | | | - Sahana Shivakumar
- Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Bhopal, IND
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Derieux C, Léauté A, Brugoux A, Jaccaz D, Terrier C, Pin JP, Kniazeff J, Le Merrer J, Becker JAJ. Chronic sodium bromide treatment relieves autistic-like behavioral deficits in three mouse models of autism. Neuropsychopharmacology 2022; 47:1680-1692. [PMID: 35418620 PMCID: PMC9283539 DOI: 10.1038/s41386-022-01317-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 12/15/2022]
Abstract
Autism Spectrum Disorders (ASD) are neurodevelopmental disorders whose diagnosis relies on deficient social interaction and communication together with repetitive behavior. To date, no pharmacological treatment has been approved that ameliorates social behavior in patients with ASD. Based on the excitation/inhibition imbalance theory of autism, we hypothesized that bromide ions, long used as an antiepileptic medication, could relieve core symptoms of ASD. We evaluated the effects of chronic sodium bromide (NaBr) administration on autistic-like symptoms in three genetic mouse models of autism: Oprm1-/-, Fmr1-/- and Shank3Δex13-16-/- mice. We showed that chronic NaBr treatment relieved autistic-like behaviors in these three models. In Oprm1-/- mice, these beneficial effects were superior to those of chronic bumetanide administration. At transcriptional level, chronic NaBr in Oprm1 null mice was associated with increased expression of genes coding for chloride ions transporters, GABAA receptor subunits, oxytocin and mGlu4 receptor. Lastly, we uncovered synergistic alleviating effects of chronic NaBr and a positive allosteric modulator (PAM) of mGlu4 receptor on autistic-like behavior in Oprm1-/- mice. We evidenced in heterologous cells that bromide ions behave as PAMs of mGlu4, providing a molecular mechanism for such synergy. Our data reveal the therapeutic potential of bromide ions, alone or in combination with a PAM of mGlu4 receptor, for the treatment of ASDs.
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Affiliation(s)
- Cécile Derieux
- grid.464126.30000 0004 0385 4036Physiologie de la Reproduction et des Comportements, INRAE UMR0085, CNRS UMR7247, IFCE, Université de Tours, Inserm, 37380 Nouzilly, France ,grid.12366.300000 0001 2182 6141UMR1253, iBrain, Université de Tours, Inserm, CNRS, Faculté des Sciences et Techniques, Parc de Grandmont, 37200 Tours, France ,grid.121334.60000 0001 2097 0141Institut de Génomique Fonctionnelle (IGF), Université de Montpellier, CNRS, Inserm, 34094 Montpellier, France
| | - Audrey Léauté
- grid.464126.30000 0004 0385 4036Physiologie de la Reproduction et des Comportements, INRAE UMR0085, CNRS UMR7247, IFCE, Université de Tours, Inserm, 37380 Nouzilly, France
| | - Agathe Brugoux
- grid.464126.30000 0004 0385 4036Physiologie de la Reproduction et des Comportements, INRAE UMR0085, CNRS UMR7247, IFCE, Université de Tours, Inserm, 37380 Nouzilly, France ,grid.12366.300000 0001 2182 6141UMR1253, iBrain, Université de Tours, Inserm, CNRS, Faculté des Sciences et Techniques, Parc de Grandmont, 37200 Tours, France
| | - Déborah Jaccaz
- Unité Expérimentale de Physiologie Animale de l’Orfrasière, INRAE UE0028, 37380 Nouzilly, France
| | - Claire Terrier
- grid.464126.30000 0004 0385 4036Physiologie de la Reproduction et des Comportements, INRAE UMR0085, CNRS UMR7247, IFCE, Université de Tours, Inserm, 37380 Nouzilly, France ,grid.12366.300000 0001 2182 6141UMR1253, iBrain, Université de Tours, Inserm, CNRS, Faculté des Sciences et Techniques, Parc de Grandmont, 37200 Tours, France
| | - Jean-Philippe Pin
- grid.121334.60000 0001 2097 0141Institut de Génomique Fonctionnelle (IGF), Université de Montpellier, CNRS, Inserm, 34094 Montpellier, France
| | - Julie Kniazeff
- grid.121334.60000 0001 2097 0141Institut de Génomique Fonctionnelle (IGF), Université de Montpellier, CNRS, Inserm, 34094 Montpellier, France
| | - Julie Le Merrer
- Physiologie de la Reproduction et des Comportements, INRAE UMR0085, CNRS UMR7247, IFCE, Université de Tours, Inserm, 37380, Nouzilly, France. .,UMR1253, iBrain, Université de Tours, Inserm, CNRS, Faculté des Sciences et Techniques, Parc de Grandmont, 37200, Tours, France.
| | - Jerome A. J. Becker
- grid.464126.30000 0004 0385 4036Physiologie de la Reproduction et des Comportements, INRAE UMR0085, CNRS UMR7247, IFCE, Université de Tours, Inserm, 37380 Nouzilly, France ,grid.12366.300000 0001 2182 6141UMR1253, iBrain, Université de Tours, Inserm, CNRS, Faculté des Sciences et Techniques, Parc de Grandmont, 37200 Tours, France
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Shaw KA, McArthur D, Hughes MM, Bakian AV, Lee LC, Pettygrove S, Maenner MJ. Progress and Disparities in Early Identification of Autism Spectrum Disorder: Autism and Developmental Disabilities Monitoring Network, 2002-2016. J Am Acad Child Adolesc Psychiatry 2022; 61:905-914. [PMID: 34838692 PMCID: PMC9353949 DOI: 10.1016/j.jaac.2021.11.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/28/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Early identification can improve outcomes for children with autism spectrum disorder (ASD). We sought to assess changes in early ASD identification over time and by co-occurring intellectual disability (ID) and race/ethnicity. METHOD Using data for 2002-2016 from a biennial population-based ASD surveillance program among 8-year-old children in the United States, we defined identification as a child's earliest recorded ASD diagnosis or special education eligibility. Unidentified children had characteristics meeting the ASD surveillance case definition but no recorded identification by age 8 years. We calculated median age at identification among identified children, median age at identification including unidentified children, and cumulative incidence of identification by age 48 months. RESULTS ASD identification by age 48 months was 4 times (95% CI: 3.6-4.3) as likely in 2016 as in 2002, with the largest increases among children without ID. Median age at ASD identification among identified children decreased 3 months during this time. Children of every race/ethnicity were more likely to be identified over time. There were racial disparities stratified by ID: in 2016, Black and Hispanic children without ID were less likely to be identified with ASD than were White children (both groups risk ratio: 0.7; 95% CI: 0.5-0.8), but Black children were 1.5 times (95% CI: 1.3-1.9) as likely as White children to be identified with ASD and ID. CONCLUSION Substantial progress has been made to identify more children with ASD early, despite minimal decrease in median age at diagnosis. Considerable disparities remain in early ASD identification by race/ethnicity and co-occurring intellectual disability.
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Affiliation(s)
- Kelly A Shaw
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Dedria McArthur
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michelle M Hughes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Matthew J Maenner
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Lynch GTF, James SM, Cardon TA, McPherson SM. Sensitivity and specificity of pupillary light reflex measures for ASD using monocular pupillometry. Neurol Sci 2022; 43:4537-4545. [DOI: 10.1007/s10072-022-05976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 02/23/2022] [Indexed: 10/19/2022]
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Puglisi A, Caprì T, Pignolo L, Gismondo S, Chilà P, Minutoli R, Marino F, Failla C, Arnao AA, Tartarisco G, Cerasa A, Pioggia G. Social Humanoid Robots for Children with Autism Spectrum Disorders: A Review of Modalities, Indications, and Pitfalls. CHILDREN 2022; 9:children9070953. [PMID: 35883937 PMCID: PMC9316169 DOI: 10.3390/children9070953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Robot-assisted therapy (RAT) is a promising area of translational neuroscience for children with autism spectrum disorders (ASDs). It has been widely demonstrated that this kind of advanced technological tool provides a reliable and efficient intervention for promoting social skills and communication in children with ASD. This type of treatment consists of a human-assisted social robot acting as an intervention mediator to increase competence and skills in children with ASD. Several social robots have been validated in the literature; however, an explicit technical comparison among devices has never been performed. For this reason, in this article, we provide an overview of the main commercial humanoid robots employed for ASD children with an emphasis on indications for use, pitfalls to be avoided, and recent advances. We conclude that, in the near future, a new generation of devices with high levels of mobility, availability, safety, and acceptability should be designed for improving the complex triadic interaction among teachers, children, and robots.
