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Kumar MA, N S. Effect of Video Modeling With Simulation on Improving Menstrual Hygiene Skills for Adolescents With Autism Spectrum Disorder. Cureus 2024; 16:e62847. [PMID: 39040730 PMCID: PMC11260660 DOI: 10.7759/cureus.62847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Background Menstruation is a biological process experienced by women every month. This project intends to improve menstrual hygiene skills using video modeling with simulation. Educating adolescent girls with autism spectrum disorder to engage in personal care during their menstrual cycle, particularly sanitation and hygiene, is essential. It is important to develop the knowledge and skills necessary for effective self-care during menstruation to prevent sexual health problems. Additionally, the project aims to provide a safe environment for adolescents to practice their menstrual hygiene routines and relieve the stress from their caregivers. Aim and objective The study aims to evaluate the effect of video modeling with simulation to improve menstrual hygiene skills in adolescents with autism. The ultimate objective of the study is to determine whether video modeling with simulation in the experimental group enhances the practice of menstrual hygiene among adolescent girls with autism, as well as the impact of traditional occupational therapy intervention on improving menstrual hygiene in this population. Methodology This is a quasi-experimental design with convenience sampling and selected samples (n=50), who were then split into two groups: an experimental group (n=25) and a control group (n=25) based on the inclusion and exclusion criteria. The experimental group received video modeling and simulation, while the control group did not receive any specific intervention except parent education and pictorial representations. Pre- and post-tests were conducted to measure the changes. Indian Scale for Assessment of Autism was the screening tool used and the Menstrual Practice Needs Scale (MNPS) was administered. The duration of the study was six months, three sessions per week, lasting 45 minutes to an hour each. The statistical analysis was done with significance at a 1% alpha level using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, USA). Results The pre-test and post-test data were analyzed using the Wilcoxon signed-rank test and the Mann-Whitney test. The results demonstrated the comparison of the pre-test and post-test mean scores of the MNPS scores were highly statistically significant (p-value of 0.000) when compared to the control group. Following the implementation of video modeling with simulation, the experimental group's post-test scores were significantly higher than the control group's (p-value of 0.000). Thus, the study showed that video modeling with simulation improved menstrual hygiene in adolescents with autism spectrum disorder. Conclusion The clinical significance of this study was that the adolescents were excited to watch the videos and perform the activities; furthermore, after video modeling with simulation was implemented, there was a significant improvement in the experimental group when compared to the control group. This enhances the practice of the menstrual hygiene skills independently by the adolescents. Video modeling with simulation has paved the way for improving menstrual hygiene in adolescents with autism. Although the findings from the study are positive, more clinical trials are needed to prove that video modeling with simulation can be used as a therapeutic modality.
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Affiliation(s)
- M Arun Kumar
- Occupational Therapy, Saveetha College of Occupational Therapy, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Shweta N
- Occupational Therapy, Saveetha College of Occupational Therapy, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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2
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Horata E, Ay H, Aslan D. Autistic-like behaviour and changes in thalamic cell numbers a rat model of valproic acid-induced autism; A behavioural and stereological study. Brain Res 2024; 1840:149047. [PMID: 38823508 DOI: 10.1016/j.brainres.2024.149047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
The contribution of the thalamus to the development and behavioural changes in autism spectrum disorders (ASD), a neurodevelopmental syndrome, remains unclear. The aim of this study was to determine the changes in thalamic volume and cell number in the valproic acid (VPA)-induced ASD model using stereological methods and to clarify the relationship between thalamus and ASD-like behaviour. Ten pregnant rats were administered a single dose (600 mg/kg) of VPA intraperitoneally on G12.5 (VPA group), while five pregnant rats were injected with 5 ml saline (control group). Behavioural tests were performed to determine appropriate subjects and ASD-like behaviours. At P55, the brains of the subjects were removed. The sagittal sections were stained with cresyl violet and toluidine blue. The thalamic and hemispheric volumes with their ratios, the total number of thalamic cells, neurons and non-neuronal cells were calculated using stereological methods. Data were compared using a t-test and a Pearson correlation analysis was performed to examine the relationship between behaviour and stereological outcomes. VPA-treated rats had lower sociability and sociability indexes. There was no difference in social novelty preference and anxiety. The VPA group had larger hemispheric volume, lower thalamic volume, and fewer neurons. The highest percentage decrease was in non-neuronal cells. There was a moderate positive correlation between the number of non-neuronal cells and sociability, thalamic volume and the number of neurons as well as the time spent in the light box. The correlation between behaviour and stereological data suggests that the thalamus is associated with ASD-like behaviour.
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Affiliation(s)
- Erdal Horata
- Orthopedic Prosthesis Orthotics, Atatürk Health Services Vocational School, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Hakan Ay
- Department of Anatomy, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Duygu Aslan
- Department of Anatomy, Faculty of Medicine, Kafkas University, Kars, Turkey
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3
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Alper M, Christiansen E, Allen AA, Mello S. Pediatric Media Guidance for Parents of Children on the Autism Spectrum: A Thematic Analysis. HEALTH COMMUNICATION 2023; 38:1572-1580. [PMID: 34963394 DOI: 10.1080/10410236.2021.2020982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Very little is known about pediatric media guidance, or the one-on-onse advice that medical and clinical professionals (MCPs) communicate to parents about their children's recreational media and technology (RMT) use. One population that stands to benefit from a closer examination is children on the autism spectrum due to their behavior and communication challenges. We surveyed one group of pediatric autism MCPs, applied behavioral analysis (ABA) providers (N = 234), due to their proximity to families and conducted an applied thematic analysis of RMT advice they deliver. Providers reported primarily suggesting that caregivers employ restrictive parental mediation with their autistic child, that RMT should primarily be limited to use as a reward or reinforcement, and that parents should set time limits. Our findings offer new insights into the intersections of health communication theory and practice, while highlighting the need for greater research into RMT guidance for children with and without disabilities.
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Affiliation(s)
- Meryl Alper
- Department of Communication Studies, College of Arts, Media, and Design, Northeastern University
| | - Erika Christiansen
- Department of Communication Studies, College of Arts, Media, and Design, Northeastern University
| | | | - Susan Mello
- Department of Communication Studies, College of Arts, Media, and Design, Northeastern University
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4
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Brewster PR, Mohammad Ishraq Bari S, Walker GM, Werfel TA. Current and Future Directions of Drug Delivery for the Treatment of Mental Illnesses. Adv Drug Deliv Rev 2023; 197:114824. [PMID: 37068660 DOI: 10.1016/j.addr.2023.114824] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/22/2023] [Accepted: 04/11/2023] [Indexed: 04/19/2023]
Abstract
Mental illnesses including anxiety disorders, autism spectrum disorder, post-traumatic stress disorder, schizophrenia, depression, and others exact an immense toll on the healthcare system and society at large. Depression alone impacts 21 million adults and costs over $200 billion annually in the United States. However, pharmaceutical strategies to treat mental illnesses are lagging behind drug development in many other disease areas. Because many of the shortcomings of therapeutics for mental illness relate to delivery problems, drug delivery technologies have the potential to radically improve the effectiveness of therapeutics for these diseases. This review describes the current pharmacotherapeutic approaches to treating mental illnesses as well as drug delivery approaches that have improved existing therapies. Approaches to improve drug bioavailability, provide controlled release of therapeutics, and enable drug targeting to the central nervous system (CNS) will be highlighted. Moreover, next-generation delivery approaches such as environmentally-controlled release and interval/sequential drug release will be addressed. Based on the evolving landscape of the treatment of mental illnesses, the nascent field of drug delivery in mental health has tremendous potential for growth in terms of both economic and patient impact.
