151
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Abstract
Borderline intellectual functioning (BIF), that is to say, tested IQ levels in the range of 70-84/85, is prevalent, affecting about 12%-14% of the population depending on the exact level for "diagnostic" cutoff. In the current Diagnostic and Statistical Manual of Mental Disorders, BIF does not have a separate diagnostic category but can be categorized with a V-code. Children and adolescents with BIF usually struggle both as regards school performance and in respect of social functioning. BIF is common in attention deficit hyperactivity disorder, but sometimes attention problems in schoolchildren with BIF may be a consequence of nonadapted academic demands. Autism and BIF may also coexist, and there are many cases of so-called high-functioning autism who are high functioning only in the sense that they do not meet criteria for intellectual disability, but function in the area of BIF. Currently, too little attention is given to the negative effects of BIF on child development and adaptation. Learning, academic, and behavioral problems and grade retention may be markers of BIF. Our diagnostic and classification manuals need to have specific categories that clarify the problems that BIF entails so that affected individuals can avail themselves of better educational support and understanding.
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Affiliation(s)
- Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Gothenburg University, Gothenburg, Sweden.
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152
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Abstract
Children and adolescents with neurodevelopmental disorders often show complex developmental disorders, including multiple areas of dysfunction such as emotional regulation and behavior, school integration, and learning difficulties. These multidimensionally impaired children share some common features with children with autism spectrum disorders (ASDs). However, paradoxically, they could qualify as diagnostically homeless. Several proposals have been formulated to categorize subgroups of these children, whose diversity and overlap in clinical expression emphasize the importance of using a multidimensional assessment inscribed in a developmental perspective. Here, we review these different classification proposals and describe a multidimensional approach that, in addition to a categorical approach, could constitute a complementary point of view. We believe that this multidimensional perspective allows one to address the child holistically, taking into account his or her interactive experience with the environment, and achieve a functional diagnosis enabling the elaboration of a tailored therapeutic plan and better school inclusion.
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Affiliation(s)
- Jean Xavier
- Centre Hospitalier Spécialisé Henri Laborit and Centre de Recherches sur la Cognition et l'Apprentissage, Poitiers, France
| | - David Cohen
- Institut des Systèmes Intelligents et Robotiques, Sorbonne Université, Paris, France; Service de Psychiatrie de l'Enfant et de l'Adolescent, APHP.Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
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153
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Påhlman M, Gillberg C, Wentz E, Himmelmann K. Autism spectrum disorder and attention-deficit/hyperactivity disorder in children with cerebral palsy: results from screening in a population-based group. Eur Child Adolesc Psychiatry 2020; 29:1569-1579. [PMID: 31927764 PMCID: PMC7595991 DOI: 10.1007/s00787-020-01471-1] [Citation(s) in RCA: 8] [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: 08/06/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022]
Abstract
Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are more common in children with cerebral palsy (CP) than in the general population, but may still be underdiagnosed. This study aimed to estimate screen-positive ASD and ADHD in a population-based group of 264 school-aged children with CP born 1999-2006 from the CP register of western Sweden. Validated parent-completed questionnaires were used at a median age of 12 years 11 months (range 8-17 years). Three different scales were used to detect signs of ASD and ADHD, respectively. Response rate was 88% (232/264). In 19 children, all in the most disabled group, the screening procedure was not feasible due to too few questionnaire items completed, leaving 213 for analyses. One third (74/213) of the children screened positive for ASD and half of the children (106/213) for ADHD, which was about twice as often as ASD/ADHD diagnoses had been clinically identified. Children with intellectual disability, epilepsy and/or impaired speech ability more often screened positive for ASD as well as ADHD. Severe motor impairment was more frequently associated with screen-positive ASD, but not ADHD. Neither sex nor CP type was associated with screen-positive ASD/ADHD. In conclusion, school-aged children with CP very often screened positive for ASD and/or ADHD. The prevalence of ASD and ADHD is most likely underestimated in children with CP. These screening findings require further investigations.
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Affiliation(s)
- Magnus Påhlman
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Wentz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kate Himmelmann
- Regional Rehabilitation Centre, Queen Silvia Children’s Hospital, Gothenburg, Sweden ,Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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154
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Aggernæs B. Suggestion of a dynamic model of the development of neurodevelopmental disorders and the phenomenon of autism. AIMS MOLECULAR SCIENCE 2020. [DOI: 10.3934/molsci.2020008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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155
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Casanova MF, Frye RE, Gillberg C, Casanova EL. Editorial: Comorbidity and Autism Spectrum Disorder. Front Psychiatry 2020; 11:617395. [PMID: 33329163 PMCID: PMC7714785 DOI: 10.3389/fpsyt.2020.617395] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/23/2020] [Indexed: 12/25/2022] Open
Affiliation(s)
- Manuel F Casanova
- University of South Carolina School of Medicine Greenville, Greenville, SC, United States
| | | | | | - Emily L Casanova
- University of South Carolina School of Medicine Greenville, Greenville, SC, United States
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156
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Jansen R, Maljaars J, Verhappen A. Problem behavior in young children referred with language difficulties: Relations to language and intentional communication. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2020; 5:2396941519900076. [PMID: 36381553 PMCID: PMC9620458 DOI: 10.1177/2396941519900076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS This exploratory study aims to examine the relative contribution of language and intentional communication to internalizing and externalizing problem behavior. METHODS Twenty-nine Dutch-speaking children (age range 24-46 months) referred with language difficulties participated in this study. For the majority of children, these early language difficulties appeared to be part of a broader neurodevelopmental disorder, mainly autism spectrum disorder. Parent ratings on the Achenbach Child Behavior Checklist 1½-5 were predicted from children's language level and intentional communicative abilities, the latter being assessed by both parent report and direct observation. In all series of hierarchical regression analyses, chronological age and nonverbal mental age were included as covariates. RESULTS Parents commonly reported withdrawal, emotionally reactive behavior, attention problems, and aggressive behavior. Parent-rated intentional communication was the most important predictor of internalizing problem behavior and played an important role in the prediction of aggressive behavior as well. However, chronological age and/or nonverbal mental age also predicted parent-rated levels of externalizing problem behavior, especially attention problems. CONCLUSIONS The relation between language difficulties and problem behavior may be influenced by maturation and children's ability to communicate intentionally.Implications: Language proficiency should, therefore, be independently assessed from children's intentional communicative abilities which, in turn, may differ across contexts.
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Affiliation(s)
| | - Jarymke Maljaars
- Jarymke Maljaars, KU Leuven, Leopold
Vanderkelenstraat 32 box 3765, Leuven 3000, Belgium.
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157
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Taylor B, Hanna D, McPhillips M. Motor problems in children with severe emotional and behavioural difficulties. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2019; 90:719-735. [PMID: 31811653 DOI: 10.1111/bjep.12327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/24/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is growing evidence that children with motor difficulties are at risk of psychosocial problems and vice versa. However, it is not clear how far different aspects of motor function are predictive of psychosocial well-being in the context of other powerful factors, such as family upset, that are known to affect psychosocial development. AIMS To investigate the role of basic motor skills and primary reflex persistence in young children with severe emotional and behavioural difficulties (EBD). SAMPLE From a total sample of 225 children, three groups were selected: children excluded from school (severe EBD) (n = 29), a male comparison group (n = 38), and a female comparison group (n = 45). The groups were matched (at group level) on age, IQ, and level of social disadvantage. METHOD All of the selected children completed a range of standardized motor, cognitive, social, and behavioural measures, as well as a clinical protocol for primary reflex persistence. RESULTS Children with severe EBD had significant levels of motor difficulties, primary reflex persistence, and family upset, as well as significant literacy problems, attention deficits, and raised levels of hyperactivity/impulsivity relative to the comparison groups. A hierarchical multiple regression analysis revealed that basic motor skills, primary reflex persistence, family upset, hyperactivity, and literacy were all significant predictors of psychosocial functioning. CONCLUSIONS The findings suggest that motor difficulties and primary reflex persistence may act as independent stressors of psychosocial functioning in children with EBD. We suggest that specific movement interventions should be adopted to complement existing provision for children at risk of psychosocial problems.
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158
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Sheehan WA, Iarocci G. Executive Functioning Predicts Academic But Not Social Adjustment to University. J Atten Disord 2019; 23:1792-1800. [PMID: 26537893 DOI: 10.1177/1087054715612258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Adjusting well academically and socially has been associated with enhanced academic performance and student retention. The purpose of this study was to examine subthreshold levels of ADHD symptoms such as inattention, hyperactivity, and executive functioning as potential predictors of academic and social adjustment in a healthy sample of university students. Method: Participants were 135 undergraduate university students who completed self-report questionnaires. Results: Hierarchical regression analyses revealed that metacognition (an aspect of executive function), gender, and age were significant predictors of academic adjustment beyond hyperactivity, inattention, and depression. Depression was the only significant predictor of social adjustment. Conclusion: The BASC-College form may identify depression symptoms predictive of social adjustment, but symptoms of inattention or hyperactivity are not sufficiently sensitive to predict academic adjustment. Measures of executive function that include metacognition such as the BRIEF-A may be most promising in identifying skills predictive of academic adjustment.
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Affiliation(s)
| | - Grace Iarocci
- Simon Fraser University, Burnaby, British Columbia, Canada
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159
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The Child Evaluation Checklist (CHECK): A Screening Questionnaire for Detecting Daily Functional "Red Flags" of Underrecognized Neurodevelopmental Disorders among Preschool Children. Occup Ther Int 2019; 2019:6891831. [PMID: 31866801 PMCID: PMC6914930 DOI: 10.1155/2019/6891831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/23/2019] [Accepted: 11/11/2019] [Indexed: 01/06/2023] Open
Abstract
Background Early identification of invisible comorbid neurodevelopmental disorders, such as specific learning disorders, attention deficit hyperactive disorders, and developmental coordination disorders, is crucial to improving children's daily functional deficits related to executive functions. However, a practical questionnaire to address parents' concerns is lacking. Aims To develop a reliable and valid assessment tool that can identify young children at risk for invisible underrecognized neurodevelopmental disorders. This article describes the development and standardization of the Child Evaluation Checklist (CHECK). Methods and Procedures Participants were 186 children aged 3 to 6 years: 91 with suspected invisible neurodevelopmental disorders, and 95 controls with typical development. Parents completed a demographic questionnaire, the CHECK, and the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Outcomes and Results The CHECK's construct validity indicated high internal consistency for each part (Part A: α = .94; Part B: α = .90) and moderate-to-high consistency for each of Part A's four factors. Significant correlations, as well as significant group differences, were found between the CHECK factors and BRIEF-P scores. Conclusions and Implications Use of the CHECK allows for timely identification of suspicious ("red flags") invisible neurodevelopmental disorders. It may support parents' sufficient awareness and knowledge to refer their children for comprehensive evaluation and intervention.
