Role of gastrointestinal health in managing children with autism spectrum disorder

Children with autism spectrum disorders(ASD)or autism are more prone to gastrointestinal(GI)disorders than the general population.These disorders can significantly affect their health,learning,and development due to various factors such as genetics,environment,and behavior.The causes of GI disorders in children with ASD can include gut dysbiosis,immune dysfunction,food sensitivities,digestive enzyme deficiencies,and sensory processing differences.Many studies suggest that numerous children with ASD experience GI problems,and effective management is crucial.Diagnosing autism is typically done through genetic,neurological,functional,and behavioral assessments and observations,while GI tests are not consistently reliable.Some GI tests may increase the risk of developing ASD or exacerbating symptoms.Addressing GI issues in individuals with ASD can improve their overall well-being,leading to better behavior,cognitive function,and educational abilities.Proper management can improve digestion,nutrient absorption,and appetite by relieving physical discomfort and pain.Alleviating GI symptoms can improve sleep patterns,increase energy levels,and contribute to a general sense of well-being,ultimately leading to a better quality of life for the individual and improved family dynamics.The primary goal of GI interventions is to improve nutritional status,reduce symptom severity,promote a balanced mood,and increase patient independence.

Exploring the Lives of Mothers Raising Children with Autism Spectrum Disorder in Japan

Background: Examining the lives that mothers experience and build will allow us to deepen our understanding of children with ASD and their mothers and facilitate developing support methods. The study aimed to examine the lives of mothers raising children with autism spectrum disorder (ASD) and investigate their sources of support. Method: We conducted a qualitative inductive study using semi-structured interviews to identify characteristics of the lives that mothers have created. Results: Semi-structured interviews were conducted with 11 mothers having children with ASD. The analysis comprised three stages of coding and yielded eight categories. The lives of these mothers contained three themes: preoccupation with parenting children with ASD and their siblings;evolving mother;and using social resources. Mothers engaged in “assessing the characteristics, growth, and changes in the child with ASD”, had a “preoccupation with parenting children with ASD”, and were “thinking about the future of the child with ASD”, and “having goals and plans for parenting” while having “consideration toward the child’s siblings”. During this process, mothers experienced “changes in perspective or approach” and created lifestyles while “receiving help from people around them” and engaged in the “use of social resources”. Conclusions: To avoid becoming preoccupied with parenting and being burdened by their lifestyle, mothers require social support to monitor their perceptions. Furthermore, the utilization of social resources requires the supporting individuals to understand the characteristics of children with ASD, provide appropriate information, and assist in decision-making.

Metabolomic changes in children with autism

BACKGROUND Autism spectrum disorder(ASD)is a neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors.Metabolomic profiling has emerged as a valuable tool for understanding the underlying metabolic dysregulations associated with ASD.AIM To comprehensively explore metabolomic changes in children with ASD,integrating findings from various research articles,reviews,systematic reviews,meta-analyses,case reports,editorials,and a book chapter.METHODS A systematic search was conducted in electronic databases,including PubMed,PubMed Central,Cochrane Library,Embase,Web of Science,CINAHL,Scopus,LISA,and NLM catalog up until January 2024.Inclusion criteria encompassed research articles(83),review articles(145),meta-analyses(6),systematic reviews(6),case reports(2),editorials(2),and a book chapter(1)related to metabolomic changes in children with ASD.Exclusion criteria were applied to ensure the relevance and quality of included studies.RESULTS The systematic review identified specific metabolites and metabolic pathways showing consistent differences in children with ASD compared to typically developing individuals.These metabolic biomarkers may serve as objective measures to support clinical assessments,improve diagnostic accuracy,and inform personalized treatment approaches.Metabolomic profiling also offers insights into the metabolic alterations associated with comorbid conditions commonly observed in individuals with ASD.CONCLUSION Integration of metabolomic changes in children with ASD holds promise for enhancing diagnostic accuracy,guiding personalized treatment approaches,monitoring treatment response,and improving outcomes.Further research is needed to validate findings,establish standardized protocols,and overcome technical challenges in metabolomic analysis.By advancing our understanding of metabolic dysregulations in ASD,clinicians can improve the lives of affected individuals and their families.

Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.

Understanding Autism Spectrum Disorder(ASD)Unraveling the Mysteries(A Short Review)

Autism Spectrum Disorder(ASD)is a multifaceted neurodevelopmental condition characterized by a spectrum of symptoms and behaviors,challenging to fully comprehend due to its variability.This article provides an overview of ASD,including its characteristics,prevalence,diagnosis,and causes.The prevalence of ASD has been on the rise,with improved awareness and diagnostic tools.While genetics and environmental factors play a role,the exact causes remain elusive.Early intervention and various therapies are crucial for improving outcomes,although there is no cure.Ongoing research aims to uncover the complexities of ASD and develop effective treatments.Embracing diversity and fostering inclusion is essential for supporting individuals with ASD.As we continue to unravel the mysteries of ASD,we move closer to a more understanding and inclusive society.This article explores the role of Transcranial Magnetic Stimulation(TMS)in the treatment of Autism Spectrum Disorder(ASD).TMS,a non-invasive neurostimulation technique,is gaining attention as a potential therapy to address specific aspects of ASD.

Dimensional Characteristics of Children and Adolescents with Mood Disorders and Autism Spectrum Disorders

Objective: We sought to identify clinical discriminators between predominantly mood disordered and predominantly autism spectrum disordered research subjects that may reflect phenotypic state and treatment response characteristics. Method: Participants were 26 boys and 4 girls aged 2 to 18 years (Mean Age = 7.70). Subjects with DSM-IV diagnoses of Major depression (N = 2), Bipolar Disorder (N = 4) and Mood Disorder not otherwise specified (NOS) (N = 11) represented the mood disorder group (MD) (N = 17, Mean Age = 8.2) and those with diagnoses of Autistic Disorder (N = 1), Asperger’s Disorder (7) or Pervasive Developmental Disorder (NOS) (N = 3) comprised the autism spectrum disorder (ASD) group (N = 9, Mean Age = 6.8). Primary outcome measurements were continuous actigraphic measurements collected over one to three week periods. Secondary outcomes included personality and observational measurements. Personality characteristics reflected significant cross-group impairments related to self-control and self-discipline and differed relative to intellectual measures. Observational measurements reflected greater general impairments among the ASD group. Results: Predominantly mood disordered children demonstrated greater impairments related to sleep (P = 0.000) and sleep onset latency (P = 0.000) and were more active than ASD children during evening periods (P = 0.000). ASD children had lower verbal functioning and greater deviations from the norm on measures of cognitive development (P = 0.003) and psychosis (P = 0.047). Conclusions: Sleep disturbances, evening activity levels and phase delayed sleep appear to differentiate predominant mood and autism spectrum disordered children suggesting future areas for further exploration of neurological and phenotypic treatment response characteristics.

Play therapy in children with autism:Its role,implications,and limitations

Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.

Efficacy of Static and Intermittent Gravity Inverted Therapy Techniques in Improvement of Motor Apraxia and Cognitive Abilities in Autism Spectrum Disorder (ASD)

This work was carried out to investigate the efficacy of static and intermittent gravity inverted therapy techniques in improvement of motor apraxia and cognitive abilities in Autism Spectrum Disorder (ASD). 30 children were randomly joined in this study into two groups;Group A (sensory integration therapy approach plus static and intermittent inversion therapy techniques) and Group B (sensory integration therapy approach only). Block design test was used to locate and follow constructional apraxia, computerized information processing speed test to locate and follow cognitive processing and grooved pegboard test was used to locate and follow fine motor skills. The variance between pre- and post-treatment results was highly significant in the study group in all variables. By comparison of the two groups in constructional apraxia variables test at post-treatment, there was a highly representative elevation in favour to study groups (p < 0.05). By comparison of the two groups in cognitive processing variable at post-treatment, there was a highly representative elevation in favour to study group (p < 0.05). By comparison of the two groups in fine motor skills variable at post-treatment, there was a highly representative elevation in favor to study group (p < 0.05). According to the outcomes of this study, it can be terminated that the sensory integration therapy approach plus static and intermittent inversion therapy techniques can be recommended in improvement constructional apraxia and cognitive processing abilities in autism spectrum disorder (ASD) children.

