Pub Date : 2024-04-23DOI: 10.1016/j.rasd.2024.102406
Susan D. Simmons , Concetta Brugaletta , Anton V. Emmanuel
Background
Autistic individuals face barriers to healthcare access and premature mortality. There is an increased prevalence of gastrointestinal (GI) disorders in autistic children compared to not-autistic children. There is a complex interplay between these GI symptoms and various aspects of behaviour, sleep, and mental health in autistic children. Lockdowns during the Covid-19 pandemic changed the delivery of healthcare for all patient groups, and it is particularly important to understand the effects of this on vulnerable groups. In this qualitative study we document the family experiences associated with managing persistent GI symptoms in autistic children and access to related healthcare for these children during Covid-19 lockdowns and restrictions.
Method
We conducted semi-structured interviews with 12 parents of autistic children and subjected data from these interviews to qualitative analysis.
Results
Two themes emerged (i) Covid-19 lockdowns and restrictions changed the children’s reported GI symptoms in a non-uniform manner; and (ii) parents were divided on the appropriateness of telemedicine services for their child. Some parents reported an increase in their child’s anxiety level that was linked to worsening of GI symptoms. Those parents who reported a reduction in their child’s social anxiety during lockdown related this to improved GI symptoms. Parents reported advantages and disadvantages of both in-person and telemedicine consultations, and they were split on their preferences for these appointment types.
Conclusions
Telemedicine is preferred by some but not all families of autistic children. Clinicians should consider the interplay between anxiety and GI symptoms in autistic children when assessing and treating GI symptoms.
{"title":"Gastrointestinal symptoms in autistic children during Covid-19 lockdown: A qualitative study of family experience","authors":"Susan D. Simmons , Concetta Brugaletta , Anton V. Emmanuel","doi":"10.1016/j.rasd.2024.102406","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102406","url":null,"abstract":"<div><h3>Background</h3><p>Autistic individuals face barriers to healthcare access and premature mortality. There is an increased prevalence of gastrointestinal (GI) disorders in autistic children compared to not-autistic children. There is a complex interplay between these GI symptoms and various aspects of behaviour, sleep, and mental health in autistic children. Lockdowns during the Covid-19 pandemic changed the delivery of healthcare for all patient groups, and it is particularly important to understand the effects of this on vulnerable groups. In this qualitative study we document the family experiences associated with managing persistent GI symptoms in autistic children and access to related healthcare for these children during Covid-19 lockdowns and restrictions.</p></div><div><h3>Method</h3><p>We conducted semi-structured interviews with 12 parents of autistic children and subjected data from these interviews to qualitative analysis.</p></div><div><h3>Results</h3><p>Two themes emerged (i) Covid-19 lockdowns and restrictions changed the children’s reported GI symptoms in a non-uniform manner; and (ii) parents were divided on the appropriateness of telemedicine services for their child. Some parents reported an increase in their child’s anxiety level that was linked to worsening of GI symptoms. Those parents who reported a reduction in their child’s social anxiety during lockdown related this to improved GI symptoms. Parents reported advantages and disadvantages of both in-person and telemedicine consultations, and they were split on their preferences for these appointment types.</p></div><div><h3>Conclusions</h3><p>Telemedicine is preferred by some but not all families of autistic children. Clinicians should consider the interplay between anxiety and GI symptoms in autistic children when assessing and treating GI symptoms.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102406"},"PeriodicalIF":2.5,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1750946724000813/pdfft?md5=e6a741ad6ca5446d50d803944302b61e&pid=1-s2.0-S1750946724000813-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-17DOI: 10.1016/j.rasd.2024.102391
Lies Van Den Plas , Gert-Jan Vanaken , Jean Steyaert , Kristien Hens , Ilse Noens
<div><h3>Introduction</h3><p>Psycho-education is a practice often used in autism care, bridging between diagnosis and clinical counselling. In the autism literature, there is a shift towards defining autism in terms of deficit to defining autism in terms of neurodiversity. Literature increasingly indicates that this neurodiversity conceptualisation may lead to a more positive identity and less internalised stigma. Therefore we investigated to what extent this shift to neurodiversity-affirmative psycho-education has already occurred in the context of clinical care in Flanders, Belgium.</p></div><div><h3>Methods</h3><p>We reviewed the three psycho-educational tools that are most recommended and practically used in our region (<em>I am special 2, Brain Blocks, Give me 5)</em>, deploying a reflexive thematic analysis.</p></div><div><h3>Results</h3><p>Three overarching themes emerged from the analysis: (1) differing but mainly deficit-based autism conceptualisations (2) needs are important but little specified; (3) knowledge transfer as the main goal.</p></div><div><h3>Discussion</h3><p>The shift to neurodiversity-affirmative psycho-education has not yet occurred in clinical care in Flanders. We recommend centring lived experiences in psycho-educational tools, including more recent theories such as monotropism and the double empathy problem, and conducting more participatory research concerning different stakeholders’ needs.