1
|
Pua EPK, Desai T, Green C, Trevis K, Brown N, Delatycki M, Scheffer I, Wilson S. Endophenotyping social cognition in the broader autism phenotype. Autism Res 2024; 17:1365-1380. [PMID: 38037242 DOI: 10.1002/aur.3057] [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: 07/13/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023]
Abstract
Relatives of individuals with autism spectrum disorder (ASD) may display milder social traits of the broader autism phenotype (BAP) providing potential endophenotypic markers of genetic risk for ASD. We performed a case-control comparison to quantify social cognition and pragmatic language difficulties in the BAP (n = 25 cases; n = 33 controls) using the Faux Pas test (FPT) and the Goldman-Eisler Cartoon task. Using deep phenotyping we then examined patterns of inheritance of social cognition in two large multiplex families and the spectrum of performance in 32 additional families (159 members; n = 51 ASD, n = 87 BAP, n = 21 unaffected). BAP individuals showed significantly poorer FPT performance and reduced verbal fluency with the absence of a compression effect in social discourse compared to controls. In multiplex families, we observed reduced FPT performance in 89% of autistic family members, 63% of BAP relatives and 50% of unaffected relatives. Across all affected families, there was a graded spectrum of difficulties, with ASD individuals showing the most severe FPT difficulties, followed by the BAP and unaffected relatives compared to community controls. We conclude that relatives of probands show an inherited pattern of graded difficulties in social cognition with atypical faux pas detection in social discourse providing a novel candidate endophenotype for ASD.
Collapse
Affiliation(s)
- Emmanuel Peng Kiat Pua
- Department of Medicine and Radiology, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tarishi Desai
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Cherie Green
- Department of Psychology, Counselling & Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Krysta Trevis
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Natasha Brown
- Victorian Clinical Genetics Service, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Martin Delatycki
- Victorian Clinical Genetics Service, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Bruce Lefroy Centre, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Ingrid Scheffer
- Department of Medicine and Radiology, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Sarah Wilson
- Department of Medicine and Radiology, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Goodrich AJ, Kleeman MJ, Tancredi DJ, Ludeña YJ, Bennett DH, Hertz-Picciotto I, Schmidt RJ. Pre-pregnancy ozone and ultrafine particulate matter exposure during second year of life associated with decreased cognitive and adaptive functioning at aged 2-5 years. ENVIRONMENTAL RESEARCH 2024; 252:118854. [PMID: 38574983 DOI: 10.1016/j.envres.2024.118854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/17/2024] [Accepted: 03/31/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND This study sought to investigate the association of prenatal and early life exposure to a mixture of air pollutants on cognitive and adaptive outcomes separately in children with or without autism spectrum disorder (ASD). METHODS Utilizing data from the CHARGE case-control study (birth years: 2000-2016), we predicted daily air concentrations of NO2, O3, and particulate matter <0.1 μm (PM0.1), between 0.1 and 2.5 μm (PM0.1-2.5), and between 2.5 and 10 μm (PM2.5-10) using chemical transport models with ground-based monitor adjustments. Exposures were evaluated for pre-pregnancy, each trimester, and the first two years of life. Individual and combined effects of pollutants were assessed with Vineland Adaptive Behavior Scales (VABS) and Mullen Scales of Early Learning (MSEL), separately for children with ASD (n = 660) and children without ASD (typically developing (TD) and developmentally delayed (DD) combined; n = 753) using hierarchical Bayesian Kernel Machine Regression (BKMR) models with three groups: PM size fractions (PM0.1, PM0.1-2.5, PM2.5-10), NO2, and O3. RESULTS Pre-pregnancy Ozone was strongly negatively associated with all scores in the non-ASD group (group posterior inclusion probability (gPIP) = 0.83-1.00). The PM group during year 2 was also strongly negatively associated with all scores in the non-ASD group (gPIP = 0.59-0.93), with PM0.1 driving the group association (conditional PIP (cPIP) = 0.73-0.96). Weaker and less consistent associations were observed between PM0.1-2.5 during pre-pregnancy and ozone during year 1 and VABS scores in the ASD group. CONCLUSIONS These findings prompt further investigation into ozone and ultrafine PM as potential environmental risk factors for neurodevelopment.
Collapse
Affiliation(s)
- Amanda J Goodrich
- Department of Public Health Sciences, School of Medicine, University of California Davis, 128 Medical Sciences 1C, One Shields Ave, Sacramento, CA, USA.
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering, University of California Davis, Sacramento, CA, USA
| | - Daniel J Tancredi
- Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Yunin J Ludeña
- Department of Public Health Sciences, School of Medicine, University of California Davis, 128 Medical Sciences 1C, One Shields Ave, Sacramento, CA, USA; Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, School of Medicine, University of California Davis, 128 Medical Sciences 1C, One Shields Ave, Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California Davis, 128 Medical Sciences 1C, One Shields Ave, Sacramento, CA, USA; Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California Davis, 128 Medical Sciences 1C, One Shields Ave, Sacramento, CA, USA; Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| |
Collapse
|
3
|
Frazier TW, Whitehouse AJO, Leekam SR, Carrington SJ, Alvares GA, Evans DW, Hardan AY, Uljarević M. Reliability of the Commonly Used and Newly-Developed Autism Measures. J Autism Dev Disord 2024; 54:2158-2169. [PMID: 37017861 DOI: 10.1007/s10803-023-05967-y] [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] [Accepted: 03/11/2023] [Indexed: 04/06/2023]
Abstract
PURPOSE The aim of the present study was to compare scale and conditional reliability derived from item response theory analyses among the most commonly used, as well as several newly developed, observation, interview, and parent-report autism instruments. METHODS When available, data sets were combined to facilitate large sample evaluation. Scale reliability (internal consistency, average corrected item-total correlations, and model reliability) and conditional reliability estimates were computed for total scores and for measure subscales. RESULTS Generally good to excellent scale reliability was observed for total scores for all measures, scale reliability was weaker for RRB subscales of the ADOS and ADI-R, reflecting the relatively small number of items for these measures. For diagnostic measures, conditional reliability tended to be very good (> 0.80) in the regions of the latent trait where ASD and non-ASD developmental disability cases would be differentiated. For parent-report scales, conditional reliability of total scores tended to be excellent (> 0.90) across very wide ranges of autism symptom levels, with a few notable exceptions. CONCLUSIONS These findings support the use of all of the clinical observation, interview, and parent-report autism symptom measures examined, but also suggest specific limitations that warrant consideration when choosing measures for specific clinical or research applications.
Collapse
Affiliation(s)
- Thomas W Frazier
- Department of Psychology, John Carroll University, Cleveland, OH, USA.
- Departments of Pediatrics and Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.
| | | | - Susan R Leekam
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Sarah J Carrington
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - David W Evans
- Department of Psychology, Program in Neuroscience, Bucknell University, Lewisburg, PA, USA
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| |
Collapse
|
4
|
Wang X, Ling Z, Luo T, Zhou Q, Zhao G, Li B, Xia K, Li J. Severity of Autism Spectrum Disorder Symptoms Associated with de novo Variants and Pregnancy-Induced Hypertension. J Autism Dev Disord 2024; 54:749-764. [PMID: 36445517 DOI: 10.1007/s10803-022-05824-4] [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] [Accepted: 11/10/2022] [Indexed: 11/30/2022]
Abstract
Genetic factors, particularly, de novo variants (DNV), and an environment factor, exposure to pregnancy-induced hypertension (PIH), were reported to be associated with risk of autism spectrum disorder (ASD); however, how they jointly affect the severity of ASD symptom is unclear. We assessed the severity of core ASD symptoms affected by functional de novo variants or PIH. We selected phenotype data from Simon's Simplex Collection database, used genotypes from previous studies, and created linear regression models. We found that ASD patients carrying DNV with PIH exposure had increased adaptive and cognitive ability, decreased social problems, and enhanced repetitive behaviors; however, there was no difference in patients without DNV between those with or without PIH exposure. In addition, the DNV genes carried by patients exposed to PIH were enriched in ubiquitin-dependent proteolytic processes, highlighting how candidate genes in pathways and environments interact. The results indicate the joint contribution of DNV and PIH to ASD.
Collapse
Affiliation(s)
- Xiaomeng Wang
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
- Centre for Medical Genetics, Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, 41008, Hunan, China
| | - Zhengbao Ling
- Centre for Medical Genetics, Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, 41008, Hunan, China
| | - Tengfei Luo
- Centre for Medical Genetics, Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, 41008, Hunan, China
| | - Qiao Zhou
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
- Bioinformatics Center, National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guihu Zhao
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Bioinformatics Center, National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bin Li
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Bioinformatics Center, National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kun Xia
- Centre for Medical Genetics, Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, 41008, Hunan, China.
- University of South China, Hengyang, Hunan, China.
| | - Jinchen Li
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.
- Centre for Medical Genetics, Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, 41008, Hunan, China.
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- Bioinformatics Center, National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| |
Collapse
|
5
|
Akintunde ME, Lin YP, Krakowiak P, Pessah IN, Hertz-Picciotto I, Puschner B, Ashwood P, Van de Water J. Ex vivo exposure to polybrominated diphenyl ether (PBDE) selectively affects the immune response in autistic children. Brain Behav Immun Health 2023; 34:100697. [PMID: 38020477 PMCID: PMC10654005 DOI: 10.1016/j.bbih.2023.100697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Children on the autism spectrum have been shown to have immune dysregulation that often correlates with behavioral deficits. The role of the post-natal environment in this dysregulation is an area of active investigation. We examined the association between plasma levels of polybrominated diphenyl ether (PBDE) and immune cell function in age-matched autistic children and non-autistic controls. Plasma from children on the autism spectrum (n = 38) and typically developing controls (TD; n = 60) were analyzed for 14 major PBDE congeners. Cytokine/chemokine production was measured in peripheral blood mononuclear cell (PBMC) supernatants with and without ex vivo BDE-49 exposure. Total plasma concentration (∑PBDE14) and individual congener levels were also correlated with T cell function. ∑PBDE14 did not differ between diagnostic groups but correlated with reduced immune function in children on the autism spectrum. In autistic children, IL-2 and IFN-γ production was reduced in association with several individual BDE congeners, especially BDE-49 (p = 0.001). Furthermore, when PBMCs were exposed ex vivo to BDE-49, cells from autistic children produced elevated levels of IL-6, TNF-α, IL-1β, MIP-1α and MCP-1 (p < 0.05). Therefore, despite similar plasma levels of PBDE, these data suggest that PBMC function was differentially impacted in the context of several PBDE congeners in autistic children relative to TD children where increased body burden of PBDE significantly correlated with a suppressed immune response in autistic children but not TD controls. Further, acute ex vivo exposure of PBMCs to BDE-49 stimulates an elevated cytokine response in AU cases versus a depressed response in TD controls. These data suggest that exposure to the toxicant BDE-49 differentially impacts immune cell function in autistic children relative to TD children providing evidence for an underlying association between susceptibility to PBDE exposure and immune anomalies in children on the autism spectrum.
Collapse
Affiliation(s)
- Marjannie Eloi Akintunde
- School of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, United States
- NIEHS Center for Children's Environmental Health, University of California, Davis, United States
| | - Yan-ping Lin
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, United States
- The MIND Institute, University of California, Davis, United States
- NIEHS Center for Children's Environmental Health, University of California, Davis, United States
| | - Paula Krakowiak
- The MIND Institute, University of California, Davis, United States
- School of Public Health Sciences, University of California, Davis, United States
| | - Isaac N. Pessah
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, United States
- The MIND Institute, University of California, Davis, United States
- NIEHS Center for Children's Environmental Health, University of California, Davis, United States
| | - Irva Hertz-Picciotto
- The MIND Institute, University of California, Davis, United States
- School of Public Health Sciences, University of California, Davis, United States
| | - Birgit Puschner
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, United States
- NIEHS Center for Children's Environmental Health, University of California, Davis, United States
| | - Paul Ashwood
- The MIND Institute, University of California, Davis, United States
- NIEHS Center for Children's Environmental Health, University of California, Davis, United States
- School of Medicine, Department of Microbiology and Immunology, University of California, Davis, United States
| | - Judy Van de Water
- School of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, United States
- The MIND Institute, University of California, Davis, United States
- NIEHS Center for Children's Environmental Health, University of California, Davis, United States
| |
Collapse
|
6
|
Midya V, Alcala CS, Rechtman E, Gregory JK, Kannan K, Hertz-Picciotto I, Teitelbaum SL, Gennings C, Rosa MJ, Valvi D. Machine Learning Assisted Discovery of Interactions between Pesticides, Phthalates, Phenols, and Trace Elements in Child Neurodevelopment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:18139-18150. [PMID: 37595051 PMCID: PMC10666542 DOI: 10.1021/acs.est.3c00848] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
A growing body of literature suggests that developmental exposure to individual or mixtures of environmental chemicals (ECs) is associated with autism spectrum disorder (ASD). However, investigating the effect of interactions among these ECs can be challenging. We introduced a combination of the classical exposure-mixture Weighted Quantile Sum (WQS) regression and a machine-learning method termed Signed iterative Random Forest (SiRF) to discover synergistic interactions between ECs that are (1) associated with higher odds of ASD diagnosis, (2) mimic toxicological interactions, and (3) are present only in a subset of the sample whose chemical concentrations are higher than certain thresholds. In a case-control Childhood Autism Risks from Genetics and Environment (CHARGE) study, we evaluated multiordered synergistic interactions among 62 ECs measured in the urine samples of 479 children in association with increased odds for ASD diagnosis (yes vs no). WQS-SiRF identified two synergistic two-ordered interactions between (1) trace-element cadmium (Cd) and the organophosphate pesticide metabolite diethyl-phosphate (DEP); and (2) 2,4,6-trichlorophenol (TCP-246) and DEP. Both interactions were suggestively associated with increased odds of ASD diagnosis in the subset of children with urinary concentrations of Cd, DEP, and TCP-246 above the 75th percentile. This study demonstrates a novel method that combines the inferential power of WQS and the predictive accuracy of machine-learning algorithms to discover potentially biologically relevant chemical-chemical interactions associated with ASD.