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160
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Foubister L, Rennie F, Williams J. Parents in Control: Parental perceptions of problem behaviors before and after attending an ADHD-specific parent-training program. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2019; 33:30-37. [PMID: 31763749 DOI: 10.1111/jcap.12261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/24/2019] [Accepted: 11/17/2019] [Indexed: 11/29/2022]
Abstract
PROBLEM There is scant evidence to support the efficacy of attention deficit hyperactivity disorder (ADHD)-specific parent-training programs in the treatment of preadolescent children with ADHD. This study explores the effectiveness of the Parents in Control (PINC) parent-training program, designed specifically for children with ADHD. METHODS In this pragmatic uncontrolled pre-poststudy parents of preadolescent children with a diagnosis of ADHD were invited to attend the 6-week PINC course. Fifty-seven parent-report pre/postprogram questionnaires were completed. FINDINGS Parental ratings of the intensity and frequency of problem behaviors after completing PINC showed a significant reduction (p < .001) with a moderate effect size (0.6-0.7). CONCLUSIONS Our findings demonstrate the efficacy of PINC in reducing the parental perception of problem behaviors and support a need for further rigorous randomised controlled trial (RCT) evaluation of this ADHD-specific intervention.
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Affiliation(s)
- Louise Foubister
- CAMHS, Royal Aberdeen Children's Hospital, Aberdeen, United Kingdom
| | - Fiona Rennie
- CAMHS, Royal Aberdeen Children's Hospital, Aberdeen, United Kingdom
| | - Justin Williams
- CAMHS, Royal Aberdeen Children's Hospital, Aberdeen, United Kingdom
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161
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He GH, Strodl E, Liu L, Ruan ZL, Yin XN, Wen GM, Sun DL, Xian DX, Jiang H, Jing J, Jin Y, Wu CA, Chen WQ. Teacher's Type D Personality and Chinese Children's Hyperactive Behaviors: Moderation Effect of Parental Type D Personality and Mediation Effect of Teacher-Student Relationship. Front Psychol 2019; 10:2517. [PMID: 31781007 PMCID: PMC6856868 DOI: 10.3389/fpsyg.2019.02517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/24/2019] [Indexed: 02/02/2023] Open
Abstract
This study aimed to explore the association between teacher’s type D personality (TDP) and children’s hyperactive behaviors, along with the moderation effect of parental TDP and the mediation effect of the teacher–student relationship. In this prospective study, a total of 25,852 children were surveyed from 2014 to 2016 in Longhua District of Shenzhen, China, and followed up 1 year later. At baseline, parents provided data on parental TDP and children’s hyperactive behaviors, while teachers reported on their TDP. At follow-up, parents provided data on children’s hyperactive behaviors again, and teachers described their relationship with each student. Two-level multilevel logistic models were conducted to assess the influence of a teacher’s TDP, parental TDP, and their interaction on children’s hyperactive behaviors. Mediation analysis was used to examine the mediating role of the teacher–student relationship. Results indicated that teachers’ TDP was not a significant predictor of children’s hyperactive behaviors after 1 year in kindergarten. Conversely, maternal and paternal TDP were prospectively and positively associated with children’s subsequent hyperactive behaviors. However, the children with a TDP teacher, a TDP mother, and/or a TDP father had higher risk of hyperactive behaviors than those with either a TDP teacher or a TDP mother or a TDP father. In addition, the teacher–student relationship was not a significant mediator between teacher’s TDP and children’s hyperactive behaviors. Further, researchers may consider the effect of the combination of teacher’s TDP, maternal TDP, and paternal TDP on hyperactive behaviors in children in further studies.
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Affiliation(s)
- Guan-Hao He
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Li Liu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zeng-Liang Ruan
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Na Yin
- Women's and Children's Hospital of Longhua District, Shenzhen, China
| | - Guo-Ming Wen
- Women's and Children's Hospital of Longhua District, Shenzhen, China
| | - Deng-Li Sun
- Women's and Children's Hospital of Longhua District, Shenzhen, China
| | - Dan-Xia Xian
- Women's and Children's Hospital of Longhua District, Shenzhen, China
| | - Hui Jiang
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Department of Women and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yu Jin
- Department of Women and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuan-An Wu
- Women's and Children's Hospital of Longhua District, Shenzhen, China
| | - Wei-Qing Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou, China
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162
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Påhlman M, Gillberg C, Himmelmann K. One-third of school-aged children with cerebral palsy have neuropsychiatric impairments in a population-based study. Acta Paediatr 2019; 108:2048-2055. [PMID: 31077607 DOI: 10.1111/apa.14844] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 11/29/2022]
Abstract
AIM To describe motor function and associated impairments, particularly autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), in school-aged children with cerebral palsy (CP). METHODS Population-based study of all children with CP born 1999-2006 from the county of Västra Götaland, Sweden; 264 children (141 males, 123 females). Information was obtained from the CP Register of western Sweden (data collected at 4-8 years of age) and all medical records at 10-17 years of age. RESULTS Cerebral palsy was spastic in 76%, dyskinetic in 17% and ataxic in 7% of all children. Sixty-three per cent were independent walkers. Associated impairments were present in 75%. Vision was impaired in 19%, hearing in 8% and speech in 54%. Intellectual disability (ID) was present in 53% and epilepsy in 41%. ID had increased from 42% to 53% since preschool-age. Neuropsychiatric impairments were present in 32% of the children; ASD in 18%; and ADHD in 21%. All impairments, except for ASD and ADHD, increased with more severe motor impairment. CONCLUSION Three in four school-aged children with CP have associated impairments, underscoring the need to broadly assess every child. The high rate of ASD and ADHD points to the importance of in-depth studies of such impairments in CP.
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Affiliation(s)
- Magnus Påhlman
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
- Regional Rehabilitation Centre, Queen Silvia Children’s Hospital Gothenburg Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Kate Himmelmann
- Regional Rehabilitation Centre, Queen Silvia Children’s Hospital Gothenburg Sweden
- Department of Pediatrics, Institute of Clinical Sciences Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
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163
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Peyre H, Albaret JM, Bernard JY, Hoertel N, Melchior M, Forhan A, Taine M, Heude B, De Agostini M, Galéra C, Ramus F. Developmental trajectories of motor skills during the preschool period. Eur Child Adolesc Psychiatry 2019; 28:1461-1474. [PMID: 30864072 DOI: 10.1007/s00787-019-01311-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 03/06/2019] [Indexed: 12/14/2022]
Abstract
Children with developmental coordination disorder also manifest difficulties in non-motor domains (attentional, emotional, behavioral and socialization skills). Longitudinal studies can help disentangle the complex relationships between the development of motor skills and other cognitive domains. This study aims to examine the contribution of early cognitive factors to changes in motor skills during the preschool period. Children (N = 1144) from the EDEN mother-child cohort were assessed for motor skills with the Copy Design task (NEPSY battery) and the parent-rated Ages and Stages Questionnaire (fine and gross motor skills scores) at ages 3 and 5-6 years. At 3 years, language skills were evaluated using tests from the NEPSY and ELOLA batteries. Emotional problems, conduct problems, inattention and hyperactivity symptoms, peer relationships and pro-social behavior were assessed with the Strengths and Difficulties Questionnaire (SDQ) also at 3 years. Linear and logistic regression models were performed to examine whether positive and negative changes in motor skills between 3 and 5-6 years are associated with specific cognitive skills at 3 years, while adjusting for a broad range of pre- and postnatal environmental factors. In the linear regression model, the SDQ Inattention symptoms score at 3 years was associated with negative changes in motor skills (standardized β = - 0.09, SD = 0.03, p value = 0.007) and language skills at 3 years were associated with positive changes in motor skills (standardized β = 0.05, SD = 0.02, p value = 0.041) during the preschool period. In logistic regression models, the SDQ Inattention symptoms score at 3 years was associated with a higher likelihood of a declining trajectory of motor skills (OR [95% CI] = 1.37 [1.02-1.84]). A higher language skills score at 3 years was associated with an increased likelihood of a resilient trajectory (1.67 [1.17-2.39]). This study provides a better understanding of the natural history of developmental coordination delays by identifying cognitive factors that predict changes in motor skills between the ages of 3 and 5-6 years.
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Affiliation(s)
- Hugo Peyre
- Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France. .,Laboratoire de Sciences Cognitives et Psycholinguistique (ENS, EHESS, CNRS), Département d'Etudes Cognitives, Ecole Normale Supérieure, PSL Research University, 29 rue d'Ulm, 75005, Paris, France. .,INSERM UMRS, Paris Diderot University, Sorbonne Paris Cité, 1141, Paris, France.
| | - Jean-Michel Albaret
- INSERM, UPS, Toulouse NeuroImaging Center, ToNIC, Université de Toulouse, Toulouse, France
| | - Jonathan Y Bernard
- Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Research team on Early life origins of health (EAROH), Villejuif, France.,Paris Descartes University, Paris, France
| | - Nicolas Hoertel
- INSERM, UMR 894, Psychiatry and Neurosciences Center, Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Corentin Celton Hospital, APHP, Issy-les-Moulineaux, Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France
| | - Maria Melchior
- INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, 75012, Paris, France
| | - Anne Forhan
- Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Research team on Early life origins of health (EAROH), Villejuif, France.,Paris Descartes University, Paris, France
| | - Marion Taine
- Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Research team on Early life origins of health (EAROH), Villejuif, France.,Paris Descartes University, Paris, France
| | - Barbara Heude
- Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Research team on Early life origins of health (EAROH), Villejuif, France.,Paris Descartes University, Paris, France
| | - Maria De Agostini
- Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Research team on Early life origins of health (EAROH), Villejuif, France.,Paris Descartes University, Paris, France
| | - Cédric Galéra
- The Bordeaux School of Public Health (Institut de Santé Publique, d'Epidémiologie et de Développement), Centre INSERM U1219, Epidemiology-Biostatistics, Université de Bordeaux, Bordeaux, France
| | - Franck Ramus
- Laboratoire de Sciences Cognitives et Psycholinguistique (ENS, EHESS, CNRS), Département d'Etudes Cognitives, Ecole Normale Supérieure, PSL Research University, 29 rue d'Ulm, 75005, Paris, France
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164
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Landgren V, Svensson L, Gyllencreutz E, Aring E, Grönlund MA, Landgren M. Fetal alcohol spectrum disorders from childhood to adulthood: a Swedish population-based naturalistic cohort study of adoptees from Eastern Europe. BMJ Open 2019; 9:e032407. [PMID: 31666274 PMCID: PMC6830611 DOI: 10.1136/bmjopen-2019-032407] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorders (FASD) are a global health concern. To further understand FASD in adulthood is a major public health interest. OBJECTIVE To describe the clinical characteristics of young adults with FASD adopted from orphanages to a socially more favourable and stable rearing environment as children. DESIGN Prospective observational cohort study SETTING: Western Sweden PARTICIPANTS: A population-based cohort of 37 adoptees diagnosed with FASD in childhood. OUTCOME MEASURES Assessment consisted of clinical evaluations of social, medical, psychiatric, neuropsychological, adaptive and ophthalmological status by a physician, ophthalmologist, orthoptist and psychologist. RESULTS Out of 37 adoptees with FASD, 36 (15 females) were evaluated at a median age of 22 years (range 18-28) and a mean follow-up time of 15.5 years (range 13-17). Twenty (56%) were dependent on social support. Sexual victimisation was reported by nine (26%). In 21 individuals with fetal alcohol syndrome, growth restriction in height and head circumference of approximately -1.8 SD persisted into adulthood. Of 32 examined, 22 (69%) had gross motor coordination abnormalities. High blood pressure was measured in nine (28%). Ophthalmological abnormalities were found in 29 of 30 (97%). A median IQ of 86 in childhood had declined significantly to 71 by adulthood (mean difference: 15.5; 95% CI 9.5-21.4). Psychiatric disorders were diagnosed in 88%, most commonly attention deficit hyperactivity disorder (70%). Three or more disorders were diagnosed in 48%, and 21% had attempted suicide. The median Clinical Global Impression-Severity score was 6 = 'severely ill'. CONCLUSION Major cognitive impairments, psychiatric morbidity, facial dysmorphology, growth restriction and ophthalmological abnormalities accompanies FASD in adulthood. Recognition of FASD in childhood warrants habilitation across the lifespan.
