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This study examined the similarities/differences between the social phenotypes of Williams syndrome (WS) and autism spectrum disorder (ASD). As cultural norms may affect symptom evaluation, this study administered the Social Responsiveness Scale-2 to Japanese individuals with WS (n = 78, 4.4–44.0 years) and ASD (n = 75, 4.7–55.4 years). The scores for Social Motivation and Social Communication were significantly more severe in the ASD than WS group. Overall, the similarities and differences between the social phenotypes of the syndromes were consistent with the findings of a recent study conducted in the UK, except for the social awareness subscale score. This highlights the importance of cross-cultural investigations of WS and ASD. [ABSTRACT FROM AUTHOR]

Introduction: Children with autism spectrum disorder (ASD) face numerous challenges in transitioning to elementary school, which can cause confusion for the children and concern among their parents. Aims: This study aimed to identify the process of school transition from kindergarten to elementary school for children with autism spectrum disorder in Japan, by evaluating the effectiveness of a school transition program. Methods: A focus group interview was conducted with seven parents who participated in a transition program. They were asked about communication with the teachers, support obtained from the school, and their experiences after their children entered elementary school. After the group interview was recorded and transcribed, the data were analyzed using inductive content analysis to determine the parents' experiences of the school transition process. Findings: Six main themes emerged from the focus group interview: acquisition of prerequisite skills, adjustment in dealing with children with ASD, communication between school and home, communication between peers and children with autism spectrum disorder, collaboration with special needs education teachers, and the principal's understanding of special needs education. Conclusion: These findings provide an overview of the challenges and possible solutions to support school transitions for children with autism spectrum disorder in inclusive educational environments. [ABSTRACT FROM AUTHOR]

Recently, individuals with autistic traits, especially female, have been known to use compensatory strategies (e.g. hiding their autistic traits or compensatory learning) for better adaptation. Though these strategies are predicted to be relevant with the non-clinical undiagnosed autistic people, their adaptive status and the factor contributing to it remain largely unexplored, especially the influence of gender. We explored the strengths of non-clinical adults with high autistic traits (high, N = 89, scored 19 or higher on Autism Spectrum Screening Questionnaire: ASSQ, self- and/or other-ratings) who were respondents to an online survey recruited from all over Japan, using items of the personal strengths in the Adult Self Report (ASR) and Adult Behavior Checklist (rating by others). We compared the high group with the low autistic traits group (low, N = 408, less than 19 on both ASSQ self- and other- ratings on the online survey) and the autism spectrum disorder group (ASD, N = 50, initial visit to hospital), as well as by gender. Personal strengths estimated by others were significantly higher than those by self in the high group, especially in females, but were opposite in the ASD group and equivalent in the low group, respectively. Multiple regression analysis revealed that personal strengths estimated by others increased adaptive functioning, with worsening of internalizing symptoms in high group females, both of which were assessed using ASR. Thus, non-clinical autistic females appeared to have unique adaptation styles. [ABSTRACT FROM AUTHOR]

People with autism spectrum disorder (ASD) experience stigmatization rooted in negative attitudes or prejudice toward them due to social awkwardness. However, little is known about implicit attitudes toward ASD, especially differences in attitudes compared to those of more visible conditions; physical disabilities. In this study, we implemented implicit association tests (IATs) to assess implicit attitudes. Sixty-three university students participated in IATs and answered questionnaires that measured explicit attitudes, social desirability, knowledge about—and familiarity with—disorders. The results demonstrated that implicit attitude toward ASD was significantly less negative than toward physical disabilities. Regarding the discrepancy, not socially awkward behavior but appearance of people with ASD can be evaluated as 'in-group' members and lead to less negative attitude compared with physical disabilities. [ABSTRACT FROM AUTHOR]

Background: This study aims to determine the extent to which preschool teachers and childcare workers are aware of the presence of developmental problems among children and to what extent they share information with parents about their concerns regarding a child's development or diagnosis of neurodevelopmental disorders (NDDs). Methods: We wrote to all 924 preschools and childcare centres in Japan's Nagano and Yamanashi prefectures to request participants. We then sent survey forms to the preschools and childcare centres that agreed to cooperate for three grades comprising 3‐, 4‐ and 5‐year‐olds in the school year 2020. We asked the staff member in charge of each child to complete the survey. The survey included questions about the teacher's concerns regarding the possibility of an NDD and whether the matter had been shared with the children's parents. Results: We obtained data for 10 354 children from 206 preschools and childcare centres (response rate = 22.3%). Among these children, 457 (4.4%) had an NDD diagnosis that their parents shared with the teachers. However, the teachers of 1274 children (12.3%) had concerns regarding their development but were not informed by the parents about the diagnosis, if any. These 1274 children included 775 (60.8%) cases where the teachers failed to share their concerns with parents because (1) the teachers could not communicate with parents (n = 119), (2) the teachers were not sure if there was a neurodevelopmental problem (n = 360) and (3) the parents were not aware of the problem (n = 296). Conclusions: Preschool teachers and childcare workers had concerns about the development of a substantial proportion of children in their charge. However, teachers and childcare workers did not share their concerns regarding many children's developmental problems with their parents. The findings suggest that there are challenges in information‐sharing between teachers/childcare workers and parents. [ABSTRACT FROM AUTHOR]

Certain individuals are clinically undiagnosed for Autism Spectrum Disorder (ASD) but exhibit strong ASD characteristics. This study examined the differences between a control group and a "high autistic traits" group involving individuals who scored 9 or higher on the Autism-Spectrum Quotient-16 Japanese Version, based on their sense of belonging, help-seeking style, and relationship with mental health. The participants were 608 Japanese public high school students. Of them, 129 (21.2%) and 479 (78.8%) were in the high autistic traits and control groups, respectively. A multiple regression analysis was performed using the General Health Questionnaire (GHQ) as the dependent variable for the groups. The analysis revealed no differences between the two groups regarding grade, gender, physical illness, insomnia, or mental health status; however, they differed regarding avoidant help-seeking style and teacher acceptance. Moreover, avoidant help-seeking scores in the high autistic traits group and teacher acceptance showed a significantly positive and significantly negative association with GHQ, respectively. The results indicated that children with autistic traits internally suppress them, experiencing distress. Teachers are aware that these students seek support from them, but the students seem reluctant to ask them for help. This can negatively impact the mental health of children with high autistic traits. [ABSTRACT FROM AUTHOR]

Background: There is a rising interest in perinatal mental health studies, and proper psychometric tools to assess autistic traits among this population in Japan are vital. Objective: This study aimed to clarify the optimal factor structure of the AQ as part of a perinatal mental health research project. Methods: We used the Japanese version of the AQ (AQ-J) to measure autistic-like traits in pregnant women. Participants were 4,287 Japanese women who were pregnant or who had given birth within the last month. We performed exploratory factor analysis (EFA) using the first sample group (n = 2,154) to obtain factor structures for the final item selections. We performed confirmatory factor analysis (CFA) using the second sample group (n = 2,133) to obtain a model with good fit, then compared the model to all previously proposed models to determine the best-fitting model. Results: The EFA analysis identified a model consisting of 25 items distributed across three factors. Cronbach's alpha for the total 25-item AQ-J, 9-item "Social interaction" factor, 11-item "Non-verbal communication" factor, and 5-item "Restricted interest" factor was 0.829, 0.829, 0.755, and 0.576, respectively. McDonald's omega and its 95% confidence interval were 0.826 (0.821-0.836), 0.835 (0.821-0.837), 0.755 (0.744-0.766), and 0.603 (0.556-0.596), respectively. CFA confirmed that the three-factor structure had an acceptable fit (goodness of fit index: 0.900, comparative fit index: 0.860, root mean square error of approximation: 0.066). These findings indicated that the three-factor model was better than the 13 existing models. Conclusion: The findings are discussed in relation to the adequacy of the AQ-J for assessing autistic traits in perinatal women. We recommend the use of this 25-item, three-factor AQ-J model for this population owing to its superiority to all previous models. [ABSTRACT FROM AUTHOR]