Collapse
Affiliation(s)
- Vishal Midya
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Cecilia Sara Alcala
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Elza Rechtman
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Jill K. Gregory
- Instructional
Technology Group,Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Kurunthachalam Kannan
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Irva Hertz-Picciotto
- Department
of Public Health Sciences, School of Medicine, University of California at Davis, Davis, California 95616, United States
- UC
Davis MIND (Medical Investigations of Neurodevelopmental Disorders)
Institute, University of California at Davis, Sacramento, California 95817, United States
| | - Susan L. Teitelbaum
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Chris Gennings
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Maria J. Rosa
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Damaskini Valvi
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| |
Collapse
|
7
|
Frazier TW, Dimitropoulos A, Abbeduto L, Armstrong-Brine M, Kralovic S, Shih A, Hardan AY, Youngstrom EA, Uljarević M. The Autism Symptom Dimensions Questionnaire: Development and psychometric evaluation of a new, open-source measure of autism symptomatology. Dev Med Child Neurol 2023; 65:1081-1092. [PMID: 36628521 DOI: 10.1111/dmcn.15497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 01/12/2023]
Abstract
AIM To describe the development and initial psychometric evaluation of a new, freely available measure, the Autism Symptom Dimensions Questionnaire (ASDQ). METHOD After development and revision of an initial 33-item version, informants completed a revised 39-item version of the ASDQ on 1467 children and adolescents (aged 2-17 years), including 104 with autism spectrum disorder (ASD). RESULTS The initial 33-item version of the ASDQ had good reliability and construct validity. However, only four specific symptom factors were identified, potentially due to an insufficient number of items. Factor analyses of the expanded instrument identified a general ASD factor and nine specific symptom factors with good measurement invariance across demographic groups. Scales showed good-to-excellent overall and conditional reliability. Exploratory analyses of predictive validity for ASD versus neurotypical and other developmental disability diagnoses indicated good accuracy for population and at-risk contexts. INTERPRETATION The ASDQ is a free and psychometrically sound informant report instrument with good reliability of measurement across a continuous range of scores and preliminary evidence of predictive validity. The measure may be a useful alternative to existing autism symptom measures but further studies with comparison of clinical diagnoses using criterion-standard instruments are needed. WHAT THIS PAPER ADDS The Autism Symptom Dimensions Questionnaire (ASDQ) is a new, freely available measure of autism symptoms. The ASDQ showed reliable and accurate measurement of autism symptoms. The measure had good screening efficiency for autism spectrum disorder relative to other developmental conditions.
Collapse
Affiliation(s)
- Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights, OH, USA
- Autism Speaks, Princeton, NJ, USA
| | | | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, Davis, CA, USA
| | | | - Shanna Kralovic
- Division of Developmental Behavioral Pediatrics and Psychology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | | | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
- Helping Give Away Psychological Science, Chapel Hill, NC, USA
| | - Mirko Uljarević
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Victoria, Australia
| |
Collapse
|
8
|
Frazier TW, Chetcuti L, Al‐Shaban FA, Haslam N, Ghazal I, Klingemier EW, Aldosari M, Whitehouse AJO, Youngstrom EA, Hardan AY, Uljarević M. Categorical versus dimensional structure of autism spectrum disorder: A multi-method investigation. JCPP ADVANCES 2023; 3:e12142. [PMID: 37753161 PMCID: PMC10519739 DOI: 10.1002/jcv2.12142] [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: 09/06/2022] [Accepted: 01/08/2023] [Indexed: 02/23/2023] Open
Abstract
Background A key question for any psychopathological diagnosis is whether the condition is continuous or discontinuous with typical variation. The primary objective of this study was to use a multi-method approach to examine the broad latent categorical versus dimensional structure of autism spectrum disorder (ASD). Method Data were aggregated across seven independent samples of participants with ASD, other neurodevelopmental disorders (NDD), and non-ASD/NDD controls (aggregate Ns = 512-16,755; ages 1.5-22). Scores from four distinct phenotype measures formed composite "indicators" of the latent ASD construct. The primary indicator set included eye gaze metrics from seven distinct social stimulus paradigms. Logistic regressions were used to combine gaze metrics within/across paradigms, and derived predicted probabilities served as indicator values. Secondary indicator sets were constructed from clinical observation and parent-report measures of ASD symptoms. Indicator sets were submitted to taxometric- and latent class analyses. Results Across all indicator sets and analytic methods, there was strong support for categorical structure corresponding closely to ASD diagnosis. Consistent with notions of substantial phenotypic heterogeneity, the ASD category had a wide range of symptom severity. Despite the examination of a large sample with a wide range of IQs in both genders, males and children with lower IQ were over-represented in the ASD category, similar to observations in diagnosed cases. Conclusions Our findings provide strong support for categorical structure corresponding closely to ASD diagnosis. The present results bolster the use of well-diagnosed and representative ASD groups within etiologic and clinical research, motivating the ongoing search for major drivers of the ASD phenotype. Despite the categorical structure of ASD, quantitative symptom measurements appear more useful for examining relationships with other factors.
Collapse
Affiliation(s)
- Thomas W. Frazier
- Department of PsychologyJohn Carroll UniversityUniversity HeightsOhioUSA
| | - Lacey Chetcuti
- Olga Tennison Autism Research CentreSchool of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Fouad A. Al‐Shaban
- Neurological Disorders Research CenterQatar Biomedical Research InstituteHamad Bin Khalifa UniversityDohaQatar
| | - Nick Haslam
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Iman Ghazal
- Neurological Disorders Research CenterQatar Biomedical Research InstituteHamad Bin Khalifa UniversityDohaQatar
| | | | | | | | - Eric A. Youngstrom
- Department of Psychology and NeuroscienceUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral SciencesStanford UniversityStanfordCaliforniaUSA
| | - Mirko Uljarević
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| |
Collapse
|
9
|
Gipson TT, Oller DK, Messinger DS, Perry LK. Understanding speech and language in tuberous sclerosis complex. Front Hum Neurosci 2023; 17:1149071. [PMID: 37323931 PMCID: PMC10267356 DOI: 10.3389/fnhum.2023.1149071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Tuberous Sclerosis Complex (TSC), is a neurocutaneous disorder, associated with a high prevalence of autism spectrum disorder (ASD; ∼50% of individuals). As TSC is a leading cause of syndromic ASD, understanding language development in this population would not only be important for individuals with TSC but may also have implications for those with other causes of syndromic and idiopathic ASD. In this mini review, we consider what is known about language development in this population and how speech and language in TSC are related to ASD. Although up to 70% of individuals with TSC report language difficulties, much of the limited research to date on language in TSC has been based on summary scores from standardized assessments. Missing is a detailed understanding of the mechanisms driving speech and language in TSC and how they relate to ASD. Here, we review recent work suggesting that canonical babbling and volubility-two precursors of language development that predict the emergence of speech and are delayed in infants with idiopathic ASD-are also delayed in infants with TSC. We then look to the broader literature on language development to identify other early precursors of language development that tend to be delayed in children with autism as a guide for future research on speech and language in TSC. We argue that vocal turn-taking, shared attention, and fast mapping are three such skills that can provide important information about how speech and language develop in TSC and where potential delays come from. The overall goal of this line of research is to not only illuminate the trajectory of language in TSC with and without ASD, but to ultimately find strategies for earlier recognition and treatment of the pervasive language difficulties in this population.
Collapse
Affiliation(s)
- Tanjala T Gipson
- Department of Pediatrics, Le Bonheur Children's Hospital, The Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, TN, United States
| | - D Kimbrough Oller
- School of Communication Sciences and Disorders, Institute for Intelligent Systems, The University of Memphis, Memphis, TN, United States
| | - Daniel S Messinger
- Department of Psychology, University of Miami, Miami, FL, United States
- Department of Pediatrics, University of Miami, Miami, FL, United States
- Department of Electrical and Computer Engineering, University of Miami, Miami, FL, United States
- Department of Music Engineering, University of Miami, Miami, FL, United States
| | - Lynn K Perry
- Department of Psychology, University of Miami, Miami, FL, United States
| |
Collapse
|
10
|
Oh J, Shin HM, Kannan K, Busgang SA, Schmidt RJ, Schweitzer JB, Hertz-Picciotto I, Bennett DH. Childhood exposure to per- and polyfluoroalkyl substances and neurodevelopment in the CHARGE case-control study. ENVIRONMENTAL RESEARCH 2022; 215:114322. [PMID: 36108719 PMCID: PMC9976729 DOI: 10.1016/j.envres.2022.114322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are shown to have neurotoxic effects on animals, but epidemiological evidence for associations between childhood PFAS exposure and neurodevelopment is inconclusive. We examined if childhood PFAS concentrations are associated with a diagnosis of autism spectrum disorder (ASD), developmental delay (DD), and other early concerns (OEC) in development. METHODS We included 551 children 2-5 years old from the CHildhood Autism Risks from Genetics and Environment (CHARGE) case-control study. Children were clinically diagnosed and classified as having ASD, DD, OEC, and typical development (TD). Fourteen PFAS were quantified in child serum samples collected when diagnostic assessments were performed. We used multinomial logistic regression models to investigate the cross-sectional associations of individual PFAS concentrations with neurodevelopmental outcomes and weighted quantile sum (WQS) regression models with repeated holdout validation to investigate the associations with PFAS mixtures. RESULTS Childhood perfluorooctanoic acid (PFOA) was associated with increased odds of ASD (odds ratio [OR] per ln ng/mL increase: 1.99, 95% confidence interval [CI]: 1.20, 3.29) and DD (OR: 2.16, 95% CI: 1.21, 3.84) versus TD. Perfluoroheptanoic acid (PFHpA) was associated with increased odds of ASD (OR: 1.61, 95% CI: 1.21, 2.13). However, perfluroundecanoic acid (PFUnDA) was associated with decreased odds of ASD (OR: 0.43, 95% CI: 0.26, 0.69). From mixture analyses, the WQS index was associated with increased odds of ASD (average OR: 1.57, 5th and 95th percentile: 1.16, 2.13). Child's sex and homeownership modified associations of perfluorodecanoic acid (PFDA) with DD and ASD, respectively. CONCLUSIONS In this case-control study, childhood PFOA, PFHpA, and a PFAS mixture was associated with increased odds of ASD, while PFUnDA was associated with decreased odds of ASD. Because we used concurrent measurements of PFAS, our results do not imply causal relationships and thus need to be interpreted with caution.
Collapse
Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA.
| | - Hyeong-Moo Shin
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA; Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Stefanie A Busgang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Julie B Schweitzer
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California at Davis (UC Davis), Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
| |
Collapse
|
11
|
GABA Receptor SNPs and Elevated Plasma GABA Levels Affect the Severity of the Indian ASD Probands. J Mol Neurosci 2022; 72:1300-1312. [PMID: 35562522 DOI: 10.1007/s12031-022-02023-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/01/2022] [Indexed: 10/18/2022]
Abstract
Altered signaling of the chief inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), has been speculated in the etiology of autism spectrum disorder (ASD). We have investigated the association of six GABAA-receptor genetic variants and plasma GABA levels with ASD. Subjects were recruited based on the DSM, and CARS2-ST and ADI-R assessed disease severity. Peripheral blood was collected from the ASD probands (N = 251), their parents, and ethnically matched controls (N = 347). A positive correlation between the CARS2-ST and ADI-R scores was observed; domain scores of ADI-R were higher in the severe group categorized by the CARS2-ST. GABRB3 rs1432007 "A," GABRG3 rs897173 "A," and GABRA5 rs140682 "T" showed significant association with ASD. Trait scores were influenced by rs1432007 "AA" and rs140682 "TT." GABA level was significantly higher in the probands than the age-matched controls. Our findings indicate an influence of GABA in the etiology of ASD in the Indian probands.
