Autism Severity Research Articles

Dysregulation Profile in Preschoolers with Autism Spectrum Disorder: An Italian Multi-Center Perspective

Background/Objectives: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition characterized by social communication impairments and repetitive behaviors. Recent reports show that one in thirty-six 8-year-old children are autistic, signifying a considerable public health concern. According to previous studies, emotional dysregulation (ED) affects 50–60% of individuals with ASD and includes symptoms such as poor emotional control, heightened reactivity, and a low frustration tolerance. The main aims of the current study are to investigate the prevalence of ED among autistic preschoolers (below 6 years of age) and to assess the impacts of gender and intellectual disability on their emotional dysregulation profile. Methods: Data have been collected from three children’s research hospitals in Italy (IRCCS Stella Maris Foundation, Stella Maris Mediterraneo Foundation, and IRCCS Bambino Gesù). Parents of 825 autistic pre-schooled children (mean age: 39.68 months, SD: 10.51 months) completed a general questionnaire and the Child Behaviour Checklist (CBCL), a reliable caregiver-reported assessment tool which provides a dysregulation profile. Results: A total of 30% of the children displayed a severe-to-moderate ED (emotional dysregulation) profile, with these children exhibiting significantly higher emotional–behavioral problems compared to those without ED. Males with ED exhibited greater emotional reactivity than females with ED. However, no significant relationships were found between ED and age, autism severity (ADOS-2), or intellectual disability. Conclusions: The results underline the importance of early, tailored interventions to face emotional challenges in young children with ASD, potentially improving long-term outcomes for this population.

Obsessive–Compulsive Traits and Problematic Internet Use Are Increased Among Adults with Autism Spectrum Disorder: Is There a Role of Obsessive Doubts and Communication Impairment?

Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits in autistic individuals are scarce and even less take into account the role that this overlap may have on the development and maintenance of PIU. We aimed to investigate OCD features in ASD individuals and their association with autism severity and the prevalence of PIU, and the potential dimensions associated with a greater probability of PIU. Methods: a total of 46 participants with ASD and 53 controls were assessed with the Adult Autism Subthreshold Spectrum questionnaire and the Obsessive–Compulsive Spectrum—Short Version. Results: There were significantly higher OCD features in ASD participants along with important correlations between OCD and ASD dimensions and a higher prevalence of PIU in the ASD group. Participants with putative PIU reported greater scores on some ASD and OCD dimensions, the with Doubt and Non-verbal communication domains emerging as significant predictors of the presence of putative PIU. Conclusions: These results support the three-way link between ASD, OCD, and PIU, contributing to the hypothesis of a neurodevelopmental basis for those conditions.

Impact of gene polymorphisms involved in the vitamin D metabolic pathway on the susceptibility to and severity of autism spectrum disorder

This study explores the association between genetic variations in the vitamin D pathway and autism spectrum disorder (ASD) susceptibility and severity in Thai children. A total of 276 participants, including 169 children with ASD and 107 healthy controls, were recruited. Genotyping of vitamin D pathway genes (CYP2R1, CYP27B1, GC, and VDR) was conducted using TaqMan-based real-time PCR, while serum vitamin D levels were measured by chemiluminescence immunoassay. ASD severity was assessed via the Childhood Autism Rating Scale, 2nd Edition. Results reveal that the VDR gene (ApaI) rs7975232 is linked to a reduced ASD risk. In contrast, the GC gene rs7041 (A > C) polymorphism shows a significant association with increased ASD risk and severity, particularly in individuals with both the GC gene polymorphism and vitamin D insufficiency. Additionally, there was a higher prevalence of the GC1s isoform and GC1s-GC1s haplotype in children with ASD, associated with ASD severity. This study identified that individuals possessing GC rs7041 C alleles and the GC1s genotype (rs7041C/rs4588G) exhibit an increased susceptibility to and more severity of ASD. Further studies with larger cohorts are essential to fully understand these genetic polymorphisms’ roles.

