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Zarezadeh M, Mahmoudinezhad M, Hosseini B, Khorraminezhad L, Razaghi M, Alvandi E, Saedisomeolia A. Dietary pattern in autism increases the need for probiotic supplementation: A comprehensive narrative and systematic review on oxidative stress hypothesis. Clin Nutr 2023; 42:1330-1358. [PMID: 37418842 DOI: 10.1016/j.clnu.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/15/2023] [Accepted: 06/11/2023] [Indexed: 07/09/2023]
Abstract
Autism spectrum disorders (ASDs) are associated with specific dietary habits, including limited food selection and gastrointestinal problems, resulting in an altered gut microbiota. Autistic patients have an elevated abundance of certain gut bacteria associated with increased oxidative stress in the gastrointestinal tract. Probiotic supplementation has been shown to decrease oxidative stress in a simulated gut model, but the antioxidant effects of probiotics on the oxidative stress of the gut in autistic patients have not been directly studied. However, it is speculated that probiotic supplementation may help decrease oxidative stress in the gastrointestinal tract of autistic patients due to their specific dietary habits altering the microbiota. PubMed, Scopus and Web of Science databases and Google Scholar were searched up to May 2023. This systematic-narrative review aims to present the latest evidence regarding the changes in eating habits of autistic children which may further increase the gut microbiota induced oxidative stress. Additionally, this review will assess the available literature on the effects of probiotic supplementation on oxidative stress parameters.
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Affiliation(s)
- Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Banafshe Hosseini
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, Sainte-Justine University Health Centre, Montreal, QC H3T 1C5, Canada
| | - Leila Khorraminezhad
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Maryam Razaghi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ehsan Alvandi
- School of Medicine, Western Sydney University, NSW, Australia
| | - Ahmad Saedisomeolia
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada.
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2
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Mahboub S, Al-Suhaibani S, Ellatif HA, Elkholi SM. Maternal- and child-related risk factors for autism during the perinatal period. MIDDLE EAST CURRENT PSYCHIATRY 2023; 30:53. [DOI: 10.1186/s43045-023-00326-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/29/2023] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder commonly prevalent in children worldwide including KSA. It causes disability in social interaction, communication, and restrictive and repetitive behaviors. Detecting risk factors for ASD could help initiate screening and risk prevention approaches. Herein, this study aimed to detect several maternal and neonatal risk factors for ASD in KSA.
Results
Ninety-four cases and 282 control completed an online survey tool. The survey items were close-ended questions. Participants were asked about maternal-related risk factors for autism during perinatal period. The logistic regression model revealed having a child diagnosed with autism with two predictors: factors related to the mother and factors related to the baby during perinatal period. The whole model was sig (p < 0.0001). The factors related to the baby have more impact on developing autism than maternal factors (OR is 3 vs 2.3, respectively, p < 0.01 for both).
Conclusion
The findings of this study will be beneficial for subsequent nationwide screenings and educational programs. The study brought to light the potential for identifying children in need of early intervention.
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Fieiras C, Chen MH, Escobar Liquitay CM, Meza N, Rojas V, Franco JVA, Madrid E. Risperidone and aripiprazole for autism spectrum disorder in children: an overview of systematic reviews. BMJ Evid Based Med 2023; 28:7-14. [PMID: 35101925 DOI: 10.1136/bmjebm-2021-111804] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To assess the effectiveness and safety of risperidone and aripiprazole in children with autism spectrum disorder (ASD). DESIGN AND SETTING Overview of systematic reviews (SRs). SEARCH METHODS In October 2021, we searched Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycInfo and Epistemonikos placing no restrictions on language or date of publication. PARTICIPANTS Children aged 12 years or less with ASD. INTERVENTIONS Risperidone and aripiprazole with no dosage restrictions. DATA COLLECTION AND ANALYSIS We rated the methodological quality of the included SRs using A Measurement Tool to Assess Systematic Reviews (AMSTAR 2). We reported the Grading of Recommendations, Assessment, Development and Evaluation certainty of the evidence according to the analysis conducted by the authors of the included SRs. MAIN OUTCOMES MEASURED A multidisciplinary group of experts agreed on analysing nine critical outcomes evolving core and non-core ASD symptoms. PATIENT AND PUBLIC INVOLVEMENT Organisations of parents of children with ASD were involved during part of the process, participating in external revision of the final version of the report for the Chilean Ministry of Health with no additional comments (ID 757-22-L120 DIPRECE, Ministry of Health, Chile). The organisations involved were: Fundación Unión Autismo y Neurodiversidad, Federación Nacional de Autismo, Vocería Autismo del Sur, and Vocería Autismo del Norte. RESULTS We identified 22 SRs within the scope of this overview, of which 16 were of critically low confidence according to AMSTAR 2 and were excluded from the analysis. Both aripiprazole and risperidone were effective for reducing autism symptoms severity, repetitive behaviours, inappropriate language, social withdrawal and behavioural problems compared with placebo. The certainty of the evidence for most outcomes was moderate. Risperidone and aripiprazole are associated with metabolic and neurological adverse events. Follow-up was short termed. CONCLUSIONS We found that aripiprazole and risperidone probably reduce symptom severity at short-term follow-up but may also cause adverse events. High-quality and updated SRs and larger randomised controlled trials with longer term follow-up are needed on this topic. OVERVIEW PROTOCOL PROSPERO CRD42020206535.
