Autism as a disorder of biological and behavioral rhythms: toward new therapeutic perspectives.

Sylvie Tordjman,David Cohen,Geraldine Dawson,Nicolas Georgieff,Marie-Maude Geoffray,Michel Botbol,Aude Tavenard,Jean Xavier,Nathalie Coulon,Anne Hespel,Cã©Cile Oriol,Mario Speranza,Julie Vernay-Leconte,Claire Fougerou,George M Anderson,Olivier Bonnot,Eric Bellissant,Katherine S Davlantis,Solenn Kermarrec

doi:10.3389/fped.2015.00001

Abstract

There is a growing interest in the role of biological and behavioral rhythms in typical and atypical development. Recent studies in cognitive and developmental psychology have highlighted the importance of rhythmicity and synchrony of motor, emotional, and interpersonal rhythms in early development of social communication. The synchronization of rhythms allows tuning and adaptation to the external environment. The role of melatonin in the ontogenetic establishment of circadian rhythms and the synchronization of the circadian clocks network suggests that this hormone might be also involved in the synchrony of motor, emotional, and interpersonal rhythms. Autism provides a challenging model of physiological and behavioral rhythm disturbances and their possible effects on the development of social communication impairments and repetitive behaviors and interests. This article situates autism as a disorder of biological and behavioral rhythms and reviews the recent literature on the role of rhythmicity and synchrony of rhythms in child development. Finally, the hypothesis is developed that an integrated approach focusing on biological, motor, emotional, and interpersonal rhythms may open interesting therapeutic perspectives for children with autism. More specifically, promising avenues are discussed for potential therapeutic benefits in autism spectrum disorder of melatonin combined with developmental behavioral interventions that emphasize synchrony, such as the Early Start Denver Model.

Highlights

Endogenous physiological variations involved in biological rhythms reflect adaptation to the environment
The autistic deficit in melatonin secretion might lead to physiological rhythm disturbances in autism impairing biological circadian rhythms and even, in certain cases, to an “endless” physiological continuity provoked by the absence of variation in melatonin levels
TOWARD AN INTEGRATIVE APPROACH COMBINING THE USE OF MELATONIN WITH THE Early Start Denver Model (ESDM) Taken all together, Autism spectrum disorder (ASD) could be seen as a disorder of rhythmicity with, impairments in the synchrony of rhythms

Summary

INTRODUCTION

Endogenous physiological variations involved in biological rhythms reflect adaptation to the environment. Abnormally low daytime and nighttime melatonin secretion was associated with an absence of melatonin circadian variation in some individuals with autism [18, 19], which in turn, given the role of synchronizer of melatonin, has consequences on the circadian rhythms network, including the cortisol circadian rhythm [13, 20]. This blunted circadian rhythmicity with no or little variability might be related to the difficulties in adapting to changes typically observed in individuals with autism. Blunted circadian rhythmicity may explain the difficulty observed in many children with autism in adapting to

Results

Design

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CONCLUSION