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Onovbiona H, Quetsch L, Bradley R. Racial and Practical Barriers to Diagnostic and Treatment Services for Black Families of Autistic Youth: A Mixed-Method Exploration. J Autism Dev Disord 2023:10.1007/s10803-023-06166-5. [PMID: 38038872 DOI: 10.1007/s10803-023-06166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/02/2023]
Abstract
The present study explored the role race-related barriers and practical barriers to treatment participation play in treatment effectiveness and satisfaction among Black families with autistic youth using a mixed-method approach. In a sample of Black caregivers with autistic youth (N = 101), multiple regressions were conducted to examine the impact of reported racial and practical barriers on parental stress, treatment effectiveness, and treatment satisfaction. Caregivers provided further narratives on their experience navigating diagnostic and treatment services in qualitative interviews. The study demonstrated that Black caregivers of autistic youth are still encountering several racial and logistical barriers when seeking treatment and diagnostic services for their children. These barriers negatively impact caregiver stress and caregiver perceived treatment quality. Contrary to the barriers and stress experienced by Black caregivers, caregivers are generally satisfied with the treatments they are utilizing and find them helpful. The narratives told by caregivers further elucidate the tumultuous experiences of Black caregivers as they seek diagnostic and treatment services for their children. An experience that may be worsened by family, professional, and systemic barriers, and can be improved by advocacy, acceptance, peer and community support, and increased knowledge. Black families of autistic youth call for increased compassion, support, training, and humility among professionals who serve autistic youth.
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Faraji R, Ganji Z, Zamanpour SA, Nikparast F, Akbari-Lalimi H, Zare H. Impaired white matter integrity in infants and young children with autism spectrum disorder: What evidence does diffusion tensor imaging provide? Psychiatry Res Neuroimaging 2023; 335:111711. [PMID: 37741094 DOI: 10.1016/j.pscychresns.2023.111711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/26/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Abnormal functional connections are associated with impaired white matter tract integrity in the brain. Diffusion tensor imaging (DTI) is a promising method for evaluating white matter integrity in infants and young children. This work aims to shed light on the location and nature of the decrease in white matter integrity. METHODS Here, the results of 19 studies have been presented that investigated white matter integrity in infants and young children (6 months to 12 years) with autism using diffusion tensor imaging. RESULTS In most of the reviewed studies, an increase in Fractional Anisotropy (FA) and a decrease in Radial Diffusivity (RD) were reported in Corpus Callosum (CC), Uncinate Fasciculus (UF), Cingulum (Cg), Inferior Longitudinal Fasciculus (ILF), and Superior Longitudinal Fasciculus (SLF), and in the Inferior Fronto-Occipital Fasciculus (IFOF) tract, a decrease in FA and an increase in RD were reported. CONCLUSION In the reviewed articles, except for one study, the diffusion indices were different compared to the control group.
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Affiliation(s)
- Reyhane Faraji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohreh Ganji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Amir Zamanpour
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Nikparast
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Akbari-Lalimi
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Zare
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Abdelhamid N, Thind R, Mohammad H, Thabtah F. Assessing Autistic Traits in Toddlers Using a Data-Driven Approach with DSM-5 Mapping. Bioengineering (Basel) 2023; 10:1131. [PMID: 37892861 PMCID: PMC10604105 DOI: 10.3390/bioengineering10101131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/27/2023] [Accepted: 09/07/2023] [Indexed: 10/29/2023] Open
Abstract
Autistic spectrum disorder (ASD) is a neurodevelopmental condition that characterises a range of people, from individuals who are not able to speak to others who have good verbal communications. The disorder affects the way people see, think, and behave, including their communications and social interactions. Identifying autistic traits, preferably in the early stages, is fundamental for clinicians in expediting referrals, and hence enabling patients to access to required healthcare services. This article investigates various ASD behavioral features in toddlers and proposes a data process using machine-learning techniques. The aims of this study were to identify early behavioral features that can help detect ASD in toddlers and to map these features to the neurodevelopment behavioral areas of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To achieve these aims, the proposed data process assesses several behavioral features using feature selection techniques, then constructs a classification model based on the chosen features. The empirical results show that during the screening process of toddlers, cognitive features related to communications, social interactions, and repetitive behaviors were most relevant to ASD. For the machine-learning algorithms, the predictive accuracy of Bayesian network (Bayes Net) and logistic regression (LR) models derived from ASD behavioral data subsets were consistent pinpointing to the suitability of ML techniques in predicting ASD.
