Autism Research Articles

Metallomic profiling and natural copper isotopic signatures of childhood autism in serum and red blood cells

Excessive exposure to metals directly threatens human health, including neurodeve lopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder, leaving great harms to children themselves, their families, and even society. In view of this, it is critical to develop reliable biomarkers for ASD in early childhood. Here we used inductively coupled plasma mass spectrometry (ICP-MS) to identify the abnormalities in ASD-associated metal elements in children blood. Multi-collector inductively coupled plasma mass spectrometry (MC-ICP-MS) was applied to detect isotopic differences in copper (Cu) for further assessment on account of its core role in the brain. We also developed a machine learning classification method for unknown samples based on a support vector machine (SVM) algorithm. The results indicated significant differences in the blood metallome (chromium (Cr), manganese (Mn), cobalt (Co), magnesium (Mg), and arsenic (As)) between cases and controls, and a significantly lower Zn/Cu ratio was observed in the ASD cases. Interestingly, we found a strong association of serum copper isotopic composition (δ65Cu) with autistic serum. SVM was successfully applied to discriminate cases and controls based on the two-dimensional Cu signatures (Cu concentration and δ65Cu) with a high accuracy (94.4%). Overall, our findings revealed a new biomarker for potential early diagnosis and screening of ASD, and the significant alterations in the blood metallome also helped to understand the potential pathogenesis of ASD in terms of metallomics.

The association of vitamin A, zinc and copper levels with clinical symptoms in children with autism spectrum disorders in Jilin Province, China

BackgroundThis study evaluated vitamin A (VA), copper (Cu), and zinc (Zn) levels in the population with autism spectrum disorder (ASD) in Jilin Province, China. Furthermore, we examined their links to core symptoms and neurodevelopment, as well as gastrointestinal (GI) comorbidities and sleep disorders.MethodsThis study included 181 children with autism and 205 typically developing (TD) children. The participants had not taken vitamin/mineral supplements in the prior three months. High-performance liquid chromatography was used to measure serum VA levels. By using inductively coupled plasma–mass spectrometry, Zn and Cu concentrations in plasma were determined. Importantly, the Childhood Autism Rating Scale, the Social Responsiveness Scale, and the Autism Behavior Checklist were used to measure core ASD symptoms. However, the Griffith Mental Development Scales-Chinese were used to measure neurodevelopment. GI comorbidities and sleep abnormalities were assessed with the 6 Item-Gastrointestinal Severity Index and Children’s Sleep Habits Questionnaire, respectively. Children with ASD with GI issues were grouped according to severity (low GI severity and high GI severity groups).Results(i) The difference in VA, Zn, Cu levels and the Zn/Cu ratio between ASD and TD children is small. But children with ASD had lower VA levels and Zn/Cu ratio, higher Cu levels than TD children. Cu levels in children with ASD were associated with the severity of core symptoms. (ii) Children with ASD were much more likely than their TD counterparts to suffer from GI comorbidities or sleep problems. Furthermore, it was observed that high GI severity was associated with lower levels of VA, whereas low GI severity was associated with higher levels of VA. (iii) The children with ASD who had both lower VA and lower Zn/Cu ratio had more severe scores on the Autism Behavior Checklist, but not on other measures.ConclusionChildren with ASD had lower VA and Zn/Cu ratio, and higher Cu levels. Cu levels in children with ASD were weakly correlated with one subscale on social or self-help. ASD children with lower VA levels may face more serious GI comorbidities. Children with ASD combined VA-Zn/Cu lower had more severe core symptoms.Trial registrationRegistration number: ChiCTR-OPC-17013502. Date of registration: 2017-11-23.

