BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an e...BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an equally ample effort to employ clinical studies for studying the ASD causes and cell therapies.Stem cells have yielded so far mixed results in clinical trials,and at patient level the results varied from impressive to no improvement.In this context we have administered autologous cord blood(ACB)and a non-placebo,material intervention repre-sented by an individualized combination of supplements(ICS)to ASD children.METHODS CORDUS clinical study is a crossover study in which both oral ICS and intravenous ACB were sequentially administered to 56 children;ACB was infused as an inpatient procedure.Treatment efficacy was evaluated pre-treatment and post-treatment at 6 months by an independent psychotherapist with Autism Treatment Evaluation Checklist,Quantitative Checklist for Autism in Toddlers and a 16-item comparative table score,after interviewing the children’s parents and therapists.Before and after each intervention participants had a set of blood tests including inflammatory,metabolic and oxidative markers,and the neuronal specific enolase.RESULTS No serious adverse reactions were noted during and after cord blood or supplement administration.ACB improved evaluation scores in 78%of children with age 3–7-years(n=28),but was much less effective in kids older than 8 years or with body weight of more than 35 kg(n=28;only 11%of children improved scores).ICS yielded better results than ACB in 5 cases out of 28,while in 23 kids ACB brought more improvement than ICS(P<0.05);high initial levels of inflammation and ferritin were associated with no improvement.Ample individual differences were noted in children's progress,and statistically significant improvements were seen after ACB on areas such as verbalization and social interaction,but not on irritability or aggressive behavior.CONCLUSION ACB has superior efficacy to ICS in ASD;high inflammation,ferritin,age and body weight predict less improvement;more clinical studies are needed for studying ACB efficacy in ASD.展开更多
Objectives:To investigate the parenting stress,care burden,and coping styles in mothers of autistic children during the pandemic of COVID-19.The outbreak of COVID-19 and the closure of education and care centers for t...Objectives:To investigate the parenting stress,care burden,and coping styles in mothers of autistic children during the pandemic of COVID-19.The outbreak of COVID-19 and the closure of education and care centers for these children may affect stress,care burden,and adaptation of these mothers.Methods:This study was a cross-sectional research.A total of 110 mothers completed questionnaires.Data were analyzed by descriptive statistics(frequency,percentage,mean,and standard deviation),independent t-test,ANOVA,and multiple linear regressions.Results:Findings showed that parenting stress has a strong and direct correlation with caring burden(P<0.001,r=0.95),and a strong and indirect correlation with coping styles(P<0.001,r=−0.91).Variables of caring burden,coping strategies,mother’s age,mother’s job,mother’s education,number of autistic children,economic status,children’s age,and functional level of autism in children can predict 72.21%of the variance in parenting stress in these mothers.Conclusions:In the present study,parenting stress of mothers of autistic children was reported to be high during the COVID-19 pandemic.Based on the findings of this study,it can be concluded that pediatric nurses and health policymakers should provide a suitable educational and supportive environment for mothers of autistic children to enhance the coping level of these mothers and consequently reduce their parenting stress and care burden.展开更多
Children with autism spectrum disorder(ASD)often encounter difficulties in language learning and utilization,a concern that has gained significant academic attention,particularly given the widespread occurrence of ASD...Children with autism spectrum disorder(ASD)often encounter difficulties in language learning and utilization,a concern that has gained significant academic attention,particularly given the widespread occurrence of ASD globally.Previous reviews,however,have relied on empirical observations rather than a more rigorous selection criterion.This preliminary study seeks to systematize the scientific knowledge base regarding language development in autistic children by utilizing the analysis tool Citespace 6.2.R5.We visualized and analyzed research patterns and trends regarding autism by drawing data from the Web of Science.Through document citation and emerging trend analyses,seven key research clusters and their chronological associations are identified,along with research hotspots such as language disorder diagnosis and intervention,social communication,language acquisition,and multilingual and multicultural influences.Research findings show that there exist some issues with the current research,including small sample sizes,the need for further investigation into receptive language development,and a lack of cross-cultural comparative studies.Meanwhile,the scope and depth of interdisciplinary research on language development in autistic children also need to be further enhanced.The research contributes to the extant literature by providing valuable references for autism researchers and practitioners.展开更多
Introduction:Auditory symptoms in individuals with Autistic Spectrum Disorder(ASD)are well described within the neurodevelopmental literature,yet there is minimal mention of ASD in Otolaryngology literature.This is su...Introduction:Auditory symptoms in individuals with Autistic Spectrum Disorder(ASD)are well described within the neurodevelopmental literature,yet there is minimal mention of ASD in Otolaryngology literature.This is surprising considering the potential clinical and diagnostic implications of this link,and the potential for ASD to present to Otolaryngologists in the form of unexplained auditory symptoms.The aims of this literature review were to explore the intersection of auditory symptoms and ASD from the perspective of clinical Otolaryngology,and to outline a clinically focused research agenda based on emerging themes relevant to Otolaryngology.Methods:We searched Pubmed,Embase,Ovid and Cochrane library for studies until November 2021.Four authors independently reviewed 227 publications identified.39 were filtered into the final analysis.The PRISMA 2020 guidelines were followed.The heterogeneity of literature meant that a Systematic Review was not feasible.Included studies were therefore classified thematically,forming the basis of the scoping review.Results:Diagnostic theories for auditory symptoms in ASD include the entire auditory pathway and brain.There is a growing body of literature on auditory symptoms in ASD,suggesting that a primary diagnosis of ASD should be considered in patients presenting with otherwise unexplained auditory symptoms,and indicating a learning need for Otolaryngologists and audiologists,to whom these patients may present.Conclusion:We recommend a research agenda focusing on multidisciplinary collaboration,stakeholder engagement,responsible clinical screening,and clarification of pathophysiological mechanisms and terminology.展开更多
