Gender differences among children with autism spectrum disorder: differential symptom patterns

Sex differences in antioxidant defence and the regulation of redox homeostasis in physiology and pathology

Reactive oxygen species (ROS) is a term that defines a group of unstable compounds derived from exogenous sources or endogenous metabolism. Under physiological conditions, low levels of ROS play a key role in the regulation of signal transduction- or transcription-mediated cellular responses. In contrast, excessive and uncontrolled loading of ROS results in a pathological state known as oxidative stress (OS), a leading contributor to aging and a pivotal factor for the onset and progression of many disorders. Evolution has endowed cells with an antioxidant system involved in stabilizing ROS levels to a specific threshold, preserving ROS-induced signalling function and limiting negative side effects. In mammals, a great deal of evidence indicates that females defence against ROS is more proficient than males, determining a longer lifespan and lower incidence of most chronic diseases. In this review, we will summarize the most recent sex-related differences in the regulation of redox homeostasis. We will highlight the peculiar aspects of the antioxidant defence in sex-biased diseases whose onset or progression is driven by OS, and we will discuss the molecular, genetic, and evolutionary determinants of female proficiency to cope with ROS.

Sleep Problem of Children with Autistic Spectrum Disorder Assessed by Children Sleep Habits Questionnaire-Abbreviated in Indonesia and Japan

BACKGROUND

Sleep problems are associated with problems of cognitive functioning, learning, attention and school performance. It has been found that sleep problems are highly prevalent in children with Autistic spectrum disorders (ASD), with rates ranging from 40% to 80%. We aimed to identify the prevalence of sleep problems on children with ASD in Indonesia and Japan.

METHODS

A cross-sectional study was conducted in Surabaya, Indonesia and Kobe, Japan. Children aged 4 -10 years old were enrolled using stratified cluster sampling. Children's Sleep Habits Questionnaire-Abbreviated (CSHQ-A) was used in this research to assess the sleep problems, consisted of 22 questions (NICHD SECCYD-Wisconsin). Data were analyzed with Mann-Whitney U test to compare the CSHQ-A scores between Indonesian and Japanese children, while the proportion of sleep problems was evaluated by chi-square test with 95% confidence interval.

RESULTS

Fifty children with ASD were included in this study, 25 children from Kobe, Japan and 25 children from Surabaya, Indonesia. The prevalence of sleep problems on children with ASD was 60% (15 children) in Indonesia and 16% (4 children) in Japan respectively. There were significant differences in total waking during the night and in morning wake for the CSHQ-A between children from Indonesia and Japan (p<0.005).

CONCLUSIONS

The prevalence of sleep problems on children with ASD was higher in children from Indonesia than from Japan.

Objectively Measured Physical Activity and Health-Related Physical Fitness in Secondary School-Aged Male Students With Autism Spectrum Disorders

BACKGROUND

Recent evidence suggests that childhood obesity is increasing in children with typical development (TD) and in children with autism spectrum disorders (ASD). The associations between physical activity (PA) levels and physical fitness components have not yet been objectively examined in this population but may have clinical implications for the development of secondary health complications.

OBJECTIVE

The aims of this study were: (1) to compare PA and physical fitness between secondary school-aged male students with ASD and their peers with TD and (2) to assess possible interrelationships between PA and physical fitness levels in each group.

DESIGN

This was a cross-sectional study.

METHODS

Physical activity was recorded every 10 seconds by using accelerometry in 70 male students with (n=35) and without (n=35) ASD for up to 5 weekdays and 2 weekend days. The Brockport Physical Fitness Test was used to assess physical fitness.

RESULTS

The primary findings were: (1) participants with ASD were less physically active overall and engaged in moderate-to-vigorous PA for a lower percentage of time compared with participants with TD during weekdays; (2) participants with ASD had significantly lower scores on all physical fitness measures, except body composition; and (3) group-dependent relationships existed between physical fitness profiles and PA levels.

LIMITATIONS

The study design limits causal inference from the results.

CONCLUSION

Specific interventions for maximizing PA and physical fitness levels in secondary school-aged male students with ASD are urgently needed.

Secular trend of sex ratio and symptom patterns among children with autism spectrum disorders

An information technology invention embodied in a website serving the interests of the autism community was designed to "let the data talk." By its use, the authors have detected a downward temporal trend in 2013 in the sex ratio of 2431 members of Autism360.org from a yearly average between 2010 and 2012 of 4.24 to 3.01 in 2013. As of the first two months of 2014, the average sex ratio is 2.69. We report contemporaneous changes in previously reported male vs female symptom patterns. Such changes suggest a convergence in which distinctive severity of certain grouped central nervous, emotional, and immune profile items in females have diminished toward that of males. The data also show correlations among these profile items that add further credence to the sex ratio findings. A wider dispersion of the female data as compared with the male data was found in the year preceding the downward trend in the mean sex ratio. The authors suggest that such a trend toward an increase in the variance of the data points to instability in the biological system-the autism spectrum. We conclude that public policy would be better served by monitoring changes in the standard deviation as compared with the mean in large data sets to better anticipate changes. The findings we report raise questions based on known sex differences in detoxification chemistry. One such question would be whether maternal, fetal, or individual exposure to a novel environmental factor may have breached the taller fence of female protection from toxins.

Learning about Autism

A medical essay written in 1923 pointed out the fallacy of blaming a chronic illness on the name of a disease. The focus of treatment should be the individual, not the disease. With a focus on options based on the individuality of each patient, I ask a simple two-part question: Does my patient need to avoid or be rid of substances and/or to be provided with substances that would favor nature's impulse toward healing?

In my academic training as a physician, I learned that a clinically effective stance favored an optimistic intent combined with the objective application of my skills—refined though the practice of listening, prescribing, and observing outcome. My understanding of autism has rested on a foundation of the individuality of every living thing, the rhythmicity of life, and the balance that characterizes healthy systems. The first autistic child I examined struck me with a nonverbal message: “I am in here; see me.”

The recognition of the role of bacterial toxins amplified my notion that a general disorder of the microbiome underlies the loss of immune tolerance that accompanies the global state of sensitivity found in individuals in the autism spectrum. Depletion of organisms that have populated the human gut since before the dawn of our species arises as the most recent elevation of my learning curve.