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Papers of the Week

  • 1) Annu Rev Clin Psychol. 2015 Jan 2. [Epub ahead of print]

    Recent Advances in Autism Research as Reflected in DSM-5 Criteria for Autism Spectrum Disorder.

    Lord C(1), Bishop SL.
    Author information: 
    (1)Department of Psychiatry, Weill Cornell Medical College, White Plains, NY
    10605; email: cal2028@med.cornell.edu.
    This article provides a selective review of advances in scientific knowledge
    about autism spectrum disorder (ASD), using DSM-5 (Diagnostic and Statistical
    Manual of Mental Disorders, fifth edition) diagnostic criteria as a framework for
    the discussion. We review literature that prompted changes to the organization of
    ASD symptoms and diagnostic subtypes in DSM-IV, and we examine the rationale for 
    new DSM-5 specifiers, modifiers, and severity ratings as well as the introduction
    of the diagnosis of social (pragmatic) communication disorder. Our goal is to
    summarize and critically consider the contribution of clinical psychology
    research, along with that of other disciplines, to the current conceptualization 
    of ASD. Expected final online publication date for the Annual Review of Clinical 
    Psychology Volume 11 is March 28, 2015. Please see
    http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
    PMID: 25581244  [PubMed - as supplied by publisher]
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  • 2) Nucleic Acids Res. 2015 Jan 10. pii: gku1386. [Epub ahead of print]

    Transient DNMT1 suppression reveals hidden heritable marks in the genome.

    McGraw S(1), Zhang JX(1), Farag M(1), Chan D(1), Caron M(2), Konermann C(3),
    Oakes CC(3), Mohan KN(4), Plass C(3), Pastinen T(2), Bourque G(2), Chaillet
    JR(5), Trasler JM(6).
    Author information: 
    (1)Departments of Pediatrics, Human Genetics and Pharmacology & Therapeutics,
    McGill University and the Research Institute of the McGill University Health
    Centre at the Montreal Children's Hospital, Montreal, QC H3Z 2Z3, Canada.
    (2)Department of Human Genetics, McGill University and Genome Quebec Innovation
    Centre, Montreal, QC H3A 1A4, Canada. (3)Division of Epigenomics and Cancer Risk 
    Factors, German Cancer Research Center, Heidelberg 69120, Germany. (4)Department 
    of Biological Sciences, Birla Institute of Technology and Science Pilani,
    Hyderabad 500 078, India. (5)Department of Microbiology and Molecular Genetics,
    University of Pittsburgh, Pittsburgh, PA 15213-3005, USA. (6)Departments of
    Pediatrics, Human Genetics and Pharmacology & Therapeutics, McGill University and
    the Research Institute of the McGill University Health Centre at the Montreal
    Children's Hospital, Montreal, QC H3Z 2Z3, Canada jacquetta.trasler@mcgill.ca.
    Genome-wide demethylation and remethylation of DNA during early embryogenesis is 
    essential for development. Imprinted germline differentially methylated domains
    (gDMDs) established by sex-specific methylation in either male or female germ
    cells, must escape these dynamic changes and sustain precise inheritance of both 
    methylated and unmethylated parental alleles. To identify other, gDMD-like
    sequences with the same epigenetic inheritance properties, we used a modified
    embryonic stem (ES) cell line that emulates the early embryonic demethylation and
    remethylation waves. Transient DNMT1 suppression revealed gDMD-like sequences
    requiring continuous DNMT1 activity to sustain a highly methylated state.
    Remethylation of these sequences was also compromised in vivo in a mouse model of
    transient DNMT1 loss in the preimplantation embryo. These novel regions,
    possessing heritable epigenetic features similar to imprinted-gDMDs are required 
    for normal physiological and developmental processes and when disrupted are
    associated with disorders such as cancer and autism spectrum disorders. This
    study presents new perspectives on DNA methylation heritability during early
    embryo development that extend beyond conventional imprinted-gDMDs.
    © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic
    Acids Research.
    PMID: 25578964  [PubMed - as supplied by publisher]
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  • 3) Neurosci Lett. 2015 Jan 8. pii: S0304-3940(15)00016-6. doi: 10.1016/j.neulet.2015.01.011. [Epub ahead of print]

    Dendritic spine dysgenesis in Autism Related Disorders.