Meeting Summary Autism is a neurodevelopmental disorder defined by the of a set of characteristic behavioral features. One of the most common neurodevelopmental disorders, autism is recognized as heterogeneous in etio...Meeting Summary Autism is a neurodevelopmental disorder defined by the of a set of characteristic behavioral features. One of the most common neurodevelopmental disorders, autism is recognized as heterogeneous in etiology, phenotype, behavioral trajectory and response to treatment. While the etiology and specific pathogenetic mechanisms underlying autism are unknown, those mechanisms which underlie a small subset of etiologically-defined neurodevelopmental disorders （e.g., Fragile X Syndrome, tuberous sclerosis）, that are associated with autism and autistic behaviors, have been well described.展开更多
Studies on the evaluation by therapists of parental behavior towards their children with Autistic Spectrum Disorder(ASD)and towards the therapists of their children are scarce.They are necessary,however,for enabling p...Studies on the evaluation by therapists of parental behavior towards their children with Autistic Spectrum Disorder(ASD)and towards the therapists of their children are scarce.They are necessary,however,for enabling parents to become co-therapists.The present study’s purpose was the evaluation by therapists of the behavior of parents towards their children,of their relationship to therapists,and therapy outcome.The sample consisted of 178 parents of 89 children(72 boys)with ASD,who underwent intensive early intervention at a day centre for developmental disabilities.The professional team completed a questionnaire,separately for the mother and father,evaluating the parental attitude towards their children and towards the therapists.The behavior of parents was less satisfactory than expected.The fathers had difficulties in understanding their child’s problems,and had unrealistic expectations;mothers’behavior towards their children and therapists was better than the fathers’.Mothers had difficulty mostly in the management of the child’s behavior,and did not do well with feeding.It might be difficult for every parent to become co-therapist.Understanding the child’s difficulties by the mother,adequate handling of feeding and homework,were statistically significant in the good outcome of therapy.展开更多
To examine the difference between early-onset (< age 3) childhood disintegrative disorder (CDD) and autistic disorder with speech loss (ADSL), 8 children with early-onset CDD (mean age = 7.6 years, SD = 3.8;6 males...To examine the difference between early-onset (< age 3) childhood disintegrative disorder (CDD) and autistic disorder with speech loss (ADSL), 8 children with early-onset CDD (mean age = 7.6 years, SD = 3.8;6 males) were compared with 92 age and gender-ratio comparable children with ADSL (mean age = 6.8 years, SD = 4.1;70 males) on 24 variables not directly related to the key features of CDD (regression after normal development for at least the first 2 years after birth). Compared with the ADSL group, the early-onset CDD group had a tendency to have a higher rate of a psychosocial event before speech loss (SL) (early-onset CDD, 75.0% vs ADSL, 37.0%, p = 0.057;effect size (phi) = 0.211, p < 0.05);a significantly higher rate of fearfulness during SL (62.5% vs 4.3%, p = 0.000;phi = 0.551, p < 0.05);and a tendency to have a higher rate of epilepsy (25.0% vs 3.3%, p = 0.050;phi = 0.271, p < 0.05), a tendency to have a lower rate of the Childhood Autism Rating Scale-Tokyo Version (CARS-TV) total score ≥ 30 (75.0% vs 95.7%, p = 0.072;phi = 0.236, p < 0.05), and a significantly lower rate of CARS-TV item 2 (imitation) score ≥ 2 (50.0% vs 82.6%, p = 0.049;phi = 0.221, p < 0.05) on the first visit. The two groups did not exhibit any significant difference in the other 19 variables. The findings of no significant difference in the great majority and a significant difference in the small minority of the 24 variables between the two groups support integrating CDD into regressive autism spectrum disorder and studying CDD as its prototypical form.展开更多
Objective:To study the effect of family follow-up nursing in rehabilitation of elderly autistic patients in community institutions.Methods:120 elderly autistic patients from February 2021 to July 2022 were randomly di...Objective:To study the effect of family follow-up nursing in rehabilitation of elderly autistic patients in community institutions.Methods:120 elderly autistic patients from February 2021 to July 2022 were randomly divided into a control group and a test group with 60 cases each.The patients in the control group were cared for at home by their family members,while the patients in the test group were given family follow-up rehabilitation care on the basis of the control group.The compliance of patients in the rehabilitation process,the UCLA loneliness score,the autism treatment assessment scale(ATEC)score of patients after this nursing care,and the quality-of-life scores of patients of the two groups before and after nursing care were compared.Results:The compliance of patients in the process of rehabilitation treatment was better in the experimental group than in the experimental group.The physical function score of patients after nursing was better in the experimental group than in the experimental group.The UCLA loneliness score and ATEC score of patients in the experimental group after nursing were lower than those of the control group(P<0.05);the quality-of-life score was higher in the experimental group(P<0.05).Conclusion:The application of family follow-up nursing in the rehabilitation of elderly autistic patients in community institutions can significantly improve patients’compliance and improve their prognosis,thus having high clinical value.展开更多
Objective: to analyze and explore the relationship between family rearing environment and autistic characteristics of children, so as to improve the present situation of autistic characteristics of children. Methods: ...Objective: to analyze and explore the relationship between family rearing environment and autistic characteristics of children, so as to improve the present situation of autistic characteristics of children. Methods: From July 2019 to July 2020, 8 kindergartens were randomly selected from the kindergartens in our district. 1600 children were selected as the subjects of this experimental study, except for the children with mental diseases. All the children were investigated by using Chinese Creutzfeldt-Jakob Autism Screening Scale and Family Parenting Environment Scale. Record and analyze the final results. Results: a total of 1,500 questionnaires were collected in this study, with a recovery rate of 93.75%. 132 children were found to be autistic children, with a detection rate of 8.8%. There was a significant difference in patient data between male and female (P<0.05). In addition, the data of children with loneliness were significantly lower than those without loneliness, the difference was significant and had statistical significance (P<0.05). Conclusion: the analysis of the relationship between family rearing environment and autistic characteristics of children shows that male, history of separation, poor social adaptability (or self-care ability), frequent punishment (or neglect) and environmental atmosphere are all important influencing factors. Therefore, improvement must be made from these aspects.展开更多
