Hyperacusis in Autism Spectrum Disorders

Feeling like an untapped resource. Experiences of working life among nurses with ADHD and/or autism: An interview study

BACKGROUND

ADHD and autism are common and increasing neurodevelopmental disorders in the world and also occur among nurses. However, almost nothing is known about nurses with these diagnoses. To promote high-quality care provision and well-being in the nursing workforce, it is important to discover more about these nurses. Therefore, in the present study, we aimed to describe how nurses with ADHD and/or autism experience their working life.

METHODS

The study was descriptive in design. Nurses were invited via Swedish Facebook groups targeting nurses. Semi-structured individual interviews were conducted with 17 nurses with ADHD and/or autism, online or by telephone. Data were analyzed using qualitative content analysis.

RESULTS

One overarching theme and seven subthemes emerged from the analysis. The theme "feeling like an untapped resource" reflected the subthemes: 1) Being passionate about one's job, 2) having strengths and talents to use in working life, 3) a stressful and disturbing work environment inhibits personal strengths, 4) managers show goodwill but lack knowledge and resources, 5) feeling appreciated but socially different among colleagues, 6) using a variety of strategies to facilitate working life and 7) toward an uncertain future.

CONCLUSION

Nurses with ADHD and/or autism experience having abilities and talents that are useful in the nursing profession. However, they feel that the physical and organizational working conditions and lack of managerial support entail challenges that prevent them from making optimal use of their strengths.

Noise sensitivity or hyperacusis? Comparing the Weinstein and Khalfa questionnaires in a community and a clinical samples

Noise sensitivity and hyperacusis are decreased sound tolerance conditions that are not well delineated or defined. This paper presents the correlations and distributions of the Noise Sensitivity Scale (NSS) and the Hyperacusis Questionnaire (HQ) scores in two distinct large samples. In Study 1, a community-based sample of young healthy adults (n = 103) exhibited a strong correlation (r = 0.74) between the two questionnaires. The mean NSS and HQ scores were 54.4 ± 16.9 and 12.5 ± 7.5, respectively. NSS scores displayed a normal distribution, whereas HQ scores showed a slight positive skew. In Study 2, a clinical sample of Veterans with or without clinical comorbidities (n = 95) showed a moderate correlation (r = 0.58) between the two questionnaires. The mean scores were 66.6 ± 15.6 and 15.3 ± 7.3 on the NSS and HQ, respectively. Both questionnaires' scores followed a normal distribution. In both samples, participants who self-identified as having decreased sound tolerance scored higher on both questionnaires. These findings provide reference data from two diverse sample groups. The moderate to strong correlations observed in both studies suggest a significant overlap between noise sensitivity and hyperacusis. The results underscore that NSS and HQ should not be used interchangeably, as they aim to measure distinct constructs, however to what extent they actually do remains to be determined. Further investigation should distinguish between these conditions through a comprehensive psychometric analysis of the questionnaires and a thorough exploration of psychoacoustic, neurological, and physiological differences that set them apart.

Effects of 700 and 3500 MHz 5G radiofrequency exposure on developing zebrafish embryos

Telecommunications industries are rapidly deploying the fifth generation (5G) spectrum and there is public concern about the safety and health impacts of this type of Radio Frequency Radiation (RFR), in part because of the lack of comparable scientific evidence. In this study we have used a validated commercially available setting producing a uniform field to expose zebrafish embryos (ZFe) to unmodulated 700 and 3500 MHz frequencies. We have combined a battery of toxicity, developmental and behavioral assays to further explore potential RFR effects. Our neurobehavioral profiles include a tail coiling assay, a light/dark activity assay, two thigmotaxis anxiety assays (auditory and visual stimuli), and a startle response - habituation assay in response to auditory stimuli. ZFe were exposed for 1 and 4 h during the blastula period of development and endpoints evaluated up to 120 hours post fertilization (hpf). Our results show no effects on mortality, hatching or body length. However, we have demonstrated specific organ morphological effects, and behavioral effects in activity, anxiety-like behavior, and habituation that lasted in larvae exposed during the early embryonic period. A decrease in acetylcholinesterase activity was also observed and could explain some of the observed behavioral alterations. Interestingly, effects were more pronounced in ZFe exposed to the 700 MHz frequency, and especially for the 4 h exposure period. In addition, we have demonstrated that our exposure setup is robust, flexible with regard to frequency and power testing, and highly comparable. Future work will include exposure of ZFe to 5G modulated signals for different time periods to better understand the potential health effects of novel 5G RFR.

Incidence of Otolaryngological Manifestations in Individuals with Autism Spectrum Disorder: A Special Focus on Auditory Disorders

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by stereotyped and repetitive behavior patterns. In addition to neurological and behavioral problems, individuals with ASD commonly experience otolaryngological comorbidities. Individuals with ASD often have auditory disorders including hearing loss and auditory processing disorders such as central auditory processing disorder (CAPD), as well as both chronic and recurrent otitis media. These challenges negatively impact a person's ability to effectively communicate and may further impact their neurological functioning, particularly when not appropriately treated. Individuals diagnosed with ASD also have difficulty sleeping which contributes to increased irritability and may further aggravate the core behavioral symptoms of autism. The individuals with ASD also have a higher rate of sinusitis which contributes to the worsening of the autism behavior phenotype. The high prevalence of otolaryngological comorbidities in individuals with ASD warrants a better collaboration between their various healthcare providers and otolaryngologists with expertise in auditory, sleep, and sinus disorders in pursuit of improving the quality of life of affected individuals and their families/caregivers.

