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Waizbard-Bartov E, Fein D, Lord C, Amaral DG. Autism Severity and its Relationship to Disability. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:252-262. [PMID: 38680979 PMCID: PMC11046712 DOI: 10.1176/appi.focus.24022007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Autism severity is currently defined and measured based exclusively on the severity levels of the two core symptom domains: social-communication and restricted or repetitive patterns of behaviors and interests. Autistic individuals, however, are often diagnosed with other medical, developmental, and psychological co-occurring conditions. These additional challenges such as intellectual disability, limited expressive and/or receptive language, and anxiety disorders, can have a tremendous impact on the day-to-day lives of autistic individuals, for both their adaptive functioning as well as their sense of wellbeing. Furthermore, the initial presentation of core symptoms and their likelihood of changing over time are influenced by the presence of such co-occurring conditions. In order to truly understand how a person's autism impacts their life, both core symptoms as well as other challenges should be considered. This approach was recently taken by The Lancet Commission on the future of care and clinical research in autism, which proposed the term "profound autism" for a subgroup of individuals presenting with high core symptom severity, co-occurring intellectual disability, and little or no language, who require extensive long-term care. Considering other individual factors such as daily living skills, specific support needs and environmental resources would also enhance the evaluation of disability in autistic individuals. As currently employed in the assessment of intellectual disability, a multidimensional approach to autism could provide a more comprehensive system for classification of impairment. At present, however, there is no formal way to designate the combined effect of these different aspects of autism on a person's life. A comprehensive outlook that acknowledges impairments, capabilities, co-occurring conditions, and environmental factors would be useful for identifying subgroups of individuals as well as for determining individual needs and strengths in clinical assessments. Lay Summary: The severity of a person's autism is currently defined based on the severity of their core autism symptoms: impaired social-communication and the presence of restricted or repetitive patterns of behaviors and interests. But autistic people often face additional challenges such as intellectual disability, epilepsy, and anxiety disorder, that considerably impact their everyday life, wellbeing, and the need for support. A more complete view of autism severity, one that includes core symptoms as well as additional challenges, could help identify meaningful sub-groups of autistic individuals and could be useful in clinical care. Appeared originally in Autism Res 2023; 16:685-696.
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Affiliation(s)
- Einat Waizbard-Bartov
- Department of Psychology, University of California Davis, Davis, California, USA (Waizbard-Bartov); The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, California, USA (Waizbard-Bartov, Amaral); Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA; Department of Pediatrics, University of Connecticut, Farmington, Connecticut, USA (Fein); Departments of Psychiatry and Human Development and Psychology, University of California, Los Angeles, California, USA (Lord)
| | - Deborah Fein
- Department of Psychology, University of California Davis, Davis, California, USA (Waizbard-Bartov); The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, California, USA (Waizbard-Bartov, Amaral); Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA; Department of Pediatrics, University of Connecticut, Farmington, Connecticut, USA (Fein); Departments of Psychiatry and Human Development and Psychology, University of California, Los Angeles, California, USA (Lord)
| | - Catherine Lord
- Department of Psychology, University of California Davis, Davis, California, USA (Waizbard-Bartov); The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, California, USA (Waizbard-Bartov, Amaral); Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA; Department of Pediatrics, University of Connecticut, Farmington, Connecticut, USA (Fein); Departments of Psychiatry and Human Development and Psychology, University of California, Los Angeles, California, USA (Lord)
| | - David G Amaral
- Department of Psychology, University of California Davis, Davis, California, USA (Waizbard-Bartov); The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, California, USA (Waizbard-Bartov, Amaral); Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA; Department of Pediatrics, University of Connecticut, Farmington, Connecticut, USA (Fein); Departments of Psychiatry and Human Development and Psychology, University of California, Los Angeles, California, USA (Lord)
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2
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Kamensek T, Susilo T, Iarocci G, Oruc I. Are people with autism prosopagnosic? Autism Res 2023; 16:2100-2109. [PMID: 37740564 DOI: 10.1002/aur.3030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/30/2023] [Indexed: 09/24/2023]
Abstract
Difficulties in various face processing tasks have been well documented in autism spectrum disorder (ASD). Several meta-analyses and numerous case-control studies have indicated that this population experiences a moderate degree of impairment, with a small percentage of studies failing to detect any impairment. One possible account of this mixed pattern of findings is heterogeneity in face processing abilities stemming from the presence of a subpopulation of prosopagnosic individuals with ASD alongside those with normal face processing skills. Samples randomly drawn from such a population, especially relatively smaller ones, would vary in the proportion of participants with prosopagnosia, resulting in a wide range of group-level deficits from mild (or none) to severe across studies. We test this prosopagnosic subpopulation hypothesis by examining three groups of participants: adults with ASD, adults with developmental prosopagnosia (DP), and a comparison group. Our results show that the prosopagnosic subpopulation hypothesis does not account for the face impairments in the broader autism spectrum. ASD observers show a continuous and graded, rather than categorical, heterogeneity that span a range of face processing skills including many with mild to moderate deficits, inconsistent with a prosopagnosic subtype account. We suggest that pathogenic origins of face deficits for at least some with ASD differ from those of DP.
