151
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Willig TN, Blanc JP, Assathiany R. [The private pediatrician in the clinical care pathway for children affected by specific learning disorders in France]. Arch Pediatr 2017; 24:1088-1095. [PMID: 28970040 DOI: 10.1016/j.arcped.2017.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 07/11/2017] [Accepted: 08/30/2017] [Indexed: 11/29/2022]
Abstract
The clinical care pathway for children presenting specific learning disorders, including language, motor coordination, and attention disorders is based on different levels of assessment by the professionals involved. In France, a first step of organization was established in 2002 by founding of a network of structures devoted to clinical assessment of complex cases, research, and teaching for the professionals involved. Although this organization proved to contribute an essential service, the demand largely exceeded the availability of access. A three-level organization was therefore suggested in 2013 including a first-level devoted to clinical analysis of simple cases, together with the professionals involved in rehabilitation (i.e., speech therapists, occupational therapists, psychologists), a second-level in charge of analyzing complex situations, involving comorbidities and failure of first-level care, together with the already structured third level of assessment devoted to genetic disorders, severe situations, and association with neurological conditions. To plan the practical application of these different levels, we assessed the situation of ambulatory pediatricians working in private practice, because this network appeared to be the most available in France to play these roles. A survey was therefore conducted among the main representative association of pediatricians (Association française de pédiatrie ambulatoire), including 1565 members of the 2700 in activity in France, on their level of knowledge and clinical expertise, and the drawbacks encountered in their practice in this field. Of the 481 respondents (36%), 25% were not yet in 2016 self-confident in assuming a first-level role, while 56% were ready to participate in a first-level response and 18% in a second-level response. In the 5 upcoming years, the vast majority of pediatricians intended to progress in their involvement, which should provide all regions in France with a network of professionals able to respond to the specific needs of children (48% in the first-level and 43.5% in the second-level of expertise). Specific obstacles have already been encountered by professionals who wish to play a full role in this domain: insufficient funding for medical evaluations and lack of access to specialized evaluations. This survey emphasizes the need for obtaining access to both practical and theoretical professional development programs (77.5%), funding of clinical assessment time (76%), all of which need to be answered by the French health authorities. To date, very few nationwide programs of clinical care pathways in these fields have been developed, but examples are available in France on Alzheimer disease and elderly populations, providing a model for children affected by specific development and learning difficulties. Setting up a clinical care pathway by the French Ministry of Health (Haute Autorité de santé) assumes that the needs expressed by ambulatory pediatricians will be taken into account, including the design and implementation of Medical Education programs according to the level of expertise, together with the adequate funding of diagnosis, follow-up, and care pathway coordination time.
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Affiliation(s)
- T-N Willig
- Clinique Ambroise-Paré, 387, route de Saint-Simon, 31082 Toulouse cedex 01, France; Réseau Ptitmip, troubles des apprentissages, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Association française de pédiatrie ambulatoire, 54, rue Léon-Desoyer, 78100 Saint-Germain-en-Laye, France.
| | - J P Blanc
- Association française de pédiatrie ambulatoire, 54, rue Léon-Desoyer, 78100 Saint-Germain-en-Laye, France; 17, rue Nicolas-Chaize, 42100 Saint-Étienne, France
| | - R Assathiany
- Association française de pédiatrie ambulatoire, 54, rue Léon-Desoyer, 78100 Saint-Germain-en-Laye, France; 30, avenue Victor-Cresson, 92130 Issy-les-Moulineaux, France
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152
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Eyuboglu M, Baykara B, Eyuboglu D. Broad autism phenotype: theory of mind and empathy skills in unaffected siblings of children with autism spectrum disorder. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1379714] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Murat Eyuboglu
- Department of Child and Adolescent Psychiatry, Mardin Public Hospital, Mardin, Turkey
| | - Burak Baykara
- Department of Child and Adolescent Psychiatry, Dokuz Eylül Unversity, Izmir, Turkey
| | - Damla Eyuboglu
- Department of Child and Adolescent Psychiatry, Mardin Public Hospital, Mardin, Turkey
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153
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Lahvis GP. What California sea lions exposed to domoic acid might teach us about autism: lessons for predictive and preventive medicine. EPMA J 2017; 8:229-235. [PMID: 29021833 PMCID: PMC5607054 DOI: 10.1007/s13167-017-0118-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Abstract
Autism spectrum disorder (ASD) shares many biological and behavioral similarities with the deleterious effects of domoic acid (DA) exposure. DA is produced by marine algae and most commonly by species of Pseudo-nitzschia. Humans and marine mammals can be exposed to DA when they consume whole fish or shellfish. The mammalian fetus is highly sensitive to the deleterious effects of DA exposure. Both ASD and exposures to toxic levels of DA feature repetitive behaviors, challenges with social interaction, and seizures. They can also share a commonality in brain anatomy and function, particularly the balance between excitatory and inhibitory mechanisms. The current article is relevant to predictive, preventive, and personalized medicine for three reasons. First, shellfish consumption may be a risk factor for ASD and the regulatory limit for DA should be adjusted to prevent this possibility. Human contributions to increased algal production of DA in coastal waters should be identified and reduced. Second, evaluations of sentinel species wild and free-roaming in the environment, though typically outside the purview of biomedical research, should be much more fully employed to gain insights to risk factors for human disease. To better identify and prevent disease, biomedical researchers should study wild populations. Third, studies of DA exposure highlight the possibility that glutamate additives to processed foods may also have deleterious impacts on human brain development and behavior.
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Affiliation(s)
- Garet Paul Lahvis
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239 USA
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154
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Vyshedskiy A, Mahapatra S, Dunn R. Linguistically deprived children: meta-analysis of published research underlines the importance of early syntactic language use for normal brain development. RESEARCH IDEAS AND OUTCOMES 2017. [DOI: 10.3897/rio.3.e20696] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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155
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Lyall K, Croen LA, Weiss LA, Kharrazi M, Traglia M, Delorenze GN, Windham GC. Prenatal Serum Concentrations of Brominated Flame Retardants and Autism Spectrum Disorder and Intellectual Disability in the Early Markers of Autism Study: A Population-Based Case-Control Study in California. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:087023. [PMID: 28895873 PMCID: PMC5783661 DOI: 10.1289/ehp1079] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 05/18/2017] [Accepted: 05/25/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Prior studies suggest neurodevelopmental impacts of polybrominated diphenyl ethers (PBDEs), but few have examined diagnosed developmental disorders. OBJECTIVES Our aim was to determine whether prenatal exposure to brominated flame retardants (BFRs) is associated with autism spectrum disorder (ASD) or intellectual disability without autism (ID). METHODS We conducted a population-based case-control study including children with ASD (n=545) and ID (n=181) identified from the California Department of Developmental Services and general population (GP) controls (n=418) from state birth certificates. ASD cases were matched to controls by sex, birth month, and birth year. Concentrations of 10 BFRs were measured in maternal second trimester serum samples stored from routine screening. Logistic regression was used to calculate crude and adjusted odds ratios (AOR) for associations with ASD, and separately for ID, compared with GP controls, by quartiles of analyte concentrations in primary analyses. RESULTS Geometric mean concentrations of five of the six congeners with ≥55% of samples above the limit of detection were lower in mothers of children with ASD or ID than in controls. In adjusted analyses, inverse associations with several congeners were found for ASD relative to GP (e.g., quartile 4 vs. 1, BDE-153: AOR=0.56, 95% CI: 0.38, 0.84). When stratified by child sex (including 99 females with ASD, 77 with ID, and 73 with GP), estimates were consistent with overall analyses in boys, but in the opposite direction among girls, particularly for BDE-28 and -47 (AOR=2.58, 95% CI: 0.86, 7.79 and AOR=2.64, 95% CI: 0.97, 7.19, respectively). Similar patterns overall and by sex were observed for ID. CONCLUSIONS Contrary to expectation, higher PBDE concentrations were associated with decreased odds of ASD and ID, though not in girls. These findings require confirmation but suggest potential sexual dimorphism in associations with prenatal exposure to BFRs. https://doi.org/10.1289/EHP1079.
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Affiliation(s)
- Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University , Philadelphia, Pennsylvania, USA
| | - Lisa A Croen
- Autism Research Program, Division of Research, Kaiser Permanente , Oakland, California, USA
| | - Lauren A Weiss
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco , San Francisco, California, USA
| | - Martin Kharrazi
- Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California, USA
| | - Michela Traglia
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco , San Francisco, California, USA
| | - Gerald N Delorenze
- Autism Research Program, Division of Research, Kaiser Permanente , Oakland, California, USA
| | - Gayle C Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California, USA
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156
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Boutrus M, Maybery MT, Alvares GA, Tan DW, Varcin KJ, Whitehouse AJO. Investigating facial phenotype in autism spectrum conditions: The importance of a hypothesis driven approach. Autism Res 2017; 10:1910-1918. [PMID: 28816000 DOI: 10.1002/aur.1824] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 04/20/2017] [Accepted: 05/23/2017] [Indexed: 11/11/2022]
Abstract
Atypical facial characteristics have been observed in many disorders associated with developmental disability. While autism spectrum conditions (ASC) have not previously been thought to be associated with a distinct facial phenotype, an emerging research literature is casting doubt on this assumption. The identification of differences in the facial phenotype of individuals with ASC may contribute to efforts to promote early identification of the condition and help elucidate etiological pathways. With the aim of identifying facial phenotypes associated with ASC, this commentary evaluated facial features purported to distinguish ASC from typical development. Although there is little consensus across the reviewed studies for the majority of facial characteristics described, preliminary evidence suggests increased facial asymmetry may be more common in ASC. There is also evidence to suggest that there are morphologically distinct subgroups within ASC that correspond with different cognitive and behavioral symptomatology. However, in light of the various inconsistencies in the reported literature, and based on an accumulating understanding of etiological pathways proposed to be associated with ASC, we propose an alternative paradigm for investigating facial phenotypes in ASC. A series of studies are outlined to demonstrate the promise of a research program that has taken a hypothesis-driven approach to examine facial phenotypes associated with increased exposure to prenatal testosterone and to ASC. Autism Res 2017, 10: 1910-1918. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This commentary reviewed studies that found differences in the facial features of individuals with autism spectrum conditions (ASC) compared to typically developing individuals. While there is little agreement between studies, there is some support for asymmetrical facial features associated with ASC, and preliminary evidence that particular facial features relate to specific patterns of cognitive and behavioral symptoms. However, in light of inconsistencies between studies and based on accumulating understanding of etiological pathways, we propose an alternative approach to investigating facial differences in ASC.