</p></div><div><h3>Lay abstract</h3><p>Psycho-education is a practice that is often used in clinical care in the context of autism to bridge diagnostics and clinical counselling. There are different definitions of what psycho-education should entail, but possible themes can be ‘what autism is’ and how the current needs of the individual and the environment can be addressed. At the same time, there is a shift in literature from defining autism in terms of deficits to defining autism in terms of difference (neurodiversity), where difficulties arise from a mismatch between the individual and their context. In this paper, we investigated three psycho-educational tools (<em>I am special 2, Brain Blocks, Give me 5).</em> More specifically, we investigated to what extent these psycho-educational tools are in line with neurodiversity-affirmative views. We found that the psycho-educational tools did not always specify how they understood autism. Autism was frequently described in terms of deficits. Also, the tools did not always mention which and whose needs they wanted to cater for (an autistic person, relatives,…). Lastly, the tools had a strong focus on addressing ‘what autism is’ – thereby mainly focussing on knowledge, and less on needs or emotional support. This differs from the approach recommended by recent literature in relevant fields. This paper gives a starting point to evaluate current psycho-education practices and recommends developing new psycho-educational tools that place first-hand autistic needs and experiences at the ce
{"title":"Towards a neurodiversity-affirmative conceptualisation of psycho-education in the context of autism","authors":"Lies Van Den Plas , Gert-Jan Vanaken , Jean Steyaert , Kristien Hens , Ilse Noens","doi":"10.1016/j.rasd.2024.102391","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102391","url":null,"abstract":"<div><h3>Introduction</h3><p>Psycho-education is a practice often used in autism care, bridging between diagnosis and clinical counselling. In the autism literature, there is a shift towards defining autism in terms of deficit to defining autism in terms of neurodiversity. Literature increasingly indicates that this neurodiversity conceptualisation may lead to a more positive identity and less internalised stigma. Therefore we investigated to what extent this shift to neurodiversity-affirmative psycho-education has already occurred in the context of clinical care in Flanders, Belgium.</p></div><div><h3>Methods</h3><p>We reviewed the three psycho-educational tools that are most recommended and practically used in our region (<em>I am special 2, Brain Blocks, Give me 5)</em>, deploying a reflexive thematic analysis.</p></div><div><h3>Results</h3><p>Three overarching themes emerged from the analysis: (1) differing but mainly deficit-based autism conceptualisations (2) needs are important but little specified; (3) knowledge transfer as the main goal.</p></div><div><h3>Discussion</h3><p>The shift to neurodiversity-affirmative psycho-education has not yet occurred in clinical care in Flanders. We recommend centring lived experiences in psycho-educational tools, including more recent theories such as monotropism and the double empathy problem, and conducting more participatory research concerning different stakeholders’ needs.</p></div><div><h3>Lay abstract</h3><p>Psycho-education is a practice that is often used in clinical care in the context of autism to bridge diagnostics and clinical counselling. There are different definitions of what psycho-education should entail, but possible themes can be ‘what autism is’ and how the current needs of the individual and the environment can be addressed. At the same time, there is a shift in literature from defining autism in terms of deficits to defining autism in terms of difference (neurodiversity), where difficulties arise from a mismatch between the individual and their context. In this paper, we investigated three psycho-educational tools (<em>I am special 2, Brain Blocks, Give me 5).</em> More specifically, we investigated to what extent these psycho-educational tools are in line with neurodiversity-affirmative views. We found that the psycho-educational tools did not always specify how they understood autism. Autism was frequently described in terms of deficits. Also, the tools did not always mention which and whose needs they wanted to cater for (an autistic person, relatives,…). Lastly, the tools had a strong focus on addressing ‘what autism is’ – thereby mainly focussing on knowledge, and less on needs or emotional support. This differs from the approach recommended by recent literature in relevant fields. This paper gives a starting point to evaluate current psycho-education practices and recommends developing new psycho-educational tools that place first-hand autistic needs and experiences at the ce","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102391"},"PeriodicalIF":2.5,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140558193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-13DOI: 10.1016/j.rasd.2024.102397
Kaylin Russell , Aneri Bhatt , Kelsea Rackham , Ty Vernon
Background
Promising social skill interventions have emerged to target socialization vulnerabilities of autistic adolescents, but there remains a critical need for effective dissemination of these programs to improve service access. The Social Tools And Rules for Teens (START) Program is a group-based intervention program for increasing social motivation while enhancing social communication skill use.
