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O'Sharkey K, Mitra S, Paik SA, Chow T, Cockburn M, Ritz B. Trends in the Prevalence of Autism Spectrum Disorder in California: Disparities by Sociodemographic Factors and Region Between 1990-2018. J Autism Dev Disord 2025; 55:2503-2511. [PMID: 38700778 PMCID: PMC12167244 DOI: 10.1007/s10803-024-06371-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 01/06/2025]
Abstract
Autism Spectrum Disorders (ASD) prevalence has risen globally, with regional variation and sociodemographic disparities affecting diagnosis and intervention. This study examines ASD trends from 1990 to 2018 in California (CA), focusing on sociodemographic factors that may inform policy/interventions. Using CA Department of Public Health birth records (1990-2018) and Developmental Services ASD cases (1994-2022), we analyzed diagnosis incidence by age 4 or 8, stratified by sociodemographic and regional factors. From 1990 to 2018, for each birth year the cumulative incidence of ASD by 4 and 8 years of age in CA increased while the diagnosis age decreased. Distinct patterns emerged over these three decades. Children born to White and Asian and Pacific Islander (API) mothers, or to mothers with higher education or living in high socioeconomic status (SES) neighborhoods exhibited higher ASD cumulative incidences throughout the 1990s and early 2000s. However, in the mid-2000s, ASD incidence in children born to Black or Hispanic mothers, with low education, or living in low SES neighborhoods surpassed that of White/API children or those living in high SES neighborhoods. Black or Hispanic children now have the highest ASD cumulative incidence, even though age at first diagnosis remains lowest in high SES regions, for the highly educated, and for White/API children. ASD cumulative incidence in CA from 1990 to 2018 exhibited demographic reversals with higher rates in children born to Black or Hispanic mothers or lower SES neighborhoods. Black and Hispanic children still have delayed age at diagnosis compared to White/API children.
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Affiliation(s)
- Karl O'Sharkey
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA
| | - Sanjali Mitra
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA
| | - Seung-A Paik
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA
| | - Ting Chow
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA
| | - Myles Cockburn
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, 90032, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA.
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA.
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA.
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O'Sharkey K, Chow T, Mitra S, Thompson L, Su J, Cockburn M, Liew Z, Ritz B. Exploring the link between grandmaternal air pollution exposure and Grandchild's ASD risk: A multigenerational population-based study in California. ENVIRONMENT INTERNATIONAL 2025; 200:109526. [PMID: 40378475 DOI: 10.1016/j.envint.2025.109526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Revised: 05/02/2025] [Accepted: 05/09/2025] [Indexed: 05/19/2025]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with increasing prevalence. While genetics play a strong causal role, among environmental factors, air pollution (AP) exposure in pregnancy and infancy has been strongly endorsed as a risk factor. However, potential multigenerational impacts through the exposure of the grandmother during her pregnancy remain unexplored. METHODS Using a multigenerational, population-based cohort from California spanning three decades (1990-2019), we examined the association between grandmother's gestational AP exposure (PM2.5, NO2, O3) and ASD risk in grandchildren using logistic regression per 1-IQR unit increase, adjusting for maternal exposure in pregnancy or infant's exposure in the first year of life. We used continuous AP exposure as well as a categorical variable representing high and/or low (above or below median) exposure levels for both the grandmaternal and maternal pregnancies. Pregnancy and first year of life AP exposures were assigned using a land-use regression model with advanced machine-learning approaches. RESULTS We observed associations between PM2.5 (OR = 1.07, 95 % CI: 1.05, 1.10) and NO2 (OR = 1.09, 95 % CI: 1.05, 1.13) exposure during the grandmaternal pregnancy and increased ASD risk in the grandchild. However, only for PM2.5 did the increased effect estimates persist after adjusting for maternal pregnancy exposure (OR = 1.05; 95 % CI: 1.02, 1.08). High compared to low exposures in both grandmaternal and maternal pregnancies to PM2.5 (OR = 1.16, 95 % CI: 1.11, 1.23) and NO2 (OR = 1.12, 95 % CI: 1.06, 1.17) showed the strongest joint effects for ASD in the grandchild. CONCLUSIONS Multigenerational exposure to air pollution, particularly PM2.5 exposure in grandmaternal pregnancy, may influence ASD risk. Our study also suggests that ASD risk due to air pollution may be compounded by multigenerational exposures.
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Affiliation(s)
- Karl O'Sharkey
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Ting Chow
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Sanjali Mitra
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Laura Thompson
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, CA 94720, USA
| | - Myles Cockburn
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, CT 06510 USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA; Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA; Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
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Shuffrey LC, Rennie B, Li X, Galai N, Pini N, Akbaryan A, Alshawabkeh A, Aschner J, Vargas JC, Costello L, D'Sa V, Deoni S, Dunlop A, Elliott AJ, Fifer WP, Hash J, Koinis-Mitchell D, Lai JS, Leventhal BL, Lewis J, Lucchini M, McArthur KL, Morales S, Nozadi SS, O'Connor TG, O'Shea TM, Page GP, Propper C, Sania A, Shuster C, Zimmerman E, Margolis AE. Combining developmental and sleep health measures for autism spectrum disorder screening: an ECHO study. Pediatr Res 2025; 97:411-421. [PMID: 38867029 PMCID: PMC11635013 DOI: 10.1038/s41390-024-03306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses. METHODS Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses. RESULTS The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis. CONCLUSION While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. IMPACT Parental-reported sleep problems are common in autism spectrum disorder (ASD). We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism. We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance.
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Affiliation(s)
- Lauren C Shuffrey
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
| | - Brandon Rennie
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noya Galai
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Statistics, University of Haifa, Mt Carmel, Israel
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Anahid Akbaryan
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Judy Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Julianna Collazo Vargas
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Lauren Costello
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Viren D'Sa
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Sean Deoni
- Maternal Newborn and Child Health: Discovery & Tools, The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Anne Dunlop
- Department of Gynecology & Obstetrics, Emory University, Atlanta, Georgia
| | - Amy J Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, USA
| | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA
| | - Jonica Hash
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - Daphne Koinis-Mitchell
- Departments of Pediatrics and Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bennett L Leventhal
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Johnnye Lewis
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Kristen L McArthur
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Santiago Morales
- Departments of Psychology and Pediatrics, Developmental and Brain and Cognitive Science Areas, University of Southern California, Los Angeles, CA, USA
| | - Sara S Nozadi
- Community Environmental Health Program, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Grier P Page
- Analytics Program, RTI International, Research Triangle Park, NC, USA
| | - Cathi Propper
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Coral Shuster
- The Brown Center for the Study of Children at Risk, Woman & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Chicago, IL, USA
| | - Amy E Margolis
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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Horecka-Lewitowicz A, Lewitowicz W, Wawszczak-Kasza M, Lim H, Lewitowicz P. Autism Spectrum Disorder Pathogenesis-A Cross-Sectional Literature Review Emphasizing Molecular Aspects. Int J Mol Sci 2024; 25:11283. [PMID: 39457068 PMCID: PMC11508848 DOI: 10.3390/ijms252011283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 10/14/2024] [Accepted: 10/16/2024] [Indexed: 10/28/2024] Open
Abstract
The etiology of autism spectrum disorder (ASD) has not yet been completely elucidated. Through time, multiple attempts have been made to uncover the causes of ASD. Different theories have been proposed, such as being caused by alterations in the gut-brain axis with an emphasis on gut dysbiosis, post-vaccine complications, and genetic or even autoimmune causes. In this review, we present data covering the main streams that focus on ASD etiology. Data collection occurred in many countries covering ethnically diverse subjects. Moreover, we aimed to show how the progress in genetic techniques influences the explanation of medical White Papers in the ASD area. There is no single evidence-based pathway that results in symptoms of ASD. Patient management has constantly only been symptomatic, and there is no ASD screening apart from symptom-based diagnosis and parent-mediated interventions. Multigene sequencing or epigenetic alterations hold promise in solving the disjointed molecular puzzle. Further research is needed, especially in the field of biogenetics and metabolomic aspects, because young children constitute the patient group most affected by ASD. In summary, to date, molecular research has confirmed multigene dysfunction as the causative factor of ASD, the multigene model with metabolomic influence would explain the heterogeneity in ASD, and it is proposed that ion channel dysfunction could play a core role in ASD pathogenesis.
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Affiliation(s)
- Agata Horecka-Lewitowicz
- Institute of Medical Sciences, Jan Kochanowski University, Al. IX Wiekow Kielc 19A, 25-516 Kielce, Poland
| | - Wojciech Lewitowicz
- Student Scientific Society at Collegium Medicum, Jan Kochanowski University, Al. IX Wiekow Kielc 19A, 25-516 Kielce, Poland; (W.L.); (H.L.)
| | - Monika Wawszczak-Kasza
- Institute of Health Sciences, Jan Kochanowski University, Al. IX Wiekow Kielc 19A, 25-516 Kielce, Poland
| | - Hyebin Lim
- Student Scientific Society at Collegium Medicum, Jan Kochanowski University, Al. IX Wiekow Kielc 19A, 25-516 Kielce, Poland; (W.L.); (H.L.)
| | - Piotr Lewitowicz
- Institute of Medical Sciences, Jan Kochanowski University, Al. IX Wiekow Kielc 19A, 25-516 Kielce, Poland
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5
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Winter AS, Yartel AK, Fountain C, Cheslack-Postava K, Zhang Y, Schieve LA, Kissin DM, Bearman P. The role of multiple birth and birth complications in the association between assisted reproductive technology conception and autism diagnosis. Am J Epidemiol 2024; 193:1426-1432. [PMID: 38629582 DOI: 10.1093/aje/kwae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 02/24/2024] [Accepted: 04/10/2024] [Indexed: 10/09/2024] Open
Abstract
In recent decades, the use of assisted reproductive technology (ART) has increased rapidly. To assess the relationship between ART and autism diagnosis, we linked California birth records from 2000 through 2016 with contemporaneous records from the National ART Surveillance System (NASS) and autism caseload records from California's Department of Developmental Services from 2000 through November 2019. All 95 149 birth records that were successfully linked to a NASS record, indicating an ART birth, were matched 1:1 using propensity scores to non-ART births. We calculated the hazard risk ratio for autism diagnosis and the proportions of the relationship between ART conception and autism diagnosis mediated by multiple birth pregnancy and related birth complications. The hazard risk ratio for autism diagnosis following ART compared with non-ART conception is 1.26 (95% CI, 1.17-1.35). Multiple birth, preterm birth, and cesarean delivery jointly mediate 77.9% of the relationship between ART conception and autism diagnosis. Thus, increased use of single embryo transfer in the United States to reduce multiple births and related birth complications may be a strategy to address the risk of autism diagnosis among ART-conceived children.
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Affiliation(s)
- Alix S Winter
- Incite, Columbia University, New York, NY 10115, United States
| | - Anthony K Yartel
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
- CDC Foundation, Atlanta, GA 30308, United States
| | - Christine Fountain
- Department of Sociology and Anthropology, Fordham University, New York, NY 10023, United States
| | - Keely Cheslack-Postava
- New York State Psychiatric Institute, Columbia University, New York, NY 10032, United States
| | - Yujia Zhang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Dmitry M Kissin
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Peter Bearman
- Incite, Columbia University, New York, NY 10115, United States
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Girolamo T, Shen L, Gulick AM, Rice ML, Eigsti IM. Studies assessing domains pertaining to structural language in autism vary in reporting practices and approaches to assessment: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1602-1621. [PMID: 38145307 PMCID: PMC11189763 DOI: 10.1177/13623613231216155] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
LAY ABSTRACT Under the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), language impairment can co-occur with autism. It is not yet clear how research defines, reports, and characterizes structural language abilities of autistic individuals eligible for school-based special education services (aged 3-21 years) in the United States. In the United States, students typically must be formally diagnosed to be eligible for services and supports. However, the quality of diagnosis is only as good as the research evidence on which diagnosis depends. To evaluate evidence quality, we examined how studies of school-aged autistic individuals report assessments of language ability. This systematic review included 57 studies using English language age-referenced assessments used to measure structural language. Findings showed many differences across studies in how language abilities were measured and reported. Also, none of the studies fully reported the variables relevant to characterizing language impairment. Outcomes were similar across versions of the Diagnostic and Statistical Manual of Mental Disorders. Findings indicate that researchers and clinicians should pay attention to reporting diagnostic and grouping criteria. Carefully interpreting research evidence is critical for ensuring that diagnostic criteria and supports are representative of and accessible to autistic individuals and relevant parties.