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Affiliation(s)
- Maryam Boutrus
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Murray T Maybery
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Diana Weiting Tan
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Kandice J Varcin
- Telethon Kids Institute, University of Western Australia, West Perth, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
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157
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White EI, Wallace GL, Bascom J, Armour AC, Register-Brown K, Popal HS, Ratto AB, Martin A, Kenworthy L. Sex differences in parent-reported executive functioning and adaptive behavior in children and young adults with autism spectrum disorder. Autism Res 2017; 10:1653-1662. [PMID: 28568910 DOI: 10.1002/aur.1811] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/14/2017] [Accepted: 04/28/2017] [Indexed: 01/28/2023]
Abstract
This study is the largest to date examining executive function and adaptive skills in females with autism spectrum disorder (ASD). Its primary aim was to utilize parent ratings of real-world executive functioning and adaptive behavior to better understand whether females with ASD differ from males with ASD in these areas of everyday functioning. We compared 79 females with ASD to 158 males with ASD (ages 7-18) who were statistically matched on age, IQ, and level of ADHD or ASD traits. All participants were assessed using the Behavior Rating Inventory of Executive Function (BRIEF) and a subset (56 females and 130 males) also received the Vineland Adaptive Behavior Scales (VABS). Females were rated by parents as having greater problems with executive function on the BRIEF. Parents also rated females as exhibiting more difficulties than males on the Daily Living Skills domain of the VABS. There was a correlation between increased global EF difficulty and decreased adaptive ability in both males and females. Our results indicate relative weaknesses for females compared to males diagnosed with ASD on executive function and daily living skills. These differences occur in the absence of sex differences in our sample in age, IQ, clinician ratings of core ASD symptomatology, parent ratings of ADHD symptoms, and parent-reported social and communication adaptive skills on the VABS. These findings indicate specific liabilities in real world EF and daily living skills for females with ASD and have important implications for targeting their treatments. Autism Res 2017, 10: 1653-1662. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Emily I White
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD
| | - Gregory L Wallace
- Deparment of Speech and Hearing Sciences, The George Washington University, Washington, DC
| | | | - Anna C Armour
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC
| | | | - Haroon S Popal
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD
| | - Allison B Ratto
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC.,Children's Research Institute, Children's National Health System, Washington, DC
| | - Alex Martin
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC.,Children's Research Institute, Children's National Health System, Washington, DC
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158
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Loomes R, Hull L, Mandy WPL. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry 2017; 56:466-474. [PMID: 28545751 DOI: 10.1016/j.jaac.2017.03.013] [Citation(s) in RCA: 1215] [Impact Index Per Article: 173.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/17/2017] [Accepted: 03/29/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To derive the first systematically calculated estimate of the relative proportion of boys and girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies conducted since the introduction of the DSM-IV and the International Classification of Diseases, Tenth Revision. METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The Medline, Embase, and PsycINFO databases were searched, and study quality was rated using a risk-of-bias tool. Random-effects meta-analysis was used. The pooled outcome measurement was the male-to-female odds ratio (MFOR), namely the odds of being male in the group with ASD compared with the non-ASD group. In effect, this is the ASD male-to-female ratio, controlling for the male-to-female ratio among participants without ASD. RESULTS Fifty-four studies were analyzed, with 13,784,284 participants, of whom 53,712 had ASD (43,972 boys and 9,740 girls). The overall pooled MFOR was 4.20 (95% CI 3.84-4.60), but there was very substantial between-study variability (I2 = 90.9%). High-quality studies had a lower MFOR (3.32; 95% CI 2.88-3.84). Studies that screened the general population to identify participants regardless of whether they already had an ASD diagnosis showed a lower MFOR (3.25; 95% CI 2.93-3.62) than studies that only ascertained participants with a pre-existing ASD diagnosis (MFOR 4.56; 95% CI 4.10-5.07). CONCLUSION Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis.
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159
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Montiel-Nava C, Chacín JA, González-Ávila Z. Age of diagnosis of autism spectrum disorder in Latino children: The case of Venezuelan children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 21:573-580. [DOI: 10.1177/1362361317701267] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Latino children are diagnosed with autism spectrum disorder later in life, usually with more severe symptoms, and lower IQs, compared with non-Latino children. Possible reasons for such disparities could be due to lower levels of parent education, lower socioeconomic status, limited knowledge of parents about autism spectrum disorder, and diminished health-care knowledge. The goal of the study was to describe the age of parental concerns and at first autism spectrum disorder diagnosis, and factors associated with age at the first diagnosis in a sample of Venezuelan children. Diagnostic and demographic data were collected from 103 children between 2 and 7 years of age. Although the mean age of first concerns was 17 months, the age of diagnosis varied from 53.03 months for the Pervasive Developmental Disorders–Not Otherwise specified group to 54.38 months for the autism group. Although parents were aware of developmental difficulties before the second year of life, their children were diagnosed 36 months later. In Latin cultures, behavior problems are usually attributed to poor parenting skills, so parents might take longer to seek professional help. A better understanding of cultural influences on age of diagnosis will translate to quicker use of services independent of ethnicity.
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Affiliation(s)
- Cecilia Montiel-Nava
- Universidad del Zulia, Venezuela
- Universidad Latina de Panama, Panama
- Instituto de Investigaciones Cientificas y Servicios de Alta Tecnologia (INDICASAT AIP)
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160
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Bello-Mojeed MA, Omigbodun OO, Bakare MO, Adewuya AO. Pattern of impairments and late diagnosis of autism spectrum disorder among a sub-Saharan African clinical population of children in Nigeria. Glob Ment Health (Camb) 2017; 4:e5. [PMID: 28596906 PMCID: PMC5454767 DOI: 10.1017/gmh.2016.30] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 11/11/2016] [Accepted: 12/02/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders. Studies conducted among Africans living outside the continent indicate that African children are more likely than Caucasian children to have a late diagnosis of ASD. There is a dearth of information on this topic among children with ASD living in Africa. METHODS To determine the pattern of impairments and age at diagnosis in ASD, sixty Nigerian children with a diagnosis of ASD were recruited from a neurodevelopmental clinic. DSM-V criteria were used to make a diagnosis of ASD, while a symptom checklist for ASD was used to determine the pattern of impairments in ASD. RESULTS Ages of the children ranged from 2 to 17 years with a mean age of 9.45 ± 4.33 years with the majority of them (75%) being 12 years or younger. All the children (100%) with ASD exhibited poor eye contact, difficulty in mixing with other children and inability to consistently respond to his/her name. More than a half of them (55%) lack verbal communication. Impairments that were uncommon are in the areas of object attachment (20.0%), odd postures (26.7%) and inappropriate facial expression (30.0%). Mean age at the observation of ASD features was 17.0 ± 6.7 months. Mean age at diagnosis of ASD was 9.00 ± 4.30 years. The mean time lag from a parental concern of ASD features to seeking specialist care was 85 months and to diagnosis was 91 months. CONCLUSIONS Core symptoms/impairments of ASD are present in Nigerian children but a late diagnosis is common.
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Affiliation(s)
- M. A. Bello-Mojeed
- Child and Adolescent Mental Health Service Centre, Federal Neuro-Psychiatric Hospital, Lagos, Nigeria
- Childhood Neuropsychiatric Disorders Initiatives, Nigeria
| | - O. O. Omigbodun
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - M. O. Bakare
- Childhood Neuropsychiatric Disorders Initiatives, Nigeria
- College of Medicine, Enugu State University of Science and Technology (ESUT), Enugu, Nigeria
- Child and Adolescent Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Nigeria
| | - A. O. Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
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161
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Lyall K, Croen LA, Sjödin A, Yoshida CK, Zerbo O, Kharrazi M, Windham GC. Polychlorinated Biphenyl and Organochlorine Pesticide Concentrations in Maternal Mid-Pregnancy Serum Samples: Association with Autism Spectrum Disorder and Intellectual Disability. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:474-480. [PMID: 27548254 PMCID: PMC5332182 DOI: 10.1289/ehp277] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/27/2016] [Accepted: 07/20/2016] [Indexed: 05/18/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) are neurodevelopmental toxicants, but few studies have examined associations with autism spectrum disorder (ASD). OBJECTIVES We aimed to determine whether prenatal exposure to PCBs and OCPs influences offspring risk of ASD and intellectual disability without autism (ID). METHODS We conducted a population-based case-control study among Southern California births, including children with ASD (n = 545) meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV-TR) criteria and ID (n = 181), as well as general population (GP) controls (n = 418). Concentrations of 11 PCB congeners and 2 OCPs measured in banked second-trimester serum samples were compared between the diagnostic groups. Logistic regression was used to calculate crude and adjusted odds ratios (AOR) for associations with ASD, and separately for ID, compared with GP controls, by quartiles of analyte concentrations in primary analyses. RESULTS Geometric mean levels of several PCB congeners were higher in the ASD group than in the ID and GP groups. ASD risk was elevated for a number of PCB congeners, particularly for the highest vs. lowest quartile of PCB138/158 (AOR = 1.79; 95% CI: 1.10, 2.71) and PCB153 (AOR = 1.82; 95% CI: 1.10, 3.02), and for highest deciles of other congeners in secondary analyses. PCB138/158 was also associated with increased ID (AOR = 2.41; 95% CI: 1.18, 4.91), though no trend was suggested. OCPs were not associated with increased risk of ASD in primary analyses, whereas nonmonotonic increases in risk of ID were found with p,p´-DDE. CONCLUSIONS Our results suggest higher levels of some organochlorine compounds during pregnancy are associated with ASD and ID. Citation: Lyall K, Croen LA, Sjödin A, Yoshida CK, Zerbo O, Kharrazi M, Windham GC. 2017. Polychlorinated biphenyl and organochlorine pesticide concentrations in maternal mid-pregnancy serum samples: association with autism spectrum disorder and intellectual disability. Environ Health Perspect 125:474-480; http://dx.doi.org/10.1289/EHP277.
