Autism Behavior Checklist Research Articles

Risk factors for developmental quotients in ASD children: A cross-sectional study.

To analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD. We retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent-child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales-Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD. Vitamin D (β = 0.180, p = 0.002), age (β = -0.283, p = 0.000) and CARS score (β = -0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β = -0.503, p = 0.000), ADOS-2 severity score (β = -0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β = -0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β = -0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β = -0.140, p = 0.020), CARS score (β = -0.342, p = 0.000), ADOS-2 severity score (β = -0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD. Vitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.

Acupuncture for children with autism spectrum disorder: A systematic review and meta-analysis.

The aim of this study was to assess the efficiency and safety of acupuncture in core symptomatic improvement of children with autism spectrum disorder (ASD). We searched the following databases: Cochrane Library, PubMed, Embase, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Science and Technology Periodical (VIP) and Chinese Biological Medicine (CBM), from 1 January 2012 to 25 September 2022. The Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Treatment Evaluation Checklist (ATEC) were adopted as outcome indicators. Three reviewers independently assessed the risk of bias (ROB) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)assessment. Utilizing Review Manager (RevMan) 5.3 and Stata 12.0, data were analyzed. A total of 38 trials were included, and 2862 participants participated in qualitative synthesis and meta-analysis. Only 1 trial was assessed as having a low ROB, and 37 trials were assessed as having an overall high ROB. The quality of evidence for most indicators were considered very low by the GRADE criteria. The results showed that acupuncture groups might have a higher clinical effective rate than nonacupuncture groups (relative risk [RR] = 1.33,95% confidence interval [CI] = 1.25-1.41; heterogeneity: x2=18.15, P = .64, I2 = 0%). Regarding changes in ABC scores, the acupuncture groups might exhibit greater decrease than nonacupuncture groups (MMD = -6.06, 95%CI = -7.25 to -4.87, P < .00001; heterogeneity: x2 =73.37, P = .03, I2 = 77%). In terms of changes in CARS score, acupuncture group may benefit more than nonacupuncture group (MMD = -3.93, 95%CI = 4.90 to -2.95, P < .00001; heterogeneity: x2=234.47, P < .00001, I2 = 90%). Additionally, in terms of ATEC score, acupuncture groups showed more benefit than nonacupuncture groups (MMD = -10.24, 95%CI = -13.09 to -7.38, P < .00001; heterogeneity: x2=45.74, P = .04, I2 = 85%). Both subgroup analysis and sensitivity analysis are existing heterogeneity. Only 1 RCT study involved adverse events with mild symptoms that did not interfere with treatment and evaluation. Children with ASD may benefit from acupuncture because of its effectiveness and safety. Nevertheless, given the low quality of the evidence for the assessed outcomes and the high ROB of analyzed trials, the results should be regarded with caution.

Analysis of salivary steroid hormones in boys with autism spectrum disorder

BackgroundAutism spectrum disorders (ASD) is a neurodevelopmental disorder with high incidence rate and difficult diagnosis. The purpose of this study was to explore whether salivary cortisol, dehydroepiandrosterone (DHEA) and pregnenolone can be used as biomarkers of ASD children.MethodsThe saliva samples of 55 boys with ASD were collected as the experimental group, and the saliva samples of 24 neurotypical boys were collected as the control group. The Child Behavior Checklist (CBCL), Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Repetitive Behavior Scale (RBS) were used to assess the severity of symptoms in boys with ASD. Cortisol, DHEA and pregnenolone concentrations in saliva were measured using an ABSSCIEX QTRAP® 6500 + LC/MS/MS system. SPSS 23.0 was used for statistical analysis. Comparisons between the two groups which conform to normal distribution were performed by T-test, and those which don’t conform to normal distribution were performed by Mann–Whitney U test. Correlation analysis between two variables was performed using Spearman's correlation analysis. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the discriminatory sensitivity of each hormone between ASD and normal control groups. Logistic regression models were used to analyze whether DHEA and salivary pregnenolone can be used as a biomarker of ASD.ResultsThere were no significant differences in age, and weight between the ASD group and the normal control group. The ABC, SRS, RBS and CBCL scale scores in the ASD group were significantly higher than those in the normal control group. The salivary DHEA and pregnenolone concentrations in the ASD group were significantly higher than those in the normal control group, but there was no significant difference in cortisol. Spearman's correlation analysis showed that only pregnenolone associated with ABC. Logistic regression model analysis suggested that pregnenolone in saliva was an independent predictor of ASD. ROC analysis found that pregnenolone had good discrimination sensitivity between ASD and normal controls.ConclusionGave salivary preoperative a space for utilization as biomarker as number of cases are limited to this high expectation.

