Autism Research and Treatment http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. What Do Parents Think about Chromosomal Microarray Testing? A Qualitative Report from Parents of Children with Autism Spectrum Disorders Mon, 20 Jun 2016 14:29:22 +0000 http://www.hindawi.com/journals/aurt/2016/6852539/ Background. Chromosomal Microarray Analysis (CMA) is increasingly utilized to detect copy number variants among children and families affected with autism spectrum disorders (ASD). However, CMA is controversial due to possible ambiguous test findings, uncertain clinical implications, and other social and legal issues related to the test. Methods. Participants were parents of children with ASD residing in the North Eastern region of North Carolina, USA. We conducted individual, face-to-face interviews with 45 parents and inquired about their perceptions of CMA. Results. Three major themes dominated parents’ perceptions of CMA. None of the parents had ever heard of the test before and the majority of the parents postulated positive attitudes toward the test. Parents’ motivations in undergoing the test were attributed to finding a potential cause of ASD, to being better prepared for having another affected child, and to helping with future reproductive decisions. Perceived barriers included the cost of testing, risk/pain of CMA testing, and fear of test results. Conclusion. This study contributes to the understanding of psychosocial aspects and cultural influences towards adoption of genetic testing for ASD in clinical practice. Genetic education can aid informed decision-making related to CMA genetic testing among parents of children with ASD. Lei Xu, Linda Crane Mitchell, Alice R. Richman, and Kaitlyn Clawson Copyright © 2016 Lei Xu et al. All rights reserved. Calcium and Vitamin D Supplement Prescribing Practices among Providers Caring for Children with Autism Spectrum Disorders: Are We Addressing Bone Health? Sun, 06 Mar 2016 13:13:10 +0000 http://www.hindawi.com/journals/aurt/2016/6763205/ Children with autism spectrum disorders (ASD) have several risk factors for low bone mineral density. The gluten-free, casein-free (GFCF) diet is a complementary therapy sometimes used in ASD that raises concerns for the adequacy of calcium and vitamin D intake. This study evaluated the prescribing practices of calcium and vitamin D supplements and the practice of checking 25-hydroxy vitamin D (25(OH)D) levels by providers in 100 children with ASD, 50 of whom were on the GFCF diet. Fifty-two percent and 46% of children on the GFCF diet were on some form of vitamin D and calcium supplements, respectively, compared to 18% and 14% of those not on this diet. Twenty-four percent of children in the GFCF group had a documented 25(OH)D level compared to none in the non-GFCF group. The data highlight a gap in calcium and vitamin D supplement prescribing practices among providers caring for children with ASD as well as a gap in the practice of checking 25(OH)D levels. Shylaja Srinivasan, Julia O’Rourke, Sara Bersche Golas, Ann Neumeyer, and Madhusmita Misra Copyright © 2016 Shylaja Srinivasan et al. All rights reserved. The Association between Adult Participation and the Engagement of Preschoolers with ASD Wed, 24 Feb 2016 16:14:43 +0000 http://www.hindawi.com/journals/aurt/2016/6029837/ The ability for a child to engage in the classroom is associated with better academic outcomes. Yet, there is limited information on how child characteristics of autism and adult behavior impact engagement. This study examined (1) the pattern of adult participation and child engagement in preschool classrooms that serve children with ASD, (2) the associations between child engagement and adult participation, and (3) how characteristics of ASD (autism severity, language ability, and challenging behavior) moderate the relationship between adult participation and child engagement. Overall, children were less likely to be engaged when adults were actively or passively participating with them. Moderators impacted this relationship. Children with higher levels of autism severity were more likely to be engaged when adults were actively or passively participating with them. Similarly, children with lower language abilities were more likely to be engaged when adults were actively or passively participating with them. Finally, children with higher levels of challenging behaviors were less likely to be engaged when adults were actively or passively participating with them. These findings have important implications for how adults can best support the engagement of children with ASD. Ann M. Sam, Stephanie S. Reszka, Brian A. Boyd, Yi Pan, Kara Hume, and Samuel L. Odom Copyright © 2016 Ann M. Sam et al. All rights reserved. Factor Structure, Internal Consistency, and Screening Sensitivity of the GARS-2 in a Developmental Disabilities Sample Mon, 15 Feb 2016 07:07:02 +0000 http://www.hindawi.com/journals/aurt/2016/8243079/ The Gilliam Autism Rating Scale-Second Edition (GARS-2) is a widely used screening instrument that assists in the identification and diagnosis of autism. The purpose of this study was to examine the factor structure, internal consistency, and screening sensitivity of the GARS-2 using ratings from special education teaching staff for a sample of 240 individuals with autism or other significant developmental disabilities. Exploratory factor analysis yielded a correlated three-factor solution similar to that found in 2005 by Lecavalier for the original GARS. Though the three factors appeared to be reasonably consistent with the intended constructs of the three GARS-2 subscales, the analysis indicated that more than a third of the GARS-2 items were assigned to the wrong subscale. Internal consistency estimates met or exceeded standards for screening and were generally higher than