Autism Spectrum Research Articles

Psychogenic fever and neurodevelopmental disorders among Japanese children

BackgroundPsychosocial stress can induce various physical symptoms, including fever, which is a commonly seen symptom in pediatric practice. In cases of unexplained fever, psychogenic fever should be considered as a potential cause. Children with neurodevelopmental disorders may be more vulnerable to stress and therefore more prone to developing somatic symptoms than their peers. This study aimed to elucidate the characteristics of children with psychogenic fever and comorbidity.MethodsThis study included 21 patients with psychogenic fever who visited the Department of Pediatric Psychosomatic Medicine, Okayama University Hospital. Information on age, sex, disease onset, final estimated diagnosis, comorbidities, treatment course, and outcome was obtained from the patients’ medical records.ResultsOf the 21 patients included, 7 were boys and 14 were girls, and their median age was 13.0 (range: 8.6–14.6) years. A total of 19 patients had no attendance at school, and all patients showed signs of maladjustment in school. The comorbidities included orthostatic dysregulation (n = 4) and migraine (n = 3). Neurodevelopmental disorders were observed in nine patients, eight of whom were diagnosed after the initial visit. The mean treatment duration was 37.2 months. The outcomes were complete remission (n = 9), improvement (n = 4), discontinuation (n = 1), and referral to another physician (n = 7).ConclusionVarious comorbidities were observed in the patients of this study with psychogenic fever, including the coexistence of neurodevelopmental disorders, such as autistic spectrum disorder. Children with neurodevelopmental disorders are prone to psychological stress resulting from difficulties in social adjustment. It is crucial to understand the developmental characteristics and environmental adaptation of patients to facilitate accurate diagnosis and treatment.

Using Heart Rate and Behaviors to Predict Effective Intervention Strategies for Children on the Autism Spectrum: Validation of a Technology-Based Intervention.

Many children on the autism spectrum engage in challenging behaviors, like aggression, due to difficulties communicating and regulating their stress. Identifying effective intervention strategies is often subjective and time-consuming. Utilizing unobservable internal physiological data to predict strategy effectiveness may help simplify this process for teachers and parents. This study examined whether heart rate data can predict strategy effectiveness. Teachers and coders from the research team recorded behavioral and heart rate data over three months for each participating student on the autism spectrum using the KeepCalm app, a platform that provides in-the-moment strategy suggestions based on heart rate and past behavioral data, across 226 instances of strategy interventions. A binary logistic regression was performed to assess whether heart rate reduction, time to return to heart rate baseline, and documented skills and challenging behaviors predicted strategy effectiveness. Results suggested that heart rate reduction may be a significant predictor, and supported the existing practice of using behavioral patterns as proxies for strategy effectiveness. Additional analyses indicate proactive strategies are more effective and are associated with greater reduction in heart rate, relative to reactive strategies. Further exploration of how internal physiological data can complement observable behaviors in assessing intervention strategy effectiveness is warranted given the novelty of our findings.

Sensory Processing and Anxiety: Within and Beyond the Autism Spectrum.

In this article, we briefly overview how the expression, measurement, and treatment of anxiety in autism may be different from the general population. We review the literature on links between sensory processing differences and anxiety, which show transdiagnostic patterns but are an especially prominent feature of anxiety in autism. Specifically, we focus on how the sense of interoception, i.e., how we perceive sensory information from within our bodies, contributes to anxiety in autism. We present new findings integrating multimodal interoceptive measures and total anxiety symptoms in a sample of n=38 non-autistic and n=43 autistic individuals, ages 8-55years. Using principal components analysis, we found two components relating to interoceptive confusion (i.e., self-reported ability to localize and interpret interoceptive cues): one component that closely relates to anxiety symptoms and one component that is distinct from anxiety. Interoceptive perception (i.e., performance on a lab-based task) was uniformly related to interoceptive confusion when distinguished from anxiety but showed complex relations with total anxiety symptoms. Combined, these findings suggest meaningful subtypes of interoceptive difficulties and their interrelationship with anxiety. We present conclusions and future directions for consideration of individual differences, toward creating a personalized understanding of anxiety-interoception links.

Predictors of Adaptive Behaviors in Individuals on the Autism Spectrum as Assessed by Teachers and Parents: An Analysis Based on ABAS-3.