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Affiliation(s)
- Cecilia Fieiras
- School of Medicine, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Nicolás Meza
- Interdisciplinary Centre for Health Studies (CIESAL) - Cochrane Chile Associate Centre, Universidad de Valparaíso, Viña del Mar, Chile
| | - Valeria Rojas
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
- Autism program, Hospital Gustavo Fricke, Viña del Mar, Chile
| | - Juan Victor Ariel Franco
- Associate Cochrane Centre-Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Eva Madrid
- Interdisciplinary Centre for Health Studies (CIESAL) - Cochrane Chile Associate Centre, Universidad de Valparaíso, Viña del Mar, Chile
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Recent Developments in Autism Genetic Research: A Scientometric Review from 2018 to 2022. Genes (Basel) 2022; 13:genes13091646. [PMID: 36140813 PMCID: PMC9498399 DOI: 10.3390/genes13091646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 12/13/2022] Open
Abstract
Genetic research in Autism Spectrum Disorder (ASD) has progressed tremendously in recent decades. Dozens of genetic loci and hundreds of alterations in the genetic sequence, expression, epigenetic transformation, and interactions with other physiological and environmental systems have been found to increase the likelihood of developing ASD. There is therefore a need to represent this wide-ranging yet voluminous body of literature in a systematic manner so that this information can be synthesised and understood at a macro level. Therefore, this study made use of scientometric methods, particularly document co-citation analysis (DCA), to systematically review literature on ASD genetic research from 2018 to 2022. A total of 14,818 articles were extracted from Scopus and analyzed with CiteSpace. An optimized DCA analysis revealed that recent literature on ASD genetic research can be broadly organised into 12 major clusters representing various sub-topics. These clusters are briefly described in the manuscript and potential applications of this study are discussed.
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Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M. Global prevalence of autism: A systematic review update. Autism Res 2022; 15:778-790. [PMID: 35238171 PMCID: PMC9310578 DOI: 10.1002/aur.2696] [Citation(s) in RCA: 946] [Impact Index Per Article: 315.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/20/2023]
Abstract
Prevalence estimates of autism are essential for informing public policy, raising awareness, and developing research priorities. Using a systematic review, we synthesized estimates of the prevalence of autism worldwide. We examined factors accounting for variability in estimates and critically reviewed evidence relevant for hypotheses about biological or social determinants (viz., biological sex, sociodemographic status, ethnicity/race, and nativity) potentially modifying prevalence estimates of autism. We performed the search in November 2021 within Medline for studies estimating autism prevalence, published since our last systematic review in 2012. Data were extracted by two independent researchers. Since 2012, 99 estimates from 71 studies were published indicating a global autism prevalence that ranges within and across regions, with a median prevalence of 100/10,000 (range: 1.09/10,000 to 436.0/10,000). The median male‐to‐female ratio was 4.2. The median percentage of autism cases with co‐occurring intellectual disability was 33.0%. Estimates varied, likely reflecting complex and dynamic interactions between patterns of community awareness, service capacity, help seeking, and sociodemographic factors. A limitation of this review is that synthesizing methodological features precludes a quality appraisal of studies. Our findings reveal an increase in measured autism prevalence globally, reflecting the combined effects of multiple factors including the increase in community awareness and public health response globally, progress in case identification and definition, and an increase in community capacity. Hypotheses linking factors that increase the likelihood of developing autism with variations in prevalence will require research with large, representative samples and comparable autism diagnostic criteria and case‐finding methods in diverse world regions over time.
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Affiliation(s)
- Jinan Zeidan
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health and Science University, Portland, Oregon, USA
| | - Julie Scorah
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Alaa Ibrahim
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Maureen S Durkin
- Population Health Sciences, Department of Pediatrics, Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Afiqah Yusuf
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
| | - Andy Shih
- Autism Speaks, New York City, New York, USA
| | - Mayada Elsabbagh
- Montreal Neurological Institute-Hospital, Faculty of Medicine & Health Sciences, McGill University Montreal, Montreal, Canada
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6
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Corbett GA, Lee S, Woodruff TJ, Hanson M, Hod M, Charlesworth AM, Giudice L, Conry J, McAuliffe FM. Nutritional interventions to ameliorate the effect of endocrine disruptors on human reproductive health: A semi-structured review from FIGO. Int J Gynaecol Obstet 2022; 157:489-501. [PMID: 35122246 PMCID: PMC9305939 DOI: 10.1002/ijgo.14126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/02/2022] [Indexed: 11/09/2022]
Abstract
Background Endocrine disrupting chemicals have harmful effects on reproductive, perinatal, and obstetric outcomes. Objective To analyze the evidence on nutritional interventions to reduce the negative effects of endocrine disruptors on reproductive, perinatal, and obstetric outcomes. Search strategy A search of MEDLINE (PubMed), Allied Health Literature (CINAHL), EMBASE, Web of Science, and the Cochrane Database was conducted from inception to May 2021. Selection criteria Experimental studies on human populations. Data collection and analysis Data were collected from eligible studies. Risk of bias assessment was completed using the Cochrane risk of bias tool and the ROBINS‐I Tool. Results Database searches yielded 15 362 articles. Removing 11 181 duplicates, 4181 articles underwent abstract screening, 26 articles were eligible for full manuscript review, and 16 met full inclusion criteria. Several interventions were found to be effective in reducing exposure to endocrine disruptors: avoidance of plastic containers, bottles, and packaging; avoidance of canned food/beverages; consumption of fresh and organic food; avoidance of fast/processed foods; and supplementation with vitamin C, iodine, and folic acid. There were some interventional studies examining therapies to improve clinical outcomes related to endocrine disruptors. Conclusion Dietary alterations can reduce exposure to endocrine disruptors, with limited data on interventions to improve endocrine‐disruptor–related clinical outcomes. This review provides useful instruction to women, their families, healthcare providers, and regulatory bodies. Nutritional interventions shown to reduce exposure to endocrine disruptors include avoidance of canned/processed or plastic‐packaged foods. Consumption of fresh/organic foods and vitamin C, iodine, and folic acid also reduce exposure.