Method
The current study aimed to evaluate START Connections, an online adaptation of the original START model. We (1) assessed the preliminary efficacy, feasibility, and acceptability of START Connections, and (2) compared its outcomes to a prior in-person START clinical trial. Participants were 41 autistic adolescents aged 11–16 and their parent. Each bi-weekly START Connections session consisted of a check-in, socialization time, group discussion and practice of social topics, group activity, and check-out.
Results
Attendance for the program was high and teens endorsed high levels of enjoyment and skill improvement. Analysis of treatment gains yielded evidence of increased emotion regulation, social skills, and social motivation. Improvements in behaviorally coded target skills were observed for many participants during naturalistic conversations. An analytical comparison revealed a comparable trend in outcomes between START Connections and in-person START groups for social challenges, self-reported social skill use, and social motivation and competence.
Conclusion
Overall, these pilot outcomes are extremely promising and suggest that the START Connections model is feasible and has the potential to improve social communication and emotion regulation in autistic teens. These results warrant a follow-up, RCT investigation evaluating the unique benefits of in-person versus online START Programs.
{"title":"Online social interaction skill group for adolescents on the autism spectrum: Preliminary outcomes of the START Connections program","authors":"Kaylin Russell , Aneri Bhatt , Kelsea Rackham , Ty Vernon","doi":"10.1016/j.rasd.2024.102397","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102397","url":null,"abstract":"<div><h3>Background</h3><p>Promising social skill interventions have emerged to target socialization vulnerabilities of autistic adolescents, but there remains a critical need for effective dissemination of these programs to improve service access. The Social Tools And Rules for Teens (START) Program is a group-based intervention program for increasing social motivation while enhancing social communication skill use.</p></div><div><h3>Method</h3><p>The current study aimed to evaluate START Connections, an online adaptation of the original START model. We (1) assessed the preliminary efficacy, feasibility, and acceptability of START Connections, and (2) compared its outcomes to a prior in-person START clinical trial. Participants were 41 autistic adolescents aged 11–16 and their parent. Each bi-weekly START Connections session consisted of a check-in, socialization time, group discussion and practice of social topics, group activity, and check-out.</p></div><div><h3>Results</h3><p>Attendance for the program was high and teens endorsed high levels of enjoyment and skill improvement. Analysis of treatment gains yielded evidence of increased emotion regulation, social skills, and social motivation. Improvements in behaviorally coded target skills were observed for many participants during naturalistic conversations. An analytical comparison revealed a comparable trend in outcomes between START Connections and in-person START groups for social challenges, self-reported social skill use, and social motivation and competence.</p></div><div><h3>Conclusion</h3><p>Overall, these pilot outcomes are extremely promising and suggest that the START Connections model is feasible and has the potential to improve social communication and emotion regulation in autistic teens. These results warrant a follow-up, RCT investigation evaluating the unique benefits of in-person versus online START Programs.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102397"},"PeriodicalIF":2.5,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1750946724000722/pdfft?md5=6127034ed8d116539a88d4f71182e3ba&pid=1-s2.0-S1750946724000722-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1016/j.rasd.2024.102395
Jingyuan Jiang , Guoxiang Wang , Qinwen Gu , Xue Wang , Jingxin Liu
Background
This study aimed to explore the effects of physical activity (PA) on motor skills and stereotypical behavior in children with autism spectrum disorder (ASD).
Methods
Studies were searched in PubMed, Web of Science, Embase, the Cochrane Library, and CNKI. A total of 14 studies with 345 participants were included in this study, and a random-effects model with the standard mean difference (SMD) was used to calculate the effect size. We include 6 scales to evaluate motor skills and 2 scales to evaluate stereotyped behavior.
Results
Compared with the baseline, the PA group showed a significantly improved Test of Gross Motor Skills (TGMD) [SMD = 1.90 (95%CI: 0.78 to 3.02), p < 0.001] and Brininx-Oresetsky Test (BOT) [SMD = 7.37 (95%CI: 1.72 to 13.02), p = 0.01], while the control group did not significantly change in TGMD. For stereotyped behavior, there was a significant reduction in GARS-2 [SMD = −0.64 (95%CI: −1.10 to −0.18), p = 0.01] in the PA group compared with the baseline, while the control group did not significantly change.
Conclusion
This meta-analysis confirmed the beneficial effects of PA on motor skills and stereotyped behavior in children with ASD. Engaging in activities like ball games at moderate intensity can be beneficial. Further research should examine the specific effects of various PA types and intensities to enhance PA-based interventions for ASD.
背景本研究旨在探讨体育活动(PA)对自闭症谱系障碍(ASD)儿童运动技能和刻板行为的影响。方法在PubMed、Web of Science、Embase、Cochrane Library和CNKI中检索研究。本研究共纳入了 14 项研究,345 名参与者,并采用随机效应模型和标准均值差异(SMD)计算效应大小。结果与基线相比,PA 组的大运动技能测试(TGMD)[SMD = 1.90 (95%CI: 0.78 to 3.02),p < 0.001]和布里宁克斯-奥雷斯基测试(BOT)[SMD = 7.37 (95%CI: 1.72 to 13.02),p = 0.01]有显著改善,而对照组的大运动技能测试没有显著变化。在刻板行为方面,与基线相比,PA 组的 GARS-2 显著降低[SMD = -0.64 (95%CI: -1.10 to -0.18),p = 0.01],而对照组则无明显变化。参与中等强度的球类运动等活动是有益的。进一步的研究应探讨各种体育锻炼类型和强度的具体效果,以加强以体育锻炼为基础的 ASD 干预措施。
{"title":"Quantifying the efficacy of physical activity on motor skills and stereotypies in children with autism spectrum disorder: A meta-analysis of randomized controlled trials from the last decade","authors":"Jingyuan Jiang , Guoxiang Wang , Qinwen Gu , Xue Wang , Jingxin Liu","doi":"10.1016/j.rasd.2024.102395","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102395","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to explore the effects of physical activity (PA) on motor skills and stereotypical behavior in children with autism spectrum disorder (ASD).</p></div><div><h3>Methods</h3><p>Studies were searched in PubMed, Web of Science, Embase, the Cochrane Library, and CNKI. A total of 14 studies with 345 participants were included in this study, and a random-effects model with the standard mean difference (SMD) was used to calculate the effect size. We include 6 scales to evaluate motor skills and 2 scales to evaluate stereotyped behavior.</p></div><div><h3>Results</h3><p>Compared with the baseline, the PA group showed a significantly improved Test of Gross Motor Skills (TGMD) [SMD = 1.90 (95%CI: 0.78 to 3.02), p < 0.001] and Brininx-Oresetsky Test (BOT) [SMD = 7.37 (95%CI: 1.72 to 13.02), p = 0.01], while the control group did not significantly change in TGMD. For stereotyped behavior, there was a significant reduction in GARS-2 [SMD = −0.64 (95%CI: −1.10 to −0.18), p = 0.01] in the PA group compared with the baseline, while the control group did not significantly change.</p></div><div><h3>Conclusion</h3><p>This meta-analysis confirmed the beneficial effects of PA on motor skills and stereotyped behavior in children with ASD. Engaging in activities like ball games at moderate intensity can be beneficial. Further research should examine the specific effects of various PA types and intensities to enhance PA-based interventions for ASD.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102395"},"PeriodicalIF":2.5,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140546153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1016/j.rasd.2024.102394
Shawna M. Gray , Carly A. McMorris , Tanya E. Mudry , Adam W. McCrimmon
Researchers have explored long-term outcomes for those diagnosed on the autism spectrum, including how autistic individuals come to develop a diagnostic identity. Establishing an identity around a diagnostic label may lead to positive impacts, including a sense of community for those who experience stigma. The topic of autistic diagnostic identity is relatively new and, as such, a synthesized understanding of this literature has yet to be conducted. This systematic review gathered peer-reviewed literature related to autistic diagnostic identity; 20 articles were included. Data were extracted based on design, funding, location, participant age/demographics, age of diagnosis, and definition, description, and impacts of autistic diagnostic identity. Findings highlight that autistic diagnostic identity formation is a time-sensitive process influenced by factors such as age at reporting and societal considerations. Impacts of autistic diagnostic identity, gaps in the literature, and implications for clinicians and professionals working with autistic individuals are discussed.
{"title":"An exploration of diagnostic identity for autistic individuals: A systematic review of existing literature","authors":"Shawna M. Gray , Carly A. McMorris , Tanya E. Mudry , Adam W. McCrimmon","doi":"10.1016/j.rasd.2024.102394","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102394","url":null,"abstract":"<div><p>Researchers have explored long-term outcomes for those diagnosed on the autism spectrum, including how autistic individuals come to develop a diagnostic identity. Establishing an identity around a diagnostic label may lead to positive impacts, including a sense of community for those who experience stigma. The topic of autistic diagnostic identity is relatively new and, as such, a synthesized understanding of this literature has yet to be conducted. This systematic review gathered peer-reviewed literature related to autistic diagnostic identity; 20 articles were included. Data were extracted based on design, funding, location, participant age/demographics, age of diagnosis, and definition, description, and impacts of autistic diagnostic identity. Findings highlight that autistic diagnostic identity formation is a time-sensitive process influenced by factors such as age at reporting and societal considerations. Impacts of autistic diagnostic identity, gaps in the literature, and implications for clinicians and professionals working with autistic individuals are discussed.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102394"},"PeriodicalIF":2.5,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-11DOI: 10.1016/j.rasd.2024.102393
Dorothy H. Hoang Reede , Daniel J. Tancredi , Rebecca J. Schmidt
Background
Findings for prenatal stress, previously measured through stressful life event surveys items or biomarkers, in association with ASD are inconsistent. We prospectively examined prenatal perceived stress and prenatal urinary cortisol (PUC) in association with ASD and other non-typical developmental (Non-TD) outcomes in the child in a high familial likelihood cohort.