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Affiliation(s)
- Kristen Lyall
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
- Address correspondence to K. Lyall, AJ Drexel Autism Institute, Suite 560, 3200 Market St., Philadelphia, PA 19104 USA. Telephone: (215) 571-3215. E-mail:
| | - Lisa. A. Croen
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Andreas Sjödin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Ousseny Zerbo
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Gayle C. Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
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162
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Autism with intellectual disability is associated with increased levels of maternal cytokines and chemokines during gestation. Mol Psychiatry 2017; 22:273-279. [PMID: 27217154 PMCID: PMC5122473 DOI: 10.1038/mp.2016.77] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 12/29/2022]
Abstract
Immune abnormalities have been described in some individuals with autism spectrum disorders (ASDs) as well as their family members. However, few studies have directly investigated the role of prenatal cytokine and chemokine profiles on neurodevelopmental outcomes in humans. In the current study, we characterized mid-gestational serum profiles of 22 cytokines and chemokines in mothers of children with ASD (N=415), developmental delay (DD) without ASD (N=188), and general population (GP) controls (N=428) using a bead-based multiplex technology. The ASD group was further divided into those with intellectual disabilities (developmental/cognitive and adaptive composite score<70) (ASD+ID, N=184) and those without (composite score⩾70) (ASD-noID, N=201). Levels of cytokines and chemokines were compared between groups using multivariate logistic regression analyses, adjusting for maternal age, ethnicity, birth country and weight, as well as infant gender, birth year and birth month. Mothers of children with ASD+ID had significantly elevated mid-gestational levels of numerous cytokines and chemokines, such as granulocyte macrophage colony-stimulating factor, interferon-γ, interleukin-1α (IL-1α) and IL-6, compared with mothers of children with either ASD-noID, those with DD, or GP controls. Conversely, mothers of children with either ASD-noID or with DD had significantly lower levels of the chemokines IL-8 and monocyte chemotactic protein-1 compared with mothers of GP controls. This observed immunologic distinction between mothers of children with ASD+ID from mothers of children with ASD-noID or DD suggests that the intellectual disability associated with ASD might be etiologically distinct from DD without ASD. These findings contribute to the ongoing efforts toward identification of early biological markers specific to subphenotypes of ASD.
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163
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Vargason T, Howsmon DP, Melnyk S, James SJ, Hahn J. Mathematical modeling of the methionine cycle and transsulfuration pathway in individuals with autism spectrum disorder. J Theor Biol 2016; 416:28-37. [PMID: 28040439 DOI: 10.1016/j.jtbi.2016.12.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/23/2016] [Accepted: 12/28/2016] [Indexed: 01/08/2023]
Abstract
Previous research has shown a connection between metabolic abnormalities in the methionine cycle and transsulfuration pathway and autism spectrum disorder. Using clinical data from a case-control study investigating measurements of transmethylation and transsulfuration metabolites, a steady-state model of these metabolites in liver cells was developed and participant-specific parameters were identified. Comparison of mean parameter values and parameter distributions between neurotypical study participants and those on the autism spectrum revealed significant differences for four model parameters. Sensitivity analysis identified the parameter describing the rate of glutamylcysteine synthesis, the rate-limiting step in glutathione production, to be particularly important in determining steady-state metabolite concentrations. These results may provide insight into key reactions to target for potential intervention strategies relating to autism spectrum disorder.
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Affiliation(s)
- Troy Vargason
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, 110 8th Street, Troy, NY 12180, USA
| | - Daniel P Howsmon
- Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute, 110 8th Street, Troy, NY 12180, USA
| | - Stepan Melnyk
- Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - S Jill James
- Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Juergen Hahn
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, 110 8th Street, Troy, NY 12180, USA; Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute, 110 8th Street, Troy, NY 12180, USA.
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164
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Aiello R, Ruble L, Esler A. National Study of School Psychologists’ Use of Evidence-Based Assessment in Autism Spectrum Disorder. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2016. [DOI: 10.1080/15377903.2016.1236307] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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165
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Elchaar GM, Maisch NM, Augusto LMG, Wehring HJ. Pediatrics Efficacy and Safety of Naltrexone Use in Pediatric Patients with Autistic Disorder. Ann Pharmacother 2016; 40:1086-95. [PMID: 16735648 DOI: 10.1345/aph.1g499] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: To review the efficacy and safety of naltrexone in pediatric patients with autistic disorder (AD). Data Sources: Using the terms pediatric, child, naltrexone, autism, and autistic disorder, a literature search was performed using MEDLINE (1966–May 18, 2006) and the International Pharmaceutical Abstracts (1971–May 18, 2006) database. The references of these articles were scanned for additional relevant literature. Study Selection and Data Extraction: All articles describing or evaluating the efficacy and/or safety of naltrexone in pediatric patients with AD were included in this review. Three case reports, 8 case series, and 14 clinical studies were identified as pertinent. Data Synthesis: Naltrexone has been used most commonly at doses ranging from 0.5 to 2 mg/kg/day and found to be predominantly effective in decreasing self-injurious behavior. Naltrexone may also attenuate hyperactivity, agitation, irritability, temper tantrums, social withdrawal, and stereotyped behaviors. Patients may also exhibit improved attention and eye contact. Transient sedation was the most commonly reported adverse event. Small sample size, short duration, and inconsistent evaluative methods characterize the available research. Conclusions: A child affected by AD may benefit from a trial of naltrexone therapy, particularly if the child exhibits self-injurious behavior and other attempted therapies have failed. Serious adverse effects have not been reported in short-term studies.
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Affiliation(s)
- Gladys M Elchaar
- Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, Queens, NY 11439, USA
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166
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Gross Motor Profile and Its Association with Socialization Skills in Children with Autism Spectrum Disorders. Pediatr Neonatol 2016; 57:501-507. [PMID: 27161079 DOI: 10.1016/j.pedneo.2016.02.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/03/2015] [Accepted: 02/24/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and socialization skills in children with ASD. METHODS This was a cross-sectional study including 40 ASD children aged from 18 months to 6 years and 40 age-matched typically developing controls. Gross motor and socialization skills were scored using the Vineland Adaptive Behavior Scales, 2nd edition (Vineland-II). RESULTS Below average gross motor function was found in eight of 40 (20%) ASD children. The mean gross motor v-scale score in the ASD group was 15.1 [standard deviation (SD) 3.12], significantly lower than in the control group [18.7, SD 2.09, p = 0.0001; 95% confidence intervals (CI) from -4.725 to -2.525]. The differences were most prominent in ball throwing and catching, using stairs, jumping, and bicycling. The ASD children with gross motor impairments had a mean socialization domain score of 66.6 (SD 6.50) compared to 85.7 (SD 10.90) in those without gross motor impairments (p = 0.0001, 95% CI from -25.327 to -12.736). CONCLUSION Children with ASD had lower gross motor skills compared to typically developing children. Gross motor impairments were found in 20% of the ASD children, and these children also had lower socialization skills than those without gross motor impairments.
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167
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Tonnsen BL, Boan AD, Bradley CC, Charles J, Cohen A, Carpenter LA. Prevalence of Autism Spectrum Disorders Among Children With Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:487-500. [PMID: 27802102 DOI: 10.1352/1944-7558-121.6.487] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Autism spectrum disorders (ASD) often co-occur with intellectual disability (ID) and are associated with poorer psychosocial and family-related outcomes than ID alone. The present study examined the prevalence, stability, and characteristics of ASD estimates in 2,208 children with ASD and ID identified through the South Carolina Autism and Developmental Disabilities Network. The prevalence of ASD in ID was 18.04%, relative to ASD rates of 0.60%-1.11% reported in the general South Carolina population. Compared to children with ASD alone, those with comorbid ID exhibited increased symptom severity and distinct DSM-IV-TR profiles. Further work is needed to determine whether current screening, diagnostic, and treatment practices adequately address the unique needs of children and families affected by comorbid ASD and ID diagnoses.
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Affiliation(s)
- Bridgette L Tonnsen
- Bridgette L. Tonnsen, Department of Psychological Sciences, Purdue University; Andrea Boan, Catherine Bradley, and Jane Charles, Department of Developmental and Behavioral Pediatrics, Medical University of South Carolina; Amy Cohen, Department of Psychology, University of Illinois at Urbana-Champaign; and Laura A. Carpenter, Department of Developmental and Behavioral Pediatrics, Medical University of South Carolina
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168
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Erickson SR, Spoutz P, Dorsch M, Bleske B. Cardiovascular risk and treatment for adults with intellectual or developmental disabilities. Int J Cardiol 2016; 221:371-5. [DOI: 10.1016/j.ijcard.2016.07.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
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169
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Schuetze M, Park MTM, Cho IYK, MacMaster FP, Chakravarty MM, Bray SL. Morphological Alterations in the Thalamus, Striatum, and Pallidum in Autism Spectrum Disorder. Neuropsychopharmacology 2016; 41:2627-37. [PMID: 27125303 PMCID: PMC5026732 DOI: 10.1038/npp.2016.64] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 01/18/2023]
Abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with cognitive, motor, and emotional symptoms. The thalamus and basal ganglia form circuits with the cortex supporting all three of these behavioral domains. Abnormalities in the structure of subcortical regions may suggest atypical development of these networks, with implications for understanding the neural basis of ASD symptoms. Findings from previous volumetric studies have been inconsistent. Here, using advanced surface-based methodology, we investigated localized differences in shape and surface area in the basal ganglia and thalamus in ASD, using T1-weighted anatomical images from the Autism Brain Imaging Data Exchange (373 male participants aged 7-35 years with ASD and 384 typically developing). We modeled effects of diagnosis, age, and their interaction on volume, shape, and surface area. In participants with ASD, we found expanded surface area in the right posterior thalamus corresponding to the pulvinar nucleus, and a more concave shape in the left mediodorsal nucleus. The shape of both caudal putamen and pallidum showed a relatively steeper increase in concavity with age in ASD. Within ASD participants, restricted, repetitive behaviors were positively associated with surface area in bilateral globus pallidus. We found no differences in overall volume, suggesting that surface-based approaches have greater sensitivity to detect localized differences in subcortical structure. This work adds to a growing body of literature implicating corticobasal ganglia-thalamic circuits in the pathophysiology of ASD. These circuits subserve a range of cognitive, emotional, and motor functions, and may have a broad role in the complex symptom profile in ASD.
