Autism Research Articles

O PAPEL DO PROFISSIONAL DE ENFERMAGEM NA ATENÇÃO A CRIANÇAS E ADOLESCENTES COM TRANSTORNO DO ESPECTRO AUTISTA: UMA REVISÃO SISTEMÁTICA

Among the professionals involved in the health care of children with Autism Spectrum Disorder (ASD), nurses stand out as the first to establish contact, maintaining significant proximity with this patient. However, the theme of nursing care aimed at childhood autism is still little disseminated in the scientific community and in the practice of nursing professionals, especially when the focus is the mental health of children and adolescents with ASD. The objective of this study is to investigate the fundamental role of nursing professionals in the care of children and adolescents with Autism Spectrum Disorder (ASD), with an emphasis on promoting the mental health of both these individuals and those who live directly with them. To this end, a qualitative and descriptive research was carried out based on a systematic bibliographic review using the descriptors “Autism Spectrum Disorder”, “Nursing”, “Mental health”, "Child", "Adolescent" in the scientific platforms Google Scholar, PUBMED, LILACS, SCIELO and MEDLINE. A total of 1,098 articles were identified, of which 1,090 were obtained from the Google Scholar database, 4 from MEDLINE, 3 from SCIELO, 1 from PUBMED and none from LILACS. Of this total, 28 were considered eligible after applying the inclusion and exclusion criteria. A huge gap was found in Brazilian research regarding the promotion of mental health of children and adolescents with ASD by nursing professionals. Therefore, it is considered urgent to conduct scientific studies that offer nurses more knowledge about ASD, helping them to develop a critical, analytical and humanized perspective.

Effectiveness of autism training program introduction at primary health care (PHC) level

Background: Autism spectrum disorder (ASD) has become a public health issue in many countries especially in developing countries. Family members who have a toddler with ASD face significant physical, emotional, and financial challenges. Early detection is crucial to achieve improvement in children with ASD. Objectives: The aim of the current research is to study the implementation of a training program for Autism in 4 health care facilities and to evaluate its initial outcomes. Methodology: An interventional study conducted among 63 health care workers dealing with children 18-30 months in 4 health care facilities (2 urban health care facilities and 2 rural health care facilities) in Giza governorate. A tailored autism health education message as well as training on using the Arabic validated version of the Modified Checklist for Autism in Toddlers (M-CHAT) were provided to the HCWs. Results: 58.7% of participating primary health care workers (HCWs) had a satisfactory level of awareness about childhood autism prior to the intervention, and 71.4% had a satisfactory level of understanding following it. When comparing the study subjects' pre-intervention knowledge scores to their post-intervention knowledge scores, there was a statistically significant improvement in their knowledge about autism (p < 0.001). Conclusion: The study's findings validate the value of specialized training programs in raising healthcare workers' awareness of childhood autism. Recommendations: Incorporation of autism spectrum disorder (ASD) within the educational curriculum of medical and nursing schools and ongoing education and training in ASD for health care workers.

Low-intensity ABA intervention for young children with ASD in Italy

ABSTRACT This study investigated the effects of a 12-hr per week education package for 7 children with autism spectrum disorders (ASD) within the context of the Italian public health system. Different from the US, the Italian public health system traditionally offers 1 to 3 hrs per week of speech, occupational, or physical therapy, and/or ABA-based activity for children with ASD. Hence, it is imperative to assess the criteria for effective ABA interventions to enable comparison with various models of care for children with ASD. We employed a treatment package based on the Comprehensive Application of Behavior Analysis to Schooling (CABAS®) model. Each participant received interventions for 4 hours a day, 3 days a week for one year. The results revealed a significant difference in the total scores and each sub-test score of both the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and the Childhood Autism Rating Scale-Second Edition (CARS-2) before and after one year of instruction. Our low-intensity intervention appears to effectively improve the participants’ various academic, verbal, and self-management skills, positively impacting their overall development. Our findings provide insights into testing the effectiveness of an alternative model of ABA intervention while also expanding the application of advanced ABA practices to enhance the developmental trajectory of young children.

Music therapy improves engagement and initiation for autistic children with mild intellectual disabilities: A randomized controlled study.

