The Sensory Profiles, Eating Behaviors, and Quality of Life of Children with Autism Spectrum Disorder and Avoidant/Restrictive Food Intake Disorder.

Eating disorders frequently accompany autism spectrum disorder (ASD). One such novel eating disorder is avoidant/restrictive food intake disorder (ARFID). This study compares the eating attitudes, quality of life, and sensory processing of typically developing children (TDC), autistic children, and autistic children with ARFID. A total of 111 children aged 4-10 with a diagnosis of ASD and ARFID (n = 37), ASD without ARFID (n = 37), and typical development (n = 37) were recruited. After an interview in which Childhood Autism Rating Scale (CARS) was administered, Child Eating Behavior Questionnaire (CEBQ), Pediatric Quality of Life Inventory (PedsQL), Social Responsiveness Scale (SRS) and Sensory Profile (SP) were completed by caregivers. Autistic children with ARFID had higher scores in CEBQ subscales relating to low appetite and lower scores on the subscales associated with weight gain. Both groups of autistic children scored lower than TDC on all PedsQL subscales and autistic children with ARFID had lower social QL scores than both groups. SRS scores were highest in autistic children with ARFID, followed by autistic and typically developing children. CARS scores were similar in both groups of autistic children, but higher than TDC. Auditory, vision, touch, multi-sensory, oral processing scores; as well as all quadrant scores, were significantly lower in autistic children with ARFID. Oral sensory processing scores were found to be the most significant predictor of ARFID comorbidity in ASD and reliably predicted ARFID in autistic children in the clinical setting. Autistic children with ARFID demonstrate differences in social functioning, sensory processing, eating attitudes, and quality of life compared to autistic and TD children.

Association of Psychopharmacological Medication Preference with Autistic Traits and Emotion Regulation in ADHD.

Background: This study intends to evaluate the relationship between medication switching and autistic traits, emotion dysregulation, and methylphenidate side effects in children with attention deficit hyperactivity disorder (ADHD). Methods: Children with ADHD, ages 9-18, treated with methylphenidate (MTP) (n = 23), and switched to atomoxetine (ATX) (n = 20) were included. All participants were interviewed with K-SADS-PL to confirm ADHD diagnosis and exclude comorbid psychiatric disorders. The participants then completed Difficulty in Emotion Regulation Scale (DERS) and Autism-Spectrum Quotient (AQ) and their parents completed Autism Spectrum Screening Questionnaire (ASSQ) and Barkley Stimulant Side Effect Rating Scale(BSSERS). Results: The MTP group scored higher than the ATX group in ASSQ, AQ, and the lack of emotional clarity subscale of DERS, while the ATX group had higher scores in the emotional non-acceptance subscale of DERS. No differences were found between the MTP and ATX groups in methylphenidate side-effect severity. Multiple regression analyses revealed that non-acceptance of emotions predicted the switch to ATX while lack of emotional clarity predicted the maintenance of MTP therapy, rather than autistic traits. Conclusions: This study highlights emotion regulation difficulties and how different emotional profiles may influence medication selection in children with ADHD.

Effect of metabolic control on cognitive functions in children and adolescents with type 1 diabetes mellitus.

OBJECTIVES: Neurocognitive functions of children with type 1 diabetes mellitus (T1D) are reported to be poorer than those of healthy peers. The aim was to investigate the effects of age of onset of diabetes, metabolic control, and type of insulin regimen on neurocognitive functions in children and adolescents with T1D. METHODS: Forty-seven children aged 6-18 years, with T1D for at least five years, were included. Children with a known psychiatric disorder or chronic diseases other than T1D were excluded. Intelligence via the Wechsler children's intelligence scale (WISC-R), short-term memory via the audio-auditory digits form B (GISD-B) test, visual motor perception via the Bender Gestalt test, and attention via the Moxo continuous attention and performance test, timing, hyperactivity, and impulsivity (Moxo-dCPT) were assessed. RESULTS: Compared with the T1D group, healthy controls had higher scores in terms of verbal intelligence quotient (IQ), performance IQ, and total IQ mean scores on WISC-R (p=0.01, p=0.05 and p=0.01, respectively). On the MOXO-dCPT test, the T1D group had higher impulsivity compared to the control group (p=0.04). Verbal IQ was better in the moderate control group than in the poorer metabolic control (p=0.01). Patients with no history of diabetic ketoacidosis (DKA) had higher performance, verbal and total intelligence scores than the group with history of DKA. CONCLUSIONS: Poor metabolic control and a history of DKA in children with T1D adversely affected neurocognitive functions. It would be beneficial to consider the assessment of neurocognitive functions in T1D and to take the necessary precautions in follow-up.

The Relationship Between Social Skills and Sensory Profile, Emotion Regulation, and Empathizing/Systemizing in Adolescents on the Autism Spectrum.