Methods
The Perceived Stress Scale questionnaire was used to measure perceived stress in the longitudinal Markers of Autism Risk in Babies: Learning Early Signs (MARBLES) Study. Cortisol was measured through 24-hr urine collections. At three years of age, an algorithm consisting of scores from the Autism Diagnostic Observation Schedule (ADOS) and Mullen Scales of Early Learning (MSEL) was used to classify children with ASD, Non-TD, or typically developing (TD) outcomes. Relative risk ratios (RRR) with TD as the reference were estimated using multinomial logistic regression.
Results
Increased perceived stress was associated with Non-TD in trimester 1 (RRR 1.10; 95% CI: 1.00, 1.21) and ASD in trimesters 2 and 3 (RRR 1.08; 95% CI: 1.02, 1.14 and RRR 1.08; 95% CI: 1.03, 1.14, respectively). Results with PUC were non-significant but were in the direction consistent with previous findings suggesting that decreased cortisol levels are associated with higher likelihood of ASD.
Conclusions
Findings support the hypothesis that higher perceived stress is associated with increased likelihood of ASD and possibly Non-TD, relative to TD. This suggests that stress reduction interventions during pregnancy could serve as preventative measures that help optimize the child’s long-term health. Larger studies are needed to replicate these findings.
{"title":"Prenatal perceived stress and urinary cortisol as risk factors for ASD and non-typical developmental outcomes in the MARBLES study","authors":"Dorothy H. Hoang Reede , Daniel J. Tancredi , Rebecca J. Schmidt","doi":"10.1016/j.rasd.2024.102393","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102393","url":null,"abstract":"<div><h3>Background</h3><p>Findings for prenatal stress, previously measured through stressful life event surveys items or biomarkers, in association with ASD are inconsistent. We prospectively examined prenatal perceived stress and prenatal urinary cortisol (PUC) in association with ASD and other non-typical developmental (Non-TD) outcomes in the child in a high familial likelihood cohort.</p></div><div><h3>Methods</h3><p>The Perceived Stress Scale questionnaire was used to measure perceived stress in the longitudinal Markers of Autism Risk in Babies: Learning Early Signs (MARBLES) Study. Cortisol was measured through 24-hr urine collections. At three years of age, an algorithm consisting of scores from the Autism Diagnostic Observation Schedule (ADOS) and Mullen Scales of Early Learning (MSEL) was used to classify children with ASD, Non-TD, or typically developing (TD) outcomes. Relative risk ratios (RRR) with TD as the reference were estimated using multinomial logistic regression.</p></div><div><h3>Results</h3><p>Increased perceived stress was associated with Non-TD in trimester 1 (RRR 1.10; 95% CI: 1.00, 1.21) and ASD in trimesters 2 and 3 (RRR 1.08; 95% CI: 1.02, 1.14 and RRR 1.08; 95% CI: 1.03, 1.14, respectively). Results with PUC were non-significant but were in the direction consistent with previous findings suggesting that decreased cortisol levels are associated with higher likelihood of ASD.</p></div><div><h3>Conclusions</h3><p>Findings support the hypothesis that higher perceived stress is associated with increased likelihood of ASD and possibly Non-TD, relative to TD. This suggests that stress reduction interventions during pregnancy could serve as preventative measures that help optimize the child’s long-term health. Larger studies are needed to replicate these findings.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102393"},"PeriodicalIF":2.5,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1750946724000680/pdfft?md5=7debd3595d8a1bf572c0261411030882&pid=1-s2.0-S1750946724000680-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140546156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-09DOI: 10.1016/j.rasd.2024.102396
Dimitar Marinov, Rositsa Chamova, Ruzha Pancheva
Background
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that may be influenced by various factors, including nutritional status. This scoping review, adhering to PRISMA-ScR guidelines, aims to systematically explore and synthesize the existing literature on micronutrient (vitamins, minerals and trace elements) deficiencies in children with ASD and how they may differ from the general population of typically developing children.
Methods
A comprehensive search strategy was employed across multiple databases, selecting studies that quantitatively assessed micronutrient levels in children with ASD and control groups. The inclusion of 34 full-text publications from 17 countries provided a geographically diverse sample, ensuring a broad overview of the field.
