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Advancing research on early autism through an integrated risk and resilience perspective. Dev Psychopathol 2023; 35:44-61. [PMID: 35379370 DOI: 10.1017/s0954579421001437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To date, a deficit-oriented approach dominates autism spectrum disorder (ASD) research, including studies of infant siblings of children with ASD at high risk (HR) for the disabilities associated with this disorder. Despite scientific advances regarding early ASD-related risk, there remains little systematic investigation of positive development, limiting the scope of research and quite possibly a deeper understanding of pathways toward and away from ASD-related impairments. In this paper, we argue that integrating a resilience framework into early ASD research has the potential to enhance knowledge on prodromal course, phenotypic heterogeneity, and developmental processes of risk and adaptation. We delineate a developmental systems resilience framework with particular reference to HR infants. To illustrate the utility of a resilience perspective, we consider the "female protective effect" and other evidence of adaptation in the face of ASD-related risk. We suggest that a resilience framework invites focal questions about the nature, timing, levels, interactions, and mechanisms by which positive adaptation occurs in relation to risk and developmental pathways toward and away from ASD-related difficulties. We conclude with recommendations for future research, including more focus on adaptive development and multisystem processes, pathways away from disorder, and reconsideration of extant evidence within an integrated risk-and-resilience framework.
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Dougherty JD, Marrus N, Maloney SE, Yip B, Sandin S, Turner TN, Selmanovic D, Kroll KL, Gutmann DH, Constantino JN, Weiss LA. Can the "female protective effect" liability threshold model explain sex differences in autism spectrum disorder? Neuron 2022; 110:3243-3262. [PMID: 35868305 PMCID: PMC9588569 DOI: 10.1016/j.neuron.2022.06.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/09/2022] [Accepted: 06/24/2022] [Indexed: 11/25/2022]
Abstract
Male sex is a strong risk factor for autism spectrum disorder (ASD). The leading theory for a "female protective effect" (FPE) envisions males and females have "differing thresholds" under a "liability threshold model" (DT-LTM). Specifically, this model posits that females require either a greater number or larger magnitude of risk factors (i.e., greater liability) to manifest ASD, which is supported by the finding that a greater proportion of females with ASD have highly penetrant genetic mutations. Herein, we derive testable hypotheses from the DT-LTM for ASD, investigating heritability, familial recurrence, correlation between ASD penetrance and sex ratio, population traits, clinical features, the stability of the sex ratio across diagnostic changes, and highlight other key prerequisites. Our findings reveal that several key predictions of the DT-LTM are not supported by current data, requiring us to establish a different conceptual framework for evaluating alternate models that explain sex differences in ASD.
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Affiliation(s)
- Joseph D Dougherty
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA.
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Susan E Maloney
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Benjamin Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Seaver Autism Center for Research and Treatment at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tychele N Turner
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA; Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Din Selmanovic
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kristen L Kroll
- Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - David H Gutmann
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - John N Constantino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Lauren A Weiss
- Institute for Human Genetics, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
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Amini F, Yee KW, Soh SC, Alhadeethi A, Amini R, Ng ESC. Awareness and perception of medical genetic services among Malaysian parents of autism spectrum disorders children: the lessons to be learned. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-08-2020-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Autism spectrum disorder (ASD) is a group of complex neurodevelopmental disorders with uncertain etiology. Evidence shows that genetic testing can explain about 20% of cases. This study aims to assess the level of awareness and perception of medical genetic services among Malaysian parents with ASD children.
Design/methodology/approach
A cross-sectional survey using an interviewer-administered questionnaire was done among 111 parents of children with ASD from August 2017 to September 2019 in two clinics in Malaysia.
Findings
A majority of children with ASD (80.20%) were male and diagnosed at the age of 3–4 years old (47.80%). When the autistic child was born, most mothers and fathers were aged 26–30 (40.50%) and 31–35 years old (42.30%), respectively. Another child with ASD in nuclear and extended families was reported for 11.70% and 13.50%, respectively. Only 24.30% have seen a professional genetic consultant, and 19.8% have done genetic testing for affected children. The mean score of awareness of genetic services for ASD was 2.48 ± 3.30. Having medical insurance and another child with ASD in the nuclear family was significantly associated with a higher level of awareness (p = 0.01 and p < 0.001, respectively). Most of the participants have a positive perception of these services.
Originality/value
Regardless of demographic factors, participants have poor awareness of genetic services for ASD, likely because the primary physician did not recommend it upon diagnosis. Increasing health-care providers’ knowledge about the current potential of genetic testing for ASD and educational campaigns for the public are critical components of using available genetic tests to improve ASD management.
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Lin Y, Yerukala Sathipati S, Ho SY. Predicting the Risk Genes of Autism Spectrum Disorders. Front Genet 2021; 12:665469. [PMID: 34194469 PMCID: PMC8236850 DOI: 10.3389/fgene.2021.665469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022] Open
Abstract
Autism spectrum disorder (ASD) refers to a wide spectrum of neurodevelopmental disorders that emerge during infancy and continue throughout a lifespan. Although substantial efforts have been made to develop therapeutic approaches, core symptoms persist lifelong in ASD patients. Identifying the brain temporospatial regions where the risk genes are expressed in ASD patients may help to improve the therapeutic strategies. Accordingly, this work aims to predict the risk genes of ASD and identify the temporospatial regions of the brain structures at different developmental time points for exploring the specificity of ASD gene expression in the brain that would help in possible ASD detection in the future. A dataset consisting of 13 developmental stages ranging from 8 weeks post-conception to 8 years from 26 brain structures was retrieved from the BrainSpan atlas. This work proposes a support vector machine–based risk gene prediction method ASD-Risk to distinguish the risk genes of ASD and non-ASD genes. ASD-Risk used an optimal feature selection algorithm called inheritable bi-objective combinatorial genetic algorithm to identify the brain temporospatial regions for prediction of the risk genes of ASD. ASD-Risk achieved a 10-fold cross-validation accuracy, sensitivity, specificity, area under a receiver operating characteristic curve, and a test accuracy of 81.83%, 0.84, 0.79, 0.84, and 72.27%, respectively. We prioritized the temporospatial features according to their contribution to the prediction accuracy. The top identified temporospatial regions of the brain for risk gene prediction included the posteroventral parietal cortex at 13 post-conception weeks feature. The identified temporospatial features would help to explore the risk genes that are specifically expressed in different brain regions of ASD patients.
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Affiliation(s)
- Yenching Lin
- Interdisciplinary Neuroscience Ph.D. Program, National Chiao Tung University, Hsinchu, Taiwan
| | - Srinivasulu Yerukala Sathipati
- Center for Precision Medicine Research, Marshfield Clinic Research Institute, Marshfield, WI, United States.,Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shinn-Ying Ho
- Interdisciplinary Neuroscience Ph.D. Program, National Chiao Tung University, Hsinchu, Taiwan.,Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.,Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Center For Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Chiao Tung University, Hsinchu, Taiwan
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5
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Merikangas AK, Almasy L. Using the tools of genetic epidemiology to understand sex differences in neuropsychiatric disorders. GENES BRAIN AND BEHAVIOR 2020; 19:e12660. [PMID: 32348611 PMCID: PMC7507200 DOI: 10.1111/gbb.12660] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/01/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
Many neuropsychiatric disorders exhibit differences in prevalence, age of onset, symptoms or course of illness between males and females. For the most part, the origins of these differences are not well understood. In this article, we provide an overview of sex differences in psychiatric disorders including autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), anxiety, depression, alcohol and substance abuse, schizophrenia, eating disorders and risk of suicide. We discuss both genetic and nongenetic mechanisms that have been hypothesized to underlie these differences, including ascertainment bias, environmental stressors, X‐ or Y‐linked risk loci, and differential liability thresholds in males and females. We then review the use of twin, family and genome‐wide association approaches to study potential genetic mechanisms of sex differences and the extent to which these designs have been employed in studies of psychiatric disorders. We describe the utility of genetic epidemiologic study designs, including classical twin and family studies, large‐scale studies of population registries, derived recurrence risks, and molecular genetic analyses of genome‐wide variation that may enhance our understanding sex differences in neuropsychiatric disorders.
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Affiliation(s)
- Alison K Merikangas
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Almasy
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Abstract
PURPOSE OF REVIEW Consanguinity can increase the risk for autosomal recessive conditions, along with autism spectrum disorder (ASD). Rarely outside of the genetics community is this discussed. Understanding its impact on the development of ASD and increasing awareness for physicians is important. RECENT FINDINGS ASD is a polygenic multifactorial disorder associated with morbidity and burden of care. Studies have confirmed its heritability, suspecting to an autosomal recessive transmission. Consanguinity increases the risk for uncovering recessive disorder and its role as an independent contributor for the development of ASD should be examined. With consanguinity being a known risk factor for autosomal recessive conditions, clinicians should routinely screen for it when evaluating for ASD, as this is inconsistently done. If suspected, genetic testing should be also recommended. Understanding current risk as well as future risk and providing families with the education to make the most informed decisions is necessary.
