Autism Severity Research Articles

The latent structure of the Delis-Kaplan system for autism.

A core feature of autism is deficits in executive functioning (EF), including difficulty with planning, cognitive flexibility, and working memory. Despite a growing need for evidence-based assessments of EF for autism populations, statistical models of many commonly used measures of EF, including the Delis-Kaplan Executive Function System (D-KEFS), have not been investigated for a sample of autistic participants. The purpose of this study was to address a gap in the literature regarding the latent structure of the D-KEFS in a sample of autistic individuals. The D-KEFS is one of the most widely used clinical assessments of executive function, but its factor structure has not been examined in a sample of autistic participants. Reliability analyses were performed for sample subgroups based on participants' clinical and demographic characteristics, including IQ, autism severity, age, and race/ethnicity. Verbal Fluency (VF) was found to consistently decrease or not affect the overall reliability score. Additionally, one- and two-factor structure models were tested for the D-KEFS with a sample of autistic participants. The one-factor model was not found to be a good fit for the data. However, the two-factor model, with Cognitive Flexibility and Abstraction latent factors, was found to fit the data relatively well. This two-factor model was reexamined excluding the VF observed variable, resulting in a better overall model fit. Communication deficits are a common feature of autism, which explains why the VF task, that requires participants to produce novel words, may not be an adequate measure of executive function for autism populations.

Expressive language variation, growth and predictors in Mandarin-exposed young children with autism spectrum disorder

Utilizing the Putonghua Communicative Development Inventory-Toddler Form, this longitudinal study assessed expressive language development (including lexicon, grammar, and decontextualized language) twice over a year’s span in two subgroups (high verbal, low verbal) of 77 2–6-year-old Mandarin-exposed children with autism spectrum disorder (ASD). Both subgroups showed the steeper increase of structural language (lexicon and grammar) vs. the flatter growth of decontextualized language. Moreover, children’s initial language skills (but not autism severity or language environment) predicted language outcomes one year later in both groups. The use of decontextualized language also predicted structural language development in the low verbal group. These findings confirmed the uneven expressive language growth across multiple language domains in subgroups of children with ASD and underscored the contribution of early language skills to their expressive language development. Moreover, the slow growth and significant predictivity of decontextualized language warrant targeted intervention in promoting children with ASD’s talk beyond the ‘here-and-now’ situation in communication.

The role of infectious agents and the gut microbiome in the development of the autistic spectrum in children

The article presents the results of studies of microbiome features in patients with autism spectrum disorders. The role of the microbiota as a part of the enteral nervous system influencing the dynamics of autism symptoms is considered. The links between eating behavior and the severity of autistic disorders, increased permeability of the gastrointestinal mucosa and hypoxia of brain cells, the nature of intestinal dysbiotic disorders, the severity and clinical manifestations of autism are shown. Taking into account the presented data, optimal approaches to the diagnosis and therapy of autism spectrum disorders are shown, which can significantly improve the quality of life of patients.

Comparison of MicroRNA Levels of 18-60-month-old Autistic Children with Those of Their Siblings and Controls.

The present study aims to compare the levels of 7 microRNAs (mi-RNAs) (mi-RNA-125b, mi-RNA-23a-3p, mi-RNA-146a-5p, mi-RNA-106a, mi-RNA-151a-3p, mi-RNA-28, mi-RNA-125a) in the blood of the preschool children with autism and those of their siblings with healthy controls, and to investigate the association between these mi-RNAs and the severity of autism, behavioral problems, and siblings' autistic traits. A total of 35 children diagnosed with autism spectrum disorder (ASD) at the ages of 18-60 months (patient group), 35 non-affected siblings of the ASD group (sibling group), and 30 control subjects (control group) were involved in the study. The severity of ASD was measured using the Childhood Autism Rating Scale and the Autism Behavior Checklist (ABC). The behavioral problems of the children with ASD were assessed with the Aberrant Behavior Checklist, and the autistic traits of the siblings were assessed using the Autism spectrum screening scale for children. mi-RNA-106a-5p, mi-RNA-151a-3p, and mi-RNA-28-3p were found to be expressed significantly lower in the patient group compared to the control group. There was a significant positive correlation between mi-RNA-23a and the sensory subscale of the ABC. mi-RNA-151a was significantly associated with sound sensitivity and mi-RNA-28 with echolalia. After controlling for age and sex, the differences between groups were disappeared. The present study examined mi-RNAs that have been reported as biomarkers in the literature. Although several symptom clusters are found to be related to certain mi-RNA expression levels, they were not found to be significant in discriminating the patient and healthy groups.

