1
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Joseph RM, Lai ER, Bishop S, Yi J, Bauman ML, Frazier JA, Santos HP, Douglas LM, Kuban KK, Fry RC, O’Shea MT. Comparing autism phenotypes in children born extremely preterm and born at term. Autism Res 2023; 16:653-666. [PMID: 36595641 PMCID: PMC10551822 DOI: 10.1002/aur.2885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
Children born preterm are at increased risk for autism spectrum disorder (ASD). There is limited knowledge about whether ASD phenotypes in children born preterm differ from children born at term. The objective of this study was to compare ASD core symptoms and associated characteristics among extremely preterm (EP) and term-born children with ASD. EP participants (n = 59) from the Extremely Low Gestational Age Newborn Study who met diagnostic criteria for ASD at approximately 10 years of age were matched with term-born participants from the Simons Simplex Collection on age, sex, spoken language level, and nonverbal IQ. Core ASD symptomatology was evaluated with the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). Developmental milestones, anthropometrics, seizure disorder, and psychiatric symptoms were also investigated. The EP group had lower parent-reported symptom scores on ADI-R verbal communication, specifically stereotyped language, and restricted, repetitive behaviors. There were no between-group differences on ADI-R nonverbal communication and ADI-R reciprocal social interaction or with direct observation on the ADOS-2. The EP group was more likely to have delayed speech milestones and lower physical growth parameters. Results from female-only analyses were similar to those from whole-group analyses. In sum, behavioral presentation was similar between EP and IQ- and sex-matched term-born children assessed at age 10 years, with the exception of less severe retrospectively reported stereotyped behaviors, lower physical growth parameters, and increased delays in language milestones among EP-born children with ASD.
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Affiliation(s)
- Robert M. Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Emily R. Lai
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Somer Bishop
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Joe Yi
- Department of Allied Health Sciences, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Margaret L. Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Jean A. Frazier
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Hudson P. Santos
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | | | - Karl K.C. Kuban
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michael T. O’Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
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2
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Ji Y, Ji Y, Zhu HL, Cheng SM, Zou XB, Zhu FL. Examine sex differences in autism spectrum disorder in school-aged children and adolescents with fluent language. Front Psychiatry 2023; 14:1151596. [PMID: 37091718 PMCID: PMC10117662 DOI: 10.3389/fpsyt.2023.1151596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
There are noteworthy sex disparities in the prevalence of autism spectrum disorders (ASD), while findings regarding the sex differences in core symptoms are inconsistent. There are few relevant studies on sex differences in mainland China. This study was dedicated to a deeper understanding of the impact of sex differences on the clinical presentation of ASD with fluent language. We retrospectively studied 301 children with ASD (58 females) and utilized raw scores from the ADI-R and ADOS and the intelligence quotient (IQ) to measure symptomatology. Based on the Full-Scale IQ (FS-IQ), a binary split of average, above-average IQ (high-IQ), and below-average IQ (low IQ) occurs at 85. Across the entire sample, males and females are comparable in the FS-IQ, while males scored higher in the Perceptual Reasoning Index (PRI) (F = 7.812, p = 0.006). ADI-R did not find any statistically significant sex differences in the diagnostic cutoff score satisfaction or the raw domain scores. While a significant effect of sex on ADOS social affect domain scores was found in the total sample [λ = 0.970, partial η2 = 0.030, F (3,295) = 3.019, p = 0.030]. Tests of between-subjects effects revealed that males scored higher than females mainly in the ADOS reciprocal social interaction subcategory (partial η2 = 0.022, F = 6.563, p = 0.011). Stratified analysis revealed that the effect of sex on ADOS reciprocal social interaction subcategory scores only significant in the low-IQ children with ASD (partial η2 = 0.092, F = 10.088, p = 0.002). In general, overall cognitive functioning is similar across males and females with ASD, while males have a higher perceptual reasoning ability. Females with ASD are more likely to have comorbid intellectual impairment than males, and they could require additional intervention support. Autistic children with low IQs are more likely to exhibit sex differences in their core symptoms than children with high IQs. Intelligence plays a key role in sex-based differences in the core symptoms of ASD.