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Hertz-Picciotto I, Schmidt RJ, Krakowiak P. Understanding environmental contributions to autism: Causal concepts and the state of science. Autism Res 2018; 11:554-586. [PMID: 29573218 DOI: 10.1002/aur.1938] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/12/2017] [Accepted: 10/19/2017] [Indexed: 11/06/2022]
Abstract
The complexity of neurodevelopment, the rapidity of early neurogenesis, and over 100 years of research identifying environmental influences on neurodevelopment serve as backdrop to understanding factors that influence risk and severity of autism spectrum disorder (ASD). This Keynote Lecture, delivered at the May 2016 annual meeting of the International Society for Autism Research, describes concepts of causation, outlines the trajectory of research on nongenetic factors beginning in the 1960s, and briefly reviews the current state of this science. Causal concepts are introduced, including root causes; pitfalls in interpreting time trends as clues to etiologic factors; susceptible time windows for exposure; and implications of a multi-factorial model of ASD. An historical background presents early research into the origins of ASD. The epidemiologic literature from the last fifteen years is briefly but critically reviewed for potential roles of, for example, air pollution, pesticides, plastics, prenatal vitamins, lifestyle and family factors, and maternal obstetric and metabolic conditions during her pregnancy. Three examples from the case-control CHildhood Autism Risks from Genes and the Environment Study are probed to illustrate methodological approaches to central challenges in observational studies: capturing environmental exposure; causal inference when a randomized controlled clinical trial is either unethical or infeasible; and the integration of genetic, epigenetic, and environmental influences on development. We conclude with reflections on future directions, including exposomics, new technologies, the microbiome, gene-by-environment interaction in the era of -omics, and epigenetics as the interface of those two. As the environment is malleable, this research advances the goal of a productive and fulfilling life for all children, teen-agers and adults. Autism Res 2018, 11: 554-586. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This Keynote Lecture, delivered at the 2016 meeting of the International Society for Autism Research, discusses evidence from human epidemiologic studies of prenatal factors contributing to autism, such as pesticides, maternal nutrition and her health. There is no single cause for autism. Examples highlight the features of a high-quality epidemiology study, and what comprises a compelling case for causation. Emergent research directions hold promise for identifying potential interventions to reduce disabilities, enhance giftedness, and improve lives of those with ASD.
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Affiliation(s)
- Irva Hertz-Picciotto
- Department of Public Health Sciences, MIND Institute (Medical Investigations of Neurodevelopmental Disorders), University of California, Davis, Davis, California
| | - Rebecca J Schmidt
- Department of Public Health Sciences, MIND Institute (Medical Investigations of Neurodevelopmental Disorders), University of California, Davis, Davis, California
| | - Paula Krakowiak
- Department of Public Health Sciences, MIND Institute (Medical Investigations of Neurodevelopmental Disorders), University of California, Davis, Davis, California
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Gong T, Dalman C, Wicks S, Dal H, Magnusson C, Lundholm C, Almqvist C, Pershagen G. Perinatal Exposure to Traffic-Related Air Pollution and Autism Spectrum Disorders. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:119-126. [PMID: 27494442 PMCID: PMC5226686 DOI: 10.1289/ehp118] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/23/2016] [Accepted: 07/12/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND Studies from the United States indicate that exposure to air pollution in early life is associated with autism spectrum disorders (ASD) in children, but the evidence is not consistent with European data. OBJECTIVE We aimed to investigate the association between exposure to air pollution from road traffic and the risk of ASD in children, with careful adjustment for socioeconomic and other confounders. METHOD Children born and residing in Stockholm, Sweden, during 1993-2007 with an ASD diagnosis were identified through multiple health registers and classified as cases (n = 5,136). A randomly selected sample of 18,237 children from the same study base constituted controls. Levels of nitrogen oxides (NOx) and particulate matter with diameter ≤ 10 μm (PM10) from road traffic were estimated at residential addresses during mother's pregnancy and the child's first year of life by dispersion models. Odds ratios (OR) and 95% confidence intervals (CI) for ASD with or without intellectual disability (ID) were estimated using logistic regression models after conditioning on municipality and calendar year of birth as well as adjustment for potential confounders. RESULT Air pollution exposure during the prenatal period was not associated with ASD overall (OR = 1.00; 95% CI: 0.86, 1.15 per 10-μg/m3 increase in PM10 and OR = 1.02; 95% CI: 0.94, 1.10 per 20-μg/m3 increase in NOx during mother's pregnancy). Similar results were seen for exposure during the first year of life, and for ASD in combination with ID. An inverse association between air pollution exposure and ASD risk was observed among children of mothers who moved to a new residence during pregnancy. CONCLUSION Early-life exposure to low levels of NOx and PM10 from road traffic does not appear to increase the risk of ASD. Citation: Gong T, Dalman C, Wicks S, Dal H, Magnusson C, Lundholm C, Almqvist C, Pershagen G. 2017. Perinatal exposure to traffic-related air pollution and autism spectrum disorders. Environ Health Perspect 125:119-126; http://dx.doi.org/10.1289/EHP118.
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Affiliation(s)
- Tong Gong
- Department of Medical Epidemiology and Biostatistics, and
| | - Christina Dalman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Susanne Wicks
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Henrik Dal
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Cecilia Magnusson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, and
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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Christensen J, Overgaard M, Parner ET, Vestergaard M, Schendel D. Risk of epilepsy and autism in full and half siblings-A population-based cohort study. Epilepsia 2016; 57:2011-2018. [DOI: 10.1111/epi.13595] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2016] [Indexed: 01/18/2023]
Affiliation(s)
| | - Morten Overgaard
- Department of Public Health; Section for Biostatistics; Aarhus University; Aarhus Denmark
| | - Erik T. Parner
- Department of Public Health; Section for Biostatistics; Aarhus University; Aarhus Denmark
| | - Mogens Vestergaard
- Research Unit and Section for General Practice; Department of Public Health; Aarhus University; Aarhus Denmark
| | - Diana Schendel
- Department of Public Health; Section of Epidemiology; Aarhus University; Aarhus Denmark
- Department of Economics and Business; National Center for Register-based Research; Aarhus University; Aarhus Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research; iPSYCH; Aarhus University; Aarhus Denmark
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Is the Risk of Autism in Younger Siblings of Affected Children Moderated by Sex, Race/Ethnicity, or Gestational Age? J Dev Behav Pediatr 2016; 37:603-9. [PMID: 27500597 DOI: 10.1097/dbp.0000000000000341] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate the recurrence risk of autism spectrum disorders (ASD) in younger siblings of affected children and determine how it is modified by race/ethnicity and sex. METHOD Medical records of children born in a large health maintenance organization (Kaiser Permanent Southern California) hospitals from January 1, 2001, through December 31, 2010, and who remained in our system until 2 to 11 years of age were used to assess the risk of recurrence of ASD in younger siblings. Children born at <28 or >42 weeks gestation, multiple births, or those who were not active members for ≥3 months were excluded. ASD diagnosis was ascertained from DSM-IV codes, and the magnitude of the association was estimated using adjusted relative risks (aRRs). RESULTS Among eligible younger siblings, 592 (1.11%) had the diagnosis of ASD. The ASD rates were 11.30% and 0.92% for younger siblings of older affected and unaffected siblings, respectively (aRR: 14.27; 95% confidence interval, 11.41-17.83). This association remained after adjusting for potential confounding factors. Race/ethnicity- and gestational age-specific analyses revealed a positive association of similar magnitude across groups. Risk remained higher in younger boys than girls regardless of the sex of affected older siblings. CONCLUSION The findings of this study suggest that the risk of ASD in younger siblings is higher if the older sibling has ASD. The risk of ASD in younger siblings of older affected siblings was comparable across gestational age at birth and child's race/ethnicity groups. However, risk remains higher for boys. This study contributes to a better understanding of the influence of race/ethnicity, sex, and gestational age at birth in identifying children at higher risk of ASD.
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Abstract
International school psychologists play an important professional role in providing early diagnostic, consultative and treatment-planning services for autistic children and their families. Recent advances in our understanding of this complex disorder necessitates updating professionals in the etiology and treatment of autism. The article describes components of making a differential diagnosis of autism from developmental language/speech disorders, mental retardation and schizophrenia. Etiological theories based on recent neurobiological data are outlined and the psychometric properties of cognitive ability and behavioral rating instruments frequently used with this population are delineated. Specific innovative educational and pharmacological treatment approaches are reviewed.
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Kumar A, Juneja M, Mishra D. Prevalence of Autism Spectrum Disorders in Siblings of Indian Children With Autism Spectrum Disorders. J Child Neurol 2016; 31:873-8. [PMID: 26733506 DOI: 10.1177/0883073815624764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 12/06/2015] [Indexed: 11/16/2022]
Abstract
This study determined the prevalence of autism spectrum disorders in 201 siblings of children with autism spectrum disorders. Siblings were screened using Modified Checklist for Autism in Toddlers and Social Responsiveness Scale, parent version. Screen-positive siblings were assessed using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. The risk of autism spectrum disorder in siblings was correlated with various familial and disease characteristics of the index case. Prevalence of autism spectrum disorder in siblings was 4.97%. There was a significant effect of the presence of aggressive behavior, externalizing problems and total problems in the proband, assessed using Childhood Behavior Checklist, and the young age of the father at conception on sibling risk of autism spectrum disorder. Results of our study are in line with previous studies reporting similar prevalence but have also brought up the association with behavioral problems as a possible risk factor. Siblings of children with autism spectrum disorder should be routinely screened, and genetic counseling for this increased risk should be explained to the family.
