Infantile autism: A total population study of reduced optimality in the pre-, peri-, and neonatal period

Twenty-five autistic children, constituting a total population sample of children with infantile autism, were compared with 25 sex- and maternityclinic-matched controls for occurrence of reduced optimality in the pre-, peri-, and neonatal period, as noted in medical records. Autistic children showed greatly increased scores for reduced optimality, especially with regard to prenatal factors. The findings are at odds with early reports that children with autism had not suffered potential brain injury. The reasons for the discrepancy are discussed.We gratefully acknowledge the assistance of Mrs. Doris Andrén in the collecting of the pertinent data, and Mrs. Gun Jakobsson for skillful secretarial assistance. This work was financially supported by a grant from the Swedish Save the Children Fund (Rädda Barnens Riksförbund).     

Early childhood autism and the question of egocentrism

An individual's social competence is often considered in terms of his role-taking abilities. In the light of studies by Piaget, it has been supposed that a child's developing capacity to appreciate the viewpoints of others in a social context is reflected in his ability to recognize points of view in a visuospatial setting. If this is valid, then visuospatial role-taking tasks may afford a measure of some relatively “cognitive” component of the capacity to engage in social behavior. Tasks in which subjects were required to make judgments about different and yet related views of a three-dimensional scene or object, together with tests of operational thinking, were presented to normal children and to subjects with the diagnosis of infantile autism. The results indicate that autistic children are no more impaired in their recognition of visuospatial perspectives than are normal children of comparable intellectual level in tests of operational thinking. A further, more limited study yielded suggestive evidence that over this series of tasks, autistic children perform as well as subjects with Down's syndrome who have a similar verbal mental age. These findings render it improbable that autistic children are especially “egocentric” in their appreciation of visuospatial perspectives. The present research was undertaken in partial fulfillment of a Ph.D. degree at the Institute of Psychiatry, University of London. Some of the tasks were originally devised in collaboration with David Mant in the course of undergraduate work at Cambridge University. I am indebted to the subjects who took part in the study and to the teaching staff who helped me, particularly Mrs. Wendy Brown, Mrs. Elizabeth Kelleher, and the staff at the Helen Alisson School for Autistic Children, Gravesend. I am grateful to Dr. Beate Hermelin, Professor Michael Rutter, and Dr. Peter Clark for their encouragement and advice, and to Ms. Maria Callias and Dr. Richard Cromer for their helpful criticisms.     

微生物-肠-脑轴与孤独症谱系障碍研究进展

孤独症谱系障碍（ASD）是一种严重神经发育性障碍，是遗传因素和环境因素共同作用的 结果。近年来，越来越多的证据支持肠道内的微生物通过肠-脑轴影响脑发育，并产生相应的行为表现 型。肠道微生物失调和ASD的关系也日益受到重视，可能参与了部分ASD的发生与发展。现综述微生物- 肠-脑轴与ASD 间的关系。     

Behavioral relationship between autism and fragile x syndrome

Previous researchers have reported autistic features in children with fragile X syndrome. We compared 21 children with pervasive developmental disorders (autism group) to 15 with fragile X syndrome on the Childhood Autism Rating Scale and the Reiss Scales for Children's Dual Diagnosis. The 7 children (47%) with fragile X who scored above the Childhood Autism Rating Scale cut-off (fragile X-autism group) were more impaired than the remaining children (fragile X-no autism) on Childhood Autism Rating Scale subscales related to emotion, visual and listening responses, and communication. The autism group's Reiss scores were higher than fragile X-no autism group, but not fragile X-autism group. Although the Childhood Autism Rating Scale identified almost 50% of children with fragile X as having autism, qualitative differences may exist in specific autistic-like behaviors between children with autism and children with fragile X.     

儿童孤独症与感觉统合失调的相关分析

目的:探索儿童孤独症与感觉统合失调的关系.方法:对60例符合国际疾病分类第10版(ICD-10)诊断标准的儿童孤独症患儿(患者组)与60名健康儿童(对照组)填写儿童情况调查表,并分别进行感觉统合评定量表(SIS)、克氏孤独症行为量表(CBRS)及并儿童孤独症评定量表(CARS)评定孤独症患儿症状严重程度.结果:患者组伴感觉统合失调的占95.0%,而对照组存在感觉统合失调的仅占3.3%;患者组与对照组的感觉统合评定结果比较,差异具有显著性(P＜0.01);病程长短不同的患儿感觉统合失调严重度不同,差异具有显著性(P＜0.05);智力水平与感觉统合失调显著相关(P＜0.05);多元逐步回归分析结果:是否诊断为儿童孤独症与CBRS总分、本体感、母孕期有无高危因素、既往有重大疾病史、有无窒息史、母亲文化程度有关.结论:儿童孤独症患儿普遍存在感觉统合失调,在对儿童孤独症患儿进行个别化训练的同时应进行感觉统合训练.     