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Affiliation(s)
- Alfio Puglisi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Tindara Caprì
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
- Department of Life and Health Sciences, Link Campus University, Via del Casale di S. Pio V, 44, 00165 Rome, Italy
| | | | - Stefania Gismondo
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Roberta Minutoli
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Antonino Andrea Arnao
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
- S’Anna Institute, 88900 Crotone, Italy;
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Arcavacata, Italy
- Correspondence:
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
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Wong WCP, Chow SL. Evaluation on the effectiveness on the implementation of WHO caregiver skills training (CST) programme in Hong Kong: a randomised controlled trial protocol. BMJ Open 2022; 12:e054099. [PMID: 35725254 PMCID: PMC9214403 DOI: 10.1136/bmjopen-2021-054099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION This protocol delineates the research design and analytical framework used to evaluate the effectiveness of the WHO-CST (CST, caregiver skills training) in Hong Kong. The WHO-CST aims to enhance the caregiver skills of parents of children with potential autism spectrum disorders (ASD) and/or developmental delays. METHODS AND ANALYSIS In this study, 130 eligible caregiver-child dyads were recruited and randomly assigned to the experimental and wait-list-control groups. A randomised controlled trial design was adopted to compare the changes between the two groups regarding caregivers' skills, knowledge and practices when interacting with their children with impairments due to ASD. Assessments were conducted before, immediately after and 1 month after the completion of the WHO-CST programme. The primary measurement tool was the joint engagement rating inventory developed by WHO experts to gauge how parents engage their children. A 10-min video recording of their dyadic interaction and behaviours in a defined play setting was used for the measurement. A set of other measurements of caregivers' knowledge, confidence and experience of using the caregiving skills were also measured. ETHICS AND DISSEMINATION Ethics approval was received from the Human Research Ethics Committee (EA1901033), The University of Hong Kong. The final findings of this study will be disseminated through public reports, peer-reviewed publication or at a conference launched for the WHO-CST programme. TRIAL REGISTRATION NUMBER ChiCTR2000034585.
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Affiliation(s)
- Wai-Ching Paul Wong
- Department of Social Work and Social Administration, University of Hong Kong Faculty of Social Sciences, Hong Kong
| | - Siu-Lun Chow
- Department of Social Work and Social Administration, University of Hong Kong Faculty of Social Sciences, Hong Kong
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Marszałek A, Kasperczyk T, Walaszek R. Dog Therapy in Supporting the Rehabilitation Process of Children with Autism. REHABILITACJA MEDYCZNA 2022. [DOI: 10.5604/01.3001.0015.8748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Autism is not a specific condition. It is, however, a comprehensive disorder of psychomotor and social development. A number of factors, both environmental (family-related) and genetic, are believed to be the cause of autism. The percentage of children affected by autism has been increasing over the past 20 years. It is assumed that statistically, approximately 20 children in every 10,000 will become affected by this condition. Autism is 4 times more common in boys than in girls. The disorder is characterised by impaired mental growth, and, consequently, social and motor development.
Research objective: The aim of the article is to present the role of dog therapy in supporting the process of therapeutic rehabilitation among children with autism. In particular, the following aspects were taken into account: breeds of canines used in dog therapy, mechanisms of influence concerning dog therapy on the child's body, as well as the forms and results obtained.
Material and methods: The work is a narrative review. It was written on the basis of the document analysis method with the use of quantitative and qualitative techniques, as well as database searches for Polish and foreign scientific literature on the subject, i.e. Web of Science, PubMed and Google Scholar. In the article, the research results are presented in relation to the efficiency of applying dog therapy in the treatment of autistic children between 2002 and 2017, with emphasis on foreign literature.
Results: The most commonly used forms of dog therapy used are: Animal Assisted Activity (AAA), Animal Assisted Therapy (AAT) and Animal Assisted Education (AAE).
Conclusions: The use of dogs in the process of therapeutic rehabilitation has positive influence both on the autistic child and his/her family environment. It helps cope better with many difficulties and motivates to take up more activities. Dog therapy affects all spheres of personal development, i.e. mental, motor and socio-emotional.
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Affiliation(s)
- Anna Marszałek
- Public Elementary School – Friends of Catholic School Association, Hucisko-Pewelka, Poland
| | - Tadeusz Kasperczyk
- Department of Aesthetic Cosmetology, University of Physical Education, Kraków, Poland
| | - Robert Walaszek
- Department of Recreology and Biological Regeneration, University of Physical Education, Krakow, Poland
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Sterrett K, Magaña MT, Gulsrud A, Paparella T, Kasari C. Predictors of Attrition in a Randomized Trial of a Social Communication Intervention for Infant-Toddlers at Risk for Autism. J Autism Dev Disord 2022:10.1007/s10803-022-05616-w. [PMID: 35678946 DOI: 10.1007/s10803-022-05616-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Addressing factors that make it more likely for families to attrite from early intervention trials will allow researchers to ensure that families reap the full benefits of participation. This study was an analysis of 78 children (Mage = 18.38 months, SD = 5.78) at risk for autism participating in a university-based randomized controlled trial of two 8-week long early intervention programs. Overall, attrition through 8-weeks was low, approximately 13%, however by the one-year follow-up attrition rates were approximately 50%. The most consistent predictor of attrition was the distance that families had to travel to the university. These data highlight the importance of providing services and support (e.g., financial and logistic) during follow-up to families to maximize their participation. Clincaltrials.gov Identifier: NCT01874327, 6/11/2013.
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Affiliation(s)
- Kyle Sterrett
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States. .,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza 68-262B, 90024, Los Angeles, CA, United States.
| | - Maira Tafolla Magaña
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| | - Amanda Gulsrud
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| | - Tanya Paparella
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| | - Connie Kasari
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
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Cleary DB, Bunney A, Henry L, Renton M, Granich J, Green J, Maybery MT, Whitehouse AJO. A Parent-Mediated Intervention for Newborns at Familial Likelihood of Autism: Initial Feasibility Study in the General Population. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 6:494-505. [PMID: 35698574 PMCID: PMC9178338 DOI: 10.1007/s41252-022-00262-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Developmental theory and previous studies support the potential value of prodromal interventions for infants at elevated likelihood of developing autism. Past research has supported the efficacy of parent-mediated prodromal therapies with infants from as early as 7 months. We outline the rationale for implementing interventions following this model from even earlier in development and report on the feasibility of a novel intervention developed following this model of parent-mediated infant interventions. METHODS We report a feasibility study (n = 13) of a parent-mediated, video-aided intervention, beginning during pregnancy, focussed on parent-infant interactions. The study evaluated the feasibility of this intervention initially with a general population sample. Feasibility was assessed across four domains (acceptability, implementation, practicality and integration) using self-report questionnaire, semi-structured interviews with parents and therapists, attendance and assessment completion. RESULTS Feasibility assessment shows that the intervention was acceptable, with all participants reporting that they had benefited from the program, with perceived positive benefits to their understanding of and communication with their infant, and that they had integrated program teachings into everyday life. The intervention was implemented as planned with 100% attendance for the core sessions. Changes to minimise the number of antenatal sessions was suggested to improve practicality. CONCLUSIONS This study found initial feasibility for this intervention in a general population sample. This suggests parent-mediated video feedback interventions are a promising format to be implemented within the perinatal developmental time period.
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Affiliation(s)
- Dominique B. Cleary
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, Western Australia 6008 Australia
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Angela Bunney
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, Western Australia 6008 Australia
| | - Lindy Henry
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, Western Australia 6008 Australia
| | - Michelle Renton
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, Western Australia 6008 Australia
| | - Joanna Granich
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, Western Australia 6008 Australia
| | - Jonathan Green
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Murray T. Maybery
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Andrew J. O. Whitehouse
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, Western Australia 6008 Australia
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Autism Screening Practices in Preschools and Early Childcare Centers: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00323-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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118
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Yaylaci F, Guller B. Diagnostic evaluation of patients referred by family physicians with the suspicion of autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 69:936-945. [PMID: 37885848 PMCID: PMC10599202 DOI: 10.1080/20473869.2022.2070419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/18/2022] [Indexed: 10/28/2023]
Abstract
Current evidence shows that early interventions in children with autism spectrum disorder (ASD) are more efficient and associated with better long-term outcomes. This also highlights the need for early recognition of children with ASD symptoms by family physicians and referral to child psychiatrists. This study aimed to evaluate how family physicians' knowledge about ASD is reflected in clinical practice by making a diagnostic evaluation of the cases referred with suspected ASD. The study included 149 cases that family physicians referred to child psychiatrists regarding the assessment for ASD. Diagnostic evaluation of the subjects was carried out using the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used in the evaluation process. Denver II developmental screening inventory was used to evaluate all subjects under six. The mean age of all participants was 39.1 (±13.2) months, and in ASD cases, it was 34.6 (±7.8) months. Of all referred cases, 72,5% were diagnosed according to the DSM-5 criteria. The most common diagnoses were global developmental delay (28.9%), language disorder (15.4%), ASD (15.4%), and attention deficit hyperactivity disorder (8.7%), respectively. The most common reason for referral specified on the consultation note was delayed speech, with a rate of 87.2%. In addition, 148 (99.3%) of the symptoms noted on the referral note were clustered within the DSM-5 ASD A criteria and 19 (12.8%) within the ASD B criteria. Developmental delay was more prominent in cases with ASD when compared to those with global developmental delay and language disorder. The most common diagnosis was a global developmental delay in referred cases, and only some of the symptoms seen in ASD from the referral notes of family physicians stood out as the reason for referral. These results underline the necessity of continuing ASD training for family physicians.
