Spectrum Disorder Children Research Articles

Exposure to Aluminum, Cadmium, and Mercury and Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis.

Autism spectrum disorder (ASD) is a complex neurobehavioral disorder that is believed to be multifactorial in origin. As the incidence of ASD is rising along with industrialization, and because certain metals have been linked to neurological problems, it is important to consider whether such metals may play a role in the development of ASD. Previously, we performed a meta-analysis of existing literature to examine the potential link between inorganic arsenic and lead exposure and ASD. This is a continuation of that study investigating the association of the exposure to aluminum (Al), cadmium (Cd), and mercury (Hg) and ASD. These metals were chosen because they are abundant in our environment, are known to cause neurological problems in humans, and have multiple published studies examining their potential links with ASD. Following the same approach as our previous paper, we conducted a systematic review of the existing literature and performed a meta-analysis to evaluate the current evidence regarding these metals and their potential relationship with autism. We reviewed 18 studies on Al, 18 on Cd, and 23 on Hg, and the individual studies showed inconsistent results. When the measurements were integrated into the meta-analysis, we found significant associations between all the metals and ASD, but the associations were not always in the same direction. Levels of Hg in hair, urine, and blood were all positively associated with ASD. Levels of Al in hair and urine were positively associated with ASD, while levels of Al in blood were negatively associated. In comparison, levels of Cd in hair and urine were negatively associated with ASD. These results imply that, while these metals are all neurotoxic, their impact on the development of ASD and their modes of action could be different. Further research is warranted to examine the longitudinal effects of these toxic metals on the risk of ASD, to assess the critical period when exposure may affect development, and to investigate potential factors that may enhance or ameliorate the effect of metals. Overall, these findings support policies that advocate limiting exposure to neurotoxic metals, particularly for pregnant women and young children, in order to help reduce the rising incidence of ASD.

A Systematic Review of the Risk Factors for Autism Spectrum Disorder in Children Born Preterm.

Preterm birth is associated with an increased risk for autism spectrum disorder, with various factors proposed to underlie this relationship. The aim of this systematic review was to provide a narrative synthesis of the literature regarding the prenatal, perinatal and postnatal factors associated with autism spectrum disorder in children born preterm. Medline, Embase and PsycINFO databases were searched via Ovid to identify studies published from January 1990 to December 2019. Original studies in which a standardized diagnostic tool and/or clinical assessment was used to diagnose autism, along with a risk factor analysis to identify associated predictors, were included. A total of 11 eligible studies were identified. Male sex, being born small for gestational age and general cognitive impairment were the most robust findings, with each reported as a significant factor in at least two studies. Comparisons across studies were limited by variation in risk factor measurement and gestational age ranges investigated.

Social and Economic Effect of Comprehensive Prevention of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders in Children: A Review

Introduction: Maternal alcohol consumption during pregnancy and its effects on the developing fetus are a serious global healthcare issue. The damage caused by alcohol goes far beyond mother’s health and spreads to the child’s physical and mental health.
 Aim of Review: Analysis of existing approaches in organizing the necessary rehabilitation programs and preventing the consequences of drinking alcohol during pregnancy, assessing the potential socio-economic effect of organizing comprehensive prevention of fetal alcohol syndrome (FAS) and fetal-alcohol spectrum of disorders (FASD).
 Materials and Methods: Children with FAS and influence of consequences of FAS/FASD on the nation’s material well-being conducted in Russia and abroad were analyzed by studying various published literature. Necessary rehabilitation measures for children with FAS/FASD were identified; analyzed international studies on the economic implications of the FAS/FASD; economic costs for medical and correctional services for children with FAS/FASD in Russia were assessed.
 Results: This review found that the Not all children with FAS/FASD are mentally retarded, they have behavioral disorders and the development of the emotional-volitional sphere is significantly behind the age norms. So, at 10-12 years of age, these children are still not contractual and cannot remain without adult supervision even for several hours. They require ongoing parental or tutor support. The range of disorders in fetal alcohol syndrome is very diverse, therefore, each child requires an individual approach in the formation of a rehabilitation program, which significantly increases costs in general and requires the involvement of highly qualified specialists.
 Conclusion: There is a need for additional economic calculations to scale up a comprehensive prevention program throughout the country. It is also important to note that the implementation of preventive measures does not eliminate the need for organizing assistance programs for families raising children with FAS/FASD.

