Autism Symptom Severity Research Articles

Cortical Thickness Differences in Autistic Children With and Without Intellectual Disability.

Of the 1 in 36 individuals in the United States who are diagnosed with autism spectrum disorder, nearly 40% also have intellectual disability (ID). The cortex has been widely implicated in neural processes underlying autistic behaviors as well as intellectual ability. Thus, neuroimaging features such as cortical thickness are of particular interest as a possible biomarkers of the condition. However, neuroimaging studies often fail to include autistic individuals with ID. As a result, there are few studies of cortical thickness in autistic individuals across the entire range of intellectual abilities. This study used MRI to evaluate cortical thickness in young autistic children (n = 88, mean age 5.37 years) with a large range of intellectual ability (IQ 19-133) as well as nonautistic, nondevelopmentally delayed (referred to here as typically developing [TD]) peers (n = 53, mean age 5.29 years). We first investigated associations between full scale IQ and cortical thickness in both autistic and TD children. Autistic children had significant negative associations (i.e., thinner cortex, higher IQ) in bilateral entorhinal cortex, right fusiform gyrus, superior, middle and inferior temporal gyri, and right temporal pole that were not present in TD children. Significantly thicker cortex was also observed in these regions for autistic children with ID (i.e., IQ ≤ 70) compared with those without. Last, given the reported correspondence between the severity of autism symptoms and intellectual ability, we compared cortical thickness associations with both IQ and ADOS Calibrated Severity Scores and found these patterns overlapped to a significant degree across the cortex.

Transdiagnostic Predictors of Health-Related Quality of Life in Children with Autism and Epilepsy: A Cross-Sectional Study.

Background/Objectives: Our understanding of the transdiagnostic factors that influence health-related quality of life (HRQOL) in individuals with neurodivergent conditions is very sparse and highly siloed by diagnosis labels. Research on transdiagnostic predictors of HRQOL across neurodevelopmental conditions is needed to enable care models that address shared needs of neurodivergent individuals beyond diagnostic boundaries. Our objective was to identify transdiagnostic factors associated with HRQOL in children with autism, epilepsy, or comorbid autism/epilepsy. Methods: This cross-sectional study included 37 autistic and/or epileptic children (mean age = 9.2; SD = 3.9; boys = 28). Parents provided sociodemographic information and completed the following measures: Social Communication Questionnaire (measure of severity of autistic symptoms); Parenting Stress Index, Fourth Edition; Pediatric Quality of Life Inventory; and the Behavioral Assessment System for Children, Third Edition. Child intellectual functioning was measured using age-appropriate scales: the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition: Canadian or the Wechsler Intelligence Scale for Children-Fifth Edition: Canadian. Results: Higher autistic symptom severity (OR = 0.851 95% CI: 0.732-0.988, p = 0.034) and parenting stress (OR = 0.687 95% CI: 0.493-0.959, p = 0.027) were associated with poorer HRQOL. Full Scale IQ and adaptive skills showed trend level associations with HRQOL. Sociodemographic factors including maternal education, child sex, and child age as well as child diagnosis were not associated with HRQOL. Conclusions: In this transdiagnostic sample of children, autism symptom severity and parenting stress were shared predictors of HRQOL. Interventions targeting child autistic symptoms and parents' levels of stress could result in improved HRQOL in neurodivergent populations.

Autistic symptoms and clinical features of individuals at clinical high risk for psychosis and first-episode psychosis.

