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Stark I, Rast JE, Lundberg M, Döring N, Ohlis A, Idring Nordström S, Rai D, Magnusson C. Completion of Upper Secondary Mainstream School in Autistic Students in Sweden. J Autism Dev Disord 2024:10.1007/s10803-024-06470-8. [PMID: 39017805 DOI: 10.1007/s10803-024-06470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
Higher education is an increasingly necessary achievement to attain employment. However, even in cases where a student has the academic skills to succeed, educational environments may not support students across all other domains necessary for education success, including social and communication needs. This is especially true for students with disabilities and autistic students, where the rate of completion of non-compulsory education is unknown. We used the Stockholm Youth Cohort (children aged 0-17 years from 2001 to 2011), a total population cohort (N = 736,180) including 3,918 autistic individuals, to investigate the association between autism without intellectual disability and completion of upper secondary education. We assessed the impact of sex and co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) on this association. By age 20 years (the expected age of completion), 68% of autistic students and 91% of non-autistic students admitted to upper secondary education had completed. In logistic regression models adjusted for student demographics, autistic students had almost five-fold higher odds of not completing secondary school (OR 4.90, 95% CI 4.56 5.26) compared to their non-autistic peers. Autistic students with ADHD had particularly high odds of non-completion of upper secondary school. Autistic students without intellectual disability attending mainstream education are substantially less likely to complete upper secondary education as compared to their peers. These findings have implications for the appraisal of how inclusive school policies serve autistic students' academic and social needs, ultimately addressing population health and independent living.
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Affiliation(s)
- Isidora Stark
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jessica E Rast
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Michael Lundberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Nora Döring
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Ohlis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | | | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
- Bristol Autism Spectrum Service, Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Cecilia Magnusson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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Croom K, Rumschlag JA, Erickson MA, Binder D, Razak KA. Sex differences during development in cortical temporal processing and event related potentials in wild-type and fragile X syndrome model mice. J Neurodev Disord 2024; 16:24. [PMID: 38720271 PMCID: PMC11077726 DOI: 10.1186/s11689-024-09539-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is currently diagnosed in approximately 1 in 44 children in the United States, based on a wide array of symptoms, including sensory dysfunction and abnormal language development. Boys are diagnosed ~ 3.8 times more frequently than girls. Auditory temporal processing is crucial for speech recognition and language development. Abnormal development of temporal processing may account for ASD language impairments. Sex differences in the development of temporal processing may underlie the differences in language outcomes in male and female children with ASD. To understand mechanisms of potential sex differences in temporal processing requires a preclinical model. However, there are no studies that have addressed sex differences in temporal processing across development in any animal model of ASD. METHODS To fill this major gap, we compared the development of auditory temporal processing in male and female wildtype (WT) and Fmr1 knock-out (KO) mice, a model of Fragile X Syndrome (FXS), a leading genetic cause of ASD-associated behaviors. Using epidural screw electrodes, we recorded auditory event related potentials (ERP) and auditory temporal processing with a gap-in-noise auditory steady state response (ASSR) paradigm at young (postnatal (p)21 and p30) and adult (p60) ages from both auditory and frontal cortices of awake, freely moving mice. RESULTS The results show that ERP amplitudes were enhanced in both sexes of Fmr1 KO mice across development compared to WT counterparts, with greater enhancement in adult female than adult male KO mice. Gap-ASSR deficits were seen in the frontal, but not auditory, cortex in early development (p21) in female KO mice. Unlike male KO mice, female KO mice show WT-like temporal processing at p30. There were no temporal processing deficits in the adult mice of both sexes. CONCLUSIONS These results show a sex difference in the developmental trajectories of temporal processing and hypersensitive responses in Fmr1 KO mice. Male KO mice show slower maturation of temporal processing than females. Female KO mice show stronger hypersensitive responses than males later in development. The differences in maturation rates of temporal processing and hypersensitive responses during various critical periods of development may lead to sex differences in language function, arousal and anxiety in FXS.
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Affiliation(s)
- Katilynne Croom
- Graduate Neuroscience Program, University of California, Riverside, USA
| | - Jeffrey A Rumschlag
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, USA
| | - Michael A Erickson
- Department of Psychology, University of California, 900 University Avenue, Riverside, USA
| | - Devin Binder
- Graduate Neuroscience Program, University of California, Riverside, USA
- Biomedical Sciences, School of Medicine, University of California, Riverside, USA
| | - Khaleel A Razak
- Graduate Neuroscience Program, University of California, Riverside, USA.
- Department of Psychology, University of California, 900 University Avenue, Riverside, USA.
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Cary E, Rao A, Matsuba ESM, Russo N. Barriers to an Autistic Identity: How RRBs may Contribute to the Underdiagnosis of Females. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 109:102275. [PMID: 38187508 PMCID: PMC10768999 DOI: 10.1016/j.rasd.2023.102275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Autistic females are frequently underdiagnosed, misdiagnosed, and/or diagnosed later in life. Restricted and Repetitive Behaviors (RRBs) are increasingly critical for diagnosis and yet are commonly rated lower in females. Whether this reflects genuinely lower levels of these traits, or if female-typical RRBs have a different phenotypic presentation that may not register on current quantitative measurement tools is unclear. Methods Twenty-one autistic females and 21 autistic males matched on chronological age and FSIQ completed the AQ, ADOS-2, and ADI-R. Items from the ADOS-2 and ADI-R were selected that were relevant to the four areas of restricted and repetitive behavior in the DSM-5 diagnostic criteria of autism. Using a mixed-methods analytical approach, scores and comments on these measures were compared between sexes to better characterize RRBs in autistic females. Results There were no sex differences on the AQ, which broadly assesses autistic traits. When analyzed by the four DSM-5 RRB criteria, there were no sex differences on the ADI-R when using traditional algorithm scoring that narrows questions down to those that are more sensitive and specific in capturing autism in research samples with a high proportion of males. When incorporating additional items relevant to the DSM-5 to identify sex changes in a broader pool of items, females scored higher on stereotyped movements and speech. Females also engaged in more sensory behaviors during the ADOS-2. Qualitative analyses indicated that females were more likely to engage in stereotyped body rocking and spinning, stereotyped behaviors when anxious, to show major reactions to changes, repetitive language including listing and counting, and sensory behaviors, especially in the tactile domain. Conclusion Exploratory findings highlight sex differences in RRBs that may help enhance diagnostic clarity for females. Higher tactile sensory behaviors in females suggests there may be increased diagnostic sensitivity for females with the updated DSM-5 that now includes sensory components as part of the diagnostic criteria.
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Affiliation(s)
- Emily Cary
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244 2340
| | - Aparajita Rao
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244 2340
| | | | - Natalie Russo
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244 2340
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Torske T, Nærland T, Quintana DS, Hypher RE, Kaale A, Høyland AL, Hope S, Johannessen J, Øie MG, Andreassen OA. Sex as a Moderator Between Parent Ratings of Executive Dysfunction and Social Difficulties in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3847-3859. [PMID: 35838825 PMCID: PMC10499744 DOI: 10.1007/s10803-022-05629-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/25/2022]
Abstract
Girls and boys might differ in autistic symptoms and associated cognitive difficulties such as executive function (EF). We investigated sex differences in the relationship between parent rated EF and autistic symptoms in 116 children and adolescents (25 girls) aged 5-19 years with an intelligence quotient above 70 and an autism spectrum disorder (ASD) diagnosis. They were rated with the behavior rating inventory of executive function (BRIEF) and the autism diagnostic interview revised (ADI-R). We found a positive association between EF and the ADI-R domains of reciprocal social interaction (p < 0.001) and communication (p = 0.001) in girls, while these relationships were small and non-significant in boys. Our results provide a greater understanding of the sex-specific characteristics of children and adolescents with ASD.
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Affiliation(s)
- Tonje Torske
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Postboks 800, 3004, Drammen, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Terje Nærland
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Daniel S Quintana
- Department of Psychology, University of Oslo, Oslo, Norway
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ruth Elizabeth Hypher
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Anett Kaale
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Anne Lise Høyland
- Faculty of Medicine and Health Sciences, Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Sigrun Hope
- NORMENT, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway
| | - Jarle Johannessen
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- Department of Medicine, University of Oslo, Oslo, Norway
| | - Merete G Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ole A Andreassen
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, University of Oslo and Oslo University Hospital, Oslo, Norway
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St. John T, Estes AM, Hazlett HC, Marrus N, Burrows CA, Donovan K, Torres Gomez S, Grzadzinski RL, Parish-Morris J, Smith R, Styner M, Garic D, Pandey J, Lee CM, Schultz RT, Botteron KN, Zwaigenbaum L, Piven J, Dager SR. Association of Sex With Neurobehavioral Markers of Executive Function in 2-Year-Olds at High and Low Likelihood of Autism. JAMA Netw Open 2023; 6:e2311543. [PMID: 37140923 PMCID: PMC10160873 DOI: 10.1001/jamanetworkopen.2023.11543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/19/2023] [Indexed: 05/05/2023] Open
Abstract
Importance Children with autism and their siblings exhibit executive function (EF) deficits early in development, but associations between EF and biological sex or early brain alterations in this population are largely unexplored. Objective To investigate the interaction of sex, autism likelihood group, and structural magnetic resonance imaging alterations on EF in 2-year-old children at high familial likelihood (HL) and low familial likelihood (LL) of autism, based on having an older sibling with autism or no family history of autism in first-degree relatives. Design, Setting, and Participants This prospective cohort study assessed 165 toddlers at HL (n = 110) and LL (n = 55) of autism at 4 university-based research centers. Data were collected from January 1, 2007, to December 31, 2013, and analyzed between August 2021 and June 2022 as part of the Infant Brain Imaging Study. Main Outcomes and Measures Direct assessments of EF and acquired structural magnetic resonance imaging were performed to determine frontal lobe, parietal lobe, and total cerebral brain volume. Results A total of 165 toddlers (mean [SD] age, 24.61 [0.95] months; 90 [54%] male, 137 [83%] White) at HL for autism (n = 110; 17 diagnosed with ASD) and LL for autism (n = 55) were studied. The toddlers at HL for autism scored lower than the toddlers at LL for autism on EF tests regardless of sex (mean [SE] B = -8.77 [4.21]; 95% CI, -17.09 to -0.45; η2p = 0.03). With the exclusion of toddlers with autism, no group (HL vs LL) difference in EF was found in boys (mean [SE] difference, -7.18 [4.26]; 95% CI, 1.24-15.59), but EF was lower in HL girls than LL girls (mean [SE] difference, -9.75 [4.34]; 95% CI, -18.32 to -1.18). Brain-behavior associations were examined, controlling for overall cerebral volume and developmental level. Sex differences in EF-frontal (B [SE] = 16.51 [7.43]; 95% CI, 1.36-31.67; η2p = 0.14) and EF-parietal (B [SE] = 17.68 [6.99]; 95% CI, 3.43-31.94; η2p = 0.17) associations were found in the LL group but not the HL group (EF-frontal: B [SE] = -1.36 [3.87]; 95% CI, -9.07 to 6.35; η2p = 0.00; EF-parietal: B [SE] = -2.81 [4.09]; 95% CI, -10.96 to 5.34; η2p = 0.01). Autism likelihood group differences in EF-frontal (B [SE] = -9.93 [4.88]; 95% CI, -19.73 to -0.12; η2p = 0.08) and EF-parietal (B [SE] = -15.44 [5.18]; 95% CI, -25.86 to -5.02; η2p = 0.16) associations were found in girls not boys (EF-frontal: B [SE] = 6.51 [5.88]; 95% CI, -5.26 to 18.27; η2p = 0.02; EF-parietal: B [SE] = 4.18 [5.48]; 95% CI, -6.78 to 15.15; η2p = 0.01). Conclusions and Relevance This cohort study of toddlers at HL and LL of autism suggests that there is an association between sex and EF and that brain-behavior associations in EF may be altered in children at HL of autism. Furthermore, EF deficits may aggregate in families, particularly in girls.
