Therapy For Autism Spectrum Disorder Research Articles

Hypothesis for How Hyperoxic Therapy May Facilitate Effective Biologic “Correction” of Autism Spectrum Disorders

The existence of morphological and physiological abnormalities in the autism brain was recognized in the 1960s. Today, in view of many such extensive pathological findings, it has been stated and reiterated that autism spectrum disorder (ASD) has a biological rather than a psychological basis. Despite this, other than pharmacologic agents that address limited aspects of symptoms, development of therapies for ASD has been focused primarily on psychosocial measures based on principles of applied behavioral analysis. With this latter approach, however, a generally accepted intervention or group of interventions which consistently and comprehensively address the needs of most individuals with autism in a cost-effective and time-efficient manner has not yet been established. While examining reports of another medical intervention, hyperbaric oxygen therapy with inspired oxygen partial pressures typically ranging from 0.31 to 1.5 atm. for neurological conditions such as autism, we wondered if increased oxygen partial pressure, alone, without the encumbrance, risk, and cost of hyperbaric exposure would produce useful clinical outcomes. In five pilot cases, therefore, a normobaric hyperoxic treatment we have called Microbaric® Oxygen Therapy (MBO2) was administered to preteen and teenage boys with ASD. All results were positive, some remarkably so, and addressed the full scope of the subject’s symptoms. Also, follow-up for over seven years in several cases suggests these outcomes are permanent. To help encourage controlled research on MBO2 for ASD, we have laid out a hypothetical basis for its efficacy using our own pilot study outcomes and observations together with relevant information from the scientific literature, the most important of which we believe relates to regional brain hypoperfusion, neuroinflammation, and angiogenesis. In investigating research on angiogenesis and autism, we found a 2016 publication concerning autism postmortem brains which identified persistent splitting angiogenesis, as opposed to sprouting angiogenesis, in some regions of all donated autism brains and in none of the age-matched control brains. With this finding and the established effects of hyperoxia on angiogenesis and inflammation, we have developed a hypothesis that potentially accounts for regional cerebral hypoperfusion; delayed, progressive onset of ASD over the early years of life; increased perfusion in hypoperfused regions of the brain following hyperoxic therapy; the broad range of oxygen partial pressures that seem to have impact; permanent reduction in the symptoms of autism resulting from MBO2; and perhaps, a time-efficient and cost-effective method of treating autism that will help upgrade the long-term prognosis for affected individuals.

Collaborative and Inclusive Process with the Autism Community: A Case Study in Colombia About Social Robot Design

One of the most promising areas in which social assistive robotics has been introduced is therapeutic intervention for children with autism spectrum disorders (CwASD). Even though there are promising results in therapeutic contexts, there is a lack of guidelines on how to select the appropriate robot and how to design and implement the child–robot interaction. The use of participatory design (PD) methods in the design of technology-based processes for CwASD is a recognition of the stakeholders as “experts” in their fields. This work explores the benefits brought by the use of PD methods in the design of a social robot, with a specific focus on their use in autism spectrum disorders therapies on the Colombian autism community. Based on what proved to be effective in our previous research, we implemented participatory methods for both the CwASD and the stakeholders. The process leverages the active role of participants using a focus group approach with parents and specialists, and scene cards, narrative and handmade generative methods with the children. To overcome some challenges of traditional PD processes, where not all community actors are considered, we included a Colombian community consisting of therapists, nurses, caregivers and parents. The proposed PD process provides an opportunity to learn from several community actors (and thus different cultural and social aspects of developing countries), improving traditional robot design methods. In this way, the findings are summarized through a set of guidelines regarding the design of a social robot-device suitable to be implemented for robot-assisted therapy for CwASD.

