Neurofeedback in autism spectrum disorders

Autism Spectrum Disorders (ASDs) are characterized by pervasive impairments in communication, socialization, and repetitive behaviors or interests. While there is a growing interest in early ASDs, very few studies have looked at the nature of these impairments before age 3. In order to better strengthen early assessment and intervention for ASDs, more knowledge is needed in this area. The current studies aimed to determine if, and in what ways, communication impairments are present in infants and toddlers (17-37 months) diagnosed with autism and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS). In the first study, infants with autism and PDD-NOS (i.e., the ASD group) were compared to typically developing infants. In the second study, three groups were compared: autism, PDD-NOS, and non-ASD related developmentally delayed. Differences in communication impairments were assessed using the endorsement of communication items found on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT), Part 1. Differences in overall communication impairments were assessed, as well as differences on specific communication items. Results found that infants with an ASD exhibit greater communication impairments than do typically developing infants, with all items displaying significant differences. Additionally, significant differences were found in overall communication impairments between all three groups in the second study, with the majority of items differentiating between the groups. The implications of these results, as well as directions for future research, are discussed.

Association of schizophrenia spectrum and autism spectrum disorder (ASD) symptoms in children with ASD and clinic controls

The aim of this study was to investigate melatonin-related findings in autism spectrum disorders (ASD), including autistic disorder, Asperger syndrome, Rett syndrome, and pervasive developmental disorders, not otherwise specified. Comprehensive searches were conducted in the PubMed, Google Scholar, CINAHL, EMBASE, Scopus, and ERIC databases from their inception to October 2010. Two reviewers independently assessed 35 studies that met the inclusion criteria. Of these, meta-analysis was performed on five randomized double-blind, placebo-controlled studies, and the quality of these trials was assessed using the Downs and Black checklist. Nine studies measured melatonin or melatonin metabolites in ASD and all reported at least one abnormality, including an abnormal melatonin circadian rhythm in four studies, below average physiological levels of melatonin and/or melatonin derivates in seven studies, and a positive correlation between these levels and autistic behaviors in four studies. Five studies reported gene abnormalities that could contribute to decreased melatonin production or adversely affect melatonin receptor function in a small percentage of children with ASD. Six studies reported improved daytime behavior with melatonin use. Eighteen studies on melatonin treatment in ASD were identified; these studies reported improvements in sleep duration, sleep onset latency, and night-time awakenings. Five of these studies were randomized double-blind, placebo-controlled crossover studies; two of the studies contained blended samples of children with ASD and other developmental disorders, but only data for children with ASD were used in the meta-analysis. The meta-analysis found significant improvements with large effect sizes in sleep duration (73 min compared with baseline, Hedge's g 1.97 [95% confidence interval {CI} CI 1.10-2.84], Glass's Δ 1.54 [95% CI 0.64-2.44]; 44 min compared with placebo, Hedge's g 1.07 [95% CI 0.49-1.65], Glass's Δ 0.93 [95% CI 0.33-1.53]) and sleep onset latency (66 min compared with baseline, Hedge's g-2.42 [95% CI -1.67 to -3.17], Glass's Δ-2.18 [95% CI -1.58 to -2.76]; 39 min compared with placebo, Hedge's g-2.46 [95% CI -1.96 to -2.98], Glass's Δ-1.28 [95% CI -0.67 to -1.89]) but not in night-time awakenings. The effect size varied significantly across studies but funnel plots did not indicate publication bias. The reported side effects of melatonin were minimal to none. Some studies were affected by limitations, including small sample sizes and variability in the protocols that measured changes in sleep parameters. Melatonin administration in ASD is associated with improved sleep parameters, better daytime behavior, and minimal side effects. Additional studies of melatonin would be helpful to confirm and expand on these findings.

Autism spectrum disorders (ASDs) also known as pervasive developmental disorders (PDD) are a behaviorally defined group of neurodevelopmental disorders that are usually diagnosed in early childhood. ASDs disproportionately affect male children. Mercury (Hg) a heavy metal, is widespread and persistent in the environment. Mercury is a ubiquitous source of danger in fish, drugs, fungicides/herbicides, dental fillings, thermometers, and many other products. Elevated Hg concentrations may remain in the brain from several years to decades following exposure. This is important because investigators have long recognized that Hg is a neurodevelopmental poison; it can cause problems in neuronal cell migration and division, and can ultimately cause cell degeneration and death. Case-reports of patients have described developmental regressions with ASD symptoms following fetal and/or early childhood Hg exposure, and epidemiological studies have linked exposure to Hg with an elevated risk of a patient being diagnosed with an ASD. Immune, sensory, neurological, motor, and behavioral dysfunctions similar to traits defining or associated with ASDs were reported following Hg intoxication with similarities extending to neuroanatomy, neurotransmitters, and biochemistry. The sexual dimorphism of ASDs may result from synergistic neurotoxicity caused by the interaction of testosterone and Hg; in contrast, estrogen is protective, mitigating the toxicity of Hg. Mercury exposure may significantly increase androgen levels, and as a result, patients diagnosed with an ASD may significantly benefit from anti-androgen therapy. Finally, the clinical geneticist has a wealth of biomarkers to evaluate and treat patients diagnosed with an ASD.

Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders that affect social communication, behavior, and sensory processing, in which PUFAs are considered important. This mini-review article aims to investigate the current evidence regarding the use of essential fatty acids (EFAs) in the treatment of autism spectrum disorders (ASDs). The study examines various research studies, related to EFAs, their benefits, and their role in ASD treatment. The article focuses on exploring the potential mechanisms underlying the effects of EFAs on ASDs, including their anti-inflammatory, antioxidant, and neuroprotective properties. Furthermore, the study discusses limitations and challenges associated with the use of EFAs in ASD treatment, including variability in dosage and duration of treatment. The results of this review indicate that while some studies suggest a positive effect of EFAs on ASD symptoms, there is currently insufficient evidence to support their routine use as a stand-alone treatment for ASD. The need for further research to better understand the potential benefits and limitations of EFAs in ASD treatment is highlighted.

BackgroundRestricted and repetitive behaviors (RRBs) are highly prevalent and reduce function in individuals with fragile X syndrome (FXS). As transdiagnostic features of intellectual disability, elevated rates of RRBs in FXS could represent various underlying known co-occurring conditions in FXS such as anxiety or autism spectrum disorder (ASD), yet this distinction has not been investigated. Further, delineating whether RRBs are more indicative of anxiety or ASD in FXS may clarify phenotypic profiles within FXS and improve differential assessment.MethodsWe longitudinally examined the potentially independent or multiplicative effect of ASD and anxiety symptom severity on RRBs in 60 children with FXS. Anxiety was measured using the Child Behavior Checklist (CBCL), ASD severity was measured using the Childhood Autism Rating Scale (CARS), and RRBs were measured using the Repetitive Behavior Scale – Revised (RBS-R). We estimated a series of moderated regression models with anxiety and ASD symptoms at the initial assessment (Time 1) as predictors of RRBs at the outcome assessment two years later (Time 2), along with an anxiety-by-ASD interaction term to determine the potential multiplicative effect of these co-occurring conditions on RRBs.ResultsResults identified a significant interaction between ASD and anxiety symptom severity at the initial assessment that predicted elevated sensory-motor RRBs two years later. Increased sensory-motor RRBs were predicted by elevated ASD symptoms only when anxiety symptom severity was low. Likewise, increased sensory-motor RRBs were predicted by elevated anxiety symptoms only when ASD symptom severity was low. Interestingly, this relationship was isolated to Sensory-Motor RRBs, with evidence that it could also apply to total RRBs.ConclusionsFindings suggest that ASD and anxiety exert independent and differential effects on Sensory-Motor RRBs when at high severity levels and a multiplicative effect when at moderate levels, which has important implications for early and targeted interventions.

Introduction Autism Spectrum Disorder (ASD) is a group of disorders that are manifested primarily by difficulties in interpersonal contact. Moreover, children with ASD have specific food habits, which can disturb their proper development. Nowadays, it is suggested that appropriate dietary interventions could help in the treatment of ASD. We will consider how effective a diet could be in this role. Aim This review aims to estimate the effectiveness of dietary interventions used in children with ASD based on scientific research. Material and method This article was created on the basis of a systematic review. Articles were searched using PubMed. The applied terms were: ‘diet in ASD’, ‘dietary interventions in Autism Spectrum Disorder’, ‘Autism Spectrum Disorder’, ‘therapies in ASD’. We searched for studies that were published in less than the last 5 years, but older references were also obtained from analyzed articles. Results We received a total of 227 results. After selection, It was decided to use 21 studies with dietetic interventions. Conclusions The most commonly performed interventions are the ketogenic diet, the gluten-free caseinfree diet, and probiotic supplementation. Most studies do not have enough evidence that would allow drawing definite conclusions. Currently, modifying the diet does not appear to have a significant impact on ASD symptoms.

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.

Many children with autism spectrum disorder have problems with managing their emotions (emotion regulation) and anxiety. In this study, over 1000 parents completed an online survey which showed that emotion regulation and anxiety are closely linked. Although emotion regulation and anxiety are inter-connected, the results also show that autism symptoms play an important role in anxiety in autism spectrum disorder. Emotion regulation problems may be an important target for the treatment of anxiety in autism.

