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Focaroli V, Taffoni F, Velardi A, Caravale B, Keller F. Object Exploration and Manipulation in Infants at Typical vs. Elevated Likelihood for ASD: A Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:825. [PMID: 39062274 PMCID: PMC11276247 DOI: 10.3390/children11070825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024]
Abstract
The present review considers the growing body of literature on fine motor skills in infants at elevated genetic likelihood (EL) for autism spectrum disorder (ASD). This area of study aims to identify crucial motor markers associated with the disorder, facilitating earlier and more accurate identification of ASD, using various experimental methodologies, including standardized assessments, observational measures, and technological tools. The reviewed evidence revealed distinct developmental trajectories in EL infants, marked by differences in fine motor skills and exploratory behaviors compared to typically developing infants. We discuss the developmental trajectory of fine motor skills in infants and their predictive value for later ASD diagnosis, highlighting the significance of fine motor skills as early indicators of ASD risk in infants and emphasizing the need for further research to elucidate their predictive value and underlying mechanisms.
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Affiliation(s)
- Valentina Focaroli
- Department of Economic, Psychological and Communication Sciences, Niccolò Cusano University, 00166 Rome, Italy
| | - Fabrizio Taffoni
- CREO LAB, Advanced Robotics and Human Centred-Technologies Laboratory, Campus Bio-Medico University, 00128 Rome, Italy;
| | - Andrea Velardi
- Department of Humanities, Motor Sciences and Education, Niccolò Cusano University, 00166 Rome, Italy;
| | - Barbara Caravale
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy;
| | - Flavio Keller
- Laboratory of Developmental Neuroscience, Campus Bio-Medico University, 00128 Rome, Italy;
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Vu H, Bowden N, Gibb S, Audas R, Dacombe J, McLay L, Sporle A, Stace H, Taylor B, Thabrew H, Theodore R, Tupou J, Schluter PJ. Mortality risk among Autistic children and young people: A nationwide birth cohort study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231224015. [PMID: 38311609 DOI: 10.1177/13623613231224015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
LAY ABSTRACT Existing literature indicates that Autistic people have shorter life expectancy, but little is known about the mortality risk among Autistic children and young people (0-24 years). We used a 15-year nationwide birth cohort study to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. The study included 895,707 children and 11,919 (1.4%) were Autistic. We found that autism was associated with a significantly higher mortality risk compared to the non-Autistic population. In addition, we found that this risk was significantly higher among females compared to males and for those with a co-occurring intellectual disability. Increased efforts are required to better meet the health needs of this population.
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Affiliation(s)
- Hien Vu
- University of Otago, Dunedin, New Zealand
| | - Nicholas Bowden
- University of Otago, Dunedin, New Zealand
- National Science Challenge, New Zealand
| | - Sheree Gibb
- National Science Challenge, New Zealand
- University of Otago, Wellington, New Zealand
| | - Richard Audas
- Memorial University of Newfoundland and Labrador, Canada
| | | | | | - Andrew Sporle
- INZight Analytics Ltd., New Zealand
- University of Auckland, New Zealand
| | | | - Barry Taylor
- University of Otago, Dunedin, New Zealand
- National Science Challenge, New Zealand
| | - Hiran Thabrew
- National Science Challenge, New Zealand
- University of Auckland, New Zealand
| | | | | | - Philip J Schluter
- National Science Challenge, New Zealand
- University of Canterbury, New Zealand
- University of Queensland, Australia
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3
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Dückert S, Bart S, Gewohn P, König H, Schöttle D, Konnopka A, Rahlff P, Erik F, Vogeley K, Schulz H, David N, Peth J. Health-related quality of life in family caregivers of autistic adults. Front Psychiatry 2023; 14:1290407. [PMID: 38193135 PMCID: PMC10773769 DOI: 10.3389/fpsyt.2023.1290407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Family members of autistic individuals often provide support for their autistic relative throughout the lifespan which can lead to massive burden themselves. Reduced health-related Quality of Life (HRQoL) in family caregivers is assumed; however, only a handful studies on the HRQoL of family caregivers providing care to adult relatives exist as opposed to autistic children. Thus, the current study aimed to (i) investigate the current state of physical and mental HRQoL of family caregivers of autistic adults compared to the general population, and (ii) examine caregiver-related (e.g., age, subjective caregiver burden) and care recipient-related variables (e.g., symptom severity, utilization of formal services) explaining variance in the caregivers' HRQoL. Methods N = 149 family caregivers completed a nationwide online survey, including the Short-Form Health Survey (SF-8) in order to assess the HRQoL. T-tests were used to compare the HRQoL of family caregivers with the general population. Bivariate correlational and multiple linear regression analyses were conducted in order to identify predictors explaining variance in family caregivers' HRQoL. Results Family caregivers of autistic adults reported significantly lower physical (M = 46.71, SD = 8.72, Cohen's d = 0.42) and mental HRQoL (M = 40.15, SD = 11.28, Cohen's d = 1.35) compared to the general population. Multiple linear regression with the mental HRQoL as the outcome showed a significant model (F(11, 95) = 5.53, p < .001, adj. R2 = .32) with increased subjective burden explaining most of the variance in mental HRQoL (ß = .32, GDW = .141, p < .001). Multiple linear regression analysis with the outcome physical HRQoL did not reveal a statistically significant model (F(11,95) = 1.09, p = .38). However, bivariate analyses also showed a positive correlation with the subjective caregiver burden (r= .20, p < .05). Discussion Findings highlight the need to consider HRQoL (and caregiver burden) of family caregivers of autistic adults in several healthcare settings to monitor a potential comprised health status in early stages, with the long-term goal to improve family caregivers' HRQoL.
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Affiliation(s)
- Sophia Dückert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Bart
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department Health Sciences, Faculty Life Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Petia Gewohn
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pascal Rahlff
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Erik
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kai Vogeley
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole David
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Judith Peth
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gupta V, Ben-Mahmoud A, Ku B, Velayutham D, Jan Z, Yousef Aden A, Kubbar A, Alshaban F, Stanton LW, Jithesh PV, Layman LC, Kim HG. Identification of two novel autism genes, TRPC4 and SCFD2, in Qatar simplex families through exome sequencing. Front Psychiatry 2023; 14:1251884. [PMID: 38025430 PMCID: PMC10644705 DOI: 10.3389/fpsyt.2023.1251884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
This study investigated the genetic underpinnings of autism spectrum disorder (ASD) in a Middle Eastern cohort in Qatar using exome sequencing. The study identified six candidate autism genes in independent simplex families, including both four known and two novel autosomal dominant and autosomal recessive genes associated with ASD. The variants consisted primarily of de novo and homozygous missense and splice variants. Multiple individuals displayed more than one candidate variant, suggesting the potential involvement of digenic or oligogenic models. These variants were absent in the Genome Aggregation Database (gnomAD) and exhibited extremely low frequencies in the local control population dataset. Two novel autism genes, TRPC4 and SCFD2, were discovered in two Qatari autism individuals. Furthermore, the D651A substitution in CLCN3 and the splice acceptor variant in DHX30 were identified as likely deleterious mutations. Protein modeling was utilized to evaluate the potential impact of three missense variants in DEAF1, CLCN3, and SCFD2 on their respective structures and functions, which strongly supported the pathogenic natures of these variants. The presence of multiple de novo mutations across trios underscored the significant contribution of de novo mutations to the genetic etiology of ASD. Functional assays and further investigations are necessary to confirm the pathogenicity of the identified genes and determine their significance in ASD. Overall, this study sheds light on the genetic factors underlying ASD in Qatar and highlights the importance of considering diverse populations in ASD research.
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Affiliation(s)
- Vijay Gupta
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Afif Ben-Mahmoud
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Bonsu Ku
- Disease Target Structure Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Dinesh Velayutham
- College of Health & Life Sciences, Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Zainab Jan
- College of Health & Life Sciences, Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Abdi Yousef Aden
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Ahmad Kubbar
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Fouad Alshaban
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
- College of Health & Life Sciences, Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Lawrence W. Stanton
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
- College of Health & Life Sciences, Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Puthen Veettil Jithesh
- College of Health & Life Sciences, Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Lawrence C. Layman
- Section of Reproductive Endocrinology, Infertility and Genetics, Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, United States
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, United States
| | - Hyung-Goo Kim
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
- College of Health & Life Sciences, Qatar Foundation, Hamad Bin Khalifa University (HBKU), Doha, Qatar
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Carey ME, Rando J, Melnyk S, James SJ, Snyder N, Salafia C, Croen LA, Fallin MD, Hertz-Picciotto I, Volk H, Newschaffer C, Lyall K. Examining associations between prenatal biomarkers of oxidative stress and ASD-related outcomes using quantile regression. J Autism Dev Disord 2023; 53:2975-2985. [PMID: 35678944 PMCID: PMC9732143 DOI: 10.1007/s10803-022-05625-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 12/13/2022]
Abstract
We examined associations between prenatal oxidative stress (OS) and child autism-related outcomes. Women with an autistic child were followed through a subsequent pregnancy and that younger sibling's childhood. Associations between glutathione (GSH), glutathione disulfide (GSSG), 8-oxo-deoxyguanine (8-OHdG), and nitrotyrosine and younger sibling Social Responsiveness Scale (SRS) scores were examined using quantile regression. Increasing GSH:GSSG (suggesting decreasing OS) was associated with minor increases in SRS scores (50th percentile β: 1.78, 95% CI: 0.67, 3.06); no other associations were observed. Results from this cohort with increased risk for autism do not support a strong relationship between OS in late pregnancy and autism-related outcomes. Results may be specific to those with enriched autism risk; future work should consider other timepoints and biomarkers.
