Archive

Archive for the ‘autism spectrum disorders’ Category

Autism and Sensory Processing Disorders: Shared White Matter Disruption in Sensory Pathways but Divergent Connectivity in Social-Emotional Pathways

August 19, 2014 Comments off

Autism and Sensory Processing Disorders: Shared White Matter Disruption in Sensory Pathways but Divergent Connectivity in Social-Emotional Pathways
Source: PLoS ONE

Over 90% of children with Autism Spectrum Disorders (ASD) demonstrate atypical sensory behaviors. In fact, hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment is now included in the DSM-5 diagnostic criteria. However, there are children with sensory processing differences who do not meet an ASD diagnosis but do show atypical sensory behaviors to the same or greater degree as ASD children. We previously demonstrated that children with Sensory Processing Disorders (SPD) have impaired white matter microstructure, and that this white matter microstructural pathology correlates with atypical sensory behavior. In this study, we use diffusion tensor imaging (DTI) fiber tractography to evaluate the structural connectivity of specific white matter tracts in boys with ASD (n = 15) and boys with SPD (n = 16), relative to typically developing children (n = 23). We define white matter tracts using probabilistic streamline tractography and assess the strength of tract connectivity using mean fractional anisotropy. Both the SPD and ASD cohorts demonstrate decreased connectivity relative to controls in parieto-occipital tracts involved in sensory perception and multisensory integration. However, the ASD group alone shows impaired connectivity, relative to controls, in temporal tracts thought to subserve social-emotional processing. In addition to these group difference analyses, we take a dimensional approach to assessing the relationship between white matter connectivity and participant function. These correlational analyses reveal significant associations of white matter connectivity with auditory processing, working memory, social skills, and inattention across our three study groups. These findings help elucidate the roles of specific neural circuits in neurodevelopmental disorders, and begin to explore the dimensional relationship between critical cognitive functions and structural connectivity across affected and unaffected children.

See: Kids with autism and sensory processing disorders show differences in brain wiring (Science Daily)

About these ads

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update (August 6, 2014)

August 6, 2014 Comments off

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update (PDF)
Source: Agency for Healthcare Research and Quality

Objective
We updated a prior systematic review of interventions for children (0–12 years) with autism spectrum disorder (ASD), focusing on recent studies of behavioral interventions.

Data sources
We searched the MEDLINE® (PubMed®), PsycInfo, and Educational Resources Information Clearinghouse (ERIC) databases as well as the reference lists of included studies and recent systematic reviews. We conducted the search in December 2013.

Methods. We included comparative studies (with treatment and comparison groups) of behavioral interventions with at least 10 participants with ASD in the update, and made our conclusions based on the cumulative comparative evidence across the original report and update. Two investigators independently screened studies against predetermined inclusion criteria and independently rated the quality of included studies.

Results
We included 65 unique studies comprising 48 randomized trials and 17 nonrandomized comparative studies (19 good, 39 fair, and 7 poor quality) published since the prior review. The quality of studies improved compared with that reported in the earlier review; however, our assessment of the strength of evidence (SOE), our confidence in the stability of effects of interventions in the face of future research, remains low for many intervention/outcome pairs. Early intervention based on high-intensity applied behavior analysis over extended timeframes was associated with improvement in cognitive functioning and language skills (moderate SOE for improvements in both outcomes) relative to community controls in some groups of young children. The magnitude of these effects varied across studies, potentially reflecting poorly understood modifying characteristics related to subgroups of children. Early intensive parent training programs modified parenting behaviors during interactions; however, data were more limited about their ability to improve developmental skills beyond language gains for some children (low SOE for positive effects on language). Social skills interventions varied in scope and intensity and showed some positive effects on social behaviors for older children in small studies (low SOE for positive effects on social skills). Studies of play/interaction-based approaches reported that joint attention interventions may demonstrate positive outcomes in preschool-age children with ASD when targeting joint attention skills (moderate SOE); data on the effects of such interventions in other areas were limited (low SOE for positive effects on play skills, language, social skills). Studies examining the effects of cognitive behavioral therapy on anxiety reported positive results in older children with IQs ≥70 (high SOE for improvements in anxiety in this population). Smaller short-term studies of other interventions reported some improvements in areas such as sleep and communication, but data were too sparse to assess their overall effectiveness.