This study aims to evaluate the relationship between social skills and sensory features, emotion regulation, and empathy in adolescents on the autism spectrum. One hundred and twenty-three adolescents were included in the study (50 autistic, 73 typically developing-TD adolescents). The participants filled out the Adolescent/Adult Sensory Profile (AASP) and Emotion Regulation Questionnaire. Parents of the participants completed the Child Empathy and Systemizing Quotient (EQ-C/SQ-C) and Autism-Social Skills Profile (ASSP) scales. Social reciprocity, social participation/avoidance, ASSP total scores, empathy and systemizing scores were lower, and detrimental social behaviors, low registration sensory profile scores were higher in the autism spectrum group. While a difference between genders was observed in sensory sensitivity, sensation avoiding, low registration quadrants and empathy scores, no gender and group interaction was found in any domain. Social skill total scores were correlated to sensation seeking and low registration sensory features, empathy, systemizing, and reappraisal emotion regulation scores. A hierarchical multiple linear regression analysis was conducted controlling for group and gender, sensation seeking (p = .032, ß = 0.138), low registration (p = .012, ß = - 0.215) of the AASP, and empathy (p < .001, ß = 0.555) and systemizing (p = .033, ß = 0.138) scores of the EQ/SQ-C was found to significantly predict social skill total scores. Although emotional regulation strategies may play a role, sensory processing features and empathy and systemizing skills seem to be the more significant contributors to social skills during adolescence. Interventions targeting sensory processing and especially improving empathy and systematization skills may positively affect social skills in adolescents on the autism spectrum.

Child and adolescent psychiatric emergency admissions before, during and after the Covid-19 pandemic: An Interrupted time series analysis from Turkey.

BACKGROUND: Acute psychiatric care of youth is paramount as prompt evaluation is known to mitigate potentially catastrophic outcomes in the future. The aim of this study was to analyze changes in child and adolescent psychiatric (CAP) emergency admissions within a 4-year period, including the pandemic course. METHODS: Electronic patient health records of children and adolescents aged 0-18 years, admitted to the pediatric emergency department (ED) for psychiatric complaints between January 2018-December 2021, were retrospectively reviewed (n = 2014). Data including the age, sex, presenting complaint and preliminary diagnosis, length of stay in the ED, and history of previous psychiatric outpatient/emergency admissions were recorded. Interrupted Time series analysis was conducted to detect changes. RESULTS: During the first month of the COVID-19 pandemic period (March 2020); low-risk suicide attempts (60.6%;IRR=0.394;CI=0.216-0.718), high-risk suicide attempts (82.2%;IRR=0.178;CI=0.070-0.457), manic symptoms (87.9%;IRR=0.121;CI=0.016-0.896), and total CAP emergency admissions were found to have decreased (30.7%;IRR=0.693;CI=0.543-0.885). CAP consultations due to general medical conditions were found to have increased by 7.3% (IRR=1.073;CI=1.019-1.130), and total CAP emergency admissions showed a mild increase of 1.8% (IRR=1.018;CI=1.001-1.036) through April 2020 to December 2021. CONCLUSION: While suicide attempts, manic symptoms, and total CAP emergency admissions decreased during the first month of the pandemic, there was an increase in total CAP emergency admissions, especially in general medical conditions presenting with psychiatric symptoms during the following pandemic period. This study highlights the importance of accounting for underlying medical conditions in patients presenting with psychiatric complaints to the ED in the normalization phase. AVAILABILITY OF THE DATA AND MATERIAL: The datasets generated and/or analyzed during the present study are available from the corresponding author on reasonable request.

Evaluation of choroid plexus with fetal magnetic resonance imaging: What happens in ventriculomegaly?

OBJECTIVES: Diagnosis of ventriculomegaly (VM) and identification of choroid plexus (CP) can be challenging with fetal magnetic resonance imaging (MRI). Our aim is to create an adjunct method for supporting the diagnosis of VM by investigating the CP-ventricular wall separation distance in fetuses with and without VM (nV) with fetal MRI. METHODS: T2-weighted fetal MRIs of 154 fetuses were retrospectively evaluated. The CP separation was defined as the distance between the medial wall of the dependent ventricle and distal tip of the CP glomus. The measurement was performed at the same plane with the dependent ventricle measurement by two blinded readers. RESULTS: 41 fetuses with VM (mean gestational age 27 (19-35 weeks), and 44 nV fetuses (mean gestational age 28 (20-39 weeks) were included. Interobserver reliability was excellent for ventricle diameters (R = 0.99, confidence interval (CI) 95%) and the separation of CP (R = 0.98, CI 95%). Mean distance of CP separation was 10.7 mm ±â€¯4.2 mm and 3.0 ±â€¯1.6 mm in VM and nV fetuses, respectively (p < 0.001). The distance of CP separation to differentiate VM cases was 6.5 mm (sensitivity: 0.98, specificity: 0.98). Separation of CP was correlated to ventricle diameter in cases with (R = 0.674) and without VM (R = 0.805). For the cut-off value >0.65 cm for the distance between the medial wall of the dependent ventricle and the medial border of choroid plexus sensitivity is 97.56, specificity 95.45, positive predictive value (PPV) 95.20, negative predictive value (NPV) 97.70, and likelihood ratio (LR) (+) is 21.46. CONCLUSION: Fetal CP can be efficiently evaluated with MRI, and the increase of CP-ventricular wall separation distance in correlation with the ventricle diameter is a reliable sign in the diagnosis of fetal VM.