Associations of physical activity with fatness and fitness in adolescents with Down syndrome: The UP&DOWN study

The aim of the present study was to examine the associations of objectively measured physical activity (PA) with several markers of fatness and fitness in a relatively large sample of adolescents with Down syndrome (DS). This study comprised a total of 100 adolescents with DS (37 females) aged 11–20 years-old, and a sex-matched sample of 100 adolescents without disabilities, participating in the UP&DOWN study. The ALPHA health-related fitness test battery for adolescents was used to assess fatness and fitness. PA was measured by accelerometry. Adolescents with DS had higher fatness and significantly lower fitness levels in all variables measured than adolescents without DS (all p < 0.05). Moderate-to-large effects were observed in fatness variables (d = 0.65–1.42), but particularly large values were found in fitness variables (d = 2.05–2.43). In addition, PA levels was not associated with fatness variables, whereas total PA and vigorous PA were associated with all fitness variables (p < 0.05), and moderate-vigorous PA (MVPA) was associated with muscular fitness (p < 0.05), after adjusting for potential confounders. Further analysis revealed that there were differences in fitness by tertiles of vigorous PA between the lowest and the highest groups in all fitness variables (all p < 0.05). However, no significant differences were found in fitness by tertiles of MVPA according with PA guidelines (≥60 min in MVPA). Our findings indicate that PA levels are not associated with fatness variables, whereas high PA levels, in particular vigorous PA, are positively associated with high fitness in adolescents with DS.     

Physical activity during the segmented school day in adolescents with and without autism spectrum disorders

The purpose of this study was to assess the intensity of physical activity (PA) that secondary school-aged students with autism spectrum disorders (ASD) and typically developing (TD) students exert during a school day, and to compare the percentages of students achieving the recommended guidelines between groups. The PA of 60 male students (ASD, n = 30; TD, n = 30) was recorded every 10 s for up to 5 school days by performing uniaxial accelerometry. The main results are listed as follows: (a) daily PA was significantly lower among the students with ASD than among the TD students; (b) students with ASD spent significantly lower proportion of their time in moderate PA than TD students did during physical education (PE), recess, and lunchtime; and (c) fewer students with ASD than TD students achieved the PA guidelines during the school day and PE time. Schools should increase PA opportunities across the school day.     

Assessment of cardiorespiratory and neuromotor fitness in children with developmental coordination disorder

The decreased participation in physical activity by children with probable developmental coordination disorder (pDCD) has raised concerns about their aerobic fitness and lung function levels. The purpose of the present study was to examine assessment of cardiorespiratory and neuromotor fitness, using laboratory-based tests during an incremental treadmill protocol in healthy children with and without pDCD. Twenty sex children ages 6–9 years took part in this study. Motor coordination was assessed using the Movement Assessment Battery for Children (MABC). All participants performed a cardiopulmonary exercise test (CPET) on a cycle ergometer. Pulmonary function was assessed by spirometric measurements (forced vital capacity: FVC, forced expiratory volume in 1 s: FEV₁) and walking distance (6MWD) was assessed using the 6-min walking test. The children with pDCD had lower VO_2 max than children without pDCD (p < 0.01). Moreover, FVC and FEV₁ were significantly higher in children without pDCD than in children with the disorder (p < 0.05, p < 0.01 respectively). Likewise, children with pDCD had poorer performance on the 6MWD than children without pDCD (p < 0.01). A significant correlation between the absolute value for FEV₁ and 6MWD (r = 0.637, p < 0.05) in pDCD group was observed. We found a significant correlation between VO_2 max and MABC score (r = −0.612, p < .001) and between VO_2 max and 6MWD (r = 0.502, p < .001) for all children. Moreover, a significant correlation between VO_2 max and FEV₁ (r = 0.668, p < .05) was found in children with pDCD. Overall, the reduced aerobic capacity of DCD was associated with decreased of lung function, as well as an alteration of peripheral muscle responses.     