Management of Autism Spectrum Disorder in Children and Treatment

Autism spectrum disorder is mainly characterized by impaired social function and disruptions of communication in a variety of Neurodevelopmental disorders. Symptoms involve conflict, loss of comprehension, intense emphasis on one task. Discussing the indications, Influenced youngsters to experience the absence of social correspondence and communication practices, for example, making conflicting eye contacts, not having the option to tune in and comprehend individuals around them, Rarely sharing happiness regarding items or exercises by pointing or demonstrating things to other people, Being delayed in reacting to their names or some other verbal endeavours to pick up consideration; Having outward appearances, developments and signals that don't coordinate with the circumstance; Having a surprising manner of speaking. It can have different etiological causes such as anatomy, maternal and perinatal influences, neuroanatomic anomalies, and environmental factors. As we examined the intricacy in the etiology and indications of the confusion, we may comprehend the trouble in the board intercessions and treatment ways to deal with the disorder. However, different specialists throughout the world had worked enthusiastically in building numerous intercession models that help in lessening the indications and in improving the social-relational abilities of the influenced. The review addresses various clinical, scientific, psychological, family-based and recovery strategies.

Environmental pollution as a risk factor for autism spectrum disorders in children and adolescents

Abstract Autism spectrum disorders caused, inter alia, by environmental pollutions have been in focus of public health leaders, doctors (paediatricians, perinatologists, nutrition experts). Based on the data from 2016 Demographic Yearbook, it has been established that among children and adolescents in the age below 17, the population of boys is 3155000 and girls 3994000. In USA in recent decades the CDC studies have shown that the incidence of ASD has increased from 1 case per 150 children in 2000 to 1 case per 59 children in 2014 i.e. it more than doubled. Three groups of factors modifying the risk of ASD development in children and adolescent populations, being more common in boys population, were identified: the declining environmental chemical pollution by POP, probably reduces the inflammation status of microglia cells in the central nervous system. Significant gender distinction of the microglia cells of the mouse brain, caused probably by steroid hormones at the transcriptome level, results in a different behaviour of the microglia in female individuals. The microglia cells of this gender reduce the level of microglia damage caused by acute focal ischemia. It seems likely that the lower prevalence of ASD in girls may be due to the effective protective activity of female sex hormones, at this level. Meanwhile the elimination of chemical pollutants from the discussed substances on the gastrointestinal tract - white part of the brain axis strengthens the proper functioning of the intestinal microbiome - brain axis. Demographic data, it has been estimated that the number of boys at risk of ASD in Poland may be approximately 30000 and girls fourfold less, i.e. approximately 7500. A definite absence of epidemiological data collected through representative studies on the prevalence of ASD in children aged 3-17 years in Poland indicates a need for a proper diagnosis in order to develop a more effective health care system for population in question compared to the existing one. Key messages The female sex hormones protect the majority of girls against ASD, probably at a brain microglia level. Brain microglia, may be key to mitigation of the risk of asd health disorder in the population of girls and women.

Recent Advances in the Pharmacological Management of Behavioral Disturbances Associated with Autism Spectrum Disorder in Children and Adolescents

Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition affecting an estimated one in 36 children. Youth with ASD may have severe behavioral disturbances including irritability, aggression, and hyperactivity. Currently, there are only two medications (risperidone and aripiprazole) approved by the US Food and Drug Administration (FDA) for the treatment of irritability associated with ASD. Pharmacologic treatments are commonly used to target ASD-associated symptoms including irritability, mood lability, anxiety, and hyperactivity. However, evidence for the efficacy of many commonly used treatments is limited by the lack of large placebo-controlled trials of these medications in this population. Research into the pathophysiology of ASD has led to new targets for pharmacologic therapy including the neuroimmune system, the endocannabinoid system, and the glutamatergic neurotransmitter system. The goal of this review is to provide an overview of the current evidence base for commonly used treatments, as well as emerging treatment options for common behavioral disturbances seen in youth with ASD.