Being the Mother of a Special Child: Resilience and Marital Adjustment in Mothers of Children with Autism Spectrum Disorder.

This study aims to examine the levels and the relationship between resilience and marital adjustment in mothers of a child diagnosed with autism spectrum disorder. Seventy mothers with a child diagnosed with autism spectrum disorder who have been followed up in the Child and Adolescent Psychiatry Outpatient Clinic of Bakırköy Training and Research Hospital for Psychiatry Neurology and Neurosurgery and 74 mothers with a typically developing child to form the control group were included in the study. The Childhood Autism Rating Scale was applied to assess the severity of autism symptoms in children. Sociodemographic form, Beck Depression Scale and Beck Anxiety Scale were applied. The Psychological Resilience Scale for Adults was used to assess resilience. The Marital Adjustment Scale was applied to evaluate the participants' marital adjustment. The level of resilience (P < .001) and marital adjustment (P = .002) in mothers of children with autism spectrum disorder were found to be lower when compared to mothers with a typically developing child. There is a negative correlation between the level of resilience and the severity of autism (P = .002) (r = -0.361). A positive correlation was found between marital adjustment and resilience (P < .001) (r = 0.465). High levels of depressive symptoms (P = .003), low marital adjustment (P = .003), and low educational level were found to be predictive of low resilience (P = .044). Taking advantage of the fact that resilience is a dynamic process, there is a need to develop strategies to increase resilience in mothers of children with autism spectrum disorder, which will also give rise to individual and marital well-being.

Evaluation of sleep problems and related factors in children newly diagnosed with autism spectrum disorder

Objectives The aim of this study was to examine sleep problems in newly diagnosed children with autism spectrum disorder (ASD) and compared these problems with typically developing (TD) children in early childhood period. We also evaluated the factors that may be related to sleep problems in ASD group. Methods Forty-eight children with ASD and 46 TD children, and their parents were enrolled in the study. The severity of autistic symptoms and mother–child relationship of children with ASD, and developmental level of all children were assessed. The parents completed questionnaires related to their children’s sleep, behavioral problems, and their own psychiatric symptoms. Results ASD group did not differ from controls in terms of sleep problems. Sleep problems were associated with behavioral problems (p < 0.001), developmental level (p < 0.05), autism severity (p < 0.01), maternal psychopathology (p < 0.01) and mother–child relationship quality (p < 0.05) in ASD group. However, behavioral problems had the strongest association with sleep problems. Conclusions The similarity in sleep problems between children with ASD and typically developing (TD) children during early childhood highlights the clinical importance of recognizing and addressing these challenges early on. Particularly, given the strong association with behavioral problems in children with ASD, clinicians should prioritize comprehensive assessments and interventions targeting behavioral aspects to improve sleep outcomes. This study calls for further research into the developmental trajectory of sleep problems in ASD children, contributing valuable insights to the broader literature on effective clinical approaches for this population in their management.