Autistic symptoms in schizophrenia are reportedly associated with cognitive and social functions. However, few studies have investigated the association between autistic symptoms and clinical features in individuals with a clinical high risk for psychosis (CHR-P) and first-episode psychosis (FEP). We aimed to determine the association between autistic symptoms and clinical features in a cohort of individuals with CHR-P or FEP. This cross-sectional study included 111 participants (CHR-P: 61, FEP: 50). Autistic symptoms were assessed using the Positive and Negative Syndrome Scale for Schizophrenia Autism Severity Scale. We assessed the association between autistic symptoms and global and social functioning, and cognitive function in individuals with CHR-P or EFP. Multiple regression analysis was also performed using age and sex as covariates to determine the association between autistic symptoms and global functioning. The participants with FEP had more severe autistic symptoms than those with CHR-P. The results of bivariate correlation analysis showed a significantly negative association of autistic symptoms with global and cognitive functions in both participants with CHR-P and those with FEP. Multiple regression analysis showed that sex, autistic symptoms, and positive symptoms were significant predictors of overall functioning in those participants. These findings suggest that autistic symptoms are associated with lower global functioning with both individuals at CHR-P and those with FEP. Further longitudinal analysis is needed to characterize the association between autistic symptoms and global functioning in CHR-P and FEP.

Music therapy for autism spectrum disorder: does it have a role?

SUMMARYMusic therapy attempts to facilitate communication and expression – core problems for autistic people – through the development of experiences and relationships mediated by music. This commentary assesses a Cochrane Review of the effects of music therapy, compared with placebo or standard care, for autistic people, and its conclusion that music therapy is probably associated with an increased chance of global improvement and perhaps a slight increase in quality of life and reduction in total autism symptom severity in the short to medium term. The review was not able to examine longer-term effects as the longest follow-up period was 12 months. The certainty of the evidence was graded from moderate to very low, and therefore the results need to be viewed with caution.

Affective mentalizing in children with and without Autism Spectrum Disorder at school age

Difficulties in the capacities of inferring and attributing cognitions and emotions to oneself or other people –referred to as those of mentalizing - are very consistently documented in subjects with autism spectrum disorder (ASD). These socio-cognitive capacities have typically been shown to be impaired in ASD while their impairment is proposed to lie behind the symptoms of ASD.The purpose of the study is to examine affective mentalizing inArabic-speaking children with ASD, in comparison with children with typical development (TD).Thirty-six children with ASD and 36 TD children, aged 8 to 12 years-old, took the RMET (child) tasks to assess and explore their affective mentalizing.The results indicated that children with ASD perform worse in affective mentalizing than do TD children. Compared to the latter, they have clear difficulties in affective mentalizing. Except for differences in sex, factors of age and severity of autistic symptoms affect the affective mentalizing performance of subjects with ASD.In general, difficulties in affective mentalizing are a feature of ASD. In this context, our study continues to propose to train and educate affective mentalizing skills in subjects with ASD in order to reduce the severity of their autistic symptoms and to facilitate their social integration.

Salivary vitamin D levels in children with autism in relation to oral health status and disease severity

Background: Autism spectrum disorder is characterized by difficulties with social interaction and communication, as well as limited patterns of behavior and atypical sensory sensitivity. Although vitamin D insufficiency has previously been observed in autistic children, evidence on the link between vitamin D deficiency, oral health condition, and autism severity is scarce. The purpose of this study was to investigate vitamin D levels in relation to oral health status of children with autism, as well as the relationship between vitamin D and disease severity. Materials and methods: Two groups were included in this study: 40 institutionalized autistic children as a study group and 40 apparently healthy children as a control group with age range (3-12) years. Depending on the severity of autistic symptoms, the group was classified into three subgroups: mild, moderate, and severe. The oral examination was performed using simplified oral hygiene and decayed, missing and filled tooth indices to measure oral health status for both groups. Three millilitres of un-stimulated salivary sample was taken by drooling technique, the salivary level of vitamin D assessed by enzyme-linked immunosorbent assay. The data from the current study were analysed using SPSS version 21. Results: Salivary vitamin D levels were found to be significantly lower in the study group than in the control group. This reduction was not correlated with the severity of autism. 37.5% of the autistic patient group had fair oral hygiene, compared to 20% of the control group; simplified oral hygiene index shows negative significant correlation with vitamin D level while caries experience was significantly higher in patient group and there was a negative non-significant correlation with vitamin D level. Conclusion: The vitamin D level was significantly lower in the patient group with no correlation with disease severity, fair oral hygiene and more caries in both primary and permanent dentition was observed in autistic patients with significant negative correlation between the simplified oral hygiene index and vitamin D, while negative non-significant correlation with dental caries

Association between autistic features and empathy in Chinese patients with chronic schizophrenia.