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Affiliation(s)
- Ankur Kumar
- Department of Pediatrics, Advanced Pediatric Centre, PGIMER, Chandigarh, India
| | - Monica Juneja
- Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Devendra Mishra
- Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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Ziats MN, Rennert OM. The Evolving Diagnostic and Genetic Landscapes of Autism Spectrum Disorder. Front Genet 2016; 7:65. [PMID: 27200076 PMCID: PMC4844926 DOI: 10.3389/fgene.2016.00065] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/08/2016] [Indexed: 11/24/2022] Open
Abstract
The autism spectrum disorders (ASD) are a heterogeneous set of neurodevelopmental syndromes defined by impairments in verbal and non-verbal communication, restricted social interaction, and the presence of stereotyped patterns of behavior. The prevalence of ASD is rising, and the diagnostic criteria and clinical perspectives on the disorder continue to evolve in parallel. Although the majority of individuals with ASD will not have an identifiable genetic cause, almost 25% of cases have identifiable causative DNA variants. The rapidly improving ability to identify genetic mutations because of advances in next generation sequencing, coupled with previous epidemiological studies demonstrating high heritability of ASD, have led to many recent attempts to identify causative genetic mutations underlying the ASD phenotype. However, although hundreds of mutations have been identified to date, they are either rare variants affecting only a handful of ASD patients, or are common variants in the general population conferring only a small risk for ASD. Furthermore, the genes implicated thus far are heterogeneous in their structure and function, hampering attempts to understand shared molecular mechanisms among all ASD patients; an understanding that is crucial for the development of targeted diagnostics and therapies. However, new work is beginning to suggest that the heterogeneous set of genes implicated in ASD may ultimately converge on a few common pathways. In this review, we discuss the parallel evolution of our diagnostic and genetic understanding of autism spectrum disorders, and highlight recent attempts to infer common biology underlying this complicated syndrome.
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Affiliation(s)
- Mark N. Ziats
- Laboratory of Clinical and Developmental Genomics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Physiology, Development and Neuroscience, University of CambridgeCambridgeshire, UK
- Medical Scientist Training Program, Baylor College of MedicineHouston, TX, USA
| | - Owen M. Rennert
- Laboratory of Clinical and Developmental Genomics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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Clinical Genetic Aspects of ASD Spectrum Disorders. Int J Mol Sci 2016; 17:ijms17020180. [PMID: 26840296 PMCID: PMC4783914 DOI: 10.3390/ijms17020180] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/19/2016] [Accepted: 01/26/2016] [Indexed: 01/26/2023] Open
Abstract
Early presumptions opined that autism spectrum disorder (ASD) was related to the rearing of these children by emotionally-distant mothers. Advances in the 1960s and 1970s clearly demonstrated the biologic basis of autism with a high heritability. Recent advances have demonstrated that specific etiologic factors in autism spectrum disorders can be identified in 30%–40% of cases. Based on early reports newer, emerging genomic technologies are likely to increase this diagnostic yield to over 50%. To date these investigations have focused on etiologic factors that are largely mono-factorial. The currently undiagnosed causes of ASDs will likely be found to have causes that are more complex. Epigenetic, multiple interacting loci, and four dimensional causes (with timing as a variable) are likely to be associated with the currently unidentifiable cases. Today, the “Why” is more important than ever. Understanding the causes of ASDs help inform families of important issues such as recurrence risk, prognosis, natural history, and predicting associated co-morbid medical conditions. In the current era of emerging efforts in “personalized medicine”, identifying an etiology will be critical in identifying endo-phenotypic groups and individual variations that will allow for tailored treatment for persons with ASD.
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Sacrey LAR, Bennett JA, Zwaigenbaum L. Early Infant Development and Intervention for Autism Spectrum Disorder. J Child Neurol 2015; 30:1921-9. [PMID: 26323499 DOI: 10.1177/0883073815601500] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 07/25/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective is to overview recent findings on early detection/diagnosis of autism spectrum disorders, as well as clinical trials of early interventions for toddlers at risk for/diagnosed with autism spectrum disorder. FINDINGS Prospective studies of infants at high risk of autism spectrum disorder have yielded significant advances in understanding early development in autism spectrum disorder. Findings from prospective studies indicate that abnormalities in social communication and repetitive behaviors emerge during the second year, whereas additional "prodromal features" (motor and sensory abnormalities) emerge in the first year. Subsequently, exciting progress has been made in establishing the efficacy of autism spectrum disorder-specific interventions for toddlers as young as 15 months. Finally, efforts occur to characterize autism spectrum disorder-specific characteristics in genetic syndromes with concurrent autism spectrum disorder symptomatology. CONCLUSION Substantial progress in characterizing early developmental trajectories as well as the identification of specific behavioral markers has aided early detection. Work remains to ensure that research findings are translated into clinical practice for uptake in the health care system.
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Affiliation(s)
- Lori-Ann R Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Jeffrey A Bennett
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
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16
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Zwaigenbaum L, Bauman ML, Fein D, Pierce K, Buie T, Davis PA, Newschaffer C, Robins DL, Wetherby A, Choueiri R, Kasari C, Stone WL, Yirmiya N, Estes A, Hansen RL, McPartland JC, Natowicz MR, Carter A, Granpeesheh D, Mailloux Z, Smith Roley S, Wagner S. Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research. Pediatrics 2015; 136 Suppl 1:S41-59. [PMID: 26430169 PMCID: PMC9923900 DOI: 10.1542/peds.2014-3667d] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This article reviews current evidence for autism spectrum disorder (ASD) screening based on peer-reviewed articles published to December 2013. Screening provides a standardized process to ensure that children are systematically monitored for early signs of ASD to promote earlier diagnosis. The current review indicates that screening in children aged 18 to 24 months can assist in early detection, consistent with current American Academy of Pediatrics' recommendations. We identify ASD-specific and broadband screening tools that have been evaluated in large community samples which show particular promise in terms of accurate classification and clinical utility. We also suggest strategies to help overcome challenges to implementing ASD screening in community practice, as well as priorities for future research.
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Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;
| | - Margaret L. Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Karen Pierce
- Department of Neurosciences, University of California San Diego, La Jolla, California
| | - Timothy Buie
- Harvard Medical School and Massachusetts General Hospital for Children, Boston, Massachusetts
| | | | - Craig Newschaffer
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Amy Wetherby
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, Florida
| | - Roula Choueiri
- Division of Developmental and Behavioral Pediatrics, University of Massachusetts Memorial Children’s Medical Center, Worcester, Massachusetts
| | - Connie Kasari
- Graduate School of Education & Information Studies, University of California Los Angeles, Los Angeles, California
| | | | - Nurit Yirmiya
- Department of Psychology, Hebrew University of Jerusalem Mount Scopus, Jerusalem, Israel
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Robin L. Hansen
- Department of Pediatrics, University of California Davis MIND Institute, Sacramento, California
| | | | | | - Alice Carter
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | | | - Zoe Mailloux
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Susanne Smith Roley
- USC Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California; and
| | - Sheldon Wagner
- Behavioral Development & Educational Services, New Bedford, Massachusetts
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17
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Mahfouz A, Ziats MN, Rennert OM, Lelieveldt BPF, Reinders MJT. Shared Pathways Among Autism Candidate Genes Determined by Co-expression Network Analysis of the Developing Human Brain Transcriptome. J Mol Neurosci 2015; 57:580-94. [PMID: 26399424 PMCID: PMC4644211 DOI: 10.1007/s12031-015-0641-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 08/14/2015] [Indexed: 11/24/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental syndrome known to have a significant but complex genetic etiology. Hundreds of diverse genes have been implicated in ASD; yet understanding how many genes, each with disparate function, can all be linked to a single clinical phenotype remains unclear. We hypothesized that understanding functional relationships between autism candidate genes during normal human brain development may provide convergent mechanistic insight into the genetic heterogeneity of ASD. We analyzed the co-expression relationships of 455 genes previously implicated in autism using the BrainSpan human transcriptome database, across 16 anatomical brain regions spanning prenatal life through adulthood. We discovered modules of ASD candidate genes with biologically relevant temporal co-expression dynamics, which were enriched for functional ontologies related to synaptogenesis, apoptosis, and GABA-ergic neurons. Furthermore, we also constructed co-expression networks from the entire transcriptome and found that ASD candidate genes were enriched in modules related to mitochondrial function, protein translation, and ubiquitination. Hub genes central to these ASD-enriched modules were further identified, and their functions supported these ontological findings. Overall, our multi-dimensional co-expression analysis of ASD candidate genes in the normal developing human brain suggests the heterogeneous set of ASD candidates share transcriptional networks related to synapse formation and elimination, protein turnover, and mitochondrial function.
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Affiliation(s)
- Ahmed Mahfouz
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands. .,Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Mark N Ziats
- National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.,University of Cambridge, Cambridge, UK.,Baylor College of Medicine, Houston, TX, USA
| | - Owen M Rennert
- National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Boudewijn P F Lelieveldt
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Intelligent Systems, Delft University of Technology, Delft, The Netherlands
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
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18
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Jin Y, Wee CY, Shi F, Thung KH, Ni D, Yap PT, Shen D. Identification of infants at high-risk for autism spectrum disorder using multiparameter multiscale white matter connectivity networks. Hum Brain Mapp 2015; 36:4880-96. [PMID: 26368659 DOI: 10.1002/hbm.22957] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 07/27/2015] [Accepted: 08/20/2015] [Indexed: 12/26/2022] Open
Abstract
Autism spectrum disorder (ASD) is a wide range of disabilities that cause life-long cognitive impairment and social, communication, and behavioral challenges. Early diagnosis and medical intervention are important for improving the life quality of autistic patients. However, in the current practice, diagnosis often has to be delayed until the behavioral symptoms become evident during childhood. In this study, we demonstrate the feasibility of using machine learning techniques for identifying high-risk ASD infants at as early as six months after birth. This is based on the observation that ASD-induced abnormalities in white matter (WM) tracts and whole-brain connectivity have already started to appear within 24 months after birth. In particular, we propose a novel multikernel support vector machine classification framework by using the connectivity features gathered from WM connectivity networks, which are generated via multiscale regions of interest (ROIs) and multiple diffusion statistics such as fractional anisotropy, mean diffusivity, and average fiber length. Our proposed framework achieves an accuracy of 76% and an area of 0.80 under the receiver operating characteristic curve (AUC), in comparison to the accuracy of 70% and the AUC of 70% provided by the best single-parameter single-scale network. The improvement in accuracy is mainly due to the complementary information provided by multiparameter multiscale networks. In addition, our framework also provides the potential imaging connectomic markers and an objective means for early ASD diagnosis.