The interface of paediatric ENT and autism spectrum disorder: a complex conundrum for otolaryngologists

OBJECTIVE

Autism spectrum disorder is a lifelong neurodevelopmental condition encompassing complex physical and neurological symptoms, including complex sensory symptoms. This review explores the interface between autism spectrum disorder and paediatric ENT.

METHODS

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ('PRISMA') guideline, a robust literature search and review was conducted by two researchers. Thirty-four papers were filtered into the final review.

RESULTS

Published literature clearly demonstrates potential for autism spectrum disorder to present in the form of auditory and other sensory symptoms to ENT surgeons and audiologists who may not fully appreciate this complex condition. Despite this well-documented link, auditory symptoms, auditory processing disorders and hearing loss within autism spectrum disorder remain poorly understood.

CONCLUSION

Improved recognition and understanding of autism spectrum disorder by otolaryngologists could enable more effective diagnostic and management strategies for autistic children who present with auditory and other sensory symptoms. In light of the current 'autism epidemic,' there is an urgent need for further research on this theme.

Circuit-level theories for sensory dysfunction in autism: convergence across mouse models

Individuals with autism spectrum disorder (ASD) exhibit a diverse range of behavioral features and genetic backgrounds, but whether different genetic forms of autism involve convergent pathophysiology of brain function is unknown. Here, we analyze evidence for convergent deficits in neural circuit function across multiple transgenic mouse models of ASD. We focus on sensory areas of neocortex, where circuit differences may underlie atypical sensory processing, a central feature of autism. Many distinct circuit-level theories for ASD have been proposed, including increased excitation-inhibition (E-I) ratio and hyperexcitability, hypofunction of parvalbumin (PV) interneuron circuits, impaired homeostatic plasticity, degraded sensory coding, and others. We review these theories and assess the degree of convergence across ASD mouse models for each. Behaviorally, our analysis reveals that innate sensory detection behavior is heightened and sensory discrimination behavior is impaired across many ASD models. Neurophysiologically, PV hypofunction and increased E-I ratio are prevalent but only rarely generate hyperexcitability and excess spiking. Instead, sensory tuning and other aspects of neural coding are commonly degraded and may explain impaired discrimination behavior. Two distinct phenotypic clusters with opposing neural circuit signatures are evident across mouse models. Such clustering could suggest physiological subtypes of autism, which may facilitate the development of tailored therapeutic approaches.

Comprehensive intervention for reducing stigma of autism spectrum disorders: Incorporating the experience of simulated autistic perception and social contact

Stigma of autism spectrum disorders (ASD) is a crucial factor leading to a lower quality of life for individuals with ASD. This research evaluated an intervention effect for the stigma through an experience of simulated autistic visual perception and video-based social contact. The intervention was conducted as an experiential workshop for the ASD simulator. Participants (N = 217; 156 women, 61 men; a mean age of 41.3) voluntarily attended the workshop. In the workshop, they received a short lecture on autistic perception, a simulated experience using the ASD simulator, a narrative video of individuals with ASD, and a group discussion. They completed the multidimensional attitudes scale, which was developed to measure four attitudes toward ASD: negative affect, calm, cognitions, and behaviors. The attitudes were measured three times: the period of registration with the workshop, during participation in the workshop, and six weeks after the workshop. With regard to the measure during participation in the workshop, attendees responded to the attitudes at the beginning or end of the workshop, to confirm whether attitudes changes were attributed to the effectiveness of the intervention or artifacts resulting from participation in the workshop. A significant reduction was observed in negative affective attitudes at the end of the workshop and persisted even six weeks afterward, even though not observed in calm, cognitive, and behavioral attitudes. Our findings suggest that implementation of our intervention can bring about reduction of the stigma associated with ASD. Further studies with a random sampling method are needed to validate its generalizability and elaborate the components of the intervention.

Transient hearing abnormalities precede social deficits in a mouse model of autism

Hearing abnormalities are important symptoms of autism spectrum disorders (ASDs), a neurological and developmental disorder. However, the characteristics of hearing abnormalities associated with ASD during development have not been fully investigated. We found that in Shank3B knockout mice (a high-confidence mouse model of ASD), transient hearing abnormalities can be found in auditory brainstem response, auditory cortical activity, as well as acoustic startle response. More importantly, all hearing abnormalities at 4 weeks were most prominent and preceded the onset of social deficits at 6 weeks. These hearing abnormalities gradually recovered with age. In addition, analysis of ABR data at 4 weeks using Support Vector Machine (SVM) can faithfully predict the genotype of mice with an accuracy of 85.71%. These findings not only revealed hearing changes in Shank3B knockout autistic-like mice during development, but also suggested that hearing abnormalities could potentially be used as an early and effective indicator of ASD risk.