Background and aims: Research on the psychological impact of the coronavirus disease 2019 pandemic has highlighted its negative and positive effects on children with autism spectrum disorder and their families. However, little is known about the neutral effects that remain the same, even in particular circumstances, and how children with autism spectrum disorder and their parents perceive each other. We explored how children with autism spectrum disorder and their mothers perceived and experienced the pandemic in Japan. Methods: A mixed-methods design was employed. Thirteen children with autism spectrum disorder and 12 mothers participated. Data were collected through online semi-structured interviews and analyzed using thematic analysis. Similarities and differences in perceptions were compared. Results: The results revealed six broad themes and 27 categories. Regarding neutral effects, some mothers reported no substantial impact because there were no changes in their jobs or other dramatic life changes. In addition, some children were not affected because they had had no social contact before the pandemic or because their lives had not changed dramatically. Regarding the perceptions of children/mothers, most expressed that they/their children enjoyed spending time with their families. At home, mothers made various efforts to interact with their children. However, mothers and children differed in their perceptions, such as regarding the emergence of anxiety about conducting school events and the resolution of study-related concerns. Conclusions: There were negative, neutral, and positive effects on both children with autism spectrum disorder and their mothers; specifically, they were striving to move forward to overcome the problems posed by the pandemic. Both parties tapped into their resilience by enhancing family interactions, such as cooking together or discussing children's interests. Implications: These findings have important implications for developing more creative solutions to the challenges of coping and resilience in future crises. [ABSTRACT FROM AUTHOR]

Background: Early detection of autism spectrum disorder (ASD) is essential to provide children with timely treatment and support. Evidence‐based screening measures make it possible to identify children with suspected ASD at an early stage. Although Japan has a universal healthcare system that covers well‐child visits, detection rates of developmental disorders, including ASD, at 18 months vary widely between municipalities (0.2%–48.0%). The reasons for this high level of variation are poorly understood. The present study aims to describe the barriers and facilitators of incorporating ASD identification during well‐child visits in Japan. Methods: This is a qualitative study that conducts semi‐structured in‐depth interviews in two municipalities of Yamanashi Prefecture. We recruited all public health nurses (n = 17) and paediatricians (n = 11) involved in the well‐child visit in each municipality and caregivers of children who also participated in the visits during the study period (n = 21). Results: We identified four themes characterizing the process of ASD identification in the target municipalities: (1) Identification of children with ASD is driven by caregivers' sense of concern, acceptance and awareness. (2) Multidisciplinary cooperation and shared decision‐making is limited. (3) Skills and training for developmental disabilities screening are underdeveloped. (4) Caregivers' expectations shape the interaction in important ways. Conclusions: Non‐standardization of screening methods, limited knowledge and skills on screening and child development among healthcare providers and poor coordination among healthcare providers and caregivers are the main barriers to effective early detection of ASD through well‐child visits. The findings suggest the importance of promoting a child‐centred care approach through the application of evidence‐based screening measures and effective information sharing. [ABSTRACT FROM AUTHOR]

Food selectivity in children with autism spectrum disorder (ASD) is a serious issue in special needs schools, and special education teachers face various difficulties in their management of the problem. The aim of this study is to investigate the difficulties that special education teachers face in managing food selectivity in children with ASD. Data were obtained from 12 special education teachers in 2018 via semi-structured in-depth interviews. Thematic analysis was used to identify key conceptions of the participants' experiences, while qualitative analysis of the interview data revealed three major themes. Their personal and professional thoughts and hopes regarding eating habits in children, feelings of uncertainty about their practice, and their interactions with the children and their parents were the key factors behind the difficulties they experience as special education teachers. The findings improve our understanding of the challenges experienced by teachers managing food selectivity in children with ASD. A different conceptualisation of the problem may lead to difficulties in collaboration among the people who are tasked with solving the problem. [ABSTRACT FROM AUTHOR]

Although it remains debatable, exogenous oxytocin, commonly used for labour induction and augmentation, reportedly increases risks of neurodevelopment delay, attention-deficit/hyperactivity disorder, and autism spectrum disorder among children prenatally exposed to exogenous oxytocin. However, only few studies have objectively examined exogenous oxytocin's impact on early childhood development through scoring evaluations. This study investigated the association between exogenous oxytocin exposure and neurodevelopment in 3-year-old children using the Ages and Stages Questionnaires, Third Edition. In this nationwide prospective cohort study, we extracted data from 104,062 foetal records regarding exogenous oxytocin use during labour from the Japan Environment and Children's Study. Participants completed questionnaires throughout the pregnancy and postpartum periods. Outcomes comprised the developmental status less than each cut-off value for the five domains of the Ages and Stages Questionnaire, Third Edition. We conducted multivariable logistic regression analyses on the data of 55,400 children after controlling for confounders. Among the 55,400 included women, 19.0% (n = 10,506) used exogenous oxytocin during labour and 81.0% (n = 44,894) did not. Children exposed to exogenous oxytocin showed no significantly increased risk of developmental delay in any domain (communication: odds ratio [OR] 1.04, 95% confidence interval [CI] 0.92–1.16; gross motor: OR 0.97, 95% CI 0.87–1.08; fine motor: OR 1.00, 95% CI 0.92–1.09; problem-solving: OR 1.02, 95% CI 0.94–1.11; personal-social: OR 0.91, 95% CI 0.80–1.03). Conclusion: Exogenous oxytocin for labour induction did not adversely affect early childhood development. Further studies accounting for the degree of exogenous oxytocin exposure are required to confirm these results. What is Known: • In developed countries, labour is induced in 20–25% of all pregnancies, for which oxytocin is commonly used. • Studies have associated risks of neurodevelopment delay, attention-deficit/hyperactivity disorder, and autism spectrum disorder with exposure to exogenous oxytocin. What is New: • Evaluation with the Ages and Stages Questionnaire, Third Edition, revealed that exogenous oxytocin use did not adversely affect early childhood development. • This prospective study reinforced the lack of evidence of an association between exogenous oxytocin use and early childhood development after adjustment for confounding and rigorous bias elimination. [ABSTRACT FROM AUTHOR]

Studies have proposed that individuals with autism spectrum disorder (ASD) can be divided into several subtypes depending on their sensory features. However, consideration of social communication features is also crucial for configuring ASD subtypes, because social and sensory features are tightly interrelated. In this study, we asked Japanese individuals with ASD to answer the Short Sensory Profile (SSP) and the Social Responsiveness Scale, Second Edition (SRS-2), which measure sensory and social aspects, respectively. Consequent latent profile analysis demonstrated that the participants could be divided into five subgroups: two groups exhibited opposite or inconsistent patterns between the SSP and SRS-2 scores, while the other groups exhibited consistent patterns. Our findings indicate the existence of diverse phenotypes in individuals with ASD. [ABSTRACT FROM AUTHOR]

Background: The long-term effects of a Cesarean section (CS) birth on child neurodevelopment are of increasing interest. In this study, we examined the associations between mode of delivery and presence of neurodevelopmental disorders in toddlers. Moreover, given that the prevalence of several neurodevelopmental disorders such as autism spectrum disorder (ASD) is known to differ by sex, we also investigated these associations separately in male and female toddlers. Methods: We investigated 65,701 mother–toddler pairs from the Japan Environment and Children's Study, a nationally representative children's cohort study. To investigate the associations between mode of delivery (CS or vaginal delivery) and neurodevelopmental disorders (motor delay, intellectual disability, and ASD) in 3-year-old toddlers as a whole and stratified by sex, we used logistic regression models to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: The morbidity of ASD at age 3 years was higher for children delivered by CS than those delivered vaginally (aOR 1.38, 95% CI 1.04–1.83). However, no such difference was evident in the case of motor delay or intellectual disability (aOR 1.33, 95% CI 0.94–1.89; aOR 1.18, 95% CI 0.94–1.49, respectively). In the analysis by sex, CS was not associated with increased risk of any of the neurodevelopmental disorders in males, but it was associated with increased risks of motor delay (aOR 1.88, 95% CI 1.02–3.47) and ASD (aOR 1.82, 95% CI 1.04–3.16) in females. Conclusions: This study provides evidence of significant associations between mode of delivery and neurodevelopmental disorders in early childhood. Females may be more sensitive to the effects of CS than males. [ABSTRACT FROM AUTHOR]

