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Pediatric Clinics of North America Apr 2024The diagnosis of autism spectrum disorder (ASD) brings a lifetime of considerations for individuals and their families. The core symptoms of ASD vary in severity and... (Review)
Review
The diagnosis of autism spectrum disorder (ASD) brings a lifetime of considerations for individuals and their families. The core symptoms of ASD vary in severity and influence behavior and function across all environments. Co-occurring medical, mental health, cognitive, language, learning, and behavioral differences add challenges to those associated with core symptoms. Navigating the preschool, school, and transition ages in the educational setting requires continual reassessment of the strengths, weaknesses, and needs of the student to provide appropriate placement and services.
Topics: Child, Preschool; Humans; Autism Spectrum Disorder; Schools; Educational Status; Students; Mental Health
PubMed: 38423717
DOI: 10.1016/j.pcl.2024.01.008 -
Psychopharmacology Bulletin Dec 2023A renewed interest in the use of β-blockers for neurodevelopmental disorders has recently resurfaced, notably as an addition to the limited psychopharmacological... (Review)
Review
A renewed interest in the use of β-blockers for neurodevelopmental disorders has recently resurfaced, notably as an addition to the limited psychopharmacological armamentarium of autism spectrum disorders (ASD). In this clinical perspective, authors decently argue this use could be advantageous and multi-folded for this population.
Topics: Humans; Autistic Disorder; Autism Spectrum Disorder
PubMed: 38076666
DOI: No ID Found -
Medical Archives (Sarajevo, Bosnia and... 2024Attention-deficit hyperactivity disorder (ADHA) is one of the most common comorbid disorders of autism spectrum disorder (ASD) that can accompany autism, triggered by... (Review)
Review
BACKGROUND
Attention-deficit hyperactivity disorder (ADHA) is one of the most common comorbid disorders of autism spectrum disorder (ASD) that can accompany autism, triggered by it, or be a consequence of it.
OBJECTIVE
This review explored the prevalence of the comorbidity of both disorders, neurobiological background, symptoms, latest assessment methods, and therapeutic approaches. It concluded that effective assessment, diagnosis and management of ADHD in ASD children and adults is essential for this group of patients to thrive and live a good quality of life. Further research is recommended to explore the most effective intervention for such important members of our society.
CONCLUSION
More studies are needed to understand the mechanisms underlying these comorbidities, and to prevent the misdiagnosis and mismanagement of these disorders. Also, to develop up to date personalized therapeutic plans for such children.
Topics: Child; Adult; Humans; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Quality of Life; Comorbidity; Prevalence
PubMed: 38566879
DOI: 10.5455/medarh.2024.78.159-163 -
JPMA. the Journal of the Pakistan... Sep 2023
Topics: Humans; Autism Spectrum Disorder
PubMed: 37817726
DOI: 10.47391/JPMA.8207 -
Journal of Neurodevelopmental Disorders Oct 2023Plasma levels of vitamin D have been reported to be low in persons with Down syndrome (DS) and existing data is limited to small and homogenous cohorts. This is of...
BACKGROUND
Plasma levels of vitamin D have been reported to be low in persons with Down syndrome (DS) and existing data is limited to small and homogenous cohorts. This is of particular importance in persons with DS given the high rates of autoimmune disease in this population and the known relationship between vitamin D and immune function. This study sought to investigate vitamin D status in a multi-center cohort of individuals with DS and compare them to individuals with autism spectrum disorder (ASD) and neurotypical (NT) controls.
METHODS
A retrospective, multi-center review was performed. The three sites were located at latitudes of 42.361145, 37.44466, and 34.05349. Patients were identified by the International Classification of Diseases (ICD)-9 or ICD-10 codes for DS, ASD, or well-child check visits for NT individuals. The first vitamin D 25-OH level recorded in the electronic medical record (EMR) was used in this study as it was felt to be the most reflective of a natural and non-supplemented state. Vitamin D 25-OH levels below 30 ng/mL were considered deficient.
