Effect of Parent Training on Adaptive Behavior in Children With Autism Spectrum Disorder and Disruptive Behavior: Results of a Randomized Trial

Objective This study examined the impact of parent training on adaptive behavior in children with autism spectrum disorder (ASD) and disruptive behavior. Methods This was a 24-week, 6-site, randomized trial of parent training versus parent education in 180 children with ASD (aged 3−7 years; 158 boys and 22 girls) and moderate or greater behavioral problems. Parent training included specific strategies to manage disruptive behavior over 11 to 13 sessions, 2 telephone boosters, and 2 home visits. Parent education provided useful information about autism but no behavior management strategies over 12 core sessions and 1 home visit. In a previous report, we showed that parent training was superior to parent education in reducing disruptive behavior in young children with ASD. Here, we test whether parent training is superior to parent education in improving daily living skills as measured by the parent-rated Vineland Adaptive Behavior Scales II. The long-term impact of parent training on adaptive functioning is also presented. Results At week 24, the parent training group showed a 5.7-point improvement from baseline on the Daily Living domain compared to no change in parent education (p = .004; effect size = 0.36). On the Socialization domain, there was a 5.9-point improvement in parent training versus a 3.1-point improvement in parent education (p = .11; effect size = 0.29). Gains in the Communication domain were similar across treatment groups. The gain in Daily Living was greater in children with IQ of >70. However, the interaction of treatment-by-IQ was not significant. Gains in Daily Living at week 24 were maintained upon re-evaluation at 24 weeks posttreatment. Conclusion These results support the model that reduction in disruptive behavior can lead to improvement in activities of daily living. By contrast, the expected trajectory for adaptive behavior in children with ASD is often flat and predictably declines in children with intellectual disability. In the parent training group, higher-functioning children achieved significant gains in daily living skills. Children with intellectual disability kept pace with time

Toward Innovative, Cost-Effective, and Systemic Solutions to Improve Outcomes and Well-Being of Military Families Affected by Autism Spectrum Disorder

The burdens faced by military families who have a child with autism are unique. The usual challenges of securing diagnostic, treatment, and educational services are compounded by life circumstances that include the anxieties of war, frequent relocation and separation, and a demand structure that emphasizes mission readiness and service. Recently established military autism-specific health care benefits set the stage for community-viable and cost-effective solutions that can achieve better outcomes for children and greater well-being for families. Here we argue for implementation of evidence-based solutions focused on reducing age of diagnosis and improving access to early intervention, as well as establishment of a tiered menu of services, individualized to the child and family, that fit with the military ethos and system of health care. Absence of this new model of care could compromise the utility and sustainability of the autism-specific benefit

Sensory reactivity in children with and without autism

Using the Sensory Survey, a 103-item scale measuring overreactivity, underreactivity and stimulus seeking behavior, abnormal reactivity to sensory stimuli was shown to be common in autism but not in typical children. The Sensory Survey was administered to parents of 222 children with Pervasive Developmental Disorders and parents of 195 typical children. Parents were also administered the Vineland Adaptive Behavior Scales and the Kinsbourne Focus of Attention Rating Scale. The Sensory Survey had high reliability for both groups. There were significant diagnostic differences in reactivity between Autistic Disorder, PDD-NOS, and typical children, with age as a covariate. Pairwise comparisons indicated that children with Autistic Disorder demonstrated the most overreactivity, undereactivity and seeking behavior, followed by children with PDD-NOS, and that typical children demonstrated the least overreactivity, underreactivity, and seeking behavior. Results also indicated significant diagnostic differences in overfocused attention, while covarying for age, with the highest scores found in Autistic Disorder and the lowest in typical children. Overfocused attention was most highly correlated with overreactivity to sensory stimuli. Hierarchical regression analyses indicated that the Sensory Survey adds unique variance to adaptive functioning impairments in autism, but in not typical children. Specifically, stimulus seeking behavior contributed to communication impairments; underreactivity contributed to socialization impairments; and both underreactivity and stimulus seeking behaviors contributed to impairments in daily living skills. Age trends in reactivity were found for children with autism and typical children. In PDD, overreactivity showed an increase with age and stimulus seeking behaviors showed a decrease with age. In typical children, there was also a slight trend for a decrease in seeking behaviors with age. Factor analyses showed items to cluster by reactivity rather than sensory modality for both groups. Results of a discriminant function analysis revealed a 90% predicted group membership rate for PDD and typical children based on scale mean scores. Results indicate that abnormal sensory reactivity is prevalent in children with autism and relates to adaptive impairment and overfocused attention. Abnormal responses to sensory stimuli do not appear to be prevalent in typical children.

Deficits in socialization and daily living skills associated with gastrointestinal symptoms in children with autism spectrum disorder

Recent research has demonstrated greater prevalence of gastrointestinal (GI) symptoms in children with autism spectrum disorder (ASD) as compared to their typically developing peers. While there is an existing body of research that examines behavioral correlates of ASD and GI symptoms, few specifically examine social and adaptive profiles in this context. The aim of the current study was to identify correlations between social and adaptive skills in children with ASD, with the endorsement of GI symptoms. Significant correlations were found between GI symptoms and overall adaptive functioning, socialization, and daily living skills. No significant correlations were found between GI symptoms and communication skills, motor skills, or ADOS-2 severity scores. Strengths, limitations, and directions for future research are discussed

Défi MOREST - Mortalités estivales de l'huître creuse Crassostrea gigas - Caractérisation des facteurs de risques associés aux mortalités estivales - Synthèse du thème 5 - Risque associé aux pathogènes. (La Rochelle 14-15 mars 2006)

