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Advances in Autism Research: Diagnosis, Treatment and Best Practices

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

Deadline for manuscript submissions: closed (10 May 2023) | Viewed by 21222

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Special Issue Editors

Dr. Raffaella Devescovi

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Guest Editor

Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
Interests: autism spectrum disorder; screening; early detection

Dr. Antonio Narzisi

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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

Special Issue Information

Dear Colleagues,

Autism spectrum disorders (ASDs) are heterogeneous neurodevelopmental disorders characterized by impairments in social interaction and communication, as well as by the presence of repetitive patterns of interests and behaviors.

The number of children diagnosed with ASD has steadily increased over the last two decades, as too has the body of literature.

The goal of this Special Issue of Children is to give broad attention to the most recent advances in autism research, including the diagnostic processes, the effectiveness and feasibility of evidence-based treatments, and best practices in caregiving for children and their families.

Authors are encouraged to submit cutting-edge research and reviews. In particular, we aim to present advances in the field of autism that could have a significant impact on clinical services.

Dr. Raffaella Devescovi
Dr. Antonio Narzisi
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 Spectrum Disorders
Neurodevelopmental Disorders
Autism Intervention
Best practices
Children
Diagnoses

Published Papers (10 papers)

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Research

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12 pages, 1192 KiB

Open AccessArticle

Intervention Based on Psychomotor Rehabilitation in Children with Autism Spectrum Disorder ASD: Effect on Postural Control and Sensory Integration

by Imen Ben Hassen, Rihab Abid, Fatma Ben Waer, Liwa Masmoudi, Sonia Sahli, Tarak Driss and Omar Hammouda

Children 2023, 10(9), 1480; https://0-doi-org.brum.beds.ac.uk/10.3390/children10091480 - 30 Aug 2023

Viewed by 2106

Abstract

Postural stability and control are essential motor skills for successfully performing various activities of daily living. However, children with autism spectrum disorder (ASD) exhibit significant sensorimotor impairments. The aim of this study was to investigate the efficacy of psychomotricity training on postural control (PC) of children with ASD. We recruited thirty children (age = 8.01 ± 1.2; weight = 31.66 ± 8.1 kg; height = 129.7 ± 10.8 cm) diagnosed with ASD (intellectual quotient > 50) to participate in this study. They were divided into two groups: the experimental group (n = 16) and control group (n = 14). Children in the experimental group were trained with psychomotor activities two times a week for nine weeks. Statistic postural balance was assessed before and after intervention and on different vision conditions. The results showed that the psychomotor training significantly improved PC in standing position under different conditions when compared to the control group, in all parameters (CoP_A; CoP_LX; CoP_Ly) (p < 0.01). Our preliminary findings suggest the usefulness of the psychomotor training in children with ASD on static PC. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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11 pages, 565 KiB

Open AccessArticle

Short-Term Outcomes of an ESDM Intervention in Italian Children with Autism Spectrum Disorder following the COVID-19 Lockdown

by Raffaella Devescovi, Giulia Bresciani, Vissia Colonna, Marco Carrozzi, Andrea Dissegna, Maria Antonella Celea, Devid Cescon, Sara Frisari, Marcella Guerrieri, Francesca Placer, Monica Stocchi, Chiara Terpini and Costanza Colombi

Children 2023, 10(4), 691; https://0-doi-org.brum.beds.ac.uk/10.3390/children10040691 - 06 Apr 2023

Cited by 2 | Viewed by 1989

Abstract

The COVID-19 pandemic caused a temporary lockdown period in Italy, during which the delivery of in-person treatment for children with autism spectrum disorder (ASD) in public health services was discontinued. This occurrence represented a crucial challenge for both families and professionals. We assessed the short-term outcomes of a sample of 18 children who received an early intervention with the Early Start Denver Model (ESDM), delivered at low intensity over one year in the pre-pandemic period, after six months of interruption of in-presence treatment due to lockdown restrictions. Children who received the ESDM treatment maintained their gains in sociocommunicative skills and did not exhibit any developmental regression. Additionally, there was evidence of a decrease in the restrictive and repetitive behavior (RRB) domain. The parents, who were already familiar with the principles of the ESDM, only received telehealth support from therapists that aimed to sustain the gains already achieved. We believe that it is always helpful to support parents in their daily lives by implementing interactional and play skills with their children to integrate and consolidate the results obtained in the individual interventions conducted by experienced therapists. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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11 pages, 421 KiB

