Mild Autism Spectrum Disorder Research Articles

Efficacy of social skills group intervention among children with mild autism spectrum disorder.

Efficacy of social skills group intervention among children with mild autism spectrum disorder.

Family-Centric Applied Behavior Analysis Promotes Sustained Treatment Utilization and Attainment of Patient Goals.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication difficulties and restricted repetitive behaviors or interests. Applied behavior analysis (ABA) has been shown to significantly improve outcomes for individuals on the autism spectrum. However, challenges regarding access, cost, and provider shortages remain obstacles to treatment delivery. To this end, parents were trained as parent behavior technicians (pBTs), improving access to ABA, and empowering parents to provide ABA treatment in their own homes. We hypothesized that patients diagnosed with severe ASD would achieve the largest gains in overall success rates toward skill acquisition in comparison to patients diagnosed with mild or moderate ASD. Our secondary hypothesis was that patients with comprehensive treatment plans (>25-40 hours/week) would show greater gains in skill acquisition than those with focused treatment plans (less than or equal to 25 hours/week). Methods: This longitudinal, retrospective chart review evaluated data from 243 patients aged two to 18 years who received at least three months of ABA within our pBT treatment delivery model. Patients were stratified by utilization of prescribed ABA treatment, age, ASD severity (per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), and treatment plan type (comprehensive vs. focused). Patient outcomes were assessed by examining success rates in acquiring skills, both overall and in specific focus areas (communication, emotional regulation, executive functioning, and social skills). Patients receiving treatment within the pBT model demonstrated significant progress in skill acquisition both overall and within specific focus areas, regardless of cohort stratification. Patients with severe ASD showed greater overall skill acquisition gains than those with mild or moderate ASD. In addition, patients with comprehensive treatment plans showed significantly greater gains than those with focused treatment plans. The pBT model achieved both sustained levels of high treatment utilization and progress toward patient goals. Patients showed significant gains in success rates of skill acquisition both overall and in specific focus areas, regardless of their level of treatment utilization. This study reveals that our pBT model of ABA treatment delivery leads to consistent improvements in communication, emotional regulation, executive functioning, and social skills across patients on the autism spectrum, particularly for those with more severe symptoms and those following comprehensive treatment plans.

EEG findings and clinical severity and quality of life in non-epileptic patients with autism spectrum disorders

ABSTRACT Electroencephalogram (EEG) abnormalities could be seen in up to 60% of non-epileptic children with autism spectrum disorder (ASD). They have been used as biomarkers of ASD severity. The objective of our study is to identify EEG abnormalities in children with different degrees of ASD severity based on the Autism Treatment Evaluation Checklist (ATEC). We also want to assess the quality of life for children with ASD. All of the children underwent at least one hour of sleep-deprived EEG. Forty-five children were enrolled, of whom 42 were male. EEG abnormalities were found in 10 (22.2%) children, predominantly in the bilateral frontal areas. There were no differences in EEG findings among the mild, moderate, and severe ASD groups. The severity of ASD was associated with female sex (p-value = 0.013), ASD with attention deficit hyperactivity disorder (ADHD) (p-value = 0.032), ASD children taking medications (p-value = 0.048), and a lower Pediatric Quality of Life Inventory (PedsQL) (p-value <0.001). Social and emotional domains were the most problematic for health-related quality of life in ASD children, according to parent reports of PedsQL. Further studies with a larger sample size will help to clarify the potential associations between EEG abnormalities and the severity of ASD, as well as the impact on quality of life.

EXPLORING MINDMEND: AN INNOVATIVE MENTAL HEALTH SUPPORT APP FOR AUTISTIC ADOLESCENTS AND THEIR CAREGIVERS

Teenagers with mild autism spectrum disorders (ASD) and those who care for them face difficulties. Conventional mental health therapies frequently ignore culturally specific factors that are crucial to the patient's overall wellness. The paper aims to introduce and evaluate "MindMend" a smartphone software specifically designed for teenagers with mild autism spectrum disorders (ASD) and their caregivers. It focuses on examining the effectiveness of MindMend in reducing caregiver stress and alleviating autism symptoms. Additionally, it emphasises the significance of providing comprehensive support that considers the cultural and religious nuances of the target population. The software includes modules for social skills training, emotion regulation, and cognitive-behavioural therapy. Users may participate in a helpful online community, track their progress, and set goals. Early research demonstrates encouraging outcomes in reducing caregiver stress and autism symptoms. MindMend seeks to be a flexible instrument that enhances mental health while honouring subtleties related to culture and religion. The methodology integrates software development, evidence-based therapeutic approaches, and outcome evaluation. It aims to create a specialised mental health solution for teenagers with mild autism and their caregivers. The approach strongly emphasises addressing their unique challenges and providing comprehensive support. The development of MindMend involves creating an innovative smartphone application that offers specialised content. The paper assesses how well MindMend helps reduce stress for caregivers and alleviate autism symptoms in teenagers with mild ASD. The evaluation likely includes quantitative and qualitative methods to measure the digital system's impact on users' well-being.

Evaluation of the Impact of Screen Time and Parental Play on Children with an Autism Spectrum Disorder in Comparison with Normal Children

Background: There is a decremental trend seen in parental play in recent times, and there is a mounting trend in screen exposure in children. This changing trend in parental play and screen time exposure may affect child social and communication domains.Objective: To assess the impact of screen time and parental play in children with autism spectrum disorder.Methodology: This is a comparative cross sectional study with a sample of 60 children. Thirty children of age group 2-6 years diagnosed with Autism Spectrum Disorder as per DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) attending child guidance Clinic, Government Hospital for Mental care were included in the study.The Parental Play Questionnaire assessed parental play in children. The Digital Screen Exposure Questionnaire(DSEQ) evaluated child screen time exposure. The severity of ASD was assessed by using the CARS scale.Results: Out of thirty samples with Autism spectrum disorder (ASD), 60% of children had moderate ASD, while 20% accounted for mild and severe ASD. Nearly 53.3% of ASD children had a frequency of watching smartphones more than 5 times a week with an average duration of more than 2 hours a day. In contrast, in normal children, only 6.7% have such frequency and an average time of watching smartphones less than 1 hour, significant with a p-value of &lt;0.001. Among the ASD group, 80% of children had active physical parent-child play frequency of less than twice a week. In normal children, about 60% had a frequency of parent-child play several times daily.(p-value &lt;0.001). About 66.7% of ASD children never had to pretend play, and 30% had pretend play once a week.Conclusion: The result showed significantly higher screen time exposure and lack of parental play in childrenwith ASD than in normal children. The need of this digital era is mounting concern about reducing screen time exposure and increasing parental play in childhood.

Divergent electroencephalogram resting-state functional network alterations in subgroups of autism spectrum disorder: a symptom-based clustering analysis.

Autism spectrum disorder (ASD) is characterized by etiological and phenotypic heterogeneity. Despite efforts to categorize ASD into subtypes, research on specific functional connectivity changes within ASD subgroups based on clinical presentations is limited. This study proposed a symptom-based clustering approach to identify subgroups of ASD based on multiple clinical rating scales and investigate their distinct Electroencephalogram (EEG) functional connectivity patterns. Eyes-opened resting-state EEG data were collected from 72 children with ASD and 63 typically developing (TD) children. A data-driven clustering approach based on Social Responsiveness Scales-Second Edition and Vinland-3 scores was used to identify subgroups. EEG functional connectivity and topological characteristics in four frequency bands were assessed. Two subgroups were identified: mild ASD (mASD, n = 37) and severe ASD (sASD, n = 35). Compared to TD, mASD showed increased functional connectivity in the beta band, while sASD exhibited decreased connectivity in the alpha band. Significant between-group differences in global and regional topological abnormalities were found in both alpha and beta bands. The proposed symptom-based clustering approach revealed the divergent functional connectivity patterns in the ASD subgroups that was not observed in typical ASD studies. Our study thus provides a new perspective to address the heterogeneity in ASD research.

