Exploring Strategies of Incorporating Multicultural Values in the Teaching and Learning Process at an Inclusive Primary School in North Bali

Multiscale entropy (MSE) model quantifies the complexity of brain functions by measuring the entropy across multiple time-scales. Although MSE model has been applied in children with Autism spectrum disorders (ASD) in previous studies, they were limited to distinguish children with ASD from those normally developed without corresponding severity level of their autistic features. Therefore, we aims toexplore and to identify the MSE features and patterns in children with mild and severe ASD by using a high dense 64-channel array EEG system. Thisstudy is a cross-sectional study, where 36 children with ASD were recruited and classified into two groups: mild and severe ASD (18 children in each). Three calculated outcomes identified brain complexity of mild and severe ASD groups: averaged MSE values, MSE topographical cortical representation, and MSE curve plotting. Averaged MSE values of children with mild ASD were higher than averaged MSE value in children with severe ASD in right frontal (0.37 vs. 0.22, respectively, p=0.022), right parietal (0.31 vs. 0.13, respectively, p=0.017), left parietal (0.37 vs. 0.17, respectively, p=0.018), and central cortical area (0.36 vs. 0.21, respectively, p=0.026). In addition, children with mild ASD showed a clear and more increase in sample entropy values over increasing values of scale factors than children with severe ASD. Obtained data showed different brain complexity (MSE) features, values and topographical representations in children with mild ASD compared with those with severe ASD. As a result of this, MSE could serve as a sensitive method for identifying the severity level of ASD.

This study aims to develop an English-speaking skills assessment rubric for children with autism spectrum disorder (ASD) using the Universal Design for Learning (UDL) approach in an inclusive school setting. The research involved 24 regular students and one student with mild ASD in the 7th grade at Sekolah Alam Bekasi, offering a comparison framework. However, children with ASD have unique cognitive, social, and communication needs that differ from neurotypical students. Comparisons must therefore be approached carefully, considering these differences. The study followed Borg & Gall's Research and Development (R&D) model, starting with a needs analysis, followed by product design, expert validation, product revision, and limited testing. Data was gathered through questionnaires, interviews, and documentation. The needs analysis revealed that both teachers and parents require a flexible, inclusive, and ASD-sensitive assessment tool, especially for evaluating verbal and non-verbal communication skills. The resulting rubric is based on the three UDL principles: Multiple Means of Engagement, Representation, and Action and Expression, with specific, measurable, and context-appropriate indicators. Content validation by three experts in special education, language assessment, and inclusive pedagogy produced Aiken’s V values between 0.85 and 0.95, indicating strong validity. A limited trial with five students with ASD demonstrated the rubric’s effectiveness in assessing individual speaking abilities and guiding teachers in providing adaptive interventions. By incorporating both verbal and non-verbal aspects like gestures and eye contact, the rubric offers a fairer and more holistic assessment for students with ASD.

