Multimodal Physiotherapy Approach for Autism With Speech Impairment and Attention Deficit: A Case Report

Autism is a disorder distinguished by significant challenges in social interaction and communication coupled with repetitive and stereotypical patterns of behavior and activities. Deficits in social interaction and language development become apparent before age three. In children, this condition is referred to as autism spectrum disorder (ASD). Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. Individuals with ADHD may struggle with sustaining attention, organizing tasks, and completing assignments. They may exhibit hyperactive behaviors such as fidgeting, difficulty staying seated, and impulsive actions like interrupting others. ADHD can significantly impact daily functioning and is often diagnosed in childhood, with symptoms potentially persisting into adulthood. The disorder has three main subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined presentation. Treatment typically involves a combination of behavioral interventions, psychoeducation, and, in some cases, medication, aiming to provide support and strategies for individuals to manage their symptoms effectively in various aspects of life. Cognitive impairment in ASD varies, meaning it could be at the sensory perception level of cognitive processing, learning, and memory. The goal of the training intervention was to control physiological arousal, enhance awareness, keep annoyance from getting worse, and encourage self-regulation abilities. In this case report, we discuss the approach of multimodal physiotherapy for autism with speech impairment and attention deficit. Furthermore, physiotherapy needs to find a position in the new mental health care paradigm in order to contribute to mental health care.

Saliva based diagnostic methodologies for a fast track detection of autism spectrum disorder: A mini-review

Autism spectrum disorder (ASD) is considered a complicated neurodevelopment disorder with rising prevalence globally. ASD is characterized by a series of events including varying degrees of defects in communication, learning, and social interaction which is accompanied by stereotypical behavioral patterns. Despite extensive research, the current diagnosis for ASD is complex and almost solely based on the behavioral assessments of the suspected individuals. The multifactorial etiopathology of this disease along with the diversity of symptoms among different individuals adds to the current intricacies for accurate prognosis of ASD. Hence, there exists a dire need for biologically relevant biomarkers for an early diagnosis and for tracking the efficacy of therapeutic interventions. Until recently, among various biofluids, saliva has gained increasing interest for biomarker identification, the advantages include the non-invasive nature and ease of sample handling. This mini-review aims to provide a succinct summary of recent literature on saliva-based diagnostic modalities for ASD, examine various studies that highlight the potential use of proteomic and/or RNA-based biomarkers. Finally, some conclusive perspectives of using the salivary system for ASD mechanistic details and diagnosis are also discussed.

Node Centrality Measures Identify Relevant Structural MRI Features of Subjects with Autism

Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions characterized by impairments in social interaction and communication and restricted patterns of behavior, interests, and activities. Although the etiopathogenesis of idiopathic ASD has not been fully elucidated, compelling evidence suggests an interaction between genetic liability and environmental factors in producing early alterations of structural and functional brain development that are detectable by magnetic resonance imaging (MRI) at the group level. This work shows the results of a network-based approach to characterize not only variations in the values of the extracted features but also in their mutual relationships that might reflect underlying brain structural differences between autistic subjects and healthy controls. We applied a network-based analysis on sMRI data from the Autism Brain Imaging Data Exchange I (ABIDE-I) database, containing 419 features extracted with FreeSurfer software. Two networks were generated: one from subjects with autistic disorder (AUT) (DSM-IV-TR), and one from typically developing controls (TD), adopting a subsampling strategy to overcome class imbalance (235 AUT, 418 TD). We compared the distribution of several node centrality measures and observed significant inter-class differences in averaged centralities. Moreover, a single-node analysis allowed us to identify the most relevant features that distinguished the groups.

Trajectories in Symptoms of Autism and Cognitive Ability in Autism From Childhood to Adult Life: Findings From a Longitudinal Epidemiological Cohort

OBJECTIVE

For the first time, we use a longitudinal population-based autism cohort to chart the trajectories of cognition and autism symptoms from childhood to early adulthood and identify features that predict the level of function and change with development.

