Phenotypic characteristics and rehabilitation effect of children with regressive autism spectrum disorder: a prospective cohort study.

BACKGROUND: In this prospective cohort study, we determined the phenotypic characteristics of children with regressive autism spectrum disorder (ASD) and explored the effects of rehabilitation. METHODS: We recruited 370 children with ASD aged 1.5-7 years. Based on the Regression Supplement Form, the children were assigned to two groups: regressive and non-regressive. The core symptoms and neurodevelopmental levels of ASD were assessed before and after 1 year of behavioral intervention using the Autism Diagnostic Observation Schedule (ADOS), Social Response Scale (SRS), Children Autism Rating Scale (CARS), and Gesell Developmental Scale (GDS). RESULTS: Among the 370 children with ASD, 28.38% (105/370) experienced regression. Regression was primarily observed in social communication and language skills. Children with regressive ASD exhibited higher SRS and CARS scores and lower GDS scores than those with non-regressive ASD. After 1 year of behavioral intervention, the symptom scale scores significantly decreased for all children with ASD; however, a lesser degree of improvement was observed in children with regressive ASD than in those with non-regressive ASD. In addition, the symptom scores of children with regressive ASD below 4 years old significantly decreased, whereas the scores of those over 4 years old did not significantly improve. Children with regressive ASD showed higher core symptom scores and lower neurodevelopmental levels. Nevertheless, after behavioral intervention, some symptoms exhibited significant improvements in children with regressive ASD under 4 years of age. CONCLUSION: Early intervention should be considered for children with ASD, particularly for those with regressive ASD.

Sex/gender differences in children with autism spectrum disorder: A brief overview on epidemiology, symptom profile, and neuroanatomy.

Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental conditions whose shared core features are impairments in social interaction and communication as well as restricted patterns of behavior, interests, and activities. The significant and consistent male preponderance in ASD prevalence has historically affected the scientific knowledge of autism in females as regards, inter alia, the clinical presentation, the genetic architecture, and the structural brain underpinnings. Indeed, females with ASD are under-investigated as samples recruited for clinical research typically reflect the strong male bias of the disorder. In the last years, the study of the various aspects of sex/gender (s/g) differences in ASD is gaining increased clinical and research interest resulting in a growing number of investigations on this topic. Here, I review and discuss evidence emerged from epidemiological, clinical, and neuroimaging studies in the last decade focusing on s/g differences in children with ASD. These studies are the prerequisites for the development of assessment and treatment practices which take into consideration s/g differences in ASD. Ultimately, a better understanding of s/g differences aims at improving healthcare for both ASD males and females.

Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study.

BACKGROUND: Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. Our goal was to examine the type of symptom clusters of older maintenance hemodialysis patients during dialysis and construct a symptom network to understand the symptom characteristics of this population. METHODS: The modified Dialysis Symptom Index was used for a cross-sectional survey. Network analysis was used to analyze the symptom network and node characteristics, and factor analysis was used to examine symptom clusters. RESULTS: A total of 167 participants were included in this study. The participants included 111 men and 56 women with a mean age of 70.05 ± 7.40. The symptom burdens with the highest scores were dry skin, dry mouth, itching, and trouble staying asleep. Five symptom clusters were obtained from exploratory factor analysis, of which the clusters with the most severe symptom burdens were the gastrointestinal discomfort symptom cluster, sleep disorder symptom cluster, skin discomfort symptom cluster, and mood symptom cluster. Based on centrality markers, it could be seen that feeling nervous and trouble staying asleep had the highest strength, and feeling nervous and feeling irritable had the highest closeness and betweenness. CONCLUSIONS: Hemodialysis patients have a severe symptom burden and multiple symptom clusters. Dry skin, itching, and dry mouth are sentinel symptoms in the network model; feeling nervous and trouble staying asleep are core symptoms of patients; feeling nervous and feeling irritable are bridge symptoms in this symptom network model. Clinical staff can formulate precise and efficient symptom management protocols for patients by using the synergistic effects of symptoms in the symptom clusters based on sentinel symptoms, core symptoms, and bridge symptoms.

Correlations between sleep problems, core symptoms, and behavioral problems in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis.