Attention deficit disorder is a frequently observed symptom in individuals with autism spectrum disorder(ASD).This condition can present significant obstacles for those affected,manifesting in challenges such as susta...Attention deficit disorder is a frequently observed symptom in individuals with autism spectrum disorder(ASD).This condition can present significant obstacles for those affected,manifesting in challenges such as sustained focus,task completion,and the management of distractions.These issues can impede learning,social interactions,and daily functioning.This complexity of symptoms underscores the need for tailored approaches in both educational and therapeutic settings to support individuals with ASD effectively.In this study,we have expanded upon our initial virtual reality(VR)prototype,originally created for attention therapy,to conduct a detailed statistical analysis.Our objective was to precisely identify and measure any significant differences in attention-related outcomes between sessions and groups.Our study found that heart rate(HR)and electrodermal activity(EDA)were more responsive to attention shifts than temperature.The‘Noise’and‘Score’strategies significantly affected eye openness,with the ASD group showing more responsiveness.The control group had smaller pupil sizes,and the ASD group’s pupil size increased notably when switching strategies in Session 1.Distraction log data showed that both‘Noise’and‘Object Opacity’strategies influenced attention patterns,with the‘Red Vignette’strategy showing a significant effect only in the ASD group.The responsiveness of HR and EDA to attention shifts and the changes in pupil size could serve as valuable physiological markers to monitor and guide these interventions.These findings further support evidence that VR has positive implications for helping those with ASD,allowing for more tailored personalized interventions with meaningful impact.展开更多
BACKGROUND Autism spectrum disorders(ASD)represent a substantial social problem affecting at least 1 in 100 children worldwide.These conditions are very often accompanied by intellectual disability(ID)and speech delay...BACKGROUND Autism spectrum disorders(ASD)represent a substantial social problem affecting at least 1 in 100 children worldwide.These conditions are very often accompanied by intellectual disability(ID)and speech delay;thus,they can be considered within a clinical continuum of neurodevelopmental disorders.Given the high heterogeneity of ASD,the subjective nature of diagnostic criteria,and the presence of phenocopies,identifying genetic determinants of these disorders remains a challenge.AIM To investigate the spectrum and frequency of rare genetic variants in genes with proven association with ASD in Russian children.METHODS 110 patients from 106 families were recruited into the study mean age at diagnosis 6 years;boy-to-girl ratio 3:1.Most of the patients(84%)demonstrated a combination of ASD with developmental delay(DD)or ID.Patients with syndromic features were subjected to the chromosomal microarray analysis.The remained children underwent clinical exome sequencing aimed at identifying presumably monogenic causes of ASD.The study focused on rare(minor allele frequency≤0.001)variants affecting high-confidence ASD-associated genes.RESULTS Pathogenic copy number variations were detected in three(7%)of the patients examined.Clinical exome sequencing revealed pathogenic/likely pathogenic variants in 12 of 105 cases(11%),indicating the presence of monogenic syndromes with established clinical significance(Pitt-Hopkins syndrome,ZTTK syndrome,syndromic X-linked ID of Billuart type,Snijders-Blok-Campeau,Helsmoortel-van der Aa,Coffin-Siris,Clark-Baraitser,Keefstra syndromes,etc.).In addition,27 patients(26%)had 37 rare variants of unknown clinical significance in DSCAM,SHANK2,AUTS2,ADNP,ANKRD11,APBA2,ARID1B,ASTN2,ATRX,SCN1A,CHD2,DEAF1,EHMT1,GRIN2B,NBEA,NR4A2,TRIO,TRIP12,POGZ,EP300,FOXP1,PCDH19,GRIN2A,NCKAP1,and CHD8 genes.No specific variant was detected more than once in unrelated patients.Among the genes with rare variants found in 2 or more patients were TRIP12(n=4),AUTS2(n=3),ARID1B(n=3),PCDH19(n=3),EP300(n=3),TRIO(n=2),ASTN2(n=2),EHMT1(n=2),and CHD2(n=2).Of note,5 male ASD/DD patients from 3 unrelated families had PCDH19 missense variants,confirming that at least some hemizygous males with non-mosaic PCDH19 variants may present with neurobehavioral abnormalities.These variants did not cause epilepsy restricted to females in patients’mothers or sisters.CONCLUSION These data confirm a tremendous diversity of genetic causes of ASD.Clinical exome sequencing may serve as a reasonable alternative to whole-exome sequencing.展开更多
We examined parenting stress and mental health status in parents of autistic children and assessed factors associated with such stress. Participants were parents of 188 autistic children diagnosed with DSM-IV criteria...We examined parenting stress and mental health status in parents of autistic children and assessed factors associated with such stress. Participants were parents of 188 autistic children diagnosed with DSM-IV criteria and parents of 144 normally developing children. Parents of autistic children reported higher levels of stress, depression, and anxiety than parents of normally developing children. Mothers of autistic children had a higher risk of depression and anxiety than that did parents of normally developing children. Mothers compared to fathers of autistic children were more vulnerable to depression. Age, behavior problems of autistic children, and mothers' anxiety were significantly associated with parenting stress.展开更多
Introduction Currently,interventions for children with autism spectrum disorders(ASD)in China are mainly carried out by professionals in rehabilitation institutions and special schools.However,when autistic children a...Introduction Currently,interventions for children with autism spectrum disorders(ASD)in China are mainly carried out by professionals in rehabilitation institutions and special schools.However,when autistic children are older,they do not receive effective training and treatment,and there is no specific place in society to accommodate autistic adults.Mental hospitals are usually their ultimate home.Case presentation We report a 22‐year‐old male with ASD.The manifestation and/or intervention from the age of 3 years to now were recorded.He has been hospitalized in the closed ward of a mental hospital since 2015.Conclusion This report typically present the current problems in treatment and training of autistic children growing up in China.Life‐long rehabilitation training is important for every patient with ASD.Relevant policies and resources in China should be optimized in terms of medical treatment and health care,education and training,social assistance,social security,labor employment,and social culture.展开更多
The objective was to investigate the effects of volatile components in Jiawei Wendan prescription on autistic behavior in rats,to analyze the volatile constituents and then to explore its effective components based on...The objective was to investigate the effects of volatile components in Jiawei Wendan prescription on autistic behavior in rats,to analyze the volatile constituents and then to explore its effective components based on the treatment of autism.The pregnant mice were divided into two groups according to the method that Schneider used.展开更多
Amother considers her child to be a continuation of her own life, and places her own desires that she cannot achieve on her child. A child is a mother’s sun, a mother’s hope. In this world, however, there exists ano...Amother considers her child to be a continuation of her own life, and places her own desires that she cannot achieve on her child. A child is a mother’s sun, a mother’s hope. In this world, however, there exists another group of mothers whose children have autism. These children act as if they are completely alone, do not interact with others, and even refuse the love展开更多
