Criteria For Autism Spectrum Disorder Research Articles

Clinical Spectrum and Associated Features of Autism Spectrum Disorders: Experience in A Tertiary Level Hospital

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with a heterogeneous and complex presentation of clinical symptoms related to social communicative and interactive behavior. Thus, the aim was to evaluate the clinical features and associated condition of autism spectrum disorder in Bangladeshi children. Method: A cross-sectional study was done in Out-patient department of Paediatric Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2023 to June 2023 Children age 3 to 10 years who satisfied the inclusion and exclusion criteria and met the diagnostic criteria (DSM-V) of ASD were enrolled in this study. In all confirmed cases, clinical features and co-occurring condition were evaluated. Data was collected by a structured questionnaire supplied by department of Pediatric Neurology. Informed written consent was taken from all legal guardians. Results: A total of 75 children of 3-10 years were included. Mean age was 4.27±1.99 with male predominance. Among the associated features; pointing, social interaction, response to call and eye contact were absent in 94.67 %, 97.33%, 92% and 86.67% cases respectively. In this study more than three fourth of studied children were presented with speech delay (80%) and more than half of the children presented with speech regression. ADHD (46.67%), bruxism (25.33%) constipation (22.67%), epilepsy (5.33%), febrile seizure (9.33%) and gratification syndrome (12%) were mostly observed in ASD children. Conclusion: In our study, more than one-third of studied children had ADHD and sleep disturbance followed by bruxism, epilepsy, febrile seizure, gratification syndrome and constipation as other associated features. J Bangladesh Coll Phys Surg 2025; 43: 53-58

Protocol for evaluating the effects of integrating music with taekwondo training in children with autism spectrum disorder: A randomized controlled trial.

Children with autism spectrum disorder (ASD) are known to experience difficulties in coordinating fine- and gross-motor movement. Previous interventional studies have reported significant effect of exercise-based intervention programs on improving motor skills and alleviating symptoms in ASD; however, researchers are yet to know why some participants experienced less improvement than others. One plausible explanation for suboptimal treatment outcomes is insufficient engagement in the exercise programs due to the children's difficulties in following instructions and performing the correct movements. In the proposed research, we will test the above speculation by manipulating the amount of music-therapy elements into a 10-week Taekwondo training program designed specifically for children with autism. This is a randomized controlled trial. Seventy-two children aged 7 to 9 years who meet the diagnostic criteria of ASD will be recruited and randomized into either the "Taekwondo training with elements of music therapy" group or the "Taekwondo training alone" group. In both groups, the participating children will attend Taekwondo training sessions twice a week over 10 consecutive weeks. In the "Taekwondo training with elements of music therapy" group, elements of music therapy will be incorporated into the Taekwondo training. Assessment will be conducted before the program commences, immediately after the completion of the 10-week program, and 2 months after the post-test. The outcome domains to be evaluated include the immediate effects during the exercise sessions. These effects include the level of engagement in the exercise sessions (primary outcome), enjoyment, physical activity level, and rate of perceived exertion. Furthermore, the evaluation will also cover the overall effects of the training program on gross motor skills, Taekwondo skills performance, executive function, psychosocial functioning, and behavioral problems. The findings of this study will inform strategies for the promotion of physical activity and engagement among children with ASD when participating in exercise training classes. The study will also suggest the importance of regular physical activity for the physical and mental well-being of children with ASD. Clinical trial registration: URL: http://www.clinicaltrials.gov. ClinicalTrials.gov Identifier: NCT06277778. Registered on 15 February 2024.

¿Es el trastorno del espectro autista un diagnóstico persistente en el tiempo?

