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Tse, Andy CY, CCW Yu, and Paul H. Lee. "Comparing sleep patterns between children with autism spectrum disorder and children with typical development: A matched case–control study." Autism 24, no. 8 (July 7, 2020): 2298–303. http://dx.doi.org/10.1177/1362361320936827.
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Children with autism spectrum disorder are often reported to have more sleep deficits and poorer sleep quality compared with children with typical development. However, most previous studies have serious methodological limitations, such as varying sample sizes in the comparison groups, wide age range of participants, and body mass index not matched between participants. This study investigated whether sleep patterns differed between children with autism spectrum disorder and those with typical development using a carefully matched case–control design and incorporating both actigraphy and sleep log assessments. A total of 78 children diagnosed with autism spectrum disorder were matched with 78 typical development controls in this study. The matched variables included age, gender, and body mass index. The results showed that children with autism spectrum disorder had shorter sleep duration, reduced sleep efficiency, longer sleep-onset latency, and longer wake after sleep onset than children with typical development ( ps < 0.05). Further studies are needed to explore the mechanisms underlying these sleep deficits in children with autism spectrum disorder. Lay abstract This study compared the sleep pattern between children with autism spectrum disorders and children with typical development using a matched case–control design (matched age, gender, and body mass index). Significant differences were found in night-time sleep duration (total amount of sleep at night), sleep efficiency (percentage of time spent asleep), sleep-onset latency (length of time that it takes to transit from awake to asleep), and wake after sleep onset (total amount of time spent awake after defined sleep onset). Findings showed that children with autism spectrum disorder had poorer sleep quality than children with typical development. Mechanisms underlying the differences should be further explored in order to develop an effective treatment intervention.
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Neysmith-Roy, Joan M. "The Tomatis Method with Severely Autistic Boys: Individual Case Studies of Behavioral Changes." South African Journal of Psychology 31, no. 1 (March 2001): 19–28. http://dx.doi.org/10.1177/008124630103100105.
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Six severely autistic males ranging in age from 4 years to 11 years received the Tomatis Method to assist in alleviating the severity of behaviours contributing to the diagnosis of autism. Ten minute video samples were taken of each boy, under two conditions of play, every time he completed one section of the treatment programme. As measured by the Children's Autism Rating Scale (CARS) all of the boys were severely autistic at the beginning of treatment. Three (50%) of the boys demonstrated positive behavioural changes by the end of the treatment. One boy was no longer considered to be autistic, two boys showed mild symptoms of autism and three boys remained within the severely autistic range. Of particular interest were the changes that occurred in pre-linguistic areas for five of the six boys. These included Adaptation to Change, Listening Response, Non Verbal Communication, Emotional Response and Activity Level. These behaviours are considered prerequisites for successful verbal communication. The children who demonstrated behavioural change were 6 years of age or younger at the beginning of treatment. The author suggests that the Tomatis Method may be helpful in making prelinguistic behaviours manageable and thus help prepare the child to learn basic skills necessary for the development of language and learning.
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Beiting, Molly, and Edwin Maas. "Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS): A Single-Case Experimental Design Study." American Journal of Speech-Language Pathology 30, no. 3S (June 18, 2021): 1525–41. http://dx.doi.org/10.1044/2020_ajslp-20-00131.
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Purpose A subset of children with autism spectrum disorder (ASD) has speech sound disorders, including childhood apraxia of speech (CAS). To date, virtually all speech treatment studies consider ASD an exclusionary criterion, resulting in little scientific evidence for treatment of CAS for children who also have ASD. This study proposes and tests a novel approach, Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS), as a theoretically and clinically informed speech treatment option for this population. Method Using a multiple-baseline design within and across participants, three children with co-occurring ASD and CAS received 11–18 treatment sessions. Treatment targets were individually designed and matched with untreated control words. Probes were administered at the start of each session to assess speech production accuracy perceptually. Changes in production accuracy were examined through visual inspection and quantified with effect sizes. Results Findings were mixed, with one child showing significant gains for half of the treated targets at follow-up and two children showing no clear improvement. Conclusions Preliminary evidence suggests potentially positive treatment effects for ACT4CAS when implemented as intended, although treatment intensity and disorder severity likely influence treatment outcome. Replication and comparison of ACT4CAS to other speech treatments is needed. Supplemental Material https://doi.org/10.23641/asha.14110445
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Lozada, Luis E., Cade M. Nylund, Gregory H. Gorman, Elizabeth Hisle-Gorman, Christine R. Erdie-Lalena, and Devon Kuehn. "Association of Autism Spectrum Disorders With Neonatal Hyperbilirubinemia." Global Pediatric Health 2 (January 1, 2015): 2333794X1559651. http://dx.doi.org/10.1177/2333794x15596518.
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Autism spectrum disorders (ASD) are a common neurodevelopmental disorder of unknown etiology. Studies suggest a link between autism and neonatal jaundice. A 1:3 matched case–control study was conducted with children enrolled in the Military Health System born between October 2002 and September 2009. Diagnostic and procedure codes were used for identifying ASD and hyperbilirubinemia. Two definitions for hyperbilirubinemia were evaluated: an inpatient admission with a diagnosis of jaundice and treatment with phototherapy. A total of 2917 children with ASD and 8751 matched controls were included in the study. After adjustment, there remained an association between ASD in children and an admission with a diagnosis of jaundice (odds ratio = 1.18; 95% confidence interval = 1.06-1.31; P = .001) and phototherapy treatment (odds ratio = 1.33; 95% confidence interval = 1.04-1.69; P = .008). Children who develop ASD are more likely to have an admission with a diagnosis of jaundice in the neonatal period and more likely to require treatment for this jaundice.
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Sulaj, Migen. "ABA Based Intervention Implemented by a Mother of a Child with ASD." European Journal of Social Sciences Education and Research 4, no. 1 (August 30, 2015): 180. http://dx.doi.org/10.26417/ejser.v4i1.p180-185.
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Over the past 15 years there has been a dramatic increase in the incidence of autism. In 2014 the American Autism and Developmental Disabilities Monitoring Network reported estimated prevalence rates for Autism Spectrum Disorder (ASD) to be 1 in 68. At the same time, the number of professionals qualified to coordinate effective behavioral interventions has been limited and often prohibitively expensive. Several recent studies that include randomized trials have shown very promising results for involving parents of very young children with autism to integrate evidence-based strategies into daily routines with positive effects on core symptoms of the disorder. The present article shows that additional to staff treatment outcomes, positive treatment outcomes provided by parent involved in therapy are possible. The purpose of this case study article is to promote parent involvement in early intervention programs for children with autism. The objective is to open a new discussion on potential ways for better treatment outcomes hoping to propose a more economic model for a poor country like Albania.
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Levin, Darren S., Valerie M. Volkert, and Cathleen C. Piazza. "A Multi-Component Treatment to Reduce Packing in Children With Feeding and Autism Spectrum Disorders." Behavior Modification 38, no. 6 (September 29, 2014): 940–63. http://dx.doi.org/10.1177/0145445514550683.
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Despite the high prevalence and potential negative consequences of feeding disorders in children with autism spectrum disorder (ASD), there are surprisingly few studies that examine the efficacy of treatment exclusively with these children. Children with feeding disorders also frequently exhibit packing (holding or pocketing food without swallowing). Investigators have evaluated procedures in the general pediatric population to treat packing, and some have shown that procedures need to be combined to form an effective treatment. Although investigators have evaluated the efficacy of re-distribution, swallow facilitation, and a chaser, these procedures have not been evaluated specifically with children with ASD. Prior to the current investigation, we successfully used nonremoval procedures to increase acceptance of pureed foods and liquids and decrease the inappropriate mealtime behavior of two children diagnosed with ASD and feeding problems; however, in each case, packing emerged during initial treatment. We then used different combinations of re-distribution, swallow facilitation, and chaser treatments to decrease packing for both children.
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Baraskewich, Jessica, Kristin M. von Ranson, Adam McCrimmon, and Carly A. McMorris. "Feeding and eating problems in children and adolescents with autism: A scoping review." Autism 25, no. 6 (March 2, 2021): 1505–19. http://dx.doi.org/10.1177/1362361321995631.
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Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other feeding and eating problems (e.g. disordered eating, fear of trying new foods, and insistence on specific food presentation) are also common in this population. This scoping review describes the nature and extent of feeding and eating problems in autistic youth and reports characteristics of autistic youth who experience such issues. Thirty-four studies were included in the current review, with almost all studies (91%) investigating feeding problems. Only 9% of studies examined concern with weight, shape, and/or body image, but several authors noted that disordered eating attitudes and behaviors may occur more frequently in those with autism than their peers without autism. No common individual characteristics (e.g. cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems. Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so. We propose that in future research “eating problems” be used when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” be used when such preoccupation is absent. Lay abstract Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms “feeding” and “eating” problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use “eating problems” when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child’s treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
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Stachoń, Małgorzata, Milena Sierocka, Piotr Poniewierski, Anna Kostiukow, and Włodzimierz Samborski. "Cannabinoids in the treatment of children with autism spectrum disorder." Aktualności Neurologiczne 20, no. 3 (November 30, 2020): 119–24. http://dx.doi.org/10.15557/an.2020.0015.
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Introduction: Isolation of two compounds, tetrahydrocannabinol (THC) and cannabidiol (CBD), contributed to an increased interest in the use of marijuana for medicinal purposes. It was then that research on the effects of marijuana on the course of different diseases began. Aim: The aim of this paper was to analyse the use of cannabinoids in the treatment of children with autism spectrum disorder. Results: There are different methods for cannabinoid administration. Researchers use various preparations with doses ranging between 0.04 mg to 900 mg. Preliminary studies are conducted on animal models, usually in genetically modified mice. Cannabinoids have been found to have a positive effect on social and emotional behaviours of children, as well as to show anxiolytic and antipsychotic effects. Cannabidiol plays an important role in the secretion of vasopressin and oxytocin. Some patients experience adverse effects. Antidepressant and anticonvulsant effects have been observed in patients with neurological and mental disorders. Conclusions: Cannabinoid therapy is not the standard of care in children with autism spectrum disorders, and the doses used vary significantly. There is evidence for the positive effects of cannabinoids in patients with comorbidities. It is possible that cannabinoids have an anxiolytic effect and allow for a reduced use of antipsychotics in the analysed group of patients. Antidepressant and anticonvulsant effects have also been observed. Furthermore, it was shown that CBDs administered in mice with Dravet syndrome improve social behaviour, dysfunction of which is one of the central symptoms of autism spectrum disorder.
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Ramani, Pooja, and Regina Sala. "Can probiotics benefit young people with autism spectrum disorders?" BJPsych Open 7, S1 (June 2021): S282. http://dx.doi.org/10.1192/bjo.2021.752.
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AimsThe aims are to evaluate the effectiveness of Probiotics on young people with Autism Spectrum Disorder.We hypothesized that there will be an improvement of the comorbid gastrointestinal symptoms that can accompany Autism Spectrum Disorder.We believe that the use of probiotics can exert bidirectional effects on the gut-brain axis which may result in improvements in core Autism symptoms.MethodA literature search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We used databases including OVID MEDLINE, Pubmed, EMBASE, AMED and the Cochrane register of controlled trials. Studies using Probiotics as a treatment for children with ASD were identified by key search terms; Child*, young person*, adoles*, teenagers, ASD, Autism Spectrum Disorder, Autism, Pervasive developmental disorder, PDD, Probiotics, Supplements, Lactobacillus, and Bifidobacterium. Inclusion criteria: Children of age range 2-18 with a diagnosis of ASD and having at least one gastrointestinal symptom were included. Exclusion criteria: The following were excluded: studies looking at Autism with interventions aside from Probiotics; studies where Probiotics were tested in conjunction with other interventions; studies where there were additional neurodevelopmental disorders.ResultTwelve studies identified all utilized probiotics. This included 7 Randomised Control Trials, 2 Open-Label studies, 1 pre and post-intervention design and 1 Case study. All RCTs gave probiotics or placebo to children.Ten studies showed an improvement in gastrointestinal symptoms. Six studies showed improvements in various behavioral measures. Four studies showed improvements in core autism symptoms. However, the sample sizes in these studies were not large enough to prove statistical significance.ConclusionNo studies showed an adverse reaction which indicates probiotics can be considered a safe treatment.The improvements in a variety of parameters imply probiotics a suitable adjunctive intervention that may help improve ASD core symptoms in young people as well as improving physical and behavioural comorbidities which in some cases was noted by parents.However, due to high dropout rates and generally small sample sizes, larger-scale trials are needed to critically confirm the efficacy of probiotics for children with ASD.
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Erturk, Buket, Wendy Machalicek, and Christine Drew. "Self-Injurious Behavior in Children With Developmental Disabilities: A Systematic Review of Behavioral Intervention Literature." Behavior Modification 42, no. 4 (November 27, 2017): 498–542. http://dx.doi.org/10.1177/0145445517741474.
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We reviewed single-case research studies examining the effects of behavioral interventions for self-injurious behavior (SIB) in young children with autism and developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 46 studies (66 participants younger than the age of 12) meeting inclusion criteria. Studies were examined based on (a) participant demographics, (b) topography and function of SIB, (c) type of functional behavior assessment (FBA), (d) intervention procedures and outcomes, and (e) experimental design and measurement. Intervention strategies were categorized as antecedent manipulations, teaching behavior, consequence-based procedures, and/or extinction procedures. Positive outcomes were reported for 78% of participants in the reviewed studies and 88% of the participants were diagnosed with autism. Results suggest the effectiveness of behavioral interventions to decrease SIB for young children with disabilities; however, the frequent use of packaged interventions without component analysis limits the conclusiveness of any treatment recommendation. Suggestions for future research are discussed.
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Crittenden, Patricia M. "Formulating autism systemically: Part 1 – A review of the published literature and case assessments." Clinical Child Psychology and Psychiatry 22, no. 3 (July 2017): 378–89. http://dx.doi.org/10.1177/1359104517713241.
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Autism is a psychiatric disorder of unknown aetiology. In this article, the literature on genetic, neurological, psychological, relational and cultural causes of autism is reviewed, beginning with the 2014 review of Crittenden, Dallos, Landini et al. (pp. 64–70) up to and including recent publications in 2017. Some of the findings were unexpected; others led to new questions. The unexpected findings were the minimal contribution of genes to autism, the extremely evident neurological differences, the interpersonal quality of the psychological findings (that lacked evidence of parents’ behaviour), the relational evidence that mothers’ childhood trauma, perinatal stress and marital stress increased the risk of autism, and the reciprocal relation between funding for treatment of autism and diagnoses of autism. Notably, there was an abundance of genetic studies, numerous neurological studies and only scattered psychological, relational and cultural studies, thus rendering those findings speculative. The new questions included whether mothers used postural/gestural signs to signal their children to maintain distance and whether mothers experienced wariness of males as a result of childhood trauma, with their sons possibly experiencing gender confusion. Following the literature review, a small archival set of video-recorded and transcribed assessments of attachment of cases of autism were examined for evidence to corroborate or refute the psychological and relational findings of the literature review. The findings were striking in their support of mothers’ use of postural/gestural communication regarding distance, children’s close attention to mothers’ bodily signals, without looking at mothers’ face, mothers’ greater comfort when they approached their sons than when their sons approached them, one boy’s lack of verbal self-representation and mothers’ childhood triangulation. These became hypotheses regarding what to look for in Part 2 of this article, a prospective, 12-year case study.
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van Deurs, Jenna R., Karyn G. France, Laurie K. McLay, and Neville M. Blampied. "Cognitive-behavioral treatment of sleep disturbance in children and adolescents with autism: Eight case studies using functional behavior assessment." Research in Autism Spectrum Disorders 86 (August 2021): 101823. http://dx.doi.org/10.1016/j.rasd.2021.101823.
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Jia, Weihua, and Jinghong Xie. "IMPROVEMENT OF THE HEALTH OF PEOPLE WITH AUTISM SPECTRUM DISORDER BY EXERCISE." Revista Brasileira de Medicina do Esporte 27, no. 3 (September 2021): 282–85. http://dx.doi.org/10.1590/1517-8692202127032021_0081.
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ABSTRACT Introduction Autism Spectrum Disorder (ASD) is a typical neurological development disorder of the brain, exhibiting social communication and communication disorders, narrow interests, and repetitive, stereotyped behaviors. Movement development is an important evaluation index for the development of early motor function in children, so exercise intervention in children with ASD is of great significance. Objective This article conducts exercise intervention on children with ASD to stimulate their exercise ability and improve their self-care ability. Methods The article randomly grouped 24 children with an autism spectrum disorder. The experimental group received exercise intervention, and the control group had regular classes. After the experiment is completed, the influence of exercise intervention on children with autism is analyzed. Results The motor skills of the two groups of children were different after the intervention. The motor skills of the experimental group improved more significantly. Conclusion Exercise intervention can significantly improve the motor skills of children with an autism spectrum disorder. To evaluate whether the large-muscle motor skill learning of children with ASD and its influence on basic motor skills can be transferred to provide a reference for related motor intervention. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Watkins, Nicholas, Lisa Paananen, Eric Rudrud, and John T. Rapp. "Treating Vocal Stereotypy With Environmental Enrichment and Response Cost." Clinical Case Studies 10, no. 6 (December 2011): 440–48. http://dx.doi.org/10.1177/1534650111429377.
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The authors describe the assessment and treatment of vocal stereotypy in two children diagnosed with an autism spectrum disorder. Both the case studies evaluated the effectiveness of response cost (RC). The RC interventions quickly reduced and eventually eliminated the vocal stereotypy in one participant and reduced it to near-zero levels in the second. Postintervention probes for one participant confirmed the continued reduction of vocal stereotypy 1 month after treatment and its elimination 8 months after treatment. Directions for future research are also discussed.
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Frye, Richard E., and Daniel A. Rossignol. "Identification and Treatment of Pathophysiological Comorbidities of Autism Spectrum Disorder to Achieve Optimal Outcomes." Clinical Medicine Insights: Pediatrics 10 (January 2016): CMPed.S38337. http://dx.doi.org/10.4137/cmped.s38337.
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Despite the fact that the prevalence of autism spectrum disorder (ASD) continues to rise, no effective medical treatments have become standard of care. In this paper we review some of the pathophysiological abnormalities associated with ASD and their potential associated treatments. Overall, there is evidence for some children with ASD being affected by seizure and epilepsy, neurotransmitter dysfunction, sleep disorders, metabolic abnormalities, including abnormalities in folate, cobalamin, tetrahydrobiopterin, carnitine, redox and mitochondrial metabolism, and immune and gastrointestinal disorders. Although evidence for an association between these pathophysiological abnormalities and ASD exists, the exact relationship to the etiology of ASD and its associated symptoms remains to be further defined in many cases. Despite these limitations, treatments targeting some of these pathophysiological abnormalities have been studied in some cases with high-quality studies, whereas treatments for other pathophysiological abnormalities have not been well studied in many cases. There are some areas of more promising treatments specific for ASD including neurotransmitter abnormalities, particularly imbalances in glutamate and acetylcholine, sleep onset disorder (with behavioral therapy and melatonin), and metabolic abnormalities in folate, cobalamin, tetrahydrobiopterin, carnitine, and redox pathways. There is some evidence for treatments of epilepsy and seizures, mitochondrial and immune disorders, and gastrointestinal abnormalities, particularly imbalances in the enteric microbiome, but further clinical studies are needed in these areas to better define treatments specific to children with ASD. Clearly, there are some promising areas of ASD research that could lead to novel treatments that could become standard of care in the future, but more research is needed to better define subgroups of children with ASD who are affected by specific pathophysiological abnormalities and the optimal treatments for these abnormalities.
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Fung, Suk Chun. "An Observational Study on Canine-assisted Play Therapy for Children with Autism: Move towards the Phrase of Manualization and Protocol Development." Global Journal of Health Science 9, no. 7 (April 6, 2017): 67. http://dx.doi.org/10.5539/gjhs.v9n7p67.