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Affiliation(s)
- Gillian A Corbett
- UCD Perinatal Research Centre, UCD School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sadhbh Lee
- UCD Perinatal Research Centre, UCD School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Tracey J Woodruff
- Program on Reproductive Health and Environment, Department of Obstetrics and Gynecology, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Mark Hanson
- International Federation of Gynaecology and Obstetrics (FIGO) Committee on Impact of Pregnancy on Long-term Health.,Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and NIHR Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Moshe Hod
- International Federation of Gynaecology and Obstetrics (FIGO) Committee on Impact of Pregnancy on Long-term Health.,Mor Comprehensive Women's Health Care Centre, Tel Aviv, Israel
| | - Anne Marie Charlesworth
- Program on Reproductive Health and Environment, Department of Obstetrics and Gynecology, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Linda Giudice
- International Federation of Gynecology and Obstetrics (FIGO) Committee on Climate Change and Toxic Environmental Exposures.,Centre for Reproductive Sciences, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Jeanne Conry
- Environmental Health and Leadership Foundation, United States
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, UCD School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,International Federation of Gynaecology and Obstetrics (FIGO) Committee on Impact of Pregnancy on Long-term Health
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7
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Young E, Jegathesan T, Park H, Zubairi MS. The paediatric developmental toolkit: Facilitating learning of child development. Paediatr Child Health 2020; 26:149-153. [PMID: 33936333 DOI: 10.1093/pch/pxaa061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 03/26/2020] [Indexed: 11/13/2022] Open
Abstract
Background Recent paediatric and family medicine graduates report feeling unprepared to identify and address children and youth with developmental disorders. Developmental history taking and physical examination alone limit engagement with children and youth in an interactive manner to assess development. The paediatric developmental toolkit (PDT) was developed to provide trainees with the opportunity to interact with a child in a play-based manner. Objectives The primary objective of this study was to determine the feasibility of PDT within clinical settings, and qualitatively explore how the PDT can be used by teachers and trainees. Methods Trainees and their clinical teachers participated in a qualitative study. Trainees used the PDT in clinical settings and were interviewed following their clinical encounters. Interactions between clinical teachers and trainees following the use of the PDT were also recorded. Teachers were interviewed following the trainees' case presentations and closures of clinic visits. Trainee interviews, teacher and trainee interactions, and teacher interviews were audiotaped, transcribed, and analyzed thematically. Results Nine trainees (six paediatric residents, two family medicine residents, and one clinical clerk medical student) and four developmental paediatricians participated in the study. Each trainee used the PDT twice in two different clinical encounters. All residents agreed the PDT enabled them to observe a child's developmental skills in a short period of time. Clinical teachers all felt the toolkit allowed trainees to more holistically consider a child's development and diagnosis. Conclusions As medical education shifts to a competency-based education curriculum, the PDT is an innovative tool that can be used to enhance paediatric and family medicine residents' learning of child development by enabling opportunities for interaction with children.
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Affiliation(s)
- Elizabeth Young
- Department of Pediatrics, Li Ka Shing Knowledge Institute, Unity Health Toronto, St. Michaels Hospital, Toronto, Ontario.,Department of Pediatrics, Division of Developmental Pediatrics, University of Toronto, Toronto, Ontario
| | - Thivia Jegathesan
- Department of Pediatrics, Li Ka Shing Knowledge Institute, Unity Health Toronto, St. Michaels Hospital, Toronto, Ontario.,Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario.,Centre of Ambulatory Care Education, Women's College Hospital, Toronto, Ontario
| | - Hyeji Park
- Department of Pediatrics, Li Ka Shing Knowledge Institute, Unity Health Toronto, St. Michaels Hospital, Toronto, Ontario.,Department of Linguistics, University of Toronto, Toronto, Ontario
| | - Mohammad Samad Zubairi
- Department of Pediatrics, Division of Developmental Pediatrics, McMaster University, Hamilton, Ontario.,McMaster Education Research, Innovation and Theory (MERIT) Program, Hamilton, Ontario.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario
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8
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Chiarotti F, Venerosi A. Epidemiology of Autism Spectrum Disorders: A Review of Worldwide Prevalence Estimates Since 2014. Brain Sci 2020; 10:brainsci10050274. [PMID: 32370097 PMCID: PMC7288022 DOI: 10.3390/brainsci10050274] [Citation(s) in RCA: 286] [Impact Index Per Article: 57.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Abstract
The prevalence of Autism Spectrum Disorder (ASD) has increased dramatically in recent decades, supporting the claim of an autism epidemic. Systematic monitoring of ASD allows estimating prevalence and identifying potential sources of variation over time and geographical areas. At present, ASD prevalence estimates are available worldwide, coming either from surveillance systems using existing health and educational databases or from population studies specifically performed. In the present article, we present a review of the ASD prevalence estimates published since 2014. Data confirm a high variability in prevalence across the world, likely due to methodological differences in case detection, and the consistent increase of prevalence estimates within each geographical area.
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Liu J, Chen LL, Shen S, Mao J, Lopes M, Liu S, Kong X. Challenges in the Diagnosis and Management of Pain in Individuals with Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00199-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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10
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Siddiqua A, Duku E, Georgiades K, Mesterman R, Janus M. Neighbourhood-level prevalence of teacher-reported Autism Spectrum Disorder among kindergarten children in Canada: A population level study. SSM Popul Health 2019; 10:100520. [PMID: 31872037 PMCID: PMC6909034 DOI: 10.1016/j.ssmph.2019.100520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/03/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022] Open
Abstract
Number of children with ASD per neighbourhood varies from none to as high as 21. Developmental vulnerabilities were not associated with levels of clustering. Highest level of clustering of children with ASD was found in Nova Scotia.