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Affiliation(s)
- Parker R Brewster
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA; Department of Chemical Engineering, University of Mississippi, University, MS 38677, USA
| | | | - Glenn M Walker
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA
| | - Thomas A Werfel
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA; Department of Chemical Engineering, University of Mississippi, University, MS 38677, USA; Department of BioMolecular Sciences, University of Mississippi, University, MS 38677, USA; Cancer Center and Research Institute, University of Mississippi Medical Center, Jackson, MS 39216, USA
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5
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Paley R. The 'insanity' of Lady Durham. HISTORY OF PSYCHIATRY 2022; 33:217-229. [PMID: 35588213 PMCID: PMC9121518 DOI: 10.1177/0957154x211064952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This essay draws on evidence in a late nineteenth-century court case and surviving medical notes to provide a case study of a hitherto unidentified case of Autism Spectrum Disorder. The case is particularly interesting in that it not only appears to be the first identification of historical ASD in a female, but also because the patient subsequently developed symptoms of psychosis suggestive of schizophrenia or schizoaffective disorder. The unusual survival of detailed medical notes also throws light on the ways in which a difficult patient was treated by supposedly enlightened pioneers of psychiatry.
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Affiliation(s)
- Ruth Paley
- Ruth Paley, Oxford Brookes University,
Harcourt Hill Campus, Oxford OX2 9AT, UK.
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6
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Lombardo MV, Mandelli V. Rethinking Our Concepts and Assumptions About Autism. Front Psychiatry 2022; 13:903489. [PMID: 35722549 PMCID: PMC9203718 DOI: 10.3389/fpsyt.2022.903489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/16/2022] [Indexed: 12/13/2022] Open
Abstract
Autism is a clinical consensus diagnosis made based on behavioral symptoms of early developmental difficulties in domains of social-communication (SC) and restricted repetitive behaviors (RRB). Many readily assume that alongside being optimal for separating individuals based on SC and RRB behavioral domains, that the label should also be highly useful for explaining differential biology, outcomes, and treatment (BOT) responses. However, we also now take for granted the fact that the autism population is vastly heterogeneous at multiple scales, from genome to phenome. In the face of such multi-scale heterogeneity, here we argue that the concept of autism along with the assumptions that surround it require some rethinking. While we should retain the diagnosis for all the good it can do in real-world circumstances, we also call for the allowance of multiple other possible definitions that are better tailored to be highly useful for other translational end goals, such as explaining differential BOT responses.
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Affiliation(s)
- Michael V Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Veronica Mandelli
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy.,Center for Mind/Brain Sciences, University of Trento, Rovereto, Italy
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Rosen NE, Lord C, Volkmar FR. The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond. J Autism Dev Disord 2021; 51:4253-4270. [PMID: 33624215 PMCID: PMC8531066 DOI: 10.1007/s10803-021-04904-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 12/27/2022]
Abstract
In this paper we review the impact of DSM-III and its successors on the field of autism-both in terms of clinical work and research. We summarize the events leading up to the inclusion of autism as a "new" official diagnostic category in DSM-III, the subsequent revisions of the DSM, and the impact of the official recognition of autism on research. We discuss the uses of categorical vs. dimensional approaches and the continuing tensions around broad vs. narrow views of autism. We also note some areas of current controversy and directions for the future.
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Affiliation(s)
| | | | - Fred R. Volkmar
- Yale University, New Haven, USA
- Southern Connecticut State University, New Haven, USA
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Karadaş C, Bakkaloğlu H, Demir Ş. Exploring the effect of motor coordination on repetitive behaviours in children with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:238-247. [PMID: 37025329 PMCID: PMC10071942 DOI: 10.1080/20473869.2021.1948318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/24/2021] [Accepted: 06/22/2021] [Indexed: 06/19/2023]
Abstract
Objective: This study was conducted to explore the effect of motor coordination on repetitive behaviors in children with Autism Spectrum Disorder (ASD) aged 5-15 years. Methods: The study employed the causal-comparative design, one of the correlational survey designs. The study was carried out with data obtained from parents of 241 children with ASD. The parents were administered the measurement tools of Gilliam Autism Rating Scale-2-Turkish Version to confirm the diagnosis of ASD, Demographic Information Form to obtain information about the child and the parent, Repetitive Behavior Scale-Revised-Turkish Version to evaluate the repetitive behaviors, and Developmental Coordination Disorder Questionnaire-07-Turkish Version to evaluate the motor coordination performance. The data were analyzed MANCOVA in the R package program. Results: The study results revealed that 72% of children with ASD had a risk of Developmental Coordination Disorder (DCD). The repetitive behaviors of children with and without DCD risk differed significantly. The severity and intensity of the repetitive behaviors of children with DCD risk were higher than those without DCD risk when age, gender, and comorbidity were taken under control. Conclusion: The motor coordination problems in children with ASD are effective on repetitive behaviors.
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Affiliation(s)
- Cebrail Karadaş
- Department of Special Education, Ankara University, Ankara, Turkey
| | | | - Şeyda Demir
- Department of Special Education, Ankara University, Ankara, Turkey
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9
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Khullar V, Singh HP, Bala M. Deep Neural Network-based Handheld Diagnosis System for Autism Spectrum Disorder. Neurol India 2021; 69:66-74. [PMID: 33642273 DOI: 10.4103/0028-3886.310069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective The aim of the present work was to propose and implement deep neural network (DNN)-based handheld diagnosis system for more accurate diagnosis and severity assessment of individuals with autism spectrum disorder (ASD). Methods Initially, the learning of the proposed system for ASD diagnosis was performed by implementing DNN algorithms such as a convolutional neural network (CNN) and long short-term memory (LSTM), and multilayer perceptron (MLP) with DSM-V based acquired dataset. The performance of the DNN algorithms was analyzed based on parameters viz. accuracy, loss, mean squared error (MSE), precision, recall, and area under the curve (AUC) during the training and validation process. Later, the optimum DNN algorithm, among the tested algorithms, was implemented on handheld diagnosis system (HDS) and the performance of HDS was analyzed. The stability of proposed DNN-based HDS was validated with the dataset group of 20 ASD and 20 typically developed (TD) individuals. Results It was observed during comparative analysis that LSTM resulted better in ASD diagnosis as compared to other artificial intelligence (AI) algorithms such as CNN and MLP since LSTM showed stabilized results achieving maximum accuracy in less consumption of epochs with minimum MSE and loss. Further, the LSTM based proposed HDS for ASD achieved optimum results with 100% accuracy in reference to DSM-V, which was validated statistically using a group of ASD and TD individuals. Conclusion The use of advanced AI algorithms could play an important role in the diagnosis of ASD in today's era. Since the proposed LSTM based HDS for ASD and determination of its severity provided accurate results with maximum accuracy with reference to DSM-V criteria, the proposed HDS could be the best alternative to the manual diagnosis system for diagnosis of ASD.