Transcranial Direct Current Stimulation Modulates EEG Microstates in Low-Functioning Autism: A Pilot Study.

Autism spectrum disorder (ASD) is a heterogeneous disorder that affects several behavioral domains of neurodevelopment. Transcranial direct current stimulation (tDCS) is a new method that modulates motor and cognitive function and may have potential applications in ASD treatment. To identify its potential effects on ASD, differences in electroencephalogram (EEG) microstates were compared between children with typical development (n = 26) and those with ASD (n = 26). Furthermore, children with ASD were divided into a tDCS (experimental) and sham stimulation (control) group, and EEG microstates and Autism Behavior Checklist (ABC) scores before and after tDCS were compared. Microstates A, B, and D differed significantly between children with TD and those with ASD. In the experimental group, the scores of microstates A and C and ABC before tDCS differed from those after tDCS. Conversely, in the control group, neither the EEG microstates nor the ABC scores before the treatment period (sham stimulation) differed from those after the treatment period. This study indicates that tDCS may become a viable treatment for ASD.

Potential dynamic regional brain biomarkers for early discrimination of autism and language development delay in toddlers.

The early diagnosis of autism in children is particularly important. However, there is no obvious objective indices for the diagnosis of autism spectrum disorder (ASD), especially in toddlers aged 1-3 years with language development delay (LDD). The early differential diagnosis of ASD is challenging. To examine differences in the dynamic characteristics of regional neural activity in toddlers with ASD and LDD, and whether the differences can be used as an imaging biomarker for the early differential diagnosis of ASD and LDD. Dynamic regional homogeneity (dReHo) and dynamic amplitude of low-frequency fluctuations (dALFF) in 55 children with ASD and 31 with LDD, aged 1-3 years, were compared. The correlations between ASD symptoms and the values of dReHo/dALFF within regions showing significant between-group differences were analyzed in ASD group. We further assessed the accuracy of dynamic regional neural activity alterations to distinguish ASD from LDD using receiver operating characteristic (ROC) analysis. Compared with the LDD group, the ASD group showed increased dReHo in the left cerebellum_8/Crust2 and right cerebellum_Crust2, and decreased dReHo in the right middle frontal gyrus (MFG) and post-central gyrus. Patients with ASD also exhibited decreased dALFF in the right middle temporal gyrus (MFG) and right precuneus. Moreover, the Childhood Autism Rating Scale score was negatively correlated with the dReHo of the left cerebellum_8/crust2 and right cerebellum_crust2. The dReHo value of the right MFG was negatively correlated with social self-help of the Autism Behavior Checklist score. The pattern of resting-state regional neural activity variability was different between toddlers with ASD and those with LDD. Dynamic regional indices might be novel neuroimaging biomarkers that allow differentiation of ASD from LDD in toddlers.

Integrative treatment program for the treatment of children with autism spectrum disorder: A prospective observational case series.

