Kerim Munir

Prenatal stress and risk for autism.

This paper reviews several converging lines of research that suggest that prenatal exposure to environmental stress may increase risk for Autistic Disorder (AD). We first discuss studies finding that prenatal exposure to stressful life events is associated with significantly increased risk of AD, as well as other disorders, such as schizophrenia and depression. We then review evidence from animal and human studies that prenatal stress can produce both (a) abnormal postnatal behaviors that resemble the defining symptoms of AD, and (b) other abnormalities that have elevated rates in AD, such as learning deficits, seizure disorders, perinatal complications, immunologic and neuroinflammatory anomalies, and low postnatal tolerance for stress. We explain why an etiologic role for prenatal stress is compatible with genetic factors in AD, and describe how stress can disrupt fetal brain development. Finally, we discuss implications for understanding underlying processes in AD, including potential gene-environment interactions, and developing new therapies and early prevention programs.

Conduct and Oppositional Disorder in Clinically Referred Children With Attention Deficit Disorder: A Controlled Family Study

In a controlled family study of clinically-referred children with attention deficit disorder (ADD), data were collected on first-degree relatives of 22 children with ADD and 20 normal children. Fourteen (64%) probands had associated diagnoses of conduct disorder (CD) or oppositional disorder (OPD). The data indicate two familial patterns. For children with associated CD/OPD, the rates of antisocial disorders (CD, OPD, antisocial personality disorder) in relatives were significantly higher than the rates of these disorders in relatives of probands without associated CD/OPD (46% versus 13%, p p

Economic Burden of Childhood Autism Spectrum Disorders

OBJECTIVE: To estimate the associations between autism spectrum disorder (ASD) diagnoses and service use, caregiver time, and cost outcomes. METHODS: We used national data from the Medical Expenditure Panel Survey linked to the National Health Interview Survey and a study-specific survey to estimate the annual utilization and costs for health care, school, ASD-related therapy, family-coordinated services, as well as caregiver time in children aged 3 to 17 years, with and without parent-reported ASD. Regression analyses estimated the association between ASD diagnosis and cost, controlling for child gender, age, race/ethnicity, insurance status, household income, country region and urban/rural classification, and non–ASD-related illnesses. RESULTS: Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD (P < .05). A greater proportion of children in the ASD group used special educational services (76% vs 7% in the control group, P < .05). After adjusting for child demographic characteristics and non–ASD-associated illnesses, ASD was associated with

A family study of patients with attention deficit disorder and normal controls

3020 (95% confidence interval [CI]:

Psychiatric Comorbidity in Patients With Attention Deficit Disorder: A Controlled Study

1017–

Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorder?

4259) higher health care costs and

Stability of Autistic Traits in the General Population: Further Evidence for a Continuum of Impairment

14 061 (95% CI:

A multivariate twin study of autistic traits in 12-year-olds: testing the fractionable autism triad hypothesis

4390–

Effects of diagnostic comorbidity and dimensional symptoms of attention-deficit-hyperactivity disorder in men with antisocial personality disorder

24 302) higher aggregate non–health care costs, including

Regulatory and Ethical Principles in Research Involving Children and Individuals with Developmental Disabilities

8610 (95% CI: