Autistic Children Research Articles

Case report: Multicomponent intervention for severe food selectivity in autism spectrum disorder: a single case study

Food selectivity is common in children with Autism Spectrum Disorder (ASD). The treatment used can be invasive and difficult to implement, necessitating the exploration of multicomponent approaches. This study presents the case of a 9-year-old autistic girl with severe food selectivity, who ate exclusively liquid and semi-solid foods. A multicomponent intervention protocol was developed, including stimulus fading and positive reinforcement techniques, to increase acceptance of new textures and foods. Treatment sessions showed significant improvement in acceptance of semi-solid and novel foods, with a reduction in problem behaviors associated with mealtime. This study suggests that a multicomponent intervention can significantly improve food acceptance and reduce mealtime distress, proving to be a practical and effective treatment strategy in an autistic child. The intervention led to an increase in food acceptance and a reduction in mealtime-related distress, potentially improving the child and family’s quality of life.

Suicidal risk among Chinese parents of autistic children and its association with perceived discrimination, affiliate stigma and social alienation

BackgroundCaring for autistic children becomes challenging and may lead to negative psychological outcomes, even increasing the suicide risk (SR). Researchers have studied the SR among parents of autistic children in Western nations, but little is known about it in China and how it relates to perceived discrimination (PD), affiliate stigma (AS), and social alienation (SA). The current study aimed to reveal the SR prevalence rate among Chinese parents of autistic children, and clarify whether AS and SA may play mediating roles in the association between SR and PD.MethodsA total of 645 Chinese parents of autistic children were recruited to complete a series of scales to evaluate SR, SA, AS, and PD using the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Perceived Discrimination Scale for Parents of Children with Autism Spectrum Disorders (PDS-FP), Affiliate Stigma Scale (ASS), and General Social Alienation Scale (GSAS), respectively. Then, the SR prevalence rate among Chinese parents of autistic children was evaluated; and the multiple mediation analysis and structural equation modeling with the bootstrap method were conducted to test the mediating effects of AS and SA in the association between SR and PD.Results34.6% Chinese parents of autistic children had high SR. In particular, the incidence rate of suicide ideation, suicide plans, suicide attempts, and suicide likelihood during the previous year were 49.8%, 11.9%, 2.5%, and 13.8%, respectively. Additionally, PD was positively associated with SR (r = .40, p < .01); and AS and SA showed significant mediating effects on the association between PD and SR (p < .01).ConclusionsThe current study evaluated the SR prevalence rate among Chinese parents of autistic children, and clarified the mediating effects of AS and SA in the association between SR and PD. Findings might bring new insights and guidance for intervention of suicidality among Chinese parents of autistic children.

An ‘explosion in the mouth’: The oral health experiences of autistic children

In England, a quarter of 5-year-olds have tooth decay. For families with autistic children, establishing optimal habits (toothbrushing twice a day with fluoride toothpaste, limiting sugar intake and regular dental visits) can be difficult. Oral health experiences from the perspective of autistic children remains unexplored. Interviewing autistic children is crucial as it provides direct insights into their unique experiences and needs, ensuring their voices are represented in research. Therefore, we aimed to explore autistic children’s oral health experiences, including the barriers and facilitators to optimal oral health behaviours. We sought the views of 10 autistic children (aged 7–13 years old) about toothbrushing, healthy eating and visiting the dentist, using spoken interviews and Talking Mats®. Data were analysed using reflexive thematic analysis. Two themes were identified: (1) The diverse sensory nature of oral health activities; and (2) developing trust and routine through consistency, communication and collaboration. Our inclusive methodologies enabled autistic children with diverse communication needs to participate. Such methodologies improve the representation of autistic children in oral health research and autism-related studies more generally. The findings are informing the development of a new personalised support package to help families meet their autistic children’s unique needs. Lay abstract In England, one in four children have tooth decay by the age of 5 years. Tooth decay affects many autistic children. Communication differences, sensory sensitivities and preferred routines can make dental care difficult. Daily toothbrushing, healthy eating and drinking, and attending the dentist may be challenging for autistic children. We do not know much about how autistic children feel about looking after their teeth. Learning from them directly is important to understand their needs and make sure their voices are heard. We interviewed 10 autistic children aged between 7 and 13 years to discover how they care for their teeth, what helped and what did not. We talked about toothbrushing, healthy eating and drinking and visiting the dentist. To support our conversations, we used Talking Mats® – a tool that can help with communication. Autistic children described a wide range of sensory issues related to looking after their teeth. This finding shows how important it is to tailor care to each child’s needs. Children wanted to be included in conversations about their teeth at home and at the dentist. This was felt to make a big difference in building trust and making them feel comfortable and supported. Overall, we found Talking Mats® can be used in dental research to engage with autistic children. By understanding children’s views, we can better help professionals and parents to support their dental needs. Our research showed that every child’s experience is unique, so dental support must be tailored and inclusive to meet children’s needs.

Emotion dysregulation in autism: Severity and correlates in early childhood

AbstractEmotion dysregulation (ED) is common and severe in older autistic youth, but is rarely the focus of early autism screening or intervention. Moreover, research characterizing ED in the preschool years (when autism is typically diagnosed) is limited. This study aimed to characterize ED in autistic children by examining (1) prevalence and severity of ED as compared to children without an autism diagnosis; and (2) correlates of ED in autistic children. A sample of 1864 parents (Mean child age = 4.21 years, SD = 1.16 years; 37% female) of 2–5 year‐old children with (1) autism; (2) developmental concerns, but no autism; and (3) no developmental concerns or autism completed measures via an online questionnaire. ED was measured using the Emotion Dysregulation Inventory‐Young Child, a parent report measure characterizing ED across two dimensions: Reactivity (fast, intense emotional reactions) and dysphoria (low positive affect, sadness, unease). Autistic preschoolers, compared to peers without developmental concerns, had more severe ED (+1.12 SD for reactivity; +0.60 SD for dysphoria) and were nearly four and three times more likely to have clinically significant reactivity and dysphoria, respectively. Autistic traits, sleep problems, speaking ability, and parent depression were the strongest correlates of ED in the autism sample. While more work is needed to establish the prevalence, severity, and correlates of ED in young autistic children, this study represents an important first step. Results highlight a critical need for more high‐quality research in this area as well as the potential value of screening and intervention for ED in young autistic children.

Correction: Gastrointestinal, Behaviour and Anxiety Outcomes in Autistic Children Following an Open Label, Randomised Pilot Study of Synbiotics vs Synbiotics and Gut-Directed Hypnotherapy

Correction: Gastrointestinal, Behaviour and Anxiety Outcomes in Autistic Children Following an Open Label, Randomised Pilot Study of Synbiotics vs Synbiotics and Gut-Directed Hypnotherapy

Feasibility and cross-cultural validation of an adapted social skills group training programme (KONTAKTTM CHILD) for Chinese autistic children: a waitlist RCT protocol

IntroductionSchool-age autistic children commonly experience social communication and interaction challenges in their everyday lives. While international evidence suggests that social skills group training (SSGT) programmes can support autistic children, improving...

Enhancing cognitive abilities in autistic children through AI-enabled iot intervention and cognicare framework

Enhancing cognitive abilities in autistic children through AI-enabled iot intervention and cognicare framework

Multilingualism impacts children's executive function and core autism symptoms.

Autism spectrum disorder (ASD) is associated with marked heterogeneity in executive function (EF) abilities. EF components including inhibition and shifting are related to ASD core symptoms such as perspective taking, social communication, and repetitive behavior. Recent research suggests that multilingualism may have a beneficial impact on EF abilities, especially in children with ASD. However, there remains a lack of comprehensive understanding regarding the relationships between multilingualism, EF, and core symptoms in children with ASD. Here, we examined these associations in 7-12-year-old children with and without ASD (N = 116; 53 ASD, Mean age = 9.94 years). Results suggest that multilingual children have stronger parent-reported inhibition, shifting, and perspective-taking skills than monolingual children. Furthermore, we found a significant interaction between diagnosis and multilingual status on inhibition, such that the effects of multilingualism were stronger for children with ASD than typically developing (TD) children. Finally, we found indirect effects of multilingualism on perspective taking, social communication, and repetitive behaviors mediated by EF skills. These results demonstrate the supportive influences multilingual experience might have on bolstering EF and reducing ASD-related symptoms.

Music therapy improves engagement and initiation for autistic children with mild intellectual disabilities: A randomized controlled study.

