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1.
BMC Pediatr ; 24(1): 270, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38664754

RESUMEN

BACKGROUND: Recently, studies on behavioral interventions for autism have gained popularity. Naturalistic Developmental Behavior Interventions (NDBIs) are among the most effective, evidence-based, and widely used behavior interventions for autism. However, no research has been conducted on which of the several NDBI methods is most effective for parents and children with autism spectrum disorders. Therefore, we conducted a network meta-analysis to compare the specific effects of each type of parental-mediated NDBI on children's developmental skills and parent fidelity. METHODS: PubMed, Embase, Cochrane Library, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), CINAHL, and Wanfang databases were searched from inception to August 30, 2023. A total of 32 randomized controlled trial studies that examined the efficacy of different NDBIs were included. RESULTS: Parents of children with ASD who received Pivotal Response Treatment (PRT) reported significant improvements in their children's social skills (SUCRA, 74.1%), language skills (SUCRA, 88.3%), and parenting fidelity (SUCRA, 99.5%). Moreover, parents who received Early Start Denver Model (ESDM) reported significant improvements in their children's language (SMD = 0.41, 95% CI: 0.04, 0.79) and motor skills (SMD = 0.44, 95% CI: 0.09, 0.79). In terms of the efficacy of improving parent fidelity, the results showed that the Improving Parents as Communication Teachers (ImPACT) intervention significantly improved parent fidelity when compared with the treatment-as-usual group (TAU) (SMD = 0.90, 95% CI: 0.39, 1.42) and the parental education intervention (PEI) (SMD = 1.10, 95% CI:0.28, 1.91).There was a difference in parent fidelity among parents who received PRT(SMD = 3.53, 95% CI: 2.26, 4.79) or ESDM(SMD = 1.42, 95% CI: 0.76, 2.09) training compared with PEI. CONCLUSION: In conclusion, this study revealed that parents can achieve high fidelity with the ImPACT intervention, and it can serve as an early first step for children newly diagnosed with ASD. It also showed that parent-mediated ESDM is effective in improving language and motor skills for children with ASD and can be used as part of the second stage of parent training. Parent-mediated PRT can also be used as a third stage of parent training with sufficient training intensity to further improve language, social, and motor skills.


Asunto(s)
Trastorno del Espectro Autista , Metaanálisis en Red , Padres , Humanos , Trastorno del Espectro Autista/terapia , Padres/educación , Niño , Terapia Conductista/métodos , Habilidades Sociales , Desarrollo Infantil , Responsabilidad Parental , Preescolar , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
2.
J Psychiatr Res ; 173: 363-366, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38593694

RESUMEN

In the last decades, growing caseness for Autism Spectrum Disorder (ASD) has been observed, owing to the diagnostic accretion of low-impairment forms, over and above other possible causes. Unrecognized ASD is likely to be mislabeled as a psychotic disorder (PD), as people in the spectrum may show 'pseudopsychotic' symptoms, resembling both negative and positive symptoms. On the other hand, PDs are likely to be overlooked when they arise in people with ASD, due to the 'diagnostic overshadowing' of new-onset conditions by lifelong core autistic symptoms. The three available metanalyses on the occurrence of psychosis in adults with ASD convergently reported a rate of PDs that is at least ten times higher than in the general population. Therefore, the lack of literature addressing risk factors, outcomes, and treatment options for psychosis in the context of ASD is utterly concerning. The present review aims to summarize up-to-date knowledge of PDs with comorbid ASD in terms of clinical features, course, and treatment.