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Affiliation(s)
- Valdemar Landgren
- Psychiatry, Skaraborg Hospital Skövde, Skövde, Sweden
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Leif Svensson
- Pediatrics, Skaraborg Hospital Mariestad, Mariestad, Sweden
| | - Emelie Gyllencreutz
- Ophthalmology, Skaraborg Hospital Skövde, Skövde, Sweden
- Clinical Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Eva Aring
- Clinical Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Marita Andersson Grönlund
- Clinical Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Magnus Landgren
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
- Pediatrics, Skaraborg Hospital Mariestad, Mariestad, Sweden
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165
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Whiteley P, Carr K, Shattock P. Is Autism Inborn And Lifelong For Everyone? Neuropsychiatr Dis Treat 2019; 15:2885-2891. [PMID: 31632036 PMCID: PMC6789180 DOI: 10.2147/ndt.s221901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/13/2019] [Indexed: 01/08/2023] Open
Abstract
Autism or autism spectrum disorder (ASD) is described as a lifelong condition with core behavioural symptoms appearing during infancy or early childhood. Genetic and other effects occurring during the earliest times of life are thought to play a significant contributory role to the presentation of autism, denoting that autism is typically seen as an innate or inborn condition. Such descriptions have, and continue to, define autism research and clinical practice. Inspection of the existing research literature, however, suggests that within the vast heterogeneity of autism, not everyone experiences autism in such a prescribed way. Various reports have observed the presentation of "acquired autism" following a period of typical development. Other findings have documented an abatement of clinically relevant autistic features and related comorbid pathology for some. Such reports offer important insights into the heterogeneity and complexity of autism.
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166
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Zakopoulou V, Vlaikou AM, Darsinou M, Papadopoulou Z, Theodoridou D, Papageorgiou K, Alexiou GA, Bougias H, Siafaka V, Zoccolotti P, Chroussos GP, Syrrou M, Michaelidis TM. Linking Early Life Hypothalamic-Pituitary-Adrenal Axis Functioning, Brain Asymmetries, and Personality Traits in Dyslexia: An Informative Case Study. Front Hum Neurosci 2019; 13:327. [PMID: 31632253 PMCID: PMC6779713 DOI: 10.3389/fnhum.2019.00327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 09/05/2019] [Indexed: 12/22/2022] Open
Abstract
Developmental dyslexia (DD) is a multi-system disorder, combining influences of susceptibility genes and environmental factors. The causative interaction between specific genetic factors, brain regions, and personality/mental disorders, as well as specific learning disabilities, has been thoroughly investigated with regard to the approach of developing a multifaceted diagnostic procedure with an intervention strategy potential. In an attempt to add new translational evidence to the interconnection of the above factors in the occurrence of DD, we performed a combinatorial analysis of brain asymmetries, personality traits, cognitive and learning skills, and expression profiles of selected genes in an adult, early diagnosed with DD, and in his son of typical development. We focused on the expression of genes, based on the assumption that the regulation of transcription may be affected by genetic and epigenetic factors. The results highlighted a potential chain link between neuroplasticity-related as well as stress-related genes, such as BDNF, Sox4, mineralocorticoid receptor (MR), and GILZ, leftward asymmetries in the amygdala and selective cerebellum lobules, and tendencies for personality disorders and dyslexia. This correlation may reflect the presence of a specific neuro-epigenetic component of DD, ensuing from the continuous, multifaceted difficulties in the acquisition of cognitive and learning skills, which in turn may act as a fostering mechanism for the onset of long-term disorders. This is in line with recent findings demonstrating a dysfunction in processes supported by rapid neural adaptation in children and adults with dyslexia. Accordingly, the co-evaluation of all the above parameters may indicate a stress-related dyslexia endophenotype that should be carefully considered for a more integrated diagnosis and effective intervention.
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Affiliation(s)
- Victoria Zakopoulou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Angeliki-Maria Vlaikou
- Laboratory of Biology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Marousa Darsinou
- Department of Biomedical Research, Foundation for Research and Technology-Hellas, Institute of Molecular Biology and Biotechnology, Ioannina, Greece.,Department of Biological Applications and Technologies, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Zoe Papadopoulou
- Laboratory of Biology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Daniela Theodoridou
- Laboratory of Biology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Kyriaki Papageorgiou
- Department of Biomedical Research, Foundation for Research and Technology-Hellas, Institute of Molecular Biology and Biotechnology, Ioannina, Greece.,Department of Biological Applications and Technologies, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - George A Alexiou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Haralambos Bougias
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Pierluigi Zoccolotti
- Neuropsychology Unit, Department of Psychology, IRCCS (National Institute for Research and Treatment) Fondazione Santa Lucia, Sapienza University of Rome, Rome, Italy
| | - George P Chroussos
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Maria Syrrou
- Laboratory of Biology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Theologos M Michaelidis
- Department of Biomedical Research, Foundation for Research and Technology-Hellas, Institute of Molecular Biology and Biotechnology, Ioannina, Greece.,Department of Biological Applications and Technologies, School of Health Sciences, University of Ioannina, Ioannina, Greece
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167
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Lombardo MV, Lai MC, Baron-Cohen S. Big data approaches to decomposing heterogeneity across the autism spectrum. Mol Psychiatry 2019; 24:1435-1450. [PMID: 30617272 PMCID: PMC6754748 DOI: 10.1038/s41380-018-0321-0] [Citation(s) in RCA: 225] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 10/30/2018] [Accepted: 11/12/2018] [Indexed: 12/27/2022]
Abstract
Autism is a diagnostic label based on behavior. While the diagnostic criteria attempt to maximize clinical consensus, it also masks a wide degree of heterogeneity between and within individuals at multiple levels of analysis. Understanding this multi-level heterogeneity is of high clinical and translational importance. Here we present organizing principles to frame research examining multi-level heterogeneity in autism. Theoretical concepts such as 'spectrum' or 'autisms' reflect non-mutually exclusive explanations regarding continuous/dimensional or categorical/qualitative variation between and within individuals. However, common practices of small sample size studies and case-control models are suboptimal for tackling heterogeneity. Big data are an important ingredient for furthering our understanding of heterogeneity in autism. In addition to being 'feature-rich', big data should be both 'broad' (i.e., large sample size) and 'deep' (i.e., multiple levels of data collected on the same individuals). These characteristics increase the likelihood that the study results are more generalizable and facilitate evaluation of the utility of different models of heterogeneity. A model's utility can be measured by its ability to explain clinically or mechanistically important phenomena, and also by explaining how variability manifests across different levels of analysis. The directionality for explaining variability across levels can be bottom-up or top-down, and should include the importance of development for characterizing changes within individuals. While progress can be made with 'supervised' models built upon a priori or theoretically predicted distinctions or dimensions of importance, it will become increasingly important to complement such work with unsupervised data-driven discoveries that leverage unknown and multivariate distinctions within big data. A better understanding of how to model heterogeneity between autistic people will facilitate progress towards precision medicine for symptoms that cause suffering, and person-centered support.
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Affiliation(s)
- Michael V Lombardo
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | - Meng-Chuan Lai
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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168
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Biederman J, Fried R, DiSalvo M, Storch B, Pulli A, Woodworth KY, Biederman I, Faraone SV, Perlis RH. Evidence of Low Adherence to Stimulant Medication Among Children and Youths With ADHD: An Electronic Health Records Study. Psychiatr Serv 2019; 70:874-880. [PMID: 31242830 DOI: 10.1176/appi.ps.201800515] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate rates and correlates of stimulant medication adherence in a sample of pediatric patients using data derived from electronic medical records (EMRs) from a large health care organization in a large metropolitan area. The study relied on a novel definition of medication adherence as a timely renewal of an index prescription determined using the electronically recorded issuance of a stimulant prescription in the EMR ("refill"). METHODS Prescription and sociodemographic data were extracted from the Partners HealthCare Research Patient Data Registry to calculate adherence to stimulant medication treatment. RESULTS In the EMR, 2,206 patients with prescriptions for central nervous system stimulant medication were identified. Results showed that 46% of the index prescriptions were refilled within the timeframe necessary for the patient to be considered consistently medicated. A multivariable logistic regression model predicting medication adherence from patient demographic and treatment characteristics yielded an area-under-the-curve statistic of 0.57, indicating that these characteristics predicted adherence only modestly better than chance. CONCLUSIONS EMR data from a large health care organization showed that 46% of pediatric patients were adherent to treatment with stimulants. Rates of medication adherence were worse among patients receiving care from a primary care provider than among those receiving care from a psychiatrist, in older patients, and in female patients and did not appear to be influenced by racial-ethnic group, economic class, stimulant type, or medication formulation (short or long acting). These findings, which show low rates of medication adherence among children and adolescents with ADHD, suggest the need for efforts to improve these rates.
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Affiliation(s)
- Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Ronna Fried
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Barbara Storch
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Alexa Pulli
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - K Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Itai Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Stephen V Faraone
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
| | - Roy H Perlis
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston (J. Biederman, Fried, DiSalvo, Storch, Pulli, Woodworth, I. Biederman); Department of Psychiatry, Harvard Medical School, Boston (J. Biederman, Fried, Perlis); Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York, and K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway (Faraone); Center for Quantitative Health, Massachusetts General Hospital, Boston (Perlis)
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169
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Johnston K, Murray K, Spain D, Walker I, Russell A. Executive Function: Cognition and Behaviour in Adults with Autism Spectrum Disorders (ASD). J Autism Dev Disord 2019; 49:4181-4192. [PMID: 31281952 PMCID: PMC6751156 DOI: 10.1007/s10803-019-04133-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Studies of executive function (EF) in autism spectrum disorder (ASD) have reported mixed findings. Possible confounds include EF domain assessed and co-occurring neurodevelopmental diagnoses. EF task performance across multiple domains and everyday function of autistic adults (n = 110) was significantly different to age- and IQ-matched controls (n = 31). Although significantly more likely to fall into the clinically impaired range, 35.8% of the ASD group showed no impairment on EF measures. Factor analysis revealed a single unifying EF construct rather than a selective pattern of impairment. Dysexecutive behaviours were frequently reported in the ASD group, unrelated to Autism symptoms, EF task performance or co-occurring conditions. This study suggests autistic adults can experience clinically significant executive function difficulties and co-occuring dysexecutive behaviours that are disabling in everyday life.
