Auditory symptoms and autistic spectrum disorder:A scoping review and recommendations for future research

Introduction:Auditory symptoms in individuals with Autistic Spectrum Disorder(ASD)are well described within the neurodevelopmental literature,yet there is minimal mention of ASD in Otolaryngology literature.This is surprising considering the potential clinical and diagnostic implications of this link,and the potential for ASD to present to Otolaryngologists in the form of unexplained auditory symptoms.The aims of this literature review were to explore the intersection of auditory symptoms and ASD from the perspective of clinical Otolaryngology,and to outline a clinically focused research agenda based on emerging themes relevant to Otolaryngology.Methods:We searched Pubmed,Embase,Ovid and Cochrane library for studies until November 2021.Four authors independently reviewed 227 publications identified.39 were filtered into the final analysis.The PRISMA 2020 guidelines were followed.The heterogeneity of literature meant that a Systematic Review was not feasible.Included studies were therefore classified thematically,forming the basis of the scoping review.Results:Diagnostic theories for auditory symptoms in ASD include the entire auditory pathway and brain.There is a growing body of literature on auditory symptoms in ASD,suggesting that a primary diagnosis of ASD should be considered in patients presenting with otherwise unexplained auditory symptoms,and indicating a learning need for Otolaryngologists and audiologists,to whom these patients may present.Conclusion:We recommend a research agenda focusing on multidisciplinary collaboration,stakeholder engagement,responsible clinical screening,and clarification of pathophysiological mechanisms and terminology.

Towards Defining the Pathophysiology of Autistic Behavior (Z4)

Meeting Summary Autism is a neurodevelopmental disorder defined by the of a set of characteristic behavioral features. One of the most common neurodevelopmental disorders, autism is recognized as heterogeneous in etiology, phenotype, behavioral trajectory and response to treatment. While the etiology and specific pathogenetic mechanisms underlying autism are unknown, those mechanisms which underlie a small subset of etiologically-defined neurodevelopmental disorders （e.g., Fragile X Syndrome, tuberous sclerosis）, that are associated with autism and autistic behaviors, have been well described.

Parents of Children with Autistic Spectrum Disorder (ASD) as Co-therapists: The Therapists’ View

Studies on the evaluation by therapists of parental behavior towards their children with Autistic Spectrum Disorder(ASD)and towards the therapists of their children are scarce.They are necessary,however,for enabling parents to become co-therapists.The present study’s purpose was the evaluation by therapists of the behavior of parents towards their children,of their relationship to therapists,and therapy outcome.The sample consisted of 178 parents of 89 children(72 boys)with ASD,who underwent intensive early intervention at a day centre for developmental disabilities.The professional team completed a questionnaire,separately for the mother and father,evaluating the parental attitude towards their children and towards the therapists.The behavior of parents was less satisfactory than expected.The fathers had difficulties in understanding their child’s problems,and had unrealistic expectations;mothers’behavior towards their children and therapists was better than the fathers’.Mothers had difficulty mostly in the management of the child’s behavior,and did not do well with feeding.It might be difficult for every parent to become co-therapist.Understanding the child’s difficulties by the mother,adequate handling of feeding and homework,were statistically significant in the good outcome of therapy.

How different is early-onset childhood disintegrative disorder from autistic disorder with speech loss?

To examine the difference between early-onset (< age 3) childhood disintegrative disorder (CDD) and autistic disorder with speech loss (ADSL), 8 children with early-onset CDD (mean age = 7.6 years, SD = 3.8;6 males) were compared with 92 age and gender-ratio comparable children with ADSL (mean age = 6.8 years, SD = 4.1;70 males) on 24 variables not directly related to the key features of CDD (regression after normal development for at least the first 2 years after birth). Compared with the ADSL group, the early-onset CDD group had a tendency to have a higher rate of a psychosocial event before speech loss (SL) (early-onset CDD, 75.0% vs ADSL, 37.0%, p = 0.057;effect size (phi) = 0.211, p < 0.05);a significantly higher rate of fearfulness during SL (62.5% vs 4.3%, p = 0.000;phi = 0.551, p < 0.05);and a tendency to have a higher rate of epilepsy (25.0% vs 3.3%, p = 0.050;phi = 0.271, p < 0.05), a tendency to have a lower rate of the Childhood Autism Rating Scale-Tokyo Version (CARS-TV) total score ≥ 30 (75.0% vs 95.7%, p = 0.072;phi = 0.236, p < 0.05), and a significantly lower rate of CARS-TV item 2 (imitation) score ≥ 2 (50.0% vs 82.6%, p = 0.049;phi = 0.221, p < 0.05) on the first visit. The two groups did not exhibit any significant difference in the other 19 variables. The findings of no significant difference in the great majority and a significant difference in the small minority of the 24 variables between the two groups support integrating CDD into regressive autism spectrum disorder and studying CDD as its prototypical form.