Asunto(s)
Trastorno del Espectro Autista , Trastornos Psicóticos , Adulto , Humanos , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/terapia , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/terapia , Trastornos Psicóticos/diagnóstico , Imaginación
3.
Med Arch ; 78(2): 159-163, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38566879

RESUMEN

Background: Attention-deficit hyperactivity disorder (ADHA) is one of the most common comorbid disorders of autism spectrum disorder (ASD) that can accompany autism, triggered by it, or be a consequence of it. Objective: This review explored the prevalence of the comorbidity of both disorders, neurobiological background, symptoms, latest assessment methods, and therapeutic approaches. Results and Discussion: It concluded that effective assessment, diagnosis and management of ADHD in ASD children and adults is essential for this group of patients to thrive and live a good quality of life. Further research is recommended to explore the most effective intervention for such important members of our society. Conclusion: More studies are needed to understand the mechanisms underlying these comorbidities, and to prevent the misdiagnosis and mismanagement of these disorders. Also, to develop up to date personalized therapeutic plans for such children.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Trastorno del Espectro Autista , Niño , Adulto , Humanos , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/terapia , Calidad de Vida , Comorbilidad , Prevalencia
4.
PLoS One ; 19(4): e0301517, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38574084

RESUMEN

The use of virtual reality in social skills training for high functioning autism spectrum disorder (HFASD) youth has been found to be engaging and enjoyable. Despite the promising results, previous literature indicates that there has been no consensus on the social skills target in the training content. There is also limited research on how evidence-based strategies like cognitive and behaviour techniques are instantiated into the VR environment to teach social skills. The aim of this study is to determine the key components to design a social skills training content using virtual reality for youths with HFASD. The Fuzzy Delphi method (FDM) was used to obtain expert consensus on social skills difficulties and cognitive behavioral techniques included in the content in three phases. In phase 1, a questionnaire was developed from in-depth interviews and scientific literature review. The in-depth interviews were conducted with 13 HFASD youth, 7 parents and 6 experts. In phase 2, 3 experts rated the relevance of the items in the questionnaire using an item-level content validity index (I-CVI) assessment. In phase 3, the questionnaire was distributed to 10 experts to rate their level of agreement on each component using a 7-point Likert scale. Components that received a value above 75%, threshold value (d) ≤ 0.2, fuzzy score (A) ≥ α - cut value = 0.5 and higher rank based on defuzzification score were prioritized to be included in the content. Items that received higher expert consensus on social skills difficulties included assessing non-verbal responses, initiating, maintaining, and leaving conversations, emotional difficulties and difficulties in perspective taking. Cognitive and behavioral techniques that received higher expert consensus were psychoeducation, modelling, relaxation techniques, reinforcements, and perspective-taking questions. These key components can be used as a framework for the development of virtual learning content for social skills training in future studies.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Realidad Virtual , Humanos , Adolescente , Habilidades Sociales , Trastorno del Espectro Autista/terapia , Técnica Delfos
5.
Ital J Pediatr ; 50(1): 60, 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38575971

RESUMEN

BACKGROUND: The goal of our contribution is to discuss a preschool intervention based on the Early Start Denver Model and the use of the main tools for the detection of adaptive behaviour in cases of autism: Vineland, ABAS. CASE PRESENTATION: the work is the presentation of a clinical case that has benefited from an intervention with the Early Start Denver Model methodology for the benefit of a child with socio-cultural and economic disadvantages. This early intervention, in a child of 36 months, which followed the diagnosis, was possible thanks to the intervention of many third-sector organizations which allowed this child, with a serious autism profile, to receive an evidence-based intervention for free. At the beginning of the intervention, the child presented a diagnosis of severe autism with absence of gaze, vocalizations and other communicative impairments. The level of motor clumsiness was also quite high, as were stereotypies. CONCLUSIONS: Research has shown the usefulness of intervening in this area with an early assessment and/or diagnosis and immediate intervention; however, public health services are not always able to maintain this pace. Our contribution therefore shows on the one hand the evidence of the improvements achieved by the child despite the low intensity of the treatment, and on the other hand, demonstrates the total versatility and adaptability of the Denver Model to the Italian context. In our conclusions, there are also some reflections on the tools used to measure adaptive behavior which seem to have a number of limitations and criticalities.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Medicina Social , Niño , Humanos , Preescolar , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/terapia , Trastorno del Espectro Autista/psicología , Trastorno Autístico/diagnóstico , Trastorno Autístico/terapia , Adaptación Psicológica , Italia
6.
Zhongguo Dang Dai Er Ke Za Zhi ; 26(4): 414-419, 2024 Apr 15.
Artículo en Chino | MEDLINE | ID: mdl-38660907