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Affiliation(s)
- Vikas Khullar
- I.K.G. Punjab Technical University, Kapurthala; CT Institute of Engineering, Management and Technology, Jalandhar, Punjab, India
| | - Harjit Pal Singh
- I.K.G. Punjab Technical University, Kapurthala; CT Institute of Engineering, Management and Technology, Jalandhar, Punjab, India
| | - Manju Bala
- I.K.G. Punjab Technical University, Kapurthala; Khalsa College of Engineering and Technology, Amritsar, Punjab, India
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10
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A High Prevalence of Autism Spectrum Disorder in Preschool Children in an Immigrant, Multiethnic Population in Sweden: Challenges for Health Care. J Autism Dev Disord 2020; 51:538-549. [PMID: 32533384 PMCID: PMC7835151 DOI: 10.1007/s10803-020-04563-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study examines the prevalence of autism spectrum disorder (ASD) in preschool children in an immigrant population. Possible risk factors for ASD and individual needs for the children and their families are described, as well as implications for health care. The estimated minimum prevalence for ASD in the area was 3.66% for children aged 2–5 years. Multiple risk factors and extensive individual needs for the children and their families were observed. The high prevalence of ASD and the plethora of needs in immigrant communities pose challenges for health care. A coordinated health care system is necessary to meet the many and individual needs.
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11
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12
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The Effectiveness of Dance/Movement Therapy Interventions for Autism Spectrum Disorder: A Systematic Review. AMERICAN JOURNAL OF DANCE THERAPY 2019. [DOI: 10.1007/s10465-019-09296-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Nomura K, Yamaguchi M, Yokoyama M, Shiota M, Ohno K, Maegaki Y. A Study on the Incidence and Comorbidities of Autism Spectrum Disorders Accompanied by Intellectual Disabilities in Yonago City, Japan. Yonago Acta Med 2019. [DOI: 10.33160/yam.2019.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Kazuyo Nomura
- *Faculty of Education, Tokoha University, Shizuoka 422-8581, Japan
- ¶Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | | | | | - Madoka Shiota
- §Tottori Prefecture Rehabilitation Center for children with disabilities, Yonago 683-0004, Japan
| | | | - Yoshihiro Maegaki
- ¶Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
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Hennessey T, Andari E, Rainnie DG. RDoC-based categorization of amygdala functions and its implications in autism. Neurosci Biobehav Rev 2018; 90:115-129. [PMID: 29660417 PMCID: PMC6250055 DOI: 10.1016/j.neubiorev.2018.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 03/09/2018] [Accepted: 04/09/2018] [Indexed: 12/28/2022]
Abstract
Confusion endures as to the exact role of the amygdala in relation to autism. To help resolve this we turned to the NIMH's Research Domain Criteria (RDoC) which provides a classification schema that identifies different categories of behaviors that can turn pathologic in mental health disorders, e.g. autism. While RDoC incorporates all the known neurobiological substrates for each domain, this review will focus primarily on the amygdala. We first consider the amygdala from an anatomical, historical, and developmental perspective. Next, we examine the different domains and constructs of RDoC that the amygdala is involved in: Negative Valence Systems, Positive Valence Systems, Cognitive Systems, Social Processes, and Arousal and Regulatory Systems. Then the evidence for a dysfunctional amygdala in autism is presented with a focus on alterations in development, prenatal valproic acid exposure as a model for ASD, and changes in the oxytocin system therein. Finally, a synthesis of RDoC, the amygdala, and autism is offered, emphasizing the task of disambiguation and suggestions for future research.
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Affiliation(s)
- Thomas Hennessey
- Department of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, United States
| | - Elissar Andari
- Silvio O. Conte Center for Oxytocin and Social Cognition, Department of Psychiatry and Behavioral Sciences, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, United States
| | - Donald G Rainnie
- Department of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, United States.
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15
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Nevison CD, Blaxill M. Diagnostic Substitution for Intellectual Disability: A Flawed Explanation for the Rise in Autism. J Autism Dev Disord 2018; 47:2733-2742. [PMID: 28589495 DOI: 10.1007/s10803-017-3187-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Time trends in autism spectrum disorder (ASD) and intellectual disability (ID) prevalence from the United States Individuals with Disabilities Education Act data were computed from 2000 to 2011 for each state and each age from 6 to 17. These trends did not support the hypothesis that diagnostic substitution for ID can explain the ASD rise over recent decades, although the hypothesis appeared more plausible when the data were aggregated across all states and ages. Nationwide ID prevalence declined steeply over the last two decades, but the decline was driven mainly by ~15 states accounting for only one-fourth of the U.S. school population. More commonly, including in the most populous states, ID prevalence stayed relatively constant while ASD prevalence rose sharply.
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Affiliation(s)
- Cynthia D Nevison
- Institute for Arctic and Alpine Research, University of Colorado, Cynthia Nevison, Campus Box 450, Boulder, CO, 80309-0450, USA.
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16
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Verhoeff ME, Blanken LME, Kocevska D, Mileva-Seitz VR, Jaddoe VWV, White T, Verhulst F, Luijk MPCM, Tiemeier H. The bidirectional association between sleep problems and autism spectrum disorder: a population-based cohort study. Mol Autism 2018; 9:8. [PMID: 29423134 PMCID: PMC5791216 DOI: 10.1186/s13229-018-0194-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 01/16/2018] [Indexed: 01/02/2023] Open
Abstract
Background Sleep difficulties are prevalent in children with autism spectrum disorder (ASD). The temporal nature of the association between sleep problems and ASD is unclear because longitudinal studies are lacking. Our aim is to clarify whether sleep problems precede and worsen autistic traits and ASD or occur as a consequence of the disorder. Methods Repeated sleep measures were available at 1.5, 3, 6, and 9 years of age in 5151 children participating in the Generation R Study, a large prospective birth cohort in the Netherlands. Autistic traits were determined with the Pervasive Developmental Problems score (PDP) of the Child Behavior Checklist (CBCL) at 1.5 and 3 years and the Social Responsiveness Scale (SRS) at 6 years. This cohort included 81 children diagnosed with ASD. Results Sleep problems in early childhood were prospectively associated with a higher SRS score, but not when correcting for baseline PDP score. By contrast, a higher SRS score and an ASD diagnosis were associated with more sleep problems at later ages, even when adjusting for baseline sleep problems. Likewise, a trajectory of increasing sleep problems was associated with ASD. Conclusions Sleep problems and ASD are not bidirectionally associated. Sleep problems do not precede and worsen autistic behavior but rather co-occur with autistic traits in early childhood. Over time, children with ASD have an increase in sleep problems, whereas typically developing children have a decrease in sleep problems. Our findings suggest that sleep problems are part of the construct ASD.
