Identifying Predictors of Diagnostic Instability of Autism Spectrum Disorder and Global Developmental Delay In Toddlers

Although Autism Spectrum Disorder (ASD) is considered to be a lifelong condition, some toddlers experience diagnostic instability over time. In particular, some toddlers’ diagnosis changes between ASD and Global Developmental Delay (GDD). However, little is known about the subset of children who change diagnosis. In a total of 424 toddlers who either maintained or changed diagnosis, the current study identified predictors of change in diagnosis and severity in those who change from ASD to non-ASD (ASD-NON), ASD to GDD (ASD-GDD), non-ASD to ASD (NON-ASD), and GDD to ASD (GDD-ASD) between two years old and four years old. Initial ASD symptom severity and participation in intervention services were predictive of all transitions. Additionally, receptive language predicted ASD-NON transition and socioeconomic status predicted ASD-GDD transition. Implications for informing prognosis of children, identifying targets of intervention, refining of screening and diagnostic measures, and measuring change in severity regardless of categorical change are discussed

Short Report: The Role of Emotion Perception in Adaptive Functioning of People with Autism Spectrum Disorders

Cognitive functioning has historically been used to predict adaptive outcomes of people with autism spectrum disorders (ASDs); however, research shows that it is not a complete predictor. The current study explored whether emotion perception was a predictor of adaptive outcomes, and more specifically, hypothesized that emotion perception (DANVA-2 error scores) would mediate adaptive functioning of people with ASDs (Vineland-II). People with ASDs demonstrated significantly lower adaptive functioning and emotion perception skills compared to typically-developing individuals. Emotion perception acted as a significant mediator for socialization, but not communication or daily living skills, highlighting that in people with ASDs, lower socialization abilities is the result, in part, of emotion perception deficits. It was unexpected that emotion perception was not a mediator for communication skills. This may be related to sample restrictions, or the narrow focus on emotion perception. Future research should involve a larger, more inclusive ASD sample, broaden approaches to exploring relationships between social perception and adaptive outcomes, and relate findings to brain mechanisms underlying emotion perception

Toddler Screening for Autism Spectrum Disorder: A Meta-Analysis of Diagnostic Accuracy

[EN] Great efforts focus on early detection of autism spectrum disorder, although some scientists and policy-makers have questioned early universal screening. The aim of this meta-analysis was to evaluate the diagnostic accuracy of the different screening tools. Several electronic databases were used to identify published studies. A Bayesian model was used to estimate the screening accuracy. The pooled sensitivity was 0.72 (95% CI 0.61-0.81), and the specificity was 0.98 (95% CI 0.97-0.99). Subgroup analyses to remove heterogeneity indicated sensitivity was 0.77 (95% CI 0.69-0.84), and specificity was 0.99 (95% CI 0.97-0.99; SD ≤ 0.01). Level 1 screening tools for ASD showed consistent statistically significant results and therefore are adequate to detect autism at 14-36 months.Fulbright Comisio

Autistic children who create imaginary companions: Evidence of social benefits

Past research shows that autistic children can and do create imaginary companions (ICs), and that these ICs resemble those that neurotypical children create. Neurotypical children creating ICs have been found to have significantly more developed theory of mind (ToM) and social understanding among other enhanced social cognitive skills. The study set out to determine if this finding applies to autistic children. Parents of 124 (38 female) autistic children, ages from 5 to –12 years old, completed questionnaires evaluating communication, social understanding, and social skills. Children with ICs had significantly higher ToM and social skills scores regardless of their communication abilities. Findings suggest that there is a variability in ToM and social skills in autistic children in reference to an IC play profile. Results are discussed in terms of direction of causality and lab-based investigations

The impact of different CD4 monitoring and switching strategies on mortality in HIV-infected African adults on antiretroviral therapy; an application of dynamic marginal structural models

