Autism Research and Treatment http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Prevalence and Predictors of Psychotropic Use in Children with High-Functioning ASDs Thu, 16 May 2013 09:24:29 +0000 http://www.hindawi.com/journals/aurt/2013/384527/ This study examined (1) the prevalence of psychotropic medication use for a sample of children with high-functioning autism spectrum disorders (HFASDs), (2) the extent to which psychotropic agents were linked to targeted symptoms, and (3) predictors of psychotropic use. A total of 115 children, ages 6–13, with HFASDs who were enrolled in psychosocial treatment trials were included in this study. Parents completed extensive background and rating forms prior to treatment that included data on demographic characteristics, child health, child medication use, and child ASD-related symptoms. Results indicated that 33% () of the sample was taking psychotropic medication with the most common being stimulants (25%; ), antidepressants (10%; ), and neuroleptics (6%; ). All children taking stimulants had target symptoms that were appropriate for stimulant medication, whereas 57% of those taking neuroleptics and 42% of those taking antidepressants did not have targeted symptoms consistent with the medication. Logistic regression for the major psychotropic drug categories indicated that lower IQ was a significant predictor of increased antidepressant and neuroleptic use. A higher level of ASD-related symptoms was related to the likelihood of stimulant use. Christopher Lopata, Jennifer A. Toomey, Jeffery D. Fox, Marcus L. Thomeer, Martin A. Volker, and Gloria K. Lee Copyright © 2013 Christopher Lopata et al. All rights reserved. Validation of Autism Spectrum Quotient Adult Version in an Australian Sample Sun, 12 May 2013 08:17:21 +0000 http://www.hindawi.com/journals/aurt/2013/984205/ The Autism Spectrum Quotient is used to assess autistic spectrum traits in intellectually competent adults in both the general population and the autism spectrum community. While the autism spectrum Quotient has been validated in several different cultures, to date no study has assessed the psychometrics of the Autism Spectrum Quotient on an Australian population. The purpose of this study was to assess the psychometrics of the autism spectrum Quotient in an Australian sample of both typically developing individuals () and individuals with autism spectrum disorder (). The results revealed that the internal consistency and the test-retest reliability were satisfactory; individuals with autism spectrum disorder scored higher on total Autism Spectrum Quotient score and its subscales than typically developing individuals; however, gender differences were not apparent on total score. Possible cultural differences may explain some of the psychometric variations found. The results of this analysis revealed that the Autism Spectrum Quotient was a reliable instrument for investigating variation in autistic symptomology in both typically developing and Autism Spectrum Disorders populations within an Australian population. J. Broadbent, I. Galic, and M. A. Stokes Copyright © 2013 J. Broadbent et al. All rights reserved. Early Infant Exposure to Excess Multivitamin: A Risk Factor for Autism? Mon, 04 Mar 2013 13:49:38 +0000 http://www.hindawi.com/journals/aurt/2013/963697/ Autism, a neurodevelopmental disorder that affects boys more than girls, is often associated with altered levels of monoamines (serotonin and catecholamines), especially elevated serotonin levels. The monoamines act as both neurotransmitters and signaling molecules in the gastrointestinal and immune systems. The evidence related to monoamine metabolism may be summarized as follows: (i) monoamine neurotransmitters are enzymatically degraded/inactivated by three mechanisms: oxidative deamination, methylation, and sulfation. The latter two are limited by the supply of methyl groups and sulfate, respectively. (ii) A decrease in methylation- and sulfation-mediated monoamine inactivation can be compensated by an increase in the oxidative deamination catalyzed by monoamine oxidase, an X-linked enzyme exhibiting higher activity in females than in males. (iii) Vitamins can, on one hand, facilitate the synthesis of monoamine neurotransmitters and, on the other hand, inhibit their inactivation by competing for methylation and sulfation. Therefore, we postulate that excess multivitamin feeding in early infancy, which has become very popular over the past few decades, may be a potential risk factor for disturbed monoamine metabolism. In this paper, we will focus on the relationship between excess multivitamin exposure and the inactivation/degradation of monoamine neurotransmitters and its possible role in the development of autism. Shi-Sheng Zhou, Yi-Ming Zhou, Da Li, and Qiang Ma Copyright © 2013 Shi-Sheng Zhou et al. All rights reserved. Atypical Functional Connectivity of the Amygdala in Childhood Autism Spectrum Disorders during Spontaneous Attention to Eye-Gaze Thu, 27 Dec 2012 16:38:21 +0000 http://www.hindawi.com/journals/aurt/2012/652408/ We examined functional connectivity of the