RESULTS
In total, 1624 individuals with DS, 5208 with ASD, and 30,775 NT controls were identified. Individuals with DS had the lowest mean level of vitamin D 25-OH at 20.67 ng/mL, compared to those with ASD (23.48 ng/mL) and NT controls (29.20 ng/mL) (p < 0.001, 95% CI: -8.97 to -6.44). A total of 399 (24.6%) individuals with DS were considered vitamin D deficient compared to 1472 (28.3%) with ASD and 12,397 (40.3%) NT controls (p < 0.001, 95% CI: -5.43 to -2.36). Individuals with DS with higher body mass index (BMI) were found to be more likely to have lower levels of vitamin D (p < 0.001, 95% CI: -0.3849 to -0.1509). Additionally, having both DS and a neurologic diagnosis increased the likelihood of having lower vitamin D levels (p < 0.001, 95% CI: -5.02 to -1.28). Individuals with DS and autoimmune disease were much more likely to have lower vitamin D levels (p < 0.001, 95% CI: -6.22 to -1.55). Similarly, a history of autoimmunity in a first-degree relative also increased the likelihood of having lower levels of vitamin D in persons with DS (p = 0.01, 95% CI: -2.45 to -0.63).
CONCLUSIONS
Individuals with DS were noted to have hypovitaminosis D in comparison to individuals with ASD and NT controls. Associations between vitamin D deficiency and high BMI, personal autoimmunity, and familial autoimmunity were present in individuals with DS.
Topics: Humans; Autism Spectrum Disorder; Down Syndrome; Retrospective Studies; Vitamin D; Vitamin D Deficiency; Autoimmune Diseases
PubMed: 37880588
DOI: 10.1186/s11689-023-09503-y -
Current Pain and Headache Reports Oct 2023Migraine is a common condition affecting an estimated billion people across the world. The incidence in individuals with neurodevelopmental disorders or intellectual... (Review)
Review
PURPOSE OF REVIEW
Migraine is a common condition affecting an estimated billion people across the world. The incidence in individuals with neurodevelopmental disorders or intellectual disabilities like those seen in severe autism spectrum disorder (ASD) is unknown. This is likely due to the limited capacity to communicate the specifics of pain. The expression of pain with maladaptive behaviors, such as self-injurious behavior (SIB), has been described and can alert the clinician to the presence of untreated pain. This review article serves to educate the reader about clinical and treatment considerations when managing headaches in individuals with severe or non-verbal neurodevelopmental disorders given their communication challenges. It will include some clinical experiences and the gaps in our current knowledge.
RECENT FINDINGS
A comprehensive literature review was conducted using scientific databases, including PubMed, Medline, and Google Scholar. Only 1 article addressed the consideration for headaches in this population. The search was conducted using a combination of the following keywords: headache, intellectual disabilities, autism, pain, and behavior. Headache pain is likely underestimated and represents a disservice to this population of people. The consideration for headache pain should be explored when maladaptive behaviors are otherwise unexplainable. Further studies are needed in the area.
Topics: Humans; Autism Spectrum Disorder; Intellectual Disability; Headache; Migraine Disorders; Pain
PubMed: 37566221
DOI: 10.1007/s11916-023-01153-y -
Fortschritte Der Neurologie-Psychiatrie Nov 2023Autism is a neurodevelopmental disorder that starts in early childhood and persists over the lifespan. A combination of genetic factors and environmental factors around...
Autism is a neurodevelopmental disorder that starts in early childhood and persists over the lifespan. A combination of genetic factors and environmental factors around birth contribute to its etiology. Autistic individuals show differences and difficulties in social interaction and communication as well as repetitive, stereotypical behavior and interests. The diagnostic procedure is complex and should be carried out in a specialized assessment unit. Diagnostic assessment is based on behavioral observation and a careful evaluation of developmental history. A wide range of potential differential diagnoses should be considered. Autistic adults have a higher risk of developing psychiatric disorders such as anxiety and depression. Psychotherapeutic treatment that is adapted to autism-related difficulties can be helpful. Co-occurring conditions should be treated in accordance with disorder-specific guidelines. Psychopharmacological treatment of co-occurring conditions is, in most cases, only recommended as an addition to behavioral interventions. Autistic people often experience difficulties in social participation, which can be targeted with sociotherapeutic interventions.
Topics: Child, Preschool; Adult; Humans; Autism Spectrum Disorder; Autistic Disorder; Diagnosis, Differential; Anxiety Disorders; Psychotropic Drugs
PubMed: 37944552
DOI: 10.1055/a-1898-5347 -
Journal of Attention Disorders Nov 2023We examined the characteristics and heritability of Autism Spectrum Disorder (ASD) and ADHD through a twin study.