Results
The findings present a complex picture of micronutrient levels in children with ASD. A recurrent observation was lower vitamin D levels in children with ASD across multiple studies, while results for other vitamins, such as vitamins A and E, and minerals like iron (ferritin), iodine, and zinc were mixed and contradictory. The heterogeneity in study methodologies, participant characteristics, and controls for confounding factors, such as supplementation, were noted as significant variables influencing outcomes.
Conclusion
This scoping review accentuates the crucial need for standardized methodologies in future research to explore the underlying mechanisms of altered micronutrient levels in children with ASD and determine potential therapeutic implications. Emphasis on careful consideration of external variables, such as dietary habits and supplementation, is imperative to draw valid, reproducible conclusions in subsequent studies.
背景自闭症谱系障碍(ASD)是一种神经发育障碍,可能受到包括营养状况在内的各种因素的影响。本范围界定综述遵循 PRISMA-ScR 指南,旨在系统地探讨和综合有关 ASD 儿童微量营养素(维生素、矿物质和微量元素)缺乏的现有文献,以及他们与一般发育正常儿童的不同之处。方法 在多个数据库中采用综合检索策略,选择定量评估 ASD 儿童和对照组微量营养素水平的研究。结果研究结果呈现了 ASD 儿童微量营养素水平的复杂情况。在多项研究中反复出现的现象是 ASD 儿童维生素 D 水平较低,而其他维生素(如维生素 A 和 E)以及矿物质(如铁蛋白)、碘和锌的研究结果则参差不齐,相互矛盾。研究方法、参与者特征以及对混杂因素(如补充剂)的控制等方面的异质性被认为是影响研究结果的重要变量。结论本范围综述强调了在未来的研究中采用标准化方法来探索 ASD 儿童微量营养素水平改变的内在机制并确定潜在治疗意义的迫切需要。为了在后续研究中得出有效的、可重复的结论,必须强调对外部变量(如饮食习惯和补充剂)的仔细考虑。
{"title":"Micronutrient deficiencies in children with autism spectrum disorders compared to typically developing children – A scoping review","authors":"Dimitar Marinov, Rositsa Chamova, Ruzha Pancheva","doi":"10.1016/j.rasd.2024.102396","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102396","url":null,"abstract":"<div><h3>Background</h3><p>Autism spectrum disorder (ASD) is a neurodevelopmental disorder that may be influenced by various factors, including nutritional status. This scoping review, adhering to PRISMA-ScR guidelines, aims to systematically explore and synthesize the existing literature on micronutrient (vitamins, minerals and trace elements) deficiencies in children with ASD and how they may differ from the general population of typically developing children.</p></div><div><h3>Methods</h3><p>A comprehensive search strategy was employed across multiple databases, selecting studies that quantitatively assessed micronutrient levels in children with ASD and control groups. The inclusion of 34 full-text publications from 17 countries provided a geographically diverse sample, ensuring a broad overview of the field.</p></div><div><h3>Results</h3><p>The findings present a complex picture of micronutrient levels in children with ASD. A recurrent observation was lower vitamin D levels in children with ASD across multiple studies, while results for other vitamins, such as vitamins A and E, and minerals like iron (ferritin), iodine, and zinc were mixed and contradictory. The heterogeneity in study methodologies, participant characteristics, and controls for confounding factors, such as supplementation, were noted as significant variables influencing outcomes.</p></div><div><h3>Conclusion</h3><p>This scoping review accentuates the crucial need for standardized methodologies in future research to explore the underlying mechanisms of altered micronutrient levels in children with ASD and determine potential therapeutic implications. Emphasis on careful consideration of external variables, such as dietary habits and supplementation, is imperative to draw valid, reproducible conclusions in subsequent studies.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102396"},"PeriodicalIF":2.5,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1750946724000710/pdfft?md5=978cc06b1a307ae889b8eb4f5cb3ea06&pid=1-s2.0-S1750946724000710-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140540118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Autism is a common neurodevelopmental disorder in children. Evidence suggests that autism is associated with changes in puberty onset. Precocious puberty (PP) is the early development of secondary sex characteristics. This nationwide cohort study explored PP risk in autistic children.
Methods
Using data from the Taiwan National Health Insurance Research Database, 11,104 autistic children and 11,104 age- and sex-matched non-autistic children were enrolled between 2001 and 2011. Participants were followed from enrollment until the end of 2011 to determine the incidence of PP. Cox regression models were used to account for confounding factors, such as demographic characteristics and physical and psychological comorbidities.