Open AccessArticle

Neuroactive Amino Acid Profile in Autism Spectrum Disorder: Results from a Clinical Sample

by Martina Randazzo, Adriana Prato, MariaAnna Messina, Concetta Meli, Antonino Casabona, Renata Rizzo and Rita Barone

Children 2023, 10(2), 412; https://0-doi-org.brum.beds.ac.uk/10.3390/children10020412 - 20 Feb 2023

Cited by 6 | Viewed by 2490

Abstract

Biological bases of autism spectrum disorder (ASD) include both genetic and epigenetic causes. Patients with ASD show anomalies in the profile of certain plasma amino acids, including neuroactive amino acids. Monitoring plasma amino acids may be relevant for patient care and interventions. We evaluated the plasma amino acid profile in samples extracted from dry blood spots by electrospray ionization-tandem mass spectrometry. Fourteen amino acids and eleven amino acid ratios were examined in patients with ASD and intellectual disability (ID), and neurotypical control subjects (TD). The amino acid profile in the ASD group showed reduced levels of ornithine (p = 0.008), phenylalanine (p = 0.042) and tyrosine (p = 0.013). The statistically significant amino acid ratios were Leu+Val/Phe+Tyr (p = 0.002), Tyr/Leu (p = 0.007) and Val/Phe (p = 0.028), such differences remaining significant only in the comparison between ASD and TD. Finally, a positive correlation emerged between the score of the restricted and repetitive behavior on ADOS-2 and the citrulline levels in the ASD group (p = 0.0047). To conclude, patients with ASD may show a distinguishable metabolic profile useful for studying their metabolic pathways in order to develop screening tests and targeted therapies. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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13 pages, 968 KiB

Open AccessArticle

Gastrointestinal Disorders and Food Selectivity: Relationship with Sleep and Challenging Behavior in Children with Autism Spectrum Disorder

by Giulia Bresciani, Prisca Da Lozzo, Sara Lega, Matteo Bramuzzo, Grazia Di Leo, Andrea Dissegna, Vissia Colonna, Egidio Barbi, Marco Carrozzi and Raffaella Devescovi

Children 2023, 10(2), 253; https://0-doi-org.brum.beds.ac.uk/10.3390/children10020253 - 30 Jan 2023

Cited by 4 | Viewed by 2663

Abstract

The aim of this study was to evaluate the interaction between gastrointestinal (GI) disorders, sleep problems, and challenging behaviors in children with a diagnosis of Autism Spectrum Disorder (ASD) and their effect on parental stress. The secondary objective was to assess the frequency and type of GI and feeding disorders in a sample of children with ASD through a multidisciplinary assessment and, finally, to investigate families’ perceptions and satisfaction with the proposed multidisciplinary approach. All children underwent a comprehensive gastroenterological and neuropsychiatric evaluation supported by standardized questionnaires. Pediatric gastroenterologists, specifically trained in Applied Behavior Analysis (ABA), provided advice for parent-delivered behavioral intervention for food selectivity. Thirty-six children with an autism diagnosis (29 males, age 4.5 +/−2.2 years, mean +/− SD) were enrolled. A positive correlation between sleep problems and aggressive behavior was found, and this association was stronger in children experiencing more problematic mealtime behaviors (b = 0.788, p = 0.014). Sleep difficulties were associated with stereotyped behaviors and parent-perceived stress. Parents interviewed about the gastroenterology visit perceived this multidisciplinary approach as helpful in addressing food selectivity. This study shows that sleep and mealtime issues can have a synergistic negative impact on ASD symptoms. A multidisciplinary approach and an integrated assessment of GI, feeding problems, and sleep disorders could be helpful in diagnosing comorbidities and to provide targeted advice to parents. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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10 pages, 600 KiB

Open AccessArticle

Food Neophobia in Children with Autistic Spectrum Disorder (ASD): A Nationwide Study in Brazil

by Priscila Claudino de Almeida, Renata Puppin Zandonadi, Eduardo Yoshio Nakano, Ivana Aragão Lira Vasconcelos and Raquel Braz Assunção Botelho

Children 2022, 9(12), 1907; https://0-doi-org.brum.beds.ac.uk/10.3390/children9121907 - 06 Dec 2022