Investigation of communicative behaviors and communication functions of Turkish individuals with autism spectrum disorder through Communication Matrix

Objectives This study investigates the communication functions and communicative behaviors of Turkish individuals with Autism Spectrum Disorder (ASD), using the Turkish adaptation of the Communication Matrix. Methods Thirty participants with ASD (24 males, six females; age 2;5–22;11) were assessed using the Turkish Communication Matrix, the Childhood Autism Rating Scale (CARS), and Denver-II Developmental Screening Test. Based on the CARS scores, the participants were categorized into mild-moderate and moderate-severe autism groups. Differences in Communication Matrix scores between the groups were analyzed using the Mann Whitney-U Test, while the relationship between Communication Matrix and CARS scores was examined through Spearman’s correlation. Results Mild-to-moderate autistic participants exhibited more often and diverse communication functions and communicative behaviors, especially in behavior regulation (refuse and obtain), social interaction, and information-seeking or information-providing behaviors than those with moderate-to-severe autism. Significant differences emerged in communicative behaviors for social interaction and information-seeking or information-providing behaviors. A significant negative correlation was observed between CARS scores and communicative behaviors for social interaction and information-seeking or information-providing behaviors. Conclusions Increased autism severity reduces the diversity and functionality of communicative behaviors. Social interaction and information-seeking or information-providing behaviors are the skills that are most impacted by autism severity.

Flourishing and Functional Difficulties among Autistic Youth: A Confirmatory Factor Analysis.

The International Classification of Functioning, Disability, and Health for Children and Youth outlines body structures and functions and activities and participation to fully describe elements that support or detract from participation. While flourishing has gained attention in recent literature, research also points to the role of functional difficulties among autistic youth in influencing participation. Clearly, function is a multi-dimensional and complex construct and likely consists of both indicators of flourishing and functional difficulties. We used data from the National Survey of Children's Health (NSCH) from 2016 to 2020 to identify aspects of flourishing functional difficulties to achieve the following aims: (1) Investigate the factor structure of flourishing and functional difficulties among autistic youth ages 10-17 years; and (2) examine the extent to which child variables (i.e., sex, age, race, ethnicity, autism severity, poverty) are associated with flourishing and functional difficulties. Autistic children (n = 2960) between the ages of 10 and 17 years were included. We used confirmatory factor analysis followed by a multivariate general linear model (GLM) to examine the association between child variables and factors. Results indicated a six-factor structure (medical conditions, instrumental activities of daily living, activities of daily living, social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08 [p = 0.926], comparative fit index = 0.94, Tucker-Lewis index = 0.91). Multivariate GLM showed that child factors were differentially and significantly associated with factors of functional difficulties and flourishing. Current findings suggest that 16 items measured by the NSCH result in a six-factor structure of flourishing and functional difficulties among autistic youth. A comprehensive approach to capture function among autistic youth must assess aspects of flourishing and difficulties.

Assessment of brain-derived neurotrophic factor levels in serum of children with autism spectrum disorders

BackgroundThe autism spectrum disorder (ASD) has no identified biomarker for early detection or for its severity. As for the brain-derived neurotrophic factor (BDNF), it is a crucial neurotropic factor that regulates the plasticity and maturing of neuronal synapses. Accordingly, it might influence how children with autism develop.MethodTo evaluate the BDNF serum levels in autistic children and their relationship with the illness severity as well as with the common drugs received by autistic patients, 60 patients with autism along with another 60 normally developing children were involved in the study. Using the Childhood Autism Rating Scale (CARS), the severity of autism was then evaluated. The ELISA method was used to measure the BDNF level.ResultsIt was seen that the BDNF concentrations were higher in autism patients (P < 0.001). There was also a highly strong positive association between the CARS score and the BDNF (P < 0.001). Using the cut-off value of > 2.8 of BDNF helped to distinguish between well-developing and autistic children, with the aspects of “sensitivity” and “specificity” being 88.3% and 80%, respectively. Moreover, children with autism who received omega-3 had statistically lower levels of BDNF than those who did not take any (P = 0.040).ConclusionThe serum BDNF concentration is higher in autism; this proposes that the BDNF may contribute to the onset or progress of autism. Therefore, it may be used as a noninvasive biomarker for the illness severity because of its greater occurrence in autistic children who have severe social impairment.

