scholarly journals Social Interaction Improved by Oxytocin in the Subclass of Autism with Comorbid Intellectual Disabilities

Diseases ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Haruhiro Higashida ◽  
Toshio Munesue ◽  
Hirotaka Kosaka ◽  
Hidenori Yamasue ◽  
Shigeru Yokoyama ◽  
...  
Keyword(s):  
Social Interaction ◽  
Adverse Effects ◽  
Intellectual Disabilities ◽  
Autism Spectrum ◽  
Pilot Studies ◽  
Therapeutic Benefits ◽  
Adolescents And Adults ◽  
History Of ◽  
History Of Epilepsy ◽  
Adults With Asd

Approximately half of all autism spectrum disorder (ASD) individuals suffer from comorbid intellectual disabilities. Furthermore, the prevalence of epilepsy has been estimated to be 46% of patients with low intelligence quotient. It is important to investigate the therapeutic benefits and adverse effects of any recently developed drugs for this proportion of individuals with the so-called Kanner type of ASD. Therefore, we investigated the therapeutic and/or adverse effects of intranasal oxytocin (OT) administration, especially in adolescents and adults with ASD and comorbid intellectual disability and epilepsy, with regard to core symptoms of social deficits. We have already reported three randomized placebo-controlled trials (RCTs). However, we revisit results in our pilot studies from the view of comorbidity. Most of the intellectually disabled participants were found to be feasible participants of the RCT. We observed significantly more events regarded as reciprocal social interaction in the OT group compared with the placebo group. In the trial, no or little differences in adverse events were found between the OT and placebo arms, as found in some other reports. However, seizures were induced in three participants with medical history of epilepsy during or after OT treatment. In conclusion, we stress that behavioral changes in ASD patients with intellectual disabilities could be recognized not by the conventional measurements of ASD symptoms but by detailed evaluation of social interactions arising in daily-life situations.

scholarly journals Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Emily R. Bemmer ◽  
Kelsie A. Boulton ◽  
Emma E. Thomas ◽  
Ben Larke ◽  
Suncica Lah ◽  
...  
Keyword(s):  
Young Adults ◽  
Social Anxiety ◽  
Social Functioning ◽  
Autism Spectrum ◽  
Self Report ◽  
Post Intervention ◽  
Adults With Autism ◽  
Adolescents And Adults ◽  
Adults With Asd ◽  
Young Adults With Asd

Abstract Background There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. Method Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). Results Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program. Limitations The absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study. Conclusions These findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.

scholarly journals Addressing medical needs of adolescents and adults with autism spectrum disorders in a primary care setting

Autism ◽  
2017 ◽  
Vol 22 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Youssra Saqr ◽  
Erika Braun ◽  
Kyle Porter ◽  
Debra Barnette ◽  
Christopher Hanks
Keyword(s):  
Autism Spectrum Disorder ◽  
Health Care Access ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adults With Autism ◽  
Medical Needs ◽  
Medical Regimen ◽  
Care Access ◽  
Adolescents And Adults ◽  
History Of

Little has been reported about how to improve health care access and delivery for adolescents and adults with autism spectrum disorder. To understand the contributions to the health disparities in the autism spectrum disorder population, we conducted two independent research approaches to learn about current medical needs. A retrospective chart review was performed to evaluate medical comorbidities and medication use. A focus group was also created to address barriers faced in providing medical care. Of 126 charts reviewed, 49% (n = 62) had intellectual disability, 49% (n = 62) had attention-deficit hyperactivity disorder, 52% (n = 65) had anxiety, 41% (n = 52) had obesity, 31% (n = 39) with a history of aggressive behavior, 31% (n = 31) had depression, 22% (n = 28) had seizures, and 9% (n = 11) had hypertension. A Medical Regimen Complexity Index score was determined to examine medication use trends in the autism spectrum disorder population. Medical Regimen Complexity Index scores were significantly higher for patients with intellectual disability, patients with seizures, and patients with a history of aggressive behavior. Both the focus group and our pre-visit assessment identified the waiting room and waiting time as barriers to care. Understanding the comorbidities, polypharmacy, and medical barriers should provide a better understanding of the current health care access and delivery needs of adolescents and adults with autism spectrum disorder.

