Victimization of students with autism spectrum disorder: A review of prevalence and risk factors

Bullying is a serious problem among school-aged youth. Research suggests students with autism spectrum disorder (ASD) are overrepresented as victims within the bullying dynamic. This review synthesizes 21 articles involving prevalence rates of victimization of school-age youth with ASD and factors related to the victimization of youth with ASD. Prevalence studies suggest students with ASD are frequent victims of bullying with victimization rates ranging by study methodology. Studies reporting factors related to the victimization of students with ASD include individual (i.e., characteristics of ASD, social vulnerability, behavior problems, disability, race, academic achievement, and age of student) and contextual (i.e., educational setting, school transportation, parental mental health, parental engagement and confidence, family socioeconomic status, and social support from peers and friendship) factors. Strategies for prevention and intervention are posed. Limitations and directions for future inquiry are addressed.     

The prevalence of autism in Nagoya,Japan: A total population study

The prevalence rate of autism has been reported as 0.04% to 0.05%, but one recent study in Japan found prevalence of 0.16%. The authors have been involved in routine well-child medical examinations at 18 months of age, at the Midori Public Health Center in Nagoya. A statistical survey of diagnoses was made from April 1979 to March 1984 for the purpose of conducting an epidemiological study of autism. Of 12,263 children examined, 168 were identified as having developmental problems and, of these, 139 underwent a second examination. Autism was diagnosed in 16 of these children and a category called autism suspected was defined in an additional 10 of these 139 children. The 16 cases of autism gave a minimum prevalance of 0.13%, three times the usually reported rate. The validity of the higher prevalence rates is discussed.     

The neuropathology of autism: a review

Presented is a review of recent progress in the understanding of autism based on investigations of donated human brain tissue. Autism is a pervasive developmental disorder by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, manifesting by age 3 and characterized by impairments in social interaction and communication, as well as restricted, repetitive, stereotyped patterns of behavior. Based on reported neuropathologic findings, these characteristic behaviors are clinical manifestations of both pre- and postnatal alterations. This review summarizes the current data obtained from postmortem brain studies in the areas of stereology, neurotransmitter systems/synaptic processes, molecular mechanisms, and neuroimmunology. In addition, we discuss current research strategies designed to facilitate translational research and maximize the yield of precious resources (e.g. the Autism Tissue Program), highlight barriers to research, and consider future trends.     

The symbolic and object play of children with autism: A review

The unique characteristics of autistic children's symbolic and object play are presented and discussed in the context of a literature review covering research since 1964. Several theoretical issues are highlighted: the relationship of play in facilitating language and cognition, play as an intervention, and play as an assessment tool. Difficulties in research methodology due to pooling autistic and schizophrenic subject are raised, as well as possible difficulties inherent in ignoring severity levels within the autistic population. The appropriateness of play therapy is questioned, and evidence is presented to provide encouragement for further inquiry into the study of autistic play.This article was written in partial fulfillment of the requirements for a master's degree in psychology at the University of Colorado at Denver under the direction of Carolyn Simmons, Ph.D. The author wishes to thank Gordon Farley, M.D., Eben Ingram, Ph.D., Carolyn Simmons, Ph.D., and Graham Sterritt, Ph.D., for their wisdom, patience, encouragement, and good humor.     

The UCLA-University of Utah epidemiologic survey of autism: prevalence

The authors conducted an epidemiologic survey in Utah using a four-level ascertainment system, blind current diagnostic assessments, and DSM-III criteria. Of 483 individuals ascertained, 241 were diagnosed as having autism. The best estimate for the prevalence rate was 4 per 10,000 population. Autism was not associated with parental education, occupation, racial origin, or religion. Sixty-six percent of the autistic subjects scored below 70 on standardized IQ tests, and females scored proportionately lower than males. Twenty (9.7%) of 207 families had more than one autistic sibling, which supports the authors' previous finding that there may be a familial subtype of autism.     