Examining Erythrocytes as Potential Blood Biomarkers for Autism Spectrum Disorder: Their Relationship to Symptom Severity and Adaptive Behavior.

Multiple research teams have documented various abnormalities in erythrocyte properties in children with autism spectrum disorder (ASD) compared with neurotypical individuals. Reduced erythrocyte deformability, a crucial factor for microcirculation and oxygen delivery, may affect brain function. Other key factors like nitric oxide (NO) and Na,K-ATPase-regulated cation transport also play roles in both erythrocyte deformability and ASD, suggesting a possible relationship between erythrocyte parameters and autism severity. Thus, this study aims to describe these associations, exploring erythrocyte properties as potential biomarkers in ASD. A total of 179 ASD children were enrolled in this study. Diagnosis was confirmed by the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and Autism Diagnostic Interview-Revised. The Vineland Adaptive Behavior Scales, Third Edition (VABS-3), was used to assess adaptive behavior. RBC deformability was measured using a filtration technique, while NO production by RBCs was assessed via DAF-2DA fluorescence. Na,K-ATPase kinetics and RBC osmotic resistance were evaluated spectrophotometrically. Children with more severe ASD symptoms had more impaired deformability and osmotic resistance than children with mild symptoms. Higher RBC NO production was linked to better scores in some VABS-3 subdomains, and in the social affect domain of ADOS-2. Higher affinity of Na,K-ATPase for sodium negatively correlated with the occurrence of repetitive and restricted behavior-one of the core ASD symptoms. This study identified potential links between ASD severity and RBC properties. While erythrocyte quality can influence ASD symptomatology, the observed relationships-such as those involving RBC deformability, NO production, Na,K-ATPase kinetics, and osmotic resistance-were not strong or consistent enough to be considered reliable diagnostic or prognostic biomarkers.

Exploring the Link between Autistic Traits, Emotional Intelligence, and Self-efficacy in Understanding Social Anhedonia

Abstract: Autism severity has been found to be associated with social anhedonia. However, the mechanisms linking the two have not been clarified. Objective: The study was designed to examine the link between autistic traits and social anhedonia. The present study tested a serial mediation model, in which it was hypothesized that emotional intelligence and self-efficacy were serial mediators of the relationship between autistic traits and social anhedonia. Methods: Data from 245 participants (57.4% females, n = 134) ranging in age from 18 to 65 years were collected through self-report. Participants completed an online composite questionnaire consisting of The Comprehensive Autistic Trait Inventory, the Wong and Law Emotional Intelligence Scale, The General Self-Efficacy Scale and the Revised Social Anhedonia Scale. Results: The relationship between autistic traits and social anhedonia was mediated by emotional intelligence and serially mediated by emotional intelligence and self-efficacy. Self-efficacy alone failed to link autistic traits to social anhedonia. Conclusion: The study provides evidence for the significant role of emotional intelligence and self-efficacy as mechanisms underlying the relationship between autistic traits and social anhedonia. The findings are discussed in terms of elucidating the processes through which autistic traits may confer vulnerability to compromised emotional intelligence and self-efficacy, which then serve as additional risk factors for social anhedonia.

Gray Matter Volume Correlates of Co-Occurring Depression in Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) involves neurodevelopmental syndromes with significant deficits in communication, motor behaviors, emotional and social comprehension. Often, individuals with ASD exhibit co-occurring depression characterized by a change in mood and diminished interest in previously enjoyable activities. Due to communicative challenges and a lack of appropriate assessments in this cohort, co-occurring depression can often go undiagnosed during routine clinical examinations and, thus, its management neglected. The literature on co-occurring depression in adults with ASD is limited. Therefore, understanding the neural basis of the co-occurring psychopathology of depression in ASD is crucial for identifying brain-based markers for its timely and effective management.Using structural MRI and phenotypic data from the Autism Brain Imaging Data Exchange (ABIDE II) repository, we examined the pattern of relationship regional grey matter volume (rGMV) has with co-occurring depression and autism severity within regions of a priori interest in adults with ASD (n = 44; age = 17-28 years). Further, we performed an exploratory analysis of the rGMV differences between ASD and matched typically developed (TD, n = 39; age = 18-31 years) samples. The severity of co-occurring depression correlated negatively with the rGMV of the right thalamus. Additionally, a significant interaction was evident between the severity of co-occurring depression and core ASD symptoms towards explaining the rGMV in the left cerebellum crus II. The results further the understanding of the neurobiological underpinnings of co-occurring depression in adults with ASD towards exploring neuroimaging-based biomarkers in the same cohort.

