Assessment of feeding problems in children with autism spectrum disorder

There is growing, but inconsistent, literature on feeding problems for children with Autism Spectrum Disorder. The purposes of this study were to (a) investigate the relation of feeding problems to autism severity, (b) assess the validity of parent-report questionnaires widely used to assess feeding problems in terms of their relation to systematic behavior observations, and (c) determine the relation between child feeding behavior and family mealtime environment. Thirty-eight children and their parents participated in the study. Parents completed questionnaires, and both parents and children participated in mealtime observations. Results indicated that autism severity predicted scores on a measure of feeding problems as well as the duration of negative vocalizations during meal observations. Food Frequency Questionnaires better predicted behavior during meals than the Brief Mealtime Autism Behavior Inventory. Family environment alone did not explain feeding difficulties.     

Response to second generation antipsychotics in youth with comorbid bipolar disorder and autism spectrum disorder

Objective: To assess the impact of comorbid autism spectrum disorders (ASD) on the response to second‐generation antipsychotics (SGA) in pediatric bipolar disorder (BPD). Methods: Secondary analysis of identically designed 8‐week open‐label trials of SGA monotherapy (risperidone, olanzapine, quetiapine, ziprasidone, or aripiprazole) in youth with BPD. Results: Of the 151 BPD subjects 15% (n= 23) met criteria for comorbid ASD. There were no differences in the rate of antimanic response (YMRS change ≥30% or CGI‐Improvement ≤2: 65% vs. 69%; P= 0.7) in the presence of comorbid ASD. Conclusion: No difference observed in the rate of antimanic response or tolerability to SGA monotherapy in the presence of ASD comorbidity.     

Reduced anxiety following pivotal response treatment in young children with autism spectrum disorder

Up to 40% of children with Autism Spectrum Disorder (ASD) exhibit co-occurring anxiety symptoms. Despite recent success in mitigating anxiety symptoms in school-aged children with ASD (mean age >9 years) using adapted versions of Cognitive Behavioural Therapy, little is known about potential treatment outcomes for younger children. To address the gap in the literature, this open-label study evaluated change in anxiety following a 16-week open-label trial of Pivotal Response Treatment (PRT) in children with ASD aged 4–8 years. PRT is a behavioural treatment based on the principles of Applied Behaviour Analysis and has a primary aim of increasing social communication skills in children with ASD through natural reinforcements. To minimise conflation of anxiety and other co-occurring symptoms such as disruptive behaviour and attention-deficit hyperactivity disorder, we measured anxiety using the autism anxiety subscale of the Child and Adolescent Symptom Inventory (CASI) devised by Sukhodolsky et al. (2008). We observed significant anxiety reduction over 16-weeks of PRT. Furthermore, anxiety reduction was independent of changes in autism symptom severity. This study shows promising results for PRT as an intervention for reducing anxiety in young children with ASD.     

Atypical recognition of dynamic changes in facial expressions in autism spectrum disorders

Previous studies have suggested that the processing of dynamic facial expressions is impaired in autism spectrum disorders (ASD). However, the specific component that is impaired in the processing of dynamic facial expressions has not been identified. We investigated the recognition of dynamic changes in facial expressions among individuals with ASD and age- and sex-matched typically developing controls. Morphing animations of facial expressions of six emotions were presented at four different changing speeds, and participants rated the naturalness of the expression changes. The correspondence between reduced speeds and decreased naturalness ratings was weaker in the ASD than in the control group. These results suggest that the atypical visual analysis of dynamic changes in facial expressions underlies the impairment in real-life social interaction among individuals with ASD.     

Characterizing difficulties with emotion regulation in toddlers with autism spectrum disorder

BackgroundDifficulties with emotion regulation (ER) underlie emotional/behavioral challenges and co-occurring psychiatric symptoms in autism spectrum disorder (ASD), yet very little is known about the early development of emotion dysregulation. The present study aimed to identify differences in positive and negative emotional reactivity and regulation strategies in toddlers with and without ASD.MethodNine tasks from the Laboratory Temperament Assessment Battery (Lab-TAB) were completed with 37 toddlers with and without ASD (22–28 months). Video-recordings of these tasks were coded by research assistants using a behavioral coding scheme tapping facial, bodily, and vocal affect and the frequency of ER strategies. Mixed model analyses were performed to examine the mean affect and total regulation strategies across each task and t-tests were conducted to assess the types of ER strategies utilized.ResultsToddlers with ASD showed significantly less positive affect and greater frustration compared to non-ASD toddlers; reactivity was comparable between the groups for fear. Both groups used ER strategies in a similar pattern across tasks, with the exception that toddlers with ASD more often engaged in distraction to regulate. Effects of age and developmental level are discussed.ConclusionsToddlers with ASD were robustly characterized by greater frustration and lower joy despite frequent and age appropriate attempts to regulate their emotions. This study provides preliminary evidence that observable indicators of emotion dysregulation are present by two years of age. Clinical implications and future research directions are discussed.     