RESUMEN

Autism spectrum disorder (ASD) is one of the neurodevelopmental disorders in children, and there are currently no specific treatments, with the main interventions focusing on educational training and behavioral correction. Virtual reality, as an emerging technology, is a computer-based environmental simulation system that achieves interactive dynamics and immersive experiences by integrating information from multiple sources. In recent years, it has been gradually applied in intervention training for children with ASD. This paper reviews the recent studies on the effects of virtual reality intervention on emotional cognition, social skills, daily living skills, motor skills, and specific phobias in children with ASD, offering a new direction for ASD intervention training.


Asunto(s)
Trastorno del Espectro Autista , Realidad Virtual , Humanos , Trastorno del Espectro Autista/terapia , Trastorno del Espectro Autista/psicología , Niño , Habilidades Sociales
7.
J Neurodev Disord ; 16(1): 14, 2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38605323

RESUMEN

BACKGROUND: Deficits in executive function (EF) are consistently reported in autism spectrum disorders (ASD). Tailored cognitive training tools, such as neurofeedback, focused on executive function enhancement might have a significant impact on the daily life functioning of individuals with ASD. We report the first real-time fMRI neurofeedback (rt-fMRI NF) study targeting the left dorsolateral prefrontal cortex (DLPFC) in ASD. METHODS: Thirteen individuals with autism without intellectual disability and seventeen neurotypical individuals completed a rt-fMRI working memory NF paradigm, consisting of subvocal backward recitation of self-generated numeric sequences. We performed a region-of-interest analysis of the DLPFC, whole-brain comparisons between groups and, DLPFC-based functional connectivity. RESULTS: The ASD and control groups were able to modulate DLPFC activity in 84% and 98% of the runs. Activity in the target region was persistently lower in the ASD group, particularly in runs without neurofeedback. Moreover, the ASD group showed lower activity in premotor/motor areas during pre-neurofeedback run than controls, but not in transfer runs, where it was seemingly balanced by higher connectivity between the DLPFC and the motor cortex. Group comparison in the transfer run also showed significant differences in DLPFC-based connectivity between groups, including higher connectivity with areas integrated into the multidemand network (MDN) and the visual cortex. CONCLUSIONS: Neurofeedback seems to induce a higher between-group similarity of the whole-brain activity levels (including the target ROI) which might be promoted by changes in connectivity between the DLPFC and both high and low-level areas, including motor, visual and MDN regions.


Asunto(s)
Trastorno del Espectro Autista , Neurorretroalimentación , Humanos , Función Ejecutiva , Trastorno del Espectro Autista/terapia , Encéfalo/diagnóstico por imagen , Mapeo Encefálico
8.
BMC Med ; 22(1): 157, 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38609939

RESUMEN

BACKGROUND: Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual's journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes. METHODS: This consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS. RESULTS: The authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS. CONCLUSION: Greater attention needs to be given to this population as they navigate the CJS.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Humanos , Trastorno Autístico/diagnóstico , Trastorno Autístico/epidemiología , Trastorno Autístico/terapia , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/terapia , Derecho Penal , Comunicación , Reino Unido/epidemiología
9.
Sci Rep ; 14(1): 8082, 2024 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-38582936