Factors Related to Complications Among Adult Patients With Intellectual Disabilities Hospitalized at an Academic Medical Center

2015 ◽  
Vol 53 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Sarah H. Ailey ◽  
Tricia J. Johnson ◽  
Louis Fogg ◽  
Tanya R. Friese
Keyword(s):  
Intellectual Disabilities ◽  
Medical Center ◽  
Academic Medical Center ◽  
Autism Spectrum ◽  
Adult Patients ◽  
Respiratory Disorder ◽  
Academic Medical ◽  
History Of ◽  
Healthcare Acquired Infections ◽  
Improve Hospital

Abstract People with intellectual disabilities (ID) represent a small but important group of hospitalized patients who have higher rates of complications than do patients without ID hospitalized for the same reasons. Complications are potentially avoidable conditions, such as healthcare-acquired infections, healthcare-acquired skin breakdown, falls, and medication errors and reactions. Addressing factors related to complications can focus efforts to improve hospital care. The purpose of this exploratory study was to analyze data from reviews of academic medical center charts (N  =  70) about complications and to examine patient and hospitalization characteristics in relation to complications among adult patients (age ≥ 18 years) with ID hospitalized for nonpsychiatric reasons. Adults with ID tended to be twice as likely to have complications (χ2  =  2.893, df  =  1, p  =  .09) if they had a surgical procedure and were nearly four times as likely to have complications (χ2  =  6.836, df  =  1, p  =  .009) if they had multiple chronic health conditions (three of the following: history of cerebral palsy, autism spectrum symptoms, aggressive behavior, respiratory disorder, and admission through the emergency department). Findings suggest preliminary criteria for assessing risk for complications among hospitalized people with ID and the need for attention to their specific needs when hospitalized.

scholarly journals Categorization in ASD: The Role of Typicality and Development

2012 ◽  
Vol 19 (2) ◽  
pp. 66-74 ◽  
Author(s):  
Holly Zajac Gastgeb ◽  
Mark S. Strauss
Keyword(s):  
Cognitive Processing ◽  
Autism Spectrum ◽  
Object Category ◽  
Adolescents And Adults ◽  
Category Labels ◽  
And Gender ◽  
Typical Object ◽  
And Control ◽  
Adults With Asd

There is a growing amount of evidence suggesting that individuals with autism spectrum disorders (ASD) differ in the way in which they cognitively process information. A critical aspect of cognitive processing that is receiving more attention in studies of ASD is categorization. The studies presented here examined the effect of typicality on categorization of objects and gender in high-functioning children, adolescents, and adults with ASD and matched controls. The ASD and control groups showed improved categorization throughout the lifespan for typical and somewhat typical object category members and typical gender faces. However, individuals with ASD took more time to categorize atypical object category members and were less accurate in categorizing atypical gender faces from age 8–12 years through adulthood. We will discuss the implications of these results for teaching categories and category labels to individuals with ASD.

Metabolic profiles in adults with autism spectrum disorder and intellectual disabilities

2014 ◽  
Vol 29 (7) ◽  
pp. 397-401 ◽  
Author(s):  
L. Moses ◽  
N. Katz ◽  
A. Weizman
Keyword(s):  
Intellectual Disabilities ◽  
Liver Enzyme ◽  
Psychiatric Patients ◽  
Autism Spectrum ◽  
Psychotropic Medications ◽  
Blood Cholesterol ◽  
Lipid Lowering ◽  
Metabolic Profiles ◽  
Community Based ◽  
Adults With Asd