Conclusions
A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. Despite improvements in the quality of the included literature, a need remains for studies of interventions across settings and continued improvements in methodologic rigor. Substantial scientific advances are needed to enhance our understanding of which interventions are most effective for specific children with ASD and to isolate elements or components of interventions most associated with effects.

Neurodevelopmental Disorders and Prenatal Residential Proximity to Agricultural Pesticides: The CHARGE Study

June 24, 2014 Comments off

Neurodevelopmental Disorders and Prenatal Residential Proximity to Agricultural Pesticides: The CHARGE Study
Source: Environmental Health Perspectives

Background:
Gestational exposure to several common agricultural pesticides can induce developmental neurotoxicity in humans, and has been associated with developmental delay and autism.

Objectives:
To evaluate whether residential proximity to agricultural pesticides during pregnancy is associated with autism spectrum disorders (ASD) or developmental delay (DD) in the Childhood Autism Risks from Genetics and Environment (CHARGE) Study.

Methods:
The CHARGE study is a population-based case-control study of ASD, developmental delay (DD), and typical development. For 970 participants, commercial pesticide application data from the California Pesticide Use Report (1997-2008) were linked to the addresses during pregnancy. Pounds of active ingredient applied for organophophates, organochlorines, pyrethroids, and carbamates were aggregated within 1.25km, 1.5km, and 1.75km buffer distances from the home. Multinomial logistic regression was used to estimate the odds ratio (OR) of exposure comparing confirmed cases of ASD (n = 486) or DD (n = 168) with typically developing referents (n = 316).

Results:
Approximately one-third of CHARGE Study mothers lived, during pregnancy, within 1.5 km (just under one mile) of an agricultural pesticide application. Proximity to organophosphates at some point during gestation was associated with a 60% increased risk for ASD, higher for 3rd trimester exposures [OR = 2.0, 95% confidence interval (CI) = (1.1, 3.6)], and 2nd trimester chlorpyrifos applications: OR = 3.3 [95% CI = (1.5, 7.4)]. Children of mothers residing near pyrethroid insecticide applications just prior to conception or during 3rd trimester were at greater risk for both ASD and DD, with OR’s ranging from 1.7 to 2.3. Risk for DD was increased in those near carbamate applications, but no specific vulnerable period was identified.

Conclusions:
This study of ASD strengthens the evidence linking neurodevelopmental disorders with gestational pesticide exposures, and particularly, organophosphates and provides novel results of ASD and DD associations with, respectively, pyrethroids and carbamates.

New from the GAO

May 21, 2014 Comments off

New GAO Reports and Testimonies
Source: Government Accountability Office

Reports
 
1. Tax Policy: Economic Benefits of Income Exclusion for U.S. Citizens Working Abroad Are Uncertain. GAO-14-387, May 20.
http://www.gao.gov/products/GAO-14-387
Highlights – http://www.gao.gov/assets/670/663323.pdf
 
2. State Department: Process to Track Responses to Congressional Correspondence Can Be Improved. GAO-14-424, May 20.
http://www.gao.gov/products/GAO-14-424
Highlights – http://www.gao.gov/assets/670/663330.pdf
 
Testimonies
 
1. Federal Autism Activities: Funding and Coordination Efforts, by Marcia Crosse, director, health care, before the Subcommittee on Government Operations, House Committee on Oversight and Government Reform. GAO-14-613T, May 20.
http://www.gao.gov/products/GAO-14-613T
Highlights – http://www.gao.gov/assets/670/663314.pdf
 
2. Nanomanufacturing and U.S. Competitiveness: Challenges and Opportunities, by Timothy M. Persons, chief scientist, applied research and methods, before the Subcommittee on Research and Technology, House Committee on Science, Space, and Technology. GAO-14-618T, May 20.
http://www.gao.gov/products/GAO-14-618T
Highlights – http://www.gao.gov/assets/670/663320.pdf
 
3. Medicare: Further Action Could Improve Improper Payment Prevention and Recoupment Efforts, by Kathleen M. King, director, health care, before the Subcommittee on Energy Policy, Health Care and Entitlements, House Committee on Oversight and Government Reform. GAO-14-619T, May 20.
http://www.gao.gov/products/GAO-14-619T
Highlights – http://www.gao.gov/assets/670/663317.pdf