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Affiliation(s)
- Ferhat Yaylaci
- Department of Child and Adolescent Psychiatry, Bursa Dörtcelik Child Hospital, Bursa, Turkey
| | - Baris Guller
- Department of Child and Adolescent Psychiatry, Bursa Dörtcelik Child Hospital, Bursa, Turkey
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Dockrell JE, Forrest CL, Law J, Mathers S, Charlton J. Screening for Language Difficulties in Disadvantaged Populations on Entry to Early Years Education: Challenges and Opportunities. Front Pediatr 2022; 10:833603. [PMID: 35601421 PMCID: PMC9119430 DOI: 10.3389/fped.2022.833603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/18/2022] [Indexed: 11/30/2022] Open
Abstract
Children aged 3-4 years (n = 876) were recruited from deprived areas in England, and a significant minority of the sample were second language learners. Oral language ability was assessed using child administered standardized measures, and parents reported on children's language. We adapted the Language Use Inventory [LUI; (1)] to capture carer's reports of the children's structural language in the language of instruction and their home language (where appropriate). The final measure included six subscales from the original: use of simple words, requests for help, gaining attention, talking about activities/actions, interactions with others, and building sentences. Children's language abilities and non-verbal abilities were below norms on all standardized tests administered except non-word repetition. Factor analysis indicated that all the six scales of the adapted parent completed measure loaded on one language factor. The revised total scale score correlated significantly (p < 0.0005) with child assessed language measures, specifically expressive vocabulary and grammar. Different patterns across gender, language status and parental education were examined. Sensitivity and specificity of the scale to identify children with the greatest delays were evaluated. These preliminary data indicated that parent-reported information on children's language skills at 3 years of age has the potential to provide a reliable indicator to inform pedagogy and practice at the start of nursery school. Study limitations are examined and avenues for future development explored.
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Affiliation(s)
- Julie E. Dockrell
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - Claire L. Forrest
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - James Law
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sandra Mathers
- Department of Education, Social Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Jenna Charlton
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Waddington H, Macaskill E, Whitehouse AJO, Billingham W, Alvares GA. Parent-reported atypical development in the first year of life and age of autism diagnosis. J Autism Dev Disord 2022:10.1007/s10803-022-05506-1. [PMID: 35441920 DOI: 10.1007/s10803-022-05506-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 10/18/2022]
Abstract
This study examined whether parent-reported atypical development in their child's first year was associated with age of diagnosis and age when parents first needed to consult a specialist about their child's development. It involved 423 children who participated in the Australian Autism Biobank. Most parents retrospectively identified ≥ 1 domain of atypical child development. Atypical development in most domains was associated with an earlier age when parents felt specialist consultation was needed. Atypical development in the "gaze abnormalities", "lack of response to social stimuli", and "no social communication" subdomains within the social domain was associated with an earlier age of diagnosis, as was atypical development in the "hypo/hypersensitivity" and "preoccupation with parts of objects" subdomains within the stereotyped/restricted behavior domain.
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Affiliation(s)
- Hannah Waddington
- School of Education, Victoria University of Wellington, Wellington, New Zealand.
| | - Ella Macaskill
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Wesley Billingham
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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Wolff N, Stroth S, Kamp-Becker I, Roepke S, Roessner V. Autism Spectrum Disorder and IQ - A Complex Interplay. Front Psychiatry 2022; 13:856084. [PMID: 35509885 PMCID: PMC9058071 DOI: 10.3389/fpsyt.2022.856084] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/02/2022] [Indexed: 01/02/2023] Open
Abstract
Autism spectrum disorder (ASD) is characterized as a very heterogeneous child-onset disorder, whose heterogeneity is partly determined by differences in intelligence quotient (IQ). Older epidemiological studies suggested that the IQ-related spectrum tends to be skewed to the left, i.e., a larger proportion of individuals with ASD have below average intelligence, while only few individuals with ASD may have an IQ above average. This picture changed over time with broadening the spectrum view. Within the present perspective article, we discuss discrepancies in IQ profiles between epidemiological and clinical studies and identify potential underlying aspects, for example, the influence of external factors such as sample biases or differences in availability of autism health services. Additionally, we discuss the validity and reciprocal influences of ASD diagnostics and IQ measurement. We put the impact of these factors for diagnostic as well as care and support situations of patients into perspective and want to encourage further research to contribute to the conceptualization of "autism" more comprehensively including the IQ as well as to examine broader (life) circumstances, interacting factors and diagnostic requirements of given diagnoses in childhood as compared to adulthood.
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Affiliation(s)
- Nicole Wolff
- Department of Child and Adolescent Psychiatry, Medical Faculty of the Technische Universität (TU) Dresden, Dresden, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Stefan Roepke
- Department of Psychiatry, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Medical Faculty of the Technische Universität (TU) Dresden, Dresden, Germany
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Zhao H, Zaini Amat A, Migovich M, Swanson A, Weitlauf AS, Warren Z, Sarkar N. INC-Hg: An Intelligent Collaborative Haptic-Gripper Virtual Reality System. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2022. [DOI: 10.1145/3487606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Collaborative Virtual Environments (CVE) have shown potential to be an effective social skill training platform for children with Autism Spectrum Disorders (ASD) to learn and practice collaborative and communication skills through peer interactions. However, most existing CVE systems require that appropriately matched partners be available at the same time to promote interaction, which limits their applicability to some community settings due to scheduling constraints. A second shortcoming of these more naturalistic peer-based designs is the intensive resources required to manually code the unrestricted conversations that occurred during the peer-based interactions. To preserve the benefits of CVE-based platforms and mitigate some of the resource limitations related to peer availability, we developed an Intelligent Collaborative Haptic-Gripper System (INC-Hg). This system provides an intelligent agent partner who can understand, communicate, and haptically interact with the user, without requiring the presence of another human peer. The INC-Hg operates in real time and thus is able to perform collaborative training tasks at any time and at the user's pace. INC-Hg can also record the real-time data regarding spoken language and task performance, thereby greatly reducing the resource burden of communication and interaction performance analysis. A preliminary usability study with 10 participants with ASD (ages 8–12 years) indicated that the system could classify the participant's utterances into five classes with an accuracy of 70.34%, which suggested the potential of INC-Hg to automatically recognize and analyze conversational content. The results also indicated high accuracies of the agent to initiate a conversation (97.56%) and respond to the participants (86.52%), suggesting the capability of the agent to conduct proper conversations with the participants. Compared to the results of human-to-human collaborative tasks, the human-to-agent mode achieved higher average collaborative operation ratio (61% compared to 40%) and comparable average frequencies for Initiations and Responses among the participants with ASD. These results offer preliminary support as well as areas of improvement regarding the agent's ability to respond to participants, work with participants to complete tasks, engage in back-and-forth conversations, and support the potential of the agent to be a useful partner for individuals with ASD completing CVE tasks.
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Affiliation(s)
- Huan Zhao
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University, Nashville, Tennessee
| | - Ashwaq Zaini Amat
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University, Nashville, Tennessee Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Miroslava Migovich
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University, Nashville, Tennessee Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Amy Swanson
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University, Nashville, Tennessee
| | - Amy S. Weitlauf
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University, Nashville, Tennessee
| | - Zachary Warren
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University, Nashville, Tennessee
| | - Nilanjan Sarkar
- Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee
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123
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Rivard M, Mestari Z, Morin D, Coulombe P, Mello C, Morin M. Cluster Analysis of Clinical Features of Children Suspected to Have Neurodevelopmental Disorders. J Autism Dev Disord 2022; 53:2409-2420. [DOI: 10.1007/s10803-022-05533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
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124
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Salgado-Cacho JM, Moreno-Jiménez MDP, Ríos-Rodríguez ML. Intensive Family Intervention as Support for Professional Treatment: Evolution of Symptoms in a Diagnosed Case of Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:400. [PMID: 35327776 PMCID: PMC8946976 DOI: 10.3390/children9030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
This article shows the progress achieved in a child who has received professional treatment combined with a family intervention at home. It discusses a 22-month-old patient identified as showing warning signs of autism spectrum disorder (ASD), a diagnosis that was subsequently confirmed through a standardized ADOS-2 test at 31 months of age. To establish the initial working objectives, a functional diagnosis was carried out at 23 months of age using the Battelle Developmental Inventory; a maturational delay was detected, situating the child at an age equivalent to 16 months. A professional intervention was designed in an early childhood care center, complemented by family intervention, so that the hours in which the child participated in learning experiences were increased. Notable advances were made in the areas of cognitive and motor skills, with more standard scores than when initially evaluated. Progress was also observed (though to a lesser extent) in other developmental areas such as language total, adaptive behavior, and self-help, while slight delays in the areas of socio-emotional development and reasoning and academic skills were found.
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Affiliation(s)
- José María Salgado-Cacho
- Faculty of Psychology, University of Málaga, 29010 Málaga, Spain; (M.d.P.M.-J.); (M.L.R.-R.)