The role of adverse childhood experiences in obesity among adolescents with autism spectrum disorder: National survey of Children’s health 2018-2019

BackgroundAdolescents with autism spectrum disorder (ASD) are at an increased risk of overweight/obesity and adverse childhood experiences (ACEs). ObjectiveThis study examined whether ACEs increased the odds of overweight/obesity in adolescents with ASD. MethodsThis cross-sectional study used National Survey of Children's Health (NSCH) 2018-2019 data (N = 31,533 children ages 10–17 years, including n = 480 children with mild ASD and n = 423 children with moderate/severe ASD with normal or overweight/obese BMI). Parent-reported body mass index (BMI) was coded as overweight/obesity vs. normal weight. The independent variable was the count of nine ACEs. Binary logistic regression was conducted, controlling for social ecological factors. ResultsThe odds of overweight/obesity in adolescents with ASD with 1–2 ACEs (OR 1.3, CI 1.1-1.4) and 3+ ACEs (OR 1.6, CI 1.3-2.0) were higher than those with 0 ACEs; odds increased with higher counts of ACEs. Household income level was the most significant sociodemographic influence on odds of obesity in adolescents with ASD (0–99 % Federal Poverty Level: OR 1.9, CI 1.6-2.3). Adolescents with moderate/severe ASD (OR 1.7, CI 1.2-2.5) and mild ASD (OR 1.6, CI 1.0-2.4) had higher odds of overweight/obesity after accounting for ACEs, race/ethnicity, sex, household income, and physical activity. ConclusionFindings indicated ACEs are associated with ASD, which calls for integration of ACEs information within trauma-informed care practices for obesity prevention and intervention for adolescents with ASD. Persistent disparities of overweight/obesity exist by race/ethnicity, sex, and household income within this population, which indicates the need for tailoring trauma-informed approaches to the unique needs of this population.

A personalized classification of behavioral severity of autism spectrum disorder using a comprehensive machine learning framework

Autism Spectrum Disorder (ASD) is characterized as a neurodevelopmental disorder with a heterogeneous nature, influenced by genetics and exhibiting diverse clinical presentations. In this study, we dissect Autism Spectrum Disorder (ASD) into its behavioral components, mirroring the diagnostic process used in clinical settings. Morphological features are extracted from magnetic resonance imaging (MRI) scans, found in the publicly available dataset ABIDE II, identifying the most discriminative features that differentiate ASD within various behavioral domains. Then, each subject is categorized as having severe, moderate, or mild ASD, or typical neurodevelopment (TD), based on the behavioral domains of the Social Responsiveness Scale (SRS). Through this study, multiple artificial intelligence (AI) models are utilized for feature selection and classifying each ASD severity and behavioural group. A multivariate feature selection algorithm, investigating four different classifiers with linear and non-linear hypotheses, is applied iteratively while shuffling the training-validation subjects to find the set of cortical regions with statistically significant association with ASD. A set of six classifiers are optimized and trained on the selected set of features using 5-fold cross-validation for the purpose of severity classification for each behavioural group. Our AI-based model achieved an average accuracy of 96%, computed as the mean accuracy across the top-performing AI models for feature selection and severity classification across the different behavioral groups. The proposed AI model has the ability to accurately differentiate between the functionalities of specific brain regions, such as the left and right caudal middle frontal regions. We propose an AI-based model that dissects ASD into behavioral components. For each behavioral component, the AI-based model is capable of identifying the brain regions which are associated with ASD as well as utilizing those regions for diagnosis. The proposed system can increase the speed and accuracy of the diagnostic process and result in improved outcomes for individuals with ASD, highlighting the potential of AI in this area.