    Phillips M(1), Pozzo-Miller L(2).
    Author information: 
    (1)Department of Neurobiology, Civitan International Research Center, The
    University of Alabama at Birmingham, Birmingham AL, 35294, USA. (2)Department of 
    Neurobiology, Civitan International Research Center, The University of Alabama at
    Birmingham, Birmingham AL, 35294, USA. Electronic address: lucaspm@uab.edu.
    PMID: 25578949  [PubMed - as supplied by publisher]
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  • 4) J Autism Dev Disord. 2015 Jan 13. [Epub ahead of print]

    Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review.

    Wong C(1), Odom SL, Hume KA, Cox AW, Fettig A, Kucharczyk S, Brock ME, Plavnick
    JB, Fleury VP, Schultz TR.
    Author information: 
    (1)Frank Porter Graham Child Development Institute, University of North Carolina 
    at Chapel Hill, CB 8180, 105 Smith Level Road, Chapel Hill, NC, 27599-8180, USA.
    The purpose of this study was to identify evidenced-based, focused intervention
    practices for children and youth with autism spectrum disorder. This study was an
    extension and elaboration of a previous evidence-based practice review reported
    by Odom et al. (Prev Sch Fail 54:275-282, 2010b, doi: 10.1080/10459881003785506
    ). In the current study, a computer search initially yielded 29,105 articles, and
    the subsequent screening and evaluation process found 456 studies to meet
    inclusion and methodological criteria. From this set of research studies, the
    authors found 27 focused intervention practices that met the criteria for
    evidence-based practice (EBP). Six new EBPs were identified in this review, and
    one EBP from the previous review was removed. The authors discuss implications
    for current practices and future research.
    PMID: 25578338  [PubMed - as supplied by publisher]
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  • 5) Res Dev Disabil. 2015 Jan 6;38C:242-255. doi: 10.1016/j.ridd.2014.12.020. [Epub ahead of print]

    Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement.

