Autism spectrum disorder in the United Arab Emirates: potential environmental links

Metallomic Profiling of Autism Spectrum Disorder in Sarajevo Canton, Bosnia and Herzegovina: Insights from Hair Sample Analysis

The rising prevalence of autism spectrum disorder (ASD) in Bosnia and Herzegovina over the past decade is a pressing concern that underscores the urgent need to investigate its etiology. While this issue is recognized globally, there is a significant lack of data specific to Bosnia and Herzegovina, making comprehensive analysis essential. To address this gap, this study analyzed 41 hair samples from children categorized into three age subgroups (3-5 years, 6-9 years, 10-12 years) and differentiated by gender within both control and ASD groups. The concentrations of essential metals (Cu, Fe, Mn, Zn) as well as potentially toxic metals (Cd, Co, Ni, Pb) were measured using atomic absorption spectrometry (AAS). This research aims to provide valuable insights into the metallomic differences that may contribute to the understanding of ASD in this population. Females with autism spectrum disorder (ASD) exhibited elevated levels of Fe, Ni, and Cd across all age subgroups, surpassing reference values, while ASD males also showed increased Cd content. The control subgroup of 3-5-year-olds and all ASD female subgroups had Co levels exceeding the reference limit. Alarmingly, elevated Pb levels were found in all hair samples, with ASD males showing values that were twice as high as the reference. Statistically significant differences were identified in the concentrations of Cd, Fe, and Zn in females, as well as Pb in males, between the control and ASD groups. These findings underscore the urgent need for further research to elucidate the role of heavy metals in the etiology of ASD.

Mothers' evaluations of fathers' contributions to raising children with autism spectrum disorder in the United Arab Emirates

BACKGROUND

Autism spectrum disorder (ASD) is a lifelong neurological condition which results in social skill deficits, communication difficulties, and restrictive and repetitive behaviour. The difficulties associated with parenting children with ASD have been studied extensively, mainly from the perspectives of mothers. The extent of involvement of fathers in the raising of children with ASD has received limited scholarly attention, especially in non-Western contexts such as the United Arab Emirates.

OBJECTIVES

This study asked mothers to evaluate the involvement of fathers in the development of children with ASD.

METHODS

In all, 240 mothers completed the Fathers' Involvement in Development and Rehabilitation Scale, designed based on a review of literature on the construct of involvement, namely attitude, participation in training, and support domains. The data were subjected to computation of mean scores, multivariate analysis of variance, hierarchical regression, and moderation analyses.

RESULTS

The results suggested that fathers held positive attitudes and provided substantial support to their children with ASD. However, mothers were ambivalent regarding the participation of fathers in training to support the development of their children. Differences were also observed between participants according to marital status, location, child gender, and ASD severity.

CONCLUSION

Recommendations for targeted training for fathers and other study implications are discussed.

Exploration of radiographers' knowledge, attitudes, and practices in delivering healthcare to children with autism spectrum disorder

INTRODUCTION

Autism Spectrum Disorder (ASD) poses unique challenges in healthcare settings, including radiographic examinations. This study aimed to assess the knowledge, attitudes, and practices (KAP) of radiographers in the United Arab Emirates (UAE) towards ASD children, a population with increased healthcare needs.

METHODS

A cross-sectional survey was conducted online, targeting radiographers across the UAE. The instrument utilized was a comprehensive and validated self-administered questionnaire developed based on relevant literature. The questionnaire incorporated sections to gauge radiographers' knowledge about ASD, their attitudes towards working with ASD children, and their adherence to recommended practices during radiographic examinations. Descriptive and inferential statistics were employed to describe KAP and identify any influencing factors.

RESULTS

Radiographers demonstrated a moderate level of knowledge regarding ASD. Despite the knowledge, misconceptions about ASD nature were common. The radiographers generally acknowledged the need for special care for ASD children during radiographic procedures. High confidence in working with ASD children was noted, particularly among older participants, despite a clear interest in further training. Good adherence to recommended practices was observed, with physical restraints not being a common practice. However, areas for improvement were identified, such as the use of visual aids.

CONCLUSION

Despite a moderate level of knowledge and good practices, there is a need to improve UAE radiographers' understanding and handling of ASD children.

IMPLICATIONS FOR PRACTICE

This study highlights the need for enhancing ASD-specific knowledge and training and integrating supportive tools in radiographic procedures. This comprehensive approach could significantly improve the radiographic service quality for ASD children in the UAE.

Human biomonitoring of environmental contaminants in Gulf Countries - current status and future directions

BACKGROUND

This systematic review aimed to evaluate the status of Human Biomonitoring (HBM) in the Gulf Cooperation Council (GCC) region and provide recommendations for future research, considering the increased environmental contaminants that pose a threat to human health in this rapidly industrializing area.

