Type Of Neurodevelopmental Disorder Research Articles

Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders

Children and adolescents with neurodevelopmental disorders experience mental health issues and are encouraged to be brought together in real-life treatment. However, physical activity, which is a promising method for boosting mental health, has only been examined in children and adolescents with certain types of neurodevelopmental disorders. To examine the association of physical activity interventions with mental health (ie, cognitive function, psychological well-being, internalizing, and externalizing problems) in children and adolescents with neurodevelopmental disorders and to identify possible moderators. Studies were searched from inception to May 2023 through Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC. Randomized clinical trials or nonrandomized designs applying physical activity interventions and reporting at least 1 mental health outcome in children and adolescents aged 5 to 17 years with neurodevelopmental disorders were included. Two independent reviewers selected and assessed the studies. Random multilevel meta-analysis using Hedges g was performed. Data extraction and risk-of-bias assessment were conducted by multiple reviewers. Heterogeneity, publication bias, sensitivity analysis, and moderator analysis were examined to substantiate the results. The main outcomes were mental health related to cognitive function, psychological well-being, internalizing, or externalizing problems measured by neurocognitive tasks or subjective questionnaires. A total of 76 studies involving 3007 participants were included in systematic review, 59 of which were used for meta-analysis. The findings indicated that physical activity interventions were associated with significant benefits for overall mental health (g, 0.67; 95% CI, 0.50-0.85), cognitive function (g, 0.74; 95% CI, 0.53-0.95), psychological well-being (g, 0.56; 95% CI, 0.16-0.96), internalizing (g, 0.72; 95% CI, 0.34-1.10), and externalizing problems (g, 0.58; 95% CI, 0.28-0.89). Moderators were also identified: frequency, total sessions, and total duration for overall mental health; total sessions, and total duration for cognitive function; session duration and frequency for psychological well-being; physical activity type for internalizing problems; and session duration for externalizing problems. Moderator analyses showed that type of neurodevelopmental disorder did not modify the associations between physical activity and overall mental health or its subgroups. The findings in this study suggest that children and adolescents with different types of neurodevelopmental disorders may be grouped together when performing physical activity interventions, which were confirmed to be beneficial to overall mental health and its subgroups in this new diagnostic population, but that physical activity interventions should be tailored when targeting different mental health domains.

Sentence Length Effects on Intelligibility in Two Groups of Older Children With Neurodevelopmental Disorders.

The purpose of this study was to examine the impact of sentence length on intelligibility in two groups of older children with neurodevelopmental disabilities. Nine children diagnosed with cerebral palsy (CP) and eight children diagnosed with Down syndrome (DS), between the ages of 8 and 17 years, repeated sentences varying in length from two to seven words. Three hundred forty adult listeners (20 listeners per child) provided orthographic transcriptions of children's speech, which were used to calculate intelligibility scores. There was a significant main effect of sentence length on intelligibility for children with CP. Intelligibility significantly increased from two- and three-word sentences to four-, five-, and six-word sentences, then significantly decreased from four-, five-, and six-word sentences to seven-word sentences. There was a main effect of sentence length on intelligibility for children with DS. Intelligibility significantly increased from two-word sentences to four-, five-, and six-word sentences. The primary findings of this study include the following: (a) Unlike in typically developing children, sentence length continues to influence intelligibility well into adolescence for children with neurodevelopmental disorders, and (b) sentence length may influence intelligibility differently in children with CP than in children with DS; however, other factors besides the type of neurodevelopmental disorder (e.g., severity of speech motor involvement and/or cognitive-linguistic impairment) could play a role in the relationship between sentence length and intelligibility and must be investigated in future studies.

A nationwide study of prenatal exposure to illicit drugs and risk of neurodevelopmental disorders and disruptive behavioral disorders.