This study aimed to evaluate the effectiveness of music therapy (MT) for children with co-occurring autism spectrum disorder (ASD) and intellectual disabilities (ID) and explore whether pre-intervention quantitative electroencephalogram (qEEG) responses can predict outcomes. A randomized controlled trial was conducted with 33 children receiving MT and 34 receiving an active control therapy. Participants received either MT or a non-musical social skills intervention for 45 min weekly over 12 weeks. Primary outcomes were measured using the Childhood Autism Rating Scale (CARS-2), along with the parent-rated Social Responsiveness Scale (SRS-2) and video coding of social behaviors. Both conditions significantly improved in CARS-2 scores at 2 weeks and 4 months post-intervention, with no differences between MT and control conditions. No changes were found in SRS-2 scores. While both conditions showed reduced disengagement after intervention, only the MT condition showed increased engagement and initiation. Strong qEEG responses to social scenes and music predicted increased initiation, indicating its potential to help tailor interventions. These results support incorporating MT into standard services and further research on qEEG predictors.

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.

Elemental examination in blood and urine samples of Jordanian children with autism spectrum disorder

Autism Spectrum disorder (ASD) is one of the psychiatric disorders with unknown etiology, which possibly affects children in the first three years of their life. This case-control study was performed to explore the differences in concentrations of 9 elements: sodium (Na), aluminum (Al), potassium (K), calcium (Ca), vanadium (V), manganese (Mn), cobalt (Co), thorium (Th), and uranium (U) in whole blood and urine specimens of children with ASD, neurotypical children, and their mothers. The study investigates the associations between the elements, sex, and severity of ASD. Methods and Materials: The study rincluded 21 children with ASD and 19 age-sex-matched neurotypical children. Elemental analysis was carried out by inductively coupled plasma-mass spectroscopy (ICP-MS). The behaviors of ASD were assessed using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and the Childhood Autism Rating Scale (CARS). The results indicated a significant increase of Al (198 ± 87, p= 0.05) and significant decrease of Ca (50 ± 3, p= 0.007) and Mn (10 ± 1, p= 0.004) in blood sample of ASD compared to the neurotypical group. In the urine sample, a significant decrease level appeared in Ca (41 ± 10, p=0.05) of ASD compared to neurotypical. The maternal samples showed no significant difference between ASD and neurotypical. The main finding of this study could help the specialist to diagnose and relieve symptoms of ASD. Thus, the heavy and trace elements analysis is a biomarker for ASD.

Substantial elevation of telomeric oxidized bases in childhood autism

BackgroundThe underlying molecular mechanisms responsible for the etiology of autism and its sex-biased prevalence remain largely elusive. We have previously shown that children with non-syndromic low-functioning idiopathic autism exhibit a sexually dimorphic pattern of relative telomere length (RTL), with autistic male children having significantly shorter RTL than autistic female children, healthy controls, and paired siblings. By contrast, a number of autistic girls had longer RTLs than healthy controls. Here, we investigated levels of telomeric oxidized base (TelOB) lesions among the same study subjects and groups. MethodsEmploying a quantitative PCR (qPCR)-based method, which combines DNA digestion targeting oxidized bases and telomere measurement, TelOB lesions were measured using genomic DNA extracted from saliva samples collected from 24 children (14 male and 10 female) with autism, 10 paired siblings, and 24 sex, age, and location-matched typically-developing controls. ResultsOur findings show that both male and female autistic children exhibit substantially higher TelOB lesions at their telomeres than healthy controls and paired siblings. Interestingly, these elevated levels of TelOBs show a direct correlation with RTL values in autistic children but not in healthy controls. However, TelOB levels do not show any association with age either in the autistic children or the healthy control group. ConclusionsOur findings open a fresh angle into autism spectrum disorders (ASD), raise new questions, and lay the foundation for further research into telomere biology and underlying molecular mechanisms involved in ASD. TelOB levels are likely set during early development and may serve as biomarkers for childhood autism.

