State-dependent changes of connectivity patterns and functional brain network topology in Autism Spectrum Disorder

Anatomical and functional brain studies have converged to the hypothesis that Autism Spectrum Disorders (ASD) are associated with atypical connectivity. Using a modified resting-state paradigm to drive subjects' attention, we provide evidence of a very marked interaction between ASD brain functional connectivity and cognitive state. We show that functional connectivity changes in opposite ways in ASD and typicals as attention shifts from external world towards one's body generated information. Furthermore, ASD subject alter more markedly than typicals their connectivity across cognitive states. Using differences in brain connectivity across conditions, we classified ASD subjects at a performance around 80% while classification based on the connectivity patterns in any given cognitive state were close to chance. Connectivity between the Anterior Insula and dorsal-anterior Cingulate Cortex showed the highest classification accuracy and its strength increased with ASD severity. These results pave the path for diagnosis of mental pathologies based on functional brain networks obtained from a library of mental states

Exploring the relationship between autism spectrum disorder traits and metacognition sensitivity

Given the large amounts of data that are currently acquired and manipulated, a new field called Computational Psychiatry has emerged. One of the best examples where computational psychiatry has contributed to neurodevelopmental syndromes comes from the study on Autism Spectrum Disorder (ASD). One of the current problems to which attention has recently begun to be paid is whether or not people with ASD have altered metacognition. The importance of exploring metacognition in ASD lies in practical and theoretical implications. However, the results found by studies exploring metacognition in people with ASD are inconsistent with each other. Only one study has utilized a bias-free measure of metacognition as in the present study. The main objective of this study was to contribute to the debate, through the study of metacognition in ASD traits in a sample of neurotypical people in an online experiment with a perceptual task. The results have not shown a statistically significant relationship between ASD traits and metacognition. These results are consistent with some of the previous studies.Sociedad Argentina de Informática e Investigación Operativ

Service encounters across the lifespan in individuals with autism spectrum disorders: Results from a multisite study in Latin America

Background Core symptoms of Autism Spectrum Disorder (ASD) continue to affect everyday life as children grow and transition into adulthood. That way, different services may be needed at various stages of their lifetimes. This study aimed to describe service encounters and hours of service per week for individuals with ASD in Latin American countries and compare the data from three age groups (preschoolers, school-aged, and adolescents). Methods: The data were obtained from an online survey adapted by Red Espectro Autista Latinoamerica (REAL) in 6 different countries in South & Central America. The total sample was composed of 2520 caregivers of children and adolescents with ASD. Results: Services encounters for Speech, Occupational and Behavioral Therapies decreased with patient age, while medication increased. Regardless of the age group, a large proportion of individuals (19-37%) were not receiving treatment, and those receiving treatment got fewer hours than best practice recommendations. For adolescents, the gaps in treatment are even greater and less consistent. Discussion Failure to offer timely identification and intervention for ASD will result in more impairment of the individual and burden for the family. Although there are several initiatives to develop more resources for this population in Latin-America, the provision of services for ASD is still undervalued. Many such individuals might not be receiving the services they need, while most children are mainly receiving therapies with low to moderate evidence at a frequency below the recommended standards

Organization of brain networks governed by long-range connections index autistic traits in the general population

Background: The dimensional approach to Autism Spectrum Disorder (ASD) considers ASD as the extreme of a dimension traversing through the entire population. We use electroencephalography (EEG) functional connectivity to explore its potential utility as a biomarker. We hypothesized that individual differences in autistic traits of typical subjects would involve a long-range connectivity diminution within the delta band. Methods: Resting state EEG functional connectivity was measured for 74 neurotypical subjects. All participants also provided a questionnaire (Social Responsiveness Score, SRS) by an informant who knows the participant in social settings. We conducted multivariate regression between SRS score and functional connectivity in all EEG frequency bands. We explored modulations of network graph metrics characterizing the optimality of a network by SRS score. Results: Our results show a decay in functional connectivity mainly within delta and theta band (the lower part of the EEG spectrum) associated with increasing amount of autistic traits. When inspecting the impact of autistic traits on the global organization of functional network we found that optimal properties of the network are inversely related to the amount of autistic traits, suggesting that the autistic dimension, throughout the entire population, modulates the efficiency of functional brain networks. Conclusions: EEG functional connectivity at low frequencies and its associated network properties may be associated with some autistic traits in the general population.Fil: Barttfeld, Pablo. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; Argentina. Institut National de la Santé et de la Recherche Médicale. Cognitive Neuroimaging Unit; Francia;Fil: Amoruso, Lucía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; Argentina. Instituto de Neurologia Cognitiva; ArgentinaFil: Ais, Joaquin. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; ArgentinaFil: Cukier, Sebastián. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; ArgentinaFil: Bavassi, Mariana Luz. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; ArgentinaFil: Tomio, Ailin. Instituto de Neurologia Cognitiva; ArgentinaFil: Manes, Facundo Francisco. Instituto de Neurologia Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ibanez Barassi, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Neurologia Cognitiva; Argentina. Universidad Diego Portales; ChileFil: Sigman, Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Universidad Torcuato Di Tella; Argentin

