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Results for “Autism Spectrum Disorder”

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PubMed2005

Screening electroencephalograms in autism spectrum disorders: evidence-based guideline.

The purpose of this study was to establish guidelines for the use of screening electroencephalograms (EEGs) in autism spectrum disorders to identify subclinical epileptiform activity. MEDLINE and EMBASE were searched for relevant articles. The evidence was reviewed using the methodology of the Canadian Task Force on Preventive Health Care. A priori criteria were established for article selection and for grading the quality and strength of the evidence. Seizures are common, occurring in 20 to 30% of patients based on the majority of studies. Epileptiform EEG abnormalities are present in 10.3% to 72.4% of patients and subclinical abnormalities in 6.1% to 31%. Evidence for the effectiveness of anticonvulsants and corticosteroids in reducing seizures and/or autistic symptoms is based primarily on case series and case reports, with only one published randomized trial. There is currently insufficient evidence to recommend for or against the use of screening EEGs in autistic patients. Given the frequency of seizure disorders in this patient population, a high index of clinical suspicion should be maintained for subtle symptoms of seizures.

Anticonvulsants↗

PubMed2006

Examining communication repairs of 2 young children with autism spectrum disorder: the influence of the environment.

PURPOSE: The purpose of this study was to examine the repair strategies of 2 young children with autism spectrum disorder from an environmental rather than a developmental perspective. METHOD: A scripted protocol that included opportunities for requests and repair was followed. The environmental variables investigated were activity type (e.g., puzzle, shapes, book) and breakdown type (i.e., request for clarification, wrong response, and ignore). The sessions were videotaped, and each child's behavior was coded. RESULTS: The results revealed that (a) both participants repaired the majority (70%) of their unsuccessful initial requests and (b) the repair strategies varied across children, activities, and breakdowns. CONCLUSIONS: The findings of this study suggest that the 2 young children with autism and limited expressive language discriminated among environmental variables (i.e., type of activity and type of breakdown). The participants modified their repair topographies to correspond to changes in the environment. The findings from this study offer ways to enhance assessment and intervention of early communication. Implications for future research and practice are discussed.

Autistic Disorder↗

PubMed2007

Temporal coordination of joint attention behavior in preschoolers with autism spectrum disorder.

The current study investigated initiating and following declarative joint attention, and initiating requesting joint attention in a group of preschool children with autism spectrum disorder (ASD) and an age-matched control group. Different forms of joint attention were elicited while children interacted with their mothers. Temporal coordination of the children's joint attention behavior was examined using three levels of coding. Children with ASD showed less but similar requesting abilities and slower point following combined with an abnormal behavioral pattern of looking at the other person's pointing finger instead of the object pointed at. Initiating declarative behavior was qualitatively and quantitatively different, characterized by isolated instances of communication instead of a fluent shift of attention between object and person.

Attention↗

PubMed2007

Use of complementary and alternative medicine among children diagnosed with autism spectrum disorder.

This study examined the prevalence of the use of different types of conventional, complementary and alternative therapies by children diagnosed with an autism spectrum disorder (ASD). Of 112 families surveyed, 74% were using complementary and alternative medicine (CAM) for their child with ASD. CAM use was most strongly associated with parent report of child's diagnosis. Most CAM was reported by families to be either helpful or without effect, but not harmful. The main reasons for choosing CAM were related to concerns with the safety and side effects of prescribed medications. Conventional health care providers should be aware of the high prevalence of use among children with ASD and be prepared to discuss the use of CAM with families.

Autistic Disorder↗

PubMed2006

The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders.

BACKGROUND: The purpose of this study was to examine the correlates of caregiver stress in a large sample of young people with autism spectrum disorders (ASDs). Two main objectives were to: (1) disentangle the effects of behaviour problems and level of functioning on caregiver stress; and (2) measure the stability of behaviour problems and caregiver stress. METHODS: Parents or teachers of 293 young people with ASDs completed measures of stress, behaviour problems and social competence. Parents also completed an adaptive behaviour scale. Eighty-one young people were rated twice at a 1-year interval. RESULTS: Parents and teachers did not perfectly agree on the nature and severity of behaviour problems. However, both sets of ratings indicated that behaviour problems were strongly associated with stress. Conduct problems in particular were significant predictors of stress. Adaptive skills were not significantly associated with caregiver stress. Parental reports of behaviour problems and stress were quite stable over the 1-year interval, much more so than teacher reports. Parent ratings suggested that behaviour problems and stress exacerbated each other over time. This transactional model did not fit the teacher data. CONCLUSION: Results of this study suggested that it is a specific group of externalized behaviours that are the most strongly associated with both parent and teacher stress. Results were discussed from methodological and conceptual perspectives.