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Affiliation(s)
- Tanya St. John
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Annette M. Estes
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Heather C. Hazlett
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St Louis, Missouri
| | | | - Kevin Donovan
- Department of Biostatistics, University of Pennsylvania, Philadelphia
| | - Santiago Torres Gomez
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Rebecca L. Grzadzinski
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Rachel Smith
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
| | - Martin Styner
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Dea Garic
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Chimei M. Lee
- Department of Pediatrics, University of Minnesota, Minneapolis
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine in St Louis, Missouri
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Stephen R. Dager
- Department of Radiology, University of Washington Medical Center, Seattle
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Santos S, Martins B, Sereno J, Martins J, Castelo-Branco M, Gonçalves J. Neurobehavioral sex-related differences in Nf1 +/- mice: female show a "camouflaging"-type behavior. Biol Sex Differ 2023; 14:24. [PMID: 37101298 PMCID: PMC10131355 DOI: 10.1186/s13293-023-00509-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is an inherited neurocutaneous disorder associated with neurodevelopmental disorders including autism spectrum disorder (ASD). This condition has been associated with an increase of gamma-aminobutyric acid (GABA) neurotransmission and, consequently, an excitation/inhibition imbalance associated with autistic-like behavior in both human and animal models. Here, we explored the influence of biological sex in the GABAergic system and behavioral alterations induced by the Nf1+/- mutation in a murine model. METHODS Juvenile male and female Nf1+/- mice and their wild-type (WT) littermates were used. Hippocampus size was assessed by conventional toluidine blue staining and structural magnetic resonance imaging (MRI). Hippocampal GABA and glutamate levels were determined by magnetic resonance spectroscopy (MRS), which was complemented by western blot for the GABA(A) receptor. Behavioral evaluation of on anxiety, memory, social communication, and repetitive behavior was performed. RESULTS We found that juvenile female Nf1+/- mice exhibited increased hippocampal GABA levels. Moreover, mutant female displays a more prominent anxious-like behavior together with better memory performance and social behavior. On the other hand, juvenile Nf1+/- male mice showed increased hippocampal volume and thickness, with a decrease in GABA(A) receptor levels. We observed that mutant males had higher tendency for repetitive behavior. CONCLUSIONS Our results suggested a sexually dimorphic impact of Nf1+/- mutation in hippocampal neurochemistry, and autistic-like behaviors. For the first time, we identified a "camouflaging"-type behavior in females of an animal model of ASD, which masked their autistic traits. Accordingly, like observed in human disorder, in this animal model of ASD, females show larger anxiety levels but better executive functions and production of normative social patterns, together with an imbalance of inhibition/excitation ratio. Contrary, males have more externalizing disorders, such as hyperactivity and repetitive behaviors, with memory deficits. The ability of females to camouflage their autistic traits creates a phenotypic evaluation challenge that mimics the diagnosis difficulty observed in humans. Thus, we propose the study of the Nf1+/- mouse model to better understand the sexual dimorphisms of ASD phenotypes and to create better diagnostic tools.
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Affiliation(s)
- Sofia Santos
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Beatriz Martins
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - José Sereno
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - João Martins
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Joana Gonçalves
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.
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Park HO. Autism Spectrum Disorder and Savant Syndrome: A Systematic Literature Review. Soa Chongsonyon Chongsin Uihak 2023; 34:76-92. [PMID: 37035789 PMCID: PMC10080257 DOI: 10.5765/jkacap.230003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 04/11/2023] Open
Abstract
Objectives This study aimed to analyze research trends in autism spectrum disorder (ASD) and savant syndrome and their cognitive characteristics through a systematic literature review. The objectives of this study were to establish an overview of research trends in ASD and savant syndrome, analyze the overall characteristics of individuals with ASD and savant syndrome, and examine their cognitive characteristics. Methods For the systematic literature review, three criteria were used to select review articles: 1) literature from peer-reviewed journals, published in the past 15 years, from 2008 to 2022; 2) subjects with ASD and savant syndrome; 3) study objectives focused on the basic phenomenon and cognitive characteristics of ASD and savant syndrome. Finally, based on the selection criteria, a total of 40 articles were included. Results Five themes and nine subthemes were derived from the analysis of 40 studies. The five main themes were as follows: 1) What is savant syndrome? 2) Demographic characteristics of savant syndrome; 3) Spectra of savant syndrome; 4) Savant syndrome and ASD; and 5) Cognitive characteristics of ASD with savant syndrome. The subthemes of the cognitive characteristics were weak central coherence, detail-focused cognitive processing, enhanced perceptual functioning, and hyper-systemizing. Conclusion Several studies have been conducted to understand ASD and savant syndrome; however, no single theory can specify the cognitive characteristics of people with ASD and savant syndrome. Therefore, further systematic and multi-layered research on ASD and savant syndrome are required for more comprehensive results.
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Affiliation(s)
- Hyun Ok Park
- Department of Early Childhood Special Education, Baekseok University, Cheonan, Korea
- Address for correspondence: Hyun Ok Park, Department of Early Childhood Special Education, 1 Baekseokdaehak-ro, Dongnam-gu, Cheonan 31065, Korea Tel: +82-41-550-2467, Fax: +82-41-550-9089, E-mail:
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Bölte S, Neufeld J, Marschik PB, Williams ZJ, Gallagher L, Lai MC. Sex and gender in neurodevelopmental conditions. Nat Rev Neurol 2023; 19:136-159. [PMID: 36747038 PMCID: PMC10154737 DOI: 10.1038/s41582-023-00774-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 02/08/2023]
Abstract
Health-related conditions often differ qualitatively or quantitatively between individuals of different birth-assigned sexes and gender identities, and/or with different gendered experiences, requiring tailored care. Studying the moderating and mediating effects of sex-related and gender-related factors on impairment, disability, wellbeing and health is of paramount importance especially for neurodivergent individuals, who are diagnosed with neurodevelopmental conditions with uneven sex/gender distributions. Researchers have become aware of the myriad influences that sex-related and gender-related variables have on the manifestations of neurodevelopmental conditions, and contemporary work has begun to investigate the mechanisms through which these effects are mediated. Here we describe topical concepts of sex and gender science, summarize current knowledge, and discuss research and clinical challenges related to autism, attention-deficit/hyperactivity disorder and other neurodevelopmental conditions. We consider sex and gender in the context of epidemiology, behavioural phenotypes, neurobiology, genetics, endocrinology and neighbouring disciplines. The available evidence supports the view that sex and gender are important contributors to the biological and behavioural variability in neurodevelopmental conditions. Methodological caveats such as frequent conflation of sex and gender constructs, inappropriate measurement of these constructs and under-representation of specific demographic groups (for example, female and gender minority individuals and people with intellectual disabilities) limit the translational potential of research so far. Future research and clinical implementation should integrate sex and gender into next-generation diagnostics, mechanistic investigations and support practices.
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Affiliation(s)
- Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
| | - Janina Neufeld
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Swedish Collegium for Advanced Study (SCAS), Uppsala, Sweden
| | - Peter B Marschik
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen and Leibniz ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Zachary J Williams
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Louise Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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Use of Oculomotor Behavior to Classify Children with Autism and Typical Development: A Novel Implementation of the Machine Learning Approach. J Autism Dev Disord 2023; 53:934-946. [PMID: 35913654 DOI: 10.1007/s10803-022-05685-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
This study segmented the time series of gaze behavior from nineteen children with autism spectrum disorder (ASD) and 20 children with typical development in a face-to-face conversation. A machine learning approach showed that behavior segments produced by these two groups of participants could be classified with the highest accuracy of 74.15%. These results were further used to classify children using a threshold classifier. A maximum classification accuracy of 87.18% was achieved, under the condition that a participant was considered as 'ASD' if over 46% of the child's 7-s behavior segments were classified as ASD-like behaviors. The idea of combining the behavior segmentation technique and the threshold classifier could maximally preserve participants' data, and promote the automatic screening of ASD.
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10
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Sex-Specific Neurocognitive Impairment. Neurol Clin 2023; 41:359-369. [PMID: 37030963 DOI: 10.1016/j.ncl.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-specific neurocognitive impairment across a range of medical conditions including neurodegenerative diseases and coronavirus disease-2019.
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11
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Saure E, Castrén M, Mikkola K, Salmi J. Intellectual disabilities moderate sex/gender differences in autism spectrum disorder: a systematic review and meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1-34. [PMID: 36444668 DOI: 10.1111/jir.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Girls/women with autism spectrum disorder (ASD) are suggested to exhibit different symptom profiles than boys/men with ASD. Accumulating evidence suggests that intellectual disability (ID) may affect sex/gender differences in ASD. However, a systematic review and meta-analysis on this topic is missing. METHODS Two databases (MEDLINE and PsycINFO) were used to search for studies reporting sex/gender differences (girls/women versus boys/men) in social communication and interaction, restrictive and repetitive behaviour and interests (RRBIs), sensory processing, and linguistic and motor abilities in ASD. The final sample consisted of 79 studies. The meta-analysis was performed with Review Manager using a random-effects model. Participants with ASD without and with ID were analysed as separate subgroups, and the effects in these two subgroups were also compared with each other. RESULTS Girls/women with ASD without ID displayed fewer RRBIs, more sensory symptoms and less problems in linguistic abilities than their boys/men counterparts. In contrast, girls/women with ASD with ID displayed more social difficulties and RRBIs, poorer linguistic abilities and more motor problems than boys/men with ASD with ID. Comparisons of groups of participants with ASD without ID versus participants with ASD with ID confirmed differences in sex/gender effects on social difficulties, sensory processing, linguistic abilities and motor abilities. CONCLUSIONS Our results clearly suggest that the female phenotype of ASD is moderated by ID. Among individuals with ASD with ID, girls/women seem to be more severely affected than boys/men, whereas among individuals with ASD without ID, girls/women with ASD may have less symptoms than boys/men. Such phenotypic differences could be a potential cause of underrecognition of girls/women with ASD, and it is also possible that observed phenotypic differences may reflect underdiagnosing of girls/women with ASD.
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Affiliation(s)
- E Saure
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- BABA Center and Department of Clinical Neurophysiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - M Castrén
- Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - K Mikkola
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Salmi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
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12
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Redquest B, Tint A, St. John L, Hutton S, Palmer P, Lunsky Y. Virtual group-based mindfulness program for autistic women: A feasibility study. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142369. [PMID: 36560924 PMCID: PMC9793023 DOI: 10.1177/17455057221142369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Autistic women experience life differently than autistic men. For example, autistic women tend to be diagnosed significantly later than autistic men, they experience a higher number of traumas, and are at increased risk for mental health conditions. Given gender-specific life experiences, autistic women may benefit from gender-specific group-based supports. Virtual mindfulness has been shown to be helpful in improving well-being among autistic adults; however, limited research has explored the impact of virtual mindfulness when it is delivered to a group of autistic women only. OBJECTIVES The aim of this article is to describe a preliminary evaluation of a virtual mindfulness group piloted for autistic women. Five key areas of feasibility were assessed in the current study: demand, implementation, acceptability, practicality, and limited efficacy testing. METHODS Twenty-eight women participated in a 6-week virtual autism-informed mindfulness program and were asked to complete measures assessing psychological distress, self-compassion, and mindfulness at pre and post. Participants were also asked to complete a satisfaction survey after the program. RESULTS Results showed that the program was feasible in terms of demand, implementation, practicality, and acceptability. While quantitative results showed there were no changes in psychological distress, self-compassion, and mindfulness from pre- to post-program, qualitative results showed some benefits. CONCLUSION Given the unique challenges that some autistic women experience, offering groups to autistic women may have some value and it would be important to continue exploring this topic area.