Collapse
|
12
|
An evaluation of the diagnostic validity of the structured questionnaires of the adult Asperger's Assessment. J Autism Dev Disord 2022:10.1007/s10803-022-05544-9. [PMID: 35441251 DOI: 10.1007/s10803-022-05544-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
The Adult Autism Quotient (AQ), the Empathy Quotient (EQ) and the Relative's Questionnaire (RQ) were used as part of the Adult Asperger's Assessment (AAA) by a diagnostic service for adults without an intellectual disability with suspected autism spectrum disorder (ASD). This service is part of the National Health Service (NHS) in England. Little is known about the utility of these structured questionnaires despite wide use in clinical practice. It was investigated whether the questionnaires could discriminate between individuals with and without a diagnosis of ASD. Receiver Operating Curve analysis showed good levels of sensitivity to detect a positive diagnosis, but the specificity to exclude those without a diagnosis was poor. A binary logistic regression showed that a combination of the questionnaires also showed limited diagnostic validity. These findings have clinical implications in reviewing the efficiency of the assessment process.
Collapse
|
13
|
Bennett DH, Busgang SA, Kannan K, Parsons PJ, Takazawa M, Palmer CD, Schmidt RJ, Doucette JT, Schweitzer JB, Gennings C, Hertz-Picciotto I. Environmental exposures to pesticides, phthalates, phenols and trace elements are associated with neurodevelopment in the CHARGE study. ENVIRONMENT INTERNATIONAL 2022; 161:107075. [PMID: 35085933 PMCID: PMC9317896 DOI: 10.1016/j.envint.2021.107075] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/21/2021] [Accepted: 12/31/2021] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To determine if higher exposures measured in early childhood to environmental phenols, phthalates, pesticides, and/or trace elements, are associated with increased odds of having a diagnosis of Autism Spectrum Disorder (ASD), Developmental Delay (DD), or Other Early Concerns (OEC) compared to typically developing children (TD). METHODS This study included 627 children between the ages of 2-5 who participated in the Childhood Autism Risks from Genetics and Environment (CHARGE) study. Urine samples were collected at the same study visit where diagnostic assessments to confirm diagnosis indicated during the recruitment process were performed. Adjusted multinomial regression models of each chemical with diagnosis as the outcome were conducted. Additionally, two methods were used to analyze mixtures: repeated holdout multinomial weighted quantile sum (WQS) regression for each chemical class; and a total urinary mixture effect was assessed with repeated holdout random subset WQS. RESULTS Many urinary chemicals were associated with increased odds of ASD, DD or OEC compared to TD; however, most did not remain significant after false discovery rate adjustment. Repeated holdout WQS indices provided evidence for associations of both a phenol/paraben mixture effect and a trace element mixture effect on DD independently. In analyses adjusted for confounders and other exposures, results suggested an association of a pesticide mixture effect with increased risk for ASD. Results also suggested associations of a total urinary mixture with greater odds of both ASD and DD separately. CONCLUSION Higher concentrations of urinary biomarkers were associated with ASD, DD, and OEC compared to TD, with consistency of the results comparing single chemical analyses and mixture analyses. Given that the biospecimens used for chemical analysis were generally collected many months after diagnoses were made, the direction of any causal association is unknown. Hence findings may reflect higher exposures among children with non-typical development than TD children due to differences in behaviors, metabolism, or toxicokinetics.
Collapse
Affiliation(s)
- Deborah H Bennett
- Department of Public Health Sciences, School of Medicine, University of California at Davis (UC Davis), Davis, CA, USA.
| | - Stefanie A Busgang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA; Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Patrick J Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Mari Takazawa
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Christopher D Palmer
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California at Davis (UC Davis), Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Sacramento, CA, USA
| | - John T Doucette
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie B Schweitzer
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Sacramento, CA, USA; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California at Davis (UC Davis), Sacramento, CA, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California at Davis (UC Davis), Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Sacramento, CA, USA
| |
Collapse
|
14
|
Increased Monocyte Production of IL-6 after Toll-like Receptor Activation in Children with Autism Spectrum Disorder (ASD) Is Associated with Repetitive and Restricted Behaviors. Brain Sci 2022; 12:brainsci12020220. [PMID: 35203983 PMCID: PMC8870658 DOI: 10.3390/brainsci12020220] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 01/27/2023] Open
Abstract
The prevalence of autism spectrum disorder (ASD) has starkly increased, instigating research into risk factors for ASD. This research has identified immune risk factors for ASD, along with evidence of immune dysfunction and excess inflammation frequently experienced by autistic individuals. Increased innate inflammatory cytokines, including interleukin (IL)-6, are seen repeatedly in ASD; however, the origin of excess IL-6 in ASD has not been identified. Here we explore specific responses of circulating monocytes from autistic children. We isolated CD14+ monocytes from whole blood and stimulated them for 24 h under three conditions: media alone, lipoteichoic acid to activate TLR2, and lipopolysaccharide to activate TLR4. We then measured secreted cytokine concentrations in cellular supernatant using a human multiplex bead immunoassay. We found that after TLR4 activation, CD14+ monocytes from autistic children produce increased IL-6 compared to monocytes from children with typical development. IL-6 concentration also correlated with worsening restrictive and repetitive behaviors. These findings suggest dysfunctional activation of myeloid cells, and may indicate that other cells of this lineage, including macrophages, and microglia in the brain, might have a similar dysfunction. Further research on myeloid cells in ASD is warranted.
Collapse
|
15
|
Peristeri E, Silleresi S, Tsimpli IM. Bilingualism effects on cognition in autistic children are not all-or-nothing: The role of socioeconomic status in intellectual skills in bilingual autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2084-2097. [PMID: 35102760 DOI: 10.1177/13623613221075097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Previous research has suggested that bilingualism may improve cognition in children with autism, and that this boost may stem from improvement in executive functions. The Wechsler Intelligence Scales for Children are considered to be reliable and valid measures of intelligence when administered to autistic children. These measures have so far revealed unusual psychometric properties in monolingual autistic children, notably distinctive patterns of strengths and weaknesses and low inter-correlation among verbal and nonverbal IQ subtests. The way bilingualism affects the intellectual functioning of autistic children has not been explored yet. Nor has there been a satisfactory factor structure that explains monolingual and bilingual autistic children's IQ performance in terms of individual factors, such as age and socioeconomic status. The current study examined the intelligence profiles of 316 bilingual and age- and gender-matched monolingual children with autism using the Wechsler Intelligence Scales for Children-Third Edition. The study applied clustering models to extract intelligence subtypes of autism, and mediation analyses to examine potential mediation effects of age and socioeconomic status on the children's verbal and nonverbal IQ performance. The results support the mediational role of the children's socioeconomic status in the association between bilingualism and intelligence. Low-socioeconomic status bilingual autistic children outperformed their monolingual peers on both verbal and nonverbal subtests, while the differences faded in medium-socioeconomic status and high-socioeconomic status children. The findings emphasize the positive effects of bilingualism on low-socioeconomic status autistic children's intelligence and also highlight high-socioeconomic status as a factor that may mitigate discrepant patterns of strengths and weaknesses in monolingual children's IQ performance.
Collapse
|
16
|
Hughes HK, Rowland ME, Onore CE, Rogers S, Ciernia AV, Ashwood P. Dysregulated gene expression associated with inflammatory and translation pathways in activated monocytes from children with autism spectrum disorder. Transl Psychiatry 2022; 12:39. [PMID: 35082275 PMCID: PMC8791942 DOI: 10.1038/s41398-021-01766-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 01/26/2023] Open
Abstract
Autism spectrum disorder (ASD) is a complex developmental disorder characterized by deficits in social interactions, communication, and stereotypical behaviors. Immune dysfunction is a common co-morbidity seen in ASD, with innate immune activation seen both in the brain and periphery. We previously identified significant differences in peripheral monocyte cytokine responses after stimulation with lipoteichoic acid (LTA) and lipopolysaccharide (LPS), which activate toll-like receptors (TLR)-2 and 4 respectively. However, an unbiased examination of monocyte gene expression in response to these stimulants had not yet been performed. To identify how TLR activation impacts gene expression in ASD monocytes, we isolated peripheral blood monocytes from 26 children diagnosed with autistic disorder (AD) or pervasive developmental disorder-not otherwise specified (PDDNOS) and 22 typically developing (TD) children and cultured them with LTA or LPS for 24 h, then performed RNA sequencing. Activation of both TLR2 and TLR4 induced expression of immune genes, with a subset that were differentially regulated in AD compared to TD samples. In response to LPS, monocytes from AD children showed a unique increase in KEGG pathways and GO terms that include key immune regulator genes. In contrast, monocytes from TD children showed a consistent decrease in expression of genes associated with translation in response to TLR stimulation. This decrease was not observed in AD or PDDNOS monocytes, suggesting a failure to properly downregulate a prolonged immune response in monocytes from children with ASD. As monocytes are involved in early orchestration of the immune response, our findings will help elucidate the mechanisms regulating immune dysfunction in ASD.
Collapse
Affiliation(s)
- Heather K Hughes
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, USA
- M.I.N.D. Institute, University of California, Davis, CA, USA
| | - Megan E Rowland
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Charity E Onore
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, USA
- M.I.N.D. Institute, University of California, Davis, CA, USA
| | - Sally Rogers
- M.I.N.D. Institute, University of California, Davis, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Annie Vogel Ciernia
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, USA.
- M.I.N.D. Institute, University of California, Davis, CA, USA.
| |
Collapse
|
17
|
Barbier A, Chen JH, Huizinga JD. Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory. Front Psychiatry 2022; 13:830234. [PMID: 35370829 PMCID: PMC8964964 DOI: 10.3389/fpsyt.2022.830234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
The quest to understand the pathophysiology of autism spectrum disorder (ASD) has led to extensive literature that purports to provide evidence for autonomic dysfunction based on heart rate and heart rate variability (HRV), in particular respiratory sinus arrhythmia (RSA), a measure of parasympathetic functioning. Many studies conclude that autism is associated with vagal withdrawal and sympathetic hyperactivation based on HRV and electrodermal analyses. We will argue that a critical analysis of the data leads to the hypothesis that autonomic nervous system dysfunction is not a dominant feature of autism. Most children with ASD have normal parasympathetic baseline values and normal autonomic responses to social stimuli. The existing HRV and electrodermal data cannot lead to the conclusion of an over-excitation of the sympathetic nervous system. A small subgroup of ASD children in experimental settings has relatively low RSA values and relatively high heart rates. The data suggest that this is likely associated with a relatively high level of anxiety during study conditions, associated with co-morbidities such as constipation, or due to the use of psychoactive medication. Many studies interpret their data to conform with a preferred hypothesis of autonomic dysfunction as a trait of autism, related to the polyvagal theory, but the HRV evidence is to the contrary. HRV analysis may identify children with ASD having autonomic dysfunction due to co-morbidities.
Collapse
Affiliation(s)
- Ashley Barbier
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ji-Hong Chen
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jan D Huizinga
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
18
|
Gipson TT, Ramsay G, Ellison EE, Bene E, Long HL, Oller DK. Early Vocal Development in Tuberous Sclerosis Complex. Pediatr Neurol 2021; 125:48-52. [PMID: 34628143 PMCID: PMC8557126 DOI: 10.1016/j.pediatrneurol.2021.08.009] [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: 12/22/2020] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Our goal was to assess for the first time early vocalizations as precursors to speech in audio-video recordings of infants with tuberous sclerosis complex (TSC). METHODS We randomly selected 40 infants with TSC from the TSC Autism Center of Excellence Research Network dataset. Using human observers, we analyzed 74 audio-video recordings within a flexible software-based coding environment. During the recordings, infants were engaged in developmental testing. We determined syllables per minute (volubility), the number of consonant-vowel combinations, such as 'ba' (canonical babbling), and the canonical babbling ratio (canonical syllables/total syllables) and compared the data with two groups of typically developing (TD) infants. One comparison group's data had come from a laboratory setting, while the other's had come from all-day Language Environment Analysis recordings at home. RESULTS Compared with TD infants in laboratory and all-day Language Environment Analysis recordings, entry into the canonical babbling stage was delayed in the majority of infants with TSC, and the canonical babbling ratio was low (TD mean = 0.346, SE = 0.19; TSC mean = 0.117, SE = 0.023). Volubility level in infants with TSC was less than half that of TD infants (TD mean = 9.82, SE = 5.78; TSC mean = 3.99, SE = 2.16). CONCLUSIONS Entry into the canonical stage and other precursors of speech development were delayed in infants with TSC and may signal poor language and developmental outcomes. Future studies are planned to assess prediction of language and developmental outcomes using these measures in a larger sample and in more precisely comparable recording circumstances.