Gaze patterns during scene processing in typical adults and adults with autism spectrum disorders

BackgroundLittle is known about how adults with autism spectrum disorder (ASD) process dynamic social scenes.MethodWe studied gaze behavior in 16 adults with ASD without intellectual impairment and 16 sex- and age-matched controls during passive scene processing.ResultsAdding more characters to a scene resulted in a drop in time spent looking at faces, and an increase in time spent looking at bodies (static trials) or off-person (dynamic trials) [Scene Type × AOI × Mode: F(2, 60) = 3.54, p = .04, η²_p = .11]. Unlike controls, adults with ASD showed only a small drop in the number of fixations made [Mode × Group: F(1, 30) = 11.30, p = .002, η²_p = .27] and no increase in the duration of face fixations [Mode × AOI × Group: F(2, 60) = 3.50, p = .04, η²_p = .11] when dynamic cues were added. Thus, particularly during dynamic trials, adults with ASD spent less time looking at faces and slightly more time looking off-person than did controls [Mode × AOI × Group: F(2, 60) = 3.10 p = .05, η²_p = .09]. Exhibiting more autistic traits and being less empathic were both associated with spending less time fixating on faces [.34 < |r| < .55, p < .05].ConclusionsThese results suggest that adults with ASD may be less sensitive to, or have more difficulty processing, dynamic cues—particularly those conveyed in faces. The findings demonstrate the importance of using dynamic displays in studies involving this clinical population.     

Assessment of physical fitness and exercise tolerance in children with developmental coordination disorder

Children with developmental coordination disorder (DCD) have been shown to be less physically fit when compared to their typically developing peers. The purpose of the present study was to examine the relationships among body composition, physical fitness and exercise tolerance in children with and without DCD. Thirty-seven children between the ages of 7 and 9 years participated in this study. Participants were classified according to results obtained on the Movement Assessment Battery for Children (MABC) and were divided in 2 groups: 19 children with DCD and 18 children without DCD. All children performed the following physical fitness tests: The five-jump test (5JT), the triple-hop distance (THD) and the modified agility test (MAT). Walking distance was assessed using the 6-min walking test (6MWT). Children with DCD showed higher scores than children without DCD in all MABC subscale scores, as well as in the total score (p < 0.001). Participants with DCD were found to perform significantly worse on the MAT (p < 0.001), the THD (p < 0.001) and 5JT (p < 0.05). Moreover, children with DCD had poorer performance on the 6MWT than children without DCD (p < 0.01). Our results found significant correlations among body mass index (BMI), THD (r = 0.553, p < 0.05), 5JT (r = 0.480, p < 0.05) and 6MWT (r = 0.544, p < 0.05) only in DCD group. A significant correlation between MAT and 5JT (r = −0.493, p < 0.05) was found. Similarly, THD and 5JT (r = 0.611, p < 0.01) was found to be correlated in children with DCD. We also found relationships among 6MWT and MAT (r = −0.522, p < 0.05) and the 6MWT and 5JT (r = 0.472, p < 0.05) in DCD group. In addition, we found gender specific patterns in the relationship between exercise tolerance, explosive strength, power, DCD, and BMI. In conclusion, the present study revealed that BMI was indicative of poorer explosive strength, power and exercise tolerance in children with DCD compared to children without DCD probably due to a limited coordination on motor control.     

Psychopathology: Differences among adults with intellectually disabled,comorbid autism spectrum disorders and epilepsy

The goal of this study was to systematically examine group differences among adults with intellectual disabilities (ID), comorbid autism spectrum disorders (ASD), and epilepsy through a detailed exploration of the characteristics that these disorders present in the area of psychopathology. Previous studies indicating that individuals with ID have comorbid ASD and epilepsy tend to stop short of addressing these disorders’ impact on the full range of psychosocial issues, particularly in adult samples. Assessment of psychopathology was made with the ASD-comorbidity-adult version (ASD-CA). One hundred participants, with ID held constant, were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, results of the MANOVA revealed significant differences among groups, Wilks's Λ = .76, F(15, 254) = 1.82, p < .05, η² = .09. A one-way ANOVA was conducted for each of the five subscales of the ASD-CA as follow-up tests to the MANOVA. Groups differed significantly Anxiety/Repetitive Behavior subscale, F(3, 96) = 2.93, p < .05, η² = .08, Irritability/Behavior excess subscale, F(3, 96) = 4.74, p < .01, η² = .13, Attention/Hyperactivity subscale, F(3, 96) = 5.18, p < .01, η² = .14, and Depressive Symptoms subscale, F(3, 96) = 3.73, p < .01, η² = .10. Trend analysis demonstrated that individuals with ID expressing combined comorbid ASD and epilepsy were significantly more impaired than the control group (ID only) or groups containing only a single comorbid factor with ID (ASD or epilepsy only). Implications of these findings elucidate the nature of these disorders and their influence on patient care and management.     