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Affiliation(s)
- Maria E Verhoeff
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Laura M E Blanken
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Desana Kocevska
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Viara R Mileva-Seitz
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,3Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.,4Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tonya White
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands.,5Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Frank Verhulst
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Maartje P C M Luijk
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands.,6Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands.,4Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,7Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
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Abstract
Autism is a pervasive and life-long disorder that is characterised by profound deficits in communication and social understanding, together with ritualistic and obsessional behaviours and a general resistance to change. Although usually associated with additional cognitive impairments (approximately 50% of those affected have an IQ below 50) the condition can occur in individuals of all levels of ability, and around 20% of cases have an IQ within the normal range. Estimates of prevalence vary from 3.3 to 16.0 per 10 000 and rates may be even higher if children within the autistic wider spectrum are included (Wing, 1993, 1996). Understanding of causation is still limited, although genetic factors are now known to play a major role (Lord & Rutter, 1994).
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18
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Falls N. Specialist assessment clinic for pervasive developmental disorders. PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.22.11.706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodThe Joint Committee on Higher Psychiatric Training lists the ability to carry out a thorough clinical assessment including physical and mental state examination, as one of the essential core skills in child and adolescent psychiatry. Experience of the assessment of comparatively rare disorders may depend upon the organisation of regional services, as well as good working relationships between teams willing to involve the trainee.ResultsThis paper describes a six-month attachment to the first multi-disciplinary Specialist Assessment Clinic for Pervasive Developmental Disorders to be created in Northern Ireland. Assessments are multi-dimensional and multi-professional. Attachment to this specialist clinic has become a valuable resource, with demand exceeding availability of places.Clinical implicationsThe pervasive developmental disorders are characterised by onset before 36 months, qualitative impairments in social interaction and communication (both verbal and non-verbal), and a pattern of repetitive or stereotyped activities or interests (DSM-IV). Diagnostic criteria for these disorders have broadened since the introduction of DSM-IV and ICD–10. For example, both have now agreed the validity of Asperger's syndrome, featuring difficulties in social interaction, restricted and repetitive areas of interest, without clinically significant impairment of intelligence or language development.
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Hossain MD, Ahmed HU, Jalal Uddin MM, Chowdhury WA, Iqbal MS, Kabir RI, Chowdhury IA, Aftab A, Datta PG, Rabbani G, Hossain SW, Sarker M. Autism Spectrum disorders (ASD) in South Asia: a systematic review. BMC Psychiatry 2017; 17:281. [PMID: 28826398 PMCID: PMC5563911 DOI: 10.1186/s12888-017-1440-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/23/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. METHODS We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. RESULTS We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. CONCLUSIONS Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.
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Affiliation(s)
- Mohammad Didar Hossain
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
- Foundation for Advancement of Innovations in Technology and Health (faith), Bangladesh, Iqbal Road, Mohammadpur, Dhaka, 1207 Bangladesh
| | - Helal Uddin Ahmed
- National Institute of Mental Health, Bangladesh (NIMH,B), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - M M Jalal Uddin
- National Institute of Neurosciences & Hospital, Bangladesh (NINS,B), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - Waziul Alam Chowdhury
- Bangladesh Association of psychiatrists, National Institute of Mental Health, Bangladesh (NIMH,B), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - Mohd S Iqbal
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Razin Iqbal Kabir
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
| | - Imran Ahmed Chowdhury
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
| | - Afzal Aftab
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
- Foundation for Advancement of Innovations in Technology and Health (faith), Bangladesh, Iqbal Road, Mohammadpur, Dhaka, 1207 Bangladesh
| | - Pran Gopal Datta
- Shuchona Foundation, Bangabandhu Memorial Trust Building, 2nd floor, 8 Rd No 11, Dhaka, 1209 Bangladesh
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, 1000 Bangladesh
| | - Golam Rabbani
- Neuro-Developmental Disability Protection Trust, Department of Social Services Building, Agargaon, Sher-e-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - Saima Wazed Hossain
- Shuchona Foundation, Bangabandhu Memorial Trust Building, 2nd floor, 8 Rd No 11, Dhaka, 1209 Bangladesh
- Expert Advisory Panel on Mental Health; Global Autism Advocate, World Health Organization, Dhaka, Bangladesh
- National Advisory Committee for Autism and Neurodevelopmental Disorders, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | - Malabika Sarker
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
- Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, 69120 Germany
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Fernańdez-Alcántara M, García-Caro MP, Pérez-Marfil MN, Hueso-Montoro C, Laynez-Rubio C, Cruz-Quintana F. Feelings of loss and grief in parents of children diagnosed with autism spectrum disorder (ASD). RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 55:312-321. [PMID: 27235768 DOI: 10.1016/j.ridd.2016.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/24/2016] [Accepted: 05/09/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Various authors have reported feelings of loss and grief in parents of children with autism spectrum disorder. However, no previous studies have investigated the structure of these feelings. AIMS To analyze in depth the feelings of loss in parents of children diagnosed with autism spectrum disorder. METHOD A qualitative study was conducted based on grounded theory. Twenty parents participated through purposive sampling. PROCEDURE Semi-structured interviews were conducted, asking about different emotional aspects of the upbringing of a child with autism spectrum disorder. Atlas.ti 6.2 program was used for open, axial, and selective coding. RESULTS The core category that explained the feelings of these parents was unexpected child loss, associated with shock, negation, fear, guilt, anger, and/or sadness. Two processes were identified, one associated with the resolution of grief and the other with obstacles to overcoming it. IMPLICATIONS Feelings of loss play an important role in explaining the complex emotions experienced by these parents. Different intervention strategies are proposed.