Authors´ conclusions: the findings of this cohort study suggest that among toddlers diagnosed with autism spectrum disorder (ASD), baseline adaptive function and sex may be associated with persistence of ASD. Reviewers´ commentary: the results of this study show that more than a third of children who received a clinical diagnosis of ASD between the ages of 1 and 3 years no longer met the criteria for ASD on a subsequent evaluation, although the diagnostic methodology used was different, validated only in research. Importantly, ASD-specific intervention was not predictive of non-persistent ASD at 6 years. Together with the published literature, these data raise important considerations regarding early diagnosis and treatment of the disorder. Early diagnosis and intervention of ASD increases parental stress and pressure on young children. In fact, PrevInfad suggests since 2010 not to screen for ASD in the context of the well-child follow-up program at 18-24 months.

Associations of maternal peripregnancy cannabis use with behavioral and developmental outcomes in children with and without symptoms of autism spectrum disorder: Study to Explore Early Development.

Some studies report increased prevalence of autism spectrum disorder (ASD) and associated symptoms with prenatal cannabis exposure. We examined whether associations of maternal cannabis use from 3 months preconception through delivery ("peripregnancy") with behavior and development in the offspring varied with the presence of ASD symptoms. Children ages 30-68 months with ASD symptoms (i.e., met study criteria for ASD or had ASD symptoms on standardized assessments or community ASD diagnosis, N = 2734) and without ASD symptoms (other developmental delay/disorders or general population sample, N = 3454) were evaluated with the Child Behavior Checklist and Mullen Scales of Early Learning. We examined cannabis use during three time periods: peripregnancy, pregnancy, and only preconception. Peripregnancy cannabis exposure was reported for 6.0% of children with and 4.6% of children without ASD symptoms. Preconception-only cannabis use (versus no use) was associated with more aggressive behavior, emotional reactivity, and sleep problems in children with ASD symptoms, but not in children without ASD symptoms. Cannabis use during pregnancy was associated with increased attention and sleep problems in children with ASD symptoms; these associations did not differ significantly by ASD symptoms. Peripregnancy cannabis use was not associated with child developmental abilities regardless of ASD symptoms. In summary, associations of peripregnancy cannabis use with some behavioral outcomes differed in children with and without ASD symptoms. With rising cannabis use among pregnant women, future studies that examine a range of developmental risks associated with timing and patterns of cannabis use prior to conception as well as during pregnancy could inform clinical guidance.

Differential diagnosis: Understanding nonverbal learning disorder and autism spectrum disorder

Previous research has suggested that children with Nonverbal Learning Disorder (NLD) share similar clinical profiles to those with autism spectrum disorder (ASD). Three groups of children were identified for the purpose of the current study: NLD (n = 41), ASD (n = 55), and ASD with a NLD profile (n = 17). Children who met DSM-5 criteria for ASD after a neuropsychological evaluation were included in this sample. The NLD group was defined by VSI < VCI, with a minimum of a 15-point discrepancy between indices and average to above average verbal intelligence, whereas children who met DSM-5 criteria for ASD and also demonstrated visual-spatial deficits met criteria for the NLD + ASD group. As anticipated, the ASD group performed better on measures of VSI compared to the NLD and ASD + NLD groups. There was not a significant difference between groups on measures of visuomotor and construction abilities, visual integration, motor processing speed, and academic achievement. No significant differences between groups were found on the CBCL/TRF Social Problems, Attention Problems, or Internalizing/Externalizing Problems scales, indicating similar phenotypes. However, there was a significant difference between groups on the Thought Problems subscale for teacher and parent rating scales. Results corroborate previous research indicating similarities between neuropsychological profiles and suggest that the ASEBA Thought Problems scale may aid in discriminating individuals with ASD from those with NLD.

Broad Autism Phenotype Questionnaire - Translation and Validation in a South Indian Language.