Autistic spectrum disorder(ASD)is a male-biased,heterogeneous neurodevelopmental disorder that affects approximately 1%e2%of the population.Prenatal exposure to valproic acid(VPA)is a recognized risk factor for ASD,bu...Autistic spectrum disorder(ASD)is a male-biased,heterogeneous neurodevelopmental disorder that affects approximately 1%e2%of the population.Prenatal exposure to valproic acid(VPA)is a recognized risk factor for ASD,but the cellular and molecular basis of VPA-induced ASD at the single-cell resolution is unclear.Here,we aim to compare the cellular and molecular differences in the hippocampus between male and female prenatal mice with ASD at the single-cell transcriptomic level.The transcriptomes of more than 45,000 cells are assigned to 12 major cell types,including neurons,glial cells,vascular cells,and immune cells.Cell type-specific genes with altered expression after prenatal VPA exposure are analyzed,and the largest number of differentially expressed genes(DEGs)are found in neurons,choroid plexus epithelial cells,and microglia.In microglia,several pathways related to inflammation are found in both males and females,including the tumor necrosis factor(TNF),nuclear factor kappa B(NF-kB),toll-like receptor(TLR),and mitogen-activated protein kinase(MAPK)signaling pathways,which are important for the induction of autistic-like behavior.Additionally,we note that several X-linked genes,including Bex1,Bex3,and Gria3,were among the male-specific DEGs of neurons.This pioneering study describes the landscape of the transcriptome in the hippocampus of autistic mice.The elucidation of sexual differences could provide innovative strategies for the prevention and treatment of ASD.展开更多
In recent years evidence has emerged suggesting that Mini-basketball training program(MBTP)can be an effec-tive intervention method to improve social communication(SC)impairments and restricted and repetitive beha-vio...In recent years evidence has emerged suggesting that Mini-basketball training program(MBTP)can be an effec-tive intervention method to improve social communication(SC)impairments and restricted and repetitive beha-viors(RRBs)in preschool children suffering from autism spectrum disorder(ASD).However,there is a considerable degree if interindividual variability concerning these social outcomes and thus not all preschool chil-dren with ASD profit from a MBTP intervention to the same extent.In order to make more accurate predictions which preschool children with ASD can benefit from an MBTP intervention or which preschool children with ASD need additional interventions to achieve behavioral improvements,further research is required.This study aimed to investigate which individual factors of preschool children with ASD can predict MBTP intervention out-comes concerning SC impairments and RRBs.Then,test the performance of machine learning models in predict-ing intervention outcomes based on these factors.Participants were 26 preschool children with ASD who enrolled in a quasi-experiment and received MBTP intervention.Baseline demographic variables(e.g.,age,body,mass index[BMI]),indicators of physicalfitness(e.g.,handgrip strength,balance performance),performance in execu-tive function,severity of ASD symptoms,level of SC impairments,and severity of RRBs were obtained to predict treatment outcomes after MBTP intervention.Machine learning models were established based on support vector machine algorithm were implemented.For comparison,we also employed multiple linear regression models in statistics.Ourfindings suggest that in preschool children with ASD symptomatic severity(r=0.712,p<0.001)and baseline SC impairments(r=0.713,p<0.001)are predictors for intervention outcomes of SC impair-ments.Furthermore,BMI(r=-0.430,p=0.028),symptomatic severity(r=0.656,p<0.001),baseline SC impair-ments(r=0.504,p=0.009)and baseline RRBs(r=0.647,p<0.001)can predict intervention outcomes of RRBs.Statistical models predicted 59.6%of variance in post-treatment SC impairments(MSE=0.455,RMSE=0.675,R2=0.596)and 58.9%of variance in post-treatment RRBs(MSE=0.464,RMSE=0.681,R2=0.589).Machine learning models predicted 83%of variance in post-treatment SC impairments(MSE=0.188,RMSE=0.434,R2=0.83)and 85.9%of variance in post-treatment RRBs(MSE=0.051,RMSE=0.226,R2=0.859),which were better than statistical models.Ourfindings suggest that baseline characteristics such as symptomatic severity of 144 IJMHP,2022,vol.24,no.2 ASD symptoms and SC impairments are important predictors determining MBTP intervention-induced improvements concerning SC impairments and RBBs.Furthermore,the current study revealed that machine learning models can successfully be applied to predict the MBTP intervention-related outcomes in preschool chil-dren with ASD,and performed better than statistical models.Ourfindings can help to inform which preschool children with ASD are most likely to benefit from an MBTP intervention,and they might provide a reference for the development of personalized intervention programs for preschool children with ASD.展开更多
Therapeutic horseback riding(THR)as an animal-assisted intervention is one of the innovative approaches emer-ging in the treatment for children with autism spectrum disorder(ASD).The current study was designed to inve...Therapeutic horseback riding(THR)as an animal-assisted intervention is one of the innovative approaches emer-ging in the treatment for children with autism spectrum disorder(ASD).The current study was designed to inves-tigate the effects of a 12-week,twice a week THR program on motor skills in sixty-eight children with ASD aged 5–10 years old.All participants selected met the DSM-V criteria for ASD,and a total offifty-three participants completed the study.A randomized controlled trial design was utilized for the study.Data was collected via a pre-THR test,interim-THR test,and post-THR test to investigate the possible changes in motor skills throughout the 12-week THR program.Results showed that the THR program significantly improved overall motor skills across time points(p<0.05)and sub-skills of run,gallop and two-hand catch(as compared to the control group,p<0.05).In conclusion,the THR program may be an effective option for improving motor skills in children with ASD and further investigation with a longer period of intervention is warranted.展开更多
BACKGROUND Empathy has long been considered a multidimensional construct,encompassing cognitive,affective and behavioral domains.Deficits in empathic competences in early childhood contribute to psychopathology,and ha...BACKGROUND Empathy has long been considered a multidimensional construct,encompassing cognitive,affective and behavioral domains.Deficits in empathic competences in early childhood contribute to psychopathology,and have been variably implicated in several clinical conditions,such as autism spectrum disorders(ASD)and conduct disorders.AIM To identify and describe empirically validated questionnaires assessing empathy in children and adolescents and to provide a summary of related theoretical perspectives on empathy definitional issues.METHODS A systematic review of the literature was conducted.Three bibliographic databases were searched.A total of 47 studies were selected for final analysis and 16 distinct measures were identified and described.RESULTS Questionable to excellent levels of internal consistency were observed,while few studies assessed test-retest reliability.Although construct definitions only partially overlapped,affective and cognitive domains of empathy were the commonest internal factors that were often separately evaluated.New facets of the construct(i.e.,somatic empathy and sympathy)and specific clinical populations(i.e.,ASD)could be specifically addressed through more recent instruments.CONCLUSION The combination of different assessment methods is recommended in order to foresee further improvements in this field and try to overcome the problem of limited convergence with more objective measures.展开更多