This cohort study aimed to examine the association between prenatal exposure to illicit drugs and neurodevelopmental and disruptive behavioral disorders (DBD) in children aged 7-12 years, using data from four national databases in Taiwan from 2004 to 2016. We linked parental and child IDs from the Taiwan Maternal and Child Health database to track children's health status from birth to at least age 7 and identify those diagnosed with neurodevelopmental disorders. The study included 896,474 primiparous women who gave birth between 2004 and 2009, with 752 pregnant women with illicit drug use history and 7520 matched women without. The results of the study showed that prenatal illicit drug exposure was significantly associated with the development of neurodevelopmental disorders and DBD in offspring. The adjusted hazard ratios for developmental delay, mild-to-severe intellectual disability, attention deficit hyperactivity disorder, and DBD were 1.54 (95 % CI: 1.21-1.95), 2.63 (95 % CI: 1.64-4.19), 1.58 (95 % CI: 1.23-2.03), and 2.57 (95 % CI: 1.21-5.48), respectively. Furthermore, prenatal exposure to methamphetamine increased the risk of neurodevelopmental disorders and DBD in offspring, while opioid use was significantly associated with a higher risk of three types of neurodevelopmental disorders, but not with DBD. The use of sedative hypnotic drugs alone was not associated with any increased risk of the three types of neurodevelopmental disorders or DBD. However, we found a significant interaction effect between prenatal illicit drug exposure and the use of sedative hypnotic drugs, which increased the risk of developmental delay.

1198-P: Gestational Diabetes Mellitus and Childhood Neurodevelopment Disorders in Offspring—Results from a Large Multi–racial/ethnic Cohort Study

Objectives: Gestational diabetes mellitus (GDM) has been linked to a higher risk of certain neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring; however, other types of NDDs are rarely studied and whether the associations vary by race/ethnicity remains unknown. Thus, we aimed to examine the association of GDM with different types of NDDs and by race/ethnicity. Methods: This retrospective cohort study included 14,480 singletons born to mothers without pre-existing diabetes and were followed to at least 1 year old in a large medical system in the US from 3/1/2013 to 8/31/2021. We ascertained GDM using the International Classification of Disease (ICD) codes (ICD-9: 648.8x; ICD-10: O24.4x) and defined NDDs (speech/language disorder [SLD], developmental coordination disorder [DCD], ASD, and others [ADHD, behavioral disorder, intellectual disability, and learning difficulty]) using validated algorithms. We compared the risk of NDDs during the entire follow-up period between offspring born to mothers with GDM and without GDM using multivariable Cox regression models. Results: During the median of 3.2 years (interquartile range: 2.0-4.9) follow-up period, GDM was significantly associated with a higher risk of SLD (adjusted hazard ratio: 1.62; 95% CI: 1.10, 2.40), DCD (2.35; 95% CI: 1.38, 4.02), ASD (3.28; 95% CI: 1.42, 7.58), and other NDDs (3.20; 95% CI: 1.55, 6.60) among children born to non-Hispanic White mothers. No significant association of GDM with any type of NDDs was observed among other race/ethnicity. Conclusion: Young children born to non-Hispanic White mothers with GDM had an elevated risk of NDDs. However, the results may be affected by differential outcome misclassification by race/ethnicity. Disclosure X.Liu: None. C.Janzen: None. M.Seamans: None. R.Nianogo: None. Z.Fei: None. L.Chen: None.

PARK2 Microdeletion or Duplications Have Been Implicated in Different Neurological Disorders Including Early Onset Parkinson Disease

The PARK2 gene is located on 6q26, encodes ubiquitin-E3- ligase, and is a transcriptional repressor of p53. It contains 12 exons. PARK2 copy number variants has been reported in various types of neurodevelopmental disorders, namely schizophrenia, Parkinson's disease (PD), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). In this retrospective study, nine cases (five with microdeletion and four with microduplication) are reported with 6q26 deletion disrupting the PARK2 gene. Microdeletion sizes ranged between 215 Kb and 356 Kb, and duplication between 279 Kb and 726 Kb. These were present within the exons 7-10. Family follow up with FISH probes revealed paternal inheritance in two cases, maternal in two cases, and de novo origin in one case. Our results support previous studies showing that patients with PARK2 CNVs involving exons 5-12 might be more deleterious and cause a unique syndrome. Comprehensive analysis of additional case studies is needed to have a full characterization of this neurological disorder syndrome.