amygdala in preadolescent children with Autism Spectrum Disorders (ASDs) during spontaneous attention to eye-gaze in emotional faces. Children responded to a target word (“LEFT/RIGHT”) printed on angry or fearful faces looking in a direction that was congruent, incongruent, or neutral with the target word. Despite being irrelevant to the task, gaze-direction facilitated (Congruent > Neutral) or interfered with (Incongruent > Congruent) performance in both groups. Despite similar behavioral performance, amygdala-connectivity was atypical and more widespread in children with ASD. In control children, the amygdala was more strongly connected with an emotional cognitive control region (subgenual cingulate) during interference, while during facilitation, no regions showed greater amygdala connectivity than in ASD children. In contrast, in children with ASD the amygdala was more strongly connected to salience and cognitive control regions (posterior and dorsal cingulate) during facilitation and with regions involved in gaze processing (superior temporal sulcus), cognitive control (inferior frontal gyrus), and processing of viscerally salient information (pregenual cingulate, anterior insula, and thalamus) during interference. These findings showing more widespread connectivity of the amygdala extend past findings of atypical functional anatomy of eye-gaze processing in children with ASD and challenge views of general underconnectivity in ASD. Eric R. Murphy, Jennifer Foss-Feig, Lauren Kenworthy, William D. Gaillard, and Chandan J. Vaidya Copyright © 2012 Eric R. Murphy et al. All rights reserved. A Review of Complementary and Alternative Treatments for Autism Spectrum Disorders Wed, 28 Nov 2012 15:41:47 +0000 http://www.hindawi.com/journals/aurt/2012/870391/ Given the severe and chronic problems associated with Autism Spectrum Disorders (ASD) and the limitations of available treatments, there exists a large public health need for additional interventions. As more parents are inquiring about complementary and alternative treatments (CATs), both parents and practitioners require up-to-date information about them and whether and how to integrate them into treatment. After presenting data on CAT usage patterns for ASD, we review 13 ingestible (i.e., orally administered) and 6 noningestible (i.e., externally administered) CATs for ASD. For each CAT we briefly describe its definition; rationale for use; current research support, limitations, and future directions; safety issues; and whether we currently recommend, not recommend, or find it acceptable for the treatment of ASD. We conclude this paper with recommendations for future research and ten clinical recommendations for practitioners. Nicholas Lofthouse, Robert Hendren, Elizabeth Hurt, L. Eugene Arnold, and Eric Butter Copyright © 2012 Nicholas Lofthouse et al. All rights reserved. Telehealth for Expanding the Reach of Early Autism Training to Parents Thu, 22 Nov 2012 15:49:17 +0000 http://www.hindawi.com/journals/aurt/2012/121878/ Although there is consensus that parents should be involved in interventions designed for young children with autism spectrum disorder (ASD), parent participation alone does not ensure consistent, generalized gains in children’s development. Barriers such as costly intervention, time-intensive sessions, and family life may prevent parents from using the intervention at home. Telehealth integrates communication technologies to provide health-related services at a distance. A 12 one-hour per week parent intervention program was tested using telehealth delivery with nine families with ASD. The goal was to examine its feasibility and acceptance for promoting child learning throughout families’ daily play and caretaking interactions at home. Parents became skilled at using teachable moments to promote children’s spontaneous language and imitation skills and were pleased with the support and ease of telehealth learning. Preliminary results suggest the potential of technology for helping parents understand and use early intervention practices more often in their daily interactions with children. Laurie A. Vismara, Gregory S. Young, and Sally J. Rogers Copyright © 2012 Laurie A. Vismara et al. All rights reserved. What Works for You? Using Teacher Feedback to Inform Adaptations of Pivotal Response Training for Classroom Use Sun, 18 Nov 2012 17:45:16 +0000 http://www.hindawi.com/journals/aurt/2012/709861/ Several evidence-based practices (EBPs) have been identified as efficacious for the education of students with autism spectrum disorders (ASD). However, effectiveness research has rarely been conducted in schools and teachers express skepticism about the clinical utility of EBPs for the classroom. Innovative methods are needed to optimally adapt EBPs for community use. This study utilizes qualitative methods to identify perceived benefits and barriers of classroom implementation of a specific EBP for ASD, Pivotal Response Training (PRT). Teachers' perspectives on the components of PRT, use of PRT as a classroom intervention strategy, and barriers to the use of PRT were identified