Mastery motivation in adolescents with cerebral palsy

The aim of this study is to describe motivation in adolescents with cerebral palsy (CP) and factors associated with motivation level. The Dimensions of Mastery Questionnaire (DMQ) measures motivation in mastering challenging tasks and expressive elements. It was completed by 153 parents and 112 adolescents with CP. Adolescents (GMFCS in n = 146 – I:50, II:43, III:13, IV:15, V:25) were assessed using the Leiter IQ and Gross Motor Function Measure. Parents completed the Vineland Adaptive Behavior Scale and the Strengths and Difficulties Questionnaire. Motivation scores were highest for mastery pleasure and social persistence with adults and lowest for gross motor and object-oriented persistence. Socio-demographic factors were not strongly correlated with DMQ. Higher gross motor ability (r = 0.24–0.52) and fewer activity limitations (r = 0.30–0.64, p < .001) were associated with persistence in cognitive, motor and social tasks, but not mastery pleasure. Higher IQ was associated with persistence in object-oriented tasks (r = 0.42, p < .001). Prosocial behaviors correlated with high motivation (r = 0.39–0.53, p < .001). Adolescents’ motivation scores were higher than parents’ scores. Adolescents with CP express high mastery pleasure, not related to abilities. High motivation was associated with fewer activity limitations and prosocial behaviors and aspects of family environment. Findings elucidate those at-risk for low motivation, which can influence treatment adherence and participation in challenging but meaningful activities.     

Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement

During adolescence, some individuals with autism spectrum disorder (ASD) engage in severe challenging behaviors, such as aggression, self-injury, disruption, agitation and tantrums. We aimed to assess risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents and young adults with ASD hospitalized for severe challenging behaviors and proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 patients recruited for the same indications between 2010 and 2012. In total, 58 patients were admitted (n = 70 hospitalizations, mean age = 15.66 (±4.07) years, 76% male). We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), comorbid organic conditions, etiologic diagnosis of the episode, and treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) score and duration of hospitalization at discharge. All but 2 patients exhibited severe autistic symptoms and intellectual disability (ID), and two-thirds had no functional verbal language. During the inpatient stay (mean = 84.3 (±94.9) days), patients doubled on average their GAFS scores (mean = 17.66 (±9.05) at admission vs. mean = 31.4 (±9.48) at discharge). Most common etiologies for acute behavioral crises were organic causes [n = 20 (28%), including epilepsy: n = 10 (14%) and painful medical conditions: n = 10 (14%)], environmental causes [n = 17 (25%) including lack of treatment: n = 11 (16%) and adjustment disorder: n = 6 (9%)], and non-ASD psychiatric condition [n = 33 (48%) including catatonia: n = 5 (7%), major depressive episode: n = 6 (9%), bipolar disorder: n = 4 (6%), schizophrenia: n = 6 (9%), other/unknown diagnosis: n = 12 (17%)]. We found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge. Severity of autism at admission was the only negative predictor (p < .001). Painful medical conditions (p = .04), non-ASD psychiatric diagnoses (p = .001), prior usage of specialized ASD care programs (p = .004), functional language (p = .007), as well as a higher number of challenging behaviors upon admission (p = .001) were associated with higher GAFS scores at discharge. Clinical severity at admission, based on the number of challenging behaviors (r = .35, p = .003) and GAFS score (r = −.32, p = .008) was correlated with a longer inpatient stay. Longer hospitalization was however correlated (r = .27, p = .03) with higher GAFS score at discharge even after adjustment for confounding factors. Challenging behaviors among adolescents with ASD may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic illness such as epilepsy or acute pain. The management of these behavioral challenges requires a unified, multidisciplinary approach.     