Broad Autism Phenotype (BAP) refers to specific behaviors or minor deficits in social/communication skills not meeting the diagnostic criteria for autism spectrum disorders (ASDs). The BAP Questionnaire (BAPQ) measures aloof personality (AP), rigid personality (RP), and pragmatic language (PL) deficits of BAP. The study objective is to translate and validate BAPQ into Malayalam, a South Indian language, and to establish new cut-off scores for detecting BAP in the Indian population. BAPQ was translated into Malayalam (BAPQ-M), following which it was tested for reliability and internal consistency and factor analysis was conducted in 40 parents of ASD and neurotypical children. The receiver operating characteristic curve analysis generated new cut-off scores. The content validity index was ≥ 0.8 for each item. For the self and informant versions, Cronbach's α was 0.753 and 0.807, respectively, while Spearman's correlation coefficient was 0.953 ( P < 0.001) and 0.918 ( P < 0.001). The items demonstrated good communality (0.532-0.870), and on factor rotation, 12 components had eigenvalues > 1, which explained 72.3% of the total variance. The new cut-off scores for total estimate, AP, RP, and PL subscales were 2.60 (sensitivity 0.825; specificity 0.575; odds ratio [OR] 6.38, 95% confidence interval [CI] 2.28-17.84; P < 0.001), 2.60 (sensitivity 0.60; specificity 0.75; OR 4.50, 95% CI 1.73-11.70; P 0.002), 2.90 (sensitivity 0.8; specificity 0.475; OR 3.62, 95% CI 1.342-9.77; P 0.011), and 2.70 (sensitivity 0.5; specificity 0.825; OR 4.71, 95% CI 1.69-13.13; P 0.003), respectively. BAPQ-M has good psychometric properties for determining the presence of BAP among the people of Kerala, a South Indian state.

21 Exploring the clinical presentation and health service utilization in autistic children and adolescents diagnosed with avoidant / restrictive food intake disorder: A descriptive study

Abstract Background Avoidant/restrictive food intake disorder (ARFID) is an eating disorder with much clinical variability, negatively impacting growth, nutrition, psychosocial functioning and overall well-being. ARFID is more frequently reported in neurotypical populations than in neurodivergent populations. Little is known about the clinical presentation and healthcare utilization of autistic individuals with ARFID. Objectives The purpose of this study was to understand the clinical presentation, laboratory abnormalities and health system utilization amongst autistic individuals diagnosed with ARFID within the community. Design/Methods We completed a comprehensive multidisciplinary assessment on autistic individuals less than18 years of age who were diagnosed with ARFID by their community physician. Recruitment period: June 2020-June 2021. Results Nineteen autistic individuals completed a comprehensive multidisciplinary assessment; of these, 42.1% (8/19) met criteria for Autism Spectrum Disorder (ASD) severity level 1. The onset of restrictive eating manifested at M(SD)= 2.5 (0.7) years, and the age of ASD diagnosis was 4.2 (3.8) years. Of these, 78.9% (15/19) had the onset of feeding difficulties either prior to or at the time of their ASD diagnosis (Figure 1). Dependence on enteral feeding or nutritional supplements (74%), psychosocial impairment (68%), and nutritional deficiencies (42%) were the criteria commonly met for ARFID. Sensory-based avoidance (100%) and lack of interest in food (89%) were the two most reported potential drivers for the dysfunctional feeding behaviour based on the Pica , ARFID, and Rumination Disorder Interview-AR-Q. Neurodevelopment disorder comorbidities included ADHD (26.3%), Anxiety (21.1%), and Intellectual Developmental Disability (15.8%). Constipation (68.4%) and nutritional deficits (63.15%) were the most common medical comorbidities recorded. Nutritional profile revealed Vitamin D deficit in 50% (8/16), Anaemia 21% (4/19), Vitamin B1 deficit 20% (2/10). Additionally, three participants (17.7%, 3/17) had deficits in Vitamin B12, Zinc, Vitamin C and low ferritin levels. Four autistic individuals (21.1%, 4/19) were hospitalized because of their restrictive eating. 68.4% (13/19) autistic individuals had involvement of at least one allied health professional (OT or SLP or BT). No participants had a prior multidisciplinary feeding assessment or intervention to address restrictive eating. Conclusion ARFID is an eating disorder observed within autistic individuals. Evidence suggests food related sensory sensitivities and lack of interest in food are potential drivers of ARFID in the context of ASD. A comprehensive multidisciplinary assessment is needed to elucidate factors driving restrictive eating to inform targeted evidence-based interventions.