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Affiliation(s)
- Kate Johnston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London & Maudsley NHS Foundation Trust, National & Specialist CAMHS, Adolescent At-risk & Forensic Service, Michael Rutter Centre, Maudsley Hospital, De Crespigny Park, London, SE5 8AZ UK
| | - Kim Murray
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Debbie Spain
- Autism Assessment and Behavioural Genetics Clinic, South London and Maudsley Foundation NHS Trust, London, UK
- MRC Centre for Social Genetic and Developmental Psychiatry, King’s College London, London, SE5 8AF UK
| | - Ian Walker
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Ailsa Russell
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY UK
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170
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Torske T, Naerland T, Bettella F, Bjella T, Malt E, Høyland AL, Stenberg N, Øie MG, Andreassen OA. Autism spectrum disorder polygenic scores are associated with every day executive function in children admitted for clinical assessment. Autism Res 2019; 13:207-220. [PMID: 31571410 PMCID: PMC7027890 DOI: 10.1002/aur.2207] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/24/2019] [Indexed: 12/27/2022]
Abstract
Autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDs) are behaviorally defined disorders with overlapping clinical features that are often associated with higher‐order cognitive dysfunction, particularly executive dysfunction. Our aim was to determine if the polygenic score (PGS) for ASD is associated with parent‐reported executive dysfunction in everyday life using the Behavior Rating Inventory of Executive Function (BRIEF). Furthermore, we investigated if PGS for general intelligence (INT) and attention deficit/hyperactivity disorder (ADHD) also correlate with BRIEF. We included 176 children, adolescents and young adults aged 5–22 years with full‐scale intelligence quotient (IQ) above 70. All were admitted for clinical assessment of ASD symptoms and 68% obtained an ASD diagnosis. We found a significant difference between low and high ASD PGS groups in the BRIEF behavior regulation index (BRI) (P = 0.015, Cohen's d = 0.69). A linear regression model accounting for age, sex, full‐scale IQ, Social Responsiveness Scale (SRS) total score, ASD, ADHD and INT PGS groups as well as genetic principal components, significantly predicted the BRI score; F(11,130) = 8.142, P < 0.001, R2 = 0.41 (unadjusted). Only SRS total (P < 0.001), ASD PGS 0.1 group (P = 0.018), and sex (P = 0.022) made a significant contribution to the model. This suggests that the common ASD risk gene variants have a stronger association to behavioral regulation aspects of executive dysfunction than ADHD risk or INT variants in a clinical sample with ASD symptoms. Autism Res 2020, 13: 207–220. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary People with autism spectrum disorder (ASD) often have difficulties with higher‐order cognitive processes that regulate thoughts and actions during goal‐directed behavior, also known as executive function (EF). We studied the association between genetics related to ASD and EF and found a relation between high polygenic score (PGS) for ASD and difficulties with behavior regulation aspects of EF in children and adolescents under assessment for ASD. Furthermore, high PGS for general intelligence was related to social problems.
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Affiliation(s)
- Tonje Torske
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Terje Naerland
- NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway.,NORMENT Centre, University of Oslo, Oslo, Norway
| | - Francesco Bettella
- NORMENT Centre, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thomas Bjella
- NORMENT Centre, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Eva Malt
- Institute of Clinical Medicine, Ahus Campus, University of Oslo, Oslo, Norway.,Department of Adult Habilitation, Akershus University Hospital, Lørenskog, Norway
| | - Anne Lise Høyland
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Nina Stenberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ole A Andreassen
- NORMENT Centre, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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171
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Papadopoulos N, Stavropoulos V, McGinley J, Bellgrove M, Tonge B, Murphy A, Cornish K, Rinehart N. Moderating Effect of Motor Proficiency on the Relationship Between ADHD Symptoms and Sleep Problems in Children With Attention Deficit Hyperactivity Disorder-Combined Type. Behav Sleep Med 2019. [PMID: 29528702 DOI: 10.1080/15402002.2018.1443455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES/BACKGROUND A high proportion of children with Attention Deficit Hyperactivity Disorder- Combined type (ADHD-CT) experience sleep and motor problems. This study investigated (a) whether motor proficiency moderated the relationship between ADHD symptoms and sleep problems in children with and without ADHD-CT and (b) whether this moderation differed as a function of ADHD diagnosis. PARTICIPANTS A sample of 70 primary school male children between 8-15 years were recruited; children with ADHD-CT (n = 38; mean age 10 years, 2 months [SD = 1 year, 6 months]) and a typically developing (TD) (n = 32; mean age 9 years, 6 months [SD = 1 year, 5 months]) group. METHODS Motor proficiency was measured using the Movement Assessment Battery for Children-2nd Edition (MABC-2), ADHD symptoms were measured using the Conners' Parent Rating Scale (CPRS) and parent reported sleep problems were measured using the Children's Sleep Habits Questionnaire (CSHQ). RESULTS Children who reported higher ADHD symptoms and lower motor proficiency scores reported more sleep problems. The moderation effect only held in children with a diagnosis of ADHD-CT and not in the typically developing group. CONCLUSIONS These findings indicate that children who experience greater severity of ADHD symptoms who also have lower motor proficiency may be at increased risk of experiencing sleep problems. These findings also illustrate the importance of considering motor proficiency when exploring risk factors for sleep problems in children with ADHD-CT as well as sleep interventions.
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Affiliation(s)
- Nicole Papadopoulos
- a Deakin University, Geelong, Australia, Deakin Child Study Centre, School of Psychology, Faculty of Health , Geelong , Australia
| | | | - Jennifer McGinley
- c Department of Physiotherapy, The University of Melbourne , Melbourne , Australia
| | - Mark Bellgrove
- d Monash Institute of Cognitive and Clinical Neuroscience & School of Psychological Sciences, Monash University , Melbourne , Australia
| | - Bruce Tonge
- e Centre for Developmental Psychiatry and Psychology, Monash University , Melbourne , Australia
| | - Anna Murphy
- f Clinical Research Centre for Movement Disorders & Gait, Monash Health, Melbourne, Australia
| | - Kim Cornish
- d Monash Institute of Cognitive and Clinical Neuroscience & School of Psychological Sciences, Monash University , Melbourne , Australia
| | - Nicole Rinehart
- a Deakin University, Geelong, Australia, Deakin Child Study Centre, School of Psychology, Faculty of Health , Geelong , Australia
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172
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Simmons GL, Hilton DC, Jarrett MA, Tomeny TS, White SW. Considering equifinality in treatment planning for social impairment: Divergent paths in neurodevelopmental disorders. Bull Menninger Clin 2019; 83:278-300. [DOI: 10.1521/bumc.2019.83.3.278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Youth with autism spectrum disorder (ASD) present with deficits in both social cognition and executive functioning (EF), which contribute to social impairment. Autistic youth are also frequently diagnosed with comorbid attention-deficit/hyperactivity disorder (ADHD), a disorder that, like ASD, includes impaired EF and social functioning. The comorbidity of ASD and ADHD may result in compounded social impairment, but prior research has not sufficiently evaluated the extent to which this comorbidity profile responds to evidence-based intervention targeting social deficits. It is conceivable that dually targeting EF and social cognition impairment will be more impactful than direct social skills training alone. The authors present an integrative model for intervention programming that examines pathways to social impairment in order to more effectively improve social skills and thereby impact both proximal (e.g., emotion expression, current peer relationships) and more distal outcomes (e.g., depression, self-esteem) in youth with ASD and other neurodevelopmental disorders.
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Affiliation(s)
- Grace Lee Simmons
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
| | - Dane C. Hilton
- Department of Psychology, Roanoke College, Salem, Virginia
| | | | | | - Susan W. White
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
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173
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Sim F, Thompson L, Marryat L, Law J, Wilson P. Preschool developmental concerns and adjustment in the early school years: Evidence from a Scottish birth cohort. Child Care Health Dev 2019; 45:719-736. [PMID: 31209912 DOI: 10.1111/cch.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 04/29/2019] [Accepted: 06/07/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preschool language and behavioural difficulties impact on multiple domains of the child's early life and can endure into adulthood, predicting poor educational, social, and health outcomes. Highlighting risk factors associated with poor outcomes following language and behavioural difficulties raised in early childhood may facilitate early identification and intervention. METHODS Data from the Growing Up in Scotland national birth cohort study were used. Language and behavioural difficulties were assessed at age 4 years using parent-reported language concerns and the Strengths and Difficulties Questionnaire. Measures of adjustment were collated into four key outcome domains: attitude to school life, language and general development, behaviour, and general health at age 6 years. Both univariate and multivariate logistic regression models were fitted in order to explore independent associations between language and behavioural difficulties at age 4 years and adjustment to life circumstances at age 6 years, whilst controlling for other risk factors. RESULTS Language difficulties at age 4 years increased the odds of the child experiencing difficulty with language and general development, poorer health outcomes, and behavioural difficulties at age 6 years. Behavioural difficulties alone at age 4 years were associated with increased odds of the child experiencing all of the aforementioned outcomes and difficulties in early school life. Lone parent family, low income, and male gender were identified as risk factors for poorer outcomes in the domains measured. At age 4 years, there was no additive effect found with the presence of behaviour difficulties on the relationship between language difficulties and language and developmental outcomes at 6 years. CONCLUSIONS This paper demonstrates language and behavioural difficulties are associated with poor social, educational, health, and behavioural outcomes. Taking seriously parent-reported concerns and identifying risk factors could limit negative outcomes for the child, their family, and society.
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Affiliation(s)
- Fiona Sim
- Centre for Rural Health, Centre for Health Sciences, University of Aberdeen, Inverness, UK
- Farr Institute/Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, UK
| | - Lucy Thompson
- Centre for Rural Health, Centre for Health Sciences, University of Aberdeen, Inverness, UK
- Farr Institute/Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, UK
| | - Louise Marryat
- Farr Institute/Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, UK
- Institute of Health and Wellbeing, College of Medical, Veterinary and Health Sciences, University of Glasgow, Glasgow, UK
| | - James Law
- School of Education, Communication and Language Sciences, University of Newcastle, Newcastle, UK
| | - Philip Wilson
- Centre for Rural Health, Centre for Health Sciences, University of Aberdeen, Inverness, UK
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174
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Connolly A, Fielding J, Papadopoulos N, McGinley J, Murphy A, Rinehart NJ. Factors Associated With Accidental Injuries in Children With ADHD-Combined Type: More Than a Motor Problem? J Atten Disord 2019; 23:1320-1330. [PMID: 26975838 DOI: 10.1177/1087054716633857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: We explored the relationship between accidental injuries, motor impairment, and co-occurring autism spectrum disorder (ASD) symptoms in children with ADHD-combined type (ADHD-CT). Method: Participants were 32 male children diagnosed with ADHD-CT and 23 typically developing male children (7-12 years, full scale IQ [FSIQ] > 80). Parents completed a customized questionnaire on the occurrence of accidental injuries (e.g., bruises, cuts) their child experienced in the past 12 months. Motor proficiency was assessed using the Movement ABC-2 (MABC-2). Parents rated motor, ADHD-CT, ASD, and anxiety symptoms. Results: Children with ADHD-CT had significantly increased parent-reported accidental injuries compared with typically developing children. Among children with ADHD-CT, Spearman's rho rank correlations revealed no association between increased accidental injuries and MABC-2 score, but significant associations with increased hyperactivity/impulsivity, ASD, and anxiety symptoms. Conclusion: Although these findings require validation, they suggest a need for further research investigating the contribution of co-occurring ASD and anxiety symptoms to accidental injuries in children with ADHD-CT.
