Rates Of Autism Research Articles

Reversal of memory and autism-related phenotypes in Tsc2+/- mice via inhibition of Nlgn1.

Tuberous sclerosis complex (TSC) is a rare monogenic disorder co-diagnosed with high rates of autism and is caused by loss of function mutations in the TSC1 or TSC2 genes. A key pathway hyperactivated in TSC is the mammalian/mechanistic target of rapamycin complex 1 (mTORC1), which regulates cap-dependent mRNA translation. We previously demonstrated that exaggerated cap-dependent translation leads to autism-related phenotypes and increased mRNA translation and protein expression of Neuroligin 1 (Nlgn1) in mice. Inhibition of Nlgn1 expression reversed social behavior deficits in mice with increased cap-dependent translation. Herein, we report elevated translation of Nlgn1 mRNA and an increase in its protein expression. Genetic or pharmacological inhibition of Nlgn1 expression in Tsc2 +/- mice rescued impaired hippocampal mGluR-LTD, contextual discrimination and social behavior deficits in Tsc2 +/- mice, without correcting mTORC1 hyperactivation. Thus, we demonstrate that reduction of Nlgn1 expression in Tsc2 +/- mice is a new therapeutic strategy for TSC and potentially other neurodevelopmental disorders.

Higher rates of autism and attention deficit/hyperactivity disorder in American children: Are food quality issues impacting epigenetic inheritance?

In the United States, schools offer special education services to children who are diagnosed with a learning or neurodevelopmental disorder and have difficulty meeting their learning goals. Pediatricians may play a key role in helping children access special education services. The number of children ages 6-21 in the United States receiving special education services increased 10.4% from 2006 to 2021. Children receiving special education services under the autism category increased 242% during the same period. The demand for special education services for children under the developmental delay and other health impaired categories increased by 184% and 83% respectively. Although student enrollment in American schools has remained stable since 2006, the percentage distribution of children receiving special education services nearly tripled for the autism category and quadrupled for the developmental delay category by 2021. Allowable heavy metal residues remain persistent in the American food supply due to food ingredient manufacturing processes. Numerous clinical trial data indicate heavy metal exposures and poor diet are the primary epigenetic factors responsible for the autism and attention deficit hyperactivity disorder epidemics. Dietary heavy metal exposures, especially inorganic mercury and lead may impact gene behavior across generations. In 2021, the United States Congress found heavy metal residues problematic in the American food supply but took no legislative action. Mandatory health warning labels on select foods may be the only way to reduce dietary heavy metal exposures and improve child learning across generations.

Predicting the level of autism and improvement rate from assessment dataset using machine learning techniques

Predicting the level of autism and improvement rate from assessment dataset using machine learning techniques

Examining case complexity among Pasifika with autism/Takiwātanga in Aotearoa New Zealand: a national cross-sectional study

Introduction: Autism is a lifelong neurodevelopmental condition that is estimated to impact 1 in 44 children. In Aotearoa New Zealand, the rate of autism among Pasifika children and young people (38.6 per 10,000 people) is substantively lower than other ethnic groups (67.5 for European and 47.2 for Māori); however, the complexities associated with Autism diagnosis in Pasifika is unknown.
 Aim: We compared rates of Autism and co-occurring diagnoses of conditions as a proxy for Autism case complexity between Pasifika and NMNP young people (aged 0-24 years) in Aotearoa New Zealand.
 Methods: This national, cross-sectional study was undertaken using data from a national database; the Integrated Data Infrastructure (IDI). Three separate indicators were created to reflect different types of complexity for someone with autism: Asperger’s syndrome (identifies those with lower complexity with fewer demands on support services); intellectual disability (higher needs/greater complexity); ORS funding (higher needs/greater complexity).
 Findings: In this present study, Pasifika in Aotearoa New Zealand had much lower autism identification rates in comparison to Non-Māori Non-Pasifika (NMNP) (53.3 per 10,000 vs 83 per 10,000). After adjusting for socioeconomic differences, Pasifika had significantly lower odds (Odds Ratio (OR) = 0.47) of having an Asperger’s syndrome diagnosis. However, Pasifika had significantly higher odds of having an intellectual disability (OR = 2.23) and being Ongoing Resources Scheme funded (OR = 2.18).
 Conclusions: Using this method within the IDI, Pasifika children in Aotearoa continue to have lower rates of Autism diagnosis; however, they are more likely to have a higher complexity of autism diagnosis.

