眼动跟踪技术在孤独症谱系障碍诊治中的应用

在过去的几十年中,大规模观察性研究中收集的临床和神经影像资料的稳步增加使得人 们能够更充分地了解孤独症谱系障碍（ASD）群体社交眼神接触的特异性,探索了具体的视觉加工认知 过程。此外,这些大规模数据支持了ASD辅助诊断、疗效判断和个性化治疗设施的开发和更广泛的应用, 这对于改善ASD 预期临床进展和预后具有很大的帮助,并为开发个性化精准治疗方法提供了重要方向。 现对眼动跟踪技术在ASD 诊治中的应用进行综述。     

孤独症谱系障碍药物治疗研究进展

对孤独症谱系障碍的药物治疗研究进展进行综述。     

孤独症谱系障碍早期症状研究进展

本文综述了孤独症谱系障碍早期症状的近年研究进展.总结了孤独症谱系障碍早期症状的出现时间及其特点,而且重点介绍了具有代表性的研究方法和结果,为孤独症谱系障碍的早期诊断和干预提供了指导性依据.     

孤独症谱系障碍儿童语言/言语情况分析

正孤独症谱系障碍(ASD)是以社会交往和沟通模式质的损害,局限、重复刻板的兴趣和行为为临床特征[1];言语障碍为三大核心症状之一。本研究对ASD儿童语言/言语情况进行分析。1对象和方法选取2018年7月至2018年11月期间北京大学第六医院专家门诊确诊为ASD患儿83例,男72例,女11例;年龄29～72个月,平均48个月。由主要照顾者填写自拟ASD语言/言语调查问卷,该问卷表参照2017年ASD儿童早期识别筛查和早期干预专家共识[2],并结合孤独症儿童行为量表(ABC)言语因子项目及儿童沟通量表(CCC-2);总计     

孤独症谱系障碍的环境危险因素研究进展

孤独症谱系障碍(autism spectrum disorder,ASD)是一种有生物学基础的神经发育障碍,表现社交交流与社交互动缺陷,及行为、兴趣和活动模式的刻板重复.在过去的10余年中,孤独症谱系障碍的发病率仍在逐年上升.然而,再临床上这种疾病的发病机制仍未明确.在这篇论文中,我们回顾了 ASD相关危险因素的文献、...     

孤独症谱系障碍的相关遗传学机制研究进展

孤独症谱系障碍（ASD）是一组高异质性的神经发育性障碍,遗传因素对发病起了重要作用,解释了 25%～35% 患儿的发病原因,但遗传学机制还不清楚。分子遗传学研究发现 ASD 存在常见和罕见拷贝数或单核苷酸变异体,突变基因编码蛋白质影响早期大脑发育,干扰神经元间的连接、突触形成以及功能,可能是其病理学机制。     

孤独症面孔-表情识别的眼动研究进展

许多眼动研究表明,孤独症患者及一级亲属存在面孔-表情识别等领域的缺陷,本文对此进行总结。     

微小RNA与孤独症谱系障碍研究进展

孤独症谱系障碍（ASD）是一组严重的高异质性神经发育障碍,是遗传因素和复杂环境因 素共同作用的结果,病理学机制还不清楚。大量的研究提示表观遗传学机制尤其是特殊脑区的miRNA 表达异常可能参与了ASD 的发生发展,循环miRNA 有望成为早期诊断的生物学标志物。     

孤独症谱系障碍儿童入普通学校就读相关问题探讨

孤独症谱系障碍(ASD)是一组起病于婴幼儿时期的全面性精神发育障碍,包括儿童孤独症,不典型孤独症、Rett综合征、Hell综合征、Asperger综合征(AS)及其他待分类的广泛发育障碍[1],其共同特点是人际交往与沟通模式异常,言语和非言语交流障碍,兴趣和活动内容局限、刻板、重复[1]。其中绝大多数存在严重的社会适应障碍,极少能进普通学校     

孤独症谱系障碍患者的脑电相干性研究进展

孤独症谱系障碍（ASD）是一组病因不明的神经发育障碍性疾病。既往研究提示患者脑功 能连接的异常可能是ASD的病理基础。不同脑区之间的相互协作对大脑完成认知任务具有重要意义, 脑区电活动的相干性（coherence）被认为是这种协作的表现形式,可以作为评价大脑连通性的指标,在 ASD 患者神经心理机制方面具有广泛的应用前景。     