The relationship between disgust sensitivity and avoidant behavior: studies of clinical and nonclinical samples

Researchers have reported links between specific phobias (of small animals and blood/ injection/injury (BII)) and disgust sensitivity. Avoidance is one route by which disgust sensitivity may play a role in the etiology or maintenance of pathological fear. This paper discusses a series of three studies to examine behavior associated with disgust sensitivity. Study I examined disgust sensitivity and avoidance of disgust-evoking tasks among spider fearful and nonfearful participants. Study 2 reanalyzed previously published data on the relationship between disgust sensitivity and visual avoidance of BII stimuli and spiders. Study 3 examined disgust sensitivity in obsessive-compulsive disorder (OCD). Results indicate the trait of disgust sensitivity is a poor predictor of avoidance behavior in specific situations, but state disgust more consistently predicts avoidance, suggesting future research in specific phobia should shift emphasis toward examining the role of state disgust.     

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。     

The question of autism in an atypical infant

The evaluation and brief treatment of a less-than-a-year-old girl whose parents were concerned she was autistic is described. We review what is known about the initial symptoms of autism and consider how early it is feasible to make a diagnosis. We outline the domains of cognitive, language, and social development that ought to be monitored given concern about autism and explain how we evaluated these domains in our home-based intervention. Finally, we consider possible explanations for this infant's recovery from a serious early disturbance in social relatedness.     

Monoamine metabolites in lumbar CSF: the question of their origin in relation to clinical studies

The sources of homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) and 5-hydroxyindoleacetic acid (5HIAA) in lumbar CSF of man are discussed. Although HVA in lumbar CSF is derived from the brain, and MHPG seems to be mainly from the spinal cord, the origin of 5HIAA is uncertain. The evidence for and against a brain contribution to 5HIAA of the lumbar CSF is evaluated. It is concluded that the brain can contribute 5HIAA to lumbar CSF under some circumstances. Measurement of 5HIAA concentrations in lumbar CSF can be of clinical value in detecting changes of 5-hydroxytryptamine (5HT) metabolism in the CNS if the changes are general throughout the CNS.     

The relationship between autism and psychiatric disorders in Intellectually Disabled Adults

Intellectual Disability (ID) shows a high comorbidity with psychiatric disorders with a great variability in the prevalence rates. An important subgroup is represented by subjects with ID and autism or other autistic spectrum disorders (PDD). The purpose of the present study was to assess PDD with specific screening tools in a population of people with ID and compare the groups with or without PDD through the administration of a psychopathological scale in order to verify the differences of psychiatric disorders’ rates. The study was conducted on 90 subjects attending daily centres or residential centres in Florence, Italy. In order to assess the presence of PDD, the PDD-MRS was administrated, while for the assessment of the psychopathological aspects we have used the DASH-II. The presence of a psychiatric disorder has a significant effect on anxiety, depression and organic syndromes and statistically significant differences have been registered in many DASH-II subscales. The statistical comparison between the two groups shows that PDD was clearly correlated with an increased presence of psychiatric disorders. The variable PDD could be considered as a vulnerability factor for psychiatric disorders. However there was still the need to focus on categorical diagnoses, in order to increase our knowledge about the concept of vulnerability in people with ID.     

Systematic review investigating the relationship between autism spectrum disorder and metabolic dysfunction

The objective of this systematic review is to examine metabolic dysfunction, specifically metabolic syndrome and its components, as well as type 2 diabetes mellitus (T2DM) as it relates to individuals with a diagnosis of Autism Spectrum Disorder (ASD). We searched PubMed, Embase, Cochrane, PsychInfo, and Scopus from January 1, 1998 to October 12, 2018 for English, peer-reviewed, original articles containing adult and pediatric populations with any form of ASD and metabolic dysfunction, including T2DM, hyperglycemia, hypertension, dyslipidemia, or central obesity. Exclusion criteria included studies without ASD-specific results, basic science research, review papers, case studies, and medication clinical trials. Eight studies were included in this review, with a total of 70,503 participants with ASD and 2,281,891 in comparison groups. Within ASD populations, higher prevalence for metabolic syndrome components hyperglycemia, hypertension, and dyslipidemia were observed, as well as increased incidence and prevalence of T2DM. However, heterogeneity of study definitions and measurements should be noted. While there is evidence of increased prevalence of T2DM, hyperglycemia, hypertension, and dyslipidemia for those with ASD, the relationship is poorly understood. There is also lack of research investigating central obesity and risk of metabolic syndrome as a diagnosis. More research addressing these gaps is warranted to evaluate the risk of metabolic dysfunction in populations with ASD.     

The relationship between autism spectrum disorders and anxiety: The moderating effect of communication

Communication skills have been shown to have differing effects on levels of anxiety depending on whether or not a child has an autism spectrum disorder (ASD) or is typically developing. This article examined whether or not communication deficits differentially affect children with ASD compared to those without ASD. Ninety-nine children with autistic disorder (n = 33), Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; n = 33), and no diagnosis (n = 33) were examined using the Autism Spectrum Disorders Diagnostic for Children and Comorbidity for Children scales to determine their level of anxiety and degree of communication deficits. Results indicated that anxiety decreased as communication deficits increased for those with autistic disorder compared to those with PDD-NOS or no diagnosis; however, for those with PDD-NOS anxiety increased as communication deficits increased compared to those with no diagnosis. The importance and differential impact of communication deficits on anxiety for different groups is highlighted.     