Effect of Ayurveda gut therapy protocol in managing dysbiosis of children with autism: study protocol for a randomized controlled trial

Background and objectives: Emerging evidences indicate an invariable relationship between gut dysbiosis and neurobehavioral symptoms of autism spectrum disorder. In India, Ayurveda is widely accepted among the complementary and alternative medicine. This study aimed to assess the efficacy of an Ayurveda gut therapy protocol in autism spectrum disorder. Subjects and methods: In this randomized controlled trial, 60 children with autism spectrum disorder admitted to Vaidyaratnam P S Varier Ayurveda College, India will be randomly assigned to intervention and control groups. The intervention group will undergo Ayurveda gut therapy protocol for 30 days and interdisciplinary interventions for 2 months, whereas the control group will undergo only interdisciplinary interventions for 2 months. A final assessment will be done on the 60 th day. Patient recruitment began in July 2018. The primary and secondary outcome measure will be completed in January 2021 and the study will be completed in September 2022. The study was approved by the Institutional Ethical Committee of Vaidyaratnam P S Varier Ayurveda College, India (Proceedings No: IEC/CI/24/17) on May 4, 2017. Protocol version: 1.0. Outcome measures: The expected primary outcome is to assess the quality and quantity of the gut microbes through 16s rRNA sequencing. The secondary outcome expected is the changes in the neurobehavioral symptoms assessed through the Childhood Autism Rating Scale and also changes in the gastrointestinal symptoms assessed through Ayurveda Gut Health Assessment Questionnaire. Discussion: The current protocol discusses the relationship between Autism and gut dysbiosis and its management through Ayurveda, and provides evidence for the rationality of using Ayurveda gut therapy as an alternative therapy for autism spectrum disorder in clinical practice. Trial registration: The study was registered with Clinical Trial Registry of India (registration No. CTRI/2018/05/014017, registered on May 21, 2018).

The Role of Gluten in Autism.

Autism spectrum disorder (ASD) is an inherited neurodevelopmental disorder of social communication and restricted, repetitive behaviors. Much remains unknown about their mechanisms of action and physiological effects. In recent years, there has been a growing interest in nutritional diets, which can be used as a form of therapeutic intervention for ASD with a recent increase in the research being carried out in this field. Selective nutrition therapy for ASD and brain function shows improvement in behavioral changes and reduction in malnutrition seemingly associated with the allergies or food intolerances to gluten. Therefore, a gluten-free diet has yielded positive outcomes giving hope in developing therapy for ASD.

Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial.

The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6months and a GFCF diet for another 6months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets.

Synchronicity in improvisational music therapy – Developing an intersubjective field with a child with autism spectrum disorder

ABSTRACTIntroduction: For children with severe autism spectrum disorder (ASD) intersubjective relating through interactional synchronicity is challenging. However, in a case of improvisational music therapy (IMT) with a 5-year-old boy with severe ASD several moments of synchronicity occurred. The following study aims to characterize the phenomenon of synchronicity as it occurred in the case, and to interpret the intersubjective meaning of the synchronicity.Method: Explorative microanalyses of videotaped IMT sessions were conducted within an interpretivist theoretical framework to investigate the phenomenon of synchronicity. Literature from the field of developmental psychology, ASD and music therapy was reviewed in order to interpret the intersubjective meaning of the occurring synchronicity.Results: Three types of synchronicity were identified: Synchronicity type one (initiated by the music therapist), synchronicity type two (co-creation of a shared rhythmicity between child and therapist) and synchronicity type three (initiated by the child). The three types of synchronicity worked on different levels of intersubjective relating.Discussion: Participation in interactional synchronicity may be reachable within the frame of IMT for a child with severe ASD, because it is facilitated by the inherent property of pulse in music and the way IMT reinforces the intersubjective dynamics of early interplay. A clinical focus on synchronicity can provide an arena for the child to show hitherto unseen resources and participate in synchronous interactions fundamental to further development. The benefit of an interdisciplinary approach to such work is highlighted, as is the need for further research on the topic.

Effect of Outpatient Service Utilization on Hospitalizations and Emergency Visits Among Youths With Autism Spectrum Disorder.