In a situation where conventional treatments for autism spectrum disorder (ASD) are labor-intensive and there are concerns about the side effects of conventional medications, a 6-month integrative treatment program, including herbal medicine (HM), Floortime, and sensory enrichment therapy (SET) has been used on children with ASD in Korean medicine clinical settings. We observed the treatment responses of 18 children with ASD (66.7% male, mean age 3.9 ± 0.9 years) to the integrative treatment program as part of a prospective, single-center, observational case series. Individualized HMs were administered according to the patient's symptoms, and parents were instructed to perform Floortime and SET with their children at home for 2 h and 20 min a day, 5 days a week, respectively. The Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used to evaluate the core symptoms of ASD. A linear mixed model for repeated measures was used for analyzing the effect of the program over time, and logistic regression used to explore the predictors of treatment response. The CARS and ABC scores were significantly improved from 34.58 ± 6.27 and 69.28 ± 15.73 at baseline to 28.56 ± 6.05 and 39.67 ± 20.36 after 6 months (p < 0.0001, respectively). No serious adverse events (AEs) were reported, and compliance with HM, Floortime, and SET was high at >90%. This 6-month integrative treatment program appears to be a potentially effective, safe, and feasible option for children with ASD. Low baseline CARS scores may be predictors of higher treatment response.

A follow-up study of early intensive behavioral intervention program for children with Autism in Syria

We examined the sustained effects of early intensive behavioral intervention (EIBI) on 66 children with autism spectrum disorder who participated in the Future Center’s EIBI program. Children were assessed using the childhood autism rating scale (CARS), autism behavior checklist (ABC), and adaptive behavior scale (ABS-Arabic) 3 years after leaving the program. Continued positive effects were observed in several areas, including adaptive behavior and autism symptoms. However, participants’ social skills might have declined on the ABS-Arabic after service withdrawal. Additionally, a significant negative association (p < .001) was found between participants’ performance on the CARS and the number of weekly trials. This is encouraging, given the lack of EIBI services and regional instability. Future research should increase the sample size and use a more rigorous design.

Low-frequency prefrontal cortex magnetic stimulation improves autism spectrum disorder symptoms: A pilot study

Aim: Autism spectrum disorder (ASD) is a common neurodevelopmental disorder affecting multiple levels of social and cognitive skills and causing a significant health-care burden. Currently, there is no approved treatment for ASD. Methods: In this study, 10 children with ASD between the ages 6 and 19 years (M = 12.3, standard deviation = 3.94) were recruited. Repetitive transcranial magnetic stimulation (rTMS) was applied and symptom severity was measured before and after treatment using the Childhood Autism Rating Scale (CARS) and Autistic Behavior Checklist (ABC). All children received sessions of low-frequency rTMS to the bilateral prefrontal cortices. Results: The results showed that the children improved according to both symptom ratings. Specifically, both the relating (z = −2.02, P < 0.05), body and object use (z = −2.03, P < 0.05) and language (z = −2.21, P < 0.05) subscale scores and the total score of ABC (z = −2.37, P < 0.05) decreased. Regarding CARS, visual response (z = −2.06, P < 0.05), verbal communication (z = −2.12, P < 0.05) subscale scores, and the total score (z = −2.52, P = 0.01) decreased significantly after TMS therapy. Conclusion: Our study was open label and in terms of sample size should be considered a pilot study. Although the results should be evaluated cautiously, the findings suggest that rTMS might be a safe and useful tool for improving deficits related to ASD in children.

Efficacy of Faecal Microbiota Transplantation for the Treatment of Autism in Children: Meta-Analysis of Randomised Controlled Trials.