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Affiliation(s)
| | - Joanne Fielding
- 1 Monash University, Clayton, Victoria, Australia.,2 University of Melbourne, Parkville, Victoria, Australia
| | | | | | - Anna Murphy
- 4 Monash Health, Cheltenham, Victoria, Australia
| | - Nicole J Rinehart
- 1 Monash University, Clayton, Victoria, Australia.,3 Deakin University, Burwood, Victoria, Australia
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175
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Peskin M, Rotem A, Golubchik P, Weizman A, Manor I. Demographic and Clinical Predictors of Hospitalization in Preschoolers With ADHD. J Atten Disord 2019; 23:1284-1290. [PMID: 29749278 DOI: 10.1177/1087054718772145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This chart review study characterized demographic and clinical indicators of the need for hospitalization in preschoolers with ADHD. Method: Medical records of preschoolers with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) ADHD during 2009-2012 were systematically reviewed. The cohort included 111 children (aged 5.13 ± 0.55 years, 77.47% boys). The demographic and clinical variables of hospitalized at a day-care unit (n = 30) and nonhospitalized (n = 81) preschoolers were compared. Results: Hospitalized preschoolers were younger (p < .0001), had higher rates of unmarried mothers (p < .001), and a higher number of comorbidities. The number of inattentive/hyperactivity-impulsivity symptoms was similar in both groups. Neurodevelopmental comorbidity (p < .0001), but not externalized (p = .82) or internalized (p = .20) psychopathology, was significantly higher in the hospitalized group. Conclusion: ADHD severity in preschoolers tends to be associated with younger age, specific parenthood constellations, and a high rate of neurodevelopmental, but not other, comorbidities. These findings emphasize the importance of the neurodevelopmental context in planning ADHD interventions at preschool age.
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Affiliation(s)
- Miriam Peskin
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
| | - Ann Rotem
- 1 Geha Mental Health Center, Petah Tikva, Israel
| | - Pavel Golubchik
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
| | - Abraham Weizman
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
| | - Iris Manor
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
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176
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Stordeur C, Boele A, Peyre H, Delorme R, Acquaviva E. Psychometric properties of the French Version of the Social Responsiveness Scale in autism spectrum disorder with or without attention deficit hyperactivity disorder. Encephale 2019; 45:285-289. [PMID: 30470500 DOI: 10.1016/j.encep.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/03/2018] [Accepted: 08/09/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The Social Responsiveness Scale (SRS) is an instrument that is commonly used to screen for Autism Spectrum Disorder (ASD). Attention Deficit Hyperactive Disorder (ADHD) frequently occurs with ASD and both disorders share some phenotypic similarities. In the present study, we aimed to determine the psychometric properties of the French version of the Social Responsiveness Scale (SRS) and its 5 subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerisms) to discriminate between children with ADHD and those with ASD (differential diagnosis) and children with ADHD from those with a dual diagnosis of ADHD and ASD (comorbid diagnosis). METHOD SRS total scores and the 5 subscores of the SRS were compared between 4 groups of children: ADHD (n=32), ASD+ADHD (n=30), ASD (n=31) and typical neurodevelopment (TD; n=30) children. The discriminant validity was estimated using the Area Under the ROC Curves (AUC). RESULTS SRS Social cognition (AUC=0.73) and Autistic mannerisms (AUC=0.70) subscores were the most discriminating for differential diagnosis of ASD and ADHD. SRS total scores (AUC=0.70), and Social communication (AUC=0.66) and Autistic mannerisms (AUC=0.75) subscores were the most discriminating for comorbid diagnosis of ASD among ADHD children. CONCLUSION The SRS autistic mannerisms subscore was found to be clinically relevant for both differential diagnosis of ASD and ADHD and comorbid diagnoses of ASD among ADHD children but with a modest discriminant power.
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Affiliation(s)
- C Stordeur
- Child and adolescent psychiatry department, Robert-Debré hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France.
| | - A Boele
- Child and adolescent psychiatry department, Robert-Debré hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - H Peyre
- Child and adolescent psychiatry department, Robert-Debré hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France; Cognitive sciences and psycholinguistic laboratory, école normale supérieure, 75005 Paris, France; Paris Diderot university, Paris 7, 75006 Paris, France
| | - R Delorme
- Child and adolescent psychiatry department, Robert-Debré hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France; Paris Diderot university, Paris 7, 75006 Paris, France; Human genetics and cognitive functions, Pasteur Institute, 75015 Paris, France
| | - E Acquaviva
- Child and adolescent psychiatry department, Robert-Debré hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
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177
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Kinnear D, Rydzewska E, Dunn K, Hughes-McCormack LA, Melville C, Henderson A, Cooper SA. Relative influence of intellectual disabilities and autism on mental and general health in Scotland: a cross-sectional study of a whole country of 5.3 million children and adults. BMJ Open 2019; 9:e029040. [PMID: 31462474 PMCID: PMC6719834 DOI: 10.1136/bmjopen-2019-029040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To determine the relative extent that autism and intellectual disabilities are independently associated with poor mental and general health, in children and adults. DESIGN Cross-sectional study. For Scotland's population, logistic regressions investigated odds of intellectual disabilities and autism predicting mental health conditions, and poor general health, adjusted for age and gender. PARTICIPANTS 1 548 819 children/youth aged 0-24 years, and 3 746 584 adults aged more than 25 years, of whom 9396/1 548 819 children/youth had intellectual disabilities (0.6%), 25 063/1 548 819 children/youth had autism (1.6%); and 16 953/3 746 584 adults had intellectual disabilities (0.5%), 6649/3 746 584 adults had autism (0.2%). These figures are based on self-report. MAIN OUTCOME MEASURES Self-reported general health status and mental health. RESULTS In children/youth, intellectual disabilities (OR 7.04, 95% CI 6.30 to 7.87) and autism (OR 25.08, 95% CI 23.08 to 27.32) both independently predicted mental health conditions. In adults, intellectual disabilities (OR 3.50, 95% CI 3.20 to 3.84) and autism (OR 5.30, 95% CI 4.80 to 5.85) both independently predicted mental health conditions. In children/youth, intellectual disabilities (OR 18.34, 95% CI 17.17 to 19.58) and autism (OR 8.40, 95% CI 8.02 to 8.80) both independently predicted poor general health. In adults, intellectual disabilities (OR 7.54, 95% CI 7.02 to 8.10) and autism (OR 4.46, 95% CI 4.06 to 4.89) both independently predicted poor general health. CONCLUSIONS Both intellectual disabilities and autism independently predict poor health, intellectual disabilities more so for general health and autism more so for mental health. Intellectual disabilities and autism are not uncommon, and due to their associated poor health, sufficient services/supports are needed. This is not just due to coexistence of these conditions or just to having intellectual disabilities, as the population with autism is independently associated with substantial health inequalities compared with the general population, across the entire life course.
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Affiliation(s)
- Deborah Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ewelina Rydzewska
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kirsty Dunn
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Craig Melville
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Angela Henderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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178
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Thompson L, Gillberg C, Landberg S, Kantzer AK, Miniscalco C, Barnevik Olsson M, Eriksson MA, Fernell E. Autism With and Without Regression: A Two-Year Prospective Longitudinal Study in Two Population-Derived Swedish Cohorts. J Autism Dev Disord 2019; 49:2281-2290. [PMID: 30734177 PMCID: PMC6546868 DOI: 10.1007/s10803-018-03871-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Two community-based cohorts of children with autism spectrum disorder, examined using similar assessment protocols, were pooled (n = 301) and subdivided according to history of regression. Those with regression (n = 62), 20.5% of the combined cohort, were contrasted with those without regression (n = 241) at first assessment (age range 19–60 months) and at 2-year follow-up on a range of measures. The regression group was significantly more functionally impaired, with regard to intellectual function (p < .001), language development (p < .001), and to severity of autism (p < .01) at both T1 and T2. Only 14 (23.3%) had a clearly identified underlying etiology [24 (18.6%) in the non-regressive group]. There were no significant differences between those who had regressed ‘from normal’ and those who had regressed ‘from low’ functioning.
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Affiliation(s)
- Lucy Thompson
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. .,Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK.
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Sara Landberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Anne-Katrin Kantzer
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Martina Barnevik Olsson
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,PRIMA Child and Adult Psychiatry, Stockholm, Sweden
| | - Mats A Eriksson
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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179
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Nilsson G, Westerlund J, Fernell E, Billstedt E, Miniscalco C, Arvidsson T, Olsson I, Gillberg C. Neurodevelopmental problems should be considered in children with febrile seizures. Acta Paediatr 2019; 108:1507-1514. [PMID: 30614569 DOI: 10.1111/apa.14716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/03/2018] [Accepted: 01/03/2019] [Indexed: 01/08/2023]
Abstract
AIM Clinical developmental phenotyping of four- to five-year-old children with febrile seizures (FSs). METHODS Children with FS (n = 157, corresponding to 3.7% of the targeted general population of four-five-year-olds) had been identified at child healthcare centres in Gothenburg. Parents of 73 children (41 boys, 32 girls) accepted participation in the present study. The assessments included a neuropaediatric assessment, Movement ABC, Wechsler Preschool and Primary Scale of Intelligence-III and parent questionnaires (Five-to-Fifteen (FTF) and Strengths and Difficulties Questionnaire (SDQ)). Hospital records were reviewed, when applicable. RESULTS One-third of the children had at least one DSM-5 neurodevelopmental disorder diagnosis or marked developmental problems within areas of attention, activity regulation, behaviour, speech and language, general cognition or motor functioning. No differences were found between children with single vs recurrent or simple vs complex FS. CONCLUSION Febrile seizure are relatively often associated with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCEs). We found no indications that ESSENCE might be caused by FS per se. However, the results suggest that child healthcare professionals should consider the possibility of ESSENCE in children with a history of FS.
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Affiliation(s)
- Gill Nilsson
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Institute of Neuroscience and Physiology Gothenburg and Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | - Joakim Westerlund
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Institute of Neuroscience and Physiology Gothenburg and Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
- Institute of Psychology Stockholm University Stockholm Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Institute of Neuroscience and Physiology Gothenburg and Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Institute of Neuroscience and Physiology Gothenburg and Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Institute of Neuroscience and Physiology Gothenburg and Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | | | - Ingrid Olsson
- Department of Paediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg and Sahlgrenska University Hospital Gothenburg Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Institute of Neuroscience and Physiology Gothenburg and Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
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180
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Van Herwegen J, Ashworth M, Palikara O. Views of professionals about the educational needs of children with neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 91:103422. [PMID: 31247387 DOI: 10.1016/j.ridd.2019.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/03/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Professionals play a key role in supporting children with special educational needs in schools. However, the views of those working with neurodevelopmental disorders are less known. AIMS This study examined the views of professionals (including teachers, teaching assistants, educational psychologists, speech and language therapists, physio and occupational therapists etc.) working with children with Williams Syndrome (WS), Down Syndrome (DS) or with Autism Spectrum Disorders (ASD) in terms of how informed professionals are about the disorder and their views about the type of support these children need to be receiving. METHODS AND PROCEDURES Professionals working with 77 children with ASD, 26 with DS and 38 with WS completed an online questionnaire. OUTCOMES AND RESULTS Professionals in all three groups highlighted relevant areas of difficulty for these children, but they did not recognise some of the less phenotypical difficulties that children with a specific disorder may experience. In addition, there was a disconnect between the difficulties identified by the professionals and the type of specialist support that may be necessary. CONCLUSIONS AND IMPLICATIONS Although professionals have a lot of knowledge about the specific neurodevelopmental disorders, further evidence-based training would allow more effective support for children with neurodevelopmental disorders in the classroom but also equip professionals better and raise their confidence in meeting these children's needs.