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Affiliation(s)
- Todd Kamensek
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tirta Susilo
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ipek Oruc
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada
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3
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Waizbard-Bartov E, Fein D, Lord C, Amaral DG. Autism severity and its relationship to disability. Autism Res 2023; 16:685-696. [PMID: 36786314 PMCID: PMC10500663 DOI: 10.1002/aur.2898] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/19/2023] [Indexed: 02/15/2023]
Abstract
Autism severity is currently defined and measured based exclusively on the severity levels of the two core symptom domains: social-communication and restricted or repetitive patterns of behaviors and interests. Autistic individuals, however, are often diagnosed with other medical, developmental, and psychological co-occurring conditions. These additional challenges such as intellectual disability, limited expressive and/or receptive language, and anxiety disorders, can have a tremendous impact on the day-to-day lives of autistic individuals, for both their adaptive functioning as well as their sense of wellbeing. Furthermore, the initial presentation of core symptoms and their likelihood of changing over time are influenced by the presence of such co-occurring conditions. In order to truly understand how a person's autism impacts their life, both core symptoms as well as other challenges should be considered. This approach was recently taken byThe Lancet Commission on the future of care and clinical research in autism, which proposed the term "profound autism" for a subgroup of individuals presenting with high core symptom severity, co-occurring intellectual disability, and little or no language, who require extensive long-term care. Considering other individual factors such as daily living skills, specific support needs and environmental resources would also enhance the evaluation of disability in autistic individuals. As currently employed in the assessment of intellectual disability, a multidimensional approach to autism could provide a more comprehensive system for classification of impairment. At present, however, there is no formal way to designate the combined effect of these different aspects of autism on a person's life. A comprehensive outlook that acknowledges impairments, capabilities, co-occurring conditions, and environmental factors would be useful for identifying subgroups of individuals as well as for determining individual needs and strengths in clinical assessments.