In Africa, antiretroviral therapy (ART) is delivered with limited laboratory monitoring, often none. In 2003–2004, investigators in the Development of Antiretroviral Therapy in Africa (DART) Trial randomized persons initiating ART in Uganda and Zimbabwe to either laboratory and clinical monitoring (LCM) or clinically driven monitoring (CDM). CD4 cell counts were measured every 12 weeks in both groups but were only returned to treating clinicians for management in the LCM group. Follow-up continued through 2008. In observational analyses, dynamic marginal structural models on pooled randomized groups were used to estimate survival under different monitoring-frequency and clinical/immunological switching strategies. Assumptions included no direct effect of randomized group on mortality or confounders and no unmeasured confounders which influenced treatment switch and mortality or treatment switch and time-dependent covariates. After 48 weeks of first-line ART, 2,946 individuals contributed 11,351 person-years of follow-up, 625 switches, and 179 deaths. The estimated survival probability after a further 240 weeks for post-48-week switch at the first CD4 cell count less than 100 cells/mm3 or non-Candida World Health Organization stage 4 event (with CD4 count <250) was 0.96 (95% confidence interval (CI): 0.94, 0.97) with 12-weekly CD4 testing, 0.96 (95% CI: 0.95, 0.97) with 24-weekly CD4 testing, 0.95 (95% CI: 0.93, 0.96) with a single CD4 test at 48 weeks (baseline), and 0.92 (95% CI: 0.91, 0.94) with no CD4 testing. Comparing randomized groups by 48-week CD4 count, the mortality risk associated with CDM versus LCM was greater in persons with CD4 counts of <100 (hazard ratio = 2.4, 95% CI: 1.3, 4.3) than in those with CD4 counts of ≥100 (hazard ratio = 1.1, 95% CI: 0.8, 1.7; interaction P = 0.04). These findings support a benefit from identifying patients immunologically failing first-line ART at 48 weeks

Happy being me in the UK: A controlled evaluation of a school-based body image intervention with pre-adolescent children

This study evaluated an adapted version of 'Happy Being Me', a school-based body image intervention, with girls and boys aged 10-11 years. Forty-three children participated in a three-week intervention, and 45 children formed a control group. Both groups completed measures of body satisfaction, risk factors for negative body image, eating behaviors, self-esteem, and intervention topic knowledge, at baseline, post-intervention, and 3-month follow-up. For girls, participation in the intervention resulted in significant improvements in body satisfaction, appearance-related conversations, appearance comparisons, eating behaviors and intervention topic knowledge at post-intervention, although only the change in body satisfaction was maintained. There was also a significant decrease in internalization of cultural appearance ideals from baseline to follow-up. For boys, participation in the intervention resulted in significant improvements in internalization and appearance comparisons at post-intervention; however, neither of these changes were sustained at follow-up. There were no improvements in the control group over time. © 2013 Elsevier Ltd

GEO-6 assessment for the pan-European region

Through this assessment, the authors and the United Nations Environment Programme (UNEP) secretariat are providing an objective evaluation and analysis of the pan-European environment designed to support environmental decision-making at multiple scales. In this assessment, the judgement of experts is applied to existing knowledge to provide scientifically credible answers to policy-relevant questions. These questions include, but are not limited to the following:• What is happening to the environment in the pan-European region and why?• What are the consequences for the environment and the human population in the pan-European region?• What is being done and how effective is it?• What are the prospects for the environment in the future?• What actions could be taken to achieve a more sustainable future?<br/

Imaginary Companions in Children with Autism Spectrum Disorder

One of the deficits observed in autism spectrum disorder (ASD) is impaired imaginative play. One form of imaginative play common in many typically developing (TD) children is having an imaginary companion (IC). The occurrence of ICs has not been investigated extensively in children with ASD. We examined differences in parent report of IC between TD and ASD populations in 215 (111 with ASD) gender-matched children aged between 2 and 8 years. Findings indicate that significantly fewer children with ASD created ICs, although there were many between-group similarities in IC forms and functions. Results are discussed in terms of qualitative differences in play, social attributions, and how children with ASD conceptualize their ICs’ minds. Keywords Autism spectrum disorder Imagination Imaginary companions Social attribution Social developmen