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Affiliation(s)
- Meghan E Carey
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, United States.
| | - Juliette Rando
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, United States
| | - Stepan Melnyk
- Arkansas Children's Hospital Research Institute, 13 Childrens Way, Little Rock, AR, 72202, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, United States
| | - S Jill James
- Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, United States
| | - Nathaniel Snyder
- Lewis Katz School of Medicine, Temple University, 3500 N Broad St, Philadelphia, PA, 19140, United States
| | - Carolyn Salafia
- Department of Pathology, New York Methodist Hospital, 506 6th St, Brooklyn, NY, 11215, United States
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, United States
| | - M Daniele Fallin
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, United States
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, 1 Shields Ave, Davis, CA, 95616, United States
| | - Heather Volk
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St, Baltimore, MD, 21205, United States
| | - Craig Newschaffer
- College of Health and Human Development, The Pennsylvania State University, 325 Health and Human Development Building, University Park, State College, PA, 16802, United States
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, United States
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Dückert S, Gewohn P, König H, Schöttle D, Konnopka A, Rahlff P, Erik F, Vogeley K, Schulz H, David N, Peth J. Barriers and needs in mental healthcare of adults with autism spectrum disorder in Germany: a qualitative study in autistic adults, relatives, and healthcare providers. BMC Psychiatry 2023; 23:528. [PMID: 37479974 PMCID: PMC10362719 DOI: 10.1186/s12888-023-05026-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 07/13/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Autism refers to a neurodevelopmental condition with characteristic impairments in social interaction and communication, restrictive and repetitive behaviors, as well as difficulties in sensory information processing and daily living skills. Even though symptoms persist from early childhood throughout the lifespan and often require long-term support, there is a lack of mental health services that sufficiently meet the needs of autistic adults. Previous evidence suggested individual, professional and structural barriers to healthcare for autistic adults. Here, using a peer research approach, we sought to systematically investigate barriers and needs in mental healthcare of autistic adults in Germany at the three relevant levels (individual, professional, structural) and from three relevant perspectives (autistic adults, relatives and healthcare providers), in order to obtain specific recommendations for optimized healthcare. METHODS Maximum variation sampling was used to account for the complexity of the research field. Semi-structured, open-ended interviews were conducted with autistic adults (n = 15) and focus groups with relatives/partners (n = 12), and healthcare providers of several professions (n = 15). Data analysis was performed using the codebook approach of thematic analysis. RESULTS Poor mental healthcare of autistic adults in Germany was characterized by six central and overarching themes: (i) lack of knowledge about autism, (ii) a need for increased participation/involvement, (iii) consideration of autism-specific needs in treatment, (iv) lack of services, (v) limited access to services, and (vi) improvement of stakeholder collaboration. Themes were similarly reported across participants, emphasizing dissatisfaction in all stakeholders. CONCLUSIONS We identified major barriers to mental healthcare for autistic adults in Germany that affect autistic adults, but are also of concern to relatives and healthcare providers. Our results point to specific and generic areas for improvement, independent of stakeholder perspectives, which could guide future development of needs- and evidence-based services, recommendations and guidelines of mental healthcare for people with autism across the lifespan. TRIAL REGISTRATION This study protocol was preregistered at the Open Science Framework ( https://osf.io/5x8pg ).
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Affiliation(s)
- Sophia Dückert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Petia Gewohn
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | - Hannah König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pascal Rahlff
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Frank- Erik
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Kai Vogeley
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Nicole David
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Judith Peth
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Marinopoulou M, Billstedt E, Wessman C, Bornehag CG, Hallerbäck MU. Association Between Intellectual Functioning and Autistic Traits in the General Population of Children. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01562-5. [PMID: 37351708 DOI: 10.1007/s10578-023-01562-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
Autistic traits are continuously distributed in the general population. The associations between autistic traits and intellectual functioning and/or behavioural difficulties, and the impact of intellectual functioning on behavioural difficulties are unclear. The study aims to describe the distribution of autistic traits in a population-based cross-sectional sample of children. Further aims are to examine the association between intellectual functioning and autistic traits, and between autistic traits and behavioural difficulties. Wechsler scales and ratings of autistic traits and behavioural problems in 874 children aged 7-9 years in the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study were assessed. We found a continuous distribution of autistic traits. Intellectual functioning was negatively associated with autistic traits but not with behavioural difficulties. Behavioural difficulties were associated with autistic traits.
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Affiliation(s)
- Maria Marinopoulou
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Child and Adolescent Habilitation, Region Värmland, Karlstad, Sweden.
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Catrin Wessman
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Unenge Hallerbäck
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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8
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Lukito S, O'Daly OG, Lythgoe DJ, Hodsoll J, Maltezos S, Pitts M, Simonoff E, Rubia K. Reduced inferior fronto-insular-thalamic activation during failed inhibition in young adults with combined ASD and ADHD compared to typically developing and pure disorder groups. Transl Psychiatry 2023; 13:133. [PMID: 37087490 PMCID: PMC10122665 DOI: 10.1038/s41398-023-02431-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 04/24/2023] Open
Abstract
Autism spectrum disorder (ASD) often co-occurs with attention-deficit/hyperactivity disorder (ADHD) and people with these conditions have frontostriatal functional atypicality during motor inhibition. We compared the neural and neurocognitive correlates of motor inhibition and performance monitoring in young adult males with "pure" and combined presentations with age-and sex-matched typically developing controls, to explore shared or disorder-specific atypicality. Males aged 20-27 years with typical development (TD; n = 22), ASD (n = 21), combined diagnoses ASD + ADHD (n = 23), and ADHD (n = 25) were compared using a modified tracking fMRI stop-signal task that measures motor inhibition and performance monitoring while controlling for selective attention. In addition, they performed a behavioural go/no-go task outside the scanner. While groups did not differ behaviourally during successful stop trials, the ASD + ADHD group relative to other groups had underactivation in typical performance monitoring regions of bilateral anterior insula/inferior frontal gyrus, right posterior thalamus, and right middle temporal gyrus/hippocampus during failed inhibition, which was associated with increased stop-signal reaction time. In the behavioural go/no-go task, both ADHD groups, with and without ASD, had significantly lower motor inhibition performance compared to TD controls. In conclusion, only young adult males with ASD + ADHD had neurofunctional atypicality in brain regions associated with performance monitoring, while inhibition difficulties on go/no-go task performance was shared with ADHD. The suggests that young people with ASD + ADHD are most severely impaired during motor inhibition tasks compared to ASD and ADHD but do not reflect a combination of the difficulties associated with the pure disorders.
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Affiliation(s)
- Steve Lukito
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Owen G O'Daly
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - David J Lythgoe
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - John Hodsoll
- Department of Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Stefanos Maltezos
- The Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust, London, UK
| | - Mark Pitts
- The Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Rogge N. How the anchor moves: Measuring and comparing the anchoring bias in autistic and neurotypical individuals. JOURNAL OF BEHAVIORAL DECISION MAKING 2023. [DOI: 10.1002/bdm.2317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Nicky Rogge
- Faculty of Economics and Business Ku Leuven Brussels Belgium
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10
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Alenezi S, Alkhiri A, Hassanin W, AlHarbi A, Al Assaf M, Alzunaydi N, Alsharif S, Alhaidar M, Alnujide A, Alkathiri F, Alyousef A, Albassam R, Alkhamees H, Alyahya AS. Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study. Behav Sci (Basel) 2022; 12:bs12120509. [PMID: 36546992 PMCID: PMC9774162 DOI: 10.3390/bs12120509] [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: 11/06/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
Children with ASD have a wide spectrum of functional deficits in multiple neurodevelopmental domains. A multidisciplinary team assessment (MDT) is required to assess those deficits to help construct a multimodal intervention plan. This is a retrospective chart review of the assessment for children who were referred for an assessment of potential neurodevelopmental disorders. We reviewed 221 participants' charts from January 2019 to January 2020. The mean age of the children was 7.95 ± 3.69, while the mean age of the fathers and mothers was 37.31 ± 8.57 and 31.95 ± 6.93, respectively. Consanguinity was as high as 37.9% for the referred children with developmental delay who were first-degree related, and 13.2% of the parents were second-degree relatives. Approximately 26.6% of children had a family history of mental illness in first-degree relatives. ASD was the most commonly reported diagnosis post-assessment, and ADHD was the most common reported comorbidity at 64.3% and 88.5%, respectively. The MDT findings showed that 58% of children required moderate or higher assistance with toileting, 79.2% were unable to answer yes/no questions, and 86.8% were unable to understand "wh" questions. Only 26% of the nonverbal children had average IQ testing results, and 31% of verbal children did. In conclusion, the mean age of the children when assessed was above that recommended for early screening and intervention. An increased paternal and maternal age was noticeable. Consanguinity and a family history of mental disorders in first-degree relatives were high, attesting to a possible genetic risk.
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Affiliation(s)
- Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia
- SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence:
| | - Aqeel Alkhiri
- Department of Mental Health, Al Qunfudah General Hospital, Al Qunfudah 28821, Saudi Arabia
| | - Weaam Hassanin
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Amani AlHarbi
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Munirah Al Assaf
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Norah Alzunaydi
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Salma Alsharif
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Mohammad Alhaidar
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Abdulaziz Alnujide
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Fatimah Alkathiri
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Abdulaziz Alyousef
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Razan Albassam
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Hadeel Alkhamees
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Ahmed S. Alyahya
- Department of Psychiatry, Eradah Complex for Mental Health, Riyadh 12571, Saudi Arabia
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11
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Badal KK, Puthanveettil SV. Axonal transport deficits in neuropsychiatric disorders. Mol Cell Neurosci 2022; 123:103786. [PMID: 36252719 DOI: 10.1016/j.mcn.2022.103786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/02/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Axonal transport is a major cellular process that mediates bidirectional signaling between the soma and synapse, enabling both intracellular and intercellular communications. Cellular materials, such as proteins, RNAs, and organelles, are transported by molecular motor proteins along cytoskeletal highways in a highly regulated manner. Several studies have demonstrated that axonal transport is central to normal neuronal function, plasticity, and memory storage. Importantly, disruptions in axonal transport result in neuronal dysfunction and are associated with several neurodegenerative disorders. However, we do not know much about axonal transport deficits in neuropsychiatric disorders. Here, we briefly discuss our current understanding of the role of axonal transport in schizophrenia, bipolar and autism.
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Affiliation(s)
- Kerriann K Badal
- Department of Neuroscience, UF Scripps Biomedical Research, University of Florida, 130 Scripps Way, Jupiter, FL 33458, USA; Integrative Biology PhD Program, Charles E. Schmidt College of Science, Florida Atlantic University, Jupiter, FL 33458, USA
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12
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Chancel R, Miot S, Dellapiazza F, Baghdadli A. Group-based educational interventions in adolescents and young adults with ASD without ID: a systematic review focusing on the transition to adulthood. Eur Child Adolesc Psychiatry 2022; 31:1-21. [PMID: 32889578 DOI: 10.1007/s00787-020-01609-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022]
Abstract
There is a growing number of young people, diagnosed with an autism-spectrum disorder (ASD), transitioning to adulthood. Among this number, individuals without an intellectual disability have significant adaptive deficits and need individualized care and support services to better target vocational, social, and educational prospects and outcomes. Group-based interventions, including patient education, social-skills training, and cognitive-behavioral therapy, are widely used in clinical settings to improve the daily life and prospects of ASD individuals facing the challenge of transitioning to adulthood. We performed a systematic review of studies concerning the efficiency of group-based educational interventions with a focus on the transition to adulthood for young, ASD individuals without intellectual disability (ID). As a result of this systematic search, 21 studies out of 163 were found to be eligible for inclusion. We observed considerable heterogeneity across the studies, in terms of effect sizes and intervention design, delivery, and the comparison of controls. Strong evidence was found in favor of social-skills training and cognitive-behavioral therapy interventions. Professionals should consider group-based psychoeducational intervention to be an appropriate and relevant service for young subjects with ASD without ID transitioning to adulthood. Further research is needed on larger samples using multicentric designs to validate efficacy before generalization.