Sensory Issues and Their Impact Among Autistic Children: A Cross-Sectional Study in Northern Sri Lanka.

Sensory processing issues are among the key diagnostic criteria for autism spectrum disorder (ASD). As altered sensory processing causes autistic children to react differently to sensory experiences and has a profound impact on their development, affecting their learning ability, social interaction, and ability to adapt to a new environment, there is a need to recognize and address these issues in children diagnosed with ASD during assessments and interventions. This study aimed to identify the patterns of sensory issues and their impact, and selected correlates among autistic children attending a center for neurodevelopmental disorders in northern Sri Lanka. This institution-based, descriptive, cross-sectional study was conducted at a center for neurodevelopmental disorders in Jaffna among 100 children diagnosed with ASD. The sociodemographic details of the child, and scores of the Childhood Autism Rating Scale second edition (CARS™ 2), Sensory Profile™ 2, and a locally developed Behavioral Checklist were extracted from the records available at the center. Data were analyzed using R statistical computing software (R Foundation for Statistical Computing, Vienna, Austria) using general linear models. All the children in this study had at least one sensory issue, with 50% having visual processing issues. The severity of ASD increased as auditory processing issues increased. Behavioral issues, in general, increased significantly with increasing auditory and visual processing issues. Repetitive behaviors significantly increased with increasing auditory processing issues, while problems with self-regulation increased significantly with increasing visual and movement processing issues. Conduct-related issues were found to increase significantly with increasing movement and visual processing issues, and attentional response issues were found to increase significantly with increasing auditory, visual, and touch processing issues. The high prevalence of sensory issues in autistic children and its impact on the severity of ASD and behavioral issues are reiterated in this study. These results emphasize the importance of including interventions targeting sensory issues with the routine therapy for ASD.

Characteristics of Individuals Losing Autism Diagnosis: A Comparative Study With Typically Developing and Autism Spectrum Disorder Individuals.

This study aims to reveal the characteristics of individuals who have lost an autism spectrum disorder (ASD) diagnosis and to evaluate their current psychiatric diagnoses. Additionally, the study aims to compare individuals who have lost ASD with typically developing (TD) individuals and those with ASD in terms of current psychopathology, functionality and sociodemographic and clinical variables. The study included a total of 85 participants aged between 5 and 18, comprising 30 individuals who no longer meet the criteria for ASD (loss of autism diagnosis or LAD), 32 individuals with ASD and 23 TD individuals. While the sociodemographic data form and Childhood Autism Rating Scale (CARS) were completed by the clinician, the Autism Behavior Checklist (ABC) and Social Responsiveness Scale (SRS) were completed by the parents. It was found that the LAD group acquired speaking skills earlier, started special education sooner, received preschool education and physical exercise support for a longer duration and exhibited higher mental capacity and lower symptom severity compared to the ASD group. Moreover, 80% of the LAD group had at least one DSM-5 diagnosis. Scores on the ABC and SRS indicated a significant difference, with ASD > LAD > TD. Even if ASD regresses, individuals may still experience residual difficulties and remain at risk for other psychopathologies. Therefore, it is crucial to maintain monitoring and support processes.

Traits of Developmental Disorders in Adults With Listening Difficulties Without Diagnosis of Autism Spectrum Disorder And/or Attention-Deficit/Hyperactivity Disorder.