OBJECTIVE
We examined the characteristics and heritability of Autism Spectrum Disorder (ASD) and ADHD through a twin study.
METHOD
Our sample included 44 twins, with at least one twin diagnosed with ASD. Among the participants, 30 had ASD, and 18 of them also had coexisting ADHD.
RESULTS
We observed higher concordance rates for ASD in monozygotic twins compared to dizygotic twins (67% vs. 25%), indicating a genetic influence on ASD. Inattentive symptoms of ADHD were more prevalent in monozygotic twins. The ASD + ADHD group exhibited significantly higher Social Responsiveness Scale scores, indicating greater social difficulties compared to the ASD and typical development groups. Twin analyses revealed that shared genetic factors accounted for 72.25% of the variance in both ASD and ADHD symptoms.
CONCLUSIONS
Our findings suggest that the comorbidity of ASD and ADHD may indicate increased severity and can be explained by shared genetic factors underlying both conditions.
Topics: Humans; Child; Autism Spectrum Disorder; Attention Deficit Disorder with Hyperactivity; Twins, Monozygotic; Twins, Dizygotic; Comorbidity
PubMed: 37480257
DOI: 10.1177/10870547231187166 -
Italian Journal of Pediatrics Jul 2023In recent decades some studies described the frequent co-occurrence of celiac disease autoimmunity and overt celiac disease in patients with autism. Therefore, it was...
BACKGROUND
In recent decades some studies described the frequent co-occurrence of celiac disease autoimmunity and overt celiac disease in patients with autism. Therefore, it was suggested that celiac disease could play a possible role in the etiopathogenesis of autism spectrum disorder. However, several other studies have not confirmed this association. The aim of the present study was to elucidate the potential association between autism spectrum disorder and celiac disease.
METHODS
We prospectively collected data from an Italian cohort of 223 children at the time of their clinical diagnosis of autism spectrum disorder in the 2019-2020 period. A serological celiac disease screening was performed and data were available for 196 patients; male (M):female (F) ratio = 4.4:1; median age = 3.6 years; age range = 1.6-12.8 years. Full-blown celiac disease was established according to the diagnostic algorithm of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2012 or 2019 guidelines. Fisher's exact test was used to compare the celiac disease seroprevalence and prevalence in our autism spectrum disorder cohort and in the Italian healthy pediatric population studied by Gatti et al. to highlight the possible differences between the two groups.
RESULTS
A not statistically significant difference between the celiac disease seroprevalence in our autism spectrum disorder cohort (4.08%) and Gatti's Italian healthy group (2.22%) was found, p = 0.0810; OR = 1.871. A similar result emerged for overt celiac disease prevalences (2.24% versus 1.58%, respectively), p = 0.2862; OR = 1.431.
CONCLUSIONS
Our data validates a weakness of association between autism spectrum disorder and celiac disease. On the basis of our results, a regular screening for CD in patients with ASD is not recommended to a greater extent than in the general population.
Topics: Humans; Child; Male; Female; Child, Preschool; Infant; Celiac Disease; Autism Spectrum Disorder; Seroepidemiologic Studies; Italy
PubMed: 37400878
DOI: 10.1186/s13052-023-01484-x -
Genes Aug 2023Complex interactions between gene variants and environmental risk factors underlie the pathophysiological pathways in major psychiatric disorders. Autism Spectrum... (Review)
Review
Complex interactions between gene variants and environmental risk factors underlie the pathophysiological pathways in major psychiatric disorders. Autism Spectrum Disorder is a neuropsychiatric condition in which susceptible alleles along with epigenetic states contribute to the mutational landscape of the ailing brain. The present work reviews recent evolutionary, molecular, and epigenetic mechanisms potentially linked to the etiology of autism. First, we present a clinical vignette to describe clusters of maladaptive behaviors frequently diagnosed in autistic patients. Next, we microdissect brain regions pertinent to the nosology of autism, as well as cell networks from the bilateral body plan. Lastly, we catalog a number of pathogenic environments associated with disease risk factors. This set of perspectives provides emerging insights into the dynamic interplay between epigenetic and environmental variation in the development of Autism Spectrum Disorders.
Topics: Humans; Autism Spectrum Disorder; Autistic Disorder; Alleles; Biological Evolution; Epigenesis, Genetic
PubMed: 37761876
DOI: 10.3390/genes14091734