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3
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Sano M, Yoshimura Y, Hirosawa T, Hasegawa C, An KM, Tanaka S, Naitou N, Kikuchi M. Joint attention and intelligence in children with autism spectrum disorder without severe intellectual disability. Autism Res 2021; 14:2603-2612. [PMID: 34427050 PMCID: PMC9291323 DOI: 10.1002/aur.2600] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/27/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
In children with autism spectrum disorder (ASD), joint attention is regarded as a predictor of language function, social skills, communication, adaptive function, and intelligence. However, existing information about the association between joint attention and intelligence is limited. Most such studies have examined children with low intelligence. For this study, we investigated whether joint attention is related to intelligence in young children with autism spectrum disorder (ASD) without severe intellectual disability. We analyzed 113 children with ASD aged 40–98 months. Their Kaufman Assessment Battery (K‐ABC) Mental Processing Index (MPI) scores are 60 and more (mean 93.4). We evaluated their intelligence using K‐ABC and evaluated their joint attention using ADOS‐2. After we performed simple regression analyses using K‐ABC MPI and its nine subscales as dependent variables, using joint attention as the independent variable, we identified joint attention as a positive predictor of the MPI and its two subscales. From this result, we conclude that joint attention is related to intelligence in young children with ASD without severe intellectual disability. This result suggests a beneficial effect of early intervention targeting joint attention for children with ASD.
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Affiliation(s)
- Masuhiko Sano
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Yuko Yoshimura
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan.,Faculty of Education, Institute of Human and Social Sciences, Kanazawa University, Kanazawa, Japan
| | - Tetsu Hirosawa
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.,Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Chiaki Hasegawa
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Kyung-Min An
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Sanae Tanaka
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Nobushige Naitou
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.,Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
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4
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Chen D, Jia T, Zhang Y, Cao M, Loth E, Lo CYZ, Cheng W, Liu Z, Gong W, Sahakian BJ, Feng J. Neural Biomarkers Distinguish Severe From Mild Autism Spectrum Disorder Among High-Functioning Individuals. Front Hum Neurosci 2021; 15:657857. [PMID: 34025376 PMCID: PMC8134539 DOI: 10.3389/fnhum.2021.657857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/11/2021] [Indexed: 01/01/2023] Open
Abstract
Several previous studies have reported atypicality in resting-state functional connectivity (FC) in autism spectrum disorder (ASD), yet the relatively small effect sizes prevent us from using these characteristics for diagnostic purposes. Here, canonical correlation analysis (CCA) and hierarchical clustering were used to partition the high-functioning ASD group (i.e., the ASD discovery group) into subgroups. A support vector machine (SVM) model was trained through the 10-fold strategy to predict Autism Diagnostic Observation Schedule (ADOS) scores within the ASD discovery group (r = 0.30, P < 0.001, n = 260), which was further validated in an independent sample (i.e., the ASD validation group) (r = 0.35, P = 0.031, n = 29). The neuroimage-based partition derived two subgroups representing severe versus mild autistic patients. We identified FCs that show graded changes in strength from ASD-severe, through ASD-mild, to controls, while the same pattern cannot be observed in partitions based on ADOS score. We also identified FCs that are specific for ASD-mild, similar to a partition based on ADOS score. The current study provided multiple pieces of evidence with replication to show that resting-state functional magnetic resonance imaging (rsfMRI) FCs could serve as neural biomarkers in partitioning high-functioning autistic individuals based on their symptom severity and showing advantages over traditional partition based on ADOS score. Our results also indicate a compensatory role for a frontocortical network in patients with mild ASD, indicating potential targets for future clinical treatments.