Collapse
Affiliation(s)
- Tanjala T. Gipson
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children’s Hospital, 50 N. Dunlap St., Memphis, TN 38105
| | - Gordon Ramsay
- Department of Pediatrics, Emory University School of Medicine Atlanta GA, & Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta GA
| | - Ellen E. Ellison
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children’s Hospital, Memphis, TN
| | - Edina Bene
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN
| | - Helen L. Long
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN
| | - D. Kimbrough Oller
- University of Memphis, School of Communication Sciences and Disorders, Institute for Intelligent Systems, Memphis, TN,Konrad Lorenz Institute for Evolution and Cognition Research, Klosterneuburg, Austria
| |
Collapse
|
19
|
Gipson TT, Ramsay G, Ellison EE, Bene ER, Long HL, Oller DK. Early Vocal Development in Tuberous Sclerosis Complex. Pediatr Neurol 2021; 125:48-52. [PMID: 34628143 DOI: 10.1101/2021.01.06.21249364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Our goal was to assess for the first time early vocalizations as precursors to speech in audio-video recordings of infants with tuberous sclerosis complex (TSC). METHODS We randomly selected 40 infants with TSC from the TSC Autism Center of Excellence Research Network dataset. Using human observers, we analyzed 74 audio-video recordings within a flexible software-based coding environment. During the recordings, infants were engaged in developmental testing. We determined syllables per minute (volubility), the number of consonant-vowel combinations, such as 'ba' (canonical babbling), and the canonical babbling ratio (canonical syllables/total syllables) and compared the data with two groups of typically developing (TD) infants. One comparison group's data had come from a laboratory setting, while the other's had come from all-day Language Environment Analysis recordings at home. RESULTS Compared with TD infants in laboratory and all-day Language Environment Analysis recordings, entry into the canonical babbling stage was delayed in the majority of infants with TSC, and the canonical babbling ratio was low (TD mean = 0.346, SE = 0.19; TSC mean = 0.117, SE = 0.023). Volubility level in infants with TSC was less than half that of TD infants (TD mean = 9.82, SE = 5.78; TSC mean = 3.99, SE = 2.16). CONCLUSIONS Entry into the canonical stage and other precursors of speech development were delayed in infants with TSC and may signal poor language and developmental outcomes. Future studies are planned to assess prediction of language and developmental outcomes using these measures in a larger sample and in more precisely comparable recording circumstances.
Collapse
Affiliation(s)
- Tanjala T Gipson
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children's Hospital, Memphis, Tennessee.
| | - Gordon Ramsay
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Ellen E Ellison
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Edina R Bene
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Helen L Long
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - D Kimbrough Oller
- University of Memphis, School of Communication Sciences and Disorders, Institute for Intelligent Systems, Memphis, Tennessee; Konrad Lorenz Institute for Evolution and Cognition Research, Klosterneuburg, Austria
| |
Collapse
|
20
|
Williams ZJ, Suzman E, Woynaroski TG. Prevalence of Decreased Sound Tolerance (Hyperacusis) in Individuals With Autism Spectrum Disorder: A Meta-Analysis. Ear Hear 2021; 42:1137-1150. [PMID: 33577214 PMCID: PMC8349927 DOI: 10.1097/aud.0000000000001005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Hyperacusis, defined as decreased tolerance to sound at levels that would not trouble most individuals, is frequently observed in individuals with autism spectrum disorder (ASD). Despite the functional impairment attributable to hyperacusis, little is known about its prevalence or natural history in the ASD population. The objective of this study was to conduct a systematic review and meta-analysis estimating the current and lifetime prevalence of hyperacusis in children, adolescents, and adults with ASD. By precisely estimating the burden of hyperacusis in the ASD population, the present study aims to enhance recognition of this particular symptom of ASD and highlight the need for additional research into the causes, prevention, and treatment of hyperacusis in persons on the spectrum. DESIGN We searched PubMed and ProQuest to identify peer-reviewed articles published in English after January 1993. We additionally performed targeted searches of Google Scholar and the gray literature, including studies published through May 2020. Eligible studies included at least 20 individuals with diagnosed ASD of any age and reported data from which the proportion of ASD individuals with current and/or lifetime hyperacusis could be derived. To account for multiple prevalence estimates derived from the same samples, we utilized three-level Bayesian random-effects meta-analyses to estimate the current and lifetime prevalence of hyperacusis. Bayesian meta-regression was used to assess potential moderators of current hyperacusis prevalence. To reduce heterogeneity due to varying definitions of hyperacusis, we performed a sensitivity analysis on the subset of studies that ascertained hyperacusis status using the Autism Diagnostic Interview-Revised (ADI-R), a structured parent interview. RESULTS A total of 7783 nonduplicate articles were screened, of which 67 were included in the review and synthesis. Hyperacusis status was ascertained in multiple ways across studies, with 60 articles employing interviews or questionnaires and seven using behavioral observations or objective measures. The mean (range) age of samples in the included studies was 7.88 years (1.00 to 34.89 years). The meta-analysis of interview/questionnaire measures (k(3) = 103, nASD = 13,093) estimated the current and lifetime prevalence of hyperacusis in ASD to be 41.42% (95% CrI, 37.23 to 45.84%) and 60.58% (50.37 to 69.76%), respectively. A sensitivity analysis restricted to prevalence estimates derived from the ADI-R (k(3) = 25, nASD = 5028) produced similar values. The estimate of current hyperacusis prevalence using objective/observational measures (k(3) = 8, nASD = 488) was 27.30% (14.92 to 46.31%). Heterogeneity in the full sample of interview/questionnaire measures was substantial but not significantly explained by any tested moderator. However, prevalence increased sharply with increasing age in studies using the ADI-R (BF10 = 93.10, R2Het = 0.692). CONCLUSIONS In this meta-analysis, we found a high prevalence of current and lifetime hyperacusis in individuals with ASD, with a majority of individuals on the autism spectrum experiencing hyperacusis at some point in their lives. The high prevalence of hyperacusis in individuals with ASD across the lifespan highlights the need for further research on sound tolerance in this population and the development of services and/or interventions to reduce the burden of this common symptom.
Collapse
Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
| | - Evan Suzman
- Graduate Program in Biomedical Sciences, Vanderbilt University, Nashville, TN
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
21
|
Lai PT, Ng R, Bellugi U. Parents' perspective on the social traits observed in school-age children with autism and children with Williams syndrome. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 8:174-184. [PMID: 38868455 PMCID: PMC11168778 DOI: 10.1080/23297018.2021.1934893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 06/14/2024]
Abstract
Individuals with autism spectrum disorders and those with Williams syndrome often have impairments in social behaviors. These two neurodevelopmental disorders are often reputed to be on the opposite ends of the social spectrum, with autistic individuals being socially avoidant and those with Williams syndrome highly social. Most research on children with autism and Williams syndrome has focused on preschool and younger school-age children. The current study assessed school-age children between the ages of 7-14 years with high-functioning autism, Williams syndrome, and neurotypical developing peers. Parents completed the Salk Institute Sociability Questionnaire and the Social Responsiveness Scale, to provide unique insights into social functioning and tap into different behavioral areas, social approach behaviors, and social responsiveness. This study provides additional evidence that young children with autism and Williams syndrome continue to show divergent social-behavioral tendencies at school-age, despite controlling for age and intellect. Results of this study better elucidate disparities as well as commonalities across school-age children with neurodevelopmental disorders and their typically developing peers, providing insight into everyday social functioning.
Collapse
Affiliation(s)
- Philip T. Lai
- Language and Communicative Disorders, San Diego State University, San Diego, CA, USA
- Language and Communicative Disorders, University of California San Diego, San Diego, CA, USA
- Laboratory for Cognitive Neuroscience, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Rowena Ng
- Laboratory for Cognitive Neuroscience, Salk Institute for Biological Studies, La Jolla, CA, USA
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Ursula Bellugi
- Laboratory for Cognitive Neuroscience, Salk Institute for Biological Studies, La Jolla, CA, USA
| |
Collapse
|
22
|
Vuijk R, Deen M, Arntz A, Geurts HM. First Psychometric Properties of the Dutch Interview for Diagnostic Assessment of Autism Spectrum Disorder in Adult Males Without Intellectual Disability. J Autism Dev Disord 2021; 52:3523-3535. [PMID: 34409554 DOI: 10.1007/s10803-021-05225-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 12/28/2022]
Abstract
For autism spectrum disorder (ASD) in adults there are several diagnostic instruments available with a need for consideration of the psychometric properties. This study aimed to conduct a first psychometric evaluation of a new diagnostic ASD instrument, the NIDA (Dutch Interview for Diagnostic assessment of ASD in adults) in 90 adult males without intellectual disability (age 18-65 years) in the Netherlands: 30 with ASD, 30 with a Personality Disorder and 30 nonpatient controls. The interrater agreement ranged from 0.79 to 1.00, the convergent validity including sensitivity and specificity ranged from 0.76 to 1.00, and we observed an adequate concurrent criterion-related validity. These promising findings can serve as foundation for future psychometric NIDA studies in a more diverse population. TRIAL REGISTRATION: The Netherlands National Trial Register NTR6391. Registered 04 May 2017.
Collapse
Affiliation(s)
- Richard Vuijk
- Sarr Autism Rotterdam (Parnassia Psychiatric Institute), Dynamostraat 18, 3083 AK, Rotterdam, The Netherlands.
| | - Mathijs Deen
- Parnassia Psychiatric Institute, Kiwistraat 32, 2552 DH, The Hague, The Netherlands.,Institute of Psychology, Methodology and Statistics Unit, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Arnoud Arntz
- University of Amsterdam, Postbus 15933, 1001 NK, Amsterdam, The Netherlands
| | - Hilde M Geurts
- University of Amsterdam, Postbus 15933, 1001 NK, Amsterdam, The Netherlands.,Dr. Leo Kanner Huis, Youz, Parnassia Psychiatric Institute, Derkinderenstraat 10-18, 1062 DB, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Fetit R, Hillary RF, Price DJ, Lawrie SM. The neuropathology of autism: A systematic review of post-mortem studies of autism and related disorders. Neurosci Biobehav Rev 2021; 129:35-62. [PMID: 34273379 DOI: 10.1016/j.neubiorev.2021.07.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/13/2021] [Accepted: 07/10/2021] [Indexed: 02/07/2023]
Abstract
Post-mortem studies allow for the direct investigation of brain tissue in those with autism and related disorders. Several review articles have focused on aspects of post-mortem abnormalities but none has brought together the entire post-mortem literature. Here, we systematically review the evidence from post-mortem studies of autism, and of related disorders that present with autistic features. The literature consists of a small body of studies with small sample sizes, but several remarkably consistent findings are evident. Cortical layering is largely undisturbed, but there are consistent reductions in minicolumn numbers and aberrant myelination. Transcriptomics repeatedly implicate abberant synaptic, metabolic, proliferation, apoptosis and immune pathways. Sufficient replicated evidence is available to implicate non-coding RNA, aberrant epigenetic profiles, GABAergic, glutamatergic and glial dysfunction in autism pathogenesis. Overall, the cerebellum and frontal cortex are most consistently implicated, sometimes revealing distinct region-specific alterations. The literature on related disorders such as Rett syndrome, Fragile X and copy number variations (CNVs) predisposing to autism is particularly small and inconclusive. Larger studies, matched for gender, developmental stage, co-morbidities and drug treatment are required.