Psychiatric hospitalizations and emergency department (ED) visits occur more frequently for youths with autism spectrum disorder (ASD). One mechanism that may reduce the likelihood of these events is utilization of home and community-based care. Using commercial claims data and a rigorous analytical framework, this retrospective study examined whether spending on outpatient services for ASD, including occupational, physical, and speech therapies and other behavioral interventions, reduced the likelihood of psychiatric hospitalizations and ED visits. The study sample was composed of >100,000 children and young adults with ASD and commercial insurance from every state between 2008 and 2012. The authors estimated maximum-likelihood complementary log-log link survival models with robust standard errors. The outcomes of interest were a hospitalization or an ED visit with an associated psychiatric diagnosis code (ICD-9-CM 290 through 319) in a given week. An increase of $125 in weekly spending on ASD-specific outpatient services in the 7 to 14 weeks prior to a given week reduced the likelihood of a psychiatric hospitalization in that week by 2%. ASD-specific outpatient spending during the 6 weeks prior to a psychiatric hospitalization did not decrease risk of hospitalization. Spending on ASD-specific outpatient services did not reduce the likelihood of a psychiatric ED visit. The financial burden associated with ASD is extensive, and psychiatric hospitalizations remain the most expensive type of care, costing more than $4,000 per week on average. Identifying the mechanisms by which psychiatric hospitalizations occur may reduce the likelihood of these events.

Patient-Derived Stem Cells, Another in vitro Model, or the Missing Link Toward Novel Therapies for Autism Spectrum Disorders?

Autism Spectrum Disorders (ASDs) is a multigenic and multifactorial neurodevelopmental group of disorders diagnosed in early childhood, leading to deficits in social interaction, verbal and non-verbal communication and characterized by restricted and repetitive behaviors and interests. To date, genetic, descriptive and mechanistic aspects of the ASDs have been investigated using mouse models and post-mortem brain tissue. More recently, the technology to generate stem cells from patients' samples has brought a new avenue for modeling ASD through 2D and 3D neuronal models that are derived from a patient's own cells, with the goal of building new therapeutic strategies for treating ASDs. This review analyses how studies performed on mouse models and human samples can complement each other, advancing our current knowledge into the pathophysiology of the ASDs. Regardless of the genetic and phenotypic heterogeneities of ASDs, convergent information regarding the molecular and cellular mechanisms involved in these disorders can be extracted from these models. Thus, considering the complexities of these disorders, patient-derived models have immense potential to elucidate molecular deregulations that contributed to the different autistic phenotypes. Through these direct investigations with the human in vitro models, they offer the potential for opening new therapeutic avenues that can be translated into the clinic.

The Liver X Receptor Agonist TO901317 Ameliorates Behavioral Deficits in Two Mouse Models of Autism.

Autism spectrum disorder (ASD) is a developmental disability characterized by social deficits and repetitive stereotyped behaviors. There are currently no drugs available for the treatment of the core symptoms of ASD, suggesting an urgent need for new therapeutic strategies. The neurobiology of autism is complex, but emerging research indicates that defects in hippocampal neurogenesis are associated with ASD in both humans and mouse models of ASD, leading to the suggestion that restoring neurogenesis may be a novel therapeutic approach for ASD. Here, we found that postnatal treatment with TO901317 (TO), a potent liver X receptor (LXR) agonist, typically activated LXRβ and its target genes in the hippocampus, and alleviated the social deficits and stereotypical behaviors in BTBR T+ tf/J (BTBR) and valproic acid (VPA)-induced mouse models. In addition, we further confirmed that TO postnatal treatment also rescued the inhibition of adult hippocampal neurogenesis in these two models. In summary, our study suggests that LXR agonist targeting hippocampal neurogenesis may represent a novel potential therapy for ASD.