Evidence-based research methods were applied to assess the efficacy of faecal microbiota transplantation (FMT) for the treatment of autism in children. We searched the Chinese Biomedical Literature, CNKI, Wanfang, PubMed, Embase, Web of Science, and the Cochrane Library databases to collect randomised controlled trials on faecal microbiota transplantation for the treatment of autism in children. The search included studies published from the creation of the respective database to 5 April 2022. Literature screening, data extraction, and quality evaluation were implemented by three investigators according to the inclusion and exclusion criteria. The meta-analysis was performed using the RevMan 5.1 software. Nine studies with population-based subjects and four studies with animal-based subjects were included. Five papers were screened for the meta-analysis. The results showed that FMT markedly reduced Autism Behaviour Checklist (ABC) scores in children with autism spectrum disorder (weighted mean difference (WMD) = -14.96; 95% confidence intervals (CI), -21.68 to -8.24; P < 0.001; I 2 = 0%). FMT also reduced Childhood Autism Rating Scale (CARS) scores (WMD = -6.95; 95% CI, -8.76 to -5.14; P < 0.001; I 2 = 28.1%). Our results indicate that FMT can benefit children with autism by reducing ABC and CARS scores, but more high-quality studies are needed to verify these results.

THE EFFECT OF PLAY ON SOCIAL AND LINGUISTIC SKILLS OF CHILDREN WITH AUTISM SPECTRUM DISORDER

Children who are diagnosed with autism usually have similar problems with linguistic and social skills (making eye contact, starting a dialogue or continuing dialogues…) The main aim of this study is to examine the effect of play in social and linguistic skill development of children diagnosed with Autism Spectrum Disorder (ASD).In this study, 28 structured and semi-structured interviews were conducted with 27 parents in Izmir, Turkey (a parent had two autistic children). The Turkish translation of the Autism Behavior Checklist (ABC) (Irmak et al., 2007) was directed to the parents twice in the structured interviews in order to compare and contrast the presence of autism symptoms after the diagnosis (before play, over 6 months ago) and after play (present day). In the semi-structured interviews, open-ended questions prepared by the researchers were directed to the parents to capture and document more detailed information about the play process such as the duration and type of play. All interviews were recorded with permission, documents and dates were collected, and informed consent according to the Declaration of Helsinki was received.Analysis shows an overall decline or disappearance in nearly all attributes in the ABC. Results of the semi-structured interviews demonstrate that most frequently played games were as follows: Traditional and role play/imitation games (hide and seek, blindman’s buff…); make-believe games (house, teaching, hairdressing…) ; athletics (basketball, football…), and educational activities (drawing, card and board games…).According to the results, play affected the social and linguistic skills of autistic children positively.

Influence of acupuncture on the clinical manifestations and gastrointestinal symptoms of children with autism spectrum disorder

To observe the effect of acupuncture therapy based on "gut-brain axis" on clinical manifestations and gastrointestinal symptoms of children with autism spectrum disorder (ASD). A total of 66 children with ASD were randomly divided into an observation group and a control group, 33 cases in each group. The control group was treated by routine rehabilitation training. On the basis of the control group, the observation group was treated with acupuncture based on "gut-brain axis", and the acupoints were Touwei (ST 8), Shenting (GV 24), Sishencong (EX-HN 1), Tianshu (ST 25), Zhongwan (CV 12), Zusanli (ST 36), etc. Both treatments were given once every other day, 3 times a week, 4 weeks as a course of treatment, consecutively for 3 courses. The scores of autism behavior checklist (ABC), TCM symptoms of gastrointestinal disease and childhood autism rating scale (CARS) were compared between the two groups before and after treatment, and the clinical efficacy was evaluated. After treatment, the scores of ABC, CARS and TCM symptoms of gastrointestinal disease in the two groups were lower than before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). The total effective rate of the observation group was 90.9% (30/33), which was higher than 81.8% (27/33) in the control group (P<0.05). On the basis of routine rehabilitation training, acupuncture therapy based on "gut-brain axis" is effective in treating ASD, which can relieve the clinical manifestations and gastrointestinal symptoms.

Application of pseudocontinuous arterial spin labeling perfusion imaging in children with autism spectrum disorders.