A pilot randomized controlled clinical trial of dance practice for functionality in autistic children and adolescent with all levels of need support

ObjectiveThis study addressed dance practice intertwining communication, functional independence and social behavior in autistic children and adolescents with all levels of need support. DesignA pilot randomized clinical trial with seventy-two participants between 8 and 15 years old were assessed for eligibility. SettingTheater rehearsal room and mental health clinic. InterventionsDance group (n = 17) or control group (n = 19), 24 sessions, once a week, lasting 40 min. Main outcome measuresThe Autism Behavior Checklist (ABC), Autistic Screening Questionnaire (ASQ), Childhood Autism Rate Scale (CARS), Functional Independence Measure (FIM), and World Health Organization Disability Assessment Schedule (WHODAS, version 2.0, to assess mothers’ functioning) were applied at two time points: baseline and end-point. ResultsDifferences between dance and control groups were significant at post-intervention for communication (mean difference: 1.31; 99.8%CI: 0.29, 2.32, p < 0.001, d = 0.93); social cognition (mean difference: 1.01; 99.8%CI: 0.13, 1.89, p < 0.001, d = 0.82); autistic behavior (mean difference: 11.82; 99.8%CI: 17.33, −6.31, p < 0.001, d = 1.45). ConclusionsIn this preliminary study, the findings provide ways of communication and social interaction through dance practice by autistic children and adolescents with all levels of support needs. Research on neurodiversity is needed to understand its feasibility and the lifestyle appropriation.

Does Vaccination Increase the Risk of Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a developmental disorder that can cause significant social, communicative, and behavioral difficulties. With autism rates rising dramatically in recent years, researchers and concerned parents have theorized the causes of autism, and the subject has received much attention. Is the high rate of autism now due to increased diagnosis and reporting, changing autism definitions, or a rise in the number of people with ASD? People started to blame vaccines as a cause of the increased number of people with ASD. Vaccines and their connection to autism have been the subject of continuous debate. Some parents are concerned that vaccines, particularly the measles-mumps-rubella (MMR) vaccine and preservatives used in other childhood vaccines, may play a role in developing autism in their children. This systemic review explores the link between vaccination and autism in children. We conducted a literature search using PubMed and Google Scholar. We included papers written in the English language from 1998 to 2022, conducting human research that examines the relationship between vaccination and the development of autism using appropriate quality assessment tools. Two reviewers independently reviewed the content of the included studies. In total, 21 studies were deemed eligible.

Autistic characteristics in youth with anorexia nervosa before and after treatment.

Cognitive characteristics common to autistic individuals are often seen in adults with anorexia nervosa (AN), raising the question of whether autistic people and people with AN may share an endophenotype. We need to examine autistic characteristics during the early stages of AN to accurately parse true symptom co-occurrence from behavioural alterations due to prolonged illness. We conducted a post-hoc analysis examining autistic characteristics in 59 youth with AN. Adolescents and parents participating in a randomised-clinical trial for AN completed questionnaires probing autistic characteristics at baseline and treatment end. We categorised participants as above or below cut-offs of clinical indicators of autism using the Autism Probability Index (API) and the Autism Spectrum Quotient-10. Rates of high autistic characteristics ranged between 0% and 36% depending on the instrument used and how the data was obtained (i.e., by informant report or self-report). Paternal report of autistic characteristics differed across treatment completers versus non completers and maternal report indicated lower weight gain for those with elevated characteristics. Low rates of autism and fluctuations in autistic features during treatment underscore the importance of longitudinal examinations of autistic characteristics in adolescents with AN. Future studies need to replicate findings in a larger adolescent sample. ClinicalTrails.gov Identifier NCT03928028.