    Guinchat V(1), Cravero C(1), Diaz L(1), Périsse D(1), Xavier J(1), Amiet C(1),
    Gourfinkel-An I(2), Bodeau N(1), Wachtel L(3), Cohen D(4), Consoli A(5).
    Author information: 
    (1)Department of Child and Adolescent Psychiatry, AP-HP, Groupe Hospitalier
    Pitié-Salpêtrière, Université Pierre et Marie Curie, 47 bd de l'Hôpital, 75013
    Paris, France. (2)Center of Epileptology, Reference Center for Rare Epilepsies
    and Department of Genetics, AP-HP, Groupe Hospitalier Pitié-Salpêtrière,
    Université Pierre et Marie Curie, 47 bd de l'Hôpital, 75013 Paris, France.
    (3)Kennedy Krieger Institute, Johns Hopkins School of Medicine, 707 North
    Broadway Street, Baltimore, MD 21205, USA. (4)Department of Child and Adolescent 
    Psychiatry, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et
    Marie Curie, 47 bd de l'Hôpital, 75013 Paris, France; Institut des Systèmes
    Intelligents et Robotiques, CNRS UMR 7222, Université Pierre et Marie Curie, 1
    Place Jussieu, 75005 Paris, France. Electronic address: david.cohen@psl.aphp.fr. 
    (5)Department of Child and Adolescent Psychiatry, AP-HP, Groupe Hospitalier
    Pitié-Salpêtrière, Université Pierre et Marie Curie, 47 bd de l'Hôpital, 75013
    Paris, France; INSERM U669, Maison de Solenn, 97 bd de Port Royal, 75014 Paris,
    During adolescence, some individuals with autism spectrum disorder (ASD) engage
    in severe challenging behaviors, such as aggression, self-injury, disruption,
    agitation and tantrums. We aimed to assess risk factors associated with very
    acute behavioral crises in adolescents with ASD admitted to a dedicated
    neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents
    and young adults with ASD hospitalized for severe challenging behaviors and
    proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 
    patients recruited for the same indications between 2010 and 2012. In total, 58
    patients were admitted (n=70 hospitalizations, mean age=15.66 (±4.07) years, 76% 
    male). We systematically collected data describing socio-demographic
    characteristics, clinical variables (severity, presence of language, cognitive
    level), comorbid organic conditions, etiologic diagnosis of the episode, and
    treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) 
    score and duration of hospitalization at discharge. All but 2 patients exhibited 
    severe autistic symptoms and intellectual disability (ID), and two-thirds had no 
    functional verbal language. During the inpatient stay (mean=84.3 (±94.9) days),
    patients doubled on average their GAFS scores (mean=17.66 (±9.05) at admission
    vs. mean=31.4 (±9.48) at discharge). Most common etiologies for acute behavioral 
    crises were organic causes [n=20 (28%), including epilepsy: n=10 (14%) and
    painful medical conditions: n=10 (14%)], environmental causes [n=17 (25%)
    including lack of treatment: n=11 (16%) and adjustment disorder: n=6 (9%)], and
    non-ASD psychiatric condition [n=33 (48%) including catatonia: n=5 (7%), major
    depressive episode: n=6 (9%), bipolar disorder: n=4 (6%), schizophrenia: n=6
    (9%), other/unknown diagnosis: n=12 (17%)]. We found no influence of age, gender,
    socio-economic status, migration, level of ID, or history of seizure on
    improvement of GAFS score at discharge. Severity of autism at admission was the
    only negative predictor (p<.001). Painful medical conditions (p=.04), non-ASD
    psychiatric diagnoses (p=.001), prior usage of specialized ASD care programs
    (p=.004), functional language (p=.007), as well as a higher number of challenging
    behaviors upon admission (p=.001) were associated with higher GAFS scores at
    discharge. Clinical severity at admission, based on the number of challenging
    behaviors (r=.35, p=.003) and GAFS score (r=-.32, p=.008) was correlated with a
    longer inpatient stay. Longer hospitalization was however correlated (r=.27,
    p=.03) with higher GAFS score at discharge even after adjustment for confounding 
    factors. Challenging behaviors among adolescents with ASD may stem from diverse
    risk factors, including environmental problems, comorbid acute psychiatric
    conditions, or somatic illness such as epilepsy or acute pain. The management of 
    these behavioral challenges requires a unified, multidisciplinary approach.
    Copyright © 2014 Elsevier Ltd. All rights reserved.
    PMID: 25575287  [PubMed - as supplied by publisher]
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  • 6) Psychol Sch. 2015 Feb 1;52(2):181-195.

    Training Teachers to use Evidence-Based Practices for Autism: Examining Procedural Implementation fidelity.

    Stahmer AC(1), Reed S(1), Lee E(2), Reisinger EM(3), Connell JE(4), Mandell
    Author information: 
    (1)Child and Adolescent Services Research Center & Autism Discovery Institute,
    Rady Children's Hospital, San Diego, 3020 Children's Way, MC5033, San Diego, CA
    92123 ; Department of Psychiatry, University of California, San Diego, 9500
    Gilman Drive, 0812, La Jolla, CA 92073-0812. (2)Child and Adolescent Services
    Research Center & Autism Discovery Institute, Rady Children's Hospital, San
    Diego, 3020 Children's Way, MC5033, San Diego, CA 92123. (3)Penn Medicine, Dept. 
    of Psychiatry, The Children's Hospital of Philadelphia Center for Autism
    Research, 3535 Market Street, 8th floor, Philadelphia, PA 19104. (4)AJ Drexel
    Autism Institute, 3020 Market Street, Suite 560, Philadelphia, PA 19104.
    The purpose of this study was to examine the extent to which public school
    teachers implemented evidence-based interventions for students with autism in the
    way these practices were designed. Evidence-based practices for students with
    autism are rarely incorporated into community settings, and little is known about
    the quality of implementation. An indicator of intervention quality is procedural
    implementation fidelity (the degree to which a treatment is implemented as
    prescribed). Procedural fidelity likely affects student outcomes. This project
    examined procedural implementation fidelity of three evidence-based practices
    used in a randomized trial of a comprehensive program for students with autism in
    partnership with a large, urban school district. Results indicate that teachers
    in public school special education classrooms can learn to implement
    evidence-based strategies; however they require extensive training, coaching, and
    time to reach and maintain moderate procedural implementation fidelity.
    Procedural fidelity over time, and across intervention strategies is examined.
    PMID: 25593374  [PubMed]
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  • 7) Disabil Health J. 2014 Dec 1. pii: S1936-6574(14)00188-5. doi: 10.1016/j.dhjo.2014.10.005. [Epub ahead of print]

    Examining treatment adherence among parents of children with autism spectrum disorder.