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Affiliation(s)
- Ayesha Siddiqua
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Kathy Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Ronit Mesterman
- Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
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11
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Cost-Effectiveness of Universal or High-Risk Screening Compared to Surveillance Monitoring in Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:2968-2979. [PMID: 29644584 DOI: 10.1007/s10803-018-3571-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The American Academy of Pediatrics recommends universal screening for autism spectrum disorder at 18 and 24 months. This study compared the cost-effectiveness of universal or high-risk screening to surveillance monitoring. Simulation models estimated the costs and outcomes from birth to age 6 years. The incremental cost per child diagnosed by 36 months was $41,651.6 for high-risk screening and $757,116.9 for universal screening from the societal perspective. Universal screening may not be a cost-effective approach to increase earlier treatment initiation, as most children initiated treatment after age 60 months. Eliminating wait times resulted in more children initiated treatment by 48 months, but at a high initial cost that may be offset by future cost-savings related to better outcomes.
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12
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Probiotic Therapy for Treating Behavioral and Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review of Clinical Trials. Curr Med Sci 2019; 39:173-184. [DOI: 10.1007/s11596-019-2016-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/01/2019] [Indexed: 10/27/2022]
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13
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Croteau C, Mottron L, Dorais M, Tarride JE, Perreault S. Use, costs, and predictors of psychiatric healthcare services following an autism spectrum diagnosis: Population-based cohort study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:2020-2030. [PMID: 30943759 DOI: 10.1177/1362361319840229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A number of cross-sectional studies report extensive use of psychiatric services and high healthcare costs in autistic youths. However, little is known about how the use of these services evolves from the time of diagnosis, as children grow up. Our objectives were to investigate the use, costs, and predictors of psychiatric services following autism spectrum diagnosis. We built a cohort of 1227 newly diagnosed autism spectrum individuals identified in the Quebec (Canada) Régie de l'assurance maladie du Québec administrative database (January 1998 to December 2010). Mean number and cost per individual of psychiatric healthcare use (hospitalizations, medical visits, psychoactive drug use) were calculated yearly for 5 years following autism spectrum diagnosis. Mean number of psychiatric visits decreased over time by more than threefold (7.5 vs 2.1 visits) from year 1 to year 5, whereas psychoactive drug use increased from 16.0 to 25.2 claims. Psychiatric hospitalizations decreased during follow-up, but still represented the greatest costs per individual (CAD9820 for year 1; CAD4628 for year 5). Antipsychotics represented over 50% of drug costs. Mixed-effect model with repeated measures showed that previous psychoactive drug use was the strongest predictor of greater psychiatric healthcare cost during follow-up (odds ratio: 9.96; 95% confidence interval: 7.58-13.10). These trends contrast with guidelines advocating cautious prescribing of antipsychotics with periodical re-assessment of their benefit.
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Affiliation(s)
| | | | | | - Jean-Eric Tarride
- McMaster University, Canada.,The Research Institute of St. Joseph's Hamilton, Canada
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14
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Ali Y, Anderson LN, Smile S, Chen Y, Borkhoff CM, Koroshegyi C, Lebovic G, Parkin PC, Birken CS, Szatmari P, Maguire JL. Prospective cohort study of vitamin D and autism spectrum disorder diagnoses in early childhood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:584-593. [PMID: 38321697 DOI: 10.1177/1362361318756787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Several studies have suggested an association between vitamin D in childhood and autism spectrum disorder. No prospective studies have evaluated whether lower vitamin D levels precede ASD diagnoses - a necessary condition for causality. The objective of this study was to prospectively evaluate whether vitamin D serum levels in early childhood was associated with incident physician diagnosed ASD. A prospective cohort study was conducted using data from preschool-aged children in the TARGet Kids! practice-based research network in Toronto, Canada, from June 2008 to July 2015. 25-hydroxyvitamin D concentration was measured through blood samples and vitamin D supplementation from parent report. Autism spectrum disorder diagnosis was determined from medical records at follow-up visits. Covariates included age, sex, family history of autism spectrum disorder, maternal ethnicity, and neighborhood household income. Unadjusted and adjusted relative risks and 95% confidence intervals were estimated using Poisson regression with a robust error variance. In this study, 3852 children were included. Autism spectrum disorder diagnosis was identified in 41 children (incidence = 1.1%) over the observation period (average follow-up time = 2.5 years). An association between 25-hydroxyvitamin D concentration and autism spectrum disorder was not identified in the unadjusted (relative risk = 1.04, 95% confidence interval: 0.97, 1.11 per 10 nmol/L increase in 25-hydroxyvitamin D concentration) or adjusted models (adjusted relative risk = 1.06; 95% confidence interval: 0.95, 1.18). An association between vitamin D supplementation in early childhood and autism spectrum disorder was also not identified (adjusted relative risk = 0.86, 95% confidence interval: 0.46, 1.62). Vitamin D in early childhood may not be associated with incident physician diagnoses of autism spectrum disorder.
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Affiliation(s)
- Yamna Ali
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Laura N Anderson
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Sharon Smile
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Yang Chen
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Hospital for Sick Children Research Institute, Toronto, Canada
| | | | - Gerald Lebovic
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Catherine S Birken
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | | | - Jonathon L Maguire
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
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15
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McCrimmon AW, Climie EA, Huynh S. The relation between emotional intelligence and resilience in at-risk populations. Dev Neurorehabil 2018; 21:326-335. [PMID: 29083944 DOI: 10.1080/17518423.2017.1387873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Resilience factors and their relation to emotional intelligence (EI) as a potential strength for children with attention-deficit/hyperactivity disorder (ADHD) or high-functioning autism spectrum disorder (HFASD) were investigated. Children with either ADHD or HFASD were hypothesized to demonstrate reduced EI and differential relations between EI and resilience as compared to typically developing (TD) children. METHODS Fifty-four children aged 8-12 years (18 with ADHD, 18 with HFASD, and 18 TD controls) completed the Resilience Scales for Children and Adolescents and BarOn Emotional Quotient Inventory. Differences between groups (analysis of variance) and unique relations among the variables (correlation) for each group were examined. RESULTS No group differences; however, unique relations between the variables were found within each sample. CONCLUSIONS EI may be a unique area of interest for clinical populations and an important consideration in the development and implementation of interventions to capitalize upon inherent strengths. Implications of these results for intervention are discussed.