Activities of Daily Living↗

PubMed2006

Auditory integration training and other sound therapies for autism spectrum disorders: a systematic review.

OBJECTIVES: To determine the effectiveness of auditory integration training (AIT) or other methods of sound therapy in people with autism spectrum disorders (ASD). STUDY DESIGN: A systematic review was carried out of randomised controlled trials (RCTs) of adults or children with ASD. Meta-analysis was attempted. RESULTS: Six RCTs of AIT, including one crossover trial, were identified, with a total of 171 participants aged 3-39 years. 17 different outcome measures were used, with only two outcome measures used by three or more studies. Meta-analysis was not possible owing to very high heterogeneity or presentation of data in unusable forms. Three studies did not show any benefit of AIT over control conditions. Three studies reported improvements at 3 months in the AIT group for total mean scores of the Aberrant Behaviour Checklist (ABC), which is of questionable validity. Of these, one study also reported improvements at 3 months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported. CONCLUSION: At present there is not sufficient evidence to support its use.

Acoustic Stimulation↗

PubMed2005

Subset of individuals with autism spectrum disorders and extreme macrocephaly associated with germline PTEN tumour suppressor gene mutations.

The genetic aetiology of autism remains elusive. Occasionally, individuals with Cowden syndrome (a cancer syndrome) and other related hamartoma disorders such as Bannayan-Riley-Ruvalcaba syndrome, Proteus syndrome, and Proteus-like conditions, are characterised by germline PTEN mutations, and may have neurobehavioural features resembling autism as well as overgrowth and macrocephaly. Therefore, we undertook PTEN gene mutation analysis in 18 subjects mainly prospectively ascertained with autism spectrum disorder and macrocephaly. Of these 18 autistic subjects (13 males and five females; ages 3.1-18.4 years) with a head circumference range from 2.5 to 8.0 standard deviations above the mean, three males (17%) carried germline PTEN mutations. These three probands had previously undescribed PTEN mutations: H93R (exon 4), D252G (exon 7), and F241S (exon 7). They had the larger head circumference measurements amongst all our study subjects. The three residues altered in our patients were highly evolutionarily conserved. We suggest that PTEN gene testing be considered for patients with autistic behaviour and extreme macrocephaly. The gene findings may impact on recurrence risks as well as medical management for the patient.

Adolescent↗

PubMed2003

Low prevalence of smoking in patients with autism spectrum disorders.

Psychiatric patients are significantly more often smokers than the general population, the only known exception being obsessive-compulsive disorder (OCD) and catatonic schizophrenia. We have investigated nicotine use in subjects with autism spectrum disorders (ASD). Ninety-five subjects (25 females and 70 males) consecutively diagnosed with any ASD and of normal intelligence were included in the study. Only 12.6% were smokers, compared with 19% in the general population and 47% in a control group of 161 outpatients diagnosed with schizophrenia or a schizophreniform disorder. The results suggest that smoking is rare among subjects with ASD, while the opposite was shown for schizophrenia. If replicated, this finding could suggest biological differences between non-catatonic schizophrenia and ASD, and support the theory of a biological link between ASD and a subtype of OCD, and between ASD and catatonic schizophrenia.

Adolescent↗

PubMed2006

Effects of circumscribed interests on the social behaviors of children with autism spectrum disorders.

This study compared the effects of circumscribed interests (CI) to less preferred (LP) tangible stimuli on the social behaviors of three children with autism spectrum disorders (ASD). Based on single subject design methodology, the CI experimental sessions resulted in longer durations of target-child initiated social interactions in comparison to LP sessions. In addition, latency of participant's initial social bids to peers was decreased when CI were present. The results suggest that embedding CI into dyadic play situations with typical peers can be used to increase the social behavior children with ASD direct toward typical peers. Future research should examine the specific environmental conditions that must be present in naturalistic settings to facilitate generalization of social behavior.

Attention↗

PubMed2006

Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution.

Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number-symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ-, age- and sex-matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory-related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.

Adult↗

PubMed2005

Evidence-based assessment of autism spectrum disorders in children and adolescents.