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Affiliation(s)
- Raphael Chancel
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
| | - Stephanie Miot
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.,Gerontology Centre, Antonin Balmès, University Hospital of Montpellier, CHU de Montpellier, Université de Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier, France
| | - Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France. .,Faculté de Médecine, Université de Montpellier, Montpellier, France. .,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
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13
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Bissell S, Oliver C, Moss J, Heald M, Waite J, Crawford H, Kothari V, Rumbellow L, Walters G, Richards C. The behavioural phenotype of SATB2-associated syndrome: a within-group and cross-syndrome analysis. J Neurodev Disord 2022; 14:25. [PMID: 35350986 PMCID: PMC8966214 DOI: 10.1186/s11689-022-09426-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background SATB2-associated syndrome (SAS) is a multisystem neurodevelopmental disorder characterised by intellectual disability, speech delay, and craniofacial anomalies. Although the clinical presentation of SAS is well-delineated, behaviours associated with SAS are less well-defined. Given the varied social profile reported in SAS of a ‘jovial’ predisposition and autistic behaviours, there may be phenotypic overlap with both Angelman syndrome (AS) and non-syndromal autism. This study aimed to describe behaviours in SAS in relation to chronological age and level of ability and contrast aspects of the behavioural phenotype with AS and non-syndromal autism. Methods Informant report questionnaire measures of behaviour, emotion, and autism characteristics were completed for 81 individuals with SAS (aged 1–36 years; 43 male). Within-group associations were analysed, and categorical data were compared between pre-school (1–5 years), school-age (6–15 years), and adolescent and adult SAS sub-groups (16 years and over). Cross-syndrome subscale and item-level analyses were conducted for 63 individuals with SAS (aged 1–27 years; 31 male), who were matched according to age and level of ability to 63 individuals with AS (aged 2–25 years; 32 male) and 63 individuals with non-syndromal autism (aged 3–26 years; 53 male). Results In SAS, higher rates of overactivity were moderately associated with lower self-help ability, and higher general anxiety scores were reported for males compared with females. Cross-syndrome subscale analyses uncovered several significant differences (p < .01), with comparatively low rates of stereotyped behaviour, overactivity, insistence on sameness and positive affect, and comparatively greater interest and pleasure and compulsive behaviour in individuals with SAS. Item-level analyses revealed a distinct profile of repetitive and autistic behaviours. Limitations Developmental analysis was based on a cross-sectional rather than a longitudinal research design, the contribution of pain and sleep to behaviour was not explored, and molecular genetic testing to determine genotype–phenotype behavioural relationships was not possible. Conclusions This study highlights the importance of behavioural comparisons to well-delineated groups and the utility of fine-grained item-level analyses to elucidate aspects of behaviour that might be syndrome related or shared across neurodevelopmental disorders. Future research is needed to further describe the distinctive repetitive and autistic behavioural phenotype in SAS. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09426-0.
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Affiliation(s)
- Stacey Bissell
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Joanna Moss
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Mary Heald
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, Lancashire, UK
| | - Jane Waite
- School of Health and Life Sciences, Aston University, Birmingham, UK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Vishakha Kothari
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Lauren Rumbellow
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Grace Walters
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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14
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Pinals DA, Hovermale L, Mauch D, Anacker L. Persons With Intellectual and Developmental Disabilities in the Mental Health System: Part 1. Clinical Considerations. Psychiatr Serv 2022; 73:313-320. [PMID: 34346730 DOI: 10.1176/appi.ps.201900504] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Individuals with intellectual and developmental disabilities (IDD) are at high risk of co-occurring mental health conditions, including major depressive disorder, bipolar disorder, anxiety disorders, psychotic illnesses, impulse control disorders, and others. Because of symptoms associated with these illnesses and with the disabilities themselves, these individuals are often served in a mental health service system framework. However, treatment for them in these settings has typically not been sufficiently nimble, knowledgeable, or adept. Most mental health professionals receive little training about the needs of this population, and system structures typically bifurcate care, when, in reality, conditions can be complex and overlapping. In this first of two articles on care for persons with IDD in the mental health system, the authors provide a clinical overview of these neurodevelopmental disorders and of mental health and other conditions that co-occur with IDD. Considerations and challenges for treating this population in the mental health system include early recognition of mental health conditions, which often requires caregiver and family input, as well as information from a variety of additional collateral sources; the importance of trauma-informed and person-centered care; the promotion of self-determination through use of decision supports; use of approaches such as applied behavior analysis to develop a frame to address challenging behaviors; and the need to properly assess and provide thoughtful pharmacologic intervention when appropriate. The ability of individuals with IDD to thrive in a wide range of community integration opportunities depends on many factors, and clinicians must understand and use the available approaches for treating them.
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Affiliation(s)
- Debra A Pinals
- Department of Psychiatry, University of Michigan, Ann Arbor (Pinals, Anacker); Maryland Developmental Disabilities Administration, Annapolis (Hovermale); Massachusetts Association for Mental Health, Boston (Mauch)
| | - Lisa Hovermale
- Department of Psychiatry, University of Michigan, Ann Arbor (Pinals, Anacker); Maryland Developmental Disabilities Administration, Annapolis (Hovermale); Massachusetts Association for Mental Health, Boston (Mauch)
| | - Danna Mauch
- Department of Psychiatry, University of Michigan, Ann Arbor (Pinals, Anacker); Maryland Developmental Disabilities Administration, Annapolis (Hovermale); Massachusetts Association for Mental Health, Boston (Mauch)
| | - Lisa Anacker
- Department of Psychiatry, University of Michigan, Ann Arbor (Pinals, Anacker); Maryland Developmental Disabilities Administration, Annapolis (Hovermale); Massachusetts Association for Mental Health, Boston (Mauch)
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15
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Wittwer J. Autismus: Ein Überblick über Lernvoraussetzungen und Fördermaßnahmen. ZEITSCHRIFT FUR PADAGOGISCHE PSYCHOLOGIE 2022. [DOI: 10.1024/1010-0652/a000326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Autistische Schülerinnen und Schüler besitzen häufig geringere schulische Kompetenzen als nicht-autistische Schülerinnen und Schüler. Zugleich bestehen große Unterschiede in den schulischen Kompetenzen zwischen autistischen Schülerinnen und Schülern. Nicht selten weisen sie schulische Kompetenzen auf, die niedriger sind, als es aufgrund ihrer kognitiven Fähigkeiten zu erwarten wäre. Um zu verstehen, welche Faktoren das Lernen autistischer Schülerinnen und Schüler beeinflussen, wird in diesem Artikel ein Überblick über die Lernvoraussetzungen autistischer Schülerinnen und Schüler gegeben. Der Überblick zeigt, dass es autistischen Schülerinnen und Schülern schwerfallen kann, Vorwissen abzurufen und in Lernsituationen aktiv anzuwenden, Lernprozesse aufgrund von Einschränkungen in den exekutiven Funktionen angemessen zu steuern, verbale und visuelle Informationen im Arbeitsgedächtnis zu verarbeiten, kognitive und metakognitive Lernstrategien spontan anzuwenden, sich mit Lerninhalten auseinanderzusetzen, die nicht ihren eigenen Interessen entsprechen, und lernabträgliche Emotionen mittels geeigneter Strategien zu regulieren. Um autistische Schülerinnen und Schüler im Lernen zu unterstützen, werden Fördermaßnahmen zu den einzelnen Lernvoraussetzungen vorgestellt. Implikationen für Forschung und Praxis werden diskutiert.
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Affiliation(s)
- Jörg Wittwer
- Albert-Ludwigs-Universität Freiburg, Deutschland
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16
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Katusic MZ, Myers SM, Weaver AL, Voigt RG. IQ in Autism Spectrum Disorder: A Population-Based Birth Cohort Study. Pediatrics 2021; 148:183390. [PMID: 34851412 DOI: 10.1542/peds.2020-049899] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We aimed to describe the intellectual ability and ratio of boys to girls with average or higher IQ within autism spectrum disorder (ASD) cases identified in a population-based birth cohort. We hypothesized that research-identified individuals with ASD would be more likely to have average or higher IQ, compared to clinically diagnosed ASD. We also hypothesized the male to female ratio would decrease as the definition of ASD broadened. METHODS ASD incident cases were identified from 31 220 subjects in a population-based birth cohort. Research-defined autism spectrum disorder, inclusive criteria (ASD-RI) was based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, autistic disorder (AD), Asperger Disorder, and pervasive developmental disorder not otherwise specified criteria. Research-defined autism spectrum disorder, narrow criteria (ASD-RN) was a narrower definition based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision AD criteria. Clinical diagnoses of ASD were abstracted from medical and school records. Intellectual ability was based on the last IQ score or on documented diagnoses of intellectual disability if no scores available. Average or higher IQ was defined as IQ ≥86. RESULTS A total of 59.1% of those with ASD-RI (n = 890), 51.2% of those with ASD-RN (n = 453), and 42.8% of those with clinically diagnosed autism spectrum disorder (n = 187) had average or higher IQ. Within the ASD-RI and ASD-RN groups, boys were more likely than girls to have an average or higher IQ (62.0% vs 51.3% [P = .004] and 54.1% vs. 42.5% [P = .03], respectively). CONCLUSION Our data suggest that nearly half of individuals with ASD have average or higher IQ. Boys with ASD are more likely to have average or higher IQ than girls. Patients with ASD and higher IQ remain at risk for not being identified.