Cited by 2 | Viewed by 1609

Abstract

Food neophobia (FN) is common among children with autistic spectrum disorder (ASD), potentially impairing their health and diet quality. This study aimed to investigate and classify the prevalence of FN among 4-to-11-year-old Brazilian children with ASD. This descriptive cross-sectional study was performed by applying online a validated instrument to identify FN in Brazilian children with ASD through their caregivers’ responses for a national prevalence of FN in this group. The final sample included 593 children with ASD, 80.1% of boys, with a mean age of 6.72 ± 2.31 years, and 83% having only ASD. Almost 75% (n = 436) of the children with ASD had high food neophobia scores. The fruit neophobia domain had the lowest prevalence of high neophobia (63.7%). No significant difference in FN (total, fruit, and vegetable domains) was found, considering gender and age. There was no statistical difference in FN (all domains) by the number of residents in the same household, income, or the caregivers’ educational level. FN did not decrease in older children with ASD. FN is a more complex problem, requiring a multidisciplinary trained team to face the problem. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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11 pages, 289 KiB

Open AccessArticle

Video-Feedback Approach Improves Parental Compliance to Early Behavioral Interventions in Children with Autism Spectrum Disorders during the COVID-19 Pandemic: A Pilot Investigation

by Stefania Aiello, Elisa Leonardi, Antonio Cerasa, Rocco Servidio, Francesca Isabella Famà, Cristina Carrozza, Agrippina Campisi, Flavia Marino, Renato Scifo, Sabrina Baieli, Flavio Corpina, Gennaro Tartarisco, David Vagni, Giovanni Pioggia and Liliana Ruta

Children 2022, 9(11), 1710; https://0-doi-org.brum.beds.ac.uk/10.3390/children9111710 - 08 Nov 2022

Cited by 1 | Viewed by 1494

Abstract

In the field of autism intervention, a large amount of evidence has demonstrated that parent-mediated interventions are effective in promoting a child’s learning and parent caring skills. Furthermore, remote delivery treatments are feasible and can represent a promising opportunity to reach families at distance with positive results. Recently, the sudden outbreak of COVID-19 dramatically disrupted intervention services for autism and forced an immediate reorganization of the territory services toward tele-assisted intervention programs, according to professional and local resources. Our study aimed to conduct a retrospective pilot exploratory investigation on parental compliance, participation, and satisfaction in relation to three different telehealth intervention modalities, such as video feedback, live streaming, and psychoeducation, implemented in the context of a public community setting delivering early autism intervention during the COVID-19 emergency. We found that parents who attended video feedback expressed the highest rate of compliance and participation, while parental psychoeducation showed significantly lower compliance and the highest drop-out rate. Regardless of the tele-assistance modality, all the participants expressed satisfaction with the telehealth experience, finding it useful and effective. Potential benefits and advantages of different remote modalities with reference to parent involvement and effectiveness are important aspects to be taken into account and should be further investigated in future studies. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

13 pages, 734 KiB

Open AccessArticle

The Impact of a Rater Training Program on the TGMD-3 Scoring Accuracy of Pre-Service Adapted Physical Education Teachers

by Hyunjin Kwon and Hyokju Maeng

Children 2022, 9(6), 881; https://0-doi-org.brum.beds.ac.uk/10.3390/children9060881 - 13 Jun 2022

Cited by 7 | Viewed by 1923

Abstract

This study aimed to examine the impact of a TGMD-3 rater training program on pre-service adapted physical education (APE) teachers’ ability to score fundamental motor skills for children with developmental disabilities (DD). The training program consisted of a description of the TGMD-3 instrument and DD, as well as content focused on skill performance and correct scoring through systematic analysis of 13 FMS via the instrument. Three experts established the standard score through the TGMD-3 performance evaluation of a child with DD. Thirty-nine pre-service APE teachers in the experimental group and 30 pre-service teachers in the control group completed the pre- and post-test process in this study. There were significant impacts on the pre-service teachers’ ability to score the locomotor, ball skill subtests, and total skill scores (p < 0.05) compared to the control group. Specifically, the results of the three locomotor skills (running, horizontal jump, & slide) and three ball skills (two-hand strike, dribble, & kick) significantly improved in scoring accuracy. The results of this study can evidence that a TGMD-3 rater training program for pre-service APE teachers enhances the scoring accuracy of FMS among children with DD. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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Review

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13 pages, 802 KiB

Open AccessReview

Genus-Level Analysis of Gut Microbiota in Children with Autism Spectrum Disorder: A Mini Review

by Mariya Levkova, Trifon Chervenkov and Rouzha Pancheva

Children 2023, 10(7), 1103; https://0-doi-org.brum.beds.ac.uk/10.3390/children10071103 - 23 Jun 2023

