Autism Research Articles

ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА РЕЧЕВЫХ НАРУШЕНИЙ У ДЕТЕЙ С АУТИЗМОМ И СПЕЦИФИЧЕСКИМИ РАССТРОЙСТВАМИ РЕЧИ И ЯЗЫКА

A wide range of speech disorders causes the complex structure of the defect, which results in a disharmonious clinical and psychological characteristic of autism. The expediency of using the method of speech disorders in children with infantile autism is justified by the results of diagnostic efficiency analysis from the standpoint of evidence-based medicine. A wide range of speech disorders causes the complex structure of the defect, which results in a disharmonious clinical and psychological characteristic of autism. Objectivization of speech pathologies with the help of scientifically grounded diagnostic method of speech disorders in children with infantile autism gives an opportunity to create a speech profile of the child, which helps to determine the principles of their correction. The expediency of using the method is justified by the results of diagnostic efficiency analysis from the standpoint of evidence-based medicine.

125 Adverse labor events and childhood autism- is there a link?

125 Adverse labor events and childhood autism- is there a link?

Análise do escore do Childhood Autism Rating Scale de crianças com Transtorno do Espectro do Autismo pré e pós-intervenção com Método de Desenvolvimento das Habilidades de Comunicação no Autismo

ABSTRACT Purpose: to analyze changes in autism classification after intervention with the Development of Communication Skills in Autism (DHACA method) in children assessed with the Childhood Autism Classification Scale. Methods: a quantitative analysis study applying the Childhood Autism Rating Scale before and after 20 speech-language-hearing sessions, using the DHACA method with 14 nonverbal or minimally verbal children, of both sexes, aged 2 to 6 years, presented with autism spectrum disorder. The Shapiro-Wilk test was used to verify the normality pattern, and the Wilcoxon test to compare measures of central tendency of the items assessed by the scale before and after the intervention, with a p-value < 0.05 (5%) considered significant. Results: the level of autism support needs in the sample decreased after the intervention. The largest sample group classified by the scale before the intervention was “Moderate Autism” (42.86%), followed by “Severe Autism” and “Mild Autism”, both with 28.57%. After the intervention, most groups had scores equivalent to “Mild Autism” (64.29%), followed by “No Autism” (21.43%), “Moderate Autism” and “Severe Autism”, both with 7.14%. Conclusion: implementing the DHACA method helped develop communication, cognitive, and behavioral skills and decreased the level of autism support needs in this sample of children.

Pannexin1 Mediates Early-Life Seizure-Induced Social Behavior Deficits.

There is a high co-morbidity between childhood epilepsy and autism spectrum disorder (ASD), with age of seizure onset being a critical determinant of behavioral outcomes. The interplay between these comorbidities has been investigated in animal models with results showing that the induction of seizures at early post-natal ages leads to learning and memory deficits and to autistic-like behavior in adulthood. Modifications of the excitation/inhibition (glutamate/GABA, ATP/adenosine) balance that follows early-life seizures (ELS) are thought to be the physiological events that underlie neuropsychiatric and neurodevelopmental disorders. Although alterations in purinergic/adenosinergic signaling have been implicated in seizures and ASD, it is unknown whether the ATP release channels, Pannexin1 (Panx1), contribute to ELS-induced behavior changes. To tackle this question, we used the ELS-kainic acid model in transgenic mice with global and cell type specific deletion of Panx1 to evaluate whether these channels were involved in behavioral deficits that occur later in life. Our studies show that ELS results in Panx1 dependent social behavior deficits and also in poor performance in a spatial memory test that does not involve Panx1. These findings provide support for a link between ELS and adult behavioral deficits. Moreover, we identify neuronal and not astrocyte Panx1 as a potential target to specifically limit astrogliosis and social behavioral deficits resultant from early-life seizures.