- Hogar Abierto Foundation, 29001 Málaga, Spain
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125
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Wallis KE, Abdul-Chani MM, Zuckerman KE. Screen Often and With Trusted Community Members to Improve Autism Identification for Latine Children. JAMA Pediatr 2022; 176:229-231. [PMID: 34982108 DOI: 10.1001/jamapediatrics.2021.5377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kate E Wallis
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Katharine E Zuckerman
- Division of General Pediatrics, Oregon Health & Science University, Portland.,Oregon Health & Science University-Portland State University School of Public Health, Portland
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126
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Eilenberg JS, Kizildag D, Blakey A, Cardona ND, Oberoi A, Broder-Fingert S, Feinberg E, Long KA. Implications of Universal Autism Screening: Perspectives From Culturally Diverse Families With False-Positive Screens. Acad Pediatr 2022; 22:279-288. [PMID: 34963655 PMCID: PMC8939055 DOI: 10.1016/j.acap.2021.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The American Academy of Pediatrics (AAP) recommends that pediatricians screen all young children for autism spectrum disorder (ASD). However, the US Preventive Services Task Force stated that there is insufficient evidence about the potential harms and benefits of universal ASD screening. To address this gap, we conducted qualitative interviews with caregivers of children who received a false-positive ASD screen to learn about families' perceptions of the harms and benefits of universal ASD screening. METHODS Culturally diverse caregivers (N = 26) of children with false-positive ASD screens completed qualitative interviews focused on parents' experiences with and recommendations to improve the ASD screening and evaluation process. Interviews were transcribed verbatim, coded, and analyzed using applied thematic analysis. RESULTS Parents explained that the ASD screening and evaluation process increased their knowledge about child development and substantiated existing concerns. The ASD screening and evaluation process resulted in connecting their child to services, which parents felt led to improvements in their child's delays. Parents endorsed anxiety during wait times for the formal developmental assessment. However, all parents expressed that, if given the option, they would repeat the screening and evaluation process again. Caregivers recommended universal screening for ASD and suggested that screening extend beyond the pediatrician to other settings. CONCLUSIONS From parents' perspectives, the connection to developmental services and increased knowledge of child development that resulted from the false-positive ASD screen outweighed the time-limited emotional distress triggered by a positive ASD screen. Overall, parents' preferences for universal ASD screening align with the AAP's recommendations.
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Affiliation(s)
- Jenna Sandler Eilenberg
- Department of Psychological and Brain Sciences, Boston University (JS Eilenberg, D Kizildag, AO Blakey, ND Cardona, A Oberoi, and KA Long), Boston, Mass.
| | - Deniz Kizildag
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA
| | - Ariel Blakey
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA
| | - Nicole D. Cardona
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA
| | - Anjali Oberoi
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA
| | - Sarabeth Broder-Fingert
- Department of Pediatrics, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Emily Feinberg
- Department of Pediatrics, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA,Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA
| | - Kristin A. Long
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA
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127
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Penney AM, Greenson J, Schwartz IS, Estes AM. "On-Time Autism Intervention": A Diagnostic Practice Framework to Accelerate Access. Front Psychiatry 2022; 13:784580. [PMID: 35250660 PMCID: PMC8891635 DOI: 10.3389/fpsyt.2022.784580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
It is well-documented that autism can be reliably diagnosed by age two and that early signs emerge most often between 18 and 24 months. However, despite the increased awareness and focus on early diagnosis, the average age of diagnosis is over 4 years old; even later for Black children and those who are Medicaid-eligible. In this paper, we will propose a framework for accurate and accelerated autism diagnosis for children before age three. The proposed framework emphasizes a collaborative diagnostic process, which relies heavily on Birth to Three provider knowledge and expertise. Considerations for next steps are presented. This approach could increase access to diagnosis of young children soon after first signs of autism emerge.
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128
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Hsu YH, Chen CW, Lin YJ, Li CY. Urban-Rural Disparity in the Incidence of Diagnosed Autism Spectrum Disorder in Taiwan: A 10-Year National Birth Cohort Follow-up Study. J Autism Dev Disord 2022; 53:2127-2137. [PMID: 35132529 DOI: 10.1007/s10803-022-05453-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 12/15/2022]
Abstract
Autism spectrum disorder (ASD) is reportedly more prevalent in urban areas partly because of better accessibility and affordability to healthcare. With universal health insurance coverage in Taiwan, a previous study has shown no urban-rural disparity in the utilization rate of a child's preventive healthcare. Under this circumstance, we followed a birth cohort of 176,273 live births from 2006 to 2015 to detect the differences in ASD incidence between urbanicities. After adjusting for socioeconomic factors, children were 1.28 (95% confidence interval (CI): 1.13-1.44) and 1.54 (95% CI: 1.36-1.75) more likely to acquire ASD in satellite and urban areas compared with those in rural areas, respectively. A gradient association between parental educational attainment and ASD incidence was also noted. Greater ASD incidences in more urbanized areas and more advanced educated parents' children were detected under a circumstance with low barriers to healthcare.
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Affiliation(s)
- Yuu-Hueih Hsu
- Department of Public Health, National Cheng Kung University, No. 138, Shengli Rd., North Dist., Tainan, 704302, Taiwan
| | - Chi-Wen Chen
- College of Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, 112, Taiwan
| | - Yuh-Jyh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, No. 138, Shengli Rd., North Dist., Tainan, 704302, Taiwan
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, No. 138, Shengli Rd., North Dist., Tainan, 704302, Taiwan. .,Department of Public Health, College of Public Health, China Medical University, No. 91, Hsueh-Shih Rd., Taichung, 40402, Taiwan. .,Department of Healthcare Administration, College of Medical and Health Science, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan.
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129
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DeGuzman PB, Lyons G, Huang G, Keim-Malpass J, Mazurek MO. Statewide Analysis Reveals Period of Well-Child Visit Attendance for Earlier Diagnosis of Autism Spectrum Disorder. J Pediatr 2022; 241:181-187.e1. [PMID: 34571021 DOI: 10.1016/j.jpeds.2021.09.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 09/13/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore the relationship between well-child visit (WCV) attendance during early childhood and age at autism spectrum disorder (ASD) diagnosis using data drawn from a statewide all-payer claims database. STUDY DESIGN We used a correlational study design with longitudinal data drawn from the Virginia All-Payer Claims Database. All children born in 2011 with a diagnosis of ASD were included (n = 253). Survival analysis determined the impact of WCV attendance on ASD diagnosis at each American Academy of Pediatrics-recommended early childhood visit, and the 5-year visit. RESULTS Survival analysis revealed a significant impact of WCV attendance at the 24-month, 3-, and 4-year visits on earlier ASD diagnosis. Children who attended the 24-month visit were diagnosed nearly 10 months earlier than those who did not. Overall, children with ASD attended fewer than 50% of visits during early childhood. CONCLUSIONS Promoting consistent WCV attendance during early childhood is an actionable strategy for improving early identification of ASD. Further exploration is needed to determine barriers to visit attendance and the impact of patterns of early childhood WCV attendance on age of ASD diagnosis. Development and implementation of interventions to promote adherence to the American Academy of Pediatrics-recommended visits is needed.
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Affiliation(s)
| | - Genevieve Lyons
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA
| | - Guoping Huang
- Department of Geography and the Environment, University of Richmond, Richmond, VA
| | | | - Micah O Mazurek
- University of Virginia School of Education and Human Development, Charlottesville, VA
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130
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Petruccelli M, Ramella L, Schaefer AJ, Sheldrick RC, Carter AS, Eisenhower A, Broder-Fingert S, Mackie TI. A Taxonomy of Reported Harms in Pediatric Autism Spectrum Disorder Screening: Provider and Parent Perspectives. J Autism Dev Disord 2022; 52:647-673. [PMID: 33751375 PMCID: PMC8455720 DOI: 10.1007/s10803-021-04964-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 02/03/2023]
Abstract
The U.S. Preventive Services Task Force (USPSTF) report on screening for Autism Spectrum Disorder (ASD) highlighted the need for research that examines the harms potentially associated with screening so as to assess the overall net benefit of universal screening. In response, this study engages qualitative, semi-structured interviews to generate a taxonomy outlining potential harms reported by parents and providers (pediatricians and Early Intervention providers) with experience in screening young children for ASD. Potential harms emerged including: physical, psychological, social, logistical/financial, opportunity cost, attrition, and exacerbation of non-targeted disparities. Respondents reported harms being experienced by the toddlers, parents, and providers. The harms reported highlight opportunities for providers to offer resources that mitigate the potential for these unintended consequences.