Collapse
Affiliation(s)
- Rana Fetit
- Simons Initiative for the Developing Brain, University of Edinburgh, Hugh Robson Building, George Square, Edinburgh, EH8 9XD, UK.
| | - Robert F Hillary
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - David J Price
- Simons Initiative for the Developing Brain, University of Edinburgh, Hugh Robson Building, George Square, Edinburgh, EH8 9XD, UK
| | - Stephen M Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH10 5HF, UK; Patrick Wild Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH10 5HF, UK
| |
Collapse
|
24
|
Yin Y, Xu S, Li C, Li M, Liu M, Yan J, Lan Z, Zhan W, Jiang G, Tian J. Association of Reduced Tract Integrity with Social Communication Deficits in Preschool Autism Children: A Tract-Based Spatial Statistics Study. Neuropsychiatr Dis Treat 2021; 17:2003-2010. [PMID: 34168457 PMCID: PMC8219119 DOI: 10.2147/ndt.s306596] [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: 02/14/2021] [Accepted: 05/17/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To analyze the changes in white matter tracts in preschool children with autism spectrum disorder (ASD), and the correlation between these changes and social communication deficits. METHODS Diffuse tensor imaging was used to assess white matter integrity using tract-based spatial statistics in a sample of 50 right-handed children with ASD aged 2-6 years vis a reference sample of 46 typically developing children aged 2-6 years. We then correlated these significant different fiber tracts between groups with communication and social interaction scores using the Autism Diagnostic Interview-Revised Assessment (ADI-R) Scale. RESULTS We observed decreased fractional anisotropy (FA) in tracts including the left superior longitudinal fasciculus (SLF), the splenium of the corpus callosum (splCC), the left corticospinal tracts, and the left inferior longitudinal fasciculus (ILF) in children with ASD. Specifically, there was reduced white matter integrity of these tracts in the left cerebral hemisphere. In addition, we found that the decreased FA of left SLF and ILF was negatively associated with the ADI-R scores in children with ASD. CONCLUSION The structural integrity of some white matter tracts in the five-level anatomical model for the social communication was reduced. The reduced integrity white matter that we observed primarily in the left cerebral hemisphere may be a neural substrate of social communication deficits in preschool children with ASD, and we speculate that the reduction is associated with the severity of social interaction. The reduced FA of the splCC might be a substantial biomarker for children with ASD.
Collapse
Affiliation(s)
- Yi Yin
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Shoujun Xu
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Chao Li
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Meng Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Mengchen Liu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Jianhao Yan
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Zhihong Lan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Wenfeng Zhan
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guihua Jiang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Junzhang Tian
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| |
Collapse
|
25
|
Abstract
Purpose The purpose of this study is to investigate the social and affective aspects of communication in school-age children with HFA and school-age children with WS using a micro-analytic approach. Social communication is important for success at home, school, work and in the community. Lacking the ability to effectively process and convey information can lead to deficits in social communication. Individuals with high functioning autism (HFA) and individuals with Williams syndrome (WS) often have significant impairments in social communication that impact their relationships with others. Currently, little is known about how school-age children use and integrate verbal and non-verbal behaviors in the context of a social interaction. Design/methodology/approach A micro-analytic coding scheme was devised to reveal which channels children use to convey information. Language, eye gaze behaviors and facial expressions of the child were coded during this dyadic social interaction. These behaviors were coded throughout the entire interview, as well as when the child was the speaker and when the child was the listener. Findings Language results continue to pose problems for the HFA and WS groups compared to their typically developing (TD) peers. For non-verbal communicative behaviors, a qualitative difference in the use of eye gaze was found between the HFA and WS groups. For facial expression, the WS and TD groups produced more facial expressions than the HFA group. Research limitations/implications No differences were observed in the HFA group when playing different roles in a conversation, suggesting they are not as sensitive to the social rules of a conversation as their peers. Insights from this study add knowledge toward understanding social-communicative development in school-age children. Originality/value In this study, two non-verbal behaviors will be assessed in multiple contexts: the entire biographical interview, when the child is the speaker and when the child is the listener. These social and expressive measures give an indication of how expressive school-age children are and provide information on their attention, affective state and communication skills when conversing with an adult. Insights from this study will add knowledge toward understanding social-communicative development in school-age children.
Collapse
Affiliation(s)
- Philip To Lai
- Department of Communication Disorders, University of Nebraska Kearney, Kearney, Nebraska, USA
| |
Collapse
|
26
|
Trevis KJ, Brown NJ, Green CC, Lockhart PJ, Desai T, Vick T, Anderson V, Pua EPK, Bahlo M, Delatycki MB, Scheffer IE, Wilson SJ. Tracing Autism Traits in Large Multiplex Families to Identify Endophenotypes of the Broader Autism Phenotype. Int J Mol Sci 2020; 21:E7965. [PMID: 33120939 PMCID: PMC7663259 DOI: 10.3390/ijms21217965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
Families comprising many individuals with Autism Spectrum Disorders (ASD) may carry a dominant predisposing mutation. We implemented rigorous phenotyping of the "Broader Autism Phenotype" (BAP) in large multiplex ASD families using a novel endophenotype approach for the identification and characterisation of distinct BAP endophenotypes. We evaluated ASD/BAP features using standardised tests and a semi-structured interview to assess social, intellectual, executive and adaptive functioning in 110 individuals, including two large multiplex families (Family A: 30; Family B: 35) and an independent sample of small families (n = 45). Our protocol identified four distinct psychological endophenotypes of the BAP that were evident across these independent samples, and showed high sensitivity (97%) and specificity (82%) for individuals classified with the BAP. Patterns of inheritance of identified endophenotypes varied between the two large multiplex families, supporting their utility for identifying genes in ASD.
Collapse
Affiliation(s)
- Krysta J. Trevis
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC 3084, Australia; (K.J.T.); (C.C.G.); (T.D.); (E.P.K.P.); (I.E.S.)
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Natasha J. Brown
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (N.J.B.); (M.B.D.)
- Barwon Health, Geelong, VIC 3220, Australia;
| | - Cherie C. Green
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC 3084, Australia; (K.J.T.); (C.C.G.); (T.D.); (E.P.K.P.); (I.E.S.)
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia;
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia
| | - Paul J. Lockhart
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Tarishi Desai
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC 3084, Australia; (K.J.T.); (C.C.G.); (T.D.); (E.P.K.P.); (I.E.S.)
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Tanya Vick
- Barwon Health, Geelong, VIC 3220, Australia;
| | - Vicki Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia;
- Psychological Service, The Royal Children’s Hospital, Parkville, VIC 3052, Australia
- Clinical Sciences Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Emmanuel P. K. Pua
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC 3084, Australia; (K.J.T.); (C.C.G.); (T.D.); (E.P.K.P.); (I.E.S.)
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia;
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Martin B. Delatycki
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (N.J.B.); (M.B.D.)
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Ingrid E. Scheffer
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC 3084, Australia; (K.J.T.); (C.C.G.); (T.D.); (E.P.K.P.); (I.E.S.)
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (N.J.B.); (M.B.D.)
- Clinical Sciences Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia
| | - Sarah J. Wilson
- Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, VIC 3084, Australia; (K.J.T.); (C.C.G.); (T.D.); (E.P.K.P.); (I.E.S.)
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia;
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia
| |
Collapse
|
27
|
Patel S, Dale RC, Rose D, Heath B, Nordahl CW, Rogers S, Guastella AJ, Ashwood P. Maternal immune conditions are increased in males with autism spectrum disorders and are associated with behavioural and emotional but not cognitive co-morbidity. Transl Psychiatry 2020; 10:286. [PMID: 32796821 PMCID: PMC7429839 DOI: 10.1038/s41398-020-00976-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
Epidemiological and animal research shows that maternal immune activation increases the risk of autism spectrum disorders (ASD) in offspring. Emerging evidence suggests that maternal immune conditions may play a role in the phenotypic expression of neurodevelopmental difficulties in children with ASD and this may be moderated by offspring sex. This study aimed to investigate whether maternal immune conditions were associated with increased severity of adverse neurodevelopmental outcomes in children with ASD. Maternal immune conditions were examined as predictors of ASD severity, behavioural and emotional well-being, and cognitive functioning in a cohort of 363 children with ASD (n = 363; 252 males, 111 females; median age 3.07 [interquartile range 2.64-3.36 years]). We also explored whether these outcomes varied between male and female children. Results showed that maternal asthma was the most common immune condition reported in mothers of children with ASD. A history of maternal immune conditions (p = 0.009) was more common in male children with ASD, compared to female children. Maternal immune conditions were associated with increased behavioural and emotional problems in male and female children. By contrast, maternal immune conditions were not associated with decreased cognitive function. The findings demonstrate that MIA may influence the expression of symptoms in children with ASD and outcomes may vary between males and females.
Collapse
Affiliation(s)
- Shrujna Patel
- grid.1013.30000 0004 1936 834XAutism Clinic for Translational Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
| | - Russell C. Dale
- grid.1013.30000 0004 1936 834XKids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Westmead, NSW Australia
| | - Destanie Rose
- grid.27860.3b0000 0004 1936 9684Department of Medical Microbiology and Immunology and MIND Institute, UC Davis, Davis, CA USA
| | - Brianna Heath
- grid.27860.3b0000 0004 1936 9684Department of Psychiatry and MIND Institute, UC Davis, Davis, CA USA
| | - Christine W. Nordahl
- grid.27860.3b0000 0004 1936 9684Department of Psychiatry and MIND Institute, UC Davis, Davis, CA USA
| | - Sally Rogers
- grid.27860.3b0000 0004 1936 9684Department of Psychiatry and MIND Institute, UC Davis, Davis, CA USA
| | - Adam J. Guastella
- grid.1013.30000 0004 1936 834XAutism Clinic for Translational Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology and MIND Institute, UC Davis, Davis, CA, USA.
| |
Collapse
|
28
|
Shin HM, Bennett DH, Calafat AM, Tancredi D, Hertz-Picciotto I. Modeled prenatal exposure to per- and polyfluoroalkyl substances in association with child autism spectrum disorder: A case-control study. ENVIRONMENTAL RESEARCH 2020; 186:109514. [PMID: 32353786 PMCID: PMC7363534 DOI: 10.1016/j.envres.2020.109514] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND/OBJECTIVE Per- and polyfluoroalkyl substances (PFAS) display neurobehavioral toxicity in laboratory animal studies. We examined associations of modeled prenatal maternal exposure to PFAS with child diagnosis of autism spectrum disorder (ASD). METHODS Participants were 453 mother-child pairs from CHARGE (CHildhood Autism Risk from Genetics and Environment), a population-based case-control study. Children underwent psychometric testing and were clinically confirmed for ASD (n = 239) or typical development (TD, n = 214). At the end of the clinic visit, maternal blood specimens were collected. We quantified nine PFAS in maternal serum samples collected when their child was 2-5 years old. As surrogate in utero exposure, we used a model built from external prospective data in pregnancy and 24 months post-partum and then reconstructed maternal PFAS serum concentrations during pregnancy in this case-control sample. We used logistic regression to evaluate associations of modeled prenatal maternal PFAS concentrations with child ASD. RESULTS Modeled prenatal maternal perfluorohexane sulfonate (PFHxS) and perfluorooctane sulfonate (PFOS) were borderline associated with increased odds of child diagnosis of ASD (per nanogram per milliliter increase: odds ratio [OR] = 1.46; 95% confidence interval [CI]: 0.98, 2.18 for PFHxS, OR = 1.03; 95% CI: 0.99, 1.08 for PFOS). When compared to the lowest quartile (reference category), the highest quartile of modeled prenatal maternal PFHxS was associated with increased odds of child diagnosis of ASD (OR = 1.95; 95% CI: 1.02, 3.72). CONCLUSIONS In analyses where modeled prenatal maternal PFAS serum concentrations served as in utero exposure, we observed that prenatal PFHxS and PFOS exposure, but not other PFAS, were borderline associated with increased odds of child diagnosis of ASD. Further studies in which PFAS concentrations are prospectively measured in mothers and children at a range of developmental stages are needed to confirm these findings.
Collapse
Affiliation(s)
- Hyeong-Moo Shin
- Department of Earth and Environmental Sciences, University of Texas, Arlington, TX, USA.
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - Daniel Tancredi
- Department of Pediatrics, University of California, Davis, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| |
Collapse
|
29
|
Lai PT, Ng R, Bellugi U. Parental report of cognitive and social-emotionality traits in school-age children with autism and Williams syndrome. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:309-316. [PMID: 35603004 PMCID: PMC9122353 DOI: 10.1080/20473869.2020.1765296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/28/2020] [Accepted: 04/30/2020] [Indexed: 06/15/2023]
Abstract
The majority of the research examining children with Autism Spectrum Disorder (ASD) and Williams Syndrome (WS) focus on the social domain while few have examined cognitive style and emotionality. Accordingly, this current study assessed the day-to-day cognitive and behavioral functioning of school-age children with ASD, WS, and neurotypical development (ND) through caregiver-report inventories to further delineate commonalities and disparities in cognitive and social-emotional traits. Two caregiver-report inventories, the Children's Behavior Questionnaire and the Multidimensional Personality Questionnaire were employed to assess the day-to-day functioning of children ages 7-14 years. Participants included 64 caregivers of children, of these, 25 were caregivers of children with high functioning autism (HFA), 14 with WS, and 25 with ND. Multivariate analysis of covariance was computed to assess between-group differences for each subscale within a questionnaire. Covariates included age and full-scale IQ. For cognitive traits, group differences were observed across two categories while seven were present within the social-emotional categories. The majority of the group effects reflected differences in social-emotional traits between ND and both neurodevelopmental groups, while limited distinctions were found between the two clinical groups. This brief report provides additional evidence that HFA and WS may show similarities in cognitive traits but more divergent social-emotional tendencies, despite controlling for age and intellect. This study highlights the large social-emotional differences that supports prior phenotypic descriptions of both neurodevelopmental groups. Future research in these domains are needed to determine focused interventions to address social impairment.