Using a Gluten-Free Diet in Integrated Therapy of Autism Spectrum Disorders in Children: A Clinical Case

Currently, many studies show the effectiveness of elimination (gluten-free and case-free) diets in correcting not only the symptoms of gastrointestinal disorders in patients with autism but also in correcting behavioral indicators. The results of the inclusion of gluten and case free diets were analyzed in the complex of therapeutic measures in a child with autism spectrum disorders. The clinical efficacy of adherence was revealed to a strict gluten-free diet for 2 years in a child with autism spectrum disorders with gluten sensitivity. An individual approach is necessary to the appointment of a gluten-free diet for children with autism spectrum disorders, it is required to survey before it begins to exclude various forms of gluten intolerance.

Maternal and paternal Age and Risk of Autism Spectrum Disorder (ASD) in Banyumas District, Central Java, Indonesia

Introduction: The prevalence of autism spectrum disorders has increased in the last three decades. The genetic etiological component of ASD is quite strong and complex. Although genetic factors clearly contribute to ASD risk, environmental, prenatal and post-natal factors are also involved. Father's age and mother's age at the conception of children contribute to the occurrence of autism spectrum disorders in children.Objective: To explore the association between maternal and paternal age and risk of autis, spectrum disorders (ASD) in Banyumas district, Central Java, IndonesiaMethods: An analytical study with case control approach was conducted. This study used case control method that include 43 children with ASD as case group and 189 normal children as control group. Consecutive cases were selected over 4 months, with every weekend allocated to visit the school of children with special needs. Controls were selected from normal children who came with their parents and were also visited by our team at local schools, until the required sample size was reached.Results: This study showed that paternal and maternal age at conception onset were not associate with the occurence of asutism spectrum disorders in children based on the statistical annalyzes in every range of paternal and maternal age results p value > 0,05.Conclusion: Paternal and maternal age were not related with the occurence of autism spectrum disorders

Fourier Transform Infrared Spectroscopy Based Complementary Diagnosis Tool for Autism Spectrum Disorder in Children and Adolescents.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that begins early in life and continues lifelong with strong personal and societal implications. It affects about 1%–2% of the children population in the world. The absence of auxiliary methods that can complement the clinical evaluation of ASD increases the probability of false identification of the disorder, especially in the case of very young children. In this study, analytical models for auxiliary diagnosis of ASD in children and adolescents, based on the analysis of patients’ blood serum ATR-FTIR (Attenuated Total Reflectance-Fourier Transform Infrared) spectra, were developed. The models use chemometrics (either Principal Component Analysis (PCA) or Partial Least Squares Discriminant Analysis (PLS-DA)) methods, with the infrared spectra being the X-predictor variables. The two developed models exhibit excellent classification performance for samples of ASD individuals vs. healthy controls. Interestingly, the simplest, unsupervised PCA-based model results to have a global performance identical to the more demanding, supervised (PLS-DA)-based model. The developed PCA-based model thus appears as the more economical alternative one for use in the clinical environment. Hierarchical clustering analysis performed on the full set of samples was also successful in discriminating the two groups.

Association of Grandparental and Parental Age at Childbirth With Autism Spectrum Disorder in Children

Advanced parental age has been associated with autism spectrum disorders (ASDs) in children. However, little is known about the association between grandparental age at the time of birth of the parent and the risk of ASD in the grandchildren. To estimate the associations between parental and grandparental age and ASD risk in children. This population-based, multigenerational cohort study used data from Danish national health registries. A parental age cohort was constructed to evaluate the association between parental age and ASD in 1 476 783 singleton children born from 1990 to 2013, and a multigenerational cohort was also constructed including 362 438 fathers and 458 234 mothers born from 1973 to 1990 for whom information on grandparental age was available. Data analyses were conducted from November 1, 2018, through February 7, 2020. Parental age at childbirth and grandparental age at the time of the birth of the parent. Diagnoses of ASD in children were obtained from the Danish Psychiatric Central Register (1994-2017). Logistic regression analysis was used to estimate the associations between parental or grandparental age and ASD in children. Of the 1 476 783 children born from 1990 to 2013, 758 066 (51.3%) were male, and 27 616 (1.9%) had ASD (20 467 [74.1%] were male). Advanced paternal or maternal age over 30 years was monotonically associated with increased ASD risk, with odds ratios (ORs) of 1.56 (95% CI, 1.45-1.68) for maternal age 40 years and older and 1.57 (95% CI, 1.39-1.78) for paternal age 50 years and older, compared with parents aged 25 to 29 years. In the multigenerational cohort, 9364 grandchildren (1.7%) had ASD. This study found U-shaped associations, in that ASD risk was higher among grandchildren of younger (≤19 years) maternal grandmothers (OR, 1.68; 95% CI, 1.52-1.85), younger maternal grandfathers (OR, 1.50; 95% CI, 1.26-1.78), and younger paternal grandmothers (OR, 1.18; 95% CI, 1.04-1.34), and older (≥40 years) paternal grandmothers (OR, 1.40; 95% CI, 1.03-1.90) compared with the grandchildren of grandparents who were aged 25 to 29 years at the time of giving birth to the parents. These findings corroborate previous studies suggesting that advanced parental age is independently associated with increased ASD risk in children. This study also found that children with young maternal grandparents and children with young and old paternal grandparents had elevated ASD risk. Possible transmission of ASD risk across generations should be considered in etiological research on ASD.