Children and adolescents with autism spectrum disorder (ASD) experience various sleep problems. Sleep problems co-occur in a bidirectional relationship with ASD core symptoms and behavioral problems. However, studies on how these three factors are intricately linked to each other are limited. This meta-analysis examined the differential relationship between specific sleep problems, core symptoms, and behavioral problems in this population. This study was registered in PROSPERO (CRD42022339695). We systematically searched the PubMed/MEDLINE, Web of Science, and Scopus databases from inception to April 27, 2022. Observational studies that reported correlations between measures of sleep problems, ASD core symptoms, or ASD behavioral problems were included, and participants aged 18 years or below were enrolled. The correlation coefficient (r) was assessed as the primary effect metric. Total 22 cross-sectional studies were included, which comprised 2655 participants (mean age = 6.60 years old; mean percentage of boys = 80.64%). We found correlations between total sleep problems and total core symptoms (r 0.293 [95% confidence interval - 0.095 to 0.604]), total sleep problems and total behavioral problems (r 0.429 [0.299-0.544]), and total core symptoms and total behavioral problems (r - 0.050 [- 0.177 to 0.079]) and identified statistically significant correlations between specific components of sleep problems, ASD core symptoms, and ASD behavioral problems. Each specific sleep problem showed a unique association with core symptoms and behavioral problems. Sleep problems in ASD should be explored in detail, and the closely linked core symptoms and behavioral problems should be common therapeutic targets.

The effect of vitamin D supplementation in treatment of children with autism spectrum disorder: a systematic review and meta-analysis of randomized controlled trials.

Objective: The effect of vitamin D supplementation on the risk of Autism Spectrum Disorder (ASD) is conflicting. The aim of this study was to estimate the efficacy of vitamin D supplementation on ASD in children.Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) in which vitamin D supplementation was used as a therapy in children with ASD. The PubMed, PsychINFO, Cochrane CENTRAL library, Web of Science, and Cinahl databases were searched from inception to March 20, 2019, for all publications on vitamin D and ASD with no restrictions. Studies involving individuals aged <18 years diagnosed with ASD and with all functional outcomes assessed by measurement scales for ASD were included. Mean differences were pooled, and a meta-analysis was performed using a random-effects model due to differences between the individual RCTs.Results: There were five RCTs with 349 children with ASD in the review, of which three RCTs were included in the meta-analysis. Vitamin D supplementation indicated a small but significant improvement in hyperactivity scores (pooled MD: -3.20; 95% CI: [-6.06, -0.34]) with low heterogeneity (I2 = 10%, p = 0.33), but there were no other statistically significant differences in ASD symptoms between groups as measured by validated scales.Conclusion: Vitamin D supplementation appears to be beneficial for hyperactivity but not for core symptoms or other co-existing behaviors and conditions of ASD. Future RCTs with large sample sizes examining the effect of vitamin D supplementation on ASD among individuals with low serum vitamin D levels at baseline are needed.

Neurodevelopmental domain characteristics and their association with core symptoms in preschoolers with autism spectrum disorder in China: a nationwide multicenter study.

BACKGROUND: Autism spectrum disorder (ASD) is a group of clinically heterogenic neurodevelopmental disorders, with intellectual disability being one of its common comorbidities. No large-sample, multicenter study has focused on the neurodevelopmental aspect of preschoolers with ASD. This study investigated the neurodevelopmental characteristics of preschoolers with ASD in China and explored the association between them and the core symptoms. METHODS: We enrolled 1019 ASD preschoolers aged 2-7 years old from 13 cities around China between May 2018 and December 2019, and used the revised Children Neuropsychological and Behavior Scale (CNBS-R2016) to assess their neurodevelopment. Their autistic core behaviors were evaluated based on their Social Responsiveness Scale (SRS), Autism Behavior Checklist (ABC), Child Autism Rating Scale (CARS), and communication warning behavior (CWB) scores in the CNBS-R2016. RESULTS: Based on general developmental quotient (GQ) < 70, 68.4% of the preschoolers with ASD had a developmental delay (DD), rated mild in 32.7% of them. The highest DD rate (> 70%) was found in language and personal-social skills, followed by fine motor skills (68.9%). Gross motor skills had the lowest DD rate (34.0%). We found that fine motor, language, and personal-social developmental quotients (DQs) were significantly lower than gross motor skills in no DD (GQ > 70), mild DD (GQ 55-69), and moderate and below DD groups (GQ ≤ 54). Furthermore, the DQs for language and personal-social skills were significantly lower than for gross and fine motor skills in both DD groups. The ABC, SRS, CARS, and CWB scores in the no DD group were the lowest, moderate in the mild DD group, and highest in the moderate and below DD group. Besides, negative correlations were found between the DQs of the four domains and the ABC, SRS, CARS, and CWB scores, of which the language and personal-social skills DQs had the strongest correlations. CONCLUSIONS: Preschoolers with ASD had unbalanced neurodevelopment domain patterns and their neurodevelopmental levels were negatively correlated with the autism core symptoms. Hence, pediatricians should actively evaluate the neurodevelopment of children with ASD and conduct long-term follow-up during their early childhood to promote early diagnosis and develop personalized intervention plans. TRIAL REGISTRATION: ChiCTR2000031194 , registered on 03/23/2020.