those in previous studies. Screening sensitivity was .65 and specificity was .81 for the Autism Index using a cut score of 85. Based on these findings, recommendations are made for instrument revision. Martin A. Volker, Elissa H. Dua, Christopher Lopata, Marcus L. Thomeer, Jennifer A. Toomey, Audrey M. Smerbeck, Jonathan D. Rodgers, Joshua R. Popkin, Andrew T. Nelson, and Gloria K. Lee Copyright © 2016 Martin A. Volker et al. All rights reserved. An Analysis of Canadian Institute for Health Research Funding for Research on Autism Spectrum Disorder Wed, 10 Feb 2016 09:33:47 +0000 http://www.hindawi.com/journals/aurt/2016/8106595/ We examined patterns of Canadian Institute for Health Research (CIHR) funding on autism spectrum disorder (ASD) research. From 1999 to 2013, CIHR funded 190 ASD grants worth $48 million. Biomedical research received 43% of grants (46% of dollars), clinical research 27% (41%), health services 10% (7%), and population health research 8% (3%). The greatest number of grants was given in 2009, but 2003 saw the greatest amount. Funding is clustered in a handful of provinces and institutions, favouring biomedical research and disfavouring behavioural interventions, adaptation, and institutional response. Preference for biomedical research may be due to the detriment of clinical research. R. Deonandan, E. Y. Liu, B. Kolisnyk, and A. T. M. Konkle Copyright © 2016 R. Deonandan et al. All rights reserved. Illness Severity, Social and Cognitive Ability, and EEG Analysis of Ten Patients with Rett Syndrome Treated with Mecasermin (Recombinant Human IGF-1) Tue, 26 Jan 2016 13:54:45 +0000 http://www.hindawi.com/journals/aurt/2016/5073078/ Rett Syndrome (RTT) is a severe neurodevelopmental disorder characterized by an apparently normal development followed by an arrest and subsequent regression of cognitive and psychomotor abilities. At present, RTT has no definitive cure and the treatment of RTT represents a largely unmet clinical need. Following partial elucidation of the underlying neurobiology of RTT, a new treatment has been proposed, Mecasermin (recombinant human Insulin-Like Growth Factor 1), which, in addition to impressive evidence from preclinical murine models of RTT, has demonstrated safety in human studies of patients with RTT. The present clinical study examines the disease severity as assessed by clinicians (International Scoring System: ISS), social and cognitive ability assessed by two blinded, independent observers (RSS: Rett Severity Score), and changes in brain activity (EEG) parameters of ten patients with classic RTT and ten untreated patients matched for age and clinical severity. Significant improvement in both the ISS () and RSS () was found in patients treated with IGF1 in comparison to untreated patients. Analysis of the novel RSS also suggests that patients treated with IGF1 have a greater endurance to social and cognitive testing. The present clinical study adds significant preliminary evidence for the use of IGF-1 in the treatment of RTT and other disorders of the autism spectrum. Giorgio Pini, Laura Congiu, Alberto Benincasa, Pietro DiMarco, Stefania Bigoni, Adam H. Dyer, Niall Mortimer, Andrea Della-Chiesa, Sean O’Leary, Rachel McNamara, Kevin J. Mitchell, Michael Gill, and Daniela Tropea Copyright © 2016 Giorgio Pini et al. All rights reserved. Theory of Mind Indexes the Broader Autism Phenotype in Siblings of Children with Autism at School Age Sun, 10 Jan 2016 09:54:34 +0000 http://www.hindawi.com/journals/aurt/2016/6309189/ Subclinical variants of the social-communicative challenges and rigidity that define autism spectrum disorder (ASD) are known as the broader autism phenotype (BAP). The BAP has been conceptualized categorically (as specific to a subset of relatives of individuals with ASD) and dimensionally (as continuously distributed within the general population). The current study examined the compatibility of these two approaches by assessing associations among autism symptoms and social-communicative skills in young school-age children with ASD, children who have a sibling with ASD, and children without a sibling with ASD. Autism symptoms were associated with reduced Theory of Mind (ToM), adaptive skills, cognitive empathy, and language skills across the full sample. Reduced ToM was a core aspect of the BAP in the current sample regardless of whether the BAP was defined categorically (in terms of siblings of children with ASD who exhibited atypical developmental) or dimensionally (in terms of associations with autism symptoms across the entire sample). Early language skills predicted school-age ToM. Findings support the compatibility of categorical and dimensional approaches to the BAP, highlight reduced ToM as a core aspect of the school-age BAP, and suggest that narrative-based approaches to promoting ToM may be beneficial for siblings of children with ASD. Tawny Tsang, Kristen Gillespie-Lynch, and Ted Hutman Copyright © 2016 Tawny Tsang et al. All rights reserved. Neural Mechanisms Involved in Hypersensitive Hearing: Helping Children with ASD Who Are Overly Sensitive to Sounds Mon, 28 Dec 2015 09:26:41 +0000 http://www.hindawi.com/journals/aurt/2015/369035/ Professionals working with children diagnosed with autism spectrum disorder (ASD) may find that these children are overly sensitive to sounds. These professionals are often concerned as to why children may have auditory hypersensitivities. This review article discusses the neural mechanisms identified underlying hypersensitive hearing in people. The authors focus on brain research to support the idea of the nonclassical auditory pathways being involved in connecting the auditory system with the emotional system of the brain. The authors also discuss brain mechanisms felt to be involved in auditory hypersensitivity. The authors conclude