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Affiliation(s)
- Brianne Redquest
- School and Applied Child Psychology,
Werklund School of Education, University of Calgary, Calgary, AB, Canada,Alberta Children’s Hospital Research
Institute, University of Calgary, Calgary, AB, Canada,Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Ami Tint
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Laura St. John
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Sue Hutton
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Pamela Palmer
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada,Department of Psychiatry, Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Yona Lunsky, Azrieli Adult
Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen
Street West, Toronto M6J 1H4, Ontario, Canada.
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13
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Walsh MJM, Ofori E, Pagni BA, Chen K, Sullivan G, Braden BB. Preliminary findings of accelerated visual memory decline and baseline brain correlates in middle-age and older adults with autism: The case for hippocampal free-water. Front Aging Neurosci 2022; 14:1029166. [PMID: 36437999 PMCID: PMC9694823 DOI: 10.3389/fnagi.2022.1029166] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
Research aimed at understanding cognitive and brain aging in adults with autism spectrum disorder (ASD) is growing, but critical longitudinal work is scant. Adults with ASD struggle with tasks involving visual memory compared with neurotypical adults (NT). This may be related to differences in size or integrity of the hippocampus and its' primary structural connectivity pathway, the fornix. The aim of this study was to describe preliminary findings of longitudinal aging trajectories in short- and long-term visual memory abilities in middle-age and older adults with ASD, compared with matched NT adults. We then evaluated baseline multi-modal imaging metrics of the hippocampal system, including the relatively novel metric of free-water, as potential correlates of longitudinal memory change in the ASD group. Middle-age and older adults with ASD (n = 25) and matched NT adults (n = 25) between the ages of 40 and 70 years were followed longitudinally at ~2-year intervals (range 2-5 years). Participants completed the Wechsler Memory Scale III Visual Reproduction task. Longitudinal mixed models were utilized to detect group differences in memory change with baseline age and sex as covariates. Hippocampal volume was measured via T1-weighted MRI images with FreeSurfer. Fornix fractional anisotropy and hippocampal and fornix free-water were measured from diffusion tensor imaging scans. Exploratory correlations were run between individual hippocampal system metrics and longitudinal slopes of visual memory change. There was a significant group by time interaction for long-term visual memory, such that middle-age and older adults with ASD declined faster than matched NT adults. There was no group by time interaction for short-term visual memory. Baseline hippocampal free-water was the only hippocampal system metric that correlated with long-term visual memory change in the ASD group. As one of the first longitudinal cognitive and brain aging studies in middle-age and older adults with ASD, our findings suggest vulnerabilities for accelerated long-term visual memory decline, compared to matched NT adults. Further, baseline hippocampal free-water may be a predictor of visual memory change in middle-age and older adults with ASD. These preliminary findings lay the groundwork for future prognostic applications of MRI for cognitive aging in middle-age and older adults with ASD.
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Affiliation(s)
- Melissa J. M. Walsh
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Edward Ofori
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Broc A. Pagni
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Kewei Chen
- Banner Alzheimer’s Institute, Phoenix, AZ, United States
| | - Georgia Sullivan
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - B. Blair Braden
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
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14
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Ghahremani R, Mohammadkhani R, Salehi I, Karimi SA, Zarei M. Sex Differences in Spatial Learning and Memory in Valproic Acid Rat Model of Autism: Possible Beneficial Role of Exercise Interventions. Front Behav Neurosci 2022; 16:869792. [PMID: 35548693 PMCID: PMC9084280 DOI: 10.3389/fnbeh.2022.869792] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
In the current study, we first tried to determine sex differences in spatial learning and memory in the valproic acid (VPA) rat model of autism. Second, the effects of interval training (IT) and continuous training (CT) exercises were examined in male and female offsprings. To induce autism-like animal model, the pregnant rats were injected 500 mg/kg NaVPA (intraperitoneal) at the embryonic day 12.5. IT and CT aerobic exercises were started at postnatal day 56. Then, on postnatal days 84–89, a Morris water maze (MWM) test was conducted on the separate groups of offsprings. Aerobic training was performed on a rodent treadmill with 0% slope for 8 weeks, 5 days/week, and 50 min/day. Unlike control animals, VPA-exposed female offspring had a better performance than VPA-exposed male offspring in MWM acquisition. In the case of MWM reference memory, we did not observe a sex difference between VPA-exposed male and VPA-exposed female offspring. Both IT and CT exercises in both control and VPA-exposed male rats significantly improved MWM acquisition. Moreover, both IT and CT exercises significantly improved MWM acquisition in control female rats. In addition, IT exercise (but not CT) significantly improved MWM acquisition in VPA-exposed female offsprings. Both IT and CT exercises in VPA-exposed that male and female offsprings improved the MWM reference memory. In conclusion, our observation demonstrated that prenatal exposure to VPA affects the spatial learning and memory in a sex dependent manner. We have shown that both IT and CT exercises are able to improve cognitive function in healthy and autistic rat offsprings.
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Affiliation(s)
- Reza Ghahremani
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Birjand, Birjand, Iran
| | | | - Iraj Salehi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Asaad Karimi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Neuroscience, School of Science and Advanced Technologies in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
- *Correspondence: Seyed Asaad Karimi, , , ,
| | - Mohammad Zarei
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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15
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Male sex bias in early and late onset neurodevelopmental disorders: shared aspects and differences in autism spectrum disorder, attention deficit/hyperactivity disorder, and schizophrenia. Neurosci Biobehav Rev 2022; 135:104577. [DOI: 10.1016/j.neubiorev.2022.104577] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/23/2022] [Accepted: 02/11/2022] [Indexed: 12/22/2022]
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16
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Calderoni S. Sex/gender differences in children with autism spectrum disorder: A brief overview on epidemiology, symptom profile, and neuroanatomy. J Neurosci Res 2022; 101:739-750. [PMID: 35043482 DOI: 10.1002/jnr.25000] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/01/2021] [Accepted: 12/03/2021] [Indexed: 12/11/2022]
Abstract
Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental conditions whose shared core features are impairments in social interaction and communication as well as restricted patterns of behavior, interests, and activities. The significant and consistent male preponderance in ASD prevalence has historically affected the scientific knowledge of autism in females as regards, inter alia, the clinical presentation, the genetic architecture, and the structural brain underpinnings. Indeed, females with ASD are under-investigated as samples recruited for clinical research typically reflect the strong male bias of the disorder. In the last years, the study of the various aspects of sex/gender (s/g) differences in ASD is gaining increased clinical and research interest resulting in a growing number of investigations on this topic. Here, I review and discuss evidence emerged from epidemiological, clinical, and neuroimaging studies in the last decade focusing on s/g differences in children with ASD. These studies are the prerequisites for the development of assessment and treatment practices which take into consideration s/g differences in ASD. Ultimately, a better understanding of s/g differences aims at improving healthcare for both ASD males and females.
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Affiliation(s)
- Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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17
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Lacroix A, Dutheil F, Logemann A, Cserjesi R, Peyrin C, Biro B, Gomot M, Mermillod M. Flexibility in autism during unpredictable shifts of socio-emotional stimuli: Investigation of group and sex differences. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1681-1697. [PMID: 34957880 DOI: 10.1177/13623613211062776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Flexibility difficulties in autism might be particularly common in complex situations, when shifts (i.e. the switch of attentional resources or strategy according to the situation) are unpredictable, implicit (i.e. not guided by explicit rules) and the stimuli are complex. We analyzed the data of 101 autistic and 145 non-autistic adults, without intellectual deficiency, on two flexibility tasks performed online. The first task involved unpredictable and non-explicit shifts of complex socio-emotional stimuli, whereas the second task involved predictable and explicit shifts of character stimuli. Considering the discrepancies between laboratory results and the real-life flexibility-related challenges faced by autistic individuals, we need to determine which factor could be of particular importance in flexibility difficulties. We point out that the switch cost (i.e. the difference between shift and non-shift condition) was larger for autistic than for non-autistic participants on the complex flexibility task with unpredictable and non-explicit shifts of socio-emotional stimuli, whereas this was not the case when shifts were predictable, explicit and involved less complex stimuli. We also highlight sex differences, suggesting that autistic females have better social skills than autistic males and that they also have a specific cognitive profile, which could contribute to social camouflaging. The findings of this work help us understand which factors could influence flexibility difficulties in autism and are important for designing future studies. They also add to the literature on sex differences in autism which underpin better social skills, executive function, and camouflaging in autistic females.
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Affiliation(s)
- Adeline Lacroix
- University of Grenoble Alpes, France.,University of Savoie Mont Blanc, France
| | | | | | | | - Carole Peyrin
- University of Grenoble Alpes, France.,University of Savoie Mont Blanc, France
| | - Brigi Biro
- Eötvös Loránd University (ELTE), Hungary
| | | | - Martial Mermillod
- University of Grenoble Alpes, France.,University of Savoie Mont Blanc, France
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18
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Zhao Z, Tang H, Alviar C, Kello CT, Zhang X, Hu X, Qu X, Lu J. Excessive and less complex body movement in children with autism during face-to-face conversation: An objective approach to behavioral quantification. Autism Res 2021; 15:305-316. [PMID: 34837352 DOI: 10.1002/aur.2646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/08/2021] [Accepted: 11/16/2021] [Indexed: 11/05/2022]
Abstract
The majority of existing studies investigating characteristics of overt social behavior in individuals with autism spectrum disorder (ASD) relied on informants' evaluation through questionnaires and behavioral coding techniques. As a novelty, this study aimed to quantify the complex movements produced during social interactions in order to test differences in ASD movement dynamics and their convergence, or lack thereof, during social interactions. Twenty children with ASD and twenty-three children with typical development (TD) were videotaped while engaged in a face-to-face conversation with an interviewer. An image differencing technique was utilized to extract the movement time series. Spectral analyses were conducted to quantify the average power of movement, and the fractal scaling of movement. The degree of complexity matching was calculated to capture the level of behavioral coordination between the interviewer and children. Results demonstrated that the average power was significantly higher (p < 0.01), and the fractal scaling was steeper (p < 0.05) in children with ASD, suggesting excessive and less complex movement as compared to the TD peers. Complexity matching occurred between children and interviewers, but there was no reliable difference in the strength of matching between the ASD and TD children. Descriptive trends in the interviewer's behavior suggest that her movements adapted to match both ASD and TD movements equally well. The findings of our study might shed light on seeking novel behavioral markers of ASD, and on developing automatic ASD screening techniques during daily social interactions.