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Affiliation(s)
- Jo Van Herwegen
- Department of Psychology and Human Development, UCL Institute of Education, United Kingdom.
| | - Maria Ashworth
- Department of Psychology and Human Development, UCL Institute of Education, United Kingdom
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181
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182
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Frost-Karlsson M, Galazka MA, Gillberg C, Gillberg C, Miniscalco C, Billstedt E, Hadjikhani N, Åsberg Johnels J. Social scene perception in autism spectrum disorder: An eye-tracking and pupillometric study. J Clin Exp Neuropsychol 2019; 41:1024-1032. [DOI: 10.1080/13803395.2019.1646214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Morgan Frost-Karlsson
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | | | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Carina Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
- Harvard Medical School/MGH/MIT, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - Jakob Åsberg Johnels
- Gillberg Neuropsychiatry Centre, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
- Section for Speech and Language Pathology, Sahlgrenska academy University of Gothenburg, Gothenburg, Sweden
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183
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Ning Z, Williams JM, Kumari R, Baranov PV, Moore T. Opposite Expression Patterns of Spry3 and p75NTR in Cerebellar Vermis Suggest a Male-Specific Mechanism of Autism Pathogenesis. Front Psychiatry 2019; 10:416. [PMID: 31275178 PMCID: PMC6591651 DOI: 10.3389/fpsyt.2019.00416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/24/2019] [Indexed: 12/22/2022] Open
Abstract
Autism is a genetically complex neurobehavioral disorder with a population prevalence of more than 1%. Cerebellar abnormalities, including Purkinje cell deficits in the vermis, are consistently reported, and rodent models of cerebellar dysfunction exhibit features analogous to human autism. We previously analyzed the regulation and expression of the pseudoautosomal region 2 gene SPRY3, which is adjacent to X chromosome-linked TMLHE, a known autism susceptibility gene. SPRY3 is a regulator of branching morphogenesis and is strongly expressed in Purkinje cells. We previously showed that mouse Spry3 is not expressed in cerebellar vermis lobules VI-VII and X, regions which exhibit significant Purkinje cell loss or abnormalities in autism. However, these lobules have relatively high expression of p75NTR, which encodes a neurotrophin receptor implicated in autism. We propose a mechanism whereby inappropriate SPRY3 expression in these lobules could interact with TrkB and p75NTR signaling pathways resulting in Purkinje cell pathology. We report preliminary characterization of X and Y chromosome-linked regulatory sequences upstream of SPRY3, which are polymorphic in the general population. We suggest that an OREG-annotated region on chromosome Yq12 ∼60 kb from SPRY3 acts as a silencer of Y-linked SPRY3 expression. Deletion of a β-satellite repeat, or alterations in chromatin structure in this region due to trans-acting factors, could affect the proposed silencing function, leading to reactivation and inappropriate expression of Y-linked SPRY3. This proposed male-specific mechanism could contribute to the male bias in autism prevalence.
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Affiliation(s)
| | | | | | | | - Tom Moore
- School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland
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184
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Makushkin EV, Makarov IV, Pashkovskiy VE. [The prevalence of autism: genuine and imaginary]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:80-86. [PMID: 30874532 DOI: 10.17116/jnevro201911902180] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this review, the authors analyze the causes of the high prevalence of autism spectrum disorders (ASD) in recent decades. It is shown that the expansion of the boundaries of the 'autistic spectrum' concept led to a significant spread of data on its prevalence, depending on the time, diagnostic criteria, country and region. Stability of the diagnosis of ASD is not high and depends on the age of the child. Diagnostic practice in comorbid psychiatric disorders unfairly shifted toward ASD. At the same time, the hypothesis on the uniqueness of autistic manifestations in infancy is not convincingly confirmed. The practical aspect of the problem of the epidemiology of autism does not exclude, but on the contrary, presupposes early detection of nonspecific mental disorders followed by medical-psychological-pedagogical correction.
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Affiliation(s)
- E V Makushkin
- Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - I V Makarov
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia; Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - V E Pashkovskiy
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
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185
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Orekhova EV, Stroganova TA, Schneiderman JF, Lundström S, Riaz B, Sarovic D, Sysoeva OV, Brant G, Gillberg C, Hadjikhani N. Neural gain control measured through cortical gamma oscillations is associated with sensory sensitivity. Hum Brain Mapp 2019; 40:1583-1593. [PMID: 30549144 DOI: 10.1002/hbm.24469] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 12/17/2022] Open
Abstract
Gamma oscillations facilitate information processing by shaping the excitatory input/output of neuronal populations. Recent studies in humans and nonhuman primates have shown that strong excitatory drive to the visual cortex leads to suppression of induced gamma oscillations, which may reflect inhibitory-based gain control of network excitation. The efficiency of the gain control measured through gamma oscillations may in turn affect sensory sensitivity in everyday life. To test this prediction, we assessed the link between self-reported sensitivity and changes in magneto-encephalographic gamma oscillations as a function of motion velocity of high-contrast visual gratings. The induced gamma oscillations increased in frequency and decreased in power with increasing stimulation intensity. As expected, weaker suppression of the gamma response correlated with sensory hypersensitivity. Robustness of this result was confirmed by its replication in the two samples: neurotypical subjects and people with autism, who had generally elevated sensory sensitivity. We conclude that intensity-related suppression of gamma response is a promising biomarker of homeostatic control of the excitation-inhibition balance in the visual cortex.
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Affiliation(s)
- Elena V Orekhova
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden.,Moscow State University of Psychology and Education, Center for Neurocognitive Research (MEG Center), Moscow, Russia.,Autism Research Laboratory, Moscow State University of Psychology and Education, Moscow, Russia
| | - Tatiana A Stroganova
- Moscow State University of Psychology and Education, Center for Neurocognitive Research (MEG Center), Moscow, Russia.,Autism Research Laboratory, Moscow State University of Psychology and Education, Moscow, Russia
| | - Justin F Schneiderman
- Department of Clinical Neurophysiology, University of Gothenburg, Institute of Neuroscience & Physiology, Gothenburg, Sweden.,Chalmers University of Technology and MedTech West, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden
| | - Bushra Riaz
- Department of Clinical Neurophysiology, University of Gothenburg, Institute of Neuroscience & Physiology, Gothenburg, Sweden
| | - Darko Sarovic
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden
| | - Olga V Sysoeva
- Moscow State University of Psychology and Education, Center for Neurocognitive Research (MEG Center), Moscow, Russia.,Autism Research Laboratory, Moscow State University of Psychology and Education, Moscow, Russia
| | - Georg Brant
- Chalmers University of Technology and MedTech West, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden.,MGH/MIT/HST Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, Massachusetts
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186
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Strand M, von Hausswolff-Juhlin Y, Welch E. A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder. Int J Eat Disord 2019; 52:331-360. [PMID: 30489647 DOI: 10.1002/eat.22962] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Avoidant/restrictive food intake disorder (ARFID) was introduced as a new diagnosis in the DSM-5. This systematic scoping review explores how ARFID as a diagnostic entity is conceptualized in the research literature and evaluates the diagnostic validity according to the Feighner criteria. METHOD A systematic scoping review of papers on ARFID in PubMed/MEDLINE and Web of Science was undertaken, following PRISMA and Joanna Briggs Institute guidelines. RESULTS Fifty-one original research publications, 23 reviews and commentaries, and 20 case reports were identified. The use of ARFID as a conceptual category varies significantly within this literature. At this time, the ARFID diagnosis does not fulfil the Feighner criteria for evaluating the validity of diagnostic constructs, the most urgent problem being the demarcation toward other disorders. A three-dimensional model-lack of interest in food, selectivity based on sensory sensitivity, and fear of aversive consequences-is gaining support in the research literature. DISCUSSION The introduction of the ARFID diagnosis has undoubtedly increased the recognition of a previously largely neglected group of patients. However, this article points to an inability of the current DSM-5 diagnostic criteria to ensure optimal diagnostic validity, which risks making them less useful in clinical practice and in epidemiological research. To increase the conceptual validity of the ARFID construct, several possible alterations to the current diagnostic criteria are suggested, including a stronger emphasis of the three identified subdomains and further clarifying the boundaries of ARFID.
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Affiliation(s)
- Mattias Strand
- Stockholm Centre for Eating Disorders, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Yvonne von Hausswolff-Juhlin
- Stockholm Centre for Eating Disorders, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Elisabeth Welch
- Stockholm Centre for Eating Disorders, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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187
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He GH, Liu L, Strodl E, Ruan ZL, Jiang H, Jing J, Jin Y, Chen WQ. Parental Type D Personality and Children's Hyperactive Behaviors: The Mediating Role of Parent⁻Child Interactive Activities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071116. [PMID: 30925765 PMCID: PMC6480101 DOI: 10.3390/ijerph16071116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 01/27/2023]
Abstract
This study explored the associations between parental Type D personality (TDP), parent–child interactive activities, and children’s hyperactive behaviors. Moreover, the study examined whether parent–child interactive activities mediated the associations between parental TDP and children’s hyperactive behaviors. A cross-sectional survey was conducted among children from all kindergartens in a district of a southern city in China. Data on parental TDP, the frequency of parent–child interactive activities, children’s hyperactive behaviors, and socio-demographic characteristics were provided by 47,648 parent–child dyads. Multiple regression analysis was employed to assess the associations between parental TDP, parent–child interactive activities, and children’s hyperactive behaviors. Mediation analysis was applied to explore the mediating role of parent–child interactive activities on the associations between parental TDP and children’s hyperactive behaviors. Parental TDP was negatively associated with the frequency of parent–child interactive activities and positively associated with children’s hyperactive behaviors. The frequencies of parent–child interactive activities were negatively associated with children’s hyperactive behaviors. The frequency of parent–child interactive activities partially mediated the associations between parental TDP and children’s hyperactive behaviors. Future research may consider parental TDP and parent–child interactive activities as potential important predictors of hyperactive behaviors in children. Such research will help identify further targets for intervention to reduce hyperactive behaviors in children.
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Affiliation(s)
- Guan-Hao He
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Li Liu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane 4059, Queensland, Australia.
| | - Zeng-Liang Ruan
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hui Jiang
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Jin Jing
- Department of Women and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yu Jin
- Department of Women and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Wei-Qing Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- Department of Information Management, Xinhua College of Sun Yat-Sen University, Guangzhou 510080, China.