Tablet computer-based cognitive training for visuomotor integration in children with developmental delay: a pilot study

BackgroundImpaired visuomotor integration (VMI) is commonly observed in children with developmental delay (DD). This pilot study aimed to evaluate the effects of tablet computer-based cognitive training on the VMI in children with DD.MethodsThis study included children aged 4 to under 18 years diagnosed with DD. The children participated in a 12-week tablet computer-based visual-spatial and visuomotor training program. They were administered the Mind Rx Kids Program (Brain Academy, Seoul, South Korea). The participants underwent daily 30-min tablet computer-based training for 12 weeks. The primary visuomotor function was measured using the Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition (VMI-6). For secondary outcomes, measurements were taken before and after 12-week treatment using the Quality of Upper Extremity Skills Test (QUEST), Functional Independence Measure for Children (WeeFIM), Childhood Autism Rating Scale (CARS), Attention deficit hyperactivity disorder Rating Scale (ARS), and Child Smartphone Addiction Observer Scale. The Wilcoxon signed-rank test was used to compare the pre- and post-treatment outcomes.ResultsTen children with DD participated in this study. The results of the 12-week tablet computer-based cognitive training showed significant improvements in the raw score, standard score, percentile score, and equivalent age of the Beery VMI-6. Additionally, there were significant improvements in QUEST and WeeFIM scores. Although there were improvements in the CARS, ARS, and smartphone addiction observer scale, these were not statistically significant.ConclusionThis pilot study confirmed that applying tablet computer-based cognitive training to children with DD not only improves VMI, but also enhances fine motor skills and activities of daily living. Furthermore, the results of this study indicate that tablet computer-based cognitive training does not increase digital media addiction. Therefore, children with DD can engage in tablet computer-based cognitive training at home without concerns about digital media addiction.

Deep learning approach to predict autism spectrum disorder: a systematic review and meta-analysis

BackgroundThe use of the deep learning (DL) approach has been suggested or applied to identify childhood autism spectrum disorder (ASD). The capacity to predict ASD, however, differs across investigations. Our study’s objective was to conduct a meta-analysis to determine the DL for ASD in children’s classification accuracy.MethodsEligibility criteria were designed according to the purpose of the meta-analysis; PubMed, EMBASE, Cochrane Library, and Web of Science Database were searched for articles published up to April 16, 2023, on the accuracy of DL methods for ASD classification. Using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) to assess the quality of the included studies. Sensitivity, specificity, areas under the curve (AUC), summary receiver operating characteristic (SROC), and corresponding 95% confidence intervals (CIs) were compiled by using the bivariate random-effects models.ResultsA total of 11 predictive trials based on DL models were included, involving 9495 ASD patients from 6 different databases. According to bivariate random-effects models’ results, the overall sensitivity, specificity, and AUC of the DL technique for ASD were, 0.95 (95% CI = 0.88–0.98), 0.93 (95% CI = 0.85–0.97), and 0.98 (95%CI: 0.97–0.99), respectively. Subgroup analysis results found that different datasets did not cause heterogeneity (meta-regression P = 0.55). The Kaggle dataset’s sensitivity and specificity were 0.94 (95%CI: 0.82-1.00) and 0.91 (95%CI: 0.76-1.00), and with 0.97 (95%CI: 0.92-1.00) and 0.97 (95%CI: 0.92-1.00) for ABIDE dataset.ConclusionsDL techniques has satisfactory sensitivity, specificity, and AUC in ASD classification. However, the major heterogeneity of the included studies limited the effectiveness of this meta-analysis. Further trials need to be performed to demonstrate the clinical practicability of DL diagnosis.