FRI479 Resistance To Thyroid Hormone Due To Thyroid Hormone Receptor Alpha (THRA) Gene Mutation

Abstract Disclosure: J.O. Abdelkarim: None. S. Parveen: None. M.G. Jakoby: None. J. Fleischer: None. Introduction: Resistance to thyroid hormone (RTH) is a heritable disorder characterized by diminished response to triiodothyronine (T3). Most cases of RTH are due to mutations in the thyroid hormone receptor beta (THRB) gene (“RTH-beta”). Mutations in thyroid hormone receptor alpha (THRA) gene appear to be a rare cause of RTH (“RTH-alpha”), with the first case reported in 2012. We present a case of RTH-alpha in a patient confirmed to have a pathogenic THRA mutation. Clinical Case: A 38-year-old Caucasian male was referred to genetic clinic due to mild developmental delay, dyscalculia and mild autism spectrum disorder. He was born at term by uncomplicated spontaneous vaginal delivery. Parents first noticed developmental delays at age 5 y, though no evaluation occurred during childhood. As an adult, the patient completed seminary studies and was employed as a Catholic priest. An intellectual disability gene panel revealed a pathogenic variant of the THRA gene (c.1151G&amp;gt;A p.R384H). Both parents tested negative for the mutation. Examination was notable for obesity (183 cm, 186 kg, BMI 55.5), macrocephaly, hypertelorism, pectus excavatum and small hands with short digits. No thyroid anatomic thyroid abnormalities were appreciated on neck examination or ultrasonography. TSH was 1.860 mIU/L (0.358-3.740), free T4 0.71 ng/dL (0.76-1.46), and free T3 3.2 pg/mL (2.2-4.0). The patient had no symptoms of hypothyroidism, and supplemental thyroid hormone was deferred. Discussion: There are 29 reported THRA gene mutations and 32 cases of RTH-alpha reported in the peer reviewed literature. Common clinical features include mild-to-moderate intellectual impairment, low basal metabolic rate (BMR), mild skeletal dysplasia, normocytic anemia, bradycardia, consistent with high expression of THRA in brain, heart, gastrointestinal tract, skeletal muscle, and bone. TSH is normal to slightly increased, free T4 is low to low normal, and free T3 is normal to modestly elevated. This is the third reported case of the c.1151G&amp;gt;A missense mutation resulting in an arginine to histidine substitution at codon 384. Thyroid function tests conform to the pattern described for other cases of RTH-alpha. Like the other two patients with the R384H mutation, developmental delays occurred, though intellectual manifestations mitigated with time and the patient completed seminary studies without difficulty. Mitigation of phenotype with age has been reported in RTH-alpha mice with the R384C missense mutation. Short stature did not occur in this patient or the other R384H cases. Unlike other patients, this patient did not experience anemia or constipation. Macrocephaly is a common feature of the three R384H cases, but the patient’s other skeletal manifestations (e.g. pectus excavatum) were not reported. This case demonstrates the difficulty of recognizing THR-alpha and extends our understanding of the R384H phenotype. Presentation: Friday, June 16, 2023

Penerapan Prompts dan Reinforcement untuk Meningkatkan Frekuensi Kontak Mata pada Anak dengan Autisme

Children with autism spectrum disorder (ASD) have deficits in the ability to interact and communicate socially. The deficit in communication skills is also seen in the lack of eye contact displayed by ASD children. Eye contact plays a vital role in child development, such as responding to interactions, following instructions, and acquiring vocabulary and educational understanding. This intervention aims to increase the frequency of eye contact in a 4-year-old boy (N = 1) with mild ASD and language impairment. Researchers used prompts and reinforcement techniques, considered adequate for improving social skills in children with neurodevelopmental disorders. Researchers use designs A (Baseline) and B (Intervention). The results showed an increase in the frequency of eye contact with the subject from 0-2 times to 10 times in one session consisting of 10 times calling the child's name. Furthermore, this intervention also found an increase in children's eye contact when carried out by parents at home.