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Affiliation(s)
- Yan Jin
- Biomedical Research Imaging Center, Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
| | - Chong-Yaw Wee
- Biomedical Research Imaging Center, Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
| | - Feng Shi
- Biomedical Research Imaging Center, Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
| | - Kim-Han Thung
- Biomedical Research Imaging Center, Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
| | - Dong Ni
- The Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Department of Biomedical Engineering, Shenzhen University, China
| | - Pew-Thian Yap
- Biomedical Research Imaging Center, Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
| | - Dinggang Shen
- Biomedical Research Imaging Center, Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, North Carolina.,Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
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19
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Hua R, Wei M, Zhang C. The complex genetics in autism spectrum disorders. SCIENCE CHINA-LIFE SCIENCES 2015; 58:933-45. [PMID: 26335739 DOI: 10.1007/s11427-015-4893-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Autism spectrum disorders (ASD) are a pervasive neurodevelopmental disease characterized by deficits in social interaction and nonverbal communication, as well as restricted interests and stereotypical behavior. Genetic changes/heritability is one of the major contributing factors, and hundreds to thousands of causative and susceptible genes, copy number variants (CNVs), linkage regions, and microRNAs have been associated with ASD which clearly indicates that ASD is a complex genetic disorder. Here, we will briefly summarize some of the high-confidence genetic changes in ASD and their possible roles in their pathogenesis.
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Affiliation(s)
- Rui Hua
- State Key Laboratory of Membrane Biology, School of Life Sciences; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China
| | - MengPing Wei
- State Key Laboratory of Membrane Biology, School of Life Sciences; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China
| | - Chen Zhang
- State Key Laboratory of Membrane Biology, School of Life Sciences; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
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20
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Boukhris T, Bérard A. Selective Serotonin Reuptake Inhibitor Use during Pregnancy and the Risk of Autism Spectrum Disorders: A Review. J Pediatr Genet 2015; 4:84-93. [PMID: 27617119 PMCID: PMC4918714 DOI: 10.1055/s-0035-1556744] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 04/20/2015] [Indexed: 10/23/2022]
Abstract
Antidepressants are widely used during pregnancy. Several studies have shown that the use of antidepressants during pregnancy is linked to adverse outcomes, including congenital malformations, prematurity, and low birth weight. However, there is a knowledge gap regarding the potential association between gestational exposure to antidepressants and the risk of autism spectrum disorders (ASD). The etiology of ASD remains unclear, although studies have implicated genetic predispositions and environmental risk factors in the development of ASD in children. In this review, we describe the association between gestational use of antidepressants, specifically selective serotonin reuptake inhibitors, and the risk of ASD.
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Affiliation(s)
- Takoua Boukhris
- Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
- Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Anick Bérard
- Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
- Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada
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21
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Butler MG, Rafi SK, Manzardo AM. High-resolution chromosome ideogram representation of currently recognized genes for autism spectrum disorders. Int J Mol Sci 2015; 16:6464-95. [PMID: 25803107 PMCID: PMC4394543 DOI: 10.3390/ijms16036464] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/11/2015] [Accepted: 03/16/2015] [Indexed: 11/16/2022] Open
Abstract
Recently, autism-related research has focused on the identification of various genes and disturbed pathways causing the genetically heterogeneous group of autism spectrum disorders (ASD). The list of autism-related genes has significantly increased due to better awareness with advances in genetic technology and expanding searchable genomic databases. We compiled a master list of known and clinically relevant autism spectrum disorder genes identified with supporting evidence from peer-reviewed medical literature sources by searching key words related to autism and genetics and from authoritative autism-related public access websites, such as the Simons Foundation Autism Research Institute autism genomic database dedicated to gene discovery and characterization. Our list consists of 792 genes arranged in alphabetical order in tabular form with gene symbols placed on high-resolution human chromosome ideograms, thereby enabling clinical and laboratory geneticists and genetic counsellors to access convenient visual images of the location and distribution of ASD genes. Meaningful correlations of the observed phenotype in patients with suspected/confirmed ASD gene(s) at the chromosome region or breakpoint band site can be made to inform diagnosis and gene-based personalized care and provide genetic counselling for families.
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Affiliation(s)
- Merlin G Butler
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | - Syed K Rafi
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | - Ann M Manzardo
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS 66160, USA.
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22
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Chen LS, Xu L, Dhar SU, Li M, Talwar D, Jung E. Autism spectrum disorders: a qualitative study of attitudes toward prenatal genetic testing and termination decisions of affected pregnancies. Clin Genet 2014; 88:122-8. [PMID: 25251361 DOI: 10.1111/cge.12504] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 12/25/2022]
Abstract
In the United States, prenatal genetic testing (PGT) for Autism Spectrum Disorders (ASD) is currently available via clinical genetic services. Such testing may inform parents about their unborn child's risk for ASD, prepare parents for the birth of an affected infant, and allow them to arrange for early interventions. Although PGT for autism has potential benefits, the associated ethical, legal, and social implications (ELSI) should be considered. This first qualitative study employed a hypothetical scenario to explore the attitudes toward PGT and termination decisions of 42 parents of children with ASD. Over half of the participants expressed willingness to undergo PGT for autism. Reasons included better preparation for birth, early and better treatment, termination of affected pregnancy, contribution to research, and curiosity. Of the 31 parents who were either willing or unsure about undergoing the PGT, approximately three-fourths would continue their hypothetical affected pregnancies. Explanations included preparation for birth of the child, bonding or acceptance of existing ASD-affected children, apprehensions about test limitations, and religious concerns. Parents who reported they would terminate the affected pregnancy in this hypothetical situation were primarily Asians. This study contributes to the growing understanding of the ELSI aspects of PGT in clinical practice.
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Affiliation(s)
- L S Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - L Xu
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - S U Dhar
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - M Li
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - D Talwar
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - E Jung
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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23
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Chen LS, Li C, Wang CH, Amuta A, Li M, Huang TY, Dhar SU, Talwar D, Jung E. Autism spectrum disorders: perceptions of genetic etiology and recurrence risk among Taiwanese parents of affected children. Clin Genet 2014; 88:129-34. [PMID: 25267333 DOI: 10.1111/cge.12514] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/11/2014] [Accepted: 09/26/2014] [Indexed: 11/29/2022]
Abstract
In Taiwan, autism spectrum disorders (ASDs) are an emerging public health concern. The ongoing scientific progress for understanding the genetic etiology of ASD makes it increasingly important to examine how parents of children with ASD perceive the causes and recurrence risk of having another child with ASD. These perceptions may influence their family planning, attitudes toward genetic services, and willingness to take their children for ASD genetic testing. However, previous studies addressing this issue were conducted primarily in Western countries. As culture might shape an individual's views of genetic/genomic disorders, this first-of-its-kind study examined the perceptions of the genetic etiology for ASD and the recurrence risk among Taiwanese parents of children affected with ASD. In-depth, semi-structured interviews were conducted among 39 parents having at least one child with ASD. Although the majority of participants believed that ASD has a genetic link, less than half perceived genetic factors as the cause of their own child's ASD. Moreover, most participants articulated their recurrence risk incorrectly. Some parents were concerned about their doctors' limited genomic competencies. To provide parents with better education, counseling, and support for making reproductive decisions, ASD-related genomic education among Taiwanese physicians is needed.
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Affiliation(s)
- L S Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - C Li
- Department of Foreign Languages, WeiFang Medical University, Shandong, China
| | - C H Wang
- Department of Special Education, National HsinChu University of Education, HsinChu, Taiwan
| | - A Amuta
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - M Li
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - T Y Huang
- Department of Special Education, National HsinChu University of Education, HsinChu, Taiwan
| | - S U Dhar
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - D Talwar
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - E Jung
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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24
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Wood CL, Warnell F, Johnson M, Hames A, Pearce MS, McConachie H, Parr JR. Evidence for ASD recurrence rates and reproductive stoppage from large UK ASD research family databases. Autism Res 2014; 8:73-81. [PMID: 25273900 DOI: 10.1002/aur.1414] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 08/11/2014] [Indexed: 01/20/2023]
Abstract
Following a diagnosis of a developmental disorder such as autism spectrum disorder (ASD) in early childhood, parents may decide to have fewer children than previously planned. The tendency for families to halt reproduction after receiving a diagnosis for one child is known as reproductive stoppage. Stoppage may lead to an underestimate of recurrence risk estimates of parents having more than one child with ASD. Using two large UK ASD family databases, we investigated recurrence rates for ASD and evidence for reproductive stoppage for both ASD and undiagnosed ASD/broader autism phenotype in a subgroup of families. Reproductive stoppage was tested for using the Mann-Whitney U-test to disprove the null hypothesis that affected and nonaffected children were distributed randomly by birth order. Dahlberg's later-sib method was used to estimate recurrence risk and take stoppage into account. Data were available from 299 families (660 children) including 327 with ASD. Ten percent of the complete families had more than one child with an ASD. Using Dahlberg's later-sib method, the recurrence risk for ASD was 24.7% overall and 50.0% in families with two or more older siblings with ASD. Children with ASD were born significantly later in families than those without ASD in all sibship combinations. This study shows strong evidence that ASD is associated with reproductive stoppage. These data have important implications for family planning and genetic counseling.