Copy number variation in Han Chinese individuals with autism spectrum disorder

Background

Autism spectrum disorders (ASDs) are a group of neurodevelopmental conditions with a demonstrated genetic etiology. Rare (<1% frequency) copy number variations (CNVs) account for a proportion of the genetic events involved, but the contribution of these events in non-European ASD populations has not been well studied. Here, we report on rare CNVs detected in a cohort of individuals with ASD of Han Chinese background.

Methods

DNA samples were obtained from 104 ASD probands and their parents who were recruited from Harbin, China. Samples were genotyped on the Affymetrix CytoScan HD platform. Rare CNVs were identified by comparing data with 873 technology-matched controls from Ontario and 1,235 additional population controls of Han Chinese ethnicity.

Results

Of the probands, 8.6% had at least 1 de novo CNV (overlapping the GIGYF2, SPRY1, 16p13.3, 16p11.2, 17p13.3-17p13.2, DMD, and NAP1L6 genes/loci). Rare inherited CNVs affected other plausible neurodevelopmental candidate genes including GRID2, LINGO2, and SLC39A12. A 24-kb duplication was also identified at YWHAE, a gene previously implicated in ASD and other developmental disorders. This duplication is observed at a similar frequency in cases and in population controls and is likely a benign Asian-specific copy number polymorphism.

Conclusions

Our findings help define genomic features relevant to ASD in the Han Chinese and emphasize the importance of using ancestry-matched controls in medical genetic interpretations.     

Intact hedonic responses to sweet tastes in autism spectrum disorder

The Sweet Taste Test (STT) is a standardized measure designed to index the ability to detect differences in sweet tastes (sweet taste sensitivity) and hedonic responses to sweet tastes (sweet taste liking). Profiles of response on the STT suggest enhanced hedonic responses to sweet tastes in psychiatric disorders characterized by dysfunctional reward processing systems, including binge-eating disorders and substance use disorders, and a putative mechanism governing STT responses is the brain opioid system. The present study examined STT responses in 20 adults with autism spectrum disorder (ASD) and 38 healthy control adults. There were no differences in sweet taste sensitivity or hedonic response to sweet tastes between the ASD and control groups. Within the ASD sample, ASD symptom severity was associated with sweet taste sensitivity, but not hedonic response to sweet taste. Results may ultimately shed light on brain opioid system functioning in ASD.     

Band-specific atypical functional connectivity pattern in childhood autism spectrum disorder

Objective

Altered brain connectivity has been theorized as a key neural underpinning of autism spectrum disorder (ASD), but recent investigations have revealed conflicting patterns of connectivity, particularly hyper-connectivity and hypo-connectivity across age groups. The application of graph theory to neuroimaging data has become an effective approach for characterizing topographical patterns of large-scale functional networks. We used a graph approach to investigate alteration of functional networks in childhood ASD.

Epilepsy in autism spectrum disorder

The purpose of this review is to provide an overview of the research on epilepsy in autism spectrum disorder (ASD). Topics explored are the prevalence of epilepsy in ASD, the importance of studying epilepsy, as well as the questionnaire measures used to assess epilepsy side-effects. Research on the relationships between epilepsy and parental stress and psychological distress, developmental regression, language and communication, adaptive behavior, social skills, autism severity, challenging behavior, comorbid psychopathology, gastrointestinal symptoms, sleep problems, sensory issues and quality of life are also discussed. Finally, recommendations for treatment are given as well as areas where future research is needed.     