Особенности речи и устного дискурса при детском аутизме: описание случая спонтанного билингвизма. Часть I: Клинико-анамнестическое исследование

<p style="text-align: justify;">Impaired communication and speech behavior is considered to be one of the key manifestations of childhood autism. At the same time speech disorders in children with autism have not been sufficiently studied. In a meta-analysis of the modern studies of autism, we present different theories explaining relations between the childhood autism and im­pairments in verbal communication; among others, we focus mainly on semantic-pragmatic and structural-functional levels of speech; spontaneous bilingualism is also discussed. The study describes in detail a case of childhood autism in a Lithuanian-speaking boy D., followed for 6 years. The uniqueness of the given case is that at the very early age D. started demonstrating a preference of English for his native language. Moreover, he learned English exclusively on the basis of media resources found on the Internet by his parents (at his request) and himself. The paper (Part 1) includes detailed information on how verbal communication is formed and data of assessments carried out by a multi­disciplinary group of experts as well as several post-testings by a psychologist and speech-language pathologist.</p>

Опыт апробации психообразовательной программы для семей, воспитывающих детей с расстройствами аутистического спектра

<p style="text-align: justify;">The growing number of children with autism spectrum disorders (ASD) draws the attention of researchers to solving the problems of the family of a child with mental developmental disorders. The purpose of the pilot study was to approbate the psychoeducational program for parents raising children with ASD. The pilot study involved 75 families raising children aged 3 to 5 years with clinically verified diagnoses according to ICD-10 (F84.0x – childhood autism and F84.1x – atypical autism). The psychoeducational program was implemented with the children's parents in the form of group thematic seminars. The following methods were used in the study: Diagnosis of Attitudes towards a Child's Illness (DOBR; V.E. Kagan, I.P. Zhuravleva, 1991); Questionnaire-interview for Parents to Determine the Level of Awareness of the Child's Disease (M.V. Ivanov, O.I. Bogacheva, 2019); a Modified Parental Attitude Questionnaire for a Family Raising a Special Child (I.N. Galasyuk, O.V. Mitina, 2017); “Ways of Coping Checklist” R. Lazarus & S. Folkman (in Russian adapted by L.I. Wasserman, B.V. Iovlev, E.R. Isaeva, et al., 2009); a Questionnaire to Determine the Parenting Skills of Parents of Children with Developmental Disabilities (V.V. Tkacheva, 2006). After completing the psychoeducational program, parents of children with ASD became more aware and accepting of the child's illness, and externality decreased. Parents became more aware of the role of various factors that can both cause the disease and exacerbate its course. The strategies aimed at actively solving problems associated with the child's illness and a positive reassessment of the situation have become the leading ways of parents’ coping. Parents have a greater awareness of their own role in the treatment and rehabilitation process and the further mental development of the child. The focus of parents’ attention has shifted from the negative to positive aspects of the current difficult situation, which makes it possible to look at it not only as a hopeless situation, but also as a source of motivation for action.</p>

Serum Cingulin levels are increased in children with autism spectrum disorder

Background Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders in which the underlying pathogenesis and etiologic factors are not fully understood. The blood brain barrier (BBB) ​​plays a critical role in central nervous system defense by limiting access to circulating solutes, macromolecules, and cells that can negatively affect neuronal activity. The loss of BBB integrity is likely to be seen as a common pathologic finding for many psychiatric disorders such as schizophrenia, ASD, and mood disorders. In this study, we aimed to investigate whether serum Cingulin levels are associated with ASD. Subjects and Methods A total of 40 treatment-naive children with ASD and 40 healthy controls were included in the present study. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime Version-DSM-5 (K-SADS-PL-DSM-5) has been used to screen healthy controls for psychiatric disorders by a psychiatrist after a physical examination by a paediatrician. The clinical severity of the ASD symptoms has been assessed by the Childhood Autism Rating Scale (CARS). Venous blood samples were collected and serum Cingulin levels were measured. Results When the ASD and control groups were compared, CARS and Cingulin values of the patient group were statistically higher than the healthy group. There is a statistically positive correlation between CARS and Cingulin values. Discussion To the best of our knowledge, this study is a first in the literature conducted about the serum Cingulin levels, which is a component of BBB, among patients with ASD. Our findings demonstrate that serum Cingulin levels are meaningfully higher in ASD group compared to the healthy control group. It has been also indicated that there has been a meaningful relationship between serum Cingulin levels and ASD symptom severity.