Meta-analysis of the efficacy of camel milk consumption for improving autism symptoms in children in randomized clinical trials

Background: Camel milk has emerged as a potential complementary therapy for autism spectrum disorder (ASD). Aim: This study aimed to gather evidence from randomized controlled trials (RCTs) on the effectiveness of camel milk consumption in improving symptoms and associated measures in children with ASD. Methods: Comprehensive searches of multiple databases were conducted up to March 14, 2024, for RCTs that had evaluated whether camel milk consumption by children with ASD was more beneficial than the consumption of a control substance. Quality and bias analyses and meta-anlaysis data were synthesized and analyzed. Results: Of 136 records identified, 5 RCTs (n = 299 children) were selected. The mean difference in scores on the Childhood Autism Rating Scale (CARS) for the group given camel milk and the control groups was a mean deviation (MD) ‒0.75, 95% CI ‒1.97 to 0.47, p = .23. The mean difference in CARS scores in the subgroup analyses for raw camel milk was MD ‒0.95, 95% CI ‒2.33 to 0.44, p = .18 and boiled camel milk MD ‒0.50, 95% CI ‒1.93 to 0.93, p = .49. A qualitative synthesis found that raw camel milk intake led to improvements in various social behaviors in children with ASD. Camel milk consumption resulted in increased levels of anti-inflammatory, antioxidant, and immunomodulatory biomarkers, with some differences observed between patients given raw camel milk and boiled camel milk. Conclusion: Camel milk shows promise in improving social behaviors and certain biochemical markers in children with ASD, although the current meta-analysis did not document a significant statistical difference in CARS scores for the children studied. Future studies should focus on rigorous RCTs and larger sample sizes to substantiate these preliminary findings.

Analysis of scores in the Childhood Autism Rating Scale of children with Autism Spectrum Disorder before and after intervention with the method - Development of Communication Skills in Autism

RESUMO Objetivo: analisar as mudanças na classificação do autismo, após intervenção com o Método Desenvolvimento das Habilidades de Comunicação no Autismo, em crianças avaliadas com a Escala de Classificação do Autismo Infantil. Métodos: trata-se de um estudo de análise quantitativa. Foi aplicada a Escala de Classificação do Autismo Infantil pré e pós vinte sessões fonoaudiológicas com o método. Participaram 14 crianças com Transtorno do Espectro do Autismo, de ambos os sexos, com idades entre 2 e 6 anos, não verbais ou minimamente verbais. Utilizaram-se o Teste de Shapiro-Wilk para verificar o padrão de normalidade e o Teste de Wilcoxon para comparação de medidas de tendência central dos itens avaliados pela escala entre os momentos pré e pós-intervenção. Considerou-se associação significante o valor de p <0,05 (5%). Resultados: a amostra apresentou redução do nível de suporte do autismo após intervenção. O maior grupo classificado pela escala na amostra pré-intervenção foi de “Autismo Moderado” (42,86%), seguido por “Autismo Grave” e “Autismo Leve”, ambos com 28,57%. Pós-intervenção observou-se, na maior parte, pontuação equivalente ao “Autismo Leve” (64,29%), seguido da categoria “Sem Autismo” (21,43%) e, “Autismo Moderado” e “Grave”, ambos com 7,14%. Conclusão: a implementação do Método Desenvolvimento das Habilidades de Comunicação no Autismo favoreceu o desenvolvimento de habilidades comunicacionais, cognitivas e comportamentais, e redução do nível de suporte do autismo na amostra de crianças avaliadas.

Association of Epileptiform Discharge and Autism Spectrum Disorder Severity in Children Attending the Outpatient Clinics, Child Welfare Teaching Hospital, Baghdad