Pseudocontinuous Arterial Spin Labeling (pCASL) perfusion imaging allows non-invasive quantification of regional cerebral blood flow (CBF) as part of a multimodal magnetic resonance imaging (MRI) protocol. This study aimed to compare regional CBF in autism spectrum disorders (ASD) individuals with their age-matched typically developing (TD) children using pCASL perfusion imaging. This cross-sectional study enrolled 17 individuals with ASD and 13 TD children. All participants underwent pCASL examination on a 3.0 T MRI scanner. Children in two groups were assessed for clinical characteristics and developmental profiles using Autism Behavior Checklist (ABC) and Gesell development diagnosis scale (GDDS), respectively. We compared CBF in different cerebral regions of ASD and TD children. We also assessed the association between CBF and clinical characteristics/developmental profile. Compared with TD children, individuals with ASD demonstrated a reduction in CBF in the left frontal lobe, the bilateral parietal lobes, and the bilateral temporal lobes. Within the ASD group, CBF was significantly higher in the right parietal lobe than in the left side. Correlation analysis of behavior characteristics and CBF in different regions showed a positive correlation between body and object domain scores on the ABC and CBF of the bilateral occipital lobes, and separately, between language domain scores and CBF of the left frontal lobe. The score of the social and self-help domain was negatively correlated with the CBF of the left frontal lobe, the left parietal lobe, and the left temporal lobe. Cerebral blood flow was found to be negatively correlated with scores in the social and self-help domain, and positively correlated with those in the body and object domain, indicating that CBF values are a potential MRI-based biomarker of disease severity in ASD patients. The findings may provide novel insight into the pathophysiological mechanisms of ASD.

Early life exposure to triclosan from antimicrobial daily necessities may increase the potential risk of autism spectrum disorder: A multicenter study in China

BackgroundAutism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders with unclear etiologies. Our recent work indicated that maternal exposure to triclosan (TCS) significantly increased the autistic-like behavior in rats, possibly through disrupting neuronal retinoic acid signaling. Although environmental endocrine disruptors (EEDs) have been associated with autism in humans, the relationship between TCS, one of the EEDs found in antibacterial daily necessities, and autism has received little attention. ObjectiveThe aims of this multicenter study were to evaluate TCS concentrations in typically developing (TD) children and ASD children, and to determine the relationship between TCS levels and the core symptoms of ASD children. MethodsA total of 1345 children with ASD and 1183 TD children were enrolled from 13 cities in China. Ages ranged between 2 and 7 years. A questionnaire was used to investigate the maternal use of antibacterial daily necessities (UADN) during pregnancy. The core symptoms of ASD were evaluated using the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Social Response Scale (SRS), and the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016). The TCS concentration was measured using LC-MS/MS. ResultsMaternal UADN during pregnancy may be an unrecognized potential environmental risk factor for ASD (OR=1.267, P = 0.023). Maternal UADN during pregnancy strongly correlated with TCS levels in the offspring (Adjusted β = 0.277, P < 0.001). TCS concentration was higher in ASD children (P = 0.005), and positively correlated with ABC (Sensory subscales: P = 0.03; Social self-help subscales: P = 0.011) and SRS scale scores (Social awareness subscales: P = 0.045; Social communication subscales: P = 0.001; Autism behavior mannerisms subscales: P = 0.006; SRS total score: P = 0.003) in ASD children. This association was more pronounced in boys than in girls. ConclusionTo our knowledge, this is the first case-control study to examine the correlation between TCS and ASD. Our results suggest that maternal UADN during pregnancy may be a potential risk of ASD in offspring. Further detection of TCS levels showed that maternal UADN during pregnancy may be associated with excessive TCS exposure. In addition, the level of TCS in children with ASD is higher than TD children. The higher levels of TCS in children with ASD may be significantly associated with more pronounced core symptoms, and this association was more significant in male children with ASD.

Efficacy of auricular plaster therapy for sleep disorders in preschool children with autism spectrum disorders: Study protocol for a randomized controlled trial.