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Affiliation(s)
- Einat Waizbard-Bartov
- Department of Psychology, University of California Davis, Davis, California, USA
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, California, USA
| | - Deborah Fein
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
- Department of Pediatrics, University of Connecticut, Farmington, Connecticut, USA
| | - Catherine Lord
- Departments of Psychiatry and Human Development and Psychology, University of California, Los Angeles, California, USA
| | - David G. Amaral
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, California, USA
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4
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Buro AW, Salinas-Miranda A, Marshall J, Gray HL, Kirby RS. Autism Spectrum Disorder Diagnosis and Other Child, Family, and Community Risk Factors for Obesity among Children and Adolescents Aged Ten to Seventeen Years in the United States: A Mediation Analysis. Child Obes 2023; 19:57-67. [PMID: 35394360 PMCID: PMC9917309 DOI: 10.1089/chi.2021.0260] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: This study explored whether there are mediated effects of child and family risk in the association between community and organizational risk and obesity among children and adolescents aged 10-17 years using 2017-2018 National Survey of Children's Health (NSCH) data, addressing autism spectrum disorder (ASD) and co-occurring conditions. Methods: This cross-sectional study (N = 27,157) used 2017-2018 NSCH data. Frequency distributions and chi-square tests were used to describe participants with and without ASD. Cumulative risk indices were created for child, family, community, and organizational level risk, and mediation analyses were conducted in a two-mediator model (X1: community risk, X2: organizational risk, M1: child risk, M2: family risk) for the dichotomous outcome (Y: obesity). Path analyses were performed using generalized structural equation modeling in Stata 16.0. Results: Direct effects for all four risk indices were associated with obesity in single index models (all p < 0.001); only child and family risk indices were associated with obesity in a full model with all four risk indices (both p < 0.001). When child and family risk indices were assessed as mediators, the indirect effects of community and organizational risk were significant (all p < 0.0001). The total effect of community risk on obesity was significant with family risk as a mediator (p = 0.002). The total effect of organizational risk was not significant with either mediator. Conclusion: Findings suggest that child and family factors play a strong role in obesity risk and that ASD contributes to this risk. Community risk may be another strong predictor of obesity, mediated by family risk. Additional research on social-ecological risk factors for obesity is needed to identify leverage points to improve obesity risk in children and adolescents with and without ASD.
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Affiliation(s)
- Acadia W. Buro
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Abraham Salinas-Miranda
- Harrell Center for the Study of Family Violence, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Jennifer Marshall
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Heewon L. Gray
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Russell S. Kirby
- College of Public Health, University of South Florida, Tampa, FL, USA
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5
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Eigsti IM, Fein DA. Insights from losing the autism diagnosis: Autism spectrum disorder as a biological entity. Front Psychiatry 2022; 13:972612. [PMID: 36051556 PMCID: PMC9424653 DOI: 10.3389/fpsyt.2022.972612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Inge-Marie Eigsti
- Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Deborah A Fein
- Psychological Sciences, University of Connecticut, Storrs, CT, United States.,Pediatrics, University of Connecticut, Farmington, CT, United States
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6
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Enhancement of an Optimized Key for Database Sanitization to Ensure the Security and Privacy of an Autism Dataset. Symmetry (Basel) 2021. [DOI: 10.3390/sym13101912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Interrupting, altering, or stealing autism-related sensitive data by cyber attackers is a lucrative business which is increasing in prevalence on a daily basis. Enhancing the security and privacy of autism data while adhering to the symmetric encryption concept is a critical challenge in the field of information security. To identify autism perfectly and for its data protection, the security and privacy of these data are pivotal concerns when transmitting information over the Internet. Consequently, researchers utilize software or hardware disk encryption, data backup, Data Encryption Standard (DES), TripleDES, Advanced Encryption Standard (AES), Rivest Cipher 4 (RC4), and others. Moreover, several studies employ k-anonymity and query to address security concerns, but these necessitate a significant amount of time and computational resources. Here, we proposed the sanitization approach for autism data security and privacy. During this sanitization process, sensitive data are concealed, which avoids the leakage of sensitive information. An optimal key was generated based on our improved meta-heuristic algorithmic framework called Enhanced Combined PSO-GWO (Particle Swarm Optimization-Grey Wolf Optimization) framework. Finally, we compared our simulation results with traditional algorithms, and it achieved increased output effectively. Therefore, this finding shows that data security and privacy in autism can be improved by enhancing an optimal key used in the data sanitization process to prevent unauthorized access to and misuse of data.