It is common for patients with schizophrenia to exhibit symptoms of autism. Both autism spectrum disorders and schizophrenia share similar patterns of empathy deficits. This study purposed to explore the association between autistic features and empathy in Chinese patients with chronic schizophrenia. We enrolled 857 patients with chronic schizophrenia. The Positive and Negative Syndrome Scale (PANSS), Repeatable Battery for the Assessment of Neuropsychological 7 Status (RBANS), and Interpersonal Reactivity Index (IRI) were employed to assess the participants' clinical symptoms, neurocognition, and empathy, respectively. The severity of autistic symptoms was assessed with the PANSS Autism Severity Scale (PAUSS), with PAUSS scores ≥ 30 were considered to have significant autistic features. 114 schizophrenia patients (13.3%) had autistic features. Compared to schizophrenia patients without autistic features, those with autistic features had more severe clinical symptoms, and poorer neurocognition and empathic abilities. Female sex and empathic concerns were independently associated with autistic features in patients with chronic schizophrenia. Our results suggest that autistic features tend to manifest quite commonly among patients with chronic schizophrenia. Empathy deficits are strongly associated with autistic features in patients with chronic schizophrenia, strengthening the view that autistic features may characterize a subgroup of schizophrenia patients.

Toward workforce integration: enhancements in adaptive behaviors and social communication skills among autistic young adults following vocational training course.

Cognitively able autistic adults demonstrate low rates of employment due to social and vocational challenges. The current study aimed to examine changes in various areas among autistic young adults who participated in the 'Roim Rachok' ('Looking Ahead' in Hebrew) Training Course (RRTC). The course prepares young autistic adults for integration into military service as vocational soldiers. The study included 49 autistic participants who completed the RRTC in one of three vocational fields: Digital (n = 19), Technical (n = 9), and Visual (n = 21). Evaluations at the beginning and end of the course included adaptive behavior (Adaptive Behavior Assessment Scale 2nd Edition [ABAS-II]), autism symptom severity (Social Responsiveness Scale 2nd Edition [SRS-II]), and communication skills (Faux Pas; Empathy Quotient [EQ]; Friendship Quality Scale; Conversation task based on Yale in vivo Pragmatic Protocol [YiPP]). The results revealed a significant Time effect for the self-reported ABAS-II conceptual, social, and practical subdomains, EQ empathy quotient subdomain, Faux Pas, and SRS-II social communication interaction scores. Accordingly, participants reported increasing their adaptive skills, emotional empathy, and the ability to detect and interpret awkward statements, and decreased in their social communication interaction symptoms, following the RRTC. No significant Time x Group interaction was found for any of the examined measures, meaning similar trends were observed in all three vocational groups. Following the RRTC, participants reported significant improvements in areas essential for their future integration as soldiers in the military and as employees in the vocational world. Implications of the study findings are discussed.

Connectome-based symptom mapping and in silico related gene expression in children with autism and/or attention-deficit/hyperactivity disorder.

Clinical, neuroimaging and genomics evidence have increasingly underscored a degree of overlap between autism and attention-deficit/hyperactivity disorder (ADHD). This study explores the specific contribution of their core symptoms to shared biology in a sample of N=166 verbal children (6-12 years) with rigorously-established primary diagnoses of either autism or ADHD (without autism). We investigated the associations between inter-individual differences in clinician-based dimensional measures of autism and ADHD symptoms and whole-brain low motion intrinsic functional connectivity (iFC). Additionally, we explored their linked gene expression patterns in silico . Whole-brain multivariate distance matrix regression revealed a transdiagnostic association between autism severity and iFC of two nodes: the middle frontal gyrus of the frontoparietal network and posterior cingulate cortex of the default mode network. Across children, the greater the iFC between these nodes, the more severe the autism symptoms, even after controlling for ADHD symptoms. Results from segregation analyses were consistent with primary findings, underscoring the significance of internetwork iFC interactions for autism symptom severity across diagnoses. No statistically significant brain-behavior relationships were observed for ADHD symptoms. Genetic enrichment analyses of the iFC maps associated with autism symptoms implicated genes known to: (i) have greater rate of variance in autism and ADHD, and (ii) be involved in neuron projection, suggesting shared genetic mechanisms for this specific brain-clinical phenotype. Overall, these findings underscore the relevance of transdiagnostic dimensional approaches in linking clinically-defined phenomena to shared presentations at the macroscale circuit- and genomic-levels among children with diagnoses of autism and ADHD.