Early life exposure to triclosan from antimicrobial daily necessities may increase the potential risk of autism spectrum disorder: A multicenter study in China.

BACKGROUND: Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders with unclear etiologies. Our recent work indicated that maternal exposure to triclosan (TCS) significantly increased the autistic-like behavior in rats, possibly through disrupting neuronal retinoic acid signaling. Although environmental endocrine disruptors (EEDs) have been associated with autism in humans, the relationship between TCS, one of the EEDs found in antibacterial daily necessities, and autism has received little attention. OBJECTIVE: The aims of this multicenter study were to evaluate TCS concentrations in typically developing (TD) children and ASD children, and to determine the relationship between TCS levels and the core symptoms of ASD children. METHODS: A total of 1345 children with ASD and 1183 TD children were enrolled from 13 cities in China. Ages ranged between 2 and 7 years. A questionnaire was used to investigate the maternal use of antibacterial daily necessities (UADN) during pregnancy. The core symptoms of ASD were evaluated using the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Social Response Scale (SRS), and the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016). The TCS concentration was measured using LC-MS/MS. RESULTS: Maternal UADN during pregnancy may be an unrecognized potential environmental risk factor for ASD (OR=1.267, P = 0.023). Maternal UADN during pregnancy strongly correlated with TCS levels in the offspring (Adjusted ß = 0.277, P < 0.001). TCS concentration was higher in ASD children (P = 0.005), and positively correlated with ABC (Sensory subscales: P = 0.03; Social self-help subscales: P = 0.011) and SRS scale scores (Social awareness subscales: P = 0.045; Social communication subscales: P = 0.001; Autism behavior mannerisms subscales: P = 0.006; SRS total score: P = 0.003) in ASD children. This association was more pronounced in boys than in girls. CONCLUSION: To our knowledge, this is the first case-control study to examine the correlation between TCS and ASD. Our results suggest that maternal UADN during pregnancy may be a potential risk of ASD in offspring. Further detection of TCS levels showed that maternal UADN during pregnancy may be associated with excessive TCS exposure. In addition, the level of TCS in children with ASD is higher than TD children. The higher levels of TCS in children with ASD may be significantly associated with more pronounced core symptoms, and this association was more significant in male children with ASD.

Supplement intervention associated with nutritional deficiencies in autism spectrum disorders: a systematic review.

PURPOSE: Nutritional supplements have been used for correction of deficiencies that may occur in patient with autism spectrum disorder (ASD) and to improve core symptoms. We aim to provide current best evidence about supplements for nutritional deficiencies and core symptoms in children with ASD and to evaluate the effectiveness and safety. METHODS: A systematic literature search of scientific databases was performed to retrieve relevant randomized controlled trials. Risk of bias was assessed for each study. RESULTS: 18 randomized controlled trials of five supplements were included. B6/Mg was not helpful for improving ASD symptoms (seven RCTs). Two RCTs of methyl B12 reported some improvement in ASD severity but the effects on the correction of deficiencies were inconclusive. Two RCTs of vitamin D3 both reported increased levels of mean 25(OH)D in serum but inconsistent results in behavioral outcomes. Omega-3 fatty acid supplementation did not affect ASD behaviors but may correct deficiencies (six RCTs). One RCT of folinic acid reported positive results in improving ASD symptoms measured by various behavioral scales. CONCLUSIONS: Current evidence for the use of supplements for correcting nutritional deficiencies in children with ASD and to improve the symptoms is little. More studies are needed.

