Genetic studies in children with intellectual disability and autistic spectrum of disorders

Dietary Patterns and Anthropometric Measures of Indian Children with Autism Spectrum Disorder

Research literature on dietary patterns & eating habits of children with Autism Spectrum Disorder (ASD) in India is limited. To explore this, a pilot study (n = 53) which included 45 boys and 8 girls (age group of 2-13 years) was conducted. Three day food records, Food Frequency Questionnaire and Children Eating Behavior Inventory were used to assess the dietary intakes and mealtime behavior problems respectively. Findings revealed lower intake of fruits and vegetables which reflected on their micronutrient status which was significantly (p ≤ 0.05) in lower amounts predominantly B-Complex, Calcium and Iron. The study has suggested a strong need for future implementation of nutritional intervention programs at the earliest to expand food variety among children with ASD of this region.

Sleep Disorder, Gastrointestinal Problems and Behaviour Problems Seen in Autism Spectrum Disorder Children and Yoga as Therapy: A Descriptive Review

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with deficiencies in many developmental milestones during the infantile childhood. Recent researches have shown that apart from behaviour problems, the ASD children also suffer from physiological conditions such as disturbed sleep and gastrointestinal problems that could be the contributing factors to their daytime behaviour problems. Lots of parents have expressed that, lack of sleep among the children have resulted in high levels of stress among the family members particularly among the immediate caretakers which are in most cases the mother of the child. Early behaviour intervention is a norm for ASD children which mainly affect the psychological level. Through this paper, an effort has been made to study the contributions made by yoga in order to mitigate such problems. Yoga is a non-invasive and alternative therapy that brings change in both physiological and psychological level of an individual. High levels of stress among the caretakers of these children could make them susceptible to non-communicable diseases such as hypertension, diabetes, arthritis etc. Parental based yoga intervention can be more effective for both children and parents and subsequently to the entire family.

Brain-Derived Neurotrophic Factor in children with Autism Spectrum Disorder

BACKGROUND

Autism Spectrum Disorder (ASD) is a complex neurobehavioral syndrome with no known biomarker so far for early detection. It has been challenging, both to classify typical autism and associate a suitable biomarker with clinical phenotype spectrum. Brain-derived neurotrophic factor (BDNF) has emerged as a key neurotrophin regulating synaptic plasticity, neuronal differentiation and survival.

PURPOSE

Recently, BDNF depletion is reported in neurodegenerative as well as in psychiatric disorders, associated with severity of neurological dysfunction. Role of BDNF as a biomarker in ASD is gaining significance. Pre-clinical results have linked BDNF depletion in autism and mental retardation, however, with conflicting findings.

METHODS

In view of this, a preliminary study was carried out to measure serum BDNF levels in 48 children with ASD and mental retardation, and 29 age-matched controls.

RESULTS

Serum BDNF levels were found significantly higher (p<0.001) in atypical autistic subjects (clinically milder phenotype) as compared to controls, but not in typical ASD cases (clinically severe phenotype). BDNF levels were significantly lower in females with typical/Rett Syndrome (p<0.05), but not in males with typical autism (p>0.1), as compared to controls. Lower BDNF levels indicate impairment in neuroprotective mechanism, while higher levels may imply a manifested protective response.

CONCLUSION

Our study highlights the differential BDNF response based on the severity of neurobehavioral deficit, indicating a possible neuroprotective role of this molecule and supporting its exploration in targeted therapy in ASD.

Intellectual disability in Indian children: experience with a stratified approach for etiological diagnosis

OBJECTIVE

To study the clinico-etiological profile of children with intellectual disability using an algorithmic approach.

DESIGN

Cross-sectional study.

SETTING

Tertiary care centre in Northern India.

PARTICIPANTS

Consecutive children aged 3 months to 12 years, presenting with intellectual disability, confirmed by Developmental Assessment Scale for Indian Infants, Binet Kulshreshtha Test and Vineland Social Maturity Scale.

METHODS

All children were assessed on an internally validated structured proforma. A targeted approach included thyroid function tests, Brainstem evoked response audiometry, electroencephalogram, neuroimaging and metabolic screen done as a pre-decided schema. Genetic tests included karyotyping, molecular studies for Fragile X, Multiplex Ligation Dependent Probe Amplification and Array Comparative Genomic Hybridisation.

RESULTS

Data of 101 children (median age 22 months) was analyzed. The etiological yield was 82.1% with genetic causes being the most common (61.4%) followed by perinatal acquired (20.4%), CNS malformations (12%), external prenatal (3.6%), and postnatal acquired (2.4%). Mild delay was seen in 11.7%, moderate in 21.7%, severe in 30.6% and profound in 35.6%

CONCLUSIONS

It is possible to ascertain the diagnosis in most of the cases of intellectual disability using a judicious and sequential battery of tests.