AbstractIntroductionLow levels of blood cholesterol have been found in some children with autism spectrum disorders (ASD). Psychotropic medications, commonly used by people with ASD and people with intellectual disabilities (ID) are frequently associated with altered metabolic profiles.PurposeWe aimed to compare metabolic features of adults with ASD or ID with those of a community-based population.Subjects and methodsData on blood fasting glucose (FBG), lipid profile, liver enzyme profile, TSH, BMI, medications and diagnoses of 80 adults with ASD, 77 adults with ID and 828 control adults were drawn from medical charts/database. Candidates that used glucose or lipid lowering medications were not included.ResultsTotal-cholesterol levels of people with ASD and ID were significantly lower than those of the controls (168.3 ± 32.78, 168.2 ± 32.91, 185.4 ± 40.49 mg/dL, respectively, P < 0.001) but after adjusting for gender, age and BMI and using Bonferroni correction, the significance was lost. Compared to controls, ASD and ID had significantly lower FBG (by –14.45 ± 1.81, –14.58 ± 1.54 mg/dl, respectively; P < 0.001 for both) and liver enzymes, despite using psychotropic medications.Discussion and conclusionIn contrast to other psychiatric patients receiving similar medications, people with ASD and ID have unaltered lipid profiles and lower glucose and liver enzyme levels compared to a community-based population.

scholarly journals Cognitive Features in Adults with Autism Spectrum Disorder, Diagnosed in Childhood without Intellectual Disabilities

2021 ◽  
Vol 19 (1) ◽  
pp. 34-43
Author(s):  
M.M. Ivanova ◽  
L.G. Borodina
Keyword(s):  
Intellectual Disabilities ◽  
Autism Spectrum ◽  
Free Form ◽  
Schizophrenia Spectrum Disorders ◽  
Adults With Autism ◽  
Cognitive Component ◽  
Spectrum Disorders ◽  
Atypical Autism ◽  
Psychological Instruments ◽  
Adults With Asd

A study of cognitive features in autism spectrum disorders (ASD) adults without intellectual disabilities involved 20 participants diagnosed in childhood with Asperger’s syndrome and atypical autism, 20 respondents with schizophrenia spectrum disorders, and 20 neurotypical adults. Following psychological instruments were used “Comparison of concepts” (15 pairs of words), “Fifth extra”, “Fourth extra”. Tools were modified to identify formal thinking disorders in adults. A free-form story was also used. It was found that answers in a sample of adults with ASD, diagnosed in childhood are significantly more often indicating a distortion of the generalization process, rather than answers in a group of neurotypical participants. At the same time, this trend in the autism group is significantly lower than in the schizophrenia group. Following trend also revealed — answers identifying a decrease in the level of generalization and disorders of the motivational cognitive component. This trend is very similar in the groups of autism and schizophrenia, but significantly exceeds in the group of neurotypical subjects

scholarly journals Pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders across the lifespan

2012 ◽  
Vol 14 (3) ◽  
pp. 263-279 ◽  
Keyword(s):  
Autism Spectrum Disorders ◽  
Adverse Effects ◽  
Autism Spectrum ◽  
Social Impairment ◽  
Behavioral Symptoms ◽  
Stereotyped Behaviors ◽  
Symptom Domains ◽  
Adolescents And Adults ◽  
Spectrum Disorders ◽  
Pharmacologic Treatments

This review outlines pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders (ASDs) in children, adolescents, and adults. Symptom domains include repetitive and stereotyped behaviors, irritability and aggression, hyperactivity and inattention, and social impairment. Medications covered include serotonin reuptake inhibitors (SRIs), mirtazapine, antipsychotics, psychostimulants, atomoxetine, α-2 agonists, D-cycloserine, and memantine. Overall, SRIs are less efficacious and more poorly tolerated in children with ASDs than in adults. Antipsychotics are the most efficacious drugs for the treatment of irritability in ASDs, and may be useful in the treatment of other symptoms. Psychostimulants demonstrate some benefit for the treatment of hyperactivity and inattention in individuals with ASDs, but are less efficacious and associated with more adverse effects compared with individuals with ADHD. D-cycloserine and memantine appear helpful in the treatment of social impairment, although further research is needed.