Exploration of Core Symptoms for the Diagnosis of Alcohol Dependence in the ICD-10.

BACKGROUND: The classification of alcohol use disorder has changed over the past century. Now, the conceptualization of alcohol dependence is still controversial. Accumulating evidence has shown the reliability and validity for the diagnosis of alcohol dependence in the ICD-10 and DSM-IV. However, the meaning and association of the respective diagnostic items, which are descriptive of representative symptoms, have hardly been examined. The core symptom of substance use disorder has been debated in various situations, but has never been elucidated logically. METHODS: We consecutively registered 192 patients with alcohol-related problems who visited our hospital for the first time during a certain period. The relations and principal components among the checked items of the ICD-10 diagnostic criteria were examined statistically. RESULTS: Three diagnostic items in the ICD-10 were strongly correlated with each other and were thought to form the core symptoms of alcohol dependence: "strong desire," "difficulties in controlling," and "neglect of pleasures." One major physical phenomenon, "withdrawal," seemed to complement the core symptoms in the diagnosis of alcohol dependence. Another physical phenomenon, "tolerance," was demonstrated to be a relatively independent item. The principal component analysis also demonstrated that the diagnostic item "difficulties in controlling" had the maximum component loading value, followed by 2 items, "neglect of pleasures" and "strong desire." CONCLUSIONS: The core symptomatic elements in the diagnosis of alcohol dependence were statistically suggested in this study. Knowledge of the relations and components among the diagnostic items of alcohol dependence might also be applicable to other forms of substance use dependence and behavioral addiction.

Exploring the interplay between core and mood symptoms in schizophrenia: A network analysis.

BACKGROUND: Schizophrenia is a complex neuropsychiatric disorder characterized by positive symptoms, negative symptoms, cognitive deficits, and co-occurring mood symptoms. Network analysis offers a novel approach to investigate the intricate relationships between these symptom dimensions, potentially informing personalized treatment strategies. METHODS: A cross-sectional study was conducted from November 2019 to October 2021, involving 1285 inpatients with schizophrenia in Liaoning Province, China. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA-14), and Montreal Cognitive Assessment (MoCA). Network analysis was conducted to investigate the network structure, central symptoms, and bridge symptoms. RESULTS: The network analysis uncovered profound interconnectivity between core symptoms and the anxiety-depression community. Central symptoms, such as psychic anxiety, poor rapport, delusions, and attention, were identified as potential therapeutic targets. Bridge symptoms, including insomnia, depressed mood, anxiety-somatic, conceptual disorganization, and stereotyped thinking, emerged as key nodes facilitating interactions between symptom communities. The stability and reliability of the networks were confirmed through bootstrapping procedures. DISCUSSION: The findings highlight the complex interplay between schizophrenia symptoms, emphasizing the importance of targeting affective symptoms and cognitive impairment in treatment. The identification of central and bridge symptoms suggests potential pathways for personalized interventions aimed at disrupting self-reinforcing symptom cycles. The study underscores the need for a transdiagnostic, personalized approach to schizophrenia treatment.

A network meta-analysis of the effect of physical exercise on core symptoms in patients with autism spectrum disorders.

Objective: To compare the effects of various sports exercise programs on the core symptoms of patients with autism spectrum disorder (ASD). Methods: We searched the China National Knowledge Infrastructure, VIP databases, Wanfang databases, Cochrane Library, PubMed, EMBASE, and Web of Science databases from their inception to February 2023 for randomized controlled trial that investigated the effect of sports exercise on the core symptoms of ASD. The overall risk of bias in the included literature was summarized using the revised Cochrane Randomized Trial Risk of Bias Tool (ROB2), and network meta-analysis was used to compare the intervention effects. Results: A total of 30 studies involving 1,375 participants were included. The results showed that sports exercise programs, including 8-12 weeks of ball sports (SMD = -5.35, 95%CI: -7.57, -3.23), horse riding (SMD = -3.71, 95%CI: -6.18, -1.13), 8-12 weeks of comprehensive sports exercise (SMD = -2.17, 95%CI: -3.99, -0.44), and more than 12 weeks of comprehensive sports exercise (SMD = -3.75, 95%CI: -6.33, -1.24), significantly improved social interaction disorders. Furthermore, 8-12 weeks of ball sports (SMD = -4.36, 95%CI: 2.04, 6.73) and more than 12 weeks of comprehensive sports exercise (SMD = 3.65, 95%CI: 1.40, 6.08) significantly improved repetitive behaviors and restricted interests. Conclusion: Sports exercise can improve the core symptoms of ASD patients, and different symptoms show a selective response to different exercise elements. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023455806.