Background: Subjects with Autism Spectrum Disorder (ASD) have a higher prevalence of seizures than the general population, according to a significant body of research. Also, seizure-free patients with ASD have been found to have a higher prevalence of epileptiform discharge abnormalities compared to healthy controls across investigations. Changes in the electroencephalogram (EEG) can manifest as sharp waves or spikes, sharp and slow waves, generally distributed or general area, or focused, and can manifest in various brain regions. There is a necessity to search for a distinctive EEG characteristic in ASD patients. Objectives: This study used electroencephalography to investigate the relationship between interictal epileptiform discharges and the severity of ASD in children. Patient and methods: The study involved a total of 65 children. The first group consisted of 30 children (seven females and 23 males, 2-12 years of age) recruited from the autism center and the pediatric neurology consultancy clinic in the Child Welfare Teaching Hospital / Medical City. The second group consisted of 35 age- and gender-matched normally-developed children (10 females 25 males, 2-12 years of age) recruited from the Pediatrics Consultation Clinics in the Child Welfare Teaching Hospital. The ASD children met the DSM-5 criteria for autism and the Childhood Autism Rating Scale was utilized to determine the severity of autism. The electroencephalography signals were recorded to detect epileptiform discharge. The data was collected during the period from 5th October 2022 to 1st April 2023. Result: A statistically significant association was found between the epileptiform discharges and the study group (ASD Vs normally developed children). The EEG records were normal in 20 (66.7%), abnormal in the form of focal epileptiform discharge in 5 (16.7%), and in the form of generalized epileptiform discharge in 5 (16.7%) of ASD children. The EEG findings and the CARS-measured autism severity showed a statistically significant association (P=0.05), as the EEG abnormalities increased with the severity of autism. Conclusion: The degree of autism was found to be associated with the abnormalities of the electroencephalogram and the degree of autism. Received: May,, 2023 Accepted: Sept, 2023 Published: Jan. 2024

Parental Stress among Family Caregivers of Children with Autism in a Teaching Hospital

Parenting is a journey that may bring joy, happiness, challenges, and frustration. However, raising children with autism with unpredictable behavior may elevate parental stress among parents and family caregivers. Objective: The study aims to assess parental stress among family caregivers of children with autism in a teaching hospital. Methods:This quantitative cross-sectional study was conducted at Hospital Al-Sultan Abdullah (HASA), University Technology MARA(UiTM), using a convenient sampling technique with a total sample size of 110 parents and family caregivers of children with autism (n= 110). An online questionnaire consisting of the Parental Stress Scale (PSS) and the Childhood Autism Spectrum Test (CAST) was used in this study to assess the level of parental stress and identify the severity of probable autistic behavior. Results:The finding shows that 75.5% of the participants were female and 94.5% were Malay. Most autistic children were male (63.6%), and most children (n= 81, 73.6%) had severe autistic behavior. However, 82.7% of participants reported low parental stress (mean = 34.41±13.06). Caregivers were found to have higher stress levels t(108) = -2.16; p=0.033). Besides, there was no significant association between the level of parental stress and the severity of autism (r=0.035, p=0.715). Conclusion:Special intervention is needed for the caregiver to improve stress management strategies by involving health care professionals for counseling and assistance to address the effects of stress. Alarger sample size is recommended for future research to enhance external validity.

Donepezil as a new therapeutic potential in KCNQ2- and KCNQ3-related autism.

The KCNQ2/KCNQ3 genes encode the voltage-gated K channel underlying the neuronal M-current, regulating neuronal excitability. Loss-of-function (LoF) variants cause neonatal epilepsy, treatable with the M-current-opener retigabine, which is no longer marketed due to side effects. Gain-of-function (GoF) variants cause developmental encephalopathy and autism that could be amenable to M-current, but such therapies are not clinically available. In this translational project, we investigated whether donepezil, a cholinergic drug used in Alzheimer's, suppresses M currents in vitro and improves cognitive symptoms in patients with GoF variants. (1) The effect of 1 μM donepezil on the amplitude of the M-current was measured in excitatory and inhibitory neurons of mouse primary cultured hippocampal cells. M-current was measured using the standard deactivation protocol (holding at 0 mV and deactivation at -60 mV) in the voltage-clamp configuration of the whole-cell patch clamp technique. The impact of donepezil was also examined on the spontaneous firing activity of hippocampal neurons in the current-clamp configuration. (2) Four children with autism, aged 2.5-8 years, with the following GoF variants were enrolled: KCNQ2 (p. Arg144Gln) and KCNQ 3 (p.Arg227Gln, p.Arg230Cys). Patients were treated off-label with donepezil 2.5-5 mg/d for 12 months and assessed with: clinical Global Impression of Change (CGI-c), Childhood Autism Rating Scale 2 (CARS-2), Adaptive Behavior Assessment System-II (ABAS-II), and Child Development Inventory (CDI). (1) Application of donepezil for at least 6 min produced a significant inhibition of the M-current with an IC50 of 0.4 μM. At 1 μM, donepezil reduced by 67% the M-current density of excitatory neurons (2.4 ± 0.46 vs. 0.89 ± 0.15 pA/pF, p < 0.05*). In inhibitory neurons, application of 1 μM donepezil produced a lesser inhibition of 59% of the M-current density (1.39 ± 0.43 vs. 0.57 ± 0.21, p > 0.05). Donepezil (1 μM) potently increased by 2.6-fold the spontaneous firing frequency, which was prevented by the muscarinic receptor antagonist atropine (10 μM). (2) The CARS-2 decreased by 3.8 ± 4.9 points (p > 0.05), but in two patients with KCNQ3 variants, the improvement was over the 4.5 clinically relevant threshold. The global clinical change was also clinically significant in these patients (CGI-c = 1). The CDI increased by 65% (p < 0.05*), while the ABAS-II remained unchanged. Donepezil should be repurposed as a novel alternative treatment for GoF variants in KCNQ2/KCNQ3 encephalopathy.

