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Background: Sublime is a centuries old concept of emergent experience arising from immense and threatening awareness provoked by overwhelming fear and dread when faced with an incomprehensible situation as is common to autistic people. Extended Reality (XR) technologies have been used since the mid-1990s, in regulating emotions, behaviour and supporting social skill development for autistic people. Aims: To understand utility of XR technologies in creating immersive experiences for autistic people to alleviate anxiety and the relationship to the sublime. Method: A State of the Art literature review and narrative synthesis was conducted. PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with terms Autism AND Technology. In addition, fields of digital technologies and wellbeing, digital art and mental health, generative arts and the sublime were explored through web searches of grey literature, conversations with digital designers and explorations of extended reality platforms. No time limits were placed. Searches were done in English. Papers were screened and shortlisted using the inclusion criteria applied by two reviewers. Results: Fifty-eight papers/articles met the preliminary inclusion criteria for in-depth review of which 31 were found suitable for the narrative synthesis related to XR technologies and sublime experiences as related to autistic people. Narrative synthesis lent itself to four themes that is current utility of XR Technologies in autism, the impact of immersive experiences on Behavioural, phenomenological and biological markers of autistic people, the Benefits of increased sensory stimulation using XR on autism and an inquiry into the potential of the sublime for autism. Conclusions: Mixed reality environments that experiment with a broad range of XR technologies including incorporating notions of the sublime, might be beneficial in reducing emotional dysregulation and improving social development in autistic people especially if co-designed with them. [ABSTRACT FROM AUTHOR]

When observing other people during naturally paced and dynamic interactions, it is essential to look at specific locations at the right time to extract a maximum of socially informative content. In this study, we aimed to investigate the looking behavior of typically developing toddlers and toddlers later diagnosed with autism when observing other children interact. The sample consisted of 98 toddlers; 22 in a low-likelihood of autism group, 60 in an elevated likelihood of autism group who did not receive a subsequent diagnosis, and 16 in an elevated likelihood group who did receive an autism diagnosis. Participants performed an eye tracking task at 18 months of age and were assessed for diagnostic outcome at 36 months. The video stimuli consisted of two children interacting, where a boy reaches out for a toy and a girl refuses to give it to him. The low likelihood group showed an expected increase in ratio of looking at the girl's face after the boy requested the toy, as compared to before (t(21) = -3.337, p =.003). Toddlers with later autism showed a significantly lower ratio of looking at the girl's face during this time window, as compared to the other groups (F(2,91) = 3.698, p =.029). These findings provide new leads on how social gaze may be different in children with autism in everyday life (e.g., kindergarten), and highlight the need of studying the dynamics of gaze on short time scales. [ABSTRACT FROM AUTHOR]

The editorial delves into the role of epigenetic mechanisms in rare diseases, particularly focusing on histone post-translational modifications and DNA methylation. Specific articles within the research topic explore rare neurological diseases and the impact of epigenetics on liver fibrosis. The study highlights the presence of rare deleterious variants in the IGF signaling pathway in Han Chinese autism cohorts, suggesting a potential link between IGF1R mutations and autism pathogenesis. The research emphasizes the importance of IGF1R and IGF2R in cortical development and their influence on IN-PV neurons, indicating a possible connection between IGF signaling pathways and autism. Targeting the IGF signaling pathway could potentially offer new therapeutic approaches for autism, but further research is necessary to fully comprehend the underlying molecular mechanisms. [Extracted from the article]

In the current literature the influence of sex on the clinical presentation of the bipolar disorder (BD) in adults has been indicated. It was of the interest whether such a phenomenon is also present in the pediatric population. The authors collected retrospective clinical data in 288 patients hospitalized on the psychiatry ward aged 10–17 years; 80.2 % females and 19.8 % males. No sex differences were observed in the age of onset, the time from the onset of symptoms to the diagnosis of BD, the number of symptoms during hospital stay, or family history of psychiatric disorder (U Mann-Whitney's p > 0.05). In males the most frequently recorded first episode of BD was mania or hypomania (51 %), and in females, a depressive episode (51 %). The main reason for the hospitalization in boys was episodes of mania (63 %), then mixed episodes (30 %), and depression (7 %). Whereas girls were most often hospitalized due to mixed episodes (52 %), less frequently depression (22 %), and mania (26 %). Co-morbid psychiatric disorders were found more often in boys than in girls (63 % vs 45 %; χ2 p -value>0.05). The co-occurrence of the dissocial personality, borderline, tic disorders, pervasive developmental disorders and hyperkinetic disorders was different in both sexes. The main limitations of the study are the very high proportion of female subjects and the retrospective character of the study. It seems that the clinical presentation of BD in the pediatric population can somewhat depend on the sex of the patients. • The first diagnosed episode of BD in boys was usually mania, while in girls a depressive or mixed episode. • Boys had more than twice the risk of psychiatric co-morbidity than girls. • Frequency of pervasive developmental disroders and ADHD were respectively 4- and 6-times higher in boys. [ABSTRACT FROM AUTHOR]

Parent‐mediated interventions for infants and young children with an increased likelihood of autism may help ameliorate developmental concerns; however, generalization of parents' teaching strategies to novel child target skills has not been consistently demonstrated. This study expanded our parent training program, Parent Intervention for Children at‐Risk for Autism (PICARA), by incorporating telehealth general case training (PICARA‐TGCT) to promote generalization of teaching skills. Five parent–child dyads participated. Child target skills were chosen from the categories of imitation, receptive language, and expressive language. A concurrent multiple‐baseline‐across‐participants design was used to evaluate the effect of training across two cohorts of parent–child dyads. Dependent variables included the percentage of correct parent teaching skills and the percentage of child correct responses. Parent teaching skills increased across all participants for both trained and untrained child target skills, as did child skills. This study provides support for PICARA‐TGCT as an efficacious and efficient early intervention model. [ABSTRACT FROM AUTHOR]

Pediatric feeding disorders are common and are often associated with chronic medical conditions and developmental disorders. A multidisciplinary treatment approach may be offered through outpatient or intensive programs. Benefit has been demonstrated with intensive programs, but there is little data regarding outpatient approaches. We described outcomes from a well-established outpatient feeding assessment program related to the referral base and program outcomes. Study packets collecting demographics and self-reported feeding skills were distributed to the referral population and redistributed three months later. Standardized surveys implemented included Montreal Children's Hospital Feeding Scale (MCH-FS) and parenting stress index (PSI-SF). One hundred and ninety-eight subjects completed the initial packet. MCH-FS was elevated in all subjects indicating a broad range of feeding concerns. PSI elevation was present in a broad range of comorbidities compared to group without comorbidities. At 3 months (n = 55), MCH-FS and feeding skills improved without change in PSI-SF. The quality of therapy overall was deemed excellent to above average by most subjects. A multidisciplinary outpatient program has a role in managing infants and children with feeding disorders regardless of comorbidity. Severely affected individuals may benefit from more intensive programs and/or may require long-term care to effect significant change. [ABSTRACT FROM AUTHOR]