Leukocyte cytokine expression is associated with severity of autism in children

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with unknown etiology, high clinical heterogeneity and marked aberrations of the immune system. Evidence for an association between immune dysfunction and behavioral traits highlights the need for a study of the immune cell functional activity in order to search for pathogenesis mechanisms and potential targets for therapy at ASD. The purpose: to determine the expression levels of IL-1β, IL-2, IL-4, IL-6, IL-10, IL-18, IFNγ and TNFα in peripheral blood leukocytes of children with mild and severe ASD. The study included 81 children with ASD (77.8% boys) and 45 children with typical neurodevelopment (TDC, 71.1% boys). According to the Childhood Autism Rating Scale, 51 children (63.0%) had mild autistic symptoms (CARS score 32.0±1,5) and 30 children had severe ASD symptoms (CARS score 39.0±3,4). Cytokines expression in leukocytes was determined by quantitative PCR with SYBRGreen. The data were transformed using Box–Cox transformation. The differences between groups were assessed by one-way ANOVA and Dunn’s test for multiple comparisons. In leukocytes of children with ASD, regardless of the severity, the expression of IL-1β, IL-18 and IL-2, was significantly reduced compared to TDC. Moreover, in children with mild ASD, low expression of TNFα, compared with TDC was found. In children with severe ASD, the expression of the main cytokine of Th1 – IFNγ, was significantly increased, without an increased expression of an important cytokine of Treg – IL-10. Activation of the Th1 adaptive immune response without compensation by cytokines of Treg, the number of which is reduced in ASD, can lead to increased inflammation, even in the central nervous system, and correlates with the severity of ASD clinical symptoms. Despite extensive immunological evidence suggesting immune system dysregulation, further research is required to clarify the relationship between immune system cell function and ASD pathology.

Signes cliniques précoces chez les enfants porteurs d’un TSA léger : description et effet de genre

BackgroundIn our Autism Spectrum Disorders Reference Center, we meet young people with mild autism spectrum disorder (ASD) with normal intellectual and language skills. The objective of this article was to characterize this population by analyzing the specific profile of these young people: first signs of concern, age of diagnosis in relation to more severe disorders, previous diagnoses, and reason for the assessment. In addition, we wanted to pay particular attention to the profiles of girls with mild ASD. MethodWe carried out a retrospective study based on the analysis of the clinical records of patients with a diagnosis of autism spectrum disorder of mild intensity according to the DSM-5, having benefited from a diagnostic assessment in our service. From the patient clinical files, we compared several elements: reason for the request, requesting persons, possible previous diagnoses, common early clinical signs. We have for each element distinguished girls and boys. ResultsWe studied a population of 33 young people with mild ASD. The assessment is most often requested by parents in the context of social interaction disorders. The average age of diagnosis is higher than in children with moderate or severe ASD, and young people have sometimes received other past diagnoses. We were able to highlight certain early signs in terms of language, sleep, food, sensory sensitivities, emotional regulation and socialization, signs that are, however, not very specific. No significant difference but rather tendencies were highlighted between girls and boys, probably related to the small size of the sample. DiscussionThe retrospective nature of this study, the sample size and the absence of a control group are limitations. However, a certain camouflage, early non-specific signs as well as sometimes less suitable diagnostic tools can explain a later diagnosis in young carriers of mild ASD, some of whom have also received another diagnosis in the past. An attitude of denial of the difficulties on the part of the parents is sometimes also mentioned. As far as girls are concerned, we found them in a higher proportion than expected, given the literature which describes a sex ratio quite different from ours. ConclusionIf the early and late clinical signs concerning mild ASD are better and better known from a theoretical point of view, the diagnosis does not seem to be facilitated for all that. Also, raising the awareness of parents and first-line caregivers is required to detect children with mild ASD early in order to refer them to specialists in this disorder. Given the number of girls in our sample, it seems that they likely benefited from effective screening. A future study could relate to a comparison of our population with a control group, in order to refine the specificity of any early symptoms.