with a discussion of some treatments for hypersensitive hearing. These treatments include desensitization training and the use of listening therapies such as The Listening Program. Jay R. Lucker and Alex Doman Copyright © 2015 Jay R. Lucker and Alex Doman. All rights reserved. The Effects of Rhythm and Robotic Interventions on the Imitation/Praxis, Interpersonal Synchrony, and Motor Performance of Children with Autism Spectrum Disorder (ASD): A Pilot Randomized Controlled Trial Thu, 17 Dec 2015 09:24:24 +0000 http://www.hindawi.com/journals/aurt/2015/736516/ We assessed the effects of three interventions, rhythm, robotic, and standard-of-care, on the imitation/praxis, interpersonal synchrony, and overall motor performance of 36 children with Autism Spectrum Disorder (ASD) between 5 and 12 years of age. Children were matched on age, level of functioning, and services received, prior to random assignment to one of the three groups. Training was provided for 8 weeks with 4 sessions provided each week. We assessed generalized changes in motor skills from the pretest to the posttest using a standardized test of motor performance, the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2). We also assessed training-specific changes in imitation/praxis and interpersonal synchrony during an early and a late session. Consistent with the training activities practiced, the rhythm and robot groups improved on the body coordination composite of the BOT-2, whereas the comparison group improved on the fine manual control composite of the BOT-2. All three groups demonstrated improvements in imitation/praxis. The rhythm and robot groups also showed improved interpersonal synchrony performance from the early to the late session. Overall, socially embedded movement-based contexts are valuable in promoting imitation/praxis, interpersonal synchrony, and motor performance and should be included within the standard-of-care treatment for children with ASD. Sudha M. Srinivasan, Maninderjit Kaur, Isabel K. Park, Timothy D. Gifford, Kerry L. Marsh, and Anjana N. Bhat Copyright © 2015 Sudha M. Srinivasan et al. All rights reserved. Video Game Playing Effects on Obesity in an Adolescent with Autism Spectrum Disorder: A Case Study Thu, 10 Dec 2015 14:19:37 +0000 http://www.hindawi.com/journals/aurt/2015/128365/ Adolescent obesity has tripled in the past two decades, and adolescents with disabilities, specifically autism spectrum disorders (ASD), may be at greater risk for obesity due to the behavioral, physical, and psychosocial complications related to their disorder. This case study reports the effects of video game playing on an obese adolescent with ASD and illustrates the use of a multiple baseline single subject design. Over 12 weeks, the participant played inactive (6 weeks) and active video games (6 weeks) on the Wii console. Physiological data were evaluated weekly at home. Stress and anxiety were measured via the Stress Survey Schedule for Individuals with Autism and Other Pervasive Non-Developmental Disorders (SSS) and the Behavior Assessment System for Children Second Edition (BASC-2) pre- and postintervention. The Therapy Attitude Inventory (TAI) was used to determine parental perception of video game playing as a socially valid intervention to reduce stress and anxiety. Results demonstrated that active video game playing slowed and/or reduced weight and BMI with minimal changes to waist-to-hip ratios, triceps skinfolds, and stress and anxiety. This study demonstrates how alternative methods for physical activity may be used to improve health outcomes of overweight/obese adolescents with ASD and suggests directions for future research. Brandy E. Strahan and Jennifer H. Elder Copyright © 2015 Brandy E. Strahan and Jennifer H. Elder. All rights reserved. Characteristics of Two-Year College Students on the Autism Spectrum and Their Support Services Experiences Sun, 15 Nov 2015 08:21:35 +0000 http://www.hindawi.com/journals/aurt/2015/391693/ Approximately 80% of college-going youth with autism in the US attend a 2-year college at some point. These community-based, universally accessible institutions offer both academic and vocational courses and have experience in teaching diverse learners. This study used nationally representative survey data from the National Longitudinal Transition Study-2 to describe the characteristics and services experiences of adults with autism who attended postsecondary education after high school, focusing on those who attended a 2-year college. Over 60% of those who attended 2-year colleges had little to no trouble conversing or performing functional skills like counting change during high school, and extracurricular participation was common (93.8%). Most 2-year college attenders (85.7%) were able to navigate to places outside the home versus 43.9% of those with no postsecondary education. Over half took vocational courses at 2-year colleges, while one-quarter pursued academic study. Less than half (48.6%) of those who disclosed their disability to the school reported receiving services, accommodations, or other help. Most (87.3%) felt they received enough help, but fewer (68.0%) felt the services they received were useful. Future research should delineate specific needs of students with autism in 2-year college settings and identify what supports are needed to improve persistence and completion rates. Anne M. Roux, Paul T. Shattuck, Jessica E. Rast, Julianna A. Rava, Amy D. Edwards, Xin Wei, Mary McCracken, and Jennifer W. Yu Copyright © 2015 Anne M. Roux et al. All rights reserved. Parenting Behavior in Mothers of Preschool Children with ASD: Development of a Self-Report Questionnaire Thu, 29 Oct 2015 13:54:14 +0000 http://www.hindawi.com/journals/aurt/2015/381236/ Parents of young children with autism spectrum disorder (ASD) encounter