Primary reflexes are highly stereotypical, automatic movements comprising much of the motor repertoire of newborns. The current study examined rates of presence of five primary reflexes (snout, visual rooting, sucking, tactile rooting, and grasp) and variables predictive of their persistence for children with ASD (n = 35), developmental disability (n = 30), and typically developing children matched to participants with ASD on chronological age (n = 30). There was a higher prevalence of snout and visual rooting reflex among children with ASD. These data suggest that the persistence of primary reflexes holds promise as a biomarker for autism spectrum disorder (ASD). [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite.In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. What the paper adds to existing knowledge?: This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey.In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. What are the implications for practice?: The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user.These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. Introduction: Recovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures. Aim: This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness. Method: A cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery. Results: Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency. Discussion: In recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial. Implications for Practice: Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) ranges from mild to severe symptoms, with autistic traits possibly distributed throughout the population. However, the precise neurodevelopmental differences in children with autistic traits remain unknown. Fifty-three healthy volunteers (32 male and 21 female, mean [standard deviation] age: 12.9 [2.5] years) having a normal intelligence quotient and without social impairment were divided into two groups according to scores of the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS). Subjects with or without autistic traits were placed into the high-PARS (n = 14) or low-PARS (n = 39) group, respectively. Activation of the prefrontal cortex was estimated using change in hemoglobin oxygenation concentration (Δ[oxy-Hb]) on near-infrared spectroscopy (NIRS) during a verbal fluency test. Age-related changes in prefrontal cortex activation were first assessed for each group. Then, the effects of age (elementary school age or junior/senior high school age) and PARS score on Δ[oxy-Hb] in the task were analyzed by two-way analysis of variance. We observed significant positive correlations between mean Δ[oxy-Hb] and age in the prefrontal cortex region in the low-PARS group. Mean Δ[oxy-Hb] in the low-PARS group was significantly higher than in the high-PARS group. Task performance results were comparable between the groups. In PARS-determined typically developed children, prefrontal cortex activation on NIRS correlated positively with age. In healthy volunteers without ASD but harboring autistic traits, prefrontal cortex activation was markedly lower than in normal counterparts. Our results provide biological evidence that ASD may be a pervasively distributed disorder. [ABSTRACT FROM AUTHOR]

Early childhood development (ECD) is crucial for better health and well‐being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem‐solving and personal–social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community‐based cross‐sectional survey design, 627 mother–child (12–36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ‐3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem‐solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non‐stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition. Key messages: Studies examining early childhood development (ECD) and child nutrition are scarce in Ethiopia, mainly due to lack of reliable and disaggregated ECD data.We estimated the prevalence of ECD delays and examined how different ECD domains were associated with child nutrition in urban Ethiopia using a direct ECD measure.Our study revealed that stunted and underweight children had a higher likelihood of ECD delays. To address these issues, we recommend coordinated efforts across key sectors, such as health, education, women's affairs and social protection, to promote and implement ECD interventions, such as nurturing care. [ABSTRACT FROM AUTHOR]

Cumulative comorbidity of mental disorders is common, but the extent and patterns of comorbid psychopathology in childhood are not well established. The current study aimed to elucidate the emergent patterns of cumulative mental disorder comorbidity in children using network analysis of diagnoses recorded between birth and age 12 years. Participants were 90,269 children (mean age 12.7 years; 51.8% male) within the New South Wales Child Development Study (NSW-CDS)—a longitudinal record-linkage cohort study of Australian children born in NSW between 2002 and 2005. Binary indicators for eight types of mental disorder were derived from administrative health records. Patterns of conditional association between mental disorders were assessed utilising network analysis. Of 90,269 children, 2268 (2.5%) had at least one mental disorder by age 12 years; of the 2268 children who had at least one mental disorder by age 12 years, 461 (20.3%) were diagnosed with two or more different disorders out of the eight disorder types included in analyses. All disorders were either directly or indirectly interconnected, with childhood affective and emotional disorders and developmental disorders being most central to the network overall. Mental disorder nodes aggregated weakly (modularity = 0.185) into two communities, representative of internalising and externalising disorders, and neurodevelopmental and sleep disorders. Considerable sex differences in the structure of the mental disorder comorbidity networks were also observed. Developmental and childhood affective and emotional disorders appear to be key to mental disorder comorbidity in childhood, potentially reflecting that these disorders share symptoms in common with many other disorders. [ABSTRACT FROM AUTHOR]

Introduction: Teachers are part of a child's first social environment; therefore, their knowledge is crucial to the early diagnosis of the autism spectrum. Teachers have a fundamental role in the support services and educational advancement of autistic children. This study aims to determine teachers' knowledge levels and attitudes about autism spectrum disorders (ASD). Methods: This cross-sectional study is a descriptive, national single-center survey study. The target population is teachers who work in preschools, primary schools, and special education centers. It was aimed to reach at least 286 participants. The questionnaire contains sociodemographic data and an ASD knowledge level test. Results: 21.2% of respondents felt competent in providing training to students with ASD, and 17.2% of them found the level of their knowledge sufficient. 70.6% of the teachers stated that inclusion is required. The rate of correct answers to the statements of teachers who participated in the training about autism was significantly higher than those who didn't. Discussion and Conclusion: The knowledge level of teachers about ASD is sufficient, but they feel inadequate due to the large number of students to deal with in the classroom. The quality of life of these children with special needs will increase if primary care physicians provide education and counseling to teachers to increase awareness and knowledge about autism. [ABSTRACT FROM AUTHOR]

Background: The age of onset (AOO), incidence and cumulative incidence of mental disorders are critical epidemiological measures, providing essential insights into the development and course of these disorders across the lifespan. This study aims to provide up‐to‐date estimates of the AOO, age‐specific incidence, and cumulative incidence for a comprehensive range of mental disorders using data from Danish registers. Methods: We conducted a follow‐up study encompassing all Danish residents from January 1, 2004, to December 31, 2021, totaling 91,613,465 person‐years. Data were sourced from the Danish Psychiatric Central Research Register, identifying individuals treated for various mental disorders in psychiatric hospitals, outpatient departments, and accident/emergency departments, that is, treated in secondary care settings. We investigated specific categories of mental disorders, including substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, borderline personality disorders, intellectual disabilities, pervasive developmental disorders, and behavioral and emotional disorders. Age‐sex‐specific incidence rates were estimated using Poisson generalized linear models, and cumulative incidence was calculated using Aalen–Johansen's competing risks model. The study provides estimates of AOO, incidence, and cumulative incidence for various mental disorders, including their age and sex distributions. Results: The cumulative incidence by age 80 years for any mental disorder was 30.72% (95% confidence interval: 30.62%–30.83%) for males and 34.46% (34.35%–34.57%) for females. The most common types of mental disorders were anxiety‐related disorders 16.27% (16.19%–16.36%) for males and 23.39% (23.29%–23.50%) for females, and followed by mood disorder 10.34% (10.27%–10.41%) for males and 16.67% (16.58%–16.77%) for females. For those who develop mental disorder, half will have developed their disorder by approximately age 22 years (median and interquartile range: males 21.37 (11.85–36.00); females 22.55 (16.31–36.08)). Conclusions: Approximately one in three individuals will seek treatment for at least one mental disorder in a secondary care setting by age 80. Given that half of these individuals develop mental disorders before age 22, it is crucial to tailor service planning to meet the specific needs of young individuals. Web‐based interactive data‐visualization tools are provided for clinical utility. [ABSTRACT FROM AUTHOR]