Aim: Little is known about early manifestations of autism spectrum disorders (ASD) in females, including those who may be overlooked by the current diagnostic criteria. We longitudinally explored sex differences in the trajectories of cognitive and motor functions and adaptive behaviors in children with different levels of autistic traits. Methods: The participants were 824 children from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), Japan, who were classified into three autistic trait groups—low, moderate, and high—based on the Social Responsiveness Scale–Second Edition. Cognitive and motor functions were measured at seven time‐points from 0.5 to 3.5 years of age using the Mullen Scales of Early Learning. Adaptive behaviors were measured at five time‐points from 2.7 to 9 years of age using the Vineland Adaptive Behavior Scales–Second Edition. Trajectories were depicted using latent growth curve modeling. Results: Sex‐specific trajectories were observed in the high‐autistic‐trait group, with only males showing a temporary decline in expressive language around the age of 2 years and a slight improvement thereafter. They also showed a slight improvement around 3 years in the adaptive behavior communication domain but a gradual downward trend later. Females in the high‐autistic‐trait group showed no distinct manifestation before the age of 3 years but showed a downward trend after 3.5 years in the adaptive behavior communication domain. Conclusion: Females and males with higher autistic traits than their same‐sex peers, independent of clinical diagnosis, may have different phenotypes in certain neurodevelopmental domains during infancy and early childhood. [ABSTRACT FROM AUTHOR]

Maternal prenatal psychological distress, which includes depression and anxiety, affects the onset of autism spectrum disorder (ASD). However, there is no consistent knowledge regarding at which term during pregnancy psychological distress affects the risk of ASD among children. We used a dataset obtained from the Japan Environment and Children's Study, which is a nationwide prospective birth cohort study, to evaluate the association between the six-item Kessler Psychological Distress Scale (K6) and ASD among 3-year-old children. A total of 78,745 children were analyzed, and 355 of them were diagnosed with ASD (0.45%). The maternal K6 was administered twice during pregnancy: at a median of 15.1 weeks (M-T1) and at that of 27.4 weeks (M-T2) of gestation. Multivariate logistic regression analyses demonstrated that the group with a maternal K6 score of ≥5 at both M-T1 and M-T2 was significantly associated with ASD among the children (adjusted odds ratio, 1.440; 95% confidence interval, 1.104–1.877) compared to the group with a score of ≤4 at both M-T1 and M-T2. There was no significant difference between the group with a score of ≥5 only at M-T1 or M-T2 and that with a score of ≤4 at both M-T1 and M-T2. In conclusion, from the first to the second half of pregnancy, continuous maternal psychological distress was associated with ASD among 3-year-old children. Contrarily, in the group without persistent maternal psychological distress during pregnancy, there was no significant association. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a neurodevelopmental condition diagnosed in approximately 2% of children. Reliance on the emergence of clinically observable behavioral patterns only delays the mean age of diagnosis to approximately 4 years. However, neural pathways critical to language and social functions develop during infancy, and current diagnostic protocols miss the age when therapy would be most effective. We developed non-invasive ASD biomarkers using mass spectrometry analyses of elemental metabolism in single hair strands, coupled with machine learning. We undertook a national prospective study in Japan, where hair samples were collected at 1 month and clinical diagnosis was undertaken at 4 years. Next, we analyzed a national sample of Swedish twins and, in our third study, participants from a specialist ASD center in the US. In a blinded analysis, a predictive algorithm detected ASD risk as early as 1 month with 96.4% sensitivity, 75.4% specificity, and 81.4% accuracy (n = 486; 175 cases). These findings emphasize that the dynamics in elemental metabolism are systemically dysregulated in autism, and these signatures can be detected and leveraged in hair samples to predict the emergence of ASD as early as 1 month of age. [ABSTRACT FROM AUTHOR]

Aim: To investigate urinary incontinence prevalence and its association with neurodevelopmental disorders among children in Japan., Methods: A web-based survey was conducted on children aged 5-15 years in Japan. Information on daytime and nocturnal incontinence and neurodevelopmental disorders, such as attention deficit hyperactivity disorder, autism spectrum disorder, and intellectual disability, was collected., Results: Responses from 5186 questionnaires (2619 boys, 2517 girls) were evaluated. In total, 505 children had neurodevelopmental disorders. Furthermore, 148 children had daytime urinary incontinence. The incidence of daytime urinary incontinence did not differ significantly according to sex. Daytime urinary incontinence was associated with neurodevelopmental disorders in 33.1% of children. Moreover, 220 children had nocturnal enuresis. Boys had a significantly higher prevalence of nocturnal enuresis than girls in the overall cohort and early elementary school age group. Nocturnal enuresis was associated with neurodevelopmental disorders in 29.1% of children. Children with daytime urinary incontinence or nocturnal enuresis had a significantly higher incidence of neurodevelopmental disorders., Conclusions: The prevalence of concomitant daytime and nocturnal urinary incontinence and neurodevelopmental disorders in children is significant., (© 2024 Wiley Periodicals LLC.)

Background: Social communication is a crucial factor influencing human social life. Quantifying the degree of difficulty faced in social communication is necessary for understanding developmental and neurological disorders and for creating systems used in automatic symptom screening and assistive methods such as social skills training (SST). SST by a human trainer is a well-established method. Previous SST used a modified roleplay test to evaluate human social communication skills. However, there are no widely accepted evaluation criteria or social behavioral markers to quantify social performance during SST., Objective: This paper has 2 objectives. First, we propose applying the Social Performance Rating Scale (SPRS) to SST data to measure social communication skills. We constructed a Japanese version of the SPRS already developed in English and French. Second, we attempt to quantify action units during SST for people with autism spectrum disorder (ASD) or schizophrenia., Methods: We used videos of interactions between trainers, adults with ASD (n=16) or schizophrenia (n=15), and control participants (n=19) during SST sessions. Two raters applied the proposed scale to annotate the collected data. We investigated the differences between roleplay tasks and participant groups (ASD, schizophrenia, and control). Furthermore, the intensity of action units on the OpenFace toolkit was measured in terms of mean and SD during SST roleplaying., Results: We found significantly greater gaze scores in adults with ASD than in adults with schizophrenia. Differences were also found between the ratings of different tasks in the adults with schizophrenia and the control participants. Action units numbered AU06 and AU12 were significantly deactivated in people with schizophrenia compared with the control group. Moreover, AU02 was significantly activated in people with ASD compared with the other groups., Conclusions: The results suggest that the SPRS can be a useful tool for assessing social communication skills in different cultures and different pathologies when used with the modified roleplay test. Furthermore, facial expressions could provide effective social and behavioral markers to characterize psychometric properties. Possible future directions include using the SPRS for assessing social behavior during interaction with a digital agent., (© Hiroki Tanaka, Kana Miyamoto, Jennifer Hamet Bagnou, Elise Prigent, Céline Clavel, Jean-Claude Martin, Satoshi Nakamura. Originally published in JMIR Formative Research (https://formative.jmir.org).)