Abstract Number ‐ 197: A Single‐Center, 23‐Year Experience with the MAGIC Catheter for Pediatric AVM

Introduction The MAGIC Catheter (Balt, Montmorency, France) is a commonly used flow‐directed microcatheter for neuro‐interventions. Despite the MAGIC catheter not having FDA approval for use in pediatric and neonatal populations, our institution has used this catheter off‐label for numerous cases of pediatric arteriovenous malformation (AVM), vein of Galen malformation (VOGM), dural arteriovenous fistula (dAVF), and pial AVF (pAVF). Herein, we outline our practice’s experience with the MAGIC catheter for pediatrics. Methods We reviewed our institutional, quality‐control database for all cases of pediatric, vascular malformation that utilized the MAGIC catheter since its original use in pediatrics at our practice (March 1999) and July 2022. We describe the disease and demographic characteristics of this cohort, frequency of MAGIC catheter use, adjunct supplies, complications, smallest vessels catheterized, and clinical outcomes. Results Over the review period, 99 pediatric patients with AVM(45), VOGM(49), dAVF(3), and pAVF(2) were identified for detailed review. This cohort has collectively undergone 194 procedures. The average age at first procedure with the MAGIC catheter was 4.42 years with a wide variation (SD: 4.56; Range: 0–17.64). The majority of cases using the MAGIC catheter were cerebral angiograms with embolization (190 – 97.9%), though occasionally it was employed for angiography alone (4 – 2.1%). A 4‐Fr Berenstein Catheter was the most common adjunct catheter used during the study period (156/194; 80.4%), though the 5‐Fr Envoy appeared often as well (30/194; 15.5%). Every embolization in the series led to interval‐decrease or cure of the malformation, though five intraprocedural complications were noted in the form of transient decrease neuromonitoring evoked potentials, epidural hematoma due to vessel perforation, and three cases of vessel perforation without long‐term consequence. Periprocedural complications occurred in one patient involving an intraventricular hemorrhage requiring a ventriculoperitoneal shunt. The most common liquid embolic agent used with the MAGIC catheter was nBCA (179/190; 94.2%) with occasional use of Onyx 18, Fibered Coils, Surgi‐Flo, STS, and Ethanol. Of the 67 patients who had a follow‐up available for review, 30 (44.8%) are neurologically intact and clinically well, 19(28.4%) are clinically well with mild symptoms (mild autism spectrum disorder, mild hemiparesis, headaches, mild weakness, post‐hemorrhage/stroke excellent recovery), 9 (13.4%)have experienced moderate to severe symptoms (limb weakness, cranial neuropathies, cognitive delay/deficit, inability to ambulate, seizures), 3 (4.5%) have passed away, and 6 (9.0%) have been lost to follow‐up. Selective catheterization of small vessels was performed among the anterior choroidal, thalamoperforator, posterior choroidal, middle meningeal arteries and superior cerebellar, posterior cerebral, and deep external/internal carotid artery branches, and many others by the MAGIC microcatheter for contrast injection or delivery of embolic agents. Conclusions Flow‐directed microcatheters are a quintessential tool used in the endovascular treatment of cerebrovascular diseases, but few have regulatory approval for use in pediatric populations. The off‐label use of the MAGIC microcatheter has been shown to be safe and effective in pediatric embolization procedures. However, there still remains a technology gap in the development of flow‐directed catheters specifically designed and proportioned for use in pediatric patients.

Differentiation of children with varying levels of autism spectrum disorder symptoms from children developing typically

The DSM-5 (American Psychiatric Association, 2013) combined all previous autism diagnoses into a single diagnostic category, autism spectrum disorder (ASD). The present study examined whether an 84-item measure of the ASD DSM-5 criteria, the Coolidge Autism Symptom Survey (CASS), could differentiate between children who were developing typically (DT) and children diagnosed with mild, moderate, and severe levels of ASD. One-hundred forty-nine adult participants completed the CASS about a child (5-17 years old) they knew well. As hypothesized, DT children scored significantly lower on the CASS than children with mild, moderate, and severe ASD. The CASS sums on the latter two groups were not significantly different. The results preliminarily support the reliability and validity of the CASS. • The present study used the 84-item, Coolidge Autism Symptom Survey (CASS), which is based on DSM- 5-TR criteria. • The CASS had excellent internal reliability, Cronbach's α = 0.98. • The CASS was able to differentiate statistically between children who were developing typically (DT) and children diagnosed with mild, moderate, and severe levels of ASD.