through guided discussion. Teachers found PRT valuable; however, they also found some components challenging. Specific teacher recommendations for adaptation and resource development are discussed. This process of obtaining qualitative feedback from frontline practitioners provides a generalizable model for researchers to collaborate with teachers to optimally promote EBPs for classroom use. Aubyn C. Stahmer, Jessica Suhrheinrich, Sarah Reed, and Laura Schreibman Copyright © 2012 Aubyn C. Stahmer et al. All rights reserved. Investigating the Relationship between Self-Injurious Behavior, Social Deficits, and Cooccurring Behaviors in Children and Adolescents with Autism Spectrum Disorder Wed, 07 Nov 2012 11:45:54 +0000 http://www.hindawi.com/journals/aurt/2012/156481/ Research suggests that self-injurious behavior (SIB) is related to social deficits and cooccurring problem behaviors in children and adolescents with autism spectrum disorder. A sample of 95 participants with ASD was assessed on presence and frequency of SIB (Behavior Problems Inventory), social deficits (the Matson Evaluation of Social Skills with Youngsters-II) and cooccurring problem behaviors (ASD-Comorbidity-Child version). A model was created and tested to explain the relationship between these variables. Results showed that the model was acceptable in presenting the relationships between these variables. This information could be used to help predict which individuals are at risk of developing further cooccurring behavioral problems and determine risk markers for the development of social deficits. Paul Waters and Olive Healy Copyright © 2012 Paul Waters and Olive Healy. All rights reserved. Facing Your Fears in Adolescence: Cognitive-Behavioral Therapy for High-Functioning Autism Spectrum Disorders and Anxiety Wed, 03 Oct 2012 18:03:03 +0000 http://www.hindawi.com/journals/aurt/2012/423905/ Adolescents with high-functioning autism spectrum disorders (ASDs) are at high risk for developing psychiatric symptoms, with anxiety disorders among the most commonly cooccurring. Cognitive behavior therapies (CBTs) are considered the best practice for treating anxiety in the general population. Modified CBT approaches for youth with high-functioning ASD and anxiety have resulted in significant reductions in anxiety following intervention. The purpose of the present study was to develop an intervention for treating anxiety in adolescents with ASD based on a CBT program designed for school-aged children. The Facing Your Fears-Adolescent Version (FYF-A) program was developed; feasibility and acceptability data were obtained, along with initial efficacy of the intervention. Twenty-four adolescents, aged 13–18, completed the FYF-A intervention. Results indicated significant reductions in anxiety severity and interference posttreatment, with low rates of anxiety maintained at 3-month follow-up. In addition, nearly 46% of teen participants met criteria for a positive treatment response on primary diagnosis following the intervention. Initial findings from the current study are encouraging and suggest that modified group CBT for adolescents with high-functioning ASD may be effective in reducing anxiety symptoms. Limitations include small sample size and lack of control group. Future directions are discussed. Judy Reaven, Audrey Blakeley-Smith, Eileen Leuthe, Eric Moody, and Susan Hepburn Copyright © 2012 Judy Reaven et al. All rights reserved. Visual Scanning Patterns during the Dimensional Change Card Sorting Task in Children with Autism Spectrum Disorder Thu, 20 Sep 2012 08:25:29 +0000 http://www.hindawi.com/journals/aurt/2012/123053/ Impaired cognitive flexibility in children with autism spectrum disorder (ASD) has been reported in previous literature. The present study explored ASD children’s visual scanning patterns during the Dimensional Change Card Sorting (DCCS) task using eye-tracking technique. ASD and typical developing (TD) children completed the standardized DCCS procedure on the computer while their eye movements were tracked. Behavioral results confirmed previous findings on ASD children’s deficits in executive function. ASD children’s visual scanning patterns also showed some specific underlying processes in the DCCS task compared to TD children. For example, ASD children looked shorter at the correct card in the postswitch phase and spent longer time at blank areas than TD children did. ASD children did not show a bias to the color dimension as TD children did. The correlations between the behavioral performance and eye moments were also discussed. Li Yi, Yubing Liu, Yunyi Li, Yuebo Fan, Dan Huang, and Dingguo Gao Copyright © 2012 Li Yi et al. All rights reserved. Safety and Observations in a Pilot Study of Lenalidomide for Treatment in Autism Tue, 11 Sep 2012 13:40:37 +0000 http://www.hindawi.com/journals/aurt/2012/291601/ Autism affects 1 : 88 children in the United States. Familial history of autoimmune disease, autoantibodies in the serum of mothers when there is more than one autistic offspring, and neuroglial response in CSF and brain tissue in autistic patients suggest an immunological variable may be associated with this condition. Lenalidomide has the potential to invoke changes in TNF-α with less toxicity than thalidomide. This pilot study evaluated lenalidomide at reduction of TNF-α and improvement of behavior and language in children with autism with elevated TNF-α. Subjects with elevated TNF-α were given 2.5 mgs lenalidomide daily for 12-weeks. Pharmacodynamics and safety was evaluated. Changes in language and autistic behaviors after six and twelve weeks were measured. Although statistical significance was not achieved for most measures, there were trends toward improvement. After 6-weeks, mean receptive language increased: 60.67 ± 12.06 to 65.00 ± 15.10 (P = 0.11) and symptoms of autism decreased (40.75 ± 5.96 versus 38.67 ± 7.90, P = 0.068). After 12-weeks, CSF-TNF-α declined 57% ± 25% from 80.5 ± 41.03 to 38.0 ± 31.27 (P = 0.068). Serum TNF-α declined 57% (92.50 ± 68.92 to 40.25 ± 44.53 (P = 0.048). This study suggests that lenalidomide is tolerated as a treatment by children with autism and should be further studied as a potential agent for cytockine inflammation. Michael Chez, Renee Low, Carol Parise, and Tammy Donnel Copyright © 2012 Michael Chez et al. All rights reserved. Autism: Where Genetics Meets the Immune System Wed, 05 Sep 2012 12:52:35 +0000 http://www.hindawi.com/journals/aurt/2012/486359/ Antonio M. Persico, Judy Van de Water, and Carlos A. Pardo Copyright © 2012 Antonio M. Persico et al. All rights reserved. Mood Disorders in Mothers of Children on the Autism Spectrum Are Associated with Higher Functioning Autism Wed, 15 Aug 2012 10:54:44 +0000 http://www.hindawi.com/journals/aurt/2012/435646/ Mood disorders occur more frequently in family members of individuals with autism spectrum disorders (ASD) than in the general population. There may be associations between maternal mood disorder history patterns and specific ASD phenotypes. We therefore examined the relationship between maternal mood disorders and child autism spectrum disorders in 998 mother-child dyads enrolled in a national online autism registry and database. Mothers of children with ASD completed online questionnaires addressing their child’s ASD as well as their own mood disorder history. In multivariate logistic regression models of ASD diagnoses, the odds of an Asperger disorder versus autistic disorder diagnosis were higher among those children whose mothers had a lifetime history of bipolar disorder (OR 2.11, CI 1.20, 3.69) or depression (OR 1.62, CI 1.19, 2.19). Further, maternal mood disorder onset before first pregnancy was associated with higher odds (OR 2.35, CI 1.48, 3.73) of an Asperger versus autism diagnosis among this sample of children with ASD. These data suggest that differences in maternal mood disorder history may be associated with ASD phenotype in offspring. Roma A. Vasa, Connie Anderson, Alison R. Marvin, Rebecca E. Rosenberg, J. Kiely Law, Julia Thorn, Geeta Sarphare, and Paul A. Law Copyright © 2012 Roma A. Vasa et al. All rights reserved. Dolphin-Assisted Therapy: Claims versus Evidence Tue, 24 Jul 2012 09:46:53 +0000 http://www.hindawi.com/journals/aurt/2012/839792/ The purpose of this paper is to review and critique studies that have been conducted on dolphin-assisted therapy for children with various disorders. Studies have been released claiming swimming with dolphins is therapeutic and beneficial for children with autism, attention deficit hyperactivity disorder, physical disabilities, and other psychological disorders. The majority of the studies conducted supporting the effectiveness of dolphin-assisted therapy have been found to have major methodological concerns making it impossible to draw valid conclusions. Readers will be informed of the history of, theory behind, and variations of dolphin-assisted therapy along with a review and critique of studies published which purportedly support its use. Britta L. Fiksdal, Daniel Houlihan, and Aaron C. Barnes Copyright © 2012 Britta L. Fiksdal et al. All rights reserved. Identification of Four Novel Synonymous Substitutions in the X-Linked Genes Neuroligin 3 and Neuroligin 4X in Japanese Patients with Autistic Spectrum Disorder Mon, 16 Jul 2012 18:29:29 +0000 http://www.hindawi.com/journals/aurt/2012/724072/ Mutations in the X-linked genes neuroligin 3 (NLGN3) and neuroligin 4X (NLGN4X) were first implicated in the pathogenesis of X-linked autism in Swedish families. However, reports of mutations in these genes in autism spectrum disorder (ASD) patients from various ethnic backgrounds present conflicting results regarding the etiology of ASD, possibly because of genetic heterogeneity and/or differences in their ethnic background. Additional mutation screening study on another ethnic background could help to clarify the relevance of the genes to ASD. We scanned the entire coding regions of NLGN3 and NLGN4X in 62 Japanese patients with ASD by polymerase chain reaction-high-resolution melting curve and direct sequencing analyses. Four synonymous substitutions, one in NLGN3 and three in NLGN4X, were identified in four of the 62 patients. These substitutions