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Canine-assisted play therapy (CAPT) is an emerging psychosocial intervention for children with autism spectrum disorder (ASD). The present case studies used quantitative observation of experimenter-designated behavioral outcomes to examine the effectiveness of a planned CAPT intervention. By utilizing a coding system with typical and ASD-specific behavioral categories, the verbal and non-verbal social behaviors of two elementary-aged children with ASD as well as intellectual and language impairments at pre-treatment, during CAPT treatment, at post-treatment and at follow-up are systematically coded and analyzed. This study took the first steps toward making CAPT treatment manuals and research protocol available to a wider audience. Their publication will assist in standardizing the technique for replication in research and in practice.
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Saletin, J. M., M. Koopman-Verhoeff, G. Han, D. H. Barker, M. A. Carskadon, T. F. Anders, and S. J. Sheinkopf. "1002 Endorsement Of Sleep Problems Indexes Autism Severity In Children And Adolescents: Evidence From A Large Community Sample." Sleep 43, Supplement_1 (April 2020): A380—A381. http://dx.doi.org/10.1093/sleep/zsaa056.998.
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Abstract Introduction Individuals with autism spectrum disorder (ASD) often experience sleep problems. A reliance on case-control studies rather than dimensional samples limit our ability to understand how sleep problems distinguish diagnosis and severity of ASD. To address this need, we present preliminary findings from a large community sample of individuals with heterogeneous autism phenotypes. Methods All participants (≤ 21 years) were selected from the Rhode Island Consortium for Autism Research and Treatment (RI-CART) (final n= 977; 233F; 11.27±4.13 years), a public-private-academic registry of families in Rhode Island affected by ASD-like symptoms. Participants completed the Autism Diagnostic Observation Schedule, 2nd Edition to confirm the presence of diagnosable ASD. Each caretaker also completed dimensional measures of functional impairment: Social Responsiveness Scale, 2nd edition and the Vineland Adaptive Behavior Scale (2nd/3rd editions). Caretakers were asked whether the participant suffered current/past sleep problems: yes/no. All analyses are adjusted for age, sex, race, ethnicity, caregiver education, and scale-version (e.g., 2nd/3rd ed., where applicable). Results Endorsement of sleep problems distinguished ASD diagnosis: a confirmed diagnosis of ASD was associated with greater prevalence of sleep problems compared to ASD diagnosis (OR: 1.58; 95% CI: 1.05,2.38; p = .028). Across the sample, endorsement of sleep problems was associated with impairments in adaptive behavior (b = -4.73; 95% CI: -7.47,-2.00045; p = .001) and social responsiveness (b = 6.72; 95% CI: 3.27,10.16; p < .001). Conclusion These data from a heterogenous community sample provide evidence for a link of sleep to the phenomenology of ASD. While the search for better diagnostic indicators of ASD continues, we recommend that clinicians consider a brief assessment of sleep behaviors of patients with such neurodevelopmental conditions as autism. Support Simons Foundation Autism Research Initiative, Hassenfeld Child Health Innovation Institute at Brown University. K01MH109854 (JMS), NIGMS Advance CTR (JMS). KNAW Ter Meulen Grant (MEKV).
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Ben-Itzchak, Esther, and Ditza A. Zachor. "Dog training intervention improves adaptive social communication skills in young children with autism spectrum disorder: A controlled crossover study." Autism 25, no. 6 (March 22, 2021): 1682–93. http://dx.doi.org/10.1177/13623613211000501.
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Controlled studies examining canine therapy in autism spectrum disorder are scarce. This study examined the effectiveness of a “Dog Training Intervention” on adaptive skills, autism severity, and anxiety using a controlled crossover design. Seventy-three participants diagnosed with autism spectrum disorder ( Mage = 4:10 ± 1:0) were divided into two groups that received the dog training intervention during half of the school year in addition to standard-of-care interventions. The dog training intervention, in which the children were taught how to interact with and train dogs, was given twice weekly for 4 months within autism spectrum disorder–specific special education school. Those receiving the dog training intervention first showed significantly increased adaptive social and communication skills compared to the controls, and the gains were maintained after the dog training intervention. Belonging to the first dog training intervention group, higher pre-intervention adaptive skills, higher baseline cognitive ability, and less severe autism severity predicted better adaptive social and communication skills. The controls improved in adaptive skills only during their receipt of dog training intervention after crossover. The positive impact on social communication skills suggests that dog training may serve as an effective model for establishing social interaction. Dog training intervention appears to be an effective adjunct treatment to interventions provided in special education schools for children with autism spectrum disorder. Lay abstract There is some evidence that using therapy dogs for children with autism spectrum disorder generally results in improved social communication skills and reduced behavioral problems. However, well-controlled studies that examine its effectiveness are scarce. This study examined the effectiveness of a “Dog Training Intervention.” The study included 73 participants diagnosed with autism spectrum disorder (61 males, 12 females) with age range of 2:10–7:6 years ( M = 4:10 ± 1:0) who attend autism spectrum disorder–specific special education schools. The study population was divided into two groups. Each group received the dog training intervention during one part of the school year (first half or second half) in addition to the standard interventions provided by the special education school settings. The dog training intervention was given twice weekly for 4 months within the school setting. The group that received the dog training intervention first showed a significant increase in adaptive social and communication skills in comparison to the second group that did not receive the intervention in this period. This improvement was maintained after the dog training intervention. The second group, which received intervention at the second half of the year, showed improvement in communication and socialization adaptive skills only during the period in which they received the dog training intervention. The positive impact on social communication adaptive skills of the dog training intervention among young children with autism spectrum disorder suggests that dogs may serve as an effective model for establishing social interaction. Dog training intervention appears to be an effective adjunct treatment to the interventions provided in special education schools for young children with autism spectrum disorder.
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Rossignol, Daniel A., and Richard E. Frye. "The Effectiveness of Cobalamin (B12) Treatment for Autism Spectrum Disorder: A Systematic Review and Meta-Analysis." Journal of Personalized Medicine 11, no. 8 (August 11, 2021): 784. http://dx.doi.org/10.3390/jpm11080784.
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Autism spectrum disorder (ASD) is a common neurodevelopmental disorder affecting 2% of children in the United States. Biochemical abnormalities associated with ASD include impaired methylation and sulphation capacities along with low glutathione (GSH) redox capacity. Potential treatments for these abnormalities include cobalamin (B12). This systematic review collates the studies using B12 as a treatment in ASD. A total of 17 studies were identified; 4 were double-blind, placebo-controlled studies (2 examined B12 injections alone and 2 used B12 in an oral multivitamin); 1 was a prospective controlled study; 6 were prospective, uncontrolled studies, and 6 were retrospective (case series and reports). Most studies (83%) used oral or injected methylcobalamin (mB12), while the remaining studies did not specify the type of B12 used. Studies using subcutaneous mB12 injections (including 2 placebo-controlled studies) used a 64.5–75 µg/kg/dose. One study reported anemia in 2 ASD children with injected cyanocobalamin that resolved with switching to injected mB12. Two studies reported improvements in markers of mitochondrial metabolism. A meta-analysis of methylation metabolites demonstrated decreased S-adenosylhomocysteine (SAH), and increased methionine, S-adenosylmethionine (SAM), SAM/SAH ratio, and homocysteine (with small effect sizes) with mB12. Meta-analysis of the transsulfuration and redox metabolism metabolites demonstrated significant improvements with mB12 in oxidized glutathione (GSSG), cysteine, total glutathione (GSH), and total GSH/GSSG redox ratio with medium to large effect sizes. Improvements in methylation capacity and GSH redox ratio were significantly associated with clinical improvements (with a mean moderate effect size of 0.59) in core and associated ASD symptoms, including expressive communication, personal and domestic daily living skills, and interpersonal, play-leisure, and coping social skills, suggesting these biomarkers may predict response to B12. Other clinical improvements observed with B12 included sleep, gastrointestinal symptoms, hyperactivity, tantrums, nonverbal intellectual quotient, vision, eye contact, echolalia, stereotypy, anemia, and nocturnal enuresis. Adverse events identified by meta-analysis included hyperactivity (11.9%), irritability (3.4%), trouble sleeping (7.6%), aggression (1.8%), and worsening behaviors (7.7%) but were generally few, mild, not serious, and not significantly different compared to placebo. In one study, 78% of parents desired to continue mB12 injections after the study conclusion. Preliminary clinical evidence suggests that B12, particularly subcutaneously injected mB12, improves metabolic abnormalities in ASD along with clinical symptoms. Further large multicenter placebo-controlled studies are needed to confirm these data. B12 is a promising treatment for ASD.
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Douglas-Hall, Petrina, Sarah Curran, Victoria Bird, and David Taylor. "Aripiprazole: A Review of its Use in the Treatment of Irritability Associated with Autistic Disorder Patients Aged 6-17." Journal of Central Nervous System Disease 3 (January 2011): JCNSD.S4140. http://dx.doi.org/10.4137/jcnsd.s4140.
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A systematic review and meta-analysis were performed examining the efficacy of aripiprazole for the treatment of irritability associated with autistic disorder in children and adolescents. Aripiprazole was found to be more effective in reducing irritability compared with placebo at 8 weeks, SMD -0.64 [-0.90 to -0.39, P < 0.00001] as determined by the Aberrant Behaviour Checklist irritability subscale (ABC-I). Pooled data from two eight week trials show that sedation is the most commonly reported adverse event. Statistically significant weight gain was also associated with aripiprazole, but there was a decrease in serum prolactin. Most adverse effects were deemed to be mild to moderate in severity. Four open trials and three case series all show support for aripiprazole in reducing the behavioural symptoms of autism. Long-term studies are required to determine the efficacy and safety of aripiprazole in autistic disorder in children.
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Narzisi, Antonio, Gianluca Sesso, Stefano Berloffa, Pamela Fantozzi, Rosy Muccio, Elena Valente, Valentina Viglione, Arianna Villafranca, Annarita Milone, and Gabriele Masi. "Could You Give Me the Blue Brick? LEGO®-Based Therapy as a Social Development Program for Children with Autism Spectrum Disorder: A Systematic Review." Brain Sciences 11, no. 6 (May 26, 2021): 702. http://dx.doi.org/10.3390/brainsci11060702.