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Affiliation(s)
| | - Scott M Myers
- Geisinger Autism & Developmental Medicine Institute, Lewisburg, Pennsylvania
| | | | - Robert G Voigt
- College of Medicine, Baylor University and Texas Children's Hospital, Houston, Texas
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17
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Mandic-Maravic V, Mitkovic-Voncina M, Pljesa-Ercegovac M, Savic-Radojevic A, Djordjevic M, Ercegovac M, Pekmezovic T, Simic T, Pejovic-Milovancevic M. Glutathione S-Transferase Polymorphisms and Clinical Characteristics in Autism Spectrum Disorders. Front Psychiatry 2021; 12:672389. [PMID: 34248709 PMCID: PMC8267579 DOI: 10.3389/fpsyt.2021.672389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/24/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Autism spectrum disorders (ASD) are a heterogeneous group of developmental disorders, with different levels of symptoms, functioning, and comorbidities. Recent findings suggested that oxidative stress and genetic variability in glutathione S-transferases (GSTs) might increase the risk of ASD development. We aimed to determine whether GST polymorphisms influence the severity of symptoms as well as the cognitive and adaptive abilities in children with ASD. Methods: The sample included 113 ASD cases. All participants were genotyped for GSTA1, GSTM1, GSTT1, and GSTP1 polymorphisms. The clinical characteristics were determined with Autism Diagnostic Interview-Revised (ADI-R) in all of the participants. In non-verbal participants, we explored the adaptive functioning using the Vineland Adaptive Behavior Scale II, while in verbal participants, we used the Wechsler Abbreviated Scale of Intelligence (WASI). Results: It was shown that the GSTA1 * CC genotype was a predictor of a lower non-verbal communication impairment as well as of a lower chance of having seizures during life. GSTM1-active genotype predicted a higher adaptive functioning. The predictive effect of GSTA1, GSTM1, and GSTT1 genotype was moderated by exposure during pregnancy (maternal smoking and medication). The GSTP1 * IleIle genotype was significantly associated to a better cognitive functioning in children with ASD. Conclusion: Besides the complex gene-environment interaction for the specific risk of developing ASD, there is also a possible complexity of interactions between genetic and environmental factors influencing the level of symptoms and impairment in people with ASD. Detoxification and antioxidant enzymes, such as GSTA1, might contribute to the core of this complexity.
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Affiliation(s)
- Vanja Mandic-Maravic
- Institute of Mental Health, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Mitkovic-Voncina
- Institute of Mental Health, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Pljesa-Ercegovac
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
| | - Ana Savic-Radojevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
| | - Miroslav Djordjevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Children's Hospital, Belgrade, Serbia
| | - Marko Ercegovac
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic of Neurology, Clinical Center of Serbia, Belgrade, Serbia
| | - Tatjana Pekmezovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Epidemiology, Belgrade, Serbia
| | - Tatjana Simic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
- Serbian Academy of Sciences and Arts, Belgrade, Serbia
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18
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TrASDition Training: An online parental training for transition-age youth with autism spectrum disorder. Psychiatry Res 2021; 300:113930. [PMID: 33887518 DOI: 10.1016/j.psychres.2021.113930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 04/05/2021] [Indexed: 01/01/2023]
Abstract
Transition to the adult age represents a rather challenging period of life for youth with Autism Spectrum Disorder (ASD) and for their families. Given the actual lack of integrated healthcare systems for autistic young-adults, enhancing parental skills could represent a feasible program to improve skills preparatory for transition in adult life. The online approach, providing easy access to services which otherwise would burden a daily family organization, already strenuous for a family with an autistic person, can represent an innovative way of delivering intervention. Therefore, we developed an online psychoeducational parental training, named TrASDition Training, with a 6 months duration, addressed to parents of autistic youth with and without Intellectual Disability during the transition age. The aim of this study was to longitudinally evaluate the impact of the online parental training on the adaptive functioning, on the repetitive and problematic behaviors of ASD youth (n = 23) and on parental stress. After 6 months of Training, we found a significant improvement in adaptive functioning of ASD participants and a reduction of parental stress.
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19
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Micai M, Ciaramella A, Salvitti T, Fulceri F, Fatta LM, Poustka L, Diehm R, Iskrov G, Stefanov R, Guillon Q, Rogé B, Staines A, Sweeney MR, Boilson AM, Leósdóttir T, Saemundsen E, Moilanen I, Ebeling H, Yliherva A, Gissler M, Parviainen T, Tani P, Kawa R, Vicente A, Rasga C, Budişteanu M, Dale I, Povey C, Flores N, Jenaro C, Monroy ML, Primo PG, Charman T, Cramer S, Warberg CK, Canal-Bedia R, Posada M, Scattoni ML, Schendel D. Intervention Services for Autistic Adults: An ASDEU Study of Autistic Adults, Carers, and Professionals' Experiences. J Autism Dev Disord 2021; 52:1623-1639. [PMID: 33966137 PMCID: PMC8938388 DOI: 10.1007/s10803-021-05038-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/23/2022]
Abstract
The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services’ use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Family interventions were experienced slightly more commonly by carers than adults or professionals. Less than the 26% of autistic adult responders who had experienced challenging behaviors reported receiving an intervention to change them. These results provide insights for improving gaps in service provision of interventions among autistic adults.
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Affiliation(s)
- Martina Micai
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Antonio Ciaramella
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Tommaso Salvitti
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Laura Maria Fatta
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Gottingen, Germany
| | - Robert Diehm
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Georgi Iskrov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Faculty of Public Health, Department of Social Medicine and Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Rumen Stefanov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Faculty of Public Health, Department of Social Medicine and Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Quentin Guillon
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Bernadette Rogé
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Anthony Staines
- School of Nursing, Dublin City University, Psychotherapy & Community Health, Dublin, Ireland
| | - Mary Rose Sweeney
- School of Nursing, Dublin City University, Psychotherapy & Community Health, Dublin, Ireland
| | - Andrew Martin Boilson
- School of Nursing, Dublin City University, Psychotherapy & Community Health, Dublin, Ireland
| | - Thora Leósdóttir
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Evald Saemundsen
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Irma Moilanen
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Hanna Ebeling
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Anneli Yliherva
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Logopedic Child Language Research Center, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tarja Parviainen
- Finnish Association for Autism and Asperger's Syndrome, Helsinki, Uusimaa, Finland
| | - Pekka Tani
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Astrid Vicente
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Célia Rasga
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Magdalena Budişteanu
- Development in Pathology and Biomedical Sciences, "Victor Babeş" National Institute for Research, Timisoara, Romania
| | - Ian Dale
- The Centre for Autism, National Autistic Society, London, UK
| | - Carol Povey
- The Centre for Autism, National Autistic Society, London, UK
| | - Noelia Flores
- Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | - Cristina Jenaro
- Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | - Maria Luisa Monroy
- Departamento de Psicología Evolutiva Y de La Educación, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | | | - Tony Charman
- Institute of Psychiatry, Kings College London, London, UK
| | - Susanne Cramer
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ricardo Canal-Bedia
- Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Institute of Rare Diseases Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Economics and Business, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
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20
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Characterization of Autism Spectrum Disorder (ASD) subtypes based on the relationship between motor skills and social communication abilities. Hum Mov Sci 2021; 77:102802. [PMID: 33894651 DOI: 10.1016/j.humov.2021.102802] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/03/2021] [Accepted: 04/16/2021] [Indexed: 11/23/2022]
Abstract
Motor abnormalities are generally observed in autism spectrum disorder (ASD), and motor difficulties are certainly evident during the early years of life and may thus precede social-communication impairments. The main aim of the present study was to examine ASD subtypes based on the relationship between motor skills and social communication abilities. Motor skills and social communication abilities were evaluated through the Movement Assessment Battery for Children-Second Edition, the Autism Diagnostic Observation Schedule-Second Version and the Psychoeducational Profile-Third Edition. In addition, social communication abilities were classified according to the Autism Classification System of Functioning: Social Communication-ACSF:SC criteria. We found that children with ASD presented poorer motor skills than their TD peers, and motor impairments correlated with poorer social communication abilities in children with ASD. In addition, children with lower social and communication functioning showed a more prominent impairment in manual dexterity and fine motor skills than children with better social and communication functioning. In conclusion, we suggest that stratifying children with ASD based on motor and social endophenotypes may be useful to understand the neurobiological mechanisms of ASD and lead to new types of treatment.
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21
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How Do Adults with Autism Spectrum Disorder Participate in the Labor Market? A German Multi-center Survey. J Autism Dev Disord 2021; 52:1066-1076. [PMID: 33864556 PMCID: PMC8854283 DOI: 10.1007/s10803-021-05008-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 12/03/2022]
Abstract
International studies show disadvantages for adults with autism spectrum disorder (ASD) in the labor market. Data about their participation in the German labor market are scarce. The aim of this study was to examine the integration of adults with ASD in the German labor market in terms of education, employment and type of occupation by means of a cross-sectional-study, using a postal questionnaire. Findings show above average levels of education for adults with ASD compared to the general population of Germany and simultaneously, below average rates of employment and high rates of financial dependency. That indicates a poor integration of adults with ASD in the German labor market and emphasizes the need for vocational support policies for adults with ASD.
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22
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Cerminara M, Spirito G, Pisciotta L, Squillario M, Servetti M, Divizia MT, Lerone M, Berloco B, Boeri S, Nobili L, Vozzi D, Sanges R, Gustincich S, Puliti A. Case Report: Whole Exome Sequencing Revealed Disease-Causing Variants in Two Genes in a Patient With Autism Spectrum Disorder, Intellectual Disability, Hyperactivity, Sleep and Gastrointestinal Disturbances. Front Genet 2021; 12:625564. [PMID: 33679889 PMCID: PMC7930735 DOI: 10.3389/fgene.2021.625564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Autism Spectrum Disorder (ASD) refers to a broad range of conditions characterized by difficulties in communication, social interaction and behavior, and may be accompanied by other medical or psychiatric conditions. Patients with ASD and comorbidities are often difficult to diagnose because of the tendency to consider the multiple symptoms as the presentation of a complicated syndromic form. This view influences variant filtering which might ignore causative variants for specific clinical features shown by the patient. Here we report on a male child diagnosed with ASD, showing cognitive and motor impairments, stereotypies, hyperactivity, sleep, and gastrointestinal disturbances. The analysis of whole exome sequencing (WES) data with bioinformatic tools for oligogenic diseases helped us to identify two major previously unreported pathogenetic variants: a maternally inherited missense variant (p.R4122H) in HUWE1, an ubiquitin protein ligase associated to X-linked intellectual disability and ASD; and a de novo stop variant (p.Q259X) in TPH2, encoding the tryptophan hydroxylase 2 enzyme involved in serotonin synthesis and associated with susceptibility to attention deficit-hyperactivity disorder (ADHD). TPH2, expressed in central and peripheral nervous tissues, modulates various physiological functions, including gut motility and sleep. To the best of our knowledge, this is the first case presenting with ASD, cognitive impairment, sleep, and gastrointestinal disturbances linked to both HUWE1 and TPH2 genes. Our findings could contribute to the existing knowledge on clinical and genetic diagnosis of patients with ASD presentation with comorbidities.