Pet Dog Ownership Decisions for Parents of Children With Autism Spectrum Disorder

April 23, 2014 Comments off

Pet Dog Ownership Decisions for Parents of Children With Autism Spectrum Disorder (PDF)
Source: Journal of Pediatric Nursing (pre-publication dissertation)

This study compared the social skills of children wit h Autism Spectrum Disorder who lived with dogs and those who did not live with dogs. Interaction with dogs was investigated in this population, along with the attachment of those children who lived with dogs. This cross – sectional, descriptive study was conducted using a telephone survey. Seventy caregivers rated their child using the Social Skills Improvement System Rating Scale, and responded to open – ended questions regarding their child’s interaction with dogs. Children living with dogs completed the Companion A nimal Bonding Scale . Two – sample t – tests were used for comparison of children with and without dogs. Thematic analysis was used to evaluate the qualitative data. In seven of eight social skill areas, the mean social skill scores of children with dogs were greater than for those without dogs . Eighty – nine percent of parents with dogs described their child as “ very attached ” and children reported high bonding to their dogs using the CABS. Parents indicat ed the benefits of dog ownership for their child with ASD were companionship, unconditional love and responsibility opportunities. The findings suggest that dog ownership may be beneficial for some children with ASD.

Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010

March 31, 2014 Comments off

Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010
Source: Morbidity and Mortality Weekly Report (CDC)

For 2010, the overall prevalence of ASD among the ADDM sites was 14.7 per 1,000 (one in 68) children aged 8 years. Overall ASD prevalence estimates varied among sites from 5.7 to 21.9 per 1,000 children aged 8 years. ASD prevalence estimates also varied by sex and racial/ethnic group. Approximately one in 42 boys and one in 189 girls living in the ADDM Network communities were identified as having ASD. Non-Hispanic white children were approximately 30% more likely to be identified with ASD than non-Hispanic black children and were almost 50% more likely to be identified with ASD than Hispanic children. Among the seven sites with sufficient data on intellectual ability, 31% of children with ASD were classified as having IQ scores in the range of intellectual disability (IQ ≤70), 23% in the borderline range (IQ = 71–85), and 46% in the average or above average range of intellectual ability (IQ >85). The proportion of children classified in the range of intellectual disability differed by race/ethnicity. Approximately 48% of non-Hispanic black children with ASD were classified in the range of intellectual disability compared with 38% of Hispanic children and 25% of non-Hispanic white children. The median age of earliest known ASD diagnosis was 53 months and did not differ significantly by sex or race/ethnicity.

Environmental and State-Level Regulatory Factors Affect the Incidence of Autism and Intellectual Disability

March 26, 2014 Comments off

Environmental and State-Level Regulatory Factors Affect the Incidence of Autism and Intellectual Disability
Source: PLoS Computational Biology

Many factors affect the risks for neurodevelopmental maladies such as autism spectrum disorders (ASD) and intellectual disability (ID). To compare environmental, phenotypic, socioeconomic and state-policy factors in a unified geospatial framework, we analyzed the spatial incidence patterns of ASD and ID using an insurance claims dataset covering nearly one third of the US population. Following epidemiologic evidence, we used the rate of congenital malformations of the reproductive system as a surrogate for environmental exposure of parents to unmeasured developmental risk factors, including toxins. Adjusted for gender, ethnic, socioeconomic, and geopolitical factors, the ASD incidence rates were strongly linked to population-normalized rates of congenital malformations of the reproductive system in males (an increase in ASD incidence by 283% for every percent increase in incidence of malformations, 95% CI: [91%, 576%], p<6×10−5). Such congenital malformations were barely significant for ID (94% increase, 95% CI: [1%, 250%], p = 0.0384). Other congenital malformations in males (excluding those affecting the reproductive system) appeared to significantly affect both phenotypes: 31.8% ASD rate increase (CI: [12%, 52%], p<6×10−5), and 43% ID rate increase (CI: [23%, 67%], p<6×10−5). Furthermore, the state-mandated rigor of diagnosis of ASD by a pediatrician or clinician for consideration in the special education system was predictive of a considerable decrease in ASD and ID incidence rates (98.6%, CI: [28%, 99.99%], p = 0.02475 and 99% CI: [68%, 99.99%], p = 0.00637 respectively). Thus, the observed spatial variability of both ID and ASD rates is associated with environmental and state-level regulatory factors; the magnitude of influence of compound environmental predictors was approximately three times greater than that of state-level incentives. The estimated county-level random effects exhibited marked spatial clustering, strongly indicating existence of as yet unidentified localized factors driving apparent disease incidence. Finally, we found that the rates of ASD and ID at the county level were weakly but significantly correlated (Pearson product-moment correlation 0.0589, p = 0.00101), while for females the correlation was much stronger (0.197, p<2.26×10−16).