RESUMEN

Transcranial magnetic stimulation (TMS) is a neurostimulation device used to modulate brain cortex activity. Our objective was to enhance the therapeutic effectiveness of low-frequency repeated TMS (LF-rTMS) in a rat model of autism spectrum disorder (ASD) induced by prenatal valproic acid (VPA) exposure through the injection of superparamagnetic iron oxide nanoparticles (SPIONs). For the induction of ASD, we administered prenatal VPA (600 mg/kg, I.P.) on the 12.5th day of pregnancy. At postnatal day 30, SPIONs were injected directly into the lateral ventricle of the brain. Subsequently, LF-rTMS treatment was applied for 14 consecutive days. Following the treatment period, behavioral analyses were conducted. At postnatal day 60, brain tissue was extracted, and both biochemical and histological analyses were performed. Our data revealed that prenatal VPA exposure led to behavioral alterations, including changes in social interactions, increased anxiety, and repetitive behavior, along with dysfunction in stress coping strategies. Additionally, we observed reduced levels of SYN, MAP2, and BDNF. These changes were accompanied by a decrease in dendritic spine density in the hippocampal CA1 area. However, LF-rTMS treatment combined with SPIONs successfully reversed these dysfunctions at the behavioral, biochemical, and histological levels, introducing a successful approach for the treatment of ASD.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Efectos Tardíos de la Exposición Prenatal , Embarazo , Femenino , Ratas , Animales , Humanos , Ácido Valproico/farmacología , Trastorno Autístico/terapia , Trastorno Autístico/tratamiento farmacológico , Trastorno del Espectro Autista/terapia , Trastorno del Espectro Autista/tratamiento farmacológico , Estimulación Magnética Transcraneal , Conducta Social , Nanopartículas Magnéticas de Óxido de Hierro , Efectos Tardíos de la Exposición Prenatal/terapia , Efectos Tardíos de la Exposición Prenatal/tratamiento farmacológico , Modelos Animales de Enfermedad , Conducta Animal/fisiología
10.
Artículo en Inglés | MEDLINE | ID: mdl-38442071

RESUMEN

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.Prim Care Companion CNS Disord 2024;26(2):23f03584.Author affiliations appear at the end of this article.


Asunto(s)
Trastorno del Espectro Autista , Psiquiatría , Humanos , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/terapia , Hospitales Generales , Pacientes Internos , Derivación y Consulta
11.
IEEE Trans Vis Comput Graph ; 30(5): 2119-2128, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38457325

RESUMEN

Children diagnosed with Autism Spectrum Disorder (ASD) often exhibit motor disorders. Dance Movement Therapy (DMT) has shown great potential for improving the motor control ability of children with ASD. However, traditional DMT methods often lack vividness and are difficult to implement effectively. To address this issue, we propose a Mixed Reality DMT approach, utilizing interactive virtual agents. This approach offers immersive training content and multi-sensory feedback. To improve the training performance of children with ASD, we introduce a novel training paradigm featuring a self-guided mode. This paradigm enables the rapid creation of a virtual twin agent of the child with ASD using a single photo to embody oneself, which can then guide oneself during training. We conducted an experiment with the participation of 24 children diagnosed with ASD (or ASD propensity), recording their training performance under various experimental conditions. Through expert rating, behavior coding of training sessions, and statistical analysis, our findings revealed that the use of the twin agent for self-guidance resulted in noticeable improvements in the training performance of children with ASD. These improvements were particularly evident in terms of enhancing movement quality and refining overall target-related responses. Our study holds clinical potential in the field of medical treatment and rehabilitation for children with ASD.


Asunto(s)
Realidad Aumentada , Trastorno del Espectro Autista , Danzaterapia , Niño , Humanos , Trastorno del Espectro Autista/terapia , Trastorno del Espectro Autista/diagnóstico , Danzaterapia/métodos , Gráficos por Computador , Movimiento
12.
Autism Res ; 17(4): 690-701, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38429884