Anxiety in Adolescents and Adults with Autism Spectrum Disorder

2017 ◽  
pp. 91-116
Author(s):  
Micah O. Mazurek
Keyword(s):  
Behavioral Therapy ◽  
Specific Treatment ◽  
Autism Spectrum ◽  
Future Research ◽  
Adults With Autism ◽  
Assessment Approach ◽  
Adolescents And Adults ◽  
Clinically Significant ◽  
No Gold Standard ◽  
Adults With Asd

Adolescents and adults with ASD are at high risk for clinically significant symptoms of anxiety. Accurate symptom identification and differential diagnosis can be challenging due to the similarity of presentation of many anxiety and ASD symptoms. Although there are no gold-standard tools for assessment of anxiety in individuals with ASD, clinicians are encouraged to use a comprehensive multi-informant, multi-modal assessment approach. Research supports the use of cognitive behavioral therapy (CBT) for treatment of anxiety in ASD, particularly in high-functioning adolescents. ASD-specific treatment modifications may be helpful for achieving optimal treatment response. There is limited available evidence regarding the effectiveness or potential adverse effects of pharmacological treatments for anxiety in this population. Future research is needed to understand the etiology and mechanisms of anxiety in individuals with ASD and to examine short- and long-term efficacy and effectiveness of a range of treatments.

scholarly journals A review of emergency department visits made by youth and adults with autism spectrum disorder from the parent perspective

2018 ◽  
Vol 4 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Yona Lunsky ◽  
Ami Tint ◽  
Jonathan A. Weiss ◽  
Anna Palucka ◽  
Elspeth Bradley
Keyword(s):  
Autism Spectrum Disorder ◽  
Health Care Providers ◽  
Autism Spectrum ◽  
Emergency Department Visits ◽  
Spectrum Disorder ◽  
Care Providers ◽  
Content Type ◽  
Adolescents And Adults ◽  
Ed Visits ◽  
Adults With Asd

Purpose Past research has shown individuals with autism spectrum disorder (ASD) visit hospital emergency departments (ED) at high rates. In order to assist individuals with ASD, their families and health care providers to improve ED care, it is important to understand these encounters in greater detail. The purpose of this paper is to provide a descriptive summary of the ED experiences of adolescents and adults with ASD, from the perspective of their families. Design/methodology/approach A subset of data from a larger prospective cohort study was used. Specifically, 46 parents of adolescents and adults with ASD provided details concerning 49 ED visits over a 12-month period. Findings Results suggest a range of presentations requiring ED use, and also diverse profiles of those with ASD who visited the ED, in terms of age, gender, and ASD severity. While overall degree of satisfaction with care received in the ED was high, parents provided recommendations to improve the ED experiences for their family members with ASD. Originality/value This is the first study to provide detailed accounts of ED visits from the perspective of parents of adolescents and adults with ASD. Families play an important role in the lives of individuals with ASD across the lifespan and it is important to include their perspective to improve hospital-based care for those with ASD.

Autism Spectrum Disorder and Co-Occurring Addiction

2020 ◽  
pp. 72-80
Author(s):  
Jennifer H. Foss-Feig ◽  
Stacey Lurie ◽  
Maya F. Hubert
Keyword(s):  
Autism Spectrum Disorder ◽  
Clinical Guidelines ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
High Functioning ◽  
Adolescents And Adults ◽  
Social Difficulties ◽  
Adults With Asd ◽  
External Stimuli ◽  
Do So

For many professionals, patients, and relatives of individuals with autism spectrum disorder (ASD), the co-occurrence with addiction to alcohol or drugs seems unimaginable. How could autism be hidden behind addiction and how could someone diagnosed with autism as a child become addicted in adolescence or adulthood? In this chapter, evidence is presented that this comorbidity is far more frequent in high-functioning adolescents and adults with ASD than is often appreciated. Two different perspectives are considered. First, both conditions are related to the neurotransmitter dopamine. Second, individuals with ASD may become addicted when they try and cope with their social difficulties by taking substances that help them overcome their initial shyness and social anxiety, or they do so to soothe their high levels of arousal and/or hypersensitivity to internal or external stimuli. There are established clinical guidelines for both conditions but none for managing the combination of these two disorders. Thus, the clinician, along with being acutely aware of the possible co-occurrence, should manage individual cases by tailoring an individual approach based on the evidence from both fields. This is illustrated by two clinical cases.

Sign in / Sign up

Export Citation Format

Share Document