This study aimed to evaluate the effectiveness of music therapy (MT) for children with co-occurring autism spectrum disorder (ASD) and intellectual disabilities (ID) and explore whether pre-intervention quantitative electroencephalogram (qEEG) responses can predict outcomes. A randomized controlled trial was conducted with 33 children receiving MT and 34 receiving an active control therapy. Participants received either MT or a non-musical social skills intervention for 45 min weekly over 12 weeks. Primary outcomes were measured using the Childhood Autism Rating Scale (CARS-2), along with the parent-rated Social Responsiveness Scale (SRS-2) and video coding of social behaviors. Both conditions significantly improved in CARS-2 scores at 2 weeks and 4 months post-intervention, with no differences between MT and control conditions. No changes were found in SRS-2 scores. While both conditions showed reduced disengagement after intervention, only the MT condition showed increased engagement and initiation. Strong qEEG responses to social scenes and music predicted increased initiation, indicating its potential to help tailor interventions. These results support incorporating MT into standard services and further research on qEEG predictors.

Parental Stress in Autistic Children with Poor Oral Hygiene: A Pilot Study to Develop and Validate a Measurement Scale

Background/Objectives: Research indicates that children with autism spectrum disorder (ASD) exhibit a deficiency in skills and initiative when it comes to adhering to daily oral hygiene routines. This, in turn, increases the likelihood of oral pathologies, thereby placing a significant emotional strain on their parents. In addition to the typical stress they already experience, parents of children with ASD are also burdened with pediatric oral health issues. However, a review of the literature reveals a lack of studies measuring stress in parents of children whose oral health affects their autistic condition. This research aimed to design and to validate a stress scale for parents of autistic children with poor oral hygiene. Methods: The study used an exploratory, non-experimental design to validate and determine the reliability of the scale. Scale reliability was assessed through a cross-sectional pilot test to evaluate internal scale consistency, with a focus on item similarity. We used Aiken’s V to estimate the validity of the scale, and Cronbach’s α for calculating scale reliability. Calculations, estimations, and statistical analysis were conducted using SPSS. Results: Expert validation, a pilot test, and a cross-sectional, non-experimental design established the reliability of the scale. Conclusions: We conclude that the 20-item scale exhibits validity (0.95) and reliability (0.965), ensuring its applicability in future research.

Autism, intelligence, language, and adaptive behavior, disentangling a complex relationship

IntroductionAutism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by a range of intellectual and language abilities. Its heterogeneity is acknowledged in modern diagnostics, complicating research and necessitating precision medicine and a multidimensional approach for individualized treatment and accurate assessment. Intellectual and language functioning influence adaptive skills and symptomatology. Thus, assessing adaptive functioning in a multidimensional and multi-informant manner is crucial, highlighting the importance of comprehensive evaluations. This study explores the interplay between autistic traits, demographic variables, IQ, adaptive functioning, and the applicability of ICD-11 classifications.MethodsWe analyzed data from the initial global evaluation of 60 diverse autistic children (aged 35 to 120 months; IQ range 16 to 118). Parent-reports using the Vineland Adaptive Behavior Scale (VABS-II) were compared with standardized assessments from the PsychoEducational Profile (PEP-3). Children’s intellectual levels were assessed using Griffiths Scales of Child Development (Griffiths III) and the Autism Diagnostic Observation Schedule (ADOS-2) was used for autistic traits. They were further classified according to the ICD-11 diagnostic system, functional language, and intellectual functioning levels. Correlations among variables, group comparisons, and multivariate analyses were performed.ResultsThe analysis indicates a linear effect of IQ on all adaptive scales and the impact of autistic traits on directly measured adaptive functioning. A factorial effect was observed due to changes concerning specific age, intellectual, and linguistic levels, which do not completely align with ICD-11 categorization. Additionally, a negative correlation between intelligence and measured autistic traits was found. Parental age, education level, and age at childbirth were also found to affect various adaptive scales.DiscussionThe study questions the ICD-11’s proposed distinctions in IQ and language functioning for ASD, advocating for more refined categorization and developmental considerations. It underscores the intricate relationship between autistic traits, IQ, and communication skills, casting doubt on the precision of diagnostic tools across the spectrum. Parental reports and direct assessments are essential for comprehensive evaluation, with parental education and age influencing children’s behaviors and skills. The study calls for a nuanced approach to ASD assessment, integrating various metrics and sources of information for a detailed phenotyping necessary for personalized interventions and biological research.

Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting.

Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation.