Impact of converging sociocultural and substance-related trends on US autism rates: combined geospatiotemporal and causal inferential analysis

Whilst cannabis is known to be toxic to brain development, it is unknown if it is driving rising US autism rates (ASMR). A longitudinal epidemiological study was conducted using national autism census data from the US Department of Education Individuals with Disabilities Act (IDEA) 1991–2011 and nationally representative drug exposure (cigarettes, alcohol, analgesic, and cocaine abuse, and cannabis use monthly, daily, and in pregnancy) datasets from National Survey of Drug Use and Health and US Census (income and ethnicity) and CDC Wonder population and birth data. Analysis was conducted in R. 266,950 were autistic of a population of 40,119,464 8-year-olds in 1994–2011. At national level after adjustment, daily cannabis use was significantly related to ASMR (β estimate = 4.37 (95%C.I. 4.06, 4.68), P < 2.2 × 10–16) as was first pregnancy trimester cannabis exposure (β estimate = 0.12 (0.08, 0.16), P = 1.7 × 10–12). At state level following adjustment for cannabis, cannabigerol (from β estimate = – 13.77 (– 19.41, 8.13), P = 1.8 × 10–6) and Δ9-tetrahydrocannabinol (from β estimate = 1.96 (0.88–3.04), P = 4 × 10–4) were significant. Geospatial state-level modelling showed exponential relationship between ASMR and Δ9-tetrahydrocannabinol and cannabigerol exposure. Exponential coefficients for the relationship between modelled ASMR and Δ9-tetrahydrocannabinol and cannabigerol exposure were 7.053 (6.39–7.71) and 185.334 (167.88–202.79; both P < 2.0 × 10–7). E-values are an instrument related to the evidence for causality in observational studies. High E-values were noted. Dichotomized legal status was linked with elevated ASMR. Data show cannabis use is associated with ASMR, is powerful enough to affect overall trends, and persists after controlling for other major covariates. Cannabinoids are exponentially associated with ASMR. The cannabis–autism relationship satisfies criteria of causal inference.

Autistic traits, emotion regulation, and sensory sensitivities in children and adults with Misophonia

Misophonia is an unusually strong aversion to everyday sounds such as chewing, crunching, or breathing. Previous studies have suggested that rates of autism might be elevated in misophonia, and here we examine this claim in detail. We present a comprehensive review of the relevant literature, and two empirical studies examining children and adults with misophonia. We tested 142 children and 379 adults for traits associated with autism (i.e., attention-to-detail, attention-switching, social processing, communication, imagination, emotion regulation, and sensory sensitivity across multiple domains). Our data show that autistic traits are indeed elevated in misophonics compared to controls. We discuss our findings in relation to models of the interface between autism, sensory sensitivities, and the specific features of misophonia.

The Prevalence of Autism in the Criminal Justice System: A Systematic Review

AimsAutism prevalence is currently estimated to be approximately 1%. Ascertaining autism prevalence within the Criminal Justice System (CJS) has implications for understanding clinical and forensic need, alongside facilitating autism-specific CJS responses. This review aims to systematically identify and synthesise studies that investigate autism prevalence within CJS cohorts, and CJS involvement in autistic cohorts.MethodsA systematic review of published studies that investigated autism prevalence within the CJS. A systematic search of major online databases was conducted in November 2021, including the ancestry method/expert consultation. Studies were qualitatively analysed, with reporting quality appraised.ResultsThe search yielded 6491 articles. Following duplicate removal, 2942 articles remained for screening, of which 2857 did not meet inclusion criteria. Therefore, full texts of 85 articles were accessed, and 34 qualified for inclusion.Prevalence rates of autism in the CJS were examined in 19 studies, 12 focused on forensic settings (e.g. secure psychiatric services/prisons/court), with 7 focused on forensic psychiatric assessment referrals. Prevalence rates of autistic people within the CJS reported by the included studies varied from 1–60%. This variation appeared related to factors such as the characteristics of the forensic setting/cohort, the method of autism screening/diagnosis), and whether participants had co-occurring intellectual disabilities.Prevalence rates of CJS involvement in autistic populations were examined in 15 studies, with reported rates varying by 3–48%, with variation appearing related to a lack of cohesion in the definition of CJS involvement, with focus on variables including self-reported offending behaviour, police contact, or criminal convictions. These studies reported rates of offending by autistic people at a rate equivalent to, or lower than the general population/comparison sample.ConclusionStudies examining prevalence of CJS involvement among autistic people indicate a rate of offending at a lower, or equivalent level to the general population or comparison samples. However, studies examining prevalence of autistic people within CJS settings suggest they are over-represented. Possible explanations fall within three categories: •pre-sentencing CJS factors - e.g. autistic people being more likely to be caught for their criminal behaviour, to confess during police interviews, to enter a guilty plea, or to have difficulty advocating for their rights in court•autistic offender factors – whether autistic people who do engage in criminal behaviour, engage in behaviour of a higher severity, possibly reflecting high rates of comorbid mental disorder•post-sentencing CJS factors – whether autistic people who offend are sentenced more harshly, or the possibility that a lack of autism sensitive forensic rehabilitative programmes and risk assessments may contribute to longer stays within forensic settings.

