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Autism and Children
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Autism and Children

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child Neurology".

Deadline for manuscript submissions: closed (25 July 2022) | Viewed by 60306

Special Issue Editors

Dr. Antonio Narzisi

E-Mail Website
Guest Editor
Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56018 Pisa, Italy
Interests: autism; neurodevelopmental disorders; psychology; psychoterapy; neurosciences; precision medicine
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Francisco Alcantud-Marín

E-Mail Website
Guest Editor
Faculty of Psychology, University of Valencia, Blasco Ibañez Avenue 21, 46010 Valencia, Spain
Interests: neurodevelopmental disorders; autism spectrum disorders ASD detection; ASD diagnosis; ASD early intervention; etiology of nerodevelopmental disorders; epidemiology of neurodevelopmental disorders
Special Issues, Collections and Topics in MDPI journals
Dr. Yurena Alonso-Esteban

E-Mail Website
Guest Editor
Educational Psychology, (UNED) National University of Distance Education, Casa de la Misericòrdia 34, 46014 València, Spain
Interests: developmental delay; autism spectrum disorders; early intervention; training of parents and caregivers; screening tools
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, diagnoses of Autism Spectrum Disorders (ASD) have significantly increased. According to the DSM-V, ASD are a heterogeneous set of neurodevelopmental disorders characterised by deficits in social communications and interactions plus the presence of restricted interests and repetitive behaviours.

This Special Issue of Children aims to present a collection of studies detailing the most recent advancements in the field of autism research in school-aged children. Authors are invited to submit cutting-edge research and reviews that address a broad range of topics related to ASD including the following: school intervention; treatment; sport; motor development; sensory profile; ICT; biomarkers; biological and/or behaviour outcome predictors; parental stress; and psychotherapy.

Considering the success and popularity of the Special Issue " Screening, Diagnosis and Early Intervention in Toddlers with Autism Spectrum Disorders" previously published in the journal Children (https://0-www-mdpi-com.brum.beds.ac.uk/journal/children/special_issues/autism_screening_diagnosis), we now release a new Special Issue aimed to gather original research papers and review articles focused on the children Autism.

In particular, we aim to present advances in autism research and best practices that may have a significant translational effect to the field of clinical services.

Dr. Antonio Narzisi
Prof. Dr. Francisco Alcantud-Marín
Dr. Yurena Alonso-Esteban
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • autism
  • children
  • neurodevelopmental disorders
  • school
  • parents

Published Papers (18 papers)

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Editorial

Jump to: Research, Review, Other

5 pages, 244 KiB  
Editorial
Autism and Children: Diagnosis, Functional Profiles and Intervention
by Antonio Narzisi, Yurena Alonso-Esteban and Francisco Alcantud-Marín
Children 2023, 10(3), 522; https://0-doi-org.brum.beds.ac.uk/10.3390/children10030522 - 08 Mar 2023
Cited by 1 | Viewed by 1724
Abstract
In the last forty years, approaches to and the social perception of autism have changed significantly [...] Full article
(This article belongs to the Special Issue Autism and Children)