KNOWLEDGE OF CHILDHOOD AUTISM AMONG THE PRIMARY SCHOOL TEACHERS

Objective: Methodology: To assess the knowledge of childhood autism among primary school teachers in Villupuram district. One hundred and nine teachers were participated in this study. The Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire was used to identify the knowledge of childhood autism among the primary school teachers. The lled questionnaires were collected for data analysis. Result: This result shows majority (78%) of teachers had poor knowledge of childhood autism. Only 22% of teachers had good knowledge of childhood autism. The result of this study paves way to create an awareness Conclusion: of autism among primary school teachers as awareness leads to early identication of autism and early intervention can be provided.

Efficacy of auditory integration therapy (AIT) on plasma syntaxin1A (STX1A) levels and amelioration of behavioral, social, and sensory symptoms in children with autism spectrum disorder (ASD)

Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder. Previous research reported the beneficial effects of Auditory Integration Training (AIT) on a considerable range of behavior and learning problems. Limited studies examined the association between AIT and biological biomarkers in autistic subjects. Therefore, this study aims to examine the effect of auditory integrative training on the plasma syntaxin1A protein (STX1A) level and also to assess its impact on behavioral, social, and sensory symptoms in autistic children, using a sandwich enzyme-linked immunoassay (ELISA). Total scores of the Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Short Sensory Profile (SSP) were calculated before one month and three months after AIT for all participants. Results show that the plasma level of STX1A was significantly increased immediately, one month, and three months after AIT (P<0.05). Moreover, Pearson correlation (r) values between STX1A levels before and after AIT shows strong and positive significant correlations between STX1A levels before AIT and immediately after AIT (r=0.594, p=0.01) and one month after AIT (r=0.819, p=0.01). Additionally, our results revealed that behavioral, social, and sensory symptoms were significantly improved in terms of disease severity three months after AIT (p<0.05). The study supports the usefulness of AIT as a therapeutic intervention to improve some measures of ASD such as symptoms. It may also induce the up-regulation of STX1A in plasma in ASD subjects. However, Additional research, on a larger size population, is necessary to evaluate the AIT effect on behavioral and social changes in ASD children, and the up-regulation of STX1A.

Early diagnosis of autism and other developmental disorders, Brazil, 2013-2019.

To investigate the factors associated with the early diagnosis of autism and other types of pervasive developmental disorder (PDD) in children treated at the Psychosocial Care Center for Children and Adolescents of the Unified Health System, from 2013 to 2019,in Brazil. An exploratory cross-sectional study, based on data from the Record of Outpatient Health Actions (RAAS) of the first appointment of children aged 1 to 12 years. The gross (RRg) and adjusted (RRa) relative risks and respective 95% confidence intervals (95%CI) were estimated using the Poisson regression model with robust variance estimation. Of the 22,483 children included in the study, the majority were male (81.9%), lived in the same municipality where they were diagnosed (96.8%) and in the Southeast region (57.7%). Early diagnosis was higher for childhood autism (RRg = 1.48; 95%CI 1.27-1.71) , PDD without subtype designation (RRg = 1.55; 95%CI 1.34-1.80), other PDD (RRg = 1.48; 95%CI 1.21-1.81) and PDD not otherwise specified (RRg = 1.44; 95%CI 1.22-1.69) than for atypical autism. Children residing in the same municipality where the diagnosis was made had a higher rate of early diagnosis (RRg = 1.31; 95%CI 1.10-1.55) than the others; as well as those referred by primary care (RRg = 1.51; 95%CI 1.37-1.68) and by spontaneous demand (RRg = 1.45; 95%CI 1.31-1.61) than those from other types of referral. Early diagnosis was higher from 2014 and lower in the North region than in the other regions. In the multiple analysis, the magnitude of RRa was similar to that of RRg. Early identification of autism and other PDD has improved in Brazil, but it still represents about 30% of the diagnoses made. The variables included in the model were significant, but still explain little of the early diagnosis of children with autism and other PDD.