Genetic mechanisms underlying synaptic pathology in Autism Spectrum Disorder (ASD)

Autism spectrum disorder(ASD)is a neuronal developmental disorder that is characterized by de⁃fects both in social interaction and verbal communication,and is often accompanied by restricted interest,and repeti⁃tive and stereotyped behaviors.The prevalence of ASD is approximately 0.8%~1.2%in China.Although its etiology remains unclear in most cases,over 1000 genes or genomic loci have been linked to its pathogenic origin,indicating a strong genetic influence,as well as complicated pathogenic mechanisms.Here,we reviewed recent findings in the possible genetic effects on synaptic pathophysiology of ASD,and a particular focus was put on variants in genes that are related to synaptic morphology or functions,such as FMR1,NRXN,NLGN,SHANK and MeCP2.The synaptic pathology caused by these genetic defects may substantially contribute to the pathogenesis of ASD.This review out⁃lines several lines of evidence that have been recently reported to support the hypothesis that a genetic defect may lead to a synaptic pathology that may underlie the pathogenesis of ASD.

娄必丹基于“心脑同治”治疗ASD认知障碍的选穴思路

娄必丹教授认为,神志疾病主要责之心脑,心脑功能失常则是孤独症谱系障碍(autism spectrum disorders,ASD)患儿认知障碍的主要病机。目前,临床治疗ASD多单纯选用头针,娄教授基于“心脑同治”理论,提出宁心调神针刺方法。该针刺方法选用心经之神门、通里、少海及心包经之内关、大陵以宁心调神,聪脑益智,头部选用督脉之百会、印堂、神庭,配合经外奇穴四神聪和本神穴(与神庭穴组合为“智三针”穴组)以通督调神、醒神益智。

Facial Image-Based Autism Detection:A Comparative Study of Deep Neural Network Classifiers

Autism Spectrum Disorder(ASD)is a neurodevelopmental condition characterized by significant challenges in social interaction,communication,and repetitive behaviors.Timely and precise ASD detection is crucial,particularly in regions with limited diagnostic resources like Pakistan.This study aims to conduct an extensive comparative analysis of various machine learning classifiers for ASD detection using facial images to identify an accurate and cost-effective solution tailored to the local context.The research involves experimentation with VGG16 and MobileNet models,exploring different batch sizes,optimizers,and learning rate schedulers.In addition,the“Orange”machine learning tool is employed to evaluate classifier performance and automated image processing capabilities are utilized within the tool.The findings unequivocally establish VGG16 as the most effective classifier with a 5-fold cross-validation approach.Specifically,VGG16,with a batch size of 2 and the Adam optimizer,trained for 100 epochs,achieves a remarkable validation accuracy of 99% and a testing accuracy of 87%.Furthermore,the model achieves an F1 score of 88%,precision of 85%,and recall of 90% on test images.To validate the practical applicability of the VGG16 model with 5-fold cross-validation,the study conducts further testing on a dataset sourced fromautism centers in Pakistan,resulting in an accuracy rate of 85%.This reaffirms the model’s suitability for real-world ASD detection.This research offers valuable insights into classifier performance,emphasizing the potential of machine learning to deliver precise and accessible ASD diagnoses via facial image analysis.