Neurodevelopmental disorders and gender dysphoria: a fertile relationship?

IntroductionDevelopment of gender identity is a complicated process. During this process it is thought that many factors play a role. Gender dysphoria is a condition where there is a mismatch between the assigned gender at birth and gender identity. Although scarce, literature shows that compared to cisgender individuals, transgender and gender-diverse individuals have higher rates of autism, other neurodevelopmental and psychiatric diagnoses.ObjectivesTo describe posible relations and overlap between gender dysphoria and neurodevelopmental disorders.MethodsLiterature search in Pubmed and other similar platforms. Articles considered relevant under this theme were included.ResultsAutism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) can compromise health and may be more prevalent amongst individuals with gender dysphoria (GD). Symptoms such as attention difficulties, deficits in communication and social skills, obsessional interests, and stereotyped behaviour can significantly impact assessment of GD and the appropriate clinical care. With some overlapping symptoms, the potential for misdiagnosis is possible. Data about prevalence of this conditions in transgender community is of low quality, but ASD is more prevalent, ranging from 6-26%.ConclusionsStudies demosntrate that neurodevelopmental disorders and other psychiatric conditions are more common in transgender and gender-diverse individuals. It is important that future studies focus on exploring the mental health outcomes of neurodevelopmental-trans individuals.DisclosureNo significant relationships.

P417. In Vivo Evidence of Microstructural Hypo-Connectivity of Brain White Matter in 22q11.2 Deletion Syndrome

22q11.2 Deletion Syndrome, or 22q11.2DS, is a genetic syndrome associated with high rates of schizophrenia, autism, and attention deficit hyperactivity disorder, in addition to widespread structural and functional abnormalities throughout the brain. Experimental animal models have identified neuronal connectivity deficits, e.g., decreased axonal length and complexity of axonal branching, as a primary mechanism underlying atypical brain development in 22q11.2DS. However, it is still unclear whether deficits in axonal morphology can also be observed in people with 22q11.2DS.

Role of Type I Interferon Signaling and Microglia in the Abnormal Long-term Potentiation and Object Place Recognition Deficits of Male Mice With a Mutation of the Tuberous Sclerosis 2 Gene

BackgroundTuberous sclerosis complex is a genetic disorder associated with high rates of intellectual disability and autism. Mice with a heterozygous null mutation of the Tsc2 gene (Tsc2+/−) show deficits in hippocampal-dependent tasks and abnormal long-term potentiation (LTP) in the hippocampal CA1 region. Although previous studies focused on the role of neuronal deficits in the memory phenotypes of rodent models of tuberous sclerosis complex, the results presented here demonstrate a role for microglia in these deficits. MethodsTo test the possible role of microglia and type I interferon in abnormal hippocampal-dependent memory and LTP of Tsc2+/− mice, we used field recordings in CA1 and the object place recognition (OPR) task. We used the colony stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia in Tsc2+/− mice and interferon alpha/beta receptor alpha chain null mutation (Ifnar1−/−) to manipulate a signaling pathway known to modulate microglia function. ResultsUnexpectedly, we demonstrate that male, but not female, Tsc2+/− mice show OPR deficits. These deficits can be rescued by depletion of microglia and by the Ifnar1−/− mutation. In addition to rescuing OPR deficits, depletion of microglia also reversed abnormal LTP of the Tsc2+/− mice. Altogether, our results suggest that altered IFNAR1 signaling in microglia causes the abnormal LTP and OPR deficits of male Tsc2+/− mice. ConclusionsMicroglia and IFNAR1 signaling have a key role in the hippocampal-dependent memory deficits and abnormal hippocampal LTP of Tsc2+/− male mice.

Early Prediction and Evaluation of Risk of Autism Spectrum Disorders.