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is the name for a group of developmental disorders. ASD affects social interaction, communication, interests and behavior. It includes a wide range, “a spectrum,” of symptoms, skills, and levels of disability. It affects how a person acts and interacts with others, communicates, and learns. Children with ASD might have problems talking with others, or they might not look in the eye when one talks to them. They may often seem to be in their “own world.” People with ASD often have these characteristics: ongoing social problems that include difficulty communicating and interacting with others; repetitive behaviors as well as limited interests or activities; symptoms that typically are recognized in the first two years of life; symptoms that hurt the individual’s ability to function socially, at school or work, or other areas of life. Some people are mildly impaired by their symptoms, while others are severely disabled. According to the Centers for Disease Control and Prevention (CDC) around 1 in 68 children has been identified with some form of ASD. The symptoms are present before three years of age, although a diagnosis can sometimes be made after the age of three. More boys are diagnosed with the condition than girls. There is no “cure” for ASD, but speech and language therapy, occupational therapy, educational support, plus a number of other interventions are available to help children and parents.
 Bangladesh J Child Health 2019; VOL 43 (1) :41-48

Ketogenic diet as possible therapy of autism spectrum disorder — review and implication

Autism spectrum disorder (ASD) has become widespread neurodevelopmental disorder, which currently can be treated with only few therapeutic options. Furthermore, their effectiveness is limited therefore novel treatment strategies for ASD are needed. This review seeks to address this need by discussing a ketogenic diet (KD) in the context of ASD therapy. KD effects have been examined in animal and human studies. They indicate effectiveness of KD by improving autistic features. Moreover, animal studies have revealed clinically useful information about caloric restriction component of KD, which is not necessary to achieve therapeutic effects. Significantly administration of KD but not β-hydroxybutyrate or acetone has a therapeutic effect on social interactions. Human studies are scarce, however previous researches imply KD as an effective treatment at least in certain types of autism. KD in an altered form as: modified Atkins diet (MAD), ketogenic gluten-free diet with supplemental medium-chain triglyceride (MCT), and John Radcliffe ketogenic diet is an alternative to classic KD. These variants provide better quality of nutrition and are less strict, thus less difficult to maintain. KD is described as safe with limited, easily manageable adverse effects. Taken together human and animal studies would seem to suggest that KD will become part of ASD treatment. However, in order to determine accurate recommendations for all ASD patients, further studies are required.

Interactive robots with model-based ‘autism-like’ behaviors

AbstractDue to their predictability, controllability, and simple social abilities, robots are starting to be used in diverse ways to assist individuals with Autism Spectrum Disorder (ASD). In this work, we investigate an alternative and novel research direction for using robots in relation to ASD, through programming a humanoid robot to exhibit behaviors similar to those observed in children with ASD. We designed 16 ‘autism-like’ behaviors of different severities on a NAO robot, based on ADOS-2, the gold standard for ASD diagnosis. Our behaviors span four dimensions, verbal and non-verbal, and correspond to a spectrum of typical ASD responses to 3 different stimulus families inspired by standard diagnostic tasks. We integrated these behaviors in an autonomous agent running on the robot, with which humans can continuously interact through predefined stimuli. Through user-controllable features, we allow for 256 unique customizations of the robot’s behavioral profile.We evaluated the validity of our interactive robot both in video-based and ‘in situ’ studies with 3 therapists. We also present subjective evaluations on the potential benefits of such robots to complement existing therapist training, as well as to enable novel tasks for ASD therapy.

Rational use of mesenchymal stem cells in the treatment of autism spectrum disorders.

Autism and autism spectrum disorders (ASD) refer to a range of conditions characterized by impaired social and communication skills and repetitive behaviors caused by different combinations of genetic and environmental influences. Although the pathophysiology underlying ASD is still unclear, recent evidence suggests that immune dysregulation and neuroinflammation play a role in the etiology of ASD. In particular, there is direct evidence supporting a role for maternal immune activation during prenatal life in neurodevelopmental conditions. Currently, the available options of behavioral therapies and pharmacological and supportive nutritional treatments in ASD are only symptomatic. Given the disturbing rise in the incidence of ASD, and the fact that there is no effective pharmacological therapy for ASD, there is an urgent need for new therapeutic options. Mesenchymal stem cells (MSCs) possess immunomodulatory properties that make them relevant to several diseases associated with inflammation and tissue damage. The paracrine regenerative mechanisms of MSCs are also suggested to be therapeutically beneficial for ASD. Thus the underlying pathology in ASD, including immune system dysregulation and inflammation, represent potential targets for MSC therapy. This review will focus on immune dysfunction in the pathogenesis of ASD and will further discuss the therapeutic potential for MSCs in mediating ASD-related immunological disorders.