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LEGO®-based therapy is a social skills development program aimed at children with autism spectrum disorder (ASD). A systematic review of the literature was conducted using PRISMA guidelines. PubMed, Scopus and Web of Science bibliographic databases were searched from their date of inception to August 2020. The review included 19 studies. Studies were classified according to experimental designs (e.g., Randomized Control Trial, Non-Randomized Studies of Interventions and case report and series) and a narrative synthesis of each was provided, along with a critical discussion of the strengths and weaknesses of the available literature on the topic. Although LEGO®-based therapy appears a promising treatment for social interaction in ASD, the findings of LEGO®-based therapy studies should be interpreted and generalized with caution, due to the low quality of the studies and the small sample sizes.
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Su, Pumpki L., George Castle, and Stephen Camarata. "Cross-modal generalization of receptive and expressive vocabulary in children with autism spectrum disorder." Autism & Developmental Language Impairments 4 (January 2019): 239694151882449. http://dx.doi.org/10.1177/2396941518824495.
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Background and aims Word learning is an area that poses a particular challenge to children with autism spectrum disorder. A unique challenge for this population is generalization of learned skills across new learning contexts. In clinical settings, a common assumption in teaching vocabulary for children with autism spectrum disorder is that learning in one modality will generalize incidentally to untreated modalities, but very few studies have evaluated the validity of this assumption. The purpose of this study was to investigate receptive and expressive word acquisition and cross-modal generalization in children with autism spectrum disorder. Methods A single-case parallel treatments design was used to compare word learning and cross-modal generalization in children with autism spectrum disorder. Ten children with autism spectrum disorder were taught unfamiliar vocabulary words in a combined storybook and play intervention. For each child, half of the target words were trained expressively and the other half were trained receptively by random assignment. No direct cross-modal instruction was delivered. A series of probe sessions were completed to assess participants’ within-modal learning and cross-modal generalization of vocabulary learning. Results All children learned target words in both receptive and expressive conditions, as evidenced by an average of 80% accuracy across three trials at the end of each intervention. Overall, cross-modal generalization was higher for the expressive-to-receptive direction than for the receptive-to expressive direction. Nine out of ten children demonstrated successful cross-modal generalization on the expressive-to-receptive probes and only three children demonstrated successful cross-modal generalization on the receptive-to-expressive probes. Large variability was observed with regard to number of intervention sessions needed to reach mastery criterion and there were individual patterns of word learning. Conclusion Contrary to the assumption that vocabulary learning will be “automatically” generalized across modalities, results from this study indicate that cross-modal generalization at the word level is not automatic nor consistent in children with autism spectrum disorder, particularly in the receptive-to-expressive direction. Implications The finding that more children demonstrated expressive-to-receptive generalization than the opposite direction suggests that targeting expressive vocabulary first with the goal of incidentally increasing receptive vocabulary may be more efficient than starting with the receptive modality. Additionally, the finding that not all children demonstrated successful expressive-to-receptive cross-modal generalization indicates that teaching vocabulary in the expressive modality exclusively does not guarantee receptive understanding in this population. We recommend that practitioners periodically monitor children’s vocabulary learning in both modalities or set an explicit generalization goal to ensure complete learning of trained words.
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Petruzzelli, Maria Giuseppina, Emilia Matera, Donatella Giambersio, Lucia Marzulli, Alessandra Gabellone, Anna Rosi Legrottaglie, Anna Margari, and Lucia Margari. "Subjective and Electroencephalographic Sleep Parameters in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review." Journal of Clinical Medicine 10, no. 17 (August 30, 2021): 3893. http://dx.doi.org/10.3390/jcm10173893.
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Background: Sleep problems have commonly manifested in children and adolescents with autism spectrum disorder (ASD) with a complex and multifactorial interaction between clinical and etiological components. These disorders are associated with functional impairment, and provoke significant physical and mental affliction. The purpose of this study is to update the existing literature about objective and subjective sleep parameters in children and adolescents with ASD, extrapolating information from polysomnography or sleep electroencephalography, and sleep related questionnaires. Methods: We have conducted a systematic review of case-control studies on this topic, performing a web-based search on PubMed, Scopus and the Web of Science databases according to the Preferred Reporting items for Systematic Review and Meta-analyses (PRISMA) guidelines. Results: Data collected from 20 survey result reports showed that children and adolescents with ASD experienced a higher rate of sleep abnormalities than in typically developing children. The macrostructural sleep parameters that were consistent with subjective parent reported measures unveil a greater percentage of nighttime signs of insomnia. Sleep microstructure patterns, in addition, pointed towards the bidirectional relationship between brain dysfunctions and sleep problems in children with ASD. Conclusions: Today’s literature acknowledges that objective and subjective sleep difficulties are more often recognized in individuals with ASD, so clinicians should assess sleep quality in the ASD clinical population, taking into consideration the potential implications on treatment strategies. It would be worthwhile in future studies to examine how factors, such as age, cognitive level or ASD severity could be related to ASD sleep abnormalities. Future research should directly assess whether sleep alterations could represent a specific marker for atypical brain development in ASD.
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Broder Fingert, Sarabeth, Alice Carter, Karen Pierce, Wendy L. Stone, Amy Wetherby, Chris Scheldrick, Christopher Smith, et al. "Implementing systems-based innovations to improve access to early screening, diagnosis, and treatment services for children with autism spectrum disorder: An Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services network study." Autism 23, no. 3 (April 10, 2018): 653–64. http://dx.doi.org/10.1177/1362361318766238.
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In 2013, the National Institute of Mental Health funded five trials of unique, multicomponent, systems-based innovations designed to improve access to early screening, diagnosis, and treatment of autism spectrum disorder—collectively known as the Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services Network. As part of an ongoing effort to pool data and learn from shared experience, we collected information across all studies about innovation components and implementation strategies. First, each study group completed standardized checklists based on the Template for Intervention Description and Replication and the Expert Recommendation for Implementing Change. Then, we interviewed principal and co-investigators of each study (n = 9) to further explore innovation components and assess barriers and facilitators to implementation. Innovation strategies were diverse (five different autism spectrum disorder screeners were used, 40% included early intervention trainings, 60% involved new technology). Common implementation strategies included developing stakeholder relationships and provider trainings. Barriers included inefficient systems of care, difficulty engaging families in the innovations, provider attitudes, and organizational culture (e.g. difficulty changing clinic processes). These findings suggest that—despite diverse settings and a variety of innovation content—common facilitators and challenges exist in implementing innovations to enhance access to early autism spectrum disorder screening, diagnosis, and treatment.
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Noiprawa, Nipattha, and Nopadon Sahachaisaeree. "Interior Environment Enhancing Child Development." Asian Journal of Environment-Behaviour Studies 2, no. 5 (October 25, 2017): 53–61. http://dx.doi.org/10.21834/aje-bs.v2i5.222.
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Environment has been a crucial factor determining the effectiveness of medical treatment, especially for mentally related disorders. The study uses the autistic treatment environment as a case study to examine relevant environmental factors supporting the learning process of autistic children towards an environmental design model, the improvement in behaviour, and be able to stabilize the patient’s emotion. Results from the study are useful for the prognostic study in autism. The final modelling could be applied as a part of special educational programs to extenuate the behavioural and emotional disorders and to improve the social skills in autistic children.
Keywords: Physical Treatment; Interior-Environment; Child Autistic
eISSN 2514-751X © 2017 The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
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Williams Buckley, Ashura, Deborah Hirtz, Maryam Oskoui, Melissa J. Armstrong, Anshu Batra, Carolyn Bridgemohan, Daniel Coury, et al. "Practice guideline: Treatment for insomnia and disrupted sleep behavior in children and adolescents with autism spectrum disorder." Neurology 94, no. 9 (February 12, 2020): 392–404. http://dx.doi.org/10.1212/wnl.0000000000009033.
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ObjectiveTo review pharmacologic and nonpharmacologic strategies for treating sleep disturbances in children and adolescents with autism spectrum disorder (ASD) and to develop recommendations for addressing sleep disturbance in this population.MethodsThe guideline panel followed the American Academy of Neurology 2011 guideline development process, as amended. The systematic review included studies through December 2017. Recommendations were based on evidence, related evidence, principles of care, and inferences.Major recommendations (Level B)For children and adolescents with ASD and sleep disturbance, clinicians should assess for medications and coexisting conditions that could contribute to the sleep disturbance and should address identified issues. Clinicians should counsel parents regarding strategies for improved sleep habits with behavioral strategies as a first-line treatment approach for sleep disturbance either alone or in combination with pharmacologic or nutraceutical approaches. Clinicians should offer melatonin if behavioral strategies have not been helpful and contributing coexisting conditions and use of concomitant medications have been addressed, starting with a low dose. Clinicians should recommend using pharmaceutical-grade melatonin if available. Clinicians should counsel children, adolescents, and parents regarding potential adverse effects of melatonin use and the lack of long-term safety data. Clinicians should counsel that there is currently no evidence to support the routine use of weighted blankets or specialized mattress technology for improving disrupted sleep. If asked about weighted blankets, clinicians should counsel that the trial reported no serious adverse events with blanket use and that blankets could be a reasonable nonpharmacologic approach for some individuals.
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Lucchelli, Juan Pablo, and Gilles Bertschy. "Low-Dose Fluoxetine in Four Children with Autistic Spectrum Disorder Improves Self-Injurious Behavior, ADHD-Like Symptoms, and Irritability." Case Reports in Psychiatry 2018 (May 30, 2018): 1–4. http://dx.doi.org/10.1155/2018/6278501.
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Autism Spectrum Disorder (ASD) is defined by the copresence of two core symptoms: alteration in social communication and repetitive behaviors and/or restricted interests. In ASD children and adults, irritability, self-injurious behavior (SIB), and Attention Deficit and Hyperactivity Disorders- (ADHD-) like symptoms are regularly observed. In these situations, pharmacological treatments are sometimes used. Selective Serotonin Reuptake Inhibitors- (SSRI-) based treatments have been the subject of several publications: case reports and controlled studies, both of which demonstrate efficacy on the symptoms mentioned above, even if no consensus has been reached concerning their usage. In this article four clinical cases of children diagnosed with ASD and who also present ADHD-like symptoms and/or SIB and/or other heteroaggressive behaviors or irritability and impulsivity treated with low doses of fluoxetine are presented.