Objectives: This present study focuses on analyzing the adaptive behaviors of individuals on the autism spectrum as perceived by parents and teachers of these individuals. Methods: This study was conducted in Poland with the use of the ABAS-3 (Adaptive Behavior Assessment System). The ABAS-3 tool involves both parents (or primary caregivers) and teachers in the diagnostic process and monitoring of adaptive development. The study included 99 individuals (29 girls, 70 boys) aged between 5 and 21 years. Results: The analysis of the results showed statistically significant discrepancies in the perception of adaptive skills diagnosed as assessed by parents and teachers. Furthermore, differences were found in the predictors of the General Adaptive Composite and adaptive domains. Conclusions: The results indicate the complexity of the assessment of adaptive skills by a parent of a child with autism spectrum disorder, as well as a teacher, and the need to include different perspectives in the process of diagnosing and supporting individuals with ASD.

Intestinal Dysbiosis and its Relationship with Autistic Spectrum Disorder in Kids

This systematic review analyses the possible association between the intestinal microbiota and Autism Spectrum Disorder (ASD). It delves into the involvement of the gut-brain-microbiota axis and other factors implicated in maintaining a healthy microbiota. The brain and the gastrointestinal tract (GIT) exchange information with a bidirectional pathway. Multiple neurodegenerative diseases such as Parkinson's and Alzheimer's are linked to dysbiosis, an alteration in the gut microbiota. However, there is evidence supporting the association between dysbiosis and the neurodevelopment of ASD. Therefore, current treatment options focus on patient nutrition and diet. In this review, the best evidence regarding the effect of nutrition on children with ASD.

Is it still autism? The increasing broadening of the autism spectrum.

Clinical significance of a broad autism phenotype (BAP) seems to be increasingly supported by growing reports of high prevalence of subthreshold autism spectrum disorder (sASD) or autistic traits (AT) in various demographic samples, particularly in individuals with psychiatric conditions. We question this increasing extension of the autism spectrum and its potential negative consequences for clinical services, research, cultural attitudes, and resource allocation, as well as alternative explanations of what is currently attributed to sASD and AT. In modern psychiatry the diagnostic threshold is paramount and associated with a significant impairment of functioning, implying that symptom specificity is more relevant than sensitivity. Within a syndrome, symptoms have to be present together, with the parts related to and interconnected with the whole. Single autism symptomatic dimensions have low syndromic specificity and can be observed in many different mental disorders. For instance, communication problems may present in communication disorders, social-cognitive difficulties can be found in schizophrenia, and rigid and/or repetitive behaviors can be found in obsessive compulsive disorder. One alternative interpretation of AT and/or sASD relates to personality traits. For example, within the Big 5 Model, low openness is associated with a dislike of change and a narrow range of interests, low extraversion with social withdrawal and coldness, and low agreeableness with disinterest in others and disregard for their feelings. These risks of overreliance on non-specific aspects of autism are particularly likely to occur with screening checklists, self-assessment, or assessment by a lay interviewer with only limited expertise in clinical assessment.

NRXN1-related disorders, attempt to better define clinical assessment.

NRXN1-related disorders are uncommonly reported. The clinical features of the disorders are wide and heterogeneous mainly consisting of undistinctive facial dysmorphism, mild to severe intellectual and speech delay, epileptic seizures, and motor dysfunction. Defects in NRXN1 gene have been identified in cases diagnosed as Pitt-Hopkins-like-syndrome 2 (PTHLS2; OMIM#614325). Literature review of NRXN1-related disorders was conducted and main clinical features of individuals affected by these disorders were analyzed. In addition, clinical features of individuals labelled with PTHSL2 diagnosis were reported. A comparison between international consensus diagnostic criteria for Pitt-Hopkins syndrome (PTHS) and twins presenting with NRXN1-related disorder and followed by this institution were also presented. Our data confirmed that NRXN1-related disorders mainly manifest with undistinctive dysmorphic features and neurological involvement consisting of more or less severe developmental delay/intellectual disability, autistic spectrum disorder, and epilepsy. Relationship between PTHSL2 and NRXN1 remains to be established. Our present analysis denoted a heterogeneous and unspecific clinical framework of the NRXN1-related disorders mainly affecting the nervous system for which the clinical diagnosis remains inconclusive without the support of genetic analysis. Further contributions are necessary to better clarify the clinical assessment of PTHSL2.

Exploring the relationship among hikikomori tendencies, autistic traits, computer game use and eating disorder symptoms.