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Affiliation(s)
- Manuel Fernańdez-Alcántara
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, Brain, Mind and Behavior Research Center (CIMCYC), University of Granada, Spain.
| | - M Paz García-Caro
- Faculty of Health Sciences, Department of Nursing, University of Granada, Spain
| | - M Nieves Pérez-Marfil
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, Brain, Mind and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Cesar Hueso-Montoro
- Faculty of Health Sciences, Department of Nursing, University of Granada, Spain
| | - Carolina Laynez-Rubio
- Unit of Monitoring and Early Assistance (UMEA), San Cecilio Clinical Hospital, Granada, Spain
| | - Francisco Cruz-Quintana
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, Brain, Mind and Behavior Research Center (CIMCYC), University of Granada, Spain
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Bramati-Castellarin I, Patel VB, Drysdale IP. Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic technique (VOT). J Bodyw Mov Ther 2016; 20:461-70. [PMID: 27634066 DOI: 10.1016/j.jbmt.2016.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 12/11/2015] [Accepted: 12/29/2015] [Indexed: 12/18/2022]
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Stores G, Wivggs L. Abnormal Sleep Patterns Associated with Autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016. [DOI: 10.1177/1362361398022004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Statements have recurrently been made about the high rate of sleep problems reported in children with autism, particularly difficulty initiating and maintaining sleep at appropriate times of the night and day. Autism itself is frequently associated with the presence of learning disability and a variety of other medical conditions. These often coexisting factors are themselves associated with sleep abnormalities and therefore caution is needed when attempting to assess the relationship between autism and sleep abnormalities. Detailed consideration of the various possible causes of sleep problems is required to reach meaningful diagnostic and treatment decisions. The present account reviews the published work on sleep disturbance and autism, highlighting theoretical and practical issues which need further attention. Methods of assessing and treating sleep disorders are also discussed, with special consideration of factors related to autism which may affect the choice of method.
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Arvidsson T, Danielsson B, Forsberg P, Gillberg C, Johansson M, Kjellgren G. Autism in 3-6-Year-Old Children in a Suburb of Goteborg, Sweden. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016. [DOI: 10.1177/1362361397012004] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
1941 ofthe 3-6-year-old children living in a community outside Gbteborg on the Swedish west coast were screened with a view to identifying all individuals with severe degrees of autistic behaviour. All children in the population were known to well baby clinic staff, and any child suspected of suffering from autism was referred to a specialized clinical research team. The nurses and doctors working in the well baby clinics were well informed about autism. Clinical and ADI-R diagnoses of autism were established after thorough clinical assessments of each suspected case. All children were seen at least twice, and all were over the age of 3 years at the time of diagnosis. The general population prevalence for autism was 3 I in I o,ooo children (9; percent confidence interval 7/ g;). Classic Kanner autism was found in I o in Io,ooo children (9; percent confidence interval-4/24). These rates appear to reflect higher rates than previously reported. Some reasons for the possibly higher prevalence are discussed.
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Affiliation(s)
| | | | - P. Forsberg
- Sahlgren University Hospital, Goteborg, Sweden
| | - C. Gillberg
- Sahlgren University Hospital, Goteborg, Sweden
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Wing L, Gould J. Prevalence of Autistic Spectrum Disorder in the UK: E. Frombonne Autism, 1997, 1(2), 227-9. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016. [DOI: 10.1177/1362361398021008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
The development of ideas about the nature of autism is described, covering myths and legends, accounts of individuals in the historical literature, the search for identifiable subgroups, Kanner's autistic and Asperger syndromes, and the current view of a wide spectrum. Changes in theories of aetiology are outlined, including the early magical and mystical beliefs, the era when purely psychological and emotional causes were promulgated, and the present day research into biological mechanisms. The major advances in understanding the neurological and psychological aspects of autism, which have led to the development of special methods of education, are discussed. The rate of increase in knowledge in recent years gives hope for future progress in understanding and treatment.
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Affiliation(s)
- Lorna Wing
- The National Autistic Society, London, UK
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O'Brien G, Pearson J. Autism and Learning Disability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 8:125-40. [PMID: 15165430 DOI: 10.1177/1362361304042718] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this article a short overview is given of the relationship between autism and learning disability. Autism exists with any level of intelligence, but many individuals with autism suffer also from learning disability. Although both disorders show overlap in some behaviours they are different in many aspects. Are they distinct syndromes which influence each other, or do they belong to a broad spectrum of a condition?
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Affiliation(s)
- Christopher Gillberg
- Department of Child and Adolescent Psychiatry Annedals Clinics, G6teborg University S-413 45 Goteborg, Sweden
| | - Harald Heijbel
- Department of Immunization Research Karolinska Institute Stockholm, Sweden
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Graf WD, Miller G, Nagel SK. Addressing the problem of ADHD medication as neuroenhancements. Expert Rev Neurother 2014; 14:569-81. [PMID: 24738763 DOI: 10.1586/14737175.2014.908707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The prevalence of attention deficit hyperactivity disorder (ADHD) diagnoses is rising. ADHD is closely linked to its treatment with medications such as methylphenidate and amphetamines, which have popular appeal as neuroenhancement drugs by persons without a neurological disorder. The three main reasons for the increase in ADHD medication demand, production, and consumption are a) the inclusion of milder ADHD diagnoses; b) the vast marketing of ADHD medications by the pharmaceutical industry; and c) the illegal diversion of controlled ADHD medication to consumers seeking stimulants as neuroenhancements. Rapidly rising rates of any neurological disorder - especially a behaviorly-defined disorder closely linked to potent medications currently prescribed to more than 5% of the population - deserves ongoing scrutiny. Major social and ethical problems arise from vague-symptom medicalization, neurological disorder trivialization, medication overuse, and controlled substances diversion to healthy persons for nonmedical purposes. We argue against the 'spectrumization' of ADHD in an effort to curtail further diagnosis creep.
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Affiliation(s)
- William D Graf
- Departments of Pediatrics and Neurology, Yale University, PO Box 208064, 333 Cedar Street, New Haven, CT 06510, USA
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Nesbitt S. An Evaluation of Multi-Agency Service Provision for Children with Autistic Spectrum Disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/096979500799155757] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Fernell E, Eriksson MA, Gillberg C. Early diagnosis of autism and impact on prognosis: a narrative review. Clin Epidemiol 2013; 5:33-43. [PMID: 23459124 PMCID: PMC3583438 DOI: 10.2147/clep.s41714] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Autism spectrum disorders involve a set of clinical phenotypes that mirror an early onset of neurodevelopmental deviations, with core symptoms that can probably be related to a deficiency in the social instinct. Underlying the cognitive impairments there are physiological brain problems, caused by a large number of medical factors. This narrative review of systematic reviews and meta-analyses from the last 5 years (2008-2012) presents aspects from many areas in autism spectrum disorder research, with a particular focus on early intervention and the subsequent impact on prognosis. Other major areas discussed are epidemiology, early symptoms and screening, early diagnosis, neuropsychology, medical factors, and the existence of comorbidities. There is limited evidence that any of the broadband "early intervention" programs are effective in changing the natural long-term outcome for many individuals with an early diagnosis of autism. However, there is some evidence that Early Intensive Behavioral Intervention (EIBI) is an effective treatment for some children with ASD. Nevertheless, there is emerging consensus that early diagnosis and information are needed in order that an autism-friendly environment be "created" around affected individuals.