The increasing prevalence of autism spectrum disorders

Undoubtedly, one of the most frequently studied conditions in the field of mental health today is the autism spectrum disorders (ASD). One of the most controversial topics with respect to this population is the prevalence of this spectrum of disorders. The number of cases has risen dramatically, and various hypotheses have been put forward to explain this phenomenon. Among the most frequently addressed possibilities are expanded diagnostic criteria, more awareness of the disorder, diagnosis at earlier ages, and the recognition that ASD is a lifelong condition. The current paper is a review of the extant literature on this topic. Current status of prevalence research is reviewed and conclusions about the current state of the research are discussed.     

The changing prevalence of autism in California

We conducted a population-based study of eight successive California births cohorts to examine the degree to which improvements in detection and changes in diagnosis contribute to the observed increase in autism prevalence. Children born in 1987-1994 who had autism were identified from the statewide agency responsible for coordinating services for individuals with developmental disabilities. To evaluate the role of diagnostic substitution, trends in prevalence of mental retardation without autism were also investigated. A total of 5038 children with full syndrome autism were identified from 4,590,333 California births, a prevalence of 11.0 per 10,000. During the study period, prevalence increased from 5.8 to 14.9 per 10,000, for an absolute change of 9.1 per 10,000. The pattern of increase was not influenced by maternal age, race/ethnicity, education, child gender, or plurality. During the same period, the prevalence of mental retardation without autism decreased from 28.8 to 19.5 per 10,000, for an absolute change of 9.3 per 10,000. These data suggest that improvements in detection and changes in diagnosis account for the observed increase in autism; whether there has also been a true increase in incidence is not known.     

Lauretta bender on autism: A review

Lauretta Bender, internationally known as one of the pioneers in the field of child psychiatry, has written extensively on autism and other forms of childhood disturbance. This paper reviews and analyzes the development of her theories on autism, especially as it relates to childhood schizophrenia. Bender believes that the condition is one of the manifestations of schizophrenia occurring in earliest childhood. This review traces, through her writings and through personal contact, the development and elaboration of this view, and discusses influences on her work of Schilder, Gesell and others.     

Symbolic play in autism: A review

Experimental research into the symbolic play of autistic children is reviewed in an attempt to outline the nature of their deficit in this area. While many studies can be criticized on methodological grounds, there is good evidence for an impairment in the spontaneous symbolic play of autistic children, an impairment that appears to extend to cover spontaneous functional play also. However studies that have investigated elicited and instructed play have indicated that autistic children may have a capacity for symbolic play that they do not spontaneously exhibit. The implications of these findings for various hypotheses concerning a symbolic play deficit in autism are considered and directions for future research are outlined.     

Working memory and autism: A review of literature

Research studies that evaluated working memory with students with autism and other disorders were reviewed and summarized. Results suggest that persons with autism score lower on measures of working memory than do typical controls especially on tasks that require cognitive flexibility, planning, greater working memory load, and spatial working memory, and with increasing task complexity and in dual task conditions. Lower scores in verbal working memory were associated with greater problems in adaptive behavior and more restrictive and repetitive behavior. Children with autism were as likely as typical children to employ articulatory rehearsal (verbal WM). The format of WM tasks may determine whether or not performance is impaired. Implications for educational practice and future research are discussed.     

The global prevalence of dementia: A systematic review and metaanalysis

BackgroundThe evidence base on the prevalence of dementia is expanding rapidly, particularly in countries with low and middle incomes. A reappraisal of global prevalence and numbers is due, given the significant implications for social and public policy and planning.MethodsIn this study we provide a systematic review of the global literature on the prevalence of dementia (1980–2009) and metaanalysis to estimate the prevalence and numbers of those affected, aged ≥60 years in 21 Global Burden of Disease regions.ResultsAge-standardized prevalence for those aged ≥60 years varied in a narrow band, 5%–7% in most world regions, with a higher prevalence in Latin America (8.5%), and a distinctively lower prevalence in the four sub-Saharan African regions (2%–4%). It was estimated that 35.6 million people lived with dementia worldwide in 2010, with numbers expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with this proportion anticipated to rise to 63% in 2030 and 71% in 2050.ConclusionThe detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care. The age-specific prevalence of dementia varies little between world regions, and may converge further. Future projections of numbers of people with dementia may be modified substantially by preventive interventions (lowering incidence), improvements in treatment and care (prolonging survival), and disease-modifying interventions (preventing or slowing progression). All countries need to commission nationally representative surveys that are repeated regularly to monitor trends.     

