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.

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.

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。

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.

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.

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.

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.

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。

基于RepNet的自闭症健康监测方法研究

自闭症谱系障碍(ASD)患者在社交互动、语言交流和兴趣等方面表现出正常行为的偏差。随着自闭症患者数量的增加,迫切需要在早期进行自闭症筛查,以尽早提供专业治疗。目前自闭症筛查主要仰赖家长填写调查问卷和医疗专业人员进行人工观察和评估,这种方式效率较低且需要耗费较长的时间。机器算法在自闭症筛查领域的应用尚未得到广泛采纳。为提高筛查效率和准确性,探讨机器视觉算法RepNet在识别自闭症患者重复动作方面的有效性,使用RepNet算法分析包含重复性和非重复性动作的视频,评估Repnet的准确性;通过分析包含自闭症患儿重复动作的视频,评估RepNet在自闭症重复性动作筛查中的准确性和匹配性。结果表明:RepNet在检测自闭症患者的重复行为方面表现出极高的有效性和准确性。

人际同步对孤独症儿童合作行为的影响及干预促进

合作是人类行为的核心,也是儿童社会性发展的重要体现。孤独症儿童因神经生理、时间同步以及运动能力等缺陷,导致其在社会交往中合作能力不足。研究发现,人际同步可促进儿童的合作行为。通过人际同步干预,孤独症儿童的联合注意、积极情绪及运动技能等与合作相关的能力获得改善,神经系统得到激活,社会适应能力也有所提高。人际同步干预目前仍在同步机制、感知互动质量等方面存在局限性,未来除了关注同步形式、节奏频率及个体差异等变量对孤独症儿童合作行为的作用机制外,还应关注他们在复杂开放式社交场景中的感知互动质量。

推拿不同部位对孤独症谱系障碍模型鼠行为学及肠道菌群的影响

目的探究不同部位的推拿对丙戊酸(VPA)诱导的孤独症谱系障碍(ASD)模型鼠行为学和肠道菌群的影响。方法将20只怀孕12.5天的Sprague Dawley(SD)雌性大鼠随机分为VPA模型组[腹腔注射VPA(600 mg/kg),n=15]和生理盐水组(腹腔注射等量生理盐水,n=5)。将注射生理盐水的子代雄鼠作为对照组,将注射VPA的子代雄鼠随机分为VPA组、背部组和腹部组(n=7)。在出生后第21天,通过三箱社交、旷场实验和埋珠实验观察四组大鼠的社交能力、焦虑行为和刻板行为,并开始对背部组和腹部组进行推拿,每天2次,持续14天。第35天,再次进行行为学检测,并取肠道内容物进行物种组成与结构分析、标志物种与差异物种分析。结果(1)行为学结果显示,与VPA组相比,背部组大鼠社交时间和旷场中心区运动时间显著增加(P<0.05),埋珠数量明显减少(P<0.01),说明其社交、焦虑和刻板行为得到改善;与VPA组相比,腹部组大鼠埋珠数量显著减少(P<0.05),刻板行为改善;埋珠实验中,背部组较腹部组埋珠数量更少,刻板行为改善更显著(P<0.05),而三箱社交和旷场实验两组结果无显著差异(P>0.05)。(2)肠道微生物检测结果显示,在多样性分析中,与VPA组相比,背部组和腹部组肠道菌群丰富度显著增加(P<0.05),多样性增加(背部组P<0.05,腹部组P<0.01);在差异性分析中,在门水平上,与VPA组相比,腹部组厚壁菌门相对丰度呈现较为明显的降低趋势(P<0.05);在属水平上,与VPA组相比,背部组和腹部组的乳杆菌属相对丰度较VPA组显著下降(P<0.05);标志物种分析中,与VPA组相比,背部组布劳特氏菌属显著增加(P<0.05)。结论推拿能对ASD模型大鼠行为学和肠道菌群结构产生影响;推拿背部对ASD模型鼠的社交能力、焦虑行为和刻板行为疗效显著,推拿腹部仅对刻板行为有明显效果;推拿背部与推拿腹部均使ASD模型鼠肠道菌群丰富度和多样性增加,其中推拿腹部对肠道微生物多样性的改善更显著,并使物种分布更均匀。

与众不同:孤独症儿童的内感受特征

内感受指对自己身体内部状态及器官的感知,而非对外部刺激的感知(如视觉、听觉、触觉、味觉和嗅觉)。为探讨孤独症儿童的内感受特征,采用了心跳追踪任务,对比孤独症儿童与典型发育儿童内感受准确性的差异。结果显示,孤独症儿童的内感受呈现出独特模式,孤独症儿童在长时程的心跳追踪任务中表现出更稳定的内感受特征,这一特征可能与孤独症的社交障碍存在关联,为后续从内感受的角度深入探讨孤独症成因与干预手段提供了新的实证依据。

前庭刺激对自闭症谱系障碍儿童语言障碍的疗效分析

本研究将前庭刺激与常规语言训练相结合,观察评价其对自闭症谱系障碍(Autism Spectrum Disorder,ASD)儿童语言障碍的影响。研究选取60例ASD且伴有语言障碍的儿童,随机分为对照组(n=30)和实验组(n=30)。对照组给予常规语言训练,实验组在对照组的基础上接受前庭刺激治疗(利用宇航员旋转板及Bobath球),每次训练均在治疗师的指导下进行。分别于治疗前、治疗8周后对2组患儿的自闭症儿童行为量表(Autism Behavior Checklist,ABC)语言障碍评分和儿童语言发育迟缓检查法(Sign-Significant relations,S-S法)评级结果进行评价分析。结果表明:治疗8周后,2组患儿ABC语言障碍评分较治疗前降低,S-S法评级较治疗前提高,实验组疗效明显优于对照组(P<0.05)。综上可知,前庭刺激联合常规语言训练对改善ASD儿童语言障碍的效果较单纯常规语言训练更为显著。