Study on the Application Effect of Family Follow-Up Rehabilitation Nursing in Elderly Autistic Patients in Community Institutions

Objective:To study the effect of family follow-up nursing in rehabilitation of elderly autistic patients in community institutions.Methods:120 elderly autistic patients from February 2021 to July 2022 were randomly divided into a control group and a test group with 60 cases each.The patients in the control group were cared for at home by their family members,while the patients in the test group were given family follow-up rehabilitation care on the basis of the control group.The compliance of patients in the rehabilitation process,the UCLA loneliness score,the autism treatment assessment scale(ATEC)score of patients after this nursing care,and the quality-of-life scores of patients of the two groups before and after nursing care were compared.Results:The compliance of patients in the process of rehabilitation treatment was better in the experimental group than in the experimental group.The physical function score of patients after nursing was better in the experimental group than in the experimental group.The UCLA loneliness score and ATEC score of patients in the experimental group after nursing were lower than those of the control group(P<0.05);the quality-of-life score was higher in the experimental group(P<0.05).Conclusion:The application of family follow-up nursing in the rehabilitation of elderly autistic patients in community institutions can significantly improve patients’compliance and improve their prognosis,thus having high clinical value.

Problems in treatment and training of autistic children growing up in China:A follow‐up case report

Introduction Currently,interventions for children with autism spectrum disorders(ASD)in China are mainly carried out by professionals in rehabilitation institutions and special schools.However,when autistic children are older,they do not receive effective training and treatment,and there is no specific place in society to accommodate autistic adults.Mental hospitals are usually their ultimate home.Case presentation We report a 22‐year‐old male with ASD.The manifestation and/or intervention from the age of 3 years to now were recorded.He has been hospitalized in the closed ward of a mental hospital since 2015.Conclusion This report typically present the current problems in treatment and training of autistic children growing up in China.Life‐long rehabilitation training is important for every patient with ASD.Relevant policies and resources in China should be optimized in terms of medical treatment and health care,education and training,social assistance,social security,labor employment,and social culture.

THE POSITIVE EFFECTS OF VOLATILE COMPONENTS IN JIAWEI WENDAN PRESCRIPTION ON THE IMPROVEMENT OF THE AUTISTIC BEHAVIOR IN RATS

The objective was to investigate the effects of volatile components in Jiawei Wendan prescription on autistic behavior in rats,to analyze the volatile constituents and then to explore its effective components based on the treatment of autism.The pregnant mice were divided into two groups according to the method that Schneider used.

Scientists Wonder if Einstein,Newton Were Autistic

选注者言:正当SARS成为一个世界焦点时,我在网上读到了本文,了解到世界上还存在另一种被成称为AS的综合病症。而且本文披露了两个世界科学巨匠(爱因斯坦和牛顿)均可能患有AS病症。什么是AS病症呢?它的命名来自何处呢?AS病症的日常表现如何呢?本文均有详细介绍。

Training Helps Autistic Children Emerge from Solitude

Amother considers her child to be a continuation of her own life, and places her own desires that she cannot achieve on her child. A child is a mother’s sun, a mother’s hope. In this world, however, there exists another group of mothers whose children have autism. These children act as if they are completely alone, do not interact with others, and even refuse the love

The Effects of Therapeutic Horseback Riding Program on Motor Skills inChildren with Autism Spectrum Disorder

Therapeutic horseback riding(THR)as an animal-assisted intervention is one of the innovative approaches emer-ging in the treatment for children with autism spectrum disorder(ASD).The current study was designed to inves-tigate the effects of a 12-week,twice a week THR program on motor skills in sixty-eight children with ASD aged 5–10 years old.All participants selected met the DSM-V criteria for ASD,and a total offifty-three participants completed the study.A randomized controlled trial design was utilized for the study.Data was collected via a pre-THR test,interim-THR test,and post-THR test to investigate the possible changes in motor skills throughout the 12-week THR program.Results showed that the THR program significantly improved overall motor skills across time points(p<0.05)and sub-skills of run,gallop and two-hand catch(as compared to the control group,p<0.05).In conclusion,the THR program may be an effective option for improving motor skills in children with ASD and further investigation with a longer period of intervention is warranted.