many daily challenges and often experience much stress. However, little research exists about parenting behavior among these parents. With this study, we aim to address this gap. We examined the structure and internal consistency of a questionnaire intended to measure parenting behavior among mothers of young children with ASD. Furthermore, we compared parenting behavior among mothers of young children with and without ASD between two and six years old. Factor analyses resulted in a factor solution with seven subscales of parenting behavior. Two additional subscales especially relevant for parenting preschoolers with ASD were also considered. Analyses of covariance, controlling for gender and age, showed significantly higher scores for Discipline and Stimulating the Development in the control group in comparison with the ASD group. These findings suggest that mothers of preschoolers with ASD are still trying to find strategies to guide and stimulate their child’s behavior and development effectively. Greet Lambrechts, Jarymke Maljaars, Hannah Boonen, Lotte van Esch, Karla Van Leeuwen, and Ilse Noens Copyright © 2015 Greet Lambrechts et al. All rights reserved. About Face: Evaluating and Managing Tactile Impairment at the Time of Autism Diagnosis Wed, 28 Oct 2015 08:49:21 +0000 http://www.hindawi.com/journals/aurt/2015/612507/ Evaluation for sensory impairment is a routine part of autism diagnosis. Sensory impairment of hearing, vision, or touch results in developmental delay and must be addressed before delay can resolve. Recent studies confirm that tactile impairment is present in autism and can be effectively treated with a tactile stimulation protocol. The research suggests a change in management at the time of autism diagnosis to include evaluation and treatment of tactile impairment. Here we validate screening and management tool for tactile impairment, the Autism Touch and Self-Regulation Checklist, in 404 typical and autistic preschool children. The tool assesses tactile impairment by location and severity. Autistic children were distinguished by mixed pain and numbness on multiple areas including the face and mouth (). Oral-facial tactile impairment interferes with the tactile stimulus to orienting. We hypothesized that oral-facial tactile impairment and difficulty orienting are predictive of ASD and that severity of tactile impairment is predictive of severity of ASD. Questions evaluating oral-facial and orienting responses correctly predicted 91% of the autism group. Severity of tactile impairment correctly predicted 81% of mild versus severe ASD. Results underscore the importance of evaluating and treating tactile impairment at the time of autism diagnosis. Louisa M. T. Silva, Mark Schalock, and Kristen R. Gabrielsen Copyright © 2015 Louisa M. T. Silva et al. All rights reserved. Gaze Behavior of Children with ASD toward Pictures of Facial Expressions Tue, 19 May 2015 09:09:34 +0000 http://www.hindawi.com/journals/aurt/2015/617190/ Atypical gaze behavior in response to a face has been well documented in individuals with autism spectrum disorders (ASDs). Children with ASD appear to differ from typically developing (TD) children in gaze behavior for spoken and dynamic face stimuli but not for nonspeaking, static face stimuli. Furthermore, children with ASD and TD children show a difference in their gaze behavior for certain expressions. However, few studies have examined the relationship between autism severity and gaze behavior toward certain facial expressions. The present study replicated and extended previous studies by examining gaze behavior towards pictures of facial expressions. We presented ASD and TD children with pictures of surprised, happy, neutral, angry, and sad facial expressions. Autism severity was assessed using the Childhood Autism Rating Scale (CARS). The results showed that there was no group difference in gaze behavior when looking at pictures of facial expressions. Conversely, the children with ASD who had more severe autistic symptomatology had a tendency to gaze at angry facial expressions for a shorter duration in comparison to other facial expressions. These findings suggest that autism severity should be considered when examining atypical responses to certain facial expressions. Soichiro Matsuda, Yasuyo Minagawa, and Junichi Yamamoto Copyright © 2015 Soichiro Matsuda et al. All rights reserved. Gait Deviations in Children with Autism Spectrum Disorders: A Review Thu, 02 Apr 2015 18:23:20 +0000 http://www.hindawi.com/journals/aurt/2015/741480/ In recent years, it has become clear that children with autism spectrum disorders (ASDs) have difficulty with gross motor function and coordination, factors which influence gait. Knowledge of gait abnormalities may be useful for assessment and treatment planning. This paper reviews the literature assessing gait deviations in children with ASD. Five online databases were searched using keywords “gait” and “autism,” and 11 studies were found which examined gait in childhood ASD. Children with ASD tend to augment their walking stability with a reduced stride length, increased step width and therefore wider base of support, and increased time in the stance phase. Children with ASD have reduced range of motion at the ankle and knee during gait, with increased hip flexion. Decreased peak hip flexor and ankle plantar flexor moments in children with ASD may imply weakness around these joints, which is further exhibited by a reduction in ground reaction forces at toe-off in children with ASD. Children with ASD have altered gait patterns to healthy controls, widened base of support, and reduced range of motion. Several studies refer to cerebellar and basal ganglia involvement as the patterns described suggest alterations in those areas of the brain. Further research should