Autism is a neuro-developmental condition that first appears at less than three years of age. Autism spectrum disorders (ASD) include several symptoms, such as social communication impairment, stereotyping behaviors, speech abnormalities, and impairment of eye contact. Its prevalence has increased recently, and several factors play a role in increasing the risk of autism. Multiple studies and research explain the factors affecting the rate of autism, and in this article, we will review most of these factors. The aim of this review article is to increase awareness of the problem of autism and provide scientifically relevant information about the etiology, pathogenesis, risk factors, and management of ASD. Our perception of autism has evolved over time. A few years ago, the condition was nothing more than an unrecognized developmental delay, generally with intellectual disabilities. Today, it is recognized as a major public health issue and a topic of much research. Researchers have struggled to find a cause for ASD, and numerous treatments have been developed to maximize the potential to learn and become socially fluent, no matter how strong the impairments may be. Although there is no cure, there have been significant strides in identifying and developing treatments. Early prediction of autism is beneficial in an individual's treatment, which can be carried out by recognizing the risk factors of infants, thus leading to improved outcomes or even a complete cure. The prevalence of ASD has increased, and earlier prediction leads to the best outcomes.

A Study to Assess the Knowledge Regarding COVID-19 among Mother Child with Autism at District Disability Rehabilitation Centre at Agartala, Tripura, India

In spite of high density of population, higher in poverty, lower levels of per capita public health infrastructure in our country interestingly recovery rate of COVID-19 is good. COVID-19 is a novel respiratory disease. Studies suggest that lack of proper knowledge regarding COVID-19, severe morbidity and high mortality also high in our country. During any kind of disaster or pandemic vulnerable groups or populations like mental and neorudevelopmetal disorder like child with autism spectrum disorder known to be overly effected in negative way. According to epidemiological research report during the last decade there is dramatically increase in the rate of autism with prevalence of 5 to 10 cases of classic autism per 10,000 . Knowledge regarding COVID-19 among mothers child with autism was negatively correlated with the demographical value and social functional support reported by the mothers child with autism. This study sought to assess the knowledge toward COVID-19 among mother with autism seeking care for their child with autism in the District Disability Rehabilitation Centre, Tripura. This descriptive study hypothesized there are adequate knowledge about COVID-19 as because awareness was done by mass media from government and nongovernment side in a very intensive way. We conduct an investigation how mother child with autism with their specific demographical properties shows their knowledge about COVID-19 awareness and strategy they applied to prevent and recover from COVID-19.Our sample was selected randomly. Our study shows that knowledge and strategy of mother regarding COVID-19 significantly associated with their education, mother with special training, source of income, background of family support. The awareness level high among mothers about COVID-19 in percent was high 6.7 levels. Proportion of High Strategic capacity with COVID- 19 as high percentage18.7. This descriptive study is according result is significant with selected demographical variables of mothers child with autism.Method: A descriptive study was conducted in District Disability Rehabilitation Centre, Tripura. A simple random sampling technique was conducted with structured questionnaire in this centre. A total 50 mothers with child autism were randomly sampled. Descriptive analysis was used to assess the knowledge between the mothers with autism with demographic variables. Data was analyzed depending priorities on source of hearing and visualizing awareness, awareness regarding source of infection, sign and symptoms of infection, strategies adopted to withstand challenges from COVID-19,vulnerable group’s members, Proportion of high strategies capacity with COVID-19.Result: The awareness level high among mothers about COVID-19 in percent was 6.7 levels. Because our Government did mass awareness on Covid-19 as well as District Disability Centre also. Distribution source of hearing about COVID-19 knowledge among mothers according to study mostly from newspaper is 37%. Awareness among mothers about sources of infection high in percentage via handshaking is 70.3, CoughDroplets and Public Gathering are same as 49.3.Symptom awareness of fever, cough, breathlessness are equal asin percentage 70.Strategies adopted to withstand challenges from COVID-19 in percentages in hand washing andusing sanitizer 70.9. The demographical independent variables are the age, religion, education, family income,residential area, with chronic stress child with autism. Mothers child with autism without family support andwith no formal education negatively associated with Covid-19 strategic capacity in percentage. According to ourstudy mothers have adequate knowledge regarding COVID-19 is resulted Proportion of high Strategic capacitywith COVID-19 in percentage is 18.7Conclusion: Although majority of mothers have adequate knowledge about COVID-19 and engaged in goodpractice of COVID-19, awareness level have to increase in all mothers with different demographical variables .Asa study result mothers are aware about COVID-19 in percent 33.3 in low lavel,60 percent are in medium level.From result there is some decrease in awareness depending on demographical value as education, family income,special training, background of family support and types of family negatively impact- the adequate knowledgeamong mothers. From we come in conclusion that mothers have adequate knowledge about COVID-19 withpath of strategic capacity.