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Affiliation(s)
- Adam W McCrimmon
- a Werklund School of Education , University of Calgary , Calgary , Alberta , Canada
| | - Emma A Climie
- a Werklund School of Education , University of Calgary , Calgary , Alberta , Canada
| | - Stephany Huynh
- a Werklund School of Education , University of Calgary , Calgary , Alberta , Canada
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Lemay JF, Yohemas M, Langenberger S. Redesign of the autism spectrum screening and diagnostic process for children aged 12 to 36 months. Paediatr Child Health 2018; 23:308-313. [PMID: 30046268 DOI: 10.1093/pch/pxx187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diagnosing autism spectrum disorder (ASD) is challenging, resource-intense and time-consuming due to clinical and etiologic heterogeneity. With the rapid increase in prevalence of ASD, higher demand for diagnostic assessment often means long waitlists for families, and limited access to specialized intervention and support. In 2013, the Alberta Children's Hospital-Autism Spectrum Disorder Diagnostic Clinic (ACH-ASDC) experienced a significant waitlist in the 12 to 36 months' population. A Quality Improvement Project was started in 2014; one program aim was to create an efficient, sustainable and evidence-based ASD diagnostic evaluation process. The redesigned diagnostic process included: 1) pre- and postassessment parent information sessions, 2) a screening appointment and 3) standardized clinical appointment pathways. Within its first year, the new process reduced wait times to under a month without an increase in resources, leading to an efficient diagnostic process being sustained since its implementation.
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Affiliation(s)
- Jean-François Lemay
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital, Calgary, Alberta
| | - Meridith Yohemas
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital, Calgary, Alberta
| | - Shauna Langenberger
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital, Calgary, Alberta
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17
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Autism Diagnosis: The Local Context Matters. J Dev Behav Pediatr 2017; 38:663-664. [PMID: 28937448 DOI: 10.1097/dbp.0000000000000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Penner M, King GA, Hartman L, Anagnostou E, Shouldice M, Hepburn CM. Community General Pediatricians' Perspectives on Providing Autism Diagnoses in Ontario, Canada: A Qualitative Study. J Dev Behav Pediatr 2017; 38:593-602. [PMID: 28937447 PMCID: PMC5625971 DOI: 10.1097/dbp.0000000000000483] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/02/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Community general pediatricians (CGPs) are a potential resource to increase capacity for autism spectrum disorder (ASD) diagnostic assessments. The objective of this study was to explore factors influencing CGPs' perspectives on and practices of providing ASD diagnoses. METHODS This qualitative study used a constructivist modified grounded theory approach. Participants included CGPs who had attended ASD educational events or had referred a child with suspected ASD to a tertiary rehabilitation center. Individual in-depth interviews with CGPs were recorded, transcribed, and coded. An explanatory framework was developed from the data. A summary of the framework was sent to participants, and responses indicated that no changes were needed. RESULTS Eleven CGPs participated. Assessment for ASD consists of 3 stages: (1) determining the diagnosis; (2) communicating the diagnosis; and (3) managing next steps after diagnosis. Each of these stages of ASD diagnostic assessment exists within an ecological context of child/family factors, personal CGP factors, and contextual/systems factors that all influence diagnostic decision making. CONCLUSION Community general pediatrician ASD diagnostic capacity must be considered within the larger context of ASD care. Suggestions to improve diagnostic capacity include preparing families for the diagnosis, changing CGP perceptions of ASD, providing community-based training, improving financial remuneration, and providing service navigation. Further study is needed to ensure that CGPs are providing accurate, high-quality assessments.
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Affiliation(s)
- Melanie Penner
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Gillian A. King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Laura Hartman
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Michelle Shouldice
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Charlotte Moore Hepburn
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
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Montgomery JM, McCrimmon AW. Contemporary Issues in School-Based Practice for Students With Autism Spectrum Disorder. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2017. [DOI: 10.1177/0829573517717161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Höfer J, Hoffmann F, Bachmann C. Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:387-402. [DOI: 10.1177/1362361316646559] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. A systematic search of three electronic databases was performed. All research studies in English or German reporting data on the frequency of complementary and alternative medicine use in individuals with autism spectrum disorder were included. Two independent reviewers searched the literature, extracted information on study design and results, and assessed study quality using an established quality assessment tool. Twenty studies with a total of 9540 participants were included. The prevalence of any complementary and alternative medicine use ranged from 28% to 95% (median: 54%). Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.
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Affiliation(s)
| | | | - Christian Bachmann
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
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21
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Kerns KA, Macoun S, MacSween J, Pei J, Hutchison M. Attention and working memory training: A feasibility study in children with neurodevelopmental disorders. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:120-137. [PMID: 27049769 DOI: 10.1080/21622965.2015.1109513] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current study investigated the efficacy of a game-based process specific intervention for improving attention and working memory in children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD). The Caribbean Quest (CQ) is a 'serious game' that consists of five hierarchically structured tasks, delivered in an adaptive format, targeting different aspects of attention and/or working memory. In addition to game play, the intervention incorporates metacognitive strategies provided by trained educational assistants (EAs), to facilitate generalization and far transfer to academic and daily skills. EAs delivered the intervention to children (ages 6-13) during their regular school day, providing children with instruction in metacognitive strategies to improve game play, with participants completing approximately 12 hours of training over an 8 to 12 school week period. Pre- and post-test analyses revealed significant improvement on measures of working memory and attention, including reduced distractibility and improved divided attention skills. Additionally, children showed significant gains in performance on an academic measure of reading fluency, suggesting that training-related gains in attention and working memory transferred to classroom performance. Exit interviews with EAs revealed that the intervention was easily delivered within the school day, that children enjoyed the intervention, and that children transferred metacognitive strategies learned in game play into the classroom. Preliminary results support this game-based process specific intervention as a potentially effective treatment and useful tool for supporting cognitive improvements in children with FASD or ASD, when delivered as part of an overall treatment plan.
