Autism Spectrum Disorder In Japan Research Articles

Qualitative Study of Wives of Husbands with Autism Spectrum Disorder: Subjective Experience of Wives from Marriage to Marital Crisis

Despite increasing recognition of the involvement of adults with autism spectrum disorder (ASD) in intimate relationships, little is known about the dynamics of marriages where one partner has ASD. This study aimed to clarify the subjective experiences of wives of husbands with ASD from marriage to marital crisis. Semi-structured interviews were conducted with 15 women married to men with ASD in Japan, in 2016-17. The analysis conducted in this study was based on a modified version of the grounded theory approach. Our investigation revealed how the wives of ASD husbands respond to a crisis after their marriage. The findings describe a process beginning with wives perceiving their husbands as attractive before marriage and then progressing to feeling discomfort with their husbands and struggling with loneliness after marriage. Experiences with social exclusion/inclusion affected this progression. The wives’ repeated discomfort with their husbands and struggles with loneliness eventually led to a major crisis. Finally, the work discusses how these findings may contribute to improving the lives of women with partners with ASD and advances the family stress model.

Food repertoire history in children with autism spectrum disorder in Japan.

Food selectivity is commonly reported in children with autism spectrum disorder (ASD). The aim of this study was to investigate eating habit history in children with ASD. We analyzed 3 day food records completed by the parents and assessed how many unique foods each child consumed. The parents were also interviewed about their child's diet of complementary (i.e. transition) foods and estimated food repertoire at the ages of 3, 6, 12 and 18 years. A total of 28 participants were enrolled in this study. Some participants had ongoing changes in food repertoire from the age of 3 years onward. In two cases, although the number of foods consumed at age 3 years was approximately 50, this decreased markedly, becoming severely limited, by age 5 years. One of the reasons for diminished repertoire was infection, such as acute gastroenteritis and upper respiratory tract infection. In contrast, five patients had a severely limited food repertoire at age 3 years, which later increased to 15 or more. Four patients had good opportunity at school to increase their food repertoire. Diet history varied and changed in response to new opportunities, education and/or the environment. In some cases the number of foods consumed decreased gradually due to anxiety and stress, resulting in a severely limited food repertoire. Some patients had good opportunities to increase their repertoire at school. If an effective program in the early years achieves progress, the eating habits of children with ASD might be changed.

Aripiprazole in the Treatment of Irritability in Children and Adolescents with Autism Spectrum Disorder in Japan: A Randomized, Double-blind, Placebo-controlled Study

We evaluated the efficacy and safety of aripiprazole in the treatment of irritability in children and adolescents (6–17 years) with autism spectrum disorder (ASD) in a randomized, double-blind, placebo-controlled 8-week study in Japan. Patients received flexibly dosed aripiprazole (1–15 mg/day) or placebo. Ninety-two patients were randomized to placebo (n = 45) or aripiprazole (n = 47). Aripiprazole produced a significant improvement in the mean parent/caregiver-rated Aberrant Behavior Checklist Japanese Version irritability subscale score relative to placebo from week 3 through week 8. Administration of aripiprazole provided significantly greater improvement in the mean clinician-rated Clinical Global Impression-Improvement scores than placebo from week 2 through week 8. All patients randomized to aripiprazole completed the study, and no serious adverse events were reported. Three patients in placebo group discontinued. Aripiprazole was effective and generally safe and well-tolerated in the treatment of irritability associated with ASD in Japanese children and adolescents.