were not present in 278 control X-chromosomes from unrelated Japanese individuals and were not registered in the database of Single Nucleotide Polymorphisms build 132 or in the Japanese Single Nucleotide Polymorphisms database, indicating that they were novel and specific to ASD. Though further analysis is necessary to determine the physiological and clinical importance of such substitutions, the possibility of the relevance of both synonymous and nonsynonymous substitutions with the etiology of ASD should be considered. Kumiko Yanagi, Tadashi Kaname, Keiko Wakui, Ohiko Hashimoto, Yoshimitsu Fukushima, and Kenji Naritomi Copyright © 2012 Kumiko Yanagi et al. All rights reserved. The Development of Executive Function in Autism Thu, 05 Jul 2012 09:45:04 +0000 http://www.hindawi.com/journals/aurt/2012/146132/ Autism is a common and often highly debilitating neurodevelopmental condition, whose core behavioral features are believed to be rooted in disrupted neurocognitive processes, including especially “executive function.” Researchers have predominantly focused upon understanding the putative causal relationship between difficulties in EF and autistic symptomatology. This paper suggests, however, that the effects of individual differences in EF should be more far-reaching, playing a significant part in the real-life outcomes of individuals with autism, including their social competence, everyday adaptive behavior, and academic achievement. It further considers the nature of the EF-outcome relationship, including the possible determinants of individual differences in EF, and makes several recommendations for future research. Elizabeth Pellicano Copyright © 2012 Elizabeth Pellicano. All rights reserved. Is Autism a Member of a Family of Diseases Resulting from Genetic/Cultural Mismatches? Implications for Treatment and Prevention Tue, 26 Jun 2012 13:35:52 +0000 http://www.hindawi.com/journals/aurt/2012/910946/ Several lines of evidence support the view that autism is a typical member of a large family of immune-related, noninfectious, chronic diseases associated with postindustrial society. This family of diseases includes a wide range of inflammatory, allergic, and autoimmune diseases and results from consequences of genetic/culture mismatches which profoundly destabilize the immune system. Principle among these consequences is depletion of important components, particularly helminths, from the ecosystem of the human body, the human biome. Autism shares a wide range of features in common with this family of diseases, including the contribution of genetics/epigenetics, the identification of disease-inducing triggers, the apparent role of immunity in pathogenesis, high prevalence, complex etiologies and manifestations, and potentially some aspects of epidemiology. Fortunately, using available resources and technology, modern medicine has the potential to effectively reconstitute the human biome, thus treating or even avoiding altogether the consequences of genetic/cultural mismatches which underpin this entire family of disease. Thus, if indeed autism is an epidemic of postindustrial society associated with immune hypersensitivity, we can expect that the disease is readily preventable. Staci D. Bilbo, John P. Jones, and William Parker Copyright © 2012 Staci D. Bilbo et al. All rights reserved. Prenatal and Postnatal Epigenetic Programming: Implications for GI, Immune, and Neuronal Function in Autism Tue, 19 Jun 2012 17:44:09 +0000 http://www.hindawi.com/journals/aurt/2012/190930/ Although autism is first and foremost a disorder of the central nervous system, comorbid dysfunction of the gastrointestinal (GI) and immune systems is common, suggesting that all three systems may be affected by common molecular mechanisms. Substantial systemic deficits in the antioxidant glutathione and its precursor, cysteine, have been documented in autism in association with oxidative stress and impaired methylation. DNA and histone methylation provide epigenetic regulation of gene expression during prenatal and postnatal development. Prenatal epigenetic programming (PrEP) can be affected by the maternal metabolic and nutritional environment, whereas postnatal epigenetic programming (PEP) importantly depends upon nutritional support provided through the GI tract. Cysteine absorption from the GI tract is a crucial determinant of antioxidant capacity, and systemic deficits of glutathione and cysteine in autism are likely to reflect impaired cysteine absorption. Excitatory amino acid transporter 3 (EAAT3) provides cysteine uptake for GI epithelial, neuronal, and immune cells, and its activity is decreased during oxidative stress. Based upon these observations, we propose that neurodevelopmental, GI, and immune aspects of autism each reflect manifestations of inadequate antioxidant capacity, secondary to impaired cysteine uptake by the GI tract. Genetic and environmental factors that adversely affect antioxidant capacity can disrupt PrEP and/or PEP, increasing vulnerability to autism. Mostafa I. Waly, Mady Hornig, Malav Trivedi, Nathaniel Hodgson, Radhika Kini, Akio Ohta, and