METHOD

Latent growth curve models were fitted to data from the Special Needs and Autism Project cohort at three time points: 12, 16, and 23 years. Outcome measures were IQ and parent-reported Social Responsiveness Scale autism symptoms. Of the 158 participants with an autism spectrum disorder at 12 years, 126 (80%) were reassessed at 23 years. Child, family, and contextual characteristics obtained at 12 years predicted intercept and slope of the trajectories.

RESULTS

Both trajectories showed considerable variability. IQ increased significantly by a mean of 7.48 points from 12 to 23 years, whereas autism symptoms remained unchanged. In multivariate analysis, full-scale IQ was predicted by initial language level and school type (mainstream/specialist). Participants with a history of early language regression showed significantly greater IQ gains. Autism symptoms were predicted by Social Communication Questionnaire scores (lifetime version) and emotional and behavioral problems. Participants attending mainstream schools showed significantly fewer autism disorder symptoms at 23 years than those in specialist settings; this finding was robust to propensity score analysis for confounding.

CONCLUSION

Our findings suggest continued cognitive increments for many people with autism across the adolescent period, but a lack of improvement in autism symptoms. Our finding of school influences on autism symptoms requires replication in other cohorts and settings before drawing any implications for mechanisms or policy.

Animal-Assisted Activity for Children with Autism Spectrum Disorder: Parents' and Therapists' Perception

Autism spectrum disorder (ASD), characterized by communication and social interaction difficulties, might be positively influenced by animal-assisted activity (AAA). The aim of this study was to investigate the parents' and therapists' perception to behavior in children with ASD after they underwent AAA. The study was performed in a specialized therapeutic center in Curitiba, South of Brazil. A total of 15 children (14 boys and 1 girl), aged 5.6 ± 1.6 years, diagnosed with ASD, underwent at least 10 weekly 30-min AAA sessions. Three trained dogs were used in total, and there were two dogs in each session. Children were free to interact with dogs and among themselves, in groups of 11.2 ± 2.2 children per session, in the presence of therapists, the researcher, and a veterinarian observing the dogs and ensuring safety. The parents and therapists completed two questionnaires on their perception of the children's behavior before and after AAA. A total of 18 visits were necessary to complete the 10 sessions for each of the 15 children. According to the therapists' perception, AAA increased positive gestures and facial expression in children (p = 0.010) and improved peer interaction. Even though there was a 50% reduction in the parents' feedback at the end of the study, according to their perception there was a reduction in self-aggression and repetitive stereotyped movements, as well as an improvement in speech communication and creativity. This study demonstrated the positive effects of the AAA on the social behavior of children with ASD.

Is visuomotor training an effective intervention for children with autism spectrum disorders?

PURPOSE

Investigation of autism spectrum disorder (ASD) is somewhat dependent on addressing main core features of ASD. But it is not clear which kind of investigation can effect on more difficulties features. So, this study examines the effect of the visuomotor, motor, and computer-based training programs on social behavior, motor skills, and repetitive behaviors of children with ASD.

PATIENTS AND METHODS

Sixty children with ASD aged 6-12 years were recruited and assigned to one of the three experimental groups and the control group (each group n=15). Training was provided in 30 sessions, scheduled 3 times a week. Social behavior and repetitive behaviors were determined objectively using the observation method, and motor skills were evaluated by the Test of Gross Motor Development-2.

RESULTS

Our results suggested that children in the visuomotor group showed a significant reduction in the repetitive behaviors and an increase in gross motor skill scores in the post-test and follow-up. Also, the results exhibited that motor training group significantly improved in social behavior either in the post-test or follow-up. Although the post-test illustrated a considerable improvement of gross motor skills, this difference was not significant in follow-up. Similarly, no significant change was observed in visual training and control groups in relation to study variables.

CONCLUSION

Given the improvement of repetitive behaviors and gross motor skills in post-test and follow-up, it seems that this investigation had a positive effect with a good retention effect on two core features of children with ASD. But according to group-based training protocol in motor training group and improvement in social communication, and mutual effect on gross motor skills, it seems that group-based practice can also be used to achieve the benefits of social communication in the investigations.