Development and validation of a paediatric version of the Khalfa Hyperacusis Questionnaire for children with and without autism.

OBJECTIVE: Hyperacusis is reported to occur in 3.2-17.1% of the general paediatric population with higher rates in clinical populations such as autism spectrum disorders (ASD). Although hyperacusis is a relatively common form of decreased sound tolerance (DST), no valid paediatric hyperacusis measures are currently available. The purpose of the present study was to develop and validate a paediatric version of the Khalfa Hyperacusis Questionnaire (HQ) as a first step towards filling this measurement gap. DESIGN: A cross-sectional design was used to evaluate therapist opinions of the paediatric version (P-HQ) and to field test the P-HQ in parents of children with and without ASD. Total scores were compared between ASD and non-ASD groups. STUDY SAMPLE: Eleven paediatric occupational and speech therapists with expertise in ASD, 64 parents of children with ASD and 37 parents of children without ASD completed online questionnaires. Psychometric analyses were conducted. RESULTS: A unidimensional construct was found underlying P-HQ and all items displayed sufficient theoretical relevance to hyperacusis and adequate psychometric properties. CONCLUSIONS: The P-HQ demonstrates good internal consistency and shows promise as a potential screening tool for identifying DST in ASD. Further research is warranted to establish normative data and validate cut-off scores.

Black Seed Oil, Bentonite Clay, and Probiotics: A Comprehensive Holistic Cure for Clostridium difficile Infection in a 2-Year-Old Female Child.

There has been a rise in antibiotic resistance in secondary conditions such as Clostridium difficile (C. difficile) due to overuse of antibiotics. Oral antibiotics are used to treat C. difficile, which further disrupts the intestinal flora resulting in unwanted side effects. Naturopathic treatments often have fewer side effects and lower secondary infection risk than pharmaceutical interventions making them ideal for pediatric use. This case report describes the effective treatment of a pediatric clinical case of C. difficile using naturopathic and complementary alternative medicines (CAMs) including black seed oil (Nigella sativa), bentonite clay, and probiotics. A healthy two-year-old patient presented to a pediatrician with symptoms of, and subsequently confirmed, C. difficile after having been recently hospitalized and treated for a gluteal abscess and cellulitis using clindamycin, vancomycin, and piperacillin/tazobactam. Through a shared decision-making process, the patient's mother and providers developed a treatment plan for the C. difficile infection (CDI), which included black seed oil, bentonite clay, and Lactobacillus probiotics. No C. difficile was detected via stool immunoassay after 4 days of combined CAM therapy. Our results underscore the need for additional research regarding the effectiveness of naturopathic CAMs including black seed oil, bentonite clay, and probiotics as alternatives to antibiotic treatment of CDI in children.

Brief Report: Prevalence and Severity of Auditory Sensory Over-Responsivity in Autism as Reported by Parents and Caregivers.

Auditory sensory over-responsivity (aSOR) is a frequently reported sensory feature of autism spectrum disorders (ASD); however, there is little consensus regarding its prevalence and severity. This cross-sectional study uses secondary data from the Autism Diagnostic Interview-Revised (ADI-R; Item 72: undue sensitivity to noise) housed in the US National Institute of Mental Health Data Archives to identify prevalence and severity of aSOR. Of the 4104 subjects with ASD ages 2-54 (M = 9, SD = 5.8) who responded to item 72, 60.1% (n = 1876) had aSOR currently (i.e., point prevalence) and 71.1% (n = 2221) reported having aSOR ever (i.e., lifetime prevalence). aSOR prevalence and severity were affected by age, but there were no associations with sex.

Vestibulo-ocular reflex function in children with high-functioning autism spectrum disorders.

Sensorimotor processing alterations are a growing focus in the assessment and treatment of Autism Spectrum Disorders (ASD). The rotational vestibulo-ocular reflex (rVOR), which functions to maintain stable vision during head movements, is a sensorimotor system that may be useful in understanding such alterations and their underlying neurobiology. In this study, we assessed post-rotary nystagmus elicited by continuous whole body rotation among children with high-functioning ASD and typically developing children. Children with ASD exhibited increased rVOR gain, the ratio of eye velocity to head velocity, indicating a possible lack of cerebellar inhibitory input to brainstem vestibular nuclei in this population. The ASD group also showed less regular or periodic horizontal eye movements as indexed by greater variance accounted for by multiple higher frequency bandwidths as well as greater entropy scores compared to typically developing children. The decreased regularity or dysrhythmia in the temporal structure of nystagmus beats in children with ASD may be due to alterations in cerebellum and brainstem circuitry. These findings could potentially serve as a model to better understand the functional effects of differences in these brain structures in ASD. Autism Res 2017, 10: 251-266. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Oculomotor performance in children with high-functioning Autism Spectrum Disorders.

Sensorimotor issues are of increasing focus in the assessment and treatment of Autism Spectrum Disorders (ASD). The oculomotor system is a sensorimotor network that can provide insights into functional neurobiology and has well-established methodologies for investigation. In this study, we assessed oculomotor performance among children with high functioning ASD and typically developing children, ages 6-12 years. Children with ASD exhibited greater horizontal saccade latency and greater phase lag during vertical smooth pursuit. Saccades and smooth pursuit are mediated by spatially distant brain regions and the long-fiber tracts connecting them, many of which are implicated in ASD. Training paradigms for oculomotor deficits have shown positive outcomes in other clinical populations, and deficits described here may provide useful targets for interventions.