compare children with ASD to other clinical groups to improve assessment and treatment planning. Deirdre Kindregan, Louise Gallagher, and John Gormley Copyright © 2015 Deirdre Kindregan et al. All rights reserved. Parent-Child Agreement Using the Spence Children’s Anxiety Scale and a Thermometer in Children with Autism Spectrum Disorder Thu, 02 Apr 2015 07:36:09 +0000 http://www.hindawi.com/journals/aurt/2015/315495/ Children with Autism Spectrum Disorder (ASD) experience high anxiety which often prompts clinical referral and requires intervention. This study aimed to compare parent and child reports on the Spence Children’s Anxiety Scale (SCAS) and a child-reported “worry thermometer” in 88 children aged 8–13 years, 44 with ASD and 44 age, gender, and perceptual IQ matched typically developing children. There were no gender differences in child report on the SCAS and worry thermometers. Results indicated generally good correlations between parent and child self-reported SCAS symptoms for typically developing children but poor agreement in parent-child ASD dyads. The worry thermometer child-report did not reflect child or parent reports on the SCAS. Findings suggest 8–13-year-old children with ASD may have difficulties accurately reporting their anxiety levels. The clinical implications were discussed. T. May, K. Cornish, and N. J. Rinehart Copyright © 2015 T. May et al. All rights reserved. Early Intervention with a Parent-Delivered Massage Protocol Directed at Tactile Abnormalities Decreases Severity of Autism and Improves Child-to-Parent Interactions: A Replication Study Tue, 24 Mar 2015 07:43:36 +0000 http://www.hindawi.com/journals/aurt/2015/904585/ Tactile abnormalities are severe and universal in preschool children with autism. They respond well to treatment with a daily massage protocol directed at tactile abnormalities (QST massage for autism). Treatment is based on a model for autism proposing that tactile impairment poses a barrier to development. Two previous randomized controlled trials evaluating five months of massage treatment reported improvement of behavior, social/communication skills, and tactile and other sensory symptoms. This is the first report from a two-year replication study evaluating the protocol in 103 preschool children with autism. Parents gave daily treatment; trained staff gave weekly treatment and parent support. Five-month outcomes replicated earlier studies and showed normalization of receptive language (18%, ), autistic behavior (32%, ), total sensory abnormalities (38%, ), tactile abnormalities (49%, ), and decreased autism severity (medium to large effect size, ). In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, ). Early childhood special education programs are tasked with addressing sensory abnormalities and engaging parents in effective home programs. Until now, they have lacked research-based methods to do so. This program fulfills the need. It is recommended to parents and ECSE programs (ages 3–5) at autism diagnosis. Louisa M. T. Silva, Mark Schalock, Kristen R. Gabrielsen, Sarojini S. Budden, Martha Buenrostro, and Gretchen Horton Copyright © 2015 Louisa M. T. Silva et al. All rights reserved. Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria Mon, 23 Mar 2015 12:21:57 +0000 http://www.hindawi.com/journals/aurt/2015/892301/ Autism is a neurodevelopmental disorder with serious implications in childhood. There is a significant gap in the identification and provision of health and social services for autism in Africa. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes. A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants) attending an annual scientific meeting in northwest Nigeria. Other parameters assessed were sociodemographic and professional characteristics of the participants and challenges encountered in the management of autism. Out of 175 questionnaires distributed, 167 (95.4%) were returned. Good knowledge (KCAHW score ≥15) was significantly associated with being a paediatrician or psychiatrist and practicing in a tertiary health facility (), while poor knowledge (KCAHW score <15) was significant among general practitioners (). The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4) while the least was concerning communication impairments (KCAHW Domain 2). Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism. E. E. Eseigbe, F. T. Nuhu, T. L. Sheikh, P. Eseigbe, K. A. Sanni, and V. O. Olisah Copyright © 2015 E. E. Eseigbe et al. All rights reserved. Preliminary Efficacy of Adapted Responsive Teaching for Infants at Risk of Autism Spectrum Disorder in a Community Sample Sun, 11 Jan 2015 06:33:21 +0000 http://www.hindawi.com/journals/aurt/2015/386951/ This study examined the (a) feasibility of enrolling 12-month-olds at risk of ASD from a community sample into a randomized controlled trial, (b) subsequent utilization of community services, and (c) potential of a novel parent-mediated intervention to improve outcomes. The First Year Inventory was used to screen and recruit 12-month-old infants at risk of ASD to compare the effects of 6–9 months of Adapted Responsive Teaching (ART) versus referral to early intervention and monitoring (REIM). Eighteen families were followed for ~20 months. Assessments were conducted before randomization, after treatment, and at 6-month follow-up. Utilization of community services was highest for the REIM group. ART significantly outperformed REIM on parent-reported and observed measures of child receptive language with good linear model fit. Multiphase growth models had better fit for more variables, showing the greatest effects in the active treatment phase, where ART outperformed REIM on parental interactive style (less directive), child sensory responsiveness (less hyporesponsive), and adaptive behavior (increased communication and