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Affiliation(s)
- Marisa Petruccelli
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA
| | - Leah Ramella
- Department of Health Law, Policy and Management, School of Public Health, Boston University, One Silber Way, Boston, MA 02215, USA
| | - Ana J. Schaefer
- 683 Hoes Lane West, Rutgers School of Public Health, Piscataway, NJ, USA
| | - R. Christopher Sheldrick
- Department of Health Law, Policy and Management, School of Public Health, Boston University, One Silber Way, Boston, MA 02215, USA
| | - Alice S. Carter
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA
| | - Abbey Eisenhower
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA
| | | | - Thomas I. Mackie
- 683 Hoes Lane West, Rutgers School of Public Health, Piscataway, NJ, USA,112 Paterson Ave, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA 08901
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131
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Li M, Zhao SX, Chen WJ, Huang TY, Chen LS. Knowledge and Attitudes toward Genetic Testing for Autism Spectrum Disorders among Parents of Affected Children in Taiwan. Genes (Basel) 2022; 13:239. [PMID: 35205283 PMCID: PMC8871752 DOI: 10.3390/genes13020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023] Open
Abstract
The prevalence of autism spectrum disorders (ASD) in Taiwan has been increasing, and genetic testing for ASD has been available and provided to parents of children diagnosed with ASD in Taiwan. However, there is still limited understanding of Taiwanese parents' knowledge of and attitudes toward such testing. Therefore, the present study addressed this gap by assessing the attitudes toward as well as actual and perceived knowledge of ASD genetic testing among Taiwanese parents of children diagnosed with ASD. A sample of 443 parents of children with ASD recruited from 236 public schools in Taiwan completed a paper-and-pencil survey. Although parents generally held favorable attitudes toward ASD genetic testing, they had deficient knowledge of such test (with only a 31.4% average correct rate on the actual knowledge scale). Tailored health education materials should be developed to improve the knowledge of ASD genetic testing among parents with affected children in Taiwan.
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Affiliation(s)
- Ming Li
- Department of Health Sciences, Towson University, Towson, MD 21252, USA;
| | - Shi-Xi Zhao
- Department of Health, Exercise & Sports Sciences, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Wei-Ju Chen
- Department of Psychology, The University of Texas Permian Basin, Odessa, TX 79762, USA;
| | - Tse-Yang Huang
- Department of Special Education, National Tsing Hua University, Hsinchu 30013, Taiwan;
| | - Lei-Shih Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, TX 77843, USA
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132
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Deep learning-based school attendance prediction for autistic students. Sci Rep 2022; 12:1431. [PMID: 35082310 PMCID: PMC8791997 DOI: 10.1038/s41598-022-05258-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/07/2022] [Indexed: 12/31/2022] Open
Abstract
Autism Spectrum Disorder is a neurodevelopmental disorder characterized by deficits in social communication and interaction as well as the presence of repetitive, restricted patterns of behavior, interests, or activities. Many autistic students experience difficulty with daily functioning at school and home. Given these difficulties,
regular school attendance is a primary source for autistic students to receive an appropriate range of needed educational and therapeutic interventions. Moreover, school absenteeism (SA) is associated with negative consequences such as school drop-out. Therefore, early SA prediction would help school districts to intervene properly to ameliorate this issue. Due to its heterogeneity, autistic students show within-group differences concerning their SA. A comprehensive statistical analysis performed by the authors shows that the individual and demographic characteristics of the targeted population are not predictive factors of SA. So, we used the students’ recent previous attendance to predict their future attendance. We introduce a deep learning-based framework for predicting short-and long-term SA of autistic students using the Long Short-Term Memory (LSTM) and Multilayer Perceptron (MLP) algorithms. The adopted algorithms outperform other machine learning algorithms. In detail, LSTM increased the accuracy and recall of short-term SA prediction by 20% and 13%, while the same scores of long-term SA prediction increased by 5% using MLP.
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133
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Sukiennik R, Marchezan J, Scornavacca F. Challenges on Diagnoses and Assessments Related to Autism Spectrum Disorder in Brazil: A Systematic Review. Front Neurol 2022; 12:598073. [PMID: 35126275 PMCID: PMC8812524 DOI: 10.3389/fneur.2021.598073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Being a continental country, with over 210 million citizens, Brazil is similar to all of those who are part of the LAMIC (Low and middle income countries). It shows a big concentration of wealth, mainly in its south and southeast regions, as well as areas with immense poverty. In that sense, the health system also faces a huge amount of contrast. Inside University hospitals and facilities there are sophisticated tools and trained doctors prepared to assist in any kind of medical subject, including autism. But, unfortunately, at other times, the access to a good health system is made much harder. This results in many issues in the medical community, e.g., looking at the data regarding autism, there is a high average of the age of diagnosis. Another issue is the low number of professionals trained in ASD diagnosis and the few tools translated to Portuguese.
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Affiliation(s)
- Ricardo Sukiennik
- Pediatrics Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Josemar Marchezan
- Pediatrics Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
- Postgraduate Program in Medical Sciences, Universidade do Vale do Taquari (Univates), Lajeado, Brazil
| | - Francisco Scornavacca
- Pediatrics Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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134
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Experiences and Attitudes on Early Identification Practices of Autism: A Preliminary Survey of Pediatric Professionals in Ecuador. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020123. [PMID: 35204844 PMCID: PMC8869979 DOI: 10.3390/children9020123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/16/2022]
Abstract
Early identification of children with autism is necessary to support their social and communicative skills and cognitive, verbal, and adaptive development. Researchers have identified several barriers to early diagnosis. Data collected in low- and middle-income contexts—where the vast majority of children in the world live—is scarce. In Ecuador, as in many other countries, estimates are lower compared to the global prevalence. Health authorities estimate a prevalence of 0.28% (0.18%–0.41%) in children aged five years old or less. Based on the hypothesis that, as in many parts of the world, children in Ecuador are not routinely screened and that this situation may result from poor recognition of this condition, our objective was to identify potential obstacles to case identification in pediatric settings. Several barriers, consistent with those identified in other countries, were reported by 153 participants on a survey, including lack of time, lack of resources to refer, fear of unnecessarily alarming families, and lack of information to guide families with concerns. The vast majority of participants are aware of the need for a screening tool for autism detection but report a lack of knowledge of its formal application. Most of the barriers reported in this study could be overcome by educational programs tailored to professional needs in order to support the well-being of children with autism and their families.
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135
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Chevalier P, Ghiglino D, Floris F, Priolo T, Wykowska A. Visual and Hearing Sensitivity Affect Robot-Based Training for Children Diagnosed With Autism Spectrum Disorder. Front Robot AI 2022; 8:748853. [PMID: 35096980 PMCID: PMC8790526 DOI: 10.3389/frobt.2021.748853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/09/2021] [Indexed: 11/20/2022] Open
Abstract
In this paper, we investigate the impact of sensory sensitivity during robot-assisted training for children diagnosed with Autism Spectrum Disorder (ASD). Indeed, user-adaptation for robot-based therapies could help users to focus on the training, and thus improve the benefits of the interactions. Children diagnosed with ASD often suffer from sensory sensitivity, and can show hyper or hypo-reactivity to sensory events, such as reacting strongly or not at all to sounds, movements, or touch. Considering it during robot therapies may improve the overall interaction. In the present study, thirty-four children diagnosed with ASD underwent a joint attention training with the robot Cozmo. The eight session training was embedded in the standard therapy. The children were screened for their sensory sensitivity with the Sensory Profile Checklist Revised. Their social skills were screened before and after the training with the Early Social Communication Scale. We recorded their performance and the amount of feedback they were receiving from the therapist through animations of happy and sad emotions played on the robot. Our results showed that visual and hearing sensitivity influenced the improvements of the skill to initiate joint attention. Also, the therapists of individuals with a high sensitivity to hearing chose to play fewer animations of the robot during the training phase of the robot activity. The animations did not include sounds, but the robot was producing motor noise. These results are supporting the idea that sensory sensitivity of children diagnosed with ASD should be screened prior to engaging the children in robot-assisted therapy.
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Affiliation(s)
- P. Chevalier
- Social Cognition in Human-Robot Interaction, Istituto Italiano di Tecnologia (IIT), Genoa, Italy
| | - D. Ghiglino
- Social Cognition in Human-Robot Interaction, Istituto Italiano di Tecnologia (IIT), Genoa, Italy
- DIBRIS, Università degli Studi di Genova, Genoa, Italy
| | - F. Floris
- Piccolo Cottolengo Genovese di Don Orione, Genoa, Italy
| | - T. Priolo
- Piccolo Cottolengo Genovese di Don Orione, Genoa, Italy
| | - A. Wykowska
- Social Cognition in Human-Robot Interaction, Istituto Italiano di Tecnologia (IIT), Genoa, Italy
- *Correspondence: A. Wykowska,
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136
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Ramclam AN, Truong DM, Mire SS, Smoots KD, McNeel MM, Sakyi GJ, Daniels FM. Autism disparities for Black children: Acknowledging and addressing the problem through culturally responsive and socially just assessment practices. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ashley N. Ramclam
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Dieu M. Truong
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Sarah S. Mire
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Kimberly D. Smoots
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Morgan M. McNeel
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Georgina J. Sakyi
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Fre'Dasia M. Daniels
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
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Zhang Y, Zhou Z, Xu Q, Li H, Lv Y, Zhu G, Dong P, Li D, Wang Y, Tang X, Xu X. Screening for Autism Spectrum Disorder in Toddlers During the 18- and 24-Month Well-Child Visits. Front Psychiatry 2022; 13:879625. [PMID: 35573353 PMCID: PMC9097214 DOI: 10.3389/fpsyt.2022.879625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/31/2022] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Early screening contributes to the early detection of children with autism spectrum disorder (ASD). We conducted a longitudinal ASD screening study in a large community setting. The study was designed to investigate the diagnostic rate of ASD screening and determine the effectiveness of ASD screening model in a community-based sample. METHODS We enrolled children who attended 18- and 24-month well-child care visits in Shanghai Xuhui District. Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) and Binomial Observation Test (BOT) were selected as screening instruments. Screen-positive children were referred to a tertiary diagnostic center for comprehensive ASD diagnostic evaluation. Screen-negative children received well-child checkups and follow-up every 3-6 months until age three and were referred if they were suspected of having ASD. RESULTS A total of 11,190 toddlers were screened, and 36 screen-positive toddlers were diagnosed with ASD. The mean age at diagnosis for these children was 23.1 ± 4.55 months, diagnosed 20 months earlier than ASD children not screened. The diagnostic rate of ASD was 0.32% (95% CI: 0.23-0.45%) in this community-based sample. In addition, 12 screen-negative children were diagnosed with ASD during subsequent well-child visit and follow-up. The average diagnostic rate of ASD rose to 0.43% (95% CI: 0.32-0.57%) when toddlers were followed up to 3 years old. The positive predictive values (PPVs) of M-CHAT-R/F, M-CHAT-R high risk, and BOT for ASD were 0.31, 0.43, and 0.38 respectively. CONCLUSION Our findings provide reliable data for estimating the rate of ASD detection and identifying the validity of community-based screening model. M-CHAT-R/F combined with BOT can be an effective tool for early detection of ASD. This community-based screening model is worth replicating.
