The relationship between irritability and autism symptoms in children with ASD in COVID-19 home confinement period

[A review of research on psychological and behavioral problems in children with autism spectrum disorder during the coronavirus disease 2019 epidemic]

Since December 2019, coronavirus disease 2019 (COVID-19) has been rapidly spreading worldwide and affecting the physical and mental health of the general population. It may have even more serious potential harm to children with autism spectrum disorder (ASD). This paper provides a literature review on the psychological and behavioral problems experienced by children with ASD during the COVID-19 epidemic, as well as the factors influencing these issues. The findings of this review can serve as a basis for clinical research on ASD children.

Validation and Analysis of the Psychometric Properties of Two Irritability-Measuring Tools: The Affective Reactivity Index (ARI) and the Born-Steiner Irritability Scale (BSIS) in the Italian Adult and Adolescent Populations

Irritability is a transdiagnostic symptom that affects quality of life during the lifespan of individuals. The objective of the present research was to validate two assessment tools, namely the Affective Reactivity Index (ARI) and the Born-Steiner Irritability Scale (BSIS). We investigated internal consistency as measured with Cronbach's alpha, test-retest with intraclass correlation coefficient (ICC) and convergent validity confronting ARI and BSIS scores with the strength and difficulties questionnaire (SDQ). Our results revealed ARI good internal consistency with a Cronbach's α of 0.79 for adolescent and 0.78 for adults. The BSIS also demonstrated good internal consistency for both samples with Cronbach's α = 0.87. Test-retest analysis showed excellent values for both tools. Convergent validity showed positive and significant correlation with SDW, albeit weak for some sub-scales. In conclusion, we found ARI and BSIS to be good tools for measuring irritability in adolescents and adults, and now, Italian healthcare professionals can use it with more confidence.

COVID-19 Pandemic and Autism Spectrum Disorder, Consequences to Children and Adolescents - a Systematic Review

In this systematic review, we aimed to identify the impact of the COVID-19 pandemic on children/adolescents with a diagnosis of autism spectrum disorder (ASD). The protocol was registered on PROSPERO CRD42021255848. Articles were selected from PubMed, Embase, and LILACS according to these characteristics: patients from zero to 18 years old, exposed to the COVID-19 pandemic, impact on social communication/interaction and restricted/repetitive behavior domains. The Newcastle-Ottawa Scale was used to assess methodological quality and the risk of bias. Of the 351 articles initially identified, 26 were finally included with information on 8,610 patients. Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ASD were mostly manifested in their behavior and sleep patterns.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40489-022-00344-4.

The relationship between irritability and autism symptoms in children with ASD in COVID-19 home confinement period

OBJECTIVE

This study investigated the impact of COVID-19 home confinement on autism spectrum disorder (ASD) symptoms and irritability in children and adolescents with ASD.

METHOD

The study participants included 46 drug-naive children aged 4-17 years diagnosed with ASD. Parents of the participants completed the Autism Behaviour Checklist (AuBC) and Affective Reactivity Index (ARI) scales for both normal conditions and COVID-19 home confinement.

RESULTS

All subscale scores for AuBC (sensory, relating, body and object use, language, and social and self-help) and ARI scores significantly increased during the COVID-19 home confinement period (P < .05). The participants' irritability and ASD symptoms were significantly worse during the COVID-19 outbreak and home confinement period compared to normal conditions. The variables that predicted irritability were the social and self-help subscales of AuBC.

DISCUSSION

These results have alerted us of the importance of focusing on the symptoms such as irritability exhibited by extremely vulnerable populations during disease outbreaks and of the necessity of developing new strategies to avoid such adverse outcomes in similar situations.