    Hock R(1), Kinsman A(2), Ortaglia A(3).
    Author information: 
    (1)College of Social Work, University of South Carolina, 1731 College St., Rm.
    202, Columbia, SC 29208, USA. Electronic address: roberth@sc.edu. (2)Autism
    Wonders Program, Greenville Health System Children's Hospital, 200 Patewood
    Drive, Suite 200A, Greenville, SC 29615, USA. (3)University of South Carolina,
    Department of Epidemiology and Biostatistics, Arnold School of Public Health,
    Devine Street Research Center #114, 730 Devine Street, Columbia, SC 29208, USA.
    BACKGROUND: Children with Autism Spectrum Disorder (ASD) participate in a variety
    of treatments, including medication, behavioral, alternative and developmental
    treatments. Parent adherence to these treatments is crucial for positive child
    OBJECTIVE: The current study: 1) Explored patterns of parent adherence across the
    full range of treatments that are prescribed to children with ASD and, 2)
    Examined whether parent demographics, parent treatment attitudes, and child ASD
    severity contribute to parents' adherence across ASD treatments.
    METHOD: Questionnaires were distributed to parents of children with ASD in a
    southeastern state. Parents (N = 274) were included if they were parenting a
    child with ASD who was receiving treatment for ASD symptoms. Paired t-tests and
    multiple linear regression were used to assess the study aims.
    RESULTS: Adherence to medication treatment was significantly greater than
    adherence to behavioral, developmental, or alternative treatments (adjusted
    p-values 0.0006, 0.0030, 0.0006 respectively). Perceived family burden of a
    treatment was associated with lower adherence to medication, developmental, and
    alternative treatments. Finally, greater ASD severity was associated with lower
    adherence to alternative treatments.
    CONCLUSION: Overall, the independent variables accounted for more variance in
    adherence to medication and alternative treatments than in behavioral and
    developmental treatments. Parents' adherence to ASD treatment differs
    significantly by treatment type and is influenced by parental perceptions of the 
    burden of treatment on the family. These findings highlight the importance of
    understanding and addressing the impact of ASD treatment regimens on family life.
    Copyright © 2015 Elsevier Inc. All rights reserved.
    PMID: 25595296  [PubMed - as supplied by publisher]
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  • 8) Nat Neurosci. 2015 Jan 19. doi: 10.1038/nn.3919. [Epub ahead of print]

    The idiosyncratic brain: distortion of spontaneous connectivity patterns in autism spectrum disorder.

    Hahamy A(1), Behrmann M(2), Malach R(1).
    Author information: 
    (1)Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.
    (2)Department of Psychology, Carnegie Mellon University, Pittsburgh,
    Pennsylvania, USA.
    Autism spectrum disorder (ASD) has been associated with a reduction in resting
    state functional connectivity, though this assertion has recently been challenged
    by reports of increased connectivity in ASD. To address these contradictory
    findings, we examined both inter- and intrahemispheric functional connectivity in
    several resting state data sets acquired from adults with high-functioning ASD
    and matched control participants. Our results reveal areas of both increased and 
    decreased connectivity in multiple ASD groups as compared to control groups. We
    propose that this heterogeneity stems from a previously unrecognized ASD
    characteristic: idiosyncratic distortions of the functional connectivity pattern 
    relative to the typical, canonical template. The magnitude of an individual's
    pattern distortion in homotopic interhemispheric connectivity correlated
    significantly with behavioral symptoms of ASD. We propose that individualized
    alterations in functional connectivity organization are a core characteristic of 
    high-functioning ASD, and that this may account for previous discrepant findings.
    PMID: 25599222  [PubMed - as supplied by publisher]
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  • 9) Curr Opin Psychiatry. 2015 Jan 19. [Epub ahead of print]

    Brain imaging research in autism spectrum disorders: in search of neuropathology and health across the lifespan.