Research

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10 pages, 1067 KiB  
Article
Working with Children with Autism Undergoing Health-Care Assessments in a Day Hospital Setting: A Perspective from the Health-Care Professionals
by Chiara Davico, Daniele Marcotulli, Elisa Succi, Carlotta Canavese, Ancuta F. Bodea, Mariacristina Pellegrino, Enrica Cuffari, Valentina F. Cudia, Barbara Svevi, Federico Amianto, Federica Ricci and Benedetto Vitiello
Children 2023, 10(3), 476; https://0-doi-org.brum.beds.ac.uk/10.3390/children10030476 - 27 Feb 2023
Cited by 3 | Viewed by 2787
Abstract
Background: Hospitals can be especially stressful for children with autism spectrum disorder (ASD) due to the communication and social skills deficits, lower capacity to adapt to disruption, and sensory hypersensitivity that are typical of these patients. Purpose: This study investigated how health-care professionals [...] Read more.
Background: Hospitals can be especially stressful for children with autism spectrum disorder (ASD) due to the communication and social skills deficits, lower capacity to adapt to disruption, and sensory hypersensitivity that are typical of these patients. Purpose: This study investigated how health-care professionals (HPs) experienced the clinical care and management of children with ASD undergoing medical testing in a day hospital setting, and assessed the rate of successful completion of laboratory tests and instrumental examinations. Methods: A cross-sectional questionnaire was administered to 45 HPs, inquiring about their experience in obtaining blood and urine tests, ECG, audiometry, and EEG from children with ASD. The clinical sample included 153 consecutively referred children with ASD (74.5% males, mean age 5.6 years) undergoing a medical diagnostic work-up as part of their diagnostic evaluation. The success rate of completing the various assessments was examined. Results: HPs identified aggressive behavior and communication deficits as the major challenges when providing care to children with ASD. The parents were seen as an important resource for managing the children. The completion rate of the laboratory tests and instrumental examinations was high (between 88.5% and 98.4% according to the specific type of examination). The lowest non-completion rate was found for the EEG (12.5%). Conclusions: Despite considerable challenges being reported by HPs in managing children with ASD, the scheduled assessments could be completed in the large majority of cases. Targeted approaches to preventing aggressive behaviors and obviating the communication barriers in children with ASD undergoing hospital exams are warranted. Full article
(This article belongs to the Special Issue Autism and Children)
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23 pages, 387 KiB  
Article
Evaluating in the Real-World Educational Intervention to Improve Interference Control in Children with Autism Spectrum Disorder
by Elena Escolano-Pérez and Marian Acero-Ferrero
Children 2022, 9(9), 1294; https://0-doi-org.brum.beds.ac.uk/10.3390/children9091294 - 26 Aug 2022
Viewed by 1243
Abstract
Children with autism spectrum disorder (ASD) present deficiencies in interference control processes. The main aim of this pilot study was to analyze the efficacy of an educational intervention designed to optimize the interference control of eight ASD children, attending to their ASD severity [...] Read more.
Children with autism spectrum disorder (ASD) present deficiencies in interference control processes. The main aim of this pilot study was to analyze the efficacy of an educational intervention designed to optimize the interference control of eight ASD children, attending to their ASD severity level. A mixed-methods approach grounded in systematic observation and nomothetic/follow-up/multidimensional observational designs was used. An observation instrument was developed to code data, which were grouped according to the ASD severity level (Group 1, requires support; Group 2, requires substantial support) and were analyzed using a lag sequential analysis. The results show that, although both groups progressed during the intervention and could have continued to improve, each group evolved differently. Group 1 performed relatively well from the onset and increased and developed their interference control strategies throughout the intervention, while Group 2, despite also acquiring new interference control strategies, took more time to show improvements. One month after the intervention ended, both groups were unable to consolidate the strategies learned. A mixed-methods approach allowed for real interference control deficits in ASD children to be captured in a natural context. To conclude, it would be necessary to lengthen this intervention and adapt it to the needs of each group. Full article
(This article belongs to the Special Issue Autism and Children)
9 pages, 255 KiB  
Article
Early Neuro-Psychomotor Therapy Intervention for Theory of Mind and Emotion Recognition in Neurodevelopmental Disorders: A Pilot Study
by Elisa Giangiacomo, Maria Castellano Visaggi, Franca Aceti, Nicoletta Giacchetti, Melania Martucci, Federica Giovannone, Donatella Valente, Giovanni Galeoto, Marco Tofani and Carla Sogos