This article reviews evidence-based criteria that can guide practitioners in the selection, use, and interpretation of assessment tools for autism spectrum disorders (ASD). As Mash and Hunsley (2005) discuss in this special section, evidence-based assessment tools not only demonstrate adequate psychometric qualities, but also have relevance to the delivery of services to individuals with the disorder (see also Hayes, Nelson, & Jarrett, 1987). Thus, we use what is known about the symptoms, etiologies, developmental course, and outcome of ASD to evaluate the utility of particular assessment strategies and instruments for diagnosis, treatment planning and monitoring, and evaluation of outcome. The article begins with a review of relevant research on ASD. Next we provide an overview of the assessment process and some important issues that must be considered. We then describe the components of a core (minimum) assessment battery, followed by additional domains that might be considered in a more comprehensive assessment. Domains covered include core autism symptomatology, intelligence, language, adaptive behavior, neuropsychological functions, comorbid psychiatric illnesses, and contextual factors (e.g., parent well-being, family functioning, quality of life). We end with a discussion of how well the extant literature meets criteria for evidence-based assessments.

Achievement↗

PubMed2005

The fears, phobias and anxieties of children with autism spectrum disorders and Down syndrome: comparisons with developmentally and chronologically age matched children.

This study compared the fears and behavior problems of 25 children with an autism spectrum disorder (ASD), 43 children with Down syndrome (DS), 45 mental age (MA) matched children, and 37 chronologically age (CA) matched children. Children's fears, phobias, anxieties and behavioral problems were assessed using parent reports. Significant differences emerged across the diagnostic groups on a variety of fears. Children with ASD were reported to have more situation phobias and medical fears, but fewer fears of harm/injury compared to all other groups. The groups also differed in terms of the pattern of correlations between fears, phobias, anxieties and behavior problems. For children with ASD, fears, phobias and anxieties were closely related to problem behaviors, whereas fears, phobias, and anxieties were less related to behavioral symptoms for the other groups of subjects. Such findings suggest that children with ASD exhibit a distinct profile of fear and anxiety compared to other mental age and chronologically age-matched children, and these fears are related to the symptoms associated with ASD.

Anxiety Disorders↗

PubMed2006

Focused stimulation for a child with autism spectrum disorder: a treatment study.

This study explored the use of focused stimulation as an intervention technique for a three-year-old boy diagnosed with autism spectrum disorder (ASD). His parents were trained to use focused stimulation to facilitate comprehension of what is x doing question forms. Responses to question probes were collected at both pre- and post-treatment intervals. At the beginning of the study, the child did not respond correctly to any of the target questions. Following intervention, the child made significant gains towards the target goal, but little change towards a control goal used for comparison. These findings provide preliminary support for the usefulness of focused stimulation as an intervention strategy for at least some children with ASD.

Attention↗

PubMed2004

Outcome classification of preschool children with autism spectrum disorders using MRI brain measures.

OBJECTIVE: To test the hypothesis that a combination of magnetic resonance imaging (MRI) brain measures obtained during early childhood distinguish children with autism spectrum disorders (ASD) from typically developing children and is associated with functional outcome. METHOD: Quantitative MRI technology was used to measure gray and white matter volumes (cerebrum and cerebellum), total brain volume, and the area of the cerebellar vermis in 52 boys with a provisional diagnosis of autism (aged 1.9-5.2 years) and 15 typically developing young children (aged 1.7-5.2 years). Diagnostic confirmation and cognitive outcome data were obtained after the children reached 5 years of age. RESULTS: A discriminant function analysis of the MRI brain measures correctly classified 95.8% of the ASD cases and 92.3% of the control cases. This set of variables also correctly classified 85% of the ASD cases as lower functioning and 68% of the ASD cases as higher functioning. CONCLUSIONS: These results indicate that variability in cerebellar and cerebral size is correlated with diagnostic and functional outcome in very young children with ASD.

Analysis of Variance↗

PubMed2006

Visual scanning and pupillary responses in young children with Autism Spectrum Disorder.

Using eye-tracking technology we investigated visual scanning and pupillary responses to face and non-face stimuli in nine children (M = 49.6 months) with Autism Spectrum Disorder (ASD) compared to six mental-age and nine chronological-age matched children. The results revealed a significant decrease in visual scanning to landscapes. In addition, the ASD group showed pupillary constriction to children's faces, while control groups showed pupillary dilation. Visual scanning responses to landscapes had a negative correlation with the Behavior subscale of the Autism Diagnostic Observation Schedule-Generic for the ASD group. Potential use of these measures as early indicators of ASD is discussed.