Background: With a recent increase in the prevalence of autism spectrum disorder (ASD), an important issue has emerged in clinical practice regarding when and how patients themselves should be given explanations following a diagnosis of ASD. The clinical guidelines of the UK National Institute for Health and Care Excellence state that children diagnosed with ASD should receive an explanation about what ASD is and how it affects their development and functioning—"if appropriate". However, the guidelines do not provide any specifics regarding what constitutes "appropriate" situations Methods: We conducted an anonymous self-administered postal questionnaire survey targeting all members of the Japanese Society for Child and Adolescent Psychiatry (n=1,995). The analysis included only physicians who had newly diagnosed pediatric patients with ASD in the past year. We imposed a limit of one year because diagnoses further back than that are difficult to recall; in other words, this would enhance the recall bias Results: The recovery rate was 30.8%, and the rate of diagnosis disclosure to patients themselves without intellectual disability was 15.3%. We asked 361 physicians who responded that "deciding on a case-by-case basis" was the ideal way to disclose an ASD diagnosis about 20 items prioritized by physicians at the time of diagnosis disclosure and extracted three factors through exploratory factor analysis. Multiple logistic regression analysis was performed with physician attributes, awareness of ASD as a disorder or personality, and the three extracted factors as explanatory variables; diagnosis disclosure was the dependent variable. The patient age group and only one of the three factors (i.e., "factor related to readiness to accept diagnosis") showed a significant association with disclosure of the diagnosis to the individual. Items included in the "factor related to readiness to accept diagnosis" were as follows: the degree of parental understanding, relationship of the patient with their parents/physician, agreement in opinion between parents, parental consent, "sufficient" patient understanding, symptom stabilization, and a guarantee of sufficient time required to explain the diagnosis to the patient Conclusion: In clinical settings, disclosing an ASD diagnosis with the consideration of patient/parent readiness toward accepting the diagnosis could help to guide physicians in determining an ideal timing for disclosure. Future studies are needed to establish detailed and concrete guidelines regarding disclosure of an ASD diagnosis to patients. [ABSTRACT FROM AUTHOR]

Objective: Developmental disorders, such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), are some of the biggest contributors to mental health problems. However, it is not well known whether and how experiencing ADHD- or ASD-related symptoms can cause mental illness later in life. Participants: The sample initially included 124 college students, and 54 completed the study (Mage = 21.9 ± 2.8). Methods: In this study, a longitudinal survey was conducted to investigate the relationship between current ADHD- and ASD-related symptoms and later mental distress in college students. Participants answered the same questionnaire on two occasions, at an interval of approximately 8.5 months. Results: The results suggested that experiencing hyperactivity-impulsivity at this point in life causes later psychiatric illness. Conclusion: These findings highlight the importance of early assessments and providing support for college students with ADHD-related symptoms, especially hyperactivity-impulsivity. [ABSTRACT FROM AUTHOR]

Background: Contactin-5 (CNTN5), a neural adhesion molecule involved in synaptogenesis and synaptic maturation in the auditory pathway, has been associated with the pathophysiology of autism spectrum disorder (ASD), particularly hyperacusis. To investigate the role of rare CNTN5 variants in ASD susceptibility, we performed resequencing and association analysis in a Japanese population., Methods: We resequenced the CNTN5 coding regions in 302 patients with ASD and prioritized rare putatively damaging variants. The prioritized variants were then genotyped in 313 patients with ASD and 1065 controls. Subsequently, we conducted an association study of selected variants with ASD in 614 patients with ASD and 61 057 controls. Clinical data were reviewed for patients carrying prioritized variants., Results: Through resequencing, we prioritized three rare putatively damaging missense variants (W69G, I227L, and L1000S) in patients with ASD. Although we found a nominally significant association between the I227L variant and ASD, it did not remain significant after post hoc correction. Hyperacusis was found in three out of nine patients carrying prioritized variants., Conclusion: This study does not provide evidence for the contribution of rare CNTN5 variants to the genetic etiology of ASD in the Japanese population., (© 2025 The Author(s). Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology.)

In March 2020, many schools were closed to prevent the spread of COVID-19 in Japan, and it is predicted that many children, especially those with neurodevelopmental disorders (NDDs), will be affected emotionally and behaviorally. Here, we examined the impact of school closures due to COVID-19 on school-aged children with NDDs using the Child Behavior Checklist. Totally, data on 121 children diagnosed with autism spectrum disorder, attention-deficit hyperactivity disorder, and/or intellectual disorder were analyzed and it was found that externalizing and aggressive behavior increased in all NDDs, regardless of the type of diagnosis. A clear prospect is important for children with NDDs children to lead a stable life, and more generous supports for children with NDDs and their families are needed. [ABSTRACT FROM AUTHOR]

Background: Determining when caregivers should take their children to a hospital is crucial in ensuring the health and safety of children. Because children cannot make these decisions on their own, caregivers bear the core responsibility for the wellness of their children. The aim of this study was to determine how disease, disability, and child behavior affect when and how often caregivers take their children to a hospital. Methods: A structured anonymous online survey was circulated to pediatricians in Japan. Pediatricians were queried about the characteristics of their patients, including reactivity to pain, expression of pain, behavior at the hospital, and the timing of presentation. Patients were school-aged children and included those with autism spectrum disorder, attention-deficit hyperactivity disorder, Down syndrome, mental retardation, epilepsy, premature birth, and allergies. Results: Sixty-eight of 80 pediatricians responded to the survey (85% response rate). The results indicated that caregivers of children with autism spectrum disorder, attention-deficit hyperactivity disorder, and mental retardation took them to the hospital later than was optimal. Conversely, children born prematurely and those with allergies were taken to hospitals even when symptoms were mild. Conclusions: Caregivers make decisions on when to present to hospital on the basis of their child's expression of pain and behavior. Guidelines should be developed to assist caregivers in determining when to present for treatment at a hospital. [ABSTRACT FROM AUTHOR]

Background: Teenage suicide-related behaviors have been highlighted in Japan in recent years, but the background factors and characteristics of these behaviors have not been clarified. Therefore, we investigated the characteristics of teenage suicide attempters who were admitted to an emergency room., Methods: The subjects were suicide attempters in their teens and twenties who were admitted to the Critical Care Medical Center of Nippon Medical School Hospital between January 1, 2010 and December 31, 2021. The means of suicide attempt, sociodemographic data, psychiatric diagnoses, and causes and motives for suicide attempts were retrospectively examined from medical records. Teenage suicide attempters were compared to those in their twenties in regard to the acquired data, and logistic regression analysis was conducted to evaluate the influence on teenage suicide attempts by the aspects that have been shown to be closely associated with teenage suicides., Results: Among 860 suicide attempters between 2010 and 2021, 59 (6.9%) were teenage suicide attempters and 216 (25.1%) were suicide attempters in their twenties. The large number of females, the history of self-harm, the great number of drug overdoses as a means of attempting suicide, and the large number of individuals with psychiatric disorders, especially with mood disorders and personality disorders, were commonly shared by suicide attempters both in their teens and twenties. On the other hand, family problems, school problems and autism spectrum disorder significantly influenced mostly teenage suicide attempters., Conclusions: It was suggested that teenage suicide attempters may have attempted suicide due to environmental difficulties and conflicts about not being able to escape from them. It has become clear that teenage suicide attempters have unique characteristics and background factors, and that it is important to take these into account when taking measures to prevent teenage suicides., (© 2024. The Author(s).)