Assessment of predisposition in the acquisition of the english language and motor development in children with autism spectrum disorder: Case report

Background: Autism Spectrum Disorder (ASD) is a complex neurobiological disorder. Characterized by language deficits, however, it is known that there is a development of bilingualism in the autistic population. Delay in motor development is present in the population, with deficits in fine and gross motor coordination. Objective: The present study aims to evaluate the predisposition to acquire a second language and motor development in children with ASD. Method: The case report is composed of four children, verbal with the cognitive and physical capacity to participate in the evaluations. Mean age ± 8 years and 3 months, 50% male, 100% literate. Distributed into two groups: group I: two children diagnosed with ASD according to DSM-V and group II: two children with typical development. The group of children with ASD underwent the assessment protocol consisting of the application of the Childhood Autism Rating Scale (CARS) while the Revised Psychoeducational Profile (PEP-R) and the Placement Test were applied in both groups. Result: Children with ASD assessed with CARS had a low level of support. Regarding the PEP-R, the same group showed a deficit in the development of fine and gross motor coordination compared to group II. The child with ASD from the public network had a lower score compared to the child from the private network in relation to the level of development of bilingualism, both in reading and writing. Conclusion: It is possible to suggest that the development of fine and gross motor skills of children with ASD are deficient, however, they demonstrated a good result in the predisposition to learning a second language, including the child who studies in a public school. Although its development is a little smaller.

Gamma-Aminobutyric Acid Type A Receptor Variants are Associated with Autism Spectrum Disorders.

Despite several efforts to identify the causes of autism spectrum disorders (ASD), its etiology remains still unclear. Among other aspects, genes that encode neurotransmitter receptors are strong candidates for autism. Here, we wanted to study some genetic variants of gamma-aminobutyric acid (GABA) receptor subunit genes GABRB3, GABRG3, and GABRA5, located on chromosome 15q11-q13 that might contribute to the etiology of ASD in the affected children of West Bengal. rs7180158, rs2081648 (GABRB3); rs12910555 (GABRG3); rs35399885, rs35832850 (GABRA5) were analyzed in 316 children with ASD and 227 healthy controls. Phenotypic associations were evaluated by Childhood Autism Rating Scale (CARS). Gene expression levels were measured by quantitative real-time PCR. ASD probands showed a higher frequency of "A" allele for rs7180158, "G" allele for rs12901555, and "T" allele for rs35399885. The GA + AA genotypes (rs7180158) and CT + TT genotypes (rs35399885) were found to confer significant risk towards ASD. rs2081648 was found to have transmission bias in the family. Additionally, these variants were found to be associated with one or more of ASD-associated phenotypic traits. Multifactor dimensionality reduction (MDR) analyses showed mostly independent contributory effects of some of the variants. Again, the gene expression levels of GABRB3, GABRG3, and GABRA5 were downregulated in the cases than the controls. ForGABRA5 rs35399885, the CC genotypes corresponded to higher expression levels compared to the other groups. This study reveals that genetic variants of GABAA receptor subunit genes are significantly associated with ASD. No data for the mentioned variants are found in the population of West Bengal, India.

Blood and hair copper levels in childhood autism spectrum disorder: a meta-analysis based on case-control studies.

The association between copper levels and autism spectrum disorder (ASD) has been a controversial topic. This study investigated relationship between copper levels and ASD. The following databases are searched until April 2022: PubMed, EMBASE and Web of Science. Combined effect size standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated with Stata 12.0. In this meta-analysis, 29 case-control studies were included, which included 2,504 children with ASD and 2,419 healthy controls. The copper levels in hair (SMD:-1.16, 95% CI:-1.73 to-0.58) was significantly lower in ASD children than healthy controls. The copper levels in blood (SMD: 0.10, 95% CI:-0.12 to 0.32) not significantly compare ASD with controls. Copper may be associated with the development of ASD in children.

