Sex as a Moderator Between Parent Ratings of Executive Dysfunction and Social Difficulties in Children and Adolescents with Autism Spectrum Disorder.

Girls and boys might differ in autistic symptoms and associated cognitive difficulties such as executive function (EF). We investigated sex differences in the relationship between parent rated EF and autistic symptoms in 116 children and adolescents (25 girls) aged 5-19 years with an intelligence quotient above 70 and an autism spectrum disorder (ASD) diagnosis. They were rated with the behavior rating inventory of executive function (BRIEF) and the autism diagnostic interview revised (ADI-R). We found a positive association between EF and the ADI-R domains of reciprocal social interaction (p < 0.001) and communication (p = 0.001) in girls, while these relationships were small and non-significant in boys. Our results provide a greater understanding of the sex-specific characteristics of children and adolescents with ASD.

Autism spectrum disorder in preschool children in Sør-Trøndelag 2016-19. / Autismespekterforstyrrelser hos barn i førskolealder i Sør-Trøndelag 2016­19.

BACKGROUND: Autism spectrum disorder (ASD) is an umbrella term covering a range of conditions characterised by challenges with social interaction, restricted interests and repetitive behaviours. The prevalence of ASD has increased significantly in recent years, and there is a clinical impression of a preponderance of cases among young children whose mothers were not born in Norway. MATERIAL AND METHOD: The study included 142 children aged 2 to 6 years who were diagnosed with autism in the county of Sør-Trøndelag, Norway in the period 2016-2019. The following information was collected: age at onset of symptoms and diagnosis, primary diagnosis, ADOS-2 (Autism Diagnostic Observation Schedule) scores, whether the child was born in Norway and the mother's country of birth. RESULTS: Children of mothers born outside of Norway had a 7.7 times higher risk of being diagnosed with autism than children of Norwegian-born mothers, with an annual incidence of 0.74 % and 0.10 % respectively. These children were diagnosed earlier, at an average age (standard deviation) of 41.9 (11.8) and 51.8 (18.1) months respectively (95 % CI 4.7 to 15.2); a p-value of <0.001 for the difference. They also had a higher ADOS score, with an average (standard deviation) of 19.0 (6.2) and 15.3 (7.1) respectively. INTERPRETATION: The preponderance of autism diagnoses may be an indication that the mothers' country of origin has an impact on the development of the condition. This has implications for adaptions to the assessment and follow-up of this patient group.

Autism spectrum disorder polygenic scores are associated with every day executive function in children admitted for clinical assessment.

Autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDs) are behaviorally defined disorders with overlapping clinical features that are often associated with higher-order cognitive dysfunction, particularly executive dysfunction. Our aim was to determine if the polygenic score (PGS) for ASD is associated with parent-reported executive dysfunction in everyday life using the Behavior Rating Inventory of Executive Function (BRIEF). Furthermore, we investigated if PGS for general intelligence (INT) and attention deficit/hyperactivity disorder (ADHD) also correlate with BRIEF. We included 176 children, adolescents and young adults aged 5-22 years with full-scale intelligence quotient (IQ) above 70. All were admitted for clinical assessment of ASD symptoms and 68% obtained an ASD diagnosis. We found a significant difference between low and high ASD PGS groups in the BRIEF behavior regulation index (BRI) (P = 0.015, Cohen's d = 0.69). A linear regression model accounting for age, sex, full-scale IQ, Social Responsiveness Scale (SRS) total score, ASD, ADHD and INT PGS groups as well as genetic principal components, significantly predicted the BRI score; F(11,130) = 8.142, P < 0.001, R2 = 0.41 (unadjusted). Only SRS total (P < 0.001), ASD PGS 0.1 group (P = 0.018), and sex (P = 0.022) made a significant contribution to the model. This suggests that the common ASD risk gene variants have a stronger association to behavioral regulation aspects of executive dysfunction than ADHD risk or INT variants in a clinical sample with ASD symptoms. Autism Res 2020, 13: 207-220. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: People with autism spectrum disorder (ASD) often have difficulties with higher-order cognitive processes that regulate thoughts and actions during goal-directed behavior, also known as executive function (EF). We studied the association between genetics related to ASD and EF and found a relation between high polygenic score (PGS) for ASD and difficulties with behavior regulation aspects of EF in children and adolescents under assessment for ASD. Furthermore, high PGS for general intelligence was related to social problems.

The relation between face-emotion recognition and social function in adolescents with autism spectrum disorders: A case control study.

