Search

Introduction: Autism is a neurodevelopmental condition that is increasing in prevalence worldwide. There has been an exponential increase in autism-related research since 2010, when the first Singapore Clinical Practice Guidelines (CPG) on autism was published. Understanding of autism has since evolved to adopt a lifespan approach beyond that of a childhood condition. The aim of this CPG was to provide an updated set of recommendations for children and adolescents to aid clinical practice for professionals., Method: A multidisciplinary workgroup that comprised representatives from various sectors worked on this CPG. Clinical questions were organised into 10 different sections, each with its own subgroup of members. Seventeen existing international guidelines were evaluated using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) framework, of which 4 met criteria to act as references. Literature review across multiple databases was conducted between January 2011 to 2023; Grading of Recommendations, Assessment, Development and Evaluation (GRADE-like) methodology was used to synthesise evidence. Recommendation statements were derived, following Delphi-style consensus surveys among the workgroup. The draft guidelines underwent external review and public consultation before being formalised., Results: Recommendation and good practice statements pertaining to care of children and adolescents on the autism spectrum across 10 different sections were developed. Evidence matrices complement these recommendations and detail relevant evidence behind each recommendation statement., Conclusion: It is intended for these guidelines to promote effective management and healthcare services for children and adolescents on the autism spectrum, by reinforcing good and evidence-based clinical practice within our national context., Competing Interests: All authors declare that they have no affiliations or financial involvement with any commercial organisation with a direct financial interest in the subject or materials discussed in the manuscript.

Social and non-social deficits in autism spectrum disorders (ASD) persist into adulthood and may share common regions of aberrant neural activations. The current meta-analysis investigated activation differences between ASD and neurotypical controls irrespective of task type. Activation likelihood estimation meta-analyses were performed to examine consistent hypo-activated and/or hyper-activated regions for all tasks combined, and for social and non-social tasks separately; meta-analytic connectivity modelling and behavioral/paradigm analyses were performed to examine co-activated regions and associated behaviors. One hundred studies (mean age range = 18-41 years) were included. For all tasks combined, the ASD group showed significant (p < .05) hypo-activation in one cluster around the left amygdala (peak - 26, -2, -20, volume = 1336 mm 3 , maximum ALE = 0.0327), and this cluster co-activated with two other clusters around the right cerebellum (peak 42, -56, -22, volume = 2560mm 3 , maximum ALE = 0.049) Lobule VI/Crus I and the left fusiform gyrus (BA47) (peak - 42, -46, -18, volume = 1616 mm 3 , maximum ALE = 0.046) and left cerebellum (peak - 42, -58, -20, volume = 1616mm 3 , maximum ALE = 0.033) Lobule VI/Crus I. While the left amygdala was associated with negative emotion (fear) (z = 3.047), the left fusiform gyrus/cerebellum Lobule VI/Crus I cluster was associated with language semantics (z = 3.724) and action observation (z = 3.077). These findings highlight the left amygdala as a region consistently hypo-activated in ASD and suggest the potential involvement of fusiform gyrus and cerebellum in social cognition in ASD. Future research should further elucidate if and how amygdala-fusiform/cerebellar connectivity relates to social and non-social cognition in adults with ASD., (© 2022. The Author(s).)

Purpose of Review: With the increasing incidence of individuals diagnosed with autism spectrum disorders, there is a need to develop programs to support them throughout their lifespan but research in adulthood support is still scarce. This article aims to provide an up-to-date review of the research on the core characteristics of autism spectrum disorder (ASD), social attainments, and efforts to improve their outcomes., Recent Findings: The core social communication impairments continue into adulthood among persons with ASD, but the restrictive, repetitive patterns of behavior and activities have received less attention. Adults with ASD experience more behavioral and emotional regulation issues than their peers. In terms of social attainments, adults with ASD have a greater tendency to be overeducated for their jobs and have a lower employment rate. They are also more likely to live with their parents. Interventions make a positive impact upon social communication skills and employment., Summary: Future research could focus on the repetitive behavior of adults with ASD. Likewise, interventions examining the extent to which repetitive behavior and interests can be managed, as well as the degree to which they can be supported in their community access, living arrangements, as well as family quality of life can be further conducted.

Anxiety-related problems are among the most frequently reported mental health difficulties in autism spectrum disorder. As most research has focused on clinical samples or high-functioning children with autism spectrum disorder, less is known about the factors associated with anxiety in community samples across the ability range. This cross-sectional study examined the association of gender, age, adaptive functioning and autism symptom severity with different caregiver-reported anxiety symptoms. Participants were caregivers of 241 children (6-18 years old) with autism spectrum disorder attending special schools in Singapore. Measures included the Spence Children's Anxiety Scale and assessments of overall emotional, behavioural and adaptive functioning. Caregivers reported more anxiety symptoms in total, but fewer social anxiety symptoms, than Spence Children's Anxiety Scale Australian/Dutch norms. There were no gender differences. Variance in total anxiety scores was best explained by severity of repetitive speech/stereotyped behaviour symptoms, followed by adaptive functioning. Severity of repetitive speech/behaviour symptoms was a significant predictor of separation anxiety, generalized anxiety, panic/agoraphobia and obsessive-compulsive subscale symptoms, but not of social phobia and physical injury fears. Adaptive functioning and chronological age predicted social phobia and generalized anxiety symptoms only. Severity of social/communication autism symptoms did not explain any anxiety symptoms, when the other variables were controlled for. Findings are discussed in relation to the existing literature. Limitations and possible implications for prevention, assessment and intervention are also discussed., (© The Author(s) 2015.)

It has been reported that there is a rise in the number of individuals being diagnosed with autism spectrum disorder (ASD) in Singapore along with evolving changes in public awareness, attitudes, and levels of financial support occurring in the field in recent years. As such, this column presents the current status and issues related to the identification of individuals with ASD and the provision of early intervention services, education, and transition services for these people in Singapore. Additional needs and future recommendations are also included. [ABSTRACT FROM AUTHOR]

Anxiety-related problems are among the most frequently reported mental health difficulties in autism spectrum disorder. As most research has focused on clinical samples or high-functioning children with autism spectrum disorder, less is known about the factors associated with anxiety in community samples across the ability range. This cross-sectional study examined the association of gender, age, adaptive functioning and autism symptom severity with different caregiver-reported anxiety symptoms. Participants were caregivers of 241 children (6–18 years old) with autism spectrum disorder attending special schools in Singapore. Measures included the Spence Children’s Anxiety Scale and assessments of overall emotional, behavioural and adaptive functioning. Caregivers reported more anxiety symptoms in total, but fewer social anxiety symptoms, than Spence Children’s Anxiety Scale Australian/Dutch norms. There were no gender differences. Variance in total anxiety scores was best explained by severity of repetitive speech/stereotyped behaviour symptoms, followed by adaptive functioning. Severity of repetitive speech/behaviour symptoms was a significant predictor of separation anxiety, generalized anxiety, panic/agoraphobia and obsessive–compulsive subscale symptoms, but not of social phobia and physical injury fears. Adaptive functioning and chronological age predicted social phobia and generalized anxiety symptoms only. Severity of social/communication autism symptoms did not explain any anxiety symptoms, when the other variables were controlled for. Findings are discussed in relation to the existing literature. Limitations and possible implications for prevention, assessment and intervention are also discussed. [ABSTRACT FROM AUTHOR]