Association between peripheral blood levels of C-reactive protein and Autism Spectrum Disorder in children: A systematic review and meta-analysis

IntroductionIn the past five years, a growing number of studies have tried to illustrate the association between the peripheral blood level of C-reactive protein (CRP) and Autism Spectrum Disorders (ASD). However, the results have been inconsistent. To assess whether abnormal CRP in peripheral blood was associated with ASD, we conducted a systematic review and meta-analysis. MethodsA systematic literature search was performed using the Embase, PubMed, Web of Knowledge, PsycINFO, and Cochrane databases through August 27, 2019. Reference lists were also checked by hand-searching. Clinical studies exploring CRP concentration in the peripheral blood of autistic children and healthy controls were included in our meta-analysis. Overlapping samples were excluded. We pooled obtained data using a fixed- or random-effect model based on a heterogeneity test with Comprehensive Meta-Analysis software and STATA software. Standardized mean differences were converted to Hedges’ g statistic in order to obtain the effect size adjusted for sample size. Subgroup analyses, sensitivity analyses, meta-regression, and publication bias tests were also undertaken. ResultsNine studies with 592 ASD children and 604 healthy children were included in our meta-analysis. Significantly elevated CRP levels in peripheral blood were found in ASD children compared with healthy controls (Hedges’ g = 0.527, 95% CI: 0.224–0.830, p = 0.001). Subgroup analyses based on sample types and ethnicity also showed similar results, except for the plasma subgroup. There was also a significant association between peripheral CRP concentration and ASD after removing the studies identified by Galbraith plots. The results of the sensitivity analysis revealed that no single study could reverse our results. Meta-regression analyses revealed that the gender of autistic children had a moderating effect on the outcome of the meta-analysis. In addition, no obvious publication bias was found in the meta-analysis. Conclusions and relevanceIn our study, peripheral CRP levels were significantly elevated in autistic children compared with healthy children. These results may provide us some new insights about ASD.

Development of clinical prediction rule for diagnosis of autistic spectrum disorder in children.

This study aims to develop a clinical prediction rule for the diagnosis of autistic spectrum disorder (ASD) in children. This population-based study was carried out in children aged 2 to 5 years who were suspected of having ASD. Data regarding demographics, risk factors, histories taken from caregivers and clinical observation of ASD symptoms were recorded before specialists assessed patients using standardized diagnostic tools. The predictors were analyzed by multivariate logistic regression analysis and developed into a predictive model. An ASD diagnosis was rendered in 74.8 per cent of 139 participants. The clinical prediction rule consisted of five predictors, namely, delayed speech for their age, history of rarely making eye contact or looking at faces, history of not showing off toys or favorite things, not following clinician's eye direction and low frequency of social interaction with the clinician or the caregiver. At four or more predictors, sensitivity was 100 per cent for predicting a diagnosis of ASD, with a positive likelihood ratio of 16.62. This practical clinical prediction rule would help general practitioners to initially diagnose ASD in routine clinical practice.