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Affiliation(s)
- Neda Abdelhamid
- Abu Dhabi School of Management, Abu Dhabi P.O. Box 6844, United Arab Emirates
| | - Rajdeep Thind
- Manukau Institute of Technology, Auckland 2023, New Zealand
| | - Heba Mohammad
- Higher Colleges of Technology, Abu Dhabi P.O. Box 25026, United Arab Emirates
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Maffei MF, Chenausky KV, Gill SV, Tager-Flusberg H, Green JR. Oromotor skills in autism spectrum disorder: A scoping review. Autism Res 2023; 16:879-917. [PMID: 37010327 PMCID: PMC10365059 DOI: 10.1002/aur.2923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Oromotor functioning plays a foundational role in spoken communication and feeding, two areas of significant difficulty for many autistic individuals. However, despite years of research and established differences in gross and fine motor skills in this population, there is currently no clear consensus regarding the presence or nature of oral motor control deficits in autistic individuals. In this scoping review, we summarize research published between 1994 and 2022 to answer the following research questions: (1) What methods have been used to investigate oromotor functioning in autistic individuals? (2) Which oromotor behaviors have been investigated in this population? and (3) What conclusions can be drawn regarding oromotor skills in this population? Seven online databases were searched resulting in 107 studies meeting our inclusion criteria. Included studies varied widely in sample characteristics, behaviors analyzed, and research methodology. The large majority (81%) of included studies report a significant oromotor abnormality related to speech production, nonspeech oromotor skills, or feeding within a sample of autistic individuals based on age norms or in comparison to a control group. We examine these findings to identify trends, address methodological aspects hindering cross-study synthesis and generalization, and provide suggestions for future research.
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Affiliation(s)
- Marc F. Maffei
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Karen V. Chenausky
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Neurology Department, Harvard Medical School, Boston, Massachusetts, USA
| | - Simone V. Gill
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, Massachusetts, USA
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Jordan R. Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Speech and Hearing Biosciences and Technology Program, Harvard University, Cambridge, Massachusetts, USA
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Sivayokan B, Sivayokan S, Thirunavukarasu K, Sathiadas G, Sivapathamoorthy T. The Characteristics of Autistic Children Attending a Neuro-Developmental Center in Northern Sri Lanka. Cureus 2023; 15:e35970. [PMID: 37041896 PMCID: PMC10082937 DOI: 10.7759/cureus.35970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION The global prevalence of autism spectrum disorder is rising. However, the services related to autism are only slowly being developed in poor-resource nations. There is a need to understand the characteristics of autistic children in order to develop individualized, evidence-based interventions. This study aims to analyze the sociodemographic profile and initial clinical presentations of autistic children in the northern part of Sri Lanka and determine the differences in these factors between this region and the rest of the country and the globe. METHODS This retrospective descriptive study in a center for neuro-developmental disorders in Northern Sri Lanka analyzed data extracted from clinical records of 123 autistic children using a predesigned data extraction form. Descriptive analyses and chi-square tests were performed using RStudio. RESULTS Among the 123 children, 71.5% were males. The mean age of diagnosis was 3.4 years. Most children (69.9%) had mild to moderate symptoms of autism. At the time of presentation, all children had speech-related complaints, while behavioral issues, poor social interaction, and sensory issues were reported in 91.9%, 96.7%, and 78% respectively. Social stigma was found to be the prime challenge faced by caregivers. CONCLUSION The findings show that speech and language-related problems are universal among autistic children in this region, while behavioral issues, poor social interaction, and sensory issues are highly prevalent. Further, this study highlights the need for community awareness through the primary healthcare system to address delays in detecting red-flag signs of autism by parents and seeking professional help.
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Vasilakis M, Polychronis K, Panagouli E, Tzila E, Papageorgiou A, Thomaidou L, Psaltopoulou T, Tsolia M, Sergentanis TN, Tsitsika AK. Food Difficulties in Infancy and ASD: A Literature Review. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010084. [PMID: 36670635 PMCID: PMC9857150 DOI: 10.3390/children10010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE The aim of this literature review is to investigate the potential association between specific food difficulties and autism spectrum disorder (ASD) during the first two years of life. MATERIALS The search was conducted in PubMed, Google Scholar, Embase and PsycInfo databases. RESULTS Twenty-one studies were synthesized (3763 infants and children). Difficulties during breastfeeding, breast milk refusal and avoidance of taking solids have been linked to ASD. Infants with ASD have been referred to as picky eaters. Problematic mealtime behaviour during infancy has also been associated with ASD. CONCLUSIONS The present review highlights the association between food difficulties, including problematic mealtime behaviours, food selectivity, breastfeeding difficulties and food refusal during infancy and ASD early during life, including the first months.