RESUMEN

High quality science relies upon psychometrically valid and reliable measurement, yet very few Patient Reported Outcome Measures (PROMs) have been developed or thoroughly validated for use with autistic individuals. The present commentary summarizes the current state of autism PROM science, based on discussion at the Special Interest Group (SIG) at the 2022 International Society for Autism Research (INSAR) Annual Meeting and collective expertise of the authors. First, we identify current issues in autism PROM research including content and construct operationalization, informant-structure, measure accessibility, and measure validation and generalization. We then enumerate barriers to conducting and disseminating this research, such as a lack of guidance, concerns regarding funding and time, lack of accessible training and professionals with psychometric skills, difficulties collecting large representative samples, and challenges with dissemination. Lastly, we offer future priorities and resources to improve PROMs in autism research including a need to continue to evaluate and develop PROMs for autistic people using robust methods, to prioritize diverse and representative samples, to expand the breadth of psychometric properties and techniques, and to consider developing field specific guidelines. We remain extremely optimistic about the future directions of this area of autism research. This work is well positioned to have an immense, positive impact on our scientific understanding of autism and the everyday lives of autistic people and their families.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Humanos , Trastorno Autístico/terapia , Encuestas y Cuestionarios , Medición de Resultados Informados por el Paciente , Calidad de Vida , Trastorno del Espectro Autista/terapia
13.
Nat Commun ; 15(1): 2769, 2024 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-38553486

RESUMEN

Multiple neurological disorders are associated with gastrointestinal (GI) symptoms, including autism spectrum disorder (ASD). However, it is unclear whether GI distress itself can modify aspects of behavior. Here, we show that mice that experience repeated colitis have impaired active social engagement, as measured by interactions with a foreign mouse, even though signs of colitis were no longer present. We then tested the hypothesis that individuals with ASD harbor a microbiota that might differentially influence GI health by performing microbiota transplantation studies into male germfree animals, followed by induction of colitis. Animals that harbor a microbiota from ASD individuals have worsened gut phenotypes when compared to animals colonized with microbiotas from familial neurotypical (NT) controls. We identify the enrichment of Blautia species in all familial NT controls and observe an association between elevated abundance of Bacteroides uniformis and reductions in intestinal injury. Oral treatment with either of these microbes reduces colon injury in mice. Finally, provision of a Blautia isolate from a NT control ameliorates gut injury-associated active social engagement in mice. Collectively, our data demonstrate that past intestinal distress is associated with changes in active social behavior in mice that can be ameliorated by supplementation of members of the human microbiota.


Asunto(s)
Trastorno del Espectro Autista , Colitis , Enfermedades Gastrointestinales , Microbiota , Humanos , Masculino , Ratones , Animales , Trastorno del Espectro Autista/terapia , Participación Social , Colitis/terapia , Suplementos Dietéticos
14.
Med J Malaysia ; 79(Suppl 1): 187-196, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38555904

RESUMEN

INTRODUCTION: Children with Autism Spectrum Disorder (ASD) often face significant challenges in verbal communication, social interaction, and exhibit repetitive behavioral patterns. These challenges persist across various developmental stages, particularly impacting their social communication abilities. This scoping review aims to explore the range of occupational therapy interventions that are employed to enhance social communication skills in children with ASD. MATERIALS AND METHODS: A literature search was conducted independently on scientific databases: Scopus, Google Scholar, Science Direct, and Web of Science (WOS). The process was carried out according to the PRISMA guidelines. RESULT: Of the 195 studies identified, 8 articles involving 185 participants, aged 17 months to 12 years old, across six countries met the inclusion criteria. The majority of studies indicate significant improvement in social communication abilities, while one study demonstrates insignificant results and another study presents mixed outcomes, utilising two different assessment tools. CONCLUSION: Occupational therapy has showed promise in improving social communication in children with ASD. Nonetheless, this review emphasises the need for greater indepth study and long-term evaluation to better explain and sustain these benefits. More research is needed to develop OT interventions that are both effective and evidence-based.