Autism in Children

Austic spectrum disorder is a very common presentation where children present with social communication difficulties. They can have behavioural problems and other times anxiety. Every autistic child is different and they may come anywhere in the autistic spectrum, ranging from sensory difficulties, social adjustment to food, sleep and concentration challenges. The main aim of this article to bring awareness about autism to the society and to give Austic children help and support to be able to maintain a safe and healthy lifestyle. It is very important to involve a health care practitioner and get the necessary care and advice from the doctor. It is equally important to organize fun interactive games, activities and book reading for children with Autism to help and support them with their difficulties. All of these things can be done with family support and encouragement, however, it can be very challenging and Children with Autism need professional diagnosis, support in community and teachers to guide them.

Exploring the Effects of Augmented Reality on the Emotion Recognition Skills of Autistic Children

Autistic children have significant difficulties in recognizing and labeling emotions, difficulties which may hinder the natural development of their ability to express and regulate further emotions. The purpose of this study was to evaluate the effect of an augmented reality emotion recognition program (ARERP) delivered in a group format on the emotion recognition of young autistic children. This study employed a concurrent multiple probe design across behaviors to evaluate the effects of the training on children’s emotion recognition. The target behavior was recognizing three emotion sets: positive, negative, and complex. The sequence of conditions included pre-test, baseline, training, post-test, and follow-up sessions. Positive results were found across all four children who all achieved 100% accuracy in identifying emotions during the training. Further, the emotion recognition skills were successfully maintained for 4–7 weeks post-training, with observed generalization to untrained still pictures and GIFs. This study provides preliminary evidence supporting the effectiveness of AR-based group training for young autistic children.

The use of Language ENvironment Analysis in autism research: A systematic review.

In research, language ability has historically been measured using structured tasks in laboratory settings. In recent years, there has been a growing emphasis on the need to instead capture language ability in an individual's natural setting (i.e. through social interaction or in their home). Considering natural language may be particularly important for the autistic population, as an autistic child's language ability can be very different depending on the setting. One common tool for capturing natural language is the LENA recording system, which takes audio recordings over long periods of time and provides estimates of children's and caregivers' speech. The purpose of this systematic review is to summarize the use of LENA in autism research, to highlight the strengths and limitations of the system as identified by researchers, and to provide recommendations for future research and clinical use. We identified 42 autism studies that used LENA in a variety of ways and settings. Most studies used LENA within the guidelines put forth by its creators, and it was most commonly used to understand speech or speech development for autistic children. LENA is a useful tool for clinicians and caregivers to gain some insights into child speech, but those considering using it should be aware of concerns about its accuracy and limitations about the information it provides. In this review, we supplement the official LENA guidelines with specific suggestions for use with the autistic population.

Seeing it in others versus doing it yourself: Social desirability judgements and conversation production data from autistic and non-autistic children.

During a conversation, on average, autistic individuals are often more likely than non-autistic people to provide an off-topic comment and/or to pause for longer before providing a response. One possible explanation for this is that autistic individuals prefer, or are more tolerant of, unconventional communication styles. To explore this possibility, we investigated whether autistic and non-autistic 9-13-year-olds find off-topic or delayed responding a deterrent to friendship or interaction. Participants listened to scripted conversations and then rated social desirability statements, such as 'I would enjoy chatting to the [target speaker]'. We also examined the prevalence of these behaviours in children's own conversational responses. We found that autistic children were just as likely as non-autistic children to dis-prefer unconventional conversational responding. Both groups indicated that they were less likely to want to be friends with the speaker, or to chat with them, when they provided off-topic or delayed responses. However, despite their judgements of others, the same autistic children were more likely to provide off-topic responses themselves than their non-autistic peers, as well as giving fewer on-topic responses which facilitate back-and-forth conversation. Overall, this is problematic for autistic children, as our findings suggest that the tendency to exhibit unconventional conversational behaviours will have negative social consequences, even when interacting with other autistic peers.

What role does the environment play in language development? Exploring the associations among socioeconomic status, parent language input, and language skills in school-aged children with autism.

Language development in children with autism is influenced by proximal (e.g., parent language input) and distal (e.g., socioeconomic status) environmental constructs. Studies have found that "rich and responsive" parent language input supports autistic children's language development, and recent work has reported positive associations between measures of socioeconomic status (SES) and child language skills. However, little is known about how these proximal and distal environmental constructs interact to shape language development in autism. In a sample of 74 autistic school-aged children, the present study investigated the associations among measures of SES, the quantity and quality of language produced by parents and children during home-based dyadic parent-child interactions, and children's expressive and receptive language skills. Results showed that annual household income was positively associated with parent number of total words (NTW), parent number of different words (NDW), and parent mean length of utterance (MLU), while neither parent education level nor annual household income were significantly associated with measures of child language skills. Parent MLU was positively associated with child MLU and child expressive language skills. Findings suggest that annual household income may influence both the quantity and quality of parent language input, and that parent MLU, a qualitative measure of parent language input, may play a particularly important role in shaping autistic children's expressive language development. Future research should study longitudinal associations among SES, parent language input, and child language skills, as identifying environmental predictors of language skills in autism may facilitate the creation of more effective interventions that support language development.