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Affiliation(s)
- Marios Vasilakis
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Konstantinos Polychronis
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Eleni Panagouli
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Efthalia Tzila
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Alexia Papageorgiou
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Loretta Thomaidou
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Theodora Psaltopoulou
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Maria Tsolia
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Theodoros N. Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 115 21 Athens, Greece
| | - Artemis K. Tsitsika
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
- Correspondence: ; Tel.: +30-216-0033-788
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Wang X, Carroll X, Zhang P, du Prel JB, Wang H, Xu H, Leeper-Woodford S. Exploring brainstem auditory evoked potentials and mental development index as early indicators of autism spectrum disorders in high-risk infants. Autism Res 2022; 15:2012-2025. [PMID: 36135806 DOI: 10.1002/aur.2821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 09/10/2022] [Indexed: 12/15/2022]
Abstract
This study of infants from Hubei Province, China examined brainstem auditory evoked potentials (BAEP) and mental development index (MDI) as possible early indicators associated with autism spectrum disorders (ASD). The 34 ASD cases and 102 controls who had recovered from perinatal conditions were matched for age, sex, gestational age, birth weight and maternal age. BAEP absolute latencies (AL) I, III, V and interpeak latencies (IPL) I-III, III-V, I-V were compared in ASD cases and controls at ages 1, 3 and 6 months. MDI scores were compared in these infants from 1 month to 2 years old. Multiple logistic regression analysis was performed to test associations among ASD, BAEP and MDI. Results showed BAEP AL I, V and IPL III-V prolonged in the ASD group (p < 0.001), and MDI scores in ASD cases sharply declining from 12 to 24 months (p < 0.001). Regression analysis revealed odds ratios (OR) indicating that ASD was likely associated with abnormal values of BAEP AL I at 1 and 3 months (ORAL I : 4.27; ORAL I : 4.13), and AL V at 6 months (ORAL V : 7.85). Lower MDI scores (MDI < 80) in infants at 1, 3, and 6 months were likely associated with ASD (ORMDI : 2.58; ORMDI : 3.83; ORMDI : 4.87). These data show that abnormal BAEP values and low MDI scores are independent factors associated with ASD, and that monitoring of BAEP and MDI during infancy might facilitate screening for ASD development.
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Affiliation(s)
- Xiaoyan Wang
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xianming Carroll
- Department of Public Health, Mercer University College of Health Professions, Atlanta, Georgia, USA
| | - Ping Zhang
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Hong Wang
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Haiqing Xu
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Sandra Leeper-Woodford
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, Georgia, USA
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Posar A, Visconti P. Early Motor Signs in Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020294. [PMID: 35205014 PMCID: PMC8870370 DOI: 10.3390/children9020294] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022]
Abstract
A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, we aimed at performing an update about the available data on the early motor function in children with autism spectrum disorder. Early motor impairment in these children can manifest itself both as a mere delay of motor development and as the presence of atypicalities of motor function, such as a higher rate and a larger inventory, of stereotyped movements both with and without objects. In the perspective of a timely diagnosis, the presence of early motor signs can be an important clue, especially in an individual considered at high risk for autism. Motor and communication (both verbal and non-verbal) skills are connected and a pathogenetic role of early motor dysfunctions in the development of autism can be hypothesized. From this, derives the importance of an early enabling intervention aimed at improving motor skills, which could also have favorable effects on other aspects of development.