Sleep problems are more frequent and associated with problematic behaviors in preschoolers with autism spectrum disorder

BackgroundChildren with autism spectrum disorder (ASD) often suffer from sleep problems that in turn correlate with behavioral problems. However, in Japan, there have been few studies of sleep problems in children with ASD. AimsThis study compared sleep problems in preschoolers from the community and preschoolers with ASD in Japan, and examined whether sleep problems were related to problematic behaviors in ASD preschoolers. Methods and proceduresSleep problems were assessed in 965 community and 193 ASD preschoolers using the Japanese Sleep Questionnaire for Preschoolers, which was developed to assess sleep problems in Japanese preschoolers. Behavioral problems were assessed in 107 ASD preschoolers using the Child Behavior Checklist. Outcomes and resultsCompared with community preschoolers, ASD preschoolers experienced significantly more sleep problems, including obstructive sleep apnea and parasomnias. ASD preschoolers with sleep problems exhibited more behavioral problems than those without sleep problems. The severity of sleep problems, especially insomnia, was significantly correlated with behavioral problems in ASD preschoolers. Conclusions and implicationsThe present study suggests that sleep problems, especially obstructive sleep apnea, are more common in ASD preschoolers than in community preschoolers. The study also shows that sleep problems, especially insomnia, are related to problematic behavior in ASD preschoolers.

Psychometric properties of the Repetitive Behavior Scale-Revised for individuals with autism spectrum disorder in Japan

Restricted and repetitive behaviors (RRBs) constitute a core symptom of autism spectrum disorder (ASD). The Repetitive Behavior Scale-Revised (RBS-R) is a widely used questionnaire administered by parents or caregivers to assess RRBs in individuals with ASD. This study evaluated the psychometric properties of the RBS-R Japanese Version (RBS-R-J). The ASD and non-ASD groups comprised 274 and 36 participants, respectively. We examined corrected item-total correlation, Cronbach's alpha, and RBS-R-J scores of different diagnostic groups, as well as correlations between RBS-R-J scores and intelligence quotient (IQ), autistic symptoms, adaptive/maladaptive functioning, aberrant behaviors, and sensory processing. All items showed moderate corrected item-total correlations. Cronbach's alpha coefficient was .93. We found significant differences in the mean RBS-R-J scores of the low-functioning ASD group and the intellectual disabilities group, and of low-functioning and high-functioning ASD groups. RBS-R-J scores negatively correlated with IQ and scores on the Sensory Profile (Japanese version) and Adaptive Behavior Composite of the Maladaptive Behavior Index of the Vineland Adaptive Behavior Scales-Second Edition (VABS-II; Japanese version), but positively correlated with scores on the peak and current symptoms subscales of the Pervasive Developmental Disorders Autism Society Japan Rating Scale, the VABS-II, and the Aberrant Behavior Checklist-Community (Japanese version). From these results, we conclude that RBS-R-J showed good reliability, diagnostic validity, and convergent validity, indicating that it is a reliable, valid instrument for use among ASD individuals in clinical and research settings.

From research to practice in child and adolescent mental health

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PP249-MON: Food Selectivity and Nutritional Deficiencies in Children with Autism Spectrum Disorders in Japan

PP249-MON: Food Selectivity and Nutritional Deficiencies in Children with Autism Spectrum Disorders in Japan

Factors influencing time lag between first parental concern and first visit to child psychiatric services in children with autism spectrum disorders in Japan

The early assessment of autism spectrum disorders (ASDs) is important to improving patient outcomes, allowing family members to prepare for and cope with symptoms, and assisting in plans for appropriate educational opportunities. However, little is known about factors that influence the time lag between the parents’ first concerns and the first visit to a hospital that offers child psychiatric service. We investigated factors associated with the time lag between the first parental concern and the first visit to a hospital that offers child psychiatric services, among children in Japan with ASDs. A questionnaire was distributed to caregivers of ASD children, through child psychiatrists who work at 16 leading hospitals in child psychiatric services in Japan ( N = 1513). We found that a younger child age, a caregiver's lack of knowledge of whom to consult when first concerned about symptoms, and the typically indirect means of attaining services (especially without a referral) each heightened the odds of there being a longer time lag. Visiting another institution, and then going to a hospital that offers child psychiatric services without a referral, was a typical scenario that often led to such time lags. A national health policy to facilitate a referral system that coordinates hospitals that offer child psychiatric services with other medical institutions, the health sector, the welfare sector, and educational institutions is needed, to promote the timely provision of child psychiatric services.