Decreased wrist rotation imitation abilities in children with autism spectrum disorder.

While meaningless gross motor imitation (GMI) is a common challenge for children diagnosed with autism spectrum disorder (ASD), this topic has not attracted much attention and few appropriate test paradigms have been developed. The current study proposed a wrist rotation imitation (WRI) task (a meaningless GMI assignment), and established a WRI ability evaluation system using low-cost wearable inertial sensors, which acquired the simultaneous data of acceleration and angular acceleration during the WRI task. Three metrics (i.e., total rotation time, rotation amplitude, and symmetry) were extracted from those data of acceleration and angular acceleration, and then were adopted to construct classifiers based on five machine learning (ML) algorithms, including k-nearest neighbors, linear discriminant analysis, naive Bayes, support vector machines, and random forests. To illustrate our technique, this study recruited 49 ASD children (aged 3.5-6.5 years) and 59 age-matched typically developing (TD) children. Findings showed that compared with TD children, those with ASD may exhibit shorter total rotation time, lower rotation amplitude, and weaker symmetry. This implies that children with ASD might exhibit decreased WRI abilities. The classifier with the naive Bayes algorithm outperformed than other four algorithms, and achieved a maximal classification accuracy of 88% and a maximal AUC value of 0.91. Two metrics (i.e., rotation amplitude and symmetry) had high correlations with the gross and fine motor skills [evaluated by Gesell Developmental Schedules-Third Edition and Psychoeducational Profile-3 (PEP-3)]. While, the three metrics had no significant correlation with the visual-motor imitation abilities (evaluated by the subdomain of PEP-3) and the ASD symptom severity [evaluated by the Childhood Autism Rating Scale (CARS)] . The strengths of this study are associated with the low-cost measurement system, correlation between the WRI metrics and clinical measures, decreased WRI abilities in ASD, and high classification accuracy.

Periconceptional Serum Creatinine and Risk of Childhood Autism Spectrum Disorder: A Research Letter.

Autism spectrum disorder (ASD) is a neurodevelopmental condition that manifests in early childhood, in which the maternal metabolic syndrome may be a risk factor. The kidney is a barometer of maternal metabolic syndrome duration and severity. The main objective of this study is to determine whether periconceptional kidney function is associated with ASD in early childhood. This retrospective population-based cohort study was completed in Ontario, Canada. Included were singleton children born in an Ontario hospital between April 2007 and March 2021, who were alive at age 48 months and whose mother had a recorded prepregnancy body mass index (BMI) and a measured serum creatinine (SCr) between 120 days preconception and 28 days postconception. The main study outcome was a diagnosis of ASD between ages 24 and 48 months. Relative risks (RRs) of ASD in association with periconceptional SCr were generated using modified Poisson regression and adjusted for several confounders. The cohort comprised 86 054 women, who had 89 677 liveborn children surviving to at least 48 months of age. There was no significant association between periconceptional SCr and ASD (RR: 0.86; 95 % confidence interval: [0.67, 1.10]). Selection bias may have arisen had SCr been ordered on clinical grounds. Further study is warranted to determine whether prepregnancy glomerular hyperfiltration is a marker of ASD and other behavioral conditions in childhood. To do so, a more accurate measure of hyperfiltration is needed than SCr.