Processing of Emotional Words in Children and Adolescents with Autism Spectrum Disorders.

Individuals with autism spectrum disorder (ASD) have difficulties in understanding emotional language, but little research has discussed the developmental course of the processing of emotional words in the clinical population. Previous studies have revealed distinct processing for emotion-label (e.g., happiness) and emotion-laden (e.g., birthday) words in typically developing (TD) children and adolescents. Extending these findings, the study used event-related potentials (ERPs) to explore the processing of these two types of emotional words in children and adolescents with ASD. The stimuli included two-character Chinese words with factors of word type (emotion-label versus emotion-laden) and valence (positive versus negative). The participants were 11 to 14-year-old children and adolescents with ASD (N = 23) and age-matched TD peers (N = 23). They categorized emotion valence for words while their brain responses were recorded. Both the TD and the ASD groups exhibited emotional processing for all emotional words across the N400 and late positivity component (LPC). The emotional processing was modulated by word type but varied with group and valence. A trend for group differences was observed in processing positive words at 500-600ms. In particular, the emotion effects of positive emotion-label words were positively correlated with social dysfunction across all participants. These findings suggested that children and adolescents with ASD have a selective impairment in understanding emotional concepts from language. The ERP measurements may reflect atypical emotional word processing for individuals with higher autistic severity in positive valence contexts.

Comparative effectiveness trial: Modular behavior approach for young autistic children compared to comprehensive behavioral intervention.

This 24-week single-blind trial tested a modular approach for young autistic children (MAYAC) that was delivered for fewer hours per week and modified based on child progress and parental input compared to comprehensive behavioral intervention treatment as usual (CBI, TAU). Participants were autistic children, ages 18-60 months of age. MAYAC was initially 5 h of intervention per week, one of which was parent training and the other four direct therapy focusing on social communication and engagement, but additional modules could be added for up to 10 h per week. Comprehensive behavior intervention was delivered for ≥15 h per week. Outcome measures included the Vineland Adaptive Behavior Scales; VABS, the Ohio Autism Clinical Improvement Scale - Autism Severity; OACIS - AS and the Pervasive Developmental Disorder Behavior Inventory - Parent; PDDBI-P. Implementation and parent satisfaction measures were also collected. Fifty-six children, mean age of 34 months, were randomized. Within-group analysis revealed significant improvements from baseline to week 24 for both MAYAC (p < 0.0001) and CBI, TAU (p < 0.0001) on the VABS. The noninferiority test was performed to test between group differences and MAYAC was not inferior to CBI, TAU on the VABS (p = 0.0144). On the OACIS - AS, 48.0% of MAYAC and 45.5% of CBI were treatment responders there were no significant changes on the PDDBI-P, for either group. Treatment fidelity was high for both groups (>95%) as was parent satisfaction. Findings from this small trial are promising and suggest MAYAC may be an alternative for some young autistic children and their families to CBI, TAU.

Assessment of Serum Levels of Specific IgE to Cow Milk and Gluten Antigens in Autistic Children