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Affiliation(s)
- Kimberly A Kerns
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada
| | - Sarah Macoun
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada
| | - Jenny MacSween
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada
| | - Jacqueline Pei
- b Department of Educational Psychology , University of Alberta , Edmonton , Alberta , Canada
| | - Marnie Hutchison
- b Department of Educational Psychology , University of Alberta , Edmonton , Alberta , Canada
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22
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Leung BMY, Giesbrecht GF, Letourneau N, Field CJ, Bell RC, Dewey D. Perinatal nutrition in maternal mental health and child development: Birth of a pregnancy cohort. Early Hum Dev 2016; 93:1-7. [PMID: 26704573 DOI: 10.1016/j.earlhumdev.2015.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/23/2015] [Accepted: 11/24/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mental disorders are one of the leading contributors to the global burden of disease. The Alberta Pregnancy Outcomes and Nutrition (APrON) study was initiated in 2008 to better understand perinatal environmental impacts on maternal mental health and child development. AIMS This pregnancy cohort was established to investigate the relationship between the maternal environment (e.g. nutritional status), maternal mental health status, birth outcomes, and child development. The purpose of this paper is to describe the creation of this longitudinal cohort, the data collection tools and procedures, and the background characteristics of the participants. SUBJECTS Participants were pregnant women age 16 or older, their infants and the biological fathers. OUTCOME MEASURES For the women, data were collected during each trimester of pregnancy and at 3, 6, 12, 24, and 36months after the birth of their infant. Maternal measures included diet, stress, current mental and physical health, health history, and lifestyle. In addition, maternal biological samples (DNA, blood, urine, and spot breast milk samples) were banked. Paternal data included current mental and physical health, health history, lifestyle, and banked DNA samples. For infants, DNA and blood were collected as well as information on health, development and feeding behavior. RESULTS At the end of recruitment in 2012, the APrON cohort included 2140 women, 2172 infants, and 1417 biological fathers. Descriptive statistics of the cohort, and comparison of women who stayed in the study and those who dropped out are discussed. CONCLUSION Findings from the longitudinal cohort may have important implications for health policy and clinical practice.
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Affiliation(s)
- Brenda M Y Leung
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Nicole Letourneau
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Faculty of Nursing, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Deborah Dewey
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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Idring S, Lundberg M, Sturm H, Dalman C, Gumpert C, Rai D, Lee BK, Magnusson C. Changes in prevalence of autism spectrum disorders in 2001-2011: findings from the Stockholm youth cohort. J Autism Dev Disord 2015; 45:1766-73. [PMID: 25475364 DOI: 10.1007/s10803-014-2336-y] [Citation(s) in RCA: 192] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In a record-linkage study in Stockholm, Sweden, the year 2011 prevalence of diagnosed autism spectrum disorders (ASD) was found to be 0.40, 1.74, 2.46, and 1.76% among 0-5, 6-12, 13-17, and 18-27 year olds, respectively. The corresponding proportion of cases with a recorded diagnosis of intellectual disability was 17.4, 22.1, 26.1 and 29.4%. Between 2001 and 2011, ASD prevalence increased almost 3.5 fold among children aged 2-17 years. The increase was mainly accounted for by an eightfold increase of ASD without intellectual disability (from 0.14 to 1.10 %), while the prevalence of ASD with intellectual disability increased only slightly (from 0.28 to 0.34%). The increase in ASD prevalence is likely contributed to by extrinsic factors such as increased awareness and diagnostics.
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Affiliation(s)
- Selma Idring
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden,
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Zhou H, Zhang L, Wu L, Zou X, Luo X, Xia K, Wang Y, Xu X, Ge X, Sun C, Deng H, Fombonne E, Jiang YH, Yan W, Wang Y. Validity and reliability analysis of the Chinese parent version of the Autism Spectrum Rating Scale (6-18 years). Psychiatry Res 2015; 230:255-61. [PMID: 26384573 DOI: 10.1016/j.psychres.2015.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 08/31/2015] [Accepted: 09/03/2015] [Indexed: 12/23/2022]
Abstract
This study aimed to investigate the validity and reliability of the Chinese parent version of the Autism Spectrum Rating Scale (ASRS, 6-18 years) for a general sample of Chinese children. The study involved assessing 1625 community-based subjects aged 6-12 years from four sites (Shanghai, Guangzhou, Changsha, and Harbin city) in China and 211 clinic-based participants aged 6-18 with a confirmed diagnosis of autism spectrum disorders (ASDs). The internal consistency (Cronbach's alpha) ranged from 0.585 to 0.929, and the test-retest reliability (interclass correlations) ranged from 0.542 to 0.749, indicating no significant difference between the two tests at an interval of 2-4 weeks. The construct validity was relatively excellent, and the concurrent validity with the Social Responsiveness Scale (SRS) (Pearson correlations) was 0.732 between the two total scores. Receiver operating characteristics (ROC) analyses showed excellent and comparable discriminant validity of the ASRS with respect to the SRS, with an area under the curve (AUC) of 0.9507 (95% CI: 0.93-0.97) versus 0.9703 (95% CI: 0.96-0.98), respectively. Our data suggested a cutoff ≥60 for the Chinese version of the ASRS, with good accuracy in screening autism symptoms (sensitivity=94.2%, specificity=77%). The Chinese parent version of the ASRS is therefore a reliable and valid tool for screening autistic symptoms in Chinese children in general.