Impaired representational gaze following in children with autism spectrum disorder

Using eye-tracking methodology, we compared spontaneous gaze following in young children with Autism Spectrum Disorder (mean age 5.8 years) to that of typically developing children (mean age 5.7 years). Participants saw videos in which the position of a hidden object was either perceptually visible or was only represented in another person’s mind. The findings indicate that children with Autism Spectrum Disorder were significantly less accurate in gaze following and observed the attended object for less time than typically developing children only in the Representational Condition. These results show that children with Autism Spectrum Disorder are responsive to gaze as a perceptual cue although they ignore its representational meaning.     

Parent-reported problematic sleep behaviors in children with comorbid autism spectrum disorder and attention-deficit/hyperactivity disorder

BackgroundSleep problems are frequent and well documented in children with Autism Spectrum Disorders (ASD), children with Attention Deficit/Hyperactivity Disorder (ADHD) and children with internalizing problems, however limited work has examined sleep problems in children presenting with comorbid ASD/ADHD. In healthy children, sleep problems negatively impact social, emotional, and academic functioning. The current study sought to examine diagnostic severity as predictors of sleep problems in children with comorbid ASD/ADHD. Additionally, the association between sleep and “real-life” functional domains (i.e., intellectual functioning, academic achievement, and executive functioning) were assessed.MethodSleep, internalizing difficulties, intellectual functioning, academic achievement and executive functioning were assessed in 85 children with who carried the dual diagnoses of ASD and ADHD.ResultsInternalizing difficulties, rather than ASD or ADHD symptom severity, was the most consistent predictor of problematic sleep behaviors (i.e., nightmares overtiredness, sleeping less than other children, trouble sleeping, and Total Problematic Sleep Behaviors) in this sample. Further, parent report of problematic sleep behaviors was significantly associated with functional domains after controlling for ASD, ADHD, and internalizing symptoms.ConclusionsResults suggest that internalizing symptoms are associated with problematic sleep behaviors in children with comorbid ASD/ADHD and may have implications for the “real-life” functioning among children with comorbid ASD/ADHD.     

Assessment of feeding problems in children with autism spectrum disorder

There is growing, but inconsistent, literature on feeding problems for children with Autism Spectrum Disorder. The purposes of this study were to (a) investigate the relation of feeding problems to autism severity, (b) assess the validity of parent-report questionnaires widely used to assess feeding problems in terms of their relation to systematic behavior observations, and (c) determine the relation between child feeding behavior and family mealtime environment. Thirty-eight children and their parents participated in the study. Parents completed questionnaires, and both parents and children participated in mealtime observations. Results indicated that autism severity predicted scores on a measure of feeding problems as well as the duration of negative vocalizations during meal observations. Food Frequency Questionnaires better predicted behavior during meals than the Brief Mealtime Autism Behavior Inventory. Family environment alone did not explain feeding difficulties.     

Patterns of gaze behavior during an eye-tracking measure of joint attention in typically developing children and children with autism spectrum disorder

This study evaluated whether diagnostic classifications or features of ASD were associated with individual differences in children's gaze pattern during an eye-tracking measure of joint attention. The sample included 21 children with ASD (mean age, 7.3 ± 1.5 years) and 24 typically developing children (mean age, 6.8 ± 1.6 years), matched on receptive language abilities. Results revealed no significant group differences on global measures of gaze allocation (total gaze time allocation). However, significant group differences emerged using a measure evaluating a microstructure of children's gaze (duration of first fixation). In addition, individual differences in children's gaze pattern were reliably predicted by parent report measures of children's social abilities. The majority of children in this sample (including all typically developing children and those children with ASD who scored lowest on the SRS Social Awareness subscale) showed significant modulation in eye-gaze between the two experimental conditions. In contrast, children with ASD who also scored the highest on the SRS Social Awareness subscale consistently failed to modulate their eye gaze in accordance with the experimental condition. This failure to flexibly modulate gaze in the context of a joint attention eye-tracking paradigm may reveal children's limited awareness of social cues that may further limit social learning.     