Knowledge of Childhood Autism among Health Workers of Peshawar: A Cross-Sectional Study

Background: Early detection of Autism Spectrum Disorder (ASD) symptoms is crucial for timely intervention services and a better prognosis. Healthcare professionals play a pivotal role in recognizing ASD features, diagnosis, and providing support. This study aimed to assess the knowledge of healthcare workers in Peshawar regarding childhood autism. Objective: The objective of this study was to evaluate the level of knowledge among healthcare professionals in Peshawar, Pakistan, regarding the early symptoms, diagnosis, and intervention strategies for Autism Spectrum Disorder (ASD), in order to identify knowledge gaps and inform the development of targeted educational and training programs. Methods: This cross-sectional study was conducted from September 2021 to February 2022 in public and private hospitals in Peshawar, Pakistan. Data were collected using the convenience sampling method. A total of 270 healthcare professionals (Doctors, Dentists, Psychologists, Occupational Therapists, Physical Therapists, and Speech &amp; Language Pathologists) participated. Data analysis was performed using SPSS version 22. Descriptive analysis calculated the mean of each domain and the total score, and frequencies for gender, age, and occupation. Results: The total mean score of the study population was 10.40. The mean score in Domain 1 (Social Interaction) was 4.73 (SD ±1.53), in Domain 2 (Language) was 0.60 (SD ±0.499), in Domain 3 (Behaviors) was 2.38 (SD ±1.102), and in Domain 4 (Etiology) it was 2.74 (SD ±1.214). Conclusion: Healthcare professionals in Peshawar, Pakistan, demonstrated limited knowledge about the early symptoms of Autism Spectrum Disorder. These findings have significant implications for policy and practice, health profession program directors, and future research.

Maternal multivitamin supplementation is associated with symptoms in offspring with autism spectrum disorder: A multi-center study in China

BackgroundWe aimed to investigate the relationship between maternal vitamin D and multivitamin supplementation during pregnancy and the risk of autism spectrum disorder (ASD) and symptoms in offspring with ASD. MethodsThis study enrolled 1321 children with ASD and 1200 typically developing (TD) children under 7 years old in China. Maternal vitamin supplements were classified for vitamin D, multivitamin (with or without vitamin D), and none (no use of vitamin D or multivitamin). For children with 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). ResultsMaternal vitamin D and multivitamin supplementation during pregnancy were both significantly associated with a decreased risk of ASD in offspring (P = 0.024 and P < 0.001). The ASD children born to mothers with gestational multivitamin supplementation had lower CARS [β = −1.342 (−2.275, −0.409), P = 0.005] and communication warning behavior [β = −6.631 (−9.899, −3.363), P < 0.001] scores and higher personal-social quotient [β = 3.347 (0.190, 6.504), P = 0.038] than children born to mothers without supplementation. Maternal vitamin D supplementation was not associated with symptoms and development quotients in ASD children (P > 0.05). ConclusionsThis study supports a protective association between maternal vitamin D and multivitamin supplementation during pregnancy and the risk of ASD in offspring. Maternal multivitamin supplementation may potentially moderate the symptoms and personal-social ability in ASD children. Further studies are needed on the role of maternal nutrition in the etiology and autistic symptoms and the underlying molecular mechanisms.

Distinctive In Vitro Phenotypes in iPSC-Derived Neurons From Patients With Gain- and Loss-of-Function SCN2A Developmental and Epileptic Encephalopathy.