文摘BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an equally ample effort to employ clinical studies for studying the ASD causes and cell therapies.Stem cells have yielded so far mixed results in clinical trials,and at patient level the results varied from impressive to no improvement.In this context we have administered autologous cord blood(ACB)and a non-placebo,material intervention repre-sented by an individualized combination of supplements(ICS)to ASD children.METHODS CORDUS clinical study is a crossover study in which both oral ICS and intravenous ACB were sequentially administered to 56 children;ACB was infused as an inpatient procedure.Treatment efficacy was evaluated pre-treatment and post-treatment at 6 months by an independent psychotherapist with Autism Treatment Evaluation Checklist,Quantitative Checklist for Autism in Toddlers and a 16-item comparative table score,after interviewing the children’s parents and therapists.Before and after each intervention participants had a set of blood tests including inflammatory,metabolic and oxidative markers,and the neuronal specific enolase.RESULTS No serious adverse reactions were noted during and after cord blood or supplement administration.ACB improved evaluation scores in 78%of children with age 3–7-years(n=28),but was much less effective in kids older than 8 years or with body weight of more than 35 kg(n=28;only 11%of children improved scores).ICS yielded better results than ACB in 5 cases out of 28,while in 23 kids ACB brought more improvement than ICS(P<0.05);high initial levels of inflammation and ferritin were associated with no improvement.Ample individual differences were noted in children's progress,and statistically significant improvements were seen after ACB on areas such as verbalization and social interaction,but not on irritability or aggressive behavior.CONCLUSION ACB has superior efficacy to ICS in ASD;high inflammation,ferritin,age and body weight predict less improvement;more clinical studies are needed for studying ACB efficacy in ASD.
基金supported by Hamadan University of Medical Sciences supported financially this research(No.140005123994).
文摘Objectives:To investigate the parenting stress,care burden,and coping styles in mothers of autistic children during the pandemic of COVID-19.The outbreak of COVID-19 and the closure of education and care centers for these children may affect stress,care burden,and adaptation of these mothers.Methods:This study was a cross-sectional research.A total of 110 mothers completed questionnaires.Data were analyzed by descriptive statistics(frequency,percentage,mean,and standard deviation),independent t-test,ANOVA,and multiple linear regressions.Results:Findings showed that parenting stress has a strong and direct correlation with caring burden(P<0.001,r=0.95),and a strong and indirect correlation with coping styles(P<0.001,r=−0.91).Variables of caring burden,coping strategies,mother’s age,mother’s job,mother’s education,number of autistic children,economic status,children’s age,and functional level of autism in children can predict 72.21%of the variance in parenting stress in these mothers.Conclusions:In the present study,parenting stress of mothers of autistic children was reported to be high during the COVID-19 pandemic.Based on the findings of this study,it can be concluded that pediatric nurses and health policymakers should provide a suitable educational and supportive environment for mothers of autistic children to enhance the coping level of these mothers and consequently reduce their parenting stress and care burden.
文摘Children with autism spectrum disorder(ASD)often encounter difficulties in language learning and utilization,a concern that has gained significant academic attention,particularly given the widespread occurrence of ASD globally.Previous reviews,however,have relied on empirical observations rather than a more rigorous selection criterion.This preliminary study seeks to systematize the scientific knowledge base regarding language development in autistic children by utilizing the analysis tool Citespace 6.2.R5.We visualized and analyzed research patterns and trends regarding autism by drawing data from the Web of Science.Through document citation and emerging trend analyses,seven key research clusters and their chronological associations are identified,along with research hotspots such as language disorder diagnosis and intervention,social communication,language acquisition,and multilingual and multicultural influences.Research findings show that there exist some issues with the current research,including small sample sizes,the need for further investigation into receptive language development,and a lack of cross-cultural comparative studies.Meanwhile,the scope and depth of interdisciplinary research on language development in autistic children also need to be further enhanced.The research contributes to the extant literature by providing valuable references for autism researchers and practitioners.
基金supported by the National Institute for Health ResearchManchester Biomedical Research Centre.
文摘Introduction:Auditory symptoms in individuals with Autistic Spectrum Disorder(ASD)are well described within the neurodevelopmental literature,yet there is minimal mention of ASD in Otolaryngology literature.This is surprising considering the potential clinical and diagnostic implications of this link,and the potential for ASD to present to Otolaryngologists in the form of unexplained auditory symptoms.The aims of this literature review were to explore the intersection of auditory symptoms and ASD from the perspective of clinical Otolaryngology,and to outline a clinically focused research agenda based on emerging themes relevant to Otolaryngology.Methods:We searched Pubmed,Embase,Ovid and Cochrane library for studies until November 2021.Four authors independently reviewed 227 publications identified.39 were filtered into the final analysis.The PRISMA 2020 guidelines were followed.The heterogeneity of literature meant that a Systematic Review was not feasible.Included studies were therefore classified thematically,forming the basis of the scoping review.Results:Diagnostic theories for auditory symptoms in ASD include the entire auditory pathway and brain.There is a growing body of literature on auditory symptoms in ASD,suggesting that a primary diagnosis of ASD should be considered in patients presenting with otherwise unexplained auditory symptoms,and indicating a learning need for Otolaryngologists and audiologists,to whom these patients may present.Conclusion:We recommend a research agenda focusing on multidisciplinary collaboration,stakeholder engagement,responsible clinical screening,and clarification of pathophysiological mechanisms and terminology.
