Autism spectrum disorder during French COVID-19 lockdown: The importance of individualized support.

AIM: This observational and repeated measures study assesses the impact of the first, most restrictive, COVID-19 lockdown in France on children with autism spectrum disorder (ASD) and their families. METHOD: During the first COVID-19 lockdown, families of ASD children enrolled in the day-care centre of the child and adolescent psychiatry department of the Tours University Hospital were contacted weekly. A total of 95 parents took part in this study between the 18th of March and the 8th of May 2020. Advice and personalized support materials were provided by professionals involved in children's care. Questions regarding clinical outcomes were addressed to parents, and their assessments were reported on a 5-point Likert scale. Two time points were considered: the first 3 weeks and the three last weeks of the lockdown period. RESULTS: No difference was highlighted between clinical scores collected at the beginning and at the end of the lockdown. No effect of intellectual disability, accommodation type (house or apartment) or parental status was observed. The reasons for the relatively minor impact of the COVID-19 lockdown observed in this study are discussed. CONCLUSIONS: Individualized and regular support provided by caregivers, familiar with ASD children's clinical specificities, in the context of a trusted relationship with parents may have contributed to the stability of this population. This 'tailor-made' approach should be promoted, in order to help support families of ASD children in this challenging period.

Adult attention-deficit/hyperactivity disorder among alcohol use disorder inpatients is associated with food addiction and binge eating, but not BMI.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is associated with binge eating (BE), food addiction (FA), and obesity/higher BMI in individuals without alcohol use disorder (AUD). ADHD is highly prevalent in patients with AUD, but it is unknown whether the presence of comorbid AUD might change the nature of the association between ADHD, BE, FA and BMI (food and alcohol may either compete for the same brain neurocircuitry or share vulnerability risk factors). Here, we filled this gap by testing the association between ADHD and FA/BE in adult patients hospitalized for AUD, with the strength of simultaneously assessing childhood and adult ADHD. We also investigated the association between ADHD and BMI, and the other factors associated with BMI (FA/BE, AUD severity). METHODS: We included 149 AUD inpatients between November 2018 and April 2019. We assessed both childhood and adulthood ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (modified Yale Food Addiction Scale 2.0), BE (Binge Eating Scale), and BMI and AUD (clinical assessment). RESULTS: In multivariable analyses adjusted for age, adult ADHD was associated with higher BE scores (p = .048), but not significant BE (9% vs. 7%; p = .70). ADHD was also associated with FA diagnosis and the number or FA symptoms, with larger effect size for adult (ORs: 9.45[95%CI: 2.82-31.74] and 1.38[1.13-1.69], respectively) than childhood ADHD (ORs: 4.45[1.37-14.46] and 1.40[1.13-1.75], respectively). In multivariable analysis, BMI was associated with both significant BE (p < .001) and FA diagnosis (p = .014), but not adult ADHD nor AUD severity. CONCLUSION: In patients hospitalized for AUD, self-reported adult ADHD was associated with FA and BE, but not BMI. Our results set the groundwork for longitudinal research on the link between ADHD, FA, BE, and BMI in AUD inpatients.

[How and why to diagnose autism?] / Comment et pourquoi faire le diagnostic d'autisme ?

How and why to diagnose autism? The diagnosis of autism spectrum disorder can be made today before the age of 3 years. a consensus is emerging today that early care is fundamental to improving behavioral prognosis. In fact the determining neural plasticity in the first years of life of all children is the key argument of the search for early detection. Beyond the disorders highlighted, any concern of parents for development, especially that of language and social interaction, should be considered as a major warning sign and give rise to a thorough review of the development of the child by the doctor ensures his usual follow-up, within the framework of a consultation dedicated to the identification of a TSA. The child must quickly be referred to a second-line team trained in early diagnosis.

Comment et pourquoi faire le diagnostic d'autisme ? Le diagnostic de trouble du spectre de l'autisme peut être aujourd'hui porté avant l'âge de 3 ans. Un consensus se dégage aujourd'hui pour dire que des soins précoces sont fondamentaux pour une amélioration du pronostic comportemental. En fait, la plasticité neuronale déterminante dans les premières années de vie de tous les enfants est l'argument clé de la recherche d'un dépistage précoce. Au-delà des troubles mis en exergue, toute inquiétude des parents pour le développement, et particulièrement celui du langage et des interactions sociales, doit être considérée comme un signe d'alerte majeur et donner lieu à un examen approfondi du développement de l'enfant par le médecin assurant son suivi habituel, dans le cadre d'une consultation dédiée au repérage d'un trouble du spectre de l'autisme. Rapidement, l'enfant doit être orienté vers une équipe de seconde ligne formée au diagnostic précoce.