See: Autism, intellectual disability incidence linked with environmental factors (Science Daily)

States Grapple With Autism’s Rising Tide

March 21, 2014 Comments off

States Grapple With Autism’s Rising Tide (PDF)
Source: Education Commission of the States

Autism Spectrum Disorders are the fastest-growing developmental disability in the United States. In March 2013, the Centers for Disease Control estimated the prevalence of diagnosed ASD in 2011-12 to be one in 50 based on parent reports for children ages 6 to 17. Six years earlier, the CDC estimated the rate was one in 86.

In recognizing the increasing needs of children affected by ASD, as well as the associated financial implications for local governments, some states are re-assessing their current systems of support and looking for better and more efficient ways to serve individuals with ASD and their families.

As states have struggled to respond to the phenomenon, they have formed task forces, created pilot programs and launched resource and support services.

New From the GAO

November 20, 2013 Comments off

New GAO Reports and Testimony
Source: Government Accountability Office

Reports

1. Civil Support: Actions Are Needed to Improve DOD’s Planning for a Complex Catastrophe. GAO-13-763, September 30.
http://www.gao.gov/products/GAO-13-763
Highlights – http://www.gao.gov/assets/660/658407.pdf

2. Federal Autism Activities: Better Data and More Coordination Needed to Help Avoid the Potential for Unnecessary Duplication. GAO-14-16, November 20.
http://www.gao.gov/products/GAO-14-16
Highlights – http://www.gao.gov/assets/660/659148.pdf

3. Immigration Detention: Additional Actions Could Strengthen DHS Efforts to Address Sexual Abuse. GAO-14-38, November 20.
http://www.gao.gov/products/GAO-14-38
Highlights – http://www.gao.gov/assets/660/659146.pdf

Testimony

1. Personnel Security Clearances: Actions Needed to Help Ensure Correct Designations of National Security Positions, by Brenda S. Farrell, director, defense capabilities and management, before the Subcommittee on the Efficiency and Effectiveness of Federal Programs and the Federal Workforce, Senate Committee on Homeland Security and Governmental Affairs. GAO-14-139T, November 20.
http://www.gao.gov/products/GAO-14-139T
Highlights – http://www.gao.gov/assets/660/659120.pdf

Changes in Prevalence of Parent-reported Autism Spectrum Disorder in School-aged U.S. Children: 2007 to 2011–2 012

March 20, 2013 Comments off

Changes in Prevalence of Parent-reported Autism Spectrum Disorder in School-aged U.S. Children: 2007 to 2011–2012 (PDF)

Source: National Center for Health Statistics

Objectives—This report presents data on the prevalence of diagnosed autism spectrum disorder (ASD) as reported by parents of school-aged children (ages 6–17 years) in 2011–2012. Prevalence changes from 2007 to 2011–2012 were evaluated using cohort analyses that examine the consistency in the 2007 and 2011–2012 estimates for children whose diagnoses could have been reported in both surveys (i.e., those born in 1994–2005 and diagnosed in or before 2007).

Data sources—Data were drawn from the 2007 and 2011–2012 National Survey of Children’s Health (NSCH), which are independent nationally representative telephone surveys of households with children. The surveys were conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics with funding and direction from the Health Resources and Services Administration’s Maternal and Child Health Bureau

Results—The prevalence of parent-reported ASD among children aged 6–17 was 2.00% in 2011–2012, a significant increase from 2007 (1.16%). The magnitude of the increase was greatest for boys and for adolescents aged 14–17. Cohort analyses revealed consistent estimates of both the prevalence of parentreported ASD and autism severity ratings over time. Children who were first diagnosed in or after 2008 accounted for much of the observed prevalence increase among school-aged children (those aged 6–17). School-aged children diagnosed in or after 2008 were more likely to have milder ASD and less likely to have severe ASD than those diagnosed in or before 2007.