An altered processing of emotions may contribute to a reduced ability for social interaction and communication in autism spectrum disorder, ASD. We investigated how face-emotion recognition in ASD is different from typically developing across adolescent age groups. Fifty adolescents diagnosed with ASD and 49 typically developing (age 12-21 years) were included. The ASD diagnosis was underpinned by parent-rated Social Communication Questionnaire. We used a cued GO/ NOGO task with pictures of facial expressions and recorded reaction time, intra-individual variability of reaction time and omissions/commissions. The Social Responsiveness Scale was used as a measure of social function. Analyses were conducted for the whole group and for young (< 16 years) and old (≥ 16 years) age groups. We found no significant differences in any task measures between the whole group of typically developing and ASD and no significant correlations with the Social Responsiveness Scale. However, there was a non-significant tendency for longer reaction time in the young group with ASD (p = 0.099). The Social Responsiveness Scale correlated positively with reaction time (r = 0.30, p = 0.032) and intra-individual variability in reaction time (r = 0.29, p = 0.037) in the young group and in contrast, negatively in the old group (r = -0.23, p = 0.13; r = -0.38, p = 0.011, respectively) giving significant age group interactions for both reaction time (p = 0.008) and intra-individual variability in reaction time (p = 0.001). Our findings suggest an age-dependent association between emotion recognition and severity of social problems indicating a delayed development of emotional understanding in ASD. It also points towards alterations in top-down attention control in the ASD group. This suggests novel disease-related features that should be investigated in more details in experimental settings.

Parents' Attitudes toward Clinical Genetic Testing for Autism Spectrum Disorder-Data from a Norwegian Sample.

Clinical genetic testing (CGT) of children with autism spectrum disorder (ASD) may have positive and negative effects. Knowledge about parents' attitudes is needed to ensure good involvement of caregivers, which is crucial for accurate diagnosis and effective clinical management. This study aimed to assess parents' attitudes toward CGT for ASD. Parent members of the Norwegian Autism Society were given a previously untested questionnaire and 1455 answered. Linear regression analyses were conducted to evaluate contribution of parent and child characteristics to attitude statements. Provided it could contribute to a casual explanation of their child's ASD, 76% would undergo CGT. If it would improve the possibilities for early interventions, 74% were positive to CGT. Between 49-67% agreed that CGT could have a negative impact on health insurance, increase their concern for the child's future and cause family conflicts. Parents against CGT (9%) were less optimistic regarding positive effects, but not more concerned with negative impacts. The severity of the children's ASD diagnosis had a weak positive association with parent's positive attitudes to CGT (p-values range from <0.001 to 0.975). Parents prefer that CGT is offered to those having a child with ASD (65%), when the child's development deviates from normal (48%), or before pregnancy (36%). A majority of the parents of children with ASD are positive to CGT due to possibilities for an etiological explanation.

[Asperger syndrome in a Norwegian county 2005-08]. / Aspergers syndrom i Sør-Trøndelag 2005-08.

BACKGROUND: The prevalence of autism spectrum disorders (ASD) has increased 10-fold in recent years. We have assessed the prevalence of high functioning autism spectrum disorders in a clinical sample in a Norwegian county. MATERIAL AND METHOD: Medical records from the health specialist services were assessed for children (0-18 years of age) with a diagnosis of Asperger syndrome or pervasive developmental disorder not otherwise specified (PDD-NOS) in South Trøndelag county at two time-points (1.1.2005 and 1.1.2008). We also estimated the prevalence of high functioning children with autism (HFA) 1.1.2008. RESULTS: The number of children and adolescents with the diagnosis Asperger syndrome increased from 70 in 2005 to 121 in 2008 and that for children with PDD-NOS increased from 22 to 44 in the same period. In the child mental health service, the number of patients with Asperger syndrome increased from 51 in 2005 to 99 in 2008 and in the habilitation services there were 32 such patients in both years assessed. Some patients were registered in both services: 13 in 2005 and 10 in 2008. In 2008, the prevalence of all high functioning autism spectrum disorders together was 0.35 % of the population in the age 5-18 years. Almost none of the children were below 5 years at the time of assessment. INTERPRETATION: In South Trøndelag the prevalence of children with high functioning autism spectrum disorders are in the same size order as that reported from international surveys. This can be explained by increased awareness on such disorders and that more able people are diagnosed. The difference in prevalence between the health services reflects different diagnostic traditions and changed referral routines.