Children 2022, 9(8), 1142; https://0-doi-org.brum.beds.ac.uk/10.3390/children9081142 - 29 Jul 2022
Cited by 6 | Viewed by 2262
Abstract
The aim of the present study is to explore the effect of early neuro-psychomotor therapy to improve theory of mind skills and emotion recognition in children with neurodevelopmental disorders. A pilot study was set up, consisting of in-group training activities based on the [...] Read more.
The aim of the present study is to explore the effect of early neuro-psychomotor therapy to improve theory of mind skills and emotion recognition in children with neurodevelopmental disorders. A pilot study was set up, consisting of in-group training activities based on the neuro-psychomotor approach. Children were evaluated using Neuropsychological Assessment for Child (Nepsy-II), Test of Emotion Comprehension (TEC), and Social Communication Questionnaire (SCQ). For data analysis, one-sample Wilcoxon signed rank test was used with a significance of p < 0.05. Two children with a developmental language disorder and four children with autism spectrum disorders participated in a 3-month training program. Our findings revealed significant improvement in emotion recognition, as measured with Nepsy-II (p = 0.04), while no statistical improvement was found for theory of mind. Despite the limited sample, early neuro-psychomotor therapy improves emotion recognition skills in children with neurodevelopmental disorders. However, considering the explorative nature of the study, findings should be interpreted with caution. Full article
(This article belongs to the Special Issue Autism and Children)
14 pages, 713 KiB  
Article
The Influence of ASD Severity on Parental Overload: The Moderating Role of Parental Well-Being and the ASD Pragmatic Level
by Eva M. Lira Rodríguez, Rocío Cremallet Pascual, Miguel Puyuelo Sanclemente, Pilar Martín-Hernández, Marta Gil-Lacruz and Ana I. Gil-Lacruz
Children 2022, 9(6), 769; https://0-doi-org.brum.beds.ac.uk/10.3390/children9060769 - 24 May 2022
Cited by 2 | Viewed by 1626
Abstract
The aim of the present study is to analyze the relation between the severity of symptoms in people with ASD on their parents’ overload, moderated by parental well-being and the ASD pragmatic level. A sample consisted of 28 fathers and mothers whose children [...] Read more.
The aim of the present study is to analyze the relation between the severity of symptoms in people with ASD on their parents’ overload, moderated by parental well-being and the ASD pragmatic level. A sample consisted of 28 fathers and mothers whose children had ASD. The obtained results showed that the higher the ASD severity, the better the parental overload was perceived if parents had low well-being levels. However, this relation did not occur if the parental well-being level was high. Moreover, the relation between severity and parental overload moderated by parental well-being occurred regardless of the pragmatic language level. Therefore, the main results of this study are that the responsibility for parental overload depends more on parental well-being than on the symptom severity of the person with ASD. The relevance of carrying out interventions with not only people with ASD, but also with their parents or caregivers for their well-being is highlighted. Full article
(This article belongs to the Special Issue Autism and Children)
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10 pages, 824 KiB  
Article
Parent-Reported Assessment Scores Reflect the ASD Severity Level in 2- to 7-Year-Old Children
by Priyanka Jagadeesan, Adam Kabbani and Andrey Vyshedskiy
Children 2022, 9(5), 701; https://0-doi-org.brum.beds.ac.uk/10.3390/children9050701 - 10 May 2022
Cited by 7 | Viewed by 2281
Abstract
We investigated the relationship between parent-reported assessments and autism spectrum disorder (ASD) severity level. Parents evaluated 9573 children with ASD on five subscales—combinatorial receptive language, expressive language, sociability, sensory awareness, and health—using the Autism Treatment Evaluation Checklist (ATEC) and Mental Synthesis Evaluation Checklist [...] Read more.
We investigated the relationship between parent-reported assessments and autism spectrum disorder (ASD) severity level. Parents evaluated 9573 children with ASD on five subscales—combinatorial receptive language, expressive language, sociability, sensory awareness, and health—using the Autism Treatment Evaluation Checklist (ATEC) and Mental Synthesis Evaluation Checklist (MSEC). The scores in every subscale improved with age, and there were clear differences between the three diagnostic categories. The differences between mild and moderate ASD, and moderate and severe ASD reached statistical significance in each subscale and in every age group in children 3 years of age and older. These findings demonstrate a consistent relationship between children’s diagnoses and their assessments and provide evidence in support of the reliability of parent-report evaluations for ASD. Additionally, this is the first investigation of the relationship between ASD severity level and the ATEC/MSEC scores for the age range from 2 to 7 years. Full article
(This article belongs to the Special Issue Autism and Children)