Observing the behavioural effects of methylphenidate in children and adolescents with ASD-ADHD dual diagnosis: A mini review

Research aimThe aim of this study is to focus on the main neurophysiological aspects of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and the current pharmacological treatment used for the management of hyperactivity and attention deficits in children aged 6-20 years with a diagnosis of ASD, not associated with other genetic or epileptic disorders, such as Fragile X Syndrome (FXS), Tuberous Sclerosis, Kleefstra Syndrome or Angelman Syndrome.MethodsThis mini review was conducted according to the P.I.C.O. model and according to the PRISMA guidelines. The keywords used were: autism spectrum disorder; attention deficit hyperactivity disorder; attention deficit disorder; methylphenidate; ritalin; ADHD; youth autism; childhood autism; childhood autism spectrum disorder; adolescent autism. The strings produced were compared and selected by a third independent clinician. The PubMed and PsycArticles search yielded a total of 3,200 articles. For their inclusion, the 3,200 articles were examined by two clinicians who ultimately selected 28 (15 clinical trials and 13 reviews/meta-analyses) articles analysed according to their consistency with the inclusion and exclusion criteria.ConclusionsThree main aspects emerged from the review: (1) According to the existing literature, new randomized controlled trials are needed to ensure a better understanding of the most effective drug treatments for dual-diagnosed ASD-ADHD patients and of the related behavioural effects. Currently, the use of drugs varies depending on psychiatric comorbidity, symptoms, age and gender and there is no univocal reference therapy; (2) Methylphenidate (MPH) has currently been shown to be the most suitable drug for the treatment of hyperactivity and inattention in individuals diagnosed with ASD and ADHD; (3) There is a need to create and evaluate appropriate tests to analyse more specific patterns of behaviour presented in the two conditions.

Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey

BackgroundWe aimed to compare differences in infant feeding patterns (breastfeeding and complementary food supplementation) between children with the autism spectrum disorder (ASD) and typically developing (TD) children through a multicentre study. The relationship between these patterns and later core symptoms and neurodevelopment in children with ASD was also investigated.MethodsWe analysed breastfeeding and complementary feeding patterns in 1389 children with ASD and 1190 TD children. The Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was used to assess neurodevelopmental levels. The Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Childhood Autism Rating Scale (CARS), and ASD Warning Behavior Subscale of the CNBS-R2016 were used to assess ASD symptoms.ResultsChildren with ASD had a shorter breastfeeding duration in infancy (8 (3–12) months vs. 10 (6–14) months, P < 0.001), later introduction of complementary foods (P < 0.001), and poorer acceptance of complementary foods (P < 0.001) than TD children. Total ABC and CARS scores were lower in the group of children with ASD who had been breastfed for 12 months or more than in the group who had been breastfed for less than 6 months. Children with ASD who were given complementary food after 6 months had lower general quotient (GQ), adaptive ability, fine motor and language scores than those who were given complementary food within 4–6 months. Children with ASD with poor acceptance of complementary foods had higher ABC and SRS scores and lower gross motor scores than those who had good acceptance.ConclusionsChildren with ASD have a shorter duration of breastfeeding, a later introduction of complementary foods, and poorer acceptance of complementary foods than TD children. These feeding patterns may be related to the symptoms and growth of children with ASD. The research suggests that continued breastfeeding for longer than 12 months may be beneficial in reducing ASD symptoms and that infants who have difficulty introducing complementary foods should be followed up for neurodevelopment.Trial registrationThe ethics committee of the Children’s Hospital of Chongqing Medical University approved the study. Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194, registered on 23/03/2020).

Toxoplasmosis and cytomegalovirus infection and their role in Egyptian autistic children