Alterations in the white matter fiber tracts of preschool-aged children with autism spectrum disorder: an automated fiber quantification study.

Little is known about the precise impaired patterns of white matter (WM) fiber tracts in preschool-aged children with autism spectrum disorder (ASD). Thus, we used diffusion tensor imaging (DTI)-based automated fiber quantification (AFQ) to explore the changes in WM fiber tracts in preschool-aged children with ASD and its correlation with the severity of clinical manifestations. A total of 43 pediatric ASD and 42 age- and sex-matched typical developing children were examined with DTI. AFQ was used to quantify 100 nodes of 16 specific WM fiber tracts. The DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were compared between the two groups. Correlation analysis was performed to evaluate whether abnormal DTI metrics correlated with the Childhood Autism Rating Scale. Compared with typical developing children, at the entire level, the ASD group exhibited a decreased FA [P=0.04 after false discovery rate (FDR) correction] and an increased MD (P=0.048 after FDR correction), and RD (P=0.024 after FDR correction) in the left inferior longitudinal fasciculus (ILF). A decreased FA (P=0.02 after FDR correction) and an increased RD (P=0.024 after FDR correction) were shown in forceps minor. An increased MD (P=0.016 after FDR correction) and RD (P=0.026 after FDR correction) were shown in the left inferior frontal-occipital fasciculus (IFOF). At the point-wise level, significantly decreased FA, and increased MD and RD were observed in the anterior part of forceps minor, left IFOF, and posterior part of left ILF in the ASD group (all P<0.05 after FDR correction). Furthermore, there was a negative correlation between FA of the posterior part of left ILF and the Childhood Autism Rating Scale within the ASD group (r=-0.475, P<0.001). Preschool-aged children with ASD displayed a site-specific propensity for WM fiber tract impairment, mainly in the left cerebral hemisphere. The decreased integrity for the posterior part of the left ILF may reflect the severity of autistic symptoms.

The effect of anxiety and autism symptom severity on restricted and repetitive behaviors over time in children with fragile X syndrome

BackgroundRestricted and repetitive behaviors (RRBs) are highly prevalent and reduce function in individuals with fragile X syndrome (FXS). As transdiagnostic features of intellectual disability, elevated rates of RRBs in FXS could represent various underlying known co-occurring conditions in FXS such as anxiety or autism spectrum disorder (ASD), yet this distinction has not been investigated. Further, delineating whether RRBs are more indicative of anxiety or ASD in FXS may clarify phenotypic profiles within FXS and improve differential assessment.MethodsWe longitudinally examined the potentially independent or multiplicative effect of ASD and anxiety symptom severity on RRBs in 60 children with FXS. Anxiety was measured using the Child Behavior Checklist (CBCL), ASD severity was measured using the Childhood Autism Rating Scale (CARS), and RRBs were measured using the Repetitive Behavior Scale – Revised (RBS-R). We estimated a series of moderated regression models with anxiety and ASD symptoms at the initial assessment (Time 1) as predictors of RRBs at the outcome assessment two years later (Time 2), along with an anxiety-by-ASD interaction term to determine the potential multiplicative effect of these co-occurring conditions on RRBs.ResultsResults identified a significant interaction between ASD and anxiety symptom severity at the initial assessment that predicted elevated sensory-motor RRBs two years later. Increased sensory-motor RRBs were predicted by elevated ASD symptoms only when anxiety symptom severity was low. Likewise, increased sensory-motor RRBs were predicted by elevated anxiety symptoms only when ASD symptom severity was low. Interestingly, this relationship was isolated to Sensory-Motor RRBs, with evidence that it could also apply to total RRBs.ConclusionsFindings suggest that ASD and anxiety exert independent and differential effects on Sensory-Motor RRBs when at high severity levels and a multiplicative effect when at moderate levels, which has important implications for early and targeted interventions.