Assessing the Effectiveness of Real-Time Online Parent Training for Parents of Children with Diverse Neurodevelopmental Disorders Residing in the Community.

Parents residing in the community have children with diverse neurodevelopmental disorders. Thus, developing online parent training that is effective for various types of neurodevelopmental disorders, not just for a single one, is essential. This study investigated the effects of real-time online group parent training developed for parents of children with various neurodevelopmental disorders. Twenty-two parents (two males and 20 females) of children with diagnosed or suspected neurodevelopmental disorders participated. We developed real-time online group parent training based on the Tottori University parent training (TUPT-ON), which can be implemented online as a pilot study. Parenting stress, parenting attitudes, mental health, and children's inappropriate behavior scores were measured before and after the intervention and analyzed using paired t-test. The average participation rate was 75.5%, and the average homework submission rate was 66.6%. The intervention significantly improved parents' quality of life and negative parenting. Moreover, significant improvements were found in the total problems age-standardized scores (T-scores) of the Child Behavior Checkl List in participants' children. In response to five questions about the acceptability of our online group parent training, participants rated most items as four or higher out of five. The implementation of TUPT-ON showed some improvements in children's outcomes and brought about positive changes in parental outcomes across various neurodevelopmental disorders. This result suggests the potential effectiveness of this intervention for different types of neurodevelopmental disorders. TUPT-ON could provide parent training and support for parents dealing with their children's various neurodevelopmental disorders, regardless of location, as long as they have a stable internet connection. However, the lack of a control group and the small sample size of certain diseases warrant caution in interpreting these findings, and a rigorous validation design should be employed and revalidated in the future.

A Machine Learning Framework for Early-Stage Detection of Autism Spectrum Disorders

Autism Spectrum Disorder (ASD) is a type of neurodevelopmental disorder that affects the everyday life of affected patients. Though it is considered hard to completely eradicate this disease, disease severity can be mitigated by taking early interventions. In this paper, we propose an effective framework for the evaluation of various Machine Learning (ML) techniques for the early detection of ASD. The proposed framework employs four different Feature Scaling (FS) strategies i.e., Quantile Transformer (QT), Power Transformer (PT), Normalizer, and Max Abs Scaler (MAS). Then, the feature-scaled datasets are classified through eight simple but effective ML algorithms like Ada Boost (AB), Random Forest (RF), Decision Tree (DT), K-Nearest Neighbors (KNN), Gaussian Naïve Bayes (GNB), Logistic Regression (LR), Support Vector Machine (SVM) and Linear Discriminant Analysis (LDA). Our experiments are performed on four standard ASD datasets (Toddlers, Adolescents, Children, and Adults). Comparing the classification outcomes using various statistical evaluation measures (Accuracy, Receiver Operating Characteristic: ROC curve, F1-score, Precision, Recall, Mathews Correlation Coefficient: MCC, Kappa score, and Log loss), the best-performing classification methods, and the best FS techniques for each ASD dataset are identified. After analyzing the experimental outcomes of different classifiers on feature-scaled ASD datasets, it is found that AB predicted ASD with the highest accuracy of 99.25%, and 97.95% for Toddlers and Children, respectively and LDA predicted ASD with the highest accuracy of 97.12% and 99.03% for Adolescents and Adults datasets, respectively. These highest accuracies are achieved while scaling Toddlers and Children with normalizer FS and Adolescents and Adults with the QT FS method. Afterward, the ASD risk factors are calculated, and the most important attributes are ranked according to their importance values using four different Feature Selection Techniques (FSTs) i.e., Info Gain Attribute Evaluator (IGAE), Gain Ratio Attribute Evaluator (GRAE), Relief F Attribute Evaluator (RFAE), and Correlation Attribute Evaluator (CAE). These detailed experimental evaluations indicate that proper finetuning of the ML methods can play an essential role in predicting ASD in people of different ages. We argue that the detailed feature importance analysis in this paper will guide the decision-making of healthcare practitioners while screening ASD cases. The proposed framework has achieved promising results compared to existing approaches for the early detection of ASD.