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Autism is a representative disorder of pervasive developmental disorder. It exerts influence upon an individual's behavior and performance, potentially co-occurring with other mental illnesses. Consequently, an effective diagnostic approach proves to be invaluable in both therapeutic interventions and the timely provision of medical support. Currently, most scholars' research primarily relies on neuroimaging techniques for auxiliary diagnosis and does not take into account the distinctive features of autism's social impediments. In order to address this deficiency, this paper introduces a novel convolutional neural network-support vector machine model that integrates resting state functional magnetic resonance imaging data with the social responsiveness scale metrics for the diagnostic assessment of autism. We selected 821 subjects containing the social responsiveness scale measure from the publicly available Autism Brain Imaging Data Exchange dataset, including 379 subjects with autism spectrum disorder and 442 typical controls. After preprocessing of fMRI data, we compute the static and dynamic functional connectivity for each subject. Subsequently, convolutional neural networks and attention mechanisms are utilized to extracts their respective features. The extracted features, combined with the social responsiveness scale features, are then employed as novel inputs for the support vector machine to categorize autistic patients and typical controls. The proposed model identifies salient features within the static and dynamic functional connectivity, offering a possible biological foundation for clinical diagnosis. By incorporating the behavioral assessments, the model achieves a remarkable classification accuracy of 94.30%, providing a more reliable support for auxiliary diagnosis. [ABSTRACT FROM AUTHOR]

A cohort study involving both publicly and commercially insured patients has found in adjusted analyses that exposure to stimulant medications during pregnancy did not significantly increase risk of childhood neurodevelopmental disorders. The investigators focused largely on children's risk of autism spectrum disorder (ASD) and attention‐deficit hyperactivity disorder (ADHD). Study results were published online Jan. 24, 2024, in JAMA Psychiatry. [ABSTRACT FROM AUTHOR]

Background: Early intervention is recommended for pre‐school children with low language. However, few robustly evaluated language interventions for young children exist. Furthermore, in many interventions the theoretical underpinnings are underspecified and the 'active ingredients' of the interventions not tested. This paper presents a quasi‐experimental study to test the efficacy and examine the active ingredients of Building Early Sentences Therapy (BEST): an intervention based on usage‐based theory designed to support young children to understand and produce two‐, three‐ and four‐clause element sentences. BEST manipulates the input children hear to support them to harness the cognitive mechanisms hypothesized in usage‐based theories to promote the development of abstract linguistic representations. One such input manipulation is the use of signing alongside verbal input signalling both content and morphology of target sentences. Aims: To examine whether (1) BEST is more efficacious than treatment as usual (TAU); and (2) signing of content and morphology is an active ingredient of the intervention. Methods & Procedures: A quasi‐experimental study recruited children aged 3;5–4;5 years from 13 schools. Schools were assigned to receive either BEST with sign, BEST without sign or TAU. The TAU group received their usual classroom provision. Across arms schools were matched with respect to classroom oral language environment and indices of deprivation. Participants were 48 children (28 boys) with expressive and/or receptive language abilities ≤ 16th centile measured using the New Reynell Developmental Language Scales (NRDLS). Outcomes gathered by researchers blind to treatment arm were NRDLS production and comprehension standard scores and measures of production of targeted sentence structures. Outcomes & Results: Primary outcomes indicate that BEST with sign was significantly more efficacious than TAU with respect to NRDLS production standard score, but not comprehension. The advantage for production was maintained at follow‐up. BEST without sign was significantly more efficacious than TAU on measures of targeted vocabulary, sentence structure and morphology. The results from this quasi‐experimental study provide evidence for the efficacy of a usage‐based intervention on expressive language outcomes for preschool children with low language abilities. There is also evidence to support the inclusion of sign as an active ingredient, and so efforts to train interventionists in its use are worthwhile. Conclusions & Implications: Patterns of findings across outcomes suggest signing of content and morphology may support the development of abstract linguistic representations and accelerate language learning. Given these positive results and the scale of this study, a fully powered randomized controlled trial is warranted. WHAT THIS PAPER ADDS: What is already known on the subject: Robust language skills are crucial for positive social, emotional, academic and economic outcomes across the lifespan. There is a paucity of robustly evaluated interventions for preschool children with language difficulties. The development of such interventions is crucial for ameliorating language difficulties and promoting positive educational and psychosocial outcomes. What this study adds to the existing knowledge: This paper evaluates BEST, a novel usage‐based language intervention targeting children with language difficulties in the early years. Findings indicate that a usage‐based intervention is efficacious for treating language difficulties. In particular, BEST benefited expressive language development, bringing benefits to both treated and untreated language structures and improving standard scores. The role of sign as an active ingredient is also supported. Further evaluation is warranted. What are the practical and clinical implications of this work?: Findings suggest that BEST may be effective for targeting children who have been identified as having language difficulties. In particular, expressive language may be improved when the intervention is delivered as it was originally manualized, including a signing system to represent content and grammatical morphology. More broadly, these findings also provide preliminary evidence that the use of a signing system does not hinder oral language development in children with language difficulties and may conversely support their expressive language. Future research exploring the role and underpinning mechanisms of sign in language intervention is warranted. [ABSTRACT FROM AUTHOR]

Background: Children with disabilities are among the most vulnerable groups in unforeseen and unexpected circumstances, such as pandemics that can cause a change in the vital order. Aim: The research was conducted to reveal the conditions of children with disabilities and their families affected by the COVID-19 pandemic for descriptive characteristics and to identify situations making a difference. Methodology: The research is in quantitative method. The data were collected in an internet-based digital environment. Disabled children of the participants have mental, hearing, vision, physical disabilities, pervasive developmental disorder, and special learning disabilities. Results: In the study, it was recognized that children with disabilities had other illnesses apart from their disabilities, their rehabilitation was incomplete, families were left alone with the process and they were away from professional follow-up. It was discovered that the problems of both the family and the child increased, and they did not have the desired behavior pattern in solving the issues. Conclusions: The COVID-19 pandemic has increased negative consequences for both the disabled children and their families. [ABSTRACT FROM AUTHOR]

The existence of a female phenotype profile in autistic spectrum disorder is one of the current hypotheses to explain the diagnostic discrepancy between men and women. In this context, an international literature review was carried out to evidence and describe the characteristics of restricted interests found in girls with autistic spectrum disorder. A documentary search was conducted on PubMed and a systematic literature review was carried out based on the PRISMA methodology. We selected studies with a population of boys and girls diagnosed as autistic according to the DSM-IV or the DSM-5, in which quantitative and descriptive comparisons of restricted interests, according to gender were carried out. Nineteen studies were found to be relevant. Fifteen enabled a refining of the characteristics of restricted interests among females: fewer restricted interests were identified in comparison with boys, and the autistic girls' interests seem to be closer to those of neurotypical girls than to those of autistic boys, which thus led to more complex screening. Age and Intelligence quotient seem to be two factors that trigger variations in restricted interests differently according to gender. Representations among professionals also have an impact on diagnoses among girls. For future research, one of the perspectives could be a comparison between girls with autism and neurotypical girls to limit gender bias. The present results contribute to potentially extending knowledge of a female phenotypical profile in autism and show the need to improve the general population's awareness, to improve health professionals' training and possibly to revise the diagnostic tools. [ABSTRACT FROM AUTHOR]