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Affiliation(s)
- Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, 40139 Bologna, Italy;
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6225111
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, 40139 Bologna, Italy;
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Long D, Yang T, Chen J, Dai Y, Chen L, Jia F, Wu L, Hao Y, Li L, Zhang J, Ke X, Yi M, Hong Q, Chen J, Fang S, Wang Y, Wang Q, Jin C, Li T. Age of Diagnosis and Demographic Factors Associated with Autism Spectrum Disorders in Chinese Children: A Multi-Center Survey. Neuropsychiatr Dis Treat 2022; 18:3055-3065. [PMID: 36606184 PMCID: PMC9809162 DOI: 10.2147/ndt.s374840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/28/2022] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The present study investigated the age of diagnosis, treatment and demographic factors of Chinese children with autism spectrum disorders (ASD), to provide a scientific basis for the early detection, diagnosis, and intervention of ASD. PATIENTS AND METHODS A total of 1500 ASD children aged 2-7 years old from 13 cities in China were administered questionnaires to examine their diagnosis, treatment, and basic family information. The Childhood Autism Rating Scale (CARS) was used to measure the symptoms and severity of ASD children, and the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was utilized to measure neurodevelopmental levels of ASD children. RESULTS We found that for children with ASD, the median (p25, p75) age for the initial detection of social behavioral developmental delay was 24 (18, 30) months, while the age for the initial diagnosis was 29 (24, 36) months and the age for the beginning of intervention was 33 (27, 42) months. Multiple linear regression (MLR) analysis suggested that in children with ASD whose parents were divorced, separated, or widowed, or whose mothers were engaged in physical work, the initial detection of social behavioral developmental delay happened later. For the children with ASD who lived in urban areas, had higher levels of ASD symptom severity or whose parents were not divorced or separated, the age for the initial diagnosis was earlier. For the children with ASD who lived in urban areas or whose mothers had received higher level of education, the earlier age for the beginning of intervention was observed, while for those with ASD whose mothers were engaged in physical work, the age for the beginning of training was later. CONCLUSION It is recommended to actively carry out health education of ASD and strengthen the support for ASD families to enhance their rehabilitation level.
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Affiliation(s)
- Dan Long
- Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Ting Yang
- Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jie Chen
- Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Ying Dai
- Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Li Chen
- Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Feiyong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Lijie Wu
- Research Center for Child Development and Behavior, Harbin Medical University, Harbin, People's Republic of China
| | - Yan Hao
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Ling Li
- Department of Children Rehabilitation, Hainan Women and Children's Medical Center, Haikou, People's Republic of China
| | - Jie Zhang
- Children Health Care Center, Xi'an Children's Hospital, Xi'an, People's Republic of China
| | - Xiaoyan Ke
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Mingji Yi
- Department of Child Health Care, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Qi Hong
- Maternal and Child Health Hospital of Baoan, Shenzhen, People's Republic of China
| | - Jinjin Chen
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai, People's Republic of China
| | - Shuanfeng Fang
- Department of Child Health Care, Children's Hospital Affiliated of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yichao Wang
- National Health Commission Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Hospital, Changsha, People's Republic of China
| | - Qi Wang
- Deyang Maternal and Child Health Hospital, Deyang, People's Republic of China
| | - Chunhua Jin
- Department of Children Health Care, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Tingyu Li
- Chongqing Key Laboratory of Child Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center of Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Montenegro MC, Bernal E, Cukier S, Valdez D, Rattazzi A, Garrido G, Rosoli A, Silvestre Paula C, Garcia R, Montiel-Nava C. Age of diagnosis, service access, and rights of autistic individuals in Argentina: Caregivers reports of changes and similarities across time. Front Psychiatry 2022; 13:915380. [PMID: 36051548 PMCID: PMC9424614 DOI: 10.3389/fpsyt.2022.915380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many countries have developed health initiatives to protect those with disabilities and developmental concerns in the past few years. However, the needs of autistic individuals are still short of being fulfilled. Partially due to limited research expenditure, which would allow bridging the gap between evidence and practice, the long time it takes to implement passed laws, and the limited operationalization of inclusive policies. OBJECTIVE To quantitatively examine changes in the child's age at the time of caregiver's first developmental concerns and age of diagnosis of their autistic child across 5 years. Also, to address challenges experienced by caregivers (e.g., reported service barriers) and the work still needing to be done in Argentina based on caregivers' reports of their priorities (e.g., ensuring their child receives better services). METHODS Two independent samples of caregivers of autistic individuals were surveyed by the Red Espectro Autista Latinoamerica (REAL) in 2015 (n = 763) and the World Health Organization (WHO) in 2020 (n = 422). Similar items in both surveys were compared through descriptive inferential analysis and chi-square tests for categorical variables. RESULTS Compared to the 2015 sample, for the 2020 sample, more caregivers reported an earlier age of first concerns and an earlier age of a professional diagnosis. In the 2020 sample, more children diagnosed before the age of three had a doctor or a teacher noticing the first developmental concern. Also, in this sample, fewer caregivers reported service barriers (e.g., limited availability, waitlist, costs, etc.) and a need for better social support and better health services. However, rates of caregivers indicating a need for more rights for autistic individuals and greater protection of existing rights increased. There was no change in the reported rate of family members who stopped working to care for the autistic individual. For both samples, there was statistically significant differences in individual (physician, teacher, caregiver) noticing first developmental concern and the age of diagnosis, with the majority having a caregiver noticing the first concern. CONCLUSION The 5 years that separate both samples show an improvement in developmental concerns being noticed, a decrease in age of diagnosis, and an improvement in several service areas such as community awareness. Also, caregivers reported fewer barriers to service accessibility, thus suggesting a positive impact stemming from changes in public policies, non-profit organizations' work through awareness campaigns, and advocates' strives toward greater awareness. Nonetheless, a similar proportion of family members reported ceasing working to care for autistic individuals and perceived that the fundamental rights of their autistic children needed to be protected. These results imply that despite better care pathways in Argentina, there are still gaps when attempting to meet the needs of autistic individuals and their families. The present study provides a meaningful understanding of existing gaps and help exemplify the perceived improvements when non-profit agencies and advocates promote increased rights and community awareness in addition to the established laws focusing on ASD.