The hikikomori phenomenon has recently gained growing global interest, and evidences of its association with other psychopathological dimensions are slowly but steadily emerging. We aimed to evaluate the presence and correlates of hikikomori tendencies in an Italian University population, focusing on its relationships with autism spectrum, pathological computer gaming, and eating disorders. In particular, to our knowledge, no study has yet systematically evaluated the latter association, using psychometric instruments tailored to assess eating disorder symptoms. 2574 students were recruited via an online survey. All participants were assessed with the Hikikomori Questionnaire-25 (HQ-25), the Adult Autism Subthreshold Spectrum Questionnaire (AdAS Spectrum), the Eating Attitude test-26 (EAT-26), and the Assessment of Internet and Computer Game Addiction (AICA-S). The results outlined how hikikomori risk was significantly correlated to autistic dimensions, altered eating behaviors, and videogame addiction. The closest relationship was detected with the autism spectrum. Interestingly, pathological computer gaming, most autistic dimensions, and EAT-26 oral control emerged as significant predictors of a greater risk for hikikomori, while the proneness to inflexibility and adherence to routine emerged as negative predictors. Our findings support the association among hikikomori, autism spectrum, pathological computer game use, and eating disorder symptoms.

Know the signs of autism: One of the fastest growing neurodevelopmental disorder

Autism is a lifetime neurodevelopmental condition. It is identified by difference in behavior, social interaction, communication, special interests and sensory processing. These differences can present people on the autism spectrum with challenges in how they interact with their surroundings. Autism is a complicated condition which affects speech, language, neurodevelopmental, sensory perception and social interaction. Some people on the autism spectrum may behave in non-typical ways, often in response to the different ways in which they experience their surroundings. Such behaviors are generally a way to communicate their feeling or to change to a situation, or may result from their heightened sensitivity to a sound or something they have seen or felt. The researchers suggest that genes and environment play major roles in the causing of ASD. A more recent study examined the cell structure, size and shape of the brains of personals with ASD, they demonstrated that different brain regions showed these differences more profoundly than others.

Multidisciplinary clinical assessment and interventions for childhood listening difficulty and auditory processing disorder: Relation between research findings and clinical practice.

Listening difficulty (LiD), often classified as auditory processing disorder (APD), has been studied in both research and clinic settings. The aim of this study was to examine the predictive relation between these two settings. In our "SICLiD" research study, children with normal audiometry, but caregiver-reported LiD, performed poorly on both listening and cognitive tests. Here we examined results of clinical assessments and interventions for these children in relation to research performance. Study setting was a tertiary pediatric hospital. Electronic medical records were reviewed for 64 children aged 6-13 years recruited into a SICLiD LiD group based on a caregiver report (ECLiPS). The review focused on clinical assessments and interventions provided by Audiology, Occupational Therapy, Psychology (Developmental and Behavioral Pediatrics), and Speech-Language Pathology services, prior to study participation. Descriptive statistics on clinical encounters, identified conditions, and interventions were compared with quantitative, standardized performance on research tests. Z-scores were compared for participants with and without each clinical condition using univariate and logistic prediction analyses. Overall, 24 clinical categories related to LiD, including APD, were identified. Common conditions were attention (32%), language (28%), hearing (18%), anxiety (16%), and autism spectrum (6%) disorders. Performance on research tests varied significantly between providers, conditions, and interventions. Quantitative research data combined with caregiver reports provided reliable predictions of all clinical conditions except APD. Individual test significant correlations were scarce, but included the SCAN composite score, which predicted clinical language and attention difficulties, but not APD diagnoses. The variety of disciplines, assessments, conditions and interventions revealed here supports previous studies showing that LiD is a multifaceted problem of neurodevelopment. Comparisons between clinical- and research-based assessments suggest a path that prioritizes caregiver reports and selected psychometric tests for screening and diagnostic purposes.

CHECK Visual Schedules to Support Individuals on the Autism Spectrum

Visual schedules use a series of images and text to visually illustrate a sequence of events, prepare the individual for the following action or step within an activity or chain of activities, and prompt them to follow a series of activities or tasks independently. As an evidence-based practice, visual schedules can be effectively used in different settings across age groups and a range of skills and behaviors for learners with autism spectrum disorder. The authors summarize the key steps of making and using visual schedules using the acronym CHECK. Special education and general education teachers or professionals can use the CHECK strategy to increase the participation and independence of their students on the autism spectrum.

Perceptual Experiences of Autistic People With an Intellectual Disability and People With Williams Syndrome: A Reflexive Thematic Analysis.