An Adaptive Multi-Robot Therapy for Improving Joint Attention and Imitation of ASD Children

Robot-mediated therapies for autism spectrum disorder (ASD) have shown promising results in the past. We have proposed a novel mathematical model based on an adaptive multi-robot therapy of ASD children focusing on two main impairments in autism: 1) joint attention and 2) imitation. Joint attention intervention is based on three different least-to-most (LTM) cues, whereas the adaptive imitation module uses joint attention for activation of the robot. The proposed model uses a multi-robot system as a therapist without any external stimuli (from the environment) to improve the skills of the ASD child. Another novel aspect of this paper is the deployment of a multi-robot system for introducing the ASD child to the concept of multi-person communication. This is particularly useful as, unlike humans, robots can be more consistent and relatively immune to fatigue. Two different therapies of human–robot interaction (i.e., with and without inter-robot communication) have been conducted. The model has been tested on 12 ASD children, eight sessions for each intervention over a period of six months. The effectiveness of the model is validated by analyzing the cognitive state of the brain before and after the intervention with electroencephalogram (EEG) neuroheadsets. Moreover, results obtained using the childhood autism rating scale (CARS) to measure the effectiveness of therapy also support the conclusions firmly. The statistical results with the p-value = 3.79E-07 3.28 show reliability and significance of the data. The results strongly indicate significant improvements in both modules, along with a notable improvement in multi-communication skills of the participating children.

Патофизиологическое обоснование персонифицированной метаболической терапии РАС. Перспективные методы лечения

A metabolic disorder is a serious problem. Changes that occur at the cellular level and are associated with biochemical processes lead to malfunctioning of the cell, and further, respectively, of tissue, organ, of the whole organism. Metabolic care is the basis of metabolic therapy. For almost every metabolic regimen of autism spectrum disorder, there is a counter-argument. For this reason, a unified approach to therapy is impossible, since, apart from the “autistic triad”, each person has his own peculiarities. At the present stage, in addition to a gluten-free and casein-free diet, vitamins of groups B and D, polyunsaturated fatty acids, various methods of microbiome correction are used in therapy, but there is no serious evidence base for the effectiveness of therapy for autism spectrum disorders. The article proposes options for the study of metabolic changes in the body, which are the rationale for the development of a scheme of metabolic therapy in the framework of a personalized medical approach to the treatment of autism spectrum disorders.

Long-term effects of repetitive transcranial magnetic stimulation on a sample of children with autism spectrum disorder