socialization). This study demonstrates the promise of a parent-mediated intervention for improving developmental outcomes for infants at risk of ASD in a community sample and highlights the utility of earlier identification for access to community services earlier than standard practice. Grace T. Baranek, Linda R. Watson, Lauren Turner-Brown, Samuel H. Field, Elizabeth R. Crais, Linn Wakeford, Lauren M. Little, and J. Steven Reznick Copyright © 2015 Grace T. Baranek et al. All rights reserved. Temporal Synchrony Detection and Associations with Language in Young Children with ASD Mon, 29 Dec 2014 06:37:32 +0000 http://www.hindawi.com/journals/aurt/2014/678346/ Temporally synchronous audio-visual stimuli serve to recruit attention and enhance learning, including language learning in infants. Although few studies have examined this effect on children with autism, it appears that the ability to detect temporal synchrony between auditory and visual stimuli may be impaired, particularly given social-linguistic stimuli delivered via oral movement and spoken language pairings. However, children with autism can detect audio-visual synchrony given nonsocial stimuli (objects dropping and their corresponding sounds). We tested whether preschool children with autism could detect audio-visual synchrony given video recordings of linguistic stimuli paired with movement of related toys in the absence of faces. As a group, children with autism demonstrated the ability to detect audio-visual synchrony. Further, the amount of time they attended to the synchronous condition was positively correlated with receptive language. Findings suggest that object manipulations may enhance multisensory processing in linguistic contexts. Moreover, associations between synchrony detection and language development suggest that better processing of multisensory stimuli may guide and direct attention to communicative events thus enhancing linguistic development. Elena Patten, Linda R. Watson, and Grace T. Baranek Copyright © 2014 Elena Patten et al. All rights reserved. How Sex of Children with Autism Spectrum Disorders and Access to Treatment Services Relates to Parental Stress Sun, 14 Dec 2014 00:10:20 +0000 http://www.hindawi.com/journals/aurt/2014/721418/ Parents of children with autism spectrum disorders (ASD) experience higher levels of stress in comparison to parents of neurotypical children and consequently are more susceptible to negative health and social outcomes (Dunn et al., 2001). However, less is known about how individual child characteristics impact stress levels in parents of children with ASD. In this study, we examined the relationship between individual characteristics (i.e., sex) of children with ASD and parental stress. Access to comprehensive treatment services was also examined as a contributing factor to parental stress. Parenting stress was higher for parents of girls than for parents of boys, and for parents of girls (but not boys) fewer services predicted higher parental distress. Findings highlight the importance of providing parents of girls with ASD with more tailored support. Irina Zamora, Eliza K. Harley, Shulamite A. Green, Kathryn Smith, and Michele D. Kipke Copyright © 2014 Irina Zamora et al. All rights reserved. Mild Dermatoglyphic Deviations in Adolescents with Autism Spectrum Disorders and Average Intellectual Abilities as Compared to Typically Developing Boys Wed, 19 Nov 2014 00:00:00 +0000 http://www.hindawi.com/journals/aurt/2014/968134/ Dermatoglyphics, ridge constellations on the hands and feet, are permanently formed by the second trimester of pregnancy. Consequently, they are considered “fossilized” evidence of a specific prenatal period. A high frequency of dermatoglyphic anomalies, or a high rate of dermatoglyphic asymmetry (discordance), is an indication of developmental instability (prenatal disturbances) prior to 24-week gestation. Most dermatoglyphic studies in psychiatry focus on adult schizophrenia. Studies on dermatoglyphic deviances and autism are sparse, include severely disturbed and intellectually retarded patients with autism, and are carried out mainly in non-Western European populations. In this study, finger print patterns, atd-angles, and palmar flexion crease patterns (PFCs) are compared between Western European adolescent teenage males, of average intellect, with Autism Spectrum Disorders (ASD; ) and typically developing adolescent teenage males (TD; ). Boys with ASD had a higher rate of discordance in their finger print patterns than TD boys. Thus, the hypothesized prenatal disturbances that play a role in the etiology of schizophrenia and severe autism might not be specific to these severe psychiatric disorders but might also be involved in the etiology of varying degrees of ASD. Esther I. de Bruin, John H. Graham, Anneke Louwerse, and Anja C. Huizink Copyright © 2014 Esther I. de Bruin et al. All rights reserved. Experiences of Dental Care and Dental Anxiety in Adults with Autism Spectrum Disorder Tue, 28 Oct 2014 11:51:26 +0000 http://www.hindawi.com/journals/aurt/2014/238764/ Dental anxiety is associated with previous distressing dental experiences, such as lack of understanding of the dentist intentions, perceptions of uncontrollability and experiences of pain during dental treatment. People with autism spectrum disorder (ASD) are impaired in building flexible predictions and expectations, which is very much needed during a dental visit. The aims of the study were to investigate if people with ASD have more negative dental experiences and a higher level of dental anxiety compared to a matched control group. Forty-seven adults with ASD and of normal intellectual performance, and 69 age- and sex-matched typically developing controls completed questionnaires on previous dental experiences and dental anxiety, the