Melatonin Treatment for Pediatric Patients with Insomnia: Is There a Place for It?

Sleep is a vital physiological function that is impaired in ranges from 10% in the typically developing pediatric population to over 80% in populations of children with neurodevelopmental disorders and/or psychiatric comorbidities. Pediatric insomnia disorder is an increasing public health concern given its negative impact on synaptic plasticity involved in learning and memory consolidation but also on mood regulation, hormonal development and growth, and its significant impact on quality of life of the child, the adolescent and the family. While first-line treatment of pediatric insomnia should include parental education on sleep as well as sleep hygiene measures and behavioural treatment approaches, pharmacological interventions may be necessary if these strategies fail. Melatonin treatment has been increasingly used off-label in pediatric insomnia, given its benign safety profile. This article aims to identify the possible role of melatonin treatment for pediatric insomnia, considering its physiological role in sleep regulation and the differential effects of immediate release (IR) versus prolonged release (PR) melatonin. For the physician dealing with pediatric insomnia, it is particularly important to be able to distinguish treatment rationales implying different dosages and times of treatment intake. Finally, we discuss the benefit-risk ratio for melatonin treatment in different pediatric populations, ranging from the general pediatric population to children with different types of neurodevelopmental disorders, such as autism spectrum disorder or ADHD.

Oxidative Stress in Autism Spectrum Disorder-Current Progress of Mechanisms and Biomarkers.

Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder that has been diagnosed in an increasing number of children around the world. Existing data suggest that early diagnosis and intervention can improve ASD outcomes. However, the causes of ASD remain complex and unclear, and there are currently no clinical biomarkers for autism spectrum disorder. More mechanisms and biomarkers of autism have been found with the development of advanced technology such as mass spectrometry. Many recent studies have found a link between ASD and elevated oxidative stress, which may play a role in its development. ASD is caused by oxidative stress in several ways, including protein post-translational changes (e.g., carbonylation), abnormal metabolism (e.g., lipid peroxidation), and toxic buildup [e.g., reactive oxygen species (ROS)]. To detect elevated oxidative stress in ASD, various biomarkers have been developed and employed. This article summarizes recent studies about the mechanisms and biomarkers of oxidative stress. Potential biomarkers identified in this study could be used for early diagnosis and evaluation of ASD intervention, as well as to inform and target ASD pharmacological or nutritional treatment interventions.

The Effectiveness of Assertiveness Training on Anxiety Symptoms in School-Age Children With Specific Learning Disorder