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Affiliation(s)
- Manuela Schuetze
- Child and Adolescent Imaging Research (CAIR) Program, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Neuroscience, University of Calgary, c/o Glenda Maru, 4th Floor, C4-100-07, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8, Tel: +1 403 955 2966, Fax: +1 403 955 2772, E-mail:
| | - Min Tae M Park
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Ivy YK Cho
- Child and Adolescent Imaging Research (CAIR) Program, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Frank P MacMaster
- Child and Adolescent Imaging Research (CAIR) Program, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada,Departments of Psychiatry and Pediatrics, University of Calgary, Calgary, AB, Canada,Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Calgary, AB, Canada,Strategic Clinical Network for Addictions and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada,Departments of Psychiatry and Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Signe L Bray
- Child and Adolescent Imaging Research (CAIR) Program, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada,Departments of Pediatrics and Radiology, University of Calgary, AB, Canada
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170
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Bilaver LA, Cushing LS, Cutler AT. Prevalence and Correlates of Educational Intervention Utilization Among Children with Autism Spectrum Disorder. J Autism Dev Disord 2016; 46:561-71. [PMID: 26391885 DOI: 10.1007/s10803-015-2598-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined the prevalence and correlates of educational intervention utilization among U.S. preschool aged children with autism spectrum disorder (ASD) prior to recent policy changes. The analysis was based on a nationally representative longitudinal survey of children receiving special education services during the 2003-2004 school year. All children with parent or teacher identified ASD over a 3-year study period were analyzed. Outcomes included utilization of speech therapy, occupational therapy, behavior therapy, and mental health services by service sector. The analysis revealed low rates of behavioral therapy and mental health services. Parents reported that the overwhelming majority of services were received inside school only. This study identified gaps in the provision of services for young children with ASD.
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Affiliation(s)
- Lucy A Bilaver
- Department of Public Health, School of Nursing and Health Studies, Northern Illinois University, Wirtz Hall Rm. 253, DeKalb, IL, 60115, USA. .,Chapin Hall at the University of Chicago, 1313 E. 60th St., Chicago, IL, 60637, USA.
| | - Lisa S Cushing
- Department of Special Education, College of Education, University of Illinois-Chicago, 1040 W. Harrison St., M/C 147, Chicago, IL, 60660, USA
| | - Ann T Cutler
- Institute on Disability and Human Development, University of Illinois-Chicago, 1640 W. Roosevelt Rd., M/C 727, Chicago, IL, 60608, USA
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171
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Abstract
Autism is the term commonly used to refer to autism spectrum disorders, a group of neurodevelopmental disorders involving sensory processing problems and social and language difficulties. According to the National Institute of Mental Health (NIMH), the exact prevalence of autism is unknown. Estimates range from 1 person in 500 to 1 in 1,000 in this country; and the number of people diagnosed with autism is growing. This article assesses the policy implications of the autism “epidemic.” It begins with an overview of the disability policy—making process in the United States and its implications for autism policy and proceeds to a discussion of the social construction of autism as a policy issue. This is followed by an analysis of federal and state governments' institutional capacity to respond to the autism epidemic.
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172
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Dickerson AS, Rahbar MH, Pearson DA, Kirby RS, Bakian AV, Bilder DA, Harrington RA, Pettygrove S, Zahorodny WM, Moyé LA, Durkin M, Slay Wingate M. Autism spectrum disorder reporting in lower socioeconomic neighborhoods. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:470-480. [DOI: 10.1177/1362361316650091] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Utilizing surveillance data from five sites participating in the Autism and Developmental Disabilities Monitoring Network, we investigated contributions of surveillance subject and census tract population sociodemographic characteristics on variation in autism spectrum disorder ascertainment and prevalence estimates from 2000 to 2008 using ordinal hierarchical models for 2489 tracts. Multivariable analyses showed a significant increase in ascertainment of autism spectrum disorder cases through both school and health sources, the optimal ascertainment scenario, for cases with college-educated mothers (adjusted odds ratio = 1.06, 95% confidence interval = 1.02–1.09). Results from our examination of sociodemographic factors of tract populations from which cases were drawn also showed that after controlling for other covariates, statistical significance remained for associations between optimal ascertainment and percentage of Hispanic residents (adjusted odds ratio = 0.93, 95% confidence interval = 0.88–0.99) and percentage of residents with at least a bachelor’s degree (adjusted odds ratio = 1.06, 95% confidence interval = 1.01–1.11). We identified sociodemographic factors associated with autism spectrum disorder prevalence estimates including race, ethnicity, education, and income. Determining which specific factors influence disparities is complicated; however, it appears that even in the presence of education, racial and ethnic disparities are still apparent. These results suggest disparities in access to autism spectrum disorder assessments and special education for autism spectrum disorder among ethnic groups may impact subsequent surveillance.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lemuel A Moyé
- The University of Texas Health Science Center at Houston, USA
| | - Maureen Durkin
- University of Wisconsin School of Medicine and Public Health, USA
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173
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Durkin MS, Benedict RE, Christensen D, Dubois LA, Fitzgerald RT, Kirby RS, Maenner MJ, Van Naarden Braun K, Wingate MS, Yeargin-Allsopp M. Prevalence of Cerebral Palsy among 8-Year-Old Children in 2010 and Preliminary Evidence of Trends in Its Relationship to Low Birthweight. Paediatr Perinat Epidemiol 2016; 30:496-510. [PMID: 27215680 PMCID: PMC5351288 DOI: 10.1111/ppe.12299] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The public health objective for cerebral palsy (CP) in the United States is to reduce the percentage of children with CP who were born low birthweight (LBW, <2500 g) by 10% between 2006 and 2020. This study reports the prevalence of CP in a constant surveillance area for the years 2006, 2008, and 2010 and describes initial progress towards the CP public health objective. METHODS Data on children with CP at age 8 years were ascertained by the Autism and Developmental Disabilities Monitoring (ADDM) Network, a population-based surveillance system that monitored CP in four areas of the United States. RESULTS CP prevalence in 2010 was 2.9 per 1000 [95% confidence interval (CI) 2.6, 3.2], down from 3.5 (95% CI 3.2, 3.9) in the same surveillance area in 2006. Among CP cases with no documented postneonatal aetiology, 49.1% (95% CI 42.9, 55.2) were born LBW in 2010 compared with 54.3% (95% CI 48.4, 60.1) in 2006. In 2010, 28.1% (95% CI 22.9, 30.4) were born very low birthweight (VLBW, <1500 g) compared with 35.4% (95% CI 30.0, 41.2) in 2006. The relative risks for associations between CP and both LBW and VLBW also declined, though not significantly, during the study period. CONCLUSIONS Declines in the associations between CP and LBW categories may have contributed to declines during the study period in both the prevalence of CP and the percentage of children with CP who were born LBW or VLBW. Ongoing monitoring of these trends is warranted.
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Affiliation(s)
- Maureen S. Durkin
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI,Waisman Center, University of Wisconsin-Madison, Madison, WI,Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Ruth E. Benedict
- Waisman Center, University of Wisconsin-Madison, Madison, WI,Department of Kinesiology, University of Wisconsin-Madison, Madison, WI
| | | | - Lindsay A. Dubois
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI,Waisman Center, University of Wisconsin-Madison, Madison, WI
| | - Robert T. Fitzgerald
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO
| | - Russell S. Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
| | | | | | - Martha S. Wingate
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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174
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Abstract
Differences in rates of case closure, case service cost, hours worked per week, and weekly wage between customers with autism closed successfully in competitive employment and supported employment were found using the Rehabilitation Service Administration national database of 2001. Using logistic regression, customer demographic variables related to successful competitive employment included age, years of education, and presence of a secondary disability. Case service variables related to successful competitive employment included job finding, job placement, and maintenance. Of customer demographic variables related to successful supported employment, White customers were more likely to be closed successfully. Job placement was the case service variable related to successful supported employment. Implications for rehabilitation professionals and for future research on vocational rehabilitation outcomes with customers with autism are provided.
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Affiliation(s)
| | - Nancy K. Yang
- Educational, Research, and Statistical Consultant, Austin,
Texas
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175
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Frazier TW, Hardan AY. Equivalence of symptom dimensions in females and males with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:749-759. [DOI: 10.1177/1362361316660066] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated equivalence of autism symptom domains in males and females with autism. Symptom data were obtained from 2643 children and adolescents with autism spectrum disorder (352 females, 2291 males; age range = 4–17 years) included in the Simons Simplex Collection. Items from the Social Responsiveness Scale and Autism Diagnostic Interview–Revised were mapped to nine a priori symptom dimensions. Multi-group confirmatory factor models, including measurement equivalence and item response theory analyses, examined whether males and females showed measurement or structural differences in autism symptom constructs. Results indicated mean differences in restricted interests that were not due to measurement bias. No other symptom dimension showed evidence of measurement bias and autism symptom structure was highly similar between males and females. Future studies are needed to carefully estimate any sex differences in the content, frequency, or intensity/severity of restricted interests in females and males.