Considering Toxic Chemicals in the Etiology of Autism.

Considering Toxic Chemicals in the Etiology of Autism.

Evidence of increasing recorded diagnosis of autism spectrum disorders in Wales, UK: An e-cohort study.

Estimates place the prevalence of autism spectrum disorders (autism) at around 1% in the population. New services for adult diagnosis have been set up in Wales, UK, at a time of rising awareness of the spectrum of autism experiences; however, no studies have examined adult autism prevalence in Wales. In this study, we used an anonymised e-cohort comprised of healthcare record data to produce all-age estimates of prevalence and incidence of recorded autism for the years 2001–2016. We found the overall prevalence rate of autism in healthcare records was 0.51%. The number of new-recorded cases of autism increased from 0.188 per 1000 person-years in 2001 to 0.644 per 1000 person-years in 2016. The estimate of 0.51% prevalence in the population is lower than suggested by population survey and cohort studies study methodologies, but comparable to other administrative record study estimates. Rates of new incident diagnoses of autism saw a >150% increase in the years 2008–2016, with a trend towards more diagnoses in those aged over 35 years and an eightfold increase in diagnoses in women from 2000 to 2016. This study suggests that while the number of people being diagnosed with autism is increasing, many are still unrecognised by healthcare services.Lay abstractAutism spectrum disorders (autism) are thought to be relatively common, with analyses estimating 1% in the population could meet diagnostic criteria. New services for adult diagnosis have been set up in Wales, UK; however, no studies have examined for the proportion of adults with autism in Wales. In this study, we take anonymised healthcare record data from more than 3.6 million people to produce a national estimate of recorded autism diagnoses. We found the overall prevalence rate of autism in healthcare records was 0.51%. The number of new-recorded cases of autism increased from 0.188 per 1000 person-years in 2001 to 0.644 per 1000 person-years in 2016. The estimate of 0.51% prevalence in the population is lower than suggested by population survey and cohort studies, but comparable to other administrative records. From 2001 to 2016, the number of autism services for adults has increased, and autism is more widely known in society, while concurrently in healthcare records, there was a >150% increase autism diagnoses in the years 2008–2016. An increasing number of diagnoses were among women and those aged over 35 years. This study suggests that while the number of people being diagnosed with autism is increasing, many are still unrecognised by healthcare services.

Newly Identified Developmental Delays in a Large Population of Children with Nonsyndromic Cleft Lip and/or Palate

PURPOSE: Nonsyndromic cleft lip and/or palate (NSCLP) is the most common congenital craniofacial anomaly. Early recognition of any associated developmental delay is critical to counseling families and developing individualized treatment plans. Here we sought to identify developmental delays associated with NSCLP in a large population of children in order to begin identifying etiology and improve multidisciplinary management. METHODS: This is an IRB-approved, single-center retrospective analysis of all patients with a diagnosis of cleft lip and/or cleft palate between 5 and 21 years of age. Demographic and clinical variables were collected from this patient population as well as from children comprising the 2018 National Survey of Children’s Health database. RESULTS: All children with an identified or suspected genetic syndrome were excluded (160 in our cohort and 1383 in the National Survey of Children’s Health database). Subsequently, 619 children in our cohort and 29,147 in the National Survey of Children’s Health database were identified with NSCLP and included in our analysis. The mean birth weight amongst NSCLP children was lower than that in the national cohort (108.5 ± 24.8 oz versus 117.8 ± 19.1 oz; P < 0.0001). Nearly one-fourth (25.8%) of children with NSCLP were admitted to the NICU at birth. The distribution of cleft lip/palate diagnoses in the NSCLP cohort is shown. Compared with the national cohort, children with isolated cleft palate had significantly higher rates of intellectual disability (3.2% versus 0.5%, P < 0.00001), speech delay (70.8% versus 7.1%, P < 0.00001), global developmental delay (15.7% versus 5.8%, P < 0.00001), cerebral palsy (2.2% versus 0.3%, P < 0.00001), and hearing loss (25.9% versus 1.0%, P < 0.00001). Rates of learning disability (7.0% versus 5.9%, P = 0.529), behavioral delay (7.6% versus 11.4%, P = 0.1038), ADD/ADHD (2.7% versus 2.3%, P = 0.7032), autism (4.3% versus 5.5%, P = 0.5005), and vision loss (1.6% versus 1.2%, P = 0.5764) were comparable between those with isolated cleft palate and the national cohort. Children with cleft lip (with or without cleft palate) had significantly higher rates of ADD/ADHD compared with the normative national cohort: isolated cleft lip (7.7% versus 2.3%, P = 0.0092), unilateral cleft lip and palate (4.6% versus 2.3%, P = 0.0088), bilateral cleft lip & palate (5.9% versus 2.3%, P = 0.0153). CONCLUSIONS: Our study demonstrates, for the first time, higher rates of various developmental delays in children with NSCLP compared with the general pediatric population. This includes increased rates of intellectual disability, global delay, and cerebral palsy in children with nonsyndromic isolated cleft palate and increased ADD/ADHD in children with cleft lip (with or without cleft palate). The association of NSCLP diagnoses with developmental delays highlights the importance of proper risk assessment of patients, appropriate family counseling, and multi-disciplinary team management.