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Nik Adib, Nik Aida, Mohd Ismail Ibrahim, Azriani Ab Rahman, Raishan Shafini Bakar, Nor Azni Yahaya, Suria Hussin, and Wan Nor Arifin Wan Mansor. "Perceived Stress among Caregivers of Children with Autism Spectrum Disorder: A State-Wide Study." International Journal of Environmental Research and Public Health 16, no. 8 (April 25, 2019): 1468. http://dx.doi.org/10.3390/ijerph16081468.
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Background: Caregivers of children with autism spectrum disorder (ASD) experience increased stress and more significant negative caregiving consequences than those with typically developing children. There is a lack of studies specifically focusing on stress among caregivers with ASD children in Asian countries. The current study examines levels of perceived stress and factors associated with it among caregivers in Kelantan, Malaysia. Methods: In a cross-sectional study, the Malay version of the Perceived Stress Scale (PSS) was administered to 227 caregivers of children with ASD. The caregivers were recruited from ASD databases in four tertiary hospitals in Kelantan and a meeting was set up during the child’s follow-up in the clinic. Multiple linear regression analyses were applied to determine the predictors of perceived stress. Results: The mean total perceived stress score was 20.84 (4.72). This was considered higher than average. Higher perceived stress was significantly predicted among caregivers who live far from the health institution, caregivers who do not own transportation to bring the child to the treatment center, and caregivers who have an ASD child with a learning disability. Conclusion: Caregivers of an ASD child perceived significant stress while taking care of their children. Institutions should alleviate the factors that were predicted to increase the caregivers’ perceived stress to improve the quality of the lives of children and ASD families as a whole.
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Zhao, Wang, and Long Lu. "Research and development of autism diagnosis information system based on deep convolution neural network and facial expression data." Library Hi Tech 38, no. 4 (March 25, 2020): 799–817. http://dx.doi.org/10.1108/lht-08-2019-0176.
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PurposeFacial expression provides abundant information for social interaction, and the analysis and utilization of facial expression data are playing a huge driving role in all areas of society. Facial expression data can reflect people's mental state. In health care, the analysis and processing of facial expression data can promote the improvement of people's health. This paper introduces several important public facial expression databases and describes the process of facial expression recognition. The standard facial expression database FER2013 and CK+ were used as the main training samples. At the same time, the facial expression image data of 16 Chinese children were collected as supplementary samples. With the help of VGG19 and Resnet18 algorithm models of deep convolution neural network, this paper studies and develops an information system for the diagnosis of autism by facial expression data.Design/methodology/approachThe facial expression data of the training samples are based on the standard expression database FER2013 and CK+. FER2013 and CK+ databases are a common facial expression data set, which is suitable for the research of facial expression recognition. On the basis of FER2013 and CK+ facial expression database, this paper uses the machine learning model support vector machine (SVM) and deep convolution neural network model CNN, VGG19 and Resnet18 to complete the facial expression recognition.FindingsIn this study, ten normal children and ten autistic patients were recruited to test the accuracy of the information system and the diagnostic effect of autism. After testing, the accuracy rate of facial expression recognition is 81.4 percent. This information system can easily identify autistic children. The feasibility of recognizing autism through facial expression is verified.Research limitations/implicationsThe CK+ facial expression database contains some adult facial expression images. In order to improve the accuracy of facial expression recognition for children, more facial expression data of children will be collected as training samples. Therefore, the recognition rate of the information system will be further improved.Originality/valueThis research uses facial expression data and the latest artificial intelligence technology, which is advanced in technology. The diagnostic accuracy of autism is higher than that of traditional systems, so this study is innovative. Research topics come from the actual needs of doctors, and the contents and methods of research have been discussed with doctors many times. The system can diagnose autism as early as possible, promote the early treatment and rehabilitation of patients, and then reduce the economic and mental burden of patients. Therefore, this information system has good social benefits and application value.
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Pesko, Matthew J., Eugene M. Burbige, Elise M. Sannar, Carol Beresford, Chris Rogers, Merlin Ariefdjohan, and Danielle Stutzman. "The Use of N-acetylcysteine Supplementation to Decrease Irritability in Four Youths With Autism Spectrum Disorders." Journal of Pediatric Pharmacology and Therapeutics 25, no. 2 (March 1, 2020): 149–54. http://dx.doi.org/10.5863/1551-6776-25.2.149.
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Children and adolescents with autism spectrum disorder (ASD) often experience high levels of irritability, which adversely affects their functioning and behaviors. N-acetylcysteine (NAC), an antioxidant precursor to glutathione, has recently been studied for a variety of neuropsychiatric disorders. There is growing evidence to support its use to decrease irritability and self-injurious behaviors in youth with ASD. However, previous studies were limited to outpatient youth with mild symptoms of irritability, maintained on stable medication regimens, who do not meet criteria for higher levels of care. We describe the use of NAC among 4 youths (14–17 years) with ASD who had Aberrant Behavior Checklist-Irritability (ABC-I) scores of ≥ 20 and other psychotropic medication trials prior to treatment with NAC. In all of the cases, NAC appeared to be well tolerated. There was a reduction of symptoms of irritability and/or antipsychotic medication dosages in these cases; despite this, the authors cannot know whether use of NAC or other medication or behavioral strategies were responsible for such changes because this study was not a controlled trial.
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Crawford, Mike J., Christian Gold, Helen Odell-Miller, Lavanya Thana, Sarah Faber, Jörg Assmus, Łucja Bieleninik, et al. "International multicentre randomised controlled trial of improvisational music therapy for children with autism spectrum disorder: TIME-A study." Health Technology Assessment 21, no. 59 (October 2017): 1–40. http://dx.doi.org/10.3310/hta21590.
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Background Preliminary studies have indicated that music therapy may benefit children with autism spectrum disorders (ASD). Objectives To examine the effects of improvisational music therapy (IMT) on social affect and responsiveness of children with ASD. Design International, multicentre, three-arm, single-masked randomised controlled trial, including a National Institute for Health Research (NIHR)-funded centre that recruited in London and the east of England. Randomisation was via a remote service using permuted blocks, stratified by study site. Setting Schools and private, voluntary and state-funded health-care services. Participants Children aged between 4 and 7 years with a confirmed diagnosis of ASD and a parent or guardian who provided written informed consent. We excluded children with serious sensory disorder and those who had received music therapy within the past 12 months. Interventions All parents and children received enhanced standard care (ESC), which involved three 60-minute sessions of advice and support in addition to treatment as usual. In addition, they were randomised to either one (low-frequency) or three (high-frequency) sessions of IMT per week, or to ESC alone, over 5 months in a ratio of 1 : 1 : 2. Main outcome measures The primary outcome was measured using the social affect score derived from the Autism Diagnostic Observation Schedule (ADOS) at 5 months: higher scores indicated greater impairment. Secondary outcomes included social affect at 12 months and parent-rated social responsiveness at 5 and 12 months (higher scores indicated greater impairment). Results A total of 364 participants were randomised between 2011 and 2015. A total of 182 children were allocated to IMT (90 to high-frequency sessions and 92 to low-frequency sessions), and 182 were allocated to ESC alone. A total of 314 (86.3%) of the total sample were followed up at 5 months [165 (90.7%) in the intervention group and 149 (81.9%) in the control group]. Among those randomised to IMT, 171 (94.0%) received it. From baseline to 5 months, mean scores of ADOS social affect decreased from 14.1 to 13.3 in music therapy and from 13.5 to 12.4 in standard care [mean difference: music therapy vs. standard care = 0.06, 95% confidence interval (CI) –0.70 to 0.81], with no significant difference in improvement. There were also no differences in the parent-rated social responsiveness score, which decreased from 96.0 to 89.2 in the music therapy group and from 96.1 to 93.3 in the standard care group over this period (mean difference: music therapy vs. standard care = –3.32, 95% CI –7.56 to 0.91). There were seven admissions to hospital that were unrelated to the study interventions in the two IMT arms compared with 10 unrelated admissions in the ESC group. Conclusions Adding IMT to the treatment received by children with ASD did not improve social affect or parent-assessed social responsiveness. Future work Other methods for delivering music-focused interventions for children with ASD should be explored. Trial registration Current Controlled Trials ISRCTN78923965. Funding This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 59. See the NIHR Journals Library website for further project information.
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Melbye, Sigurd, Lars Vedel Kessing, Jakob Eyvind Bardram, and Maria Faurholt-Jepsen. "Smartphone-Based Self-Monitoring, Treatment, and Automatically Generated Data in Children, Adolescents, and Young Adults With Psychiatric Disorders: Systematic Review." JMIR Mental Health 7, no. 10 (October 29, 2020): e17453. http://dx.doi.org/10.2196/17453.
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Background Psychiatric disorders often have an onset at an early age, and early identification and intervention help improve prognosis. A fine-grained, unobtrusive, and effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and potentially lead to a more efficient use of clinical resources in the current health care system. The use of smartphones to monitor and treat children, adolescents, and young adults with psychiatric disorders has been widely investigated. However, no systematic review concerning smartphone-based monitoring and treatment in this population has been published. Objective This systematic review aims at describing the following 4 features of the eligible studies: (1) monitoring features such as self-assessment and automatically generated data, (2) treatment delivered by the app, (3) adherence to self-monitoring, and (4) results of the individual studies. Methods We conducted a systematic literature search of the PubMed, Embase, and PsycInfo databases. We searched for studies that (1) included a smartphone app to collect self-monitoring data, a smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had participants who were younger than 25 years; and (4) were published in a peer-reviewed journal. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias in each individual study was systematically assessed. Results A total of 2546 unique studies were identified through literature search; 15 of these fulfilled the criteria for inclusion. These studies covered 8 different diagnostic groups: psychosis, eating disorders, depression, autism, self-harm, anxiety, substance abuse, and suicidal behavior. Smartphone-based self-monitoring was used in all but 1 study, and 11 of them reported on the participants’ adherence to self-monitoring. Most studies were feasibility/pilot studies, and all studies on feasibility reported positive attitudes toward the use of smartphones for self-monitoring. In 2 studies, automatically generated data were collected. Three studies were randomized controlled trials investigating the effectiveness of smartphone-based monitoring and treatment, with 2 of these showing a positive treatment effect. In 2 randomized controlled trials, the researchers were blinded for randomization, but the participants were not blinded in any of the studies. All studies were determined to be at high risk of bias in several areas. Conclusions Smartphones hold great potential as a modern, widely available technology platform to help diagnose, monitor, and treat psychiatric disorders in children and adolescents. However, a higher level of homogeneity and rigor among studies regarding their methodology and reporting of adherence would facilitate future reviews and meta-analyses.
