Autism Spectrum Disorder & Traumatic Brain Injury: Assessment & Treatment Strategies in the Inpatient Rehabilitation Setting

Background: Patients with autism spectrum disorder (ASD) or other mental or physical limitations experience an imbalance in the frequency of dental treatment as compared with the general patient population, in part, due to inadequate pre-graduate training of future dentists. Case presentation: This case report describes a successful anterior tooth restoration, in awake state, in a 15-year-old boy with early childhood autism. The procedure was carried out independently by students of dentistry within the scope of their integrated clinical training semesters. Desensitization sessions were used as a preparatory measure and elements of behavioral facilitation (tell-show-feel-feel-do) were applied during the treatment. Conclusions: To avoid discrimination of this group of patients in the provision and quality of dental care, a structured approach to the transfer of theoretical and practical knowledge in the field of special care dentistry is indispensable. To this end, treatment strategies for special care patients should be taught to pre-graduate dental students as a fundamental part of their university curriculum.

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Insomnia and Treatment Strategies: Improving Quality of Life in Children with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-020-04705-y ◽

2020 ◽

Author(s):

Bárbara Virginia Vitti-Ruela ◽

Vinícius Dokkedal-Silva ◽

Priscila Kalil Morelhão ◽

Sandra Doria Xavier ◽

Sergio Tufik ◽

...

Keyword(s):

Quality Of Life ◽

Autism Spectrum Disorder ◽

Treatment Strategies ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder

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Ketogenic diet as possible therapy of autism spectrum disorder — review and implication

Journal of Medical Science ◽

10.20883/jms.297 ◽

2019 ◽

Vol 87 (4) ◽

pp. 218-224

Author(s):

Aleksander Rajczewski ◽

Magdalena Gibas-Dorna

Keyword(s):

Autism Spectrum Disorder ◽

Ketogenic Diet ◽

Animal Studies ◽

Neurodevelopmental Disorder ◽

Treatment Strategies ◽

Medium Chain Triglyceride ◽

Autism Spectrum ◽

Human Studies ◽

Spectrum Disorder ◽

Therapeutic Effects

Autism spectrum disorder (ASD) has become widespread neurodevelopmental disorder, which currently can be treated with only few therapeutic options. Furthermore, their effectiveness is limited therefore novel treatment strategies for ASD are needed. This review seeks to address this need by discussing a ketogenic diet (KD) in the context of ASD therapy. KD effects have been examined in animal and human studies. They indicate effectiveness of KD by improving autistic features. Moreover, animal studies have revealed clinically useful information about caloric restriction component of KD, which is not necessary to achieve therapeutic effects. Significantly administration of KD but not β-hydroxybutyrate or acetone has a therapeutic effect on social interactions. Human studies are scarce, however previous researches imply KD as an effective treatment at least in certain types of autism. KD in an altered form as: modified Atkins diet (MAD), ketogenic gluten-free diet with supplemental medium-chain triglyceride (MCT), and John Radcliffe ketogenic diet is an alternative to classic KD. These variants provide better quality of nutrition and are less strict, thus less difficult to maintain. KD is described as safe with limited, easily manageable adverse effects. Taken together human and animal studies would seem to suggest that KD will become part of ASD treatment. However, in order to determine accurate recommendations for all ASD patients, further studies are required.

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Aggression in Autism Spectrum Disorder

The Oxford Handbook of Autism and Co-Occurring Psychiatric Conditions ◽

10.1093/oxfordhb/9780190910761.013.15 ◽

2020 ◽

pp. 283-304

Author(s):

Margaret C. Souders ◽

Briana J. Taylor ◽

Stefanie Zavodny Jackson

Keyword(s):

Autism Spectrum Disorder ◽

Treatment Effectiveness ◽

Treatment Strategies ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Behavioral Strategies ◽

Adults With Autism ◽

Assessment Approach ◽

Adolescents And Adults ◽

Underlying Mechanisms

Aggression is a clinically significant problem for many children, adolescents, and adults with autism spectrum disorder (ASD). The high prevalence and negative outcomes associated with aggression in individuals with ASD make it an especially important treatment target. Emerging research suggests that aggression is associated with both core symptoms and co-occurring conditions among individuals with ASD; however, research on etiology and underlying mechanisms of symptoms remains limited. Although there are few standardized tools developed specifically for assessment of aggression in people with ASD, practitioners are encouraged to use a multi-informant and multimodal assessment approach, with particular focus on identifying the environmental variables that contribute to the occurrence and maintenance of aggression. Treatment strategies with the most empirical evidence include behavioral strategies and medication. Future areas for research include larger scale studies of etiology, underlying mechanisms, and treatment effectiveness across the lifespan.