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Affiliation(s)
- Claire L Wood
- Department of Child Health, Newcastle Upon Tyne Hospitals Foundation Trust, Newcastle Upon Tyne, UK
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25
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Abstract
IMPORTANCE Autism spectrum disorder (ASD) aggregates in families, but the individual risk and to what extent this is caused by genetic factors or shared or nonshared environmental factors remains unresolved. OBJECTIVE To provide estimates of familial aggregation and heritability of ASD. DESIGN, SETTING, AND PARTICIPANTS A population-based cohort including 2,049,973 Swedish children born 1982 through 2006. We identified 37,570 twin pairs, 2,642,064 full sibling pairs, 432,281 maternal and 445,531 paternal half sibling pairs, and 5,799,875 cousin pairs. Diagnoses of ASD to December 31, 2009 were ascertained. MAIN OUTCOMES AND MEASURES The relative recurrence risk (RRR) measures familial aggregation of disease. The RRR is the relative risk of autism in a participant with a sibling or cousin who has the diagnosis (exposed) compared with the risk in a participant with no diagnosed family member (unexposed). We calculated RRR for both ASD and autistic disorder adjusting for age, birth year, sex, parental psychiatric history, and parental age. We estimated how much of the probability of developing ASD can be related to genetic (additive and dominant) and environmental (shared and nonshared) factors. RESULTS In the sample, 14,516 children were diagnosed with ASD, of whom 5689 had autistic disorder. The RRR and rate per 100,000 person-years for ASD among monozygotic twins was estimated to be 153.0 (95% CI, 56.7-412.8; rate, 6274 for exposed vs 27 for unexposed ); for dizygotic twins, 8.2 (95% CI, 3.7-18.1; rate, 805 for exposed vs 55 for unexposed); for full siblings, 10.3 (95% CI, 9.4-11.3; rate, 829 for exposed vs 49 for unexposed); for maternal half siblings, 3.3 (95% CI, 2.6-4.2; rate, 492 for exposed vs 94 for unexposed); for paternal half siblings, 2.9 (95% CI, 2.2-3.7; rate, 371 for exposed vs 85 for unexposed); and for cousins, 2.0 (95% CI, 1.8-2.2; rate, 155 for exposed vs 49 for unexposed). The RRR pattern was similar for autistic disorder but of slightly higher magnitude.We found support for a disease etiology including only additive genetic and nonshared environmental effects. The ASD heritability was estimated to be 0.50 (95% CI, 0.45-0.56) and the autistic disorder heritability was estimated to 0.54 (95% CI, 0.44-0.64). CONCLUSIONS AND RELEVANCE Among children born in Sweden, the individual risk of ASD and autistic disorder increased with increasing genetic relatedness. Heritability of ASD and autistic disorder were estimated to be approximately 50%. These findings may inform the counseling of families with affected children.
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Affiliation(s)
- Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden2Department of Psychosis Studies, Institute of Psychiatry, King's College London, United Kingdom
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Abraham Reichenberg
- Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, New York4Department of Preventive Medicine, Ichan School of Medicine at Mount Sinai, New York, New York5Seaver Autism Center and Friedman Brain Institute, Ichan School of Medicin
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26
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Parellada M, Penzol MJ, Pina L, Moreno C, González-Vioque E, Zalsman G, Arango C. The neurobiology of autism spectrum disorders. Eur Psychiatry 2013; 29:11-9. [PMID: 24275633 DOI: 10.1016/j.eurpsy.2013.02.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 02/20/2013] [Indexed: 01/22/2023] Open
Abstract
Data is progressively and robustly accumulating regarding the biological basis of autism. Autism spectrum disorders (ASD) are currently considered a group of neurodevelopmental disorders with onset very early in life and a complex, heterogeneous, multifactorial aetiology. A comprehensive search of the last five years of the Medline database was conducted in order to summarize recent evidence on the neurobiological bases of autism. The main findings on genetic influence, neuropathology, neurostructure and brain networks are summarized. In addition, findings from peripheral samples of subjects with autism and animal models, which show immune, oxidative, mitochondrial dysregulations, are reported. Then, other biomarkers from very different systems associated with autism are reported. Finally, an attempt is made to try and integrate the available evidence, which points to a oligogenetic, multifactorial aetiology that converges in an aberrant micro-organization of the cortex, with abnormal functioning of the synapses and abnormalities in very general physiological pathways (such as inflammatory, immune and redox systems).
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Affiliation(s)
- M Parellada
- Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Ibiza 43, 28009 Madrid, Spain.
| | - M J Penzol
- Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Ibiza 43, 28009 Madrid, Spain
| | - L Pina
- Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Ibiza 43, 28009 Madrid, Spain
| | - C Moreno
- Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Ibiza 43, 28009 Madrid, Spain
| | - E González-Vioque
- Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Ibiza 43, 28009 Madrid, Spain
| | - G Zalsman
- Child and Adolescent Psychiatry, Geha Hospital, Petach Tiqva, 49100 Tel Aviv, Israel
| | - C Arango
- Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Ibiza 43, 28009 Madrid, Spain
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27
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Schendel DE, Bresnahan M, Carter KW, Francis RW, Gissler M, Grønborg TK, Gross R, Gunnes N, Hornig M, Hultman CM, Langridge A, Lauritsen MB, Leonard H, Parner ET, Reichenberg A, Sandin S, Sourander A, Stoltenberg C, Suominen A, Surén P, Susser E. The International Collaboration for Autism Registry Epidemiology (iCARE): multinational registry-based investigations of autism risk factors and trends. J Autism Dev Disord 2013; 43:2650-63. [PMID: 23563868 PMCID: PMC4512211 DOI: 10.1007/s10803-013-1815-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in multinational collaboration concerning data access security, confidentiality and management. Data are obtained by integrating existing national or state-wide, population-based, individual-level data systems and undergo rigorous harmonization and quality control processes. Analyses are performed using database federation via a computational infrastructure with a secure, web-based, interface. iCARE provides a unique, unprecedented resource in autism research that will significantly enhance the ability to detect environmental and genetic contributions to the causes and life course of autism.
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Affiliation(s)
- Diana E Schendel
- Department of Public Health and Department of Economics and Business, University of Aarhus, 8000, Aarhus C, Denmark,
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Piven J, Vieland VJ, Parlier M, Thompson A, O'Conner I, Woodbury-Smith M, Huang Y, Walters KA, Fernandez B, Szatmari P. A molecular genetic study of autism and related phenotypes in extended pedigrees. J Neurodev Disord 2013; 5:30. [PMID: 24093601 PMCID: PMC3851306 DOI: 10.1186/1866-1955-5-30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 09/23/2013] [Indexed: 12/19/2022] Open
Abstract
Background Efforts to uncover the risk genotypes associated with the familial nature of autism spectrum disorder (ASD) have had limited success. The study of extended pedigrees, incorporating additional ASD-related phenotypes into linkage analysis, offers an alternative approach to the search for inherited ASD susceptibility variants that complements traditional methods used to study the genetics of ASD. Methods We examined evidence for linkage in 19 extended pedigrees ascertained through ASD cases spread across at least two (and in most cases three) nuclear families. Both compound phenotypes (i.e., ASD and, in non-ASD individuals, the broad autism phenotype) and more narrowly defined components of these phenotypes, e.g., social and repetitive behavior, pragmatic language, and anxiety, were examined. The overarching goal was to maximize the aggregate information available on the maximum number of individuals and to disaggregate syndromic phenotypes in order to examine the genetic underpinnings of more narrowly defined aspects of ASD behavior. Results Results reveal substantial between-family locus heterogeneity and support the importance of previously reported ASD loci in inherited, familial, forms of ASD. Additional loci, not seen in the ASD analyses, show evidence for linkage to the broad autism phenotype (BAP). BAP peaks are well supported by multiple subphenotypes (including anxiety, pragmatic language, and social behavior) showing linkage to regions overlapping with the compound BAP phenotype. Whereas 'repetitive behavior’, showing the strongest evidence for linkage (Posterior Probability of Linkage = 62% at 6p25.2-24.3, and 69% at 19p13.3), appears to be linked to novel regions not detected with other compound or narrow phenotypes examined in this study. Conclusions These results provide support for the presence of key features underlying the complexity of the genetic architecture of ASD: substantial between-family locus heterogeneity, that the BAP appears to correspond to sets of subclinical features segregating with ASD within pedigrees, and that different features of the ASD phenotype segregate independently of one another. These findings support the additional study of larger, even more individually informative pedigrees, together with measurement of multiple, behavioral- and biomarker-based phenotypes, in both affected and non-affected individuals, to elucidate the complex genetics of familial ASD.