Autistic people in England face worse health outcomes than non-autistic people. Autism-specific annual health checks have been proposed as one solution to this issue. This study identified strategies to incentivise primary care providers to offer autism-specific annual health checks, using a behavioural science approach. In phase 1, we conducted interviews and focus groups with autistic people (n = 10) and primary care providers (n = 11). In phase 2, we conducted a national survey of primary care providers (n = 196). Qualitative data were analysed using a framework method and the Theoretical Domains Framework. Quantitative data were analysed descriptively, and comparisons between sub-groups of survey respondents were made using Mann–Whitney U and Kruskal–Wallis tests. The most salient theoretical domain was environmental context and resources. Participants identified lack of time and staff as key barriers to implementation. Delegating tasks to non-physician practitioners and automating processes were seen as key facilitators. Autism-specific knowledge was another relevant domain; education produced and delivered by autistic people was posited to increase health check uptake and quality. Overall, participants were enthusiastic about autism-specific annual health checks but were concerned about the practical aspects of implementation. We identified specific barriers and facilitators that can be addressed prior to policy adoption to maximise chances of success. Autistic people are more likely to have mental and physical health problems than non-autistic people. Annual health checks could reduce these problems by finding and treating them early. Annual health checks are yearly medical appointments where a primary healthcare provider (such as a doctor or nurse) can check things like a patient's weight and heart rate and ask if they have any worries about their health. In this study, we wanted to understand what might encourage primary healthcare providers to use annual health checks with their autistic patients. First, we spoke to 10 autistic people and 11 primary healthcare providers. Using the findings from these conversations, we created an online survey for primary healthcare providers in England. We used the findings from the interviews and survey to help us understand what would encourage primary healthcare providers to offer annual health checks for autistic people. Our participants said that a lack of time and staff would make it hard to provide health checks. To help, they said other members of staff (such as nurses and healthcare assistants) could do the health checks, rather than doctors. They also said parts of the process could be made automatic to save time (e.g. sending automatic reminders). Knowledge about autism was important too (e.g. knowing about the common conditions autistic people have, and how to best support autistic patients). Participants said training on these topics, produced and delivered with autistic people, could encourage them to use annual health checks with their autistic patients. [ABSTRACT FROM AUTHOR]

Introduction. Autism spectrum disorders (ASD) represent pervasive developmental disorders of neurobiological origin, involving disruptions in communication and interaction, as well as restricted and repetitive interests and actions. According to the latest report published by the Centers for Disease Control and Prevention USA, 1 in 36 children is diagnosed with ASD. The aim of study is to estimate the prevalence of genetic disorders among children with ASD in order to enhance diagnosis and assistance for children with ASD. Materials and Methods. We employed an observational method of official studies, synthesizing and critically analyzing published articles (54 articles, 52 patients with ASD) from 2016-2024 on platforms such as PubMed, Medscape, NEJM, GeneCards, Lecturio, AMBOSS regarding ASD in children with genetic diseases. Results. The study included a group of 52 children with ASD examined during the medical genetics consultation at the Mother and Child Institute. Among them, 24 children had defects in genes or various genetic diseases associated with ASD, such as Rett syndrome, Fragile X syndrome, Angelman syndrome, tuberous sclerosis, Sotos syndrome, etc. Among the genetic mutations causing genetic disorders and ASD in children are genes responsible for transcription regulation (MECP2, MEF2C, FOXG1), cell growth (TSC1, TSC2, PTEN), synaptic channels (SCN2A), and synaptic structure (CASK, CDKL5, FMR1, SHANK3). Conclusions. ASD is encountered in children with genetic disorders. Awareness of genetic pathologies associated with ASD, will improve the assessment process for these children by specialists in genetics, neurology, and pediatrics working in pediatric medical institutions. Early clinical-genetic diagnosis of children with genetic diseases associated with ASD will enhance the psychoneurological development of these children. [ABSTRACT FROM AUTHOR]

This document provides an overview of autism spectrum disorder (ASD), including its definition, prevalence, and potential causes. It highlights the complexity and heterogeneity of ASD, making it challenging to identify common profiles and causative factors. The document also emphasizes the impact of an ASD diagnosis on families and the need for support strategies. Several articles within this special issue of Medicina explore various aspects of ASD research, management, and support. These articles cover topics such as complementary and alternative strategies for managing ASD, the impact of parental presence and antipsychotic drugs on social interaction, biomarkers for diagnosing ASD, the effect of bilingualism on language skills in Greek-speaking children with ASD, and the use of genomic analysis to improve ASD diagnosis. The document concludes by expressing hope that this collection of articles will contribute to further research and progress in the field of ASD. [Extracted from the article]

Little attention has been given to the voice of autistic individuals during the development of theories that are trying to explain the condition. This can often make individuals feel that they have to fit into the theory's definition, rather than it fitting into their experience. We aimed to understand to what extent the HIPPEA (High, Inflexible Precision of Prediction Errors in Autism) theory resonates with the lived experiences of autistic individuals. We conducted 21 questionnaires and 8 follow-up interviews and used a hybrid (deductive and inductive) approach to analyse the data. Based on the participants' views, HIPPEA provides an explanation for many of the lived experiences of autistic individuals. However, refinement is needed with respect to interpersonal interactions, emotional processing and individuals' motivation to engage with their environment despite challenges with the way the world is organised. Furthermore, more details are needed for the theory to accurately allow us to understand autism. Autism is a condition comprised of difficulties in social and communication contexts, sensory sensitivities as well as restrictive and repetitive behaviours. Many theories have tried to explain all the symptoms and behaviours associated with autism. We focus on one recent theory – High, Inflexible Precision of Prediction Errors in Autism (HIPPEA). We aim to understand how much this theory fits the experiences of autistic individuals. We collected data through 21 online questionnaires and 8 follow-up interviews. One of our participants was a parent of an autistic child, and the remaining were adults who reported a diagnosis of autism. We analysed the data by thinking about how it fitted with what we already knew and by looking for new insights which came up. Our results suggest that autistic individuals can make generalisations but that this happens more slowly across both social and non-social areas. These generalisations are very reliant on detail – in computer terms, they are 'pixelated'. This is in line with what HIPPEA suggests. We also showed that autistic individuals can be motivated to explore and engage socially, something that needs more consideration within HIPPEA. Overall, this study shows that HIPPEA can explain many autistic experiences, but that further refinement is needed. [ABSTRACT FROM AUTHOR]

This study aimed to explore experiences of support after adulthood autism diagnosis. In this mixed-methods survey study of 137 adults, we found that most common formal supports received were counselling and mental health. Common unmet support needs were sensory sensitivities and accessing other services. Cost, lack of information, and fear of not being taken seriously were common barriers. Informal support was mainly helpful for self-understanding and emotions toward diagnosis. Qualitative findings included difficulties accessing formal support, need for practical quality-of-life supports and support from autistic peers and online communities. Based on these findings, future development of supportive interventions should address unmet needs, improve access, and explore the integration of autistic peer support and online support into formal services. [ABSTRACT FROM AUTHOR]