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12 pages, 244 KiB  
Article
Autism Children and English Vocabulary Learning: A Qualitative Inquiry of the Challenges They Face in Their English Vocabulary Learning Journey
by Haida Umiera Hashim, Melor Md Yunus and Helmi Norman
Children 2022, 9(5), 628; https://doi.org/10.3390/children9050628 - 28 Apr 2022
Cited by 2 | Viewed by 3333
Abstract
Language learning is one of the most important aspects of an individual’s life development and growth. Normal learners’ English language acquisition differs depending on their preferences and learning styles. Children with autism, on the other hand, appear to have different learning methods and [...] Read more.
Language learning is one of the most important aspects of an individual’s life development and growth. Normal learners’ English language acquisition differs depending on their preferences and learning styles. Children with autism, on the other hand, appear to have different learning methods and routines. There has been a lot of previous work on the language learning styles of normal learners, but not much on the language learning path of children with autism. Due to that, this study aims at investigating the challenges children with autism face in their English vocabulary learning. Observations and focus group discussions were conducted with 45 children with autism, 4 autism education teachers, 2 occupational therapists and a parent of children with mild autism children to investigate the challenges autism children face in their vocabulary learning. The findings have gathered that autistic children encounter a few challenges occasionally in their English vocabulary learning journey. The data were gathered and arranged thematically. Further recommendations and suggestions are discussed in this study. Full article
(This article belongs to the Special Issue Autism and Children)
11 pages, 937 KiB  
Article
Joint Attention and Its Relationship with Autism Risk Markers at 18 Months of Age
by Maite Montagut-Asunción, Sarah Crespo-Martín, Gemma Pastor-Cerezuela and Ana D’Ocon-Giménez
Children 2022, 9(4), 556; https://0-doi-org.brum.beds.ac.uk/10.3390/children9040556 - 13 Apr 2022
Cited by 5 | Viewed by 2591
Abstract
(1) Joint attention is the ability to coordinate attention to share a point of reference with another person. It has an early onset and is a clear indicator of understanding the representations of others, and it is essential in the development of symbolic [...] Read more.
(1) Joint attention is the ability to coordinate attention to share a point of reference with another person. It has an early onset and is a clear indicator of understanding the representations of others, and it is essential in the development of symbolic thought and the acquisition of language. Deficiencies in this prelinguistic early communication skill are strong markers of the risk of autism spectrum disorder (ASD); (2) this longitudinal study aimed to evaluate joint attention skills in a group of 32 infants at two developmental moments (8 and 12 months) in order to explore whether their performance on this skill was related to the presence of early signs of ASD at 18 months. Logistic multiple regressions were carried out for the data analysis; (3) results of the analysis showed that the variables of initiating joint attention at 8 months and responding to joint attention at 12 months were linked to the risk of ASD at 18 months of age; (4) in conclusion, early joint attention skills had a pivotal role in defining early manifestations of ASD. Full article
(This article belongs to the Special Issue Autism and Children)
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7 pages, 210 KiB  
Article
Oral Health Preventive Program in Patients with Autism Spectrum Disorder
by Elisabetta Carli, Marco Pasini, Francesca Pardossi, Isabella Capotosti, Antonio Narzisi and Lisa Lardani
Children 2022, 9(4), 535; https://0-doi-org.brum.beds.ac.uk/10.3390/children9040535 - 10 Apr 2022
Cited by 15 | Viewed by 2701
Abstract
The aim of the study was to evaluate clinical hygienic parameters, patient collaboration, and dental habits in patients with ASD (autism spectrum disorder) before and after a tailored prevention program. A total of 100 patients (78 males and 22 females, mean age 8 [...] Read more.
The aim of the study was to evaluate clinical hygienic parameters, patient collaboration, and dental habits in patients with ASD (autism spectrum disorder) before and after a tailored prevention program. A total of 100 patients (78 males and 22 females, mean age 8 ± 0.7 years old) was recruited, with ages ranging from 7 to 16 years old, and diagnoses of ASD. We evaluated the plaque index (IP), gingival index (IG), the dmft/DMFT, the frequency of tooth brushing, and the frequency of snacks for each patient. Patient behaviour was evaluated with the Frankl scale, and each patient was individually reassessed after five visits from the first one by the same operator. The t test was used to compare the parameters before and after the inclusion in the dedicated dental pathway. From T1 to T2 we found a significant improvement of the IP (p < 0.001), IG (p < 0.001), and the frequency of tooth brushing (p < 0.001). Concerning the frequency of snacks and the parameter dmft/DMFT, the differences in the observed averages were not significant (p > 0.05). The difference in collaboration between T1 and T2 evaluated by the Frankl scale was statistically significant (p < 0.001). It was found that the prevention program allowed a significant improvement in both clinical parameters and patient behaviour. The personalized digital supports can have a key role for success in familiarization and desensitization processes of patients affected by ASD, leading an increase in their collaboration. Full article