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Affiliation(s)
- Maria Cerminara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Giovanni Spirito
- Neuroscience Area, International School for Advanced Studies (SISSA), Trieste, Italy
| | - Livia Pisciotta
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco (ASST Fbf Sacco), Milan, Italy
| | - Margherita Squillario
- Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Martina Servetti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Teresa Divizia
- Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Margherita Lerone
- Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Bianca Berloco
- Child Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Silvia Boeri
- Child Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Lino Nobili
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Diego Vozzi
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Remo Sanges
- Neuroscience Area, International School for Advanced Studies (SISSA), Trieste, Italy.,Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Stefano Gustincich
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Aldamaria Puliti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
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23
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D'Alò GL, De Crescenzo F, Amato L, Cruciani F, Davoli M, Fulceri F, Minozzi S, Mitrova Z, Morgano GP, Nardocci F, Saulle R, Schünemann HJ, Scattoni ML. Impact of antipsychotics in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Health Qual Life Outcomes 2021; 19:33. [PMID: 33494757 PMCID: PMC7831175 DOI: 10.1186/s12955-021-01669-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 01/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background The net health benefit of using antipsychotics in children and adolescents with ASD is unclear. This review was performed to provide the evidence necessary to inform the Italian national guidelines for the management of ASD. Methods We performed a systematic review of randomized controlled trials (RCTs) comparing antipsychotics versus placebo for the treatment of ASD in children and adolescents. For efficacy, acceptability and safety we considered outcomes evaluated by the guideline panel critical and important for decision-making. Continuous outcomes were analyzed by using standardized mean difference (SMD), and dichotomous outcomes by calculating the risk ratio (RR), with their 95% confidence interval (95% CI). Data were analyzed using a random effects model. We used the Cochrane tool to assess risk of bias of included studies. Certainty in the evidence of effects was assessed according to the GRADE approach. Results We included 21 RCTs with 1,309 participants, comparing antipsychotics to placebo. Antipsychotics were found effective on “restricted and repetitive interests and behaviors” (SMD − 0.21, 95% CI − 0.35 to − 0.07, moderate certainty), “hyperactivity, inattention, oppositional, disruptive behavior” (SMD − 0.67, 95% CI − 0.92 to − 0.42, moderate certainty), “social communication, social interaction” (SMD − 0.38, 95% CI − 0.59 to − 0.16, moderate certainty), “emotional dysregulation/irritability” (SMD − 0.71, 95% CI − 0.98 to − 0.43, low certainty), “global functioning, global improvement” (SMD − 0.64, 95% CI − 0.96 to − 0.33, low certainty), “obsessions, compulsions” (SMD − 0.30, 95% CI − 0.55 to − 0.06, moderate certainty). Antipsychotics were not effective on “self-harm” (SMD − 0.14, 95% CI − 0.58 to 0.30, very low certainty), “anxiety” (SMD − 0.38, 95% CI − 0.82 to 0.07, very low certainty). Antipsychotics were more acceptable in terms of dropout due to any cause (RR 0.61, 95% CI 0.48 to 0.78, moderate certainty), but were less safe in terms of patients experiencing adverse events (RR 1.19, 95% CI 1.07 to 1.32, moderate certainty), and serious adverse events (RR 1.07, 95% CI 0.48 to 2.43, low certainty). Conclusions Our systematic review and meta-analysis found antipsychotics for children and adolescents with ASD more efficacious than placebo in reducing stereotypies, hyperactivity, irritability and obsessions, compulsions, and in increasing social communication and global functioning. Antipsychotics were also found to be more acceptable, but less safe than placebo.
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Affiliation(s)
- Gian Loreto D'Alò
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy.
| | - Franco De Crescenzo
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy.,Department of Psychiatry, University of Oxford, Oxford, UK.,Pediatric University Hospital-Department (DPUO), Bambino Gesù Children's Hospital, Rome, Italy
| | - Laura Amato
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy
| | - Fabio Cruciani
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy
| | - Zuzana Mitrova
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy
| | - Gian Paolo Morgano
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Franco Nardocci
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Rosella Saulle
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy
| | - Holger Jens Schünemann
- Department of Health Research Methods, Evidence and Impact (Formerly Clinical Epidemiology and Biostatistics), McMaster GRADE Centre, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
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24
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Li HH, Wang CX, Feng JY, Wang B, Li CL, Jia FY. A Developmental Profile of Children With Autism Spectrum Disorder in China Using the Griffiths Mental Development Scales. Front Psychol 2020; 11:570923. [PMID: 33240159 PMCID: PMC7680850 DOI: 10.3389/fpsyg.2020.570923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to profile the mental development of children aged 18 to 96 months with autism spectrum disorder (ASD) using the Chinese version of the Griffiths Mental Development Scales (GMDS), and to explore the relationships between developmental levels and ASD severity, the sex of the child and the age of ASD diagnosis. Children with ASD (n = 398; 337 boys, 61 girls) were recruited and ASD severity evaluated using the Autism Behavior Checklist and the Childhood Autism Rating Scale, while the GMDS was used to evaluate the children's mental development. Study participants were divided into groups according to GMDS general and subscale quotients, ASD severity, sex, and age. The majority of groups divided according to the GMDS quotients exhibited an unbalanced distribution in respect of the six domains of the GMDS and there were significant differences within the six subscale quotients. Autism severity, sex and age had significant effects on the overall level of development of autistic children. The quotients recorded for the children with more severe ASD were significantly lower than those for the children with less severe ASD. A markedly higher proportion of developmental delay was recorded for girls than boys in relation to the performance subscale. The locomotor quotient decreased in line with age at diagnosis, while autism severity and age had significant effects on the general and subscale quotients and sex had a significant effect on performance quotient. Children with ASD exhibit an uneven cognitive development profile, and their overall developmental levels are affected by autism severity, sex and age. Specific cognitive domains differ according to sex in children with ASD. Locomotor skills tend to decrease according to the age at diagnosis for autistic children aged 18 to 84 months. Autism severity and age are also associated with the level of functioning in different cognitive areas. These findings contribute to define the cognitive developmental profiles of children with ASD.
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Affiliation(s)
- Hong-Hua Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Cheng-Xin Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Jun-Yan Feng
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Bing Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Chun-Li Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China.,Pediatric Research Institute, Changchun, China
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25
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D’Alò GL, De Crescenzo F, Amato L, Cruciani F, Davoli M, Fulceri F, Minozzi S, Mitrova Z, Morgano GP, Nardocci F, Saulle R, Schünemann HJ, Scattoni ML. Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review. BMC Psychiatry 2020; 20:561. [PMID: 33238921 PMCID: PMC7687819 DOI: 10.1186/s12888-020-02956-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It is unclear whether the administration of antipsychotics to children and adolescents with autism spectrum disorders (ASD) is acceptable, equitable, and feasible. METHODS We performed a systematic review to support a multidisciplinary panel in formulating a recommendation on antipsychotics, for the development of the Italian national guidelines for the management of ASD. A comprehensive search strategy was performed to find data related to intervention acceptability, health equity, and implementation feasibility. We used quantitative data from randomized controlled trials to perform a meta-analysis assessing the acceptability and tolerability of antipsychotics, and we estimated the certainty of the effect according to the GRADE approach. We extracted data from systematic reviews, primary studies, and grey literature, and we assessed the risk of bias and methodological quality of the published studies. RESULTS Antipsychotics were acceptable (dropouts due to any cause: RR 0.61, 95% CI 0.48-0.78, moderate certainty of evidence) and well tolerated (dropouts due to adverse events: RR 0.99, 95% CI 0.55-1.79, low certainty of evidence) by children and adolescents with ASD. Parents and clinicians did not raise significant issues concerning acceptability. We did not find studies reporting evidence of reduced equity for antipsychotics in disadvantaged subgroups of children and adolescents with ASD. Workloads, cost barriers, and inadequate monitoring of metabolic adverse events were indirect evidence of concerns for feasibility. CONCLUSION Antipsychotics in children and adolescents with ASD were likely acceptable and possibly feasible. We did not find evidence of concern for equity.
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Affiliation(s)
- Gian Loreto D’Alò
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Franco De Crescenzo
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154, Rome, Italy. .,Department of Psychiatry, University of Oxford, Oxford, UK. .,Pediatric University Hospital-Department (DPUO), Bambino Gesù Children's Hospital, Rome, Italy.
| | - Laura Amato
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Fabio Cruciani
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Francesca Fulceri
- grid.416651.10000 0000 9120 6856Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Zuzana Mitrova
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Gian Paolo Morgano
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster GRADE Centre, McMaster University, Hamilton, ON Canada
| | - Franco Nardocci
- grid.416651.10000 0000 9120 6856Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Rosella Saulle
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Holger Jens Schünemann
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster GRADE Centre, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Department of Medicine, McMaster University, Hamilton, ON Canada
| | - Maria Luisa Scattoni
- grid.416651.10000 0000 9120 6856Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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26
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Bowden N, Thabrew H, Kokaua J, Audas R, Milne B, Smiler K, Stace H, Taylor B, Gibb S. Autism spectrum disorder/Takiwātanga: An Integrated Data Infrastructure-based approach to autism spectrum disorder research in New Zealand. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2213-2227. [PMID: 32677449 PMCID: PMC7542998 DOI: 10.1177/1362361320939329] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
New Zealand has few estimates of the prevalence of autism spectrum disorder and no national registry. The use of administrative data sources is expanding and could be useful in autism spectrum disorder research. However, the extent to which autism spectrum disorder can be captured in these data sources is unknown. In this study, we utilised three linked administrative health data sources from the Integrated Data Infrastructure to identify cases of autism spectrum disorder among New Zealand children and young people. We then investigated the extent to which a range of mental health, neurodevelopmental and related problems co-occur with autism spectrum disorder. In total, 9555 unique individuals aged 0–24 with autism spectrum disorder were identified. The identification rate for 8-year-olds was 1 in 102. Co-occurring mental health or related problems were noted in 68% of the autism spectrum disorder group. The most common co-occurring conditions were intellectual disability, disruptive behaviours and emotional problems. Although data from the Integrated Data Infrastructure may currently undercount cases of autism spectrum disorder, they could be useful for monitoring service and treatment-related trends, types of co-occurring conditions and for examining social outcomes. With further refinement, the Integrated Data Infrastructure could prove valuable for informing the national incidence and prevalence of autism spectrum disorder and the long-term effectiveness of clinical guidelines and interventions for this group.