BackgroundChildren with autism spectrum disorders (ASDs) suffer from sleep disorders to a considerable degree; however, there is no safe and effective treatment available in clinical practice. The objective of the trial is to assess the clinical effectiveness of auricular plaster therapy (APT) in treating sleep disorders in children with ASD.MethodThis is a single-center, patient-assessor blind, randomized controlled trial. A total of 44 preschool children with sleep disorders with ASD will be included in this study. Eligible participants will be randomly assigned to either the auricular plaster group or the sham auricular plaster group in a 1:1 ratio. Participants in the different groups will receive APT or sham APT, respectively, for a total of 30 sessions over 30 days. The primary outcome includes the Children's Sleep Habits Questionnaire (CSHQ), while secondary outcomes include the Autism Behavior Checklist (ABC) and polysomnography (PSG) for total sleep time, sleep latency, awakening duration, and sleep structures. The CSHQ and ABC will be assessed at baseline, 10, 20, 30, 60, 90, and 120 days after randomization, whereas PSG will be assessed at baseline and 30 days after randomization. The follow-up period will be scheduled to be 60, 90, and 120 days after randomization.DiscussionThe results of this study may provide evidence of the efficacy of APT, as well as offer new alternatives for the treatment of sleep disorders in children with ASD.Trial registrationCHiCTR.org.cn (ChiCTR2100048257). Registered on July 5, 2021.

Evaluation of retinal nerve fiber layer thickness in children with autism spectrum disorders

BackgroundThe study compared retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume of children with autism spectrum disorder (ASD) to those of healthy control group and correlated the RNFL thickness with symptom severity in children with ASD. MethodForty children between the ages of 7 and 12 with normal intelligence levels and who were diagnosed with ASD as per DSM-5 were included in the ASD group. The control group consisted of healthy children, who were matched with subjects in the ASD group in terms of age and gender. The Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS) were used to evaluate the severity of the disease in the cases diagnosed with ASD. The RNFL, macular thickness, and macular volume of all participants were measured optical coherence tomography (OCT). ResultsThe temporal, temporal superior, nasal superior, temporal inferior, and global RNFL thicknesses were significantly lower in the ASD group than in the control group. There was no correlation between the RNFL thickness and ASD symptom severity. The macular thickness and volume were not significantly different between the groups. ConclusionOur data suggest that lower RNFL thickness may relate to atypical brain development in the ASD, and this can be measured in the retina.

Long-term outcomes of 328 patients with of autism spectrum disorder after fecal microbiota transplantation

Objective: To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) in the treatment of autism spectrum disorder (ASD). Methods: A longitudinal study was conducted. Clinical data from ASD patients with gastrointestinal symptoms and who underwent FMT in the Tenth People's Hospital affiliated to Tongji University or Jinling Hospital between May 2012 to May 2021 were retrospectively collected. Scores derived from the autism behavior checklist (ABC), the childhood autism rating scale (CARS), the Bristol stool form scale (BSFS), and the gastrointestinal symptom rating scale (GSRS) were analyzed at baseline and at the 1st, 3rd, 6th, 12th, 24th, 36th, 48th and 60th month after FMT. Records of any adverse reactions were collected. Generalized estimating equations were used for analysis of data on time points before and after FMT. Results: A total of 328 patients met the inclusion criteria for this study. Their mean age was 6.1±3.4 years old. The cohort included 271 boys and 57 girls. The percentage of patients remaining in the study for post-treatment follow-up at the 1st, 3rd, 12th, 24th, 36th, 48th and 60th month were as follows: 303 (92.4%), 284 (86.7%), 213 (64.9%), 190 (57.9%), 143 (43.6%), 79 (24.1%), 46 (14.0%), 31 (9.5%). After FMT, the average ABC score was significantly improved in the first 36 months and remained improved at the 48th month. However, the average score was not significantly different from baseline by the 60th month (1st-36th month, P<0.001; 48th month, P=0.008; 60th month, P=0.108). The average CARS score improved significantly during the first 48 months and remained improved at the 60th month (1st-48th month, P<0.001; 60th month, P=0.010). The average BSFS score was also significantly improved in the first 36 months (with an accompanying stool morphology that resembled type 4). This improvement was maintained at the 48th month. However, the average score was similar to baseline at the 60th month (1st-36th month, P<0.001; 48th month, P=0.008; 60th month, P=0.109). The average GSRS score was significantly improved during the first 24 months, but not afterwards (1st-24th month, P<0.001; 36th month, P=0.209; 48th month, P=0.996; 60th month, P=0.668). The adverse events recorded during treatment included abdominal distension in 21 cases (6.4%), nausea in 14 cases (4.3%), vomiting in 9 cases (2.7%), abdominal pain in 15 cases (4.6%), diarrhea in 18 cases (5.5%), fever in 13 cases (4.0%), and excitement in 24 cases (7.3%). All adverse reactions were mild to moderate and improved immediately after suspension of FMT or on treatment of symptoms. No serious adverse reactions occurred. Conclusion: FMT has satisfactory long-term efficacy and safety for the treatment of ASD with gastrointestinal symptoms.