Objective: Specific learning disorder is a type of neurodevelopmental disorder, in which children with disabilities have difficulty understanding, or using spoken and written language. The disorder diagnoses when children have significant reading, writing, and math skills lower than expected. One of the characteristics of children with a learning disorder is the presence of anxiety symptoms, which are often chronic, and failure to address them can negatively affect the child's growth and academic performance. Assertiveness training is a structured intervention that uses to reduce the symptoms of anxiety. The present study aimed to determine the effectiveness of assertiveness training on anxiety symptoms of male school-age children with special learning disorders in Tehran City, Iran. Materials and Methods: The present study was a quasi-experimental research in which a pre-test in addition post-test design with a control group used along with a five weeks follow-up. The population included 8-11 year-old male children who were studying in the Learning Disorders Centers in Tehran City in the school year 2019-2020. The sample consisted of 130 male school-age children who were in convenient selected from the five educational districts (2, 13, 12, 18, and 15). At first, the Colored Progressive Matrices (CPM) assessed all subjects and 72 children who got a normal intelligence quotient (≥85) completed the Child Spence Anxiety Scale (SCAS-C). The studied sample was selected according to the formula for the determining the sample size and the probability of its drop-out (34 people). After scoring the SCAS-C, 45 children received a moderate anxiety (44-88 points). Thirty-four students (19, 10, and 5, respectively with dyslexia, dysgraphia, and dyscalculia) were randomly selected among them and matched based on their age, school grade and socio-economic status. They randomly assigned to the experimental and control group with mean and standard deviation of age 10.45±2.25 and 8.87±1.89 respectively. The experimental group divided into three subgroups (six people in two groups and five people in one) due to the efficacy of training in small groups and participated in 10 assertiveness training sessions (twice a week and 90 minutes for per session) while the control group received only the mainstream programs in the Learning Disorder Center. All subjects assessed by the SCAS-C at the end of the training sessions and five weeks follow-up. The obtained data from pre-test and post-test situations analyzed by using univariate and multivariate analysis of covariance. In addition, the data were analysed by the analysis of variance with repeated measure to determine the stability of the assertiveness training after the five weeks follow-up Results: The results of univariate and multivariate analysis of covariance showed that there was a significant difference between the mean scores of anxiety symptoms and its components in the experimental and control groups before and after the assertiveness training sessions (p<0.01). The results based on the eta quotient show that the values of 66%, 66%, 32%, 63%, 63%, 71%, and 73% respectively of the variance of total anxiety symptoms, generalized anxiety, obsessive-compulsive disorder, personal injury fears, social phobia, separation anxiety and panic disorder/agoraphobia in students with special learning disorder can be explained by participation in assertiveness training intervention. The results of analysis of variance with repeated measure showed that the effect of assertiveness training has only lasted on reduction of generalized anxiety, personal injury fears, anxiety phobia, and obsessive-compulsive disorder after five weeks follow-up. However, the effectiveness of the intervention program not found for the total anxiety symptoms, separation anxiety and panic/agoraphobia after follow-up study. Conclusion: The results indicate that the assertiveness training can reduce the symptoms of anxiety and its components in school-age male children with specific learning disorder. Therefore, we conclude that the design and implementation of similar training programs help students to strive to establish interpersonal relationships, reduce the frustration of academic failure, express their feelings, think of possible ways to deal with anxious situations, manage their negative behaviour, and be prepared to accept multiple roles in adulthood. Thus, by providing assertiveness training, maladaptive behaviors and mental health problems (especially anxiety symptoms) can be preventive in students with special learning disorder in addition to prevent ongoing problems in the fields of education and occupation.

Clinical and molecular spectrum of P/Q type calcium channel Cav2.1 in epileptic patients

BackgroundEpilepsy is a neurological disorder characterized by the potential to induce seizure and accompanied by cognitive, psychological, and social consequences. CACNA1A gene is a voltage-gated P/Q-type Cav2.1 channel that is broadly expressed in the central nervous system, and the pathogenic variants within this gene may be associated with the epileptic phenotype. In the present study, we collected clinical and molecular data related to epileptic patients with CACNA1A pathogenic variants and investigated possible meaningful relationship between age at onset, neurodevelopmental disorders, type of seizures, brain imaging abnormalities, genotype, and protein domains.ResultsIn our retrospective literature studies, from among 890 articles reviewed, a total of 90 individuals were related to epilepsy phenotype. Our findings showed that about 90 percent of patients have shown the first symptoms in childhood and teenage years and different types of neurodevelopmental disorders, such as intellectual disability, developmental arrest, and behavioral disorders, have been common findings for these patients. Further, a wide range of abnormalities have been observed in their brain imaging, and generalized seizures have been the most type of seizures in these patients. However, our data showed no specific genotype–phenotype correlation in epileptic patients with CACNA1A pathogenic alterations.ConclusionsOur study focused on epileptic phenotype in patients with CACNA1A pathogenic variants and showed a wide range of clinical and molecular heterogeneity with no specific genotype–phenotype correlation. It seems that incomplete penetrance, de-novo variants, and modifier genes are obstacles in predicting the clinical outcome.

Distress Levels of Parents of Children with Neurodevelopmental Disorders during the COVID-19 Pandemic: A Comparison between Italy and Australia.