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Affiliation(s)
- Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Anders Eriksson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Gaigg SB. The Interplay between Emotion and Cognition in Autism Spectrum Disorder: Implications for Developmental Theory. Front Integr Neurosci 2012; 6:113. [PMID: 23316143 PMCID: PMC3540960 DOI: 10.3389/fnint.2012.00113] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 11/11/2012] [Indexed: 12/14/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is clinically defined by abnormalities in reciprocal social and communicative behaviors and an inflexible adherence to routinised patterns of thought and behavior. Laboratory studies repeatedly demonstrate that autistic individuals experience difficulties in recognizing and understanding the emotional expressions of others and naturalistic observations show that they use such expressions infrequently and inappropriately to regulate social exchanges. Dominant theories attribute this facet of the ASD phenotype to abnormalities in a social brain network that mediates social-motivational and social-cognitive processes such as face processing, mental state understanding, and empathy. Such theories imply that only emotion related processes relevant to social cognition are compromised in ASD but accumulating evidence suggests that the disorder may be characterized by more widespread anomalies in the domain of emotions. In this review I summarize the relevant literature and argue that the social-emotional characteristics of ASD may be better understood in terms of a disruption in the domain-general interplay between emotion and cognition. More specifically I will suggest that ASD is the developmental consequence of early emerging anomalies in how emotional responses to the environment modulate a wide range of cognitive processes including those that are relevant to navigating the social world.
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Affiliation(s)
- Sebastian B. Gaigg
- Department of Psychology, Autism Research Group, City University LondonLondon, UK
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Bravo Oro A, Vázquez Briseño J, Cuello García C, Calderón Sepúlveda R, Hernández Villalobos A, Esmer Sánchez C. Manifestaciones iniciales de los trastornos del espectro autista. Experiencia en 393 casos atendidos en un centro neurológico infantil. Neurologia 2012; 27:414-20. [DOI: 10.1016/j.nrl.2011.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 07/26/2011] [Accepted: 09/11/2011] [Indexed: 11/25/2022] Open
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Liu T. Motor milestone development in young children with autism spectrum disorders: an exploratory study. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2012. [DOI: 10.1080/02667363.2012.684340] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bravo Oro A, Vázquez Briseño J, Cuello García C, Calderón Sepúlveda R, Hernández Villalobos A, Esmer Sánchez C. Early manifestations of autism spectrum disorders. Experience of 393 cases in a child neurological centre. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2011.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Close HA, Lee LC, Kaufmann CN, Zimmerman AW. Co-occurring conditions and change in diagnosis in autism spectrum disorders. Pediatrics 2012; 129:e305-16. [PMID: 22271695 DOI: 10.1542/peds.2011-1717] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study aimed to investigate descriptive characteristics and co-occurring neurodevelopmental and psychiatric conditions in young children, children, and adolescents with a current and consistent or past but not current (PBNC) diagnosis of autism spectrum disorder (ASD) and how such characteristics and conditions may engender a change in diagnosis of an ASD. METHODS Cross-sectional data of 1366 children with a parent-reported current or PBNC ASD diagnosis were obtained from the National Survey of Children's Health 2007 data set across 3 developmental stages: young children (aged 3-5 years), children (aged 6-11 years), and adolescents (aged 12-17 years). Multinomial logistic regression was used to examine demographic characteristics and co-occurring conditions that differentiate the groups with a current ASD from groups with a PBNC ASD. RESULTS Results indicated the co-occurring conditions that distinguish groups currently diagnosed with an ASD from groups with a PBNC ASD diagnosis. In young children, current moderate/severe learning disability, and current moderate/severe developmental delay; in children, past speech problem, current moderate/severe anxiety, and past hearing problem; and in adolescents, current moderate/severe speech problem, current mild seizure/epilepsy, and past hearing problem. CONCLUSIONS These findings suggest that the presence of co-occurring psychiatric and neurodevelopmental conditions are associated with a change in ASD diagnosis. Questions remain as to whether changes in diagnosis of an ASD are due to true etiologic differences or shifts in diagnostic determination.
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Affiliation(s)
- Heather A Close
- Center for Autism and Developmental Disabilities Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Ashby J. Commentary on 'Helping children with autism spectrum disorders and their families: are we losing our occupation-centred focus?'. Aust Occup Ther J 2011; 58:390-1; author reply 391-2. [PMID: 21957925 DOI: 10.1111/j.1440-1630.2011.00961.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
OBJECTIVE To examine the rates of autism separately according to maternal immigrant status and ethnic origin in respect to the vitamin D insufficiency hypothesis. METHOD Articles were identified by electronic searches. Studies were selected when they analysed autism rates according to maternal immigrant status and/or ethnic origin using multivariate techniques. RESULTS This review gave further support to the association between maternal immigrant status and an increased risk of autism. The relationship with ethnic origin was more complex. Although the crude rates did not differ, multivariate analyses taking into account confounding factors found that black ethnicity was associated with an increased risk for autism. The risk was highly significant when considering the strict definition of autistic disorders as opposed to the large definition of other pervasive developmental disorders. The risk was also very significant for autism associated with mental retardation. CONCLUSION These results are consistent with the maternal vitamin D insufficiency hypothesis. Neurobiological studies are warranted to document the effect of maternal vitamin D insufficiency during pregnancy on the foetal brain and the window of vulnerability. This review stresses the importance of monitoring vitamin D levels in pregnant women, especially those who are immigrant, dark-skinned or veiled, and the urgency of randomized controlled trials.
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Affiliation(s)
- M-J Dealberto
- Department of Community Health and Epidemiology, Queen's University, Kingston, ON, Canada
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Merchán-Naranjo J, Mayoral M, Rapado-Castro M, Llorente C, Boada L, Arango C, Parellada M. Estimation of the Intelligence Quotient Using Wechsler Intelligence Scales in Children and Adolescents with Asperger Syndrome. J Autism Dev Disord 2011; 42:116-22. [DOI: 10.1007/s10803-011-1219-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tateno M, Kikuchi S, Uehara K, Fukita K, Uchida N, Sasaki R, Saito T. Pervasive developmental disorders and autism spectrum disorders: are these disorders one and the same? Psychiatry Investig 2011; 8:67-70. [PMID: 21519540 PMCID: PMC3079189 DOI: 10.4306/pi.2011.8.1.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2010] [Revised: 09/18/2010] [Accepted: 09/24/2010] [Indexed: 11/19/2022] Open
Abstract
The concept of pervasive developmental disorders (PDD) and autism spectrum disorders (ASD) closely resemble each other. Both ICD-10 and DSM-IV use the term PDD. The authors surveyed the perception of PDD/ASD and attitudes toward terminology. The subjects of this study were 205 medical/social-welfare professionals working in fields relating to developmental disorders. Questionnaires were mailed to site investigators at the collaborating institutes. With regard to what the scope of ASD and PDD encompasses, the answers were almost equally divided among three views: ASD and PDD are the same, PDD is wider in scope and ASD is wider. The terms PDD and autism were used in slightly different ways depended upon the situation. Our results demonstrate that the parameters of PDD and ASD are unclear and that the terms related to PDD/ASD are often used differently. Further studies are required to develop more clear and reliable diagnostic criteria for PDD.