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Affiliation(s)
- Nicholas Bowden
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Hiran Thabrew
- A Better Start National Science Challenge, New Zealand.,The University of Auckland, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Richard Audas
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Barry Milne
- A Better Start National Science Challenge, New Zealand.,The University of Auckland, New Zealand
| | | | | | - Barry Taylor
- A Better Start National Science Challenge, New Zealand.,University of Otago, New Zealand
| | - Sheree Gibb
- A Better Start National Science Challenge, New Zealand.,University of Otago, Wellington, New Zealand
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27
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Mitchell MJ, Newall FH, Sokol J, Williams KJ. Simulation-Based Education for Staff Managing Aggression and Externalizing Behaviors in Children With Autism Spectrum Disorder in the Hospital Setting: Pilot and Feasibility Study Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18105. [PMID: 32495742 PMCID: PMC7303837 DOI: 10.2196/18105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background Children with autism spectrum disorder (ASD) frequently demonstrate aggression and externalizing behaviors in the acute care hospital environment. Pediatric acute care nursing staff are often not trained in managing aggression and, in particular, lack confidence in preventing and managing externalizing behaviors in children with ASD. High-fidelity simulation exercises will be used in this study to provide deliberate practice for acute care pediatric nursing staff in the management of aggressive and externalizing behaviors. Objective The purpose of this study is to conduct a pilot and feasibility cluster randomized controlled trial (RCT) to evaluate the effectiveness of simulation-based education for staff in managing aggression and externalizing behaviors of children with ASD in the hospital setting. Methods This study has a mixed design, with between-group and within-participant comparisons to explore the acceptability and feasibility of delivering a large-scale cluster RCT. The trial process, including recruitment, completion rates, contamination, and completion of outcome measures, will be assessed and reported as percentages. This study will assess the acceptability of the simulation-based training format for two scenarios involving an adolescent with autism, with or without intellectual disability, who displays aggressive and externalizing behaviors and the resulting change in confidence in managing clinical aggression. Two pediatric wards of similar size and patient complexity will be selected to participate in the study; they will be randomized to receive either simulation-based education plus web-based educational materials or the web-based educational materials only. Change in confidence will be assessed using pre- and posttraining surveys for bedside nursing staff exposed to the training and the control group who will receive the web-based training materials. Knowledge retention 3 months posttraining, as well as continued confidence and exposure to clinical aggression, will be assessed via surveys. Changes in confidence and competence will be compared statistically with the chi-square test using before-and-after data to compare the proportion of those who have high confidence between the two arms at baseline and at follow-up. The simulation-based education will be recorded with trained assessors reviewing participants’ abilities to de-escalate aggressive behaviors using a validated tool. This data will be analyzed using mean values and SDs to understand the variation in performance of individuals who undertake the training. Data from each participating ward will be collected during each shift for the duration of the study to assess the number of aggressive incidents and successful de-escalation for patients with ASD. Total change in Code Grey activations will also be assessed, with both datasets analyzed using descriptive statistics. Results This study gained ethical approval from The Royal Children's Hospital Melbourne Human Research Ethics Committee (HREC) on November 1, 2019 (HREC reference number: 56684). Data collection was completed in February 2020. Data analysis is due to commence with results anticipated by August 2020. Conclusions We hypothesize that this study is feasible to be conducted as a cluster RCT and that simulation-based training will be acceptable for acute care pediatric nurses. We anticipate that the intervention ward will have increased confidence in managing clinical aggression in children with ASD immediately and up to 3 months posttraining. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000139976; http://www.ANZCTR.org.au/ACTRN12620000139976.aspx International Registered Report Identifier (IRRID) DERR1-10.2196/18105
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Affiliation(s)
- Marijke Jane Mitchell
- Department of Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Fiona Helen Newall
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Department of Nursing Research, Royal Children's Hospital, Melbourne, Australia.,Department of Nursing Education, Royal Children's Hospital, Melbourne, Australia.,Department of Nursing, The University of Melbourne, Melbourne, Australia
| | - Jennifer Sokol
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Simulation Program, Department of Medical Education, Royal Children's Hospital, Melbourne, Australia
| | - Katrina Jane Williams
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, Education and Research, Monash University, Melbourne, Australia
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28
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Palese A, Conforto L, Meloni F, Bordei V, Domenighini A, Bulfone E, Grassetti L, Gonella S. Assessing pain in children with autism spectrum disorders: findings from a preliminary validation study. Scand J Caring Sci 2020; 35:457-467. [PMID: 32311779 DOI: 10.1111/scs.12857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/15/2020] [Accepted: 03/20/2020] [Indexed: 11/29/2022]
Abstract
AIMS Assessing pain in children with autism spectrum disorders (ASDs) can be extremely challenging, since many cannot self-report pain. This study aims to test the validity of the Non-Communicating Children's Pain Checklist - Revised (NCCPC-R) in identifying pain in children and adolescents affected by ASDs. MATERIALS AND METHODS A two-phase validation study based on (a) the translation and cultural adaptation of the NCCPC-R to Italian and to ASD-specific needs and context; and (b) the validation of a modified, 32-item version of the NCCPC-R. In all, 141 carers of children aged 6-16 years with ASDs were asked to recall an in-pain episode and a not-in-pain episode of their child and to rate on a 3-point scale (0 = not at all, 3 = very often) each behaviour included in the tool. Internal consistency (Cronbach's α), explorative and confirmative factorial structure, as well as concurrent and discriminant validity, were all assessed. RESULTS Confirmatory factor analysis established the revised version of the NCCPC-R for children with ASDs (named = NCCPC-RASD ), formed from 10 of the original 30 items categorised into three factors ('Changing in mood', 'Increasing in tension' and 'Alerting reaction') to have an acceptable level of reliability. The tool was internally consistent (α = 0.741 during in-pain episodes, α = 0.790 during not-in-pain episodes) and was able to discriminate between in-pain episodes (13.36 out of 40; CI 95% 12.34-14.39) and not-in-pain episodes (7.84 out of 40; CI 95% 6.86-8.82, p < 0.001). CONCLUSIONS These results provide preliminary evidence that the 10-item version of the NCCPC-RASD is a reliable and valid tool for assessing pain in children with ASD.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Sciences, University of Udine, Udine, Italy
| | | | - Francesca Meloni
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Valeria Bordei
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Alessia Domenighini
- Responsible of Programmes offered at the ProgettoautismoFVG Onlus, Feletto Umberto, Italy
| | | | - Luca Grassetti
- Department of Economics and Statistics, University of Udine, Udine, Italy
| | - Silvia Gonella
- Department of Medical Science, AOU Città della Salute e della Scienza di Torino, Torino, Italy
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De Crescenzo F, D’Alò GL, Morgano GP, Minozzi S, Mitrova Z, Saulle R, Cruciani F, Fulceri F, Davoli M, Scattoni ML, Nardocci F, Schünemann HJ, Amato L. Impact of polyunsaturated fatty acids on patient-important outcomes in children and adolescents with autism spectrum disorder: a systematic review. Health Qual Life Outcomes 2020; 18:28. [PMID: 32066439 PMCID: PMC7026962 DOI: 10.1186/s12955-020-01284-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 02/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Recent randomized controlled trials (RCTs) claimed PUFAs to be effective for autism spectrum disorder (ASD) but international guidelines have not considered yet this body of evidence. Our aim was to assess the effectiveness of PUFAs in children and adolescents with ASD, for the Italian national guidelines on the management of ASD in children and adolescents. METHODS We performed a systematic review and meta-analysis of RCTs comparing PUFAs versus placebo or a healthy diet for the treatment of ASD in children and adolescents. The outcomes considered were deemed by the guideline panel to be highly relevant to children and adolescents with ASD and to their caregivers. The outcomes included hyperactivity, quality of sleep, self-harm, aggression, irritability, anxiety, attention, adaptive functioning, social interaction, restricted and repetitive interests and behavior, communication, hyperactivity and disruptive behaviors coexistent with core symptoms. The risk of bias of the included studies was assessed with the Cochrane tool, and the rating of the confidence in the effect estimates according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS We included 9 studies with 405 participants. The strength of evidence ranged from low to very low. Six studies included preschoolers and school-age children, three studies included both children and adolescents. The majority of participants were males (83.8%), with a mean age of 6.7 years. PUFAs were superior compared to placebo in reducing anxiety in individuals with ASD (SMD -1.01, 95% CI - 1.86 to - 0.17; very low certainty of evidence). Moreover, PUFAs worsened quality of sleep compared to a healthy diet (SMD 1.11, 95% CI 0.21 to 2.00; very low certainty of evidence). PUFAs were not better than placebo in reducing aggression, hyperactivity, adaptive functioning, irritability, restricted and repetitive interests and behaviors and communication. Effects on some critical outcomes such as sleep, self-harm and disruptive behavior are currently unknown. The main limitations were the small number of participants included in the RCTs and the dosage which varied greatly (from 200 mg/day to 1540 mg/day), making it difficult to address causal inference. CONCLUSIONS PUFAs did not show evidence of effect in children and adolescents with ASD and the certainty of evidence as measured with the GRADE was low to very low. Further research is needed on this topic because the available evidence is inconclusive.
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Affiliation(s)
- Franco De Crescenzo
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
- Department of Psychiatry, University of Oxford, Oxford, UK
- Pediatric University Hospital-Department (DPUO), Bambino Gesù Children’s Hospital, Rome, Italy
| | - Gian Loreto D’Alò
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gian Paolo Morgano
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster GRADE Centre, McMaster University, Hamilton, Canada
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Zuzana Mitrova
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Rosella Saulle
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Fabio Cruciani
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Francesco Nardocci
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Holger Jens Schünemann
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster GRADE Centre, McMaster University, Hamilton, Canada
- Michael G DeGroote Cochrane Canada Centre, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Laura Amato
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy
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30
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Autism spectrum disorder in prison and secure care. Ir J Psychol Med 2019; 39:324-326. [PMID: 31762426 DOI: 10.1017/ipm.2019.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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31
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Araujo DJ, Tjoa K, Saijo K. The Endocannabinoid System as a Window Into Microglial Biology and Its Relationship to Autism. Front Cell Neurosci 2019; 13:424. [PMID: 31619967 PMCID: PMC6759510 DOI: 10.3389/fncel.2019.00424] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/03/2019] [Indexed: 11/17/2022] Open
Abstract
Microglia are the resident, innate immune cells of the central nervous system (CNS) and are critical in managing CNS injuries and infections. Microglia also maintain CNS homeostasis by influencing neuronal development, viability, and function. However, aberrant microglial activity and phenotypes are associated with CNS pathology, including autism spectrum disorder (ASD). Thus, improving our knowledge of microglial regulation could provide insights into the maintenance of CNS homeostasis as well as the prevention and treatment of ASD. Control of microglial activity is in part overseen by small, lipid-derived molecules known as endogenous cannabinoids (endocannabinoids). Endocannabinoids are one component of the endocannabinoid system (ECS), which also includes the enzymes that metabolize these ligands, in addition to cannabinoid receptor 1 (CB1) and 2 (CB2). Interestingly, increased ECS signaling leads to an anti-inflammatory, neuroprotective phenotype in microglia. Here, we review the literature and propose that ECS signaling represents a largely untapped area for understanding microglial biology and its relationship to ASD, with special attention paid to issues surrounding the use of recreational cannabis (marijuana). We also discuss major questions within the field and suggest directions for future research.