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176
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Valero MR, Sadadcharam M, Henderson L, Freeman SR, Lloyd S, Green KM, Bruce IA. Compliance with cochlear implantation in children subsequently diagnosed with autism spectrum disorder. Cochlear Implants Int 2016; 17:200-206. [DOI: 10.1080/14670100.2016.1211226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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177
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Kubota T. Epigenetic alterations induced by environmental stress associated with metabolic and neurodevelopmental disorders. ENVIRONMENTAL EPIGENETICS 2016; 2:dvw017. [PMID: 29492297 PMCID: PMC5804531 DOI: 10.1093/eep/dvw017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/14/2016] [Accepted: 07/18/2016] [Indexed: 06/08/2023]
Abstract
Epigenetics is a gene regulation mechanism that does not depend on genomic DNA sequences but depends on chemical modification of genomic DNA and histone proteins around which DNA is wrapped. The failure of epigenetic mechanisms is known to cause various congenital disorders. It is also known that the failures of epigenetic mechanisms causes various acquired disorders since epigenetic modifications of the genome (i.e., "epigenome") are more vulnerable to environmental stress, such as malnutrition, environmental chemicals, and mental stress, than the "genome," especially during the early period of life. However, the epigenome has a reversible property since it is based on removable residues on genomic DNA. Thus, environmentally induced epigenomic alterations can be potentially restored. In fact, some medicines, especially for psychiatric diseases, are known to restore an altered epigenome, resulting in the correction of gene expression. Several lines of evidence suggest that environmentally induced epigenomic alterations are not erased completely during gametogenesis, but are transmitted to subsequent generations with disease phenotypes. In accordance with these understandings, I would like to propose the development of epigenomic-based preemptive medicine that consists of the early detection of the developmental origins of diseases using epigenomic signatures and the early intervention that take advantages of the use of epigenomic reversibility.
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Affiliation(s)
- Takeo Kubota
- Department of Epigenetic Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, 409-3898, Japan
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178
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De novo nonsense and frameshift variants of TCF20 in individuals with intellectual disability and postnatal overgrowth. Eur J Hum Genet 2016; 24:1739-1745. [PMID: 27436265 DOI: 10.1038/ejhg.2016.90] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 06/01/2016] [Accepted: 06/21/2016] [Indexed: 01/01/2023] Open
Abstract
Recently, germline variants of the transcriptional co-regulator gene TCF20 have been implicated in the aetiology of autism spectrum disorders (ASD). However, the knowledge about the associated clinical picture remains fragmentary. In this study, two individuals with de novo TCF20 sequence variants were identified in a cohort of 313 individuals with intellectual disability of unknown aetiology, which was analysed by whole exome sequencing using a child-parent trio design. Both detected variants - one nonsense and one frameshift variant - were truncating. A comprehensive clinical characterisation of the patients yielded mild intellectual disability, postnatal tall stature and macrocephaly, obesity and muscular hypotonia as common clinical signs while ASD was only present in one proband. The present report begins to establish the clinical picture of individuals with de novo nonsense and frameshift variants of TCF20 which includes features such as proportionate overgrowth and muscular hypotonia. Furthermore, intellectual disability/developmental delay seems to be fully penetrant amongst known individuals with de novo nonsense and frameshift variants of TCF20, whereas ASD is shown to be incompletely penetrant. The transcriptional co-regulator gene TCF20 is hereby added to the growing number of genes implicated in the aetiology of both ASD and intellectual disability. Furthermore, such de novo variants of TCF20 may represent a novel differential diagnosis in the overgrowth syndrome spectrum.
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179
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Radley KC, Hanglein J, Arak M. School-based social skills training for preschool-age children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 20:938-951. [DOI: 10.1177/1362361315617361] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individuals with autism spectrum disorder display impairments in social interactions and communication that appear at early ages and result in short- and long-term negative outcomes. As such, there is a need for effective social skills training programs for young children with autism spectrum disorder—particularly interventions capable of being delivered in educational settings. The study evaluated the effects of the Superheroes Social Skills program on accurate demonstration of social skills in young children with autism spectrum disorder. Two preschool-age children with autism spectrum disorder participated in a weekly social skills intervention. A multiple probe design across skills was used to determine the effects of the intervention. Both participants demonstrated substantial improvements in skill accuracy. Social skills checklists also indicated improvements in social functioning over baseline levels.
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180
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Harrington JW, Patrick PA, Edwards KS, Brand DA. Parental beliefs about autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 10:452-62. [PMID: 16940312 DOI: 10.1177/1362361306066609] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated parental beliefs about the etiology, diagnosis, and treatment of autism spectrum disorders. Sixty-two families of affected children completed a questionnaire asking when the parent first noticed developmental or behavioral problems, when they were told the diagnosis, how confident they were about the ability of their child's physician to recognize autism, whether they believed anything specific might have caused their child's autism, and what medications and complementary or alternative therapies they had tried. Two-thirds of parents suspected a specific cause, and three-quarters questioned their physician's ability. Parents who perceived a greater delay in diagnosis or who had tried more different therapies both tended to have less confidence in their physician (p = 0.20 and p = 0.07, respectively). Physicians should inquire about parental beliefs concerning etiology, learn what treatments the children are receiving, perform screening at the 18 month visit, and make referrals for further evaluation as soon as a child begins to exhibit signs suggestive of autism.
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Affiliation(s)
- John W Harrington
- Department of Pediatrics, New York Medical College,Valhalla, NY 10595, USA.
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181
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Wehman P, Brooke V, Brooke AM, Ham W, Schall C, McDonough J, Lau S, Seward H, Avellone L. Employment for adults with autism spectrum disorders: A retrospective review of a customized employment approach. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 53-54:61-72. [PMID: 26855048 DOI: 10.1016/j.ridd.2016.01.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/14/2016] [Accepted: 01/21/2016] [Indexed: 06/05/2023]
Abstract
Over the past few decades, there has been an increase in prevalence of children with autism spectrum disorders (ASD), and those children are now becoming young adults in need of competitive integrated employment (CIE). Customized employment (CE) is one pathway to employment that has been successful for other individuals with developmental disabilities (DD), though research has been very limited on the effectiveness with individuals with ASD. This paper provides a retrospective review of 64 individuals with ASD who came to our program from 2009 to 2014 for supported employment services as referred by the state vocational rehabilitation services agency. Employment specialists engaged in situational assessment, discovery, job development, customized job descriptions, on-site training and support, positive behavioral supports, and job retention techniques. The employment specialists were responsible for tracking their actual time spent working directly with or for the jobseeker with autism spectrum disorders (ASD). All vocational rehabilitation clients with ASD served during this time successfully secured CIE, and maintained their employment with ongoing supports, with intensity of support time decreasing over time. The majority (63/64, 98.4%) of individuals successfully secured CIE through the use of supported employment, in 72 unique employment positions. Of the majority of the individuals who secured employment, 77% (50) individuals indicated that they had never worked before and additional 18% (12) reported having short intermittent histories of employment. Despite this lack of employment experience, in all cases the jobseeker directed the job search and ultimately the job selection.
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Affiliation(s)
- Paul Wehman
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Valerie Brooke
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Alissa Molinelli Brooke
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Whitney Ham
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Carol Schall
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Jennifer McDonough
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Stephanie Lau
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Hannah Seward
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
| | - Lauren Avellone
- Virginia Commonwealth University, Rehabilitation Research and Training Center, 1314 West Main Street, Richmond, VA 23284, USA.
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182
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Howe YJ, O'Rourke JA, Yatchmink Y, Viscidi EW, Jones RN, Morrow EM. Female Autism Phenotypes Investigated at Different Levels of Language and Developmental Abilities. J Autism Dev Disord 2016; 45:3537-49. [PMID: 26100851 DOI: 10.1007/s10803-015-2501-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study investigated the differences in clinical symptoms between females and males with autism spectrum disorder (ASD) across three verbal ability groups (nonverbal, phrase and fluent speech), based on which Autism Diagnostic Observation Schedule module was administered to 5723 individuals in four research datasets. In the Simons Simplex Collection and Autism Treatment Network, females with ASD and phrase or fluent speech had lower cognitive, adaptive, and social abilities than males. In the Autism Genetics Resource Exchange and the Autism Consortium, females with phrase or fluent speech had similar or better adaptive and social abilities than males. Females who were nonverbal had similar cognitive, adaptive, and social abilities as males. Population-based longitudinal studies of verbally fluent females with ASD are needed.
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Affiliation(s)
- Yamini J Howe
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Hasbro Children's/Rhode Island Hospital, Brown University, Providence, RI, USA
- Lurie Center for Autism, Massachusetts General Hospital for Children, Lexington, MA, USA
| | - Julia A O'Rourke
- Lurie Center for Autism, Massachusetts General Hospital for Children, Lexington, MA, USA
- Laboratory of Computer Science, Massachusetts General Hospital, Boston, MA, USA
| | - Yvette Yatchmink
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Hasbro Children's/Rhode Island Hospital, Brown University, Providence, RI, USA
| | - Emma W Viscidi
- Division of Biology and Medicine, Department of Community Health/Epidemiology, Brown University, Providence, RI, USA
- Biogen, Cambridge, MA, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA
| | - Eric M Morrow
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA.
- Department of Molecular Biology, Cell Biology and Biochemistry and Institute for Brain Science, Brown University, Providence, RI, USA.
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, Providence, RI, USA.
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183
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Burkett K, Morris E, Manning-Courtney P, Anthony J, Shambley-Ebron D. African American families on autism diagnosis and treatment: the influence of culture. J Autism Dev Disord 2016; 45:3244-54. [PMID: 26055985 DOI: 10.1007/s10803-015-2482-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cultural factors such as health care access and autism spectrum disorder (ASD) symptom interpretations have been proposed as impacting delayed diagnosis and treatment for African American children with ASD. A qualitative study of urban African American families caring for their child with autism was conducted with 24 family members and 28 ASD professionals. Cultural caring meant families protected their child from harm including potential or actual distrustful encounters, and took action for their child and community to optimize their child's health and address the knowledge deficits of ASD within their community. Families and professionals believed cultural influences delayed families' receiving and seeking appropriate health care for the African American child with ASD affecting timely autism diagnosis and treatment.