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7
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Fein D, Eigsti IM, Barton M. Response to "A radical change in our autism research strategy is needed: Back to prototypes" by Mottron et al. (2021). Autism Res 2021; 14:2237-2238. [PMID: 34423923 PMCID: PMC8549012 DOI: 10.1002/aur.2596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 02/02/2023]
Affiliation(s)
| | - Inge-Marie Eigsti
- Director, Connecticut Autism and Language Lab (CALL), University of
Connecticut,Co-Director, Cognitive Neuroscience of Communication T32 training
program
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8
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Coulter KL, Barton ML, Robins DL, Stone WL, Fein DA. DSM-5 symptom expression in toddlers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1653-1665. [PMID: 33779335 PMCID: PMC8324506 DOI: 10.1177/13623613211000160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Children with autism show more social-communication symptoms and repetitive behaviors than children with typical development or those diagnosed with other developmental disorders; however, non-autistic children often show some behaviors that are associated with autism. We compared the behavioral reports from caregivers of children in these three groups to identify the behaviors that were specific to autism. Children with autism were found to show more of these behaviors, and behaviors that are particularly indicative of autism were identified. These behaviors included social symptoms (approaching others to interact, showing things, looking back while showing, responding to an approaching child, spontaneous imitation) and repetitive behavior symptoms (specific, inflexible play, unusual body movements, strong specific interest, carrying around an unusual object, sensory seeking, and sensory hyper-reactivity).These findings may aid professionals in determining the most appropriate diagnosis for a child between the ages of 12 and 36 months.
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9
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Bjørklund G, Doşa MD, Maes M, Dadar M, Frye RE, Peana M, Chirumbolo S. The impact of glutathione metabolism in autism spectrum disorder. Pharmacol Res 2021; 166:105437. [PMID: 33493659 DOI: 10.1016/j.phrs.2021.105437] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
This paper reviews the potential role of glutathione (GSH) in autism spectrum disorder (ASD). GSH plays a key role in the detoxification of xenobiotics and maintenance of balance in intracellular redox pathways. Recent data showed that imbalances in the GSH redox system are an important factor in the pathophysiology of ASD. Furthermore, ASD is accompanied by decreased concentrations of reduced GSH in part caused by oxidation of GSH into glutathione disulfide (GSSG). GSSG can react with protein sulfhydryl (SH) groups, thereby causing proteotoxic stress and other abnormalities in SH-containing enzymes in the brain and blood. Moreover, alterations in the GSH metabolism via its effects on redox-independent mechanisms are other processes associated with the pathophysiology of ASD. GSH-related regulation of glutamate receptors such as the N-methyl-D-aspartate receptor can contribute to glutamate excitotoxicity. Synergistic and antagonistic interactions between glutamate and GSH can result in neuronal dysfunction. These interactions can involve transcription factors of the immune pathway, such as activator protein 1 and nuclear factor (NF)-κB, thereby interacting with neuroinflammatory mechanisms, ultimately leading to neuronal damage. Neuronal apoptosis and mitochondrial dysfunction are recently outlined as significant factors linking GSH impairments with the pathophysiology of ASD. Moreover, GSH regulates the methylation of DNA and modulates epigenetics. Existing data support a protective role of the GSH system in ASD development. Future research should focus on the effects of GSH redox signaling in ASD and should explore new therapeutic approaches by targeting the GSH system.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610, Mo i Rana, Norway.
| | - Monica Daniela Doşa
- Department of Pharmacology, Faculty of Medicine, Ovidius University of Constanta, Campus, 900470, Constanta, Romania.