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188
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Dotinga BM, de Winter AF, Bocca-Tjeertes IFA, Kerstjens JM, Reijneveld SA, Bos AF. Longitudinal growth and emotional and behavioral problems at age 7 in moderate and late preterms. PLoS One 2019; 14:e0211427. [PMID: 30703154 PMCID: PMC6355004 DOI: 10.1371/journal.pone.0211427] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/14/2019] [Indexed: 11/27/2022] Open
Abstract
Objectives Moderately and late preterm children (MLPs, 32.0–36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs. Study design This study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status. Results We included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33–35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72. Conclusions In MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially.
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Affiliation(s)
- Baukje M. Dotinga
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Inger F. A. Bocca-Tjeertes
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jorien M. Kerstjens
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arend F. Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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189
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Both rare and common genetic variants contribute to autism in the Faroe Islands. NPJ Genom Med 2019; 4:1. [PMID: 30675382 PMCID: PMC6341098 DOI: 10.1038/s41525-018-0075-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/13/2018] [Indexed: 11/09/2022] Open
Abstract
The number of genes associated with autism is increasing, but few studies have been performed on epidemiological cohorts and in isolated populations. Here, we investigated 357 individuals from the Faroe Islands including 36 individuals with autism, 136 of their relatives and 185 non-autism controls. Data from SNP array and whole exome sequencing revealed that individuals with autism had a higher burden of rare exonic copy-number variants altering autism associated genes (deletions (p = 0.0352) or duplications (p = 0.0352)), higher inbreeding status (p = 0.023) and a higher load of rare homozygous deleterious variants (p = 0.011) compared to controls. Our analysis supports the role of several genes/loci associated with autism (e.g., NRXN1, ADNP, 22q11 deletion) and identified new truncating (e.g., GRIK2, ROBO1, NINL, and IMMP2L) or recessive deleterious variants (e.g., KIRREL3 and CNTNAP2) affecting autism-associated genes. It also revealed three genes involved in synaptic plasticity, RIMS4, KALRN, and PLA2G4A, carrying de novo deleterious variants in individuals with autism without intellectual disability. In summary, our analysis provides a better understanding of the genetic architecture of autism in isolated populations by highlighting the role of both common and rare gene variants and pointing at new autism-risk genes. It also indicates that more knowledge about how multiple genetic hits affect neuronal function will be necessary to fully understand the genetic architecture of autism.
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190
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Gouder L, Vitrac A, Goubran-Botros H, Danckaert A, Tinevez JY, André-Leroux G, Atanasova E, Lemière N, Biton A, Leblond CS, Poulet A, Boland A, Deleuze JF, Benchoua A, Delorme R, Bourgeron T, Cloëz-Tayarani I. Altered spinogenesis in iPSC-derived cortical neurons from patients with autism carrying de novo SHANK3 mutations. Sci Rep 2019; 9:94. [PMID: 30643170 PMCID: PMC6331634 DOI: 10.1038/s41598-018-36993-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 11/28/2018] [Indexed: 01/19/2023] Open
Abstract
The synaptic protein SHANK3 encodes a multidomain scaffold protein expressed at the postsynaptic density of neuronal excitatory synapses. We previously identified de novo SHANK3 mutations in patients with autism spectrum disorders (ASD) and showed that SHANK3 represents one of the major genes for ASD. Here, we analyzed the pyramidal cortical neurons derived from induced pluripotent stem cells from four patients with ASD carrying SHANK3 de novo truncating mutations. At 40-45 days after the differentiation of neural stem cells, dendritic spines from pyramidal neurons presented variable morphologies: filopodia, thin, stubby and muschroom, as measured in 3D using GFP labeling and immunofluorescence. As compared to three controls, we observed a significant decrease in SHANK3 mRNA levels (less than 50% of controls) in correlation with a significant reduction in dendritic spine densities and whole spine and spine head volumes. These results, obtained through the analysis of de novo SHANK3 mutations in the patients' genomic background, provide further support for the presence of synaptic abnormalities in a subset of patients with ASD.
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Affiliation(s)
- Laura Gouder
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | - Aline Vitrac
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | - Hany Goubran-Botros
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | | | | | | | - Ekaterina Atanasova
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | - Nathalie Lemière
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | - Anne Biton
- Bioinformatics and Biostatistics Hub, C3BI, USR 3756 IP CNRS, Institut Pasteur, Paris, France
| | - Claire S Leblond
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | | | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, F-91057, Evry, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, F-91057, Evry, France
| | | | - Richard Delorme
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France
| | - Isabelle Cloëz-Tayarani
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France. .,CNRS UMR 3571 « Genes, Synapses and Cognition », Institut Pasteur, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, Human Genetics and Cognitive Functions, Paris, France.
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191
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Cavonius-Rintahaka D, Aho AL, Voutilainen A, Billstedt E, Gillberg C. Health, functionality, and social support in families with a child with a neurodevelopmental disorder - a pilot study. Neuropsychiatr Dis Treat 2019; 15:1151-1161. [PMID: 31190823 PMCID: PMC6514252 DOI: 10.2147/ndt.s195722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/27/2019] [Indexed: 01/16/2023] Open
Abstract
Introduction: Several studies have reported that having a child with a neurodevelopmental disorder (NDD) increases parental stress and that parental psychosocial functioning influences child`s development and behavior. It is unclear how parents of children with NDD experience family functionality, family health and receive support and if there are differences between experiences of mothers and fathers. Methods: Families with children referred to a neurocognitive unit were invited to the study. A modified version of the FAmily Functionality, HEalth, and Social support (FAFHES) questionnaire was used. Open-ended questions were also included. Results: Parents rated their social support lower than their family functionality and family health. Family functionality correlated positively with family health. No significant differences were found between mothers' and fathers' experiences. A three-months test-retest using the FAFHES showed no significant change in ratings of family functionality, family health, and social support. Conclusions: Family functionality was connected to family health in families with a child with NDD. Mothers and fathers experienced their family health, family functionality, and received social support in similar ways.
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Affiliation(s)
- Diana Cavonius-Rintahaka
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Child Psychiatry, Neuropsychiatric Unit, Helsinki University Hospital (HUH), Helsinki, Finland
| | - Anna Liisa Aho
- Faculty of Social Sciences, Nursing Science, University of Tampere, Tampere, Helsinki
| | - Arja Voutilainen
- Child Psychiatry, Neuropsychiatric Unit, Helsinki University Hospital (HUH), Helsinki, Finland
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
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192
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Alabaf S, Gillberg C, Lundström S, Lichtenstein P, Kerekes N, Råstam M, Anckarsäter H. Physical health in children with neurodevelopmental disorders. J Autism Dev Disord 2019; 49:83-95. [PMID: 30043349 PMCID: PMC6331488 DOI: 10.1007/s10803-018-3697-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With increasing numbers of children being diagnosed with neurodevelopmental disorders (NDDs) attention has been drawn to these children's physical health. We aimed to identify the prevalence of defined physical problems (epilepsy, migraine, asthma, cancer, diabetes, psoriasis, lactose intolerance, celiac disease, diarrhea, constipation, daytime enuresis, encopresis) in a nationwide population of 9- and 12-year-old twins subdivided into those with and without indications of NDDs. Parents of 28,058 twins participated in a well-validated telephone interview regarding their children's mental health and answered questions about their physical problems. The results indicate a high rate of physical problems in children with NDDs, particularly in those with indications of the presence of combinations of several NDDs.
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Affiliation(s)
- Setareh Alabaf
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Center for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Henrik Anckarsäter
- Center for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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193
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Nilses Å, Jingrot M, Linnsand P, Gillberg C, Nygren G. Experiences Of Immigrant Parents In Sweden Participating In A Community Assessment And Intervention Program For Preschool Children With Autism. Neuropsychiatr Dis Treat 2019; 15:3397-3410. [PMID: 31827325 PMCID: PMC6902863 DOI: 10.2147/ndt.s221908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Barriers inherent in service systems for autism can hinder parents from getting help for their children, and this is probably especially true for immigrant parents. In order to provide accessible assessment and interventions for preschool children with autism, a multidisciplinary team was established in one district of a Swedish city, with a majority population of immigrants. AIM The aim of the present study was to gain knowledge of the parents' experiences of participating in the community assessment and intervention program. METHODS AND PROCEDURES A qualitative study with semi-structured interviews was conducted with parents of 11 children aged 3-5, who had been diagnosed with autism and participated in the community intervention program for at least 1 year. The interviews were recorded and transcribed verbatim, and data were analyzed following a phenomenological hermeneutical method. RESULTS The overall meaning of the parents' narratives was interpreted as "A new way of understanding my child made life more hopeful and more challenging than before". Their experience was interpreted as a process, captured in the three main themes: "An overwhelming diagnosis", "Cooperating with the team", and "Growing as a parent". CONCLUSION As lacking knowledge of available resources and support seems to be an important barrier to access services, the results underscore the importance of providing individually tailored services including comprehensive societal support to immigrant families with young children suffering from autism. The study also highlights the importance of addressing the parents' previous awareness and knowledge of autism early in the assessment process, as well as continually involving parents in the intervention program, and this may enhance parental growth.
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Affiliation(s)
- Åsa Nilses
- Center for Progress in Children's Mental Health, Region Vastra Gotaland, Gothenburg, Sweden
| | - Marianne Jingrot
- Research and Development Primary Health Care, Region Vastra Gotaland, Gothenburg, Sweden
| | - Petra Linnsand
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Child and Adolescent Specialist Centre, Angered Hospital, Region Vastra Gotaland, Angered, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Child and Adolescent Specialist Centre, Angered Hospital, Region Vastra Gotaland, Angered, Sweden
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194
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Ogrim G, Kropotov JD. Predicting Clinical Gains and Side Effects of Stimulant Medication in Pediatric Attention-Deficit/Hyperactivity Disorder by Combining Measures From qEEG and ERPs in a Cued GO/NOGO Task. Clin EEG Neurosci 2019; 50:34-43. [PMID: 29940782 PMCID: PMC6291902 DOI: 10.1177/1550059418782328] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The study aim was to develop 2 scales: predicting clinical gains and risk of acute side effects of stimulant medication in pediatric attention-deficit/hyperactivity disorder (ADHD), combining measures from EEG spectra, event-related potentials (ERPs), and a cued visual GO/NOGO task. METHODS Based on 4-week systematic medication trials, 87 ADHD patients aged 8 to 17 years were classified as responders (REs, n = 62) or non-REs (n = 25), and belonging to the side effects (SEs, n = 42) or no-SEs (n = 45) groups. Before starting the trial, a 19-channel EEG was registered twice: Test 1 (T1) without medication and T2 on a single dose of stimulant medication a few days before the trial. EEG was registered T1 and T2: 3 minutes eyes-closed, 3 minutes eyes-open, and 20 minutes cued GO/NOGO. EEG spectra, ERPs, omissions, commissions, reaction time (RT), and RT variability were computed. Groups were compared at T1 and T2 on quantitative EEG (qEEG), ERPs and behavioral parameters; effect sizes ( d) were estimated. Variables with d > 0.5 were converted to quartiles, multiplied by corresponding d, and summed to obtain 2 global scales. RESULTS Six variables differed significantly between REs and non-REs (T1: theta/alpha ratio, P3NOGO amplitude. Differences T2-T1: Omissions, RT variability, P3NOGO, contingent negative variation [CNV]). The global scale d was 1.86. Accuracy (receiver operating characteristic) was 0.92. SEs and no-SEs differed significantly on 4 variables. (T1: RT, T2: novelty component and alpha peak frequency, and RT changes. Global scale d = 1.08 and accuracy = 0.78. CONCLUSION Gains and side effects of stimulants in pediatric ADHD can be predicted with high accuracy by combining EEG spectra, ERPs, and behavior from baseline and single-dose tests. ClinicalTrials.gov identifier: NCT02695355.
