How is Anxiety Identified and Diagnosed in Individuals with Autism Spectrum Disorder and Intellectual Disability? A Scoping Review

ABSTRACT

Introduction: Individuals with Autism Spectrum Disorder display a pattern of social communication deficits and restricted and repetitive behaviors that leave them particularly vulnerable to developing anxiety. The presence of a co-occurring Intellectual Disability further complicates the situation, compromising traditional diagnostic techniques and processes. The dual diagnosis of ASD and ID appears to result in specific behavioral patterns that affect the way anxiety is identified in this population.

Method: A scoping review was undertaken to explore what is currently known about the way anxiety is identified and diagnosed in individuals with ASD and ID.

Results: In the limited research available consistent themes of difficulties with the diagnostic process, inconsistencies among measurement tools and the need to consider behavioral symptomology were found.

Conclusion: Further research needs to be conducted to enhance our understanding of how anxiety is identified in those with ASD and ID. This research could more accurately inform reliable diagnostic processes and lead to better treatment and outcomes for this population.     

Awareness and risk factors of autism spectrum disorder in an Egyptian population

BackgroundThe aim of the present study was to determine the type and percentage of referral situations, risk factors, associated syndromes, and parental awareness of autism spectrum disorder (ASD) children who visited the Medical Research Centre of Excellence, National Research Centre in Cairo, specialized in ASD diagnosis and management.MethodsThe study included 530 children who were diagnosed with ASD. For those, full medical history, clinical examination, severity evaluation, and testing the language and cognitive development were performed. The process of diagnosis and assessment of parents’ awareness and knowledge about ASD was investigated using questionnaires.ResultsThe clinic was mainly visited by self-referral. About half of the participants (51.4 %) had previously visited other doctors (1–5 physicians) who were mostly pediatricians. The parents’ awareness was mostly limited to the term “autism”, but not the nature of ASD. Caesarean section was the most common risk factor (57.4 %), followed by jaundice (30.1 %). The most common presenting symptoms were language (81.5 %) and social (60.4 %) deficits. ASD severity was found to be high in association with attention deficit hyperactivity disorder (ADHD) and electroencephalogram (EEG) changes (p = 0.001).ConclusionThe risk factors and associated syndromes in the Egyptian population studied were similar to those reported in previous studies performed in other populations, but their percentage was different. Perinatal problems were the most common risk factors, which may relate to the influence of gene-environmental interaction on the factors which could play a role in developing ASD or increasing its severity. The process of ASD diagnosis was commonly delayed among the participants. Increasing awareness and knowledge among health care professionals and parents is urgently needed to facilitate early diagnosis and intervention services, which will lead to improvement of the developmental outcomes for ASD children. The associated syndromes could be the driving force to seek medical advice and could influence the ASD severity.     

基于数据挖掘的吕英教授治疗自闭症语言障碍的用药规律分析＊

目的 基于中医传承辅助平台软件（TCMISS，V2.5）对吕英教授治疗自闭症语言障碍的处方进行数据挖掘，探索其病因病机及组方规律。方法 收集吕英教授治疗自闭症语言障碍的医案，将其方药信息录入TCMISS，借助该平台集成的关联规则、改进互信息法、复杂系统熵聚类法、无监督熵层次聚类法等分析方法探索吕英教授治疗自闭症语言障碍的药物组方规律。结果 共筛选出120个医案，包含处方共120首，涉及中药89味，其中使用频次前6味中药为桂枝、鸡蛋花、白术、泽泻、石膏、桔梗，药性以寒、温为主，药味以甘、苦居多，归经多属肺、脾、肝经。通过关联规则分析所得的用药模式中，使用频次最高的为桂枝与鸡蛋花、桂枝与泽泻、白术与桂枝，进一步分析得到的核心药物为泽泻、桂枝、白术，为五苓散的药物组成，并基于复杂熵聚类方法演化出6首新处方。结论 吕英教授治疗自闭症语言障碍以阳明“气血津”不足和三焦气化功能失常为主要病机线路，清解阳明伏火、加强阳明本体液津血的生化化生及恢复三焦气化功能正常为主要治法，其核心代表方剂为木防己汤和五苓散。