Richard Deth Copyright © 2012 Mostafa I. Waly et al. All rights reserved. Improving Psychiatric Hospital Care for Pediatric Patients with Autism Spectrum Disorders and Intellectual Disabilities Tue, 19 Jun 2012 17:17:12 +0000 http://www.hindawi.com/journals/aurt/2012/685053/ Pediatric patients with autism spectrum disorders (ASD) and/or intellectual disabilities (ID) are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children’s hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33%) and decreased average lengths of inpatient stay (as short as 26 days versus 45 days). Available data from a subset of patients (š‘›=43) in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes. Robin L. Gabriels, John A. Agnew, Carol Beresford, Mary Ann Morrow, Gary Mesibov, and Marianne Wamboldt Copyright © 2012 Robin L. Gabriels et al. All rights reserved. IGF1 as a Potential Treatment for Rett Syndrome: Safety Assessment in Six Rett Patients Wed, 13 Jun 2012 08:01:54 +0000 http://www.hindawi.com/journals/aurt/2012/679801/ Rett syndrome (RTT) is a devastating neurodevelopmental disorder that affects one in ten thousand girls and has no cure. The majority of RTT patients display mutations in the gene that codes for the methyl-CpG-binding protein 2 (MeCP2). Clinical observations and neurobiological analysis of mouse models suggest that defects in the expression of MeCP2 protein compromise the development of the central nervous system, especially synaptic and circuit maturation. Thus, agents that promote brain development and synaptic function, such as insulin-like growth factor 1 (IGF1), are good candidates for ameliorating the symptoms of RTT. IGF1 and its active peptide, (1–3) IGF1, cross the blood brain barrier, and (1–3) IGF1 ameliorates the symptoms of RTT in a mouse model of the disease; therefore they are ideal treatments for neurodevelopmental disorders, including RTT. We performed a pilot study to establish whether there are major risks associated with IGF1 administration in RTT patients. Six young girls with classic RTT received IGF1 subcutaneous injections twice a day for six months, and they were regularly monitored by their primary care physicians and by the unit for RTT in Versilia Hospital (Italy). This study shows that there are no risks associated with IGF1 administration. Giorgio Pini, Maria Flora Scusa, Laura Congiu, Alberto Benincasa, Paolina Morescalchi, Ilaria Bottiglioni, Pietro Di Marco, Paolo Borelli, Ubaldo Bonuccelli, Andrea Della-Chiesa, Adriele Prina-Mello, and Daniela Tropea Copyright © 2012 Giorgio Pini et al. All rights reserved. Meditation as a Potential Therapy for Autism: A Review Mon, 04 Jun 2012 10:06:19 +0000 http://www.hindawi.com/journals/aurt/2012/835847/ Autism is a chronic neurodevelopmental disorder of unknown cause that affects approximately 1–3 percent of children and four times more boys than girls. Its prevalence is global and its social impact is devastating. In autism, the brain is unable to process sensory information normally. Instead, simple stimuli from the outside world are experienced as overwhelmingly intense and strain the emotional centers of the brain. A stress response to the incoming information is initiated that destabilizes cognitive networks and short-circuits adequate behavioral output. As a result, the child is unable to respond adequately to stimulation and initiate social behavior towards family, friends, and peers. In addition, these children typically face immune-digestive disorders that heighten social fears, anxieties, and internal conflicts. While it is critical to treat the physical symptoms, it is equally vital to offer an evidence-based holistic solution that harmonizes both their emotional and physical well-being as they move from childhood into adult life. Here, we summarize evidence from clinical studies and neuroscience research that suggests that an approach built on yogic principles and meditative tools is worth pursuing. Desired outcomes include relief of clinical symptoms of the disease, greater relaxation, and facilitated expression of feelings and skills, as well as improved family and social quality of life. Sonia Sequeira and Mahiuddin Ahmed Copyright © 2012 Sonia Sequeira and Mahiuddin Ahmed. All rights reserved. Assessment and Treatment in Autism Spectrum Disorders: A Focus on Genetics and Psychiatry Thu, 31 May 2012 09:11:11 +0000 http://www.hindawi.com/journals/aurt/2012/242537/ Autism spectrum disorders (ASDs) are neurobehavioral disorders characterized by abnormalities in three behavioral domains including social interaction, impaired communication, and repetitive stereotypic behaviors. ASD affects approximately 1% of children and is on the rise with significant genetic mechanisms underlying these disorders. We review the current understanding of the role of genetic and metabolic factors contributing to ASD with the use of new genetic technology. Fifty percent is diagnosed with chromosomal abnormalities, small DNA deletions/duplications, single-gene conditions, or metabolic disturbances. Genetic evaluation is discussed along with psychiatric treatment and approaches for selection of medication to treat associated challenging behaviors or comorbidities seen in ASD. We emphasize the importance of prioritizing treatment based on target symptom clusters and in what order for individuals with ASD, as the treatment may vary from patient to patient. Merlin G. Butler, Erin L. Youngs, Jennifer L. Roberts, and Jessica A. Hellings Copyright © 2012 Merlin G. Butler et al. All rights reserved. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review Thu, 31 May 2012 08:57:05 +0000 http://www.hindawi.com/journals/aurt/2012/104317/ Young children with fragile X syndrome (FXS) often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL) for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC) scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD) was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99) and from 12 to 50 months (mean 29.94, SD 8.64) for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (š‘ƒ<0.0001 and š‘ƒ=0.0071, resp.). This data supports the need for a controlled trial of sertraline treatment in young children with FXS. Tri Indah Winarni, Weerasak Chonchaiya, Evan Adams, Jacky Au, Yi Mu, Susan M. Rivera, Danh V. Nguyen, and Randi J. Hagerman Copyright © 2012 Tri Indah Winarni et al. All rights reserved. Gait Symmetry in Children with Autism Sun, 20 May 2012 15:06:12 +0000 http://www.hindawi.com/journals/aurt/2012/576478/ Most studies examining gait asymmetry have focused on infants and toddlers and have tended to use subjective methods of evaluating movement. No previous studies have examined gait symmetry in older children with autism using objective motion capture systems. The purpose of this paper was to quantify gait symmetry in children with autism versus age-matched controls. Fourteen children with autism (š‘=14) and twenty-two (š‘=22) age, height, and weight-matched controls participated in the study. An eight camera Vicon motion capture system and four Kistler force plates were used to compute temporal-spatial parameters and symmetry indices during walking. Group differences in these measures were tested using MANOVAs. No significant differences between the autism and control group were found for any of the temporal-spatial measures or symmetry indices. Therefore, results suggest that children with autism demonstrate typical symmetry or interlimb movement during gait. Further research is needed to examine the use of different gait inputs to the symmetry indices (e.g., joint angles and moments). A greater awareness of the movement patterns associated with autism may increase our understanding of this disorder and have important implications for treatment planning. Victoria L. Chester and Matthew Calhoun Copyright © 2012 Victoria L. Chester and Matthew Calhoun. All rights reserved. Meta-Analysis of Studies Incorporating the Interests of Young Children with Autism Spectrum Disorders into Early Intervention Practices Mon, 14 May 2012 14:36:24 +0000 http://www.hindawi.com/journals/aurt/2012/462531/ Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus nonintervention conditions and high-interest versus low-interest contrasts indicated that interest-based intervention practices were effective in terms of increasing prosocial and decreasing aberrant child behavior. Additionally, interest-based interventions that focused on two of the three core features of autism spectrum disorders (poor communication, poor interpersonal relationships) were found most effective in influencing child outcomes. Implications for very early intervention are discussed in terms addressing the behavior markers of autism spectrum disorders before they become firmly established. Carl J. Dunst, Carol M. Trivette, and Deborah W. Hamby Copyright © 2012 Carl J. Dunst et al. All rights reserved. Looking through the Same Eyes? Do Teachers’ Participation Ratings Match with Ratings of Students with Autism Spectrum Conditions in Mainstream Schools? Tue, 08 May 2012 11:27:41 +0000 http://www.hindawi.com/journals/aurt/2012/656981/ To create an inclusive classroom and act accordingly, teachers’ understanding of the experiences of participation of students with autism spectrum conditions (ASCs) is crucial. This understanding may depend on the teachers’ professional experiences, support and personal interests. The aim of the present questionnaire study was to investigate how well the teachers’ ratings of their students with ASCs’ perception of participation matched with the students’ own ratings. Furthermore, possible correlations between the accuracy of teachers’ ratings and the teachers’ self-reported professional experience, support (including support-staff), and personal interest were investigated. Teachers’ ratings were also used to examine how their understandings correlated with classroom actions. The agreements between teachers’ and students’ ratings were moderate to high, and the ability to attune to the students’ perception of participation was not affected by the presence of a support-staff. The teachers’ personal interest in teaching students with ASC correlated with their accuracy, suggesting that this is a factor to