ASD儿童父母的亲职压力及心理影响因素研究

目的探讨孤独症谱系障碍（ASD）儿童父母的亲职压力及心理影响因素。方法选取2014至2015年由福建省福州儿童医院心理科和福建医科大学附属协和医院儿童神经专科高年资主治以上医师确诊、并其父母完成问卷调查的ASD儿童134例,采用亲职压力指标简表（包括父母困扰、亲子失功能及困难儿童3个分量表）、一般自我效能感量表、特质应对方式问卷对134名ASD儿童父母（实验组）进行调查,同时对115名正常儿童父母（对照组）施测,对结果进行分析。结果实验组亲职压力总分及各维度得分均高于对照组（t=8.40～9.95,P〈0.05）;实验组一般自我效能感低于对照组（t=-6.61,P〈0.05）,且采用更多的消极应对方式和更少的积极应对方式（t值分别为6.39、-4.72,P〈0.05）。相关分析显示：ASD儿童父母的亲职压力与消极应对呈正相关（r=0.328,P〈0.01）,ASD儿童父母的亲职压力总分、父母困扰及困难儿童得分与患儿父母一般自我效能感均呈负相关（r值分别为-0.222、-0.251、-0.177,P〈0.05）。结论 ASD儿童父母普遍存在较高水平的亲职压力,其亲职压力与家长的一般自我效能感及消极应对方式有关。

CI-WGAN:融合临床指标和WGAN的孤独症个体化脑功能连接网络生成

脑功能连接(Functional connectivity,FC)网络作为潜在的脑影像标志物对孤独症谱系障碍(Autism spectrum disorder,ASD)的辅助诊疗研究具有重要作用。然而现有的FC生成方法大多仅基于脑影像数据,未充分考虑个体的临床指标从而易丢失疾病的特异性信息。而且,ASD作为一种谱系障碍,其临床指标存在显著的个体化差异。因此,仅基于脑影像数据的传统生成模型在生成准确的且能反映个体化临床指标的ASD个体FC的任务上存在挑战。针对上述挑战,提出了个体化临床指标引导的沃瑟斯坦生成对抗网络模型(Clinical-indicator-aware Wasserstein generative adversarial network,CI-WGAN),用于生成孤独症个体化FC网络。该模型引入个体化临床指标引导机制,实现了高精度ASD患者FC网络的生成。基于全世界最大孤独症脑影像公开数据集之一的ABIDE I数据集进行实验,CI-WGAN生成FC与真实FC的峰值信噪比(Peak signal-to-noise ratio,PSNR)、结构相似度(Structural similarity,SSIM)与平均绝对误差(Mean absolute error,MAE)分别达到19.037、0.236与0.178,相较于其他FC生成模型分别提升了3%、12%与2%。此外基于生成FC和独立临床验证指标的表征相似度分析(Representational similarity analysis,RSA),CI-WGAN生成的FC相较其他模型生成FC最少提高了0.1倍和3.7倍,证明了CI-WGAN生成的FC包含更多的ASD个体特异性信息。本文提出的CI-WGAN模型实现了高质量个体化FC的生成,为ASD的早期诊断和个性化治疗提供了有力的技术支持。

孤独症谱系障碍群体的社会融合保障措施探究

近年来,孤独症谱系障碍(Autism Spectrum Disorder,以下简称ASD,俗称自闭症)的发病率呈逐年上升趋势,已成为全球关注的公共卫生问题。我国就儿童孤独症筛查出台了相应的干预服务规范,但这仅仅是医学治疗与干预的基础,面对ASD群体须回归社会的本质生存需求,因而促进此类群体从学校到社会这一过渡衔接阶段的社会融合迫在眉睫;就此须确立对该类群体症状情况相适宜的评级制度,并多角度论证其必要性,以之为基础探寻ASD群体社会融合的保障措施,且在保险制度和社会支持的辅助下,提高ASD群体家庭成员的法律意识,实现ASD群体的社会融合。

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.

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.

孤独症谱系障碍儿童的睡眠问题及其相关因素研究

目的:研究孤独症谱系障碍(autism spectrum disorder,ASD)儿童的睡眠问题与其相关因素,为ASD共患睡眠问题的儿童提供防治依据。方法:选取2019年7月-2022年12月就诊于佛山市妇幼保健院儿童保健科的84例ASD儿童(ASD组),和同地区同时期84例年龄匹配的正常儿童进行对比。收集两组儿童的社会人口学资料调查表和儿童睡眠习惯问卷(children’s sleep habits questionnaire,CHSQ),通过t检验或卡方检验对两组儿童的基本情况及睡眠情况进行比较,再通过logistic回归分析模型对ASD儿童的睡眠情况相关因素进行分析。结果:ASD组儿童和对照组儿童存在睡眠问题的检出率分别为91.7%和81.0%,两者差异具有统计学意义(P≤0.05),说明ASD组的睡眠问题检出率更高。ASD组在CHSQ总分、异态睡眠、日间嗜睡方面评分高于对照组,且两组差异具有统计学意义(P值均≤0.05),说明ASD组儿童存在睡眠问题更多,特别是在异态睡眠和日间嗜睡方面。logistic分析结果显示,母亲孕期补充维生素D有益于改善ASD儿童的睡眠问题(OR=0.01,P≤0.05)。结论:ASD儿童相比于正常儿童更可能出现睡眠问题,母亲孕期是否补充维生素D可能与ASD儿童存在睡眠问题相关。