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Affiliation(s)
- Teresa Girolamo
- San Diego State University, USA
- University of Connecticut, USA
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Gallin Z, Kolevzon AM, Reichenberg A, Hankerson SH, Kolevzon A. Racial Differences in the Prevalence of Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2024:10.1007/s10803-024-06403-5. [PMID: 38941049 DOI: 10.1007/s10803-024-06403-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Racial differences in prevalence rates of autism spectrum disorder (ASD) have shifted in the United States (US) since the 1990s. This review addresses the nature and context of this shift and discusses potential contributing factors and areas for future research. METHODS Seventeen population-based epidemiological birth cohort studies on ASD prevalence in the US that included race as a variable are included in the review. Studies were identified via a keyword search on PubMed. To be included, studies were required to include race or ethnicity as a variable in the prevalence estimates, include at least 1000 cases with autism, and be published in English by June 3rd, 2023. RESULTS Results suggest that in nearly all birth cohorts prior to 2010, ASD prevalence rates were highest among White children. ASD prevalence rates among Black, Hispanic, and Asian/Pacific Islander (API) children (22.3, 22.5, and 22.2 per 1000, respectively) surpassed prevalence rates among White children (21.2 per 1000) in the 2010 birth cohort and continued to increase in the 2012 birth cohorts. CONCLUSIONS There are persistent racial differences in ASD prevalence in the US, and these differences were inverted after 2010, when ASD prevalence among Black, Hispanic, & API children surpassed ASD prevalence among White children. Possible drivers of this racial repatterning of ASD prevalence include changes in ASD screening and diagnosis, changes to health insurance policy, changes to immigration policy, and increased education attainment by minority groups.
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Affiliation(s)
- Zachary Gallin
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Abraham Reichenberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sidney H Hankerson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Sciences & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Nielsen TC, Nassar N, Boulton KA, Guastella AJ, Lain SJ. Estimating the Prevalence of Autism Spectrum Disorder in New South Wales, Australia: A Data Linkage Study of Three Routinely Collected Datasets. J Autism Dev Disord 2024; 54:1558-1566. [PMID: 36652127 PMCID: PMC10981615 DOI: 10.1007/s10803-022-05887-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 01/19/2023]
Abstract
Routinely collected data help estimate the prevalence of autism spectrum disorder (ASD) in jurisdictions without active autism surveillance. We created a population-based cohort of 1,211,834 children born in 2002-2015 in New South Wales, Australia using data linkage. Children with ASD were identified in three datasets - disability services, hospital admissions, and ambulatory mental health data. The prevalence of ASD in the cohort was 1.3% by age 12 and prevalence at age 6 increased an average of 4.1% per year (95% Confidence Interval, 3.3%, 4.8%). Most children with ASD were identified in disability services data (87%), although data linkage identified 1,711 additional cases that were more likely female, older at first contact, and living in major cities and less disadvantaged areas.
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Affiliation(s)
- Timothy C Nielsen
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Natasha Nassar
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Kelsie A Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Adam J Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Samantha J Lain
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
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O'Sharkey K, Meng Q, Mitra S, Paik SA, Liu J, Shen J, Thompson LK, Chow T, Su J, Cockburn M, Weichenthal S, Paulson SE, Jerrett M, Ritz B. Associations between brake and tire wear-related PM 2.5 metal components, particulate oxidative stress potential, and autism spectrum disorder in Southern California. ENVIRONMENT INTERNATIONAL 2024; 185:108573. [PMID: 38484609 DOI: 10.1016/j.envint.2024.108573] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/13/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Air pollution is a global health concern, with fine particulate matter (PM2.5) constituents posing potential risks to human health, including children's neurodevelopment. Here we investigated associations between exposure during pregnancy and infancy to specific traffic-related PM2.5 components with Autism Spectrum Disorder (ASD) diagnosis. METHODS For exposure assessment, we estimated PM2.5 components related to traffic exposure (Barium [Ba] as a marker of brake dust and Zinc [Zn] as a tire wear marker, Black Carbon [BC]) and oxidative stress potential (OSP) markers (Hydroxyl Radical [OPOH] formation, Dithiothreitol activity [OPDTT], reactive oxygen species [ROS]) modeled with land use regression with co-kriging based on an intensive air monitoring campaign. We assigned exposures to a cohort of 444,651 children born in Southern California between 2016 and 2019, among whom 11,466 ASD cases were diagnosed between 2018 and 2022, Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained with logistic regression for single pollutant and PM2.5 mass co-adjusted models, also adjusting for sociodemographic characteristics. RESULTS Among PM2.5 components, we found the strongest positive association with ASD for our brake wear marker Ba (ORper IQR = 1.29, 95 % CI: 1.24, 1.34). This was followed by an increased risk for all PM2.5 oxidative stress potential markers; the strongest association was with ROS formation (ORper IQR = 1.22, 95 % CI: 1.18, 1.25). PM2.5 mass was linked to ASD in Hispanic and Black children, but not White children, while traffic-related PM2.5 and OSP markers increased ASD risk across all groups. In neighborhoods with the lowest socioeconomic status (SES), associations with ASD were stronger for all examined pollutants compared to higher SES areas. CONCLUSIONS Our findings suggest that brake wear-related PM2.5 and PM2.5 OSP are associated with ASD diagnosis in Southern California. These results suggest that strategies aimed at reducing the public health impacts of PM2.5 need to consider specific sources.
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Affiliation(s)
- Karl O'Sharkey
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Qi Meng
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Sanjali Mitra
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Seung-A Paik
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jonathan Liu
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jiaqi Shen
- Department of Atmospheric & Oceanic Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Laura K Thompson
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Ting Chow
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jason Su
- Department of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Myles Cockburn
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec H3A0G4, Canada
| | - Susanne E Paulson
- Department of Atmospheric & Oceanic Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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Aljubour AA, AbdElBaki M, El Meligy O, Al Jabri B, Sabbagh H. Culturally Adapted Dental Visual Aids Effect on Behavior Management during Dental Visits in Children with Autism Spectrum Disorder. J Contemp Dent Pract 2024; 25:20-28. [PMID: 38514427 DOI: 10.5005/jp-journals-10024-3620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by unique behavioral patterns, treating children with ASD in the dental clinic has been a great challenge due to their behavior. This study aims to determine the effectiveness of culturally adapted dental visual aids in modifying behavior patterns during dental visits in children with ASD. MATERIALS AND METHODS A controlled, blinded, randomized, clinical trial, with 64 children diagnosed with ASD, were randomly divided into two groups. The study took place between January 2019 and January 2021. The experimental group was provided with culturally adapted dental visual aids created especially for this research and the control group was provided with universal dental visual aids. The children's behavior patterns were evaluated before and after using the dental visual aids. SPSS v.25 was used to process all the data. RESULTS Behavior patterns have modified significantly in the experimental group (p < 0.001) however, it was statistically insignificant in the control group (p = 0.077). In terms of behavioral patterns, the experimental group outperformed the control group significantly (p < 0.001). CONCLUSION The culturally adapted dental visual aids have shown effectiveness in modifying behavior patterns in children diagnosed with ASD during dental visits. CLINICAL SIGNIFICANCE By evaluating the impact of culturally adapted visual aids on behavior management, the study can enhance the accessibility and effectiveness of dental care for this vulnerable population, ultimately promoting better oral health outcomes and reducing potential trauma associated with dental visits for children with ASD. How to cite this article: Aljubour AA, AbdElBaki M, El Meligy O, et al. Culturally Adapted Dental Visual Aids Effect on Behavior Management during Dental Visits in Children with Autism Spectrum Disorder. J Contemp Dent Pract 2024;25(1):20-28.
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Affiliation(s)
- Ala Abdullah Aljubour
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia, Phone: +966 558884866, e-mail: , Orcid: https://orcid.org/0000-0002-1486-5828
| | - Medhat AbdElBaki
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt, Orcid: https://orcid.org/0000-0002-6524-751X
| | - Omar El Meligy
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt, Orcid: https://orcid.org/0000-0003-1069-6374
| | - Basma Al Jabri
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, Orcid: https://orcid.org/0000-0003-1170-4188
| | - Heba Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia, Orcid: https://orcid.org/0000-0002-9788-0379
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11
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Botsas G, Koidou E, Chatzinikolaou K, Grouios G. Environmental Influences on Individuals with Autistic Spectrum Disorders with Special Emphasis on Seasonality: An Overview. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1851. [PMID: 38136053 PMCID: PMC10742301 DOI: 10.3390/children10121851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
This paper offers an in-depth exploration of the intricate relationship between environmental factors and autism spectrum disorder (ASD), with a special emphasis on seasonality. It reviews existing research, providing a comprehensive summary of findings and highlighting the multifaceted dimensions of several environmental factors influencing the etiology of ASD. The discussion encompasses various elements, including birth months, maternal health, dietary choices, and vitamin D deficiency, delving into the intricate interplay of seasonality with environmental influences such as viral infections and solar radiation. The present study raises essential questions regarding the timing of environmental influences and the factors contributing to the rising prevalence of ASD. Ultimately, it underscores the need for future epidemiological research to incorporate more extensive investigations of environmental risk factors and employ advanced statistical analyses. This comprehensive overview contributes to a deeper understanding of how environmental factors, particularly seasonality, may be linked to the occurrence of ASD and its increasing prevalence, recognizing the multifaceted and diverse nature of these interactions.
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Affiliation(s)
- George Botsas
- Department of Early Childhood and Care, School of Social Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Department of Education, School of Education and Social Sciences, Frederick University, 3080 Limassol, Cyprus
| | - Eirini Koidou
- Department of Human Performance, School of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece; (E.K.); (K.C.); (G.G.)
| | - Konstantinos Chatzinikolaou
- Department of Human Performance, School of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece; (E.K.); (K.C.); (G.G.)
| | - George Grouios
- Department of Human Performance, School of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece; (E.K.); (K.C.); (G.G.)
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12
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Girolamo T, Shen L, Gulick AM, Rice ML, Eigsti IM. Studies pertaining to language impairment in school-age autistic individuals underreport participant socio-demographics: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2218-2240. [PMID: 37157821 PMCID: PMC10592656 DOI: 10.1177/13623613231166749] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
LAY ABSTRACT Although exclusion of racially and ethnically minoritized autistic individuals from research is a long-standing issue, we have yet to determine how exclusion impacts areas of autism research important for identifying language impairment. Diagnosis depends on the quality of the evidence (i.e. research) and is often the pathway to gaining access to services. As a first step, we examined how research studies related to language impairment in school-age autistic individuals report participant socio-demographics. We analyzed reports using age-referenced assessments in English (n = 60), which are commonly used by both practitioners and researchers to diagnose or identify language impairment. Findings showed only 28% of studies reported any information on race and ethnicity; in these studies, most (at least 77%) of the participants were white. In addition, only 56% of studies reported gender or sex and specified what they were reporting (gender, sex, or gender identity). Just 17% reported socio-economic status using multiple indicators. Altogether, findings indicate broad issues with underreporting and exclusion of racially and ethnically minoritized individuals, which might overlay with other aspects of identity including socio-economic status. It is impossible to determine the extent and precise nature of exclusion without intersectional reporting. To ensure that language in autism research is representative of the autistic population, future research must implement reporting guidelines and broaden inclusion of who participates in research studies.
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Affiliation(s)
- Teresa Girolamo
- Department of Psychological Sciences, University of Connecticut
- Connecticut Institute for Brain and Cognitive Sciences
| | - Lue Shen
- Speech, Language, and Hearing Sciences, Boston University
| | | | - Mabel L. Rice
- Child Language Doctoral Program, University of Kansas
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut
- Connecticut Institute for Brain and Cognitive Sciences
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13
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Fountain C, Winter AS, Cheslack-Postava K, Bearman PS. Developmental Trajectories of Autism. Pediatrics 2023; 152:e2022058674. [PMID: 37615073 PMCID: PMC10551845 DOI: 10.1542/peds.2022-058674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES The goal of this study was to describe the typical, longitudinal, developmental trajectories of communication and social functioning in individuals with autism spectrum disorder from childhood through adulthood and to determine the correlates of these trajectories. METHODS Children with autism spectrum disorder who were born in California from 1992 through 2016 and enrolled with the California Department of Developmental Services were identified. Subjects with <4 evaluations in the database were excluded, resulting in a sample of 71 285 individuals. Score sequences were constructed based on evaluative items for communication and social functioning. Typical trajectories were identified using group-based latent trajectory modeling, and logistic regression was used to determine the odds of classification into a social adolescent decline trajectory by individual-, family-, and zip code-level factors. RESULTS Six typical patterns of communication functioning and 7 typical patterns of social functioning were identified. Whereas the majority of autistic individuals exhibit improved communication functioning as they age, the majority of individuals exhibit steady social functioning. A small group of individuals (5.0%) exhibits high social functioning in childhood that declines in adolescence. Membership in this adolescent decline group is associated with maternal non-Hispanic white race and ethnicity, female sex, moderate levels of maternal education, lower zip code-level median home values and population density, and higher zip code-level inequality. CONCLUSIONS Most autistic individuals show improved communication and social functioning as they age, but not all do. Trajectory group membership is correlated with socioeconomic status. Future research should investigate what drives these correlations.