Altered functional connectivity of unimodal sensory and multisensory integration networks is related to symptom severity in autism spectrum disorders

BackgroundAtypical sensory processing is a prevalent feature in autism spectrum disorders (ASD) and constitutes a core diagnostic criterion in the Diagnostic and Statistical Manual of Mental of Disorders, 5th edition (DSM-5). However, neurocognitive underpinnings of atypical unimodal and multimodal sensory processing and their relationships with autism symptoms remain unclear. MethodsThis study examined intrinsic functional connectivity (FC) patterns among five unimodal sensory and multisensory integration (MSI) networks in ASD with a large multi-site dataset (n = 646), and investigated the relationships among altered FC, atypical sensory processing, social communicative deficits, and overall autism symptoms with correlation and mediation analyses. ResultsRelative to typically developing (TD) controls, the ASD group demonstrated increased FC of the olfactory network, decreased FC within the MSI network, and decreased FC of the MSI-unimodal-sensory networks. Furthermore, altered FC was positively associated with autism symptom severity, and such associations were completely mediated by atypical sensory processing and social communicative deficits. ConclusionsASD-specific olfactory overconnectivity and MSI-unimodal-sensory underconnectivity lend support to the Intense World Theory and Weak Central Coherence Theory, suggesting olfactory hypersensitivity at the expense of multisensory integration as potential neural mechanisms underlying atypical sensory processing in ASD. These atypical FC patterns further suggest potential targets for psychological and neuromodulatory interventions.

Expression of key molecules of the classical inflammation activation pathway in blood leukocytes of autistic children

Autism spectrum disorders (ASD) are complex neurodevelopmental disorders, whose causes are currently not fully understood. Research suggests that inflammation and changes in immune functions may play an important role in the development of autism. Increased levels of proinflammatory cytokines in the brains of autistic children lead to negative regulation of synaptic plasticity, as well as impaired proliferation and differentiation of neurons through activation of the nuclear factor kappa B (NF-κB) signaling pathway. The purpose of the work is to analyze the levels of mRNA: TLR2, TLR4, MyD88, IκBα, NF-κB p50, NF-κB p65 in peripheral blood leukocytes of children in comparison with the severity of autism spectrum disorders. The study included 126 children aged from 3 to 13 years (the ratio of boys to girls was 4:1): 45 children with typical neurodevelopment, and 81 children with a clinically confirmed diagnosis of autism. According to the Childhood Autism Rating Scale, 51 children had mild to moderate ASD (CARS score: 29-36), and 30 children had severe autism (CARS score: 36-60). The expression of inflammatory signal transduction pathway molecules was determined in peripheral blood leukocytes using real-time polymerase chain reaction with SYBRGreen. To compare the samples, one-way ANOVA and Tukey’s test were used. It was found that in leukocytes of children with severe ASD, the expression of the adapter protein MyD88 and the p65 subunit of the nuclear transcription factor NF-κB was significantly reduced, and the expression of the NF-κB inhibitor, IκBα, was significantly increased, compared to the control group. In leukocytes of children with mild ASD, a decrease in NF-κB p65 expression was found at a trend level. When comparing groups of children with different severity of autism symptoms (mild/severe), no significant differences were found in the levels of mRNA of key signaling molecules of the classical inflammation activation pathway in blood leukocytes. Thus, in the blood leukocytes of children with severe ASD, suppression of the expression of key molecules of the classical inflammation activation pathway (NF-κB) is observed, which leads to a decrease in the expression of pro-inflammatory cytokines: IL-1β, IL-18 and IL-2, against the background of increased expression of key cytokine of Th1 cells – IFNγ.