Parents of children with autism spectrum disorder (ASD) must identify, select, and even implement treatments. Child age, cognitive functioning, ASD symptoms, family income, parent education, and cultural background, all may influence treatment selection. Parents’ perceptions about ASD also may contribute. We explored whether parents’ perceptions of ASD, along with family- and child-specific characteristics, predicted use of various ASD treatment categories. Sixty-eight families from the Simons Simplex Collection completed the Revised Illness Perception Questionnaire (IPQ-R). Logistic regression results indicated that when parent perceptions predicted use of a treatment category, relative contribution of perceptions was somewhat stronger than child- and family-specific factors (i.e., demographics, functioning). Moreover, predictive factors differed between treatment categories. Overall, treatment category use was influenced by parents’ perceptions of control over ASD treatment, behaviors perceived to be related to ASD, and beliefs about chronicity of the diagnosis. These findings may contribute to broader understanding of parents’ ASD treatment selection and enhance professionals’ ability to guide families’ decision-making.

Many studies have found a variety of SHANK3 mutants in Autism spectrum disorder (ASD) patients, and SHANK3 mutants are believed to be closely related to ASD. SHANK3 is a gene on chromosome 22 that encodes a postsynaptic density scaffold protein and is often considered to play an indispensable role in glutamatergic synapses. ASD has a rather complex mechanism and is not fully understood. It is related to many genes, and SHANK3 is a strong candidate gene. Many studies have found that a variety of SHANK3 mutant genes, especially de novo SHANK3 gene, can cause decreased excitability and even spinal dysplasia, which becomes one of the important contributing genes of ASD. ASD symptoms have also been observed by direct modification of SHANK3 gene using CRISPR in various experimental animals. At present, there are many treatments for ASD, but none of them can cure ASD. Improving knowledge of the association between the SHANK3 gene and ASD and additional research on this subject may be one of the potential therapy modalities.

Autism Spectrum Disorders (ASD) are a group of neuro‐developmental disorders caused by brain abnormalities which results in impaired social skills. There are five variants of the spectrum: Asperger Syndrome, Pervasive Developmental Disorder - Not Otherwise Specified, Autistic Disorders, Rett’s Syndrome and Childhood Disintegrative Disorders. These broad variants produce a wide variety of symptoms among children with ASD, where each child with ASD will have his own pattern of autism; however, all children with ASD will share the same deficits in the areas of social skills which include social interaction, verbal and non-verbal communication and unusual behavior/interest. Research on treatment in helping children with ASD to improve social skills is growing as the cases of children diagnosed with ASD are on the rise. Social Story™ is one of the proven methods of treatment in helping children with ASD to learn social skills. However, the current presentation format of Social Story™ has not been attractive and it requires intensive teacher‐student interaction for the full benefit of social skills acquisition. Numerous studies have proved that children with ASD are motivated and have a better understanding from reading or visual illustration learning rather than learning through spoken instructions. Results from studies have also discovered that the computer is attractive and engaging for children with ASD, as it offers much benefit to them. It has been said that learning is most effectual when motivated, thus, the purpose of this study is to discover a learning tool that children with ASD will be motivated to use on their own, and it is achievable by combining elements that they are interested in. This research focuses on the combination of Social Story™, 2D animation, and the computer as a medium of presentation to present an interactive pedagogical tool for children with ASD to learn social skills. This combination is anticipated to be an effective tool in teaching social skills to children with ASD, as they are naturally drawn to computers and visual cues, combined with the fact that Social Story™ has been effective in changing the social behavior of children with ASD. The prototype titled ‘I-Learn Social Story’ has been developed and evaluated on thirty children with ASD in a special school located in Kuching, Sarawak. A preliminary study has been conducted on three children with ASD prior to this final evaluation to ensure that the final prototype functions are properly based on the children’s needs. The method used in the evaluation study is the quantitative method, specifically single subject design, which is one type of experimental design. Results of the experimental study reveal that the prototype is effective in changing the participants’ social behavior and in improving their social skills. There are significant improvements in the appropriate social behavior, decrease in the inappropriate social behavior, and increase in the number of social interactions made by the participants. Thus, this study has contributed to the emergent research of treatment for children with ASD in social skills learning. The result of this study is important as we have discovered a novel method of treatment that can be used effectively in assisting children with ASD to improve their main deficit, social skills.

CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger’s disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children.CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.