Dental Anxiety Scale, and the Dental Beliefs Survey. The ASD group experienced pain during dental treatments more often than the controls and 22% had repeatedly experienced being forced to dental treatment they were not prepared for, compared to 3% of the controls. A higher level of dental anxiety was reported by the ASD group. Dental treatment and methods for supporting the communication with patients with ASD need to be developed, in order to reduce the negative dental experiences and dental anxiety in people with ASD. My Blomqvist, Göran Dahllöf, and Susanne Bejerot Copyright © 2014 My Blomqvist et al. All rights reserved. A Randomised Control Trial of the Impact of a Computer-Based Activity Programme upon the Fitness of Children with Autism Tue, 07 Oct 2014 13:09:11 +0000 http://www.hindawi.com/journals/aurt/2014/419653/ The poor levels of fitness in children with autism are prompting concern for the children’s future health. This study looked to assess if a computer-based activity programme could improve fitness levels (as reflected in cardiopulmonary function) of these children, and achieve a reduction in their body mass index. In a randomised controlled trial, 50 children with autism (of which 33 were under the age of 11 years and 39 were boys) were allocated to an intervention group which encouraged them to use the Nintendo Wii and the software package “Mario and Sonics at the Olympics” in addition to their routine physical education classes. 50 children with autism (34 under the age of 11 years and 40 being boys) acted as controls. At the end of one year, analysis of the changes in scores using analysis of covariance (ANCOVA) on the Eurofit fitness tests showed that the intervention group had made statistically significant improvement on all tests other than flexibility. These improvements were also significantly better than controls. This type of intervention appears to be an effective addition to standard fitness training in order to help children with autism improve their fitness levels. Kathleen Dickinson and Maurice Place Copyright © 2014 Kathleen Dickinson and Maurice Place. All rights reserved. Physical Activity and Physical Fitness of School-Aged Children and Youth with Autism Spectrum Disorders Tue, 16 Sep 2014 07:27:08 +0000 http://www.hindawi.com/journals/aurt/2014/312163/ Autism spectrum disorder (ASD) is characterized by impairments in social communication deficits and the presence of restricted and repetitive behaviors, interests, or activities. Literature comparing the physical activity and fitness of children with ASD to typically developing peers is in need of attention. The purpose of this investigation was to examine the physical activity and fitness of school-aged children with ASD () in comparison to typically developing peers (). Participants with ASD completed diagnostic and developmental assessments and a series of physical fitness assessments: 20-meter multistage shuttle, sit-and-reach test, handgrip strength, and body mass index. Physical activity was measured using accelerometry and preestablished cut-points of physical activity (Freedson et al., 2005). MANCOVA revealed significant between-group effects in strength (), while ANCOVA revealed significant between-group effects in sedentary (), light (), moderate (), and total moderate-to-vigorous () physical activity. Children with ASD are less physically active and fit than typically developing peers. Adapted physical activity programs are one avenue with intervention potential to combat these lower levels of physical activity and fitness found in children with ASD. Kiley Tyler, Megan MacDonald, and Kristi Menear Copyright © 2014 Kiley Tyler et al. All rights reserved. Mental Health Services for Individuals with High Functioning Autism Spectrum Disorder Wed, 03 Sep 2014 15:39:51 +0000 http://www.hindawi.com/journals/aurt/2014/502420/ Adolescents and adults with an autism spectrum disorder (ASD) who do not have an intellectual impairment or disability (ID), described here as individuals with high-functioning autism spectrum disorder (HFASD), represent a complex and underserved psychiatric population. While there is an emerging literature on the mental health needs of children with ASD with normal intelligence, we know less about these issues in adults. Of the few studies of adolescents and adults with HFASD completed to date, findings suggest that they face a multitude of cooccurring psychiatric (e.g., anxiety, depression), psychosocial, and functional issues, all of which occur in addition to their ASD symptomatology. Despite this, traditional mental health services and supports are falling short of meeting the needs of these adults. This review highlights the service needs and the corresponding gaps in care for this population. It also provides an overview of the literature on psychiatric risk factors, identifies areas requiring further study, and makes recommendations for how existing mental health services could include adults with HFASD. Johanna K. Lake, Andrea Perry, and Yona Lunsky Copyright © 2014 Johanna K. Lake et al. All rights reserved. Tsc2 Haploinsufficiency Has Limited Effects on Fetal Brain Cytokine Levels during Gestational Immune Activation Wed, 09 Jul 2014 07:03:00 +0000 http://www.hindawi.com/journals/aurt/2014/761279/ Dysregulated TSC/mTOR signaling may play a pathogenetic role in forms of syndromic autism, such as autism associated with tuberous sclerosis, a genetic disorder caused by heterozygous TSC1 or TSC2 mutations. Environmental risk factors, such as gestational viral infections, may, in some cases, also contribute to the pathogenesis of autism and related neuropsychiatric disorders. We have recently found that a heterozygous Tsc2 mutation and the poly I:C model of maternal immune activation (MIA) interactively perturb fetal development