Parents of children with a neurodevelopmental disorder (NDD) report higher levels of distress compared to those of typically developing children. Distress levels may be heightened by the restrictions associated with the COVID-19 pandemic. However, it is unclear whether distress levels of parents varied by the diagnosis of neurodevelopmental disorder in children during the COVID-19 pandemic. This study aims to investigate whether parental distress was influenced by the type of NDD. Participants were from Australia (N = 196) and Italy (N = 200); the parents of children aged 3–18 were invited to complete an online self-reported survey which included the 6-item Kessler Psychological Distress Scale (K6) to determine parental distress. The results show that intellectual or learning disorder (ILD) is a major contributor to parental distress compared to other NDDs in both Australia and Italy. Moreover, the worsening of symptomatic changes in children with NDDs was significantly associated with parental distress. The differences between the two countries in terms of the pandemic impact, however, were not statistically significant. The results suggest that intervention strategies need to be tailored for individual clinical information and factor in the society’s stringency level of anti-contagion policies to improve parental wellbeing.

Caregivers' Burden of School-Aged Children with Neurodevelopmental Disorders: Implications for Family-Centred Care.

Caregivers of children with neurodevelopmental disorders play a central role during the rehabilitation and education processes, but they have an increasing risk of psychosocial problems even if the literature is not so agreed upon the specific and predisposing factors to that. The aim of this study was to examine possibly differences of burden levels in an Italian sample of principal caregivers of children with different kinds of neurodevelopmental disorders and to investigate the possible links between some clinical and sociodemographic variables and the levels of caregiver’s burden. 105 caregivers of school-aged children with neurodevelopmental disorders were included in the study and completed three online questionnaires (General Questionnaire, Caregiver Burden Inventory, Zarit Caregiver Burden Scale). Results highlighted that about the half of caregivers show from moderate to high levels of stress, but parents of children with Autism Spectrum Disorder and Intellectual Disability show greater difficulties than parents of children with Attention-Deficit Hyperactivity Disorder, Language and/or Learning Disorder, and Developmental Coordination Disorder. Moreover, it was evident a negative correlation between the burden levels and the age of children, but also a direct correlation between the burden levels and the weekly hours of rehabilitation. These findings show that severity of caregiver’s burden is dependent by the type of neurodevelopmental disorder and suggest that an ecological and family-centred approach is necessary to guarantee the life health developmental course of these children.

Cross-Disorder Analysis of De Novo Variants Increases the Power of Prioritising Candidate Genes.

De novo variants (DNVs) are critical to the treatment of neurodevelopmental disorders (NDDs). However, effectively identifying candidate genes in small cohorts is challenging in most NDDs because of high genetic heterogeneity. We hypothesised that integrating DNVs from multiple NDDs with genetic similarity can significantly increase the possibility of prioritising the candidate gene. We catalogued 66,186 coding DNVs in 50,028 individuals with nine types of NDDs in cohorts with sizes spanning from 118 to 31,260 from Gene4Denovo database to validate this hypothesis. Interestingly, we found that integrated DNVs can effectively increase the number of prioritised candidate genes for each disorder. We identified 654 candidate genes including 481 shared candidate genes carrying putative functional variants in at least two disorders. Notably, 13.51% (65/481) of shared candidate genes were prioritised only via integrated analysis including 44.62% (29/65) genes validated in recent large cohort studies. Moreover, we estimated that more novel candidate genes will be prioritised with the increase in cohort size, in particular for some disorders with high putative functional DNVs per individual. In conclusion, integrated DNVs may increase the power of prioritising candidate genes, which is important for NDDs with small cohort size.