Cited by 1 | Viewed by 1597

Abstract

Autism is a global health problem, probably due to a combination of genetic and environmental factors. There is emerging data that the gut microbiome of autistic children differs from the one of typically developing children and it is important to know which bacterial genera may be related to autism. We searched different databases using specific keywords and inclusion criteria and identified the top ten bacterial genera from the selected articles that were significantly different between the studied patients and control subjects studied. A total of 34 studies that met the inclusion criteria were identified. The genera Bacteroides, Bifidobacterium, Clostridium, Coprococcus, Faecalibacterium, Lachnospira, Prevotella, Ruminococcus, Streptococcus, and Blautia exhibited the most substantial data indicating that their fluctuations in the gastrointestinal tract could be linked to the etiology of autism. It is probable that autism symptoms are influenced by both increased levels of harmful bacteria and decreased levels of beneficial bacteria. Interestingly, these genera demonstrated varying patterns of increased or decreased levels across different articles. To validate and eliminate the sources of this fluctuation, further research is needed. Consequently, future investigations on the causes of autism should prioritize the examination of the bacterial genera discussed in this publication. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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14 pages, 1262 KiB

Open AccessReview

The Healthcare Experience of Autistic Patients in Orthopaedic Surgery and Closely Related Fields: A Scoping Review

by Steven D. Criss, Shravya Kakulamarri, Raylin F. Xu, Maya Fajardo, Tamra Keeney, Dorothy W. Tolchin and Collin J. May

Children 2023, 10(5), 906; https://0-doi-org.brum.beds.ac.uk/10.3390/children10050906 - 22 May 2023

Viewed by 1757

Abstract

Orthopaedic and related care has the potential to present unique obstacles for patients with a range of autism manifestations. In this review, we aim to describe and analyze the literature on autistic patients’ experience within orthopaedics and closely related fields. This literature search utilized the PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature databases. Three major concepts were built into the search terms: (1) patients on the autism spectrum; (2) patient experience; and (3) movement sciences, including orthopaedics, physical medicine and rehabilitation (PM&R), occupational therapy (OT), and physical therapy (PT). Our search yielded 35 topical publications, with the major topic areas addressed as follows: (1) clinical and perioperative management, (2) therapy interventions, (3) participation in exercise and social play, (4) sensory management and accommodations, (5) caregiver/parent training and involvement in care, (6) healthcare needs and barriers to care, and (7) utilization of technology. In the current literature, there are no studies that attempt to directly assess autistic patient experience with care practices and clinical environments in orthopaedics. Rigorous, direct examination of the experience of autistic patients within clinical orthopaedic settings is urgently needed to address this gap. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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16 pages, 1076 KiB

Open AccessReview

Diagnostic Process for Autism Spectrum Disorder: A Meta-Analysis of Worldwide Clinical Practice Guidelines for the Initial Somatic Assessment

by Tom Dauchez, Guillaume Camelot, Charlotte Levy, Toky Rajerison, Kellen Briot, Adrien Pizano, Marie-Maude Geoffray, Loic Landrieu, Manuel Bouvard and Anouck Amestoy

Children 2022, 9(12), 1886; https://0-doi-org.brum.beds.ac.uk/10.3390/children9121886 - 01 Dec 2022

Cited by 1 | Viewed by 2424

Abstract

(1) Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is highly associated with various somatic conditions that can be masked by the core symptoms of ASD and thus complicate the diagnosis. Identifying co-occurring somatic disorders is critical for providing effective healthcare and social services for ASD populations and influences their long-term outcomes. A systematic assessment of co-occurring somatic conditions is essential during this ASD diagnostic process. Therefore, this study aimed to identify the organization and content of the initial somatic assessment (ISA). (2) Methods: We conducted a systematic review of the clinical practice guidelines (CPG) for the ASD diagnostic process published between January 2005 and December 2019 in English and French and performed an appraisal following the Appraisal of Guidelines Research and Evaluation, second edition (AGREE-II). (3) Results: We selected 14 CPGs that were heterogeneous in quality, with methodological scores between 32.3 and 91.9. Clinical examinations are the first step in the ISA, and the participation of pediatric, neuropediatric, and genetic specialists was highly recommended by the majority of the CPGs. The recommendations included hearing screening tests (10/14), visual examinations (8/14), and systematic genetic investigations (4/14). The CPGs also described additional investigations that should be conducted based on numerous warning signs. (4) Conclusions: Screening for consensual international warning signs is necessary to perform a comprehensive and systematic ISA during the ASD diagnostic process. A “referral form” could be used to guide clinicians and improve the coordination process. This tool may reinforce epidemiological data on co-occurring somatic disorders in patients with ASD. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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