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Affiliation(s)
- Maria Cecilia Montenegro
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Estefani Bernal
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Sebastian Cukier
- Research Department, Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Buenos Aires, Argentina
| | - Daniel Valdez
- Research Department, Facultad Latinoamericana de Ciencias Sociales (FLACSO), Buenos Aires, Argentina
| | - Alexia Rattazzi
- Research Department, Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Buenos Aires, Argentina
| | - Gabriela Garrido
- Department of Child and Adolescent Psychiatry, Universidad de la República, Montevideo, Uruguay
| | - Analia Rosoli
- Research Department, Organización Estados Iberoamericanos para la Educación, la Ciencia y la Cultura (OEI), Santo Domingo, Dominican Republic
| | - Cristiane Silvestre Paula
- Research Department, Programa de Pós-Graduação em Distúrbios do Desenvolvimento Universidade Presbiteriana Mackenzie (UPM), São Paulo, SP, Brazil
| | - Ricardo Garcia
- Research Department, Universidad de Chile, Santiago, Chile
| | - Cecilia Montiel-Nava
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, TX, United States
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Vallés AS, Barrantes FJ. Dysregulation of Neuronal Nicotinic Acetylcholine Receptor-Cholesterol Crosstalk in Autism Spectrum Disorder. Front Mol Neurosci 2021; 14:744597. [PMID: 34803605 PMCID: PMC8604044 DOI: 10.3389/fnmol.2021.744597] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/21/2021] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorder (ASD) is a set of complex neurodevelopmental diseases that include impaired social interaction, delayed and disordered language, repetitive or stereotypic behavior, restricted range of interests, and altered sensory processing. The underlying causes of the core symptoms remain unclear, as are the factors that trigger their onset. Given the complexity and heterogeneity of the clinical phenotypes, a constellation of genetic, epigenetic, environmental, and immunological factors may be involved. The lack of appropriate biomarkers for the evaluation of neurodevelopmental disorders makes it difficult to assess the contribution of early alterations in neurochemical processes and neuroanatomical and neurodevelopmental factors to ASD. Abnormalities in the cholinergic system in various regions of the brain and cerebellum are observed in ASD, and recently altered cholesterol metabolism has been implicated at the initial stages of the disease. Given the multiple effects of the neutral lipid cholesterol on the paradigm rapid ligand-gated ion channel, the nicotinic acetylcholine receptor, we explore in this review the possibility that the dysregulation of nicotinic receptor-cholesterol crosstalk plays a role in some of the neurological alterations observed in ASD.
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Affiliation(s)
- Ana Sofía Vallés
- Instituto de Investigaciones Bioquímicas de Bahía Blanca (UNS-CONICET), Buenos Aires, Argentina
| | - Francisco J Barrantes
- Instituto de Investigaciones Biomédicas (BIOMED), UCA-CONICET, Buenos Aires, Argentina
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12
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Tarnowska K, Gruczyńska-Sękowska E, Kowalska D, Majewska E, Kozłowska M, Winkler R. The opioid excess theory in autism spectrum disorders - is it worth investigating further? Crit Rev Food Sci Nutr 2021:1-14. [PMID: 34702104 DOI: 10.1080/10408398.2021.1996329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorders (ASD) are defined as neurodevelopmental disorders, which are highly variable in nature and do not form a uniform picture, either in terms of symptomatology or depth of the disturbance. Diagnosis of ASD is made for children who show signs of impairment in social interaction, communication and cognitive skills. The exact cause of autism spectrum disorders has not been determined to date. Although there is no cure for ASD, a variety interventions have been proposed. The most commonly used restrictive dietary intervention is the gluten-free casein-free diet (GFCF), which is based on the opioid excess theory. This paper summarizes and discusses research on the core elements of the opioid excess theory in ASD: increased levels of opioid peptides in body fluids in ASD patients, increased intestinal permeability, altered peptidase activity and the effectiveness of GFCF diet in alleviating symptoms of ASD. Furthermore, we discuss the difficulties and their causes in conducting research with ASD patients. The assumptions of the opioid excess theory have neither been definitively confirmed nor disproved. Research in this area should continue, taking into account the highest possible quality standards and the specific needs and abilities of patients with ASD and their families.