Autistic people without intellectual disabilities have increased perceptual capacity: they can process more information at any given time compared to non-autistic people. We examined whether increased perceptual capacity is evident across the autistic spectrum (i.e. for autistic people with intellectual disabilities) and whether it is specific to autism, or also experienced by people with Williams Syndrome (WS). Five autistic adults with intellectual disabilities and five adults with WS took part in accessible, qualitative interviews. Responses were analysed using thematic analysis. Both groups expressed enjoyment of focussed attention, with autistic participants preferring multiple simultaneous inputs. Responses suggested increased perceptual capacity for autistic participants only. The sensory environment was reported to be anxiety-inducing for both groups. This study gives preliminary evidence that increased perceptual capacity may be universal across the autistic spectrum, and specific to autism. Understanding differences in capacity offers more targeted suggestions to support sensory challenges.

Mobile Application for Tracking Children with Autistic Spectrum Disorder: Content Validation and Usability.

This study aims to validate the content and evaluate the usability of the Autism App for screening children with autism spectrum disorder. This methodological study was conducted between August 2023 and March 2024. The study included 15 experts for content validation and nine for usability evaluation, all of whom had experience in the health/technology field. Content validation data were analyzed using the Content Validity Ratio (CVR), and usability was assessed through heuristics using the MATcH-MED instrument. The content validation showed satisfactory CVR values, ensuring the validity of the developed application, with suggestions for revisions regarding aims and structure. The usability evaluation yielded an overall average score of 50.9 points, classified as a high level of usability. The results demonstrated that the App-Autismo has adequate evidence of content validity and usability. By incorporating the experts' suggestions, this tool can be tested in future research for its effectiveness and efficiency.

FMR1 genetically interacts with DISC1 to regulate glutamatergic synaptogenesis

Synaptic development and functions have been hypothesized as crucial mechanisms of diverse neuropsychiatric disorders. Studies in past years suggest that mutations in the fragile X mental retardation 1 (FMR1) are associated with diverse mental disorders including intellectual disability, autistic spectrum disorder, and schizophrenia. In this study, we have examined genetical interactions between a select set of risk factor genes using fruit flies to find that dfmr1, the Drosophila homolog of the human FMR1 gene, exhibits functional interactions with DISC1 in synaptic development. We show that DISC1 overexpression in the dfmr1null heterozygous background causes synaptic alterations at the larval neuromuscular junctions that are distinct from those in the wild-type background. Loss of dfmr1 modifies the DISC1 overexpression phenotype in synaptic formation, suppressing the formation of synapse boutons. Interaction between the two genes was further supported molecularly by the results that dfmr1 mutations suppress the DISC1-mediated upregulations of the postsynaptic expression of a glutamate receptor and the expression of ELKS/CAST protein, Bruchpilot, in presynaptic motoneurons. Moreover, DISC1 overexpression in the dfmr1null heterozygous background causes downregulation of a MAP1 family protein, Futsch. These results thus suggest an intriguing converging mechanism controlled by FMR1 and DISC1 in the developing glutamatergic synapses.

All Hands on Deck: Training Mental Health and Non-mental Health School Providers to Deliver a CBT Anxiety Intervention for Students on the Autism Spectrum

All Hands on Deck: Training Mental Health and Non-mental Health School Providers to Deliver a CBT Anxiety Intervention for Students on the Autism Spectrum

A neuronal marker of eye contact spontaneously activated in neurotypical subjects but not in autistic spectrum disorders

A neuronal marker of eye contact spontaneously activated in neurotypical subjects but not in autistic spectrum disorders

Asperger’s/autistic spectrum disorder project: Transition from higher education to the workplace

The main diagnostic criteria for autistic spectrum disorders (ASD) are communication and social interaction difficulties, which can make the transition from education to the workplace traumatic. A course was organised to help with this transition; with four learning outcomes: i) Knowing oneself: ASD inherent traits and the work setting; ii) Career research: mapping ASD traits onto careers; iii) Workplace issues; and iv) Developing an action plan. Qualitative interviews were conducted. All respondents agreed that the course was useful with two main themes arising: confidence building and identifying with having ASD.