Background: Some individuals have a normal audiogram but have listening difficulties (LiD). As many studies have investigated the relationship between listening and developmental disorders, the traits of developmental disorders might explain the symptoms of LiD. In this study, we examined the traits of developmental disorders of adults with LiD to help clarify the cause of LiD symptoms. Methods: In total, 60 adults with LiD and 57 adults without LiD were included. Participants completed a questionnaire for the autism spectrum quotient (AQ) test, the Adult Attention-Deficit Hyperactivity Disorder Self-Rating Scale (A-ADHD), the Adolescent/Adult Sensory Profile (SP), and the severity of subjective LiD in daily life. Results: Before analysis, we excluded participants with LiD who were already diagnosed or met the criteria for autism spectrum disorder (ASD) or ADHD, and the results of the remaining 30 participants (50.0%) with LiD were analyzed. Adults with LiD showed higher scores than those without LiD in the AQ. Attention switching in the AQ and attention ability in the A-ADHD scale were correlated with the severity of LiD symptoms in everyday life. The AQ scores were also significantly correlated with subscales of the SP. Conclusions: Adults with LiD showed greater autistic traits than those without LiD; therefore, LiD symptoms are possibly related to autistic symptoms. Furthermore, adults with LiD might have attention disorder traits of both ASD and ADHD and sensory processing problems. These findings suggest that the attention problems in adults with LiD noted in previous studies might be related to these traits of developmental disorders.

Genetic networks suggest Asperger’s syndrome as a distinct subtype of autism spectrum disorders

BackgroundThe Diagnostic and Statistical Manual of Mental Disorders (DSM-V) issued new diagnostic criteria for autism spectrum disorders (ASD) which resulted in missing the diagnosis of some cases of Asperger’s syndrome (AS). This negatively affected the support received by those affected. In this study, we explored if AS could be biologically stratified from the broader spectrum through a gene co-expression network preservation analysis. MethodsWe analysed the GEO microarray data of 24 individuals with Asperger’s syndrome and 72 individuals with autism. Then, we used a weighted gene co-expression network (WGCNA) pipeline to construct gene co-expression networks. We explored whether these modules share the same co-expression patterns between autism and Asperger’s syndrome using network preservation analysis. ResultsOur results showed that all co-expression modules of autism are preserved into the Asperger’s syndrome. However, three modules of Asperger’s syndrome out of 30 modules were not preserved in autism.Gene enrichment analysis revealed that these modules were involved in chromatin remodelling, immune and neuroinflammatory response, synaptic and neuronal development. Brain enrichment analysis showed significant downregulation of neurodevelopment genes in different brain regions associated with impaired social recognition in Asperger’s syndrome. ConclusionsThe identified genetic and molecular profiles suggest that Asperger’s syndrome, despite sharing numerous similarities with autism, possesses a distinct genetic profile that makes it a distinct subtype of autism. This distinction could have significant implications for the management and treatment strategies tailored to individuals with Asperger’s syndrome.

A - 63 Sotos Syndrome: a Case Study

Abstract Objective Sotos syndrome is a genetic disorder characterized by pre and postnatal overgrowth and a non-progressive neurological disorder frequently accompanied by intellectual disability. The estimated prevalence is 1:14,000 live births; however, misdiagnosis is common due to features being attributable to other conditions. This case study highlights the broad range of symptom presentation in individuals with Sotos syndrome and adds to the limited available literature on this rare condition. Method The patient is a 26-year-old female with no prior neuropsychological testing presenting with concerns for cognitive functioning, regression of skills, and emotional/behavioral dysregulation. Concerns were raised for an underlying autism spectrum disorder. She presents with large stature, prominent facial configuration, and hypotonia. Developmental history was significant for delayed motor and language milestones. She has a history of absence seizures in childhood and was evaluated by neurology and medical genetics and diagnosed with Sotos syndrome. Results The patient’s overall intellectual functioning was in the exceptionally low range with a personal strength in verbal skills. Her neurocognitive results and low adaptive skills are indicative of a moderate intellectual disability. The patient’s developmental history, social difficulties, restrictive interests, and repetitive behaviors met criteria for autism spectrum disorder. Another notable finding was frequent starring spells in which she became unresponsive for approximately 15 seconds. Conclusion Delayed motor and language milestones, hypotonia, behavioral problems, and intellectual disability are common in individuals with Sotos syndrome and were present in the patient. Seizures and scoliosis are less common in individuals diagnosed, for which she was referred to a neurologist for further work-up.

Neurological Validation of ASD Diagnostic Criteria Using Frontal Alpha and Theta Asymmetry.