Everyday expressions of pain in children with and without autism spectrum disorder

BackgroundAnecdotal reports from parents suggest that their children with autism spectrum disorder (ASD) may have diminished pain experiences and expressions. In contrast, objective measures of pain have been used to document typical and enhanced expressions of pain in response to noxious stimuli (e.g., blood draw) among children with autism. The purpose of this study was to compare non-biased parental ratings of pain among children with and without ASD.MethodAs an everyday measure of pain, parents completed The Non-Communicating Children’s Pain Checklist (NCCPC-R) across two time windows (i.e., 2 h and 1 week) for 31 children with ASD and 19 children without ASD.ResultsThere were no significant group differences in everyday expressions of pain between children with and without ASD. However, in general, increased autism symptomology severity was associated with decreased parental ratings of pain expressions.ConclusionThese results continue to support a framework where children with ASD may have typical pain sensitivity, however, their expressions of pain may differ based on where individuals lie on the autism spectrum.     

儿童孤独谱系障碍诊治研究进展

从1943 年Kanner 医生第一次描述儿童孤独症以来,人们对孤独症的认识已经走过了70 余年的历程,有关孤独症的知识逐渐普及,社会各界越来越重视,诊治研究前所未有的活跃,取得了一些令人瞩目的进展,主要集中在以下几个方面.     

Speech intonation in children with autism spectrum disorder

Objective: The prosody of children with autism spectrum disorder (ASD) has several abnormal features. We assessed the speech tone of children with ASD and of children with typical development (TD) by using a new quantitative acoustic analysis. Methods: Our study participants consisted of 63 children (26 with ASD and 37 with TD). The participants were divided into 4 groups based on their developmental features and age. We assessed the variety of the fundamental frequency (F0) pattern quantitatively, using pitch coefficient of variation (CV), considering the different F0 mean for each word. Results: (1) No significant difference was observed between the ASD and TD group at pre-school age. However, the TD group exhibited significantly greater pitch CV than the ASD group at school age. (2) In pitch CV, range and standard deviation of the whole speech of each participant, no significant differences were observed between the type of participants and age. (3) No significant correlation was found between the pitch CV of each word and the Japanese Autism Screening Questionnaire total score, or between the pitch CV of each word and the intelligence quotient levels in the ASD group. A significant correlation was observed between the pitch CV of each word and social reciprocal interaction score. Conclusions: We assessed the speech tone of children with ASD by using a new quantitative method. Monotonous speech in school-aged children with ASD was detected. The extent of monotonous speech was related to the extent of social reciprocal interaction in children with ASD.     

Women's posttraumatic stress symptoms and autism spectrum disorder in their children

Maternal posttraumatic stress disorder (PTSD) may be associated with autism spectrum disorder (ASD) in offspring through multiple pathways: maternal stress may affect the fetus; ASD in children may increase risk of PTSD in mothers; and the two disorders may share genetic risk. Understanding whether maternal PTSD is associated with child's ASD is important for clinicians treating children with ASD, as PTSD in parents is associated with poorer family functioning. We examined the association of maternal PTSD with offspring ASD in a large US cohort (N ASD cases = 413, N controls = 42,868). Mother's PTSD symptoms were strongly associated with child's ASD (RR 4–5 PTSD symptoms = 1.98, 95% CI = 1.39, 2.81; RR 6–7 symptoms = 2.89, 95% CI = 2.00, 4.18). Clinicians treating persons with ASD should be aware of elevated risk of PTSD in the mother. Genetic studies should investigate PTSD risk alleles in relation to ASD.     

孤独谱系障碍患儿的感觉特征

目的 使用中文版儿童感觉剖析量表探讨孤独谱系障碍(ASD)患儿的感觉特点.方法 采用中文版儿童感觉剖析量表对66例ASD患儿和66名健康发育儿童进行评定,由监护人完成.分析孤独症患儿与健康儿童在感觉方面的差异.结果 除感觉剖析量表的口腔感觉处理和影响活动水平的运动的调节部分外,ASD患儿在其他部分及全量表的得分均与健康儿童的差异有统计学意义(P<0.01).结论 除口腔感觉处理和影响活动水平的运动的调节外,ASD患儿的各项感觉特征与健康发育儿童均存在一定差异.中文版儿童感觉剖析量表对区别ASD患儿与健康发育儿童有一定的鉴别力.     

A systematic review of peer-mediated interventions for children with autism spectrum disorder

BackgroundPeer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.MethodThe current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.ResultsFour of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.ConclusionPMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.