Conclusions—The results of the cohort analyses increase confidence that differential survey measurement error over time was not a major contributor to observed changes in the prevalence of parent-reported ASD. Rather, much of the prevalence increase from 2007 to 2011–2012 for school-aged children was the result of diagnoses of children with previously unrecognized ASD.

A Systematic Review of Vocational Interventions for Young Adults With Autism Spectrum Disorders

August 31, 2012 Comments off

A Systematic Review of Vocational Interventions for Young Adults With Autism Spectrum Disorders
Source: Pediatrics

BACKGROUND AND OBJECTIVE: Many individuals with autism spectrum disorders (ASDs) are approaching adolescence and young adulthood; interventions to assist these individuals with vocational skills are not well understood. This study systematically reviewed evidence regarding vocational interventions for individuals with ASD between the ages of 13 and 30 years.

METHODS: The Medline, PsycINFO, and ERIC databases (1980–December 2011) and reference lists of included articles were searched. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes, and assigned overall quality and strength of evidence ratings based on predetermined criteria.

RESULTS: Five studies were identified; all were of poor quality and all focused on on-the-job supports as the employment/vocational intervention. Short-term studies reported that supported employment was associated with improvements in quality of life (1 study), ASD symptoms (1 study), and cognitive functioning (1 study). Three studies reported that interventions increased rates of employment for young adults with ASD.

CONCLUSIONS: Few studies have been conducted to assess vocational interventions for adolescents and young adults with ASD. As such, there is very little evidence available for specific vocational treatment approaches as individuals transition to adulthood. All studies of vocational approaches were of poor quality, which may reflect the recent emergence of this area of research. Individual studies suggest that vocational programs may increase employment success for some; however, our ability to understand the overall benefit of supported employment programs is limited given the existing research.

Interventions for Adolescents and Young Adults With Autism Spectrum Disorders

August 30, 2012 Comments off

Interventions for Adolescents and Young Adults With Autism Spectrum Disorders (PDF)

Source: Agency for Healthcare Research and Quality

Few studies have been conducted to assess treatment approaches for adolescents and young adults with ASD, and as such there is very little evidence available for specific treatment approaches in this population; this is especially the case for evidence-based approaches to support the transition of youth with autism to adulthood. Of the small number of studies available, most were of poor quality, which may reflect the relative recency of the field. Five studies, primarily of medical interventions, had fair quality. Behavioral, educational, and adaptive/life skills studies were typically small and short term and suggested some potential improvements in social skills and functional behavior. Small studies suggested that vocational programs may increase employment success for some individuals. Few data are available to support the use of medical or allied health interventions in the adolescent and young adult population. The medical studies that have been conducted focused on the use of medications to address specific challenging behaviors, including irritability and aggression, for which effectiveness in this age group is largely unknown and inferred from studies including mostly younger children.

Long-term oxytocin administration improves social behaviors in a girl with autistic disorder

August 15, 2012 Comments off

Long-term oxytocin administration improves social behaviors in a girl with autistic disorder

Source: BMC Psychiatry

Background

Patients with autism spectrum disorders (ASDs) exhibit core autistic symptoms including social impairments from early childhood and mostly show secondary disabilities such as irritability and aggressive behavior based on core symptoms. However, there are still no radical treatments of social impairments in these patients. Oxytocin has been reported to play important roles in multiple social behaviors dependent on social recognition, and has been expected as one of the effective treatments of social impairments of patients with ASDs.

Case presentation

We present a case of a 16-year-old girl with autistic disorder who treated by long-term administration of oxytocin nasal spray. Her autistic symptoms were successfully treated by two month administration; the girl’s social interactions and social communication began to improve without adverse effects. Her irritability and aggressive behavior also improved dramatically with marked decreases in aberrant behavior checklist scores from 69 to 7.

Conclusion

This case is the first to illustrate long-term administration of oxytocin nasal spray in the targeted treatment of social impairments in a female with autistic disorder. This case suggests that long-term nasal oxytocin spray is promising and well-tolerated for treatment of social impairments of patients with ASDs.

