Clinicians who treat children with attention-deficit/hyperactivity disorder (ADHD) face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased… Read More
We conducted a meta-analysis of epidemiological studies investigating the association between maternal age and autism.|Using recommended guidelines for performing meta-analyses, we systematically selected, and extracted results from, epidemiological scientific studies reported before January 2012. We calculated pooled risk estimates comparing categories of advancing maternal age with and without adjusting for possible confounding factors. We investigated the influence of gender ratio among cases, ratio of infantile autism to autism spectrum disorder (ASD), and median year of diagnosis as effect moderators in mixed-effect meta-regression.|We found 16 epidemiological papers fulfilling the a priori search criteria. The meta-analysis included 25,687 ASD cases and 8,655,576 control subjects. Comparing mothers 35 years with mothers 25 to 29 years old, the crude relative risk (RR) for autism in the offspring was 1.52 (95% confidence interval [CI] = 1.12-1.92). Comparing mothers 35
Video modeling with other as model (VMO) is a more practical method for implementing video-based modeling techniques, such as video self-modeling, which requires significantly more editing. Despite this, identification of contextual factors such as participant characteristics and targeted outcomes that moderate the effectiveness of VMO has not previously been explored. The purpose of this study was to meta-analytically evaluate the evidence base of VMO with individuals with disabilities to determine if participant characteristics and targeted outcomes moderate the effectiveness of the intervention. Findings indicate that VMO is highly effective for participants with autism spectrum disorder (IRD=.83) and moderately effective for participants with developmental disabilities (IRD=.68). However, differential effects are indicated across levels of moderators for diagnoses and targeted outcomes. Implications for practice and future research are discussed.
A comprehensive literature search was performed to collate evidence of mitochondrial dysfunction in autism spectrum disorders (ASDs) with two primary objectives. First, features of mitochondrial dysfunction in the general population of children with ASD were identified. Second, characteristics of mitochondrial dysfunction in children with ASD and concomitant mitochondrial disease (MD) were compared with published literature of two general populations: ASD children without MD, and non-ASD children with MD. The prevalence of MD in the general population of ASD was 5.0% (95% confidence interval 3.2, 6.9%), much higher than found in the general population ( 0.01%). The prevalence of abnormal biomarker values of mitochondrial dysfunction was high in ASD, much higher than the prevalence of MD. Variances and mean values of many mitochondrial biomarkers (lactate, pyruvate, carnitine and ubiquinone) were significantly different between ASD and controls. Some markers correlated with ASD
Structural alterations in brain morphology have been inconsistently reported in children compared to adults with autism spectrum disorder (ASD). We assessed these differences by performing meta-analysis on the data from 19 voxel-based morphometry studies. Common findings across the age groups were grey matter reduction in left putamen and medial prefrontal cortex (mPFC) and grey matter increases in the lateral PFC, while white matter decreases were seen mainly in the children in frontostriatal pathways. In the ASD sample, children/adolescents were more likely than adults to have increased grey matter in bilateral fusiform gyrus, right cingulate and insula. Results show that clear maturational differences exist in social cognition and limbic processing regions only in children/adolescents and not in adults with ASD, and may underlie the emotional regulation that improves with age in this population.
Recent years have seen a rapid increase in the investigation of autism spectrum disorders (ASD) through the use of functional magnetic resonance imaging (fMRI). We carried out a systematic review and ALE meta-analysis of fMRI studies of ASD. A disturbance to the function of social brain regions is among the most well replicated finding. Differences in social brain activation may relate to a lack of preference for social stimuli as opposed to a primary dysfunction of these regions. Increasing evidence points towards a lack of effective integration of distributed functional brain regions and disruptions in the subtle modulation of brain function in relation to changing task demands in ASD. Limitations of the literature to date include the use of small sample sizes and the restriction of investigation to primarily high functioning males with autism.
23403688 2013 02 13 2013 02 19 1538-3598 309 6 Feb 13 JAMA 611-3 10.1001/jama.2013.198 Berry Robert J RJ Crider Krista S KS Yeargin-Allsopp Marshalyn M eng Comment Editorial Research Support, U.S. Gov't, P.H.S. United States JAMA 7501160 0098-7484
Prenatal folic acid supplements reduce the risk of neural tube defects in children, but it has not been determined whether they protect against other neurodevelopmental disorders.|To examine the association between maternal use of prenatal folic acid supplements and subsequent risk of autism spectrum disorders (ASDs) (autistic disorder, Asperger syndrome, pervasive developmental disorder-not otherwise specified [PDD-NOS]) in children.|The study sample of 85,176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa). The children were born in 2002-2008; by the end of follow-up on March 31, 2012, the age range was 3.3 through 10.2 years (mean, 6.4 years). The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Relative risks of ASDs were estimated by odds ratios (ORs) with 95% CIs in a logistic regression
PTEN gene (phosphatase and tensin homolog deleted on chromosome ten, MIM 601628) is a tumor suppressor gene implicated in PTEN hamartoma tumor syndromes (PHTS) including Cowden syndrome, Bannayan-Riley-Ruvalcaba syndrome and Proteus-like syndrome. PTEN mutations have been more recently reported in children with macrocephaly and autism spectrum disorders or mental retardation, without other symptoms of PHTS. Although tumor risk has not been evaluated in these patients and their relatives, the same surveillance as for Cowden syndrome is usually proposed. We report a family including patients carrying a novel PTEN mutation and presenting with a mild phenotype consisting of macrocephaly, hypotonia during the first year of life and mild learning disabilities, without autistic features. None of these patients exhibited PTHS-related symptoms such as tumors, lipomas, vascular malformations or pigmented macules of the glans penis. This report raises the question of extending the indications of
23157461 2012 12 17 2013 02 19 1469-8749 55 1 Jan Dev Med Child Neurol 13-4 10.1111/dmcn.12042 Monash Alfred Psychiatry Research Center, The Alfred and Central Clinical School, Monash University, Melbourne, Vic., Australia. Enticott Peter G PG
The mirror mechanism allows the direct translation of a perceived (seen, felt, heard) action into the same motor representation of its related goal. This mechanism allows a direct comprehension of others' goals and motor intentions, enabling an embodied link between individuals. Because the mirror mechanism is a functional expression of the motor system, these findings suggest the relevance of the motor system to social cognition. It has been hypothesized that the impaired understanding of others' intentions, sensations, and emotions reported in autism spectrum disorder (ASD) could be linked to an alteration of the mirror mechanism in all of these domains. In this review, we address the theoretical issues underlying the social impairments in ASD and discuss them in relation to the cognitive role of the mirror mechanism.
Develop algorithms for the differential diagnosis of LGS in pediatric patients. ... Target Audience. This activity has been designed to meet the educational needs of pediatric neurologists and other healthcare professionals involved in the management of
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.