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Affiliation(s)
- Christine Fountain
- Department of Anthropology & Sociology, Fordham
University, New York, NY
| | - Alix S. Winter
- Interdisciplinary Center for Innovative Theory and
Empirics, Columbia University, New York, NY
| | | | - Peter S. Bearman
- Interdisciplinary Center for Innovative Theory and
Empirics, Columbia University, New York, NY
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14
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Mondal A, Sharma R, Abiha U, Ahmad F, Karan A, Jayaraj RL, Sundar V. A Spectrum of Solutions: Unveiling Non-Pharmacological Approaches to Manage Autism Spectrum Disorder. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1584. [PMID: 37763703 PMCID: PMC10536417 DOI: 10.3390/medicina59091584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
Autism spectrum disorder (ASD) is a developmental disorder that causes difficulty while socializing and communicating and the performance of stereotyped behavior. ASD is thought to have a variety of causes when accompanied by genetic disorders and environmental variables together, resulting in abnormalities in the brain. A steep rise in ASD has been seen regardless of the numerous behavioral and pharmaceutical therapeutic techniques. Therefore, using complementary and alternative therapies to treat autism could be very significant. Thus, this review is completely focused on non-pharmacological therapeutic interventions which include different diets, supplements, antioxidants, hormones, vitamins and minerals to manage ASD. Additionally, we also focus on complementary and alternative medicine (CAM) therapies, herbal remedies, camel milk and cannabiodiol. Additionally, we concentrate on how palatable phytonutrients provide a fresh glimmer of hope in this situation. Moreover, in addition to phytochemicals/nutraceuticals, it also focuses on various microbiomes, i.e., gut, oral, and vaginal. Therefore, the current comprehensive review opens a new avenue for managing autistic patients through non-pharmacological intervention.
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Affiliation(s)
- Arunima Mondal
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Ghudda 151401, India
| | - Rashi Sharma
- Department of Biotechnology, Delhi Technological University, Bawana, Delhi 110042, India
| | - Umme Abiha
- IDRP, Indian Institute of Technology, Jodhpur 342030, India
- All India Institute of Medical Sciences, Jodhpur 342005, India
| | - Faizan Ahmad
- Department of Medical Elementology and Toxicology, Jamia Hamdard University, Delhi 110062, India
| | | | - Richard L. Jayaraj
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
| | - Vaishnavi Sundar
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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15
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Chamarthi VR, Arangannal P. Prognostic Factors for Successful Dental Treatment in Autistic Children and Adolescents. Int J Clin Pediatr Dent 2023; 16:S45-S50. [PMID: 37663223 PMCID: PMC10474385 DOI: 10.5005/jp-journals-10005-2607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Aim The aim of this study was to recognize and assess the prognostic factors which could predict the level of cooperation of children with autism for dental appointments. Methods A total of 395 parents of children with autism participated in this study. Prognostic factors of cooperation were evaluated using questionnaires. Data were collected using parent surveys by a dentist. Statistical analysis Statistical analyses used in the present study include the formation one way and two-way frequency tables, binomial tests, Pearson's Chi-squared tests, Fisher's exact test, and collation of multiple proportions tests. Results Autistic children meeting their own needs, cooperation for nail-clipping and haircuts, smiling frequently, using toothbrushes and toothpaste and being assisted by parents for toothbrushing, and children who brushed their teeth once a day were more cooperative with the dentist. Children who had thumb-sucking and nail-biting habits were cooperative with the dentist. Children who bit their hands appeared to be more cooperative with the dentist when compared to other self-inflicting habits. Conclusion This study identified "prognostic factors" such as their cooperative ability during nail clipping, hair cutting, and ability to read, write, and meet their own needs that are answered by a parent and that may show a child's cooperative potential. How to cite this article Chamarthi VR, Arangannal P. Prognostic Factors for Successful Dental Treatment in Autistic Children and Adolescents. Int J Clin Pediatr Dent 2023;16(S-1):S45-S50.
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Affiliation(s)
- Vishnu R Chamarthi
- Department of Pediatric and Preventive Dentistry, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ponnudurai Arangannal
- Department of Pediatric and Preventive Dentistry, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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16
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Khandan Khadem-Reza Z, Shahram MA, Zare H. Altered resting-state functional connectivity of the brain in children with autism spectrum disorder. Radiol Phys Technol 2023; 16:284-291. [PMID: 37040021 DOI: 10.1007/s12194-023-00717-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders. Brain mapping has shown that functional brain connections are altered in autism. This study investigated the pattern of brain connection changes in autistic people compared to healthy people. This study aimed to analyze functional abnormalities within the brain due to ASD, using resting-state functional magnetic resonance imaging (fMRI). Resting-state functional magnetic resonance images of 26 individuals with ASD and 26 healthy controls were obtained from the Autism Brain Imaging Data Exchange (ABIDE) database. The DPARSF (data processing assistant for resting-state fMRI) toolbox was used for resting-state functional image processing, and features related to functional connections were extracted from these images. Then, the extracted features from both groups were compared using an Independent Two-Sample T Test, and the features with significant differences between the two groups were identified. Compared with healthy controls, individuals with ASD showed hyper-connectivity in the frontal lobe, anterior cingulum, parahippocampal, left precuneus, angular, caudate, superior temporal, and left pallidum, as well as hypo-connectivity in the precentral, left superior frontal, left middle orbitofrontal, right amygdala, and left posterior cingulum. Our findings show that abnormal functional connectivity exists in patients with ASD. This study makes an important advancement in our understanding of the abnormal neurocircuits causing autism.
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Affiliation(s)
- Zahra Khandan Khadem-Reza
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran
- Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Vakil Abad Street, Mashhad, Razavi Khorasan, Iran
| | - Mohammad Amin Shahram
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran
- Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Vakil Abad Street, Mashhad, Razavi Khorasan, Iran
| | - Hoda Zare
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran.
- Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Vakil Abad Street, Mashhad, Razavi Khorasan, Iran.
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17
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Granillo L, Iosif AM, Goodrich A, Snyder NW, Schmidt RJ. Maternal androgens and autism spectrum disorder in the MARBLES prospective cohort study. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 99:102054. [PMID: 36938498 PMCID: PMC10022653 DOI: 10.1016/j.rasd.2022.102054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Maternal hormonal risk factors for autism spectrum disorder (ASD) in offspring could intersect genetic and environmental risk factors. Objectives This analysis explored ASD risk in association with maternal testosterone, androstenedione, and dehydroepiandrosterone (DHEA) measured in first, second, and third trimesters of pregnancy. Methods MARBLES is a prospective pregnancy cohort study based at the MIND Institute in Northern California that enrolls mothers who have at least one child previously diagnosed with ASD and are expecting, or planning to have another child. At 36 months the younger sibling is clinically classified as having ASD, or as non-typically developing (Non-TD), or typically developing (TD). Maternal androgens during pregnancy were measured in serum samples from 196 mothers. Multivariable logistic regression models estimated risk of ASD and Non-TD in offspring compared to TD, in relation to the log-transformed maternal androgen concentrations, at each trimester. Results Non-significant associations were observed, and borderline significant associations were only observed in some stratified unadjusted models. Second trimester maternal testosterone was non-significantly associated with ASD in female offspring, although not after adjustment, aRR 1.54 (95% CI 0.71, 3.33), and second trimester maternal DHEA was non-significantly associated with non-TD in male offspring, again not after adjustment, aRR 0.50 (95% CI 0.21, 1.21). Secondary analysis suggested that third trimester androgen concentrations in mothers with male offspring had significant or near significant associations with their child's Social Responsiveness Scale score. Conclusion No significant associations were found between maternal androgen concentrations and risk of ASD or Non-TD in the child.
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Affiliation(s)
- Lauren Granillo
- Graduate Group in Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
- MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Amanda Goodrich
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Nathaniel W. Snyder
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
- Center for Metabolic Disease Research, Department of Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
- MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
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18
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Anne A, Saxena S, Mohan KN. Genome-wide methylation analysis of post-mortem cerebellum samples supports the role of peroxisomes in autism spectrum disorder. Epigenomics 2022; 14:1015-1027. [PMID: 36154275 DOI: 10.2217/epi-2022-0184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We tested the hypothesis that a subset of patients with autism spectrum disorder (ASD) contains candidate genes with high DNA methylation differences (effective values) that potentially affect one of the two alleles. Materials & methods: Genome-wide DNA methylation comparisons were made on cerebellum samples from 30 patients and 45 controls. Results: 12 genes with high effective values, including GSDMD, MMACHC, SLC6A5 and NKX6-2, implicated in ASD and other neuropsychiatric disorders were identified. Monoallelic promoter methylation and downregulation were observed for SERHL (serine hydrolase-like) and CAT (catalase) genes associated with peroxisome function. Conclusion: These data are consistent with the hypothesis implicating impaired peroxisome function/biogenesis for ASD. A similar approach holds promise for identifying rare epimutations in ASD and other complex disorders.
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Affiliation(s)
- Anuhya Anne
- Molecular Biology and Genetics Laboratory, Department of Biological Sciences, Birla Institute of Technology & Science, Pilani - Hyderabad Campus, 500 078, India.,Centre for Human Disease Research, Birla Institute of Technology & Science, Pilani - Hyderabad Campus, 500 078, India
| | - Sonal Saxena
- Molecular Biology and Genetics Laboratory, Department of Biological Sciences, Birla Institute of Technology & Science, Pilani - Hyderabad Campus, 500 078, India
| | - Kommu Naga Mohan
- Molecular Biology and Genetics Laboratory, Department of Biological Sciences, Birla Institute of Technology & Science, Pilani - Hyderabad Campus, 500 078, India.,Centre for Human Disease Research, Birla Institute of Technology & Science, Pilani - Hyderabad Campus, 500 078, India
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19
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Kawai T. The symbolic and non-symbolic aspect of image: clinical and cultural reflections. THE JOURNAL OF ANALYTICAL PSYCHOLOGY 2022; 67:621-634. [PMID: 35856533 DOI: 10.1111/1468-5922.12796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It is fundamental for analytical psychology to understand images symbolically. However, Jung was aware of the non-symbolic and direct appearance of image in synchronistic visions and dreams. Therefore, there are two aspects of the non-symbolic: literal and synchronistic. Firstly, the pathology of the non-symbolic was explored in psychosomatic syndromes, trauma, borderline syndromes and autism spectrum disorder (ASD). Then the historical and cultural considerations show that dreams were shared and understood directly and non-symbolically in Japanese medieval times. Historically, the symbolic aspect emerged through the loss of this directness and is characteristic for the modern, western, and adult consciousness. However, the increasing prevalence of ASD and ambiguity between reality and virtual reality show that the contemporary world is again dominated by directness and the non-symbolic, which can be called 'postmodern consciousness'.
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20
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Pham C, Symeonides C, O'Hely M, Sly PD, Knibbs LD, Thomson S, Vuillermin P, Saffery R, Ponsonby AL. Early life environmental factors associated with autism spectrum disorder symptoms in children at age 2 years: A birth cohort study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1864-1881. [PMID: 35012378 DOI: 10.1177/13623613211068223] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
LAY ABSTRACT Mounting evidence indicates the contribution of early life environmental factors in autism spectrum disorder. We aim to report the prospective associations between early life environmental factors and autism spectrum disorder symptoms in children at the age of 2 years in a population-derived birth cohort, the Barwon Infant Study. Autism spectrum disorder symptoms at the age of 2 years strongly predicted autism spectrum disorder diagnosis by the age of 4 years (area under curve = 0.93; 95% CI (0.82, 1.00)). After adjusting for child's sex and age at the time of behavioural assessment, markers of socioeconomic disadvantage, such as lower household income and lone parental status; maternal health factors, including younger maternal age, maternal pre-pregnancy body mass index, higher gestational weight gain and prenatal maternal stress; maternal lifestyle factors, such as prenatal alcohol and environmental air pollutant exposures, including particulate matter < 2.5 μm at birth, child secondhand tobacco smoke at 12 months, dampness/mould and home heating with oil, kerosene or diesel heaters at 2 years postnatal. Lower socioeconomic indexes for area, later birth order, higher maternal prenatal depression and maternal smoking frequency had a dose-response relationship with autism spectrum disorder symptoms. Future studies on environmental factors and autism spectrum disorder should consider the reasons for the socioeconomic disparity and the combined impact of multiple environmental factors through common mechanistic pathways.