Prediction of Outcomes in Mini-Basketball Training Program for Preschool Children with Autism Using Machine Learning Models

In recent years evidence has emerged suggesting that Mini-basketball training program(MBTP)can be an effec-tive intervention method to improve social communication(SC)impairments and restricted and repetitive beha-viors(RRBs)in preschool children suffering from autism spectrum disorder(ASD).However,there is a considerable degree if interindividual variability concerning these social outcomes and thus not all preschool chil-dren with ASD profit from a MBTP intervention to the same extent.In order to make more accurate predictions which preschool children with ASD can benefit from an MBTP intervention or which preschool children with ASD need additional interventions to achieve behavioral improvements,further research is required.This study aimed to investigate which individual factors of preschool children with ASD can predict MBTP intervention out-comes concerning SC impairments and RRBs.Then,test the performance of machine learning models in predict-ing intervention outcomes based on these factors.Participants were 26 preschool children with ASD who enrolled in a quasi-experiment and received MBTP intervention.Baseline demographic variables(e.g.,age,body,mass index[BMI]),indicators of physicalfitness(e.g.,handgrip strength,balance performance),performance in execu-tive function,severity of ASD symptoms,level of SC impairments,and severity of RRBs were obtained to predict treatment outcomes after MBTP intervention.Machine learning models were established based on support vector machine algorithm were implemented.For comparison,we also employed multiple linear regression models in statistics.Ourfindings suggest that in preschool children with ASD symptomatic severity(r=0.712,p<0.001)and baseline SC impairments(r=0.713,p<0.001)are predictors for intervention outcomes of SC impair-ments.Furthermore,BMI(r=-0.430,p=0.028),symptomatic severity(r=0.656,p<0.001),baseline SC impair-ments(r=0.504,p=0.009)and baseline RRBs(r=0.647,p<0.001)can predict intervention outcomes of RRBs.Statistical models predicted 59.6%of variance in post-treatment SC impairments(MSE=0.455,RMSE=0.675,R2=0.596)and 58.9%of variance in post-treatment RRBs(MSE=0.464,RMSE=0.681,R2=0.589).Machine learning models predicted 83%of variance in post-treatment SC impairments(MSE=0.188,RMSE=0.434,R2=0.83)and 85.9%of variance in post-treatment RRBs(MSE=0.051,RMSE=0.226,R2=0.859),which were better than statistical models.Ourfindings suggest that baseline characteristics such as symptomatic severity of 144 IJMHP,2022,vol.24,no.2 ASD symptoms and SC impairments are important predictors determining MBTP intervention-induced improvements concerning SC impairments and RBBs.Furthermore,the current study revealed that machine learning models can successfully be applied to predict the MBTP intervention-related outcomes in preschool chil-dren with ASD,and performed better than statistical models.Ourfindings can help to inform which preschool children with ASD are most likely to benefit from an MBTP intervention,and they might provide a reference for the development of personalized intervention programs for preschool children with ASD.

Measures of empathy in children and adolescents:A systematic review of questionnaires

BACKGROUND Empathy has long been considered a multidimensional construct,encompassing cognitive,affective and behavioral domains.Deficits in empathic competences in early childhood contribute to psychopathology,and have been variably implicated in several clinical conditions,such as autism spectrum disorders(ASD)and conduct disorders.AIM To identify and describe empirically validated questionnaires assessing empathy in children and adolescents and to provide a summary of related theoretical perspectives on empathy definitional issues.METHODS A systematic review of the literature was conducted.Three bibliographic databases were searched.A total of 47 studies were selected for final analysis and 16 distinct measures were identified and described.RESULTS Questionable to excellent levels of internal consistency were observed,while few studies assessed test-retest reliability.Although construct definitions only partially overlapped,affective and cognitive domains of empathy were the commonest internal factors that were often separately evaluated.New facets of the construct(i.e.,somatic empathy and sympathy)and specific clinical populations(i.e.,ASD)could be specifically addressed through more recent instruments.CONCLUSION The combination of different assessment methods is recommended in order to foresee further improvements in this field and try to overcome the problem of limited convergence with more objective measures.