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Affiliation(s)
- Karen Burkett
- Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML4002, Cincinnati, OH, 45229, USA.
| | - Edith Morris
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA.,Nursing Research in Patient Services, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Patricia Manning-Courtney
- Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML4002, Cincinnati, OH, 45229, USA
| | - Jean Anthony
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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184
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Autism Spectrum Disorder (ASD) Prevalence in Somali and Non-Somali Children. J Autism Dev Disord 2016; 46:2599-2608. [DOI: 10.1007/s10803-016-2793-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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185
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Zerbo O, Traglia M, Yoshida C, Heuer LS, Ashwood P, Delorenze GN, Hansen RL, Kharrazi M, Van de Water J, Yolken RH, Weiss LA, Croen LA. Maternal mid-pregnancy C-reactive protein and risk of autism spectrum disorders: the early markers for autism study. Transl Psychiatry 2016; 6:e783. [PMID: 27093065 PMCID: PMC4872404 DOI: 10.1038/tp.2016.46] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/28/2016] [Accepted: 01/31/2016] [Indexed: 12/31/2022] Open
Abstract
Maternal pregnancy levels of the inflammatory marker C-reactive protein (CRP) has been previously associated with autism spectrum disorder (ASD) in the offspring. We conducted a population-based nested case-control study with 500 children with ASD, 235 with developmental delay (DD) and 580 general population (GP) controls to further investigate whether elevated CRP during pregnancy increases the risk of ASD. Maternal CRP concentration was measured in archived serum collected during 15-19 weeks of pregnancy and genome-wide single-nucleotide polymorphism (SNP) data were generated. The levels of CRP were compared between ASD vs GP and DD vs GP. The genetic associations with CRP were assessed via linear regression. Maternal CRP levels in mid-pregnancy were lower in mothers of ASD compared with controls. The maternal CRP levels in the upper third and fourth quartiles were associated with a 45 and 44% decreased risk of ASD, respectively. Two SNPs at the CRP locus showed strong association with CRP levels but they were not associated with ASD. No difference was found between maternal CRP levels of DD and controls. The reasons for the lower levels of CRP in mothers of ASD are not known with certainty but may be related to alterations in the immune response to infectious agents. The biological mechanisms underlying this association remain to be clarified.
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Affiliation(s)
- O Zerbo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - M Traglia
- Department of Psychiatry and Institute of Human Genetics, University of California, San Francisco, San Francisco, CA, USA
| | - C Yoshida
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - L S Heuer
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA
| | - P Ashwood
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA
- MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - G N Delorenze
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - R L Hansen
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA
- Department of Pediatrics, University of California, Medical Health System, Sacramento, CA, USA
| | - M Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - J Van de Water
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, USA
| | - R H Yolken
- Stanley Division of Developmental Neurovirology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L A Weiss
- Department of Psychiatry and Institute of Human Genetics, University of California, San Francisco, San Francisco, CA, USA
| | - L A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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186
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Wong S, Napoli E, Krakowiak P, Tassone F, Hertz-Picciotto I, Giulivi C. Role of p53, Mitochondrial DNA Deletions, and Paternal Age in Autism: A Case-Control Study. Pediatrics 2016; 137:peds.2015-1888. [PMID: 27033107 PMCID: PMC4811307 DOI: 10.1542/peds.2015-1888] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The tumor suppressor p53 responds to a variety of environmental stressors by regulating cell cycle arrest, apoptosis, senescence, DNA repair, bioenergetics and mitochondrial DNA (mtDNA) copy number maintenance. Developmental abnormalities have been reported in p53-deficient mice, and altered p53 and p53-associated pathways in autism (AU). Furthermore, via the Pten-p53 crosstalk, Pten haploinsufficient-mice have autisticlike behavior accompanied by brain mitochondrial dysfunction with accumulation of mtDNA deletions. METHODS mtDNA copy number and deletions, and p53 gene copy ratios were evaluated in peripheral blood monocytic cells from children aged 2-5 years with AU (n = 66), race-, gender-, and age-matched typically neurodeveloping children (n = 46), and both parents from each diagnostic group, recruited by the Childhood Autism Risk from Genes and Environment study at the University of California, Davis. RESULTS mtDNA deletions and higher p53 gene copy ratios were more common in children with AU and their fathers. The incidence of mtDNA deletions in fathers of children with AU was increased 1.9-fold over fathers of typically neurodeveloping children, suggesting a role for deficient DNA repair capacity not driven by paternal age. Deletions in mtDNA and altered p53 gene copy ratios seem to result from genetics (children with severity scores ≥8) and/or act in concert with environmental factors (children with 6-7 severity scores). CONCLUSIONS Given pro- and antioxidant activities of p53, and associations of genomic instability with disorders other than AU, our study suggests a link between DNA repair capacity, genomic instability in the 17p13.1 region influenced by environmental triggers, and AU diagnosis.
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Affiliation(s)
- Sarah Wong
- Department of Molecular Biosciences, School of Veterinary Medicine
| | - Eleonora Napoli
- Department of Molecular Biosciences, School of Veterinary Medicine
| | | | - Flora Tassone
- Biochemistry and Molecular Medicine, School of Medicine, and,Medical Investigations of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Davis, California
| | - Irva Hertz-Picciotto
- Departments of Public Health Sciences and,Medical Investigations of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Davis, California
| | - Cecilia Giulivi
- Department of Molecular Biosciences, School of Veterinary Medicine, Medical Investigations of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Davis, California
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187
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Christensen DL, Baio J, Van Naarden Braun K, Bilder D, Charles J, Constantino JN, Daniels J, Durkin MS, Fitzgerald RT, Kurzius-Spencer M, Lee LC, Pettygrove S, Robinson C, Schulz E, Wells C, Wingate MS, Zahorodny W, Yeargin-Allsopp M. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years--Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR. SURVEILLANCE SUMMARIES : MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES 2016; 65:1-23. [PMID: 27031587 PMCID: PMC7909709 DOI: 10.15585/mmwr.ss6503a1] [Citation(s) in RCA: 935] [Impact Index Per Article: 116.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Problem/Condition Autism spectrum disorder (ASD). Period Covered 2012. Description of System The Autism and Developmental Disabilities Monitoring (ADDM) Network is an
active surveillance system that provides estimates of the prevalence and
characteristics of ASD among children aged 8 years whose parents or
guardians reside in 11 ADDM Network sites in the United States (Arkansas,
Arizona, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina,
South Carolina, Utah, and Wisconsin). Surveillance to determine ASD case
status is conducted in two phases. The first phase consists of screening and
abstracting comprehensive evaluations performed by professional service
providers in the community. Data sources identified for record review are
categorized as either 1) education source type, including developmental
evaluations to determine eligibility for special education services or 2)
health care source type, including diagnostic and developmental evaluations.
The second phase involves the review of all abstracted evaluations by
trained clinicians to determine ASD surveillance case status. A child meets
the surveillance case definition for ASD if one or more comprehensive
evaluations of that child completed by a qualified professional describes
behaviors that are consistent with the Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition, Text Revision
diagnostic criteria for any of the following conditions: autistic disorder,
pervasive developmental disorder–not otherwise specified (including
atypical autism), or Asperger disorder. This report provides ASD prevalence
estimates for children aged 8 years living in catchment areas of the ADDM
Network sites in 2012, overall and stratified by sex, race/ethnicity, and
the type of source records (education and health records versus health
records only). In addition, this report describes the proportion of children
with ASD with a score consistent with intellectual disability on a
standardized intellectual ability test, the age at which the earliest known
comprehensive evaluation was performed, the proportion of children with a
previous ASD diagnosis, the specific type of ASD diagnosis, and any special
education eligibility classification. Results For 2012, the combined estimated prevalence of ASD among the 11 ADDM Network
sites was 14.6 per 1,000 (one in 68) children aged 8 years. Estimated
prevalence was significantly higher among boys aged 8 years (23.6 per 1,000)
than among girls aged 8 years (5.3 per 1,000). Estimated ASD prevalence was
significantly higher among non-Hispanic white children aged 8 years (15.5
per 1,000) compared with non-Hispanic black children (13.2 per 1,000), and
Hispanic (10.1 per 1,000) children aged 8 years. Estimated prevalence varied
widely among the 11 ADDM Network sites, ranging from 8.2 per 1,000 children
aged 8 years (in the area of the Maryland site where only health care
records were reviewed) to 24.6 per 1,000 children aged 8 years (in New
Jersey, where both education and health care records were reviewed).
Estimated prevalence was higher in surveillance sites where education
records and health records were reviewed compared with sites where health
records only were reviewed (17.1 per 1,000 and 10.7 per 1,000 children aged
8 years, respectively; p<0.05). Among children identified with ASD by the
ADDM Network, 82% had a previous ASD diagnosis or educational
classification; this did not vary by sex or between non-Hispanic white and
non-Hispanic black children. A lower percentage of Hispanic children (78%)
had a previous ASD diagnosis or classification compared with non-Hispanic
white children (82%) and with non-Hispanic black children (84%). The median
age at earliest known comprehensive evaluation was 40 months, and 43% of
children had received an earliest known comprehensive evaluation by age 36
months. The percentage of children with an earliest known comprehensive
evaluation by age 36 months was similar for boys and girls, but was higher
for non-Hispanic white children (45%) compared with non-Hispanic black
children (40%) and Hispanic children (39%). Interpretation Overall estimated ASD prevalence was 14.6 per 1,000 children aged 8 years in
the ADDM Network sites in 2012. The higher estimated prevalence among sites
that reviewed both education and health records suggests the role of special
education systems in providing comprehensive evaluations and services to
children with developmental disabilities. Disparities by race/ethnicity in
estimated ASD prevalence, particularly for Hispanic children, as well as
disparities in the age of earliest comprehensive evaluation and presence of
a previous ASD diagnosis or classification, suggest that access to treatment
and services might be lacking or delayed for some children. Public Health Action The ADDM Network will continue to monitor the prevalence and characteristics
of ASD among children aged 8 years living in selected sites across the
United States. Recommendations from the ADDM Network include enhancing
strategies to 1) lower the age of first evaluation of ASD by community
providers in accordance with the Healthy People 2020 goal
that children with ASD are evaluated by age 36 months and begin receiving
community-based support and services by age 48 months; 2) reduce disparities
by race/ethnicity in identified ASD prevalence, the age of first
comprehensive evaluation, and presence of a previous ASD diagnosis or
classification; and 3) assess the effect on ASD prevalence of the revised
ASD diagnostic criteria published in the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition.