Attention-deficit/hyperactivity disorder (AD/HD) in autism spectrum disorder

The purpose of this review is to provide an overview of the research on attention-deficit/hyperactivity disorder (AD/HD) in individuals with autism spectrum disorder (ASD). Topics explored are the prevalence of AD/HD, the importance of studying AD/HD, as well as the questionnaire measures used to measure AD/HD in individuals with ASD. Research on the relationship between AD/HD in ASD and parental stress and psychological distress, developmental regression, language and communication, adaptive behavior, social skills, autism severity, challenging behavior, comorbid psychopathology, gastrointestinal symptoms, sleep problems, epilepsy, sensory issues, motor difficulties, and quality of life are also discussed. Research on cardiac reactivity and executive functioning are also explored. Finally, recommendations for treatment are given as well as areas where future research is needed.     

Self-face recognition in children with autism spectrum disorders: a near-infrared spectroscopy study

It is assumed that children with autism spectrum disorders (ASD) have specificities for self-face recognition, which is known to be a basic cognitive ability for social development. In the present study, we investigated neurological substrates and potentially influential factors for self-face recognition of ASD patients using near-infrared spectroscopy (NIRS). The subjects were 11 healthy adult men, 13 normally developing boys, and 10 boys with ASD. Their hemodynamic activities in the frontal area and their scanning strategies (eye-movement) were examined during self-face recognition. Other factors such as ASD severities and self-consciousness were also evaluated by parents and patients, respectively. Oxygenated hemoglobin levels were higher in the regions corresponding to the right inferior frontal gyrus than in those corresponding to the left inferior frontal gyrus. In two groups of children these activities reflected ASD severities, such that the more serious ASD characteristics corresponded with lower activity levels. Moreover, higher levels of public self-consciousness intensified the activities, which were not influenced by the scanning strategies. These findings suggest that dysfunction in the right inferior frontal gyrus areas responsible for self-face recognition is one of the crucial neural substrates underlying ASD characteristics, which could potentially be used to evaluate psychological aspects such as public self-consciousness.     

上海市松江区幼儿孤独谱系障碍流行病学特征调查

目的 了解上海市松江区公立幼儿园孤独谱系障碍(ASD)的流行现况.方法 以上海市松江区教育主管部门登记在册的33所公立幼儿园的幼儿作为调查对象,采用克氏孤独症行为量表和社会交往问卷进行筛查,对于筛查阳性者由儿少精神科医生根据美国精神疾病诊断与统计手册第五版(DSM-5)进行诊断.结果 共5704名儿童接受筛查,平均年龄(5.3±0.7)岁,其中男性2920名(51.2%),女性2784名(48.8%).6名儿童被诊断为ASD,男女比为5:1,时点患病率为1.05‰,年龄4.1~6.1岁,平均5.0岁.3名患儿的孕期及出生时存在高危因素.结论 上海市松江区公立幼儿园ASD患病率低于国内外报道,孕期保健应重视相关高危因素.     

Development of a cell-based metabolic test for the identification of individuals with autism spectrum disorder

Autism spectrum disorder (ASD) is a common neurodevelopmental condition with a tremendous impact on society and families. The biological basis of ASD has yet to be completely understood and there are no laboratory tests for this condition. Phenotype Mammalian Microarrays (PM-Ms) can distinguish patients with ASD from typically developing (TD) individuals by differential utilization of the amino acid tryptophan.By assessing several parameters of the assay utilizing customized tryptophan-containing PM-M plates, we improved the discrimination of the test, optimized test parameters, and minimized background noise by normalization while controlling for false discoveries.This improved platform can provide the first cell-based metabolic test to validate the clinical diagnosis of ASD and possibly identify individuals at risk even before the occurrence of neuro-behavioral symptoms.     

Altered effects of perspective-taking on functional connectivity during self- and other-referential processing in adults with autism spectrum disorder

In interactive social situations, it is often crucial to be able to take another person’s perspective when evaluating one’s own or another person’s specific trait; individuals with autism spectrum disorder (ASD) critically lack this social skill. To examine how perspective-dependent self- and other-evaluation processes modulate functional connectivity in ASD, we conducted a functional magnetic resonance imaging study in which 26 high-functioning adults with ASD and 24 typically developed (TD) controls were asked to decide whether an adjective describing a personality trait correctly described the participant himself/herself (“self”) or the participant’s mother (“other”) by taking either the first (1P) or third person (3P) perspective. We observed that functional connectivity between the left sensorimotor cortex and the left middle cingulate cortex was enhanced in TD control individuals taking the 3P perspective, this enhancement was significantly reduced in ASD, and the degree of reduction was significantly correlated with the severity of autistic traits. Furthermore, the self-reference effect on functional connectivity between the left inferior frontal cortex and frontopolar cortices was significantly enhanced in TD control individuals taking the 3P perspective, whereas such effect was reversed in ASD. These findings indicate altered effects of perspective on the functional connectivity, which may underlie the deficits in social interaction and communication observed in individuals with ASD.     