Network evolution of core symptoms after lung cancer thoracoscopic surgery:A dynamic network analysis.

OBJECTIVES: To investigate relationships between various symptoms occurring 1-2 and 5-6 days following days after thoracoscopic surgery, to identify core symptoms, and to monitor changes in core symptoms over time following lung cancer thoracoscopic surgery. METHODS: We evaluated symptoms using the Anderson Symptom Scale (Chinese version) and the Lung Cancer-Specific Symptoms Template in 214 lung cancer patients hospitalized in the Department of Thoracic Surgery of a provincial hospital in Jiangsu Province from March 2023 to September 2023. Data was collected at 1-2 days and 5-6 days postoperatively. Symptom networks were constructed for each time point, and centrality indicators were analyzed to identify core symptoms while controlling for influencing factors. RESULTS: According to the network analysis, fatigue (rs = 26.00、rc = 0.05、rb = 1.02) had the highest strength, closeness, and betweenness in the symptom network 1-2 days after lung cancer surgery. At 5-6 days after surgery, shortness of breath (rs = 27.00) emerged as the symptom with the highest strength, fatigue (rc = 0.04) had the highest closeness, and cough (rb = 1.08) ranked highest in betweenness within the symptom network. CONCLUSION: Fatigue stands out as the most core symptom in the network 1-2 days after lung cancer surgery. Shortness of breath, fatigue and cough are the most core symptoms in the symptom network 5-6 days after surgery. Therefore, clinical staff can improve the postoperative symptom experience of lung cancer patients by developing symptom management programmes tailored to these core symptoms.

Unraveling the core symptoms of mental health in senior grade three students- a network analysis.

Background: Adolescence is not only an important transitional period of many developmental challenges, but also a high risk period for mental health problems. Psychotherapy is recommended for mental health problems in adolescents, but its effectiveness is not always satisfactory. One possible contributing factor may be the lack of clarity surrounding core symptoms. Methods: In this study, we investigated the mental health status of senior grade three students, a group of adolescents facing college entrance exams, by the Middle School Student Mental Health Test (MHT) and analyzed the core symptoms by network analysis. This study was conducted through an online survey platform (www.xiaodongai.com) from 15 February 2023 to 28 March 2024. The subjects scanned a QR code with their mobile phone to receive the questionnaire. Results: The mean age of these 625 students were 18.11 ± 2.90 years. There are 238 male participants and 387 female participants. 107 individuals scored above 56 (107/461, 23.2%), with individual scale scores over 8 up to over 60% of participating students. Notably, the top three prominent symptoms were "academic anxiety", "allergic tendency" and "somatic symptoms". However, upon conducting network analysis, it became evident that three strongest edges in this network were "somatic symptoms" and "impulsive tendency", "academic anxiety" and "social anxiety" as well as "social anxiety" and "Loneliness tendency". "somatic symptoms", "social anxiety" and "self-blame tendency" exerted the highest expected influence. This suggests that, statistically speaking, these three symptoms exhibited the strongest interconnections within the network. Limitation: Cross-sectional analysis; Bias in self-reported variables. Conclusion: These findings can deepen the knowledge of mental health among senior grade three students and provide some implications (i.e., targeting symptoms having highest expected influence) for clinical prevention and intervention to address the mental health needs of this particular group.

Single Exercise for Core Symptoms and Executive Functions in ADHD: A Systematic Review and Meta-Analysis.