Abstract Background Regimens of dietary restrictions of cow’s milk protein and wheat showed good impact on autistic children without clear explanation. Objective To investigate the possible link between serum levels of specific IgE to cow milk and gluten allergens and the severity of autism in a group of autistic children. Methods This pilot case-control study was conducted at the Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University over a period of 6 months, from May 2022 to November 2022. Twenty four autistic children aged 4 to 12 years and twenty four age- and sex-matched healthy children were included after excluding children with any chronic, allergic or autoimmune disease. Diagnosis of autism was settled according to 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Serum levels of specific IgE for 4 cow’s milk proteins and gluten protein were assessed for the patients and healthy children using Enzyme-linked immunosorbent assay (ELISA) technique. Results Mean age of autistic patients was 6.48±2.54 years with 19 males and 5 females were studies who were age and sex matched with healthy children and served as a control group. Serum levels of specific IgE against cow’s milk protein and gluten were undetectable among the 2 groups as their level was below 0.35 ku/l. Boys had significantly higher levels of specific IgE against beta lactoglobulin compared to autistic girls in female ranging from (0.01-0.2) while in males (0.06-0.33) (p = 0.04). Specific IgE to casein was positively correlated to IQ level of the studied patients (r = 0.499, p = 0.13). Conclusion Although milk and gluten intolerance were identified in autistic children, the underlying mechanism is mostly not related to atopy. Further studies should be encouraged to identify the other possible mechanisms.

Interaction and association between multiple vitamins and social adaptability and severity of autism: A large-scale retrospective study from China.

Since children with autism spectrum disorder (ASD) often exhibit selective eating behaviors, it is generally believed that they may have abnormal nutrient structure, leading to aberrant concentrations of some serum vitamins. However, previous studies on serum vitamins in individuals with ASD are mixed. Additionally, the interaction and association between multiple serum vitamin and ASD-related symptoms remain unclear. This study utilized a cross-sectional survey with a large sample size (n = 1235) from China to clarify previous mixed findings, and examine the interaction and association between multiple serum vitamins (including folic acid [FA], vitamin A [VA], vitamin E [VE], vitamin B12 [VB12], and vitamin D [VD]) and social adaptability and symptom severity in children with ASD. Findings found that symptom severity was negatively associated with concentrations of serum VA, VE, VB12, and VD; while, social adaptability was significantly associated with the natural log-transformed concentrations of FA and VB12. Finding also revealed the interaction of VA and VE on the association between both vitamins and severity of ASD symptoms, as well as the interaction of VB12 and FA on the association between both vitamins and social adaptability. In particular, the combination of low concentration of VA and high concentration of VE is associated with the lowest risk of being "severely autistic"; while, the combination of low concentration of FA and high concentration of VB12 is associated with the lowest risk of being "poor social adaptability". This study offers the evidence for the requirement of considering multiple vitamins comprehensively, as well as valuable references for revealing the association between vitamin disparities and food selectivity in children with ASD.

Transmethylation and Oxidative Biomarkers in Children with Autism Spectrum Disorder: A Cross Sectional Study.

We aimed to investigate the potential role of biomarkers of transmethylation, oxidative stress, and mitochondrial dysfunction in children with Autism Spectrum Disorder (ASD) by comparing them with that of typically developing children (TDC) controls. We also tried to correlate them with severity of autism, sensory issues, behavioural comorbidities and developmental quotients 119 with ASD and 52 age and sex matched typically developing children (TDC) controls were enrolled excluding those with chronic-illness or on any antioxidant therapy/multivitamins/anti-epileptic drugs. Median levels of biomarkers- serum homocysteine, cysteine, methionine, urine uric acid-to-creatinine ratio, arterial lactate, serum vitamin E, vitamin B12, folate, Nε-carboxymethyllysine, Nω- carboxymethylarginine (CMA), dityrosine and MTHFR C677T polymorphism were calculated. Children with ASD were further characterised using Childhood Autism Rating Scale-2, Childhood behavioural checklist, child sensory profile 2 caregiver questionnaire, Developmental Profile 3 for any correlation with the various biomarker levels. The median level of serum homocysteine in ASD group was 9 μmol/L(Range, 7- 16μmol/L), which was significantly higher than controls 7 μmol/L(Range, 4- 11μmol/L)(p=0.01). The prevalence of hyper-homocystinemia(>15μmol/L) was 13.4% in ASD as compared to 3.8% in controls with a significant difference(p=0.04). Dityrosine level was higher among ASD children when compared to TDC (9.8 vs 2.2 counts per second(cps), p<0.001). No significant correlation was found between prevalence of hyperhomocysteinemia and severity of autism/DQ/behavioural issues. No significant difference was found between the median levels of other biomarkers. Results support possible role of transmethylation defects and oxidative stress in ASD pathogenesis. Further studies are warranted for a better understanding of ASD pathogenesis.