Introduction: The purpose of this epidemiological study was to assess the prevalence, comorbidities, and real-world management of childhood epilepsy to provide insights for enhancing epilepsy management and medical resource planning., Materials and Methods: The study encompassed insured individuals aged 0-17 years as of December 2018 who were registered at any point in 2018, for at least part of the year, in a Japanese health claims database spanning January-December 2018. Epilepsy was defined as a diagnosis of epilepsy based on the International Classification of Diseases, 10th Revision codes, and a claimed management fee for epilepsy or an anti-seizure medication (ASM) prescription for longer than 4 weeks. The prevalence of epilepsy, patient characteristics, including comorbidities, and management status, such as prescription of ASMs, were evaluated., Results: Among 1528,905 registered children, 9279 were identified as having epilepsy. The prevalence of epilepsy was the lowest at 1.97 per 1000 population (95 % confidence interval [CI] 1.80-2.15) in the 0-2-year age group and increased with age to 9.34 per 1000 population (95 % CI 8.98-9.72) in the 15-17-year age group, with a significantly higher prevalence in boys than in girls in the ≥12-year age group. ASMs were prescribed to 88.3 %-91.9 % of the patients. Moreover, 27 (0.29 %) patients underwent epilepsy surgery. The frequency of claiming intravenous ASMs and long-term electroencephalogram fees increased with a decrease in age., Conclusions: Our findings indicate that young children receive more medical resources than adolescents and that epilepsy surgery is underutilized. Further investigations will help improve the management of and develop measures against epilepsy., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Aim: Adverse childhood experiences are potentially traumatic events with long-lasting effects on the health and well-being of patients with autism spectrum disorder (ASD). It is important to clarify which types of long-lasting autism-related symptoms are influenced by childhood experiences to design future intervention studies. However, few studies have examined the association between childhood experiences and autistic symptoms in large samples of adults with ASD and individuals with typical development (TD). In this study, we evaluate the effects of adverse childhood experiences on multiple ASD phenotypes among both individuals with ASD and those with TD., Method: We combined questionnaire evaluations; Childhood Abuse and Trauma Scale, the Japanese version of the Autism-Spectrum Quotient, Conners' Adult ADHD Rating Scale, the Japanese version of the Impact of Event Scale-Revised, and the Japanese version of the Adolescent/Adult Sensory Profile., Results: Individuals with ASD and those with TD (n = 205 and 104, respectively) were included. There were significant correlations between the extent of adverse childhood experiences and severity of attention-deficit/hyperactivity disorder symptoms, posttraumatic stress disorder symptoms, and hypersensitivity in both participants with ASD and those with TD. By contrast, ASD core symptoms showed no significant correlation with adverse childhood experiences in either group. These results remained consistent after adjusting for age, sex, and the estimated intelligence quotient., Conclusion: These findings suggest the need for a detailed disentanglement of ASD-related core and peripheral symptoms of adverse childhood experiences, which may help to appropriately set outcomes for future early interventions for the childhood experiences of individuals with ASD., (© 2024 The Author(s). Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.)

The present study examined how maltreatment experience was associated with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) symptoms in children under institutional care. The key caregivers of children and adolescents aged 6 to 18 years who were under institutional care in Nagano prefecture, Japan were asked to answer the background questionnaire, ADHD‐Rating Scale, and the Japanese children's version of the Autism‐Spectrum Quotient. A total of 378 valid responses were obtained, of which 222 reported maltreatment experience prior to institutionalization. Both hyperactive/impulsive and inattentive scores were significantly higher in the maltreated group. Maltreatment experience was significantly associated with the presence of hyperactive/impulsive symptoms (p = 0.003) and inattentive symptoms (p = 0.027). Particularly, those who had experienced physical abuse were significantly more likely to have hyperactive/impulsive symptoms (p = 0.012) and autistic trait (p = 0.002). Thorough assessment of neurodevelopmental symptoms should be performed when placing children with maltreatment experience into institutional care. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the effects of a program containing a combination of social skills training (SST) and parenting training (PT) for the enrichment of social interaction skills and reduction of parenting stress for children with high-functioning autism spectrum disorder (HFASD) and their parents in Japan. Twenty-two patients with HFASD from second to fourth grade and their parents were assigned to a training group (TG) or treatment as usual (TAU) and compared. The children with HFASD and their parents who were assigned to the TG participated in the manualized program for over a period of five to six months. Subjects provided demographic and medical information and completed teacher and parent-rating scales for social competence (Social Responsiveness Scale-2: SRS-2) and parent-rating of parenting stress (Parental Stress Index: PSI) and mental health (General Health Questionnaire-28: GHQ-28). The participants exhibited some improvements pre-, middle-, and post-treatment, particularly regarding the GHQ, PSI and SRS-2, as reported by parents. However, the social skills improvement reported by teachers was not significant. At the three-month follow-up, parent-rated GHQ and PSI maintained improvement, and SRS-2 achieved the greatest improvement from the baseline rating. Although some findings indicate that a program combination of SST and PT might be useful for enhancing social skills and improving parental stress and mental health, some subscales did not show a sufficient effect. Future research should consider program contents and provide longitudinal follow-up data to test the durability of the treatment. [ABSTRACT FROM AUTHOR]

Background: In Japanese high schools, understanding of school non‐attendance and students with developmental disabilities, including autism spectrum disorder (ASD), is gradually improving. On the other hand, few people recognize social anxiety disorder (SAD), the onset of which commences during youth. Social anxiety disorder and ASD share various overlapping characteristics but have different diagnostic criteria. The anxiety caused by these disorders sometimes appears as school non‐attendance. This study examines the relationship between SAD, ASD, and history of school non‐attendance in high school students. Methods: One hundred and fifty‐eight students at one Japanese high school that accepts school non‐ attending students were investigated. To understand the features of ASD and how it relates to SAD tendencies, the Liebowitz Social Anxiety Scale – Japanese (LSAS‐J) and Autism‐Spectrum Quotient – Japanese (AQ‐J) were used. Based on the LSAS‐J cutoff point, participants were divided into high and low anxiety groups and then data were compared between the two groups. Potential factors associated with a high‐SAD trend were evaluated using multivariate logistic regression. Results: The results showed that students with high ASD scores were more likely to have SAD and that a lack of "social skill," a subscale of ASD, was closely associated with a social anxiety trend. However, the relationship between school non‐attendance and social anxiety could not be confirmed. Conclusions: Focusing on the lack of social skills in ASD may provide an opportunity to identify students with high SAD tendencies. This study will contribute to the understanding of high school students with high SAD tendencies in Japan. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the post-marketing safety and effectiveness of aripiprazole in treating irritability in pediatric patients (6–17 years) with autism spectrum disorder (ASD) in actual clinical sites of Japan. Methods: In this post-marketing surveillance, patients were enrolled into the multicenter, prospective, non-interventional, observational study for 52 weeks, and were dosed with aripiprazole (1–15 mg/day) under daily clinical settings in Japan. Results: In 510 patients, the continuation rate of aripiprazole treatment was 84.6% at day 168 (week 24) and 78.1% at day 364 (week 52). Adverse drug reactions (ADRs) occurred in 22.7% of patients (n = 116), and the most common ADRs were somnolence (9.4%), followed by weight increased (3.3%). At week 4, the mean change from baseline in the irritability subscale score for the Aberrant Behavior Checklist Japanese version (ABC-J) was − 5.7 ± 6.8 (n = 288). Based on multiple regression analysis, comorbid attention deficit and hyperactivity did not affect the ABC-J irritability subscale score at endpoint. At week 24, the mean change from baseline for the Strengths and Difficulties Questionnaire was − 3.3 ± 4.9 (n = 215) for the total difficulties score and 0.6 ± 1.7 (n = 217) for the prosocial behavior subscale score. Conclusions: Aripiprazole was well tolerated and effective in the long-term treatment of irritability associated with ASD in Japanese pediatric patients in the real-world clinical practice. Trial registration: This surveillance was registered with Clinical Trial.gov (no. NCT03179787) on June 7, 2017 (retrospectively registered). [ABSTRACT FROM AUTHOR]

There are few studies on the parenting of fathers with autism traits. To investigate this issue, we examined the type of parenting performed by fathers with autism traits using data from a nationwide birth cohort study, the Japan Environment and Children's Study. Paternal parenting was evaluated by mothers or caregivers when the child was 2 years old. Father's autism traits were measured using the Japanese version of the self-administered Autism Spectrum Quotient. Logistic regression analysis was performed to statistically analyze the data. Fathers with autism traits were significantly less likely to prepare meals for their child and helping them eat (adjusted OR (aOR): 1.11, 95% confidence interval (CI): 1.01-1.23), to helping the child change clothes (aOR: 1.17, 95% CI: 1.04-1.31). However, there were no associations between some parenting behaviors and autism traits (not changing diapers, not bathing with the child, and not playing with the child). Father's communication skill difficulties by autism traits associated with a lower tendency to perform all types of parenting. Interestingly, there were association between difficulties with social skills or attention-switching and more performing change diapers. These results indicate it is important to respect the child-rearing that fathers with autistic tendencies are able to do, while supporting them in child-rearing that they are significantly less able to do than fathers without autistic tendencies., (© 2024. The Author(s).)