Autism is a neurodevelopmental disorder with a significantly increased incidence rate across the world over the past few years. Toxoplasmosis and cytomegalovirus (CMV) infection are globally prevalent and have been associated with diverse neurological and psychiatric disorders. A few studies have demonstrated the role of toxoplasmosis and CMV as potential etiological factors for autism. Accordingly, this study was performed to estimate the relationship between toxoplasmosis and CMV infection in children with autism as well as to assess their impact on the Childhood Autism Rating Scale (CARS) score. A total of 45 autistic children (6 girls, 39 boys) and 45 (21 girls, 24 boys) healthy control children were enrolled in our study. Their blood samples were collected and tested for the presence of Toxoplasma and CMV (IgG and IgM) antibodies and DNA by ELISA and real-time PCR (RT-PCR), respectively. Toxoplasmosis was detected in 11 (24.4%) autistic children through the ELISA [10 (22.2%) IgG + /IgM − and 1 (2.2%) IgG + /IgM +]; however, RT-PCR assay recorded only 1 positive case (2.2%), while it was detected in 10 (22.2%) control children through ELISA [9 (20%) IgG + /IgM − and 1 (2.2%) IgG + /IgM +] and 1 (2.2%) by RT-PCR. On the other hand, CMV infection was detected in all autistic children with 44 (97.8%) testing positive by ELISA [24 (53.3%) IgG + /IgM − , 18 (40%) IgG + /IgM + and 2 (4.4%) IgG − /IgM +] and 25 (55.6%) testing positive by RT-PCR assay. In addition, ELISA assay recorded 43 (95.6%) [19 (42.2%) IgG + /IgM + and 22 (48.9%) IgG + /IgM − and 2 (4.4%) IgG-/IgM +] and RT-PCR recorded 21 (46.7%) positive samples in control children with CMV. No significant difference was noted between autistic and control children for the overall prevalence of Toxoplasma or/and CMV infection. Similarly, the CARS score indicated a non-significant difference with Toxoplasma or/and CMV infection. Our data does not show an association between autism and toxoplasmosis or/and CMV infection. Nevertheless, considering that autistic children are at a high risk of contracting these infections, further studies with a larger sample size are recommended.

Risk factors for developmental quotients in ASD children: A cross-sectional study.

To analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD. We retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent-child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales-Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD. Vitamin D (β = 0.180, p = 0.002), age (β = -0.283, p = 0.000) and CARS score (β = -0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β = -0.503, p = 0.000), ADOS-2 severity score (β = -0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β = -0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β = -0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β = -0.140, p = 0.020), CARS score (β = -0.342, p = 0.000), ADOS-2 severity score (β = -0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD. Vitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.

Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study

BackgroundIndividuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults.MethodsA total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis.ResultsThe results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not.ConclusionOur findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.

Exposure to local, source-specific ambient air pollution during pregnancy and autism in children: a cohort study from southern Sweden

Evidence of air pollution exposure, namely, ambient particulate matter (PM), during pregnancy and an increased risk of autism in children is growing; however, the unique PM sources that contribute to this association are currently unknown. The aim of the present study was to investigate local, source-specific ambient PM exposure during pregnancy and its associations with childhood autism, specifically, and autism spectrum disorders (ASD) as a group. A cohort of 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on locally emitted PM with an aerodynamic diameter < 2.5 µm (PM2.5). A flat, two-dimensional dispersion model was used to assess local PM2.5 concentrations (all-source PM2.5, small-scale residential heating- mainly wood burning, tailpipe exhaust, and vehicle wear-and-tear) at the mother’s residential address during pregnancy. Associations were analyzed using binary logistic regression. Exposure to local PM2.5 during pregnancy from each of the investigated sources was associated with childhood autism in the fully adjusted models. For ASD, similar, but less pronounced, associations were found. The results add to existing evidence that exposure to air pollution during pregnancy may be associated with an increased risk of childhood autism. Further, these findings suggest that locally produced emissions from both residential wood burning and road traffic-related sources (tailpipe exhaust and vehicle wear-and-tear) contribute to this association.

Evaluation of the characteristics of children with autism spectrum disorder in Vietnam

Autism spectrum disorder (ASD) is a developmental disability that causes lifelong impairments in physical, psychological, and social functioning. This disorder manifests when a baby is still in the womb and is detected around 24 months of age. Sixty children who attended part-boarding individual hours were transported to the Nhan Tam Children's Education and Counseling Center and Quang Ngai Provincial Psychiatric Hospital for intervention and evaluation; they were assessed for ASD using the Childhood Autism Spectrum Disorder scale (CARS) and were the subjects of our study. Before their involvement, the researcher explained the purpose of the research to the participants and received their informed consent. The results showed that 75% of the children had a severe form of ASD, whereas 25% had a mild or moderate type. Indicators of verbal and nonverbal communication were prominent among children with ASD. In terms of average test scores, we found a difference between children of stable-income parents and those from disadvantaged households. This offers a basis for educators, clinicians, and sociologists to implement education, intervention, and treatment for children with ASD, as well as to enhance awareness about this condition so that parents pay more attention to their children.