Autistic Disorder↗

PubMed2003

Postural stability in children with autism spectrum disorder.

Maintaining upright posture is a complex process involving multiple afferent systems. The aim of this study was to measure the postural stability of children with Autism Spectrum Disorder (ASD) compared with children with typical neurodevelopment and to measure the relative contributions of the visual, somatosensory, and vestibular afferent systems in each group. Eight boys with ASD and eight age-, race-, and gender-matched controls participated in this study using force platform technology with customized software to measure postural sway under conditions designed to eliminate or modify visual and somatosensory input. Children with ASD had significantly larger sway areas under all test conditions in which afferent input was modified. These results are consistent with a deficit in the integration of visual, vestibular, and somatosensory input to maintain postural orientation.

Autistic Disorder↗

PubMed2006

Placental trophoblast inclusions in autism spectrum disorder.

BACKGROUND: Microscopic examination of placental tissue may provide a route to assessing risk and understanding underlying biology of autism. METHODS: Occurrence of a distinctive microscopic placental morphological abnormality, the trophoblast inclusion, was assessed using archived placental tissue. The rate of occurrence of trophoblast inclusion-positive slides observed for 13 individuals with autism spectrum disorder (ASD) was compared to the rate in an anonymous consecutive birth cohort. RESULTS: The occurrence of inclusion positive slides was significantly greater in the ASD group compared to the control group (6/27 slides, 22.2% vs. 12/154, 7.8%; Fisher Exact Test, two-tailed p = .033; relative risk 2.85). The proportion of positive cases was also greater in the ASD group (5/13 cases, 38.5% vs. 8/61, 13.1%; Fisher Exact, two-tailed p = .044; relative risk 2.93). Behavioral severity scores did not differ across groups of inclusion positive (N = 4) and negative (N = 8) ASD individuals. CONCLUSIONS: Although probably not functionally detrimental or causative, the greater occurrence of placental trophoblast inclusions observed in ASD individuals may reflect altered early developmental processes. Further research is required to replicate the basic finding, to understand the basis for the trophoblastic abnormality, and to determine the utility of the measure in early detection of ASD.

Adolescent↗

PubMedDate not supplied

Conversational repair in speakers with autism spectrum disorder.

BACKGROUND: The ability to repair communicative breakdown is an important pragmatic language skill, yet very little is known about it in the population of children with autism spectrum disorder (ASD). Previous investigations have shown that people with ASD, across a variety of ages and language levels, recognized communicative breakdown and responded to requests for clarification (RQCLs) with a wide variety of repair strategies. No previous work has assessed the repair abilities of speakers with ASD when faced with a persistent communicative breakdown indicated by a stacked series of RQCLs. AIMS: The present paper aimed to determine whether school-aged, high-functioning children with ASD responded to a stacked series of RQCLs in a way similar to children matched for language age. METHODS & PROCEDURES: Nine school-aged, high-functioning children with ASD were recruited and matched to nine control group children based on language level. During conversation, an unfamiliar examiner engineered 10 episodes of communicative breakdown. Each consisted of a stacked series of three RQCLs ('What?', 'I don't understand', 'Tell me another way'). Verbal and non-verbal responses to each RQCL were coded. Responses were analysed by a series of repeated measures analyses of variance with diagnostic group and RQCL type/position as independent variables and type of repair as the dependent variable. OUTCOMES & RESULTS: Children with ASD were similar to language age-matched control children in responding to RQCLs and employing a variety of repair strategies. In addition, their pattern of responding over the series of RQCLs was very similar to the controls in varying the repair strategy by adding increasingly more information as the breakdown persisted, i.e. as the sequence of RQCLs progressed. Children with ASD, however, were significantly more likely than language age-matched controls to respond to an RQCL with an inappropriate response. CONCLUSIONS: The ability to repair communicative breakdown successfully raises questions about some of the currently popular theories about the source and nature of social and communicative deficits in autism. In addition, the presence of significantly more inappropriate utterances in the group with ASD poses both theoretical and clinical challenges. In theoretical terms, several possible explanations are proposed, but future work will need to test these hypotheses. Clinically, it is important to focus on utterances that disrupt the conversational flow and that generate severe social penalties for the speaker with ASD.

Analysis of Variance↗