    Lainhart JE(1).
    Author information: 
    (1)Waisman Laboratory for Brain Imaging and Behavior, and Autism & Developmental 
    Disorders Clinic, Waisman Center, and Department of Psychiatry, University of
    Wisconsin-Madison, Wisconsin, USA.
    PURPOSE OF REVIEW: Advances in brain imaging research in autism spectrum
    disorders (ASD) are rapidly occurring, and the amount of neuroimaging research
    has dramatically increased over the past 5 years. In this review, advances during
    the past 12 months and longitudinal studies are highlighted.
    RECENT FINDINGS: Cross-sectional neuroimaging research provides evidence that the
    neural underpinnings of the behavioral signs of ASD involve not only
    dysfunctional integration of information across distributed brain networks but
    also basic dysfunction in primary cortices.Longitudinal studies of ASD show
    abnormally enlarged brain volumes and increased rates of brain growth during
    early childhood in only a small minority of ASD children. There is evidence of
    disordered development of white matter microstructure and amygdala growth, and at
    2 years of age, network inefficiencies in posterior cerebral regions.From older
    childhood into adulthood, atypical age-variant and age-invariant changes in the
    trajectories of total and regional brain volumes and cortical thickness are
    apparent at the group level.
    SUMMARY: There is evidence of abnormalities in posterior lobes and posterior
    brain networks during the first 2 years of life in ASD and, even in older
    children and adults, dysfunction in primary cortical areas.
    PMID: 25602243  [PubMed - as supplied by publisher]
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  • 10) Sleep Med. 2014 Nov 28. pii: S1389-9457(14)00470-5. doi: 10.1016/j.sleep.2014.11.006. [Epub ahead of print]

    Sleep problems in children with autism spectrum disorder: examining the contributions of sensory over-responsivity and anxiety.

    Mazurek MO(1), Petroski GF(2).
    Author information: 
    (1)University of Missouri, Department of Health Psychology & Thompson Center for 
    Autism and Neurodevelopmental Disorders, 205 Portland Street, Columbia, MO 65211,
    USA. Electronic address: mazurekm@missouri.edu. (2)University of Missouri, Office
    of Medical Research, Biostatistics and Research Design Unit, DC018, Columbia, MO 
    65212, USA.
    OBJECTIVES: Children with autism spectrum disorder (ASD) are at high risk for
    sleep problems. Previous research suggests that sensory problems and anxiety may 
    be related to the development and maintenance of sleep problems in children with 
    ASD. However, the relationships among these co-occurring conditions have not been
    previously studied. The current study examined the interrelations of these
    symptoms in a large well-characterized sample of children and adolescents with
    METHODS: The current study examined the relationships among sleep problems,
    sensory over-responsivity, and anxiety in 1347 children enrolled in the Autism
    Speaks Autism Treatment Network. The primary measures included the Children's
    Sleep Habits Questionnaire, the Child Behavior Checklist, and the Short Sensory
    RESULTS: In bivariate correlations and multivariate path analyses, anxiety was
    associated with all types of sleep problems (ie, bedtime resistance, sleep-onset 
    delay, sleep duration, sleep anxiety, and night wakings; p <0.01 to p <0.001;
    small to medium effect sizes). Sensory over-responsivity (SOR) was correlated
    with all sleep problems in bivariate analyses (p <0.01 to p <0.001; small effect 
    sizes). In multivariate path models, SOR remained significantly associated with
    all sleep problems except night awakenings for older children, while SOR was no
    longer significantly associated with bedtime resistance or sleep anxiety for
    younger children.
    CONCLUSIONS: Children with ASD who have anxiety and SOR may be particularly
    predisposed to sleep problems. These findings suggest that some children with ASD
    and sleep disturbance may have difficulties with hyperarousal. Future research
    using physiological measures of arousal and objective measures of sleep are
    Copyright © 2014 Elsevier B.V. All rights reserved.
    PMID: 25600781  [PubMed - as supplied by publisher]
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  • 11) Autism Res. 2015 Jan 20. doi: 10.1002/aur.1456. [Epub ahead of print]

    T-Brain-1 - A Potential Master Regulator in Autism Spectrum Disorders.