Results
Autistic children were more likely than non-autistic children to experience PP (hazard ratio: 6.48, 95% confidence interval: 3.61–11.62). Subgroup analyses by sex and intellectual disability further demonstrated consistent findings that PP was more prevalent in autistic children than in non-autistic children.
Conclusion
Autism is an independent risk factor for subsequent PP. Autistic children may have an increased PP risk, and early detection and treatment may reduce the psychological and physical consequences.
{"title":"Autism and risk of precocious puberty: A cohort study of 22,208 children","authors":"Shih-Jen Tsai , Yen-Wei Lue , Chuan-Hsun Yu , Tzeng-Ji Chen , Mu-Hong Chen","doi":"10.1016/j.rasd.2024.102390","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102390","url":null,"abstract":"<div><h3>Background</h3><p>Autism is a common neurodevelopmental disorder in children. Evidence suggests that autism is associated with changes in puberty onset. Precocious puberty (PP) is the early development of secondary sex characteristics. This nationwide cohort study explored PP risk in autistic children.</p></div><div><h3>Methods</h3><p>Using data from the Taiwan National Health Insurance Research Database, 11,104 autistic children and 11,104 age- and sex-matched non-autistic children were enrolled between 2001 and 2011. Participants were followed from enrollment until the end of 2011 to determine the incidence of PP. Cox regression models were used to account for confounding factors, such as demographic characteristics and physical and psychological comorbidities.</p></div><div><h3>Results</h3><p>Autistic children were more likely than non-autistic children to experience PP (hazard ratio: 6.48, 95% confidence interval: 3.61–11.62). Subgroup analyses by sex and intellectual disability further demonstrated consistent findings that PP was more prevalent in autistic children than in non-autistic children.</p></div><div><h3>Conclusion</h3><p>Autism is an independent risk factor for subsequent PP. Autistic children may have an increased PP risk, and early detection and treatment may reduce the psychological and physical consequences.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102390"},"PeriodicalIF":2.5,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140540119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08DOI: 10.1016/j.rasd.2024.102392
Emre Deniz , Umar Toseeb
Nearly one in two autistic individuals is involved in sibling bullying, which is linked to increased mental health difficulties. Despite its high prevalence, only a handful of studies have focused on the relationship between sibling bullying and mental health in the autistic population. Of these, a vast majority of evidence comes from Western cultures while little is known about non-western cultures. For the first time, the current study investigated the cross-cultural variability in the prevalence and demographic and mental health correlates of sibling bullying between a Western (the United Kingdom) and non-western (Turkey) country. Parents of British (N = 289) and Turkish (N = 171) autistic individuals, aged 9–20 years, completed online questionnaires. Structural equation models were fitted to test the risk factors for behavioural and mental health correlates of sibling bullying. Overall, sibling bullying was highly prevalent in the lives of both British and Turkish autistic adolescents as more than two-thirds either bullied a sibling or were bullied by a sibling every week. While some potential risk factors for sibling bullying were present in both cultures (e.g., past sibling bullying experiences), some were culture-specific (e.g., having a male sibling (British), higher parental education (Turkish)). Consistent with previous reports, higher rates of sibling bullying were significantly correlated with poorer mental health in both British and Turkish samples. Additionally, sibling bullying was indirectly linked to mental health difficulties through detrimental social behaviours (British and Turkish) and emotion regulation (British-only) in autistic children and adolescents. There were no indirect correlations between sibling bullying and mental health through social skills in either sample. Implications of these findings as well as cross-cultural similarities and differences are discussed in more detail in light of the relevant cross-cultural psychological theory.