A Sensitive Approach to Studying ASDs: Teasing Out Relationships between Autism and Maternal Smoking

July 8, 2012 Comments off

A Sensitive Approach to Studying ASDs: Teasing Out Relationships between Autism and Maternal Smoking
Source: Environmental Health Perspectives

Both genetic and environmental factors have been implicated in autism spectrum disorders (ASDs), which affect an estimated 1 in 88 children. One such environmental factor, prenatal exposure to tobacco smoke via maternal smoking, has been associated with ASDs in some studies but not others. A new study reports evidence of a positive association between maternal smoking during pregnancy and higher-functioning ASD subtypes [EHP 120(7):1042–1048; Kalkbrenner et al.].

The authors collected information on maternal smoking and other factors from the birth certificates for 633,989 children born in 1992, 1994, 1996, and 1998 in 11 U.S. states. They linked these data with surveillance data from the U.S. Centers for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring network and identified 3,315 of the children who were subsequently diagnosed with an ASD by age 8 years.

About 13% of all the mothers smoked during pregnancy, compared with about 11% of mothers with children diagnosed with an ASD. Maternal smoking has been associated with both lower education and reduced access to health care, factors that might increase the likelihood that ASDs go undiagnosed among children of women who smoked during pregnancy. When the authors corrected for this potential bias using outcome misclassification sensitivity analyses, a weak positive association emerged between maternal smoking and cases classified as “ASD not otherwise specified,” which were assumed to be higher-functioning ASDs such as Asperger’s disorder. The association was not found for lower-functioning (that is, more severe) ASDs.

The authors write that their findings concerning ASD subgroups should be interpreted with caution because the accuracy of subgroup classification may have varied depending upon mothers’ access to evaluation services, and because it was not bas ed on direct clinical observation. They also note that positive associations may reflect the presence in higher-functioning subgroups of children with co-occurring disorders (such as attention deficit/hyperactivity disorder) that can be affected by nicotine exposure.

Strengths of the study include the large sample size, the population-based design with standardized identification of ASD cases, and the use of sensitivity analyses to evaluate potential sources of bias. The authors conclude that the observed association between maternal smoking during pregnancy and higher-functioning ASDs warrants further research.

Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

July 2, 2012 Comments off

Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

Source: Annals of General Psychiatry

Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications.

Diagnostic History and Treatment of School-aged Children with Autism Spectrum Disorder and Special Health Care Needs

May 31, 2012 Comments off

Diagnostic History and Treatment of School-aged Children with Autism Spectrum Disorder and Special Health Care Needs
Source: National Center for Health Statistics

Key findings
Data from the 2011 Survey of Pathways to Diagnosis and Services

  • The median age when school-aged children with special health care needs (CSHCN) and autism spectrum disorder (ASD) were first identified as having ASD was 5 years.
  • School-aged CSHCN identified as having ASD at a younger age (under age 5 years) were identified most often by generalists and psychologists, while those identified later (aged 5 years and over) were identified primarily by psychologists and psychiatrists.
  • Nine out of 10 school-aged CSHCN with ASD use one or more services to meet their developmental needs. Social skills training and speech or language therapy are the most common, each used by almost three-fifths of these children.
  • More than one-half of school-aged CSHCN with ASD use psychotropic medication.

Use of machine learning to shorten observation-based screening and diagnosis of autism

April 13, 2012 Comments off

Use of machine learning to shorten observation-based screening and diagnosis of autism
Source: Translational Psychiatry

The Autism Diagnostic Observation Schedule-Generic (ADOS) is one of the most widely used instruments for behavioral evaluation of autism spectrum disorders. It is composed of four modules, each tailored for a specific group of individuals based on their language and developmental level. On average, a module takes between 30 and 60 min to deliver. We used a series of machine-learning algorithms to study the complete set of scores from Module 1 of the ADOS available at the Autism Genetic Resource Exchange (AGRE) for 612 individuals with a classification of autism and 15 non-spectrum individuals from both AGRE and the Boston Autism Consortium (AC). Our analysis indicated that 8 of the 29 items contained in Module 1 of the ADOS were sufficient to classify autism with 100% accuracy. We further validated the accuracy of this eight-item classifier against complete sets of scores from two independent sources, a collection of 110 individuals with autism from AC and a collection of 336 individuals with autism from the Simons Foundation. In both cases, our classifier performed with nearly 100% sensitivity, correctly classifying all but two of the individuals from these two resources with a diagnosis of autism, and with 94% specificity on a collection of observed and simulated non-spectrum controls. The classifier contained several elements found in the ADOS algorithm, demonstrating high test validity, and also resulted in a quantitative score that measures classification confidence and extremeness of the phenotype. With incidence rates rising, the ability to classify autism effectively and quickly requires careful design of assessment and diagnostic tools. Given the brevity, accuracy and quantitative nature of the classifier, results from this study may prove valuable in the development of mobile tools for preliminary evaluation and clinical prioritization—in particular those focused on assessment of short home videos of children—that speed the pace of initial evaluation and broaden the reach to a significantly larger percentage of the population at risk.