Immunotherapy In Autism Spectrum Disorder; A Case Series

IntroductionResearches has shown that a subset of the autism spectrum disorder (ASD) population presents with immune dysregulation. Based upon the immunological abnormalities, various treatment modalities have been applied to children with ASD. One immunomodulatory treatment that has been studied in ASD is intravenous immunoglobulins (IVIG).ObjectivesThis report is based upon two hypotheses: autism etiology may be closely related to neuroinflammation; and, an effective treatment should restore the individual’s comminication skills. In this report, we present two cases who were diagnosed with ASD and received IVIG treatment.MethodsCase A is a 5-year-old female patient who was diagnosed with ASD at the age of 3. The second case, B is a 9 -year-old male patient who is a 7th grade student and was also diagnosed with ASD at the age of 3. The first patient’s autism symptoms was noticed by her family at the age of 2. Although she had the ability to coordinate eye contact, understood simple commands, she was observed to lose all her acquired developmental skills one by one at around 18-24 months. Towards the age of 3, stereotypical movements such as turning around and flapping wings, started. Similarly, the second patient’s acquired skills were lost around at the age of 2-3, after having recurrent infections. Based on deficits in social‐emotional reciprocity, deficits in nonverbal communicative behaviors used for social interaction and restricted/repetitive patterns of behavior, both patients were diagnosed with ASD. Considering that autoimmune mechanisms may have been affected in ASD, IVIG treatment was initiated at 1 g/kg/month. Case A received IVIG once in a month, total 5 infusions had been applied. Case B received total 12 infusions with the same protocol. Treatment response was assessed with the Childhood Autism Rating Scale (CARS).ResultsIn these two ASD cases which were treated with IVIG ,a subjective partial reduction in autism symptoms and an objective decrease in CARS scores were detected. Current evidence suggests that there are various factors contributing to the development of autism and different combinations of these aspects give rise to different variations of some ASD subtypes. Recent studies in this field indicate a possible connection between the immune system impairments and ASD. This report, therefore, provide support for the notion that at least a subset of children with ASD might have immune abnormalities and may respond to the immune modulating effect of IVIG therapy.ConclusionsAlthough, autoimmune or inflammatory etiologies may not explain the majority of cases of autism, it might at least be useful to understand some. Further studies with larger number of patients should be conducted about the use of IVIG in selected patients with ASD.Disclosure of InterestNone Declared

Validation of the Korean Childhood Autism Rating Scale-2

BackgroundWe aimed to evaluate the psychometric properties of the Korean version of the Childhood Autism Rating Scale Second Edition (K-CARS2), which is composed of the Standard Version (K-CARS2-ST) and the High Functioning Version (K-CARS2-HF). MethodA total of 340 participants were included in this study. We assessed 145 participants (aged 2–36 years, 78.0% male) for K-CARS2-ST and 65 participants (aged 6–36 years, 81.5% male) for K-CARS2-HF, all participants were clinically diagnosed with autism spectrum disorder (ASD). We also assessed 130 participants as a control group (62 with a clinical diagnosis other than ASD and 68 without any clinical diagnosis). ResultsThe results demonstrated that the K-CARS2 showed a high degree of internal consistency, inter-rater reliability, and test-retest reliability. In terms of correlations between the instruments, the results showed significant positive correlations. Factor analysis revealed a four-factor structure for K-CARS2-ST and a three-factor structure for K-CARS2-HF. To determine the discriminant validity, a discriminant analysis for between-group comparisons was conducted with the ASD and the control groups. The sensitivity and specificity values were both 100 for K-CARS2-ST and 100 and 96.0 for K-CARS2-HF, respectively.