Visual feedback and motor memory contributions to sustained motor control deficits in autism spectrum disorder across childhood and into adulthood.

Autistic individuals show deficits in sustained fine motor control which are associated with an over-reliance on visual feedback. Motor memory deficits also have been reported during sustained fine motor control in autism spectrum disorders (ASD). The development of motor memory and visuomotor feedback processes contributing to sustained motor control issues in ASD are not known. The present study aimed to characterize age-related changes in visual feedback and motor memory processes contributing to sustained fine motor control issues in ASD. Fifty-four autistic participants and 31 neurotypical (NT) controls ages 10-25 years completed visually guided and memory guided sustained precision gripping tests by pressing on force sensors with their dominant hand index finger and thumb. For visually guided trials, participants viewed a stationary target bar and a force bar that moved upwards with increased force for 15s. During memory guided trials, the force bar was visible for 3s, after which participants attempted to maintain their force output without visual feedback for another 12s. To assess visual feedback processing, force accuracy, variability (standard deviation), and regularity (sample entropy) were examined. To assess motor memory, force decay latency, slope, and magnitude were examined during epochs without visual feedback. Relative to NT controls, autistic individuals showed a greater magnitude and steeper slope of force decay during memory guided trials. Across conditions, the ASD group showed reduced force accuracy (β = .41, R2 = 0.043, t79.3=2.36, p = 0.021) and greater force variability (β=-2.16, R2 = .143, t77.1=-4.04, p = 0.0001) and regularity (β=-.52, R2 = .021, t77.4=-2.21, p = 0.030) relative to controls at younger ages, but these differences normalized by adolescence (age × group interactions). Lower force accuracy and greater force variability during visually guided trials and steeper decay slope during memory guided trials were associated with overall autism severity. Our findings that autistic individuals show a greater rate and magnitude of force decay than NT individuals following the removal of visual feedback indicate that motor memory deficits contribute to fine motor control issues in ASD. Findings that sensorimotor differences in ASD were specific to younger ages suggest delayed development across multiple motor control processes.

Prevalence, Symptom Profiles, and Correlates of Mixed Anxiety-Depression in Male and Female Autistic Youth.

Relatively little attention has been given to mixed anxiety and depression in autistic youth, particularly how this differs between males and females. This study investigated sex-based differences in the prevalence and correlates of mixed anxiety and depression in a sample of 51 autistic males (M age = 10.16 yr, SD = 2.81 yr, and range = 6 yr to 17 yr) and 51 autistic females (M age = - 10.07 yr, SD = 2.76 yr, and range = 6 yr to 17 yr), matched for age, IQ, and autism severity. Self-reports on generalised anxiety disorder and major depressive disorder, morning salivary cortisol, ADOS-2 scores, and WASI-II full-scale scores were collected from these autistic youth, and data on the ASD-related symptoms of these youth were collected from their parents. The data were analysed for total anxiety-depression score levels, for the underlying components of this scale, and for the individual items used in the scale. The results indicate no significant sex differences for the prevalence of mixed anxiety and depression total scores or the underlying components of anxiety and depression or for the individual items of the mixed anxiety-depression scale. There were sex differences in the significant correlates of mixed anxiety and depression: morning cortisol and ASD-related difficulties in social interaction for females, and ASD-related behaviour for males. Males' feelings of being restless or edgy were correlated with their social interaction and repetitive and restricted behaviour. Females' difficulties in social interaction were correlated with their concerns about their abilities and their sleeping problems. Females' sleeping problems, their tendency to talk about dying, and feeling worthless, were correlated with their morning cortisol. These findings suggest that, while mixed anxiety and depression is experienced similarly by autistic males and females at the global, component, and individual item levels, specific aspects of the symptomatology of mixed anxiety and depression are differently associated with aspects of their ASD-related symptomatology and their levels of chronic physiological stress for males and females.