The prevalence and profile of autism in individuals born preterm: a systematic review and meta-analysis

IntroductionPreterm birth (<37 weeks) adversely affects development in behavioural, cognitive and mental health domains. Heightened rates of autism are identified in preterm populations, indicating that prematurity may confer an increased likelihood of adverse neurodevelopmental outcomes. The present meta-analysis aims to synthesise existing literature and calculate pooled prevalence estimates for rates of autism characteristics in preterm populations.MethodsSearch terms were generated from inspection of relevant high-impact papers and a recent meta-analysis. Five databases were searched from database creation until December 2020 with PRISMA guidelines followed throughout.Results10,900 papers were retrieved, with 52 papers included in the final analyses, further classified by assessment method (screening tools N=30, diagnostic assessment N=29). Pooled prevalence estimates for autism in preterm samples was 20% when using screening tools and 6% when using diagnostic assessments. The odds of an autism diagnosis were 3.3 times higher in individuals born preterm than in the general population.ConclusionsThe pooled prevalence estimate of autism characteristics in individuals born preterm is considerably higher than in the general population. Findings highlight the clinical need to provide further monitoring and support for individuals born preterm.

The Effect of Neonatal Sepsis on Risk of Autism Diagnosis.

The study aimed to examine the association between neonatal sepsis and autism risk among children and whether the risk varied with the timing of exposure, child's sex, and race/ethnicity. We conducted a retrospective cohort study using electronic health records (EHR) extracted from Kaiser Permanente Southern California Health Care System. Mother-child dyads were constructed by linking records of children born to member mothers and continuing to receive care through the system during the follow-up period with those of their biological mothers (n = 469,789). Clinical health records were used to define neonatal sepsis. Diagnosis of autism was made by medical specialists. Potential confounders included maternal sociodemographic factors, obstetrical history, child's age, sex, race/ethnicity, and maternal and child medical history. Incident rates and adjusted hazard ratios (aHR) were used to estimate the associations. Compared with children without the diagnosis of autism, children with the condition were more likely to be from Asian/Pacific Islander descent and male sex. Exposed children showed higher rates of autism as compared with unexposed children (3.43 vs. 1.73 per 1,000 person-years, aHR: 1.67-95% confidence interval [CI]: 1.39-2.00). Both preterm (aHR: 1.47; 95% CI: 1.09-1.98) and term (aHR: 1.63; 95% CI: 1.29-2.06) births were associated with increased risk for autism. Although the magnitude of the HRs and incidence ratios for neonatal sepsis to increase autism risk varied between race ethnicities, neonatal sepsis was associated with significantly increased likelihood of autism diagnosis for all race-ethic groups except for Asian/Pacific Islanders. Although neonatal sepsis was associated with significantly increased autism risk for both boys and girls, incident rates and HR point estimates suggested that the effect may be stronger in girls. Neonatal sepsis is associated with increased risk of autism diagnosis in preterm- and term-born children. The association was significant for both girls and boys and all race ethnicities except for Asian-Pacific Islanders. · Neonatal sepsis is associated with increased risk of autism diagnosis.. · The association was significant in preterm- and term-born children.. · The association was significant for all race/ethnicities except for Asian-Pacific Islanders..