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 v...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.展开更多
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 ...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.展开更多
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 understandi...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.展开更多
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 surveil...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.展开更多
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 ch...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.展开更多
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 ...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.展开更多
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 severa...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.展开更多
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 childr...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.展开更多
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...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.展开更多
Background Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and behavioral changes.Autism spectrum diso...Background Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and behavioral changes.Autism spectrum disorder(ASD)is a neurodevelopmental disorder characterized by deficits in communication and social interaction and by repetitive and restricted patterns of behavior,interests and activities.The aim of this review is to discuss the clinical features of the differential diagnoses of ASD that are prevalent among preschoolers,focusing on their similarities and disparities.Data sources The international medical literature search was conducted using PubMed and was revised regarding the subject using single and/or combined keywords as follows:differential diagnosis,preschoolers,diagnostic challenge,attention deficit hyperactivity disorder,intellectual disability,high abilities/giftedness,childhood apraxia of speech,social communication disorder,Landau–Kleffner syndrome,stereotyped movement disorder and excessive screen time.Results We describe conditions commonly found in clinical practice,taking ASD as a reference.We addressed converging and divergent aspects of behavior,cognition,communication,language,speech,socialization,and stereotypes for the diagnosis of ASD and other disorders identified as potential differential or comorbid diagnoses.Conclusions The ranking and characterization of symptoms appear to be essential for better understanding the underlying common ground between children with developmental disorders and children with ASD,thus properly diagnosing and directing social,professional,or medication interventions.This detailed discussion adds to the literature since,although ASD differential diagnoses are frequently mentioned and discussed in textbooks and journal articles,they rarely occupy a prominent place as we aimed herein.展开更多
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 c...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.展开更多
Background: Autism spectrum disorder is a condition that affects all races, ethnic and socioeconomic groups. With a high incidenee ratio of one in every 68, it has become one of the most discussed psychiatric disorder...Background: Autism spectrum disorder is a condition that affects all races, ethnic and socioeconomic groups. With a high incidenee ratio of one in every 68, it has become one of the most discussed psychiatric disorders. For this reason, the need for investigating novel treatments has been emerging. Qigong, a traditional Chinese mind-body technique, has already proven to be able to reduce symptoms of several physical and psychological illnesses. Objective: The purpose of this systematic review is to examine and categorize the current scientific evidence regarding the efficacy of Qigong on children suffering from autism spectrum disorders. Search strategy: A systematic literature search of the electronic scientific databases PubMed, Clinical Trials.gov, BioMed Central, PubMed Central and Google Scholar was performed to identify studies of Qigong in the treatment of children with autism spectrum disorder. Inclusion criteria: This review included randomized controlled trials, replication studies, retrospective studies and observational follow-up studies of Qigong on children with autism spectrum disorder. Case reports and case series were excluded. Data extraction and analysis: Two researchers independently evaluated the methodological quality of all included studies. Any discrepancies were solved by discussion until consensus was achieved. Results: Our literature search identified 157 publications, and 10 additional publications from hand search of references. After duplicate removal, 103 records remained. After the title/abstract screening, 19 publications were obtained for detailed evaluation. After detailed evaluation, 10 studies were included. Seven studies were conducted with small children with 2-6 years old employing Qigong massage, and three studies were con ducted with older children aged 7-17 years old applying both Qigong massage (one study) and Neigong (two studies). Conclusion: Studies demonstrated that Qigong has interesting and promising applicability and effect on children with autism spectrum disorder and should be tested further. Despite the need for more rigorous controlled studies, Qigong seems to be able to decrease severity of individual sensory, behavioural, and language components of autism, and improve self-control, sociability, sensory and cognitive awareness as well as healthy-physical behaviour. Besides positive effect on children and adolescents, benefits seem to extend to parents and caregivers as well. However, quality of methodology seems to be insufficient to state that Qigong is an alternative to common behavioural therapies. We suggest that, until more investigation is performed, Qigong may only be used as a complement, or when behavioural therapies are not accessible.展开更多
Searching for effective biomarkers is one of the most challenging tasks in the research ?eld of Autism Spectrum Disorder(ASD). Magnetic resonance imaging(MRI) provides a non-invasive and powerful tool for investi...Searching for effective biomarkers is one of the most challenging tasks in the research ?eld of Autism Spectrum Disorder(ASD). Magnetic resonance imaging(MRI) provides a non-invasive and powerful tool for investigating changes in the structure, function, maturation,connectivity, and metabolism of the brain of children with ASD. Here, we review the more recent MRI studies in young children with ASD, aiming to provide candidate biomarkers for the diagnosis of childhood ASD. The review covers structural imaging methods, diffusion tensor imaging, resting-state functional MRI, and magnetic resonance spectroscopy. Future advances in neuroimaging techniques, as well as cross-disciplinary studies and largescale collaborations will be needed for an integrated approach linking neuroimaging, genetics, and phenotypic data to allow the discovery of new, effective biomarkers.展开更多
文摘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.