Synucleins As Biomarkers of Severity in Autism Spectrum Disorder.

Introduction Autism spectrum disorder (ASD) is a lifelong disorder affecting children quite early in life, manifested as delays in communication and stereotypic behaviors. To date, it is diagnosed clinically using the Diagnostic and Statistical Manual-5 (DSM-V) criteria due to the lack of biomarkers that can specifically denote the disorder. The role of synucleins in this context has been considered due to the increasing evidence of neurodegeneration in many autistic children. Synucleins are a group of soluble neuronal proteins primarily expressed in the central nervous system. They are of three types: α-, β-, and ɣ-synuclein. α-synuclein is involved in vesicle trafficking and release of neurotransmitters. There is no uniformity in the scientific community regarding their levels of autism, with few studies showing increasing levels and others to the contrary. Hence, the present study was conceived to analyze the levels of α-synuclein and β-synuclein in autistic children and to correlate with the disease severity. Objectives The main objectiveof the study was to assess the levels of α- and β-synuclein in autistic children of 2-8 years of age and to identify the correlation between the severity of core symptoms of autism and α- and β-synuclein levels. It is intended to assessthe possibility of using α- and β-synuclein/their ratioas a biomarker of the severity of autism. Materials and methods Plasma levels of α-synuclein and β-synuclein were measured in 160ASD childrenand 40 healthy age and sex-matched children by ELISA. Their symptom severity was assessed with CARS-2 ST and the Indian Scale of Autism Assessment (ISAA). Values of α- and β-synuclein were analyzed for correlation with the severity rating of ASD. Cut-off values ofα-synuclein and β-synuclein that discriminate the presence of autism and its severity were assessed using Jamovi 2.4.14 software. Results The results show that α-synuclein levels were significantly reduced (5.02 ± 0.586; range: 3.13-6.0 ng/ml) when compared with healthy controls (29.47 ± 18.62 ng/ml; range: 22.39- 36.56) with p < 0.001, and β-synuclein levels were elevated (1424 ng/ml ± 122; range: 1229-1616 ng/ml) when compared to control, though not significantly. Plasma levels of α-synuclein significantly correlate with disease severity with good diagnostic accuracy (86%), but β-synuclein levels did not correlate with severity. The fold changes of synucleins, especially the fold decrease in levels of α-synuclein, were discriminative for the diagnosis and severity with good sensitivity (93.6%), specificity (74.3%), positive predictive (92.6%), and negative predictive values (76.5%). The fold increase in β-synuclein did not have any significance in predicting the severity of autism. Conclusion The present study showed thatα-synuclein and β-synuclein were associated with ASD and can be used to assess its severity. A fold decrease inα-synuclein was found to have good discriminating value in differentiating the severity of autism. It may be of use especially in mild and high-functioning autism, when clinically distinguishing them may be difficult.

Sensory and motor cortices parcellations estimated via distance-weighted sparse representation with application to autism spectrum disorder

BackgroundMotor impairments and sensory processing abnormalities are prevalent in autism spectrum disorder (ASD), closely related to the core functions of the primary motor cortex (M1) and the primary somatosensory cortex (S1). Currently, there is limited knowledge about potential therapeutic targets in the subregions of M1 and S1 in ASD patients. This study aims to map clinically significant functional subregions of M1 and S1. MethodsResting-state functional magnetic resonance imaging data (NTD = 266) from Autism Brain Imaging Data Exchange (ABIDE) were used for subregion modeling. We proposed a distance-weighted sparse representation algorithm to construct brain functional networks. Functional subregions of M1 and S1 were identified through consensus clustering at the group level. Differences in the characteristics of functional subregions were analyzed, along with their correlation with clinical scores. ResultsWe observed symmetrical and continuous subregion organization from dorsal to ventral aspects in M1 and S1, with M1 subregions conforming to the functional pattern of the motor homunculus. Significant intergroup differences and clinical correlations were found in the dorsal and ventral aspects of M1 (p < 0.05/3, Bonferroni correction) and the ventromedial BA3 of S1 (p < 0.05/5). These functional characteristics were positively correlated with autism severity. All subregions showed significant results in the ROI-to-ROI intergroup differential analysis (p < 0.05/80). LimitationsThe generalizability of the segmentation model requires further evaluation. ConclusionsThis study highlights the significance of M1 and S1 in ASD treatment and may provide new insights into brain parcellation and the identification of therapeutic targets for ASD.