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Affiliation(s)
- Cindy Pham
- Murdoch Children's Research Institute, Parkville, Australia
- The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
- The University of Melboure, Parkville, Australia
| | - Christos Symeonides
- Murdoch Children's Research Institute, Parkville, Australia
- The University of Melboure, Parkville, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Parkville, Australia
- Deakin University, Geelong, Australia
| | - Peter D Sly
- The University of Queensland, South Brisbane, Australia
| | | | - Sarah Thomson
- The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
- The University of Melboure, Parkville, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute, Parkville, Australia
- Deakin University, Geelong, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, Australia
- The University of Melboure, Parkville, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Parkville, Australia
- The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
- The University of Melboure, Parkville, Australia
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21
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Jia H, Wu X, Wu Z, Wang E. Aberrant dynamic minimal spanning tree parameters within default mode network in patients with autism spectrum disorder. Front Psychiatry 2022; 13:860348. [PMID: 36186871 PMCID: PMC9524021 DOI: 10.3389/fpsyt.2022.860348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
The altered functional connectivity (FC) level and its temporal characteristics within certain cortical networks, such as the default mode network (DMN), could provide a possible explanatory framework for Autism spectrum disorder (ASD). In the current study, we hypothesized that the topographical organization along with its temporal dynamics of the autistic brain measured by temporal mean and variance of complex network measures, respectively, were significantly altered, which may further explain the autistic symptom severity in patients with ASD. To validate these hypotheses, the precise FCs between DMN regions at each time point were calculated using the resting-state functional magnetic resonance imaging (fMRI) datasets from the Autism Brain Imaging Data Exchange (ABIDE) project. Then, the minimal spanning tree (MST) technique was applied to construct a time-varying complex network of DMN. By analyzing the temporal mean and variance of MST parameters and their relationship with autistic symptom severity, we found that in persons with ASD, the information exchange efficiencies between cortical regions within DMN were significantly lower and more volatile compared with those in typical developing participants. Moreover, these alterations within DMN were closely associated with the autistic symptom severity of the ASD group.
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Affiliation(s)
- Huibin Jia
- Institute of Psychology and Behavior, Henan University, Kaifeng, China.,School of Psychology, Henan University, Kaifeng, China
| | - Xiangci Wu
- Institute of Psychology and Behavior, Henan University, Kaifeng, China.,School of Psychology, Henan University, Kaifeng, China
| | - Zhiyu Wu
- Huaxian People's Hospital of Henan Province, Anyang, China
| | - Enguo Wang
- Institute of Psychology and Behavior, Henan University, Kaifeng, China.,School of Psychology, Henan University, Kaifeng, China
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MacInnis AG. Time-to-event estimation of birth prevalence trends: A method to enable investigating the etiology of childhood disorders including autism. PLoS One 2021; 16:e0260738. [PMID: 34855847 PMCID: PMC8638887 DOI: 10.1371/journal.pone.0260738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/17/2021] [Indexed: 12/27/2022] Open
Abstract
An unbiased, widely accepted estimate of the rate of occurrence of new cases of autism over time would facilitate progress in understanding the causes of autism. The same may also apply to other disorders. While incidence is a widely used measure of occurrence, birth prevalence-the proportion of each birth year cohort with the disorder-is the appropriate measure for disorders and diseases of early childhood. Studies of autism epidemiology commonly speculate that estimates showing strong increases in rate of autism cases result from an increase in diagnosis rates rather than a true increase in cases. Unfortunately, current methods are not sufficient to provide a definitive resolution to this controversy. Prominent experts have written that it is virtually impossible to solve. This paper presents a novel method, time-to-event birth prevalence estimation (TTEPE), to provide accurate estimates of birth prevalence properly adjusted for changing diagnostic factors. It addresses the shortcomings of prior methods. TTEPE is based on well-known time-to-event (survival) analysis techniques. A discrete survival process models the rates of incident diagnoses by birth year and age. Diagnostic factors drive the probability of diagnosis as a function of the year of diagnosis. TTEPE models changes in diagnostic criteria, which can modify the effective birth prevalence when new criteria take effect. TTEPE incorporates the development of diagnosable symptoms with age. General-purpose optimization software estimates all parameters, forming a non-linear regression. The paper specifies all assumptions underlying the analysis and explores potential deviations from assumptions and optional additional analyses. A simulation study shows that TTEPE produces accurate parameter estimates, including trends in both birth prevalence and the probability of diagnosis in the presence of sampling effects from finite populations. TTEPE provides high power to resolve small differences in parameter values by utilizing all available data points.
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O’Keefe P, Rodgers JL. Home Improvement: Evaluating Secular Changes in NLSY HOME-Cognitive Stimulation and Emotional Support Scores. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 31:1-16. [PMID: 34751208 PMCID: PMC8565176 DOI: 10.1007/s10826-021-02149-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
This study evaluated changes over time in the quality of children's home environment, using the Home Observation Measurement of the Environment (HOME). Longitudinal increases in HOME scores were predicted by both theory and past empirical results. Analysis of the National Longitudinal Survey of Youth Children data (N = 5715, aged 0-14) suggested that HOME scores have been increasing, and that the increase is a family-level phenomenon. The data were a sample of children born to mothers who were approximately representative of the United States in 1979. An increase in HOME scores occurred primarily for the three age categories younger than ten. Effect sizes were of approximately the same magnitude as the Flynn effect for intelligence. These results have implications for policy and future research regarding the home environment.
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Affiliation(s)
- Patrick O’Keefe
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L226, Portland, Oregon 97239-3098 USA
| | - Joseph Lee Rodgers
- Vanderbilt University-Department of Psychology and Human Development, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
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Wang SY, Cheng YY, Guo HR, Tseng YC. Air Pollution during Pregnancy and Childhood Autism Spectrum Disorder in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9784. [PMID: 34574710 PMCID: PMC8467611 DOI: 10.3390/ijerph18189784] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022]
Abstract
Air pollutants have been linked to some diseases in humans, but their effects on the nervous system were less frequently evaluated. Autism spectrum disorder (ASD) is a group of neurondevelopmental disorders of which the etiology is still unknown. We conducted a study in Taiwan to evaluate the possible associations between prenatal exposure to air pollutants and ASD. From a random sample of one million people in the National Insurance Research Database, we identified all the infants born between 1996 and 2000. We followed them till the end of 2013 and identified cases of ASD. We traced back the mothers' residence and assessed the exposure to air pollutants using the data obtained from the air quality monitoring database maintained by the government, which included ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matters with diameter less than 10 µm (PM10). Cox proportional hazard models were constructed to evaluate the associations between childhood ASD and exposures to the pollutants in the three trimesters and the whole gestation. We identified a total of 63,376 newborns and included 62,919 as the study cohort. After adjusting for other risk factors, we observed trimester-specific associations between levels of CO, NO2, and PM10 and the risk of childhood ASD. An increase of 1 ppm of CO in the first, second, and third trimester was associated with a hazard ratio (HR) of 1.93 (95% confidence interval [CI]: 1.55-2.39), 1.77 (95%CI: 1.41-2.22), and 1.75 (95%CI: 1.39-2.21), respectively. An increase of 10 ppb in the level of NO2 in the first, second, and third trimester was associated with an HR of 1.39 (95%CI: 1.22-1.58), 1.25 (95%CI: 1.10-1.42), and 1.18 (95%CI: 1.03-1.34), respectively. In conclusion, we found that exposures to CO and NO2 in all three trimesters were associated with increased risks of developing ASD.
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Affiliation(s)
- Shu-Yuan Wang
- Department of Environmental and Occupational Health, College of Medical, National Cheng Kung University, Tainan 704, Taiwan; (S.-Y.W.); (Y.-Y.C.); (H.-R.G.)
| | - Ya-Yun Cheng
- Department of Environmental and Occupational Health, College of Medical, National Cheng Kung University, Tainan 704, Taiwan; (S.-Y.W.); (Y.-Y.C.); (H.-R.G.)
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medical, National Cheng Kung University, Tainan 704, Taiwan; (S.-Y.W.); (Y.-Y.C.); (H.-R.G.)
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - Yen-Cheng Tseng
- Department of Tourism, Food, and Beverage Management, College of Management, Chang Jung Christian University, Tainan 711, Taiwan
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25
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Berger K, Pearl M, Kharrazi M, Li Y, DeGuzman J, She J, Behniwal P, Lyall K, Windham G. The association of in utero tobacco smoke exposure, quantified by serum cotinine, and Autism Spectrum Disorder. Autism Res 2021; 14:2017-2026. [PMID: 34165248 PMCID: PMC10752221 DOI: 10.1002/aur.2561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/06/2021] [Accepted: 06/10/2021] [Indexed: 12/11/2022]
Abstract
Previous studies on in utero exposure to maternal environmental tobacco smoke (ETS) or maternal active smoking and Autism Spectrum Disorder (ASD) have not been entirely consistent, and no studies have examined in utero cotinine concentrations as an exposure classification method. We measured cotinine in stored second trimester maternal serum for 498 ASD cases and 499 controls born in California in 2011-2012. We also obtained self-reported maternal cigarette smoking during and immediately prior to pregnancy, as well as covariate data, from birth records. Using unconditional logistic regression, we found no association between log10 cotinine concentrations and odds for developing ASD among children of non-smokers (aOR: 0.93 [95% CI: 0.69, 1.25] per ng/ml), which represents exposure to ETS, though there may be a possible interaction with race. We found no association between cotinine-defined smoking (≥3.08 ng/ml vs. <3.08 ng/ml) (adjusted odds ratio [aOR]: 0.73 (95% confidence interval [95% CI]: 0.35, 1.54)) or self-reported smoking (aOR: 1.64 [95% CI: 0.65, 4.16]) and ASD. In one of the few studies of ETS and the first with measured cotinine, our results indicate no overall relationship between in utero exposure to tobacco smoke from maternal ETS exposure or active smoking, and development of ASD. LAY SUMMARY: This study found that women who smoke or are exposed to tobacco smoke during pregnancy are not more likely to have children with Autism Spectrum Disorder (ASD). This is the first ASD study to measure a chemical in the mother's blood during pregnancy to identify exposure to tobacco smoke.
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Affiliation(s)
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Marty Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Ying Li
- Environmental Health Laboratory Branch, California Department of Public Health, Richmond, California, USA
| | - Josephine DeGuzman
- Environmental Health Laboratory Branch, California Department of Public Health, Richmond, California, USA
| | - Jianwen She
- Environmental Health Laboratory Branch, California Department of Public Health, Richmond, California, USA
| | - Paramjit Behniwal
- Environmental Health Laboratory Branch, California Department of Public Health, Richmond, California, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Gayle Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
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26
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Sasayama D, Kudo T, Kaneko W, Kuge R, Koizumi N, Nomiyama T, Washizuka S, Honda H. Brief Report: Cumulative Incidence of Autism Spectrum Disorder Before School Entry in a Thoroughly Screened Population. J Autism Dev Disord 2021; 51:1400-1405. [PMID: 32696286 DOI: 10.1007/s10803-020-04619-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present study aimed to identify the cumulative incidence of autism spectrum disorder (ASD) in a thoroughly screened population and to examine the behavioral and motor characteristics observed in children with ASD at the age of 18 months. Subjects were 1067 children who underwent a screening assessment for ASD at the routine 18-months health checkup. By the age of 6 years, 3.1% (4.3% of boys and 2.0% of girls) were diagnosed as having ASD by their attending pediatricians. Higher rate of difficulties in motor skills and social and communication skills had been reported in children with ASD at 18 months of age. This study showed that careful community-based screening system may be helpful in detecting ASD at early age.
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Affiliation(s)
- Daimei Sasayama
- Department of Psychiatry, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano, 390-8621, Japan.
- Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan.