Clinical and therapeutic implications of psychiatric comorbidity in high functioning autism/Asperger syndrome: An Italian study

The present study describes the occurrence of psychiatric comorbid disorders in a cohort of 86 high functioning autism (HFA)/Asperger syndrome (AS) patients, examined at Child Neurology and Psychiatry Unit of Tor Vergata University. 38 patients out of 86 (44.2%) presented one or more psychiatric comorbidities, such as mood disorders, Attention Deficit/Hyperactivity Disorder (ADHD), Tourette syndrome (TS), anxiety disorders, including obsessive-compulsive disorder (OCD), and psychotic symptoms. We compared our sample with the evidences from the scientific literature on psychiatric comorbidity in ASD patient, in particular in HFA/AS. In this paper we focus on the high frequency of comorbid psychiatric disorders in HFA/AS patients, such as mood disorders, Attention Deficit/Hyperactivity Disorder (ADHD), Tourette syndrome (TS), anxiety disorders, including obsessive-compulsive disorder (OCD), and psychosis, including schizophrenia. We analyzed rates of all psichiatric comorbidities diagnosed in a sample of HFA/AS subjects and we compared findings from our study with the evidences from the scientific literature on psychiatric comorbidity in ASD patients, in particular HFA/AS. We point out that comorbid psychiatric symptoms can be hardly diagnosed, because they could present atipically in ASDs then in general population. Furthermore, they could be masked by ASD core symptoms.

Social Psychology of Architect in the Course of Spatial Creation

In the course of spatial creation, architect's psychology could be influenced or restricted by the society, and based on this fact this paper summarized the individual psychology of the architect as "autistic thinking" and "controlled consciousness" and analyzed the resulting eight mental dispositions, namely, nostalgia proneness, novelty proneness, interest tendency, flaunt tendency, nihility tendency, political wil, cultural will and economic will. This research argued that the analysis and the example of the social mentality could describe, illustrate and predict the implied creation motivation of the architect as well as how they directly act on the course of spatial creation.

Autism spectrum disorder:Review of literature and dental management

With an increase in the number of cases of autism spectrum disorder(ASD),dental professionals need to be aware of the different techniques required to ensure safe dental treatments for affected patients. The concerns and preferences of the parents and the medical and dental history of each patient should be considered. The aim of this article was to provide a comprehensive update on the medical and dental health of patients with ASD. A detailed search of the electronic database PubMed/Medline/Lilacs was performed for the terms"Autism", "Autistic", "Autism Spectrum Disorder", "ASD", "Dentistry" and"Dentist", in the period between 2006 and 2017. Systemic reviews, research articles, and literature reviews were included. Expert opinions, case series, and case reports were excluded from the search. A detailed family-centered approach based on the preferences and concerns of parents is an important foundation for appropriate individualized dental treatment of patients with ASD. In addition,the knowledge of disruptive behaviors and patient′s challenges may guide dental practitioners in improving treatment planning, oral management, and the overall oral health of patients with ASD.

Inclusive Methods in Art Classroom for Students with Autism in China

Cultivating professional knowledge and developing specific inclusive training has always been important for educators in China.Within the context of special art education in China,art educators are supposed to adjust the instruction effectively for students with a variety of disabilities.This qualitative study sought to gain insight of the strategies of modifying and adapting art instruction for children with autism.Data were collected and analyzed by comparative method through interviews with three art educators.During the interview,three participants addressed strategies they use when working with autistic students in art classroom and proved the ways to modify and adapt art instruction to enhance autistic children’s pedagogical skills.Art teachers can also identify students’preferred art materials to engage autistic students in learning art.Beyond helping my educational practice,this study could further serve as an impetus to assist other educators in China thus expand teachers’professional knowledge in teaching children with special needs.

Global Functional Performance and Caregiver Assistance in Autism and Asperger Syndrome

Autism and Asperger’s syndrome belong to a family of neuro-developmental disorders called Pervasive Development Disorders. The aims of this study were to 1) quantify the overall functional performance and need for caregiver assistance in autism (A) and Asperger’s syndrome (AS), 2) compare the findings between groups and to normative data from Brazilian children. Methods: A cross-sectional study was carried out involving 52 children between three and eight years of age diagnosed with either A (n = 26) or SA (n = 26). The Brazilian version of the Pediatric Evaluation of Disability Inventory was administered. Results: The children with A and AS achieved significantly lower scores than that expected for normality. The children with AS had a significantly better social function than that the children with A had. However, those with A achieved significantly better scores than those with AS on activities related to self-care and mobility, requiring less assistance. Conclusion: While patients with AS are better at social interaction than typical autistic children, they exhibit greater deficits with regard to basic tasks, such as self-care and mobility, requiring greater assistance than children with A.