Background: Tics and stereotypies are childhood-onset repetitive behaviours that can pose significant diagnostic challenges in clinical practice. Both tics and stereotypies are characterised by a complex co-morbidity profile, however little is known about the co-occurrence of these hyperkinetic disorders in the same patient population. Objective: This review aimed to assess the relationship between tics and stereotypies when these conditions present in co-morbidity. Methods: We conducted a systematic literature review of original studies on co-morbid tics and stereotypies, according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Our literature search identified six studies of suitable sample size (n ≥ 40) presenting data on the association between tics and stereotypies in otherwise typically developing patients. A considerable proportion (23%) of patients diagnosed with stereotypic movement disorder present with co-morbid tics (range 18–43%). Likewise, the prevalence of primary stereotypies is increased in patients with tic disorders such as Tourette syndrome (8%, range 6–12%). Discussion: Tics and stereotypies can often develop in co-morbidity. The association of tics and stereotypies in the same patient has practical implications, in consideration of the different treatment approaches. Future research should focus on the assessment and management of both conditions, particularly in special populations (e.g. patients with pervasive developmental disorders). [ABSTRACT FROM AUTHOR]

The article describes the case of a six-year-old girl with schizencephaly, shunted hydrocephalus, epilepsy, global development delay, diabetes insipidus, and spastic quadriplegic cerebral palsy. Topics discussed include findings on her medical examination, major categories of the differential diagnosis for a child with acquired chest wall mass, and final diagnosis of thoraco-abdominal actinomycosis with chest wall invasion.

An earlier diagnosis of autism spectrum disorder might lead to an earlier intervention, yet knowledge and awareness of autism spectrum disorder in Latin America and Caribbean Countries are limited. A later autism spectrum disorder diagnosis has been associated with negative consequences, as it might imply later access to services. This study aims to identify factors associated with the age of autism spectrum disorder diagnosis as reported by 2520 caregivers of autistic children from six Latin America and Caribbean Countries. Results indicate that on average, caregivers were concerned about their child's development by 22 months of age; however, the diagnosis was 24 months later. Current age of autistic individuals, better language abilities, and having public health coverage increased the age of diagnosis. On the contrary, the presence of medical comorbidities, severity level, and type of diagnosis decreased the age of diagnosis. The age of diagnosis of autistic individuals in Latin America and Caribbean Countries corresponded to the start of formal schooling despite a much earlier age of first noticed developmental concern, highlighting the need to reduce this age gap and increase children's probability of benefiting from early intervention. Taken together, autism spectrum disorder personal/clinical characteristics and access to health service are the main determinants for the age of diagnosis. An earlier diagnosis of autism spectrum disorder might lead to earlier intervention. However, people living in Latin American and Caribbean countries do not have much knowledge about autism spectrum disorder symptoms. It has been suggested that the older a child is when diagnosed, the fewer opportunities he or she will have to receive services. We asked 2520 caregivers of autistic children in six different Latin America and Caribbean Countries, the child's age when they noticed some developmental delays and their child's age when they received their first autism spectrum disorder diagnosis. Results indicate that, on average, caregivers were concerned about their child's development by 22 months of age; however, the diagnosis was received when the child was 46 months of age. In addition, older children with better language abilities and public health coverage (opposed to private health coverage) were diagnosed later. On the contrary, children with other medical problems and more severe behaviors received an earlier diagnosis. In our study, children were diagnosed around the time they entered formal schooling, delaying the access to early intervention programs. In summary, the characteristics of the autistic person and the type of health coverage influence the age of diagnosis in children living in Latin America and Caribbean Countries. [ABSTRACT FROM AUTHOR]

Onset of mental health disorder peaks during adolescence making continuity of care during this period of life crucial both to ensure a smooth treatment course and high quality of mental health services for adolescents. We aimed to examine which clinical and sociodemographic features predict transfer from child and adolescent mental health services to adult mental health services and if transfer is associated with prognosis. A Danish register study including all 16–17-year-olds with an outpatient contact in child and adolescent mental health services, who were discharged in the period of 1/1/06–10/05/15. Out of 27,170 Danish adolescents, 16% transferred to adult mental health services. Transfer was predicted by schizophrenia (OR 6.16; 95% CI 5.51–6.90) and personality disorders (OR 2.08; 95% CI 1.84–2.34), while hyperkinetic (OR 0.54; 95% CI 0.49–0.59) and pervasive developmental disorders (OR 0.42; 95% CI 0.31–0.58) decreased likelihood of transfer. Transfer was also substantially predicted by inpatient admission (OR 3.37; 95% CI 3.14–3.61) and psychiatric medication (OR 2.07; 95% CI 1.92–2.23). Transfer was associated with higher rates of inpatient admission to adult mental health services (IRR 5.83; 95% CI 4.37–7.77), more psychiatric emergency contacts (IRR 12.0; 95% CI 10.7–13.4), more convictions (IRR 1.40; 95% CI 1.23–1.59) and suicide attempts (IRR 5.70; 95% CI 4.72–6.90). Policy-makers and clinicians should push for improvements and open a discussion of how to ensure continuity of care for adolescents with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Aim: To assess case fatality rate (CFR), infant mortality, and long‐term neurodevelopmental disorders (NDDs) after invasive group B streptococcal (GBS; Streptococcus agalactiae) infection in infants. Method: Children born in Norway between 1996 and 2019 were included. Data on pregnancies/deliveries, GBS infection, NDDs, and causes of death were retrieved from five national registries. The exposure was culture‐confirmed invasive GBS infection during infancy. Outcomes were mortality and NDDs, the latter at a mean age of 12 years 10 months. Results: Among 1 415 625 live‐born children, 866 (87%) of 1007 infants diagnosed with GBS infection (prevalence 0.71 per 1000) were included. The CFR was 5.0% (n = 43). GBS infection was associated with higher infant mortality (relative risk 19.41; 95% confidence interval [CI] 14.79–25.36) than the general population. Among survivors, 169 (20.7%) children were diagnosed with any NDD (relative risk 3.49; 95% CI 3.05–3.98). In particular, GBS meningitis was associated with high risks of attention‐deficit/hyperactivity disorder, cerebral palsy, epilepsy, hearing impairment, and pervasive and specific developmental disorder. Interpretation: The burden of invasive GBS infection during infancy is considerable and continues to affect children beyond infancy. These findings emphasize the need for new preventive strategies for disease reduction, and the need for survivors to be directly included into early detection pathways to access early intervention if required. What this paper adds: The burden of invasive group B streptococcal (GBS) infection in Norway is considerable.Of GBS infection survivors, 20.7% were diagnosed with neurodevelopmental disorders (NDDs) at mean age 12 years 10 months.Infants with GBS meningitis were more often diagnosed with NDDs.Absolute risks associated with GBS infections were highest for pervasive and specific developmental disorder, cerebral palsy, and attention‐deficit/hyperactivity disorder. [ABSTRACT FROM AUTHOR]