OBJECTIVES: A systematic review and meta-analysis of studies of single exercise on core symptoms and executive function in adolescents with ADHD. METHODS: Four databases were searched for studies of the effects of single exercise on core symptoms and executive functioning in adolescents with ADHD. RESULTS: Thirteen studies were included, and a single session of exercise had small effect-size improvements in core symptoms and executive function in adolescents with ADHD: 10 to 13 year olds in the early adolescent-elementary school years and 18 to 24 year olds in the late adolescent-college years. Moderate-intensity continuous training, high-intensity interval training, single sessions of less than 30 minutes, and single sessions of 30 minutes and more significantly improved cycling training, attention, inhibition, substance use, and pre-study abstinence. CONCLUSIONS: A single session of exercise had an overall ameliorative effect on core symptoms and executive function in adolescents with ADHD.

Effectiveness of physical activity interventions for core symptoms of autism spectrum disorder: A systematic review and meta-analysis.

In this paper, systematic review and meta-analysis were used to demonstrate the effectiveness of physical activity intervention on core symptoms of autism spectrum disorder (ASD). Physical activity intervention for core symptoms of ASD were retrieved by computer from the PubMed Cochrane Library, Web of Science, APA PsycNet, and CNKI database during December 1, 2022. Two researchers evaluated the quality of the included literature and extracted the data. Sixteen studies were eventually included, with a total of 587 patients with ASD. Meta-analysis showed that the core symptoms of ASD patients decreased after physical activity intervention, ES(g) = 0.681(95% CI: 0.380-0.982, p = 0.000), specifically, physical activity improved the reduction of social disorder ES(g) = 0.749(95% CI: 0.524-0.973) and repeated rigid behavior ES(g) = 0.553 (95% CI: -0.079 to 1.186). Subgroup analysis showed that preschool children with ASD who were 3-6 years old, exercised for more than 12 weeks, more than 3 times a week, and exercised for more than 90 min per session had better improvement in core symptoms after participating in physical activity. The conclusion of this paper is that physical activity intervention can improve the core symptoms of ASD, especially the reduction of social disorders and repetitive behaviors.

Effects of Vitamin D Supplementation on Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis.

The effect of vitamin D supplementation on individuals with autism spectrum disorder (ASD) is inconclusive. We aimed to conduct a meta-analysis of the available randomized controlled trials (RCTs) to explore whether vitamin D supplementation can improve core symptoms and coexisting conditions in children with ASD. Data were obtained by searching the PubMed, Embase, Web of Science, CINAHL and Cochrane Library databases up to February 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using a random-effects model, mean differences with 95% confidence intervals (CIs) were calculated through a meta-analysis. There were eight RCTs with 266 children with ASD in the present review, among which six RCTs were included in the meta-analysis. Children who received vitamin D supplementation showed a significant improvement in stereotypical behavior scores (pooled mean difference (MD): -1.39; 95% CI: -2.7, -0.07; P = 0.04) with low heterogeneity (I2 = 34%), and there was a trend toward decreased total scores on the Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS, P = 0.05); however, there were no other significant differences in the core symptoms of ASD and coexisting conditions between groups as measured by the Aberrant Behavior Checklist (ABC). Vitamin D supplementation appears to improve stereotypical behaviors but does not improve other core symptoms and coexisting conditions. Further randomized controlled trials with large sample sizes and individualized doses are needed.

Children with autism exhibit similar longitudinal changes in core symptoms when placed in special or mainstream education settings.

LAY ABSTRACT: Today, children with autism spectrum disorder (ASD) are placed in mainstream or special education settings somewhat arbitrarily with no clear clinical recommendations. Here, we compared changes in core ASD symptoms, as measured by the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) clinical assessment, across ASD preschool children placed in special or mainstream education. Longitudinal changes in ADOS-2 scores did not differ significantly across settings over a 1- to 2-year period. While some children improved in core ASD symptoms, others deteriorated in both settings. This highlights the need to identify specific criteria for establishing meaningful placement recommendations.

Executive functions in daily living skills: A study in adults with autism spectrum disorder.

