Gender profiles of behavioral attention in children with autism spectrum disorders

Objective: The attention profile of girls with autism spectrum disorder (ASD) is unclear compared with boys with ASD and typical children. This study aimed to investigate parent-reported ASD and ADHD symptoms in a large sample of boys and girls with and without ASD.

Method: A total of 124 normally intelligent children, half of them girls, 64 with autistic disorder or Asperger’s disorder, and 60 age- and gender-matched typically developing, aged 7 to 12 years, were recruited. Parents completed questionnaires regarding autistic and ADHD symptoms.

Results: No gender differences in social difficulties but more repetitive motor movements, communication difficulties, and inattention were reported in males, regardless of group. Younger boys with ASD had more elevated levels of hyperactivity-impulsivity than younger girls with ASD.

Conclusion: Gender differences in autistic symptoms and inattention in ASD reflected gender differences in typical children. More pronounced hyperactivity in younger boys with ASD could contribute to higher rates of clinical referral than girls.

Gender differences in emotionality and sociability in children with autism spectrum disorders

Background
Four times as many males are diagnosed with high functioning autism compared to females. A growing body of research that focused on females with autism spectrum disorder (ASD) questions the assumption of gender invariance in ASD. Clinical observations suggest that females with ASD superficially demonstrate better social and emotional skills than males with ASD, which may camouflage other diagnostic features. This may explain the under-diagnosis of females with ASD.

Methods
We hypothesised that females with ASD would display better social skills than males with ASD on a test of friendship and social function. One hundred and one 10- to 16-year-olds (ASD females, n = 25; typically developing (TD) females, n = 25; ASD males, n = 25; TD males, n = 26) were interviewed (using the friendship questionnaire (FQ)) with high scores indicating the child has close, empathetic and supportive relationships. One parent of each child completed the FQ to assess whether there are differences in perception of friendships between parents and children.

Results
It was found that, independent of diagnosis, females demonstrated higher scores on the FQ than males. Further, regardless of gender, children with ASD demonstrated lower scores than TD children. Moreover, the effect of ASD was independent of gender. Interestingly, females with ASD and TD males displayed similar scores on the FQ.

Conclusions
This finding is supported by clinical reports that females with ASD have more developed social skills than males with ASD. Further research is now required to examine the underlying causes for this phenomenon in order to develop gender-appropriate diagnostic criteria and interventions for ASD.

Neurobiology of schizophrenia spectrum disorders: The role of oxidative stress

Mitochondrial dysfunction and oxidative stress are increasingly implicated in the pathophysiology of schizophrenia. The brain is the body's highest energy consumer, and the glutathione system is the brain's dominant free radical scavenger. In the current paper, we review the evidence of central and peripheral nervous system anomalies in the oxidative defences of individuals with schizophrenia, principally involving the glutathione system. This is reflected by evidence of the manifold consequences of oxidative stress that include lipid peroxidation, protein carboxylation, DNA damage and apoptosis - all potentially part of the process of neuroprogression in the disorder. Importantly, oxidative stress is amenable to intervention. We consider the clinical potential of some possible interventions that help reduce oxidative stress, via augmentation of the glutathione system, particularly N-acetyl cysteine. We argue that a better understanding of the mechanisms and pathways underlying oxidative stress will assist in developing the therapeutic potential of this area.

Psychotropic medication use and autism spectrum disorders: caregiver and invidividual perspectives

 This thesis examined psychotropic medication use in Autism Spectrum Disorders in an Australian sample from caregiver and individual perspectives. This thesis found there is a clear need for collaboration between individuals with an ASD, their caregivers and professionals to ensure that psychotropic medication is used in an appropriate and transparent manner.

The effects of a course of intranasal oxytocin on social behaviors in youth diagnosed with autism spectrum disorders: A randomized controlled trial

Background There is increasing interest in oxytocin as a therapeutic to treat social deficits in autism spectrum disorders (ASD). The aim of this study was to investigate the efficacy of a course of oxytocin nasal spray to improve social behavior in youth with ASD. Methods In a double-blind, placebo-controlled trial across two Australian university sites between February 2009 and January 2012, 50 male participants aged between 12 and 18 years, with Autistic or Asperger's Disorder, were randomized to receive either oxytocin (n = 26) or placebo (n = 24) nasal sprays (either 18 or 24 International Units), administered twice-daily for 8 weeks. Participants were assessed at baseline, after 4- and 8-weeks of treatment, and at 3-month follow-up. Primary outcomes were change in total scores on the caregiver-completed Social Responsiveness Scale and clinician-ratings on the Clinical Global Impressions-Improvement scale. Secondary assessments included caregiver reports of repetitive and other developmental behaviors and social cognition. Clinical trial registration: Australian New Zealand Clinical Trials Registry www.anzctr.org.au ACTRN12609000513213. Results Participants who received oxytocin showed no benefit following treatment on primary or secondary outcomes. However, caregivers who believed their children received oxytocin reported greater improvements compared to caregivers who believed their child received placebo. Nasal sprays were well tolerated and there was no evidence of increased side effects resulting from oxytocin administration. Conclusions This is the first evaluation of the efficacy for a course of oxytocin treatment for youth with ASD. Although results did not suggest clinical efficacy, further research is needed to explore alternative delivery methods, earlier age of intervention, and the influence of caregiver expectation on treatment response.

Motor functioning in autism spectrum disorders

Motor impairment is consistently reported in autism spectrum disorders (ASD) and may be an early risk factor for core ASD symptomatology. This chapter provides an overview of empirical motor studies in ASD and considers clinical, behavioral, neurophysiological, and neuroimaging studies of motor impairment in ASD. The association between motor impairment and core social communication disturbance is also explored, as well as the high comorbidity between ASD, motor impairment, and other neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD). Future research which aims to understand the specific motor pattern that may characterize ASD is suggested.

Alongside the core diagnostic features of autism, research has highlighted the significant and pervasive impact of motor dysfunction in autism spectrum disorders (ASD) (Fournier et al., J Autism Dev Disord 40(10):1227–40, 2010). Motor difficulties are commonly associated with ASD and potentially may be considered a “cardinal feature” (Fournier et al., J Autism Dev Disord 40(10):1227–40, 2010) of the disorder. Indeed, there has been an increase in the trajectory of motor research over the past decade, with greater understanding of the underlying neurobiological disruption that characterizes the disorder (Mostofsky et al., Brain 132:2413–25, 2009). This chapter will illustrate the importance of neuromotor assessment as a routine part of the diagnostic process and provide an overview of empirical research in the field.