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Affiliation(s)
- Di Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Tianye Jia
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.,Centre for Population Neuroscience and Precision Medicine, MRC SGDP Centre, IoPPN, King's College London, London, United Kingdom
| | - Yuning Zhang
- Centre for Population Neuroscience and Precision Medicine, MRC SGDP Centre, IoPPN, King's College London, London, United Kingdom.,State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Miao Cao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Eva Loth
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, IoPPN, King's College London, London, United Kingdom
| | - Chun-Yi Zac Lo
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Zhaowen Liu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Weikang Gong
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Barbara Jacquelyn Sahakian
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.,School of Mathematical Sciences and Centre for Computational Systems Biology, Fudan University, Shanghai, China.,Department of Computer Science, University of Warwick, Coventry, United Kingdom
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5
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Schaller UM, Biscaldi M, Burkhardt A, Fleischhaker C, Herbert M, Isringhausen A, Tebartz van Elst L, Rauh R. ADOS-Eye-Tracking: The Archimedean Point of View and Its Absence in Autism Spectrum Conditions. Front Psychol 2021; 12:584537. [PMID: 33815191 PMCID: PMC8012688 DOI: 10.3389/fpsyg.2021.584537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Face perception and emotion categorization are widely investigated under laboratory conditions that are devoid of real social interaction. Using mobile eye-tracking glasses in a standardized diagnostic setting while applying the Autism Diagnostic Observation Schedule (ADOS-2), we had the opportunity to record gaze behavior of children and adolescents with and without Autism Spectrum Conditions (ASCs) during social interaction. The objective was to investigate differences in eye-gaze behavior between three groups of children and adolescents either (1) with ASC or (2) with unconfirmed diagnosis of ASC or (3) with neurotypical development (NTD) during social interaction with an adult interviewer in a diagnostic standard situation using the ADOS-2. In a case control study, we used mobile eye-tracking glasses in an ecologically valid and highly standardized diagnostic interview to investigate suspected cases of ASC. After completion of the ASC diagnostic gold standard including the ADOS-2, the participants were assigned to two groups based on their diagnosis (ASC vs. non-ASC) and compared with a matched group of neurotypically developed controls. The primary outcome measure is the percentage of total dwell times assessed for different areas of interest (AOI) with regard to the face and body of a diagnostic interviewer and the surrounding space. Overall, 65 children and adolescents within an age range of 8.3-17.9 years were included in the study. The data revealed significant group differences, especially in the central-face area. Previous investigations under laboratory conditions gave preferential attention to the eye region during face perception to describe differences between ASC and NTD. In this study - using an ecologically valid setting within a standard diagnostic procedure - the results indicate that neurotypically developed controls seem to process faces and facial expressions in a holistic manner originating from the central-face region. Conversely, participants on the Autism Spectrum (tAS) seem to avoid the central-face region and show unsystematic gaze behavior, not using the preferred landing position in the central-face region as the Archimedean point of face perception. This study uses a new approach, and it will be important to replicate these preliminary findings in future research.
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Affiliation(s)
- Ulrich Max Schaller
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monica Biscaldi
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Burkhardt
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christian Fleischhaker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Herbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Isringhausen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reinhold Rauh
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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6
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Mouga S, Castelhano J, Café C, Sousa D, Duque F, Oliveira G, Castelo-Branco M. Social Attention Deficits in Children With Autism Spectrum Disorder: Task Dependence of Objects vs. Faces Observation Bias. Front Psychiatry 2021; 12:640599. [PMID: 33828495 PMCID: PMC8019800 DOI: 10.3389/fpsyt.2021.640599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Social attention deficits represent a central impairment of patients suffering from autism spectrum disorder (ASD), but the nature of such deficits remains controversial. We compared visual attention regarding social (faces) vs. non-social stimuli (objects), in an ecological diagnostic context, in 46 children and adolescents divided in two groups: ASD (N = 23) and typical neurodevelopment (TD) (N = 23), matched for chronological age and intellectual performance. Eye-tracking measures of visual scanning, while exploring and describing scenes from three different tasks from the Autism Diagnostic Observation Schedule (ADOS), were analyzed: "Description of a Picture," "Cartoons," and "Telling a Story from a Book." Our analyses revealed a three-way interaction between Group, Task, and Social vs. Object Stimuli. We found a striking main effect of group and a task dependence of attentional allocation: while the TD attended first and longer to faces, ASD participants became similar to TD when they were asked to look at pictures while telling a story. Our results suggest that social attention allocation is task dependent, raising the question whether spontaneous attention deficits can be rescued by guiding goal-directed actions.