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Affiliation(s)
- Katarzyna Tarnowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Eliza Gruczyńska-Sękowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Dorota Kowalska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Ewa Majewska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Mariola Kozłowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Renata Winkler
- Department of Organizational Behaviors, Cracow University of Economics, Cracow, Poland
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13
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Autism-friendly MRI: Improving radiography practice in the UK, a survey of radiographer practitioners. Radiography (Lond) 2021; 28:133-141. [PMID: 34565680 DOI: 10.1016/j.radi.2021.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/11/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Autistic individuals undergoing magnetic resonance imaging (MRI) examinations may face significant challenges, mainly due to sensory overload and MRI environment-related limitations. This study aimed to explore radiographers' perspectives and experiences regarding MRI scanning of autistic individuals. METHODS Data collection was achieved using a specifically designed mixed methods questionnaire on Qualtrics. The snowball technique was used. This UK-wide survey was electronically distributed by three main recruitment agencies between December 2020 and February 2021. RESULTS 130 valid responses were received. A lack of relevant training and knowledge related to autism was noted. Effective communication, optimisation and customisation of the MRI examination, and MRI environment adjustments facilitated the completion of a safe and effective MRI examination. Poor patient-radiographer communication, unavailability of Special Educational Needs (SEN) experts, lack of specialised radiographer training and lack of specific guidelines were identified as the main barriers to successful MRI examinations. CONCLUSION Although routine MRI safety and patient care rules will apply, MRI scanning of autistic individuals requires customisation and reasonable adjustments in communication, environment, and training of clinical teams. In addition, guidelines should be established to be used as a reference point to improve clinical practice. The adjustments proposed by radiographers were all consistent with the interventions in the wider literature. IMPLICATIONS FOR PRACTICE MRI practice for personalised care of autistic individuals should be aligned with current evidence, to customise communication and offer workflow and environmental adjustments. Formal training related to autism, integrated within radiography academic curricula and better co-ordination and communication of interdisciplinary teams would provide the necessary skill mix to deliver safe, high quality MRI scans with optimal experience for autistic service users and their carer(s).
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14
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Liu X, Sun X, Sun C, Zou M, Chen Y, Huang J, Wu L, Chen WX. Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:33-50. [PMID: 34510916 DOI: 10.1177/13623613211045029] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11-17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7-10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures.
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Affiliation(s)
- Xian Liu
- Guangzhou Medical University, China.,Harbin Medical University, China
| | - Xin Sun
- Shanghai Jiao Tong University, China
| | | | | | | | | | - Lijie Wu
- Harbin Medical University, China
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15
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Pruccoli J, Spadoni C, Orsenigo A, Parmeggiani A. Should Echolalia Be Considered a Phonic Stereotypy? A Narrative Review. Brain Sci 2021; 11:brainsci11070862. [PMID: 34209516 PMCID: PMC8301866 DOI: 10.3390/brainsci11070862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/26/2022] Open
Abstract
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) defines echolalia as a pathological, parrotlike, and apparently senseless repetition (echoing) of a word or phrase just uttered by another person and classifies this condition among the “restrictive and repetitive behaviours” of Autism Spectrum Disorder (ASD). The authors reviewed the existing literature on echolalia and its role in the development of children with ASD. Current conceptualizations include echolalia among repetitive behaviors and stereotypies and thus interpret this symptom as lacking any communicative significance, with negative effects on learning and sensory processing. Echoic behaviors, however, have been described in neurotypical infants and children as having a substantial effect on the consequent development of language and communication. Relevant research has documented a functional role of echolalia in ASD children as well since it facilitates the acquisition of verbal competencies and affords a higher degree of semantic generalization. This developmental function could be restricted to specific contexts. Considering echolalia as stereotypy and treating it as a disturbing symptom could impair the development of ASD-specific learning and communication processes. In light of this evidence, the authors propose a different conceptualization of echolalia and suggest that this symptom be considered among atypical communication patterns in children with ASD, with implications for treatment and prognosis.
