Joakim Westerlund

Autism spectrum disorder and low vitamin D at birth: a sibling control study

BackgroundInsufficient vitamin D activity has attracted increasing interest as a possible underlying risk factor in disorders of the central nervous system, including autism.MethodsIn this study, 25-hydroxyvitamin D (25(OH)D) was analysed in 58 Sweden-born sibling pairs, in which one child had autism spectrum disorder (ASD) and the other did not. The study group consisted of two representative samples; 47 Gothenburg sibling pairs with mixed ethnicities and 11 Stockholm sibling pairs with Somali background. 25(OH)D levels were analysed in the stored dried blood spots taken in the neonatal period for metabolic screening.ResultsThe collapsed group of children with ASD had significantly lower vitamin D levels (M = 24.0 nM, SD = 19.6) as compared with their siblings (M = 31.9 nM, SD = 27.7), according to a paired samples t-test (P = 0.013). The difference was - most likely - not only accounted for by a difference in season of birth between ASD and non-ASD siblings since the mean 25(OH)D levels differed with similar effect size between the sibling pairs born during winter and summer, respectively. All children with African/Middle East background, both the children with ASD and their non-ASD siblings, had vitamin D deficiency.ConclusionsThe findings suggest that low prenatal vitamin D may act as a risk factor for ASD, however, there is a need for replication with larger samples. Future research should study whether or not adequate supplementation of vitamin D to pregnant women might lower the risk for ASD in the offspring.

Academic performance of adolescents with ADHD and other behavioural and learning problems -a population-based longitudinal study.

Aim:  To study academic performance (final grades at the age of 16 years) in individuals with i) attention‐deficit/hyperactivity disorder (ADHD) and ii) other learning and/or behavioural problems.

Coexisting Disorders and Problems in Preschool Children with Autism Spectrum Disorders

Objectives. To analyze cooccurring disorders and problems in a representative group of 198 preschool children with autism spectrum disorders (ASD) who had had interventions at a specialized habilitation center. Methods. Parents and children were seen by a research team. Data were based on parental interviews, pediatric assessments, and tests of the child. Information on autistic symptoms, general cognitive function, speech and language, motor function, epilepsy, vision, hearing, activity level, behavior, and sleep was collected. Results. Three ASD categories were used: (1) autistic disorder (AD), (2) autistic-like condition (ALC) or Asperger syndrome, and (3) one group with autistic symptoms/traits but not entirely all its criteria met for ASD. Children with autism had a mean of 3.2 coexisting disorders or problems, the ALC/Asperger group had a mean of 1.6, and children with autistic traits had a mean of 1.6. The most common disorder/problems in the total group pertained to language problems (78%), intellectual disability (ID) (49%), below average motor function (37%), and severe hyperactivity/ADHD (33%). Conclusions. The results accord with the concept of early symptomatic syndromes eliciting neurodevelopmental clinical examination (ESSENCE), and highlight the need of considering ASD in a broad perspective taking also other cooccurring developmental disorders into account.

Self-esteem in children with attention and/or learning deficits: the importance of gender.

Objective: Our objective was to analyze self‐esteem in children within a spectrum of attention disorders, that is, besides attention deficit hyperactivity disorder (ADHD), also children with subthreshold ADHD and even milder attention deficits and/or learning problems.

Cognitive strengths and deficits in schoolchildren with ADHD

Background: Few studies provide detailed analyses of the various aspects of the entire cognitive profile of children with ADHD.

Cognitive bias, emotion, and somatic complaints in a normal sample

Cognitive bias (Stroop interference and implicit memory bias) for masked and unmasked threat words (illness words and negative emotion words) was investigated for its associations with emotion (anxiety, anger/aggression, and positive affect) and somatic complaints in a randomly selected community sample of 138 individuals. Because measures of cognitive bias are inherently bipolar, the data were tested for both linear and curvilinear trends. Cross-sectional analysis showed that the associations between somatic anxiety and Stroop interference for unmasked threat words were better described in terms of curvilinear than linear models, and that degree of somatic complaints was associated with Stroop facilitation for masked threat words. Longitudinal analysis showed that Stroop interference for masked threat words predicted lack of positive affect during an ensuing eight weeks daily recording period. Implicit memory bias was found to be negatively associated with measures of anger/aggression, both in the cross-...

Autism before diagnosis: crying, feeding and sleeping problems in the first two years of life

To chart early registered regulatory problems (RP) in a representative group of young children with and without autism spectrum disorder (ASD).

Autism and developmental profiles in preschoolers : stability and change over time

Increasing numbers of young children are now being diagnosed with autism spectrum disorder (ASD). This study aimed to analyse developmental trajectories in a representative group of preschool children with ASD.

Stroop effects for masked threat words: Pre‐attentive bias or selective awareness?

The single‐trial emotional Stroop effect for masked threat words, and its association with anxiety, anger, and depression was studied in a group of men (n = 24) and women (n = 24) while controlling for possible differential thresholds for threat words versus neutral words. Stroop interference for masked threat words was found to correlate with trait anxiety, and the effect could not be explained by any differences in thresholds due to valence, neither at a subjective (conscious identification task) nor at an objective (lexical decision task) level of awareness. Jacobys exclusion task was explored as an alternative measure of conscious awareness, and the results corroborated the conclusion that the Stroop effect for masked threat words was the result of preattentive processes. Unexpectedly, however, the correlation between Stroop interference for masked threat words and trait anxiety was found only among the men.

“Recovery” from the diagnosis of autism – and then?

Background The aim of this study was to follow up the 17 children, from a total group of 208 children with autism spectrum disorder (ASD), who “recovered from autism”. They had been clinically diagnosed with ASD at or under the age of 4 years. For 2 years thereafter they received intervention based on applied behavior analysis. These 17 children were all of average or borderline intellectual functioning. On the 2-year follow-up assessment, they no longer met criteria for ASD. Methods At about 10 years of age they were targeted for a new follow-up. Parents were given a semistructured interview regarding the child’s daily functioning, school situation, and need of support, and were interviewed using the Vineland Adaptive Behavior Scales (VABS) and the Autism – Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) telephone interview. Results The vast majority of the children had moderate-to-severe problems with attention/activity regulation, speech and language, behavior, and/or social interaction. A majority of the children had declined in their VABS scores. Most of the 14 children whose parents were A-TAC-interviewed had problems within many behavioral A-TAC domains, and four (29%) had symptom levels corresponding to a clinical diagnosis of ASD, AD/HD, or both. Another seven children (50%) had pronounced subthreshold indicators of ASD, AD/HD, or both. Conclusion Children diagnosed at 2–4 years of age as suffering from ASD and who, after appropriate intervention for 2 years, no longer met diagnostic criteria for the disorder, clearly needed to be followed up longer. About 3–4 years later, they still had major problems diagnosable under the umbrella term of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). They continued to be in need of support, educationally, from a neurodevelopmental and a medical point of view. According to parent interview data, a substantial minority of these children again met diagnostic criteria for ASD.