Collapse
Affiliation(s)
- Philip T. Lai
- Joint Doctoral Program in Language and Communicative Disorders, School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Language and Communicative Disorders, Center for Research in Language, University of California San Diego, La Jolla, CA, USA
- Laboratory for Cognitive Neuroscience, Salk Institute for Biological Sciences, La Jolla, CA, USA
| | - Rowena Ng
- Laboratory for Cognitive Neuroscience, Salk Institute for Biological Sciences, La Jolla, CA, USA
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Ursula Bellugi
- Laboratory for Cognitive Neuroscience, Salk Institute for Biological Sciences, La Jolla, CA, USA
| |
Collapse
|
30
|
Strang JF, Knauss M, van der Miesen A, McGuire JK, Kenworthy L, Caplan R, Freeman A, Sadikova E, Zaks Z, Pervez N, Balleur A, Rowlands DW, Sibarium E, Willing L, McCool MA, Ehrbar RD, Wyss SE, Wimms H, Tobing J, Thomas J, Austen J, Pine E, Griffin AD, Janssen A, Gomez-Lobo V, Brandt A, Morgan C, Meagher H, Gohari D, Kirby L, Russell L, Powers MD, Anthony LG. A Clinical Program for Transgender and Gender-Diverse Neurodiverse/Autistic Adolescents Developed through Community-Based Participatory Design. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:730-745. [DOI: 10.1080/15374416.2020.1731817] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- John F. Strang
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- George Washington University School of Medicine, George Washington University
| | - Megan Knauss
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Alliance of Community Health Plans
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, VU University Medical Center
| | - Jenifer K. McGuire
- Department of Family Social Science, University of Minnesota
- National Center for Gender Spectrum Health, University of Minnesota
| | - Lauren Kenworthy
- George Washington University School of Medicine, George Washington University
- Center for Autism Spectrum Disorders, Children’s National Health System
| | | | | | - Eleonora Sadikova
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Zosia Zaks
- Hussman Center for Adults with Autism, Towson University
| | | | | | | | | | - Laura Willing
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- George Washington University School of Medicine, George Washington University
| | - Marissa A. McCool
- Queer Indigenous and People of Color (QIPOC), Augsburg University
- V-Day, University of Pennsylvania
| | | | - Shannon E. Wyss
- Gender and Sexuality Education and Advocacy Program, Children’s National Medical Center
- Transgender Leadership Initiative, AIDS United
| | - Harriette Wimms
- Youth Gender Care Services, The Village Family Support Center of Baltimore
| | | | - John Thomas
- Transgender and Autism Services, Falls Church Counseling
| | | | - Elyse Pine
- LGBT Health Resource Center, Chase Brexton Health Care
| | | | - Aron Janssen
- Gender and Sexuality Service, Child Study Center, New York University Medical School
| | - Veronica Gomez-Lobo
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Division of Pediatric Gynecology, Children’s National Health System
| | - Abigail Brandt
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Division of Hearing and Speech, Children’s National Health System
| | - Colleen Morgan
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Division of Hearing and Speech, Children’s National Health System
| | - Haley Meagher
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Dena Gohari
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Laura Kirby
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Laura Russell
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Meredith D. Powers
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Laura G. Anthony
- Department of Psychiatry, Pediatric Mental Health Institute, Children’s Hospital of Colorado, University of Colorado School of Medicine
| |
Collapse
|
31
|
Tomova A, Soltys K, Kemenyova P, Karhanek M, Babinska K. The Influence of Food Intake Specificity in Children with Autism on Gut Microbiota. Int J Mol Sci 2020; 21:E2797. [PMID: 32316625 PMCID: PMC7215614 DOI: 10.3390/ijms21082797] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022] Open
Abstract
Autism spectrum disorder (ASD) is a complex of neurodevelopmental conditions with increasing incidence. The microbiota of children with ASD is distinct from neurotypical children, their food habits are also different, and it is known that nutrient intake influences microbiota in a specific way. Thus, this study investigates the food habits of children with ASD and their association with the gut microbiota. Children with ASD had their dietary energy intakes similar to controls, but they more often demonstrated food selectivity, which seemed to result in deficiency of micronutrients such as vitamins K, B6, C, iron, cooper, docosahexaenoic and docosapentanoic acid. Using high-throughput sequencing, a DNA library of intestinal microbiota was performed. Core microbiota was similar in children with and without ASD, but Dichelobacter, Nitriliruptor and Constrictibacter were found to be putative markers of ASD. The changes in gut microbiota that we observed in connection to food selectivity, intake of fats and omega-3 in particular, fermented milk products and animal/plant protein consumption had similar character, independent of diagnosis. However, high fibre intake was connected with a decreased α-diversity only in children with ASD. High carbohydrate and fibre intake influenced β-diversity, changing the abundance of Bacteroides and other genera, many of them members of the Clostidiaceae. Modulating food habits of ASD children can influence their gut microbiota composition.
Collapse
Affiliation(s)
- Aleksandra Tomova
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 813 72 Bratislava, Slovakia; (P.K.); (K.B.)
| | - Katarina Soltys
- Comenius University, Science Park, Comenius University in Bratislava, 841 04 Bratislava, Slovakia;
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, 842 15 Bratislava, Slovakia
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University in Bratislava, 842 15 Bratislava, Slovakia
| | - Petra Kemenyova
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 813 72 Bratislava, Slovakia; (P.K.); (K.B.)
| | - Miloslav Karhanek
- Biomedical Research Center, Slovak Academy of Sciences, 845 05 Bratislava, Slovakia;
| | - Katarina Babinska
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 813 72 Bratislava, Slovakia; (P.K.); (K.B.)
| |
Collapse
|
32
|
Adalarasu K, Jagannath M, James O. Assessment of Techniques for Teaching School Children with Autism. Ing Rech Biomed 2020. [DOI: 10.1016/j.irbm.2019.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
33
|
Fu L, Wang Y, Fang H, Xiao X, Xiao T, Li Y, Li C, Wu Q, Chu K, Xiao C, Ke X. Longitudinal Study of Brain Asymmetries in Autism and Developmental Delays Aged 2–5 Years. Neuroscience 2020; 432:137-149. [DOI: 10.1016/j.neuroscience.2020.02.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 12/24/2022]
|
34
|
Specificity of gut microbiota in children with autism spectrum disorder in Slovakia and its correlation with astrocytes activity marker and specific behavioural patterns. Physiol Behav 2020; 214:112745. [DOI: 10.1016/j.physbeh.2019.112745] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/04/2019] [Accepted: 11/21/2019] [Indexed: 02/06/2023]
|
35
|
[ADI-R and ADOS and the differential diagnosis of autism spectrum disorders: Interests, limits and openings]. Encephale 2019; 45:441-448. [PMID: 31495549 DOI: 10.1016/j.encep.2019.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/25/2019] [Accepted: 07/18/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Current developments in international public health are leading qualified authorities to release clinical practice guidelines for Autism Spectrum Disorders (ASD) assessment and diagnosis. Such documents incorporate procedures that rely on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) which are considered to be the "gold standard" assessment measures in the evaluation of ASD. Although these tools do prove their effectiveness in the evaluation of autistic symptomatology, they nevertheless stumble whenever the situation becomes more complex and reveal differential diagnostic issues in infantile and adult autism cases. This differential diagnostic issue remains significant in the clinical practice of daily life and has strong implications for the course of therapeutic treatment. OBJECTIVES Our objective is to underline and nuance the metrological qualities of the ADI-R and the ADOS in the differential diagnosis of autistic disorders by presenting a synthesis of recent studies, thus supporting the interest of maintaining an open debate on diagnostic practices. METHODS Our selective review of the recent literature focuses on studies that confront the ADI-R and the ADOS - used either independently or in a combination - with various differential issues in adulthood and childhood autism in order to highlight their qualities and limits. RESULTS The ADI-R is a semi-structured interview applied by trained examiners and applied to relatives and/or caregivers who collect developmental information about the patient's first years of life on a variety of behaviors and skills. It is therefore relatively dependent on the availability and personal bias of the interviewed third parties. Metric features highlighted by the reviewed studies straightforwardly reveal a certain effectiveness of the tool and a good discrimination of childhood disorders. At the same time, the tool's discriminatory capacity seems insufficient when applied to toddlers, very young children, and adults alike. The latter seems particularly true when it comes to differentiating between autistic and schizophrenic spectrum disorders. The ADOS is a semi-structured standardized observation assessment tool that has experienced several successive developments, such as optimizations concerning the sensitivity of its cutoffs. Many works have contributed to building such a tool with reliable and solid metric qualities which nevertheless retain important biases such as the subjectivity of the caregiver or the evaluator during the scoring process. For assessments of autistic children the tool still has a good diagnostic validity but seems to retain cases of incorrect diagnosis of ASD (false positives). In other words, disorders or developmental disabilities of some children and adolescents could not be distinguished from ASD when relying on this test alone. The ADOS Module 4, designed for the diagnosis of adolescents and adults with fluent speech, has undergone less updating. This revisited algorithm has metrological qualities useful for clinicians and remains one of the few available tools for this population. Unfortunately, its diagnostic accuracy is lower when applied to women, the elderly, people with personality disorders or higher intellectual abilities, or for the discrimination between ASD and schizophrenia. Overall, scores from these two instruments bring strong evidence of their usefulness in the diagnostic process of ASD, provided that they are used with caution and a critical clinical perspective, and only as a secondary technical support. Their use in combination is effective since they are complementary and compensate for each other's limitations. However, their globalized hegemony as "gold-standard" tools constitutes a setback insofar as it constrains the diagnosis of ASD to a set of stereotyped items. The latter in turn sets a normative model of autism that excludes other phenotypic forms, especially in the case of women and the elderly. Finally, the discrimination between autism and psychosis for children seems to remain an insoluble task even for the ADI-R/ADOS combination. CONCLUSIONS The problematics of differential diagnosis remain critical for clinical approaches to autism. Therefore, formalizations of the diagnostic procedures must be able to remain open-minded and accompanied by a creative clinical approach, especially in the case of complex situations that are not soluble by means of conventional diagnostic tools. One possibility may lie in the deepening of the phenomenological approach to autism as an attempt to model the subjective phenomena of autistic subjects and thus operationalize elements that serve the diagnostic process. In the same way, a psychodynamic epistemology could help clinicians to go beyond the consideration of observable behaviors and scores, introducing a psychoanalytic point of view that interfaces objective behaviors with the individual's dynamic intrapsychic functioning. This project could be articulated with projective methodologies - notably the Rorschach test - which respects the needs for standardization and quantification of conventionally used diagnostic tools.
Collapse
|
36
|
Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult). J Autism Dev Disord 2019; 48:549-560. [PMID: 29116420 PMCID: PMC5807495 DOI: 10.1007/s10803-017-3321-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29) and a clinical comparison group (n = 20) who had non-autistic mental health conditions. Mean administration time was 38 min (50 min for ASC). Internal consistency (αs ≥ 0.93) and inter-rater agreement (ICCs ≥ 0.99) were high. When discriminating ASC from non-ASC, the 3Di-Adult showed excellent sensitivity (95%) and specificity (92%). The 3Di-Adult shows promise as a psychometrically sound and time-efficient interview for collecting standardised informant reports for DSM-5 assessments of ASC in adults, in research and clinical practice.
Collapse
|
37
|
Measurement considerations in pediatric research on autism spectrum disorders. PROGRESS IN BRAIN RESEARCH 2018. [PMID: 30447755 DOI: 10.1016/bs.pbr.2018.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Studying Autism Spectrum Disorders (ASD) in genetic syndromes has gained interest in the scientific community as a way to elucidate mechanisms and symptom profiles to understand ASD more broadly. Appropriate and adequate measurement of constructs, symptomatology, and outcomes in clinical research is of vital importance in establishing the prevalence of such symptoms and measuring change in symptoms in the context of clinical trials. As such, we provide an overview of the prevalence of ASD, present current diagnostic guidelines, discuss important comorbidities to consider, describe current assessment strategies in assessing ASD, and discuss these within the context of a specific genetic condition to highlight how ASD can be best evaluated.