文摘Meeting Summary Autism is a neurodevelopmental disorder defined by the of a set of characteristic behavioral features. One of the most common neurodevelopmental disorders, autism is recognized as heterogeneous in etiology, phenotype, behavioral trajectory and response to treatment. While the etiology and specific pathogenetic mechanisms underlying autism are unknown, those mechanisms which underlie a small subset of etiologically-defined neurodevelopmental disorders （e.g., Fragile X Syndrome, tuberous sclerosis）, that are associated with autism and autistic behaviors, have been well described.
文摘Studies on the evaluation by therapists of parental behavior towards their children with Autistic Spectrum Disorder(ASD)and towards the therapists of their children are scarce.They are necessary,however,for enabling parents to become co-therapists.The present study’s purpose was the evaluation by therapists of the behavior of parents towards their children,of their relationship to therapists,and therapy outcome.The sample consisted of 178 parents of 89 children(72 boys)with ASD,who underwent intensive early intervention at a day centre for developmental disabilities.The professional team completed a questionnaire,separately for the mother and father,evaluating the parental attitude towards their children and towards the therapists.The behavior of parents was less satisfactory than expected.The fathers had difficulties in understanding their child’s problems,and had unrealistic expectations;mothers’behavior towards their children and therapists was better than the fathers’.Mothers had difficulty mostly in the management of the child’s behavior,and did not do well with feeding.It might be difficult for every parent to become co-therapist.Understanding the child’s difficulties by the mother,adequate handling of feeding and homework,were statistically significant in the good outcome of therapy.
文摘To examine the difference between early-onset (< age 3) childhood disintegrative disorder (CDD) and autistic disorder with speech loss (ADSL), 8 children with early-onset CDD (mean age = 7.6 years, SD = 3.8;6 males) were compared with 92 age and gender-ratio comparable children with ADSL (mean age = 6.8 years, SD = 4.1;70 males) on 24 variables not directly related to the key features of CDD (regression after normal development for at least the first 2 years after birth). Compared with the ADSL group, the early-onset CDD group had a tendency to have a higher rate of a psychosocial event before speech loss (SL) (early-onset CDD, 75.0% vs ADSL, 37.0%, p = 0.057;effect size (phi) = 0.211, p < 0.05);a significantly higher rate of fearfulness during SL (62.5% vs 4.3%, p = 0.000;phi = 0.551, p < 0.05);and a tendency to have a higher rate of epilepsy (25.0% vs 3.3%, p = 0.050;phi = 0.271, p < 0.05), a tendency to have a lower rate of the Childhood Autism Rating Scale-Tokyo Version (CARS-TV) total score ≥ 30 (75.0% vs 95.7%, p = 0.072;phi = 0.236, p < 0.05), and a significantly lower rate of CARS-TV item 2 (imitation) score ≥ 2 (50.0% vs 82.6%, p = 0.049;phi = 0.221, p < 0.05) on the first visit. The two groups did not exhibit any significant difference in the other 19 variables. The findings of no significant difference in the great majority and a significant difference in the small minority of the 24 variables between the two groups support integrating CDD into regressive autism spectrum disorder and studying CDD as its prototypical form.
文摘Objective:To study the effect of family follow-up nursing in rehabilitation of elderly autistic patients in community institutions.Methods:120 elderly autistic patients from February 2021 to July 2022 were randomly divided into a control group and a test group with 60 cases each.The patients in the control group were cared for at home by their family members,while the patients in the test group were given family follow-up rehabilitation care on the basis of the control group.The compliance of patients in the rehabilitation process,the UCLA loneliness score,the autism treatment assessment scale(ATEC)score of patients after this nursing care,and the quality-of-life scores of patients of the two groups before and after nursing care were compared.Results:The compliance of patients in the process of rehabilitation treatment was better in the experimental group than in the experimental group.The physical function score of patients after nursing was better in the experimental group than in the experimental group.The UCLA loneliness score and ATEC score of patients in the experimental group after nursing were lower than those of the control group(P<0.05);the quality-of-life score was higher in the experimental group(P<0.05).Conclusion:The application of family follow-up nursing in the rehabilitation of elderly autistic patients in community institutions can significantly improve patients’compliance and improve their prognosis,thus having high clinical value.
文摘Objective: to analyze and explore the relationship between family rearing environment and autistic characteristics of children, so as to improve the present situation of autistic characteristics of children. Methods: From July 2019 to July 2020, 8 kindergartens were randomly selected from the kindergartens in our district. 1600 children were selected as the subjects of this experimental study, except for the children with mental diseases. All the children were investigated by using Chinese Creutzfeldt-Jakob Autism Screening Scale and Family Parenting Environment Scale. Record and analyze the final results. Results: a total of 1,500 questionnaires were collected in this study, with a recovery rate of 93.75%. 132 children were found to be autistic children, with a detection rate of 8.8%. There was a significant difference in patient data between male and female (P<0.05). In addition, the data of children with loneliness were significantly lower than those without loneliness, the difference was significant and had statistical significance (P<0.05). Conclusion: the analysis of the relationship between family rearing environment and autistic characteristics of children shows that male, history of separation, poor social adaptability (or self-care ability), frequent punishment (or neglect) and environmental atmosphere are all important influencing factors. Therefore, improvement must be made from these aspects.
基金supported by the US National Science Foundation(2244221 and 2315595).
文摘Attention deficit disorder is a frequently observed symptom in individuals with autism spectrum disorder(ASD).This condition can present significant obstacles for those affected,manifesting in challenges such as sustained focus,task completion,and the management of distractions.These issues can impede learning,social interactions,and daily functioning.This complexity of symptoms underscores the need for tailored approaches in both educational and therapeutic settings to support individuals with ASD effectively.In this study,we have expanded upon our initial virtual reality(VR)prototype,originally created for attention therapy,to conduct a detailed statistical analysis.Our objective was to precisely identify and measure any significant differences in attention-related outcomes between sessions and groups.Our study found that heart rate(HR)and electrodermal activity(EDA)were more responsive to attention shifts than temperature.The‘Noise’and‘Score’strategies significantly affected eye openness,with the ASD group showing more responsiveness.The control group had smaller pupil sizes,and the ASD group’s pupil size increased notably when switching strategies in Session 1.Distraction log data showed that both‘Noise’and‘Object Opacity’strategies influenced attention patterns,with the‘Red Vignette’strategy showing a significant effect only in the ASD group.The responsiveness of HR and EDA to attention shifts and the changes in pupil size could serve as valuable physiological markers to monitor and guide these interventions.These findings further support evidence that VR has positive implications for helping those with ASD,allowing for more tailored personalized interventions with meaningful impact.