Background: Children with congenital heart disease present a higher frequency of cardiorespiratory arrest (CRA) than the general pediatric population. The epidemiology of CRA is not exactly known in our setting, nor are the mortality risk or the neurological evolution factors. Objective: To describe the epidemiology and outcomes associated with pediatric cardiopulmonary resuscitation in a cardiovascular recovery unit. The primary endpoint was the survival to discharge and the secondary endpoints were the return to spontaneous circulation, the survival at 24 hours and the remote neurological condition. Methods: Descriptive, prospective, longitudinal cohort study in children under 18 years of age who required cardiopulmonary resuscitation between 2016 and 2019. Demographic variables, characteristics of cardiopulmonary arrest, resuscitation and outcome were analyzed. An uni- and multivariate analysis was performed comparing survivors and deceased. Results: Out of 1,842 hospitalized patients, 4.1% presented CRA. Fifty patients with complete records were analyzed. Seventy-eight percent (39) returned to spontaneous circulation with a high survival rate of 46%. Resuscitation > 6 min and the use of vasoactive drugs were predictors of mortality; 16/23 patients were followed up, 10 of them with normal development for age at 6 months, six had pervasive developmental disorder. Conclusions: 4.1% of patients presented CRA, with a rate of 3.4 CRA per 1,000 patient-days. Survival at hospital discharge (n = 50) was 46%. Resuscitation > 6 min and the use of vasoactive drugs were independent predictors of mortality. At six months, 63% had normal neurological development for age. [ABSTRACT FROM AUTHOR]

Objective Cerebral palsy is a group of movement disorders caused by damage to one or more regions of the developing brain. Therapists use different treatment approaches for children with cerebral palsy. It is important to pay attention to the priorities of the parents of these children because they spend most of the time with their children and are fully aware of their needs. The present study aims to investigate the treatment priorities of parents of children with cerebral palsy. Materials & Methods In this scoping review study, a search was first conducted in national and international databases, including SID, PubMed, Scopus, Google Scholar, OT Seeker, and the Bank of Medical Theses of the country. The articles focused on the treatment priorities of parents of children with cerebral palsy and published in English or Persian from 2000 to 2022 were included. The review studies published in other languages were excluded. After assessing the found articles based on the inclusion and exclusion criteria, 12 articles were finally selected for the review. Results The parents of children with cerebral palsy have different priorities. Teaching elf-care skills to the child was one of their most important priorities, which is not dependent on the age and level of gross motor function in children. Other important priorities were mobility and having complete information about treatment services. It seems that all the mentioned priorities are related to each other and paying attention to each one requires checking other priorities. Conclusion The priorities of the parents of children with cerebral palsy are broad and unique. Not all of these priorities are dependent on the age and severity of disability in the children, and can be different per child. It seems necessary to pay attention to the treatment priorities of the parents of these children in the rehabilitation process. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "A Systematic Review of Familiarisation Methods Used in Human-Robot Interactions for Autistic Participants" published in the International Journal of Social Robotics. The correction states that Table 3 in the original article was published incorrectly and provides the correct version of the table. The table includes a summary of studies on human-robot interactions with autistic participants, including the age of participants, diagnosis, robot used, and the type of familiarization method employed. The document also includes abbreviations and acronyms related to diagnostic tools and classifications used in the field of ASD research. [Extracted from the article]

Tailoring motor activities to the unique needs of children with special educational requirements has shown considerable efficacy. Our study aimed to develop a structured program specifically designed to enhance psychomotor abilities, focusing on balance and motor–cognitive skills among 28 students (aged 12–14) from two institutional centers in Romania. The program spanned 36 weeks, with biweekly 30 min sessions. Psychomotor skills were assessed through tests measuring balance, speed of movements, and upper limb motor laterality. Initial and final data were collected for evaluation. A statistical analysis, employing the Kolmogorov–Smirnov and Wilcoxon Z tests, compared the assessments. The results indicated significant improvements in movement speed, with a notable increase in stimulus identification (averaging from approximately 13 to 14) (p < 0.05) and reduced processing time (decreasing from about 28.7 to 28 s) (p < 0.05). However, while the structured program demonstrated substantial enhancements in specific motor and cognitive–motor skills, it did not yield significant changes in dynamic balance, maintaining values close to 0.9 (p > 0.05) for open-eyed balance and 0.88 (p > 0.05) for closed-eyed balance. Additionally, an analysis of the processing speed in pulses per second showcased a marginal decline, from approximately 0.46 to 0.45, revealing notable disparities between the initial and final measurements (p < 0.05). [ABSTRACT FROM AUTHOR]

(1) Background: Mothers of very preterm (VPT) infants may experience psychological symptoms compromising long-term emotional wellbeing. This study describes the emotional wellbeing of mothers of five-year-old children born VPT. We assess the association between sociodemographic, perinatal and neonatal characteristics, and the child's health and development at five years old and maternal emotional wellbeing. (2) Methods: Data are from the prospective European "Effective Perinatal Intensive Care in Europe" (EPICE) and subsequent "Screening for Health In very Preterm infantS in Europe" (SHIPS) projects including births <32 weeks' gestational age in 11 countries in 2011/12. Data were abstracted from obstetric and neonatal records. At five years old, 2605 mothers answered a parental questionnaire including the Mental Health Inventory-5 (MHI-5). Associations between sociodemographic and health characteristics and the mother's MHI-5 score were investigated using multilevel multivariate linear regression analysis with the country modelled as a random effect and inverse probability weighting to correct for attrition bias. (3) Results: The mean MHI-5 score was 71.3 (SD 16.7) out of 100 (highest emotional wellbeing) with a variation among countries from 63.5 (SD 16.8; Poland) to 82.3 (SD 15.8; the Netherlands). MHI-5 scores were significantly lower for mothers whose child had a severe health problem, developmental, or speech delay, for multiparous and single mothers, and when at least one of the parents was unemployed. (4) Conclusions: The emotional wellbeing of mothers of VPT infants differs between European countries. Identifying sociodemographic characteristics and child's health and developmental conditions that affect maternal emotional wellbeing may help to identify groups of mothers who need special assistance to cope with consequences of the delivery of a VPT child. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes autism, Asperger's syndrome, and pervasive developmental disorder. ASD is characterized by poor interpersonal relationships and strong attachment. The correlations between activated or inactivated gene products, which occur as a result of genetic mutations affecting neurons in ASD patients, and ASD symptoms are now of critical concern. Here, for the first time, we describe the process in which that the respective ASD-associated mutations (Arg676-to-Cys [R676C] and Ser951-to-Cys [S951C]) of semaphorin-5A (Sema5A) localize Sema5A proteins themselves around the plasma membrane in the N1E-115 cell line, a model line that can achieve neuronal morphological differentiation. The expression of each mutated construct resulted in the promotion of excessive elongation of neurite-like processes with increased differentiation protein markers; R676C was more effective than S951C. The differentiated phenotypes were very partially neutralized by an antibody, against Plexin-B3 as the specific Sema5A receptor, suggesting that the effects of Sema5A act in an autocrine manner. R676C greatly increased the activation of c-Jun N-terminal kinase (JNK), one of the signaling molecules underlying process elongation. In contrast, the blocking of JNK signaling, by a chemical JNK inhibitor or an inhibitory construct of the interaction of RhoG with Elmo1 as JNK upstream signaling molecules, recovered the excessive process elongation. These results suggest that ASD-associated mutations of Sema5A, acting through the JNK signaling cascade, lead to excessive differentiated phenotypes, and the inhibition of JNK signaling recovers them, revealing possible therapeutic targets for recovering the potential molecular and cellular phenotypes underlying certain ASD symptoms. [ABSTRACT FROM AUTHOR]

This study aims to investigate the perception of phonological, grammatical, and semantic structures by 8 children (age range: 8;2–9;5) with developmental language disorders (DLD). Another 8 age-matched (age range: 8;4–10;0) typically developing (TD) children served as controls. The results demonstrated that children with DLD had lower performance than children with TD in the phonology and grammar tests, corroborating earlier findings, which reported difficulties of children with DLD in discriminating voicing contrasts and perceiving grammatical structures. However, both groups had similar performance in the semantic test. The absence of semantic atypicality can be explained possibly due to the simplicity of the sentences included in the test. The study offers important clinical implications for the identification and treatment of the disorder. [ABSTRACT FROM AUTHOR]

Autistic children experience high rates of anxiety. Insistence on sameness behaviour (IS) is a core feature of autism that appears correlated with anxiety severity. The objective of this study was to examine the longitudinal relations between anxiety and IS in autistic children using a developmental cascade model. A longitudinal cohort of 421 autistic children was followed between 4 and 11 years of age. Anxiety was quantified using items from the Anxiety Problems subscale of the Child Behavior Checklist; sameness behaviours were measured using the Repetitive Behavior Scale-Revised, Ritualistic/sameness subscale (both parent-report measures). Structural equation modelling was used to examine the longitudinal and directional associations between anxiety and IS at four time-points, through cross-lagged panel models (CLPM) with and without a random-intercepts component (RI-CLPM). Both the CLPM and the RI-CLPM had good fit. Significant directional associations were detected whereby elevated or increasing IS preceded elevated or increasing anxiety symptoms 1–2 years later, respectively. Stable baseline tendencies towards anxiety and IS as between-person traits (intercepts) were strongly associated (standardized estimate = 0.69, p < 0.001). The magnitude of the cross-sectional associations between anxiety and IS appeared to lessen with age. IS and anxiety symptoms in autism are closely related. They appear to be shared traits that mirror each other particularly in younger children. Increasing IS may be a sign of emerging future anxiety. Interventions that target IS to reduce or prevent anxiety amongst school-aged autistic children merit further study. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the average age at diagnosis and the characteristics associated with the age of children at the diagnosis of autism spectrum disorder (ASD) at Sawanpracharak Hospital. Materials and Methods: A retrospective cross-sectional study was conducted from May 2023 to July 2023. Data were collected from the medical patient files of all children diagnosed with ASD between 2020 to 2022. Descriptive analysis was used to examine the characteristics of the children and their caregivers, and the children’s age at diagnosis. Factors associated with the age at diagnosis were assessed by chi-square test analysis. Results: In total, 100 patient records with complete information were collected. The average age at the diagnosis of ASD was 4.57± 1.61 years old, with 60% of the patients diagnosed after four years of age. Social communication deficit symptoms, including non-response to name and lack of pointing out objects of interest, were significantly associated with an early ASD diagnosis (p-value = 0.023 and 0.002, respectively). Being a firstborn child and the presence of delayed development were found to delay the diagnosis of ASD meaning it occurred at a later age (p-value = 0.002 and 0.019, respectively). However, sex, the caregiver’s education, and socioeconomic status were not related to the age at diagnosis. Conclusion: Most children with ASD who received treatment at Sawanpracharak Hospital were diagnosed late. Being a firstborn child, poor response to name being called, lack of pointing out objects of interest, and delayed development were related to the age of the children at ASD diagnosis. Differences in diagnostic age based on sociodemographic and clinical characteristics indicate the need for coordinated measures for the early detection of ASD. [ABSTRACT FROM AUTHOR]

Children who show elevated levels of indirect aggression (IA) from childhood to adolescence are at increased risks of experiencing detrimental outcomes. Some studies suggest that psychopathic traits could act as a predisposing vulnerability in the development of IA, but the contributions of all three dimensions of psychopathic traits in explaining developmental trajectories of IA from childhood to adolescence remain unclear. This study aimed to determine if the three dimensions of psychopathic traits during childhood (i.e., callous–unemotional, narcissism–grandiosity, and impulsivity–irresponsibility at 6–9 years old) increase the risk of following a high IA trajectory across preadolescence, and whether sex moderated these associations. Participants were 744 children (47% girls; 93% born in Quebec, Canada, and over 50% from low socioeconomic backgrounds) assessed annually over 5 years. Approximately half of them (n = 370; 40.3% girls) were referred to school-based services for conduct problems (CP) at study intake. Latent class growth analyses revealed four developmental trajectories of IA, which were regressed on psychopathic traits dimensions using a three-step approach. After adjusting for demographic confounders, CP, and other dimensions of psychopathic traits, only narcissism–grandiosity traits significantly predicted memberships to a high and stable trajectory of IA use. The associations between the other dimensions of psychopathic traits and IA trajectories were not significant when considering confounders. No moderating effects by child sex were observed. These results suggest that narcissism–grandiosity traits could be of use for clinicians aiming to detect children most at risk of showing high and persistent levels of IA. Public Significance Statement: Elevated levels of narcissism–grandiosity traits in children can predict a high and chronic use of indirect aggression over preadolescence. As such, an early assessment of these traits could help clinicians identify those most at risk of engaging in such behaviors and thus possibly experiencing detrimental outcomes throughout adolescence. [ABSTRACT FROM AUTHOR]

Aims: The purpose of the study was to increase the body of knowledge related to sleep in children with autism. The specific aims were to (i) identify the subgroup of children with autism, ages 3–17 years, referred for polysomnography and (ii) describe types and frequency of clinical encounters for sleep problems in a sample of children ages 3–17 with and without the diagnosis of autism. Methods: The authors performed a secondary data analysis of the de‐identified Nationwide Children's Hospital Sleep DataBank, a collection of encounters with children referred for polysomnography. The data were filtered for ages 3–17 years at the time of the participant's first sleep study, and further filtered for the presence of an autism diagnosis. Results: In the sample, there were 2838 unique participants (M = 10.5 years) with a total of 172 167 encounters between 2017 and 2019. Of these, 198 (7%) were diagnosed with Autism Spectrum Disorder, Asperger's Syndrome, or Pervasive Developmental Disorder. Among all participants, the most common sleep problems were apnea, snoring, non‐specified sleep disorders (including restless sleeper), circadian rhythm disorder (CRD), and insomnia. The subgroup of patients diagnosed with autism was noted to have higher frequency of several types of sleep problems, especially restless sleep, CRD and insomnia, compared to those without an autism diagnosis. Conclusions: Findings elucidate the increased presence of sleep problems in paediatric patients with autism, and the need for purposeful sleep evaluation and research given the potential impact on daytime function for these individuals and their families. [ABSTRACT FROM AUTHOR]

Fragile X syndrome (FXS) is a pervasive developmental disorder and the most common monogenic cause of autism spectrum disorder (ASD). Female heterozygous (HET) carriers play a major role in the transmission of the pathology and present several FXS- and ASD-like behavioral alterations. Despite their clear genetic origins, FXS symptoms are known to be modulated by environmental factors, e.g., exposure to chronic stress, especially during critical life periods, such as pregnancy. Pregnancy, together with pups' care, constitutes maternal experience, i.e., another powerful environmental factor affecting several neurobehavioral functions in females. Here we investigated the impact of maternal experience on the long-term effects of stress in Fmr1-HET female mice. Our findings demonstrated that the behavioral abnormalities of HET females, i.e., hyperactivity and memory deficits, were unaffected by stress or maternal experience. In contrast, stress, independently of maternal experience, induced the appearance of cognitive deficits in WT mice. Maternal experience increased anxiety levels in all mice and enhanced their corticosterone levels, concomitantly promoting the effects of stress on social communication and adrenal glands. In translational terms, these results advance our understanding of the environmental modulation of the behavioral alterations observed in FXS female carriers and highlight the long-term impact of maternal experience and its interactions with chronic stress. [ABSTRACT FROM AUTHOR]