基于情绪体验的ASD儿童干预机器人造型研究

目的为提升ASD儿童干预机器人的训练效果,为教辅人员、设计师等提供参考,提出以ASD儿童情绪体验特点为基础的干预机器人拟人化造型特征评价方法。方法对市场上的机器人造型样本进行拟人度评分,并从中选取代表性样本;从20余项HRV指标中筛选出8项代表性指标,通过HRV实验收集数据;使用改进的PAD情绪量表获取ASD儿童情绪体验主观得分;通过逐步回归法筛选出对情绪体验得分影响较大的HRV指标;以HRV指标为自变量、情绪体验得分为因变量,建立回归关系,为ASD儿童干预机器人造型的设计和方案评价提供理论依据。结果研究表明,几何型机器人往往带来“放松的”情绪体验,类人型机器人会带来“高兴的”情绪体验,而真人型机器人则可能带来“焦虑的”情绪体验。同时,ASD儿童的愉悦度、唤醒度、优势度与HRV指标之间存在一定的相关性。结论将改进的PAD情绪量表应用于ASD儿童干预机器人的造型评价中,建立情绪体验和HRV指标之间的回归模型,为设计和评估适合ASD儿童的机器人提供了理论依据,更好地促进了ASD儿童干预机器人的发展。

Behavioral and cognitive core domains shared between autism spectrum disorder and schizophrenia

Growing genetic evidence including results of genome-wide association studies and whole-genome sequencing is still perplexing scientists in the fields of human complex traits and compels them to reconsider the relationship between autism spectrum disorder (ASD) and schizophrenia. The developmental trajectory of schizophrenia may be characterized by difficulties in “theory of mind” tasks, poor insight or imagination, low empathy level, weak executive function, failure in social judgments, delayed language development, movement mannerisms, motoric rituals, strong preoccupation with unusual objects, bizarre habits, and high intelligence. Most of these characteristics are associated with the standard criteria for ASD and all of them are core domains or endophenotypes of ASD. The diagnosed ASD cases, which were found in individuals with schizophrenia, have a significant tendency to be highfunctioning and to have atypical age of ASD manifestation. Episodic features including reality distortion, which can be seen in individual with ASD, may be associated with hyperarousal conditions with cognitive hypersensitivity, misattribution of negative experiences, and the perceptual thinking style. Together with the emerging new genetic concepts concerning human behavioral complex traits, the results and constructions of these recent studies may further warrant that reconsideration of the relationship between ASD and psychotic conditions is necessary. In addition, the possibility that psychotic conditions are the secondary derivative states in individuals with ASD or in individuals with subclinical ASD components should be constructively examined.

Environmental Exposure to Lead, Vanadium, Copper and Selenium: Possible Implications in the Development of Autism Spectrum Disorders

Human exposure to toxic metals is on the increase especially in the developing world;this is compounded by the almost unavoidable application of the metals domestically and industrially and their implication in several genetic defects, aging and some chronic illnesses including Autism Spectrum Disorders (ASD). This study investigated the concentration of toxic metals (Pb and V) and micro-essential elements (Cu and Se) in children with ASD and controls in Nigeria towards establishing their possible associations with the aetiopathogenesis of ASD. Eight children clinically diagnosed by Paediatric Neurologist and Child Psychiatrist for ASD using DMS-IV and fifteen apparently healthy children (age range 2 - 12 years) were recruited as cases and controls respectively. Plasma levels of Pb, V, Cu and Se were analyzed using Induction ICP-MS. Results were analyzed using students t-test. The mean plasma lead and vanadium levels were (7.92 ± 1.30 μg/dl;1.07 ± 0.22 μg/dl) and (6.83 ± 0.72 μg/dl;2.59 ± 0.48 μg/dl) in children with ASD and in controls respectively. The result showed that blood lead level in ASD was slightly increased but not significant when compared with control (p < 0.433). On the other hand, plasma vanadium concentration in ASD was significantly reduced (1.07 ± 0.22 μg/dl) when compared with control (2.59 ± 0.48 μg/dl) (P < 0.038). Mean plasma copper was similar in all participants (1.98 ± 0.13, 2.23 ± 0.12) but selenium concentrations were significantly reduced (0.37 ± 0.05 mg/L;0.57 ± 0.02 mg/L) in ASD relative to controls respectively. Given the physiological functions of vanadium and selenium, the observed reduced levels of the two elements in children with ASD may account for the speech and other neurological dysfunctions of the brain in ASD.