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Affiliation(s)
- Masaru Tateno
- Psycho-Developmental Clinic, Sapporo Medical University Hospital, Sapporo, Japan
- Department of Neuropsychiatry, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Saya Kikuchi
- Department of Psychiatry, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Kumi Uehara
- Kanagawa Psychiatric Center, Serigaya Hospital, Yokohama, Japan
| | | | - Naoki Uchida
- Department of Psychiatry, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryuji Sasaki
- Department of Neuropsychiatry, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Toshikazu Saito
- Department of Neuropsychiatry, Sapporo Medical University, School of Medicine, Sapporo, Japan
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Gourdine RM, Baffour TD, Teasley M. Autism and the African American community. SOCIAL WORK IN PUBLIC HEALTH 2011; 26:454-470. [PMID: 21707353 DOI: 10.1080/19371918.2011.579499] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
It is estimated that autism spectrum disorders (ASD) affect 1 in 500 live births per year. However, due to varying techniques for diagnosis and treatment, the disability remains the subject of debate. African Americans tend to suffer disproportionate rates of disability and disease when compared to other racial and ethnic groups due to access to preventative and curative care. However, evidence demonstrates that although rates of diagnosis for autism occur at the same rates in all racial groups, diagnosis in African American children occurs later than in White children. As a result, African American children may require longer and more intensive intervention. This article examines the etiology of autism, diagnosis, and treatment strategies and its impact on African American families. A case method approach is utilized to describe the impact of autism on an African American family. Implications for future research and professional practice and policy are discussed. Understanding autism is important as it relates to the human genome.
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Affiliation(s)
- Ruby M Gourdine
- School of Social Work, Howard University, Washington, District of Columbia 20059, USA.
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O'Brien FM, Page L, O'Gorman RL, Bolton P, Sharma A, Baird G, Daly E, Hallahan B, Conroy RM, Foy C, Curran S, Robertson D, Murphy KC, Murphy DGM. Maturation of limbic regions in Asperger syndrome: a preliminary study using proton magnetic resonance spectroscopy and structural magnetic resonance imaging. Psychiatry Res 2010; 184:77-85. [PMID: 20952166 DOI: 10.1016/j.pscychresns.2010.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 07/05/2010] [Accepted: 08/11/2010] [Indexed: 11/27/2022]
Abstract
People with autistic spectrum disorders (ASD, including Asperger syndrome) may have developmental abnormalities in the amygdala-hippocampal complex (AHC). However, in vivo, age-related comparisons of both volume and neuronal integrity of the AHC have not yet been carried out in people with Asperger syndrome (AS) versus controls. We compared structure and metabolic activity of the right AHC of 22 individuals with AS and 22 healthy controls aged 10-50 years and examined the effects of age between groups. We used structural magnetic resonance imaging (sMRI) to measure the volume of the AHC, and magnetic resonance spectroscopy ((1)H-MRS) to measure concentrations of N-acetyl aspartate (NAA), creatine+phosphocreatine (Cr+PCr), myo-inositol (mI) and choline (Cho). The bulk volume of the amygdala and the hippocampus did not differ significantly between groups, but there was a significant difference in the effect of age on the hippocampus in controls. Compared with controls, young (but not older) people with AS had a significantly higher AHC concentration of NAA and a significantly higher NAA/Cr ratio. People with AS, but not controls, had a significant age-related reduction in NAA and the NAA/Cr ratio. Also, in people with AS, but not controls, there was a significant relationship between concentrations of choline and age so that choline concentrations reduced with age. We therefore suggest that people with AS have significant differences in neuronal and lipid membrane integrity and maturation of the AHC.
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Saemundsen E, Juliusson H, Hjaltested S, Gunnarsdottir T, Halldorsdottir T, Hreidarsson S, Magnusson P. Prevalence of autism in an urban population of adults with severe intellectual disabilities--a preliminary study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54:727-735. [PMID: 20633201 DOI: 10.1111/j.1365-2788.2010.01300.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Research on the prevalence of autism in Iceland has indicated that one possible explanation of fewer autism cases in older age groups was due to an underestimation of autism in individuals with intellectual disabilities (IDs). The present study systematically searched for autism cases in the adult population of individuals with severe ID living in the city of Reykjavik, Iceland. METHODS Potential participants (n = 256) were recruited through the Regional Office for the Affairs of the Handicapped in Reykjavik. First, a screening tool for autism was applied, followed by the Childhood Autism Rating Scale and finally the Autism Diagnostic Interview-Revised (ADI-R). RESULTS The point prevalence of severe ID was 3.7/1000 (95% CI 3.2-4.1) with a male-female ratio of 1.2:1. Participation rate in the study was 46.5%. Participants were younger than non-participants and more often residents of group homes. The prevalence of autism was 21% (25/119) (95% CI 14.7-29.2) with a male-female ratio of 1.8:1. Of the individuals with autism, 10/25 (40%) were verbal according to the ADI-R definition, and 18/25 (72%) had active epilepsy and/or other neurological conditions and handicaps. CONCLUSION The study identified twice the number of autism cases than those previously recognised within the service system. Autism is a prevalent additional handicap in individuals with severe ID, which should always be considered in this population. There are indications that the estimated prevalence of autism found should be considered minimal.
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Affiliation(s)
- E Saemundsen
- State Diagnostic and Counselling Centre, Division of Autism, Kopavogur, Iceland.
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Chan AS, Cheung MC, Sze SL, Leung WW. Seven-star needle stimulation improves language and social interaction of children with autistic spectrum disorders. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2009; 37:495-504. [PMID: 19606510 DOI: 10.1142/s0192415x09007004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This is a randomized controlled trial that aimed to evaluate the effect of the Seven-star Needle Stimulation treatment on children with Autistic Spectrum Disorders (ASD). Thirty-two children with ASD were assigned randomly into the treatment and control groups. Children in the treatment group underwent 30 sessions of stimulation over 6 weeks, while children in the control group were on a waiting list and did not receive treatment during this period of time. Intervention consisted of a treatment regime comprising of 30 sessions of Seven-star Needle Stimulation, delivered over 6 weeks. Each session lasted 5 to 10 min, children in the treatment group were stimulated at the front and back sides of their body and the head by using Seven-star Needles. The change in the children's behavior was evaluated using parents' report and neurophysiological changes were measured by quantitative EEG (qEEG). Results showed that the treatment group demonstrated significant improvement in language and social interaction, but not in stereotyped behavior or motor function, compared to the control group. qEEG spectral amplitudes in the treatment, but not in the control group, were also reduced significantly. The results suggested that Seven-star Needle Stimulation might be an effective intervention to improve language and social functioning of children with ASD.
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Affiliation(s)
- Agnes S Chan
- Centre for Neurocognitive Function Enhancement, The Chinese University of Hong Kong, Hong Kong.