Evaluation of neurotransmitters (Gamma-aminobutyric acid and serotonin) and apoptosis factor (Caspase-7) as biomarkers for the diagnosis of autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disability characterized by impaired communication and social skills along with restricted interests and repetitive behaviors. Biomarkers such as γ-aminobutyric acid (GABA), serotonin (5-Hydroxytryptamine, 5-HT) and caspase-7, showing potential for early diagnosis and management of ASD. To evaluate the effectiveness of GABA, serotonin and caspase-7 as novel biomarkers to predict autism at an early stage. A case- control study which started from November 2023 to June 2024, that involved 77 children’s patients, newly diagnosed with autism. The control group was comprised of 61 age- and sex-matched apparently healthy children, they had no history of autism and any other chronic diseases. Serum samples were analyzed for GABA, serotonin and caspase-7 by using enzyme linked immune-sorbent assay (ELISA) technique. The statistical package for social sciences (SPSS- 26) was used for data analyses. The study revealed significantly elevated GAMA and caspase-7 levels; while, no significant differences of serotonin level between the autistic children’s patients and the control group. This study provides a groundbreaking revelation of the biochemical markers (GAMA and caspase-7) and autism spectrum disorder, the myriad metabolic and neurochemical dysfunctions of which form a complex tapestry of ASD.

IMITASD: Imitation Assessment Model for Children with Autism Based on Human Pose Estimation

Autism is a challenging brain disorder affecting children at global and national scales. Applied behavior analysis is commonly conducted as an efficient medical therapy for children. This paper focused on one paradigm of applied behavior analysis, imitation, where children mimic certain lessons to enhance children’s social behavior and play skills. This paper introduces IMITASD, a practical monitoring assessment model designed to evaluate autistic children’s behaviors efficiently. The proposed model provides an efficient solution for clinics and homes equipped with mid-specification computers attached to webcams. IMITASD automates the scoring of autistic children’s videos while they imitate a series of lessons. The model integrates two core modules: attention estimation and imitation assessment. The attention module monitors the child’s position by tracking the child’s face and determining the head pose. The imitation module extracts a set of crucial key points from both the child’s head and arms to measure the similarity with a reference imitation lesson using dynamic time warping. The model was validated using a refined dataset of 268 videos collected from 11 Egyptian autistic children during conducting six imitation lessons. The analysis demonstrated that IMITASD provides fast scoring, takes less than three seconds, and shows a robust measure as it has a high correlation with scores given by medical therapists, about 0.9, highlighting its effectiveness for children’s training applications.

A Comprehensive Investigation of Social Anxiety and Social Evaluative Stress in Autistic Children and Adolescents and Specific Learning Disorders.

The aim was to investigate trait social anxiety and social evaluative stress in autistic children and adolescents and Specific Learning Disorders (SLD). This was done by evaluating behavioral, subjective, and autonomic responses to the Trier Social Stress Test (TSST). Study 1 included 280 children and adolescents: 60 autistic without intellectual disability (ID), 70 SLD, and 150 non-diagnosed (ND) peers. Study 2 involved 55 participants: 15 autistic without ID, 15 SLD, and 20 ND. The sample was predominantly male. In Study 1, behavioral (quality of public speech) and subjective (valence, arousal, perceived competence, and worries) aspects of social stress were examined. Study 2 expands upon the first study, as physiological responses to social stress were also measured. Trait social anxiety was investigated using both parents' and children's reports in the two studies. Parents of autistic participants and with SLD reported higher trait social anxiety in their children than the parents of ND. No differences emerged from the participants' self-reports, though those autistic and with SLD were assigned lower scores in the public speech quality than ND. Autistic children and adolescents reported lower arousal and higher perceived competence than ND, while those with SLD reported a lower perception of competence. Autistic participants had a decreased cardiac reactivity across the TSST when compared to SLD and ND. Our findings show unique patterns of responses within each group, confirming that the combined investigation of trait anxiety and social stress responses could be a valuable insight in research and clinical practice.