ABSTRACTObjectives:The aim of this study was to evaluate toothbrushing effectiveness in children with mild and moderate levels of severity of autism spectrum disorder (ASD) after using visual pedagogy.Materials and Methods:This quasi-experimental study was carried out with 30 children with ASD aged 5–17 years; 21 had mild ASD and 9 had moderate ASD. Informed consent and the subject’s demographic information were obtained from caregivers. All subjects were then asked to show their toothbrushing practices, which were recorded by video. The toothbrushing ability, toothbrushing cooperation, and plaque index were evaluated before the study and at 2 weeks, 4 weeks, 3 months, and 6 months after visual pedagogy had been used. Results were analyzed by the Friedman test, Pearson’s chi-square test, Fisher’s exact test, and Mann‒Whitney U test.Results:Toothbrushing ability was significantly improved at all periods of follow-up. Toothbrushing cooperation and the dental plaque index were significantly better than before the study at 4 weeks, 3 months, and 6 months of follow-up. The toothbrushing ability of subjects with mild ASD was significantly better than that of subjects with moderate ASD at 4 weeks and 6 months of follow-up. The toothbrushing cooperation of the mild group was significantly better than that of the moderate group at 2 weeks, 4 weeks, and 3 months. There was no statistically significant reduction in the plaque index between the two groups.Conclusion:Visual pedagogy is useful for improving toothbrushing effectiveness in children with mild or moderate severity ASD. However, children with moderate severity ASD take longer to improve.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with unknown etiology, high clinical heterogeneity and marked aberrations of the immune system. Evidence for an association between immune dysfunction and behavioral traits highlights the need for a study of the immune cell functional activity in order to search for pathogenesis mechanisms and potential targets for therapy at ASD. The purpose: to determine the expression levels of IL-1β, IL-2, IL-4, IL-6, IL-10, IL-18, IFNγ and TNFα in peripheral blood leukocytes of children with mild and severe ASD. The study included 81 children with ASD (77.8% boys) and 45 children with typical neurodevelopment (TDC, 71.1% boys). According to the Childhood Autism Rating Scale, 51 children (63.0%) had mild autistic symptoms (CARS score 32.0±1,5) and 30 children had severe ASD symptoms (CARS score 39.0±3,4). Cytokines expression in leukocytes was determined by quantitative PCR with SYBRGreen. The data were transformed using Box–Cox transformation. The differences between groups were assessed by one-way ANOVA and Dunn’s test for multiple comparisons. In leukocytes of children with ASD, regardless of the severity, the expression of IL-1β, IL-18 and IL-2, was significantly reduced compared to TDC. Moreover, in children with mild ASD, low expression of TNFα, compared with TDC was found. In children with severe ASD, the expression of the main cytokine of Th1 – IFNγ, was significantly increased, without an increased expression of an important cytokine of Treg – IL-10. Activation of the Th1 adaptive immune response without compensation by cytokines of Treg, the number of which is reduced in ASD, can lead to increased inflammation, even in the central nervous system, and correlates with the severity of ASD clinical symptoms. Despite extensive immunological evidence suggesting immune system dysregulation, further research is required to clarify the relationship between immune system cell function and ASD pathology.

Students with ASD have obvious characteristics that they have limitations in making communication and have low social awareness. For that reason, they need to be supported on how they can improve their communication ability. This research aimed to describe how the social environment is empowered and created to help students with ASD learn to communicate. The study's design was a multi-case study conducted in an inclusive school in North Bali. Three cases of students with ASD with their teachers, the school principal, and a technical assistant were involved as the study's subjects. The data were collected for 12 months and analyzed qualitatively. The study results show that several types of social environments were modified to teach students about basic communications such as morning circles, cooperative buddy programs, sensory garden programs, modelling, and go-play activities. The use of the programs functions as scaffolding, which then indicates improvements in the students ' social interactions and basic communication. The implication of this study suggests the importance of creating a supportive social environment program for students with ASD to enhance their social awareness and interaction.Students with ASD have obvious characteristics that they have limitations in making communication and have low social awareness. For that reason, they need to be supported on how they can improve their communication ability. This research aimed to describe how the social environment is empowered and created to help students with ASD learn to communicate. The study's design was a multi-case study conducted in an inclusive school in North Bali. Three cases of students with ASD with their teachers, the school principal, and a technical assistant were involved as the study's subjects. The data were collected for 12 months and analyzed qualitatively. The study results show that several types of social environments were modified to teach students about basic communications such as morning circles, cooperative buddy programs, sensory garden programs, modelling, and go-play activities. The use of the programs functions as scaffolding, which then indicates improvements in the students ' social interactions and basic communication. The implication of this study suggests the importance of creating a supportive social environment program for students with ASD to enhance their social awareness and interaction.

ABSTRACTBackground:Intellectual disability (ID) and autism spectrum disorder (ASD) are often concomitant childhood developmental disorders. These disorders can alter family quality of life (FQoL).Objective:To investigate FQoL among families who have children with mild ID, associated with mild ASD.Methods:Cross-sectional descriptive study with 69 families who have children with mild ID and ASD, ranging from six to 16 years old, and who were provided with disability-related services in Brazil. Data were collected using a family sociodemographic questionnaire, an ID and ASD personal profile form, the Barthel index for activities of daily living and the Beach Center FQoL scale.Results:People with ID and ASD had an average score of 88.2±11.5 in the Barthel index, thus indicating moderate dependency in basic activities of daily living. The average total FQoL score (3.56±0.34) was lower than the scores for the “family interaction” (3.91±0.42; p<0.001), “parenting” (3.79±0.35; p<0.001) and “disability-related support” (3.98±0.16; p<0.001) domains; and higher than the scores for the “physical/material well-being” (3.19±0.64; p<0.001) and “emotional wellbeing” (2.75±0.62; p<0.001) domains. Parents’ marital condition, monthly family income, family religious practice and effective communication skills among the people with ID and ASD were predictors for FQoL (R2=0.407; p<0.001).Conclusions:FQoL was sustained through factors such as family interaction and parents’ care for their children. Improving families’ emotional wellbeing and physical and material conditions is likely to positively affect the FQoL of these families.