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Affiliation(s)
- Zhong Zhao
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Haiming Tang
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Camila Alviar
- Cognitive and Information Sciences, University of California, Merced, USA
| | | | - Xiaobin Zhang
- Shenzhen Guangming District Center for Disease Control and Prevention, Shenzhen, China
| | - Xinyao Hu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Xingda Qu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Jianping Lu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
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19
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Zhao Z, Tang H, Zhang X, Qu X, Hu X, Lu J. Classification of Children With Autism and Typical Development Using Eye-Tracking Data From Face-to-Face Conversations: Machine Learning Model Development and Performance Evaluation. J Med Internet Res 2021; 23:e29328. [PMID: 34435957 PMCID: PMC8440949 DOI: 10.2196/29328] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies have shown promising results in identifying individuals with autism spectrum disorder (ASD) by applying machine learning (ML) to eye-tracking data collected while participants viewed varying images (ie, pictures, videos, and web pages). Although gaze behavior is known to differ between face-to-face interaction and image-viewing tasks, no study has investigated whether eye-tracking data from face-to-face conversations can also accurately identify individuals with ASD. OBJECTIVE The objective of this study was to examine whether eye-tracking data from face-to-face conversations could classify children with ASD and typical development (TD). We further investigated whether combining features on visual fixation and length of conversation would achieve better classification performance. METHODS Eye tracking was performed on children with ASD and TD while they were engaged in face-to-face conversations (including 4 conversational sessions) with an interviewer. By implementing forward feature selection, four ML classifiers were used to determine the maximum classification accuracy and the corresponding features: support vector machine (SVM), linear discriminant analysis, decision tree, and random forest. RESULTS A maximum classification accuracy of 92.31% was achieved with the SVM classifier by combining features on both visual fixation and session length. The classification accuracy of combined features was higher than that obtained using visual fixation features (maximum classification accuracy 84.62%) or session length (maximum classification accuracy 84.62%) alone. CONCLUSIONS Eye-tracking data from face-to-face conversations could accurately classify children with ASD and TD, suggesting that ASD might be objectively screened in everyday social interactions. However, these results will need to be validated with a larger sample of individuals with ASD (varying in severity and balanced sex ratio) using data collected from different modalities (eg, eye tracking, kinematic, electroencephalogram, and neuroimaging). In addition, individuals with other clinical conditions (eg, developmental delay and attention deficit hyperactivity disorder) should be included in similar ML studies for detecting ASD.
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Affiliation(s)
- Zhong Zhao
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Haiming Tang
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Xiaobin Zhang
- Shenzhen Guangming District Center for Disease Control and Prevention, Shenzhen, China
| | - Xingda Qu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Xinyao Hu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Jianping Lu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
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20
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Payne M, Mali I, McKinnell ZE, Vangsness L, Shrestha TB, Bossmann SH, Plakke B. Increased volumes of lobule VI in a valproic acid model of autism are associated with worse set-shifting performance in male Long-Evan rats. Brain Res 2021; 1765:147495. [PMID: 33894224 PMCID: PMC8205983 DOI: 10.1016/j.brainres.2021.147495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 11/27/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a skewed sex-based diagnostic ratio. While males are at a higher risk for ASD, it is critical to understand the neurobiology of the disorder to develop better treatments for both males and females. Our prior work has demonstrated that VPA (valproic acid) treated offspring had impaired performance on an attentional set-shifting task. The current study used MRI and regions of interest analyses to measure the volumes of cerebellar subregions in VPA and controls rats that had participated in the attentional set-shifting task. VPA males had significantly more volume in lobule VI compared to male controls. VPA female rats had significantly less volume in lobules I, IV and X compared to female controls. In addition, it was revealed that decreases in volume for VPA females was associated with worse performance. Males with increases in lobule VI were also impaired on the set-shifting task. Similar volumetric differences within the cerebellum have been observed in humans with ASD, which suggests that the VPA model is capturing some of the same brain changes observed in humans with ASD, and that these changes in volume may be impacting cognition.
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Affiliation(s)
- Macy Payne
- Department of Chemistry, Kansas State University, Manhattan, KS, USA
| | - Ivina Mali
- Department of Chemistry, Kansas State University, Manhattan, KS, USA
| | - Zach E McKinnell
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Lisa Vangsness
- Department of Psychology, Wichita State University, Wichita, KS, USA
| | - Tej B Shrestha
- Department of Anatomy & Physiology, Nanotechnology Innovation Center of Kansas State-NICKS, KS, USA
| | - Stefan H Bossmann
- Department of Chemistry, Kansas State University, Manhattan, KS, USA
| | - Bethany Plakke
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA.
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21
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Belcher HL, Morein-Zamir S, Mandy W, Ford RM. Camouflaging Intent, First Impressions, and Age of ASC Diagnosis in Autistic Men and Women. J Autism Dev Disord 2021; 52:3413-3426. [PMID: 34342806 PMCID: PMC9296412 DOI: 10.1007/s10803-021-05221-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 12/26/2022]
Abstract
Camouflaging of autistic traits may make autism harder to diagnose. The current study evaluated the relations between camouflaging intent, first impressions, and age of autism diagnosis. Participants comprised autistic and non-autistic adults (n = 80, 50% female) who completed the Camouflaging of Autistic Traits Questionnaire. They were later video-recorded having a conversation with a person unaware of their diagnostic status. Ten-second clips from half these videos were later shown to 127 non-autistic peers, who rated their first impressions of each participant. Results showed that autistic participants were rated more poorly on first impressions, males were rated less favourably than females, and male raters were particularly harsh in their evaluations of autistic males. Camouflaging intent did not predict first impressions but better first impressions were linked with a later age of diagnosis.
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Affiliation(s)
- Hannah L Belcher
- School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK. .,IOPPN, King's College London, 16 Crespigny Park, Camberwell, London, SE5 8AB, UK.
| | - Sharon Morein-Zamir
- School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
| | - Will Mandy
- University College London, 1-19 Torrington Place, Bloomsbury, London, WC1E 7HB, UK
| | - Ruth M Ford
- School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
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22
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Burrows CA, Bodfish JW, Wolff JJ, Vollman EP, Altschuler MR, Botteron KN, Dager SR, Estes AM, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Piven J, Elison JT. Cataloguing and characterizing interests in typically developing toddlers and toddlers who develop ASD. Autism Res 2021; 14:1710-1723. [PMID: 34021722 PMCID: PMC8714188 DOI: 10.1002/aur.2543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/16/2021] [Accepted: 05/03/2021] [Indexed: 11/06/2022]
Abstract
Intense interests are common in children with and without autism spectrum disorder (ASD), and little research has characterized aspects of interests that are unique to or shared among children with and without ASD. We aimed to characterize interests in a sample of infants at high-familial-risk (HR) and low-familial-risk (LR) for ASD using a novel interview. Participants included HR siblings who were diagnosed with ASD at 24 months (HR-ASD, n = 56), HR siblings who did not receive an ASD diagnosis at 24 months (HR-Neg, n = 187), and a LR comparison group (n = 109). We developed and collected data with the Intense Interests Inventory at 18- and 24-months of age, a semi-structured interview that measures intensity and peculiarity of interests in toddlers and preschool-aged children. Intensity of interests differed by familial risk at 24 months, with HR-ASD and HR-Neg groups demonstrating equivalent intensity of interests that were higher than the LR group. By contrast, peculiarity of interest differed by ASD diagnosis, with the HR-ASD group showing more peculiar interests than the HR-Neg and LR groups at 24 months. At 18 months the HR-ASD group had more peculiar interests than the LR group, though no differences emerged in intensity of interests. This measure may be useful in identifying clinically-relevant features of interests in young children with ASD. We also replicated previous findings of males showing more intense interests at 18 months in our non-ASD sample. These results reveal new information about the nature of interests and preoccupations in the early autism phenotype. LAY SUMMARY: Intense interests are common in young children with autism and their family members. Intense interests are also prevalent among typically-developing children, and especially boys. Here we catalog interests and features of these interests in a large sample of toddlers enriched for autism risk. Children who had family members with autism had more intense interests, and those who developed autism themselves had more unusual interests at 24 months. These results highlight the importance of different aspects of interest in autism.
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Affiliation(s)
- Catherine A Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - James W Bodfish
- Department of Hearing & Speech Sciences, Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elayne P Vollman
- Department of Psychology and Comparative Human Development, University of Chicago, Chicago, Illinois, USA
| | - Melody R Altschuler
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Annette M Estes
- Center on Human Development and Disability, University of Washington, Seattle, Washington, USA
| | - Heather C Hazlett
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - John R Pruett
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Robert T Schultz
- Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
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23
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Comparing the Executive Function Ability of Autistic and Non-autistic Adolescents with a Manualised Battery of Neuropsychological Tasks. J Autism Dev Disord 2021; 52:3169-3181. [PMID: 34286393 DOI: 10.1007/s10803-021-05034-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 10/20/2022]
Abstract
Performance on a single executive function (EF) task (e.g., a card sorting task) is often taken to represent ability on the underlying subcomponent of EF (e.g., set shifting) without accounting for the non-specific and non-executive skills employed to complete the task. This study used a manualised battery of EF tasks to derive individual task scores and latent EF scores. Seventy-nine adolescents aged between 11 and 19 years, including 37 autistic and 42 non-autistic participants, matched on cognitive ability, completed the battery. Autistic adolescents had moderate global EF difficulties and had significantly more difficulties on some individual tasks. However, the samples did not differ on any of the specific individual subcomponents of EF (fluency, cognitive control and working memory).
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24
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Shiva S, Gharesouran J, Sabaie H, Asadi MR, Arsang-Jang S, Taheri M, Rezazadeh M. Expression Analysis of Ermin and Listerin E3 Ubiquitin Protein Ligase 1 Genes in Autistic Patients. Front Mol Neurosci 2021; 14:701977. [PMID: 34349621 PMCID: PMC8326841 DOI: 10.3389/fnmol.2021.701977] [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: 04/28/2021] [Accepted: 06/28/2021] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorder (ASD) is a severe neurodevelopmental disorder that involves social interaction defects, impairment of non-verbal and verbal interactions, and limited interests along with stereotypic activities. Its incidence has been increasing rapidly in recent decades. Despite numerous attempts to understand the pathophysiology of ASD, its exact etiology is still unclear. Recent data shows the role of accurate myelination and translational regulation in ASD's pathogenesis. In this study, we assessed Ermin (ERMN) and Listerin E3 Ubiquitin Protein Ligase 1 (LTN1) genes expression in Iranian ASD patients and age- and gender-matched healthy subjects' peripheral blood using quantitative real-time PCR to recognize any probable dysregulation in the expression of these genes and propose this disorder's mechanisms. Analysis of the expression demonstrated a significant ERMN downregulation in total ASD patients compared to the healthy individuals (posterior beta = -0.794, adjusted P-value = 0.025). LTN1 expression was suggestively higher in ASD patients in comparison with the corresponding control individuals. Considering the gender of study participants, the analysis showed that the mentioned genes' different expression levels were significant only in male subjects. Besides, a significant correlation was found between expression of the mentioned genes (r = -0.49, P < 0.0001). The present study provides further supports for the contribution of ERMN and LTN1 in ASD's pathogenesis.
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Affiliation(s)
- Shadi Shiva
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Gharesouran
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hani Sabaie
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Asadi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahram Arsang-Jang
- Cancer Gene Therapy Research Center, Zanjan University of Medical Science, Zanjan, Iran
| | - Mohammad Taheri
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rezazadeh
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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25
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Rahaman MA, Lopa M, Uddin KMF, Baqui MA, Keya SP, Faruk MO, Sarker S, Basiruzzaman M, Islam M, AlBanna A, Jahan N, Chowdhury MAKA, Saha N, Hussain M, Colombi C, O'Rielly D, Woodbury-Smith M, Ghaziuddin M, Rahman MM, Uddin M. An Exploration of Physical and Phenotypic Characteristics of Bangladeshi Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:2392-2401. [PMID: 32975665 DOI: 10.1007/s10803-020-04703-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study explored the physical and clinical phenotype of Bangladeshi children with autism spectrum disorder (ASD). A totally of 283 children who were referred for screening and administered Module 1 of the Autism Diagnostic Observation Schedule (ADOS) were included. Overall, 209 met the ADOS algorithmic cutoff for ASD. A trend for greater weight and head circumference was observed in children with ASD versus non-ASD. Head circumference was significantly (p < 0.03) larger in ASD males compared with non-ASD males. A trend was also observed for symptom severity, higher in females than males (p = 0.068), with further analyses demonstrating that social reciprocity (p < 0.014) and functional play (p < 0.03) were significantly more impaired in ASD females than males. The findings help understand sex differences in ASD.