Sex-biased single-cell genetic landscape in mice with autism spectrum disorder

Autistic spectrum disorder(ASD)is a male-biased,heterogeneous neurodevelopmental disorder that affects approximately 1%e2%of the population.Prenatal exposure to valproic acid(VPA)is a recognized risk factor for ASD,but the cellular and molecular basis of VPA-induced ASD at the single-cell resolution is unclear.Here,we aim to compare the cellular and molecular differences in the hippocampus between male and female prenatal mice with ASD at the single-cell transcriptomic level.The transcriptomes of more than 45,000 cells are assigned to 12 major cell types,including neurons,glial cells,vascular cells,and immune cells.Cell type-specific genes with altered expression after prenatal VPA exposure are analyzed,and the largest number of differentially expressed genes(DEGs)are found in neurons,choroid plexus epithelial cells,and microglia.In microglia,several pathways related to inflammation are found in both males and females,including the tumor necrosis factor(TNF),nuclear factor kappa B(NF-kB),toll-like receptor(TLR),and mitogen-activated protein kinase(MAPK)signaling pathways,which are important for the induction of autistic-like behavior.Additionally,we note that several X-linked genes,including Bex1,Bex3,and Gria3,were among the male-specific DEGs of neurons.This pioneering study describes the landscape of the transcriptome in the hippocampus of autistic mice.The elucidation of sexual differences could provide innovative strategies for the prevention and treatment of ASD.

Data-driven,client-centric applied behavior analysis treatment-dose optimization improves functional outcomes

Background With increasing numbers of individuals diagnosed with autism spectrum disorder(ASD)and with affirmation of applied behavior analysis(ABA)as an evidence-based standard of care for ASD,there has been a proliferation of agencies offering ABA services over the last several decades.Disagreement exists among ABA providers and health plans that reimburse those providers on the optimal number of hours of ABA services that should be reimbursed.This study aims to understand whether children who receive more hours of ABA therapy achieve better outcomes and to evaluate the impact of the COVID-19-induced shift to telehealth clinical supervision on outcomes.Methods A retrospective cohort analysis was performed using data from the Vineland 3 Comprehensive Interview Form to assess function throughout ABA treatment.Paired sample t tests,independent sample t tests,Cohen’s D,and Pearson correlations were used to determine relationships between Vineland scores and input variables including hours of service and modality of supervision(in-person vs.telehealth).Results While statistically and clinically significant improvements in function were observed,children appear to have improved outcomes independent of the number of hours of service received.There were also no significant associations between modality of supervision and Vineland standard scores.Conclusions These findings challenge prior research that demonstrated a linear dose–response relationship.By tailoring treatment dosage to the individual client’s needs,providers may be able to better maximize functional progress of the client,to preserve family time,and to utilize health plan dollars more efficiently.

Association of neonatal blood levels of brain-derived neurotrophic factor with development of autism spectrum disorder:a systematic review and meta-analysis

Background Our goal was to evaluate the association between neonatal blood brain-derived neurotrophic factor(BDNF)level and autism spectrum disorder(ASD)diagnosis later in life.Methods MEDLINE and Web of Science databases were searched from inception until September 16,2020.Reference lists of all relevant articles also were reviewed.Mean blood BDNF concentrations,standard deviations,sample sizes,and other data needed for calculation of effect sizes were extracted by two independent investigators.The quality of the included studies was appraised using the Newcastle-Ottawa Scale for case-control studies.Data were pooled using the random-effects model.Results Five case-control studies involving 1341 cases and 3395 controls were included in the meta-analysis.The meta-analysis of all included studies showed no significant difference in blood BDNF levels between neonates diagnosed with ASD later in life and healthy controls[standardized mean difference(SMD)=0.261;95%confidence interval(CI)-0.052 to 0.573;P=0.102],with high level of heterogeneity(Q=64.346;I2=93.784;P<0.001).A subgroup analysis by assay type showed decreased blood BDNF levels in ASDs compared to controls(SMD=—0.070;95%CI-0.114 to-0.026;P=0.002),with high level of homogeneity(Q=0.894;I2=0.000;P=0.827).No evidence of publication bias was observed.Conclusions Neonates diagnosed with ASD later in life have decreased blood levels of BDNF measured by double-antibody immunoassay.More studies are warranted to facilitate a more robust conclusion.