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Affiliation(s)
- Susana Mouga
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,ICNAS - Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal.,CNC.IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Neurodevelopmental and Autism Unit From Child Developmental Centre, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João Castelhano
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,ICNAS - Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal
| | - Cátia Café
- Neurodevelopmental and Autism Unit From Child Developmental Centre, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Daniela Sousa
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,ICNAS - Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal.,Neurodevelopmental and Autism Unit From Child Developmental Centre, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Frederico Duque
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,CNC.IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Neurodevelopmental and Autism Unit From Child Developmental Centre, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Guiomar Oliveira
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,CNC.IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Neurodevelopmental and Autism Unit From Child Developmental Centre, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,ICNAS - Institute of Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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7
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Maddox BB, Rump KM, Stahmer AC, Suhrheinrich J, Rieth SR, Nahmias AS, Nuske HJ, Reisinger EM, Crabbe SR, Bronstein B, Mandell DS. Concordance between a U.S. Educational Autism Classification and the Autism Diagnostic Observation Schedule. J Clin Child Adolesc Psychol 2020; 49:469-475. [PMID: 30892948 PMCID: PMC6754325 DOI: 10.1080/15374416.2019.1567345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
States in the United States differ in how they determine special education eligibility for autism services. Few states include an autism-specific diagnostic tool in their evaluation. In research, the Autism Diagnostic Observation Schedule (ADOS for first edition, ADOS-2 for second edition) is considered the gold-standard autism assessment. The purpose of this study was to estimate the proportion of children with an educational classification of autism who exceed the ADOS/ADOS-2 threshold for autism spectrum (concordance rate). Data were drawn from 4 school-based studies across 2 sites (Philadelphia, Pennsylvania, and San Diego, California). Participants comprised 627 children (2-12 years of age; 83% male) with an autism educational classification. Analyses included (a) calculating the concordance rate between educational and ADOS/ADOS-2 classifications and (b) estimating the associations between concordance and child's cognitive ability, study site, and ADOS/ADOS-2 administration year using logistic regression. More San Diego participants (97.5%, all assessed with the ADOS-2) met ADOS/ADOS-2 classification than did Philadelphia participants assessed with the ADOS-2 (92.2%) or ADOS (82.9%). Children assessed more recently were assessed with the ADOS-2; this group was more likely to meet ADOS/ADOS-2 classification than the group assessed longer ago with the ADOS. Children with higher IQ were less likely to meet ADOS/ADOS-2 classification. Most children with an educational classification of autism meet ADOS/ADOS-2 criteria, but results differ by site and by ADOS version and/or recency of assessment. Educational classification may be a reasonable but imperfect measure to include children in community-based trials.
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Affiliation(s)
- Brenna B. Maddox
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Keiran M. Rump
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Aubyn C. Stahmer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Davis, CA,Child and Adolescent Services Research Center, San Diego, CA
| | - Jessica Suhrheinrich
- Child and Adolescent Services Research Center, San Diego, CA,San Diego State University, San Diego, CA
| | - Sarah R. Rieth
- Child and Adolescent Services Research Center, San Diego, CA,San Diego State University, San Diego, CA
| | - Allison S. Nahmias
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Davis, CA
| | - Heather J. Nuske
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Erica M. Reisinger
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Samantha R. Crabbe
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Briana Bronstein
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - David S. Mandell
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
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8
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Neuhaus E, Beauchaine TP, Bernier RA, Webb SJ. Child and family characteristics moderate agreement between caregiver and clinician report of autism symptoms. Autism Res 2017; 11:476-487. [PMID: 29251835 DOI: 10.1002/aur.1907] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 10/09/2017] [Accepted: 11/22/2017] [Indexed: 11/08/2022]
Abstract
Rates of autism spectrum disorder (ASD) and age at first diagnosis vary considerably across the United States and are moderated by children's sex, race, ethnicity, and availability of services. We additionally suggest that degree of caregiver-clinician agreement on ASD symptoms may play a role in ASD assessment. Since gold standard ASD assessment integrates caregiver-reported developmental history with clinician observations, differential agreement between reporters across demographic groups may contribute to a host of detrimental outcomes. Here, we investigate whether caregiver-clinician agreement on ASD symptoms varies according to child and family characteristics. Comprehensive data from 2,759 families in the Simons Simplex Collection were analyzed. Linear models were created with caregiver reports predicting clinician reports, and moderating effects of child characteristics and family factors were examined. Poorer reporter correspondence was observed when children had higher IQ scores, stronger adaptive behavior, and more behavioral difficulties. Greater disagreement was also associated with African American racial status (for younger children), lower household income, and paternal social difficulties (for older children). Children's biological sex did not moderate caregiver-clinician agreement. Marked disagreement between caregivers and clinicians could lead to suboptimal or insufficient intervention services and negative experiences for families throughout development. Such families may also be less likely to qualify for research studies, and therefore be underrepresented in the ASD literature. Modified assessment procedures may be required to improve assessment accuracy and family experiences. Autism Res 2018, 11: 476-487. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Evaluation of autism spectrum disorder (ASD) incorporates both caregiver and clinician perspectives of symptoms, and disagreement between these perspectives could lead to poorer outcomes for families. Using data from 2,759 families, we show that caregiver-clinician agreement on ASD symptoms is poorer for children with higher cognitive and adaptive skills, more behavioral difficulties, lower household income, and African American racial status. These children may be at higher risk for misdiagnosis, poorer family experiences during evaluations, and poorer representation in ASD research.