Examining the Link Between Social Affect and Visual Exploration of Cute Stimuli in Autistic Children.

Baby schema refers to physical features perceived as cute, known to trigger attention, induce positive emotions, and prompt social interactions. Given the reduced visual attention to social stimuli observed in individuals on the autism spectrum, the current study examines whether the sensitivity to baby schema is also affected. We expected that the looking time towards cute-featured stimuli would vary with symptom severity levels and would be associated with social affect. Ninety-four children (31 typically developing; 63 diagnosed with autism spectrum disorder - ASD) aged 20-83 months (M = 49.63, SD = 13.59) completed an eye-tracking visual exploration task. Autistic participants were separated into two groups based on symptom severity: children with high autism severity symptoms (HS ASD; N = 23) and low-moderate autism symptoms (LMS ASD; N = 40). Animals and neutral objects were simultaneously presented on the screen along with either human babies (condition 1) or adults (condition 2). The results indicated that visual attention oriented to cute-featured stimuli varied with autism symptom severity: only LMS and TD groups spend more time looking at cute-featured stimuli (babies; animals) than neutral objects. Moreover, children with higher severity in the social affect domain spent less time on the stimuli depicting cute than non-cute stimuli. These findings suggest that autism symptom severity and social skills are linked to variations in visual attention to cute stimuli. Implications of baby schema sensitivity are discussed in relation to the development of social competencies and play, responsiveness to robot-based interventions, as well as appraised relevance in autistic children.

Autism Severity, Adverse Childhood Experiences, and Oral Health: A Comparative Study of Adolescents in the United States.

Dental health significantly influences overall child physical well-being, academic success, and psychosocial development. This paper explores the intersection of a range of Autism Spectrum Disorder (ASD) functionality, multiple types of Adverse Childhood Experiences (ACEs), and dental health in adolescents. The purpose is to investigate the independent and interactive effects of ASD severity and ACEs on dental outcomes. Data from the 2018 and 2019 National Surveys of Children's Health were analyzed, focusing on 28,263 adolescents (ages 11-17). Logistic regressions assessed associations between ASD severity (mild, moderate, severe), cumulative number of ACEs, and dental outcomes (teeth condition, cavities or bleeding gums, check-ups, cleanings). Covariates included demographic and socioeconomic factors. Controlling for covariates, severe autism independently increased the odds of poor teeth (odds ratio = 6.17), cavities or bleeding gums (OR = 3.76), no previous year check-up(OR = 2.94), and no previous year cleaning (OR = 4.20). Higher ACE scores also independently increased the odds of all dental outcomes. Interactions revealed a cumulative effect of multiple ACEs on poor dental outcomes only for adolescents with severe levels of autism. This study illuminates the heightened vulnerability of adolescents with severe autism and a history of ACEs, emphasizing the need for targeted interventions. Multidisciplinary strategies integrating dental care and mental health support within tailored interventions are crucial for improving dental health and access for older youth with low functioning autism. While these findings provide valuable insights, the cross-sectional design and reliance on parental reports necessitate cautious interpretation.

Head circumference growth in children with Autism Spectrum Disorder: trend and clinical correlates in the first five years of life.