Dyslexia treatment studies: A systematic review and suggestions on testing treatment efficacy with small effects and small samples

Poor response to treatment is a defining characteristic of reading disorder. In the present systematic review and meta-analysis, we found that the overall average effect size for treatment efficacy was modest, with a mean standardized difference of 0.38. Small true effects, combined with the difficulty to recruit large samples, seriously challenge researchers planning to test treatment efficacy in dyslexia and potentially in other learning disorders. Nonetheless, most published studies claim effectiveness, generally based on liberal use of multiple testing. This inflates the risk that most statistically significant results are associated with overestimated effect sizes. To enhance power, we propose the strategic use of repeated measurements with mixed-effects modelling. This novel approach would enable us to estimate both individual parameters and population-level effects more reliably. We suggest assessing a reading outcome not once, but three times, at pre-treatment and three times at post-treatment. Such design would require only modest additional efforts compared to current practices. Based on this, we performed ad hoc a priori design analyses via simulation studies. Results showed that using the novel design may allow one to reach adequate power even with low sample sizes of 30–40 participants (i.e., 15–20 participants per group) for a typical effect size of d = 0.38. Nonetheless, more conservative assumptions are warranted for various reasons, including a high risk of publication bias in the extant literature. Our considerations can be extended to intervention studies of other types of neurodevelopmental disorders.

Improving Joint Attention in Children with Autism: A VR-AR Enabled Game Approach

Autism Spectrum Disease (ASD) can be referred to as one type of neurodevelopmental disorder, causing communication or behavioral disabilities in multiple severity levels. These challenges cause difficulties in communication, interaction, problem-solving, etc. Though having no persistent cure for ASD, several treatments and intervention strategies prevail for their behavioral development. These treatments include social skill training, sensory integration, and occasional therapy, etc. Many of these researches highly emphasize joint attention, which is the common issue of most autism cases. Joint or shared attention is highly essential for language and communication skill development. In this work, we proposed a game-based approach to improving the joint attention of children with autism. This approach focuses on the efficiency of skilling up their shared attention by interacting with digital models through problem-solving. We integrate AR (Augmented Reality) and VR (Virtual Reality) technologies for solving this issue. Using these technologies, we have designed an interactive multi-staged game module, including several types of real-life alike problems. Problem-solving and interacting with these mascots can help children build up learning and communication skills, which sometimes real-life interaction may find challenging. Again, eye screening and health can be issues in the device-centric scheme. An analytical survey has been presented in this work, confirming that all these health issues have been carefully considered. Implementation and outperforming results of this work will give a clear stand about the effectiveness of this module. Besides, we present sufficient analytics confirming that this module can also be efficient for normal children.

Early Motor Function of Children With Autism Spectrum Disorder: A Systematic Review.

Early motor impairments have been reported in children with neurodevelopmental disorders (NDD), but it is not clear if early detection of motor impairments can identify children at risk for NDD or how early such impairments might be detected. To characterize early motor function in children later diagnosed with NDD relative to typically developing children or normative data. The Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, PsycINFO, and Scopus electronic databases were searched. Eligible studies were required to include an examination of motor function in children (0-24 months) with later diagnosis of NDD by using standardized assessment tools. Data were extracted by 4 independent researchers. The quality of the studies was assessed by using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields checklist. Twenty-five studies were included in this review; in most of the studies, the authors examined children with later autism spectrum disorder (ASD). Early motor impairments were detected in children later diagnosed with ASD. The meta-analysis results indicated that differences in fine, gross, and generalized motor functions between the later ASD and typically developing groups increased with age. Motor function across different NDD groups was found to be mixed. Results may not be applicable to children with different types of NDD not reported in this review. Early motor impairments are evident in children later diagnosed with ASD. More research is needed to ascertain the clinical utility of motor impairment detection as an early transdiagnostic marker of NDD risk.

The moderating effect of types of child’s neurodevelopmental disorder on the relationship between Indonesian mothers’ perception of child’s maladaptive behaviour and maternal parenting stress

This study aimed to examine the effect of mother’s perception of child’s maladaptive behaviour and types of child’s neurodevelopment disorder on maternal parenting stress, and examine the role of types of child’s neurodevelopmental disorder in moderating the relationship between mother’ perception of child’s maladaptive behaviours and maternal parenting stress. The mother’ perception of child’s maladaptive behaviours tested included internalizing and externalizing maladaptive behaviours, while the types of child’s neurodevelopmental disorder included intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). A total of 163 mothers of children with different types of neurodevelopmental disorders were included in this study. The data were analysed with regression analysis, t-test, and ANOVA. The results showed that 1) there is an influence of the mother’s perception of child’s maladaptive behaviours and types of neurodevelopmental disorders on parenting stress; 2) types of child neurodevelopmental disorders moderate the relationship between the mother’s perception of child’s maladaptive behaviour and maternal parenting stress; 3) mothers of children with ASD experience higher levels parenting stress than mothers of children with ADHD and ID.