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Affiliation(s)
- Emily Neuhaus
- Seattle Children's Research Institute, Center on Child Health, Behavior, and Development, Seattle, Washington
| | | | - Raphael A Bernier
- University of Washington, Psychiatry and Behavioral Science, Seattle, Washington
| | - Sara J Webb
- Seattle Children's Research Institute, Center on Child Health, Behavior, and Development, Seattle, Washington.,University of Washington, Psychiatry and Behavioral Science, Seattle, Washington
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9
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Kästner A, Begemann M, Michel TM, Everts S, Stepniak B, Bach C, Poustka L, Becker J, Banaschewski T, Dose M, Ehrenreich H. Autism beyond diagnostic categories: characterization of autistic phenotypes in schizophrenia. BMC Psychiatry 2015; 15:115. [PMID: 25968177 PMCID: PMC4436160 DOI: 10.1186/s12888-015-0494-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/29/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Behavioral phenotypical continua from health to disease suggest common underlying mechanisms with quantitative rather than qualitative differences. Until recently, autism spectrum disorders and schizophrenia were considered distinct nosologic entities. However, emerging evidence contributes to the blurring of symptomatic and genetic boundaries between these conditions. The present study aimed at quantifying behavioral phenotypes shared by autism spectrum disorders and schizophrenia to prepare the ground for biological pathway analyses. METHODS Specific items of the Positive and Negative Syndrome Scale were employed and summed up to form a dimensional autism severity score (PAUSS). The score was created in a schizophrenia sample (N = 1156) and validated in adult high-functioning autism spectrum disorder (ASD) patients (N = 165). To this end, the Autism Diagnostic Observation Schedule (ADOS), the Autism (AQ) and Empathy Quotient (EQ) self-rating questionnaires were applied back to back with the newly developed PAUSS. RESULTS PAUSS differentiated between ASD, schizophrenia and a disease-control sample and substantially correlated with the Autism Diagnostic Observation Schedule. Patients with ADOS scores ≥12 obtained highest, those with scores <7 lowest PAUSS values. AQ and EQ were not found to vary dependent on ADOS diagnosis. ROC curves for ADOS and PAUSS resulted in AuC values of 0.9 and 0.8, whereas AQ and EQ performed at chance level in the prediction of ASD. CONCLUSIONS This work underscores the convergence of schizophrenia negative symptoms and autistic phenotypes. PAUSS evolved as a measure capturing the continuous nature of autistic behaviors. The definition of extreme-groups based on the dimensional PAUSS may permit future investigations of genetic constellations modulating autistic phenotypes.
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Affiliation(s)
- Anne Kästner
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany. .,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.
| | - Tanja Maria Michel
- Department of Psychiatry, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Sarah Everts
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Beata Stepniak
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Christiane Bach
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
| | - Joachim Becker
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
| | - Matthias Dose
- kbo-Isar-Amper-Klinikum Taufkirchen, Taufkirchen (Vils), Germany.
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany. .,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.
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Abstract
Standardized Autism Diagnostic Observation Schedule (ADOS) scores provide a measure of autism severity that is less influenced by child characteristics than raw totals (Gotham et al. in Journal of Autism and Developmental Disorders, 39(5), 693-705 2009). However, these scores combine symptoms from the Social Affect (SA) and Restricted and Repetitive Behaviors (RRB) domains. Separate calibrations of each domain would provide a clearer picture of ASD dimensions. The current study separately calibrated raw totals from the ADOS SA and RRB domains. Standardized domain scores were less influenced by child characteristics than raw domain totals, thereby increasing their utility as indicators of Social-Communication and Repetitive Behavior severity. Calibrated domain scores should facilitate efforts to examine trajectories of ASD symptoms and links between neurobiological and behavioral dimensions.