    Chuang HC(1), Huang TN, Hsueh YP.
    Author information: 
    (1)Graduate Institute of Life Sciences, National Defense Medical Center;
    Institute of Molecular Biology, Academia Sinica, Taipei, Taiwan.
    T-Brain-1 (TBR1), a causative gene in autism spectrum disorders (ASDs), encodes a
    brain-specific T-box transcription factor. It is therefore possible that TBR1
    controls the expression of other autism risk factors. The downstream genes of
    TBR1 have been identified using microarray and promoter analyses. In this study, 
    we annotated individual genes downstream of TBR1 and investigated any
    associations with ASDs through extensive literature searches. Of 124 TBR1 target 
    genes, 23 were reported to be associated with ASDs. In addition, one gene,
    Kiaa0319, is a known causative gene for dyslexia, a disorder frequently
    associated with autism. A change in expression level in 10 of these 24 genes has 
    been previously confirmed. We further validated the alteration of RNA expression 
    levels of Kiaa0319, Baiap2, and Gad1 in Tbr1 deficient mice. Among these 24
    genes, four transcription factors Auts2, Nfia, Nr4a2, and Sox5 were found,
    suggesting that TBR1 controls a transcriptional cascade relevant to autism
    pathogenesis. A further five of the 24 genes (Cd44, Cdh8, Cntn6, Gpc6, and Ntng1)
    encode membrane proteins that regulate cell adhesion and axonal outgrowth. These 
    genes likely contribute to the role of TBR1 in regulation of neuronal migration
    and axonal extension. Besides, decreases in Grin2b expression and increases in
    Gad1 expression imply that neuronal activity may be aberrant in Tbr1 deficient
    mice. These analyses provide direction for future experiments to reveal the
    pathogenic mechanism of autism. Autism Res 2015. © 2015 International Society for
    Autism Research, Wiley Periodicals, Inc.
    © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
    PMID: 25600067  [PubMed - as supplied by publisher]
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  • 12) Autism Res. 2015 Jan 20. doi: 10.1002/aur.1451. [Epub ahead of print]

    Electrodermal Response to Reward and Non-Reward Among Children With Autism.

    Neuhaus E(1), Bernier RA, Beauchaine TP.
    Author information: 
    (1)Seattle Children's Research Institute, Center for Child Health, Behavior, and 
    Development, M/S CW8-6. PO Box 5371, Seattle, Washington, 98121.
    Pervasive social difficulties among individuals with autism spectrum disorder
    (ASD) are often construed as deriving from reduced sensitivity to social stimuli.
    Behavioral and neurobiological evidence suggests that typical individuals show
    preferential processing of social (e.g., voices, faces) over nonsocial (e.g.,
    nonvocal sounds, images of objects) information, whereas individuals with ASD may
    not. This reduction in sensitivity may reflect disrupted reward processing
    [Dawson & Bernier, ], with significant developmental consequences for affected
    individuals. In this study, we explore effects of social and monetary reward on
    behavioral and electrodermal responses (EDRs) among 8- to 12-year-old boys with
    (n = 18) and without (n = 18) ASD, with attention to the potential moderating
    effects of stimulus familiarity. During a simple matching task, participants with
    and without ASD had marginally slower reactions during social vs. nonsocial
    reward, and boys with ASD had less accurate responses than controls. Compared to 
    baseline, reward and non-reward conditions elicited more frequent and larger EDRs
    for participants as a whole, and both groups showed similar patterns of EDR
    change within reward blocks. However, boys with and without ASD differed in their
    EDRs to non-reward, and response amplitude was correlated with social and
    emotional functioning. These findings provide some support for altered reward
    responding in ASD at the autonomic level, and highlight the discontinuation of
    reward as an important component of reward-based learning that may play a role in
    shaping behavior and guiding specialized brain development to subserve social
    behavior and cognition across the lifespan. Autism Res 2015. © 2015 International
    Society for Autism Research, Wiley Periodicals, Inc.
    © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
    PMID: 25599655  [PubMed - as supplied by publisher]
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