Background & Aims: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pervasive developmental disorders are divided into the categories of autism, RAT, child collapse disorder, and Asperger's (2). Meanwhile, autism disorder is one of the diseases of the group of pervasive developmental disorders, which is characterized by persistent destruction in mutual social interaction, communication delay or deviation, and limited stereotyped communication pattern (3). The characteristics of this disorder, as well as the sometimes difficult and late diagnosis, the appearance of symptoms after a normal child's development, the lack of definitive and effective treatments, and the not very favorable prognosis, can put severe psychological pressure on the family. And the parents of the child should impose (4). Fascination is caused by the balance between the skill required to perform the activity and the challenge caused by the activity, so that if the challenge is more than the skill, anxiety is created, if the challenge is less than the skill, boredom and if both challenge and skill are low, apathy. appears (7). On the other hand, it is important to have the spirit and attitude to help in the work environment, especially for educators of special children such as children on the autism spectrum, because in the educational environments of children with autism, there are different views about the attitude towards seeking help. Helping attitude depends on the perceived benefit and perceived threat of help-seeking. Perceived benefit means that a person sees help-seeking as an effective strategy to promote learning, while perceived threat refers to the threat to a person's self-worth that arises by admitting the need for help (8). In general, there are few studies about the attitude towards the use of the selected approaches in this research, repeating and comparing the effectiveness of the intervention method is of great importance. By repeating this treatment method on the teachers of autistic children, if the previous results are confirmed, additional evidence is provided, and if the previous evidence is not confirmed, it provides new windows for research. Based on the researches, no research has been done in Iran regarding the effectiveness of the therapeutic approach in the educators of autistic children with emphasis on the attitude to help and fascination related to work. Based on this, despite the need to conduct a detailed study and deal with the details of the phenomenon in question, the present study tries to answer the question of whether mindfulness based on spiritual schemas has an effect on the attitude towards help and fascination related to the work of educators of autistic children. Is it effective? Methods: In order to conduct the present semi-experimental research, which was carried out with a pre-test, post-test follow-up design with a control group, among male and female trainers of autistic children in private rehabilitation centers (Golhai Chalus, Nik-Andishan Sari and Mendan Sepid Babol) in Mazandaran, which in In the third quarter of 2019, 30 people were working in these specialized centers (under the cover of welfare organization) and were randomly divided into two experimental and control groups. Then the subjects completed the help-seeking attitude (HAS) questionnaires of Nickel J.S. (1998) and Bakr's passion for work (2008). received for half an hour, and the control group was placed on the waiting list. After the end and 2 months later, all subjects completed the questionnaires again. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider the key themes highlighted by Collins et al., in light of the wider research evidence base on informal sources of support for families of children with intellectual and developmental disabilities. Design/methodology/approach: This commentary reflects on the provision of informal support services for families of children with intellectual and developmental disabilities. Findings: The wider literature highlights the key role of family support in shifting negative narratives concerning parenting a child with intellectual and developmental disabilities, the impact of austerity and COVID-19 on support provision and the importance of services working effectively in collaboration to promote self-determination for families and individuals with intellectual and developmental disabilities. Originality/value: Continued efforts to explore how services and informal social supports might work together in an effective manner are key to improving the quality of life of parents caring for children with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a pervasive developmental disorder that has grown in prevalence over the past few decades and has a tremendous impact on families that struggle with adjustment to this disorder. Initial exposure to such a disorder may be a significant source of stress and tribulation for Chinese families who are not familiar with mental health discourse and how to navigate community healthcare systems. More extensive research with this population is vital to understand how cultural values and perceptions of parenting self‐efficacy contribute to parenting stress and coping in Asian families. This qualitative study sought to gain understanding of the ways that Asian families coped with stress when they had a child diagnosed with ASD. Seven Chinese families living in New York, with children between the ages of two and five, who were diagnosed with ASD, participated in semi‐structured interviews. Thematic analyses generated primary themes that explored factors contributing to Chinese parental stress: Chinese parents' perceived parenting self‐efficacy, parents' adherence to traditional Asian values, parental patterns of coping, and overall satisfaction with the early intervention services which their children were receiving. Results can guide specialized assessment and intervention for professionals who work with Chinese families within clinical, school, and community settings. Implications for practices of psychology in schools, limitations of this current study, and future directions are also discussed. Practitioner points: Chinese families of children with Autism expressed deficits in knowledge and feelings of inadequacy at the time of initial diagnosis.Families generally possessed "others as experts" worldviews toward service providers and expressed less feelings of perceived self‐efficacy.Story‐telling method reveals unique, and sometimes conflicting patterns of coping for Chinese families of children with Autism. [ABSTRACT FROM AUTHOR]

A systematic review was conducted to investigate the use of aided augmentative and alternative communication (AAC) intervention strategies for teaching symbolic communication functions other than object requests in children with autism spectrum disorder (ASD). The review included 18 studies that met the inclusion criteria and analyzed the intervention characteristics, outcomes, and participant characteristics. The most frequently targeted communicative function was acknowledging another person's utterance, and the most effective interventions primarily targeted the function of acknowledgment. Higher dosages of intervention were associated with greater effectiveness. The review highlighted the need for further research on individual characteristics and the impact of reinforcement in AAC interventions. [Extracted from the article]

Autism spectrum disorder (ASD) is a pervasive developmental disorder with severe cognitive impairment in social communication and interaction. Previous studies have reported that abnormal functional connectivity patterns within the default mode network (DMN) were associated with social dysfunction in ASD. However, how the altered causal connectivity pattern within the DMN affects the social functioning in ASD remains largely unclear. Here, we introduced the Liang information flow method, widely applied to climate science and quantum mechanics, to uncover the brain causal network patterns in ASD. Compared with the healthy controls (HC), we observed that the interactions among the dorsal medial prefrontal cortex (dMPFC), ventral medial prefrontal cortex (vMPFC), hippocampal formation, and temporo‐parietal junction showed more inter‐regional causal connectivity differences in ASD. For the topological property analysis, we also found the clustering coefficient of DMN and the In‐Out degree of anterior medial prefrontal cortex were significantly decreased in ASD. Furthermore, we found that the causal connectivity from dMPFC to vMPFC was correlated with the clinical symptoms of ASD. These altered causal connectivity patterns indicated that the DMN inter‐regions information processing was perturbed in ASD. In particular, we found that the dMPFC acts as a causal source in the DMN in HC, whereas it plays a causal target in ASD. Overall, our findings indicated that the Liang information flow method could serve as an important way to explore the DMN causal connectivity patterns, and it also can provide novel insights into the nueromechanisms underlying DMN dysfunction in ASD. [ABSTRACT FROM AUTHOR]