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Affiliation(s)
- Md Ashiquir Rahaman
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Maksuda Lopa
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - K M Furkan Uddin
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Holy Family Red Crescent Medical College, Dhaka, Bangladesh
| | - Md Abdul Baqui
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Selina Parvin Keya
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Md Omar Faruk
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Shaoli Sarker
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Department of Paediatric Neuroscience, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Mohammed Basiruzzaman
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Mazharul Islam
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Ammar AlBanna
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.,Al Jalila Specialty Children's Hospital, Dubai, UAE
| | - Nargis Jahan
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - M A K Azad Chowdhury
- Neonatology, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Narayan Saha
- Department of Paediatric Neurology, National Institute of Neurosciences, Dhaka, Bangladesh
| | - Manzoor Hussain
- Department of Paediatric Cardiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Costanza Colombi
- Department of Paediatric Cardiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Darren O'Rielly
- Faculty of Medicine, Centre for Translational Genomics, Memorial University, St. Johns, Canada
| | - Marc Woodbury-Smith
- Department of Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Mohammad Mizanur Rahman
- Department of Paediatric Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohammed Uddin
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE. .,Department of Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.
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26
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Demetriou EA, Pepper KL, Park SH, Pellicano L, Song YJC, Naismith SL, Hickie IB, Thomas EE, Guastella AJ. Autism spectrum disorder: An examination of sex differences in neuropsychological and self-report measures of executive and non-executive cognitive function. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2223-2237. [PMID: 34169770 DOI: 10.1177/13623613211014991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Research comparing females and males with a diagnosis of autism suggests that there are sex differences in some characteristics such as behaviour regulation. One area not studied in detail is whether females and males with autism perform differently in tests of cognitive ability. The results of previous research are quite mixed. One explanation may be that some research comparing females and males with autism did not include a neurotypical control group for comparison. As a result, it is not clear whether the sex differences in cognitive ability observed in people with autism are similar to differences between neurotypical males and females. To better understand whether there are unique differences between males and females with autism, it is important to also compare them with neurotypical males and females. In our research, we included a neurotypical group and compared males and females with and without a diagnosis of autism. We found that the sex differences in autism are similar to what we observe in males and females without autism. Our study showed that compared with males, females (with and without autism) do better in assessments of processing speed, cognitive flexibility, verbal learning and memory and semantic fluency. Our results suggest that although females show different cognitive performance to males, these sex differences were not specific to the group with a diagnosis of autism.
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27
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Giovanniello J, Ahrens S, Yu K, Li B. Sex-Specific Stress-Related Behavioral Phenotypes and Central Amygdala Dysfunction in a Mouse Model of 16p11.2 Microdeletion. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:59-69. [PMID: 36324434 PMCID: PMC9616311 DOI: 10.1016/j.bpsgos.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/08/2021] [Accepted: 01/26/2021] [Indexed: 12/27/2022] Open
Abstract
Background Substantial evidence indicates that a microdeletion on human chromosome 16p11.2 is linked to neurodevelopmental disorders, including autism spectrum disorder (ASD). Carriers of this deletion show divergent symptoms besides the core features of autism spectrum disorder, such as anxiety and emotional symptoms. The neural mechanisms underlying these symptoms are poorly understood. Methods We used mice heterozygous for a deletion allele of the genomic region corresponding to the human 16p11.2 microdeletion locus (i.e., 16p11.2 del/+ mice) and their sex-matched wild-type littermates for the study and examined their anxiety-related behaviors, auditory perception, and central amygdala circuit function using behavioral, circuit tracing, and electrophysiological techniques. Results Mice heterozygous for a deletion allele of the genomic region corresponding to the human 16p11.2 microdeletion locus (i.e., 16p11.2 del/+ mice) had sex-specific anxiety-related behavioral and neural circuit changes. Specifically, we found that female, but not male, 16p11.2 del/+ mice showed enhanced fear generalization-a hallmark of anxiety disorders-after auditory fear conditioning and displayed increased anxiety-like behaviors after physical restraint stress. Notably, such sex-specific behavioral changes were paralleled by an increase in activity in central amygdala neurons projecting to the globus pallidus in female, but not male, 16p11.2 del/+ mice. Conclusions Together, these results reveal female-specific anxiety phenotypes related to 16p11.2 microdeletion syndrome and a potential underlying neural circuit mechanism. Our study therefore identifies previously underappreciated sex-specific behavioral and neural changes in a genetic model of 16p11.2 microdeletion syndrome and highlights the importance of investigating female-specific aspects of this syndrome for targeted treatment strategies.
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Affiliation(s)
- Jacqueline Giovanniello
- School of Biological Sciences, Cold Spring Harbor, New York
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Sandra Ahrens
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Kai Yu
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Bo Li
- School of Biological Sciences, Cold Spring Harbor, New York
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
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28
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How children with neurodevelopmental disorders can benefit from the neurocognitive effects of exercise. Neurosci Biobehav Rev 2021; 127:514-519. [PMID: 33991545 DOI: 10.1016/j.neubiorev.2021.04.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/01/2021] [Indexed: 11/22/2022]
Abstract
Exercise is an integral part of children's lives, and research in educational settings has found that regular engagement promises improvements in executive function (i.e. top-down control of goal-directed behavior). Based on recent advances in understanding the moderators and the neurocognitive mechanisms of these effects, we highlight a potential application of exercise in the treatment of executive dysfunction. Even though different neurodevelopmental disorders are characterized by a heterogeneity in core symptoms, children affected by these disorders often face common executive function deficits. So far, exercise has not been recognized as an alternative or additional treatment for this specific cognitive impairment. The limited experimental evidence in children with neurodevelopmental disorders provides a first indication that regular exercise engagement benefits executive function. However, we identified key research questions that need to be answered before a prescription of exercise to children with executive dysfunction can be encouraged in clinical practice.
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29
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Sex Differences in Autism Spectrum Disorder: Repetitive Behaviors and Adaptive Functioning. CHILDREN-BASEL 2021; 8:children8050325. [PMID: 33922236 PMCID: PMC8146768 DOI: 10.3390/children8050325] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
Sex differences in restricted and repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD) have been explored with mixed findings. We aimed to investigate sex differences in RRBs through a specific measure—i.e., the Repetitive Behavior Scale Revised (RBS-R)—in a sample of preschool-age and school-age children with ASD. Additionally, we evaluated if RRBs were differently related to adaptive functioning within the male and the female age groups. A sample of 210 ASD individuals (3–18 years; 145 males, 65 females) underwent an in-depth assessment including a cognitive, adaptive functioning evaluation (i.e., the Adaptive Behavior Assessment System, Second Edition (ABAS-II)) and RRBs assessment (i.e., RBS-R). No significant sex differences on the RBS-R total score or any RBS-R subscale emerged. Within the group of older participants, RRBs were negatively associated with all adaptive skill domains independently from sex and age. Our results suggest a lack of sex differences in RRBs in our sample. Additionally, our findings highlight the possible negative impact of RRBs on adaptive skills in older individuals with autism, emphasizing the need for autistic individuals of both sexes to undergo an early intervention targeting RRBs, in order to improve their adaptive skills.
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30
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Tang CH, Chi MH, Hsieh YT, Lee TI, Tai YC, Lien YJ, Yang YK, Chen PS. Sex differences in the diagnosis of autism spectrum disorder and effects of comorbid mental retardation and attention-deficit hyperactivity disorder. J Formos Med Assoc 2021; 121:210-217. [PMID: 33820714 DOI: 10.1016/j.jfma.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/08/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/PURPOSE The association between sex and diagnostic behavior of autism spectrum disorder (ASD), and the effects of comorbid mental retardation (MR) and attention-deficit hyperactivity disorder (ADHD), were explored. METHODS Based on the Taiwan Longitudinal Health Insurance Database (LHID)-2000 and data from 1996 through 2008, the cumulative incidence of ASD over time was compared between the sexes (both cohorts n = 38,117) using the log-rank test. The effects of comorbid MR and ADHD on the incidence of ASD were evaluated using Cox proportional hazard regression analysis. The age at first diagnosis of ASD in the two sexes was compared using the independent-sample t-test. RESULTS The incidence was higher in males than in females (0.0007 vs. 0.0002) across ages. Comorbid MR or ADHD increased the incidence of ASD in both sexes; comorbid MR or ADHD also decreased the male to female hazard ratio of ASD, with no significant differences in the incidence density of ASD between sexes. ADHD delayed diagnosis in both sexes (males: 6.61 vs 5.10, p < 0.0001; females: 6.83 vs 4.69, p = 0.0037). CONCLUSIONS The general concept of a higher incidence of ASD among males was noted in this study of a Taiwanese population, but disappeared in those with comorbid MR or ADHD, indicating unique vulnerabilities to MR/ADHD or under-identification of high-functioning females with ASD in childhood. Increasing the diagnostic sensitivity of ASD in those with comorbid ADHD is important due to a delayed diagnostic age in this group.
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Affiliation(s)
- Chia Hung Tang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi Ting Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu I Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ying Chun Tai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yueh-Ju Lien
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
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31
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Navarro-Pardo E, López-Ramón F, Alonso-Esteban Y, Alcantud-Marín F. Diagnostic Tools for Autism Spectrum Disorders by Gender: Analysis of Current Status and Future Lines. CHILDREN (BASEL, SWITZERLAND) 2021; 8:262. [PMID: 33805261 PMCID: PMC8066607 DOI: 10.3390/children8040262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 02/07/2023]
Abstract
Studies on the prevalence of autism spectrum disorders have shown gender disproportion. In recent years, there has been an increasing interest in this investigation area. There are two main research lines; the first is focused mostly on gender-related biological reasons that could account for low ASD prevalence in women (i.e., related to some protective factors related to hormones or the immune system, among others), and the second research line studies possible diagnostic biases. In the present study, a review of the latter line of research is made based on two main objectives: (a) analysis of possible biases in diagnostic tools and (b) other nonbiological ASD prevalence explained by gender differences. As a result of our theoretical review, we found that the articles reviewed showed contradictory results and possible diagnostic biases, not only in their design but also in their assessment standards. We concluded that specific or complementary diagnostic tools and procedures differentiated by gender should be developed in order to reduce these biases.
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Affiliation(s)
| | | | | | - Francisco Alcantud-Marín
- Department of Developmental and Educational Psychology, University of Valencia, 46010 València, Spain; (E.N.-P.); (F.L.-R.); (Y.A.-E.)
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32
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Timko CA, Herrington JD, Bhattacharya A, Kuschner ES, Yerys BE. Caregiver Report of Executive Functioning in Adolescent Females With Anorexia Nervosa or Autism Spectrum Disorder. Front Psychol 2021; 11:586264. [PMID: 33633624 PMCID: PMC7899966 DOI: 10.3389/fpsyg.2020.586264] [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: 07/22/2020] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
Current literature suggesting a shared endophenotype between individuals with anorexia nervosa (AN) and autism spectrum disorder (ASD) related to executive functioning (EF) has several limitations: performance-based instead of ecologically valid measures of set-shifting are used, lack of comparisons between same-sex groups, and reliance on adult samples only. This was the first study directly comparing female youth with ASD to female youth with AN using an ecologically valid measure of EF. A secondary data analysis combined caregiver-reported EF on the Behavior Rating Inventory of Executive Functioning (BRIEF) for 22 female adolescent youth with AN and 29 female adolescent youth with ASD. EF in each group was compared to population norms, and EF was compared between groups. Compared to population norms, adolescents with AN had elevated scores on shift, initiate, and emotional control scales, and adolescents with ASD had elevated scores on all scales of the BRIEF and were more likely to have scores in the clinical range. There were significant differences between groups on all but three scales. The cognitive profiles and clinical scores of AN females were not comparable to those of ASD females. The findings reveal a clear clinical impairment in females with ASD but not in females with AN. The results do not support the hypothesis of similar real-world EF profiles between these groups. The results encourage further exploration into the similarities and distinctions between these two disorders.