Asunto(s)
Trastorno del Espectro Autista , Terapia Ocupacional , Niño , Humanos , Trastorno del Espectro Autista/terapia , Comunicación
15.
Pediatrics ; 153(4)2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38501189

RESUMEN

OBJECTIVE: Our objectives with this study were to describe the frequency of selected cooccurring health conditions and individualized education program (IEP) services and post-high school transition planning for adolescents with autism spectrum disorder and identify disparities by sex, intellectual ability, race or ethnicity, and geographic area. METHODS: The study sample included 1787 adolescents born in 2004 who were identified as having autism through a health and education record review through age 16 years in 2020. These adolescents were part of a longitudinal population-based surveillance birth cohort from the Autism and Developmental Disabilities Monitoring Network from 2004 to 2020 in 5 US catchment areas. RESULTS: Attention deficit hyperactivity disorder (47%) and anxiety (39%) were the most common cooccurring health conditions. Anxiety was less commonly identified for those with intellectual disability than those without. It was also less commonly identified among Black adolescents compared with White or Hispanic adolescents. There was wide variation across Autism and Developmental Disabilities Monitoring Network sites in the provision of school-based IEP services. Students with intellectual disability were less likely to receive school-based mental health services and more likely to have a goal for postsecondary independent living skills compared with those without intellectual disability. A total of 37% of students did not participate in standardized testing. CONCLUSIONS: We identified disparities in the identification of cooccurring conditions and school-based IEP services, practices, and transition planning. Working with pediatric health and education providers, families, and adolescents with autism will be important to identify contributing factors and to focus efforts to reduce disparities in the supports and services adolescents with autism have access to and receive.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Discapacidad Intelectual , Adolescente , Adulto , Niño , Humanos , Adulto Joven , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/terapia , Trastorno Autístico/epidemiología , Trastorno Autístico/terapia , Etnicidad , Hispánicos o Latinos , Discapacidad Intelectual/epidemiología , Discapacidad Intelectual/terapia , Negro o Afroamericano , Blanco
16.
J Clin Pediatr Dent ; 48(2): 82-87, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38548636

RESUMEN

Individuals with autism spectrum disorders (ASD) have difficulty accessing dental care. We aim to verify whether individuals with ASD are properly managed by checking the frequency of dental visits, cost and severity of dental treatment compared with those without ASD. This cross-sectional study used the Korean Health Insurance Database to analyze the frequency, cost and severity of dental treatment in 209,780 people under the age of 19 with or without ASD in 2020. The average frequency of dental visits for individuals without ASD was 2.98 times, which was significantly higher (p < 0.001) than the 2.89 times for those with ASD. However, the average dental cost for individuals with ASD was USD 132.63, which was significantly higher (p < 0.001) than USD 116.57 for those without ASD. Additionally, the average number of times that individuals without ASD received severe dental treatment was 1.23 times, significantly higher than the 1.15 times for those with ASD. Further, per 10,000 people, we found that trauma treatment was recorded for an average of 21.90 individuals with ASD, significantly higher than the 7.75 recorded for those without ASD (p < 0.001). Individuals with ASD encounter significant disparities in accessing dental care, as evidenced by their relatively infrequent dental visits. This discrepancy can be attributed to various barriers including the financial burden compared with those without ASD.


Asunto(s)
Trastorno del Espectro Autista , Niño , Humanos , Adolescente , Trastorno del Espectro Autista/terapia , Estudios Transversales , Atención Odontológica , República de Corea/epidemiología
17.
J Dev Behav Pediatr ; 45(2): e137-e142, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38451868

RESUMEN

OBJECTIVE: Catatonia is a distinct and severe medical syndrome comprising motor, somatic, and psychiatric symptoms that is reported in upwards of 17% of young patients with autism spectrum disorders. Clinical experience indicates catatonia is often under-recognized in this clinical population. Here we characterize the clinical presentation of catatonia in patients with and without neurodevelopmental disorders (NDDs) including autism, including the time from symptom onset to diagnosis of catatonia. METHOD: Retrospective chart review of electronic medical records at a large, academic pediatric medical center identified 113 pediatric and young adult patients with a charted history of catatonia, as identified by an encounter diagnosis or problem list entry between September 2017 and September 2021. Workup, treatments, and diagnoses (psychiatric, neurodevelopmental, and genetic) were identified. RESULTS: We observed a clear and substantial delay in identification of catatonia in those with NDDs (diagnosis after 330 days for those without psychosis) compared with neurotypical patients (∼16 days). Psychiatry involvement was associated with shorter delays. CONCLUSION: Intellectual disability and autism are risk factors for significantly delayed diagnosis of catatonia. It is unknown whether delayed diagnosis contributes to the difficulty in treating catatonia in this patient population or whether the treatment difficulties relate instead to differential and ongoing biological mechanisms and underlying encephalopathy. Overall, these findings highlight the importance of increased recognition of catatonia symptoms in patients with NDDs and suggest early referral to psychiatric specialists may shorten the delay to diagnosis.