Background: We constructed a hypothetical model of the knowledge of autism spectrum disorder (ASD) and self-perception of support of staff working in after-school day services to clarify structural relationships., Methods: A questionnaire survey was conducted at 194 facilities providing after-school day services in Fukushima Prefecture (October 2020), including a basic attributes questionnaire, the Literacy Scale of Characteristics of Autistic Spectrum Disorder (LS-ASD), and a staff questionnaire. We developed a hypothetical model of the relationship between self-perception and LS-ASD total scores of after-school service staff. To obtain latent variables for structural equation modeling (SEM) to confirm factor extraction and the interrelationships among variables, exploratory factor analysis was performed. SEM was used to examine the fit of the hypothetical model to the data and the relationships among variables., Results: The study included 302 staff members from 58 of 194 facilities. Four factors (Factor 1, motivation; 2, self-perception of knowledge; 3, information sharing; 4, self-confidence) were extracted. The final model showed that Factor 2 had a positive direct effect (path coefficient = 0.64) and Factor 4 had a negative direct effect (path coefficient = -0.22) on LS-ASD scores. The model goodness of fit was acceptable (Goodness-of-Fit Index = 0.890; Comparative Fit Index = 0.912; Root Mean Square Error of Approximation = 0.086; Akaike's Information Criterion = 392.7)., Conclusion: Self-perception of knowledge contributes greatly to knowledge acquisition, while excessive confidence may hinder knowledge retention.

Atypical eye gaze is an established clinical sign in the diagnosis of autism spectrum disorder (ASD). We propose a computerized diagnostic algorithm for ASD, applicable to children and adolescents aged between 5 and 17 years using Gazefinder, a system where a set of devices to capture eye gaze patterns and stimulus movie clips are equipped in a personal computer with a monitor. We enrolled 222 individuals aged 5–17 years at seven research facilities in Japan. Among them, we extracted 39 individuals with ASD without any comorbid neurodevelopmental abnormalities (ASD group), 102 typically developing individuals (TD group), and an independent sample of 24 individuals (the second control group). All participants underwent psychoneurological and diagnostic assessments, including the Autism Diagnostic Observation Schedule, second edition, and an examination with Gazefinder (2 min). To enhance the predictive validity, a best-fit diagnostic algorithm of computationally selected attributes originally extracted from Gazefinder was proposed. The inputs were classified automatically into either ASD or TD groups, based on the attribute values. We cross-validated the algorithm using the leave-one-out method in the ASD and TD groups and tested the predictability in the second control group. The best-fit algorithm showed an area under curve (AUC) of 0.84, and the sensitivity, specificity, and accuracy were 74, 80, and 78%, respectively. The AUC for the cross-validation was 0.74 and that for validation in the second control group was 0.91. We confirmed that the diagnostic performance of the best-fit algorithm is comparable to the diagnostic assessment tools for ASD. [ABSTRACT FROM AUTHOR]

Most international reports regarding research on autism spectrum disorder (ASD) and the characteristics of dreams have conducted analysis based on emotions and themes of dreams; however, there are few reports on this topic in Japan. Recently, DSM-5 added a new paresthesia to the diagnostic criteria for ASD; therefore, it is expected that future research on paresthesia and dream sensations will be needed. The purpose of this study is to classify the sensory and emotional features of dreams recorded in the home dream diaries of adolescents with ASD. Dream materials were obtained from a fourth-year college student with ASD the collaborator was able to recall their dreams in vivid detail and enjoyed the dream reports. Qualitative analysis suggested that the content of the recalled dream reflected the vividness of the visual and auditory image and hypersensitivity of the minor sensations in the dreams such as gustatory and olfactory. Additionally, the collaborator experienced many positive emotions in their recalled dreams, although few negative emotions surfaced. A future challenge is to investigate the relationship between paresthesia in ASD and dreams using an enough sample data spanning from childhood to adolescence. [ABSTRACT FROM AUTHOR]

The present study investigated how the eye contact perception of ingroup and outgroup faces by Japanese adults with high-functioning autism spectrum disorder differed from that of age-, sex-, and IQ-matched typically developing individuals. The autism spectrum disorder and typically developing individuals were equally likely to perceive subtly averted gazes as self-directed gazes. In both groups, the frequency with which self-directed gazes were perceived decreased as gaze aversion increased. In general, individuals with autism spectrum disorder were equally capable of perceiving a self-directed gaze as typically developing individuals. However, typically developing individuals, but not individuals with autism spectrum disorder, were more likely to perceive self-directed gazes from ingroup faces than from outgroup faces. Stimuli ratings revealed that individuals with autism spectrum disorder, but not those with typically developing, gave higher warmth ratings to ingroup faces with averted gazes and outgroup faces with direct gazes compared to other types of face stimuli, suggesting atypical affective experiences in response to ingroup and outgroup faces in autism spectrum disorder. These results suggest that individuals with autism spectrum disorder did not show an ingroup bias for the perception of a self-directed gaze, and raise the possibility that an atypical emotional experience contributes to the diminished ingroup bias for the perception of a self-directed gaze. The detection of a self-directed gaze is often the starting point for social interactions and a person who feels as if they are being watched can prepare to respond to others' actions irrespective of the real gaze direction because the other person may likely be motivated to approach. Although many studies demonstrated that individuals with autism spectrum disorder have difficulty discriminating gaze direction, it remains unclear how the perception of self-directed gaze by individuals with autism spectrum disorder differs from that of age-, sex-, and IQ-matched typically developing individuals. Participants observed faces with various gaze directions and answered whether the person in the photograph was looking at them or not. Individuals with and without autism spectrum disorder were just as likely to perceive subtle averted gazes as self-directed gazes. The frequency of perceiving a self-directed gaze decreased as gaze aversion increased in both groups and, in general, individuals with autism spectrum disorder showed a comparable ability to perceive a self-directed gaze as that of typically developing individuals. Interestingly, considering face membership of photographs (ingroup or outgroup faces), typically developing individuals, but not individuals with autism spectrum disorder, were more likely to perceive self-directed gazes from ingroup faces than from outgroup faces. However, individuals with autism spectrum disorder had different affective experiences in response to ingroup and outgroup faces. These results suggest that individuals with autism spectrum disorder did not show an ingroup bias for the perception of a self-directed gaze, and raise a possibility that an atypical emotional experience contributes to the diminished ingroup bias. [ABSTRACT FROM AUTHOR]

A few studies have indicated that adults with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are more inclined to ruminate than adults in the general population. The present study examined whether subclinical ASD symptoms including difficulties in social interaction and attention to detail and ADHD symptoms that were composed of inattention and hyperactivity-impulsivity were related to depressive rumination in undergraduate students. This study also examined whether rumination is a mediating factor in the relationship of ASD and ADHD symptoms with depression. Non-clinical undergraduate students (N = 294) in Japan completed the Autism-Spectrum Quotient, Adult ADHD Self-Report Scale, interpersonal conflict subscale of the Interpersonal Stress Event Scale, Ruminative Responses Scale, and Beck Depression Inventory-Second Edition. Structural equation modeling indicated that hyperactivity-impulsivity was positively associated with rumination both directly and indirectly via interpersonal conflict, and that attention to detail and inattention were directly and positively related to rumination. The significant relationship between difficulties in social interaction and rumination disappeared after controlling for the influence of depression. These findings indicated that one pathway through which hyperactivity-impulsivity symptoms prolong rumination might be through the increase in interpersonal conflict. In addition, it is possible that cognitive inflexibility, academic difficulties, and adverse driving outcomes caused by attention to detail, inattention as well as hyperactivity-impulsivity may lead to rumination. Moreover, attention to detail, inattention, and hyperactivity-impulsivity indirectly increased depression via rumination, indicating that rumination is an important mediator in the relationship of subclinical ASD and ADHD symptoms with depression. [ABSTRACT FROM AUTHOR]