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Jansen, Rianne, Jarymke Maljaars, Inge Zink, Jean Steyaert, and Ilse Noens. "The complexity of early diagnostic decision making: A follow-up study of young children with language difficulties." Autism & Developmental Language Impairments 6 (January 2021): 239694152098489. http://dx.doi.org/10.1177/2396941520984894.
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Background & aims Due to the complexity of early diagnostic decision making, we examined the predictive value of an early diagnostic classification and early abilities on later best estimate diagnosis for 22 clinically referred children with language difficulties. Methods and procedures Four years after initial evaluation (Time 1), the clinical files of these children were reviewed. A best-estimate (BE) diagnosis of language disorder (LD), intellectual disability (ID), or autism spectrum disorder (ASD) was established, with ASD being most common. Outcomes and results Early clinical classifications were relatively unstable or difficult to establish at a young age. The magnitude of children’s cognitive and receptive language delay was a significant predictor of a later BE diagnosis of ID and LD respectively. A BE diagnosis of ASD, by contrast, could not be predicted from children’s early social communication problems nor the presence of restricted and repetitive behaviors and interests. Conclusions Taken together, the results of this study suggest that language difficulties can be an early marker of a neurodevelopmental disorder which is often not identified at the age of first referral. Implications Eligibility for treatment should, therefore, be based on biopsychosocial case formulation rather than DSM or ICD diagnostic classification. What this paper adds? In this study a dimensional approach was used to characterize the abilities of young children referred with mild to profound receptive and/or expressive language difficulties. Later on, a categorical approach was adopted to establish best estimate diagnoses. Our clinical, broadly defined sample reflects the heterogeneous intake of young children referred for diagnostic assessment. Other studies on diagnostic stability often only focus on one diagnostic category (and are explicitly excluding children with specific other diagnoses), not taking into account the difficulties of early differential diagnostic decision making and stability across different categories over time. Investigations of differential diagnosis within a clinical group, instead of only differentiating children with a specific diagnosis from typically developing children, may be more informative for clinicians.
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Wright, Barry, David Marshall, Joy Adamson, Hannah Ainsworth, Shehzad Ali, Victoria Allgar, Danielle Collingridge Moore, et al. "Social Stories™ to alleviate challenging behaviour and social difficulties exhibited by children with autism spectrum disorder in mainstream schools: design of a manualised training toolkit and feasibility study for a cluster randomised controlled trial with nested qualitative and cost-effectiveness components." Health Technology Assessment 20, no. 6 (January 2016): 1–258. http://dx.doi.org/10.3310/hta20060.
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BackgroundA Social Story™ (Carol Gray) is a child-friendly intervention that is used to give children with autism spectrum disorders (ASDs) social information in situations where they have social difficulties. Limited evidence mainly using single-case designs suggests that they can reduce anxiety and challenging behaviour.ObjectivesThe objectives were to conduct a systematic review, use this to develop a manualised intervention and run a feasibility trial to inform a fully powered randomised controlled trial (RCT) on their clinical effectiveness and cost-effectiveness in schools.DesignThis is a three-stage study following the Medical Research Council framework for complex interventions. Specifically, it involved a theoretical phase, a qualitative stage and a feasibility trial stage.SettingQualitative interviews and focus groups took place in Child and Adolescent Mental Health Service and primary care settings. The feasibility study took place in 37 local mainstream schools.ParticipantsFifty children (aged 5–15 years) in mainstream school settings with a diagnosis of ASD were entered into the trial. For each child, an associated teacher and parent was also recruited.InterventionsThe intervention was a goal-setting session followed by a manualised toolkit (including a training session) for creating Social Stories™ for use with school-aged children. The comparator treatment was a goal-setting session followed by an attention control. Both arms received treatment as usual.Main outcome measuresOutcomes tested as part of the feasibility study included child- and proxy-completed questionnaires for mental health, quality of life and goal-based outcome measures. Adults additionally completed behaviour diaries and the parental stress index.ResultsThe review found that the research into social stories is predominantly based in the USA, carried out in under-12-year-olds and using single-case designs. Most studies either did not follow established Social Story criteria or did not report if they did. The assessment of effectiveness presents a largely positive picture but is limited by methodological issues. There were no adequate RCTs and insufficient information to assess a number of important sources of potential bias in most studies. A manualised intervention was produced using an iterative process between user focus groups and a writing team, and assessed in the feasibility study. All 50 participant groups were recruited within the study time frame. Two outcome measures, the Social Responsiveness Scale-2 and the custom-made goal-based measure, showed high levels of completion rates and appeared to be capturing social and behaviour skills targeted by the use of Social Stories. Detailed recommendations for a full trial are provided.LimitationsBlinding of participants was not feasible. Treatment fidelity was not assessed because of low levels of story return rates.ConclusionsThe study showed that a fully powered RCT is feasible with an extended geographical footprint. A large amount of data and information has helped to inform the design of this RCT, which will be the subject of a future research grant application. Future work could focus on developing an appropriate blinded outcome measure for this population.Study registrationThis study is registered as PROSPERO CRD42011001440.Trial registrationCurrent Controlled Trials ISRCTN96286707.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 6. See the NIHR Journals Library website for further project information.
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Bouaziz, Wajdi, Mohamed Ali Rebai, Mohamed Ali Rekik, Nabil Krid, Zoubaier Ellouz, and Hassib Keskes. "Scurvy: When it is a Forgotten Illness the Surgery Makes the Diagnosis." Open Orthopaedics Journal 11, no. 1 (November 20, 2017): 1314–20. http://dx.doi.org/10.2174/1874325001711011314.
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Background: Unlike most of animal species, human beings lack the enzymatic process for the conversion of glucose to ascorbic acid (vitaminC), and therefore getting the vitamin from food sources is essential. The association of the various signs caused by a deficiency of vitamin C is called scurvy or Barlow’s disease, an easily treatable disease but can be fatal. It is rare in the developed countries and even economically underdeveloped societies in which the basic diet is already rich in ascorbate. Methods: We describe here the case of a 4-year-old girl with cerebral palsy, in whom diagnosis concerns were oriented for osteomyelitis, based upon clinical presentation, ultrasonic and magnetic resonance imaging, led to a surgery revealing subperiosteal hematomas that argues in favor of scurvy. Results: After vitamin C therapy, the symptoms are gone and the general condition of the patient improved despite persistent radiological signs. Conclusion: Recent studies of sporadic cases report a high incidence of scurvy in children with autism or psychomotor retardation and the fact that musculoskeletal manifestations are more common. The mosaics of the symptoms of scurvy are varied and include dermatological, dental, bone and systemic manifestations, making it a forgotten and misdiagnosed illness. A heightened awareness is needed to avoid an unnecessary surgery, unnecessary tests and procedures and to be able to start treatment for a potentially fatal but easily curable disease.
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Rodgers, Mark, David Marshall, Mark Simmonds, Ann Le Couteur, Mousumi Biswas, Kath Wright, Dheeraj Rai, Stephen Palmer, Lesley Stewart, and Robert Hodgson. "Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis." Health Technology Assessment 24, no. 35 (July 2020): 1–306. http://dx.doi.org/10.3310/hta24350.
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Background Early intensive applied behaviour analysis-based interventions are intensive interventions for autistic children that are often delivered on a one-to-one basis for 20–50 hours per week. Objectives To evaluate the clinical effectiveness and cost-effectiveness of early intensive applied behaviour analysis-based interventions for autistic children, based on current evidence. Methods A systematic review and individual participant data meta-analysis were conducted to evaluate the clinical effectiveness of an early intensive applied behaviour analysis-based intervention for autistic children. An economic analysis included a review of existing analyses and the development of a new model. Results Twenty studies were included in the clinical review. Individual participant data were retrieved from 15 of these studies. Results favoured the interventions when assessing adaptive behaviour after 2 years compared with treatment as usual/eclectic interventions (mean difference 7.00, 95% confidence interval 1.95 to 12.06). In analyses of cognitive ability (intelligence quotient), results favoured the interventions by approximately 10 points after 1 year (mean difference 9.16, 95% confidence interval 4.38 to 13.93) and 2 years (mean difference 14.13, 95% confidence interval 9.16 to 19.10). Evidence for other outcomes was limited and meta-analyses were generally inconclusive. There was no evidence that the effect of the interventions varied with characteristics of the children, but data were limited. Adopting a £30,000 per quality-adjusted life-year threshold, the results of the cost-effectiveness analysis indicate that early intensive applied behaviour analysis-based interventions would need to generate larger benefits or cost savings to be cost-effective. Adopting a public sector perspective and making pessimistic assumptions about long-term effects, the incremental cost-effectiveness ratio for early intensive applied behaviour analysis-based therapy compared with treatment as usual is £189,122 per quality-adjusted life-year. When optimistic assumptions are made, the incremental cost-effectiveness ratio is £46,768 per quality-adjusted life-year. Scenario analyses indicated that these interventions can potentially be cost-effective if long-term improvements persist into adulthood, or if they have significant impact on educational placement. Care should be taken when interpreting these scenarios owing to the limited data. Limitations All included studies were at risk of bias, there was substantial heterogeneity and effects varied considerably across studies. The effect of intervention on autism symptom severity, language development and school placement remains uncertain because of the limited data. The long-term effects are unclear owing to a lack of follow-up data. Conclusions This review found limited evidence that early intensive applied behaviour analysis-based interventions may improve cognitive ability and adaptive behaviour, but the long-term impact of the interventions remains unknown. The economic analysis is constrained by the limited effectiveness evidence, but suggests that these interventions are unlikely to be cost-effective unless clear long-term benefits, or a substantial change in which schools children attend, can be identified. Future work Further studies into the effectiveness of early intensive applied behaviour analysis-based interventions may be warranted if they include well-defined, alternative interventions as comparators and collect relevant outcomes. Consideration should be given to future studies that not only address whether or not early intensive applied behaviour analysis-based interventions are clinically effective, but also aim to identify which components of early intensive applied behaviour analysis-based interventions might drive effectiveness. Study registration This study is registered as PROSPERO CRD42017068303. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 35. See the NIHR Journals Library website for further project information.