SCN2A encodes NaV1.2, an excitatory neuron voltage-gated sodium channel and a major monogenic cause of neurodevelopmental disorders, including developmental and epileptic encephalopathies (DEE) and autism. Clinical presentation and pharmocosensitivity vary with the nature of SCN2A variant dysfunction and can be divided into gain-of-function (GoF) cases with pre- or peri-natal seizures and loss-of-function (LoF) patients typically having infantile spasms after 6 months of age. We established and assessed patient induced pluripotent stem cell (iPSC) - derived neuronal models for two recurrent SCN2A DEE variants with GoF R1882Q and LoF R853Q associated with early- and late-onset DEE, respectively. Two male patient-derived iPSC isogenic pairs were differentiated using Neurogenin-2 overexpression yielding populations of cortical-like glutamatergic neurons. Functional properties were assessed using patch clamp and multielectrode array recordings and transcriptomic profiles obtained with total mRNA sequencing after 2-4 weeks in culture. At 3 weeks of differentiation, increased neuronal activity at cellular and network levels was observed for R1882Q iPSC-derived neurons. In contrast, R853Q neurons showed only subtle changes in excitability after 4 weeks and an overall reduced network activity after 7 weeks in vitro. Consistent with the reported efficacy in some GoF SCN2A patients, phenytoin (sodium channel blocker) reduced the excitability of neurons to the control levels in R1882Q neuronal cultures. Transcriptomic alterations in neurons were detected for each variant and convergent pathways suggested potential shared mechanisms underlying SCN2A DEE. In summary, patient iPSC-derived neuronal models of SCN2A GoF and LoF pathogenic variants causing DEE show specific functional and transcriptomic in vitro phenotypes.

Maternal use of hormonal contraception and risk of childhood autism spectrum disorders: A Parental Exposures and Child Health (PECH) cohort study

A recent hypothesis suggests that maternal hormonal contraception use has contributed to the increasing incidence of autism spectrum disorders (ASD). We used a nationwide population-based cohort (the PECH cohort) including 1,056,149 Danish children born in the period January 1, 1998, to December 31, 2014, to assess associations between maternal hormonal contraception use and childhood ASD (end of follow-up: December 31, 2017). Maternal hormonal contraception use was grouped as “recent use” (≤ 3 months before pregnancy start or during pregnancy), “previous use” (>3 months before pregnancy start) and “never use”, except for few products. Incidence rate ratios (IRRs) were estimated using Poisson regression. During follow-up of nearly 12 million person-years, 19,996 children were diagnosed with ASD. A slightly higher IRR was observed for maternal recent use of any hormonal contraception, compared to previous use. This association was largely driven by the non-oral progestin-only products, and associations were especially seen for infantile autism and other/unspecified ASD. An increased IRR of infantile autism was also observed for recent use of the oral progestin-only products, compared to previous use. Our results suggest that maternal use of hormonal contraception may be associated with ASD risk in children, especially for the progestin-only products.

Associations of unintended pregnancy with autism spectrum disorders and the modification of folic acid supplements.

There is limited evidence on the associations of unintended pregnancy with autism spectrum disorders (ASD). This study aimed to examine this relationship and the modification of pre-conceptional and prenatal folic acid supplements. Six thousand and five toddlers aged 16 to 30 months from seven cities of six provinces in China were eligible for participation. Information on unintended pregnancy and folic acid supplements was obtained via questionnaires from caregivers of toddlers. The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese version of the Childhood Autism Rating Scale (CARS). Of the 6005 toddlers in the study (3337 boys and 2668 girls), 71 (1.18%) received the diagnosis of ASD. Generalized linear models with a logit link function showed unintended pregnancy was positively associated with ASD (odds ratios [OR] = 1.69, 95% confidence interval [CI], 1.05-2.79). Stratified estimates indicated that the association remained stable among toddlers of mothers without pre-conceptional and prenatal folic acid supplements (OR = 2.75, 95% CI, 1.04-7.27; n = 1243, 20.70%). Unintended pregnancy was associated with higher odds of ASD in 16-30 months of toddlers, and the association was consistent among toddlers of mothers without prenatal folic acid supplements. Our findings emphasize the need to raise awareness of the risk of unintended pregnancy and the benefits of folic acid supplements among Chinese women.