Asunto(s)
Trastorno del Espectro Autista , Catatonia , Discapacidad Intelectual , Trastornos del Neurodesarrollo , Adulto Joven , Humanos , Niño , Catatonia/diagnóstico , Catatonia/etiología , Trastorno del Espectro Autista/terapia , Discapacidad Intelectual/diagnóstico , Estudios Retrospectivos , Diagnóstico Tardío/efectos adversos , Factores de Riesgo
18.
Front Immunol ; 15: 1341404, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38455067

RESUMEN

Autism spectrum disorder (ASD) encompasses a range of neurodevelopmental conditions characterized by enduring impairments in social communication and interaction together with restricted repetitive behaviors, interests, and activities. No targeted pharmacological or physical interventions are currently available for ASD. However, emerging evidence has indicated a potential association between the development of ASD and dysregulation of the gut-brain axis. Repetitive transcranial magnetic stimulation (rTMS), a noninvasive diagnostic and therapeutic approach, has demonstrated positive outcomes in diverse psychiatric disorders; however, its efficacy in treating ASD and its accompanying gastrointestinal effects, particularly the effects on the gut-brain axis, remain unclear. Hence, this review aimed to thoroughly examine the existing research on the application of rTMS in the treatment of ASD. Additionally, the review explored the interplay between rTMS and the gut microbiota in children with ASD, focusing on the gut-brain axis. Furthermore, the review delved into the integration of rTMS and gut microbiota modulation as a targeted approach for ASD treatment based on recent literature. This review emphasizes the potential synergistic effects of rTMS and gut microbiota interventions, describes the underlying mechanisms, and proposes a potential therapeutic strategy for specific subsets of individuals with ASD.


Asunto(s)
Trastorno del Espectro Autista , Microbioma Gastrointestinal , Niño , Humanos , Microbioma Gastrointestinal/fisiología , Estimulación Magnética Transcraneal , Eje Cerebro-Intestino , Trastorno del Espectro Autista/terapia , Comunicación
19.
Can Med Educ J ; 15(1): 37-47, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38528903

RESUMEN

Introduction: To provide competent care to patients with autism spectrum disorder (ASD) or intellectual developmental disorder (IDD), healthcare professionals must recognize the needs of neurodivergent populations and adapt their clinical approach. We assessed the perceived preparedness of medical students to adapt care delivery for patients with ASD/IDD, as well as their perceptions on neurodiversity education. Methods: We conducted a sequential explanatory mixed-methods study on undergraduate medical students at McGill University during the academic year 2020-2021. We administered an online survey, followed by semi-structured interviews. We analyzed data using descriptive statistics and thematic analysis. We integrated findings at the interpretation level. Results: We included two-hundred-ten survey responses (~29% of class), and 12 interviews. Few students felt prepared to adjust care for patients with ASD/IDD despite most indicating doing so was important. Ninety-seven percent desired more training regarding care accommodation for neurodivergent patients. Thematic analysis unveiled the perception of current insufficient education, and the value of experiential learning. Discussion/Conclusions: This study highlights low perceived preparedness of medical students to accommodate care for neurodivergent patients, and a desire for more instruction. Incorporating interactive training in medical school curricula regarding modifying care delivery for neurodivergent individuals may improve the perceived preparedness of medical trainees to work with these patients and care quality.