Promoting emotional and behavioral interventions in ASD treatment: Evidence from EPIGRAM, A naturalistic, prospective and longitudinal study

BackgroundPrognostic factors from naturalistic treatment studies of children with Autism Spectrum Disorder (ASD) remain largely unknown. We aimed to identify baseline and treatment-related prognostic predictors at 1-year follow-up after Integrative Care Practices (ICPs). MethodsEighty-nine preschool children with severe ASD were given ICP combining nine therapeutic workshops based on children’s needs. Participants were assessed at baseline and during 12 months follow-up with the Psycho-educational Profile-3-R, Children Autism Rating Scale, Parental Global Impression, and the Autistic Behaviors Scale. We assessed prognostic predictors using multivariable regression models and explored treatment ingredients influencing outcome using Classification and Regression Trees (CART). ResultsMultivariable models showed that being a child from first generation immigrant parents predicted increased maladaptive behaviors, whereas play activities had an opposite effect; severity of ASD symptoms and impaired cognitive functions predicted worse autism severity at follow-up; and lower play activities predicted worse parent impression. Regarding treatment effects, more emotion/behavioral interventions predicted better outcomes, and more communication interventions predicted lower autism severity, whereas more education and cognitive interventions had an opposite effect. CART confirmed that more hours of intervention in the emotion/behavioral domain helped classifying cases with better outcomes. More parental support was associated with decreased maladaptive behaviors. Sensorimotor and education interventions also significantly contributed to classifying cases according to outcomes but defined subgroups with opposite prognosis. ConclusionChildren who exhibited the best prognosis following ICPs had less autism severity, better cognition, and non-immigrant parents at baseline. Emotion/behavior interventions appeared key across all outcomes and should be promoted.

Younger age is associated with better outcomes in autism severity, language, and adaptive skills after one school year in autism special education classes

A well-accepted hypothesis in the field of autism spectrum disorder (ASD) is that early intervention is crucial for better outcomes. However, research has noted significant variability in early intervention outcomes. This study examined the role of age in relation to outcomes in comprehensive developmental domains following one year of school in community special education classes for ASD. We compared two groups: a younger group (n = 35) aged 34–59 months and an older group (n = 38) aged 60–91 months. The groups did not differ in cognitive ability, autism severity or adaptive behavioral skills at the start of the school year. After one year, the entire study population showed significant progress in all developmental domains. However, changes in effect size were much more robust in the younger ASD group. Only younger children showed a significant decrease in the severity of communication, awareness and restricted interests and repetitive behavior subdomains and a significant increase in motor adaptive skills. Younger children also showed more remarkable improvement in the naming and expressive subdomains. Respectively, older age predicted more severe ASD symptoms at the end of the educational year.Corresponding to brain plasticity theories, our findings point to an association between age and outcomes. The findings should serve as a benchmark for policymakers regarding early intervention in young children with autism.

Foundations of Vocal Category Development in Autistic Infants.

The present study comparedthe infant's tendency in the first yearof life to produce clusters of particular vocal types (squeals, vocants, and growls) in typically developing (TD) and autistic infants. Vocal clustering provides evidence of vocal category formation and may establish a foundation for speech development. Specifically, we compared the extent of vocal clustering across outcome groups and age groups. We also examined the associations between the extent of vocal clustering and later outcomes at 2years within the autistic group. Randomly selected 5-min segments (27,153 5-min segments total) from 1293 all-day home recordings from 103 TD infants and 44 autistic infants across the first year were humancoded (about 9.75h of data coded per infant on average) to derive vocal clustering patterns. Fisher's exact tests were used to compare the occurrence of squeals versus vocants, as well as growls versus vocants, across coded segments. Infants in both groups demonstrated clear clustering patterns of squeals and growls across all age groups. The extent of vocal clustering in the autistic group did not correlate significantly with later language, repetitive behavior, or autism severity outcomes. These findings highlight the robustness of the systematic production of vocal categories across the first year of life. The similarity of the clustering patterns in the TD and autistic groups suggests that vocal category formation through active infant vocal exploration is a robust feature of early speech development.