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Affiliation(s)
- C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphian, Pennsylvania
| | - John D Herrington
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphian, Pennsylvania
| | - Anushua Bhattacharya
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Emily S Kuschner
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphian, Pennsylvania
| | - Benjamin E Yerys
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphian, Pennsylvania
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33
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Prosperi M, Turi M, Guerrera S, Napoli E, Tancredi R, Igliozzi R, Apicella F, Valeri G, Lattarulo C, Gemma A, Santocchi E, Calderoni S, Muratori F, Vicari S. Sex Differences in Autism Spectrum Disorder: An Investigation on Core Symptoms and Psychiatric Comorbidity in Preschoolers. Front Integr Neurosci 2021; 14:594082. [PMID: 33584212 PMCID: PMC7876072 DOI: 10.3389/fnint.2020.594082] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/17/2020] [Indexed: 11/17/2022] Open
Abstract
Findings regarding sex differences in autism spectrum disorder (ASD), as far as core symptoms and psychiatric comorbidities (PC) are concerned, are inconsistent, inconclusive, or conflicting among studies. The lower prevalence of ASD in females than in males and the age and intelligence quotient (IQ) heterogeneity among samples made it difficult to investigate these differences. This case–control study tries to deepen the impact of sex differences on core symptoms of autism and PC in 214 preschoolers with ASD (mean age, 45.26) without impairment in non-verbal IQ (nvIQ ≥70). A total of 107 ASD females (mean age, 44.51 ± 13.79 months) were matched one by one with 107 males (mean age, 46.01 ± 13.42 months) for chronological age (±6 months) and nvIQ (±6 points). We used the Autism Diagnostic Observation Schedule 2 (ADOS-2) and the Child Behavior Checklist (CBCL) 1.5–5 to explore autism severity and PC. The results highlight that ASD females did not significantly differ from ASD males regarding the severity of autism. Statistically significant lower levels of emotionally reactive (p = 0.005, η2 = 0.04), anxious-depressed (p = 0.001, η2 = 0.05), internalizing problems (p = 0.04, η2 = 0.02), and DSM-Oriented Scales anxiety problems (p = 0.02, η2 = 0.04) in ASD females than in ASD males were also detected. Our findings of no difference in the autism severity and lower internalizing problems in females than males with ASD extend the knowledge of autism in females during preschool years. Compared to other similar studies on this topic, we can state that these results are not supported by differences in nvIQ between sexes nor by the presence of cognitive impairment. It confirms the need for clinicians to consider sex differences when describing autism psychopathology.
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Affiliation(s)
- Margherita Prosperi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marco Turi
- Fondazione Stella Maris Mediterraneo, Potenza, Italy
| | - Silvia Guerrera
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Eleonora Napoli
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Raffaella Tancredi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Roberta Igliozzi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Fabio Apicella
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Giovanni Valeri
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | | | - Andrea Gemma
- Fondazione Stella Maris Mediterraneo, Potenza, Italy
| | - Elisa Santocchi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy.,Institute of Psychiatry, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
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34
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Iversen RK, Lewis C. Executive Function Skills Are Linked to Restricted and Repetitive Behaviors: Three Correlational Meta Analyses. Autism Res 2021; 14:1163-1185. [PMID: 33410263 DOI: 10.1002/aur.2468] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/25/2020] [Accepted: 12/13/2020] [Indexed: 12/28/2022]
Abstract
There is a consensus on the centrality of restricted and repetitive behaviors (RRBs) in the diagnosis of Autism Spectrum Disorder (ASD), yet the origins of these behaviors are still debated. We reconsider whether executive function (EF) accounts of RRBs should be revisited. EF deficits and high levels of RRBs are often pronounced in individuals with ASD and are also prevalent in young typically developing children. Despite this, the evidence is mixed, and there has been no systematic attempt to evaluate the relationship across studies and between task batteries. We examine recent evidence, and in three highly powered random-effects analyses (N = 2964), examine the strength of the association between RRB levels and performance on set shifting, inhibitory control, and parental-report based EF batteries. The analyses confirm significant associations between high levels of the behaviors and poor EF skills. Moreover, the associations remained stable across typical development and in individuals with ASD and across different types of EF measures. These meta-analyses consolidate recent evidence identifying that cognitive mechanisms correlate with high RRBs that are seen in individuals with ASD, as well as in typical development. We propose that the EF account may be critical for guiding future interventions in ASD research. LAY SUMMARY: Restricted and repetitive behaviors (RRBs) are diagnostic criteria for Autism yet also common in typical development, and if they persist over time some can have a negative impact on learning and social acceptance. The present meta-analyses found that high levels of RRBs related to poor performance on set-shifting and inhibitory control tasks, as well as high ratings on parental report scales. Future studies should create interventions that aim to improve these skills as they may help manage challenging RRBs.
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Affiliation(s)
- Rebecca Kvisler Iversen
- Fylde College, Department of Psychology, Faculty of Science and Technology, Lancaster University, Lancaster, UK
| | - Charlie Lewis
- Fylde College, Department of Psychology, Faculty of Science and Technology, Lancaster University, Lancaster, UK
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35
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Stark I, Liao P, Magnusson C, Lundberg M, Rai D, Lager A, Idring Nordström S. Qualification for upper secondary education in individuals with autism without intellectual disability: Total population study, Stockholm, Sweden. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:1036-1046. [PMID: 33246359 PMCID: PMC8111225 DOI: 10.1177/1362361320975929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study used the Stockholm Youth Cohort, a total population cohort (N = 364,957), to describe patterns and predictors of qualification for upper secondary education, defined by passing graduation grades in core compulsory school subjects in contemporary young individuals diagnosed with autism spectrum disorders without intellectual disability (n = 6138). At the expected age for graduation, 16 years, 29% (adjusted rate difference 95% confidence interval (28.0–30.0)) fewer autistic than non-autistic individuals were qualified for upper secondary education (57% and 86%, respectively). Comorbid attention-deficit hyperactivity disorder further increased this difference. Within the group of autistic students without intellectual disability, female sex and lower family income were associated with non-qualification for upper secondary education. The proportion of students with autism without intellectual disability who qualified for upper secondary education increased at age 20. These findings underline the need for improved support for students with a diagnosis of autism without intellectual disability in mainstream education.
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Affiliation(s)
| | - Peiwen Liao
- Karolinska Institutet, Sweden.,University of New South Wales (UNSW), Australia
| | | | | | | | - Anton Lager
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden
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36
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Li HH, Wang CX, Feng JY, Wang B, Li CL, Jia FY. A Developmental Profile of Children With Autism Spectrum Disorder in China Using the Griffiths Mental Development Scales. Front Psychol 2020; 11:570923. [PMID: 33240159 PMCID: PMC7680850 DOI: 10.3389/fpsyg.2020.570923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to profile the mental development of children aged 18 to 96 months with autism spectrum disorder (ASD) using the Chinese version of the Griffiths Mental Development Scales (GMDS), and to explore the relationships between developmental levels and ASD severity, the sex of the child and the age of ASD diagnosis. Children with ASD (n = 398; 337 boys, 61 girls) were recruited and ASD severity evaluated using the Autism Behavior Checklist and the Childhood Autism Rating Scale, while the GMDS was used to evaluate the children's mental development. Study participants were divided into groups according to GMDS general and subscale quotients, ASD severity, sex, and age. The majority of groups divided according to the GMDS quotients exhibited an unbalanced distribution in respect of the six domains of the GMDS and there were significant differences within the six subscale quotients. Autism severity, sex and age had significant effects on the overall level of development of autistic children. The quotients recorded for the children with more severe ASD were significantly lower than those for the children with less severe ASD. A markedly higher proportion of developmental delay was recorded for girls than boys in relation to the performance subscale. The locomotor quotient decreased in line with age at diagnosis, while autism severity and age had significant effects on the general and subscale quotients and sex had a significant effect on performance quotient. Children with ASD exhibit an uneven cognitive development profile, and their overall developmental levels are affected by autism severity, sex and age. Specific cognitive domains differ according to sex in children with ASD. Locomotor skills tend to decrease according to the age at diagnosis for autistic children aged 18 to 84 months. Autism severity and age are also associated with the level of functioning in different cognitive areas. These findings contribute to define the cognitive developmental profiles of children with ASD.
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Affiliation(s)
- Hong-Hua Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Cheng-Xin Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Jun-Yan Feng
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Bing Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Chun-Li Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China.,Pediatric Research Institute, Changchun, China
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37
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McKinnell ZE, Maze T, Ramos A, Challans B, Plakke B. Valproic acid treated female Long-Evans rats are impaired on attentional set-shifting. Behav Brain Res 2020; 397:112966. [PMID: 33053383 DOI: 10.1016/j.bbr.2020.112966] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/26/2020] [Accepted: 10/07/2020] [Indexed: 01/14/2023]
Abstract
Autism spectrum disorder (ASD), is a neurodevelopmental disorder characterized by social deficits, communication impairments, restrictive behaviors, and cognitive flexibility deficits. The valproic acid (VPA) model of autism has been widely used to examine changes in rodent behavior and neurobiology to better understand ASD. This study examined social and anxiety behavior as well as cognitive flexibility in VPA and control offspring. Results for social behavior were consistent with prior studies showing reduced sociability in VPA rats and increased self-grooming, which may be viewed as a repetitive behavior. VPA rats also had deficits in performing the set-shifting task, with female VPA rats demonstrating greater impairment compared to female control rats and male VPA rats. These results support the hypothesis that females diagnosed with ASD may suffer from different symptoms and present a unique behavioral profile compared to males with ASD. Female VPA rats were also less likely to form an attentional set; offering evidence that the VPA model of autism is encompassing executive function deficits similar to those observed in humans with ASD.
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Affiliation(s)
- Zach E McKinnell
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Tessa Maze
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Alejandro Ramos
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Brandon Challans
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Bethany Plakke
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA.
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38
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Gaillard A, Fehring DJ, Rossell SL. A systematic review and meta-analysis of behavioural sex differences in executive control. Eur J Neurosci 2020; 53:519-542. [PMID: 32844505 DOI: 10.1111/ejn.14946] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/28/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022]
Abstract
Literature investigating whether an individuals' sex affects their executive control abilities and performance on cognitive tasks in a normative population has been contradictory and inconclusive. Using meta-analytic procedures (abiding by PRISMA guidelines), this study attempts to identify the magnitude of behavioural sex differences in three prominent executive control domains of cognitive set-shifting, performance monitoring, and response inhibition. PubMed, Web of Science, and Scopus were systematically searched. Across 46 included studies, a total of 1988 females and 1884 males were included in the analysis. Overall, males and females did not differ on performance in any of the three domains of performance monitoring, response inhibition, or cognitive set-shifting. Task-specific sex differences were observed in the domains of performance monitoring, in the CANTAB Spatial Working Memory task-males scored statistically higher than females (Hedges' g = -0.60), and response inhibition, in the Delay Discounting task-females scored statistically higher than males (Hedges' g = 0.64). While the meta-analysis did not detect overall behavioural sex differences in executive control, significant heterogeneity and task-specific sex differences were found. To further understand sex differences within these specific tasks and domains, future research must better control for age and sex hormone levels.