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Affiliation(s)
- Vanessa Hus
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA,
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Rumsey RK, Rudser K, Delaney K, Potegal M, Whitley CB, Shapiro E. Acquired autistic behaviors in children with mucopolysaccharidosis type IIIA. J Pediatr 2014; 164:1147-1151.e1. [PMID: 24582005 PMCID: PMC4041612 DOI: 10.1016/j.jpeds.2014.01.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 12/02/2013] [Accepted: 01/06/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To assess autism spectrum disorder (ASD) behaviors in children with mucopolysaccharidosis type IIIA (MPS IIIA) using a standard measure, understand the behavioral evolution of the disease, and provide specific guidelines for diagnosis. STUDY DESIGN Children (n = 21) with documented enzyme deficiency and SGSH gene mutations, cognitive age-equivalent >12 months, and early onset were administered the Autism Diagnostic Observation Schedule (ADOS) (module 1) and Bayley Scales of Infant Development-Third Edition. ADOS Social Affect and Restricted Repetitive Behavior total scores, as well as Bayley Scales of Infant Development-Third Edition cognitive age-equivalent scores, are reported using descriptive statistics and graphic presentations. RESULTS Thirteen of the 21 children evaluated met the ADOS criteria for ASD/autism. ADOS score was strongly associated with age; all 11 children aged >46 months met the criteria, compared with only 2 of 10 aged <46 months. Social and affective abnormalities were most frequent; restricted interests and repetitive behaviors were largely absent. Lack of cognitive growth paralleled ADOS score. CONCLUSION An increased incidence of ASD-like social behaviors was seen at age 3-4 years in children with early-onset MPS IIIA. Although more frequent in the severely impaired children, ASD-like behaviors were observed across the entire range of cognitive impairment. Clinicians must be aware that when a child acquires ASD-like behaviors, MPS IIIA should be included in the differential diagnosis.
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Affiliation(s)
| | - Kyle Rudser
- Division of Biostatistics, University of Minnesota
| | | | | | | | - Elsa Shapiro
- Department of Pediatrics, University of Minnesota
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12
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Abstract
The Autism Diagnostic Observation Schedule-Generic (ADOS) is one of the most widely used instruments for behavioral evaluation of autism spectrum disorders. It is composed of four modules, each tailored for a specific group of individuals based on their language and developmental level. On average, a module takes between 30 and 60 min to deliver. We used a series of machine-learning algorithms to study the complete set of scores from Module 1 of the ADOS available at the Autism Genetic Resource Exchange (AGRE) for 612 individuals with a classification of autism and 15 non-spectrum individuals from both AGRE and the Boston Autism Consortium (AC). Our analysis indicated that 8 of the 29 items contained in Module 1 of the ADOS were sufficient to classify autism with 100% accuracy. We further validated the accuracy of this eight-item classifier against complete sets of scores from two independent sources, a collection of 110 individuals with autism from AC and a collection of 336 individuals with autism from the Simons Foundation. In both cases, our classifier performed with nearly 100% sensitivity, correctly classifying all but two of the individuals from these two resources with a diagnosis of autism, and with 94% specificity on a collection of observed and simulated non-spectrum controls. The classifier contained several elements found in the ADOS algorithm, demonstrating high test validity, and also resulted in a quantitative score that measures classification confidence and extremeness of the phenotype. With incidence rates rising, the ability to classify autism effectively and quickly requires careful design of assessment and diagnostic tools. Given the brevity, accuracy and quantitative nature of the classifier, results from this study may prove valuable in the development of mobile tools for preliminary evaluation and clinical prioritization-in particular those focused on assessment of short home videos of children--that speed the pace of initial evaluation and broaden the reach to a significantly larger percentage of the population at risk.
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Affiliation(s)
- D P Wall
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA 02115-6030, USA.