This research aims to investigate strategic management related to literacy learning implemented by inclusive primary schools in Malang, covering (1) The formulation of vision and mission; (2) analysis of the internal and external environment that influences; (3) determination of goals, targets, and strategies; and (4) results and evaluation of the implementation of strategic management of literacy learning on reading, writing, and reading comprehension skills for students in inclusive elementary schools. Three inclusive primary schools in Malang were used for the qualitative method of this study. The principal of the school, the vice principal in charge of the curriculum and the teachers are the research subjects. Observations, interviews, and documentation shall be used for the collection of data. Data extraction, data presentation and conclusions are used to carry out the analysis. The results of the study indicate that (1) the development of literacy learning activities in inclusive schools is based on the development of a vision and mission, (2) the internal and external factors in inclusive primary schools have an impact on the development of literacy learning activities, (3) goals, objectives, and strategies for literacy learning in inclusive primary schools have been tailored to the diverse levels and needs of students, and (4) the results and evaluation of the implementation of literacy learning in inclusive primary schools enhance students' reading, writing, and comprehension skills through regular and systematic execution and evaluation.

Childhood autism spectrum disorder (ASD) can easily be misdiagnosed, due to the nonspecific social and communicational deficits associated with the disorder. The present study attempted to profile the mental development and visual attention toward emotion among preschool children with mild or moderate ASD who were attending mainstream kindergartens. A total of 21 children (17 boys and 4 girls) diagnosed with mild or moderate ASD selected from 5,178 kindergarteners from the Xi’an city were recruited. Another group of 21 typically developing (TD) children who were matched with age, gender, and class served as controls. All children were assessed using the Griffiths Mental Development Scales–Chinese (GDS-C), and their social visual attention was assessed during watching 20 ecologically valid film scenes by using eye tracking technique. The results showed that ASD children had lower mental development scores in the Locomotor, Personal-Social, Language, Performance, and Practical Reasoning subscales than the TD peers. Moreover, deficits in recognizing emotions from facial expressions based on naturalistic scene stimuli with voice were found for ASD children. The deficits were significantly correlated with their ability in social interaction and development quotient in ASD group. ASD children showed atypical eye-gaze pattern when compared to TD children during facial emotion expression task. Children with ASD had reduced visual attention to facial emotion expression, especially for the eye region. The findings confirmed the deficits of ASD children in real life multimodal of emotion recognition, and their atypical eye-gaze pattern for emotion recognition. Parents and teachers of children with mild or moderate ASD should make informed educational decisions according to their level of mental development. In addition, eye tracking technique might clinically help provide evidence diagnosing children with mild or moderate ASD.

The role of adverse childhood experiences in obesity among adolescents with autism spectrum disorder: National survey of Children’s health 2018-2019

Automated identification for autism severity level: EEG analysis using empirical mode decomposition and second order difference plot

Signes cliniques précoces chez les enfants porteurs d’un TSA léger : description et effet de genre

To investigate the characteristics of attention in school-age children with mild autism spectrum disorder (ASD), and to provide a basis for clinical treatment. A total of 20 school-age children with mild ASD were enrolled, and the intermediate visual and auditory continuous performance test (IVA-CPT) was used to assess their attention. A total of 20 children with attention deficit hyperactivity disorder (ADHD) and 40 healthy children were enrolled as controls. Compared with the normal control group, the ASD group showed significantly lower scores of full scale attention quotient, full scale response control quotient, visual/auditory full scale response control quotient, visual/auditory prudence quotient, auditory perseverance quotient, visual consistency quotient, visual/auditory vigilance quotient, visual attention quotient, visual speed quotient, number of correct visual/auditory reactions, and visual mean reaction time of the second and third phases (P<0.05). Compared with the ADHD group, the ASD group showed significantly higher scores of full scale response control quotient and auditory consistency quotient (P<0.05), as well as significantly lower scores of visual vigilance quotient and visual speed quotient (P<0.05). School-age children with mild ASD have attention deficit mainly manifested as the defect in the ability to focus attention, which is similar to the defect in children with ADHD, but ASD children have a lower degree of attention control impairment compared with children with ADHD. The defect in the ability to focus visual attention is more severe than that in the ability to focus auditory attention, while there is no significant difference between the defects in visual and auditory attention control.