Effects of COVID-19 on children with autism

The coronavirus disease 2019(COVID-19)pandemic affects all countries and populations worldwide,significantly impacting people with autism with a high risk of morbidity and mortality due to COVID-19.Approximately 25%of children with autism have an asymptomatic or symptomatic immune deficiency or dysfunction.In addition,they frequently have various comorbid conditions that increase the severity of COVID-19.In addition,severe COVID-19 during pregnancy may increase the risk of autism in the offspring.Furthermore,severe acute respiratory syndrome coronavirus 2 could target human nervous system tissues due to its neurotrophic effects.The COVID-19 pandemic intensely impacts many patients and families in the autism community,especially the complex management of autism-associated disorders during the complete lockdown.During the complete lockdown,children with autism had difficulties coping with the change in their routine,lack of access to special education services,limited physical space available,and problems related to food and sleep.Additionally,children with autism or intellectual disabilities are more liable to be abused by others during the pandemic when the standard community supports are no longer functioning to protect them.Early detection and vaccination of children with autism against COVID-19 are highly indicated.They should be prioritized for testing,vaccination,and proper management of COVID-19 and other infectious diseases.In this review,we discuss the various effects of COVID-19 on children with autism,the difficulties they face,the increased risk of infection during pregnancy,how to alleviate the impact of COVID-19,and how to correct the inequalities in children with autism.

Motor abilities of children and adolescents with a psychiatric condition:A systematic literature review

AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition.METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders(ASD), attention deficit hyperactivity disorder(ADHD), disruptive behavior disorders(DBD) and depression, a comprehensive systematic literature search was carried out using Pub Med, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder(ASD, ADHD, DBD, depression) in conjunction with each of the following keywords:(psycho/perceptuo) motor/movement skill(s),(psycho/perceptuo) motor/movement abilities,(psycho/perceptuo) motor/movement impairment,(psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression. Furthermore, methodological problems, such as measurement and comorbidity issues, complicate the generalization of the findings. CONCLUSION: Research suggests that motor impairment is highly prevalent in some psychiatric conditions, particularly ASD and ADHD. However, future work is necessary to draw sound conclusions.

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.

孤独症谱系障碍RUBI-PT方案的改编及适应性调查

目的·探究“行为干预研究单位孤独症网络家长培训”[the Research Units in Behavioral Intervention(RUBI)Autism Network Parent Training,RUBI-PT]方案的中国本土化改编并对其适应性进行调查。方法·按照文化改编的4个步骤对RUBI-PT方案进行改编,包括信息收集、初步改编设计、初步改编测试、进一步调整。信息收集阶段邀请了6位儿科专家和2位心理治疗师进行6次焦点小组访谈,并根据专家意见从语言、治疗形式、治疗设置等方面对RUBI-PT方案进行初步改编;初步改编测试阶段招募了16位孤独症谱系障碍(autism spectrum disorder,ASD)患儿的家长,分2批参加线上RUBI-PT,结束后收集项目反馈问卷并行适应性调查分析,最后根据测试结果进行方案的进一步调整。结果·RUBI-PT的初步改编方案由个体培训调整为团体培训,包含8次核心技能课程,采用线上会议形式实施。初步测试结果显示,家长对于上课进度、上课过程、课后作业完成情况、作业点评情况的满意度分别为90%、80%、100%和100%;课程难度方面,第7次课(功能性沟通训练)和第8次课(教授技能)的难度最大。依据上述调查结果和专家小组意见完成进一步调整,最终形成本土化RUBI-PT的改编方案。结论·经过改编和适应性调查,形成了适用于中国ASD儿童家庭的家长行为训练策略即RUBI-PT。