Objectives: 
\nThere has been a significant increase in the incidence rates and public awareness of autism spectrum disorder (ASD) in recent years. The DSM-5’s latest modification of diagnostic criteria for ASD has also stimulated considerable debate. Despite the rising concerns, few studies have been conducted in the Chinese population of Hong Kong, especially among youth and adolescents. This study investigates the clinical profile of ASD in adolescents in Hong Kong. In addition to using screening instruments commonly used to assess specific ASD characteristics, other psychometric measures for internalizing and externalizing problems are employed to examine their associations with the ASD symptoms. It also assesses the extent to which different ASD symptoms and their associated features predict parenting stress.
\nMethods:
\nA total of 143 adolescents aged between 11 and 17 (M = 14.17; SD = 1.76) completed this study with their parents, including 71 adolescents with ASD and 72 typically developing adolescents. Adolescents completed two self-report measures of emotional symptoms: the Spence Children’s Anxiety Scale (SCAS) and Children’s Depression Inventory (CDI). Their parents completed the Autism Spectrum Screening Questionnaire (ASSQ), Child Behaviour Checklist (CBCL), and Spence Children’s Anxiety Scale – Parent version (SCAS-P) for evaluating their child’s characteristics. Parents also completed the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Parenting Stress Index-Short Form (PSI-SF) for measuring their own parenting stress.
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\nResults:
\nAll measures showed good to excellent internal consistency. They were as reliable and internally consistent as the original English versions. Parent reports in the ASD group were significantly higher than in the control group on all measures. Mean ASSQ scores in the ASD group fell within the clinical range. Optimal ASSQ cutoff scores were estimated using receiver operating characteristics analysis. ASD symptoms, as well as internalizing and externalizing problems, were found to be significant discriminators between the ASD group and the controls. In addition, parents reported that their child’s emotional and behaviour problems were more distressing than the ASD symptoms.
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\nDiscussion:
\nThis study highlights the importance of evaluating specific ASD characteristics and their associated symptoms of emotional and behavioural disturbances. This study suggests an optimal cutoff score of 9 for the ASSQ in Hong Kong. However, there is a need to assess its generalizability using large-scale community samples and other childhood clinical conditions. Although the findings appear to support the revised DSM-5 taxonomy of ASD, they must be interpreted with caution. Future treatments should provide parents with adequate professional support for reducing parenting stress and helping them cope with their child’s social, emotional, and behavioural impairments. 
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\nConclusions:
\nThis study documents preliminary norms for a broad range of measures for adolescents with ASD in Hong Kong. It also provides a useful empirical basis for future investigations of the interplay between specific ASD characteristics and their associated features. Regarding treatment planning, this study postulates a comprehensive treatment model for adolescents with ASD to guide treatment research.

BackgroundPartially driven by public concerns about modern food production practices, organic food has gained popularity among consumers. However, the impact of organic food consumption during pregnancy on offspring health is scarcely studied. We aimed to investigate the association between maternal intake of organic food during pregnancy and symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in offspring at 8 years of age.MethodsThis study was based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). The total study sample included 40,707 mother–child pairs (children born 2002–2009). Organic food consumption during pregnancy was assessed by six questions from a food frequency questionnaire in mid-pregnancy (sum score 0–18). Symptoms of ADHD and ASD in the offspring aged 8 years were measured by ADHD (0–54) and ASD (0–39) symptom scores based on the Parent/Teacher Rating Scale for Disruptive Behaviour disorders and the Social Communication Questionnaire. Associations between maternal intake of organic food during pregnancy and symptoms of ADHD and ASD in the offspring were analyzed using regression models with adjustment for covariates such as maternal anxiety and depression, including sibling analysis.ResultsMean ADHD and ASD symptom scores in the offspring differed only slightly by maternal intake of organic food. The covariate-adjusted unstandardized regression coefficient (adjusted(Adj)beta) with 95% confidence interval for the ADHD symptom score with one unit increase in organic food sum score was 0.03 (0.01, 0.05). Similarly, Adjbeta for autism symptom score was 0.07 (0.04, 0.10). For ADHD, the adjusted estimates weakened when adjusting for maternal symptoms of ADHD. The sibling analyses showed no significant results with Adjbeta − 0.07 (− 0.15, 0.01) and − 0.001 (− 0.12, 0.12) for ADHD and ASD outcomes, respectively.ConclusionsWe observed weak positive associations between frequent maternal organic food consumption during pregnancy and offspring ADHD and ASD symptom levels at 8 years of age. This trend weakened or disappeared after adjusting for maternal symptoms of ADHD, and in sibling analyses, suggesting that the associations mainly reflect genetic confounding. Our study indicates that consumption of organic food during pregnancy should neither be considered a risk factor nor protective against symptoms of ADHD and ASD in offspring.