METHODS

A thorough search was performed in PubMed and Web of Science databases up to February 2023 to identify biomonitoring studies on human exposure and levels in the GCC region. Two independent reviewers assessed study eligibility, conducted data extraction and risk of bias assessment. The NIH Quality Assessment Tools and PRISMA guidelines were utilized for quality evaluation and reporting of results.

RESULTS

A total of 38 eligible articles were included in this systematic review out of 662 articles screened. The majority of the publications were from Saudi Arabia (n = 24) and Kuwait (n = 10), while limited representation was found from Qatar (n = 3) and the UAE (n = 1). No articles were identified from Oman and Bahrain. The studies focused on metals, organohalogen compounds, pesticides, polycyclic aromatic hydrocarbons, and phthalates. The findings revealed elevated levels of metals and established correlations between metal exposure and adverse health effects, including infant neurodevelopmental issues, vitamin D deficiency, and oxidative stress. The presence of organohalogen compounds and pesticides was prevalent in the GCC region, with significant associations between exposure to these compounds and negative health outcomes. Notably, high levels of perchlorate were observed in the Kuwaiti population, and a study from Saudi Arabia found an association between per- and polyfluorinated substances and increased odds of osteoporosis.

CONCLUSIONS

This review emphasizes the need to address environmental health challenges in the GCC region through improved HBM research methods and strategies. Implementing biomonitoring programs, conducting cohort studies, investing in tools and expertise, promoting collaboration, and engaging the community are crucial for reliable HBM data in the GCC.

Accessibility of nutritional services for children with autism spectrum disorder in the United Arab Emirates: Insights from special education teachers and parents

BACKGROUND

Goal 2 of United Nation's Sustainable Development Goals exhorts countries to provide guidelines on better nutrition for all children. In response, the United Arab Emirates (UAE) government designed a national nutrition framework to encourage better eating habits. However, large body of literature has reported that children with ASD are at high risks of malnutrition and poor eating habits. Yet, in the UAE and other contexts, there is limited research on accessibility of nutritional services to adults in the lives of children with ASD.

AIMS

As parents and teachers spend the most time with children with ASD, this study sought to understand their perceptions of the availability of nutritional services for such children in the UAE.

METHOD AND PROCEDURES

Penchansky and Thomas' (1981) health access theory served as the theoretical framework; its five tenets (geography, finance, accommodation, resources and acceptability) informed the design of a semi-structured interview guide. Data were collected from 21 participants, comprising 6 parents and 15 teachers of children with ASD.

OUTCOMES AND RESULTS

Thematic analysis revealed that participants perceived accommodation, acceptability, and human resource availability as barriers to accessibility. However, geographical and financial accessibility were not identified as challenges.

CONCLUSIONS AND IMPLICATIONS

The study calls for health policymakers to formalise nutritional services as an integrated part of the UAE health system, while also extending services to children with ASD.

CONTRIBUTION

This study makes a substantial contribution to the literature. First, it addresses the needs for nutritional services for children with ASD. There is a limited body of knowledge on whether children with ASD have access to the requisite nutrition for development This study sheds light on an area that has received limited scholarly insight. Second, it adds to the usage of health access theory in studies on nutritional services for children with ASD.

Nutritional Status and Feeding Behavior of Children with Autism Spectrum Disorder in the Middle East and North Africa Region: A Systematic Review

Autism spectrum disorder (ASD) in children is associated with increased risks of overweight/obesity and underweight, altered nutrient profile, and abnormal feeding behaviors. This systematic review aimed to elucidate the literature on the nutritional status of children with ASD in the Middle East North Africa (MENA) region, by providing a summary and assessment of the body of evidence. A systematic review of English and Arabic publications up to November 2020 was conducted of five databases in addition to the grey literature, which include a nutrition-related parameter, from both experimental and observational study designs. Children with ASD (ASD-C) between 2 and 19 years in the MENA Region were the target population. For risk of bias, the Academy of Nutrition and Dietetics' Quality Criteria Checklist (QCC) was adopted. The number of published articles was grossly limited. Forty-three articles were included, of which only four articles reported a low risk of bias; therefore, the results were interpreted in light of methodological limitations. Both overweight and underweight were common in ASD-C, although not consistently different than typically developing children. Nutrient inadequacies of energy, protein, omega-3, and others; deficiencies in serum iron indicators and calcium, as well as vitamins B12, B9, and D levels; and higher levels of homocysteine and omega-6/omega-3 ratios were reported. Feeding behavior problems were also common in ASD-C. Understanding nutritional requirements and food preferences can guide the planning of the appropriate comprehensive interventions for ASD-C. Various nutritional and behavioral concerns were identified in the included studies; however, they were subject to methodological weaknesses, which limited the generalizability of these results. Future research is warranted that must be directed to finding strong evidence using robust study designs on nutritional status and feeding behaviors of ASD-C, with a particular emphasis on the MENA Region.