L'un des objectifs principaux des travaux en pathologie des mollusques est d'identifier et d'étudier des agents infectieux capables d'induire des maladies et des mortalités chez les coquillages, en particulier, chez I'huître creuse, Crassostrea gigas, espèce principalement exploitée en France. Ces travaux semblent d'autant plus indispensables qu'il n'existait pas, jusqu'à ces dernières années, de maladies identifiées chez I'huître creuse en Europe excepté le virus herpès suspecté dès 1995 de provoquer des mortalités de naissain (Renault et al, 1995). Les principales maladies des espèces proches sont dues à des parasites comme Haplosporidium nelsoni (Ford et Heskin, 1987) et Perkinsus marinus Olivier et al, 1 998) pour Crassostrea virginica, Marteilia sydneyi, et Mikrocytos roughleyi pour Saccostrea commercialis (Hine, 1996) ou à des virus (irridovirus pour C. . angulata) mais ils n'ont pas été détectés chez C. gigas. La maladie pouvant se rapprocher des mortalités estivales est la JOD (Juvenile Oyster Disease) sur C. virginica dans laquelle les conditions environnementales jouent un rôle majeur mais où l'agent causal est encore controversé (Ford et Borrero, 2001 ; Boettcher et al, 2000)

Early social communication development in infants with autism spectrum disorder

Social-communication differences are a robust and defining feature of autism spectrum disorder (ASD) but identifying early points of divergence in infancy has been a challenge. The current study examines social communication in 9- to 12-month-old infants who develop ASD (N = 30; 23% female; 70% white) compared to typically developing (TD) infants (N = 94, 38% female; 88% white). Results demonstrate that infants later diagnosed with ASD were already exhibiting fewer social-communication skills using eye gaze, facial expression, gestures, and sounds at 9 months (effect size: 0.42–0.89). Moreover, three unique patterns of change across distinct social-communication skills were observed within the ASD group. This study documents that observable social-communication differences for infants with ASD are unfolding by 9 months, pointing to a critical window for targeted intervention

First description of French V. tubiashii strains pathogenic to mollusk: I. Characterization of isolates and detection during mortality events

Nine dominant bacterial isolates were obtained from different batches of Crassostrea gigas spat experiencing high mortality rates in a French experimental hatchery/nursery in 2007. Using phenotypic analysis combined with multilocus sequence analysis, the isolates were shown to be genetically close to the Vibrio tubiashii type strain. Based on (1) analyses of the recA gene sequences; (2) the results of DNA–DNA hybridization assays between 07/118 T2 (LMG 27884 = CECT 8426), which is a representative strain, and the V. tubiashii type strain (69%); and (3) phenotypic traits, the bacteria were classified in a group close to American V. tubiashii strain. Its virulence (70% of mortalities) and the toxicity of the extracellular products of 07/118 T2 was demonstrated (41% of mortalities). Moreover, a QPCR diagnostic tool targeting the gyrB gene was developed to investigate the epidemiological significance of V. tubiashii in French oyster mortality outbreaks recorded by the national surveillance network. Of the 21 batches originating from hatcheries, only two were positive, whereas V. tubiashii DNA could not be detected in any of the batches of moribund animals collected in field/outdoor facilities. These results demonstrate the existence of a group of virulent V. tubiashii in France that episodically infect C. gigas

Rethinking autism spectrum disorder assessment for children during COVID-19 and beyond.

The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider approaches and assumptions that underlie the diagnostic assessment process, and to adopt new ways of individualizing standard assessments according to family and child needs. Mandates for physical distancing have uncovered deficiencies in diagnostic practices for suspected autism and have illuminated biases that have posed obstacles preventing children and families from receiving the services that they truly need. This Commentary outlines several considerations for improving diagnostic practices as we move forward from the current pandemic and continue to strive to build an adaptable, sustainable, equitable, and family-centered system of care. LAY SUMMARY: Physical distancing and the abrupt end to in-person services for many children on the autism spectrum has forced clinicians to examine the existing challenges with autism spectrum disorder (ASD) diagnostic assessment and consider things they want to keep and things that should be changed in the years ahead. New approaches such as telehealth both alleviated and exacerbated existing disparities, and brought into stark focus the importance of equitable and timely access to family-centered care. This commentary suggests ways of improving clinical practices related to ASD assessment to continue along this path

Timing of the Diagnosis of Autism in African American Children

ObjectivesAfrican American (AA) children affected by autism spectrum disorder (ASD) experience delays in diagnosis and obstacles to service access, as well as a disproportionate burden of intellectual disability (ID) as documented in surveillance data recently published by the US Centers for Disease Control and Prevention. Our objective in this study was to analyze data from the largest-available repository of diagnostic and phenotypic information on AA children with ASD, and to explore the wide variation in outcome within the cohort as a function of sociodemographic risk and specific obstacles to service access for the purpose of informing a national approach to resolution of these disparities.MethodsParents of 584 AA children with autism consecutively enrolled in the Autism Genetic Resource Exchange across 4 US data collection sites completed event history calendar interviews of the diagnostic odysseys for their children with ASD. These data were examined in relation to developmental outcomes of the children with autism and their unaffected siblings.ResultsThe average age of ASD diagnosis was 64.9 months (±49.6), on average 42.3 months (±45.1) after parents' first concerns about their children's development. The relationship between timing of diagnosis and ASD severity was complex, and ID comorbidity was not predicted in a straightforward manner by familial factors associated with cognitive variation in the general population.ConclusionsThese findings document significant opportunity to expedite diagnosis, the need to further understand causes of ID comorbidity, and the necessity to identify effective approaches to the resolution of disparities in severity-of-outcome for AA children with autism