Screening for Autism Spectrum Disorder in Children up to Age 2.5 years in a Tertiary Care Hospital

Objective: To investigate the frequency of Autistic Spectrum Disorder (ASD) by screening 16 to 30 months old children, reporting to a tertiary care hospital. Study Design: Cross sectional study.Place and Duration of Study: The study was conducted in the Paediatrics Outpatient Department of Military Hospital, Rawalpindi from November 2017 to August 2018.Materials and Methods: A total of 163 children between the age of 16-30 months were screened using Urdu translated version of Modified Checklist for Autism in Toddlers, revised with Follow-Up (M-CHAT-R/FTM). Those who screened positive on MCHAT-R were assessed using Childhood Autism Rating Scale-2 (CARS 2) and Diagnostic and Statistical Manual-5 (DSM-5) as diagnostic tools.Results: Among the 163 children screened with MCHAT, 33 were found positive for autism. The positive individuals were further assessed on CARS-2 and DSM-5; five children were diagnosed with ASD at moderate to severe level. This study has shown that 3% of children visiting the hospital for various reasons suffer from ASD.Conclusion: This study concluded that 3% of the children coming to the hospital for any purpose were found to have ASD. There is a need to make Level 1 screening an essential part of regular check-ups of children in Paediatrics outpatient clinics.
 How to cite this: Farooq A, Ahmed S. Screening for Autism Spectrum Disorder in Children up to Age 2.5 years in a Tertiary Care Hospital. Life and Science. 2020; 1(1): 12-16. doi: http://doi.org/10.37185/L&S.1.1.74

Efficacy and safety of microbiota transfer therapy for the management of autism spectrum disorder in children: a systematic review

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with an unclear etiologic mechanism. Following suggestions in the literature of a close relation between the gut microbiota and the central nervous system development, neuroimmune and neuroendocrine systems, new theories and strategies of the management of ASD in children focus on the brain-gut axis via microbiota transfer therapy. Despite the regular appearance in the news, the level of evidence supporting this intervention is unclear and to this date, no systematic review on this issue has been published. Methods: We conducted a systematic literature review of the efficacy and safety of microbiota transfer therapy for the management of ASD in children. MEDLINE via PubMed, LILACS IBECS via BVS, EMBASE via Ovid, Scopus and Cochrane Library were searched on 19th April 2018. Results: One single study published in 2017 was identified. The intervention group included 18 patients and showed significant clinical improvements in the gastrointestinal and ASD-related symptoms. The clinical procedure was reported as safe and well-tolerated with some transitory adverse effects. Conclusions: The causality and correlation of the intervention and the expected outcomes cannot be assumed with current evidence. In addition, recommendations about the effectiveness or safety of microbiota transfer therapy in children with ASD cannot be currently issued. Randomized controlled trials and clinical protocols for the intervention are needed.

The Effectiveness of Neurofeedback Therapy as an Alternative Treatment for Autism Spectrum Disorders in Children

Abstract. Findings for the effectiveness of neurofeedback in autism spectrum disorder are found to be inconsistent. Therefore, this review comprehensively and systematically reviewed literature on the effectiveness of neurofeedback for the treatment of autism spectrum disorders in children. A systematic search of Embase, Medline, Web of Science, PsycINFO, Cochrane, and Google Scholar was carried out in October 2017 to find relevant papers. We selected full journal articles that reported neurofeedback as a treatment for autism in children (0–17 years). The search yielded 587 articles and we included 20 references with a total of 443 participants. Ninety-four percent of nonrandomized controlled and experimental trials concerning neurofeedback for autism spectrum disorders found positive results. The evidence for effectiveness of neurofeedback therapy was even more robust when only randomized controlled studies were considered. Although there are only a few randomized controlled studies, results support effectiveness of neurofeedback for autism spectrum disorder, including long-term positive effects. In the future, optimal treatment protocols have to be developed to guide clinicians in their neurofeedback treatment. In conclusion, neurofeedback seems to be an alternative treatment for autism spectrum disorders, with space for improvement.

Research on Interactive Design of Social Interaction Training APP for Children with Autistic Spectrum Disorder (ASD) Based on Multi-modal Interaction

A number of studies have found that the difficulty in social interactive behaviors and recognize items are two core syndromes of Autistic Spectrum Disorder (ASD) children. Previous research has found that ASD children paid more attention to robots comparing to people.Intervention programs with robots as instructors or partners were also proved to be effective in improving ASD children’s social skills.Yet, few studies find robot intervention works in ASD children training.So research explore the possibility of apply such intervention programs into product design.The present study aimed at involving an animated character of robot in an application (APP) of intervention program to facilitate ASD children’s learning of social interactive skills.In order to achieve the goal, a training system based on sensory integration training was established by the design software of Sketch.Augmented Reality (AR) technology was used to create a multi-modal interactive environment of the APP.The present study is among the first attempt to apply sensory integration training in APP design, aiming at promoting social and cognitive performance in ASD children.