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Shtayermman O. Peer Victimization in Adolescents and Young Adults Diagnosed with Asperger's Syndrome: A Link to Depressive Symptomatology, Anxiety Symptomatology and Suicidal Ideation. ACTA ACUST UNITED AC 2009; 30:87-107. [PMID: 17885828 DOI: 10.1080/01460860701525089] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The present exploratory study examined the level of peer victimization, depressive symptomatology, anxiety symptomatology, and level of suicidal ideation among adolescents and young adults diagnosed with Asperger's Syndrome (AS). This cross-sectional study used a self-administrated mail questionnaire and a Web-based questionnaire. The study included two samples. The first sample used snowball sampling, beginning with parents of adolescents and young adults diagnosed with AS who participated in a qualitative study conducted in 2002. The second sample consisted of a volunteer sample of parents who accessed Web sites for parents and individuals diagnosed with Autism Spectrum Disorder. A total sample of 10 adolescents and young adults diagnosed with AS was obtained. The high proportion of respondents with scores above the cutoff point on the overt victimization and relational victimization scales suggests that these adolescents and young adults experienced high levels of victimization. Of the sample, 20 percent met criteria for a diagnosis of Major Depressive Disorder, 30 percent met criteria for Generalized Anxiety Disorder and 50 percent had clinically significant level of suicidal ideation.
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Affiliation(s)
- Oren Shtayermman
- Rhode Island College, School of Social Work, Providence, Rhode Island 02908, USA.
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Knapp M, Romeo R, Beecham J. Economic cost of autism in the UK. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2009; 13:317-36. [PMID: 19369391 DOI: 10.1177/1362361309104246] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Autism has lifetime consequences, with potentially a range of impacts on the health, wellbeing, social integration and quality of life of individuals and families. Many of those impacts are economic. This study estimated the costs of autism spectrum disorders (ASDs) in the UK. Data on prevalence, level of intellectual disability and place of residence were combined with average annual costs of services and support, together with the opportunity costs of lost productivity. The costs of supporting children with ASDs were estimated to be pound 2.7 billion each year. For adults, these costs amount to pound 25 billion each year. The lifetime cost, after discounting, for someone with ASD and intellectual disability is estimated at approximately pound 1.23 million, and for someone with ASD without intellectual disability is approximately pound 0.80 million.
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Affiliation(s)
- Martin Knapp
- Kings College, London, Institute of Psychiatry, UK.
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Bitsika V, Sharpley CF, Orapeleng S. An exploratory analysis of the use of cognitive, adaptive and behavioural indices for cluster analysis of ASD subgroups. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:973-985. [PMID: 19017167 DOI: 10.1111/j.1365-2788.2008.01123.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) includes symptoms that vary in severity and frequency between children. Consequently, multiple psychometric assessment procedures are recommended to detect an ASD, including scales which asses the presence and nature of ASD-related behaviour. However, to date, few studies have examined the relative and specific contribution which such behaviourally oriented scales can make to the diagnosis of individual children with ASD. METHOD Cluster analysis was used to explore the common characteristics of a group of 53 preschool and elementary school children with an ASD, based upon scores on tests of cognitive ability, adaptive behaviour and behavioural checklists designed to measure the presence of typical ASD. RESULTS Data confirmed the expected variability in intelligence test scores. In addition, measures of adaptive behaviour and data from a behaviourally based rating scale suggested that children with Asperger's Disorder and autism might be reclassified into subgroups according to the presence of particular ASD-specific behaviours. CONCLUSIONS As well as confirming that children with ASD vary in their adaptive behaviour and cognitive levels, these data emphasise the limited contribution such assessment procedures make to an understanding of the child's day-to-day behaviour and functioning, thus arguing for the inclusion of behaviourally based rating scales to develop ideographic intervention plans.
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Affiliation(s)
- V Bitsika
- Faculty of Humanities and Social Sciences, Bond University, Robina, Qld, Australia.
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Background and history of autism in relation to vision care. ACTA ACUST UNITED AC 2008; 79:391-6. [DOI: 10.1016/j.optm.2007.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2006] [Revised: 06/13/2007] [Accepted: 10/29/2007] [Indexed: 11/21/2022]
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Bryson SE, Bradley EA, Thompson A, Wainwright A. Prevalence of autism among adolescents with intellectual disabilities. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2008; 53:449-59. [PMID: 18674403 DOI: 10.1177/070674370805300710] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To estimate the prevalence of autism in an epidemiologically-derived population of adolescents with intellectual disabilities (ID). METHOD The prevalence of autism was examined using the Autism Diagnostic Interview-Revised, with appropriate care taken in assessing lower functioning individuals and those with additional physical and sensory impairments. Individual assessment during psychological evaluation, and consensus classification of complex cases, involving clinicians experienced in the assessment of autism, contributed to the identification of autism. RESULTS Overall, 28% of individuals, or 2.0 of the 7.1/1000 with ID in the target population (as we have previously identified in another study), were identified with autism. Autism rates did not differ significantly across severe ID (32.0%) and mild ID (24.1%); males predominated (2.3 males to 1 female), but less so for severe ID (2 males to 1 female, compared with 2.8 males to 1 female for mild ID). Socioeconomic status did not distinguish the groups with and without autism. Less than one-half of the adolescents who met diagnostic criteria for autism were previously diagnosed as such. CONCLUSIONS Our overall prevalence estimate for autism is in the higher range of estimates reported in previous studies of ID (more so for mild ID). This likely reflects the changes in diagnostic criteria for autism that have subsequently occurred. Discussion focuses on the identification of autism in the population with ID, and on the implications for service delivery and clinical training.
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Affiliation(s)
- Susan E Bryson
- Department of Pediatrics, Dalhousie University-IWK Health Centre, Halifax, Nova Scotia.
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Free recall and forgetting of emotionally arousing words in autism spectrum disorder. Neuropsychologia 2008; 46:2336-43. [PMID: 18440037 DOI: 10.1016/j.neuropsychologia.2008.03.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 03/12/2008] [Accepted: 03/13/2008] [Indexed: 11/23/2022]
Abstract
Since the earliest descriptions of individuals with autism spectrum disorders (ASDs) abnormalities in affective behaviours have been considered a prominent feature in their clinical manifestations. What remains unclear, however, is whether these altered emotional behaviours are a mere facet of abnormalities in socio-cognitive processes or whether they constitute a primary feature of the condition. A number of studies now indicate that emotional processing atypicalities in ASD extend to domains outside the broader context of social cognition leading us to suggest that the disorder may be characterised by basic abnormalities in how psychophysiological and cognitive emotional responses modulate one another [Gaigg, S. B. & Bowler, D. M. (2007). Differential fear conditioning in Asperger's syndrome: Implications for an amygdala theory of autism. Neuropsychologia, 45, 2125-2134]. In the current study, we show that although individuals with ASD, like typical individuals, exhibit a free recall advantage for emotionally arousing and semantically related neutral as compared to unrelated neutral words, they do not show reduced forgetting rates for arousing stimuli as do typical individuals. These observations provide further support for the view that psychophysiological emotional responses do not modulate cognitive processes normally in ASD and further implicate abnormalities of amygdala connectivity (in particular with the hippocampus) in the neuropathology underlying this disorder.
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