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, 390-8621, Japan.
| | - Tetsuya Kudo
- Shinano Medical Welfare Center, Shimo-Suwa, Nagano, 393-0093, Japan
| | - Wakako Kaneko
- Shinano Medical Welfare Center, Shimo-Suwa, Nagano, 393-0093, Japan
| | - Rie Kuge
- Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, 390-8621, Japan
| | - Noriaki Koizumi
- Center for Mental Health and Welfare of Nagano Prefecture, NaganoNagano, Nagano, 380-0928, Japan
| | - Tetsuo Nomiyama
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, Matsumoto, Nagano, 390-8621, Japan
| | - Shinsuke Washizuka
- Department of Psychiatry, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Hideo Honda
- Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, 390-8621, Japan
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Lyall K, Ames JL, Pearl M, Traglia M, Weiss LA, Windham GC, Kharrazi M, Yoshida CK, Yolken R, Volk HE, Ashwood P, Van de Water J, Croen LA. A profile and review of findings from the Early Markers for Autism study: unique contributions from a population-based case-control study in California. Mol Autism 2021; 12:24. [PMID: 33736683 PMCID: PMC7977191 DOI: 10.1186/s13229-021-00429-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Early Markers for Autism (EMA) study is a population-based case-control study designed to learn more about early biologic processes involved in ASD. METHODS Participants were drawn from Southern California births from 2000 to 2003 with archived prenatal and neonatal screening specimens. Across two phases, children with ASD (n = 629) and intellectual disability without ASD (ID, n = 230) were ascertained from the California Department of Developmental Services (DDS), with diagnoses confirmed according to DSM-IV-TR criteria based on expert clinical review of abstracted records. General population controls (GP, n = 599) were randomly sampled from birth certificate files and matched to ASD cases by sex, birth month and year after excluding individuals with DDS records. EMA has published over 20 papers examining immune markers, endogenous hormones, environmental chemicals, and genetic factors in association with ASD and ID. This review summarizes the results across these studies, as well as the EMA study design and future directions. RESULTS EMA enabled several key contributions to the literature, including the examination of biomarker levels in biospecimens prospectively collected during critical windows of neurodevelopment. Key findings from EMA include demonstration of elevated cytokine and chemokine levels in maternal mid-pregnancy serum samples in association with ASD, as well as aberrations in other immune marker levels; suggestions of increased odds of ASD with prenatal exposure to certain endocrine disrupting chemicals, though not in mixture analyses; and demonstration of maternal and fetal genetic influence on prenatal chemical, and maternal and neonatal immune marker and vitamin D levels. We also observed an overall lack of association with ASD and measured maternal and neonatal vitamin D, mercury, and brain-derived neurotrophic factor (BDNF) levels. LIMITATIONS Covariate and outcome data were limited to information in Vital Statistics and DDS records. As a study based in Southern California, generalizability for certain environmental exposures may be reduced. CONCLUSIONS Results across EMA studies support the importance of the prenatal and neonatal periods in ASD etiology, and provide evidence for the role of the maternal immune response during pregnancy. Future directions for EMA, and the field of ASD in general, include interrogation of mechanistic pathways and examination of combined effects of exposures.
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Affiliation(s)
- Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Suite 560, 3020 Market St, Philadelphia, PA, 19104, USA.
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Michela Traglia
- University of California, San Francisco, San Francisco, CA, USA
| | - Lauren A Weiss
- University of California, San Francisco, San Francisco, CA, USA
| | - Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Cathleen K Yoshida
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Robert Yolken
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Ashwood
- UC Davis MIND Institute, University of California, Davis, Davis, CA, USA
| | - Judy Van de Water
- UC Davis MIND Institute, University of California, Davis, Davis, CA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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28
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Lyall K, Windham GC, Snyder NW, Kuskovsky R, Xu P, Bostwick A, Robinson L, Newschaffer CJ. Association Between Midpregnancy Polyunsaturated Fatty Acid Levels and Offspring Autism Spectrum Disorder in a California Population-Based Case-Control Study. Am J Epidemiol 2021; 190:265-276. [PMID: 33524118 DOI: 10.1093/aje/kwaa171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/16/2022] Open
Abstract
Polyunsaturated fatty acids (PUFAs) are critical for brain development and have been linked with neurodevelopmental outcomes. We conducted a population-based case-control study in California to examine the association between PUFAs measured in midpregnancy serum samples and autism spectrum disorder (ASD) in offspring. ASD cases (n = 499) were identified through the California Department of Developmental Services and matched to live-birth population controls (n = 502) on birth month, year (2010 or 2011), and sex. Logistic regression models were used to examine crude and adjusted associations. In secondary analyses, we examined ASD with and without co-occurring intellectual disability (ID; n = 67 and n = 432, respectively) and effect modification by sex and ethnicity. No clear patterns emerged, though there was a modest inverse association with the top quartile of linoleic acid level (highest quartile vs. lowest: adjusted odds ratio = 0.74, 95% confidence interval: 0.49, 1.11; P for trend = 0.10). Lower levels of total and ω-3 PUFAs were associated with ASD with ID (lowest decile of total PUFAs vs. deciles 4-7: adjusted odds ratio = 2.78, 95% confidence interval: 1.13, 6.82) but not ASD without ID. We did not observe evidence of effect modification by the factors examined. These findings do not suggest a strong association between midpregnancy PUFA levels and ASD. In further work, researchers should consider associations with ASD with ID and in other time windows.
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McGrath K, Bonuck K, Mann M. Exploratory spatial analysis of autism rates in New York school districts: role of sociodemographic and language differences. J Neurodev Disord 2020; 12:35. [PMID: 33327937 PMCID: PMC7745507 DOI: 10.1186/s11689-020-09338-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background Literature on autism spectrum disorder (ASD) suggests lower ASD prevalence and higher age of diagnosis among children of color, from lower socioeconomic backgrounds, and from families with lower educational levels. These disparities have been attributed to factors such as limited access to diagnostic and treatment services, less opportunity for upward mobility to locales with ample resources, and linguistic barriers. However, few studies describe prevalence and geographic differences of ASD diagnoses by English Language Learner (ELL) status. Objectives The primary objectives of this study are to (1) spatially explore the prevalence of ASD among New York State school districts and (2) examine differences of ASD prevalence rates between ELLs and native English-speaking peers. Methods Using the 2016–2017 district-level data on public and non-public school age students (3–21 years old) receiving special education services in New York, we analyzed sociodemographic trends among school districts with varying percentages (low, medium, and high ranges) of students with ASD and ELLs. To do this, we conducted exploratory spatial analyses using GIS software, analysis of school district level demographic data, and multivariate linear regression. Results In contrast to prior research on ASD prevalence among minority groups, we found disproportionately higher rates of ASD among school districts with higher proportions of Black and Hispanic students. Geographic analysis revealed statistically significant clustering of school districts with high ASD rates in New York City and Albany. Higher proportions of ELLs tended to be concentrated in densely populated, urban, and geographically smaller school districts and had higher proportions of Black, Hispanic, and Asian students. Conclusions Schools with higher rates of ASD and ELL students tend to be concentrated in urban regions throughout New York and have higher representation of Black and Hispanic/Latino students, as well as higher rates of learning disabilities in general. Further research is warranted to explore possible reasons for this phenomenon.
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Affiliation(s)
- Kathleen McGrath
- Albert Einstein College of Medicine, New York City, USA. .,CUNY Graduate Center, New York City, USA.
| | - Karen Bonuck
- Albert Einstein College of Medicine, New York City, USA
| | - Mana Mann
- Albert Einstein College of Medicine, New York City, USA
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30
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Winter AS, Fountain C, Cheslack-Postava K, Bearman PS. The social patterning of autism diagnoses reversed in California between 1992 and 2018. Proc Natl Acad Sci U S A 2020; 117:30295-30302. [PMID: 33199592 PMCID: PMC7720167 DOI: 10.1073/pnas.2015762117] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
As rates of autism diagnosis increased dramatically over the past number of decades, prevalence rates were generally highest among Whites and among those of higher socioeconomic status (SES). Using a unique, population-level dataset, we find that rates of autism diagnosis continued to be on the rise in recent years, but who is diagnosed changed during the study period. Our data consist of birth records of all 13,272,573 children born in the state of California in 1992 through 2016 linked to autism caseload records for January 1992 through November 2019 from California's Department of Developmental Services. California's diagnosed autism incidence rate rose from 0.49 per 1,000 3-6 y olds in 1998 to 3.49 per 1,000 3-6 y olds in 2018, a 612% increase. However, diagnosed incidence rates did not rise uniformly across sociodemographic groups. By 2018, children of Black and Asian mothers were diagnosed at higher rates than children of non-Hispanic White mothers. Furthermore, among children of non-Hispanic White and Asian mothers, children of lower SES were diagnosed at higher rates than children of higher SES. These changes align with sociological theories of health disparities and contain important clues for more fully understanding the autism epidemic.
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Affiliation(s)
- Alix S Winter
- Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, New York, NY 10027
| | - Christine Fountain
- Department of Sociology & Anthropology, Fordham University at Lincoln Center, New York, NY 10023
| | | | - Peter S Bearman
- Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, New York, NY 10027;
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31
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Hormonal contraceptives and autism epidemics. Med Hypotheses 2020; 141:109729. [DOI: 10.1016/j.mehy.2020.109729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/24/2020] [Accepted: 04/08/2020] [Indexed: 11/18/2022]
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32
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Liew Z, von Ehrenstein OS, Ling C, Yuan Y, Meng Q, Cui X, Park AS, Uldall P, Olsen J, Cockburn M, Ritz B. Ambient Exposure to Agricultural Pesticides during Pregnancy and Risk of Cerebral Palsy: A Population-Based Study in California. TOXICS 2020; 8:E52. [PMID: 32751992 PMCID: PMC7560316 DOI: 10.3390/toxics8030052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022]
Abstract
Cerebral palsy (CP) is the most common neuro-motor disability in young children. Disruptions of maternal hormone function during pregnancy have been linked to CP risk. We investigated whether prenatal exposure to pesticide compounds with endocrine-disrupting action affect CP risk. We conducted a case-control study of 3905 CP cases and 39,377 controls born between 1998 and 2010 in California to mothers who lived in proximity (within 2 km) to any agricultural pesticide application recorded in the California Pesticide Use Reporting (PUR) system. We focused on 23 pesticides considered endocrine disruptors that are frequently used, and we found that exposure to any of the 23 pesticides in the first trimester was associated with elevated CP risks in female offspring (OR = 1.19; 95% CI: 1.05-1.35) but not males (OR = 0.99; 95% CI: 0.89-1.09) compared to the unexposed offspring. Positive associations were estimated for 15 pesticides suspected to affect the estrogen and 7 pesticides suspected to affect the thyroid hormone system. Our study suggests that first trimester exposure to pesticides that are suspected endocrine disruptors are associated with CP risk in female offspring. Pesticide exposures in early pregnancy may have sex-specific influences on the neuro-motor development of the fetus by interfering with endocrine systems.
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Affiliation(s)
- Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA
| | - Ondine S. von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA;
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Chenxiao Ling
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Yuying Yuan
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Qi Meng
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Xin Cui
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA 94305, USA;
- California Perinatal Quality Care Collaborative, Palo Alto, CA 94305, USA
| | - Andrew S. Park
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Peter Uldall
- Department of Paediatrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8000 C Aarhus, Denmark;
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO 80045, USA
- Colorado Comprehensive Cancer Center, University of Colorado, Aurora, CO 80045, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
- Department of Neurology, School of Medicine, UCLA, Los Angeles, CA 90095, USA
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Garcia Primo P, Weber C, Posada de la Paz M, Fellinger J, Dirmhirn A, Holzinger D. Explaining Age at Autism Spectrum Diagnosis in Children with Migrant and Non-Migrant Background in Austria. Brain Sci 2020; 10:brainsci10070448. [PMID: 32674382 PMCID: PMC7407505 DOI: 10.3390/brainsci10070448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/31/2022] Open
Abstract
This study explored (i) differences in age at Autism Spectrum Disorder (ASD) diagnosis between children with and without a migrant background in the main diagnostic centre for ASD in Upper Austria (ii) factors related to the age at diagnosis and (iii) whether specific factors differed between the two groups. A retrospective chart analysis included all children who received their first diagnosis before the age of 10 years (n = 211) between 2013 and 2018. Children with a migrant background were diagnosed 13 months earlier than those without (r = 0.278, p < 0.001), and had more severe delays in language, more severe autism, no Asperger’s syndrome, lower parental educational level and more frequent referrals by paediatricians. For the total sample, expressive language delay, severity of restricted and repetitive behaviours, higher nonverbal development, and paediatric referrals explained earlier diagnoses. There was a stronger effect of parental education and weaker effect of language impairment on age at ASD diagnosis in children with a migrant background. In conclusion, no delay in diagnosing ASD in children with a migrant background in a country with universal health care and an established system of paediatric developmental surveillance was found. Awareness of ASD, including Asperger’s syndrome, should be raised among families and healthcare professionals.
