RESUMO
Background: Cranio-facial anomalies frequently occur in neurodevelopmental disorders because both face and brain are derived from neuroectoderm. The identification of differences in the facial phenotype of children with Autism Spectrum Disorders (ASD) may reflect alterations in embryologic brain development in children with ASD. Methods: we evaluated 33 caucasian children with ASD using a 2D computerized photogrammetry. Anthropometric euclidean measurements and landmarks located on the soft tissue of the face and head, were based on five cranio-facial indexes. Relationships between anthropometric z-scores and participant characteristics (i.e., age, Global IQ, severity of autistic symptoms measured using the CARS checklist) were assessed. Results: Cephalic index z-score differed significantly from 0 in our ASD group (p = 0.019). Moreover, a significant negative correlation was found between Facial Index z-score and CARS score (p = 0.003); conversely, a positive correlation was found between Interchantal Index z-score and CARS score (p = 0.028). Conclusion: our measurements shows a dolichocephalic head shape which is not correlated with autism severity. Importantly, two craniofacial markers were significantly correlated with autism severity: increased orbital hyperthelorism and decrease of height of the facial midline. These data support previous findings of craniofacial anomalies in autism spectrum disorder suggesting an "ASD facial phenotype" that could be used to improve ASD diagnoses.
RESUMO
BACKGROUND: Duchenne muscular dystrophy (DMD) is the most frequent and severe form of the dystrophinopathies. The literature shows that about 30-40% of DMD subjects have intellectual disability. In males with Duchenne muscular dystrophy, neuropsychiatric disorders have also been observed: attention deficit disorder and hyperactivity, autism spectrum disorders, and obsessive-compulsive disorder. Duchenne muscular dystrophy is not just a muscle disorder, but also a disease that affects the brain. The aim of the present study was to describe a case series of children with Duchenne muscular dystrophy that have also the presence of autism spectrum disorders (ASDs). They have been assessed by means of standardized autism scales and the most appropriate psycho-educational treatment is herein discussed. METHODS: In order to evaluate and identify the presence and intensity of autistic symptoms have been used the Childhood Autism Rating Scale and Autism Diagnostic Observation Schedule tools. Moreover, in order to assess the intelligence of subjects and their lower limb function, Wisch-R intelligence scale and Vignos function scale were used, respectively. RESULTS: Atypical behaviors included a preference for being alone, and selective interest in privileged objects used in a stereotyped manner, motor fretting, and attention instability were present in all children. By the administration of these scales was confirmed the presence of an autism spectrum disorders in all subjects. CONCLUSIONS: It is important for clinical practice to consider this association increased.