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Affiliation(s)
- Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, School of Medicine, CB# 3367, Chapel Hill, NC 27599, USA
| | - Veronica J Vieland
- Battelle Center for Mathematical Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, Columbus, OH 43215, USA.,Department of Pediatrics and Department of Statistics, The Ohio State University, 575 Children's Crossroad, Columbus, OH 43215, USA
| | - Morgan Parlier
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, School of Medicine, CB# 3367, Chapel Hill, NC 27599, USA
| | - Ann Thompson
- McMaster Department of Psychiatry and Behavioural Neurosciences, 1200 Main Street west, L9H 3Z5, Hamilton, ON, Canada
| | - Irene O'Conner
- McMaster Department of Psychiatry and Behavioural Neurosciences, 1200 Main Street west, L9H 3Z5, Hamilton, ON, Canada
| | - Mark Woodbury-Smith
- McMaster Department of Psychiatry and Behavioural Neurosciences, 1200 Main Street west, L9H 3Z5, Hamilton, ON, Canada
| | - Yungui Huang
- Battelle Center for Mathematical Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, Columbus, OH 43215, USA
| | - Kimberly A Walters
- Battelle Center for Mathematical Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, Columbus, OH 43215, USA
| | - Bridget Fernandez
- Provincial Medical Genetics Program, Health Sciences Center, 300 Prince Philip Drive, A1B 3V6, St. John's, Newfoundland, Canada
| | - Peter Szatmari
- McMaster Department of Psychiatry and Behavioural Neurosciences, 1200 Main Street west, L9H 3Z5, Hamilton, ON, Canada.,Centre for Addiction and Mental Health, University of Toronto, 80 Workman Way, Toronto, ON, Canada
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Grønborg TK, Schendel DE, Parner ET. Recurrence of autism spectrum disorders in full- and half-siblings and trends over time: a population-based cohort study. JAMA Pediatr 2013; 167:947-53. [PMID: 23959427 PMCID: PMC4610344 DOI: 10.1001/jamapediatrics.2013.2259] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE To date, this is the first population-based study to examine the recurrence risk for autism spectrum disorders (ASDs), including time trends, and the first study to consider the ASDs recurrence risk for full- and half-siblings. OBJECTIVES To estimate the relative recurrence risk for ASDs in a Danish population, including recurrence in full- and half-siblings, and to examine time trends in ASDs relative to the recurrence risk. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study in Denmark. All children (about 1.5 million) born in Denmark between January 1, 1980, and December 31, 2004, were identified and followed up to December 31, 2010. We identified a maternal sibling subcohort derived from mothers with at least 2 children and a paternal sibling subcohort derived from fathers with at least 2 children. EXPOSURES Children having an older sibling with ASDs are compared with children not having an older sibling with ASDs. MAIN OUTCOMES AND MEASURES The adjusted hazard ratio for ASDs among children having an older sibling with ASDs compared with children not having an older sibling with ASDs. RESULTS The overall relative recurrence risk for ASDs was 6.9 (95% CI, 6.1-7.8), and it did not change significantly over time; similar risks were observed in maternal and paternal full-siblings. The relative recurrence risks were 2.4 (95% CI, 1.4-4.1) for maternal half-siblings and 1.5 (95% CI, 0.7-3.4) for paternal half-siblings. CONCLUSIONS AND RELEVANCE Our population-based recurrence risk estimate is lower than the recently reported estimates from clinical samples. Our results demonstrate no time trend in the ASDs recurrence risk as seen in the ASDs prevalence. The difference in the recurrence risk between full- and half-siblings supports the role of genetics in ASDs, while the significant recurrence risk in maternal half-siblings may support the role of factors associated with pregnancy and the maternal intrauterine environment in ASDs.
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Affiliation(s)
- Therese K Grønborg
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
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Autism plus psychosis: A ‘one-two punch’ risk for tragic violence? Med Hypotheses 2013; 81:404-9. [DOI: 10.1016/j.mehy.2013.05.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 05/16/2013] [Accepted: 05/23/2013] [Indexed: 11/30/2022]
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Nickel LR, Thatcher AR, Keller F, Wozniak RH, Iverson JM. Posture Development in Infants at Heightened vs. Low Risk for Autism Spectrum Disorders. INFANCY 2013; 18:639-661. [PMID: 24027437 PMCID: PMC3767458 DOI: 10.1111/infa.12025] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Evidence suggests that children and adults diagnosed with autism spectrum disorders (ASD) exhibit difficulties with postural control. Retrospective video studies of infants later diagnosed with ASD indicate that infants who eventually receive an ASD diagnosis exhibit delays in postural development. This study investigates early posture development prospectively and longitudinally in 22 infants at heightened biological risk for ASD (HR) and 18 infants with no such risk (Low Risk; LR). Four HR infants received an autism diagnosis (AD infants) at 36 months. Infants were videotaped at home at 6, 9, 12, and 14 months during everyday activities and play. All infant postures were coded and classified as to whether or not they were infant-initiated. Relative to LR infants, HR infants were slower to develop skill in sitting and standing postures. AD infants exhibited substantial delays in the emergence of more advanced postures and initiated fewer posture changes. Because posture advances create opportunities for infants to interact with objects and people in new and progressively more sophisticated ways, postural delays may have cascading effects on opportunities for infant exploration and learning. These effects may be greater for infants with ASD, for whom posture delays are more significant.
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Affiliation(s)
| | | | - Flavio Keller
- Laboratory of Developmental Neuroscience, Università Campus Bio-Medico, Rome, Italy
| | | | - Jana M. Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Curtin S, Vouloumanos A. Speech preference is associated with autistic-like behavior in 18-months-olds at risk for Autism Spectrum Disorder. J Autism Dev Disord 2013; 43:2114-20. [PMID: 23334808 PMCID: PMC3648614 DOI: 10.1007/s10803-013-1759-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We examined whether infants' preference for speech at 12 months is associated with autistic-like behaviors at 18 months in infants who are at increased risk for autism spectrum disorder (ASD) because they have an older sibling diagnosed with ASD and in low-risk infants. Only low-risk infants listened significantly longer to speech than to nonspeech at 12 months. In both groups, relative preference for speech correlated positively with general cognitive ability at 12 months. However, in high-risk infants only, preference for speech was associated with autistic-like behavior at 18 months, while in low-risk infants, preference for speech correlated with language abilities. This suggests that in children at risk for ASD an atypical species-specific bias for speech may underlie atypical social development.
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Affiliation(s)
- Suzanne Curtin
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
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Trottier M, Roberts W, Drmic I, Scherer SW, Weksberg R, Cytrynbaum C, Chitayat D, Shuman C, Miller FA. Parents' perspectives on participating in genetic research in autism. J Autism Dev Disord 2013; 43:556-68. [PMID: 22782649 DOI: 10.1007/s10803-012-1592-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Genetic research in autism depends on the willingness of individuals with autism to participate; thus, there is a duty to assess participants' needs in the research process. We report on families' motives and expectations related to their participation in autism genetic research. Respondents valued having a genetic result, as it alleviates guilt, promotes awareness, and may be used to tailor interventions and for family planning. The act of participating was distinctly significant, as it provided personal control, a connection to autism experts, networking with families, and hope for the future. The results of this study highlight complex factors involved in families' decisions to participate in autism genetic research and provide points to consider for this population of research participants.
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Affiliation(s)
- Magan Trottier
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada
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Essa MM, Subash S, Braidy N, Al-Adawi S, Lim CK, Manivasagam T, Guillemin GJ. Role of NAD(+), Oxidative Stress, and Tryptophan Metabolism in Autism Spectrum Disorders. Int J Tryptophan Res 2013; 6:15-28. [PMID: 23922500 PMCID: PMC3729335 DOI: 10.4137/ijtr.s11355] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Autism spectrum disorder (ASD) is a pervasive neuro-developmental disorder characterized by impaired social interaction, reduced/absent verbal and non-verbal communication, and repetitive behavior during early childhood. The etiology of this developmental disorder is poorly understood, and no biomarkers have been identified. Identification of novel biochemical markers related to autism would be advantageous for earlier clinical diagnosis and intervention. Studies suggest that oxidative stress-induced mechanisms and reduced antioxidant defense, mitochondrial dysfunction, and impaired energy metabolism (NAD(+), NADH, ATP, pyruvate, and lactate), are major causes of ASD. This review provides renewed insight regarding current autism research related to oxidative stress, mitochondrial dysfunction, and altered tryptophan metabolism in ASD.
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Affiliation(s)
- Musthafa Mohamed Essa
- Dept of Food Science and Nutrition, College of Agriculture and Marine Sciences, Sultan Qaboos University, Oman. ; School of Medical Sciences, Department of Pharmacology, Faculty of Medicine, University of NSW, Sydney, Australia
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36
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Peripheral blood gene expression signature differentiates children with autism from unaffected siblings. Neurogenetics 2013; 14:143-52. [PMID: 23625158 DOI: 10.1007/s10048-013-0363-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 04/10/2013] [Indexed: 01/01/2023]
Abstract
Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders with high heritability, yet a majority of genetic contribution to pathophysiology is not known. Siblings of individuals with ASD are at increased risk for ASD and autistic traits, but the genetic contribution for simplex families is estimated to be less when compared to multiplex families. To explore the genomic (dis-) similarity between proband and unaffected sibling in simplex families, we used genome-wide gene expression profiles of blood from 20 proband-unaffected sibling pairs and 18 unrelated control individuals. The global gene expression profiles of unaffected siblings were more similar to those from probands as they shared genetic and environmental background. A total of 189 genes were significantly differentially expressed between proband-sib pairs (nominal p < 0.01) after controlling for age, sex, and family effects. Probands and siblings were distinguished into two groups by cluster analysis with these genes. Overall, unaffected siblings were equally distant from the centroid of probands and from that of unrelated controls with the differentially expressed genes. Interestingly, five of 20 siblings had gene expression profiles that were more similar to unrelated controls than to their matched probands. In summary, we found a set of genes that distinguished probands from the unaffected siblings, and a subgroup of unaffected siblings who were more similar to probands. The pathways that characterized probands compared to siblings using peripheral blood gene expression profiles were the up-regulation of ribosomal, spliceosomal, and mitochondrial pathways, and the down-regulation of neuroreceptor-ligand, immune response and calcium signaling pathways. Further integrative study with structural genetic variations such as de novo mutations, rare variants, and copy number variations would clarify whether these transcriptomic changes are structural or environmental in origin.