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Affiliation(s)
- Jacopo Pruccoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, U.O. Neuropsichiatria dell’Età Pediatrica, 40138 Bologna, Italy; (J.P.); (C.S.); (A.O.)
- Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, 40138 Bologna, Italy
| | - Chiara Spadoni
- IRCCS Istituto delle Scienze Neurologiche di Bologna, U.O. Neuropsichiatria dell’Età Pediatrica, 40138 Bologna, Italy; (J.P.); (C.S.); (A.O.)
- Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, 40138 Bologna, Italy
| | - Alex Orsenigo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, U.O. Neuropsichiatria dell’Età Pediatrica, 40138 Bologna, Italy; (J.P.); (C.S.); (A.O.)
- Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, 40138 Bologna, Italy
| | - Antonia Parmeggiani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, U.O. Neuropsichiatria dell’Età Pediatrica, 40138 Bologna, Italy; (J.P.); (C.S.); (A.O.)
- Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, 40138 Bologna, Italy
- Correspondence:
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16
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Gagnon D, Zeribi A, Douard É, Courchesne V, Rodríguez-Herreros B, Huguet G, Jacquemont S, Loum MA, Mottron L. Bayonet-shaped language development in autism with regression: a retrospective study. Mol Autism 2021; 12:35. [PMID: 33985558 PMCID: PMC8117564 DOI: 10.1186/s13229-021-00444-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 05/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis. Methods We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels. Results ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR. Limitations This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention. Conclusions For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00444-8.
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Affiliation(s)
- David Gagnon
- Research Center of the CIUSSS-NIM, Hôpital Rivière-Des-Prairies, 7070, Boul. Perras, Montreal, QC, H2E 1A4, Canada.,Department of psychiatry, University of Montreal, 2900 Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Abderrahim Zeribi
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,University of Sherbrooke, 2500, Boul. de L'Université, Sherbrooke, QC, J1K 2R1, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Élise Douard
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Valérie Courchesne
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada
| | - Borja Rodríguez-Herreros
- Centre Cantonal Autisme, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland
| | - Guillaume Huguet
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Sébastien Jacquemont
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Mor Absa Loum
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Laurent Mottron
- Research Center of the CIUSSS-NIM, Hôpital Rivière-Des-Prairies, 7070, Boul. Perras, Montreal, QC, H2E 1A4, Canada. .,Department of psychiatry, University of Montreal, 2900 Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.
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17
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Lanzarini E, Pruccoli J, Grimandi I, Spadoni C, Angotti M, Pignataro V, Sacrato L, Franzoni E, Parmeggiani A. Phonic and Motor Stereotypies in Autism Spectrum Disorder: Video Analysis and Neurological Characterization. Brain Sci 2021; 11:brainsci11040431. [PMID: 33800677 PMCID: PMC8066337 DOI: 10.3390/brainsci11040431] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Stereotypies are among the core symptoms of Autism spectrum disorder (ASD) and can cause significant clinical impairment. At present, phonic stereotypies in ASD have been scarcely explored. This study investigates the frequency, variability, and typologies of phonic and motor stereotypies in children with ASD and their association with clinical neurological variables. We examined 35 patients by recording standardized video sessions and administering the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Phonic stereotypies were present in 83.0% of the patients. The most prevalent subtypes were noncommunicative vocalizations (60.0%), single syllables (37.1%), and echolalic stereotypies (22.9%). Noncommunicative vocalizations were more frequent in nonverbal patients (OR = 4.629, p = 0.008), while echolalic stereotypies were more represented in verbal patients (OR = 0.279, p = 0.028). Patients with intellectual disability (ID) showed a higher number (F(1,26) = 9.406, p = 0.005) and variability (F(1,25) = 7.174, p = 0.013) of motor stereotypies, with a higher number (F(1,26) = 13.268, p = 0.005) and variability (F(1,26) = 9.490, p = 0.005) of stereotypies involving the head/trunk/shoulders category. Patients with guttural stereotypies showed a higher variability of total motor stereotypies (OR = 1.487, p = 0.032) and self-directed motor stereotypies (OR = 4.389, p = 0.042). These results, combined with a standardized video-analysis, document the frequency and variability of phonic stereotypies among children with ASD. Correlations between specific phonic stereotypies and verbal abilities should be investigated further.