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Kara, Imaan, and Melanie Penner. "MANAGEMENT OF CHILDREN AND YOUTH WITH NEURODEVELOPMENTAL DISORDERS (NDDS) IN COMMUNITY SETTINGS PRIOR TO REFERRAL TO A TERTIARY PSYCHOPHARMACOLOGY CLINIC." Paediatrics & Child Health 23, suppl_1 (May 18, 2018): e33-e34. http://dx.doi.org/10.1093/pch/pxy054.087.
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Abstract BACKGROUND The use of second-generation antipsychotic (SGA) medications to alleviate irritability and aggression in children with autism spectrum disorder (ASD) has increased in the past decade. Although efficacious, SGAs are associated with cardiometabolic and neurologic risks. In 2011, the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) published a set of SGA monitoring guidelines to minimize these adverse effects (AEs). OBJECTIVES Primary: To determine how the introduction of the CAMESA Guidelines has impacted the frequency of clinical and laboratory investigations to monitor for AEs in children/youth with NDDs treated with SGAs. Secondary: (1) Describe the sample of children/youth referred to a tertiary psychopharmacology clinic; (2) Determine SGA prescription rates and treatment duration. DESIGN/METHODS A retrospective chart review was undertaken to compare rates of clinical monitoring of children/youth with NDDs treated with SGAs and referred to a tertiary psychopharmacology clinic before (2008- 2011) and after (2013–2016) publication of the CAMESA Guidelines. Children treated with SGAs were divided into three categories based on reports of clinical monitoring: (1) Any investigations complete, (2) No investigations complete, and (3) Not specified. A Fischer’s exact test was used to detect a statistically significant change in monitoring rates between the two time periods. Thoroughness of monitoring by CAMESA standards was also assessed. Descriptive statistics were used to address secondary objectives. RESULTS A total of 285 charts were reviewed (n=135 pre-CAMESA, n=150 post-CAMESA). The average age of children referred to the psychopharmacology clinic was 10.4 years (range 2–18 years), with ASD as the most prevalent diagnosis amongst the population. The most common reasons for referral were aggression and hyperactivity/impulsivity. Forty-one percent of referred children had been prescribed an SGA before arriving at the clinic, and the median duration of treatment was 17 months at the time of the first clinic visit. There is a nonsignificant difference (p=0.62) in the proportion of children on SGAs (n=48 pre-CAMESA, n=70 post-CAMESA) being monitored for AEs before and after publication of the guidelines. Monitoring rates pre- and post-CAMESA were 35% and 44%, respectively. Of the children monitored, only 33% in the pre-CAMESA period and 63% in the post-CAMESA period underwent comprehensive investigations. This again represents a nonsignificant difference (p=0.11) in thoroughness of monitoring between the two time periods. CONCLUSION We aim to provide novel insight into current SGA monitoring practices and emphasize the importance of health risk minimization when prescribing these medications. Given that SGA monitoring rates did not significantly improve after CAMESA guideline publication, and that less than half of children on SGAs underwent monitoring, we have identified a gap in standard of care provision. There is a need to undertake future studies to identify barriers to guideline uptake and implement interventions to address them.
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Loku, Lindita, Bekim Fetaji, and Aleksandar Krsteski. "AUTOMATED MEDICAL DATA ANALYSES OF DISEASES USING BIG DATA." Knowledge International Journal 28, no. 5 (December 10, 2018): 1719–24. http://dx.doi.org/10.35120/kij28051719l.
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Diagnosis of different diseases is a growing concern and one of the most difficult challenges for modern medicine. Current diagnosis technologies (e.g. magnetic resonance imaging, electroencephalogram) produce huge quantity data (in size and dimension) for detection, monitoring and treatment of neurological diseases. In general, analysis of those medical big data is performed manually by experts to identify and understand the abnormalities. It is really difficult task for a person to accumulate, manage, analyse and assimilate such large volumes of data by visual inspection. As a result, the experts have been demanding computerised diagnosis systems, called “computer-aided diagnosis (CAD)” that can automatically detect the neurological abnormalities using the medical big data. This system improves consistency of diagnosis and increases the success of treatment, save lives and reduce cost and time. Recently, there are some research works performed in the development of the CAD systems for management of medical big data for diagnosis assessment. Such data analyses to realize diagnosis is very interesting for diabetes and autism. Many companies and research groups are working to treat diabetes, but preventing the disease will have a greater impact on health in at-risk groups. A team of US researchers are using data analytics to create a precision medicine approach to prevention of diabetes that steers efforts towards those who are at highest risk of developing the disease and who would benefit most from drug treatment or preventive lifestyle strategies. The analyses yielded most important 17 factors that were assessed that could predict an individual’s risk of diabetes. Autism Spectrum Disorder (ASD) is characterized by difficulties in social communication, social interactions, and repetitive behaviors. It is diagnosed during the first three years of life. Early and intensive interventions have been shown to improve the developmental trajectory of the affected children. The earlier the diagnosis, the sooner the intervention therapy can begin, thus, making early diagnosis is set as our important research goal. Because ASD is not a neurodegenerative disorder, many of the core symptoms can improve as the individuals learn to cope with their environments under the right conditions. The earlier the age at which intervention can be started, the better their learning and daily function can be facilitated. Recent Big Data software packages and innovations in Artificial Intelligence have tremendous potential to assist with early diagnosis and improve intervention programs. The research study will focus on methodological evaluation of emerging technologies and will investigate by comparing different data sets and find a pattern that can be established as prognosis system. The research study investigated peer-reviewed studies in order to understand the current status of empirically-based evidence on the clinical applications in the diagnosis and treatment of Autism Spectrum Disorders (ASD). Also a survey and investigation on different sensing technologies for ASD like: eye trackers, movement trackers, electrodermal activity monitors, tactile sensors, vocal prosody and speech detectors. We assess their effectiveness and study their limitations. We also examine the challenges faced by this growing field that need to be addressed before these technologies can perform up to their theoretical potential In some cases, a technology is unable to deliver up to its potential, not due to the hardware but due to the inefficiency of the accompanied algorithms, as in the case of classifiers for repetitive behavior detection. Therefore, equal emphasis needs to be placed on the improvement of all aspects of a tracking technology. The nature of the sensors makes the tracked data very sensitive to experimental and systematic errors, often causing the collected data to be discarded due to unreliability. Efforts to reduce such inaccuracies can significantly improve the performance and potential of the overall technology. By collecting specific data, these sensors may be able to acquire objective measures that can be used to identify symptoms specific to ASD. The contribution of the analyses will assist not only the therapists and clinicians in their selection of suitable tools, but to also guide the developers of the technologies and devise new algorithm in prediction of autism.
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Diehl, Sylvia, Jane Wegner, and Emily Rubin. "Children with Autism Spectrum Disorders: Three Case Studies." ASHA Leader 15, no. 1 (January 2010): 14–17. http://dx.doi.org/10.1044/leader.ftr2.15012010.14.
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James, B. Jordan, Mark A. Gales, and Barry J. Gales. "Bumetanide for Autism Spectrum Disorder in Children: A Review of Randomized Controlled Trials." Annals of Pharmacotherapy 53, no. 5 (December 2, 2018): 537–44. http://dx.doi.org/10.1177/1060028018817304.
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Objective: To evaluate clinical trials using bumetanide in autism spectrum disorder (ASD) treatment. Data Sources: PubMed and Ovid MEDLINE (1946 to October 2018) were searched using terms bumetanide and autism. Bibliographies were reviewed for other relevant trials. Study Selection and Data Extraction: English language, randomized, controlled, clinical trials in humans were evaluated. Three trials met all inclusion criteria. Data Synthesis: Oral bumetanide was studied in 208 patients, 2 to 18 years old, with ASD. Trials evaluated bumetanide’s impact on core behavioral features using several different autism assessment scales. All trials used the Childhood Autism Rating Scale to assess improvement at 90 days, with one trial finding statistical significance. The Clinical Global Impressions Scale identified statistically significant improvements in 2 of the 3 trials. The Autism Behavioral Checklist and Social Responsiveness Scales identified statistical benefit in the 2 trials utilizing those outcomes. Behaviors most improved by bumetanide included social communication, interactions, and restricted interest. No dose-effect correlation was identified in the dose-ranging trial. Adverse effects, including hypokalemia and polyuria, occurred more often with higher doses and resulted in withdrawal rates of 17% to 43%. Bumetanide 0.5 mg twice daily was the most studied and best tolerated dose. Limitations included unclear clinical success definitions and evaluation methodology variability. Relevance to Patient Care and Clinical Practice: No effective treatment options for core ASD symptoms have been approved. This review presents preliminary safety and efficacy data for bumetanide in ASD. Conclusions: Low-dose oral bumetanide may be useful in patients with moderate to severe ASD when behavioral therapies are not available.
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Sherifi, Edo. "Therapies and Treatment for Children with Autism Spectrum Disorder: (Case Study)." Mediterranean Journal of Social Sciences 9, no. 6 (November 1, 2018): 157–64. http://dx.doi.org/10.2478/mjss-2018-0171.