Background/Objectives: Diagnosis of Autism Spectrum Disorder (ASD) relies on the observation of difficulties in social communication and interaction, plus the presence of repetitive and restrictive behaviors. The identification of neurological correlates of these symptoms remains a high priority for clinical research, and has the potential to increase the validity of diagnosis of ASD as well as provide greater understanding of how the autistic brain functions. This study focused on two neurological phenomena that have been previously associated with psychiatric disorders (alpha- and theta-wave asymmetry across the frontal region of the brain), and tested for their association with the major diagnostic criteria for ASD. Methods: A total of 41 male autistic youth underwent assessment with the Autism Diagnostic Observation Schedule (ADOS-2) and 3 min of eyes-closed resting EEG to collect alpha- and theta-wave data from right and left frontal brain sites. Results: Different associations were found for theta versus alpha asymmetry and the ADOS-2 subscales, across different brain regions responsible for a varying range of cognitive functions. In general, theta asymmetry was associated with conversation with others, sharing of enjoyment, and making social overtures, whereas alpha asymmetry was linked with making eye contact, reporting events to others, and engaging in reciprocal social communication. Specific brain regions involved are identified, as well as implications for clinical practice. Conclusions: Specific autism symptoms may be associated with selected brain region activity, providing a neurological basis for diagnosis and treatment.

Neuropsychological profile in tuberous sclerosis complex: a study of clinical and cognitive variables in a cohort from Brazil.

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder with a wide clinical, cognitive, and behavioral expressivity. To assess the neuropsychological profile of individuals clinically diagnosed with TSC and the factors that could significantly impact their cognitive development. A total of 62 individuals with ages ranging from 3 to 38 years were followed up in a tertiary attention hospital in Southern Brazil, and they were assessed using a standard battery and the Vineland Adaptive Behavior Scales, when intellectual disability was observed. History of epilepsy was found in 56 participants (90.3%), and 31 (50%) presented an intellectual disability. Among the other half of TSC individuals without intellectual disability, 8 (12.9%) presented borderline classification, 20 (32.2%) presented average scores, and 3 (4.8%) were above average. In total, 17 participants (27.4%) fulfilled the diagnostic criteria for autism spectrum disorder. The results of the multiple linear regression analysis suggested that seizures, age at diagnosis, visual perception, and general attention significantly impact cognitive performance indexes. The present study suggests that the occurrence of epileptic seizures and older age at diagnosis contribute to higher impairment in the domains of cognitive development, underlining the importance of early diagnosis and the prevention of epileptic seizures or their rapid control. The development of attentional skills, visual perception, and executive functions must be followed up.

Prioritizing complex health levels beyond autism triage using fuzzy multi-criteria decision-making

This study delves into the complex prioritization process for Autism Spectrum Disorder (ASD), focusing on triaged patients at three urgency levels. Establishing a dynamic prioritization solution is challenging for resolving conflicts or trade-offs among ASD criteria. This research employs fuzzy multi-criteria decision making (MCDM) theory across four methodological phases. In the first phase, the study identifies a triaged ASD dataset, considering 19 critical medical and sociodemographic criteria for the three ASD levels. The second phase introduces a new Decision Matrix (DM) designed to manage the prioritization process effectively. The third phase focuses on the new extension of Fuzzy-Weighted Zero-Inconsistency (FWZIC) to construct the criteria weights using Single-Valued Neutrosophic 2-tuple Linguistic (SVN2TL). The fourth phase formulates the Multi-Attributive Border Approximation Area Comparison (MABAC) method to rank patients within each urgency level. Results from the SVN2TL-FWZIC weights offer significant insights, including the higher criteria values "C12 = Laughing for no reason" and "C16 = Notice the sound of the bell" with 0.097358 and 0.083832, indicating their significance in identifying potential ASD symptoms. The SVN2TL-FWZIC weights offer the base for prioritizing the three triage levels using MABAC, encompassing medical and behavioral dimensions. The methodology undergoes rigorous evaluation through sensitivity analysis scenarios, confirming the consistency of the prioritization results with critical analysis points. The methodology compares with three benchmark studies, using four distinct points, and achieves a remarkable 100% congruence with these prior investigations. The implications of this study are far-reaching, offering a valuable guide for clinical psychologists in prioritizing complex cases of ASD patients.