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Affiliation(s)
- Patricia Garcia Primo
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
| | - Christoph Weber
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
- Department for Inclusive Education, University of Education Upper Austria, 4020 Linz, Austria
| | - Manuel Posada de la Paz
- Institute of Rare Diseases Research (IIER) & CIBERER, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
| | - Johannes Fellinger
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, 4020 Linz, Austria;
- Division of Social Psychiatry, Medical University of Vienna, 1010 Vienna, Austria
| | - Anna Dirmhirn
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, 4020 Linz, Austria;
| | - Daniel Holzinger
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, 4020 Linz, Austria;
- Institute of Linguistics, Karl-Franzens University of Graz, 8010 Graz, Austria
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Girolamo TM, Rice ML, Warren SF. Assessment of Language Abilities in Minority Adolescents and Young Adults With Autism Spectrum Disorder and Extensive Special Education Needs: A Pilot Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:804-818. [PMID: 32324427 PMCID: PMC7842863 DOI: 10.1044/2020_ajslp-19-00036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/29/2019] [Accepted: 01/21/2020] [Indexed: 05/22/2023]
Abstract
Purpose Little is known about the language abilities of adolescents and young adults with autism spectrum disorder (ASD) despite the importance of language in their other life outcomes. Even less is known about the language abilities of racial/ethnic minorities with ASD and extensive special education needs. These gaps limit our understanding of adolescents and young adults with ASD. Method A pilot study evaluated the efficacy of individualized age-referenced language assessment for minority adolescents and young adults with ASD in self-contained special education settings. Participants (n = 10) completed the Clinical Evaluation of Language Fundamentals-Third Edition, Test for Early Grammatical Impairment (TEGI), Columbia Mental Maturity Scale, and Wechsler Intelligence Scale for Children-Third Edition Digit Span. Results Clinical Evaluation of Language Fundamentals-Third Edition scores showed little variation, with most participants showing a floor effect. TEGI, Columbia Mental Maturity Scale, and Digit Span scores showed greater variation. Some participants had ceiling TEGI scores, and some had variable assessment profiles. Conclusion Assessment was sensitive to variability across some measures. The pilot study outcomes support the feasibility and potential informativeness of additional investigation of conventional language assessments and change over time.
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Affiliation(s)
| | - Mabel L. Rice
- Child Language Doctoral Program, The University of Kansas, Lawrence
| | - Steven F. Warren
- Department of Speech-Language-Hearing: Sciences & Disorders, The University of Kansas, Lawrence
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A framework for an evidence-based gene list relevant to autism spectrum disorder. Nat Rev Genet 2020; 21:367-376. [PMID: 32317787 DOI: 10.1038/s41576-020-0231-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2020] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder (ASD) is often grouped with other brain-related phenotypes into a broader category of neurodevelopmental disorders (NDDs). In clinical practice, providers need to decide which genes to test in individuals with ASD phenotypes, which requires an understanding of the level of evidence for individual NDD genes that supports an association with ASD. Consensus is currently lacking about which NDD genes have sufficient evidence to support a relationship to ASD. Estimates of the number of genes relevant to ASD differ greatly among research groups and clinical sequencing panels, varying from a few to several hundred. This Roadmap discusses important considerations necessary to provide an evidence-based framework for the curation of NDD genes based on the level of information supporting a clinically relevant relationship between a given gene and ASD.
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Al-Dewik N, Al-Jurf R, Styles M, Tahtamouni S, Alsharshani D, Alsharshani M, Ahmad AI, Khattab A, Al Rifai H, Walid Qoronfleh M. Overview and Introduction to Autism Spectrum Disorder (ASD). ADVANCES IN NEUROBIOLOGY 2020; 24:3-42. [PMID: 32006355 DOI: 10.1007/978-3-030-30402-7_1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder generally manifesting in the first few years of life and tending to persist into adolescence and adulthood. It is characterized by deficits in communication and social interaction and restricted, repetitive patterns of behavior, interests, and activities. It is a disorder with multifactorial etiology. In this chapter, we will focus on the most important and common epidemiological studies, pathogenesis, screening, and diagnostic tools along with an explication of genetic testing in ASD.
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Affiliation(s)
- Nader Al-Dewik
- Clinical and Metabolic Genetics Section, Pediatrics Department, Hamad General Hospital (HGH), Women's Wellness and Research Center (WWRC) and Interim Translational Research Institute (iTRI), Hamad Medical Corporation (HMC), Doha, Qatar. .,College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar. .,Faculty of Health and Social Care Sciences, Kingston University, St. George's University of London, London, UK.
| | - Rana Al-Jurf
- Department of Biomedical Science, College of Health Science, Qatar University, Doha, Qatar
| | - Meghan Styles
- Health Profession Awareness Program, Health Facilities Development, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Sona Tahtamouni
- Child Development Center, Hamad Medical Corporation, Doha, Qatar
| | - Dalal Alsharshani
- College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Mohammed Alsharshani
- Diagnostic Genetics Division (DGD), Department of Laboratory Medicine and Pathology (DLMP), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Amal I Ahmad
- Qatar Rehabilitation Institute (QRI), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Azhar Khattab
- Qatar Rehabilitation Institute (QRI), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hilal Al Rifai
- Department of Pediatrics and Neonatology, Newborn Screening Unit, Hamad Medical Corporation, Doha, Qatar
| | - M Walid Qoronfleh
- Research and Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
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Ames JL, Windham GC, Lyall K, Pearl M, Kharrazi M, Yoshida CK, Van de Water J, Ashwood P, Croen LA. Neonatal Thyroid Stimulating Hormone and Subsequent Diagnosis of Autism Spectrum Disorders and Intellectual Disability. Autism Res 2019; 13:444-455. [DOI: 10.1002/aur.2247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/26/2019] [Accepted: 11/15/2019] [Indexed: 12/14/2022]
Affiliation(s)
| | - Gayle C. Windham
- Environmental Health Investigations BranchCalifornia Department of Public Health Richmond California
| | - Kristen Lyall
- A.J. Drexel Autism InstituteDrexel University Philadelphia Pennsylvania
| | - Michelle Pearl
- Environmental Health Investigations BranchCalifornia Department of Public Health Richmond California
| | - Martin Kharrazi
- Environmental Health Investigations BranchCalifornia Department of Public Health Richmond California
| | | | - Judy Van de Water
- Department of Public Health Sciences, Division of Rheumatology, Allergy and Clinical ImmunologyUniversity of California Davis California
- MIND (Medical Investigations of Neurodevelopmental Disorders) InstituteUniversity of California Davis California
| | - Paul Ashwood
- MIND (Medical Investigations of Neurodevelopmental Disorders) InstituteUniversity of California Davis California
- Department of Medical Microbiology and ImmunologyUniversity of California Davis California
| | - Lisa A. Croen
- Kaiser Permanente Division of Research Oakland California
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Anderson LL, Larson SA, MapelLentz S, Hall-Lande J. A Systematic Review of U.S. Studies on the Prevalence of Intellectual or Developmental Disabilities Since 2000. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:421-438. [PMID: 31568738 DOI: 10.1352/1934-9556-57.5.421] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This systematic review examined 14 U.S. studies published since 2000 reporting prevalence estimates for intellectual disability (ID) or developmental disability (DD). Prevalence rates for children were between 11.0 and 13.4 per 1,000 for ID and between 45.8 and 69.9 per 1,000 for DD using data from 2010 or later. A 2015 Ohio study of adults yielded a prevalence estimate of 41.0 per 1,000 for DD. The only study of ID in adults and the only study incorporating DD Act definitions used the 1994/1995 NHIS-D yielding prevalence estimates for ID and/or DD of 38.2 per 1,000 for children birth to 5 years, 31.7 for children 6 to 18 years, and 7.9 per 1,000 for adults. Notable differences in prevalence estimates by age and operational definition have important implications for public policy and research. Serious surveillance gaps limit our understanding of service utilization rates, unmet needs, and health and other outcomes for adults with ID or DD.
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Affiliation(s)
- Lynda Lahti Anderson
- Lynda Lahti Anderson and Sheryl A. Larson, University of Minnesota, Minneapolis; Sarah MapelLentz, Minnesota Department of Health, St. Paul; and Jennifer Hall-Lande, University of Minnesota, Minneapolis
| | - Sheryl A Larson
- Lynda Lahti Anderson and Sheryl A. Larson, University of Minnesota, Minneapolis; Sarah MapelLentz, Minnesota Department of Health, St. Paul; and Jennifer Hall-Lande, University of Minnesota, Minneapolis
| | - Sarah MapelLentz
- Lynda Lahti Anderson and Sheryl A. Larson, University of Minnesota, Minneapolis; Sarah MapelLentz, Minnesota Department of Health, St. Paul; and Jennifer Hall-Lande, University of Minnesota, Minneapolis
| | - Jennifer Hall-Lande
- Lynda Lahti Anderson and Sheryl A. Larson, University of Minnesota, Minneapolis; Sarah MapelLentz, Minnesota Department of Health, St. Paul; and Jennifer Hall-Lande, University of Minnesota, Minneapolis
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Shawler LA, Russo SR, Hilton JL, Kahng S, Davis CJ, Dorsey MF. Behavioral Treatment of Self-Injury: 2001 to 2016. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:450-469. [PMID: 31512946 DOI: 10.1352/1944-7558-124.5.450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Individuals diagnosed with intellectual and developmental disabilities (IDD) frequently exhibit self-injurious behavior (SIB). Previous research has examined the published literature on behavioral treatments of SIB from 1964-2000. Results suggested that these treatments were highly efficacious at decreasing SIB, particularly when based on the results of a functional assessment. The purpose of this review is to update, replicate, and extend the previous research. The current findings indicate an increase in studies reporting automatically maintained SIB as well as less efficacious treatments overall. Discussion of our conclusions and methods of SIB assessment and treatment are discussed, both as they relate to the previous review and for future directions.
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Affiliation(s)
- Lesley A Shawler
- Lesley A. Shawler, Samantha R. Russo, and Jennifer L. Hilton, Endicott College; SungWoo Kahng, Rutgers University; Cheryl J. Davis, The Sage Colleges; and Michael F. Dorsey, Amego, Inc
| | - Samantha R Russo
- Lesley A. Shawler, Samantha R. Russo, and Jennifer L. Hilton, Endicott College; SungWoo Kahng, Rutgers University; Cheryl J. Davis, The Sage Colleges; and Michael F. Dorsey, Amego, Inc
| | - Jennifer L Hilton
- Lesley A. Shawler, Samantha R. Russo, and Jennifer L. Hilton, Endicott College; SungWoo Kahng, Rutgers University; Cheryl J. Davis, The Sage Colleges; and Michael F. Dorsey, Amego, Inc
| | - SungWoo Kahng
- Lesley A. Shawler, Samantha R. Russo, and Jennifer L. Hilton, Endicott College; SungWoo Kahng, Rutgers University; Cheryl J. Davis, The Sage Colleges; and Michael F. Dorsey, Amego, Inc
| | - Cheryl J Davis
- Lesley A. Shawler, Samantha R. Russo, and Jennifer L. Hilton, Endicott College; SungWoo Kahng, Rutgers University; Cheryl J. Davis, The Sage Colleges; and Michael F. Dorsey, Amego, Inc
| | - Michael F Dorsey
- Lesley A. Shawler, Samantha R. Russo, and Jennifer L. Hilton, Endicott College; SungWoo Kahng, Rutgers University; Cheryl J. Davis, The Sage Colleges; and Michael F. Dorsey, Amego, Inc
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McCanlies EC, Ma CC, Gu JK, Fekedulegn D, Sanderson WT, Ludeña-Rodriguez YJ, Hertz-Picciotto I. The CHARGE study: an assessment of parental occupational exposures and autism spectrum disorder. Occup Environ Med 2019; 76:644-651. [PMID: 31248991 DOI: 10.1136/oemed-2018-105395] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/09/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study is to determine if parental occupational exposure to 16 agents is associated with autism spectrum disorder (ASD). METHODS Demographic, health and parental occupational data were collected as part of the CHildhood Autism Risks from Genetics and Environment study. The workplace exposure assessment was conducted by two experienced industrial hygienists for the parents of 537 children with ASD and 414 typically developing (TD) children. For each job, frequency and intensity of 16 agents were assessed and both binary and semi-quantitative cumulative exposure variables were derived. Logistic regression models were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess associations between parental occupational exposures 3 months pre-pregnancy until birth. RESULTS The OR of ASD in the children of mothers exposed to any solvents was 1.5 times higher than the mothers of TD children (95% CI=1.01-2.23). Cumulative exposure indicated that the OR associated with a moderate level of solvent exposure in mothers was 1.85 (95% CI=1.09, 3.15) for children with ASD compared with TD children. No other exposures were associated with ASD in mothers, fathers or the parents combined. CONCLUSION Maternal occupational exposure to solvents may increase the risk for ASD. These results are consistent with a growing body of evidence indicating that environmental and occupational exposures may be associated with ASD. Future research should consider specific types of solvents, larger samples and/or different study designs to evaluate other exposures for potential associations with ASD.