基金Supported by the Russian Science Foundation Grant,No.24-45-00067.
文摘BACKGROUND Autism spectrum disorders(ASD)represent a substantial social problem affecting at least 1 in 100 children worldwide.These conditions are very often accompanied by intellectual disability(ID)and speech delay;thus,they can be considered within a clinical continuum of neurodevelopmental disorders.Given the high heterogeneity of ASD,the subjective nature of diagnostic criteria,and the presence of phenocopies,identifying genetic determinants of these disorders remains a challenge.AIM To investigate the spectrum and frequency of rare genetic variants in genes with proven association with ASD in Russian children.METHODS 110 patients from 106 families were recruited into the study mean age at diagnosis 6 years;boy-to-girl ratio 3:1.Most of the patients(84%)demonstrated a combination of ASD with developmental delay(DD)or ID.Patients with syndromic features were subjected to the chromosomal microarray analysis.The remained children underwent clinical exome sequencing aimed at identifying presumably monogenic causes of ASD.The study focused on rare(minor allele frequency≤0.001)variants affecting high-confidence ASD-associated genes.RESULTS Pathogenic copy number variations were detected in three(7%)of the patients examined.Clinical exome sequencing revealed pathogenic/likely pathogenic variants in 12 of 105 cases(11%),indicating the presence of monogenic syndromes with established clinical significance(Pitt-Hopkins syndrome,ZTTK syndrome,syndromic X-linked ID of Billuart type,Snijders-Blok-Campeau,Helsmoortel-van der Aa,Coffin-Siris,Clark-Baraitser,Keefstra syndromes,etc.).In addition,27 patients(26%)had 37 rare variants of unknown clinical significance in DSCAM,SHANK2,AUTS2,ADNP,ANKRD11,APBA2,ARID1B,ASTN2,ATRX,SCN1A,CHD2,DEAF1,EHMT1,GRIN2B,NBEA,NR4A2,TRIO,TRIP12,POGZ,EP300,FOXP1,PCDH19,GRIN2A,NCKAP1,and CHD8 genes.No specific variant was detected more than once in unrelated patients.Among the genes with rare variants found in 2 or more patients were TRIP12(n=4),AUTS2(n=3),ARID1B(n=3),PCDH19(n=3),EP300(n=3),TRIO(n=2),ASTN2(n=2),EHMT1(n=2),and CHD2(n=2).Of note,5 male ASD/DD patients from 3 unrelated families had PCDH19 missense variants,confirming that at least some hemizygous males with non-mosaic PCDH19 variants may present with neurobehavioral abnormalities.These variants did not cause epilepsy restricted to females in patients’mothers or sisters.CONCLUSION These data confirm a tremendous diversity of genetic causes of ASD.Clinical exome sequencing may serve as a reasonable alternative to whole-exome sequencing.
基金supported by the National Basic Research Program of China(Grant No.2010CB529602)
文摘We examined parenting stress and mental health status in parents of autistic children and assessed factors associated with such stress. Participants were parents of 188 autistic children diagnosed with DSM-IV criteria and parents of 144 normally developing children. Parents of autistic children reported higher levels of stress, depression, and anxiety than parents of normally developing children. Mothers of autistic children had a higher risk of depression and anxiety than that did parents of normally developing children. Mothers compared to fathers of autistic children were more vulnerable to depression. Age, behavior problems of autistic children, and mothers' anxiety were significantly associated with parenting stress.
文摘Introduction Currently,interventions for children with autism spectrum disorders(ASD)in China are mainly carried out by professionals in rehabilitation institutions and special schools.However,when autistic children are older,they do not receive effective training and treatment,and there is no specific place in society to accommodate autistic adults.Mental hospitals are usually their ultimate home.Case presentation We report a 22‐year‐old male with ASD.The manifestation and/or intervention from the age of 3 years to now were recorded.He has been hospitalized in the closed ward of a mental hospital since 2015.Conclusion This report typically present the current problems in treatment and training of autistic children growing up in China.Life‐long rehabilitation training is important for every patient with ASD.Relevant policies and resources in China should be optimized in terms of medical treatment and health care,education and training,social assistance,social security,labor employment,and social culture.
文摘The objective was to investigate the effects of volatile components in Jiawei Wendan prescription on autistic behavior in rats,to analyze the volatile constituents and then to explore its effective components based on the treatment of autism.The pregnant mice were divided into two groups according to the method that Schneider used.
文摘Amother considers her child to be a continuation of her own life, and places her own desires that she cannot achieve on her child. A child is a mother’s sun, a mother’s hope. In this world, however, there exists another group of mothers whose children have autism. These children act as if they are completely alone, do not interact with others, and even refuse the love
基金supported by the National Natural Science Foundation of China(82074162 and 82274344)Project for Capacity Promotion of Putuo District Clinical Special Disease“Stroke”,Science and Technology Innovation Project of Putuo District Health System(ptkwws201902 and ptkwws202301)+2 种基金Training Plan of“100 professionals”of Shanghai Putuo District Central Hospital(2022-RCJC-05)Project of“XingLin Scholars Training”of Chengdu University of Traditional Chinese Medicine(YYZX2022170)Shanghai Putuo District Health System Clinical Characteristic Special Disease Construction Project(2023tszb04).