(This article belongs to the Special Issue Autism and Children)
9 pages, 5538 KiB  
Article
Quantitative Assessment of Sensory Integration and Balance in Children with Autism Spectrum Disorders: Cross-Sectional Study
by Mohamed A. Abdel Ghafar, Osama R. Abdelraouf, Abdelgalil A. Abdelgalil, Mohamed K. Seyam, Rafik E. Radwan and Amira E. El-Bagalaty
Children 2022, 9(3), 353; https://0-doi-org.brum.beds.ac.uk/10.3390/children9030353 - 03 Mar 2022
Cited by 10 | Viewed by 6397
Abstract
Postural stability is dependent on the interpretation of external inputs acquired by sensory information processes, such as visual, vestibular, and proprioceptive systems, in order to accomplish neuromuscular control, balance maintenance, and appropriate motor response. A defect in any of these systems, or in [...] Read more.
Postural stability is dependent on the interpretation of external inputs acquired by sensory information processes, such as visual, vestibular, and proprioceptive systems, in order to accomplish neuromuscular control, balance maintenance, and appropriate motor response. A defect in any of these systems, or in the integration of information given by these systems, might threaten their capacity to maintain balance. Therefore, the purpose of this study was to investigate the sensory integration and balance using the Biodex balance system (BBS) in children with autism spectrum disorder (ASD) during the static posture. Seventy-four children from both sexes, 38 with ASD matched with 36 typically developed (TD) children as a control group, were included in the study. Using the Biodex balance system, the postural sway was evaluated through the modified Clinical Test of Sensory Integration and Balance (m-CTSIB) during quiet standing. In this test, four different situations were considered from standing position: eyes open/firm surface, eyes closed/firm surface, eyes open/foam surface, and eyes closed/foam surface. ASD children showed a significant increase in postural sway under all tested conditions when compared to the TD children group, especially for the conditions in which visual and somatosensory inputs were disrupted (p-value < 0.05). These results provide evidence that postural stability decreased in ASD children. Under static postural challenges, the current study’s findings imply that children diagnosed with ASD have postural control deficiencies, especially for the conditions in which visual and somatosensory input was disrupted. Further research must be conducted to find the best balance training program for ASD cases using the Biodex balance system and considering its impact on motor skills. Full article
(This article belongs to the Special Issue Autism and Children)
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20 pages, 338 KiB  
Article
Assessment of Public Special Education Teachers Training Needs on Evidence-Based Practice for Students with Autism Spectrum Disorders in Spain
by Aitor Larraceleta, Luis Castejón, María-Teresa Iglesias-García and José Carlos Núñez
Children 2022, 9(1), 83; https://0-doi-org.brum.beds.ac.uk/10.3390/children9010083 - 06 Jan 2022
Cited by 4 | Viewed by 4481
Abstract
Over decades, the concern for the quality of psychoeducational practices for students with autism spectrum disorders has led to study to what extent are evidence-based educational methods disseminated among teachers. The purpose of this cross-sectional study, taking as reference Hsiao and Sorensen’s previous [...] Read more.
Over decades, the concern for the quality of psychoeducational practices for students with autism spectrum disorders has led to study to what extent are evidence-based educational methods disseminated among teachers. The purpose of this cross-sectional study, taking as reference Hsiao and Sorensen’s previous research, was to identify through a survey to what extent social-communication evidence-based practices for these students were provided in teacher education and in-service training programs, in a sample of 108 special education teachers from Spain, and to compare these results with Hsiao and Sorensen’s. Overall, more than 70% of the teachers reported that evidence-based practices in their teacher education programs (87.6%) and in-service training programs (73.6%) were never taught or mentioned incidentally. Finally, a higher percentage of addressing on each practice (i.e., mentioned and discussed or mentioned and taught through direct instruction) is shown in the sample of American teachers compared to the Spaniards, in both training paths. Full article
(This article belongs to the Special Issue Autism and Children)