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Affiliation(s)
- Erin C McCanlies
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Claudia C Ma
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Ja Kook Gu
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Desta Fekedulegn
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Wayne T Sanderson
- University of Kentucky Chandler Medical Center, Lexington, Kentucky, USA
| | - Yunin J Ludeña-Rodriguez
- Division of Environmental and Occupational Health, Public Health Sciences, University of California, Davis, California, USA
| | - Irva Hertz-Picciotto
- Division of Environmental and Occupational Health, Public Health Sciences, University of California, Davis, California, USA
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Abstract
Autism spectrum disorder (ASD) describes a set of neurodevelopmental disorders. Despite extensive ASD research lasting more than 60 years, its causes are still unknown. Without indicating the etiology, its development cannot be stopped. Over the years, both the definition and diagnostic criteria have developed. The number of ASD incidence is rising. The economical aspect should also be highlighted. This disorder presents particular challenges to affected children, their parents and physicians. The research of ASD, physician activities, policy making and raising the level of awareness must be coordinated. Special attention should be paid to the problem among adults with ASD.
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Affiliation(s)
- Joanna Kałużna-Czaplińska
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz, Poland
| | - Ewa Żurawicz
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
| | - Jagoda Jóźwik-Pruska
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz, Poland
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Christensen DL, Maenner MJ, Bilder D, Constantino JN, Daniels J, Durkin MS, Fitzgerald RT, Kurzius-Spencer M, Pettygrove SD, Robinson C, Shenouda J, White T, Zahorodny W, Pazol K, Dietz P. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 4 Years - Early Autism and Developmental Disabilities Monitoring Network, Seven Sites, United States, 2010, 2012, and 2014. MMWR. SURVEILLANCE SUMMARIES : MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES 2019; 68:1-19. [PMID: 30973853 PMCID: PMC6476327 DOI: 10.15585/mmwr.ss6802a1] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Problem/Condition Autism spectrum disorder (ASD) is estimated to affect up to 3% of children in
the United States. Public health surveillance for ASD among children aged 4
years provides information about trends in prevalence, characteristics of
children with ASD, and progress made toward decreasing the age of
identification of ASD so that evidence-based interventions can begin as
early as possible. Period Covered 2010, 2012, and 2014. Description of System The Early Autism and Developmental Disabilities Monitoring (Early ADDM)
Network is an active surveillance system that provides biennial estimates of
the prevalence and characteristics of ASD among children aged 4 years whose
parents or guardians lived within designated sites. During surveillance
years 2010, 2012, or 2014, data were collected in seven sites: Arizona,
Colorado, Missouri, New Jersey, North Carolina, Utah, and Wisconsin. The
Early ADDM Network is a subset of the broader ADDM Network (which included
13 total sites over the same period) that has been conducting ASD
surveillance among children aged 8 years since 2000. Each Early ADDM site
covers a smaller geographic area than the broader ADDM Network. Early ADDM
ASD surveillance is conducted in two phases using the same methods and
project staff members as the ADDM Network. The first phase consists of
reviewing and abstracting data from children’s records, including
comprehensive evaluations performed by community professionals. Sources for
these evaluations include general pediatric health clinics and specialized
programs for children with developmental disabilities. In addition, special
education records (for children aged ≥3 years) were reviewed for
Arizona, Colorado, New Jersey, North Carolina, and Utah, and early
intervention records (for children aged 0 to <3 years) were reviewed for
New Jersey, North Carolina, Utah, and Wisconsin; in Wisconsin, early
intervention records were reviewed for 2014 only. The second phase involves
a review of the abstracted evaluations by trained clinicians using a
standardized case definition and method. A child is considered to meet the
surveillance case definition for ASD if one or more comprehensive
evaluations of that child completed by a qualified professional describes
behaviors consistent with the Diagnostic and Statistical Manual of
Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR)
diagnostic criteria for any of the following conditions: autistic disorder,
pervasive developmental disorder–not otherwise specified (PDD-NOS,
including atypical autism), or Asperger disorder (2010, 2012, and 2014). For
2014 only, prevalence estimates based on surveillance case definitions
according to DSM-IV-TR and the Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition (DSM-5) were compared. This
report provides estimates of overall ASD prevalence and prevalence by sex
and race/ethnicity; characteristics of children aged 4 years with ASD,
including age at first developmental evaluation, age at ASD diagnosis, and
cognitive function; and trends in ASD prevalence and characteristics among
Early ADDM sites with data for all 3 surveillance years (2010, 2012, and
2014), including comparisons with children aged 8 years living in the same
geographic area. Analyses of time trends in ASD prevalence are restricted to
the three sites that contributed data for all 3 surveillance years with
consistent data sources (Arizona, Missouri, and New Jersey). Results The overall ASD prevalence was 13.4 per 1,000 children aged 4 years in 2010,
15.3 in 2012, and 17.0 in 2014 for Early ADDM sites with data for the
specific years. ASD prevalence was determined using a surveillance case
definition based on DSM-IV-TR. Within each surveillance year, ASD prevalence
among children aged 4 years varied across surveillance sites and was lowest
each year for Missouri (8.5, 8.1, and 9.6 per 1,000, for 2010, 2012, and
2014, respectively) and highest each year for New Jersey (19.7, 22.1, and
28.4 per 1,000, for the same years, respectively). Aggregated prevalence
estimates were higher for sites that reviewed education and health care
records than for sites that reviewed only health care records. Among all
participating sites and years, ASD prevalence among children aged 4 years
was consistently higher among boys than girls; prevalence ratios ranged from
2.6 (Arizona and Wisconsin in 2010) to 5.2 boys per one girl (Colorado in
2014). In 2010, ASD prevalence was higher among non-Hispanic white children
than among Hispanic children in Arizona and non-Hispanic black children in
Missouri; no other differences were observed by race/ethnicity. Among four
sites with ≥60% data on cognitive test scores (Arizona, New Jersey,
North Carolina, and Utah), the frequency of co-occurring intellectual
disabilities was significantly higher among children aged 4 years than among
those aged 8 years for each site in each surveillance year except Arizona in
2010. The percentage of children with ASD who had a first evaluation by age
36 months ranged from 48.8% in Missouri in 2012 to 88.9% in Wisconsin in
2014. The percentage of children with a previous ASD diagnosis from a
community provider varied by site, ranging from 43.0% for Arizona in 2012 to
86.5% for Missouri in 2012. The median age at earliest known ASD diagnosis
varied from 28 months in North Carolina in 2014 to 39.0 months in Missouri
and Wisconsin in 2012. In 2014, the ASD prevalence based on the DSM-IV-TR
case definition was 20% higher than the prevalence based on the DSM-5 (17.0
versus 14.1 per 1,000, respectively). Trends in ASD prevalence and characteristics among children aged 4 years
during the study period were assessed for the three sites with data for all
3 years and consistent data sources (Arizona, Missouri, and New Jersey)
using the DSM-IV-TR case definition; prevalence was higher in 2014 than in
2010 among children aged 4 years in New Jersey and was stable in Arizona and
Missouri. In Missouri, ASD prevalence was higher among children aged 8 years
than among children aged 4 years. The percentage of children with ASD who
had a comprehensive evaluation by age 36 months was stable in Arizona and
Missouri and decreased in New Jersey. In the three sites, no change occurred
in the age at earliest known ASD diagnosis during 2010–2014. Interpretation The findings suggest that ASD prevalence among children aged 4 years was
higher in 2014 than in 2010 in one site and remained stable in others. Among
children with ASD, the frequency of cognitive impairment was higher among
children aged 4 years than among those aged 8 years and suggests that
surveillance at age 4 years might more often include children with more
severe symptoms or those with co-occurring conditions such as intellectual
disability. In the sites with data for all years and consistent data
sources, no change in the age at earliest known ASD diagnosis was found, and
children received their first developmental evaluation at the same or a
later age in 2014 compared with 2010. Delays in the initiation of a first
developmental evaluation might adversely affect children by delaying access
to treatment and special services that can improve outcomes for children
with ASD. Public Health Action Efforts to increase awareness of ASD and improve the identification of ASD by
community providers can facilitate early diagnosis of children with ASD.
Heterogeneity of results across sites suggests that community-level
differences in evaluation and diagnostic services as well as access to data
sources might affect estimates of ASD prevalence and age of identification.
Continuing improvements in providing developmental evaluations to children
as soon as developmental concerns are identified might result in earlier ASD
diagnoses and earlier receipt of services, which might improve developmental
outcomes.
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Affiliation(s)
- Deborah L Christensen
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Matthew J Maenner
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | | | | | | | | | | | | | | | | | | | - Tiffany White
- Colorado Department of Public Health and Environment, Denver
| | | | - Karen Pazol
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Patricia Dietz
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
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Koegel LK, Glugatch LB, Koegel RL, Castellon FA. Targeting IEP Social Goals for Children with Autism in an Inclusive Summer Camp. J Autism Dev Disord 2019; 49:2426-2436. [PMID: 30927180 DOI: 10.1007/s10803-019-03992-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Children with autism spectrum disorder demonstrate challenges in socialization that can interfere with their participation in common childhood activities and can persist or worsen if not addressed. The purpose of this study was to assess whether individualized education program (IEP) social goals could be targeted by a supervised paraprofessional during a short-term inclusive summer camp program. Data were collected using a concurrent multiple baseline design across four children. Results showed that following a 2-week summer camp program all participants made social improvements, reaching their year-long IEP goals, that maintained at follow-up in natural environments. Further, the paraprofessionals reached fidelity of implementation. Findings are discussed in terms of the value and feasibility of providing social interventions in inclusive summer camps.
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Affiliation(s)
- Lynn Kern Koegel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, 94305, USA.
| | - Lindsay B Glugatch
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, 97403, USA
| | - Robert L Koegel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, 94305, USA
| | - Fernanda A Castellon
- Koegel Autism Center, University of California at Santa Barbara, Santa Barbara, CA, 93106, USA
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Maynard DW, Turowetz J. Doing Abstraction: Autism, Diagnosis, and Social Theory. SOCIOLOGICAL THEORY 2019; 37:89-116. [PMID: 31156290 PMCID: PMC6541456 DOI: 10.1177/0735275119830450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent decades have witnessed a dramatic upsurge in the prevalence of autism spectrum disorder (ASD). As researchers have investigated the responsible sociohistorical conditions, they have neglected how clinicians determine the diagnosis in local encounters in the first place. Articulating a position "between Foucault and Goffman," we ask how the interaction order of the clinic articulates with larger-scale historical forces affecting the definition and distribution of ASD. First, we show how the diagnostic process has a narrative structure. Second, case data from three decades show how narrative practices accommodate to different periods in the history of the disorder, including changing diagnostic nomenclatures. Third, we show how two different forms of abstraction-Type A, which is categorical, and Type B, which is concrete and particular-inhabit the diagnostic process. Our analysis contributes to the sociology of autism, the sociology of diagnosis, the sociology of abstraction, and social theory.