and adult social behavior in mice, suggesting that these factors converge on shared pathways. TSC/mTOR signaling plays an important role in the modulation of immune responses, raising the possibility that the damage caused by MIA was greater in Tsc2+/− than in wildtype fetuses because of an exacerbated immune response in the mutants. Here, cytokine antibody arrays were employed to measure relative cytokine abundances in the fetal brain and the placenta during MIA. Cytokines were induced by gestational poly I:C but there was no obvious modulatory effect of Tsc2 haploinsufficiency. The data indicate that cytokine exposure during MIA is comparable in Tsc2 haploinsufficient and wildtype control fetuses, suggesting that downstream molecular and cellular processes may account for the interactive effects of Tsc2 haploinsufficiency and MIA. Dan Ehninger Copyright © 2014 Dan Ehninger. All rights reserved. Computer Vision Tools for Low-Cost and Noninvasive Measurement of Autism-Related Behaviors in Infants Sun, 22 Jun 2014 12:22:07 +0000 http://www.hindawi.com/journals/aurt/2014/935686/ The early detection of developmental disorders is key to child outcome, allowing interventions to be initiated which promote development and improve prognosis. Research on autism spectrum disorder (ASD) suggests that behavioral signs can be observed late in the first year of life. Many of these studies involve extensive frame-by-frame video observation and analysis of a child's natural behavior. Although nonintrusive, these methods are extremely time-intensive and require a high level of observer training; thus, they are burdensome for clinical and large population research purposes. This work is a first milestone in a long-term project on non-invasive early observation of children in order to aid in risk detection and research of neurodevelopmental disorders. We focus on providing low-cost computer vision tools to measure and identify ASD behavioral signs based on components of the Autism Observation Scale for Infants (AOSI). In particular, we develop algorithms to measure responses to general ASD risk assessment tasks and activities outlined by the AOSI which assess visual attention by tracking facial features. We show results, including comparisons with expert and nonexpert clinicians, which demonstrate that the proposed computer vision tools can capture critical behavioral observations and potentially augment the clinician's behavioral observations obtained from real in-clinic assessments. Jordan Hashemi, Mariano Tepper, Thiago Vallin Spina, Amy Esler, Vassilios Morellas, Nikolaos Papanikolopoulos, Helen Egger, Geraldine Dawson, and Guillermo Sapiro Copyright © 2014 Jordan Hashemi et al. All rights reserved. Defining Autism: Variability in State Education Agency Definitions of and Evaluations for Autism Spectrum Disorders Mon, 02 Jun 2014 11:00:31 +0000 http://www.hindawi.com/journals/aurt/2014/327271/ In light of the steady rise in the prevalence of students with autism, this study examined the definition of autism published by state education agencies (SEAs), as well as SEA-indicated evaluation procedures for determining student qualification for autism. We compared components of each SEA definition to aspects of autism from two authoritative sources: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and Individuals with Disabilities Education Improvement Act (IDEA-2004). We also compared SEA-indicated evaluation procedures across SEAs to evaluation procedures noted in IDEA-2004. Results indicated that many more SEA definitions incorporate IDEA-2004 features than DSM-IV-TR features. However, despite similar foundations, SEA definitions of autism displayed considerable variability. Evaluation procedures were found to vary even more across SEAs. Moreover, within any particular SEA there often was little concordance between the definition (what autism is) and evaluation procedures (how autism is recognized). Recommendations for state and federal policy changes are discussed. Malinda L. Pennington, Douglas Cullinan, and Louise B. Southern Copyright © 2014 Malinda L. Pennington et al. All rights reserved. Parent Training Interventions for Toddlers with Autism Spectrum Disorder Wed, 07 May 2014 13:05:53 +0000 http://www.hindawi.com/journals/aurt/2014/839890/ Background. Now that early identification of toddlers with autism spectrum disorder (ASD) is possible, efforts are being made to develop interventions for children under three years of age. Most studies on early intervention have focused on intensive and individual interventions. However, parent training interventions that help parents interact and communicate with their toddlers with ASD might be a good alternative to promote the development of their child’s sociocommunicative skills. Objective. This review aims to systematically examine (1) the use of parent training interventions for children with ASD under three years of age and (2) their effects on children’s development, parents’ well-being and parent-child interactions. Methods. Systematic searches were conducted to retrieve studies in which at least one parent was trained to implement ASD-specific techniques with their toddlers (0–36 months old) with a diagnosis of or suspected ASD. Results. Fifteen studies, involving 484 children (mean age: 23.26 months), were included in this review. Only two of them met criteria for conclusive evidence. Results show that parents were able to implement newly learned strategies and were generally very satisfied with parent training programs. However, findings pertaining to the children’s communication and socioemotional skills, parent-child interactions, and parental well-being were inconclusive. Audrée Jeanne Beaudoin, Guillaume Sébire, and Mélanie Couture Copyright © 2014 Audrée Jeanne Beaudoin et al. All rights reserved.