Collapse
|
38
|
“They Thought It Was an Obsession”: Trajectories and Perspectives of Autistic Transgender and Gender-Diverse Adolescents. J Autism Dev Disord 2018; 48:4039-4055. [DOI: 10.1007/s10803-018-3723-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
39
|
Qian L, Wang Y, Chu K, Li Y, Xiao C, Xiao T, Xiao X, Qiu T, Xiao Y, Fang H, Ke X. Alterations in hub organization in the white matter structural network in toddlers with autism spectrum disorder: A 2-year follow-up study. Autism Res 2018; 11:1218-1228. [PMID: 30114344 DOI: 10.1002/aur.1983] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 05/17/2018] [Accepted: 06/08/2018] [Indexed: 12/27/2022]
Abstract
Little is currently known about the longitudinal developmental patterns of hubs in the whole-brain white matter (WM) structural networks among toddlers with autism spectrum disorder (ASD). This study utilized diffusion tensor imaging (DTI) and deterministic tractography to map the WM structural networks in 37 ASD toddlers and 27 age-, gender- and developmental quotient-matched controls with developmental delay (DD) toddlers aged 2-3 years old at baseline (Time 1) and at 2-year follow-up (Time 2). Furthermore, graph-theoretical methods were applied to investigate alterations in the network hubs in these patients at the two time points. The results showed that after 2 years, 17 hubs were identified in the ASD subjects compared to the controls, including 13 hubs that had not changed from baseline and 4 hubs that were newly identified. In addition, alterations in the properties of the hubs of the right middle frontal gyrus, right insula, left median cingulate gyri, and bilateral precuneus were significantly correlated with alterations in the behavioral data for ASD patients. These results indicated that at the stage of 2-5 years of age, ASD children showed distributions of network hubs that were relatively stable, with minor differences. Abnormal developmental patterns in the five areas mentioned above in ASD may contribute to abnormalities in the social and nonsocial characteristics of this disorder. Autism Res 2018, 11: 1218-1228. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This work studied the longitudinal developmental patterns of hubs in the whole-brain white matter (WM) structural network among toddlers with autism spectrum disorder (ASD). The findings of this study could have implications for understanding how the abnormalities in hub organization in ASD account for behavioral deficits in patients and may provide potential biomarkers for disease diagnosis and the subsequent monitoring of progression and treatment effects for patients with ASD.
Collapse
Affiliation(s)
- Lu Qian
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,Department of Psychiatry, Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China.,Wuxi Tongren International Rehabilitation Hospital, Wuxi, China
| | - Yao Wang
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - KangKang Chu
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yun Li
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - ChaoYong Xiao
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ting Xiao
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiang Xiao
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ting Qiu
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - YunHua Xiao
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Hui Fang
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - XiaoYan Ke
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| |
Collapse
|
40
|
Farquharson K, Hogan TP, Bernthal JE. Working memory in school-age children with and without a persistent speech sound disorder. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:422-433. [PMID: 28306339 PMCID: PMC5754259 DOI: 10.1080/17549507.2017.1293159] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE The aim of this study was to explore the role of working memory processes as a possible cognitive underpinning of persistent speech sound disorders (SSD). METHOD Forty school-aged children were enrolled; 20 children with persistent SSD (P-SSD) and 20 typically developing children. Children participated in three working memory tasks - one to target each of the components in Baddeley's working memory model: phonological loop, visual spatial sketchpad and central executive. RESULT Children with P-SSD performed poorly only on the phonological loop tasks compared to their typically developing age-matched peers. However, mediation analyses revealed that the relation between working memory and a P-SSD was reliant upon nonverbal intelligence. CONCLUSION These results suggest that co-morbid low-average nonverbal intelligence are linked to poor working memory in children with P-SSD. Theoretical and clinical implications are discussed.
Collapse
Affiliation(s)
- Kelly Farquharson
- a Department of Communication Sciences and Disorders , Emerson College , Boston , MA , USA
| | - Tiffany P Hogan
- b MGH-Institute of Health Professions , Boston , MA , USA , and
| | - John E Bernthal
- c University of Nebraska-Lincoln, Special Education and Communication Disorders , Lincoln , NE , USA
| |
Collapse
|
41
|
Balasubramanian M, Jones R, Milne E, Marshall C, Arundel P, Smith K, Bishop NJ. Autism and heritable bone fragility: A true association? Bone Rep 2018; 8:156-162. [PMID: 29955634 PMCID: PMC6020266 DOI: 10.1016/j.bonr.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/14/2018] [Accepted: 04/16/2018] [Indexed: 02/07/2023] Open
Abstract
Objectives Osteogenesis Imperfecta (OI) is a heterogeneous condition mainly characterised by bone fragility; intelligence is reported to be normal. However, a minority of children seen also show symptomology consistent with an ‘Autism Spectrum Disorder’. A joint genetics and psychology research study was undertaken to identify these patients using ‘Gold Standard’ research tools: Autism Diagnostic Inventory Revised (ADI-R); Autism Diagnostic Observation Schedule (ADOS) and undertake genetic analyses in them. Method A cohort of n = 7 children with autistic traits and severe/complex OI were recruited to the study. The study was set-up to explore whether there was a genetic link between bone fragility and autism in a sub-set of patients with bone fragility identified with autism traits in our complex/severe OI clinic. This was not set-up as a prevalence study but rather an exploration of genetics in association with ADI/ADOS confirmed ASD and bone fragility. ADI& ADOS Standardised tools were used to confirm autism diagnosis. ADI and ADOS were completed by the Clinical Psychologist; ADI comprises a 93 item semi-structured clinical review with a diagnostic algorithm diagnosing Autism; ADOS is a semi-structured assessment of socialisation, communication and play/imagination which also provides a diagnostic algorithm. Exome sequencing In patients recruited, those that fulfilled research criteria for diagnosis of autism using above tools were recruited to trio whole exome sequencing (WES). Results one patient had compound heterozygous variants in NBAS; one patient had a variant in NRX1; one patient had a maternally inherited PLS3 variant; all the other patients in this cohort had pathogenic variants in COL1A1/COL1A2. Conclusions Although, not set out as an objective, we were able to establish that identifying autism had important clinical and social benefits for patients and their families in ensuring access to services, appropriate schooling, increased understanding of behaviour and support. Lay summary It is important for clinicians looking after children with brittle bone disease, also referred to as Osteogenesis Imperfecta (OI) to be aware of early features of developmental delay/autistic traits especially with severe forms of OI as the emphasis is on their mobility and bone health. Ensuring appropriate assessment and access to services early-on will enable these patients to achieve their potential. Further investigations of genomics in bone fragility in relation to autism are required and dual diagnosis is essential for high quality clinical and educational provision. Osteogenesis Imperfecta is the commonest form of heritable bone fragility disorder with an incidence of 1 in 15,000 live births Intelligence is usually reported to be normal; however, this study describes association of autistic traits with OI It is important to undertake autism assessments early in case of clinical suspicion of ASD as children with OI would benefit from early educational intervention Early identification and clarification of diagnosis of ASD in children with OI will ensure that children are able to achieve their full potential.
Collapse
Affiliation(s)
- Meena Balasubramanian
- Highly Specialised Severe, Complex & Atypical OI Service, Sheffield Children's NHS Foundation Trust, UK.,Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, UK.,Academic Unit of Child Health, University of Sheffield, UK
| | - Rebecca Jones
- Department of Psychology, Sheffield Children's NHS Foundation Trust, UK
| | | | | | - Paul Arundel
- Highly Specialised Severe, Complex & Atypical OI Service, Sheffield Children's NHS Foundation Trust, UK
| | - Kath Smith
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, UK
| | | |
Collapse
|
42
|
Neuhaus E, Beauchaine TP, Bernier RA, Webb SJ. Child and family characteristics moderate agreement between caregiver and clinician report of autism symptoms. Autism Res 2018; 11:476-487. [PMID: 29251835 PMCID: PMC5867206 DOI: 10.1002/aur.1907] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 10/09/2017] [Accepted: 11/22/2017] [Indexed: 11/08/2022]
Abstract
Rates of autism spectrum disorder (ASD) and age at first diagnosis vary considerably across the United States and are moderated by children's sex, race, ethnicity, and availability of services. We additionally suggest that degree of caregiver-clinician agreement on ASD symptoms may play a role in ASD assessment. Since gold standard ASD assessment integrates caregiver-reported developmental history with clinician observations, differential agreement between reporters across demographic groups may contribute to a host of detrimental outcomes. Here, we investigate whether caregiver-clinician agreement on ASD symptoms varies according to child and family characteristics. Comprehensive data from 2,759 families in the Simons Simplex Collection were analyzed. Linear models were created with caregiver reports predicting clinician reports, and moderating effects of child characteristics and family factors were examined. Poorer reporter correspondence was observed when children had higher IQ scores, stronger adaptive behavior, and more behavioral difficulties. Greater disagreement was also associated with African American racial status (for younger children), lower household income, and paternal social difficulties (for older children). Children's biological sex did not moderate caregiver-clinician agreement. Marked disagreement between caregivers and clinicians could lead to suboptimal or insufficient intervention services and negative experiences for families throughout development. Such families may also be less likely to qualify for research studies, and therefore be underrepresented in the ASD literature. Modified assessment procedures may be required to improve assessment accuracy and family experiences. Autism Res 2018, 11: 476-487. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Evaluation of autism spectrum disorder (ASD) incorporates both caregiver and clinician perspectives of symptoms, and disagreement between these perspectives could lead to poorer outcomes for families. Using data from 2,759 families, we show that caregiver-clinician agreement on ASD symptoms is poorer for children with higher cognitive and adaptive skills, more behavioral difficulties, lower household income, and African American racial status. These children may be at higher risk for misdiagnosis, poorer family experiences during evaluations, and poorer representation in ASD research.
Collapse
Affiliation(s)
- Emily Neuhaus
- Seattle Children’s Research Institute, Center on Child Health, Behavior, and Development, M/S CW8-6, PO Box 5371, Seattle, WA 98145
| | - Theodore P. Beauchaine
- The Ohio State University, 135 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210
| | - Raphael A. Bernier
- University of Washington, Psychiatry and Behavioral Science, Box 357920, Seattle, WA 98195
| | - Sara J. Webb
- Seattle Children’s Research Institute, Center on Child Health, Behavior, and Development, M/S CW8-6, PO Box 5371, Seattle, WA 98145
- University of Washington, Psychiatry and Behavioral Science, Box 357920, Seattle, WA 98195
| |
Collapse
|
43
|
Wigham S, Rodgers J, Berney T, Le Couteur A, Ingham B, Parr JR. Psychometric properties of questionnaires and diagnostic measures for autism spectrum disorders in adults: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:287-305. [DOI: 10.1177/1362361317748245] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Accurately diagnosing autism spectrum disorders in adulthood can be challenging. Structured questionnaires and diagnostic measures are frequently used to assist case recognition and diagnosis. This study reviewed research evidence on structured questionnaires and diagnostic measures published since the National Institute for Health and Care Excellence evidence update. The Cochrane library, Medline, Embase and PsycINFO were searched. In all, 20 studies met inclusion criteria. Sensitivity and specificity of structured questionnaires were best for individuals with previously confirmed autism spectrum disorder diagnoses and reduced in participants referred for diagnostic assessments, with discrimination of autism spectrum disorder from mental health conditions especially limited. For adults with intellectual disability, diagnostic accuracy increased when a combination of structured questionnaires were used. Evidence suggests some utility of diagnostic measures in identifying autism spectrum disorder among clinic referrals, although specificity for diagnosis was relatively low. In mental health settings, the use of a single structured questionnaire is unlikely to accurately identify adults without autism spectrum disorder or differentiate autism spectrum disorder from mental health conditions. This is important as adults seeking an autism spectrum disorder diagnostic assessment are likely to have co-existing mental health conditions. Robust autism spectrum disorder assessment tools specifically for use in adult diagnostic health services in the presence of co-occurring mental health and neurodevelopmental disorders are a research priority.