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16 pages, 400 KiB  
Article
Parents’ Experience in Children’s Friendship Training Programme for Their Children with Autism Spectrum Disorder: A Qualitative Inquiry
by Sing Yee Ong, Samsilah Roslan, Nor Aniza Ahmad, Ahmad Fauzi Mohd Ayub, Lee Ping Chen and Sahar Mohammed Taresh
Children 2021, 8(9), 763; https://0-doi-org.brum.beds.ac.uk/10.3390/children8090763 - 31 Aug 2021
Cited by 2 | Viewed by 2349
Abstract
Background: Children’s Friendship Training (CFT) is a parent-assisted intervention programme that introduces children to basic sets of social rules to help them understand social contexts with specific guidance from their parents. It has been reported in several empirical studies that the friendship skills [...] Read more.
Background: Children’s Friendship Training (CFT) is a parent-assisted intervention programme that introduces children to basic sets of social rules to help them understand social contexts with specific guidance from their parents. It has been reported in several empirical studies that the friendship skills of children with autism spectrum disorder were enhanced after participating in CFT. However, previous studies only focused on the effectiveness of the training without exploring it from the parent’s perspective. As such, the objective of this study is to highlight the parents’ experience in assisting in the implementation of CFT. Purpose: To explore the parents’ experiences with autism spectrum disorder (ASD) in CFT and examine the experiences using the CFT as a theoretical framework. Methodology: In this study, eight parents and their school-aged children with ASD participated in 12 CFT sessions. Upon completing the CFT, the parents participated in a focus group interview. The interview session was video recorded and transcribed with the parents’ consent. Thematic analysis was employed in analysing the collected data as outlined in six different phases. Results: The generated data revealed the similarities and differences in parents’ experiences in the CFT. The current study has identified four main themes: (1) fear and resistance; (2) awareness, learning, and adjustment; (3) change is hard; and (4) identifying support. Conclusions: The findings highlighted the processes that these parents experienced and encountered while attending the CFT programme, it is important to consider these processes based on how they might impact the effectiveness of the programme. The programme’s effectiveness is reliant on the ability to work closely with parents to understand their challenges and explore the type of support they need. This study has analysed the crucial factors that provide an overview of parents’ encounters in their participation in CFT. Full article
(This article belongs to the Special Issue Autism and Children)
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11 pages, 1797 KiB  
Article
Dysregulation of Ki-67 Expression in T Cells of Children with Autism Spectrum Disorder
by Khaled Alhosaini, Mushtaq A. Ansari, Ahmed Nadeem, Sabry M. Attia, Saleh A. Bakheet, Laila Y. Al-Ayadhi, Hafiz M. Mahmood, Haneen A. Al-Mazroua and Sheikh F. Ahmad
Children 2021, 8(2), 116; https://0-doi-org.brum.beds.ac.uk/10.3390/children8020116 - 06 Feb 2021
Cited by 7 | Viewed by 3007
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral abnormalities such as impairments in social function and deficits in communication. The etiology of autism is unknown in most cases, but many studies have pointed towards the immune system as a causative [...] Read more.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral abnormalities such as impairments in social function and deficits in communication. The etiology of autism is unknown in most cases, but many studies have pointed towards the immune system as a causative agent in autism. Specific studies implicated lymphocytes, natural killer (NK) cells, monocytes, cytokines, and specific transcription factors in the development of ASD. The protein Ki-67 is n expressed in the proliferating cells and is used as a tool in several disorders. Ki-67 plays a crucial role in many neurological diseases. However, Ki-67 role in ASD is not fully understood. In this study, we investigated the possible role of Ki-67 expression in autistic children. We compared Ki-67 production in CD3+, CD4+, CD8+, CXCR4+, CXCR7+, CD45R+, HLA-DR+, GATA3+, Helios+, and FOXP3+ peripheral blood mononuclear cells (PBMCs) in autistic children to typically developing (TD) controls using immunofluorescence staining. We also determined Ki-67 mRNA levels in PBMCs using RT–PCR. The results revealed that autistic children had significantly increased numbers of CD3+Ki-67+, CD4+Ki-67+, CD8+Ki-67+, CXCR4+Ki-67+, CXCR7+Ki-67+, CD45R+Ki-67+, HLA-DR+Ki-67+, CXCR4+GATA3+, GATA3+Ki-67+ cells and decreased Helios+Ki-67+ and FOXP3+Ki-67+ cells compared with TD controls. In addition, the autistic children showed upregulation of Ki-67 mRNA levels compared with TD controls. Further studies need to be carried out to assess the exact role of Ki-67 and its therapeutic potential in ASD. Full article
(This article belongs to the Special Issue Autism and Children)
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Review