Meeting 24-hour movement guidelines among children with autism spectrum disorder and association with autism severity

Meeting 24-hour movement guidelines among children with autism spectrum disorder and association with autism severity

Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years.

Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional studywhere 30 verbal autistic children, aged eight to 15 years, withintelligence quotient (IQ) > 70 were enrolled after utilizing theBinet Kamat Test of Intelligence (BKT) to assess IQand the Indian Scale for Assessment of Autism (ISAA) tograde severity of autism. The children received GSSI frominterdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2):T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 =64.30 (p < 0.0001). This declining trend at T1, T2, and T3suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention foradolescents with ASD, with effects lasting up to three months post-intervention.

Characterising the social interaction style of autism in young adult males with fragile X syndrome.

The characterisation of autism in fragile X syndrome (FXS) has been a source of controversy due to the complexity of disentangling autism traits from common features of the FXS phenotype. Autism in FXS is significantly underdiagnosed in the community, which may be partly due to insufficient clinical description of the social interaction profile of autism within the FXS phenotype. In this study, we applied a classic framework for characterising social interaction styles in autism to a sample of young adult males with FXS and co-occurring autism to enhance understanding of how the social challenges associated with autism manifest within FXS. Participants were 41 males (M age= 18years) with FXS and co-occurring autism. Interaction samples were coded for expression of predominately 'active' (characterised by a desire to make social approaches) or 'passive' (characterised by lack of initiation of social approach towards others) interaction profiles. Differences in the expression of phenotypic features of FXS, including anxiety, attention-deficit/hyperactivity disorder, cognitive, adaptive and language impairments and autism symptom severity, were examined across those with passive and active interaction styles. Approximately half of the sample was classified as active and half as passive, demonstrating diversity in the social phenotype of autism associated with FXS. The two subtypes did not differ in autism severity, anxiety or attention-deficit/hyperactivity disorder symptoms or in cognitive, adaptive or language abilities. This study enhances understanding of FXS-associated autism by documenting phenotypic variability in the social interaction profile in this group, with active and passive social interaction styles represented. The two social interaction styles were not associated with differential expression of common phenotypic features of FXS, suggesting similar support needs.

Intellectual development in young children with autism spectrum disorders: A longitudinal study.

Intelligence profiles in autism have been characterized by great variability. The questions of how autistic children's intelligence changes over time, and what factors influence these changes deserve study as part of efforts to document child autism profiles, but also because the relationship between intellectual functioning and children's background characteristics is poorly understood, particularly in a longitudinal context. A total of 39 autistic children and 39 age-matched neurotypical children (5-9 years old) completed two IQ assessments at preschool age and up to 4 years later. Repeated-measures analyses assessed longitudinal changes in the children's verbal (VIQ), performance (PIQ), and full-scale IQ (FSIQ) at group level. We further sought to identify clusters with distinct profiles in each group by adopting an unsupervised K-means clustering approach, and detect possible between-subgroup differences in terms of children's socioeconomic status and autism severity. The largest cluster in the autistic group was composed of children whose PIQ significantly dropped at follow-up, while the second largest cluster improved in all quotients; the smallest cluster, wherein children had more highly educated mothers than the rest of the clusters, was characterized by large improvement in VIQ. For the neurotypical children, there was a two-cluster division; the majority of them improved in the three quotients, while very few dropped in PIQ at follow-up. The relation between socioeconomic status and IQ changes was significant for both groups. The findings demonstrate both the complexity of intelligence changes in autism and the need to view this complexity through the lens of the children's socioeconomic diversity.