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Affiliation(s)
- Hao Zhou
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Lili Zhang
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Lijie Wu
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xiaobing Zou
- Child Development Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Kun Xia
- State Key Laboratory of Medical Genetics, Changsha, China
| | - Yimin Wang
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiu Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaoling Ge
- Children's Hospital of Fudan University, Shanghai, China
| | - Caihong Sun
- School of Public Health, Harbin Medical University, Harbin, China
| | - Hongzhu Deng
- Child Development Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Eric Fombonne
- Oregon Health & Science University, Portland, OR, USA
| | - Yong-Hui Jiang
- Division of Medical Genetics, Department of Pediatrics and Neurobiology, Duke University School of Medicine, USA
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China.
| | - Yi Wang
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China.
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Duan G, Chen J, Zhang W, Yu B, Jin Y, Wang Y, Yao M. Physical maltreatment of children with autism in Henan province in China: A cross-sectional study. CHILD ABUSE & NEGLECT 2015; 48:140-147. [PMID: 25957752 DOI: 10.1016/j.chiabu.2015.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/20/2015] [Accepted: 03/26/2015] [Indexed: 06/04/2023]
Abstract
The aim of this study was to investigate the frequency of child physical maltreatment (CPM) in children with autism aged 2-5 years in Henan province (China), and to explore the risk factors for severe CPM in these children. This cross-sectional study was performed at the Psychology Clinic of the Third Affiliated Hospital of Zhengzhou University between September 2012 and September 2013 with 180 parents of children with autism. Children and parents had no history of any cognitive therapy. The childhood autism rating scale (CARS) was used to evaluate the severity of autism in children. Data on parental CPM during the past 3 months were collected from parental self-reporting. Logistic regression was used to investigate the risk factors of severe CPM. CPM was self-reported by 88% of the parents of children with autism. One hundred and fifty four of these cases were in the minor CPM group (86%) and 64 in the severe CPM group (36%). Most cases of severe CPM were unlikely to have caused injury. Univariate analyses showed that child's age (p=.018), age started to speak (p=.043) and CARS score (p=.048) were associated with severe CPM. Child's age (p=.011) and CARS score (p=.041) were independently associated with severe CPM. The risk of severe CPM increased with age and CARS score. Our findings showed that CPM is widespread in families of children with autism in Central China and more knowledge should be provided to parents of children with autism, particularly in cases of severe autism (those with high CARS scores).
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Affiliation(s)
- Guiqin Duan
- Center of Children Psychology and Behavior, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Jingqi Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wenjing Zhang
- Beijing Academy of Education Sciences, Beijing, China
| | - Buyi Yu
- Center of Children Psychology and Behavior, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanqin Jin
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yazhe Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Meiling Yao
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
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Lanovaz MJ, Dufour MM, Shah S. Newspaper Coverage of Autism Treatment in Canada: 10-Year Trends (2004-2013). CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015; 60:329-33. [PMID: 26175392 PMCID: PMC4500183 DOI: 10.1177/070674371506000706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 08/01/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare trends in coverage of empirically supported and alternative autism treatments in Canadian newspapers during a 10-year period and to examine whether the portrayal of empirically supported and alternative treatments differed. METHOD We searched a sample of 10 daily local and national Canadian newspapers using the word autism combined with intervention or treatment in the Proquest Canadian Newsstand and Eureka.cc databases, which yielded a total of 857 articles published between 2004 and 2013. In our subsequent analyses, we only included articles whose main topic was autism and that referred to at least one treatment. We then categorized the 137 remaining articles by treatment and rated whether each treatment category was portrayed in a favourable, unfavourable, or neutral manner. RESULTS In total, 46% of the articles discussed at least 1 empirically supported treatment, 53% at least 1 alternative treatment, and 12% at least 1 uncategorized treatment. Newspaper articles provided favourable, unfavourable, and neutral portrayals of empirically supported treatments in 75%, 10%, and 16% of cases, respectively. In contrast, alternative treatments were portrayed favourably in 52%, unfavourably in 32%, and neutrally in 16% of cases. Our analyses indicated that empirically supported treatments were portrayed more favourably than alternative treatments (χ(2) = 10.42, df = 2, P = 0.005). CONCLUSIONS Despite some encouraging trends, our study has shown that researchers and clinicians must continue to clarify misconceptions about autism treatment. Families of people with autism spectrum disorders should be directed toward more reliable and accurate sources of information.
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Affiliation(s)
- Marc J Lanovaz
- Assistant Professor, University of Montreal, Montreal, Quebec
| | | | - Shalaka Shah
- Graduate Student, McGill University, Montreal, Quebec
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Pelly L, Vardy C, Fernandez B, Newhook LA, Chafe R. Incidence and cohort prevalence for autism spectrum disorders in the Avalon Peninsula, Newfoundland and Labrador. CMAJ Open 2015; 3:E276-80. [PMID: 26442225 PMCID: PMC4593414 DOI: 10.9778/cmajo.20140056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recent studies have reported increased prevalence for autism spectrum disorders in a number of geographical locations. Our objective was to determine the incidence and 1-year cohort prevalence for autism spectrum disorders in children less than 15 years of age and living in the Avalon Peninsula at the time of diagnosis. METHODS Retrospective and prospective data were obtained from the Janeway Children's Health and Rehabilitation Centre (St. John's), including the identification and specific diagnosis for all children assessed for autism spectrum disorder from 2006 to 2010. Additional clinic data were reviewed to update the data until the end of 2013. RESULTS From 2006 to 2010, 272 children had a diagnosis of autism spectrum disorder, averaging 54 new cases per year. The incidence of new cases increased from 10.1 to 16.7 cases per 10 000 per year from 2006 to 2010. At the end of 2013, the prevalence among children born in 2006 was 1 case of autism spectrum disorder per 46 children or 215.77 per 10 000. INTERPRETATION We found higher rates of autism spectrum disorder than previously reported for this population. The prevalence in this region is also high when compared with other global populations. The high rate of diagnosis supports the need for a provincial autism spectrum disorder registry and further research on autism spectrum disorder within this population.