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Affiliation(s)
- Alexandra Gaillard
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Daniel J Fehring
- Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Department of Physiology, Monash University, Clayton, VIC, Australia.,ARC Centre of Excellence in Integrative Brain Function, Monash University, Clayton, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia.,Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
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39
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Craig F, Crippa A, De Giacomo A, Ruggiero M, Rizzato V, Lorenzo A, Fanizza I, Margari L, Trabacca A. Differences in Developmental Functioning Profiles Between Male and Female Preschoolers Children With Autism Spectrum Disorder. Autism Res 2020; 13:1537-1547. [PMID: 32282130 DOI: 10.1002/aur.2305] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/12/2020] [Accepted: 03/22/2020] [Indexed: 11/11/2022]
Abstract
This study investigated differences in clinical symptoms and developmental functioning profiles as well as sex-specific correlations of clinical characteristics and communication abilities, motor skills, and maladaptive behaviors in male and female preschoolers with autism spectrum disorder (ASD). Fifty-two females (mean age 4.5 ± 2.16 years old) and 62 males (mean age 4.2 ± 1.17 years old) with ASD were enrolled and assessed by measures including the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and Psychoeducational Profile-Third Edition (PEP-3). We found intellectual disability in 91.2% of the children. While preschoolers with ASD showed comparable severity of restricted and repetitive behaviors (P = 0.17), females with ASD were less severely affected than age and intelligence quotient-matched males with ASD in the ADOS-2 social affect domain (P value = 0.001) and calibrated severity scores (P = 0.002). Interestingly, sex-specific linear regressions revealed that fine motor skills were predictive of impaired social affect in males but not in females. Specifically, motor skills might be the core feature for sex differences in ASD. Although preliminary, this finding suggests the need for more sex-specific diagnostic and intervention strategies in order to improve early identification efforts and specific intervention targets. LAY SUMMARY: Little is known about differences in developmental and functional profiles in males and females with autism spectrum disorder (ASD). We found important similarities and differences in the core ASD symptoms between male and female preschoolers. In addition, fine motor skills seem to predict social affect impairment and ASD symptom severity in males with ASD. Autism Res 2020, 13: 1537-1547. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Francesco Craig
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy
| | - Andrea De Giacomo
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Marta Ruggiero
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Veronica Rizzato
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Alessandro Lorenzo
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Isabella Fanizza
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
| | - Lucia Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Antonio Trabacca
- Unit for Severe Disabilities in Developmental Age and Young Adults, Scientific Institute, IRCCS E. Medea, Brindisi, Italy
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40
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Zhang Y, Li N, Li C, Zhang Z, Teng H, Wang Y, Zhao T, Shi L, Zhang K, Xia K, Li J, Sun Z. Genetic evidence of gender difference in autism spectrum disorder supports the female-protective effect. Transl Psychiatry 2020; 10:4. [PMID: 32066658 PMCID: PMC7026157 DOI: 10.1038/s41398-020-0699-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 12/07/2019] [Accepted: 12/30/2019] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a male-to-female prevalence of 4:1. However, the genetic mechanisms underlying this gender difference remain unclear. Mutation burden analysis, a TADA model, and co-expression and functional network analyses were performed on de novo mutations (DNMs) and corresponding candidate genes. We found that the prevalence of putative functional DNMs (loss-of-function and predicted deleterious missense mutations) in females was significantly higher than that in males, suggesting that a higher genetic load was required in females to reach the threshold for a diagnosis. We then prioritized 174 candidate genes, including 60 shared genes, 91 male-specific genes, and 23 female-specific genes. All of the three subclasses of candidate genes were significantly more frequently co-expressed in female brains than male brains, suggesting that compensation effects of the deficiency of ASD candidate genes may be more likely in females. Nevertheless, the three subclasses of candidate genes were co-expressed with each other, suggesting a convergent functional network of male and female-specific genes. Our analysis of different aspects of genetic components provides suggestive evidence supporting the female-protective effect in ASD. Moreover, further study is needed to integrate neuronal and hormonal data to elucidate the underlying gender difference in ASD.
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Affiliation(s)
- Yi Zhang
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China ,grid.216417.70000 0001 0379 7164National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan 410008 China
| | - Na Li
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China
| | - Chao Li
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China
| | - Ze Zhang
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China
| | - Huajing Teng
- grid.9227.e0000000119573309Beijing Institutes of Life Science, Chinese Academy of Science, Beijing, 100101 China
| | - Yan Wang
- grid.9227.e0000000119573309Beijing Institutes of Life Science, Chinese Academy of Science, Beijing, 100101 China
| | - Tingting Zhao
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China
| | - Leisheng Shi
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China ,grid.9227.e0000000119573309Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101 China
| | - Kun Zhang
- grid.268099.c0000 0001 0348 3990Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325025 China
| | - Kun Xia
- grid.216417.70000 0001 0379 7164Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410008 China
| | - Jinchen Li
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China. .,Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, 410008, China.
| | - Zhongsheng Sun
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325025, China. .,Beijing Institutes of Life Science, Chinese Academy of Science, Beijing, 100101, China.
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41
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Sex differences in brain structure: a twin study on restricted and repetitive behaviors in twin pairs with and without autism. Mol Autism 2019; 11:1. [PMID: 31893022 PMCID: PMC6937723 DOI: 10.1186/s13229-019-0309-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 12/19/2019] [Indexed: 01/01/2023] Open
Abstract
Background Females with autism spectrum disorder have been reported to exhibit fewer and less severe restricted and repetitive behaviors and interests compared to males. This difference might indicate sex-specific alterations of brain networks involved in autism symptom domains, especially within cortico-striatal and sensory integration networks. This study used a well-controlled twin design to examine sex differences in brain anatomy in relation to repetitive behaviors. Methods In 75 twin pairs (n = 150, 62 females, 88 males) enriched for autism spectrum disorder (n = 32), and other neurodevelopmental disorders (n = 32), we explored the association of restricted and repetitive behaviors and interests—operationalized by the Autism Diagnostic Interview-Revised (C domain) and the Social Responsiveness Scale-2 (Restricted Interests and Repetitive Behavior subscale)—with cortical volume, surface area and thickness of neocortical, sub-cortical, and cerebellar networks. Results Co-twin control analyses revealed within-pair associations between RRBI symptoms and increased thickness of the right intraparietal sulcus and reduced volume of the right orbital gyrus in females only, even though the mean number of RRBIs did not differ between the sexes. In a sub-sample of ASD-discordant pairs, increased thickness in association with RRBIs was found exclusively in females in the orbitofrontal regions, superior frontal gyrus, and intraparietal sulcus, while in males RRBIs tended to be associated with increased volume of the bilateral pallidum. Limitations However, due to a small sample size and the small difference in RRBI symptoms within pairs, the results of this exploratory study need to be interpreted with caution. Conclusions Our findings suggest that structural alterations of fronto-parietal networks in association with RRBIs are found mostly in females, while striatal networks are more affected in males. These results endorse the importance of investigating sex differences in the neurobiology of autism symptoms, and indicate different etiological pathways underlying restricted and repetitive behaviors and interests in females and males.
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42
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Evans SC, Boan AD, Bradley C, Carpenter LA. Sex/Gender Differences in Screening for Autism Spectrum Disorder: Implications for Evidence-Based Assessment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2019; 48:840-854. [PMID: 29601216 PMCID: PMC6274603 DOI: 10.1080/15374416.2018.1437734] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Autism spectrum disorder (ASD) is diagnosed more often in boys than in girls; however, little is known about the nature of this sex/gender discrepancy or how it relates to diagnostic assessment practices. This study examined the performance of the Social Communication Questionnaire (SCQ) in screening for ASD among boys and girls. Data were drawn from the South Carolina Children's Educational Surveillance Study, a population-based study of ASD prevalence among children 8-10 years of age. Analyses were conducted using SCQ data from 3,520 children, with direct assessment data from 272 with elevated SCQ scores. A bifactor model based on the Diagnostic and Statistical Manual of Mental Disorders's (5th ed.) two ASD symptom domains fit the data well and performed slightly better for girls. In the general population sample, girls exhibited fewer social communication/interaction and restricted-repetitive behavior symptoms than boys. In the direct assessment sample, however, girls with ASD showed greater impairment in social communication/interaction than boys with ASD. Items pertaining to social communication/interaction problems at ages 4-5 were among the most diagnostically efficient overall and particularly for girls. Similarly, receiver operating characteristic analyses suggested that the SCQ performs adequately among boys and well among girls. Results support the use of the SCQ in screening for ASD but do not indicate sex/gender-specific cutoffs. Girls with ASD may exhibit pronounced intraindividual deficits in social communication/interaction compared to male peers with ASD and female peers without ASD. Although more research is needed, careful attention to social communication/interaction deficits around 4-5 years of age may be especially useful for assessing ASD in girls.
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Affiliation(s)
| | - Andrea D. Boan
- Department of Pediatrics Medical University of South
Carolina, Charleston, SC, USA
| | - Catherine Bradley
- Department of Pediatrics Medical University of South
Carolina, Charleston, SC, USA
| | - Laura A. Carpenter
- Department of Pediatrics Medical University of South
Carolina, Charleston, SC, USA
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43
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Hillus J, Moseley R, Roepke S, Mohr B. Action Semantic Deficits and Impaired Motor Skills in Autistic Adults Without Intellectual Impairment. Front Hum Neurosci 2019; 13:256. [PMID: 31404247 PMCID: PMC6669914 DOI: 10.3389/fnhum.2019.00256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/09/2019] [Indexed: 11/23/2022] Open
Abstract
Several studies indicate the functional importance of the motor cortex for higher cognition, language and semantic processing, and place the neural substrate of these processes in sensorimotor action-perception circuits linking motor, sensory and perisylvian language regions. Interestingly, in individuals with autism spectrum disorder (ASD), semantic processing of action and emotion words seems to be impaired and is associated with hypoactivity of the motor cortex during semantic processing. In this study, the relationship between semantic processing, fine motor skills and clinical symptoms was investigated in 19 individuals with ASD and 22 typically-developing matched controls. Participants completed two semantic decision tasks involving words from different semantic categories, a test of alexithymia (the Toronto Alexithymia Scale), and a test of fine motor skills (the Purdue Pegboard Test). A significant Group × Word Category interaction in accuracy (p < 0.05) demonstrated impaired semantic processing for action words, but not object words in the autistic group. There was no significant group difference when processing abstract emotional words or abstract neutral words. Moreover, our study revealed deficits in fine motor skills as well as evidence for alexithymia in the ASD group, but not in neurotypical controls. However, these motor deficits did not correlate significantly with impairments in action-semantic processing. We interpret the data in terms of an underlying dysfunction of the action-perception system in ASD and its specific impact on semantic language processing.
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Affiliation(s)
- Josephina Hillus
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - Rachel Moseley
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Stefan Roepke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - Bettina Mohr
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
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44
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Øien RA, Vambheim SM, Hart L, Nordahl-Hansen A, Erickson C, Wink L, Eisemann MR, Shic F, Volkmar FR, Grodberg D. Sex-Differences in Children Referred for Assessment: An Exploratory Analysis of the Autism Mental Status Exam (AMSE). J Autism Dev Disord 2019; 48:2286-2292. [PMID: 29423603 DOI: 10.1007/s10803-018-3488-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The autism mental status exam is an eight-item observational assessment that structures the way we observe and document signs and symptoms of ASD. Investigations of test performance indicate strong sensitivity and specificity using gold-standard assessment as reference standard. This study aims to explore potential sex differences in AMSE test performance and observations of 123 children referred for autism assessment. Results indicates more language deficits in females with ASD than in males with ASD and less sensory symptoms in females compared to males with ASD. The AMSE performance is similar in identifying ASD and non-ASD in females compared to males. Less disruptive behaviors in females, might cause a need for a bigger hit to other areas of development to raise concern.