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Affiliation(s)
- Ying Zhang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Zhaoe Zhou
- Department of Child Healthcare, Xuhui Maternal and Child Healthcare Hospital, Shanghai, China
| | - Qiong Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Huiping Li
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Yujing Lv
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Guowei Zhu
- Department of Child Healthcare, Xuhui Maternal and Child Healthcare Hospital, Shanghai, China
| | - Ping Dong
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Dongyun Li
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Wang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xinrui Tang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xiu Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
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138
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Kumazaki H, Muramatsu T, Yoshikawa Y, Matsumoto Y, Takata K, Ishiguro H, Mimura M. Android Robot Promotes Disclosure of Negative Narratives by Individuals With Autism Spectrum Disorders. Front Psychiatry 2022; 13:899664. [PMID: 35782427 PMCID: PMC9240260 DOI: 10.3389/fpsyt.2022.899664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Many individuals with autism spectrum disorders (ASD) demonstrate some challenges with personal narrative writing. Sentence completion tests (SCT) is a class of semi-structured projective techniques and encourage respondents to disclose their private narratives. Even in SCT, only providing beginning of sentences is inadequate to compensate atypicalities in their creativity and imagination, and self-disclosure is difficult for many individuals with ASD. It is reported that many individuals with ASD often achieve a higher degree of task engagement through interactions with robots and that robotic systems may be useful in eliciting and promoting social communication such as self-disclosure for some individuals with ASD. There is a possibility that exemplification by android robots in place of human interviewers can result in a higher degree of task engagement for individuals with ASD. The objective of this study was to investigate whether additional exemplifications by android robots in the SCT can prompt self-disclosure for individuals with ASD. We compared the difference in disclosure statements and subjective emotion in the testing paper of the SCT in additional exemplification by an android robot and a human interviewer. In addition, we assessed the disclosure statements and subjective emotions in the SCT, for which exemplifications were written on testing paper to make the comparison. Our quantitative data suggested that exemplification by android robot promoted more self-disclosure, especially about the negative topic compared to exemplification by a human interviewer and that written on test paper. In addition, the level of participant embarrassment in response to exemplification by the android robot seemed to be lower compared to that in the human interviewer condition. In the assessment and support for individuals with ASD, eliciting self-disclosure is a pressing issue. It is hoped that the appropriate use of robots will lead to a better understanding and support for their application.
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Affiliation(s)
- Hirokazu Kumazaki
- Department of Neuropsychiatry, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,College of Science and Engineering, Kanazawa University, Kanazawa, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Chiba, Japan
| | - Taro Muramatsu
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yuichiro Yoshikawa
- Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Yoshio Matsumoto
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,College of Science and Engineering, Kanazawa University, Kanazawa, Japan.,Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Keiji Takata
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Hiroshi Ishiguro
- Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Alves MR, Maia FA, Almeida MTC, Saeger VSDA, Silva VBD, Bandeira LVS, Cezar IAM, Oliveira SLN, Costa ADA, Oliveira AAD, Silveira MF. Estudo de Propriedades Psicométricas do M-Chat no Brasil. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2022. [DOI: 10.1590/1982-3703003238467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumo O objetivo deste estudo foi avaliar as propriedades psicométricas do Modified Checklist for Autism in Toddlers (M-Chat) em crianças de 24 a 36 meses de idade com (Grupo 1/n = 88) e sem (Grupo 2/n = 1116) o transtorno do espectro do autismo (TEA). Avaliou-se a consistência interna e estimou-se a sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN). Além disso, construiu-se a curva Receiver Operating Characteristic (ROC). Para avaliar a validade discriminante, comparou-se a proporção de falhas entre as crianças com e sem o TEA, utilizando o teste qui-quadrado ou teste Exato de Fisher. Comparou-se ainda o número de falhas segundo sexo, faixa etária e grupo do participante por meio do teste de Mann-Whitney. O M-Chat apresentou consistência interna elevada (0,78 e 0,86), reprodutibilidade satisfatória (Kappa de 0,6 a 0,79 e CCI = 0,87 e 0,89), alta sensibilidade (0,807 e 0,932), especificidade (0,927 e 0,706) e VPN (0,984 e 0,992), porém as estimativas do VPP (0,467 e 0,250) não foram satisfatórias. Quanto à validade discriminante, observou-se que a proporção de falhas foi significativamente maior no grupo de crianças com TEA. Observou-se também que o número de falhas foi maior entre as crianças do sexo masculino, com faixa etária de 25-36 meses e no grupo com TEA. A versão brasileira do M-Chat tem propriedades psicométricas adequadas no que se refere à confiabilidade, sensibilidade, especificidade, VPN e validade discriminante, o que torna recomendável sua aplicação para rastrear crianças com sinais do TEA.
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140
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Lau JSP, Lai SMK, Ip FTS, Wong PWC, Team WC, Servili C, Salomone E, Pacione L, Shire S, Brown FL. Acceptability and feasibility of the World Health Organization's Caregiver Skills Training Programme (WHO CST) delivered via eLearning, videoconferencing, and in-person hybrid modalities in Hong Kong. Front Psychiatry 2022; 13:915263. [PMID: 36172515 PMCID: PMC9511500 DOI: 10.3389/fpsyt.2022.915263] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/27/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Local children with developmental disabilities were deprived of learning opportunities due to recent social and health incidents, resulting in elevating challenging behaviors and familial conflicts. This study explored the acceptability and feasibility of the World Health Organization's Caregiver Skills Training Programme (WHO CST) in alternative delivery modes under new normal and post COVID-19 period. METHOD CST was delivered via eLearning (EL), videoconferencing (VC), and in-person hybrid (IP) modes to 34 parent-child dyads, being randomly assigned to modes of asynchronous non-interfering EL (n = 9), synchronous with online coaching VC (n = 7), synchronous with in-person coaching IP (n = 9) and Wait-list Control WLC (n = 9). Data from two standardized scales of General Health Questionnaire (GHQ-12) and Strengths and Difficulties Questionnaire (SDQ), and Post-session and Home Visit Feedback Form by Caregivers that included both structured and open-ended questions were collected before and after intervention. Both quantitative and qualitative approaches were used in studying the collected data. RESULTS High levels of acceptability and feasibility of the training programme were supported by ratings on comprehensiveness and relevance, agreement with their personal values, duration, and usefulness. IP and VC groups yielded more positive changes than EL and WLC groups with 3, 16, 13, and -3% in General Health Questionnaire (GHQ-12), -13, -15, -6 and 0% in Difficulties-total, and 36.5, 35.5, 5.8 and 2.4% in Prosocial Scale at Strengths and Difficulties Questionnaire (SDQ) for EL, VC, IP, and WLC groups respectively from baseline to 12 weeks after intervention. Results from two standardized scales echoed with qualitative observations that the programme helped improve caregivers' well-being, child's communication, and behaviors across intervention groups. CONCLUSIONS Current findings revealed that CST delivered in three alternative modes were acceptable and feasible, and yielded positive impacts toward both caregivers and children. In-person coaching, and skill-practicing sessions were effective in mitigating child's challenging behaviors while personal interaction, either face-to-face or virtual, is a significant factor in uplifting caregivers' well-being, whereas the self-learning model was appreciated by the busy caregivers. In clinical practice, needs and goals of families and the constraints of remote interventions at the settings should be balanced.