Postural sway patterns in children with autism spectrum disorder compared with typically developing children

Postural control is a fundamental building block of each child's daily activities. The aim of this study was to compare patterns of postural sway in children with autism spectrum disorder (ASD) with typically developing children (TD). We recruited 21 schoolchildren diagnosed with ASD aged 9–14 and 30 TD pupils aged 8–15. Postural sway parameters in composite, anteroposterior and mediolateral axis were reported. Furthermore we examined the impact of age and characteristics of autism on postural sway. Children with ASD exhibited higher amount of sway in anteroposterior range (p < 0.001), mediolateral range (p = 0.002), root mean square (p = 0.001), mean velocity (p = 0.03), and sway area (p = 0.007) compared with their TD peers. Children with ASD showed higher instability in mediolateral than anteroposterior axis though TD children demonstrated higher sway scores in anteroposterior than mediolateral direction. The rate of autism symptom severity significantly affected the postural sway in children with ASD (p < 0.05). In conclusion, patterns of postural control seem to be different in children with ASD compared with TD counterparts. This could be partially due to clinical features were underlying in ASD.     

Social skills: Differences among adults with intellectual disabilities,co-morbid autism spectrum disorders and epilepsy

Assessing social skills is one of the most complex and challenging areas to study because behavioral repertoires vary depending on an individual's culture and context. However, researchers have conclusively demonstrated that individuals with intellectual disabilities (ID) have impaired social skills as well as those with co-morbid autism spectrum disorders (ASD) and epilepsy. However, it is unknown how these groups differ. Assessment of social skills was made with the Matson Evaluation of Social Skills for Individuals with Severe Retardation. One hundred participants with ID were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, significant differences were found among the four groups on the MESSIER, Wilks's Λ = .58, F(18, 257) = 3.05, p < .01. The multivariate η² based on Wilks's Λ was .17. Significant differences were found on the Positive Verbal subscale, F(3, 96) = 3.70, p < .01, η² = .10, Positive Non-verbal subscale, F(3, 96) = 8.95, p < .01, η² = .22, General Positive subscale, F(3, 96) = 7.30, p < .01, η² = .19, Negative Non-verbal subscale, F(3, 96) = 5.30, p < .01, η² = .14, and General Negative subscale, F(3, 96) = 3.16, p < .05, η² = .09. Based on these results, individuals with ID expressing combined co-morbid ASD and epilepsy had significantly more impaired social skills than the ID only or groups containing only a single co-morbid factor with ID (ASD or epilepsy only). Implications of these findings are discussed.     

Stress in mothers of children with autism: Trait mindfulness as a protective factor

Mindfulness-based interventions may reduce parents’ stress and improve parent–child relationships. Given the chronic nature of autism spectrum disorder (ASD) and its influence on parents’ stress, interventions to promote mindfulness may be especially helpful for parents of children with ASD. Prior to undertaking intervention development, it is first necessary to establish the relationship between mindfulness and stress, as other factors like child behavioral difficulties may overshadow the mother's regulation strategies. In a sample of mothers of children with ASD (n = 67) and a comparison sample of mothers without ASD (n = 87), mindfulness was significantly associated with the level of maternal stress above and beyond child behavior problems (non-ASD: β = −.232; F(1, 64) = 15.749, p < .000; ASD: β = −.206; F(1, 84) = 15.576, p < .000). Results suggest that interventions to promote mindfulness may be helpful in reducing parenting stress among mothers of children with ASD, as well as mothers of typically developing children. Due to the chronic nature of ASD, such interventions may be particularly applicable.     

Children diagnosed with autism spectrum disorder before or after the age of 6 years

This study compared children with early and late diagnosis of autism spectrum disorder (ASD). All children in four consecutive birth cohorts in Iceland diagnosed with ASD were divided into two groups based on their age at initial ASD diagnosis: 58 children were diagnosed before age 6 (group 1) and 41 children after age 6 (group 2). Children in group 1 were more likely to receive a diagnosis of childhood autism (p ≤ 0.001), their average IQ/DQ was lower (p < 0.001), verbal status was lower (p < 0.001), and a history of autistic regression was more common (p < 0.01) than in group 2. Half of the children in group 2 had received other developmental diagnoses prior to the ASD diagnosis, but this applied to only a few of the children in group 1 (p < 0.001). There was no difference between the groups with regard to autistic symptoms as measured by the Autism Diagnostic Interview-Revised (p = 0.224), frequency of associated medical conditions (p = 0.640), age of first parental concern (p = 0.244), and age of first autistic symptoms on hindsight (p = 0.540). The majority of parents (76.2%) had developmental concerns before age 3, and with hindsight 83.3% thought that autistic symptoms had been present before age 2.     