consider when planning for successful placements in mainstream schools. Teachers’ understandings of the students with ASCs’ perception of being bullied or unpopular correlated with implementation of activities to improve the attitudes of classmates, but not with actions to enhance social relations for the students with ASC. Marita Falkmer, Richard Parsons, and Mats Granlund Copyright © 2012 Marita Falkmer et al. All rights reserved. Social Competence Intervention for Parents (SCI-P): Comparing Outcomes for a Parent Education Program Targeting Adolescents with ASD Wed, 18 Apr 2012 14:37:55 +0000 http://www.hindawi.com/journals/aurt/2012/681465/ Research has shown that parent education programs can address some of the distinct challenges that parents of youth with autism spectrum disorders (ASDs) encounter. This study examined the effectiveness of the Social Competence Intervention for Parents (SCI-P), a parent education program, administered in conjunction with a social competence intervention that targeted youth with ASD ages 11–14 (SCI-A). Using a quasi-experimental pre-post design, parents were assigned to either the SCI-P group (š‘›=16) or to the waitlist comparison group (š‘›=10). Analyses of covariance (ANCOVAs) revealed a significant effect for parent education participation such that SCI-P participants experienced significantly greater reductions in levels of stress and a trend for increases in parenting sense of competence from pre- to post-intervention. Moreover, parents in the SCI-P group reported high satisfaction with the program. These findings suggest that parent education can result in positive outcomes for parents’ well being. Tia R. Schultz, Janine P. Stichter, Melissa J. Herzog, Stephanie D. McGhee, and Kristin Lierheimer Copyright © 2012 Tia R. Schultz et al. All rights reserved. Experiences of Siblings of Individuals with Autism Spectrum Disorders Tue, 10 Apr 2012 16:03:47 +0000 http://www.hindawi.com/journals/aurt/2012/949586/ The purpose of this study was to explore the experiences of siblings of individuals with autism spectrum disorders (ASDs) and identify their self-reported support needs. We conducted in-person semi-structured interviews with 12 siblings aged 7 to 15 of children aged 6 to 15 with ASDs. Employing a qualitative collective case study research method, we conducted cross-case analyses to address our research questions. Three major themes emerged: (a) descriptions of the sibling subsystem (b) cohesion between and among the siblings, and (c) adaptability of the participant siblings to having family members with ASDs. Discussion of these findings and recommendations for future research contributes to the existing literature on siblings of children with disabilities. Maureen E. Angell, Hedda Meadan, and Julia B. Stoner Copyright © 2012 Maureen E. Angell et al. All rights reserved. Unique Theory of Mind Differentiation in Children with Autism and Asperger Syndrome Thu, 05 Apr 2012 08:45:32 +0000 http://www.hindawi.com/journals/aurt/2012/505393/ This study was designed to determine if ToM abilities of children with autism and Asperger syndrome differentiate into Intrapersonal ToM and Social ToM. A battery of Social and Intrapersonal ToM tasks was administered to 39 children with autism and 34 children with Asperger syndrome. For both groups of children, ToM differentiated and Intrapersonal ToM was stronger than Social ToM. This asymmetry was greater for children with autism, whose Social ToM was especially weak. These results support a differentiated, as opposed to integrated, ToM. Moreover, the findings provide a more thorough understanding of the cognitive abilities associated with autism and Asperger syndrome. Michele Tine and Joan Lucariello Copyright © 2012 Michele Tine and Joan Lucariello. All rights reserved. Visual Scanning in Very Young Children with Autism and Their Unaffected Parents Mon, 26 Mar 2012 11:43:49 +0000 http://www.hindawi.com/journals/aurt/2012/748467/ This study of gaze patterns in very young children with autism and their parents included 23 cases (with 16 fathers and 19 mothers) and 46 controls (with 14 fathers and 28 mothers). Children (mean age 3.3±1.5 years) with autism met DSM-IV and ADOS-G diagnostic criteria. The participants’ gaze patterns were recorded while they viewed four simple movies that did not feature people. In children, severity of autism is related to spending more time watching irrelevant regions in one of the four movies. The mothers of children with autism showed an atypical pattern for three movies, whereas the fathers of children with autism did not show an atypical gaze pattern. The gaze pattern of the mothers was positively correlated with that of their children. The atypical viewing pattern of autistic individuals appears not to be restricted to people and social situations but is also seen in other situations, suggesting that there is a perceptual broad autism phenotype. Wouter B. Groen, Nanda Rommelse, Tessa de Wit, Marcel P. Zwiers, Desley van Meerendonck, Rutger Jan van der Gaag, and Jan K. Buitelaar Copyright © 2012 Wouter B. Groen et al. All rights reserved.