{"title":"Sibling bullying and mental health in British and Turkish autistic children and adolescents: The role of social and emotional functioning","authors":"Emre Deniz , Umar Toseeb","doi":"10.1016/j.rasd.2024.102392","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102392","url":null,"abstract":"<div><p>Nearly one in two autistic individuals is involved in sibling bullying, which is linked to increased mental health difficulties. Despite its high prevalence, only a handful of studies have focused on the relationship between sibling bullying and mental health in the autistic population. Of these, a vast majority of evidence comes from Western cultures while little is known about non-western cultures. For the first time, the current study investigated the cross-cultural variability in the prevalence and demographic and mental health correlates of sibling bullying between a Western (the United Kingdom) and non-western (Turkey) country. Parents of British (N = 289) and Turkish (N = 171) autistic individuals, aged 9–20 years, completed online questionnaires. Structural equation models were fitted to test the risk factors for behavioural and mental health correlates of sibling bullying. Overall, sibling bullying was highly prevalent in the lives of both British and Turkish autistic adolescents as more than two-thirds either bullied a sibling or were bullied by a sibling every week. While some potential risk factors for sibling bullying were present in both cultures (e.g., past sibling bullying experiences), some were culture-specific (e.g., having a male sibling (British), higher parental education (Turkish)). Consistent with previous reports, higher rates of sibling bullying were significantly correlated with poorer mental health in both British and Turkish samples. Additionally, sibling bullying was indirectly linked to mental health difficulties through detrimental social behaviours (British and Turkish) and emotion regulation (British-only) in autistic children and adolescents. There were no indirect correlations between sibling bullying and mental health through social skills in either sample. Implications of these findings as well as cross-cultural similarities and differences are discussed in more detail in light of the relevant cross-cultural psychological theory.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102392"},"PeriodicalIF":2.5,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1750946724000679/pdfft?md5=ec190856b3f3bae5ce1590ba45068ba0&pid=1-s2.0-S1750946724000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140537051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-03DOI: 10.1016/j.rasd.2024.102389
Si Ni Li , Wai Tong Chien , Stanley Kam Ki Lam , Zeng Yu Chen , Xing Ma
Background
Parenting a child with autism spectrum disorder (ASD) is a major life challenge that leads to negative emotional distress and heavy parent duties. Parent-focused interventions have recently been developed to improve parents’ psychosocial well-being in caring for their children with ASD. This study aimed to evaluate the effectiveness of parent-focused interventions on improving psychological health in parents of children with ASD, when compared with active/inactive controls, and investigate the optimal features of the effective interventions found.
Methods
Comprehensive and systematic searches of articles was conducted in PubMed, Embase, PsycINFO, CINAHL, Cochrane Central Register, ProQuest, and CNKI, from their inceptions to 31 December 2022.
Results
A total of 21 eligible randomized controlled trials (RCTs) were included. The results indicated that the parent-focused intervention group showed reduced stress (Hedge’s g=−1.26), depressive symptoms (g=−0.71), and distress (g=−0.44) in parents and problem behaviours in children (g=−0.21) and improved parentchild relationships (g=0.51) compared with the active/inactive control group post-intervention, with moderate to high certainty of evidence. Moreover, subgroup analyses revealed that mindfulness-based interventions/acceptance commitment therapy (ACT) were the optimal intervention approach for reducing parental stress and depressive symptoms. The optimal intervention duration (five to eight weeks) and target participants (involving only parents) were also identified.
Conclusion
As mindfulness-based interventions/ACT were identified as the potentially best approach, future well-designed RCTs are recommended to further examine their effects on both parents and their children with ASD and explore the factors and mechanisms of action influencing the effectiveness of these interventions.
{"title":"Effectiveness of parent-focused interventions for improving the mental health of parents and their children with autism spectrum disorder: A systematic review and meta-analysis","authors":"Si Ni Li , Wai Tong Chien , Stanley Kam Ki Lam , Zeng Yu Chen , Xing Ma","doi":"10.1016/j.rasd.2024.102389","DOIUrl":"https://doi.org/10.1016/j.rasd.2024.102389","url":null,"abstract":"<div><h3>Background</h3><p>Parenting a child with autism spectrum disorder (ASD) is a major life challenge that leads to negative emotional distress and heavy parent duties. Parent-focused interventions have recently been developed to improve parents’ psychosocial well-being in caring for their children with ASD. This study aimed to evaluate the effectiveness of parent-focused interventions on improving psychological health in parents of children with ASD, when compared with active/inactive controls, and investigate the optimal features of the effective interventions found.</p></div><div><h3>Methods</h3><p>Comprehensive and systematic searches of articles was conducted in PubMed, Embase, PsycINFO, CINAHL, Cochrane Central Register, ProQuest, and CNKI, from their inceptions to 31 December 2022.</p></div><div><h3>Results</h3><p>A total of 21 eligible randomized controlled trials (RCTs) were included. The results indicated that the parent-focused intervention group showed reduced stress (Hedge’s g=−1.26), depressive symptoms (g=−0.71), and distress (g=−0.44) in parents and problem behaviours in children (g=−0.21) and improved parent<img>child relationships (g=0.51) compared with the active/inactive control group post-intervention, with moderate to high certainty of evidence. Moreover, subgroup analyses revealed that mindfulness-based interventions/acceptance commitment therapy (ACT) were the optimal intervention approach for reducing parental stress and depressive symptoms. The optimal intervention duration (five to eight weeks) and target participants (involving only parents) were also identified.</p></div><div><h3>Conclusion</h3><p>As mindfulness-based interventions/ACT were identified as the potentially best approach, future well-designed RCTs are recommended to further examine their effects on both parents and their children with ASD and explore the factors and mechanisms of action influencing the effectiveness of these interventions.</p></div>","PeriodicalId":48255,"journal":{"name":"Research in Autism Spectrum Disorders","volume":"114 ","pages":"Article 102389"},"PeriodicalIF":2.5,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140342161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}