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24 pages, 945 KiB  
Review
Scoping Review on Play-Based Interventions in Autism Spectrum Disorder
by Lucía López-Nieto, Laura María Compañ-Gabucio, Laura Torres-Collado and Manuela Garcia-de la Hera
Children 2022, 9(9), 1355; https://0-doi-org.brum.beds.ac.uk/10.3390/children9091355 - 05 Sep 2022
Cited by 5 | Viewed by 3392
Abstract
Play as a therapeutic strategy can help to improve daily functioning in children and adolescents with autism spectrum disorder (ASD). Play-based intervention can thus be an optimal option for treatment of this population. Our aim was to describe play-based interventions used in children [...] Read more.
Play as a therapeutic strategy can help to improve daily functioning in children and adolescents with autism spectrum disorder (ASD). Play-based intervention can thus be an optimal option for treatment of this population. Our aim was to describe play-based interventions used in children and adolescents with ASD. We conducted a scoping review. A peer-reviewed literature search was conducted on PubMed, Scopus, EMBASE, Web of Science and PsycINFO databases. We included experimental studies which analyzed play-based interventions in children and adolescents with ASD, which were published in English/Spanish with full text available. We used three tables elaborated a priori to perform data extraction by two authors. Fifteen studies were included, mostly conducted in Australia and published during the past 10 years. Play-based intervention was categorized into three groups: new technologies, symbolic play or official techniques. Interventions lasted approximately 11 weeks, contained one weekly session of 30–60 min and were delivered by parents and teachers. Play-based interventions using new technologies were the most used. Intervention duration and number of sessions varied between articles. Further studies are needed to create play-based intervention protocols which can be implemented in clinical practice with children and adolescents with ASD, thus promoting evidence-based interventions in this field. Full article
(This article belongs to the Special Issue Autism and Children)
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14 pages, 2733 KiB  
Review
Social Humanoid Robots for Children with Autism Spectrum Disorders: A Review of Modalities, Indications, and Pitfalls
by Alfio Puglisi, Tindara Caprì, Loris Pignolo, Stefania Gismondo, Paola Chilà, Roberta Minutoli, Flavia Marino, Chiara Failla, Antonino Andrea Arnao, Gennaro Tartarisco, Antonio Cerasa and Giovanni Pioggia
Children 2022, 9(7), 953; https://0-doi-org.brum.beds.ac.uk/10.3390/children9070953 - 25 Jun 2022
Cited by 17 | Viewed by 4224
Abstract
Robot-assisted therapy (RAT) is a promising area of translational neuroscience for children with autism spectrum disorders (ASDs). It has been widely demonstrated that this kind of advanced technological tool provides a reliable and efficient intervention for promoting social skills and communication in children [...] Read more.
Robot-assisted therapy (RAT) is a promising area of translational neuroscience for children with autism spectrum disorders (ASDs). It has been widely demonstrated that this kind of advanced technological tool provides a reliable and efficient intervention for promoting social skills and communication in children with ASD. This type of treatment consists of a human-assisted social robot acting as an intervention mediator to increase competence and skills in children with ASD. Several social robots have been validated in the literature; however, an explicit technical comparison among devices has never been performed. For this reason, in this article, we provide an overview of the main commercial humanoid robots employed for ASD children with an emphasis on indications for use, pitfalls to be avoided, and recent advances. We conclude that, in the near future, a new generation of devices with high levels of mobility, availability, safety, and acceptability should be designed for improving the complex triadic interaction among teachers, children, and robots. Full article
(This article belongs to the Special Issue Autism and Children)
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18 pages, 427 KiB  
Review
Early Motor Signs in Autism Spectrum Disorder
by Annio Posar and Paola Visconti
Children 2022, 9(2), 294; https://0-doi-org.brum.beds.ac.uk/10.3390/children9020294 - 21 Feb 2022
Cited by 17 | Viewed by 6283
Abstract
A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, [...] Read more.
A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, we aimed at performing an update about the available data on the early motor function in children with autism spectrum disorder. Early motor impairment in these children can manifest itself both as a mere delay of motor development and as the presence of atypicalities of motor function, such as a higher rate and a larger inventory, of stereotyped movements both with and without objects. In the perspective of a timely diagnosis, the presence of early motor signs can be an important clue, especially in an individual considered at high risk for autism. Motor and communication (both verbal and non-verbal) skills are connected and a pathogenetic role of early motor dysfunctions in the development of autism can be hypothesized. From this, derives the importance of an early enabling intervention aimed at improving motor skills, which could also have favorable effects on other aspects of development. Full article
