Psychiatry training in autism spectrum disorder and intellectual disability: Ongoing gaps and emerging opportunities

Children, adolescents, and adults with autism spectrum disorder and intellectual disability experience high rates of co-occurring psychiatric conditions throughout their lifetime. However, there is a shortage of psychiatrists to treat these populations. We evaluated how much education psychiatrists-in-training receive on how to care for individuals with autism spectrum disorder/intellectual disability. We found that in many psychiatry programs, residents receive limited training experiences in autism spectrum disorder/intellectual disability involving lectures and patient contact and that psychiatry program directors would benefit from more resources to strengthen education in autism spectrum disorder/intellectual disability

Mood Disorders in Mothers of Children on the Autism Spectrum Are Associated with Higher Functioning Autism

Mood disorders occur more frequently in family members of individuals with autism spectrum disorders (ASD) than in the general population. There may be associations between maternal mood disorder history patterns and specific ASD phenotypes. We therefore examined the relationship between maternal mood disorders and child autism spectrum disorders in 998 mother-child dyads enrolled in a national online autism registry and database. Mothers of children with ASD completed online questionnaires addressing their child’s ASD as well as their own mood disorder history. In multivariate logistic regression models of ASD diagnoses, the odds of an Asperger disorder versus autistic disorder diagnosis were higher among those children whose mothers had a lifetime history of bipolar disorder (OR 2.11, CI 1.20, 3.69) or depression (OR 1.62, CI 1.19, 2.19). Further, maternal mood disorder onset before first pregnancy was associated with higher odds (OR 2.35, CI 1.48, 3.73) of an Asperger versus autism diagnosis among this sample of children with ASD. These data suggest that differences in maternal mood disorder history may be associated with ASD phenotype in offspring

Perceptual alterations in the relationship between sensory reactivity, intolerance of uncertainty and anxiety in autistic children with and without co-occurring ADHD

Sensory differences and anxiety disorders are highly prevalent in autistic individuals with and without ADHD. Studies have shown that sensory differences and anxiety are associated and that intolerance of uncertainty (IU) plays an important role within this relationship. However, those studies predominantly assessed sensory reactivity using questionnaires (i.e., observational reports), which can be subjective, and do not differentiate between perceptual, affective, and behavioural levels of sensory processing. Psychophysical approaches can offer useful additional insight, by providing objective measures of sensory differences at the perceptual level. In the current study, we used psychophysical vibrotactile tasks to assess how alterations in sensory perception contribute to observationally assessed sensory reactivity, IU, and anxiety. 38 autistic children (aged 8-12 years; 27 with co-occurring ADHD) were included in the analyses. Consistent with previous findings, parent-report measures of sensory reactivity, anxiety, and child-reported IU, were intercorrelated. Mediation analyses showed that IU fully mediated an association between sensory reactivity and anxiety, and that anxiety partially mediated an association between sensory reactivity and IU. Of the measured vibrotactile thresholds, only simultaneous frequency discrimination (SFD) thresholds significantly correlated with parent-reported sensory reactivity. Interestingly, we found that sensory reactivity fully mediated an association between SFD threshold and anxiety, and between SFD threshold and IU. Taken together, these findings suggest a mechanistic pathway whereby low-level perceptual alterations contribute to sensory differences at the affective level, leading in turn to increased IU and anxiety. This stepwise association can inform therapeutic interventions for IU and anxiety in autistic individuals with or without ADHD

Global scale ECHO Autism model enhancing healthcare for females with autism spectrum disorder (ASD) during their transition into adulthood

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