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Affiliation(s)
- Deborah L Christensen
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
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188
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Prenatal minocycline treatment alters synaptic protein expression, and rescues reduced mother call rate in oxytocin receptor-knockout mice. Biochem Biophys Res Commun 2016; 472:319-23. [DOI: 10.1016/j.bbrc.2016.02.109] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/25/2016] [Indexed: 11/19/2022]
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189
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Abstract
Preimplantation genetic testing (PGT) of oocytes and embryos is the earliest form of prenatal testing. PGT requires in vitro fertilization for embryo creation. In the past 25 years, the use of PGT has increased dramatically. The indications of PGT include identification of embryos harboring single-gene disorders, chromosomal structural abnormalities, chromosomal numeric abnormalities, and mitochondrial disorders; gender selection; and identifying unaffected, HLA-matched embryos to permit the creation of a savior sibling. PGT is not without risks, limitations, or ethical controversies. This review discusses the techniques and clinical applications of different forms of PGT and the debate surrounding its associated uncertainty and expanded use.
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Affiliation(s)
- Anthony N Imudia
- Division of Reproductive Endocrinology and Infertility, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Suite 6022, Tampa, FL 33606, USA.
| | - Shayne Plosker
- Division of Reproductive Endocrinology and Infertility, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Suite 6022, Tampa, FL 33606, USA
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190
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Zhao H, Carney KE, Falgoust L, Pan JW, Sun D, Zhang Z. Emerging roles of Na⁺/H⁺ exchangers in epilepsy and developmental brain disorders. Prog Neurobiol 2016; 138-140:19-35. [PMID: 26965387 DOI: 10.1016/j.pneurobio.2016.02.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/03/2016] [Accepted: 02/27/2016] [Indexed: 12/15/2022]
Abstract
Epilepsy is a common central nervous system (CNS) disease characterized by recurrent transient neurological events occurring due to abnormally excessive or synchronous neuronal activity in the brain. The CNS is affected by systemic acid-base disorders, and epileptic seizures are sensitive indicators of underlying imbalances in cellular pH regulation. Na(+)/H(+) exchangers (NHEs) are a family of membrane transporter proteins actively involved in regulating intracellular and organellar pH by extruding H(+) in exchange for Na(+) influx. Altering NHE function significantly influences neuronal excitability and plays a role in epilepsy. This review gives an overview of pH regulatory mechanisms in the brain with a special focus on the NHE family and the relationship between epilepsy and dysfunction of NHE isoforms. We first discuss how cells translocate acids and bases across the membrane and establish pH homeostasis as a result of the concerted effort of enzymes and ion transporters. We focus on the specific roles of the NHE family by detailing how the loss of NHE1 in two NHE mutant mice results in enhanced neuronal excitability in these animals. Furthermore, we highlight new findings on the link between mutations of NHE6 and NHE9 and developmental brain disorders including epilepsy, autism, and attention deficit hyperactivity disorder (ADHD). These studies demonstrate the importance of NHE proteins in maintaining H(+) homeostasis and their intricate roles in the regulation of neuronal function. A better understanding of the mechanisms underlying NHE1, 6, and 9 dysfunctions in epilepsy formation may advance the development of new epilepsy treatment strategies.
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Affiliation(s)
- Hanshu Zhao
- Department of Neurology, The First Affiliated Hospital of the Harbin Medical University, Harbin, China.,Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Karen E Carney
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Lindsay Falgoust
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jullie W Pan
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Dandan Sun
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA.,Veterans Affairs Pittsburgh Health Care System, Geriatric Research, Educational and Clinical Center, Pittsburgh, PA 15213, USA
| | - Zhongling Zhang
- Department of Neurology, The First Affiliated Hospital of the Harbin Medical University, Harbin, China
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191
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Castro K, Klein LDS, Baronio D, Gottfried C, Riesgo R, Perry IS. Folic acid and autism: What do we know? Nutr Neurosci 2016; 19:310-7. [PMID: 25087906 DOI: 10.1179/1476830514y.0000000142] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorders (ASD) consist in a range of neurodevelopmental conditions that share common features with autism, such as impairments in communication and social interaction, repetitive behaviors, stereotypies, and a limited repertoire of interests and activities. Some studies have reported that folic acid supplementation could be associated with a higher incidence of autism, and therefore, we aimed to conduct a systematic review of studies involving relationships between this molecule and ASD. The MEDLINE database was searched for studies written in English which evaluated the relationship between autism and folate. The initial search yielded 60 potentially relevant articles, of which 11 met the inclusion criteria. The agreement between reviewers was κ = 0.808. The articles included in the present study addressed topics related to the prescription of vitamins, the association between folic acid intake/supplementation during pregnancy and the incidence of autism, food intake, and/or nutrient supplementation in children/adolescents with autism, the evaluation of serum nutrient levels, and nutritional interventions targeting ASD. Regarding our main issue, namely the effect of folic acid supplementation, especially in pregnancy, the few and contradictory studies present inconsistent conclusions. Epidemiological associations are not reproduced in most of the other types of studies. Although some studies have reported lower folate levels in patients with ASD, the effects of folate-enhancing interventions on the clinical symptoms have yet to be confirmed.
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Affiliation(s)
- Kamila Castro
- a Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,b Translational Research Group in Autism Spectrum Disorders (GETTEA) , Porto Alegre , Brazil.,c Instituto de Pesquisas, Ensino e Gestão em Saúde (iPGS) , Porto Alegre , Brazil
| | - Luciana da Silveira Klein
- a Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Diego Baronio
- b Translational Research Group in Autism Spectrum Disorders (GETTEA) , Porto Alegre , Brazil.,d Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Carmem Gottfried
- b Translational Research Group in Autism Spectrum Disorders (GETTEA) , Porto Alegre , Brazil
| | - Rudimar Riesgo
- b Translational Research Group in Autism Spectrum Disorders (GETTEA) , Porto Alegre , Brazil.,d Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,e Child Neurology Unit , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Ingrid Schweigert Perry
- a Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,f Academic Unit of Health Sciences, Universidade do Extremo Sul de Santa Catarina , Criciúma , Brazil
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192
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Stolerman ES, Smith B, Chaubey A, Jones JR. CHD8 intragenic deletion associated with autism spectrum disorder. Eur J Med Genet 2016; 59:189-94. [PMID: 26921529 DOI: 10.1016/j.ejmg.2016.02.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 01/29/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental disorders that are highly heritable. De novo genomic alterations are considered an important cause of autism spectrum disorders. Recent research has shown that de novo loss-of-function mutations in the chromodomain helicase DNA-binding protein 8 (CHD8) gene are associated with an increased risk of ASD. We describe a single case of an intragenic deletion of exons 26-28 in the CHD8 gene in a patient with autism and global developmental delay. Our clinical case supports the hypothesis that CHD8 may play a central role in neuronal cell development and ASD risk.
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Affiliation(s)
| | - Brooke Smith
- Greenwood Genetic Center, Greenwood, SC, 29646, USA
| | - Alka Chaubey
- Greenwood Genetic Center, Greenwood, SC, 29646, USA
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193
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Kiely B, Migdal TR, Vettam S, Adesman A. Prevalence and Correlates of Elopement in a Nationally Representative Sample of Children with Developmental Disabilities in the United States. PLoS One 2016; 11:e0148337. [PMID: 26845701 PMCID: PMC4742252 DOI: 10.1371/journal.pone.0148337] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/15/2016] [Indexed: 12/12/2022] Open
Abstract
Despite increased awareness and concern about children with developmental disabilities wandering away from adult supervision, there is a paucity of research about elopement. This is the first study to examine and report the prevalence and correlates of elopement in a nationally representative sample of school-age children in the United States with an autism spectrum disorder (ASD) and/or cognitive impairment. Data were obtained from the CDC's "Pathways" Survey, a follow-up telephone survey of the parents of 4,032 children with a developmental condition. 3,518 children that had ASD, intellectual disability (ID), and/or developmental delay (DD) at the time of survey administration were included for analysis. Children were divided into three condition groups: ASD-only; ID/DD-only; ASD+ID/DD. Logistic regression analyses were used to compare the prevalence of elopement and rates of preventive measure use (barriers and/or electronic devices) across condition groups, and to examine the clinical and demographic correlates of elopement. T-tests were also performed to compare scores on the Children's Social Behavior Questionnaire (CSBQ) between wanderers and non-wanderers. Overall, 26.7% of children had reportedly eloped within the previous year, most commonly from public places. Children with ASD-only and ASD+ID/DD were more likely to have eloped than those with ID/DD-only. Across all groups, wanderers scored higher than non-wanderers on five out of six CSBQ subscales; they were more likely not to realize when there is danger, to have difficulty distinguishing between strangers and familiar people, to show sudden mood changes, to over-react to everything/everyone, to get angry quickly, to get lost easily, and to panic in new situations or if change occurs. Even after controlling for elopement history, parents of children in the ASD+ID/DD group were more likely than those in the other condition groups to report using physical or electronic measures to prevent wandering.