Autistic Traits Associated with the Fragile X Premutation Allele: The Neurodevelopmental Profile.

Although most individuals who carry the Fragile X premutation allele, defined as 55-200 CGG repeats on the X-linked FMR1 gene (Fragile X Messenger Ribonucleoprotein 1 gene), do not meet diagnostic criteria for autism spectrum disorder, there is a suggestion of increased behaviors associated with subtle autistic traits. More autism associated characteristics have been reported among adults than children. This may highlight a possible worsening developmental trajectory, variable findings due to research quality or differences in number of studies done in adults vs children, rather than true developmental changes. This review is designed to examine the neurodevelopmental profile associated with the premutation allele from a developmental perspective, focused on autistic traits.

Autism and attention-deficit/hyperactivity disorder in children with Dravet syndrome: A population-based study.

To identify on a population basis the prevalence of autism and attention-deficit/hyperactivity disorder (ADHD) in children with Dravet syndrome and factors associated with symptoms of autism and ADHD. Forty-one of 48 children with Dravet syndrome living in Sweden, born between 1st January 2000 and 31st December 2018 underwent assessment including measures of autism and ADHD. Diagnoses of autism and ADHD were made with respect to DSM-5 criteria. Factors associated with features of autism and ADHD were analysed via regression. Twenty-five of the 41 children fulfilled DSM-5 criteria for autism spectrum disorder and 12 of 37 children considered for an ADHD diagnosis fulfilled DSM-5 criteria for ADHD. Severe intellectual disability was significantly associated with a greater degree of autistic features (p < 0.001) and a DSM-5 diagnosis of autism spectrum disorder (p = 0.029). Younger children had significantly more features of ADHD (p = 0.004) and features of inattention were significantly more common than features of hyperactivity/impulsivity (p < 0.001). Children with Dravet syndrome often have significant features of autism and ADHD, primarily inattentive type. Screening for autism and ADHD should be routine in children with Dravet syndrome. In total, 25 of 41 assessed children with Dravet syndrome fulfilled DSM-5 criteria for autism. Twelve of 37 assessed children with Dravet Syndrome met DSM-5 criteria for attention-deficit/hyperactivity disorder (ADHD). Severe intellectual disability was significantly associated with a greater degree of autism spectrum disorder features. Younger children had significantly more features of ADHD.

Factors Associated with Confirmed and Unconfirmed Autism Spectrum Disorder Diagnosis in Children Volunteering for Research.

Diagnostic accuracy of autism spectrum disorder (ASD) is crucial to track and characterize ASD, as well as to guide appropriate interventions at the individual level. However, under-diagnosis, over-diagnosis, and misdiagnosis of ASD are still prevalent. We describe 232 children (MAge = 10.71 years; 19% female) with community-based diagnoses of ASD referred for research participation. Extensive assessment procedures were employed to confirm ASD diagnosis before study inclusion. The sample was subsequently divided into two groups with either confirmed ASD diagnoses (ASD+) or unconfirmed/inaccurate diagnoses (ASD-). Clinical characteristics differentiating the groups were further analyzed. 47% of children with community-based ASD diagnoses did not meet ASD criteria by expert consensus. ASD + and ASD- groups did not differ in age, gender, ethnicity, or racial make-up. The ASD + group was more likely to have a history of early language delays compared to the ASD- group; however, no group differences in current functional language use were reported by caregivers. The ASD + group scored significantly higher on ADI-R scores and on the ADOS-2 algorithm composite scores and calibrated severity scores (CSSs). The ASD- group attained higher estimated IQ scores and higher rates of psychiatric disorders, including anxiety disorder, disruptive behavior, and mood disorder diagnoses. Broadly, caregiver questionnaires (SRS-2, CCC-2) did not differentiate groups. Increased reported psychiatric disorders in the ASD- group suggests psychiatric complexity may contribute to community misdiagnosis and possible overdiagnosis of ASD. Clinician-mediated tools (ADI-R, ADOS-2) differentiated ASD + versus ASD- groups, whereas caregiver-reported questionnaires did not.