Neurodevelopment with Low Nutritional Folate Increases Childhood Autism

Neurodevelopment with Low Nutritional Folate Increases Childhood Autism

Serum Zonulin, Claudin-5, junction Adhesion Molecule-A, Occludin and Tricellulin levels in children with autism spectrum disorder

Introduction The aim of this study is to determine whether there is a difference in serum Zonulin, Occludin, Claudin-5, Junctional Adhesion Molecule-A (JAM-A), Tricellulin levels between individuals diagnosed with Autism Spectrum Disorder (ASD) and healthy controls. Method A total of 40 children with ASD and 40 controls aged 2-12 years were enrolled in this study. Serum levels of biochemical variables were determined using commercial enzyme-linked immunosorbent assay kits. Childhood Autism Rating Scale, Autism Behavior Checklist and Aberrant Behavior Checklist were applied to determine the severity of autistic symptoms. Results Serum Zonulin, Occludin, Claudin-5, Tricellulin and JAM-A levels did not differ between the study and control groups. There was no relationship between the severity of ASD symptoms and biochemical parameters. Discussion Although the findings of the study suggest that the permeability of the Blood Brain Barrier (BBB) is not effective in the etiology of ASD, there is a need for new studies addressing the limitations of our study in a larger and heterogeneous sample in order to generalize the findings.

Qualitative and quantitative pretend play and their predictors in children with autism spectrum disorder: A path-analysis study

Children with autistic spectrum disorder (ASD) often have difficulties in both qualitive and quantitative pretend play. Theory of mind (ToM), symptom severity, and verbal comprehension appear to be potential correlates of pretend play. However, the underlying relationships of these correlates to pretend play remain unclear. Therefore, we applied path analysis to explore the relationships among these variables in children with ASD. A total of 151 children with ASD aged 3 to 12 years and their caregivers participated in this study. Children’s pretend play, ToM, verbal comprehension, and symptom severity were respectively assessed with Child Initiated Pretend Play Assessment, Theory of Mind Task Battery, The verbal comprehension index of Wechsler Intelligence Scale for children–Fourth Edition or Wechsler Preschool and Primary Scale of Intelligence–Fourth Edition, and Childhood Autism Rating Scale. The results showed that the SEM model fit well. The quality and quantity of pretend play were correlated to each other. ToM was positively related to qualitive and quantitative pretend play. Moreover, symptom severity was directly related to quality of pretend play; verbal comprehension was indirectly linked to quantity and quality of pretend play through ToM and symptom severity. In conclusion, our study reveals the underlying relationships of ToM, symptom severity, and verbal comprehension to quantitative and qualitative pretend play in children with ASD. This study both clarifies the important factors of qualitative and quantitative pretend play and provides suggestions to improve pretend play in children with ASD.

Caregiver-child interaction as an effective tool for identifying autism spectrum disorder: evidence from EEG analysis

BackgroundAutism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects individuals across their lifespan. Early diagnosis and intervention are crucial for improving outcomes. However, current diagnostic methods are often time-consuming, and costly, making them inaccessible to many families. In the current study, we aim to test caregiver-child interaction as a potential tool for screening children with ASD in clinic.MethodsWe enrolled 85 preschool children (Mean age: 4.90 ± 0.65 years, 70.6% male), including ASD children with or without developmental delay (DD), and typical development (TD) children, along with their caregivers. ASD core symptoms were evaluated by Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule-Calibrated Severity Scores (ADOS-CSS). Behavioral indicators were derived from video encoding of caregiver-child interaction, including social involvement of children (SIC), interaction time (IT), response of children to social cues (RSC), time for caregiver initiated social interactions (GIS) and time for children initiated social interactions (CIS)). Power spectral density (PSD) values were calculated by EEG signals simultaneously recorded. Partial Pearson correlation analysis was used in both ASD groups to investigate the correlation among behavioral indicators scores and ASD symptom severity and PSD values. Receiver operating characteristic (ROC) analysis was used to describe the discrimination accuracy of behavioral indicators.ResultsCompared to TD group, both ASD groups demonstrated significant lower scores of SIC, IT, RSC, CIS (all p values < 0.05), and significant higher time for GIS (all p values < 0.01). SIC scores negatively correlated with CARS (p = 0.006) and ADOS-CSS (p = 0.023) in the ASD with DD group. Compared to TD group, PSD values elevated in ASD groups (all p values < 0.05), and was associated with SIC (theta band: p = 0.005; alpha band: p = 0.003) but not IQ levels. SIC was effective in identifying both ASD groups (sensitivity/specificity: ASD children with DD, 76.5%/66.7%; ASD children without DD, 82.6%/82.2%).ConclusionOur results verified the behavioral paradigm of caregiver-child interaction as an efficient tool for early ASD screening.