Immune alterations in children with autism spectrum disorders

Autism spectrum disorders (ASD) are a heterogeneous group of mental and nervous system disorders. Patients with ASD are characterized by communication and cognitive impairments and obsessive behavior. The pathogenesis and etiology of ASD are still unclear. According to the literature, patients suffering from ASD have not only mental, but also somatic disorders, including changes in the immune system. The aim of this work was to study the concentration of cytokines in the blood plasma of children with ASD and the level of expression of proinflammatory genes in peripheral blood mononuclear cells. The clinical group included 71 children aged 4-12 years with a diagnosis of ASD (F84.02). Patients scored more than 36 on the Childhood Autism Rating Scale (CARS). The control sample included 27 apparently healthy children of the same age. The following methods were used in this study: isolation of mononuclear cells from heparinized peripheral blood, Ficoll-Verografin density gradient centrifugation, evaluation of cytokine blocks using commercially available enzyme immunoassay kits, isolation of random total RNA, reverse transcription using hexaprimers, and real-time polymerase chain reaction using intercalating dye SYBR Green. The concentration of proinflammatory cytokines IL-1β, IL-8, and IL-17A in the peripheral blood plasma of children with ASD was statistically significantly increased compared to the control sample. Moreover, the concentration of the anti-inflammatory cytokine IL-10 in patients with ASD was 3.6 times lower compared to the control sample (p 0.001). The level of expression of the NF-κB1, IL1β, IL8 and TNFα genes at the RNA level in peripheral blood mononuclear cells was increased by 2.8, 2.5, 4.8 and 4.2 times in patients with ASD compared to the control sample (all p 0.01). The results obtained indicate an increase in the concentration of proinflammatory cytokines (IL-1β, IL-8, IL-17A) in the blood plasma and a decrease in the concentration of anti-inflammatory cytokines (IL-10) in patients with ASD compared to the control sequence.

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.

Estimation of Plasma Concentration of L-Carnosine and its Correlation with Core Symptoms of Autism Spectrum Disorder Children: A Pilot Clinical Trial.

Literature indicates that L-carnosine may be deficient in autism spectrum disorder (ASD) children. The aim of the present study was to estimate the level of L-carnosine in plasma and correlate it with the Autism Treatment Evaluation Checklist (ATEC) and Childhood Autism Rating Scale 2nd Edition, Standard Version (CARS2-ST) scores. To measure L-carnosine level, a bio-analytical method was developed using reverse phase high- liquid chromatography and validated as per International Conference on Harmonization guidelines. Children were supplemented with L-carnosine (10-15 mg/kg) along with standard care therapies for 2 months. Before and after supplementation, scores on the ATEC, CARS2-ST, BEARS sleep screening tool, 6-item Gastrointestinal Severity Index, and Parental Stress Scale were evaluated, and L-carnosine was measured at the end of the trial. The calibration curve was linear in the range of 100-600 ng/mL (R2 = 0.998). The level of L-carnosine quantified was 33.7 ± 0.2 ng/mL. There was no significant difference found in any of the outcome measures (p > 0.05). Despite the fact that L-carnosine is detectable in the blood, it was found to be ineffective in the management of ASD in children. The study was registered in the Clinical Trial Registry-India, registration number: CTRI/2019/07/020102.

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.

FMT intervention decreases urine 5-HIAA levels: a randomized double-blind controlled study.

Autism spectrum disorder (ASD) is often linked to gastrointestinal issues and altered serotonin metabolism. Emerging evidence suggests gut microbiota influence both, with fecal microbiota transplantation (FMT) offering a potential therapeutic approach. However, its impact on serotonin metabolism and ASD symptoms is not well understood. In this study, we aimed to evaluate the clinical effects of FMT and examine changes in specific urinary metabolites in children with ASD. A randomized double-blind controlled trial was performed to evaluate the clinical effects of FMT on GI and ASD-related symptoms. Gastrointestinal symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), and the ASD-related symptoms were assessed using the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), and Social Responsiveness Scale (SRS) scores. Urinary metabolites were analyzed by homogeneous enzyme immunoassay using commercially available kits. Significant improvements in GI and core ASD symptoms were observed following FMT intervention. The average GSRS scores decreased from 30.17 (before) to 19 (after; p < 0.0001), CARS scores decreased from 36.22 to 33.33 (p < 0.0001), SRS scores decreased from 151.17 to 137.5 (p = 0.0002), and the ABC scores decreased 76.39 to 53.17 (p < 0.0001) in the FMT group. However, in the placebo group, GSRS, CARS, and SRS scores showed no significant changes, while ABC scores decreased from 72 to 58.75 (p = 0.034). The FMT group also showed a significant reduction in urinary 5-hydroxyindoleacetic acid (5-HIAA) levels from 8.6 to 7.32 mg/L (p = 0.022), while other metabolites showed no significant changes. FMT is a safe and effective treatment for improving GI and core symptoms in children with ASD, with 5-HIAA showing potential as a urinary biomarker for treatment response.