Introduction: Pour fournir des soins compétents aux patients atteints d'un trouble du spectre de l'autisme (TSA) ou d'un trouble du développement intellectuel (TDI), les professionnels de la santé doivent reconnaître les besoins des populations neurodivergentes et adapter leur approche clinique. Nous avons évalué le degré perçu de préparation des étudiants en médecine à adapter la prestation de soins aux patients atteints de TSA/TDI, ainsi que leurs perceptions de la formation relative à la neurodiversité. Méthodes: Nous avons mené une étude séquentielle explicative à méthodes mixtes auprès d'étudiants en médecine de premier cycle de l'Université McGill au cours de l'année universitaire 2020-2021. Nous avons administré un sondage en ligne, suivi d'entretiens semi-structurés. Nous avons analysé les données en faisant appel à la statistique descriptive et à une analyse thématique. Nous avons intégré les résultats sur le plan interprétatif. Résultats: Nous avons inclus deux cent dix réponses à l'enquête (~29% de la classe), et 12 entretiens. Peu d'étudiants se sentaient préparés à adapter les soins aux patients atteints de TSA/TDI, bien que la plupart d'entre eux aient indiqué qu'il était important de le faire. Quatre-vingt-dix-sept pour cent d'entre eux souhaitaient davantage de formation sur l'adaptation des soins aux patients neurodivergents. L'analyse thématique a révélé que les participants considéraient la formation actuelle insuffisante et jugeaient utile l'apprentissage par l'expérience. Discussion/Conclusions: Cette étude met en évidence le faible niveau de préparation perçu par les étudiants en médecine en ce qui concerne l'adaptation des soins aux patients neurodivergents, ainsi que le désir d'une formation plus poussée. L'intégration dans les programmes des facultés de médecine d'une formation interactive portant sur la modification de la prestation des soins pour les personnes neurodivergentes pourrait améliorer la perception des étudiants en médecine de leur degré de préparation à travailler avec ce type de patients et de la qualité des soins.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Discapacidad Intelectual , Estudiantes de Medicina , Humanos , Trastorno del Espectro Autista/terapia , Discapacidad Intelectual/terapia , Competencia Clínica , Atención a la Salud
20.
J Contemp Dent Pract ; 25(1): 20-28, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38514427

RESUMEN

AIM: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by unique behavioral patterns, treating children with ASD in the dental clinic has been a great challenge due to their behavior. This study aims to determine the effectiveness of culturally adapted dental visual aids in modifying behavior patterns during dental visits in children with ASD. MATERIALS AND METHODS: A controlled, blinded, randomized, clinical trial, with 64 children diagnosed with ASD, were randomly divided into two groups. The study took place between January 2019 and January 2021. The experimental group was provided with culturally adapted dental visual aids created especially for this research and the control group was provided with universal dental visual aids. The children's behavior patterns were evaluated before and after using the dental visual aids. SPSS v.25 was used to process all the data. RESULTS: Behavior patterns have modified significantly in the experimental group (p < 0.001) however, it was statistically insignificant in the control group (p = 0.077). In terms of behavioral patterns, the experimental group outperformed the control group significantly (p < 0.001). CONCLUSION: The culturally adapted dental visual aids have shown effectiveness in modifying behavior patterns in children diagnosed with ASD during dental visits. CLINICAL SIGNIFICANCE: By evaluating the impact of culturally adapted visual aids on behavior management, the study can enhance the accessibility and effectiveness of dental care for this vulnerable population, ultimately promoting better oral health outcomes and reducing potential trauma associated with dental visits for children with ASD. How to cite this article: Aljubour AA, AbdElBaki M, El Meligy O, et al. Culturally Adapted Dental Visual Aids Effect on Behavior Management during Dental Visits in Children with Autism Spectrum Disorder. J Contemp Dent Pract 2024;25(1):20-28.


Asunto(s)
Trastorno del Espectro Autista , Niño , Humanos , Recursos Audiovisuales , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/terapia , Conducta Infantil , Método Doble Ciego
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