Collapse
Affiliation(s)
- Sarah Wigham
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Jacqui Rodgers
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Tom Berney
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ann Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Barry Ingham
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
44
|
Li Y, Fang H, Zheng W, Qian L, Xiao Y, Wu Q, Chang C, Xiao C, Chu K, Ke X. A Fiber Tractography Study of Social-Emotional Related Fiber Tracts in Children and Adolescents with Autism Spectrum Disorder. Neurosci Bull 2017; 33:722-730. [PMID: 28695417 PMCID: PMC5725375 DOI: 10.1007/s12264-017-0155-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/01/2017] [Indexed: 10/19/2022] Open
Abstract
The symptoms of autism spectrum disorder (ASD) have been hypothesized to be caused by changes in brain connectivity. From the clinical perspective, the "disconnectivity" hypothesis has been used to explain characteristic impairments in "socio-emotional" function. Therefore, in this study we compared the facial emotional recognition (FER) feature and the integrity of social-emotional-related white-matter tracts between children and adolescents with high-functioning ASD (HFA) and their typically developing (TD) counterparts. The correlation between the two factors was explored to find out if impairment of the white-matter tracts is the neural basis of social-emotional disorders. Compared with the TD group, FER was significantly impaired and the fractional anisotropy value of the right cingulate fasciculus was increased in the HFA group (P < 0.01). In conclusion, the FER function of children and adolescents with HFA was impaired and the microstructure of the cingulate fasciculus had abnormalities.
Collapse
Affiliation(s)
- Yun Li
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Hui Fang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Wenming Zheng
- Key Laboratory of Child Development and Learning Science of the Ministry of Education, Research Center for Learning Science, Southeast University, Nanjing, 210096, China
| | - Lu Qian
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Yunhua Xiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Qiaorong Wu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Chen Chang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Chaoyong Xiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Kangkang Chu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China
| | - Xiaoyan Ke
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China.
| |
Collapse
|
45
|
Aoki Y, Yoncheva YN, Chen B, Nath T, Sharp D, Lazar M, Velasco P, Milham MP, Di Martino A. Association of White Matter Structure With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. JAMA Psychiatry 2017; 74:1120-1128. [PMID: 28877317 PMCID: PMC5710226 DOI: 10.1001/jamapsychiatry.2017.2573] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Clinical overlap between autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) is increasingly appreciated, but the underlying brain mechanisms remain unknown to date. OBJECTIVE To examine associations between white matter organization and 2 commonly co-occurring neurodevelopmental conditions, ASD and ADHD, through both categorical and dimensional approaches. DESIGN, SETTING, AND PARTICIPANTS This investigation was a cross-sectional diffusion tensor imaging (DTI) study at an outpatient academic clinical and research center, the Department of Child and Adolescent Psychiatry at New York University Langone Medical Center. Participants were children with ASD, children with ADHD, or typically developing children. Data collection was ongoing from December 2008 to October 2015. MAIN OUTCOMES AND MEASURES The primary measure was voxelwise fractional anisotropy (FA) analyzed via tract-based spatial statistics. Additional voxelwise DTI metrics included radial diffusivity (RD), mean diffusivity (MD), axial diffusivity (AD), and mode of anisotropy (MA). RESULTS This cross-sectional DTI study analyzed data from 174 children (age range, 6.0-12.9 years), selected from a larger sample after quality assurance to be group matched on age and sex. After quality control, the study analyzed data from 69 children with ASD (mean [SD] age, 8.9 [1.7] years; 62 male), 55 children with ADHD (mean [SD] age, 9.5 [1.5] years; 41 male), and 50 typically developing children (mean [SD] age, 9.4 [1.5] years; 38 male). Categorical analyses revealed a significant influence of ASD diagnosis on several DTI metrics (FA, MD, RD, and AD), primarily in the corpus callosum. For example, FA analyses identified a cluster of 4179 voxels (TFCE FEW corrected P < .05) in posterior portions of the corpus callosum. Dimensional analyses revealed associations between ASD severity and FA, RD, and MD in more extended portions of the corpus callosum and beyond (eg, corona radiata and inferior longitudinal fasciculus) across all individuals, regardless of diagnosis. For example, FA analyses revealed clusters overall encompassing 12121 voxels (TFCE FWE corrected P < .05) with a significant association with parent ratings in the social responsiveness scale. Similar results were evident using an independent measure of ASD traits (ie, children communication checklist, second edition). Total severity of ADHD-traits was not significantly related to DTI metrics but inattention scores were related to AD in corpus callosum in a cluster sized 716 voxels. All these findings were robust to algorithmic correction of motion artifacts with the DTIPrep software. CONCLUSIONS AND RELEVANCE Dimensional analyses provided a more complete picture of associations between ASD traits and inattention and indexes of white matter organization, particularly in the corpus callosum. This transdiagnostic approach can reveal dimensional relationships linking white matter structure to neurodevelopmental symptoms.
Collapse
Affiliation(s)
- Yuta Aoki
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York
| | - Yuliya N. Yoncheva
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York
| | - Bosi Chen
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York
| | - Tanmay Nath
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York
| | - Dillon Sharp
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York
| | - Mariana Lazar
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York
| | - Pablo Velasco
- Center for Brain Imaging, New York University, New York
| | - Michael P. Milham
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York,Child Mind Institute, New York, New York
| | - Adriana Di Martino
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York
| |
Collapse
|
46
|
Characterizing Objective Quality of Life and Normative Outcomes in Adults with Autism Spectrum Disorder: An Exploratory Latent Class Analysis. J Autism Dev Disord 2017; 46:2707-2719. [PMID: 27207091 DOI: 10.1007/s10803-016-2816-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aims to extend the definition of quality of life (QoL) for adults with autism spectrum disorder (ASD, n = 180, ages 23-60) by: (1) characterizing the heterogeneity of normative outcomes (employment, independent living, social engagement) and objective QoL (physical health, neighborhood quality, family contact, mental health issues); and (2) identifying predictors of positive normative outcomes and good objective QoL. Findings of an exploratory latent class analysis identified three groups of adults with ASD-Greater Dependence, Good Physical and Mental Health, and Greater Independence. Findings indicate that better daily living skills, better executive function, and more maternal warmth are associated with assignment to better outcome groups. Findings have implications for interventions designed to enhance achievement of normative outcomes and objective QoL.
Collapse
|
47
|
What is the association between ADI-R scores and final diagnosis of autism in an all IQ adult autism diagnostic service? ADVANCES IN AUTISM 2017. [DOI: 10.1108/aia-05-2017-0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
48
|
Schmidt RJ, Kogan V, Shelton JF, Delwiche L, Hansen RL, Ozonoff S, Ma CC, McCanlies EC, Bennett DH, Hertz-Picciotto I, Tancredi DJ, Volk HE. Combined Prenatal Pesticide Exposure and Folic Acid Intake in Relation to Autism Spectrum Disorder. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:097007. [PMID: 28934093 PMCID: PMC5915192 DOI: 10.1289/ehp604] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 03/16/2017] [Accepted: 03/18/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Maternal folic acid (FA) protects against developmental toxicity from certain environmental chemicals. OBJECTIVE We examined combined exposures to maternal FA and pesticides in relation to autism spectrum disorder (ASD). METHODS Participants were California children born from 2000-2007 who were enrolled in the Childhood Autism Risks from Genetics and the Environment (CHARGE) case-control study at age 2-5 y, were clinically confirmed to have ASD (n=296) or typical development (n=220), and had information on maternal supplemental FA and pesticide exposures. Maternal supplemental FA and household pesticide product use were retrospectively collected in telephone interviews from 2003-2011. High vs. low daily FA intake was dichotomized at 800μg (median). Mothers' addresses were linked to a statewide database of commercial applications to estimate agricultural pesticide exposure. RESULTS High FA intake (≥800μg) during the first pregnancy month and no known pesticide exposure was the reference group for all analyses. Compared with this group, ASD was increased in association with <800μg FA and any indoor pesticide exposure {adjusted odds ratio [OR]=2.5 [95% confidence interval (CI): 1.3, 4.7]} compared with low FA [OR=1.2 (95% CI: 0.7, 2.2)] or indoor pesticides [OR=1.7 (95% CI: 1.1, 2.8)] alone. ORs for the combination of low FA and regular pregnancy exposure (≥6 mo) to pet pesticides or to outdoor sprays and foggers were 3.9 (95% CI: 1.4, 11.5) and 4.1 (95% CI: 1.7, 10.1), respectively. ORs for low maternal FA and agricultural pesticide exposure 3 mo before or after conception were 2.2 (95% CI: 0.7, 6.5) for chlorpyrifos, 2.3 (95% CI: 0.98, 5.3) for organophosphates, 2.1 (95% CI: 0.9, 4.8) for pyrethroids, and 1.5 (95% CI: 0.5, 4.8) for carbamates. Except for carbamates, these ORs were approximately two times greater than those for either exposure alone or for the expected ORs for combined exposures under multiplicative or additive models. CONCLUSIONS In this study population, associations between pesticide exposures and ASD were attenuated among those with high versus low FA intake during the first month of pregnancy. Confirmatory and mechanistic studies are needed. https://doi.org/10.1289/EHP604.
Collapse
Affiliation(s)
- Rebecca J Schmidt
- Department of Public Health Sciences, University of California Davis School of Medicine , Davis, California, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis , Sacramento, California, USA
| | - Vladimir Kogan
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Janie F Shelton
- Department of Public Health Sciences, University of California Davis School of Medicine , Davis, California, USA
| | - Lora Delwiche
- Department of Public Health Sciences, University of California Davis School of Medicine , Davis, California, USA
| | - Robin L Hansen
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis , Sacramento, California, USA
- Department of Pediatrics, University of California Davis School of Medicine, Davis, California, USA
| | - Sally Ozonoff
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis , Sacramento, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Davis, California, USA
| | - Claudia C Ma
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Erin C McCanlies
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis School of Medicine , Davis, California, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California Davis School of Medicine , Davis, California, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis , Sacramento, California, USA
| | - Daniel J Tancredi
- Department of Pediatrics, University of California Davis School of Medicine, Davis, California, USA
| | - Heather E Volk
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
49
|
Nayar K, Voyles AC, Kiorpes L, Di Martino A. Global and local visual processing in autism: An objective assessment approach. Autism Res 2017; 10:1392-1404. [DOI: 10.1002/aur.1782] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 02/25/2017] [Accepted: 02/27/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Kritika Nayar
- Autism Spectrum Disorders Research Program, the Child Study Center at New York University Langone Medical Center; New York
| | | | - Lynne Kiorpes
- Center for Neural Science, New York University; New York
| | - Adriana Di Martino
- Autism Spectrum Disorders Research Program, the Child Study Center at New York University Langone Medical Center; New York
| |
Collapse
|
50
|
Samms-Vaughan M, Rahbar MH, Dickerson AS, Loveland KA, Hessabi M, Pearson DA, Bressler J, Shakespeare-Pellington S, Grove ML, Coore-Desai C, Reece J, Boerwinkle E. The diagnosis of autism and autism spectrum disorder in low- and middle-income countries: Experience from Jamaica. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 21:564-572. [PMID: 28367671 DOI: 10.1177/1362361317698938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The administration requirements of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised, widely used in high-income countries, make them less feasible for diagnosis of autism spectrum disorder in low- and middle-income countries. The flexible administration requirements of the Childhood Autism Rating Scale have resulted in its use in both high-income countries and low- and middle-income countries. This study examines the agreement between assessments using the Childhood Autism Rating Scale with those using the Autism Diagnostic Observation Schedule or Autism Diagnostic Observation Schedule, Second Edition and Autism Diagnostic Interview-Revised in Jamaica. Children aged 2-8 years (n = 149) diagnosed with autism by an experienced clinician using the Childhood Autism Rating Scale were re-evaluated using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. The proportion diagnosed with autism spectrum disorder using the Autism Diagnostic Observation Schedule, Autism Diagnostic Observation Schedule, Second Edition, and Autism Diagnostic Interview-Revised was determined and mean domain scores compared using analysis of variance (ANOVA). The mean age was 64.4 (standard deviation = 21.6) months; the male:female ratio was 6:1. The diagnostic agreement of the Childhood Autism Rating Scale with the Autism Diagnostic Observation Schedule and Autism Diagnostic Observation Schedule, Second Edition was 100.0% and 98.0%, respectively. Agreement with the Autism Diagnostic Interview-Revised was 94.6%. Domain scores were highest for children with more severe symptoms (p < 0.01). Despite a high level of agreement of the Childhood Autism Rating Scale with the Autism Diagnostic Observation Schedule, Autism Diagnostic Observation Schedule, Second Edition, and Autism Diagnostic Interview-Revised, the Childhood Autism Rating Scale should be evaluated further with a broader range of autism spectrum disorder symptomatology, and by clinicians with varying experience before recommendation for use in low- and middle-income countries.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Jan Bressler
- 2 The University of Texas Health Science Center at Houston, USA
| | | | - Megan L Grove
- 2 The University of Texas Health Science Center at Houston, USA
| | | | - Jody Reece
- 1 The University of the West Indies, Jamaica
| | - Eric Boerwinkle
- 2 The University of Texas Health Science Center at Houston, USA
| |
Collapse
|