Unraveling the relative abundance of psychobiotic bacteria in children with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by social deficits. Accumulated evidence has shown a link between alterations in the composition of gut microbiota and both neurobehavioural and gastrointestinal symptoms in children with ASD which are related to the genera Lactobacillus and Bifidobacterium. These genera have been recently categorized as “psychobiotics”. Moreover, this study aimed to compare the relative abundance of psychobiotics (L. plantarum, L. reuteri, and B. longum) to the total gut microbiome in typically developing (TD) children and those with ASD in order to correlate the distribution of psychobiotic with the severity and sensory impairments in autism. The ASD children were assessed using the Childhood Autism Rating Scale (CARS), while sensory impairments were evaluated using the Short Sensory Profile (SSP). Furthermore, the gut microbiome was analyzed using the quantitative real-time PCR. The study revealed a statistically significant increase in the relative abundance of L. reuteri and L. plantarum in the TD group in comparison to ASD children. Regarding the SSP total score of ASD children, a statistically significant negative correlation was found between both Lactobacillus and L. plantarum with the under-responsive subscale. For the Autism Treatment Evaluation Checklist (ATEC) score, B. longum and Lactobacillus showed a significant positive correlation with Health/Physical/Behaviour.

CONTINUOUS SCORING OF AUTISM SPECTRUM DISORDER PATIENTS BY ANALYZING THEIR EEG SIGNALS

Clinical manifestations and standard psychological tests have been widely used to diagnose autism spectrum disorder (ASD) patients and evaluate their severity level. The gold-standard criterion to diagnose ASD patients is the childhood autism rating scale (CARS), which is a qualitative questionnaire that is filled out through a systematic interview while no physiological test/record is performed to determine this score. To make the diagnosis process quantitative, electroencephalography (EEG) signals have been repeatedly analyzed to differentiate healthy subjects from ASD patients. However, the precise relationship between the abnormal behavior of EEG signals and different ASD severity levels is not well investigated. Here, we use CARS to qualitatively determine the severity level of 14 autistic children, who voluntarily enrolled in our study. We recorded their EEG signals from 19 scalp channels when they were awake in the idle state and elicited three informative features including approximation entropy, multiscale entropy and sample entropy in successive time frames. Among the three measures of entropy, the last one exhibits the highest sensitivity, where its correlation coefficient (CC) exceeds 0.7, on the electrode positions T6 (CC [Formula: see text] 0.74), P4 (CC [Formula: see text] 0.76) and Cz (CC [Formula: see text] 0.75). Results of sample entropy in channels Cz-versus-Pz and P4-versus-FP2 show that a simple K-nearest neighbor classifier can provide 93% classification accuracy among patients with mild, moderate and severe ASD levels. Comparing the proposed method to the conventional ones, we also extracted power spectral density features from the channels but they failed to identify the ASD severity level with an acceptable accuracy.

Level of support/commitment and behavior during mealtime and dental care negatively impact the dental caries prevalence in autistic individuals: cross-sectional study.

To verify whether factors associated with Autism Spectrum Disorder (ASD) would have impact on the dental-caries prevalence. All ASD-individuals receiving care in a specialized center with minimum of 4y old were recruited. Demographic, socioeconomic and behavioral characteristics, level of support/commitment (Childhood Autism Rating Scale), mealtime behavior (Brief Autism Mealtime Behavior Inventory) and medication use were answered by ASD-individual's parents. Behavior during dental care was evaluated from Frankl scale. Dental-caries prevalence was the primary outcome. Three examiners calibrated/trained collected the data. Chi-square test was used to compare the variables impact on the dental-caries prevalence. 61 ASD-individuals were potentially eligible, and the all parents/guardians consent to participate. Dental-caries prevalence was 42.9%, which was statistically associated with lower toothbrushing frequency, higher level of support/commitment, and worse behavior at meals and during in dental care. Dental-caries prevalence was approximately higher twice in ASD-individuals: (i) uncooperative with dental care when compared those cooperative (62% versus 32%, respectively); (ii) with severe level of support when compared to those with mild/moderate level (58% versus 28%, respectively); and (iii) with worse mealtime behavior when compared to those with better behavior (59% versus 28%, respectively). A medium statistical correlation was observed between support level and mealtime behavior (rS=0.39). The BAMBI component statistically associated with dental-caries prevalence was the food refusal (capture problem when a child rejects a presented food, crying, spitting out food). higher required level of support, worse mealtime behavior and uncooperative profile in dental care negatively affect the dental-caries prevalence. our findings provide evidence of the need of specialized, preventive and individualized dental care among ASD-individuals.