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Affiliation(s)
- Roald A Øien
- Department of Psychology, UiT - The Arctic University of Norway, PB 6050, 9037, Tromsö, Norway. .,Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Sara M Vambheim
- Department of Psychology, UiT - The Arctic University of Norway, PB 6050, 9037, Tromsö, Norway
| | - Logan Hart
- Department of Psychology, UiT - The Arctic University of Norway, PB 6050, 9037, Tromsö, Norway.,Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA
| | | | - Craig Erickson
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Logan Wink
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Martin R Eisemann
- Department of Psychology, UiT - The Arctic University of Norway, PB 6050, 9037, Tromsö, Norway
| | - Frederick Shic
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Fred R Volkmar
- Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - David Grodberg
- Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA
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45
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Exploring the female autism phenotype of repetitive behaviours and restricted interests (RBRIs): a systematic PRISMA review. ADVANCES IN AUTISM 2019. [DOI: 10.1108/aia-09-2018-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose
The purpose of this paper is to address the need for increased understanding, awareness and recognition of the autism female phenotype in terms of repetitive behaviours and restricted interests (RBRIs).
Design/methodology/approach
A systematic PRISMA review was conducted. The main aim of the present systematic review is to identify studies which have investigated RBRIs in females with autism spectrum disorder (ASD) or the differences in RBRIs between males and females with ASD.
Findings
In sum, 19 relevant articles were identified: 5 studies found no significant evidence to support the notion of sex differences in RRBIs in ASD; 1 study did not report any differences in RRBIs between males and females with ASD; 12 studies found evidence that males with ASD had significantly more RRBIs compared to females with ASD; and, lastly, 1 study found that girls with ASD have features of RRBIs which are exhibited more compared to boys with ASD.
Research limitations/implications
There is a real lack of in-depth knowledge and understanding of the female phenotype of ASD, and such lack of knowledge has a detrimental impact on the identification of autistic females and a lack of identification can have negative consequence. This is important to address in future research as it is well established that the earlier the diagnosis, the better the outcomes, due to the timely access to appropriate interventions.
Practical implications
The RBRIs exhibited in autistic females are not sufficiently captured by most currently diagnostic instruments. Clinicians are less likely to identify the RBRIs in females as they tend not to be the typical repetitive behaviours commonly associated with ASD. It has been recommended that clinicians consider “females as a whole” in terms of their clinical presentation and look for any indication of RBRIs, even repetitive interests which appear clinically innocuous.
Originality/value
There is relatively little research investigating RBRIs in autistic women and girls. There is a real need to highlight the importance of understanding and recognising how RBRIs can differ between males and females with ASD.
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46
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Uratani M, Ota T, Iida J, Okazaki K, Yamamuro K, Nakanishi Y, Kishimoto N, Kishimoto T. Reduced prefrontal hemodynamic response in pediatric autism spectrum disorder measured with near-infrared spectroscopy. Child Adolesc Psychiatry Ment Health 2019; 13:29. [PMID: 31297147 PMCID: PMC6599245 DOI: 10.1186/s13034-019-0289-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 06/22/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Functional neuroimaging studies suggest that prefrontal cortex dysfunction is present in people with autism spectrum disorder (ASD). Near-infrared spectroscopy is a noninvasive optical tool for examining oxygenation and hemodynamic changes in the cerebral cortex by measuring changes in oxygenated hemoglobin. METHODS Twelve drug-naïve male participants, aged 7-15 years and diagnosed with ASD according to DSM-5 criteria, and 12 age- and intelligence quotient (IQ)-matched healthy control males participated in the present study after giving informed consent. Relative concentrations of oxyhemoglobin were measured with frontal probes every 0.1 s during the Stroop color-word task, using 24-channel near-infrared spectroscopy. RESULTS Oxyhemoglobin changes during the Stroop color-word task in the ASD group were significantly smaller than those in the control group at channels 12 and 13, located over the dorsolateral prefrontal cortex (FDR-corrected P: 0.0021-0.0063). CONCLUSION The results suggest that male children with ASD have reduced prefrontal hemodynamic responses, measured with near-infrared spectroscopy.
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Affiliation(s)
| | - Toyosaku Ota
- 0000 0004 0372 782Xgrid.410814.8Department of Psychiatry, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522 Japan
| | - Junzo Iida
- 0000 0004 0372 782Xgrid.410814.8Faculty of Nursing, Nara Medical University, Kashihara, Japan
| | - Kosuke Okazaki
- 0000 0004 0372 782Xgrid.410814.8Department of Psychiatry, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522 Japan
| | - Kazuhiko Yamamuro
- 0000 0004 0372 782Xgrid.410814.8Department of Psychiatry, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522 Japan
| | - Yoko Nakanishi
- 0000 0004 0372 782Xgrid.410814.8Department of Psychiatry, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522 Japan
| | - Naoko Kishimoto
- 0000 0004 0372 782Xgrid.410814.8Department of Psychiatry, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522 Japan
| | - Toshifumi Kishimoto
- 0000 0004 0372 782Xgrid.410814.8Department of Psychiatry, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522 Japan
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47
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Ratto AB, Kenworthy L, Yerys BE, Bascom J, Wieckowski AT, White SW, Wallace GL, Pugliese C, Schultz RT, Ollendick TH, Scarpa A, Seese S, Register-Brown K, Martin A, Anthony LG. What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills. J Autism Dev Disord 2019; 48:1698-1711. [PMID: 29204929 DOI: 10.1007/s10803-017-3413-9] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
There is growing evidence of a camouflaging effect among females with autism spectrum disorder (ASD), particularly among those without intellectual disability, which may affect performance on gold-standard diagnostic measures. This study utilized an age- and IQ-matched sample of school-aged youth (n = 228) diagnosed with ASD to assess sex differences on the ADOS and ADI-R, parent-reported autistic traits, and adaptive skills. Although females and males were rated similarly on gold-standard diagnostic measures overall, females with higher IQs were less likely to meet criteria on the ADI-R. Females were also found to be significantly more impaired on parent reported autistic traits and adaptive skills. Overall, the findings suggest that some autistic females may be missed by current diagnostic procedures.
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Affiliation(s)
- Allison B Ratto
- Center for Autism Spectrum Disorders, Center for Neuroscience Research, Children's Research Institute, Children's National Health System, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA. .,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Center for Neuroscience Research, Children's Research Institute, Children's National Health System, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA
| | - Benjamin E Yerys
- Center for Autism Research, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19104, USA.,Department of Psychiatry, Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Julia Bascom
- Autistic Self Advocacy Network, PO Box 66122, Washington, DC, 20035, USA
| | - Andrea Trubanova Wieckowski
- Department of Psychology, Virginia Tech Center for Autism Research, Virginia Polytechnic Institute and State University, 3110 Prices Fork Rd., Blacksburg, VA, 24060, USA
| | - Susan W White
- Department of Psychology, Virginia Tech Center for Autism Research, Virginia Polytechnic Institute and State University, 3110 Prices Fork Rd., Blacksburg, VA, 24060, USA
| | - Gregory L Wallace
- Department of Speech, Language, and Hearing Sciences, The George Washington University, 2115 G St NW, Washington, DC, 20052, USA
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Center for Neuroscience Research, Children's Research Institute, Children's National Health System, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19104, USA.,Departments of Psychiatry and Pediatrics, Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Thomas H Ollendick
- Department of Psychology, Virginia Tech Center for Autism Research, Virginia Polytechnic Institute and State University, 3110 Prices Fork Rd., Blacksburg, VA, 24060, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech Center for Autism Research, Virginia Polytechnic Institute and State University, 3110 Prices Fork Rd., Blacksburg, VA, 24060, USA
| | - Sydney Seese
- Center for Autism Spectrum Disorders, Center for Neuroscience Research, Children's Research Institute, Children's National Health System, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA
| | - Kelly Register-Brown
- Department of Psychiatry, University of Maryland School of Medicine, 827 Linden Avenue, Baltimore, MD, 21201, USA
| | - Alex Martin
- Laboratory of Brain and Cognition, National Institute of Mental Health, Magnuson Clinical Center, Room 4C104, MSC 1366, Bethesda, MD, 20814, USA
| | - Laura Gutermuth Anthony
- Center for Autism Spectrum Disorders, Center for Neuroscience Research, Children's Research Institute, Children's National Health System, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA.,Pediatric Mental Health Institute, Children's Hospital of Colorado, Department of Psychiatry, University of Colorado School of Medicine, 13123 East 16th Avenue, A036/B130, Aurora, CO, 80045, USA
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48
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Xiong J, Chen S, Pang N, Deng X, Yang L, He F, Wu L, Chen C, Yin F, Peng J. Neurological Diseases With Autism Spectrum Disorder: Role of ASD Risk Genes. Front Neurosci 2019; 13:349. [PMID: 31031587 PMCID: PMC6470315 DOI: 10.3389/fnins.2019.00349] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 03/26/2019] [Indexed: 02/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is frequently comorbid with other neurological disorders such as intellectual disability (ID) or global development delay (GDD) and epilepsy. The pathogenesis of ASD is complex. So far, studies have identified more than 1000 ASD risk genes. Most of them were also reported to relate with other neurological diseases, and only several of them have been confirmed as pathogenic genes for autism. Little is known about the roles of these risk genes in neurological diseases with ASD. In the present study, we recruited a cohort of 158 neurological disorder probands with 163 variants of 48 ASD risk genes. Of these, 50 individuals (31.6%) were diagnosed with ASD. In the ASD patient subset, we identified several rarely reported candidate genes including DOLK, USH2A, and HUWE1. In a comparison of patients with neurological disorders with and without ASD, we found that ID/GDD was frequently comorbid with ASD whereas epilepsy was more common in the non-ASD group. Statistical analyses of all possible risk factors implicated that variants in synaptic genes, especially non-voltage-gated ion channel genes and in transcriptional and chromosome genes were related to ASD, but none of the investigated environmental factors was. Our results are useful for the future diagnosis and prognosis of patients with neurological disorders and emphasize the utility of genetic screening.
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Affiliation(s)
- Juan Xiong
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Shimeng Chen
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Nan Pang
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Xiaolu Deng
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Lifen Yang
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Fang He
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Liwen Wu
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Chen Chen
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Fei Yin
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Jing Peng
- Departmen of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
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49
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Green RM, Travers AM, Howe Y, McDougle CJ. Women and Autism Spectrum Disorder: Diagnosis and Implications for Treatment of Adolescents and Adults. Curr Psychiatry Rep 2019; 21:22. [PMID: 30852705 DOI: 10.1007/s11920-019-1006-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW We review the recent literature regarding the implications of gender on the diagnosis and treatment of autism spectrum disorder (ASD) in women and adolescent females. We also discuss important clinical observations in treating this population. RECENT FINDINGS Growing research supports gender specificity in ASD symptom presentation. Differing phenotypes, psychiatric co-morbidities, and level of "camouflaging" (behavioral coping strategies to conceal symptoms for use in social situations) are thought to further contribute to the discrepancy in prevalence rates and resulting misdiagnosis or delayed diagnosis in adolescent females and women. Both nosological and cultural factors appear to be contributing to differences in the diagnosis of ASD in women. These differences in presentation have important implications for late diagnosis, treatment of ASD, and the quality of life for women with autism.
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Affiliation(s)
- Renée M Green
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Alyssa M Travers
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA.,Harvard Medical School, Boston, MA, USA
| | - Yamini Howe
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA.,Harvard Medical School, Boston, MA, USA
| | - Christopher J McDougle
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02421, USA.,Harvard Medical School, Boston, MA, USA
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50
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Pearlman-Avnion S, Shlain R. Adult Women on the High-Functioning Autism Spectrum. AUTISM IN ADULTHOOD 2019. [DOI: 10.1007/978-3-030-28833-4_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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