A prevalence study of autism in tuberous sclerosis

An estimate of the prevalence of autism in tuberous sclerosis (TSC) was made by interviewing the parents of 21 children between ages 3 and 11 ascertained during a previous population study of the condition in the West of Scotland. Five of the children (24%) were rated autistic and a further four (19%), all of whom were girls, has socially impaired behavior categorized as pervasive developmental disorder, without fulfilling all the DSM-III-R criteria for autism. One further boy had disruptive attention-seeking behavior that had excluded him from his, normal school. The estimated prevalence from this study of autism in TSC is 1 in 4 children in general, and 1 in 2 of those with mental retardation. Tuberous sclerosis could be a significant cause of autism and pervasive developmental disorders, particularly in girls.This work was supported by a grant from the Tuberous Sclerosis Association of Great Britain. The authors thank Jennifer Dennis for discussions during the preparation of the questionnaire and for collaboration on validating the recorded interviews.     

The prevalence of aggression in genetic syndromes: A review

Research into behavioural phenotypes identifies both environmental and organic factors as influencing aggression in children and adults with genetic disorders associated with intellectual disability. However, in contrast to self-injury there is a paucity of research that compares aggression across relevant syndromes. The primary aim of this review is to examine the association between aggression and genetic syndromes by analysis of prevalence studies. The review also examines the literature on the form of the behaviour and influence of environmental factors.Results imply that certain syndrome groups (Cri du Chat, Smith-Magenis, Prader-Willi, Angelman, Cornelia de Lange, and Fragile X syndromes; estimates over 70%) evidence a stronger association with aggression than others (e.g. Williams and Down syndromes; estimates below 15%). However, the strength of association is difficult to quantify due to methodological differences between studies. The results from examining form and environmental influences highlight the importance of phenotype–environment interactions. Research employing group comparison designs is warranted and future work on the assessment and intervention of aggression in genetic syndromes should consider the importance of phenotype–environment interactions.     

Gender dysphoria and autism spectrum disorder: A narrative review

Abstract

The current literature shows growing evidence of a link between gender dysphoria (GD) and autism spectrum disorder (ASD). This study reviews the available clinical and empirical data. A systematic search of the literature was conducted using the following databases: PubMed, Web of Science, PsycINFO and Scopus; utilizing different combinations of the following search terms: autism, autism spectrum disorder (ASD), Asperger’s disorder (AD), co-morbidity, gender dysphoria (GD), gender identity disorder (GID), transgenderism and transsexualism. In total, 25 articles and reports were selected and discussed. Information was grouped by found co-occurrence rates, underlying hypotheses and implications for diagnosis and treatment. GD and ASD were found to co-occur frequently – sometimes characterized by atypical presentation of GD, which makes a correct diagnosis and determination of treatment options for GD difficult. Despite these challenges there are several case reports describing gender affirming treatment of co-occurring GD in adolescents and adults with ASD. Various underlying hypotheses for the link between GD and ASD were suggested, but almost all of them lack evidence.     

The ASDEU autism prevalence study in northern Spain

The prevalence of autism spectrum disorders (ASD) was studied in children in the County of Gipuzkoa (Basque Country, Spain) as part of the European Union’s Autism Spectrum Disorder in Europe project (ASDEU–https://asdeu.eu). To identify cases in a total community sample of 7- to 9-year-old pupils (N = 14,734), a multistage approach was adopted: in the first stage, a teacher nomination (TN) form was completed by school teachers; and in the second stage, all families with a child nominated by their teachers were invited to complete the Social Communication Questionnaire (SCQ). A total of 108 (59%) schools participated fully, yielding a final sample of 9177 of 14.734 (61.9%) pupils. A total of 212 (2.3%) children were nominated via the TN form, and of these, 105 (49.5%) returned the completed SCQ. Twenty-five (23.8%) cases with SCQ scores ≥ 15 were invited to undergo a free clinical assessment, and 10 (40%) new cases of ASD were identified. The prevalence estimate included the 55 cases already being supported by the Gipuzkoa’s only ASD association, the Gipuzkoa Autism Society (Asociación Guipuzcoana de Autismo/GAUTENA)), as well as the 10 new subjects identified by the ASDEU field diagnostic process. A sensitivity analysis was performed to estimate new potential ASD cases among the non-participant schools, leading to a final figure of 87 cases of ASD in this age-bracket at the date of the study. This global probabilistic estimate, including non-participating schools, would thus provide a population prevalence of 0.59% (95% CI 0.48–0.73), a result lower than those reported by some other studies. Attrition rates in cross-sectional studies are challenging and support the need for developing longitudinal ASD incidence surveillance study areas (ASD observatories)