Thumbtack needle at front-mu points for abnormal behavior in children with autism spectrum disorders

To compare the clinical effect of thumbtack needle at front-mu points combined with conventional rehabilitation training and simple conventional rehabilitation training in the treatment of autism spectrum disorders (ASD). A total of 40 children with ASD were randomly divided into a combination group (20 cases, 3 cases dropped out) and a conventional rehabilitation group (20 cases, 3 cases dropped out). Conventional rehabilitation training i.e. language-cognition training and comprehensive education training was adopted in the conventional rehabilitation group, once a day, 5 days a week. On the basis of the treatment in the conventional rehabilitation group, thumbtack needle was applied at Zhongwan (CV 12), bilateral Tianshu (ST 25) and Guanyuan (CV 4) in the combination group, the needles were retained for 3 days each time, 3-day interval was taken between each treatment, for 5 times per month. One-month treatment was as one course and a total of 3 courses were required in both groups, with 10-day break between each course. Before and after treatment, the scores of autism behavior checklist (ABC), childhood autism rating scale (CARS), TCM spleen-stomach symptoms and Achenbach child behavior checklist (CBCL) were observed, and the serum ratio of glutamate and gamma-aminobutyric acid (Glu/GABA) was measured. After treatment, the scores of ABC, CARS and CBCL were decreased compared with those before treatment (P<0.05, P<0.01) in both groups, the TCM spleen-stomach symptoms score was decreased compared with that before treatment (P<0.05) in the combination group; the changes in the scores of ABC, CARS, TCM spleen-stomach symptoms and CBCL, as well as the serum Glu/GABA in the combination group were lager than those in the conventional rehabilitation group (P<0.05, P<0.01). Both thumbtack needle at front-mu points combined with conventional rehabilitation training and simple conventional rehabilitation training can effectively treat ASD, the combination treatment has superior effect on improving the abnormal behavior, spleen-stomach symptoms and balance of nerve impulse and inhibition.

Utility of individualised homoeopathic medicines in improving social interaction in childhood autism: A prospective, open-label, single arm study

Utility of individualised homoeopathic medicines in improving social interaction in childhood autism: A prospective, open-label, single arm study

Genetic Variations and Serum Levels of Leptin and Ghrelin in Autism Spectrum Disorder.

This study aims to examine leptin and ghrelin gene polymorphisms and serum levels in children with autism spectrum disorder (ASD). The study comprised a case group of 40 children aged 2-7 diagnosed with ASD and a control group of 40 healthy children. The severity of ASD symptoms was assessed using the Childhood Autism Rating Scale and the Autism Behavior Checklist. Leptin and ghrelin gene variants were genotyped using polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) methods. Serum ghrelin and leptin levels were measured using enzyme-linked immunosorbent assay kits. In this study, gene polymorphisms and allele frequencies were examined, and no significant difference was found (P > .05 for all). Our findings indicated no significant difference in leptin serum levels between the groups (P = .584). However, ghrelin serum levels were significantly lower in the ASD group (P = .027). Receiver operating curve analysis to determine the cutoff value of serum ghrelin level as a diagnostic indicator for ASD resulted in a cutoff value of 885.7 pg/mL with 42.50% sensitivity and 85% specificity (P = .021). No significant relationship was found between leptin and ghrelin serum levels and the severity of ASD (P > .05 for all). Our study is the first to evaluate leptin and ghrelin gene polymorphisms in ASD. Our findings indicate no association between leptin and ghrelin gene polymorphisms and ASD. However, our study suggests that ghrelin serum levels may potentially contribute to the etiology of ASD. More research is needed to understand the role of leptin and ghrelin in ASD.