Professionals’ accounts of genetic testing in adoption: a qualitative study

ObjectiveTo explore social workers’ and medical advisors’ accounts of genetic testing in adoption.MethodsA qualitative study using semi-structured interviews to gather in-depth accounts of retrospective cases. Data were analysed thematically to...

EEG Spectral Features in Sleep of Autism Spectrum Disorders in Children with Tuberous Sclerosis Complex.

Tuberous sclerosis complex (TSC) is a multisystem disorder with increased prevalence of autism spectrum disorders (ASDs). This project aimed to characterize the autism phenotype of TSC and identify biomarkers of risk for ASD. Because abnormalities of EEG during sleep are tied to neurodevelopment in children, we compared electroencephalographic (EEG) measures during Stage II sleep in TSC children who either did (ASD+) or did not (ASD-) exhibit symptoms of ASD over 36-month follow up. Relative alpha band power was significantly elevated in the ASD+ group at 24months of age with smaller differences at younger ages, suggesting this may arise from differences in brain development. These findings suggest that EEG features could enhance the detection of risk for ASD.

Postnatal steroid therapy is associated with autism spectrum disorder in children and adolescents of very low birth weight infants.

This study evaluates the association between major neonatal morbidities and autism spectrum disorder (ASD) in children and adolescents born of very low birth weight (VLBW). Historical cohort study using the Israel national VLBW infant database linked with the Maccabi Healthcare Services (MHS) medical records. The study cohort comprised 4963 VLBW subjects born from 1999 to 2012, >1 year of age. Multivariable logistic regression analyses were used to assess factors associated with ASD. The diagnosis of ASD was confirmed in 113 children (2.3%). Infants with major neonatal morbidities had higher rates of ASD; however, in the multivariable analyses these were not significantly associated with ASD: severe intraventricular hemorrhage (OR 1.21 [95% CI 0.60-2.45]), post-hemorrhagic hydrocephalus (OR 1.77 [0.73-4.29]), periventricular leukomalacia (OR 1.02 [0.42-2.51]), severe retinopathy of prematurity (OR 1.91 [0.995-3.67]), and bronchopulmonary dysplasia (OR 1.44 [0.84-2.45]). Postnatal steroid therapy when included separately was associated with an OR of 1.97 [1.18-3.29] for ASD. This association remained significant when postnatal steroid therapy was included with each of the neonatal morbidities (ORs ranging from 1.91 to 2.11). This study suggests a significant association between postnatal steroid therapy and ASD in VLBW infants. This possible association should be considered in future studies evaluating potential risk factors for ASD in preterm infants.

Autism spectrum disorder in children and young people with non-epileptic seizures

PurposeNon-epileptic seizures are paroxysmal events which to an observer resemble epileptic seizures. Proposed risk factors incorporate biopsychosocial aspects including factors in the affected individual. Unexpectedly high rates of autism spectrum disorder (ASD) occurred in the clinical population reported here. Although elevated levels of psychiatric co-morbidity are known to be present in patients with NES, ASD has only been previously described in a single case report. MethodsThis case series captures rates of ASD in 59 children and young people who were referred to a specialist paediatric mental health service at Great Ormond Street Hospital, London, UK for assessment and treatment of non-epileptic seizures between 2012 and 2016. Results10/59 (16.9%) of the children and young people with non-epileptic seizures also had ASD, with 5/10 (50%) of these undiagnosed with ASD before referral. Children and young people with ASD were significantly more likely to have tics or attention-deficit hyperactivity disorder than those without ASD. ConclusionASD may be a common co-morbidity in non-epileptic seizures. Careful clinical assessment with consideration of ASD traits is therefore important in the non-epileptic seizures population. It is beneficial to diagnose ASD early as its presence is likely to require a modified approach to assessment and treatment of non-epileptic seizures. Study of the development of non-epileptic seizures in ASD may suggest hypotheses for the pathogenesis of non-epileptic seizures in the wider population.