New insights into candidate genes for autism spectrum disorder in 8p23.1 duplication syndrome

The 8p23.1 duplication syndrome is a rare condition, characterized by dysmorphisms, intellectual disability, congenital cardiac anomalies, and autism spectrum disorder (ASD). The current model for explaining the pathogenesis of this condition postulates that few dosage-sensitive genes within the duplication are sufficient for the core clinical features, although the molecular mechanisms leading to the ASD presentation remain to be solved. Herein, we described clinical and cytomolecular findings of an 8p23.1 duplication in a boy with mild facial dysmorphisms, cardiac anomalies and ASD. Therefore, we investigated the influence of duplicated genes on the pathophysiology of ASD in our patient. We identified four duplicated genes (BLK, GATA4, PINX1, TNKS) connected with proteins previously associated with ASD and involved in significant enriched pathways associated with human neurological conditions. Moreover, the candidate genes are highly expressed in brain regions associated to ASD, such as the hippocampus. Taken together, these results point out crucial interactions among BLK, GATA4, PINX1, and TNKS and genes associated with ASD. We indicate cellular networks perturbations encompassing neuronal development pathways related to our patient's condition. Thus, these findings bring new insights into the genetic basis of ASD in patients with 8p23.1 duplication syndrome.

Gaze Fixation and Visual Searching Behaviors during an Immersive Virtual Reality Social Skills Training Experience for Children and Youth with Autism Spectrum Disorder: A Pilot Study.

Children and youth with Autism Spectrum Disorder (ASD) display difficulties recognizing and interacting with behavioral expressions of emotion, a deficit that makes social interaction problematic. Social skills training is foundational to the treatment of ASD, yet this intervention is costly, time-consuming, lacks objectivity, and is difficult to deliver in real-world settings. This pilot project investigated the use of an immersive virtual reality (IVR) headset to simulate real-world social interactions for children/youth with ASD. The primary objective was to describe gaze fixation and visual search behaviors during the simulated activity. Ten participants were enrolled and completed one social-skills training session in the IVR. The results demonstrate differential patterns between participants with mild, moderate, and severe ASD in the location and duration of gaze fixation as well as the patterns of visual searching. Although the results are preliminary, these differences may shed light on phenotypes within the continuum of ASD. Additionally, there may be value in quantifying gaze and visual search behaviors as an objective metric of interventional effectiveness for social-skills training therapy.

Cytokines and neurotrophic factors in the severity assessment of children autism.

Due to the steady increase in the number of children with autism and the high heterogeneity of clinical groups, the diagnosis of these disorders and their severity is an urgent problem in modern medicine. In the course of the work, 126 children from 3 to 13 years old with typical neurodevelopment and with severe and mild autism spectrum disorders (ASD) were examined. Disease severity was determined according to the Childhood Autism Rating Scale (CARS). The levels of pro-/anti-inflammatory cytokines and neurotrophic factors (nerve growth factor beta and brain-derived neurotrophic factor) in blood plasma were assessed by enzyme immunoassay. Associations between indicators in each group of patients were assessed using the Spearman test and visualized as a heatmap of correlations. Statistical data processing was carried out in the R software. Significantly high levels of IL-4 in blood plasma and a decrease in the number of significant correlations within/between systems were revealed in children with mild autism compared with children with typical neurodevelopment. Such data can probably reflect the theory that some children with ASD are characterized by slow brain development, as a variant of the evolutionary norm. On the contrary, in children with severe ASD, high systemic levels of IL-6 and IFNg are shown against the background of low values of IL-10, IL-1β, TNFα and NGFβ, supported by the almost complete absence of intra/ and intersystem interactions. This may act as an indicator of maladaptation of the immune and nervous systems in severe autism, which contributes to the pathogenesis of the disease. Thus, a set of indicators: high levels of key pro-inflammatory cytokines - IL-6 and IFNg, low levels of IL-10, NGFβ and disintegration of the cytokine and nervous systems in the periphery can be proposed as an approach to indicate the severity of the condition in children with ASD.