A pilot randomized controlled clinical trial of dance practice for functionality in autistic children and adolescent with all levels of need support

ObjectiveThis study addressed dance practice intertwining communication, functional independence and social behavior in autistic children and adolescents with all levels of need support. DesignA pilot randomized clinical trial with seventy-two participants between 8 and 15 years old were assessed for eligibility. SettingTheater rehearsal room and mental health clinic. InterventionsDance group (n = 17) or control group (n = 19), 24 sessions, once a week, lasting 40 min. Main outcome measuresThe Autism Behavior Checklist (ABC), Autistic Screening Questionnaire (ASQ), Childhood Autism Rate Scale (CARS), Functional Independence Measure (FIM), and World Health Organization Disability Assessment Schedule (WHODAS, version 2.0, to assess mothers’ functioning) were applied at two time points: baseline and end-point. ResultsDifferences between dance and control groups were significant at post-intervention for communication (mean difference: 1.31; 99.8%CI: 0.29, 2.32, p < 0.001, d = 0.93); social cognition (mean difference: 1.01; 99.8%CI: 0.13, 1.89, p < 0.001, d = 0.82); autistic behavior (mean difference: 11.82; 99.8%CI: 17.33, −6.31, p < 0.001, d = 1.45). ConclusionsIn this preliminary study, the findings provide ways of communication and social interaction through dance practice by autistic children and adolescents with all levels of support needs. Research on neurodiversity is needed to understand its feasibility and the lifestyle appropriation.

Vitamin D status is primarily associated with core symptoms in children with autism spectrum disorder: A multicenter study in China

ObjectiveWe aimed to investigate the relationship between vitamin D status and core symptoms and neurodevelopmental levels in children with ASD with a multicenter survey. MethodsWe enrolled 1321 ASD children and 1279 typically developing (TD) children aged 2–7 years from 13 cities in China. ASD symptoms were assessed with the Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS), and neurodevelopmental levels were evaluated with the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016). ResultsChildren with ASD had lower serum 25(OH)D levels than TD children. Serum 25(OH)D levels were negatively associated with CARS and communication warning behavior of CNBS-R2016 scores, and were not associated with the development quotients of ASD children. ASD Children were grouped based on the quartiles for 25(OH)D levels in the controls, and children in the first to third quartiles had higher SRS social communication and/or CARS and communication warning behavior of CNBS-R2016 scores than those in the fourth quartile. ConclusionsSerum 25(OH)D levels were primarily associated with core symptoms in children with ASD, and individuals with relatively lower 25(OH)D levels displayed worse autistic symptomatology. More research is needed to determine whether vitamin D supplements would be a useful treatment for ASD.

Feeding problems, age of introduction of complementary food and autism symptom in children with autism spectrum disorder.