The Role of Synaptic Dysfunction as a Key Driver in Autism Pathogenesis

Autism in childhood is a heterogeneous disease with around 110 phenotypes. Around 800 genes are affiliated with autism including members of neuro-ligand, neurexin, cadherin, GABA receptors, SHANK gene families, mutated UBE3 A on chromosome 15 and SNORD 116 precursor interaction. A predominant 4:1 male to female ratio is found in autistic spectrum disorder. 50 per cent of all autistic children show chromosome deletions and duplications, these are often found on the 15th and 16th chromosome. Copy number repeat variants in DNA are also well described in pathogenesis of autism patients. There is an overlap with other neurodevelopmental syndromes like tuberous sclerosis, Williams-syndrome, Phelan McDermid syndrome and Sphrintzen syndrome. The hypothesis of the term “atypical connectivity” in different brain regions with partial under- and overconnectivity with reduced brain networking at the psychosocial level was described. Different hypothesis about the origin of autism in children were described. The hypothesis of early lack of basic trust, mercury intoxication and different aspects concerning the origin of this extraordinary disease of 2 percent of children were stated but not confirmed to date. Especially low immature production of IgF-1 by oligodendrocytes in the corpus callosum leads to slowing of the PI3K/AKT chain activation of myelination that Ig-F1 could play an important role in the origin of the disease. Synaptic dysfunction with hypomyelination and impaired impulse transmission seem to play an extraordinary role with under- and overconnectivity with reduced brain networking at the psychosocial level in autistic children. Functional underconnectivity is found in 5 different brain areas, prefrontal, parieto-occipital, motor, somatosensory and the temporal region. Functional overconnectivity is often present in temporo-thalamic regions. Recent research shed light on synaptic dysfunctions with disrupted normal impulse signaling. In this review the different neurochemical findings and the correlation of synaptic dysfunction in autistic children will be closely evaluated.

Coparenting Representations and Interactions Among Parents of Preschoolers with an Autism Spectrum Disorder

SYNOPSIS Objective. Coparenting (CP) representations as assessed using self-report or interviews are associated with coparental behavior among families with typically developing (TD) children. The current study examined whether the same would apply among families with children with an Autism Spectrum Disorder (ASD), or that there would be no such association due to the communication and behavioral difficulties related to children’s diagnosis. Design. The CP representations of parents of 80 preschooler boys with ASD were assessed using self-report, and CP behaviors were assessed in the Lausanne Trilogue Play (LTP) procedure and in a novel Coparental conversation task. Results. More positive CP representations as reported by mothers, but not fathers, were associated with more positive Coparental behaviors during the LTP and during the parental conversation task, even after controlling for children’s cognitive level and severity of symptoms and for parents’ Broad Autism Phenotype and years of education. Conclusions. Coparenting as studied in families of TD children is applicable in families with children with ASD.

Exploratory analyses of sleep intraindividual variability and fatigue in parents of children on the autism spectrum.

Fatigue is associated with numerous harmful physical and mental health outcomes. Despite the established relationship between sleep and fatigue, research examining sleep variability within a person (i.e. intraindividual variability; IIV) and fatigue is limited. In addition, the associations between child and parent sleep regarding parent fatigue have not been explicitly explored, which could be relevant for parents of autistic children with increased sleep disturbance likelihood. The current study used two weeks of objective sleep (actigraphy) and subjective fatigue data from 81 parents and their children to explore associations among child sleep IIV, parent sleep IIV, and parent average daily fatigue, including evaluating evidence for mediation. Sleep IIV was estimated using a validated Bayesian model. Linear regression analyses indicated that greater parent total sleep time IIV predicted significantly higher fatigue levels. Child sleep IIV was unrelated to parent sleep IIV and fatigue, unsupportive of hypothesized mediation. Similarly, post hoc analyses examining child sleep averages, parent total sleep time IIV, and average parent fatigue were insignificant. Findings cautiously support the uniqueness of total sleep time IIV within parental sleep's relationship with fatigue, independent of child sleep. Objective sleep IIV should continue to be examined in addition to average levels.Lay abstractFatigue is associated with numerous harmful physical and mental health outcomes. Despite research indicating a relationship between fatigue and sleep, there has been a limited focus on how the variability of a person's sleep may be associated with fatigue. In addition, previous studies have not explicitly explored relationships among child sleep, parent sleep, and parent fatigue. Increasing knowledge about this area of research could be particularly relevant for families with autistic children with an increased likelihood of sleep disturbances. The current study used two weeks of objective sleep (actigraphy) data and subjective ratings of parent fatigue from 81 parents and their autistic children to examine associations among child and parent within-person sleep variability regarding average parent fatigue levels. Evidence was assessed for the role of parent sleep variability in hypothesized connections between child sleep variability and parent fatigue. We found that only greater variability in parents' total sleep time was associated with higher levels of parents' average daily fatigue rating over the two weeks. Child sleep variability was not significantly associated with parent sleep variability or average daily fatigue. In addition, average levels of child sleep were unrelated to parent total sleep time variability and fatigue. Although cautious interpretation is required, findings support the idea that variability in total sleep time may be a unique aspect of parental sleep's association with fatigue, independent of child sleep. In addition, sleep variability could be important to consider when examining sleep in addition to average levels of parameters like total sleep time.