Living on with autism after a devastating earthquake: experiences of children and adolescents in Turkey

Introduction The current study aimed to investigate the psychological impact of the Turkey 2023 earthquakes on children with autism spectrum disorder (ASD) and their parents residing in Hatay, Sanlıurfa, and Ankara provinces, encompassing the periods both before and after the Turkey 2023 earthquakes. Method This cross-sectional, multicenter study included 103 children and adolescents with ASD aged between 6 and 18. Participants were evaluated based on their residence in Ankara, Hatay, and Sanlıurfa, three cities affected differently by the earthquake. Parent-report questionnaires were utilized to assess the children’s autism symptoms and behavioural problems. The Childhood Autism Rating Scale was used to determine autism severity. The psychiatric problems of mothers were also assessed with self-report scales. Results Significantly increased levels of core autism symptoms, irritability, and hyperactivity were found in Hatay and Sanlıurfa participants after the earthquakes compared to before, while no differences were detected in children from the Ankara group. Scale score increases in the Hatay group, which had to take a more extended break from special education, were higher than in the Sanlıurfa group. Participants with late-diagnosed ASD exhibited a more significant increase in their scale scores after the earthquake. Depression, stress and hopelessness scores were the highest, and the life satisfaction levels were the lowest in mothers of the Hatay and Sanlıurfa groups. More pronounced increases were observed in aberrant behaviours among children of mothers with low educational levels following the earthquake. Discussion Our findings demonstrate that the exacerbation of core ASD symptoms and behavioural deterioration after the earthquakes are associated with disruptions in specialized education services, exposure to earthquake-related trauma, and the educational level of mothers.

The importance and challenges of observing social interactions in autistic preschoolers during inclusive educational settings: A scoping review.

A growing number of autistic children have access to inclusive education programs as early as kindergarten. However, little is known about how they actually participate in social interactions and develop their communicative skills according to the parameters of this environment. The aim of this article is to review observational studies on this topic and critically analyze their methodological choices by arguing on the aspects of communication skills noted in the observation grids. Disparities in the information collected depending on the method used have implications for understanding and supporting autistic children in an inclusive school environment. Observational studies on social interactions of autistic preschoolers within inclusive preschool settings were scoped. The studies were analyzed according to the following parameters: aims of observation, method used for coding, communication partners considered (adults and peers), type of children's social engagement (initiatives and responses), diversity of communicative forms and communication functions, distinction and comparison of interactional contexts related to the activities, and whether changes linked to developmental variables are studied on an interindividual or longitudinal basis. Seventeen studies using the observation method in inclusive preschool settings were identified. Recordingmethods are mostly based on video recording. The coding grids mainly focus on autistic children while partners' behaviors (adults, peers) are often coded in less detail, thus providing littleinformation on their dynamic role in the interactions. Overall, autistic children were found to initiate interactions much less often than they respond to it. The data generally distinguish thecommunicative forms used by children and indicate a predominance of nonverbal means at preschool level. However, a few studies coded communicative functions, whether they areaddressed to children or produced by them. In addition, very few studies compare interactions across activity contexts. In addition, very few studies compare interactions across activity contexts.Results of some studies showed that children initiated interaction more frequently during free play than during work activity, but results are heterogeneous. Developmental trajectories in socialskills seem to be associated with the severity of autism and language skills, but longitudinal designs are still rare. Direct and fine-grained observation in the classroom is a key source of information about how communication takes place in preschool-inclusive settings. The data, despite some methodological challenges, offer opportunities for better adjustment based on professional objectives. Our review highlights the importance of offering occasions for initiatives to autistic children and training of neurotypical peers to better interact with autistic children and promote verbal communication. Further observational studies are needed to use more microanalytic measures of the functional quality of social interactions in autistic children, including joint comparisons between partners (adults vs. peers) and across contexts (e.g., play vs. structured development) so that appropriate strategies can be proposed in inclusive preschool settings.

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.