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37
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Sex differences in children with autism spectrum disorder identified within a high-risk infant cohort. J Autism Dev Disord 2013; 42:2585-96. [PMID: 22453928 DOI: 10.1007/s10803-012-1515-y] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Sex differences were examined in 3-year-olds with autism spectrum disorders (ASD) ascertained from a high-risk cohort, and high- and low-risk comparison groups. Participants included 319 high-risk siblings and 129 low-risk controls. Eighty-five siblings were diagnosed with ASD, including 57 of 176 boys (32.4 %) and 28 of 143 girls (19.6 %), implying a relative odds of ASD of 1.65 in boys versus girls. There were modest sex differences on cognitive and adaptive skills and ASD symptom severity at age 3, but differences between boys and girls with ASD mirrored those in the non-ASD groups. The lower than expected male-to-female ratio, and the relatively high cognitive level among diagnosed children, suggest that we have identified an unanticipated number of higher-functioning girls with ASD.
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38
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McCleery JP, Elliott NA, Sampanis DS, Stefanidou CA. Motor development and motor resonance difficulties in autism: relevance to early intervention for language and communication skills. Front Integr Neurosci 2013; 7:30. [PMID: 23630476 PMCID: PMC3634796 DOI: 10.3389/fnint.2013.00030] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 04/11/2013] [Indexed: 01/03/2023] Open
Abstract
Research suggests that a sub-set of children with autism experience notable difficulties and delays in motor skills development, and that a large percentage of children with autism experience deficits in motor resonance. These motor-related deficiencies, which evidence suggests are present from a very early age, are likely to negatively affect social-communicative and language development in this population. Here, we review evidence for delayed, impaired, and atypical motor development in infants and children with autism. We then carefully review and examine the current language and communication-based intervention research that is relevant to motor and motor resonance (i.e., neural "mirroring" mechanisms activated when we observe the actions of others) deficits in children with autism. Finally, we describe research needs and future directions and developments for early interventions aimed at addressing the speech/language and social-communication development difficulties in autism from a motor-related perspective.
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Affiliation(s)
- Joseph P. McCleery
- School of Psychology, University of BirminghamWest Midlands, Birmingham, UK
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39
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Droucker D, Curtin S, Vouloumanos A. Linking infant-directed speech and face preferences to language outcomes in infants at risk for autism spectrum disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:567-576. [PMID: 23690567 DOI: 10.1044/1092-4388(2012/11-0266)] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE In this study, the authors aimed to examine whether biases for infant-directed (ID) speech and faces differ between infant siblings of children with autism spectrum disorder (ASD) (SIBS-A) and infant siblings of typically developing children (SIBS-TD), and whether speech and face biases predict language outcomes and risk group membership. METHOD Thirty-six infants were tested at ages 6, 8, 12, and 18 months. Infants heard 2 ID and 2 adult-directed (AD) speech passages paired with either a checkerboard or a face. The authors assessed expressive language at 12 and 18 months and general functioning at 12 months using the Mullen Scales of Early Learning (Mullen, 1995). RESULTS Both infant groups preferred ID to AD speech and preferred faces to checkerboards. SIBS-TD demonstrated higher expressive language at 18 months than did SIBS-A, a finding that correlated with preferences for ID speech at 12 months. Although both groups looked longer to face stimuli than to the checkerboard, the magnitude of the preference was smaller in SIBS-A and predicted expressive vocabulary at 18 months in this group. Infants' preference for faces contributed to risk-group membership in a logistic regression analysis. CONCLUSION Infants at heightened risk of ASD differ from typically developing infants in their preferences for ID speech and faces, which may underlie deficits in later language development and social communication.
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Affiliation(s)
- Danielle Droucker
- School and Applied Child Psychology, University of Calgary, Alberta,Canada
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40
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Carter MT, Scherer SW. Autism spectrum disorder in the genetics clinic: a review. Clin Genet 2013; 83:399-407. [PMID: 23425232 DOI: 10.1111/cge.12101] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 01/08/2023]
Abstract
Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental disorders affecting social communication, language and behavior. The underlying cause(s) in a given individual is often elusive, with the exception of clinically recognizable genetic syndromes with readily available molecular diagnosis, such as fragile X syndrome. Clinical geneticists approach patients with ASDs by ruling out known genetic and genomic syndromes, leaving more than 80% of families without a definitive diagnosis and an uncertain risk of recurrence. Advances in microarray technology and next-generation sequencing are revealing rare variants in genes with important roles in synapse formation, function and maintenance. This review will focus on the clinical approach to ASDs, given the current state of knowledge about their complex genetic architecture.
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Affiliation(s)
- M T Carter
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada.
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41
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Manning-Courtney P, Murray D, Currans K, Johnson H, Bing N, Kroeger-Geoppinger K, Sorensen R, Bass J, Reinhold J, Johnson A, Messerschmidt T. Autism spectrum disorders. Curr Probl Pediatr Adolesc Health Care 2013; 43:2-11. [PMID: 23332397 DOI: 10.1016/j.cppeds.2012.08.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 08/30/2012] [Accepted: 08/31/2012] [Indexed: 10/27/2022]
Abstract
Autism spectrum disorders are being diagnosed with increasing frequency. The likelihood that a primary care provider will see a patient with autism spectrum disorder in their clinic is high. In this article, current diagnostic criteria and expected changes in DSM criteria, as well as prevalence rates and epidemiologic studies are reviewed. Recommendations for screening, including early warning signs, and best practices for diagnosis are discussed. Comprehensive evidence based intervention for ASD as well as the findings of the National Standards Project are reviewed. Medication management is also described, as are the roles of other treating professionals.
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Spencer MD, Chura LR, Holt RJ, Suckling J, Calder AJ, Bullmore ET, Baron-Cohen S. Failure to deactivate the default mode network indicates a possible endophenotype of autism. Mol Autism 2012. [PMID: 23206727 PMCID: PMC3539860 DOI: 10.1186/2040-2392-3-15] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Reduced activity during cognitively demanding tasks has been reported in the default mode network in typically developing controls and individuals with autism. However, no study has investigated the default mode network (DMN) in first-degree relatives of those with autism (such as siblings) and it is not known whether atypical activation of the DMN is specific to autism or whether it is also present in unaffected relatives. Here we use functional magnetic resonance imaging to investigate the pattern of task-related deactivation during completion of a visual search task, the Embedded Figures Task, in teenagers with autism, their unaffected siblings and typically developing controls. Findings We identified striking reductions in deactivation during the Embedded Figures Task in unaffected siblings compared to controls in brain regions corresponding to the default mode network. Adolescents with autism and their unaffected siblings similarly failed to deactivate regions, including posterior cingulate and bilateral inferior parietal cortex. Conclusions This suggests that a failure to deactivate these regions is a functional endophenotype of autism, related to familial risk for the condition shared between individuals with autism and their siblings.
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Affiliation(s)
- Michael D Spencer
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK.
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Spencer MD, Holt RJ, Chura LR, Calder AJ, Suckling J, Bullmore ET, Baron-Cohen S. Atypical activation during the Embedded Figures Task as a functional magnetic resonance imaging endophenotype of autism. Brain 2012; 135:3469-80. [PMID: 23065480 PMCID: PMC3501969 DOI: 10.1093/brain/aws229] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 06/02/2012] [Accepted: 06/26/2012] [Indexed: 01/08/2023] Open
Abstract
Atypical activation during the Embedded Figures Task has been demonstrated in autism, but has not been investigated in siblings or related to measures of clinical severity. We identified atypical activation during the Embedded Figures Task in participants with autism and unaffected siblings compared with control subjects in a number of temporal and frontal brain regions. Autism and sibling groups, however, did not differ in terms of activation during this task. This suggests that the pattern of atypical activation identified may represent a functional endophenotype of autism, related to familial risk for the condition shared between individuals with autism and their siblings. We also found that reduced activation in autism relative to control subjects in regions including associative visual and face processing areas was strongly correlated with the clinical severity of impairments in reciprocal social interaction. Behavioural performance was intact in autism and sibling groups. Results are discussed in terms of atypical information processing styles or of increased activation in temporal and frontal regions in autism and the broader phenotype. By separating the aspects of atypical activation as markers of familial risk for the condition from those that are autism-specific, our findings offer new insight into the factors that might cause the expression of autism in families, affecting some children but not others.
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Affiliation(s)
- Michael D Spencer
- Department of Psychiatry, University of Cambridge, Autism Research Centre, Douglas House, 18 b Trumpington Road, Cambridge CB2 8AH, UK.