In this cross-sectional study, 84 children with autism spectrum disorder (ASD) and 77 healthy subjects showing typical development (TD) were reviewed. Parents reviewed the age of introduction of complementary foods (CFs), completed a demographic, diet behavior questionnaire and the Autism Behavior Checklist (ABC). The results showed that the age of introduction of CFs was later in children with ASD than their TD counterparts. The age of introduction of CFs in ASD group was positively correlated with feeding problem. While the correlation was not observed in TD group. Children in the ASD group had higher total scores of the diet behavior questionnaire and all four subdomains (poor eating ability, mealtime eating behavior, food selectivity, and parental feeding behavior). ASD symptoms were clearly associated with feeding problems. The sensory subdomain score in ABC was positively correlated with poor eating ability, mealtime behavior and total score of the diet behavior questionnaire. The social self-care subdomain score was positively correlated with food selectivity. The interaction subdomain score was negative correlated with parental feeding behavior and total score of the diet behavior questionnaire. Further studies are required to establish the utility of delayed CFs introduction and/or early feeding problems as potential indicators of ASD.

Association of urinary polycyclic aromatic hydrocarbon metabolites with symptoms among autistic children: A case-control study in Tianjin, China.

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants that are associated with altered neurodevelopment and various neurodevelopmental disorders. However, studies evaluating internal biomarkers of PAH exposure in reference to the severity of autism spectrum disorder (ASD) symptomology and autistic behaviors are scarce. Hence, we conducted a case-control study evaluating 12 urinary hydroxylated PAH metabolites (i.e., hydroxy-PAHs) in 101 children with autism and 101 neurotypical children, matching according to sex and age in a 1:1 ratio. In children with ASD, the severity of symptomology and autistic behaviors were assessed using the child autism rating scale (CARS) and the autism behavior checklist (ABC). We found that urinary levels of nine of the hydroxy-PAHs were statistically significantly higher in the ASD group, with the exception of 2-hydroxynaphthalene (2-OHNap) and 4-hydroxyphenanthrene (4-OHPhe). Moreover, urinary hydroxy-PAH levels were associated with ASD risk, with odds ratios ranging from 1.86 to 17.19. Exposures to 1-hydroxynaphthalene (1-OHNap, β=3.32), hydroxyphenanthrenes (1/2/3 + 9-OHPhes, β=3.41-5.12), 1-hydroxypyrene (1-OH-Pyr; β=3.91), 2-hydroxybenzofuran (2-OHDBF; β=3.93), and ∑OH-PAHs (β=4.67) were positively associated with CARS scores after adjusting for covariates (all p &lt; 0.05). When applying the ABC scale, 1-OHPyr levels were positively associated with ABC total scores (β=18.54), with the strongest associations evidenced in regard to the social relatedness (β=6.51) and language domains (β=6.51) (all p &lt; 0.05). Bayesian kernel machine regression (BKMR) showed consistent positive exposure responses for 1-OHNap, 1-OHPhe, and 3 + 9-OHPhe levels in regard to CARS scores, and for 1-OHPyr levels in regard to ABC total scores. Our findings suggest that children with ASD may have higher urinary levels of hydroxy-PAHs, and that these biomarker levels are associated with an increased odds of ASD, an increased severity of autism symptomology, and increased autistic behaviors in children with autism. LAY SUMMARY: We conducted an epidemiologic study evaluating the associations of urinary hydroxy-PAH levels with autism spectrum disorder (ASD), autism symptomology, and autistic behaviors. We found that urinary hydroxy-PAHs were statistically significantly associated with ASD. We note strong statistically significant associations between 1-OHNap, 1-OHPhe, and 3 + 9-OHPhe levels and increased severity of autism symptomology, as well as a strong statistically significant association between 1-OHPyr levels and behavioral characteristics within the social and linguistic domains. This work, if confirmed, will contribute to the future development of diagnostics for children with mild autism, as well as to environmental measures to promote the health and wellbeing of children with autism spectrum disorders.