     

The incidence and prevalence of Huntington's disease: A systematic review and meta-analysis

Huntington's disease (HD) is a rare, neurodegenerative disorder characterized by chorea, behavioral manifestations, and dementia. The aim of this study was to estimate the incidence and prevalence of HD through a systematic review of the literature. Medline and Embase databases were searched using terms specific to HD as well as studies of incidence, prevalence, and epidemiology. All studies reporting the incidence and/or prevalence of HD were included. Twenty original research articles were included. Eight studies examined incidence, and 17 studies examined prevalence. Meta-analysis of data from four incidence studies revealed an incidence of 0.38 per 100,000 per year (95% confidence interval [CI]: 0.16, 0.94). Lower incidence was reported in the Asian studies (n = 2), compared to the studies performed in Europe, North America, and Australia (n = 6). The worldwide service-based prevalence of HD, based on a meta-analysis (n = 13 studies), was 2.71 per 100,000 (95% CI: 1.55-4.72). Eleven studies were conducted in Europe, North American, and Australia, with an overall prevalence of 5.70 per 100,000 (95% CI: 4.42-7.35). Three studies were conducted in Asia, with an overall prevalence of 0.40 per 100,000 (95% CI: 0.26-0.61). Metaregression revealed a significantly lower prevalence of HD in Asia, compared to European, North American, and Australian populations. HD is a devastating neurodegenerative disorder with a higher prevalence in Europe, North America, and Australia than in Asia. The difference in prevalence of this genetic disorder can be largely explained by huntingtin gene haplotypes. ? 2012 Movement Disorder Society.     

The syndrome of autism: a critical review.

The authors review the clinical features and behavioral characteristics of autism; differential diagnosis of the syndrome; clinical, neurophysiological, and biochemical research; and its medical management and treatment. They conclude that autism is a behaviorally defined, specific syndrome that is manifested at birth or shortly thereafter. Its symptoms are expressive of an underlying neuropathophysiological process that affects developmental rate; modulation of perception; language, cognitive, and intellectual development; and the ability to relate. The long-term prognosis is guarded; almost all patients manifest severe symptomatology throughout their lives. Further basic research into the neuropathophysiological process underlying the syndrome is necessary in order to reach the ultimate goal of developing etiologically specific treatment programs.     

Disruptive behavior disorders in children and adolescents with autism spectrum disorders: A review of the prevalence,presentation, and treatment

Children and adolescents with autism spectrum disorders (ASDs) often exhibit behaviors consistent with a disruptive behavior disorder (DBD) such as oppositional defiant disorder (ODD) or conduct disorder (CD). Understanding the relationship between ASDs and DBDs has important implications for clinicians and researchers. We reviewed 55 peer-reviewed articles published between 2000 and 2012 on the prevalence, phenomenology, or psychosocial treatments of DBDs in youth with ASDs. Prevalence estimates vary between 4% and 37% for ODD and 1% and 10% for CD. On the whole, approximately one in four children with an ASD meets diagnostic criteria for either ODD or CD. Most research on phenomenology has focused on distinguishing between DBDs and ASDs, rather than examining their co-occurrence. After the preschool years, the disorders can be reliably distinguished, but certain behaviors are more common among those with ASDs compared to their non-ASD counterparts. If one excludes medication trials and single-subject designs, there have been few treatment studies on DBDs in ASDs. Parent training has been the primary mode of psychosocial treatment and has some support for its efficacy. Overall, when it comes to DBDs, there has been a dearth of research using DSM-nosology in youth with ASDs.