文摘Autistic spectrum disorder(ASD)is a male-biased,heterogeneous neurodevelopmental disorder that affects approximately 1%e2%of the population.Prenatal exposure to valproic acid(VPA)is a recognized risk factor for ASD,but the cellular and molecular basis of VPA-induced ASD at the single-cell resolution is unclear.Here,we aim to compare the cellular and molecular differences in the hippocampus between male and female prenatal mice with ASD at the single-cell transcriptomic level.The transcriptomes of more than 45,000 cells are assigned to 12 major cell types,including neurons,glial cells,vascular cells,and immune cells.Cell type-specific genes with altered expression after prenatal VPA exposure are analyzed,and the largest number of differentially expressed genes(DEGs)are found in neurons,choroid plexus epithelial cells,and microglia.In microglia,several pathways related to inflammation are found in both males and females,including the tumor necrosis factor(TNF),nuclear factor kappa B(NF-kB),toll-like receptor(TLR),and mitogen-activated protein kinase(MAPK)signaling pathways,which are important for the induction of autistic-like behavior.Additionally,we note that several X-linked genes,including Bex1,Bex3,and Gria3,were among the male-specific DEGs of neurons.This pioneering study describes the landscape of the transcriptome in the hippocampus of autistic mice.The elucidation of sexual differences could provide innovative strategies for the prevention and treatment of ASD.
基金supported by grants from the National Natural Science Foundation of China(31771243)the Fok Ying Tong Education Foundation(141113)to Aiguo Chen.
文摘In recent years evidence has emerged suggesting that Mini-basketball training program(MBTP)can be an effec-tive intervention method to improve social communication(SC)impairments and restricted and repetitive beha-viors(RRBs)in preschool children suffering from autism spectrum disorder(ASD).However,there is a considerable degree if interindividual variability concerning these social outcomes and thus not all preschool chil-dren with ASD profit from a MBTP intervention to the same extent.In order to make more accurate predictions which preschool children with ASD can benefit from an MBTP intervention or which preschool children with ASD need additional interventions to achieve behavioral improvements,further research is required.This study aimed to investigate which individual factors of preschool children with ASD can predict MBTP intervention out-comes concerning SC impairments and RRBs.Then,test the performance of machine learning models in predict-ing intervention outcomes based on these factors.Participants were 26 preschool children with ASD who enrolled in a quasi-experiment and received MBTP intervention.Baseline demographic variables(e.g.,age,body,mass index[BMI]),indicators of physicalfitness(e.g.,handgrip strength,balance performance),performance in execu-tive function,severity of ASD symptoms,level of SC impairments,and severity of RRBs were obtained to predict treatment outcomes after MBTP intervention.Machine learning models were established based on support vector machine algorithm were implemented.For comparison,we also employed multiple linear regression models in statistics.Ourfindings suggest that in preschool children with ASD symptomatic severity(r=0.712,p<0.001)and baseline SC impairments(r=0.713,p<0.001)are predictors for intervention outcomes of SC impair-ments.Furthermore,BMI(r=-0.430,p=0.028),symptomatic severity(r=0.656,p<0.001),baseline SC impair-ments(r=0.504,p=0.009)and baseline RRBs(r=0.647,p<0.001)can predict intervention outcomes of RRBs.Statistical models predicted 59.6%of variance in post-treatment SC impairments(MSE=0.455,RMSE=0.675,R2=0.596)and 58.9%of variance in post-treatment RRBs(MSE=0.464,RMSE=0.681,R2=0.589).Machine learning models predicted 83%of variance in post-treatment SC impairments(MSE=0.188,RMSE=0.434,R2=0.83)and 85.9%of variance in post-treatment RRBs(MSE=0.051,RMSE=0.226,R2=0.859),which were better than statistical models.Ourfindings suggest that baseline characteristics such as symptomatic severity of 144 IJMHP,2022,vol.24,no.2 ASD symptoms and SC impairments are important predictors determining MBTP intervention-induced improvements concerning SC impairments and RBBs.Furthermore,the current study revealed that machine learning models can successfully be applied to predict the MBTP intervention-related outcomes in preschool chil-dren with ASD,and performed better than statistical models.Ourfindings can help to inform which preschool children with ASD are most likely to benefit from an MBTP intervention,and they might provide a reference for the development of personalized intervention programs for preschool children with ASD.
基金funded by Guangdong Planning Office of Philosophy and Social Science(General Project in 2021,No.GD21CTY02)Shenzhen University Young Teachers Research Initiation Project(No.20210402)+1 种基金This study is supported by Start-Up Research Grant of Shenzhen University(20200807163056003)Start-Up Research Grant(Peacock Plan:20191105534C).
文摘Therapeutic horseback riding(THR)as an animal-assisted intervention is one of the innovative approaches emer-ging in the treatment for children with autism spectrum disorder(ASD).The current study was designed to inves-tigate the effects of a 12-week,twice a week THR program on motor skills in sixty-eight children with ASD aged 5–10 years old.All participants selected met the DSM-V criteria for ASD,and a total offifty-three participants completed the study.A randomized controlled trial design was utilized for the study.Data was collected via a pre-THR test,interim-THR test,and post-THR test to investigate the possible changes in motor skills throughout the 12-week THR program.Results showed that the THR program significantly improved overall motor skills across time points(p<0.05)and sub-skills of run,gallop and two-hand catch(as compared to the control group,p<0.05).In conclusion,the THR program may be an effective option for improving motor skills in children with ASD and further investigation with a longer period of intervention is warranted.
文摘BACKGROUND Empathy has long been considered a multidimensional construct,encompassing cognitive,affective and behavioral domains.Deficits in empathic competences in early childhood contribute to psychopathology,and have been variably implicated in several clinical conditions,such as autism spectrum disorders(ASD)and conduct disorders.AIM To identify and describe empirically validated questionnaires assessing empathy in children and adolescents and to provide a summary of related theoretical perspectives on empathy definitional issues.METHODS A systematic review of the literature was conducted.Three bibliographic databases were searched.A total of 47 studies were selected for final analysis and 16 distinct measures were identified and described.RESULTS Questionable to excellent levels of internal consistency were observed,while few studies assessed test-retest reliability.Although construct definitions only partially overlapped,affective and cognitive domains of empathy were the commonest internal factors that were often separately evaluated.New facets of the construct(i.e.,somatic empathy and sympathy)and specific clinical populations(i.e.,ASD)could be specifically addressed through more recent instruments.CONCLUSION The combination of different assessment methods is recommended in order to foresee further improvements in this field and try to overcome the problem of limited convergence with more objective measures.