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Abstract Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder characterized by impairments in social communication and restricted, repetitive patterns of behavior, interests or activities (American Psychiatric Association, 1994) (APA). Case Study of autistic child D.S. treated with (IEP) program and therapeutic methods. Direct observation of the vertical grid with the child treated with (IEP) program and professional techniques was used for the realization of the study, semi-structured interviews with actors and factors that have access to autistic children. Focus group with field specialists who create a multidisciplinary team. Child testing with the SON-R test proved that the age of the trained child increased 4 years. The non-exercising child's mental age increased only 7 months (2.5-3.2) years. Achievements of an autistic child treated with the Individualized Education Program, (IEP-1+IEP-2+IEP- 3 in the spheres exercised: The child has made progress in the psychomotor skills (learning). Results: (IEP-1-15%); (IEP-2-45%); (IEP-3-80%). Linguistic skills has not progressed, because it has serious brain damage in the part of communicative ability; the results in this sphere are: IEP-1-0%; IEP-2-5%; IEP-3-10%. The achievements of the child in the social sphere are: IEP-1-35%; IEP-2-45%; IEP-3-75%. Psychological treatment of autistic child with Individualized Education Program (IEP) and therapeutic methods resulted in success story.
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Widyagarini, Amrita, and Margaretha Suharsini. "Dental care for children with autism spectrum disorder." Dental Journal (Majalah Kedokteran Gigi) 50, no. 3 (February 21, 2018): 160. http://dx.doi.org/10.20473/j.djmkg.v50.i3.p160-165.
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Background: Providing dental treatment for children with autism spectrum disorder (ASD) represents a challenge for dentists. In the dental care of such children, the treatment plans implemented are usually determined by several factors, including: the type of autism spectrum disorder, the degree of patient cooperation, dentist/patient communication, the required treatment, self-care skills and parental/dentist support. Purpose: The purpose of this case report was to report the dental care delivered in the cases of two pediatric patients with ASD. Case 1: A 10.7 year-old boy with a nonverbal form of ASD who was experiencing recurrent pain in his lower left posterior tooth and also presented a blackened tooth. Case 2: A 9.6 year-old boy with a nonverbal form of ASD suffering from numerous painful cavities. Case management 1: On the day of the first visit, the boy was the subject of several behavioral observations. During the day of the second visit, he underwent a brief intraoral examination at a dental unit in order to arrive at a temporary diagnosis before appropriate was decided upon treatment in consultation with his parents. The implemented treatment plans comprised dental extraction and preventive restoration under general anesthesia. Case management 2: On the first visit, the boy underwent behavioral observations followed by early intraoral examination involving physical restraint approach. During the second visit, several treatment plans such as: general anesthesia, tooth extraction, restoration, and pulp-capping treatment were formulated. Conclusion: It can be concluded that general anesthesia was considered an appropriate dental treatment plan since the two patients in question were extremely co-operative during the necessary procedures. In other words, pediatric dental care treatment plans in cases of ASD should be determined by clearly-defined criteria, specifically the benefits and risks of the treatment plans for the safety of both patient and dental care team.
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Kamath, Swapna. "Challenges faced in homoeopathic treatment in autism – A case series." Journal of Integrated Standardized Homoeopathy 4 (April 27, 2021): 29–36. http://dx.doi.org/10.25259/jish_49_2020.
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Objectives: Autism spectrum disorder (ASD) is one of the most puzzling and complex of the neurodevelopmental disorders, especially regarding its diagnosis and management. The objective of this study was to achieve an in-depth understanding of the various challenges faced by a homoeopath and how homoeopathy is to be used conjointly with other ancillary measures in managing ASD. The case series highlights these and presents an integrated understanding of various concepts required by a homoeopath in effectively managing children with ASD. Materials and Methods: Detailed histories of the two cases were taken from the caregivers. Both patients were also observed in their day-to-day functioning, at school and during therapies. This further contributed to the early detection and diagnosis, planning appropriate management strategies, assessing the action of the selected remedy and deriving inferences. Homoeopathic treatment was used along with the required ancillary measures. Results: The challenges in managing the cases were mainly with respect to formulating a diagnosis, understanding the importance of disease evolution, differentiating between the common and the characteristic symptoms of the disease, application of homoeopathic principles and arriving at a similimum. On reflection, it showed the value of using the bio-psychosocial model to highlight the relationships among the different forces, determine the evolution in individual cases and emphasise the need for holistic intervention. The importance of a sound knowledge of the principles of homoeopathy and their correct application to arrive at a similimum was also learnt through reviewing the results of intervention. Further, the results showed that homoeopathy along with ancillary measures helped to bring about a significant change in functioning on all fronts and a better adaptation of the children to their environments. Conclusion: Homoeopathic intervention in children with autism holds a promise. Integration with ancillary measures enhances the outcome. Homoeopaths would need to train themselves in applying the bio-psychosocial model and integrating it with homoeopathic principles to ensure a favourable outcome. The findings of this study can provide important leads for professionals involved in the care of children with ASD and the affected families.
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Gerritsen, Jan. "The Effect of Tomatis Therapy on Children with Autism: Eleven Case Studies." International Journal of Listening 24, no. 1 (January 5, 2010): 50–68. http://dx.doi.org/10.1080/10904010903466378.
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Ming, Xue, Xiang Chen, Xiao T. Wang, Zhen Zhang, Victor Kang, and Barbie Zimmerman-Bier. "Acupuncture for Treatment of Autism Spectrum Disorders." Evidence-Based Complementary and Alternative Medicine 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/679845.
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Background. There has been lack of reviews of evidence on efficacy, methodology, and/or safety of acupuncture in autism spectrum disorders. This paper examines the emerging evidence of the effects of acupuncture in the treatment of autistic children.Method. A literature review was completed via Medline and three Chinese search engines. A total of 31 studies were evaluated for acupuncture methodology, study design, treatment effects, and tolerability.Results. The acupoints used, the duration of needling, the frequency of treatment, the choice of stimulation, and the course of the treatment were highly variable amongst the studies. Behavioral and/or developmental improvements were reported in all acupuncture treatment studies. All studies reported general tolerability. Weakness of experimental designs was discussed.Conclusions. Vigorously controlled double-blinded clinical trials are needed to evaluate the efficacy and safety of acupuncture in children with autism spectrum disorders.
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Paasch, Valerie, Lucy Leibowitz, Jennifer Accardo, and Keith Slifer. "Preparing children with autism spectrum disorders for overnight sleep studies: A case series." Clinical Practice in Pediatric Psychology 4, no. 2 (2016): 153–63. http://dx.doi.org/10.1037/cpp0000139.
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Ghorbandaei Pour, Ali, Alireza Taheri, Minoo Alemi, and Ali Meghdari. "Human–Robot Facial Expression Reciprocal Interaction Platform: Case Studies on Children with Autism." International Journal of Social Robotics 10, no. 2 (January 24, 2018): 179–98. http://dx.doi.org/10.1007/s12369-017-0461-4.
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DeFilippis, Melissa. "Depression in Children and Adolescents with Autism Spectrum Disorder." Children 5, no. 9 (August 21, 2018): 112. http://dx.doi.org/10.3390/children5090112.
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Autism spectrum disorder (ASD) has a high rate of psychiatric comorbidity. The prevalence of comorbid depression seems to correlate with higher functioning forms of ASD and increasing age. Adolescence is a time when youth struggle with identity and interpersonal relationships, and a diagnosis of ASD further complicates this process. Adolescents with ASD may be more aware of the social communication deficits that come with the diagnosis than children with ASD, and it is theorized that higher functioning adolescents may experience this more acutely. While this may be true, the lack of reliable rating and diagnostic scales for depression in individuals with ASD makes it difficult to accurately measure rates of depression among individuals with more severe verbal deficits. While some research has focused on the prevalence of comorbid depression in children and adolescents with ASD and on the associated risk factors, there is very little evidence guiding treatment, including no empirical studies on psychopharmacology for depression in this population. Available evidence exists only in psychosocial approaches to treatment at this time and is mostly limited to adult studies. Current evidence will be presented in this review, including prevalence rates of depression in youth with ASD, various risk and protective factors, the use of diagnostic rating scales, and treatment studies. The lack of evidence supporting various treatment approaches will be highlighted, including challenges specific to the treatment of depression in ASD, which are not addressed in the current treatment studies in typically developing youth with depression.
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Chester, Victoria L., and Matthew Calhoun. "Gait Symmetry in Children with Autism." Autism Research and Treatment 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/576478.
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Most studies examining gait asymmetry have focused on infants and toddlers and have tended to use subjective methods of evaluating movement. No previous studies have examined gait symmetry in older children with autism using objective motion capture systems. The purpose of this paper was to quantify gait symmetry in children with autism versus age-matched controls. Fourteen children with autism (N=14) and twenty-two (N=22) age, height, and weight-matched controls participated in the study. An eight camera Vicon motion capture system and four Kistler force plates were used to compute temporal-spatial parameters and symmetry indices during walking. Group differences in these measures were tested using MANOVAs. No significant differences between the autism and control group were found for any of the temporal-spatial measures or symmetry indices. Therefore, results suggest that children with autism demonstrate typical symmetry or interlimb movement during gait. Further research is needed to examine the use of different gait inputs to the symmetry indices (e.g., joint angles and moments). A greater awareness of the movement patterns associated with autism may increase our understanding of this disorder and have important implications for treatment planning.
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Rahman, Aida Fitri, and Agustina Agustina. "THERAPIST’S EFFORTS IN RAISING CHILDREN’S AUTISTIC ATTENTION IN THEIR LETTER-RECOGNITION STUDIES." Journal of Cultura and Lingua 2, no. 1 (January 28, 2021): 39–48. http://dx.doi.org/10.37301/culingua.v2i1.19.
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Autism is a pervasive disorder in children characterized by disorders and delays in cognitive, language, behavior, communication and social interactions. Autistic children in general will experience obstacles in learning, related to lack of social skills and behavior patterns that are not the same as children in general. One of the characteristics of children with autism is having a barrier in attention span, which has an impact on the learning process. Autistic children need learning methods in accordance with their characteristics, so that they can help their learning process. This research uses qualitative research methods with case study research type. The subjects of this study were parents and therapists who handled children with autism in the X therapy center in Padang city. Data collection techniques in this study were observation and interviews. This case study aims to determine the learning methods used by therapists in teaching are suitable for the subject in recognizing letters as well as obstacles and solutions in providing letter recognition teaching to children with autism. The question in this study is how to increase the attention span of children with autism in learning letter recognition and what obstacles the therapist encounters in the process of teaching letter recognition and how to solve the obstacles in the teaching process.