Background It is important to intervene early and treat children and individuals with behavioral disorders. We conducted a functional assessment-based consultation for teachers of several students with severe behavioral disorders and examined the effects of the consultation. Methods Eight students with severe behavioral disorders were selected from two special schools for intellectual disabilities in western Japan. An external consultant team conducted a functional assessmentbased consultation in cooperation with a team of teachers. Consultations were held once a month, and comprised three to six sessions per student. Results As a result of the functional assessment, only 8 out of 10 behaviors with some communication function, and 2 with only sensory enhancements were estimated. The Effects of consultations based on functional assessment were presented. It was found that 6 out of 10 target behaviors had obtained high effects. The total score for each behavioral scale showed a statistically significant improvement. Conclusion Although consultations lasted for only six months and occurred from three to six times for each student, scale scores for problem behavior before and after intervention were improved, overall. Each case report suggested that many factors influence the difference in the effects of consultation among individual students. This study is significant in that it provides a model for the consultation system that operates on a short-term basis, and presents a means for smallscale group consultations for students with intellectual disabilities and autism in cooperation with external specialized institutions in special schools in Japan. [ABSTRACT FROM AUTHOR]

Backgrounds: Whether there is a true increase in autism spectrum disorder (ASD) frequency or not remains unclear. Additionally, the rates of co-existing neurodevelopmental disorders (NDD) in a total population sample has not been fully examined before. Therefore, using a total population sample in Japan, we aimed to estimate the prevalence and cumulative incidence of autism spectrum disorder (ASD) annually, to determine whether there is a true increase in ASD prevalence by estimating the cumulative incidence of ASD annually, and to examine the rates of co-existing neurodevelopmental disorders (NDD). Method: In this cross-sectional sequential design study, all 5-year-old children in the catchment area underwent the screening annually from the year 2013–2016. Screen-positive children were invited to participate in a comprehensive assessment, including child and parent interview, behavioral observation, and cognitive and motor function testing. All cases were reviewed by a multidisciplinary research team. Results: Caregivers of 3954 children returned the screening, among which 559 children underwent the assessment with 87 children receiving an ASD diagnosis. Adjusted ASD prevalence was 3.22% (95% confidence interval (CI) 2.66–3.76%). The male to female ratio of the crude prevalence was 2.2:1. The cumulative incidence of ASD up to 5 years of age for the total study years was 1.31% (95% CI 1.00–1.62%). A generalized linear model revealed no significant linear trends in 5-year cumulative incidence over the study years. Only 11.5% of children had ASD alone; the remaining 88.5% were found to have at least one co-existing NDD. Limitations: Modest sample size for a total population study. Conclusions: Our findings demonstrate the stability of the 5-year cumulative incidence of ASD, implying no true rise in ASD incident cases over the 4-year study period in the study catchment area. High rates of co-existing NDDs reflect the importance of investigating broad developmental challenges in children with ASD. [ABSTRACT FROM AUTHOR]

This study examines the efficacy of the Japanese version of the Program for the Education and Enrichment of Relational Skills (PEERS), which focuses on improving social functioning through making friends and maintaining good relationships for adolescents with autism spectrum disorder (ASD) without intellectual disabilities. Originally developed in the United States, PEERS is one of the few evidence-based social skills training programs for youth with ASD. The present study shows that with linguistic and cultural modifications, PEERS is effective in improving social functioning for adolescents with ASD in Japan. Positive results were found specifically in the areas of socialization, communication, knowledge of social skills, autistic mannerisms, and behavioral and emotional problems. In addition, most treatment gains were maintained at a 3-month follow-up assessment. These findings suggest that the Japanese version of PEERS is beneficial across multiple socio-emotional and behavioral domains for adolescents with ASD. [ABSTRACT FROM AUTHOR]

Psychiatric disorders are highly inheritable, and most psychiatric disorders exhibit genetic overlap. Recent studies associated the 3q29 recurrent deletion with schizophrenia (SCZ) and autism spectrum disorder (ASD). In this study, we investigated the association of genes in the 3q29 region with SCZ and ASD. TM4SF19 and PAK2 were chosen as candidate genes for this study based on evidence from previous research. We sequenced TM4SF19 and PAK2 in 437 SCZ cases, 187 ASD cases and 524 controls in the Japanese population. Through targeted sequencing, we identified 6 missense variants among the cases (ASD & SCZ), 3 missense variants among controls, and 1 variant common to both cases and controls; however, no loss-of-function variants were identified. Fisher's exact test showed a significant association of variants in TM4SF19 among cases (p=0.0160). These results suggest TM4SF19 variants affect the etiology of SCZ and ASD in the Japanese population. Further research examining 3q29 region genes and their association with SCZ and ASD is thus needed.

Obsessive-compulsive disorder (OCD) and autism spectrum disorders (ASD) are highly comorbid. In adults with OCD, cognitive-behavioral therapy (CBT) has been extensively demonstrated to be an effective treatment. However, to date, no follow-up studies exist regarding the long-term outcome of CBT in adults with OCD with comorbid ASD in a regular and naturalistic clinical setting. In the current study, we aimed to study the long-term outcome of CBT among OCD patients with and without ASD. In total, 30 patients diagnosed with OCD who received CBT at a naturalistic psychiatric clinic in Japan were included in the follow-up study. The patients were divided into two groups: OCD with ASD and OCD without ASD. The results revealed no group differences regarding age, gender and OCD symptom severity at baseline. The Yale-Brown Obsessive-Compulsive Scale total score (primary outcome) at follow-up showed decreased severity of symptoms in both groups, thus indicating both groups responded to CBT. However, no significant differences were evident between the groups. Overall, the results suggest that even adults with OCD with comorbid ASD benefit from CBT. A survey on patients' impressions of treatment effect at follow-up showed high rates of satisfaction with CBT and most participants attributed their improvement to CBT as opposed to pharmacological treatment. This study showed the outcome differences of OCD symptom dimensions in OCD with ASD patients compared with the OCD without ASD patients. These differences suggest the need for developing adapted CBT for adults with OCD with ASD and for optimizing the treatment and their lives. [ABSTRACT FROM AUTHOR]

Internet addiction (IA) has been reported as prevalent in adolescents with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). However, the course of IA in this population has not been elucidated. The authors performed a 2-year follow-up study including 89 out of 132 adolescents with ASD and/or ADHD in a psychiatric clinical setting who participated in the original cross-sectional study assessing IA prevalence. Within this sample of participants from both the original and the follow-up study, results showed a 2-year IA remission and incidence rate of 60% and 5%, respectively. Our findings imply that the course of IA in psychiatric populations with ASD and/or ADHD might be similar to reports from previous studies with general adolescent populations. [ABSTRACT FROM AUTHOR]

Abstract Ethnopharmacological relevance Kami-shoyo-san (KSS) is a Kampo formula used clinically for menopause-related symptoms in Japan. However, the effect of KSS on autism spectrum disorder (ASD), a developmental disorder with a higher prevalence in males than in females, has not been reported yet. Aim of the study It is accepted generally that dysfunction in the GABAergic system is associated with pathogenesis of ASD. In our previous study, a decrease in brain allopregnanolone (ALLO), a positive allosteric GABA A receptor modulator, induced ASD-like symptoms such as impaired sociability-related performance and increased repetitive self-grooming behavior in male mice, and that KSS ameliorated these behavioral abnormalities via GABA A receptor- and dopamine D 1 receptor-mediated mechanisms. In this study, to better understand a gender difference in the prevalence of ASD, we examined whether dissection of ovary (OVX), a major organ secreting progesterone in females, causes ASD-like behaviors in a manner dependent on brain ALLO levels, and if so, how KSS affects the behaviors. Materials and methods Six-week-old ICR female mice received ovariectomy, and KSS (74 mg/kg and 222 mg/kg, p.o.) were treated before 1 h starting each behavioral test. The sociability, social anxiety-like behavior, and self-grooming behavior were analyzed by the resident-intruder test, mirror chamber test, and open field test, respectively. After finishing the behavioral experiment, the ALLO content in the brain was measured by ELISA. Furthermore, we examined the effects of OVX on the neuro-signaling pathways in the prefrontal cortex and striatum by Western blotting. Results The results revealed that OVX induced sociability deficits and social anxiety-related behaviors, but not repetitive self-grooming behavior, and that these behavioral changes were accompanied not only by a decrease of brain ALLO levels, but also by impairment of CREB- and CaMKIIα-mediated neuro-signaling in the prefrontal cortex. Moreover, the administration of KSS had no effect on the brain ALLO level, but significantly ameliorated the OVX-induced behavioral and neurochemical changes via facilitation of GABA A receptor and dopamine D 1 receptor-mediated neurotransmission. Conclusions These findings suggest that a decrease in gonadal hormone-derived ALLO plays a major role in ASD-like behaviors in female mice and that KSS is beneficial for the treatment of ASD in females. Graphical abstract Image 1 [ABSTRACT FROM AUTHOR]