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Affiliation(s)
- Janet Siu-Ping Lau
- The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,WHO CST Regional Technical Focal Point, Geneva, Switzerland
| | | | | | | | - Who Cst Team
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Erica Salomone
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.,The University of Milano-Bicocca, Milan, Italy
| | - Laura Pacione
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.,Division of Child and Youth Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Felicity L Brown
- Research and Development Department, War Child Holland, Amsterdam, Netherlands.,Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, Netherlands
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141
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Zheng ZK, Sarkar N, Swanson A, Weitlauf A, Warren Z, Sarkar N. CheerBrush: A Novel Interactive Augmented Reality Coaching System for Toothbrushing Skills in Children with Autism Spectrum Disorder. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2021. [DOI: 10.1145/3481642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Autism Spectrum Disorder (ASD)
is a common neurodevelopmental disorder that impacts one in every 54 children in the United States. Some children with ASD have learning and fine motor skill challenges that contribute to difficulties completing daily living tasks such as toothbrushing. Lack of toothbrushing skills may cause increased need for dental care and negative social feedback from peers. Technology based intelligent support systems offer the advantages of being accessible, engaging, and cost-effective. In this work, we present a novel interactive augmented reality coaching system, CheerBrush, to improve the toothbrushing skills of children with ASD. CheerBrush allows children to manipulate virtual objects like a toothbrush and toothpaste with their actual hand motions to practice the steps of toothbrushing. The virtual tasks of CheerBrush demonstrate these steps using audio and visual cues, while also showing the brushing process through a virtual avatar. CheerBrush also assesses toothbrushing skills with a custom designed mechatronic toothbrush to evaluate the system's coaching effectiveness. A feasibility study with 12 children (six children with ASD and six typically developing children) was conducted to evaluate the acceptability and effectiveness of CheerBrush. The data showed improvements in the toothbrushing motions and reduced stress for the children in the post-test. CheerBrush detects real-time movement of children and interacts with them by augmented reality, feedback and multimodal hints. We believe that CheerBrush has the potential to provide a low-cost, engaging and, beneficial intelligent support system to improve the toothbrushing skills of children with ASD.
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Affiliation(s)
- Z. Kevin Zheng
- Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA
| | | | - Amy Swanson
- Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy Weitlauf
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zachary Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nilanjan Sarkar
- Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA
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142
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Crepeau-Hobson MF, Leech N, Russell C. CLEAR Autism Diagnostic Evaluation (CADE): Evaluation of Reliability and Validity. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2021; 34:853-869. [PMID: 34873387 PMCID: PMC8636580 DOI: 10.1007/s10882-021-09828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
Recent surveillance efforts indicate that 1 in 54 American children meet the criteria for Autism Spectrum Disorder (ASD), making it the fastest growing neurodevelopmental disorder in the U.S. Despite evidence that ASD can be reliably diagnosed as early as 24 months, the median age at ASD diagnosis in 2016 in the U.S. was 51 months. The CLEAR Autism Diagnostic Evaluation (CADE; Willard & Kroncke, 2019), was developed in response to the need to improve, shorten, and standardize the clinical ASD evaluation process. The CADE is a 33-item rating scale designed to be completed by caregivers and clinicians. The current study was conducted to examine the reliability and validity of the CADE using a sample of 191 individuals who received a private evaluation for ASD. Using the client's evaluation records, clinicians completed the CADE items. The coefficient alpha was .94, which indicates that the items form a scale that has high internal consistency. The CADE total scores were highly correlated with ADOS scores, with r values ranging from .52-.86, and discriminated between those participants with a diagnosis of ASD and those without (p < .001). Receiver operator characteristic (ROC) curve analyses indicated excellent diagnostic accuracy of the CADE total score (ROC area under the curve = .998). Results suggest that the CADE can be used as an efficient and accurate means of evaluating ASD. Limitations and implications for use of the CADE are discussed.
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Affiliation(s)
| | - Nancy Leech
- School of Education and Human Development, University of Colorado Denver, Denver, CO USA
| | - Courtney Russell
- School of Education and Human Development, University of Colorado Denver, Denver, CO USA
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143
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DuBay M, Watson LR, Méndez LI, Rojevic C. Psychometric Comparison of the English and Spanish Western-Hemisphere Versions of the Modified Checklist for Autism in Toddlers-Revised. J Dev Behav Pediatr 2021; 42:717-725. [PMID: 34840315 DOI: 10.1097/dbp.0000000000000968] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Parent-report screening tools for autism spectrum disorder (ASD) are widely used to promote early identification of children with or at risk for ASD. Most screening tools have been developed in English in the United States or United Kingdom; thus, translated versions are needed for use with culturally and linguistically diverse populations. Traditional translation methods include a forward translation, back translation, and review. However, when used in new cultural and linguistic contexts, this "forward-back" approach may have limitations, including differing psychometric properties compared with original instruments. This study presents a psychometric analysis of the forward-back translation methodology of an ASD screening tool. METHODS A retrospective chart review design was used to examine Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R; Robins et al.) records from 2974 toddlers. Data were compared between caregivers who completed the original English M-CHAT-R and caregivers who completed its forward-back "Spanish-Western Hemisphere" translation to compare select psychometric properties of the 2 instruments. RESULTS Significant differences were observed between the 2 versions, including a higher overall risk score, higher initial screen-positive rate, and increased likelihood of leaving items blank among Spanish-speaking respondents. CONCLUSION Traditional translation methods seemed to affect select psychometric properties between translations of the M-CHAT-R. A more rigorous cultural adaptation approach may be necessary to maintain equivalence with the original instrument. Until new rigorous translations are available, it is recommended that language-specific screening tools continue to be used, along with recommended follow-up interviews, to avoid exacerbating existing health disparities.
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Affiliation(s)
- Michaela DuBay
- Speech Communication Disorders Program, Department of Human Services, School of Education and Human Services, University of Virginia, Charlottesville, VA
| | - Linda R Watson
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Lucía I Méndez
- Department of Communication Sciences and Disorders, School of Health and Human Sciences, University of North Carolina, Greensboro, NC
| | - Carolina Rojevic
- Occupational Therapy Department, University of California at San Francisco Benioff Children's Hospital, Oakland, CA
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144
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Blázquez Hinojosa A, Lázaro Garcia L, Puig Navarro O, Varela Bondelle E, Calvo Escalona R. Sensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:202-211. [PMID: 34802987 DOI: 10.1016/j.rpsmen.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/16/2019] [Indexed: 10/19/2022]
Abstract
BACKGROUND Controversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD). METHODS This study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. RESULTS DSM-5 sensitivity ranged from .69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the "low-functioning" category. DSM-5 specificity ranged from .64 to .73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD. CONCLUSIONS Further research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.
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Affiliation(s)
- Ana Blázquez Hinojosa
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain.
| | - Luisa Lázaro Garcia
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Departamento de Psiquiatría y Psicobiología Clínica, Universidad de Barcelona, Barcelona, Spain
| | - Olga Puig Navarro
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Eva Varela Bondelle
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain
| | - Rosa Calvo Escalona
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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145
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Family Impact During the Time Between Autism Screening and Definitive Diagnosis. J Autism Dev Disord 2021; 52:4908-4920. [PMID: 34797470 DOI: 10.1007/s10803-021-05354-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Over the past 10 years, identification of Autism Spectrum Disorder (ASD) risk has dramatically increased due to the wide-spread implementation of screening programs; yet, there is limited understanding about parent perceptions and experiences during the time period when risk is identified, but prior to receiving a formal diagnosis-a period that can last months to years given the long wait-lists for formal ASD evaluations. The current study aimed to examine parent perceptions of family impact (i.e., the impact their child's behaviors have on the family) between the time of risk-identification and formal diagnosis among 277 children identified as at-risk for ASD through screening positive in primary care. We aimed to compare family impact among those whose child met diagnostic criteria for ASD and those who did not. Parents of children who received a non-ASD diagnosis reported a higher baseline level of family impact (F[1, 274] = 5.82, p = .017); however, perceived difficult child behavior was a stronger predictor of family impact (t[6] = 13.11, p < .001) than later diagnostic group (t[6] = - 2.10, p = .037), and child functioning did not predict family impact (t[6] = -0.31, p = .76). These results suggest that in this population, perceived difficult child behavior is a stronger predictor of family impact than later diagnostic category and should be considered an important factor in family support.
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146
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Rinehart B, Poon CS, Sunar U. Quantification of perfusion and metabolism in an autism mouse model assessed by diffuse correlation spectroscopy and near-infrared spectroscopy. JOURNAL OF BIOPHOTONICS 2021; 14:e202000454. [PMID: 34328247 DOI: 10.1002/jbio.202000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
There is a need for quantitative biomarkers for early diagnosis of autism. Cerebral blood flow and oxidative metabolism parameters may show superior contrasts for improved characterization. Diffuse correlation spectroscopy (DCS) has been shown to be reliable method to obtain cerebral blood flow contrast in animals and humans. Thus, in this study, we evaluated the combination of DCS and fNIRS in an established autism mouse model. Our results indicate that autistic group had significantly (P = .001) lower (~40%) blood flow (1.16 ± 0.26) × 10-8 cm2 /s), and significantly (P = .015) lower (~70%) oxidative metabolism (52.4 ± 16.6 μmol/100 g/min) compared to control group ([1.93 ± 0.74] × 10-8 cm2 /s, 177.2 ± 45.8 μmol/100 g/min, respectively). These results suggest that the combination of DCS and fNIRS can provide hemodynamic and metabolic contrasts for in vivo assessment of autism pathological conditions noninvasively.