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Affiliation(s)
- Lorine Pelly
- Section of Pediatric Infectious Diseases (Pelly), Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.; Discipline of Pediatrics (Vardy, Newhook, Chafe), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL; Discipline of Genetics (Fernandez), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
| | - Cathy Vardy
- Section of Pediatric Infectious Diseases (Pelly), Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.; Discipline of Pediatrics (Vardy, Newhook, Chafe), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL; Discipline of Genetics (Fernandez), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
| | - Bridget Fernandez
- Section of Pediatric Infectious Diseases (Pelly), Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.; Discipline of Pediatrics (Vardy, Newhook, Chafe), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL; Discipline of Genetics (Fernandez), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
| | - Leigh Anne Newhook
- Section of Pediatric Infectious Diseases (Pelly), Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.; Discipline of Pediatrics (Vardy, Newhook, Chafe), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL; Discipline of Genetics (Fernandez), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
| | - Roger Chafe
- Section of Pediatric Infectious Diseases (Pelly), Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.; Discipline of Pediatrics (Vardy, Newhook, Chafe), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL; Discipline of Genetics (Fernandez), Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
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Cheuk S, Lashewicz B. How are they doing? Listening as fathers of children with autism spectrum disorder compare themselves to fathers of children who are typically developing. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:343-52. [PMID: 25976158 DOI: 10.1177/1362361315584464] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The growing prevalence of autism spectrum disorder is accompanied by ongoing efforts to understand and support parents in the face of challenges related to their child's autism spectrum disorder. Although fathers are increasingly hands-on in raising children, research focus on parenting children with autism spectrum disorder continues to be skewed toward experiences of mothers. Our purpose in this article is to contribute understandings of how fathers of children with autism spectrum disorder perceive themselves to be managing, and we undertake this by examining comparisons fathers of children with autism spectrum disorder make between their parenting experiences and experiences of fathers of typically developing children. A purposive sample of 28 fathers of children (aged 2-13 years) with autism spectrum disorder living in an urban center in Western Canada participated in in-depth interviews about their parenting successes and challenges. We found fathers speak of universal fathering experiences yet articulate their own sense of loss and efforts to come to terms with unanticipated demands associated with autism spectrum disorder. Fathers of children with autism spectrum disorder feel "pangs of jealousy" toward fathers of typically developing children, yet they are keenly attentive to their own child's development and convey a sense of gratitude for their child's capabilities and personality amidst an appreciation for trials and triumphs of fathering in general and fathering a child with autism spectrum disorder in particular.
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Coo H, Ouellette-Kuntz H, Lam YM, Brownell M, Flavin MP, Roos LL. The association between the interpregnancy interval and autism spectrum disorder in a Canadian cohort. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2015; 106:e36-42. [PMID: 25955670 PMCID: PMC5319856 DOI: 10.17269/cjph.106.4667] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/18/2014] [Accepted: 11/30/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Two studies reported an increased risk of autistic disorder in children conceived less than 12 months after a previous birth. Our objective was to examine the association between the interpregnancy interval (IPI) and autism spectrum disorder (ASD) in a Canadian cohort. METHODS Using administrative datasets housed at the Manitoba Centre for Health Policy, we identified pairs of first- and second-born singleton siblings born between 1988 and 2005. Diagnoses of ASD were ascertained by searching physician billing claims, hospital discharge abstracts, education data, and a database containing information on individuals identified for a 2002-2007 ASD surveillance program in Manitoba. Logistic regression models were fit to examine the association between the IPI and ASD in 41,050 second-born siblings where the first-borns did not have ASD, using IPIs of ≥ 36 months as the reference category and specifying three case groups. Case Group 1 included individuals with at least one ASD code (n = 490); Case Group 2 included those with two or more ASD codes (n = 375); and Case Group 3 comprised individuals with a record in the ASD surveillance program database (n = 141). RESULTS The adjusted odds ratios (ORs) for IPIs shorter than 12 months ranged from 1.22 (95% CI: 0.91-1.63) for Case Group 1 to 1.72 (95% CI: 0.96-3.06) for Case Group 3. When the case groups were restricted to individuals with more severe ASD, the ORs increased and were significant for Case Groups 1 and 2. CONCLUSION Our findings also support an association between short IPIs and more severe ASD.
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Williams AL, DeSesso JM. Gestational/perinatal chlorpyrifos exposure is not associated with autistic-like behaviors in rodents. Crit Rev Toxicol 2014; 44:523-34. [PMID: 24861450 DOI: 10.3109/10408444.2014.907772] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Although animal models cannot exactly replicate human psychiatric disorders, they may be useful to investigate whether the behaviors associated with certain exposures in animals parallel those observed in people. According to the most current version of the Diagnostic and Statistical Manual of Mental Disorders, autism is diagnosed based on (1) persistent deficits in social communication and social interaction; and (2) the presence of restricted, repetitive patterns of behavior, interests and activities. To address whether developmental chlorpyrifos (CPF) exposure was associated with the development of autistic behaviors, a literature search was conducted to identify studies in rats and mice involving gestational or early postnatal exposure to CPF or CPF oxon (CPO, the active metabolite of CPF) and subsequent behavioral testing to assess behaviors related to autism. A total of 13 studies conducted in six different laboratories were identified. Analysis of these studies found that perinatal CPF exposure was generally associated with (1) no effect or increased social communications; (2) no effect or increased social encounters; (3) no effect, reduced stereotypies, or conflicting findings on stereotypic behaviors; and (4) no effect or increased preference for novelty and reduced anxiety in novel environments. These behavioral findings are generally inconsistent with the types of behaviors that would be expected in children with clinical autism. Based on the results of this analysis of rodent model studies involving CPF/CPO exposure, it cannot be concluded that gestational and/or perinatal CPF exposure is likely to be associated with the development of autism-like behaviors in humans.
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