Background Autism spectrum disorders (ASD) with intellectual disabilities may be associated with many factors. This study focused on patients with ASD with intellectual disabilities, defined by a threshold intelligence quotient (IQ) or development quotient (DQ) of 70. We also discuss comorbidities and other factors related to ASD. Method We extracted case records of patients born between April 1995 and March 2001 who lived in Yonago City, as of January 2011, and had visited the two specialist institutions for consultation regarding developmental issues. The list was further narrowed down to patients identified, as having ASD by pediatric neurologists based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). We selected patients with < IQ/DQ 70 using the most recent intelligence/development test to determine comorbidities and other factors related to ASD. Results The data of 81 patients (59 males and 22 females) were extracted, corresponding to an incidence of 76.2 patients out of every 10,000 births. The male-tofemale ratio was 2.7:1. Comorbidities and related factors of ASD were observed in 25 cases (30.9%). Eleven cases had perinatal abnormalities. Other abnormalities were observed in 17 cases, including epilepsies in 7, chromosomal abnormalities in 4, familial mental retardation in 1, and acquired brain injury in 1. Conclusion It is important to treat and support individuals with ASD and intellectual disabilities taking into account the characteristics and prognosis of the comorbidities and related factors. [ABSTRACT FROM AUTHOR]

Objective: We investigated the association between maternal antepartum intimate partner violence (IPV) and autism spectrum disorder (ASD) in 3-year-old offspring. Materials and Methods: Secondary analysis of the Japan Environment and Children's Study, a nationwide prospective birth-cohort study, for preconceptional and antepartum psychological/physical IPV against mothers was undertaken based on data obtained from a maternal self-report questionnaire. Subgroup analysis by four-level IPV frequency versus no IPV was conducted, and the incidence of ASD diagnosed during ages 2-3 years was estimated using self-reported questionnaire data of participants from when the child was 3 years old. Multivariate logistic regression was used to determine the association of preconceptional/antepartum IPV with ASD in 3-year-old offspring. Results: Among 79,324 offspring, 355 (0.45%) had ASD; preconceptionally and prenatally, 1,504 (1.9%) and 839 (1.1%) mothers were exposed to physical IPV whereas 9,162 (11.6%) and 10,240 (12.9%) mothers were exposed to psychological IPV, respectively. Multivariate logistic regression revealed a significant association of preconceptional physical IPV with ASD in offspring (adjusted odds ratio, 3.21; 95% confidence interval, 1.24-8.31), but not for antepartum physical IPV and preconceptional and antepartum psychological IPV. Conclusion: Preconceptional, but not antepartum, physical IPV was associated with ASD in 3-year-old offspring. Preconceptional and antepartum psychological IPV was unassociated with ASD in 3-year-old offspring. Preconceptional care through prevention of preconceptional physical IPV is important for neurodevelopment in offspring, and the mechanisms underlying the effects of IPV among nonpregnant individuals on ASD development in offspring should be elucidated.

Purpose: Raising a child with autism spectrum disorder (ASD) can be a stressor, and mothers of ASD children often present with high levels of stress and depression. Interventional steps to enhance parental coping skills and resiliency are more important for parental mental health and the family-centered care of children with ASD than merely reducing parental stress. Although the importance of stress-coping skills is well established, only a few studies have investigated interventional steps to improve parental coping or resiliency. Parent training (PT) is known to improve a mother's mental health. Here, we aimed to assess the effectiveness of PT in improving the stress-coping style of mothers raising children with ASD. Patients and methods: Thirty mothers of children with ASD aged 4–11 years participated in this study. The mothers underwent PT based on the Hizen Parenting Skills Training in Japan, which comprised seven sessions. Each session included education on behavior therapy, individual consultation, and workshops in small groups. Sixteen mothers completed psychological assessment, including the Stress Coping Inventory, the Beck Depression Inventory Second Edition, the State–Trait Anxiety Inventory, and the Child Behavior Checklist conducted before and after 2 months of PT. Results: The outcomes before and after the PT program were compared using the paired t-test and Pearson's correlation. After the PT program, the mothers' stress-coping strategy "positive appraisal" significantly increased (P<0.01) and "escape/avoidance" significantly decreased (P<0.01). The Beck Depression Inventory Second Edition (P<0.05) and the trait anxiety scores (P<0.01) also significantly decreased. The change in the stress-coping strategy "distancing" had a significantly negative correlation with the change in the externalizing Child Behavior Checklist T-scores of children with ASD (Pearson r=-0.518, P<0.05). Conclusion: PT may be effective for mothers of children with ASD to improve their stress-coping style and to decrease their depression and trait anxiety. [ABSTRACT FROM AUTHOR]

This study aimed to confirm whether autistic traits are normally distributed across a population and to describe their association with the sociodemographic characteristics of Japanese workers. The participants were 2075 workers aged 23–65 years from various parts of Japan. Autistic traits were measured using an abridged Japanese version of the Autism-Spectrum Quotient (AQ-Short). The AQ-Short comprises five subcomponents assessing a fascination for numbers and patterns (numbers/patterns), difficulties with imagination, a preference for routine, difficulties with social skills, and difficulties with switching attention. The five subcomponents of the autistic phenotype as well as the overall autistic phenotype itself were continuously distributed across the sample population of Japanese workers. Men had significantly higher AQ-Short scores than women. AQ-Short scores were not associated with age. Except for the numbers/patterns scores, workers of a lower socioeconomic status had significantly higher AQ-Short scores than their respective counterparts. For the numbers/patterns trait, workers of a higher socioeconomic status scored higher. Workers with low general physical activity had or tended to have higher scores for total and all subcomponent traits, except for the numbers/patterns trait. Generally, the autistic phenotype was more prevalent in workers of a low socioeconomic status, while a particular trait was prevalent among workers of a high socioeconomic status. [ABSTRACT FROM AUTHOR]

Misconceptions and stigma associated with autism vary across cultures and may be influenced by various factors. Undergraduates in Japan (N = 212) and the United States (US) (N = 365) completed an online autism training, with pre- and posttest surveys assessing autism-related stigma (i.e., social distance) and knowledge. Aims were to examine differences in autism stigma and knowledge in Japan and the US, while extending prior research demonstrating benefits of an online autism training in the US and Lebanon to Japan. The results revealed that Japanese students indicated greater autism-related stigma than US students, which was not attributable to differences in autism knowledge, prior experience with autism, or college major. In both countries, students majoring in "helping professions" exhibited greater willingness to engage with people with autism. Japanese and US students varied in their misconceptions about autism, with significant differences on about half of the knowledge items. Japanese students showed decreased stigma after completing the autism training, yet continued to exhibit greater social distance towards people with autism relative to US students. Future research should focus on identifying specific cultural factors (e.g., conformity to social norms and homogeneity within communities) that contribute to fear and exclusion of people with autism in different societies. [ABSTRACT FROM AUTHOR]