Introduction: Adults with autism and adults with schizophrenia show difficulties in adaptive skills, especially those related to daily functioning. Some studies suggest that adaptive skills are associated with deficits in executive functions (EF), while others indicate that intelligence quotient (IQ) might also play a role. Literature suggests that autistic symptoms further affect adaptive skills. The interest of the current study, therefore, was to explore to what extent IQ, EFs as well as core autistic symptoms predict adaptive skills. Methods: To do this, 25 controls, 24 adults with autism, and 12 with schizophrenia were assessed on IQ (Wechsler Adult Intelligence Scale), and executive functioning. The EF was measured with neuropsychological tasks (inhibition, updating, and task switching) and with the Dysexecutive-Spanish Questionnaire (DEX-Sp) which assessed everyday life EF problems. Core ASD symptoms were measured using the Autism Diagnostic Observation Schedule, the Autism Spectrum Quotient-Short version (AQ-S), and the Repetitive Behavior Questionnaire - 3 (RBQ-3). Results: The results indicated EF difficulties in both, autism and schizophrenia. The IQ explained a high percentage of the variance found in adaptive skills, but only in the autism group. We can conclude, therefore, that high IQ is associated with low adaptive skills levels and EFs affect adaptive functioning in people with autism; however, this does not explain the difficulties in adaptive functioning in the schizophrenia group. Core features of autism assessed with self-report questionnaires (but not the ADOS-2) predicted low scores on the adaptive skills, only in the autism group. Discussion: Both EF measures predicted adaptive skills scores in autism, but not in schizophrenia. Our results suggest that different factors affect the adaptive functioning in each disorder. For instance, the EFs should be a central focus for improvement, especially for individuals with autism.

Oppositional Defiant Disorder Symptoms and Multi-level Family Factors in Chinese Migrant Children: A Network Perspective.

Based on the network theory of mental disorders, this study used network analysis to examine the network of ODD symptoms and multilevel family factors and identify the most crucial family factors influencing ODD symptoms in children. A total of 718 Chinese migrant children aged 7-14 years participated in this study. This study measured ODD symptoms, family system-level variables (3 factors), family dyadic-level variables (6 factors), and family individual-level variables (6 factors) with factors selected based on the multilevel family factors theory of ODD symptoms. The results indicated that (1) "annoy" was the center symptom of ODD, (2) "annoy" and "vindictive" was the main bridge connecting the multilevel family factors, and (3) family cohesion at the family system level, parent-child conflict at the family dyadic level, and parental depression at the family individual level were critical central and bridging influencing factors. The findings of this study highlight the critical role of "annoy" and "vindictive" symptoms in the activation of ODD symptom networks in children and provide a basis for future improvements in diagnostic criteria. These potential core and bridge factors might become key intervention targets for childhood ODD.

Examine sex differences in autism spectrum disorder in school-aged children and adolescents with fluent language.

There are noteworthy sex disparities in the prevalence of autism spectrum disorders (ASD), while findings regarding the sex differences in core symptoms are inconsistent. There are few relevant studies on sex differences in mainland China. This study was dedicated to a deeper understanding of the impact of sex differences on the clinical presentation of ASD with fluent language. We retrospectively studied 301 children with ASD (58 females) and utilized raw scores from the ADI-R and ADOS and the intelligence quotient (IQ) to measure symptomatology. Based on the Full-Scale IQ (FS-IQ), a binary split of average, above-average IQ (high-IQ), and below-average IQ (low IQ) occurs at 85. Across the entire sample, males and females are comparable in the FS-IQ, while males scored higher in the Perceptual Reasoning Index (PRI) (F = 7.812, p = 0.006). ADI-R did not find any statistically significant sex differences in the diagnostic cutoff score satisfaction or the raw domain scores. While a significant effect of sex on ADOS social affect domain scores was found in the total sample [λ = 0.970, partial η2 = 0.030, F (3,295) = 3.019, p = 0.030]. Tests of between-subjects effects revealed that males scored higher than females mainly in the ADOS reciprocal social interaction subcategory (partial η2 = 0.022, F = 6.563, p = 0.011). Stratified analysis revealed that the effect of sex on ADOS reciprocal social interaction subcategory scores only significant in the low-IQ children with ASD (partial η2 = 0.092, F = 10.088, p = 0.002). In general, overall cognitive functioning is similar across males and females with ASD, while males have a higher perceptual reasoning ability. Females with ASD are more likely to have comorbid intellectual impairment than males, and they could require additional intervention support. Autistic children with low IQs are more likely to exhibit sex differences in their core symptoms than children with high IQs. Intelligence plays a key role in sex-based differences in the core symptoms of ASD.