Brief report: relationship between self-awareness of real-world behavior and treatment outcome in autism spectrum disorders

The aim of the present study was to investigate the influence of self-awareness of real-world behavior on treatment outcome in adolescents with ASD. For this purpose we followed 28 adolescents with ASD during their first year of specialized treatment. Results showed that better self-awareness at start of treatment was related with an increase in clinician-reported social functioning after 1 year of treatment. Additionally, an increase in self-awareness during treatment was related with a decrease of parent-reported problems in daily functioning. However, an increase in self-awareness was also related to an increase of self-reported daily and psychological problems. It is discussed that lowered self-awareness may result in an overestimation of personal real-world functioning and consequently may influence treatment course.     

The relationship between inflammation and venous thrombosis. A systematic review of clinical studies

During the past decade, the role of inflammation in the pathophysiology of arterial thrombosis has been elucidated. However, comparatively little is known about the relationship between inflammation and venous thrombosis. The aim of this study was to perform a systematic review of clinical studies that have examined the association between inflammation and venous thrombosis, specifically: (1) the value of inflammatory markers in predicting the future development of venous thrombosis; (2) test characteristics of markers of inflammation in the diagnosis of acute venous thrombosis; and (3) effect of venous thrombosis on blood levels of inflammatory markers. Using keywords venous thrombosis, venous thromboembolism, inflammation, acute phase markers, C-reactive protein (CRP), interleukin (IL)-6, IL-8, and monocyte chemotactic protein (MCP)-1, PubMed and Medline computerized databases were searched for English language articles published after 1980. Search results were restricted to clinical studies in humans that used study designs that were appropriate to address the above objectives. Results show that plasma CRP levels do not appear to predict risk of future venous thrombosis (two studies; N = 41,308). Four studies (N=562) have examined the utility of plasma CRP in the diagnosis of venous thrombosis; pooled positive and negative predictive values were 53% (95% CI:47%,59%) and 85% (95% CI: 81%, 89%), respectively. A two- to six-fold increase in the risk of deep vein thrombosis (DVT) is associated with elevations in plasma levels of CRP, IL-6, IL-8, MCP-1 or TNF-alpha (three studies). We can conclude that the nature of the relationship between inflammation and clinical venous thrombosis is not yet established. CRP does not appear to be useful in predicting future venous thrombosis or in the diagnosis of acute venous thrombosis. While several markers of inflammation are elevated in acute venous thrombosis, further research is needed to determine the precise relationship between these markers and venous thrombosis. The identification and elucidation of inflammatory markers relevant to venous thrombosis could provide targets for future therapy.     

The relationship between autism quotient,anxiety, and internet addiction

This study investigated internet addiction across the broad autism phenotype, and assessed the degree to which internet addiction in individuals with higher autism quotient scores may be mediated by co-morbid depression and anxiety. Ninety participants were given a range of psychometric assessments to determine their level of problematic internet usage (Internet Addiction Test), autism traits (Autism Quotient Scale), depression (Beck Depression Inventory), and anxiety (Speilberger Trait Anxiety Scale). Significant associations were found between both autism, and anxiety, and internet addiction. However, the association between autism traits and internet addiction was moderated by high level for anxiety, such that individuals with high numbers of autism traits showed less evidence of internet addiction if they also displayed high levels of anxiety. It is suggested that the presence of anxiety in these individuals alters the function that internet behavior serves, and makes internet addiction less likely.     

An examination of the relationship between communication and socialization deficits in children with autism and PDD-NOS

Autism Spectrum Disorders (ASDs) are characterized by pervasive impairments in repetitive behaviors or interests, communication, and socialization. As the onset of these features occurs at a very young age, early detection is of the utmost importance. In an attempt to better clarify the behavioral presentation of communication and socialization deficits to aid in early assessment and intervention, impairments in these areas were examined among infants and toddlers (17-36 months) with Autistic Disorder (AD), Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), and non-ASD related developmental delay. The Baby and Infant Screen for Children with aUtIsm Traits-Part1 (BISCUIT-Part1) and the Battelle Developmental Inventory, 2nd Edition (BDI-2) were utilized to examine communication and socialization levels, respectively, among these groups. All groups significantly differed on level of socialization impairment with the Autism group displaying the greatest impairment and the non-ASD related developmental delay group evincing the least impairment. In regards to communication deficits, the non-ASD related developmentally delayed group differed significantly in comparison to the Autism and PDD-NOS groups; however, no significant differences were found between children with AD and PDD-NOS. While communication and socialization impairments were found to significantly correlate for all participants with the exception of those with PDD-NOS, these correlations were not found to significantly differ from one another across groups. The implications, limitations, and future directions of these results are discussed.