The Parvalbumin Hypothesis of Autism Spectrum Disorder.

The prevalence of autism spectrum disorder (ASD)—a type of neurodevelopmental disorder—is increasing and is around 2% in North America, Asia, and Europe. Besides the known genetic link, environmental, epigenetic, and metabolic factors have been implicated in ASD etiology. Although highly heterogeneous at the behavioral level, ASD comprises a set of core symptoms including impaired communication and social interaction skills as well as stereotyped and repetitive behaviors. This has led to the suggestion that a large part of the ASD phenotype is caused by changes in a few and common set of signaling pathways, the identification of which is a fundamental aim of autism research. Using advanced bioinformatics tools and the abundantly available genetic data, it is possible to classify the large number of ASD-associated genes according to cellular function and pathways. Cellular processes known to be impaired in ASD include gene regulation, synaptic transmission affecting the excitation/inhibition balance, neuronal Ca2+ signaling, development of short-/long-range connectivity (circuits and networks), and mitochondrial function. Such alterations often occur during early postnatal neurodevelopment. Among the neurons most affected in ASD as well as in schizophrenia are those expressing the Ca2+-binding protein parvalbumin (PV). These mainly inhibitory interneurons present in many different brain regions in humans and rodents are characterized by rapid, non-adaptive firing and have a high energy requirement. PV expression is often reduced at both messenger RNA (mRNA) and protein levels in human ASD brain samples and mouse ASD (and schizophrenia) models. Although the human PVALB gene is not a high-ranking susceptibility/risk gene for either disorder and is currently only listed in the SFARI Gene Archive, we propose and present supporting evidence for the Parvalbumin Hypothesis, which posits that decreased PV level is causally related to the etiology of ASD (and possibly schizophrenia).

Atypical Functional Covariance Connectivity Between Gray and White Matter in Children With Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder with atypical gray matter (GM) and white matter (WM) functional developmental course. However, the functional co-developmental pattern between GM and WM in ASD is unclear. Here, we utilized a functional covariance connectivity method to explore the concordance pattern between GM and WM function in individuals with ASD. A multi-center resting-state fMRI dataset composed of 105 male children with ASD and 102 well-matched healthy controls (HCs) from six sites of the ABIDE dataset was utilized. GM and WM ALFF maps were calculated for each subject. Voxel by voxel functional covariance connectivity of the ALFF values across subjects was calculated between GM and WM for children with ASD and HCs. A Z-test combining FDR multi-comparison correction was then employed to determine whether the functional covariance is significantly different between the two groups. A "bundling" strategy was utilized to ensure that the GM/WM clusters showing atypical functional covariance were larger than 5 voxels. Finally, canonical correlation analysis was conducted to explore whether the atypical GM/WM functional covariance is related to ASD symptoms. Results showed atypical functional covariance connections between specific GM and WM regions, whereas the ALFF values of these regions indicated no significant difference between the two groups. Canonical correlation analysis revealed a significant relationship between the atypical functional covariance and stereotyped behaviors of ASD. The results indicated an altered functional co-developmental pattern between WM and GM in ASD. LAY SUMMARY: White matter (WM) and gray matter (GM) are two major human brain organs supporting brain function. WM and GM functions show a specific co-developmental pattern in typical developed individuals. This study showed that this GM/WM co-developmental pattern was altered in children with ASD, while this altered GM/WM co-developmental pattern was related to stereotyped behaviors. These findings may help understand the GM/WM functional development of ASD.