Anthropometric measures of Spanish children with autism spectrum disorder

We aimed to compare body mass index (BMI) and healthy eating index (HEI) in children with autism spectrum disorder (ASD, n = 105) and typically developing (TD, n = 495) children. They were aged 6–9 years, lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds. In this case–control study, the weight, height and BMI were measured for both groups. Three-day food records were used to assess dietary intake. Although the differences between children with ASD and TD children in raw BMI (p = 0.44), BMI z-score (p = 0.37), HEI (p = 0.43) and total energy intake (p = 0.86) were not significant, children with ASD and the boys subgroup were shorter (p = 0.01), but not the girls subgroup, compared to TD children of the same gender. Using the controls values as a reference, the BMI distribution in children with ASD became distorted, with values below the 5th percentile (11% vs. 4%, p = 0.03) and above the 95th percentile (8% vs. 5%, p = 0.04). The gender- and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39, respectively, vs. TD children. Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habits.     

Psychiatric comorbidity associated with co-occurring autism spectrum disorder and substance use disorder

BackgroundAlthough both autism spectrum disorder (ASD) and substance use disorder (SUD) are both commonly comorbid with other psychiatric conditions, there is a paucity of research on the overlap of these disorders. The primary aim of the present study was to identify the prevalence of psychiatric comorbidities in young adults with SUD and ASD compared to those with ASD only.MethodMultivariate logistic regression controlling for age was used to compare the prevalence of psychiatric disorders in a sample of treatment-seeking adult outpatients with a) ASD without SUD and b) ASD with SUD. Psychiatric and SUD diagnoses were determined by semi-structured interview (SCID for DSM IV).ResultsThe sample included 42 patients with ASD only (mean age ± SD = 26.2 ± 8.9 years) and 21 with ASD and SUD (35.2 ± 12.6). High rates of psychopathology were found in both groups. Comorbid conduct disorder (CD) was significantly more prevalent in the ASD + SUD group (25 %) compared to those without SUD (5%; p < 0.05). There were no other significant differences between groups in the rates of non-conduct comorbid psychopathology.ConclusionIn both groups, rates of psychopathology were high with CD being significantly more common in young adults with ASD and SUD. These findings highlight the importance of screening for CD in individuals with ASD to mitigate the potential development of comorbid SUD. Further research is needed to determine if CD is a true risk factor for SUD in the ASD population and identify other risk factors.     

A systematic review of weighted vests with individuals with autism spectrum disorder

The purpose of the study was to evaluate the current literature on the use of weighted vests (WV) with individuals with autism spectrum disorder (ASD). A literature review using the standards recommended by the What Works Clearinghouse was conducted. The studies included in the review met the following criteria: (a) use of a single case research design; (b) inclusion of at least one individual with ASD; (c) examination of the effects of WV on a particular dependent variable; and (d) publication in English in a peer-refereed journal in the past 25 years. The results of the review show that the use of WV with individuals with ASD is not an evidence-based practice.     

Gross motor skills are related to postural stability and age in children with autism spectrum disorder

Motor skill and postural stability deficits are commonly reported for children with autism spectrum disorder (ASD), however the relationship between these variables is not well established. We explored the relationship between motor skills, postural stability, restricted and repetitive patterns of behavior, diagnosis, age, and sex. Children (11 with and 11 without ASD), 5–12 years of age, participated in the study. The Test of Gross Motor Development-3 (TGMD-3) was used to assess fundamental motor skills. Postural sway was measured on a force plate during quiet standing on a solid and compliant surface. Center of pressure was calculated and used to compute sway area. Linear regression analysis showed that sway area on a solid surface, age, and diagnosis were significant predictors of motor skill performance (R² = .854). Severity of ASD, as assessed by the Repetitive Behavior Scale-Revised (RBS-R), was not predictive of motor skills. Children with ASD exhibited deficits in postural stability compared to children without ASD. Postural stability appears to influence the ability of children to perform gross motor skills. However, the RBS-R does not seem to be a useful tool for identifying those children with ASD who exhibit the greatest deficits in motor skills.