The correlation between central and peripheral oxytocin concentrations: A systematic review and meta-analysis

There is growing interest in the role of the oxytocin system in social cognition and behavior. Peripheral oxytocin concentrations are regularly used to approximate central concentrations in psychiatric research, however, the validity of this approach is unclear. Here we conducted a pre-registered systematic search and meta-analysis of correlations between central and peripheral oxytocin concentrations. A search of databases yielded 17 eligible studies, resulting in a total sample size of 516 participants and subjects. Overall, a positive association between central and peripheral oxytocin concentrations was revealed [r = 0.29, 95% CI (0.14, 0.42), p < 0.0001]. This association was moderated by experimental context [Q_b(4), p = 0.003]. While no association was observed under basal conditions (r = 0.08, p = 0.31), significant associations were observed after intranasal oxytocin administration (r = 0.66, p < 0.0001), and after experimentally induced stress (r = 0.49, p = 0.001). These results indicate a coordination of central and peripheral oxytocin release after stress and after intranasal administration. Although popular, the approach of using peripheral oxytocin levels to approximate central levels under basal conditions is not supported by the present results.     

Empathic accuracy in adolescents with autism spectrum disorders and adolescents with attention-deficit/hyperactivity disorder

In research on theory of mind (ToM) in individuals with an autism spectrum disorder (ASD) mainly static mind-reading tasks were used. In this study both a static (Eyes Test) and a more naturalistic (empathic accuracy task) ToM measure were used to investigate the perspective taking abilities of adolescents with ASD (n = 13), adolescents with attention-deficit/hyperactivity disorder (ADHD; n = 13) and typically developing adolescents (n = 18). An innovative aspect concerns the standard stimulus tapes of the empathic accuracy task, which showed interactions between dyads of one adolescent with ADHD and one adolescent without ADHD. In this way, we were able to compare the ‘readability’ of the thoughts and feelings of adolescents with and without ADHD. The results clearly demonstrate the impairment in perspective taking abilities of adolescents with ASD, both on the static and naturalistic mind-reading task. Moreover, the empathic accuracy task seems to be a useful and promising method to assess ToM abilities in adolescents, with or without clinical problems. Finally, thoughts and feelings of target persons with ADHD seemed to be less easy to read than the thoughts and feelings of typically developing target persons.     

Types and experiences of bullying in adolescents with an autism spectrum disorder

Being victimized by one's peers is a major problem in adolescence, and research has suggested that individuals with autism spectrum disorders (ASD) may experience higher rates of bullying than their typically-developing (TD) peers. However, it is currently unclear whether adolescents with ASD are victimized more by their peers simply because they are ‘different’. This study was designed to examine percentage rates across different types of bullying behaviour in adolescents with an ASD (n = 24), in comparison to a group of special-needs adolescents without an ASD (n = 22), and a group of typically developing peers (n = 24), to determine whether simply being ‘different’ leads to higher rates of victimization. We also examined the agreement between parental and self-reports of bullying behaviour experienced by these groups. Overall, more adolescents with ASD reported victimization than adolescents in the other two groups. In addition, those with ASD reported more social bullying in comparison to the other two groups and more physical bullying than the TD group. No difference was found between parental and self-reports for the bullying experienced by the adolescents with ASD or special needs; however, TD adolescents reported higher levels of victimization than their parents reported for them. Contributing factors for the victimization experienced by adolescents with an ASD are discussed.     

Behavior problems: Differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy

Behavior problems such as aggression, property destruction, stereotypy, self-injurious behavior, and other disruptive behavior are commonly observed among adults with intellectual disabilities (ID), autism spectrum disorders (ASD), and epilepsy residing at state-run facilities. However, it is unknown how these populations differ on behavior problem indicies. Assessment of behavior problems were made with the ASD–behavior problems-adult version battery. One hundred participants with ID were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, significant differences were found among the four groups, Wilks's Λ = .79, F(12, 246) = 1.93, p < .05. The multivariate η² based on Wilks's Λ was .08. A one-way ANOVA was conducted for each of the four subscales of the ASD–BPA as follow-up tests to the MANOVA. Groups differed on the aggression/destruction subscale, F(3, 96) = .79, p > .05, η² = .03, and stereotypy subscale, F(3, 96) = 2.62, p > .05, η² = .08. No significant differences were found on the self-injury subscale and disruptive behavior subscale. Trend analysis demonstrated that individuals with ID expressing combined co-morbid ASD and epilepsy were significantly more impaired than the control group (ID only) or groups containing only a single co-morbid factor with ID (ASD or epilepsy only) on these four subscales. Implications of these findings in the context of known issues in ID, epilepsy, and ASD, current assessment practices among these populations and associated challenges are discussed.     