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Affiliation(s)
- Benjamin Rinehart
- Department of Biomedical, Industrial and Human Factors, Wright State University, Dayton, Ohio, USA
| | - Chien-Sing Poon
- Department of Biomedical, Industrial and Human Factors, Wright State University, Dayton, Ohio, USA
| | - Ulas Sunar
- Department of Biomedical, Industrial and Human Factors, Wright State University, Dayton, Ohio, USA
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147
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Correia R, Agostinho D, Duarte IC, Sousa D, Rodrigues AP, Castelo-Branco M, Simoes M. Assessing Arousal Through Multimodal Biosignals: A Preliminary Approach. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1508-1511. [PMID: 34891571 DOI: 10.1109/embc46164.2021.9630112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The increase in Autism Spectrum Disorder (ASD) prevalence estimates over the last decades has driven a quest to develop new forms of rehabilitation that can be accessible to a larger part of this population. These rehabilitation approaches often take the form of computer games that are blind to the user's emotional state, which compromises their efficacy. In this study, a set of physiological signals were acquired in simultaneous with functional Magnetic Resonance Imaging (fMRI) with the future prospect of combining both kinds of data to create models capable of assessing the true emotional state of their users based on physiological response as a measure of autonomic nervous system, having as ground truth the activity of targeted brain regions. This paper describes an initial approach, focusing on the information contained on the physiological signals alone. A total of 35 features were extracted from biosignals' segments and subsequently used for automatic classification of arousal state (High Arousal vs. Low Arousal). The suboptimal results, although some extracted features present statistically significant differences, underline the challenging nature of our proposal and the added obstacles of recording physiological signals in the magnetic resonance environment. Further exploration of the measured signals is needed to gather a bigger number of discriminative features that can improve classification outcomes.
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148
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Williams ZJ, Suzman E, Woynaroski TG. Prevalence of Decreased Sound Tolerance (Hyperacusis) in Individuals With Autism Spectrum Disorder: A Meta-Analysis. Ear Hear 2021; 42:1137-1150. [PMID: 33577214 PMCID: PMC8349927 DOI: 10.1097/aud.0000000000001005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Hyperacusis, defined as decreased tolerance to sound at levels that would not trouble most individuals, is frequently observed in individuals with autism spectrum disorder (ASD). Despite the functional impairment attributable to hyperacusis, little is known about its prevalence or natural history in the ASD population. The objective of this study was to conduct a systematic review and meta-analysis estimating the current and lifetime prevalence of hyperacusis in children, adolescents, and adults with ASD. By precisely estimating the burden of hyperacusis in the ASD population, the present study aims to enhance recognition of this particular symptom of ASD and highlight the need for additional research into the causes, prevention, and treatment of hyperacusis in persons on the spectrum. DESIGN We searched PubMed and ProQuest to identify peer-reviewed articles published in English after January 1993. We additionally performed targeted searches of Google Scholar and the gray literature, including studies published through May 2020. Eligible studies included at least 20 individuals with diagnosed ASD of any age and reported data from which the proportion of ASD individuals with current and/or lifetime hyperacusis could be derived. To account for multiple prevalence estimates derived from the same samples, we utilized three-level Bayesian random-effects meta-analyses to estimate the current and lifetime prevalence of hyperacusis. Bayesian meta-regression was used to assess potential moderators of current hyperacusis prevalence. To reduce heterogeneity due to varying definitions of hyperacusis, we performed a sensitivity analysis on the subset of studies that ascertained hyperacusis status using the Autism Diagnostic Interview-Revised (ADI-R), a structured parent interview. RESULTS A total of 7783 nonduplicate articles were screened, of which 67 were included in the review and synthesis. Hyperacusis status was ascertained in multiple ways across studies, with 60 articles employing interviews or questionnaires and seven using behavioral observations or objective measures. The mean (range) age of samples in the included studies was 7.88 years (1.00 to 34.89 years). The meta-analysis of interview/questionnaire measures (k(3) = 103, nASD = 13,093) estimated the current and lifetime prevalence of hyperacusis in ASD to be 41.42% (95% CrI, 37.23 to 45.84%) and 60.58% (50.37 to 69.76%), respectively. A sensitivity analysis restricted to prevalence estimates derived from the ADI-R (k(3) = 25, nASD = 5028) produced similar values. The estimate of current hyperacusis prevalence using objective/observational measures (k(3) = 8, nASD = 488) was 27.30% (14.92 to 46.31%). Heterogeneity in the full sample of interview/questionnaire measures was substantial but not significantly explained by any tested moderator. However, prevalence increased sharply with increasing age in studies using the ADI-R (BF10 = 93.10, R2Het = 0.692). CONCLUSIONS In this meta-analysis, we found a high prevalence of current and lifetime hyperacusis in individuals with ASD, with a majority of individuals on the autism spectrum experiencing hyperacusis at some point in their lives. The high prevalence of hyperacusis in individuals with ASD across the lifespan highlights the need for further research on sound tolerance in this population and the development of services and/or interventions to reduce the burden of this common symptom.
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
| | - Evan Suzman
- Graduate Program in Biomedical Sciences, Vanderbilt University, Nashville, TN
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN
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149
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Onishchenko D, Huang Y, van Horne J, Smith PJ, Msall ME, Chattopadhyay I. Reduced false positives in autism screening via digital biomarkers inferred from deep comorbidity patterns. SCIENCE ADVANCES 2021; 7:eabf0354. [PMID: 34613766 PMCID: PMC8494294 DOI: 10.1126/sciadv.abf0354] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 08/11/2021] [Indexed: 05/13/2023]
Abstract
Here, we develop digital biomarkers for autism spectrum disorder (ASD), computed from patterns of past medical encounters, identifying children at high risk with an area under the receiver operating characteristic exceeding 80% from shortly after 2 years of age for either sex, and across two independent patient databases. We leverage uncharted ASD comorbidities, with no requirement of additional blood work, or procedures, to estimate the autism comorbid risk score (ACoR), during the earliest years when interventions are the most effective. ACoR has superior predictive performance to common questionnaire-based screenings and can reduce their current socioeconomic, ethnic, and demographic biases. In addition, we can condition on current screening scores to either halve the state-of-the-art false-positive rate or boost sensitivity to over 60%, while maintaining specificity above 95%. Thus, ACoR can significantly reduce the median diagnostic age, reducing diagnostic delays and accelerating access to evidence-based interventions.
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Affiliation(s)
| | - Yi Huang
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - James van Horne
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Peter J. Smith
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Chicago, Chicago, IL, USA
- American Academy of Pediatrics, Itasca, IL, USA
| | - Michael E. Msall
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Chicago, Chicago, IL, USA
- Joseph P. Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, University of Chicago, Chicago, IL, USA
| | - Ishanu Chattopadhyay
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Committee on Genetics, Genomics and Systems Biology, University of Chicago, Chicago, IL, USA
- Committee on Quantitative Methods in Social, Behavioral, and Health Sciences, University of Chicago, Chicago, IL, USA
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150
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Wieckowski AT, Thomas RP, Chen CMA, Zitter A, Fein DA, Barton ML, Adamson LB, Robins DL. Effect of Brief Training to Identify Autism Spectrum Disorder During Toddler Well-Child Care Visits. J Dev Behav Pediatr 2021; 42:666-671. [PMID: 34618724 PMCID: PMC8497937 DOI: 10.1097/dbp.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/01/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the effect of a brief Enhanced training using the information-motivation-behavior (IMB) change model on improving providers' surveillance rates and accuracy of autism spectrum disorder (ASD) detection. METHOD Toddlers (n = 5,672) were screened for ASD during their pediatric well-child visits. Pediatric providers (n = 120) were randomized to receive Enhanced (incorporating components of the IMB model) or Control training. Providers indicated whether they had an ASD concern at each well-child visit. Toddlers who were positive on any screener and/or whose provider indicated ASD concern were invited for a diagnostic evaluation. Differences in provider-indicated ASD concerns before and after training were evaluated using log-linear analyses. RESULTS The Enhanced training did not have a significant effect on provider-endorsed ASD concerns (p = 0.615) or accuracy of endorsing concerns (p = 0.619). Providers in the Control training showed a significant reduction in indicating whether or not they had concerns after the training (from 71.9% to 64.3%), which did not occur in the Enhanced group. The Enhanced training led to more frequent endorsements of language (χ2 = 8.772, p = 0.003) and restricted and repetitive behavior (χ2 = 7.918, p = 0.005) concerns for children seen after training. CONCLUSION Provider training had limited impact on ASD surveillance, indicating the importance of using formal screening instruments that rely on parent report during well-child visits to complement developmental surveillance. Future research should examine whether providers who indicate specific concerns are more likely to accurately refer children for ASD evaluations.
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Affiliation(s)
| | - Rebecca P. Thomas
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Chi-Ming A. Chen
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Ashley Zitter
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
| | - Deborah A. Fein
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Marianne L. Barton
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | | | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
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