Age of diagnosis, service access, and rights of autistic individuals in Argentina: Caregivers reports of changes and similarities across time

Background: Many countries have developed health initiatives to protect those with disabilities and developmental concerns in the past few years. However, the needs of autistic individuals are still short of being fulfilled. Partially due to limited research expenditure, which would allow bridging the gap between evidence and practice, the long time it takes to implement passed laws, and the limited operationalization of inclusive policies. Objective: To quantitatively examine changes in the child\u27s age at the time of caregiver\u27s first developmental concerns and age of diagnosis of their autistic child across 5 years. Also, to address challenges experienced by caregivers (e.g., reported service barriers) and the work still needing to be done in Argentina based on caregivers\u27 reports of their priorities (e.g., ensuring their child receives better services). Methods: Two independent samples of caregivers of autistic individuals were surveyed by the Red Espectro Autista Latinoamerica (REAL) in 2015 (n = 763) and the World Health Organization (WHO) in 2020 (n = 422). Similar items in both surveys were compared through descriptive inferential analysis and chi-square tests for categorical variables. Results: Compared to the 2015 sample, for the 2020 sample, more caregivers reported an earlier age of first concerns and an earlier age of a professional diagnosis. In the 2020 sample, more children diagnosed before the age of three had a doctor or a teacher noticing the first developmental concern. Also, in this sample, fewer caregivers reported service barriers (e.g., limited availability, waitlist, costs, etc.) and a need for better social support and better health services. However, rates of caregivers indicating a need for more rights for autistic individuals and greater protection of existing rights increased. There was no change in the reported rate of family members who stopped working to care for the autistic individual. For both samples, there was statistically significant differences in individual (physician, teacher, caregiver) noticing first developmental concern and the age of diagnosis, with the majority having a caregiver noticing the first concern. Conclusion: The 5 years that separate both samples show an improvement in developmental concerns being noticed, a decrease in age of diagnosis, and an improvement in several service areas such as community awareness. Also, caregivers reported fewer barriers to service accessibility, thus suggesting a positive impact stemming from changes in public policies, non-profit organizations\u27 work through awareness campaigns, and advocates\u27 strives toward greater awareness. Nonetheless, a similar proportion of family members reported ceasing working to care for autistic individuals and perceived that the fundamental rights of their autistic children needed to be protected. These results imply that despite better care pathways in Argentina, there are still gaps when attempting to meet the needs of autistic individuals and their families. The present study provides a meaningful understanding of existing gaps and help exemplify the perceived improvements when non-profit agencies and advocates promote increased rights and community awareness in addition to the established laws focusing on ASD

Age of autism diagnosis in Latin American and Caribbean countries

An earlier diagnosis of autism spectrum disorder might lead to an earlier intervention, yet knowledge and awareness of autism spectrum disorder in Latin America and Caribbean Countries are limited. A later autism spectrum disorder diagnosis has been associated with negative consequences, as it might imply later access to services. This study aims to identify factors associated with the age of autism spectrum disorder diagnosis as reported by 2520 caregivers of autistic children from six Latin America and Caribbean Countries. Results indicate that on average, caregivers were concerned about their child’s development by 22 months of age; however, the diagnosis was 24 months later. Current age of autistic individuals, better language abilities, and having public health coverage increased the age of diagnosis. On the contrary, the presence of medical comorbidities, severity level, and type of diagnosis decreased the age of diagnosis. The age of diagnosis of autistic individuals in Latin America and Caribbean Countries corresponded to the start of formal schooling despite a much earlier age of first noticed developmental concern, highlighting the need to reduce this age gap and increase children’s probability of benefiting from early intervention. Taken together, autism spectrum disorder personal/clinical characteristics and access to health service are the main determinants for the age of diagnosis. Lay abstract An earlier diagnosis of autism spectrum disorder might lead to earlier intervention. However, people living in Latin American and Caribbean countries do not have much knowledge about autism spectrum disorder symptoms. It has been suggested that the older a child is when diagnosed, the fewer opportunities he or she will have to receive services. We asked 2520 caregivers of autistic children in six different Latin America and Caribbean Countries, the child’s age when they noticed some developmental delays and their child’s age when they received their first autism spectrum disorder diagnosis. Results indicate that, on average, caregivers were concerned about their child’s development by 22 months of age; however, the diagnosis was received when the child was 46 months of age. In addition, older children with better language abilities and public health coverage (opposed to private health coverage) were diagnosed later. On the contrary, children with other medical problems and more severe behaviors received an earlier diagnosis. In our study, children were diagnosed around the time they entered formal schooling, delaying the access to early intervention programs. In summary, the characteristics of the autistic person and the type of health coverage influence the age of diagnosis in children living in Latin America and Caribbean Countries