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Affiliation(s)
- Evamaria Lanzarini
- Child Neurology and Psychiatry Unit, Infermi Hospital, AUSL Romagna, 47923 Rimini, Italy;
| | - Jacopo Pruccoli
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Irene Grimandi
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Chiara Spadoni
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Marida Angotti
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Veronica Pignataro
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Leonardo Sacrato
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Emilio Franzoni
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Antonia Parmeggiani
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-214-4013
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18
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Pruccoli J, Solari A, Terenzi L, Malaspina E, Angotti M, Pignataro V, Gualandi P, Sacrato L, Cordelli DM, Franzoni E, Parmeggiani A. Autism spectrum disorder and anorexia nervosa: an Italian prospective study. Ital J Pediatr 2021; 47:59. [PMID: 33750445 PMCID: PMC7945370 DOI: 10.1186/s13052-021-01006-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study investigates possible associations among the psychopathology of Eating Disorders (EDs), ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD. METHODS Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering the ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Correlations were adjusted for BMI, Obsessive Compulsive Disorder (OCD) comorbidity and concurrent antipsychotic treatments. RESULTS An ASD diagnosis was possible in 22% of patients. Significant correlations were documented between ASD traits and ED psychopathology: AQ total-Interpersonal problems (IPC) (p = 0.041); AQ total-Global psychological maladjustment (GMPC) (p = 0.027); AQ social skills-Ineffectiveness (IC) (p = 0.018); AQ social skills-IPC (p = 0.019); AQ social skills-Affective problems (APC) (p = 0.025); AQ social skills-GMPC (p = 0.007); AQ attention switching-IPC (p = 0.020); ADOS-2 imagination-IC (p = 0.035). These correlations were independent of BMI, OCD and antipsychotic treatments. CONCLUSIONS ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 4 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI.
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Affiliation(s)
- Jacopo Pruccoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Altea Solari
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Letizia Terenzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Elisabetta Malaspina
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Marida Angotti
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Veronica Pignataro
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Paola Gualandi
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Leonardo Sacrato
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Duccio Maria Cordelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Emilio Franzoni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Antonia Parmeggiani
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. .,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
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Lagus S, Fernandes FDM. Proposal of a questionnaire to investigate social communication skills of children with typical development and communication disorders. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/202123413520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to verify the possibility of administering a simple questionnaire to family members who communicate with their children to identify communication functional characteristics of children with different manifestations of language development. Methods: 95 parents/guardians were individually interviewed. Their children were afterwards diagnosed with language disorder (LD), speech production disorder (SPD), autism spectrum disorder (ASD), and typical development (TD). The interviews were conducted with the Communicative Skills Questionnaire to characterize the pragmatic performance. The Student’s t-test and the principal component analysis were used in statistical analysis, considering significant p-values < 0.05. Results: the statistical analyses reveal that the questionnaire distinguished the groups of children diagnosed with autism spectrum disorder and language disorder from the groups of children with speech production disorders and typical development. Conclusion: the questionnaire proved to be capable of distinguishing and characterizing, from the pragmatic standpoint, the children with different manifestations of communication development, revealing the impaired pragmatic skills of children with autism spectrum disorders and language disorders.
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20
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Margari L, Marzulli L, Gabellone A, de Giambattista C. Eating and Mealtime Behaviors in Patients with Autism Spectrum Disorder: Current Perspectives. Neuropsychiatr Dis Treat 2020; 16:2083-2102. [PMID: 32982247 PMCID: PMC7504729 DOI: 10.2147/ndt.s224779] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social and communication skills and repetitive and restrictive behaviors. Children and adolescents with ASD are more likely to present feeding problems than their typically developing peers are. The present narrative review of literature aims to highlight the most recent evidence about epidemiology and presentations of eating and mealtime behavioral abnormalities in ASD from infancy to adolescence. Abnormalities in breastfeeding and acceptance of complementary foods have been described by most of the studies evaluating ASD early feeding history. Among the various eating and mealtime behaviors identified in ASD children and adolescents, the most common was food selectivity. The present review also provides brief overviews of the various aspects of food that may influence food acceptance by ASD patients and of the correlation between eating problems and ASD core symptoms, as well as with cognitive level, language skills, and family environment. However, studies evaluating eating problems in ASD children and adolescents are very heterogeneous and they show methodological differences. Moreover, the absence of unique definitions of eating and mealtime behaviors in ASD further limits the comparability of studies.
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Affiliation(s)
- Lucia Margari
- Child Neuropsychiatric Unit, University of Bari Aldo Moro, Bari, Italy
| | - Lucia Marzulli
- Child Neuropsychiatric Unit, University of Bari Aldo Moro, Bari, Italy
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