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Impact Research Center, Deakin University, Geelong, Australia
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Richard E Frye
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA; Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
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10
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McCormick CEB, Kavanaugh BC, Sipsock D, Righi G, Oberman LM, Moreno De Luca D, Gamsiz Uzun ED, Best CR, Jerskey BA, Quinn JG, Jewel SB, Wu PC, McLean RL, Levine TP, Tokadjian H, Perkins KA, Clarke EB, Dunn B, Gerber AH, Tenenbaum EJ, Anders TF, Sheinkopf SJ, Morrow EM. Autism Heterogeneity in a Densely Sampled U.S. Population: Results From the First 1,000 Participants in the RI-CART Study. Autism Res 2020; 13:474-488. [PMID: 31957984 DOI: 10.1002/aur.2261] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 01/25/2023]
Abstract
The objective of this study was to establish a large, densely sampled, U.S. population-based cohort of people with autism spectrum disorder (ASD). The Rhode Island Consortium for Autism Research and Treatment (RI-CART) represents a unique public-private-academic collaboration involving all major points of service for families in Rhode Island affected by ASD. Diagnosis was based on direct behavioral observation via the Autism Diagnostic Observation Schedule, Second Edition. For the first 1,000 participants, ages ranged from 21 months to 64 years. Using Geographic Information System and published prevalence rates, the overall cohort is estimated to represent between 20% and 49% of pediatric age persons in Rhode Island with ASD, with demographics representative of U.S. Census. We observed a high rate of co-occurring medical and psychiatric conditions in affected individuals. Among the most prominent findings of immediate clinical importance, we found that females received a first diagnosis of ASD at a later age than males, potentially due to more advanced language abilities in females with ASD. In summary, this is the first analysis of a large, population-based U.S. cohort with ASD. Given the depth of sampling, the RI-CART study reflects an important new resource for studying ASD in a representative U.S. population. Psychiatric and medical comorbidities in ASD constitute a substantial burden and warrant adequate attention as part of overall treatment. Our study also suggests that new strategies for earlier diagnosis of ASD in females may be warranted. Autism Res 2020, 13: 474-488. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The Rhode Island Consortium for Autism Research and Treatment (RI-CART) represents a unique public-private-academic collaboration involving all major points of service for families in Rhode Island affected by autism spectrum disorder (ASD). In this article, we provide results from the first 1,000 participants, estimated to represent >20% of affected families in the state. Importantly, we find a later age at first diagnosis of ASD in females, which potentially calls attention to the need for improved early diagnosis in girls. Also, we report a high rate of co-occurring medical and psychiatric conditions in affected individuals.
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Affiliation(s)
- Carolyn E B McCormick
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Brian C Kavanaugh
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Danielle Sipsock
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Giulia Righi
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Lindsay M Oberman
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Daniel Moreno De Luca
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Ece D Gamsiz Uzun
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.,Center for Computational Molecular Biology, Brown University, Providence, Rhode Island
| | - Carrie R Best
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Beth A Jerskey
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | - Pei-Chi Wu
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island.,Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island
| | - Rebecca L McLean
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Todd P Levine
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Hasmik Tokadjian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Kayla A Perkins
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elaine B Clarke
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Brittany Dunn
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alan H Gerber
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elena J Tenenbaum
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Thomas F Anders
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Stephen J Sheinkopf
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Eric M Morrow
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island.,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island.,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island
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11
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de Marchena A, Kim ES, Bagdasarov A, Parish-Morris J, Maddox BB, Brodkin ES, Schultz RT. Atypicalities of Gesture Form and Function in Autistic Adults. J Autism Dev Disord 2019; 49:1438-1454. [PMID: 30523479 PMCID: PMC6451661 DOI: 10.1007/s10803-018-3829-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While well-represented on clinical measures, co-speech gesture production has never been formally studied in autistic adults. Twenty-one verbally fluent autistic adults and 21 typically developing controls engaged in a controlled conversational task. Group differences were observed in both semantic/pragmatic and motoric features of spontaneously produced co-speech gestures. Autistic adults prioritized different functions of co-speech gesture. Specifically, they used gesture more than controls to facilitate conversational turn-taking, demonstrating a novel nonverbal strategy for regulating conversational dynamics. Autistic adults were more likely to gesture unilaterally than bilaterally, a motoric feature of gesture that was individually associated with autism symptoms. Co-speech gestures may provide a link between nonverbal communication symptoms and known differences in motor performance in autism.
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Affiliation(s)
- A de Marchena
- Department of Behavioral and Social Sciences, University of the Sciences, 600 S 43rd Street, Philadelphia, PA, 19104, USA.