文摘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.
文摘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.
基金This study was supported by Emergency Technology Research Project of Huazhong University of Science and Technology(No.2020kfyXGYJ020).
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
基金We thank the editors and the anonymous referees for their valuable suggestions.
文摘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.
基金Partial financial support was received from FAEPA(fundação de apoio ao ensino,pesquisa e assistência,grant no.490/2021)HCFMRP-USP,Brazil.
文摘Background Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and behavioral changes.Autism spectrum disorder(ASD)is a neurodevelopmental disorder characterized by deficits in communication and social interaction and by repetitive and restricted patterns of behavior,interests and activities.The aim of this review is to discuss the clinical features of the differential diagnoses of ASD that are prevalent among preschoolers,focusing on their similarities and disparities.Data sources The international medical literature search was conducted using PubMed and was revised regarding the subject using single and/or combined keywords as follows:differential diagnosis,preschoolers,diagnostic challenge,attention deficit hyperactivity disorder,intellectual disability,high abilities/giftedness,childhood apraxia of speech,social communication disorder,Landau–Kleffner syndrome,stereotyped movement disorder and excessive screen time.Results We describe conditions commonly found in clinical practice,taking ASD as a reference.We addressed converging and divergent aspects of behavior,cognition,communication,language,speech,socialization,and stereotypes for the diagnosis of ASD and other disorders identified as potential differential or comorbid diagnoses.Conclusions The ranking and characterization of symptoms appear to be essential for better understanding the underlying common ground between children with developmental disorders and children with ASD,thus properly diagnosing and directing social,professional,or medication interventions.This detailed discussion adds to the literature since,although ASD differential diagnoses are frequently mentioned and discussed in textbooks and journal articles,they rarely occupy a prominent place as we aimed herein.
文摘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.
文摘Background: Autism spectrum disorder is a condition that affects all races, ethnic and socioeconomic groups. With a high incidenee ratio of one in every 68, it has become one of the most discussed psychiatric disorders. For this reason, the need for investigating novel treatments has been emerging. Qigong, a traditional Chinese mind-body technique, has already proven to be able to reduce symptoms of several physical and psychological illnesses. Objective: The purpose of this systematic review is to examine and categorize the current scientific evidence regarding the efficacy of Qigong on children suffering from autism spectrum disorders. Search strategy: A systematic literature search of the electronic scientific databases PubMed, Clinical Trials.gov, BioMed Central, PubMed Central and Google Scholar was performed to identify studies of Qigong in the treatment of children with autism spectrum disorder. Inclusion criteria: This review included randomized controlled trials, replication studies, retrospective studies and observational follow-up studies of Qigong on children with autism spectrum disorder. Case reports and case series were excluded. Data extraction and analysis: Two researchers independently evaluated the methodological quality of all included studies. Any discrepancies were solved by discussion until consensus was achieved. Results: Our literature search identified 157 publications, and 10 additional publications from hand search of references. After duplicate removal, 103 records remained. After the title/abstract screening, 19 publications were obtained for detailed evaluation. After detailed evaluation, 10 studies were included. Seven studies were conducted with small children with 2-6 years old employing Qigong massage, and three studies were con ducted with older children aged 7-17 years old applying both Qigong massage (one study) and Neigong (two studies). Conclusion: Studies demonstrated that Qigong has interesting and promising applicability and effect on children with autism spectrum disorder and should be tested further. Despite the need for more rigorous controlled studies, Qigong seems to be able to decrease severity of individual sensory, behavioural, and language components of autism, and improve self-control, sociability, sensory and cognitive awareness as well as healthy-physical behaviour. Besides positive effect on children and adolescents, benefits seem to extend to parents and caregivers as well. However, quality of methodology seems to be insufficient to state that Qigong is an alternative to common behavioural therapies. We suggest that, until more investigation is performed, Qigong may only be used as a complement, or when behavioural therapies are not accessible.
文摘Searching for effective biomarkers is one of the most challenging tasks in the research ?eld of Autism Spectrum Disorder(ASD). Magnetic resonance imaging(MRI) provides a non-invasive and powerful tool for investigating changes in the structure, function, maturation,connectivity, and metabolism of the brain of children with ASD. Here, we review the more recent MRI studies in young children with ASD, aiming to provide candidate biomarkers for the diagnosis of childhood ASD. The review covers structural imaging methods, diffusion tensor imaging, resting-state functional MRI, and magnetic resonance spectroscopy. Future advances in neuroimaging techniques, as well as cross-disciplinary studies and largescale collaborations will be needed for an integrated approach linking neuroimaging, genetics, and phenotypic data to allow the discovery of new, effective biomarkers.