(This article belongs to the Special Issue Autism and Children)
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19 pages, 647 KiB  
Review
The Implementation of Application Software to Improve Verbal Communication in Children with Autism Spectrum Disorder: A Review
by Marlyn Maseri, Mazlina Mamat, Hoe Tung Yew and Ali Chekima
Children 2021, 8(11), 1001; https://0-doi-org.brum.beds.ac.uk/10.3390/children8111001 - 03 Nov 2021
Cited by 3 | Viewed by 3012
Abstract
Autism-assistive apps offer therapists and caregivers new approaches for educating and assisting individuals with autism spectrum disorder (ASD), mainly in social interaction. Even though these apps are deemed effective, they are not. These autism-assistive apps are not highly customizable, which limits their usefulness. [...] Read more.
Autism-assistive apps offer therapists and caregivers new approaches for educating and assisting individuals with autism spectrum disorder (ASD), mainly in social interaction. Even though these apps are deemed effective, they are not. These autism-assistive apps are not highly customizable, which limits their usefulness. This article examined the application software that was applied to encourage verbal communication in the intervention for children with ASD. The aim was to determine the minimum requirements for a verbal communication intervention app that adequately satisfies children with ASD, caregivers, and therapists. Databases were searched, including Scopus, Springer, PubMed, Education Resources Information Centre, and Google Scholar, with the following free-text terms combining Boolean operators: autism, children, intervention, verbal communication, software, app, and technology. A total of fifteen studies were found relevant, and the following information was collected: participant characteristics, information on the devices and apps, target behaviors, intervention procedures, and intervention outcomes. The findings suggest that the autism-assistive apps effectively improve verbal communication of children with ASD. For that, the apps should be attractive and engaging to the children with ASD, able to identify the child’s capability and suggest appropriate lesson activities, as well as encompass specific learning outcomes with multilevel lesson strategy. The apps should also use systematic evidence-based intervention procedures in the activities, be able to evaluate the child’s learning progress, and allow caregivers or therapists to keep track of application usage and performance. The use of apps in intervention does provide many benefits. However, they should never replace qualified therapists. App-based interventions make home-based treatment more focused, systematic, and economical. Full article
(This article belongs to the Special Issue Autism and Children)
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7 pages, 253 KiB  
Perspective
Research-Based Intervention (RBI) for Autism Spectrum Disorder: Looking beyond Traditional Models and Outcome Measures for Clinical Trials
by Antonio Narzisi, Yurena Alonso-Esteban, Gabriele Masi and Francisco Alcantud-Marín
Children 2022, 9(3), 430; https://0-doi-org.brum.beds.ac.uk/10.3390/children9030430 - 18 Mar 2022
Cited by 3 | Viewed by 2559
Abstract
The rising prevalence of Autism Spectrum Disorders (ASD) has led to a quickly increasing need for effective interventions. Several criteria and measures have been developed to critically assess these interventions with particular focus on the evaluation of the efficacy. Given the huge diversity [...] Read more.
The rising prevalence of Autism Spectrum Disorders (ASD) has led to a quickly increasing need for effective interventions. Several criteria and measures have been developed to critically assess these interventions with particular focus on the evaluation of the efficacy. Given the huge diversity of ASD symptoms and the different levels of severity across individuals, identifying a one size fits all intervention approach is challenging, and the question What works and for whom? Remains still unanswered. Why do we seem to be dragging our feet on this fundamental issue? The main aim of this paper is to answer this question through four non-alternative points. First, there are a scarce number of studies with a solid methodology. Secondly, most trials on intervention efficacy for ASD are designed exclusively in terms of behavioral outcomes. Thirdly, there is a reduced use of biologically oriented outcome measures. Fourthly, in most clinical trials, appropriate practices emerging from research evidence are not systematically applied. A strong effort to improve the methodology of clinical trials is mandatory for the future of autism research. The development of a research-based intervention (RBI) perspective aimed at better integrating: (a) evidence-based approaches; (b) more sensitive behavioral outcome measures; and (c) biomarkers, with the aim of increasing a more detailed clustering of phenotypes, may strongly improve our approach to a precision medicine. Full article
(This article belongs to the Special Issue Autism and Children)
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