Gesture Imitation Performance and Visual Exploration in Young Children with Autism Spectrum Disorder.

Most studies in children with autism spectrum disorder (ASD) support a decrement in imitation performance. Factors related to visual attention and motor execution have been proposed to explain this phenomenon in ASD. However, studies investigated imitation with various methods, leading to inconsistent findings. Here, we examine imitation performance related to visual attention and motor execution. We focused on the imitation of meaningful and meaningless gestures, consistently reported as more affected than imitation of actions with objects in ASD. The imitation eye-tracking task consisted of a video of an actor demonstrating gestures and prompting children to imitate them. The demonstrations comprised meaningful and meaningless hand gestures, and meaningless facial gestures. We measured the fixation duration to the actor' face during child-directed speech and gesture demonstrations. We video-recorded children to assess their performance. Our sample comprised 100 participants (3.55 ± 1.11years old), including 84 children with ASD. The ASD and typically developing groups displayed the same visual attention toward gesture demonstrations, although children with ASD spent less time looking at the face during facial stimuli. Visual exploration of actors' gestures did not influence imitation performance. Imitation of meaningful gestures was associated with less severe autistic symptoms, whereas imitation of meaningless gestures was correlated with higher non-verbal cognitive and fine-motor skills. These findings contribute to a better understanding of the complexity of imitation. We delineated the distinct nature of imitation of meaningful and meaningless gestures in children with ASD. We discuss clinical implications in relation to assessment and intervention programs.

Опыт применения шкал развития MPR в диагностике детей раннего возраста с риском РАС

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;Early diagnosis of children with Autism Spectrum Disorder (ASD) allows parents to assess the validity of their concerns, develop individual support programs, and begin working with the child as early as possible, which will lead to greater success in educational support. To achieve these goals, a comprehensive assessment is needed, including the use of standardized tools for assessing the level of current development and identifying special characteristics of children&amp;rsquo;s functioning. In order to determine the level of development, the possibilities of using the Merril-Palmer Revised (MPR) Development Scales in assessment of children with ASD were studied.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;The pilot study involved eight children (5 toddlers and 3 preschoolers; 6 males, 2 females; Mage=2.8, SD=0.8). Children were divided into &amp;ldquo;risk of ASD&amp;rdquo; and &amp;ldquo;autism&amp;rdquo; diagnostic groups according to their ADOS-2 results. All participants were also tested using the MPR. Statistical analysis was conducted in IBM SPSS Statistics 23, using descriptive statistics, correlation analysis with Pearson and Spearman criteria.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;According to the data obtained, the development index of all children is below the age norm (M=52, SD=26), ranging from &amp;ldquo;significant developmental delay&amp;rdquo; to &amp;ldquo;below average developmental level&amp;rdquo; and does not depend on the severity of autistic symptoms. It was found that scores in the cognitive sphere correlate positively with scores obtained in fine motor skills (r=0,93, p=0,01); visual-motor coordination (r=0,95, p=0,01); speech comprehension (r=0,87, p=0,01). The results on the scale assessing protest behavior during the examination cor relate negatively with the level of development of the socio-emotional sphere (r=&amp;ndash;0,75, p=0,05) and self-care skills (r=&amp;ndash;0,79, p=0,05).&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions.&amp;nbsp;&lt;/strong&gt;Experience using the MPR Scales in evaluation of toddlers and preschoolers with ASD has shown that the tool is informative and allows a comprehensive assessment of developmental indicators in children with this nosology, which suggests its use in developing effective interventions. The limitation of the study is the small sample size, and the results obtained are planned to be verified with a larger number of participants.&lt;/p&gt;

Effect of Vitamin A Supplement on Serotonin Level and Severity of Autistic symptoms in Autistic Children