Introduction Autism spectrum disorder (ASD) is one of the most common child psychiatric disorders, with a prevalence estimated at 1.1% of the population. Children diagnosed with ASD differ from typically developing children on many cognitive and behavioral dimensions, and therefore the term ‘spectrum’ is used to emphasize its full scope. Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study and potential treatment of ASD. Aim To study long-term effects of repetitive transcranial magnetic stimulation (rTMS) on a sample of children with ASD. Patients and methods The included sample consisted of 30 children with ASD, and their ages ranged from 4 to 10 years old. They were diagnosed clinically according to Diagnostic and statistical manual of mental disorders, fifth edition through a designed semistructured interview and through application of Childhood Autistic Rating Scale (CARS). There were five female children, representing a percentage of 16.7%, whereas 25 children were males, representing a percentage of 83.3%. All patients in the sample did not stop their medical or behavioral therapy for ASD. After 3-month follow-up, 24 children were reassessed again by CARS after stoppage of rTMS sessions. Results The results of the study after the completion of 12 sessions of the rTMS showed that there is a significant difference and improvement in the severity of the clinical symptoms for ASD, except for the level of activity, listening response, and use of the body, by comparing the severity of symptoms before and after rTMS. On conducting statistical tests, the average measures of problems with respect to relationship with people, sensory responses, and verbal communication after sessions were relatively reduced. This relative decrease was found to be highly significant. The average measurements of problems such as imitation, emotional response and object use and visual response, fear or nervousness, nonverbal communication, level of consistency of intellectual response, general impression, as well as the total CARS score after conducting rTMS have relatively decreased, and it was found to be statistically significant. The average score in the CARS scale changed from 40.2 to 31.4 after 3 months of follow-up, and there was a change in the aforementioned results. Conclusion This study concluded that rTMS over left dorsolateral prefrontal cortex may be a safe and effective way of providing temporarily relief of ASD symptoms, so maintenance therapy is recommended.

Microglia as possible therapeutic targets for autism spectrum disorders.

Malfunctions of the nervous and immune systems are now recognized to be fundamental causes of autism spectrum disorders (ASDs). Studies have suggested that the brain's resident immune cells, microglia are possible key players in ASDs. Specifically, deficits in synaptic pruning by microglia may underlie the pathogenesis of ASDs, in which excess synapses are occasionally reported. This idea has driven researchers to investigate causal links between microglial dysfunction and ASDs. In this review, we first introduce the characteristics of microglia in ASD brains and discuss their possible roles in the pathogenesis of ASDs. We also refer to immunomodulatory agents that could be potentially used as symptomatic therapies for ASDs in light of their ability to modify microglial functions. Finally, we will mention a possible strategy to radically cure some of the symptoms reported in ASDs through reorganizing neural circuits via microglia-dependent synaptic pruning.

Gambaran Asupan Gluten dan Kasein pada Anak Penderita Autis

One of diet therapies for Autism Spectrum Disorder (ASD) is Gluten Free Casein Free (GFCF). Gluten and casein can increase behaviour disorder to autism. The aim of this research is to know the image of gluten and casein intake to autism. The design of this research is cross sectional with descriptive type. The identity data was gotten by interview using FFQ method. The result shows that as many as 47,4% (9 persons) autism has frequency of high gluten intake thos are 3 times per week, once per day, > once per day and 52,6% (10 persons) has frequency low gluten intake those are never and 1-2 times per week. As many as 42,1% (8 persons) autism has frequency high casein intake those are 3 times per week, once per day and > once per day and 57,9% (11 persons) has frequency low casein those are never 1-2 times per week. As many as 53,6% (10 persons) autism has frequency foods that contain high gluten casein intake those are 3 times per week, once per day, > once per day and 57,9% (11 persons) has frequency foods that contain low gluten casein intake those are never and 1-2 times per week. This research only limits on intake images, so it needs a detail research about the relationship or the influence gluten and casein intake to behaviour disorder of autism.

Project INSIDE: towards autonomous semi-unstructured human-robot social interaction in autism therapy.

This paper describes the INSIDE system, a networked robot system designed to allow the use of mobile robots as active players in the therapy of children with autism spectrum disorders (ASD). While a significant volume of work has explored the impact of robots in ASD therapy, most such work comprises remotely operated robots and/or well-structured interaction dynamics. In contrast, the INSIDE system allows for complex, semi-unstructured interaction in ASD therapy while featuring a fully autonomous robot. In this paper we describe the hardware and software infrastructure that supports such rich form of interaction, as well as the design methodology that guided the development of the INSIDE system. We also present some results on the use of our system both in pilot and in a long-term study comprising multiple therapy sessions with children at Hospital Garcia de Orta, in Portugal, highlighting the robustness and autonomy of the system as a whole.

Short-term aripiprazole therapy for autism spectrum disorder.

Short-term aripiprazole therapy for autism spectrum disorder.