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA.
| | - E S Kim
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA
| | - A Bagdasarov
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA
- Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Steven A. Levin Building, Philadelphia, PA, 19104, USA
| | - J Parish-Morris
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - B B Maddox
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Center for Mental Health Policy and Services Research, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - E S Brodkin
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Center for Neurobiology and Behavior, Translational Research Laboratory, Perelman School of Medicine at the University of Pennsylvania, 125 South 31st Street, Philadelphia, PA, 19104, USA
| | - R T Schultz
- The Children's Hospital of Philadelphia, Center for Autism Research, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
- Department of Pediatrics, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA
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Bölte S, Girdler S, Marschik PB. The contribution of environmental exposure to the etiology of autism spectrum disorder. Cell Mol Life Sci 2019; 76:1275-1297. [PMID: 30570672 PMCID: PMC6420889 DOI: 10.1007/s00018-018-2988-4] [Citation(s) in RCA: 240] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/14/2018] [Accepted: 12/04/2018] [Indexed: 01/04/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition of heterogeneous etiology. While it is widely recognized that genetic and environmental factors and their interactions contribute to autism phenotypes, their precise causal mechanisms remain poorly understood. This article reviews our current understanding of environmental risk factors of ASD and their presumed adverse physiological mechanisms. It comprehensively maps the significance of parental age, teratogenic compounds, perinatal risks, medication, smoking and alcohol use, nutrition, vaccination, toxic exposures, as well as the role of extreme psychosocial factors. Further, we consider the role of potential protective factors such as folate and fatty acid intake. Evidence indicates an increased offspring vulnerability to ASD through advanced maternal and paternal age, valproate intake, toxic chemical exposure, maternal diabetes, enhanced steroidogenic activity, immune activation, and possibly altered zinc-copper cycles and treatment with selective serotonin reuptake inhibitors. Epidemiological studies demonstrate no evidence for vaccination posing an autism risk. It is concluded that future research needs to consider categorical autism, broader autism phenotypes, as well as autistic traits, and examine more homogenous autism variants by subgroup stratification. Our understanding of autism etiology could be advanced by research aimed at disentangling the causal and non-causal environmental effects, both founding and moderating, and gene-environment interplay using twin studies, longitudinal and experimental designs. The specificity of many environmental risks for ASD remains unknown and control of multiple confounders has been limited. Further understanding of the critical windows of neurodevelopmental vulnerability and investigating the fit of multiple hit and cumulative risk models are likely promising approaches in enhancing the understanding of role of environmental factors in the etiology of ASD.
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Affiliation(s)
- Sven Bölte
- Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
| | - Sonya Girdler
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia
| | - Peter B Marschik
- Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- iDN-interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
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Abstract
After been exposed to the visual input, in the first year of life, the brain experiences subtle but massive changes apparently crucial for communicative/emotional and social human development. Its lack could be the explanation of the very high prevalence of autism in children with total congenital blindness. The present theory postulates that the superior colliculus is the key structure for such changes for several reasons: it dominates visual behavior during the first months of life; it is ready at birth for complex visual tasks; it has a significant influence on several hemispheric regions; it is the main brain hub that permanently integrates visual and non-visual, external and internal information (bottom-up and top-down respectively); and it owns the enigmatic ability to take non-conscious decisions about where to focus attention. It is also a sentinel that triggers the subcortical mechanisms which drive social motivation to follow faces from birth and to react automatically to emotional stimuli. Through indirect connections it also activates simultaneously several cortical structures necessary to develop social cognition and to accomplish the multiattentional task required for conscious social interaction in real life settings. Genetic or non-genetic prenatal or early postnatal factors could disrupt the SC functions resulting in autism. The timing of postnatal biological disruption matches the timing of clinical autism manifestations. Astonishing coincidences between etiologies, clinical manifestations, cognitive and pathogenic autism theories on one side and SC functions on the other are disclosed in this review. Although the visual system dependent of the SC is usually considered as accessory of the LGN canonical pathway, its imprinting gives the brain a qualitatively specific functions not supplied by any other brain structure.
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Affiliation(s)
- Rubin Jure
- Centro Privado de Neurología y Neuropsicología Infanto Juvenil WERNICKE, Córdoba, Argentina
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