The need to improve autism services in lower-resource settings

Effectiveness of IMPUTE ADT-1 mobile application in children with autism spectrum disorder: An interim analysis of an ongoing randomized controlled trial

Objectives

IMPUTE Inc., a software firm dedicated to healthcare technology, has developed a mobile medical application known as IMPUTE ADT-1 for children with autism spectrum disorder (ASD) based on the principle of applied behavior analysis.

Materials and Methods

The primary objective of this trial was to compare the efficacy of add-on treatment with IMPUTE ADT-1 in children with ASD aged two to six years as compared to standard care alone for 12 weeks (in terms of change in Autism Diagnostic Observation Schedule [ADOS-2] scores). The secondary objective of the study was to assess the compliance with IMPUTE ADT-1 among participants and also to evaluate the feedback of parents regarding IMPUTE ADT-1 at the end of 12 weeks. The application provides personalized programs tailored to each user's needs, and the program evolves based on the user's progress. It also utilizes face tracking, eye tracking, and body tracking to gather behavior-related information for each child and apply it in reinforcement learning employing artificial intelligence-based algorithms.

Results

Till the time of interim analysis, 37 and 33 children had completed 12-week follow-up in IMPUTE ADT-1 and control arm. At 12 weeks, as compared to baseline, change in social affect domain, repetitive ritualistic behavior domain, total ADOS-2 score, and ADOS-2 comparison score was better in the intervention group as compared to the control group (P < 0.001 for all). A total of 30 (81%), 28 (75%), and 29 (78%) caregivers in the IMPUTE ADT-1 group believed that the ADT-1 app improved their child's verbal skills, social skills, and reduced repetitive behavior, respectively.

Conclusion

IMPUTE ADT-1 mobile application has the efficacy to improve the severity of autism symptoms in children. Parents of these children also feel that the application is beneficial for improving the socialization and verbal communication of their children.

The altered expression of cytoskeletal and synaptic remodeling proteins during epilepsy

The cytoskeleton plays an important role in epilepsy; however, the mechanism is unknown. Therefore, this study aimed to reveal the mechanism of cytoskeletal proteins in epilepsy by investigating the expression of cytoskeletal proteins and synaptophysin (SYP) in mice at 0, 3, 6, and 24 h, 3 days, and 7 days in a kainic acid (KA)-induced epileptic model. Our results demonstrated that the expression of F-actin decreased significantly between 3 and 6 h, 6 and 24 h, and 24 h and 3 days (P < 0.05). Meanwhile, the expression of the neurofilament light chain, neurofilament medium chain, and neurofilament heavy chain subunits was significantly decreased (P < 0.001) at 3 h after the KA injection compared to the KA 0 h group, followed by an elevation at 6 h and a further decrease at 24 h compared to at 6 h. SYP expression was significantly decreased between 0 and 3 h as well as between 3 and 6 h (P < 0.05). At 24 h, the level was increased compared to at 6 h and continued to increase at 3 days after the KA injection. Thus, we propose that cytoskeletal proteins may be involved in the pathogenesis of epilepsy.

The future of care and clinical research in autism - recommendations from the 2021 Lancet Commission

At least 78 million people worldwide are affected by autism, a neurodevelopmental disorder characterized by deficits in social interactions, and repetitive behaviors and/or interests. Autism typically manifests in early childhood, and affects social communications and behaviors throughout the lifespan of the individual. Under the umbrella of autism spectrum disorder, it is a highly heterogeneous disorder, with some individuals profoundly affected and needing care every day, while others can live highly independent lives, with some adjustments. The past 60 years has seen a major influx of interest in autism, and significant advances in many areas. However, a large gap remains between current scientific knowledge and the help and support that people with autism and their families need. To address these concerns, the Lancet commissioned a report on the "future of care and clinical research in autism". The Commission calls for government coordination between health-care, education and social sectors, as well as active participation from people with autism and their families. The Commission proposes personalized, evidence-based assessments and intervention, that is accessible and affordable to all, and call for increased appreciation of neurodiversity and prioritization of research that can improve the lives of people with autism and their families. How to support each and every autistic individual and their families is highly challenging. The 64-page Lancet Commission Report, published on December 2021, was written jointly by 32 authors from 6 continents and 13 disciplines, including clinicians, other health-care providers, researchers, advocates, autistic individuals and their parents.