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Roberts JE, Hatton DD, Long ACJ, Anello V, Colombo J. Visual attention and autistic behavior in infants with fragile X syndrome. J Autism Dev Disord 2012; 42:937-46. [PMID: 21720726 DOI: 10.1007/s10803-011-1316-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Aberrant attention is a core feature of fragile X syndrome (FXS), however, little is known regarding the developmental trajectory and underlying physiological processes of attention deficits in FXS. Atypical visual attention is an early emerging and robust indictor of autism in idiopathic (non-FXS) autism. Using a biobehavioral approach with gaze direction and heart activity, we examined visual attention in infants with FXS at 9, 12, and 18 months of age with a cross-sectional comparison to 12-month-old typically developing infants. Analyses revealed lower HR variability, shallower HR decelerations, and prolonged look durations in 12-month old infants with FXS compared to typical controls. Look duration and increased latency to disengage attention were correlated with severity of autistic behavior but not mental age.
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Affiliation(s)
- Jane E Roberts
- FPG Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
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Selective visual attention at twelve months: signs of autism in early social interactions. J Autism Dev Disord 2012; 42:487-98. [PMID: 21519953 DOI: 10.1007/s10803-011-1262-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We examined social attention and attention shifting during (a) a play interaction between 12-month olds and an examiner and (b) after the examiner pretended to hurt herself. We coded the target and duration of infants' visual fixations and frequency of attention shifts. Siblings of children with autism and controls with no family history of autism were tested at 12 months and screened for ASD at 36 months. Groups did not differ on proportion of attention to social stimuli or attention shifting during the play condition. All groups demonstrated more social attention and attention shifting during the distress condition. Infants later diagnosed with ASD tended to continue looking at a toy during the distress condition despite the salience of social information.
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Assessment and treatment in autism spectrum disorders: a focus on genetics and psychiatry. AUTISM RESEARCH AND TREATMENT 2012; 2012:242537. [PMID: 22934170 PMCID: PMC3420490 DOI: 10.1155/2012/242537] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 03/26/2012] [Indexed: 11/18/2022]
Abstract
Autism spectrum disorders (ASDs) are neurobehavioral disorders characterized by abnormalities in three behavioral domains including social interaction, impaired communication, and repetitive stereotypic behaviors. ASD affects approximately 1% of children and is on the rise with significant genetic mechanisms underlying these disorders. We review the current understanding of the role of genetic and metabolic factors contributing to ASD with the use of new genetic technology. Fifty percent is diagnosed with chromosomal abnormalities, small DNA deletions/duplications, single-gene conditions, or metabolic disturbances. Genetic evaluation is discussed along with psychiatric treatment and approaches for selection of medication to treat associated challenging behaviors or comorbidities seen in ASD. We emphasize the importance of prioritizing treatment based on target symptom clusters and in what order for individuals with ASD, as the treatment may vary from patient to patient.
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Crosland K, Dunlap G. Effective Strategies for the Inclusion of Children With Autism in General Education Classrooms. Behav Modif 2012; 36:251-69. [DOI: 10.1177/0145445512442682] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Successful inclusion of students with autism spectrum disorder (ASD) in general education classrooms can be challenging and may require additional supports. This article provides information on recent trends in autism intervention research and a review of research that has addressed individualized and systemic interventions for promoting inclusion. Response to intervention and schoolwide positive behavior support are reviewed as organizational/ systems strategies relevant to preventing problems and improving social and academic outcomes for students with ASD. Additional individualized strategies that can be implemented within these models are described. A discussion of future research directions is provided.
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Main PAE, Angley MT, O'Doherty CE, Thomas P, Fenech M. The potential role of the antioxidant and detoxification properties of glutathione in autism spectrum disorders: a systematic review and meta-analysis. Nutr Metab (Lond) 2012; 9:35. [PMID: 22524510 PMCID: PMC3373368 DOI: 10.1186/1743-7075-9-35] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 04/24/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Glutathione has a wide range of functions; it is an endogenous anti-oxidant and plays a key role in the maintenance of intracellular redox balance and detoxification of xenobiotics. Several studies have indicated that children with autism spectrum disorders may have altered glutathione metabolism which could play a key role in the condition. METHODS A systematic literature review and meta-analysis was conducted of studies examining metabolites, interventions and/or genes of the glutathione metabolism pathways i.e. the γ-glutamyl cycle and trans-sulphuration pathway in autism spectrum disorders. RESULTS Thirty nine studies were included in the review comprising an in vitro study, thirty two metabolite and/or co-factor studies, six intervention studies and six studies with genetic data as well as eight studies examining enzyme activity. CONCLUSIONS The review found evidence for the involvement of the γ-glutamyl cycle and trans-sulphuration pathway in autistic disorder is sufficiently consistent, particularly with respect to the glutathione redox ratio, to warrant further investigation to determine the significance in relation to clinical outcomes. Large, well designed intervention studies that link metabolites, cofactors and genes of the γ-glutamyl cycle and trans-sulphuration pathway with objective behavioural outcomes in children with autism spectrum disorders are required. Future risk factor analysis should include consideration of multiple nutritional status and metabolite biomarkers of pathways linked with the γ-glutamyl cycle and the interaction of genotype in relation to these factors.
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Affiliation(s)
- Penelope AE Main
- Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide, SA 5000, Australia
- Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Kintore Ave, Adelaide, SA 5000, Australia
| | - Manya T Angley
- Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide, SA 5000, Australia
| | - Catherine E O'Doherty
- Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide, SA 5000, Australia
| | - Philip Thomas
- Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Kintore Ave, Adelaide, SA 5000, Australia
| | - Michael Fenech
- Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Kintore Ave, Adelaide, SA 5000, Australia
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Newschaffer CJ, Croen LA, Fallin MD, Hertz-Picciotto I, Nguyen DV, Lee NL, Berry CA, Farzadegan H, Hess HN, Landa RJ, Levy SE, Massolo ML, Meyerer SC, Mohammed SM, Oliver MC, Ozonoff S, Pandey J, Schroeder A, Shedd-Wise KM. Infant siblings and the investigation of autism risk factors. J Neurodev Disord 2012; 4:7. [PMID: 22958474 PMCID: PMC3436647 DOI: 10.1186/1866-1955-4-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 04/18/2012] [Indexed: 12/31/2022] Open
Abstract
Infant sibling studies have been at the vanguard of autism spectrum disorders (ASD) research over the past decade, providing important new knowledge about the earliest emerging signs of ASD and expanding our understanding of the developmental course of this complex disorder. Studies focused on siblings of children with ASD also have unrealized potential for contributing to ASD etiologic research. Moving targeted time of enrollment back from infancy toward conception creates tremendous opportunities for optimally studying risk factors and risk biomarkers during the pre-, peri- and neonatal periods. By doing so, a traditional sibling study, which already incorporates close developmental follow-up of at-risk infants through the third year of life, is essentially reconfigured as an enriched-risk pregnancy cohort study. This review considers the enriched-risk pregnancy cohort approach of studying infant siblings in the context of current thinking on ASD etiologic mechanisms. It then discusses the key features of this approach and provides a description of the design and implementation strategy of one major ASD enriched-risk pregnancy cohort study: the Early Autism Risk Longitudinal Investigation (EARLI).
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Affiliation(s)
- Craig J Newschaffer
- Department of Epidemiology and Biostatistics, Drexel School of Public Health, 1505 Race Street, Mail Stop 1033, Philadelphia, PA 19102, USA
| | - Lisa A Croen
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
| | - M Daniele Fallin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Danh V Nguyen
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Nora L Lee
- Department of Epidemiology and Biostatistics, Drexel School of Public Health, 1505 Race Street, Mail Stop 1033, Philadelphia, PA 19102, USA
| | - Carmen A Berry
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Homayoon Farzadegan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - H Nicole Hess
- Kaiser Permanente San Jose Medical Center, 6620 Via Del Oro, San Jose, CA 95119, USA
| | - Rebecca J Landa
- Kennedy Krieger Institute, 3901 Greenspring Avenue, 2nd Floor, Baltimore, MD 21211, USA
| | - Susan E Levy
- Center for Autism Research, The Children's Hospital of Philadelphia, 3535 Market Street, Suite 860, Philadelphia, PA 19104, USA
| | - Maria L Massolo
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA
| | - Stacey C Meyerer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Sandra M Mohammed
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - McKenzie C Oliver
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Sally Ozonoff
- The MIND Institute, UC Davis Medical Center, 2825 50th Street, Sacramento, CA 95817, USA
| | - Juhi Pandey
- Center for Autism Research, The Children's Hospital of Philadelphia, 3535 Market Street, Suite 860, Philadelphia, PA 19104, USA
| | - Adam Schroeder
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Kristine M Shedd-Wise
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
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Losh M, Martin GE, Klusek J, Hogan-Brown AL. Pragmatic Language in autism and fragile X syndrome: Genetic and clinical applications. PERSPECTIVES ON LANGUAGE LEARNING AND EDUCATION 2012; 19:48-55. [PMID: 24660047 PMCID: PMC3961489 DOI: 10.1044/lle19.2.48] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Evidence suggests a strong genetic basis to autism. Our research program focuses on identifying genetically meaningful phenotypes in autism, through family-genetic and cross-population methods, with a particular focus on language and social phenotypes that have been shown to aggregate in families of individuals with autism. In this article, we discuss recent findings from family study research implicating particular language and personality features as markers for genetic liability to autism and fragile X syndrome and FMR1-related variation in relatives. We conclude with consideration of the clinical implications of such findings.
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Affiliation(s)
- Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University
| | - Gary E. Martin
- FPG Child Development Institute, University of North Carolina at Chapel Hill
- Division of Speech and Hearing Sciences, Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Jessica Klusek
- FPG Child Development Institute, University of North Carolina at Chapel Hill
- Division of Speech and Hearing Sciences, Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Abigail L. Hogan-Brown
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University
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