Abstract Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder, becoming the most common condition among mental disabilities due to its recent increase in incidence. The serotonin system depends on vitamin A, which plays a crucial role in the nervous system. As a result, children's neurodevelopment and the emergence of ASD can be significantly impacted by vitamin A deficiency (VAD) The Aim We aimed in this study to evaluate vitamin A, and serotonin levels in a group of Egyptian ASD patients under the age of 8 years before and after vitamin A supplementation. In addition, we aimed to evaluate their association with ASD symptoms. Material and Methods The first part of this two-stage study is a controlled cross-sectional analysis, and the second stage is an interventional analysis that includes a clinical trial and an open-label design. Children Between the ages of 1 year and 8 years, with ASD diagnosis according to (DSM-V) criteria were included, as well as healthy controls. Results We included 30 ASD children and 30 normal children in the control group with a mean age and SD of 5.33±1.7 years. We observed that 33.3% of ASD patients had a family history of similar cases. According to Childhood Autism Rating Scale of the patients at baseline, 73.3% had mild to moderate ASD symptoms, while 26.7% had severe symptoms. Moreover, we observed a statistical decrease of Vitamin A level in the study group compared to the control group with a mean of 133.85 mmol/L, and 207.43 mmol/L, respectively. ASD patients with low vitamin A level had a mean and SD of 51.27±25 mmol/L. This was increased significantly after vitamin A supplementation to be 81.18±21.652 mmol/L with P Value = 0.04. Furthermore, serotonin level before supplementation in ASD patients was with a mean value of 590.59±163.32 ng/ml. This level was decreased Significantly after vitamin A supplementation to be with a mean value of 496.5±192.12 ng/ml with P Value = 0.015. subsequently, Autism Treatment Evaluation Chicklist (ATEC), which is used to assess the effect of the intervention on patients ASD symptoms, was decreased significantly with P Value of 0.001. The mean and SD of ATEC was 77.77±22.236 before vitamin A supplementation, while after Vitamin A supplementation was with a Mean and SD of 72.38±19.104. Furthermore, we found no statistically significant correlation between vitamin A and serotonin levels with different patients’ demographics, or anthropometric measures. Conclusion and Implications ASD children exhibited lower levels of vitamin A than normal children, even though vitamin A deficiency is common in Egypt. Children with ASD who had low serum vitamin A levels received vitamin A supplements, which not only helped lower the children's serotonin levels but also markedly reduced their autistic symptoms.

An acceptability and feasibility investigation of a community-based motor program for autistic children with moderate and high support needs

BackgroundGeneral motor impairments are ubiquitous in Autism and are positively correlated with autism symptom severity. This study assessed the feasibility and acceptability of a 13-week community-based motor program for autistic children with moderate and high support needs (MHS). MethodIn this exploratory single arm within-subject study, 10 autistic children with MHS, ages 4–10 years, completed a community-based motor program delivered in a one-on-one format by therapists. Feasibility was determined through recruitment, retention, attendance, enjoyment, engagement and useability of motor, physical activity (PA), and behavioural assessment tools. Thematic analysis evaluated post-intervention semi-structured parent interviews. ResultsHigh program attendance and retention were demonstrated, and therapists reported child engagement and enjoyment were high. Identified themes revealed parents perceived unexpected substantial positive impacts including improvements in social, motor, and behavioural outcomes. They highly valued both the program and the therapeutic relationships fostered within it. Although parents of the children with the higher support needs reported the most substantial improvements, these children were unable to score on motor assessments due to difficulties following instructions and off-task behaviours. Additionally, only four participants wore an accelerometer-based PA monitor. ConclusionsThis community-based motor program was considered feasible and acceptable by the children’s parents, and qualitative findings provided valuable insights into clinical practice for children with MHS. However, recruitment challenges and assessment tools being unfeasible for children with higher support needs led to low participant numbers. Future evaluations should explore alternative assessment measures and study designs, given the challenges associated with studying such a heterogenous and complex group.

Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism

BackgroundWhole-genome sequencing (WGS) analyses have found higher genetic burden in autistic females compared to males, supporting higher liability threshold in females. However, genomic evidence of sex differences has been limited to European ancestry to date and little is known about how genetic variation leads to autism-related traits within families across sex.MethodsTo address this gap, we present WGS data of Korean autism families (n = 2255) and a Korean general population sample (n = 2500), the largest WGS data of East Asian ancestry. We analyzed sex differences in genetic burden and compared with cohorts of European ancestry (n = 15,839). Further, with extensively collected family-wise Korean autism phenotype data (n = 3730), we investigated sex differences in phenotypic scores and gene-phenotype associations within family.ResultsWe observed robust female enrichment of de novo protein-truncating variants in autistic individuals across cohorts. However, sex differences in polygenic burden varied across cohorts and we found that the differential proportion of comorbid intellectual disability and severe autism symptoms mainly drove these variations. In siblings, males of autistic females exhibited the most severe social communication deficits. Female siblings exhibited lower phenotypic severity despite the higher polygenic burden than male siblings. Mothers also showed higher tolerance for polygenic burden than fathers, supporting higher liability threshold in females.ConclusionsOur findings indicate that genetic liability in autism is both sex- and phenotype-dependent, expanding the current understanding of autism’s genetic complexity. Our work further suggests that family-based assessments of sex differences can help unravel underlying sex-differential liability in autism.

Functional alterations of lateral temporal cortex for processing voice prosody in adults with autism spectrum disorder.

The human auditory system includes discrete cortical patches and selective regions for processing voice information, including emotional prosody. Although behavioral evidence indicates individuals with autism spectrum disorder (ASD) have difficulties in recognizing emotional prosody, it remains understudied whether and how localized voice patches (VPs) and other voice-sensitive regions are functionally altered in processing prosody. This fMRI study investigated neural responses to prosodic voices in 25 adult males with ASD and 33 controls using voices of anger, sadness, and happiness with varying degrees of emotion. We used a functional region-of-interest analysis with an independent voice localizer to identify multiple VPs from combined ASD and control data. We observed a general response reduction to prosodic voices in specific VPs of left posterior temporal VP (TVP) and right middle TVP. Reduced cortical responses in right middle TVP were consistently correlated with the severity of autistic symptoms for all examined emotional prosodies. Moreover, representation similarity analysis revealed the reduced effect of emotional intensity in multivoxel activation patterns in left anterior superior temporal cortex only for sad prosody. These results indicate reduced response magnitudes to voice prosodies in specific TVPs and altered emotion intensity-dependent multivoxel activation patterns in adult ASDs, potentially underlying their socio-communicative difficulties.

Spatiotemporal Eye Movement Dynamics Reveal Altered Face Prioritization in Early Visual Processing Among Children With Autism

BackgroundReduced social attention—looking at faces—is one of the most common manifestations of social difficulty in autism that is central to social development. Although reduced social attention is well characterized in autism, qualitative differences in how social attention unfolds across time remains unknown. MethodsWe used a computational modeling (i.e., hidden Markov modeling) approach to assess and compare the spatiotemporal dynamics of social attention in a large, well-characterized sample of children with autism (n = 280) and neurotypical children (n = 119) (ages 6–11) who completed 3 social eye-tracking assays at 3 longitudinal time points (baseline, 6 weeks, 24 weeks). ResultsOur analysis supported the existence of 2 common eye movement patterns that emerged across 3 eye-tracking assays. A focused pattern was characterized by small face regions of interest, which had high a probability of capturing fixations early in visual processing. In contrast, an exploratory pattern was characterized by larger face regions of interest, with a lower initial probability of fixation and more nonsocial regions of interest. In the context of social perception, children with autism showed significantly more exploratory eye movement patterns than neurotypical children across all social perception assays and all 3 longitudinal time points. Eye movement patterns were associated with clinical features of autism, including adaptive function, face recognition, and autism symptom severity. ConclusionsDecreased likelihood of precisely looking at faces early in social visual processing may be an important feature of autism that is associated with autism-related symptomology and may reflect less visual sensitivity to face information.