See: Web-Based Tool Produces Fast, Accurate Autism Diagnosis, Study Suggests

Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008

March 30, 2012 Comments off

Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008
Source: Morbidity and Mortality Weekly Report (CDC)

For 2008, the overall estimated prevalence of ASDs among the 14 ADDM sites was 11.3 per 1,000 (one in 88) children aged 8 years who were living in these communities during 2008. Overall ASD prevalence estimates varied widely across all sites (range: 4.8–21.2 per 1,000 children aged 8 years). ASD prevalence estimates also varied widely by sex and by racial/ethnic group. Approximately one in 54 boys and one in 252 girls living in the ADDM Network communities were identified as having ASDs. Comparison of 2008 findings with those for earlier surveillance years indicated an increase in estimated ASD prevalence of 23% when the 2008 data were compared with the data for 2006 (from 9.0 per 1,000 children aged 8 years in 2006 to 11.0 in 2008 for the 11 sites that provided data for both surveillance years) and an estimated increase of 78% when the 2008 data were compared with the data for 2002 (from 6.4 per 1,000 children aged 8 years in 2002 to 11.4 in 2008 for the 13 sites that provided data for both surveillance years). Because the ADDM Network sites do not make up a nationally representative sample, these combined prevalence estimates should not be generalized to the United States as a whole.

Familial Linkage between Neuropsychiatric Disorders and Intellectual Interests

January 30, 2012 Comments off
Source:  PLoS ONE
From personality to neuropsychiatric disorders, individual differences in brain function are known to have a strong heritable component. Here we report that between close relatives, a variety of neuropsychiatric disorders covary strongly with intellectual interests. We surveyed an entire class of high-functioning young adults at an elite university for prospective major, familial incidence of neuropsychiatric disorders, and demographic and attitudinal questions. Students aspiring to technical majors (science/mathematics/engineering) were more likely than other students to report a sibling with an autism spectrum disorder (p = 0.037). Conversely, students interested in the humanities were more likely to report a family member with major depressive disorder (p = 8.8×10−4), bipolar disorder (p = 0.027), or substance abuse problems (p = 1.9×10−6). A combined PREdisposition for Subject MattEr (PRESUME) score based on these disorders was strongly predictive of subject matter interests (p = 9.6×10−8). Our results suggest that shared genetic (and perhaps environmental) factors may both predispose for heritable neuropsychiatric disorders and influence the development of intellectual interests.

Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders

November 29, 2011 Comments off

Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders (PDF)Source: Proceedings of the National Academy of Sciences

Autism is a heterogeneous disorder with multiple behavioral and biological phenotypes. Accelerated brain growth during early childhood is a well-established biological feature of autism. Onset pattern, i.e., early onset or regressive, is an intensely studied behavioral phenotype of autism. There is currently little known, however, about whether, or how, onset status maps onto the abnormal brain growth. We examined the relationship between total brain volume and onset status in a large sample of 2- to 4-y-old boys and girls with autism spectrum disorder (ASD) [n = 53, no regression (nREG); n = 61, regression (REG)] and a comparison group of age-matched typically developing controls (n = 66). We also examined retrospective head circumference measurements from birth through 18 mo of age. We found that abnormal brain enlargement was most commonly found in boys with regressive autism. Brain size in boys without regression did not differ from controls. Retrospective head circumference measurements indicate that head circumference in boys with regressive autism is normal at birth but diverges from the other groups around 4–6 mo of age. There were no differences in brain size in girls with autism (n = 22, ASD; n = 24, controls). These results suggest that there may be distinct neural phenotypes associated with different onsets of autism. For boys with regressive autism, divergence in brain size occurs well before loss of skills is commonly reported. Thus, rapid head growth may be a risk factor for regressive autism.

Follow

Get every new post delivered to your Inbox.

Join 897 other followers