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Affiliation(s)
- Daniel John Araujo
- Department of Molecular & Cell Biology, University of California, Berkeley, Berkeley, CA, United States
| | - Karensa Tjoa
- Department of Molecular & Cell Biology, University of California, Berkeley, Berkeley, CA, United States
| | - Kaoru Saijo
- Department of Molecular & Cell Biology, University of California, Berkeley, Berkeley, CA, United States.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
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Axmon A, Björkman M, Ahlström G. Hospital readmissions among older people with intellectual disability in comparison with the general population. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:593-602. [PMID: 30734976 PMCID: PMC6850197 DOI: 10.1111/jir.12601] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Older people with intellectual disability have high multimorbidity and poor physical and mental health compared with the general population. Consequently, they have a greater need for health care. Hospital readmissions may be an indicator of the quality of health care. However, so far, only a few studies have investigated this outcome in populations of people with intellectual disability. None has focused on older people. METHOD We identified a cohort of people with intellectual disability aged 55+ years and alive at the end of 2012 (n = 7936). Moreover, we established a reference cohort from the general population, one-to-one matched by sex and year of birth. Data on hospital visits during the period 2002-2012 were collected from the Swedish National Patient Register. Readmissions were defined as unplanned visits with the same diagnosis occurring within 30 days of discharge and with no planned visit for the same diagnosis during this time. RESULTS Compared with the general population, people with intellectual disability had increased risk of readmissions for diseases of the nervous system [relative risk (RR) 2.62], respiratory system (RR 1.48), digestive system (RR 1.40) and musculoskeletal system and connective tissue (RR 2.10). Within these diagnostic groups, increased risks were found for arthropathies (RR 3.73), disorders of gallbladder, biliary tract and pancreas (RR 1.78), other diseases of intestines (RR 1.30), and other forms of heart disease (RR 1.23). Decreased risk of readmissions was found for mental and behavioural disorders (RR 0.78) and diseases of the circulatory system (RR 0.64). CONCLUSIONS The increased risk for readmissions related to diseases of the nervous and musculoskeletal systems has a clear relation to the prevalence of comorbidities in these areas. People with intellectual disability often also have inborn limitations and damages in these systems which with time lead to complications and risk for diseases, which can be difficult to discover. The increased risk for readmissions for disease of the respiratory system, together with the already known increased prevalence of such diagnoses and their occurrence as a cause for death, warrants further investigations and considerations of potential preventive measures. The pattern of readmissions among older people with intellectual disability cannot be explained solely by a higher prevalence of disorders in this group. Our finding of increased risks for readmissions for diseases in the digestive system could be interpreted as communication problems, which sometimes result in too rapid discharges and their consequential early readmissions.
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Affiliation(s)
- A. Axmon
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of MedicineLund UniversityLundSweden
- Department of Health Sciences, Faculty of MedicineLund UniversityLundSweden
| | - M. Björkman
- The Swedish Medical Institute for Adult Persons with Intellectual DisabilityIggesundSweden
| | - G. Ahlström
- Department of Health Sciences, Faculty of MedicineLund UniversityLundSweden
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33
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Array-CGH Analysis in a Cohort of Phenotypically Well-Characterized Individuals with "Essential" Autism Spectrum Disorders. J Autism Dev Disord 2019; 48:442-449. [PMID: 29027068 DOI: 10.1007/s10803-017-3329-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Copy-number variants (CNVs) are associated with susceptibility to autism spectrum disorder (ASD). To detect the presence of CNVs, we conducted an array-comparative genomic hybridization (array-CGH) analysis in 133 children with "essential" ASD phenotype. Genetic analyses documented that 12 children had causative CNVs (C-CNVs), 29 children had non-causative CNVs (NC-CNVs) and 92 children without CNVs (W-CNVs). Results on clinical evaluation showed no differences in cognitive abilities among the three groups, and a higher number of ASD symptoms and of non-verbal children in the C-CNVs group compared to the W-CNVs and NC-CNVs groups. Our results highlighted the importance of the array-CGH analyses and showed that the presence of specific CNVs may differentiate clinical outputs in children with ASD.
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34
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Milovanovic M, Radivojevic V, Radosavljev-Kircanski J, Grujicic R, Toskovic O, Aleksić-Hil O, Pejovic-Milovancevic M. Epilepsy and interictal epileptiform activity in patients with autism spectrum disorders. Epilepsy Behav 2019; 92:45-52. [PMID: 30611007 DOI: 10.1016/j.yebeh.2018.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study was to determine the prevalence of epilepsy and subclinical epileptiform abnormalities in children with autism spectrum disorder (ASD), and to investigate its effects on core autistic symptoms and adaptive behavior skills. METHODS Patients with diagnosis of ASD who met full criteria on Autism Diagnostic Interview-Revised (ADI-R) were included in the study. Adaptive behavior skills were assessed by Vineland Adaptive Behavior Scale-II (VABS-II). Clinical assessment for epilepsy and video electroencephalography (EEG) (v-EEG) examinations during wakefulness and/or sleep were prospectively performed in all patients. RESULTS A total of 112 patients with diagnosis of ASD of mean age 6.58 ± 3.72 were included in the study. Based on clinical and v-EEG assessments, three groups of patients were defined: 1) patients with epilepsy (n = 17; 15.2%); 2) patients with epileptiform discharges in absence of clinical seizures (n = 14; 12.5%); 3) patients without epilepsy and without epileptiform discharges (n = 81; 72.3%). There were no significant differences between three groups of patients on ADI-R subscores. Speech development was also not significantly related to epilepsy. There was a slight tendency of the VABS-II motor skills score to be higher in the group of patients with autism without clinical diagnosis of epilepsy and without subclinical epileptiform discharges (p < 0.05) in comparison with the two other groups. According to this tendency, we might claim that patients with higher scores on motor skills could have 0.88 times lower odds for having epileptiform EEG activity. CONCLUSIONS According to our results, we were not able to detect differences in the ADI-R between the three populations with ASD, all with unknown etiology. Epilepsy, as well as subclinical epileptic discharges, showed small effects on Motor Skills in patients with autism, and had no effect on adaptive behavior Communication/Socialization/Daily Living Skills.
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Affiliation(s)
- Maja Milovanovic
- Institute of Mental Health, Belgrade, Serbia; Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | | | | | | | - Oliver Toskovic
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | | | - Milica Pejovic-Milovancevic
- Institute of Mental Health, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
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35
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Lukito SD, O'Daly OG, Lythgoe DJ, Whitwell S, Debnam A, Murphy CM, Ashwood K, Stoencheva V, Simonoff E, Rubia K. Neural Correlates of Duration Discrimination in Young Adults with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder and Their Comorbid Presentation. Front Psychiatry 2018; 9:569. [PMID: 30487760 PMCID: PMC6246684 DOI: 10.3389/fpsyt.2018.00569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/18/2018] [Indexed: 12/12/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often co-occur and share neurocognitive deficits. One such shared impairment is in duration discrimination. However, no studies using functional magnetic resonance imaging (fMRI) have investigated whether these duration discrimination deficits are underpinned by the same or different underlying neurofunctional processes. In this study, we used fMRI to compare the neurofunctional correlates of duration discrimination between young adult males with ASD (n = 23), ADHD (n = 25), the comorbid condition of ASD+ADHD (n = 24), and typical development (TD, n = 26) using both region of interest (ROI) and whole brain analyses. Both the ROI and the whole-brain analyses showed that the comorbid ASD+ADHD group compared to controls, and for the ROI analysis relative to the other patient groups, had significant under-activation in right inferior frontal cortex (IFG) a key region for duration discrimination that is typically under-activated in boys with ADHD. The findings show that in young adult males with pure ASD, pure ADHD and comorbid ASD+ADHD with no intellectual disability, only the comorbid group demonstrates neurofunctional deficits in a typical duration discrimination region.
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Affiliation(s)
- Steve D. Lukito
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Owen G. O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - David J. Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Susannah Whitwell
- The Adult Attention-Deficit Hyperactivity Disorder National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Amanda Debnam
- The Adult Attention-Deficit Hyperactivity Disorder National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Clodagh M. Murphy
- The Adult Attention-Deficit Hyperactivity Disorder National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Karen Ashwood
- The Adult Attention-Deficit Hyperactivity Disorder National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Vladimira Stoencheva
- The Adult Attention-Deficit Hyperactivity Disorder National Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Baptista J, Sampaio A, Fachada I, Osório A, Mesquita AR, Garayzabal E, Duque F, Oliveira G, Soares I. Maternal Interactive Behaviours in Parenting Children with Williams Syndrome and Autism Spectrum Disorder: Relations with Emotional/Behavioural Problems. J Autism Dev Disord 2018; 49:216-226. [PMID: 30143949 DOI: 10.1007/s10803-018-3715-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study compared maternal responsiveness to children with two neurodevelopmental disorders sharing different but, in some cases, overlapping social phenotypes-Williams syndrome (WS) and autism spectrum disorder (ASD)-and explored the relations between maternal responsiveness and child emotional/behavioural problems (EBP). The sample included 16 pre-schoolers with WS and 43 with ASD, and their mothers. Responsiveness was assessed during a mother-child interaction task. Mothers completed the CBCL 1½-5, providing a measure of EBP. No significant differences emerged between groups, and most dyads were characterized by less responsive behaviours. Maternal responsiveness proved related to child developmental age, but not with EBP. These results provide further insight into the rearing environment of children with neurodevelopmental disorders, highlighting the need for early relationship-based interventions.