Giftedness and Twice-Exceptionality in Children Suspected of ADHD or Specific Learning Disorders: A Retrospective Study

The expression “twice-exceptionality” has been used to describe conditions in which giftedness and specific disorders coexist. Our study offers a retrospective analysis of clinical reports of gifted children evaluated for suspected specific learning disorders (SLD) or attention-deficit/hyperactivity disorder (ADHD). The initial sample included 456 school-aged children referred to our clinic for suspected SLD and/or ADHD over a two-year interval. The inclusion criteria were: a General Ability Index score above 120 in the cognitive assessment; age 6–18 years; and not satisfying diagnostic criteria for autism spectrum disorder. Forty children were selected for the study. We grouped patients according to the final diagnosis: neurodevelopmental disorder (SLD and/or ADHD) (n = 15), psychopathological disorder (n = 8), mixed neurodevelopmental and psychopathological (n = 13), no emerging disorder (n = 4). The study included 36 (90%) males. Mean age was 9.3 years (SD 1.62). Mean Full-Scale Intelligence Quotient was 121.7 (SD 7.77), mean General Ability Index was 130.2 (SD 6.79). Furthermore, the cognitive assessment of the different groups highlighted a non-homogeneous profile in all groups, with lower scores on working memory and processing speed indexes. Our results support the hypothesis that difficulties in gifted children’s adaptation to scholastic and social settings could be misinterpreted as a manifestation of a clear disease.

Specific intervention program for ARFID comorbid with ASD in a Children’s Youth Autism Day Hospital

IntroductionChildren and adolescents with ASD are more likely to have eating problems compared to the general population of the same age, one of the disorders whose prevalence is increased in people with ASD is avoidant/restrictive eating disorder Food (ARFID) ARFID is characterized by a lack of interest in eating or avoidance of food intake, which in the case of people with ASD is usually related to impaired sensory processing and cognitive rigidity. For this reason, the Autism Day Hospital carries out a specific food intervention program.ObjectivesTo retrospectively evaluate the results of the Food Program of the Autism Day Hospital during the year 2022.MethodsA retrospective analysis of the cases of patients admitted to the Food Program of the Autism Day Hospital during the year 2022 is carried out. Results of the sensory pattern and presence of genetic alterations of each one of the patients are compared. And the results of the intervention are evaluated by quantifying the new foods introduced into the diet at the end of the admission.ResultsThe sample is made up of a total of 5 children (4 boys and 1 girl) aged between 7 and 12 years. All of them meet diagnostic criteria for Autism Spectrum Disorder and present comorbidity with ARFID. Of the total sample, 1 of the patients presented in the genetic study a microdeletion S. in 15q13.3, duplication in 2q13 and duplication in 5p12-p11, with the genetic studies in the rest of the patients in the sample being normal. Regarding the results of the sensory pattern (Infant/Toddler Sensory profile test), all the patients presented differences in relation to other children of their age in the oral sensory pattern, this difference being definitive in 3 of the 5 patients in the sample. All the patients included in the program presented a satisfactory evolution, introducing at least 15-20 new foods into their usual diet, including different textures and consistencies.ConclusionsThe therapeutic approach to ARFID in children with ASD carried out from a multidisciplinary perspective; sensory integration, behavioral approach and, if necessary, psychopharmacological, has shown, based on the results obtained from the food program of the ASD Day Hospital, a favorable evolution of the eating disorder. For this reason, we consider the detection of this typical comorbidity of ASD and its referral to specific therapeutic programs to be of special importance.Disclosure of InterestNone Declared