| | - J Kosmicki
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - T F DeLuca
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - E Harstad
- Division of Developmental Medicine, Children's Hospital Boston, Boston, MA, USA
| | - V A Fusaro
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA
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13
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Gotham K, Risi S, Dawson G, Tager-Flusberg H, Joseph R, Carter A, Hepburn S, McMAHON W, Rodier P, Hyman SL, Sigman M, Rogers S, Landa R, Spence MA, Osann K, Flodman P, Volkmar F, Hollander E, Buxbaum J, Pickles A, Lord C. A replication of the Autism Diagnostic Observation Schedule (ADOS) revised algorithms. J Am Acad Child Adolesc Psychiatry 2008; 47:642-651. [PMID: 18434924 PMCID: PMC3057666 DOI: 10.1097/chi.0b013e31816bffb7] [Citation(s) in RCA: 208] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To replicate the factor structure and predictive validity of revised Autism Diagnostic Observation Schedule algorithms in an independent dataset (N = 1,282). METHOD Algorithm revisions were replicated using data from children ages 18 months to 16 years collected at 11 North American sites participating in the Collaborative Programs for Excellence in Autism and the Studies to Advance Autism Research and Treatment. RESULTS Sensitivities and specificities approximated or exceeded those of the old algorithms except for young children with phrase speech and a clinical diagnosis of pervasive developmental disorders not otherwise specified. CONCLUSIONS Revised algorithms increase comparability between modules and improve the predictive validity of the Autism Diagnostic Observation Schedule for autism cases compared to the original algorithms.
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Affiliation(s)
- Katherine Gotham
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester..
| | - Susan Risi
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Geraldine Dawson
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Helen Tager-Flusberg
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Robert Joseph
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Alice Carter
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Susan Hepburn
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - William McMAHON
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Patricia Rodier
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Susan L Hyman
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Marian Sigman
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Sally Rogers
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Rebecca Landa
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - M Anne Spence
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Kathryn Osann
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Pamela Flodman
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Fred Volkmar
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Eric Hollander
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Joseph Buxbaum
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Andrew Pickles
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
| | - Catherine Lord
- Ms. Gotham and Drs. Risi and Lord are with the University of Michigan Autism and Communication Disorders Center; Dr. Dawson is with the University of Washington; Drs. Tager-Flusberg and Joseph are with Boston University School of Medicine; Dr. Carter is with the University of Massachusetts; Dr. Hepburn is with University of Colorado Health Sciences Center; Dr. McMahon is with the University of Utah; Drs. Rodier and Hyman are with University of Rochester Medical Center; Dr. Sigman is with University of California, Los Angeles; Dr. Rogers is with the University of California, Davis M.I.N.D. Institute; Dr. Landa is with Kennedy Krieger Institute; Drs. Spence and Osann and Ms. Flodman are with University of California, Irvine; Dr. Volkmar is with the Yale Child Study Center; Drs. Hollander and Buxbaum are with the Mount Sinai School of Medicine; and Dr. Pickles is with the University of Manchester
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Bruni O, Ferri R, Vittori E, Novelli L, Vignati M, Porfirio MC, Aricò D, Bernabei P, Curatolo P. Sleep architecture and NREM alterations in children and adolescents with Asperger syndrome. Sleep 2007; 30:1577-85. [PMID: 18041490 PMCID: PMC2082103 DOI: 10.1093/sleep/30.11.1577] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
STUDY OBJECTIVES To analyze sleep in children with Asperger syndrome (AS) by means of standard sleep questionnaires, to evaluate sleep architecture and NREM sleep alterations by means of cyclic alternating pattern (CAP) and to correlate objective sleep parameters with cognitive behavioral measures. DESIGN Cross-sectional study involving validated sleep questionnaires, neuropsychological scales, and PSG recording. SETTING Sleep medicine center. PARTICIPANTS Eight children with AS, 10 children with autism, and 12 healthy control children. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Children with AS had a higher prevalence of problems of initiating sleep and daytime sleepiness. Sleep architecture parameters showed minor differences between the 3 groups. CAP parameters showed an increased percentage of A1 and a decreased percentage of A2 subtypes in subjects with AS vs. controls. All A subtype indexes (number per hour of NREM sleep) were decreased, mostly in sleep stage 2 but not in SWS. With respect to children with autism, subjects with AS showed increased CAP rate in SWS and A1 percentage. In subjects with AS, verbal IQ had a significant positive correlation with total CAP rate and CAP rate in SWS and with global and SWS A1 index. The percentage of A2 negatively correlated with full scale IQ, verbal and performance IQ. CBCL total score correlated positively with CAP rate and A1 index while externalizing score correlated negatively with A3%. CONCLUSIONS This study shows peculiar CAP modifications in children with AS and represents an attempt to correlate the quantification of sleep EEG oscillations with the degree of mental ability/disability.
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Affiliation(s)
- Oliviero Bruni
- Center for Pediatric Sleep Disorders, Department of Developmental Neurology and Psychiatry, University La Sapienza, 00185 Rome, Italy.
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