Profile of Service Use and Barriers to Access to Care among Brazilian Children and Adolescents with Autism Spectrum Disorders

Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with children with ASD (3-17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, type of health care system used, and the parents/caregivers\u27 education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors

Covid-19 y autismo: impacto en las personas con autismo y sus familias en Uruguay

La pandemia de covid-19 y las medidas asociadas determinaron cambios profundos en los individuos con trastorno del espectro autista (TEA) y sus familias. Se busca explorar estos efectos a nivel de las emociones y comportamientos en esta población en Uruguay. Dentro de un estudio multicéntrico de ocho países de Latinoamérica, se utilizó la submuestra de Uruguay para analizar los cambios de los comportamientos exhibidos por los individuos con TEA sobre la base de género y edad. Entre los 269 cuidadores que completaron una encuesta anónima, el 43,9 % reportó mayores problemas de convivencia y el 75,4 % reportó retrocesos. El empeoramiento de los comportamientos externalizados fue mayor en el sexo masculino y de los internalizados, en los adolescentes de 13 a 18 años. Estos resultados deberían considerarse a la hora de tomar medidas que comprometen la continuidad educativa, apoyos terapéuticos y de asistencia a las familias con personas con TEA en Uruguay. - COVID-19 pandemic and its associated measures, determined profound changes in individuals with autism spectrum disorder (ASD) and their families. Authors explore consequences regarding emotions and behaviors in this population in Uruguay. Within a multicentric study of eight Latin American countries, changes in behaviors in individuals with ASD based on gender and age were analyzed in the Uruguayan subsample. Among the 269 caregivers who completed an anonymous survey, 43.9% reported greater problems in daily life and 75.4% reported setbacks. The worsening of externalizing behaviors was greater in males. The internalizing ones were higher in adolescents aged 13 to 18 years. These results should be considered when taking measures that compromise educational continuity, therapeutic supports and assistance to families with people with ASD in Uruguay

Facing COVID-19: Situation of People with Autism and their Families in Latin America

We present a multicenter study conducted through an online survey of 1826 families of people with ASD from Argentina, Brazil, Chile, Mexico, Peru, the Dominican Republic, Uruguay and Venezuela. Our objective is to describe the impact of the pandemic –and social isolation– on the behavior, mood, sleep and diet of people with ASD. To this end, we have surveyed sociodemographic and housing characteristics and the modality of confinement. We analyze the effects of discontinuity in educational and therapeutic services and assess the scope of remote interventions. Some of the consequences of confinement –obligatory for the majority– has been increased irritability in people with ASD, increased wandering behavior, higher levels of anxiety, and difficulties in eating, sleeping and concentrating. Most of the families have noticed setbacks in their children during the confinement. The beneficial effects of outings and walks are highlighted. Many treatments and classes have been discontinued. Remote interventions are positively highlighted. The current crisis should be an opportunity to reorganize education and treatment devices, attending to the need for changes, with a more ecological, inclusive and autism-friendly perspective.Presentamos un estudio multicéntrico realizado a través de una encuesta en línea a 1826 familias de personas con TEA de Argentina, Brasil, Chile, México, Perú, República Dominicana, Uruguay y Venezuela. Nuestro objetivo es describir el impacto de la pandemia –y el aislamiento social– en la conducta, el estado de ánimo, el sueño y la alimentación de las personas con TEA. A tal fin hemos relevado características sociodemográficas, habitacionales y modalidad de confinamiento. Analizamos los efectos de la discontinuidad de los servicios educativos y terapéuticos y valoramos los alcances de las intervenciones a distancia. Algunas de las consecuencias del confinamiento –obligatorio para la mayoría– han sido el aumento de irritabilidad en las personas con TEA, el incremento de la conducta de deambular, mayores niveles de ansiedad, dificultades en alimentación, sueño y concentración. La mayor parte de las familias han notado retrocesos en sus hijos durante el encierro. Se destacan los efectos beneficiosos de salidas y paseos. Muchos tratamientos y clases se han suspendido. Se subrayan positivamente las intervenciones a distancia. La crisis actual debería ser una oportunidad para reorganizar dispositivos de educación y tratamiento, atendiendo a la necesidad de cambios, con una perspectiva más ecológica, inclusiva y amigable con el autismo