BackgroundPrevious studies indicate vitamin D impacts autism spectrum disorder (ASD), but its relationship with brain function is unclear. This study investigated the association between serum 25-hydroxyvitamin D [25(OH)D] levels and brain function in preschool children with ASD using resting-state functional magnetic resonance imaging (rs-fMRI), and explored correlations with clinical symptoms.MethodsA total of 226 ASD patients underwent rs-fMRI scanning and serum 25(OH)D testing. Clinical symptoms were assessed using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). Patients were categorized into mild and severe groups based on the CARS, and further divided into normal (NVD), insufficient (VDI), and deficient (VDD) serum 25(OH)D levels. Changes in brain function among these groups were analyzed using regional homogeneity (ReHo), with ABC scores used for correlation analysis.ResultsIn mild ASD, ReHo increased in the right postcentral gyrus and left precuneus in the VDI and VDD groups compared to NVD, and decreased in the bilateral middle cingulate gyrus and left superior frontal gyrus in the VDD group compared to VDI. In severe ASD, ReHo decreased in the right middle occipital gyrus and increased in the right insula in the VDI group compared to NVD, and increased in the right superior frontal gyrus in the VDD group compared to VDI. Correlation analysis revealed that in mild ASD, ReHo in the right postcentral gyrus was positively correlated with body and object use scores in the NVD and VDI groups, while ReHo in the right middle cingulate gyrus was negatively correlated with relating scores in the VDD and VDI groups. In severe ASD, ReHo in the right insula was positively correlated with language scores in the NVD and VDI groups.ConclusionsASD patients with lower serum 25(OH)D levels show multiple brain functional abnormalities, with specific brain region alterations linked to symptom severity. These findings enhance our understanding of vitamin D’s impact on ASD and suggest that future research may explore its therapeutic potential.

This study investigated the effects of participating in an educational exercise program on physical fitness and gross motor function (GMF) in adults with varying degrees of autistic spectrum disorder (ASD). The subjects consisted of 35 voluntary male participants between 20 and 29 years of age who were allocated to one of two groups: mild ASD (n=17) group and severe ASD (n=18) group. All selected tests for physical fitness, including body composition and GMF, have been used in previous studies. The results were as follows: first, with the exception of the basal metabolic rate, there were significant differences in the interaction of all other body composition variables. Second, there were significant differences in the interaction of almost all physical fitness variables, except for muscle strength. Finally, although there were significant differences in the interaction of all variables, except the locomotion skill for hopping, there were significant differences in the interaction of all variables of object control skill. Specifically, although the Δ% in the sum of locomotion skill in mild ASD group increased ~19.81%, that of severe ASD group decreased ~4.78%. The Δ% in the sum of object control skill in mild ASD group improved ~29.96%, while that of severe ASD group reduced ~15.2%. In conclusion, it is thought that these results are due to the better understanding of educational exercise and better performance of educational exercise in adults with mild ASD compared to adults with severe ASD.

BackgroundChildren with autism spectrum disorder (ASD) are at increased risk of epilepsy (EP), but distinguishing epileptic seizures from ASD-associated behavior remains a clinical challenge. Although previous studies have reported changes in peripheral immune markers in adults with EP, it remains unclear whether similar immune signatures are present in pediatric patients with both ASD and EP, and more pronounced than in children with ASD alone.MethodsWe conducted an exploratory, prospective, cross-sectional study of children aged 9–14 years with mild ASD, with or without EP, recruited from outpatient settings. Peripheral blood samples were analyzed by enzyme-linked immunosorbent assay for 23 immune proteins and by flow cytometry for leukocyte population counts. Analyses included t-tests / Mann–Whitney U-tests, post hoc tests for multiple comparisons, and effect size / power analyses.ResultsA total of 30 children were included, n = 21 with primarily mild ASD and n = 9 with mild ASD and EP. The epilepsy cases consisted of children with generalized seizures or self-limited epilepsy with centrotemporal spikes. Three immune proteins, Interleukin (IL)-12p70, IL-13 and IL-1β, were significantly increased in the ASD + EP group compared to the ASD-only group. However, the statistical power was low, and group differences did not remain significant after correction for multiple comparisons, even though effect sizes were moderate to large. No differences in the counts of activated leukocyte populations were observed.ConclusionThese findings raise the possibility that immune system alterations may be associated with EP in children with ASD and could potentially aid diagnosis, although larger studies are needed to confirm these findings.