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Affiliation(s)
- Joana Baptista
- Psychology Research Center (CIPsi), School of Psychology of the University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Adriana Sampaio
- Psychology Research Center (CIPsi), School of Psychology of the University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Inês Fachada
- Psychology Research Center (CIPsi), School of Psychology of the University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Ana Osório
- Mackenzie Presbyterian University, São Paulo, Brazil
| | - Ana R Mesquita
- Psychology Research Center (CIPsi), School of Psychology of the University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Elena Garayzabal
- Department of Linguistics, University Autónoma of Madrid, Madrid, Spain
| | - Frederico Duque
- Neurodevelopmental and Autism Unit from Child Developmental Center and Centro de Investigação e Formação Clinica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Guiomar Oliveira
- Neurodevelopmental and Autism Unit from Child Developmental Center and Centro de Investigação e Formação Clinica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel Soares
- Psychology Research Center (CIPsi), School of Psychology of the University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
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Lukito S, Jones CRG, Pickles A, Baird G, Happé F, Charman T, Simonoff E. Specificity of executive function and theory of mind performance in relation to attention-deficit/hyperactivity symptoms in autism spectrum disorders. Mol Autism 2017; 8:60. [PMID: 29152165 PMCID: PMC5680830 DOI: 10.1186/s13229-017-0177-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/31/2017] [Indexed: 01/17/2023] Open
Abstract
Background Individuals with autism spectrum disorder (ASD) frequently demonstrate symptoms of attention-deficit/hyperactivity disorder (ADHD). Previous findings in children with ASD have suggested that these symptoms are associated with an impairment in executive function (EF) abilities. However, studies rarely considered this association within a single framework that controls for other related factors such as Theory of Mind (ToM) abilities and ASD symptoms. Methods We used structural equation modeling to explore the relations among EF, ToM, and symptoms of ASD and ADHD, using data from a population-based sample of 100 adolescents with ASD and full-scale IQ ≥ 50 (the Special Needs and Autism Project (SNAP) cohort). The study used a multi-measure and multi-informant approach, where performance of inhibition, planning, switching, and working memory tasks indexed EF and performance on tasks involving mentalizing indexed ToM. Measures of ASD and ADHD symptoms included parent and teacher reports and direct observation of the children. Shared source of symptom reporting was accounted for with a parental rating latent factor indexed by symptom measures reported by parents. Results Impairments in EF abilities were specifically associated with ADHD symptoms while impaired ToM was specifically associated with ASD symptoms, when accounting for the associations of each cognitive domain with the other factors. ASD and ADHD symptom latent factors were also correlated, but this association became nonsignificant once the shared source of reporting from parents was accounted for and within a model that also controlled for the correlated pathway between EF and ToM factors. The specific relations between the cognitive domains and behavioral symptoms remained even after controlling for IQ. Conclusions In this ASD sample, symptoms of ADHD and ASD are underpinned by separate cognitive domains. The association between EF and ToM impairments is a likely partial explanation for the co-occurrence of ADHD symptoms in ASD, but the role of shared reporting effects is also important and supports the inclusion of independent informants and objective measures in future research.
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Affiliation(s)
- Steve Lukito
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Andrew Pickles
- Department of Biostatistics and Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gillian Baird
- Guy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, UK
| | - Francesca Happé
- Institute of Psychiatry, Social, Genetic and Developmental Psychiatry (SGDP) Centre, Psychology and Neuroscience, King's College London, London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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38
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Morimoto C, Hida E, Shima K, Okamura H. Temporal Processing Instability with Millisecond Accuracy is a Cardinal Feature of Sensorimotor Impairments in Autism Spectrum Disorder: Analysis Using the Synchronized Finger-Tapping Task. J Autism Dev Disord 2017; 48:351-360. [PMID: 28988374 DOI: 10.1007/s10803-017-3334-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To identify a specific sensorimotor impairment feature of autism spectrum disorder (ASD), we focused on temporal processing with millisecond accuracy. A synchronized finger-tapping task was used to characterize temporal processing in individuals with ASD as compared to typically developing (TD) individuals. We found that individuals with ASD showed more variability in temporal processing parameters than TD individuals. In addition, temporal processing instability was related to altered motor performance. Further, receiver operating characteristic (ROC) curve analyses indicated that altered temporal processing can be useful for distinguishing between individuals with and without ASD. These results suggest that instability of temporal processing with millisecond accuracy is a fundamental feature of sensorimotor impairments in ASD.
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Affiliation(s)
- Chie Morimoto
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Keisuke Shima
- Division of Intelligent Systems Engineering, Faculty of Engineering, Yokohama National University, 79-5 Tokiwadai Hodogaya-ku, Yokohama, 240-8501, Japan
| | - Hitoshi Okamura
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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Outcomes of Diagnostic Exome Sequencing in Patients With Diagnosed or Suspected Autism Spectrum Disorders. Pediatr Neurol 2017; 70:34-43.e2. [PMID: 28330790 DOI: 10.1016/j.pediatrneurol.2017.01.033] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/26/2017] [Accepted: 01/31/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Exome sequencing has recently been proved to be a successful diagnostic method for complex neurodevelopmental disorders. However, the diagnostic yield of exome sequencing for autism spectrum disorders has not been extensively evaluated in large cohorts to date. MATERIALS AND METHODS We performed diagnostic exome sequencing in a cohort of 163 individuals with autism spectrum disorder (66.3%) or autistic features (33.7%). RESULTS The diagnostic yield observed in patients in our cohort was 25.8% (42 of 163) for positive or likely positive findings in characterized disease genes, while a candidate genetic etiology was reported for an additional 3.3% (4 of 120) of patients. Among the positive findings in the patients with autism spectrum disorder or autistic features, 61.9% were the result of de novo mutations. Patients presenting with psychiatric conditions or ataxia or paraplegia in addition to autism spectrum disorder or autistic features were significantly more likely to receive positive results compared with patients without these clinical features (95.6% vs 27.1%, P < 0.0001; 83.3% vs 21.2%, P < 0.0001, respectively). The majority of the positive findings were in recently identified autism spectrum disorder genes, supporting the importance of diagnostic exome sequencing for patients with autism spectrum disorder or autistic features as the causative genes might evade traditional sequential or panel testing. CONCLUSIONS These results suggest that diagnostic exome sequencing would be an efficient primary diagnostic method for patients with autism spectrum disorders or autistic features. Moreover, our data may aid clinicians to better determine which subset of patients with autism spectrum disorder with additional clinical features would benefit the most from diagnostic exome sequencing.
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Schmeisser K, Parker JA. Worms on the spectrum - C. elegans models in autism research. Exp Neurol 2017; 299:199-206. [PMID: 28434869 DOI: 10.1016/j.expneurol.2017.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/10/2017] [Accepted: 04/18/2017] [Indexed: 12/13/2022]
Abstract
The small non-parasitic nematode Caenorhabditis elegans is widely used in neuroscience thanks to its well-understood development and lineage of the nervous system. Furthermore, C. elegans has been used to model many human developmental and neurological conditions to better understand disease mechanisms and identify potential therapeutic strategies. Autism spectrum disorder (ASD) is the most prevalent of all neurodevelopmental disorders, and the C. elegans system may provide opportunities to learn more about this complex disorder. Since basic cell biology and biochemistry of the C. elegans nervous system is generally very similar to mammals, cellular or molecular phenotypes can be investigated, along with a repertoire of behaviours. For instance, worms have contributed greatly to the understanding of mechanisms underlying mutations in genes coding for synaptic proteins such as neuroligin and neurexin. Using worms to model neurodevelopmental disorders like ASD is an emerging topic that harbours great, untapped potential. This review summarizes the numerous contributions of C. elegans to the field of neurodevelopment and introduces the nematode system as a potential research tool to study essential roles of genes associated with ASD.
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Affiliation(s)
- Kathrin Schmeisser
- Centre de Recherche du Centre Hospitalier de l'Université de Montreál (CRCHUM), 900 St-Denis Street, Montreál, Queb́ec H2X 0A9, Canada
| | - J Alex Parker
- Centre de Recherche du Centre Hospitalier de l'Université de Montreál (CRCHUM), 900 St-Denis Street, Montreál, Queb́ec H2X 0A9, Canada; Department of Neuroscience, Université de Montreál, 2960 Chemin de la Tour, Montreál, Queb́ec H3T 1J4, Canada.
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Schmeisser K, Fardghassemi Y, Parker JA. A rapid chemical-genetic screen utilizing impaired movement phenotypes in C. elegans: Input into genetics of neurodevelopmental disorders. Exp Neurol 2017; 293:101-114. [PMID: 28373024 DOI: 10.1016/j.expneurol.2017.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder with a constantly increasing prevalence. Model organisms may be tools to identify underlying cellular and molecular mechanisms, as well as aid the discovery and development of novel therapeutic approaches. A simple animal such as the nematode Caenorhabditis elegans may provide insights into the extreme complexity of ASD genetics. Despite its potential, using C. elegans in ASD research is a controversial approach and has not yet been used extensively in this context. In this study, we present a screening approach of potential C. elegans mutants as potential ASD models. We screened these mutants for motor-deficiency phenotypes, which can be exploited to study underlying mechanisms of the disorder. Selected motor-deficient mutants were then used in a comprehensive drug screen of over 3900 compounds, including many FDA-approved and natural molecules, that were analyzed for their ability to suppress motility defects caused by ASD-associated gene orthologues. This genetic-chemical approach, i.e. establishing C. elegans models for ASD and screening of a well-characterized compound library, might be a promising first step to understand the mechanisms of how gene variations cause neuronal dysfunction, leading to ASD and other neurological disorders. Positively acting compounds could also be promising candidates for preclinical studies.
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Affiliation(s)
- Kathrin Schmeisser
- Centre de Recherche du Centre Hospitalier de l'Université de Montreál (CRCHUM), 900 St-Denis Street, Montreál, Québec H2X 0A9, Canada
| | - Yasmin Fardghassemi
- Centre de Recherche du Centre Hospitalier de l'Université de Montreál (CRCHUM), 900 St-Denis Street, Montreál, Québec H2X 0A9, Canada; Department of Biochemistry and Molecular Medicine, Université de Montreál, 2960 Chemin de la Tour, Montreál, Québec H3T 1J4, Canada
| | - J Alex Parker
- Centre de Recherche du Centre Hospitalier de l'Université de Montreál (CRCHUM), 900 St-Denis Street, Montreál, Québec H2X 0A9, Canada; Department of Neuroscience, Université de Montreál, 2960 Chemin de la Tour, Montreál, Québec H3T 1J4, Canada.
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