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Affiliation(s)
| | - Jason Turowetz
- Universitat Siegen, Siegen, Nordrhein-Westfalen, Germany
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Liu Q, Chen MX, Sun L, Wallis CU, Zhou JS, Ao LJ, Li Q, Sham PC. Rational use of mesenchymal stem cells in the treatment of autism spectrum disorders. World J Stem Cells 2019; 11:55-72. [PMID: 30842805 PMCID: PMC6397804 DOI: 10.4252/wjsc.v11.i2.55] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/30/2018] [Accepted: 01/23/2019] [Indexed: 02/06/2023] Open
Abstract
Autism and autism spectrum disorders (ASD) refer to a range of conditions characterized by impaired social and communication skills and repetitive behaviors caused by different combinations of genetic and environmental influences. Although the pathophysiology underlying ASD is still unclear, recent evidence suggests that immune dysregulation and neuroinflammation play a role in the etiology of ASD. In particular, there is direct evidence supporting a role for maternal immune activation during prenatal life in neurodevelopmental conditions. Currently, the available options of behavioral therapies and pharmacological and supportive nutritional treatments in ASD are only symptomatic. Given the disturbing rise in the incidence of ASD, and the fact that there is no effective pharmacological therapy for ASD, there is an urgent need for new therapeutic options. Mesenchymal stem cells (MSCs) possess immunomodulatory properties that make them relevant to several diseases associated with inflammation and tissue damage. The paracrine regenerative mechanisms of MSCs are also suggested to be therapeutically beneficial for ASD. Thus the underlying pathology in ASD, including immune system dysregulation and inflammation, represent potential targets for MSC therapy. This review will focus on immune dysfunction in the pathogenesis of ASD and will further discuss the therapeutic potential for MSCs in mediating ASD-related immunological disorders.
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Affiliation(s)
- Qiang Liu
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Mo-Xian Chen
- School of Rehabilitation, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Lin Sun
- Department of Psychology, Weifang Medical University, Weifang 261053, Shandong Province, China
| | - Chloe U Wallis
- Medical Sciences Division, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Jian-Song Zhou
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Li-Juan Ao
- School of Rehabilitation, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Qi Li
- Department of Psychiatry, the University of Hong Kong, Hong Kong, China
| | - Pak C Sham
- Department of Psychiatry, the University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, Center for Genomic Sciences, the University of Hong Kong, Hong Kong, China
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Bar-Lev Schleider L, Mechoulam R, Saban N, Meiri G, Novack V. Real life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy. Sci Rep 2019; 9:200. [PMID: 30655581 PMCID: PMC6336869 DOI: 10.1038/s41598-018-37570-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/23/2018] [Indexed: 12/23/2022] Open
Abstract
There has been a dramatic increase in the number of children diagnosed with autism spectrum disorders (ASD) worldwide. Recently anecdotal evidence of possible therapeutic effects of cannabis products has emerged. The aim of this study is to characterize the epidemiology of ASD patients receiving medical cannabis treatment and to describe its safety and efficacy. We analysed the data prospectively collected as part of the treatment program of 188 ASD patients treated with medical cannabis between 2015 and 2017. The treatment in majority of the patients was based on cannabis oil containing 30% CBD and 1.5% THC. Symptoms inventory, patient global assessment and side effects at 6 months were primary outcomes of interest and were assessed by structured questionnaires. After six months of treatment 82.4% of patients (155) were in active treatment and 60.0% (93) have been assessed; 28 patients (30.1%) reported a significant improvement, 50 (53.7%) moderate, 6 (6.4%) slight and 8 (8.6%) had no change in their condition. Twenty-three patients (25.2%) experienced at least one side effect; the most common was restlessness (6.6%). Cannabis in ASD patients appears to be well tolerated, safe and effective option to relieve symptoms associated with ASD.
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Affiliation(s)
- Lihi Bar-Lev Schleider
- Clinical Cannabis Research Institute, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- Research Department, Tikun Olam LTD, Tel Aviv-Yafo, Israel
| | - Raphael Mechoulam
- Institute for Drug Research, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naama Saban
- Research Department, Tikun Olam LTD, Tel Aviv-Yafo, Israel
| | - Gal Meiri
- Negev Autism Centre, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Soroka University Medical and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Victor Novack
- Clinical Cannabis Research Institute, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
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Nevison C, Blaxill M, Zahorodny W. California Autism Prevalence Trends from 1931 to 2014 and Comparison to National ASD Data from IDEA and ADDM. J Autism Dev Disord 2018; 48:4103-4117. [PMID: 29974300 PMCID: PMC6223814 DOI: 10.1007/s10803-018-3670-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Time trends in U.S. autism prevalence from three ongoing datasets [Individuals with Disabilities Education Act, Autism and Developmental Disabilities Monitoring Network, and California Department of Developmental Services (CDDS)] are calculated using two different methods: (1) constant-age tracking of 8 year-olds and (2) age-resolved snapshots. The data are consistent across methods in showing a strong upward trend over time. The prevalence of autism in the CDDS dataset, the longest of the three data records, increased from 0.001% in the cohort born in 1931 to 1.2% among 5 year-olds born in 2012. This increase began around ~ 1940 at a rate that has gradually accelerated over time, including notable change points around birth years 1980, 1990 and, most recently, 2007.
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Affiliation(s)
- Cynthia Nevison
- Institute for Alpine and Arctic Research, University of Colorado, Campus Box 450, Boulder, CO, 80309-0450, USA.
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Rubenstein E, Schieve L, Wiggins L, Rice C, Van Naarden Braun K, Christensen D, Durkin M, Daniels J, Lee LC. Trends in documented co-occurring conditions in children with autism spectrum disorder, 2002-2010. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:168-178. [PMID: 30227350 PMCID: PMC6741291 DOI: 10.1016/j.ridd.2018.08.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 08/28/2018] [Indexed: 06/01/2023]
Abstract
BACKGROUND Autism spectrumdisorder (ASD) commonly presents with co-occurring medical conditions (CoCs). Little is known about patterns in CoCs in a time of rising ASD prevalence. AIMS To describe trends in number and type of documented CoCs in 8-year-old children with ASD. METHODS We used Autism and Developmental Disabilities Monitoring Network (ADDM) data, a multi-source active surveillance system monitoring ASD prevalence among 8-year-old children across the US. Data from surveillance years 2002, 2006, 2008, and 2010 were used to describe trends in count, categories, and individual CoCs. RESULTS Mean number of CoCs increased from 0.94 CoCs in 2002 to 1.06 CoCs in 2010 (p < 0.001). The percentage of children with ASD with any CoC increased from 44.5% to 56.4% (p < 0.001). CoCs with the greatest increases were in general developmental disability (10.4% to 14.5%), language disorder (18.9% to 23.6%), and motor developmental disability (10.5% to 15.6%). Sex modified the relationship between developmental (P = 0.02) and psychiatric (P < 0.001) CoCs and surveillance year. Race/ethnicity modified the relationship between neurological conditions (P = 0.04) and surveillance year. CONCLUSIONS The increase in the percentage of children with ASD and CoCs may suggest the ASD phenotype has changed over time or clinicians are more likely to diagnose CoCs.
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Affiliation(s)
- Eric Rubenstein
- Department of Epidemiology, University of North Carolina at Chapel Hill, 116A South Merrit Mill, Chapel Hill, NC 27516, United States.
| | - Laura Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Lisa Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Catherine Rice
- Department of Psychiatry, Emory University School of Medicine, 1551 Shoup Court, Atlanta, GA 30322, United States
| | - Kim Van Naarden Braun
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Deborah Christensen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Maureen Durkin
- Department of Population Health Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI 53726, United States
| | - Julie Daniels
- Department of Epidemiology, University of North Carolina at Chapel Hill, 116A South Merrit Mill, Chapel Hill, NC 27516, United States
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
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50
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Christensen DL, Braun KVN, Baio J, Bilder D, Charles J, Constantino JN, Daniels J, Durkin MS, Fitzgerald RT, Kurzius-Spencer M, Lee LC, Pettygrove S, Robinson C, Schulz E, Wells C, Wingate MS, Zahorodny W, Yeargin-Allsopp M. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR. SURVEILLANCE SUMMARIES : MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES 2018; 65:1-23. [PMID: 30439868 PMCID: PMC6237390 DOI: 10.15585/mmwr.ss6513a1] [Citation(s) in RCA: 260] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Problem/Condition Autism spectrum disorder (ASD). Period Covered 2012. Description of System The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance system that provides estimates of the prevalence and characteristics of ASD among children aged 8 years whose parents or guardians reside in 11 ADDM Network sites in the United States (Arkansas, Arizona, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, South Carolina, Utah, and Wisconsin). Surveillance to determine ASD case status is conducted in two phases. The first phase consists of screening and abstracting comprehensive evaluations performed by professional service providers in the community. Data sources identified for record review are categorized as either 1) education source type, including developmental evaluations to determine eligibility for special education services or 2) health care source type, including diagnostic and developmental evaluations. The second phase involves the review of all abstracted evaluations by trained clinicians to determine ASD surveillance case status. A child meets the surveillance case definition for ASD if one or more comprehensive evaluations of that child completed by a qualified professional describes behaviors that are consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnostic criteria for any of the following conditions: autistic disorder, pervasive developmental disorder–not otherwise specified (including atypical autism), or Asperger disorder. This report provides ASD prevalence estimates for children aged 8 years living in catchment areas of the ADDM Network sites in 2012, overall and stratified by sex, race/ethnicity, and the type of source records (education and health records versus health records only). In addition, this report describes the proportion of children with ASD with a score consistent with intellectual disability on a standardized intellectual ability test, the age at which the earliest known comprehensive evaluation was performed, the proportion of children with a previous ASD diagnosis, the specific type of ASD diagnosis, and any special education eligibility classification. Results For 2012, the combined estimated prevalence of ASD among the 11 ADDM Network sites was 14.5 per 1,000 (one in 69) children aged 8 years. Estimated prevalence was significantly higher among boys aged 8 years (23.4 per 1,000) than among girls aged 8 years (5.2 per 1,000). Estimated ASD prevalence was significantly higher among non-Hispanic white children aged 8 years (15.3 per 1,000) compared with non-Hispanic black children (13.1 per 1,000), and Hispanic (10.2 per 1,000) children aged 8 years. Estimated prevalence varied widely among the 11 ADDM Network sites, ranging from 8.2 per 1,000 children aged 8 years (in the area of the Maryland site where only health care records were reviewed) to 24.6 per 1,000 children aged 8 years (in New Jersey, where both education and health care records were reviewed). Estimated prevalence was higher in surveillance sites where education records and health records were reviewed compared with sites where health records only were reviewed (17.1 per 1,000 and 10.4 per 1,000 children aged 8 years, respectively; p<0.05). Among children identified with ASD by the ADDM Network, 82% had a previous ASD diagnosis or educational classification; this did not vary by sex or between non-Hispanic white and non-Hispanic black children. A lower percentage of Hispanic children (78%) had a previous ASD diagnosis or classification compared with non-Hispanic white children (82%) and with non-Hispanic black children (84%). The median age at earliest known comprehensive evaluation was 40 months, and 43% of children had received an earliest known comprehensive evaluation by age 36 months. The percentage of children with an earliest known comprehensive evaluation by age 36 months was similar for boys and girls, but was higher for non-Hispanic white children (45%) compared with non-Hispanic black children (40%) and Hispanic children (39%). Interpretation Overall estimated ASD prevalence was 14.5 per 1,000 children aged 8 years in the ADDM Network sites in 2012. The higher estimated prevalence among sites that reviewed both education and health records suggests the role of special education systems in providing comprehensive evaluations and services to children with developmental disabilities. Disparities by race/ethnicity in estimated ASD prevalence, particularly for Hispanic children, as well as disparities in the age of earliest comprehensive evaluation and presence of a previous ASD diagnosis or classification, suggest that access to treatment and services might be lacking or delayed for some children. Public Health Action The ADDM Network will continue to monitor the prevalence and characteristics of ASD among children aged 8 years living in selected sites across the United States. Recommendations from the ADDM Network include enhancing strategies to 1) lower the age of first evaluation of ASD by community providers in accordance with the Healthy People 2020 goal that children with ASD are evaluated by age 36 months and begin receiving community-based support and services by age 48 months; 2) reduce disparities by race/ethnicity in identified ASD prevalence, the age of first comprehensive evaluation, and presence of a previous ASD diagnosis or classification; and 3) assess the effect on ASD prevalence of the revised ASD diagnostic criteria published in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
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Affiliation(s)
- Deborah L Christensen
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Kim Van Naarden Braun
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | - Jon Baio
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
| | | | - Jane Charles
- Medical University of South Carolina, Charleston
| | | | | | | | | | | | | | | | | | - Eldon Schulz
- University of Arkansas for Medical Sciences, Little Rock
| | - Chris Wells
- Colorado Department of Public Health and Environment, Denver
| | | | | | - Marshalyn Yeargin-Allsopp
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC
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