Objective assessment of sedentary time and physical activity throughout the week in adolescents with Down syndrome. The UP&DOWN study

This study aimed to examine the patterns of sedentary time and physical activity (PA) throughout the week in adolescents with Down syndrome (DS). The study comprised 109 adolescents with DS (68 males and 41 females) aged 11–20 years, participating in the UP&DOWN study, but only a total of 100 adolescents provided valid data. Sedentary time and total, light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were measured by accelerometers. There were no significant differences in the time spent in sedentary time and PA levels between weekdays vs. weekend days, as well as between school time vs. after school-time periods (all p > 0.05). Adolescent males engaged in more total PA, moderate PA, vigorous PA and MVPA than females on weekend days (all p < 0.05). Differences between age groups showed that sedentary time increases and PA decreases with advancing age in all analyses, so that the oldest groups were more sedentary and less active (all p < 0.05). Only 43% of adolescents with DS met the PA recommendations of ≥60 min/day of MVPA. Our findings show valuable information to be considered in future interventions aiming to decrease sedentary time and increase PA levels in adolescents with DS.     

Muscle ultrasound measurements and functional muscle parameters in non-dystrophic myotonias suggest structural muscle changes

Patients with non-dystrophic myotonias, including chloride (myotonia congenita) and sodium channelopathies (paramyotonia congenita/potassium aggravated myotonias), may show muscular hypertrophy in combination with some histopathological abnormalities. However, the extent of muscle changes has never been assessed objectively in a large group genetically confirmed patients. This study quantitatively determines echo intensities, thicknesses, ranges-of-motion and force of four skeletal muscles in 63 genetically confirmed patients. The main findings revealed elevated echo intensities in all muscles except the rectus femoris (+1.3–2.2 SD, p < 0.0001), and hypertrophy in the arms (+0.5–0.9 SD, p < 0.01). Muscle echo intensities were inversely correlated to the corresponding ranges-of-motion (biceps brachii: r = ?0.43; p < 0.001, forearm flexors: r = ?0.47; p < 0.001, rectus femoris: r = ?0.40; p = 0.001, and tibial anterior: r = ?0.27; p = 0.04) and correlated positively to age (r = 0.22; p = 0.05). The echo intensity of the forearm flexors was inversely correlated to their muscles’ force (r = ?0.30; p = 0.02). Together, these data suggest that non-dystrophic myotonias may lead to structural muscle changes.     

Autism spectrum disorder symptoms in children with ADHD: A community-based study

This study examined the prevalence of autism spectrum disorder (ASD) symptoms in a community-based sample of children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. We also examined the relationship between ASD symptoms and ADHD subtype, ADHD symptom severity and child gender. Participants were 6–10-year-old children (164 ADHD; 198 non-ADHD control) attending 43 schools in Melbourne, Australia, who were participating in the Children's Attention Project. ADHD was assessed in two stages using the parent and teacher Conners’ 3 ADHD index and the Diagnostic Interview Schedule for Children IV (DISC-IV). ASD symptoms were identified using the Social Communication Questionnaire (SCQ). Unadjusted and adjusted linear and logistic regression examined continuous and categorical outcomes, respectively. Children with ADHD had more ASD symptoms than non-ADHD controls (adjusted mean difference = 4.0, 95% confidence interval (CI) 2.8; 5.3, p < 0.001, effect size = 0.7). Boys with ADHD had greater ASD symptom severity than girls with ADHD (adjusted mean difference = 2.9, 95% CI 0.8; 5.2, p = 0.01, effect size = 0.4). Greater ADHD symptom severity was associated with greater ASD symptom severity (regression co-efficient = 1.6, 95% CI 1.2; 2.0, p < 0.001). No differences were observed by ADHD subtype. Greater hyperactive/impulsive symptoms were associated with greater ASD symptoms (regression coefficient = 1.0; 95% CI 0.0; 2.0, p = 0.04) however, this finding attenuated in adjusted analyses (p = 0.45). ASD symptoms are common in children with ADHD. It is important for clinicians to assess for ASD symptoms to ensure appropriate intervention.