The association of screen time with physical activity and weight status of autistic children in Kuala Lumpur, Malaysia

PurposeThe purpose of this study was to evaluate the screen time used by Autism Spectrum Disorder (ASD) children and its association with their physical activity and weight status.Design/methodology/approachThis cross-sectional study was conducted among 100 purposive sampled children registered under the National Autism Society of Malaysia centres in Kuala Lumpur. Parents-administered questionnaire composed of socio-demographic, anthropometric data (height and weight of the children), Autism Severity Questionnaire, Screen Time Questionnaire and Physical Activity Questionnaire for Older Children (PAQ-C) was used in this study.FindingsRespondents in this study were categorised as having mild ASD (55%). Most of the respondents had higher screen time (78%), with average (4.14 ± 3.19) h spent using the devices. The respondents had low physical activity level (54%), with average PAQ-C scores of (2.38 ± 0.79). Average BMI-for-age z-scores was 1.06 ± 2.15, which was in the normal category. Approximately, 34% of the respondents were overweight and obese. BMI-for-age was positively associated with screen time during weekdays (χ2 = 11.06; p < 0.05) but not during weekend (χ2 = 3.14; p > 0.05). Spearman correlation test showed negative relationships between screen time on weekdays (rs = −0.30 and p < 0.01) and weekend (rs = −0.21 and p < 0.05) with PAQ-C of this group of ASD children.Practical implicationsScreen time was directly associated with the BMI-for-age z-score but was inversely associated with physical activity. Future studies could implement a structured physical activity intervention among children with ASD, which may increase physical activity and decrease screen time behaviours while addressing the overweight/obesity and cognitive aspects of these ASD children.Originality/valueThis study measured the amount of screen time, level of physical activity and weight status but not dietary intake of autistic children.

Selected Methods of Therapeutic Interactions With People With Mild Symptoms of Autism Spectrum Disorder.

In this review we present the behavioral aspects of interaction in people with autism spectrum disorders (ASD), taking into account some aspects of pharmacotherapy. In the treatment of people with ASD, an individual approach to emotional, social and cognitive functioning is very important. The specificity of symptoms and their severity in people with ASD results from deficits/disfunction of various areas of the brain and is associated with different levels of intelligence. This manuscript considers selected methods of interaction with ASD patients with normal IQ. Due to the different ways of functioning, these people often find it difficult to adapt to social expectations. The most important thing is to understand their perception of themselves and the world around them in order to support them in coping with the daily challenges. Due to the increasing problem, more and more attention is being focused on early detection of ASD, what allows to intervene as fast as possible and in consequence affect the quality of life of people with this dysfunctions. However, participants with mild autism symptoms are still difficult to diagnose in the practice. The effectiveness of the therapy depends largely on the cooperation of educational institutions. It is also necessary to contact specialist clinics, including a mental health counseling center. However, in the case of children and adolescents, the cooperation between the therapist and their parents is the basis. Systemic family therapy is also important in adults with ASD. An overview of the methods of therapeutic interactions in ASD, what may be helpful in diagnosing of mild ASD, were presented in our manuscript.

Parent-Reported Assessment Scores Reflect the ASD Severity Level in 2- to 7-Year-Old Children.

We investigated the relationship between parent-reported assessments and autism spectrum disorder (ASD) severity level. Parents evaluated 9573 children with ASD on five subscales—combinatorial receptive language, expressive language, sociability, sensory awareness, and health—using the Autism Treatment Evaluation Checklist (ATEC) and Mental Synthesis Evaluation Checklist (MSEC). The scores in every subscale improved with age, and there were clear differences between the three diagnostic categories. The differences between mild and moderate ASD, and moderate and severe ASD reached statistical significance in each subscale and in every age group in children 3 years of age and older. These findings demonstrate a consistent relationship between children’s diagnoses and their assessments and provide evidence in support of the reliability of parent-report evaluations for ASD. Additionally, this is the first investigation of the relationship between ASD severity level and the ATEC/MSEC scores for the age range from 2 to 7 years.