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Affiliation(s)
- Bridget Kiely
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, United States of America
| | - Talia R. Migdal
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, United States of America
| | - Sujit Vettam
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, United States of America
| | - Andrew Adesman
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, United States of America
- * E-mail:
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194
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Murray DS, Fedele A, Shui A, Coury DL. The Autism Speaks Autism Treatment Network Registry Data: Opportunities for Investigators. Pediatrics 2016; 137 Suppl 2:S72-8. [PMID: 26908480 DOI: 10.1542/peds.2015-2851e] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Patient registries can effectively collect data over a long period of time to provide a better understanding of the typical presentation of specific conditions. The autism spectrum disorders (ASDs) have experienced a marked increase in reported prevalence over the past 20 years for reasons that are not completely clear. The Autism Treatment Network (ATN) Registry was established to facilitate investigations into a variety of questions critical to expanding our understanding of ASDs. Here we describe the establishment of the registry, its components, some of its findings to date, and opportunities for further use of this data. METHODS Participants are eligible for enrollment into the ATN registry if they are between the ages of 2.0 and 17.6 years at the time of enrollment and meet criteria for ASD as determined by clinical consensus on the basis of specific diagnostic measures (Autism Diagnostic Observation Schedule/Autism Diagnostic Observation Schedule, Second Edition; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). Baseline measures include demographics, autism assessment, cognitive assessment data, behavioral data, sleep habits, quality of life, sensory data, and treatments. Several of the measures are collected at annual follow-up visits. RESULTS More than 6800 children with ASD have been enrolled in the Autism Speaks ATN registry. Data from the registry have been reported at numerous scientific meetings and in several publications and have led to new recommendations for best practices in the management of ASD. CONCLUSIONS A patient registry for children and adolescents with ASD has had and will continue to have a significant impact on care for this population. Investigators are encouraged to query this database to further its impact by testing novel hypotheses and conducting preliminary proof-of-concept analyses.
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Affiliation(s)
- Donna S Murray
- Autism Speaks Autism Treatment Network; Boston, Massachusetts Cincinnati Children's Hospital Medical Center, Division of Developmental and Behavioral Pediatrics, The Kelly O'Leary Center for Autism Spectrum Disorders, Cincinnati, Ohio; Autism Intervention Research Network on Physical Health (Health Resources and Services Administration);
| | - Angie Fedele
- Autism Speaks Autism Treatment Network; Boston, Massachusetts Autism Intervention Research Network on Physical Health (Health Resources and Services Administration)
| | - Amy Shui
- Autism Speaks Autism Treatment Network; Boston, Massachusetts Autism Intervention Research Network on Physical Health (Health Resources and Services Administration); Massachusetts General Hospital, Biostatistics Center, Boston, Massachusetts
| | - Daniel L Coury
- Autism Speaks Autism Treatment Network; Boston, Massachusetts Autism Intervention Research Network on Physical Health (Health Resources and Services Administration); Nationwide Children's Hospital, Developmental and Behavioral Pediatrics, Columbus, Ohio; and Ohio State University, College of Medicine, Columbus, Ohio
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195
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Prevalence of Autism Spectrum Disorders in Guanajuato, Mexico: The Leon survey. J Autism Dev Disord 2016; 46:1669-85. [DOI: 10.1007/s10803-016-2696-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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196
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Waters DM, Mauch A, Coffey A, Arendt EK, Zannini E. Lactic acid bacteria as a cell factory for the delivery of functional biomolecules and ingredients in cereal-based beverages: a review. Crit Rev Food Sci Nutr 2016; 55:503-20. [PMID: 24915367 DOI: 10.1080/10408398.2012.660251] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this review, we aim to describe the mechanisms by which LAB can fulfil the novel role of efficient cell factory for the production of functional biomolecules and food ingredients to enhance the quality of cereal-based beverages. LAB fermentation is a safe, economical, and traditional method of food preservation foremost, as well as having the additional benefits of flavor, texture, and nutrition amelioration. Additionally, LAB fermentation in known to render cereal-based foods and beverages safe, in a chemical-free, consumer-friendly manner, from an antinutrient and toxigenic perspective. Huge market opportunities and potential exist for food manufacturers who can provide the ideal functional beverage fulfilling consumer needs. Newly developed fermented cereal-based beverages must address markets globally including, high-nutrition markets (developing countries), lifestyle choice consumers (vegetarian, vegan, low-fat, low-salt, low-calorie), food-related non-communicable disease sufferers (cardiovascular disease, diabetes), and green label consumers (Western countries). To fulfil these recommendations, a suitable LAB starter culture and cereal-based raw materials must be developed. These strains would be suitable for the biopreservation of cereal beverages and, ideally, would be highly antifungal, anti-mycotoxigenic, mycotoxin-binding and proteolytic (neutralize toxic peptides and release flavor-contributing amino acids) with an ability to ferment cereals, whilst synthesizing oligosaccharides, thus presenting a major opportunity for the development of safe cereal-based prebiotic functional beverages to compete with and replace the existing dairy versions.
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Affiliation(s)
- Deborah M Waters
- a School of Food and Nutritional Sciences , University College Cork , Ireland
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197
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Travers JC, Ayers K, Simpson RL, Crutchfield S. Fad, Pseudoscientific, and Controversial Interventions. EVIDENCE-BASED PRACTICES IN BEHAVIORAL HEALTH 2016. [DOI: 10.1007/978-3-319-30925-5_9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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198
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Prevalence and Characteristics of Autism Spectrum Disorder Among 4-Year-Old Children in the Autism and Developmental Disabilities Monitoring Network. J Dev Behav Pediatr 2016; 37:1-8. [PMID: 26651088 DOI: 10.1097/dbp.0000000000000235] [Citation(s) in RCA: 289] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Early identification of children with autism spectrum disorder (ASD) facilitates timely access to intervention services. Yet, few population-based data exist on ASD identification among preschool-aged children. The authors aimed to describe ASD prevalence and characteristics among 4-year-old children in 5 of 11 sites participating in the 2010 Autism and Developmental Disabilities Monitoring Network. METHOD Children with ASD were identified through screening of health and education records for ASD indicators, data abstraction and compilation for each child, and clinician review of records. ASD prevalence estimates, ages at first evaluation and ASD diagnosis, cognitive test scores, and demographics were compared for 4-year-old children and 8-year-old children living in the same areas. RESULTS Among 58,467 children in these 5 sites, 4-year-old ASD prevalence was 13.4 per 1000, which was 30% lower than 8-year-old ASD prevalence. Prevalence of ASD without cognitive impairment was 40% lower among 4-year-olds compared with 8-year-olds, but prevalence of ASD with cognitive impairment was 20% higher among 4-year-olds compared with 8-year-olds. Among 4-year-olds with ASD, female and non-Hispanic white children were more likely to receive their first comprehensive evaluation by age 36 months compared with male and non-Hispanic black children, respectively. Among children diagnosed with ASD by age 48 months, median age at first comprehensive evaluation was 27 months for 4-year-olds compared with 32 months for 8-year-olds. CONCLUSION Population-based ASD surveillance among 4-year-old children provides valuable information about the early identification of children with ASD and suggests progression toward lowering the age of first ASD evaluation within participating Autism and Developmental Disabilities Monitoring communities.
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199
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Stadnick N, Brookman-Frazee L, Williams KN, Cerda G, Akshoomoff N. A Pilot Study Examining the Use of the Autism Diagnostic Observation Schedule in Community-Based Mental Health Clinics. RESEARCH IN AUTISM SPECTRUM DISORDERS 2015; 20:39-46. [PMID: 26379765 PMCID: PMC4566166 DOI: 10.1016/j.rasd.2015.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Community-based mental health (CMH) services play an important, but relatively understudied role in the identification and treatment of youth with autism spectrum disorder (ASD) who may be receiving care for other psychiatric conditions. Little is known about the role of standardized ASD assessment measures administered by providers working in generalist community-based mental health (CMH) settings. This pilot study extracted data from three CMH clinics to examine the use of the Autism Diagnostic Observation Schedule (ADOS) by 17 CMH providers who received ASD assessment training with 62 youth (Mean = 10.69 years) referred for an ASD diagnostic evaluation. Results indicated that 57% of youths assessed ultimately received an ASD diagnosis. All cases given a final ASD diagnosis were classified as "Autism" or "ASD" on the ADOS. Seventy percent of youth who did not receive a final ASD diagnosis were classified as "Non-Spectrum" on the ADOS. In these false positive cases, report narratives indicated that social communication difficulties identified on the ADOS were explained by symptoms of other mental health conditions (e.g., ADHD, anxiety). Future research is needed to examine the utility of the ADOS when used by CMH providers to facilitate CMH capacity to identify ASD.
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Affiliation(s)
- Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Lauren Brookman-Frazee
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | | | - Gabrielle Cerda
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Natacha Akshoomoff
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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200
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Ohashi K, Mizuno Y, Miyachi T, Asai T, Imaeda M, Saitoh S. Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder. Pediatr Int 2015; 57:1097-100. [PMID: 26009933 DOI: 10.1111/ped.12704] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 03/24/2015] [Accepted: 04/23/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. Autism spectrum disorder (ASD) has been structured for the three subtypes of pervasive developmental disorder (PDD), but the number of impairment in social and communication dimension is not stated. METHODS The subjects were 68 children who visited the Department of Psychology and Development at Nagoya City University Hospital for the first time between the ages of 6 and 15 years old. We retrospectively re-examined the subjects using DSM-IV-TR criteria and DSM-5 criteria with two rules (two of three and one of three on the social and communication dimension) and examined the concordance rate. RESULTS Forty subjects were diagnosed with PDD, and 28 were not. The mean PDD subject age was 9.4 years, and mean IQ was 84.0 on the Wechsler Intelligence Scale for Children III or 62.7 on the Tanaka-Binet test. Twenty-seven (68%) of the PDD subjects were classified with ASD using DSM-5 criteria when the two of three rule was applied, while 32 (80%) were classified with ASD when the one of three rule was applied. All subjects without PDD were not diagnosed with ASD on DSM-5 criteria. CONCLUSION DSM-5 criteria may exclude high functioning and older subjects from ASD because they tend to be atypical. The diagnostic procedure for DSM-5 criteria is ambiguous, especially in high functioning subjects and those diagnosed at an older age.
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Affiliation(s)
- Kei Ohashi
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University.,Department of Pediatrics, Nagoya Akebono-Gakuen
| | - Yoshifumi Mizuno
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University.,Department of Pediatrics, Nagoya City West Medical Center
| | - Taishi Miyachi
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University.,Department of Pediatrics, Nagoya Central Care Center for Disabled Children
| | - Tomoko Asai
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University.,Department of Pediatrics, Nagoya City Support Center for Developmental Disorders
| | - Masayuki Imaeda
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University.,Department of Pediatrics, Nagoya North District Care Center of Disabled Children, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
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