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Affiliation(s)
- Geir Ogrim
- 1 Neuropsychiatric Unit, Østfold Hospital Trust, Fredrikstad, Norway.,2 Institute of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,3 Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Juri D Kropotov
- 4 P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, St Petersburg, Russia.,5 Department of Neuropsychology, Andrzej Frycz-Modrzewski Krakow University, Krakow, Poland
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195
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Baeza-Velasco C, Cohen D, Hamonet C, Vlamynck E, Diaz L, Cravero C, Cappe E, Guinchat V. Autism, Joint Hypermobility-Related Disorders and Pain. Front Psychiatry 2018; 9:656. [PMID: 30581396 PMCID: PMC6292952 DOI: 10.3389/fpsyt.2018.00656] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/16/2018] [Indexed: 12/14/2022] Open
Abstract
Autism Spectrum Disorder (ASD) and Joint Hypermobility-Related Disorders are blanket terms for two etiologically and clinically heterogeneous groups of pathologies that usually appears in childhood. These conditions are seen by different medical fields, such as psychiatry in the case of ASD, and musculoskeletal disciplines and genetics in the case of hypermobility-related disorders. Thus, a link between them is rarely established in clinical setting, despite a scarce but growing body of research suggesting that both conditions co-occur more often than expected by chance. Hypermobility is a frequent sign of hereditary disorders of connective tissue (e.g., Ehlers-Danlos syndromes, Marfan syndrome), in which the main characteristic is the multisystem fragility that prone to proprioceptive and motor coordination dysfunction and hence to trauma and chronic pain. Considering the high probability that pain remains disregarded and untreated in people with ASD due to communication and methodological difficulties, increasing awareness about the interconnection between ASD and hypermobility-related disorders is relevant, since it may help identify those ASD patients susceptible to chronic pain.
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Affiliation(s)
- Carolina Baeza-Velasco
- Laboratory of Psychopathology and Health Processes, University Paris Descartes-Sorbonne Paris Cité, Boulogne-Billancourt, France
- INSERM U1061, Neuropsychiatry: Epidemiological and Clinical Research, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Reference Center for Rare Psychiatric Diseases, APHP, Groupe Hospitalier Pitié-Salpêtrière, Université Sorbonne, Paris, France
- Institut des Systèmes Intelligents et Robotiques, CNRS UMR 7222, Université Sorbonne, Paris, France
| | | | | | - Lautaro Diaz
- Department of Child and Adolescent Psychiatry, Reference Center for Rare Psychiatric Diseases, APHP, Groupe Hospitalier Pitié-Salpêtrière, Université Sorbonne, Paris, France
| | - Cora Cravero
- Department of Child and Adolescent Psychiatry, Reference Center for Rare Psychiatric Diseases, APHP, Groupe Hospitalier Pitié-Salpêtrière, Université Sorbonne, Paris, France
| | - Emilie Cappe
- Laboratory of Psychopathology and Health Processes, University Paris Descartes-Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Vincent Guinchat
- Department of Child and Adolescent Psychiatry, Reference Center for Rare Psychiatric Diseases, APHP, Groupe Hospitalier Pitié-Salpêtrière, Université Sorbonne, Paris, France
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196
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Andersson M, Sjöström S, Wängqvist M, Örtqvist L, Nordenskjöld A, Holmdahl G. Psychosocial and Sexual Outcomes in Adolescents following Surgery for Proximal Hypospadias in Childhood. J Urol 2018; 200:1362-1370. [DOI: 10.1016/j.juro.2018.06.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Marie Andersson
- Sahlgrenska Academy, Women’s and Children’s Health, Gothenburg, Sweden
- Pediatric Uro-Nephrologic Center, Department of Pediatric Surgery, Queen Silvia’s Children’s Hospital, Gothenburg, Sweden
| | - Sofia Sjöström
- Sahlgrenska Academy, Women’s and Children’s Health, Gothenburg, Sweden
- Pediatric Uro-Nephrologic Center, Department of Pediatric Surgery, Queen Silvia’s Children’s Hospital, Gothenburg, Sweden
| | - Maria Wängqvist
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Lisa Örtqvist
- Department of Women’s and Children’s Health, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Surgery, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Nordenskjöld
- Department of Women’s and Children’s Health, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Surgery, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Gundela Holmdahl
- Sahlgrenska Academy, Women’s and Children’s Health, Gothenburg, Sweden
- Pediatric Uro-Nephrologic Center, Department of Pediatric Surgery, Queen Silvia’s Children’s Hospital, Gothenburg, Sweden
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197
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Slobodin O, Cassuto H, Berger I. Age-Related Changes in Distractibility: Developmental Trajectory of Sustained Attention in ADHD. J Atten Disord 2018; 22:1333-1343. [PMID: 25791438 DOI: 10.1177/1087054715575066] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study investigated age-related changes in sustained attention in children with ADHD and in their typically developed peers. METHOD The study used a Continuous Performance Test (CPT) that includes visual and auditory stimuli serving as distractors. The rate of omission errors was used as a measurement of difficulty in sustained attention. Participants were children and adolescents aged 7 to 18 years (478 with ADHD and 361 without ADHD). RESULTS Both groups of adolescents (with and without ADHD) showed reduced distractibility than younger children from the same group. However, distractibility tended to diminish in non-ADHD adolescents, but not in adolescents with ADHD. CONCLUSION Although part of the difficulties in ADHD could be explained by developmental delay that improves with time, other deficits, such as increased distractibility causing more omission errors, do not show a clear developmental trajectory. The results suggest that deficits in inhibitory control might be the core of ADHD.
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Affiliation(s)
- Ortal Slobodin
- 1 Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Itai Berger
- 1 Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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198
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Associations Between Conduct Disorder, Neurodevelopmental Problems and Psychopathic Personality Traits in a Swedish Twin Youth Population. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018; 40:586-592. [PMID: 30459483 PMCID: PMC6223811 DOI: 10.1007/s10862-018-9689-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previous research has found a complex relationship between psychopathic traits, neurodevelopmental problems (NDPs), and conduct disorder (CD) in children. This study explores associations between psychopathic traits, assessed with the Child Problematic Traits Inventory-Short Version (CPTI-SV), and CD in children with and without coexisting NDPs (i.e., attention deficit/hyperactivity disorder [ADHD] and autism spectrum disorder [ASD]) in a community-based sample of Swedish twins (n = 8762). Findings indicate weak to moderately strong correlations between psychopathic traits and CD, ADHD, and ASD, respectively. Furthermore, in univariable analyses, both psychopathic traits and NDPs displayed significant positive associations with being screened positive for CD, though only the grandiose-deceitful dimension of CPTI-SV and the ADHD domain concentration and attention deficits remained significantly associated with CD in a multivariable regression model. The results are relevant to screening and assessment in child and youth psychiatry, as a grandiose and deceitful interpersonal style may also be a valid sign of children at risk of developing CD.
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199
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Developmental protein kinase C hyper-activation results in microcephaly and behavioral abnormalities in zebrafish. Transl Psychiatry 2018; 8:232. [PMID: 30352990 PMCID: PMC6199330 DOI: 10.1038/s41398-018-0285-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/13/2018] [Accepted: 09/10/2018] [Indexed: 12/19/2022] Open
Abstract
Susceptible genetic polymorphisms and altered expression levels of protein kinase C (PKC)-encoding genes suggest overactivation of PKC in autism spectrum disorder (ASD) development. To delineate the pathological role of PKC, we pharmacologically stimulated its activity during the early development of zebrafish. Results demonstrated that PKC hyper-activation perturbs zebrafish development and induces a long-lasting head size deficit. The anatomical and cellular analysis revealed reduced neural precursor proliferation and newborn neuron formation. β-Catenin that is essential for brain growth is dramatically degraded. Stabilization of β-catenin by gsk3β inhibition partially restores the head size deficit. In addition, the neuropathogenic effect of developmental PKC hyper-activation was further supported by the alterations in the behavioral domain including motor abnormalities, heightened stress reactivity and impaired habituation learning. Taken together, by causally connecting early-life PKC hyper-activation to these neuropathological traits and the impaired neurogenesis, these results suggest that PKC could be a critical pathway in ASD pathogenesis.
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200
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Miniscalco C, Fernell E, Thompson L, Sandberg E, Kadesjö B, Gillberg C. Development problems were common five years after positive screening for language disorders and, or, autism at 2.5 years of age. Acta Paediatr 2018; 107:1739-1749. [PMID: 29637606 DOI: 10.1111/apa.14358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 02/21/2018] [Accepted: 04/04/2018] [Indexed: 12/31/2022]
Abstract
AIM This study identified whether children who had screened positive for either developmental language disorder (DLD) or autism spectrum disorder (ASD) at the age of 2.5 years had neurodevelopmental assessments five years later. METHODS Our study cohort were 288 children born from 1 July 2008 to 20 June 2009 who screened positive for DLD and, or, ASD at 2.5 years. Of these, 237 children were referred to, and assessed, at the Paediatric Speech and Language Pathology clinic (n = 176) or the Child Neuropsychiatry Clinic (n = 61) at the Queen Silvia Children's Hospital, Gothenburg, Sweden. Clinical registers covering all relevant outpatient clinics were reviewed five years later with regard to established diagnoses. RESULTS When the 237 were followed up five years later, 96 (40%) had established neurodevelopmental disorders or problems, often beyond DLD and ASD. Co-existing problems were common in this cohort and multidisciplinary assessments were indicated. The other 60% did not appear in subsequent clinic records. It is likely that this 40% was a minimum rate and that more children will be referred for developmental problems later. CONCLUSION Five years after they had been screened positive for DLD and, or autism at 2.5 years, 40% of our cohort had remaining or other developmental problems.
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Affiliation(s)
- Carmela Miniscalco
- Gillberg Neuropsychiatry Centre; Institute of Neuroscience and Physiology; University of Gothenburg; Gothenburg Sweden
- Department of Paediatric Speech and Language Pathology; Queen Silvia Children's Hospital; Gothenburg Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre; Institute of Neuroscience and Physiology; University of Gothenburg; Gothenburg Sweden
| | - Lucy Thompson
- Gillberg Neuropsychiatry Centre; Institute of Neuroscience and Physiology; University of Gothenburg; Gothenburg Sweden
| | - Eva Sandberg
- Department of Paediatric Speech and Language Pathology; Queen Silvia Children's Hospital; Gothenburg Sweden
| | - Björn Kadesjö
- Gillberg Neuropsychiatry Centre; Institute of Neuroscience and Physiology; University of Gothenburg; Gothenburg Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre; Institute of Neuroscience and Physiology; University of Gothenburg; Gothenburg Sweden
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