Macrocephaly is described in almost 15% of children with Autism Spectrum Disorder (ASD). Relationships between head growth trajectories and clinical findings in ASD children show a high degree of variability, highlighting the complex heterogeneity of the disorder. The aim of this study was to measure differences of the early growth trajectory of head circumference (HC) in children with ASD and macrocephaly compared to ASD normocephalic children, examining clinical correlates in the two groups of patients. HC data were collected from birth to 5 years of age in a sample of children with a confirmed diagnosis of ASD. Participants were classified into two groups: ASD macrocephaly (ASD-M, Z-scores ≥1.88 in at least two consecutive HC measurements), and ASD non-macrocephaly (ASD-N). Based on the distribution of HC measurements (Z-scores), five age groups were identified for the longitudinal study. Developmental and behavioral characteristics of the ASD-M children compared to the ASD-N group were compared by using standardized scores. 20,8% of the children sample met criteria for macrocephaly. HC values became indicative of macrocephaly in the ASD-M group at the age range from 1 to 6 months, and persisted thereafter throughout the first five years of age. ASD-M children showed significantly higher developmental quotients of Griffiths III B and D subscales compared to ASD-N group. No significant differences in the severity of ASD symptoms assessed by ADOS-2 were observed between ASD-M and ASD-N groups. In this study HC size from birth to 5 years links to accelerated HC growth rate as early as the first 6 months of age in children with ASD and macrocephaly, preceding the onset and diagnosis of ASD. We found that in early childhood, children with ASD-M may exhibit some advantages in language and social communication and emotional skills without differences in autism severity, when compared with age-matched normocephalic ASD children. Longitudinal analyses are required to catch-up prospectively possible relationships between head size as proxy measure of brain development and neuro-developmental and behavioral features in children with ASD.

Impacts of Sibling Relations on Sociality, Communication, and Autism Severity in Children with Autism Spectrum Disorder: A Retrospective Analysis.

This study investigated the differences in sociality, communication, and autism severity in children with autism spectrum disorder (ASD) according to the presence or absence of siblings, the number of siblings, the order of birth, and the sex of sibling. We included 71 children with autism spectrum disorder who visited University Hospital as outpatients. We compared the communication and socialization scores using the Korean Version of the Vineland Adaptive Behavior Scale, second edition (K-VABS II); social interaction, communication, and language using the autism diagnostic interview-revised (ADI-R); and the total score of the Korean-Childhood Autism Rating Scale 2 (K-CARS 2) according to the presence or absence of siblings, the number of siblings, the order of birth and the sex of sibling. Data were evaluated with independent t-tests and analysis of variance (ANOVA) tests. The patient's average age was 48.8 ± 13.6 months. There was a significant difference in the total score of K-CARS-2 according to the sex of siblings. The male sibling group was 34.36 ± 6.11 and the female sibling group was 30.29 ± 6.41 points, respectively. This result indicates that the quality of sibling interactions in families with a child with ASD may play a significant role in reducing ASD severity and improving the quality of sibling interactions, rather than the number of siblings alone affecting the social interactions of children with ASD.

Autistic features in patients with intellectual disability attending the psychiatry outpatient department of a tertiary healthcare center.

Meta-syndromic groups with cognitive and relational impairment include both autism spectrum disorder (ASD) and intellectual disability (ID). When it comes to individuals with intellectual difficulties, autistic traits are often unexplored unless they reach the level of the syndrome. The presence of both autism and ID increases disability percentage. To study the presence of autistic symptoms in individuals with ID. This was a cross-sectional, observational study in which after informed consent from caretakers of patients with ID, clinical history and sociodemographic details were recorded. Further Indian Scale for Assessment of Autism (ISAA) was administered for evaluation of autistic features. Statistical analysis of the data was done using the Chi-square test and Spearman's correlation. Out of 150 subjects with ID, 18% (n = 27) were diagnosed with comorbid ASD. A statistically significant (P value = <0.001) association was found between the severity of ID (intelligence quotient, [IQ]) and the severity of autism in patients. Various domains of autism like social relation and reciprocity, speech, language, communication, emotional responsiveness, etc., showed a statistically significant correlation with IQ. This study finding also highlights that lower IQ scores, i.e., severe ID have higher incidence and severity of autistic features. Improving assessment both clinically and on objective testing can help in planning rehabilitation for these patients.