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Selectivity and Food Conduct in Children with Autism Spectrum Disorder: A Brief Systematic Review

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt21211 ◽

2021 ◽

pp. 71-76

Author(s):

Augusto de Almeida Segundo Neto ◽

Leandro Diniz Soares ◽

Durval Ribas Filho

Keyword(s):

Autism Spectrum Disorder ◽

Eating Behaviors ◽

Eating Habits ◽

Family Members ◽

Treatment Strategies ◽

Autism Spectrum ◽

Food Selectivity ◽

Spectrum Disorder ◽

Clinical Practices ◽

Children With Asd

Autism Spectrum Disorder (ASD) refers to an alteration in neurological development typified by deficits in social communication, as well as in restricted and repetitive patterns of behavior, interests, or activities, varying in a continuum demarcated by the severity levels of their symptomatic pictures. It is estimated that about 45 to 90% of children with ASD have deficiencies in their eating habits, which may include atypical eating patterns and persistent practices of food selectivity, thus limiting the diet of these subjects. Given this context, the present study has the central objective of discussing, through the bibliographic review, the implications resulting from selectivity and eating behaviors in children with an autism spectrum disorder. It is, therefore, a descriptive study with a qualitative approach, organized from a natural perspective, emphasizing in a contextualized and judicious way the analyzed theme. Literary findings suggest that the conduct of food selectivity is significant for both family members, through high levels of stress; as, and above all, for children with ASD, since they will be more likely to develop gastrointestinal disorders, low quality of life, reduced levels of nutrients necessary for their proper development and scurvy when compared to those with typical neurodevelopment. In this sense, it appears that recognition of the different clinical and behavioral patterns manifested in children with ASD through food selectivity, is an important issue for family members and professionals in their diverse clinical practices, considering that the recognition of these patterns will be immeasurable utility in the development of adequate and early treatment strategies.

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New Perspectives in Autism Spectrum Disorder associated with Tuberous Sclerosis

Journal of Pediatric Neurology ◽

10.1055/s-0037-1601445 ◽

2017 ◽

Vol 15 (03) ◽

pp. 123-128

Author(s):

Arianna Benvenuto ◽

Federica Graziola ◽

Romina Moavero ◽

Luigi Mazzone ◽

Leonardo Gialloreti ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

High Risk ◽

Tuberous Sclerosis ◽

Cognitive Skills ◽

Treatment Strategies ◽

Mtor Inhibitors ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Fine Motor ◽

Preclinical Studies

AbstractRecent advances in molecular genetics and preclinical studies of tuberous sclerosis complex (TSC) have helped to better understand the pathophysiology of TSC-related autism spectrum disorder (ASD). Furthermore, developmental studies have shown that infants with TSC begin to diverge from the neurotypical trajectories at the age of 6 months. Early abnormalities are often characterized by a delay in nonverbal cognitive skills, such as fine motor and visual reception domains followed by qualitative impairment of social communication. The expanding possibilities of an early diagnosis of TSC should increasingly allow the prompt identification of a population of infants at high risk for developing ASD. A presymptomatic diagnosis of TSC could facilitate not only the prospective investigation of developmental trajectories and early markers of ASD but also the evaluation of the efficacy of early interventions. Early identification of infants at high-risk for ASD, such as TSC infants, can allow designing individualized treatment strategies to address deficits in specific developmental domains associated with autism. The involvement of mammalian target of rapamycin (mTOR) in determining the behavioral phenotypes associated with TSC led to the hypothesis that mTOR inhibitors could also have a benefit on ASD symptoms. After the promising results from preclinical studies administrating rapamycin, clinical trials studying mTOR inhibitors are now undergoing.

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Reward processing in autism spectrum disorder and psychopathy: a systematic review

BJPsych Open ◽

10.1192/bjo.2021.160 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S41-S42

Author(s):

Patrick McLaughlin ◽

Marija-Magdalena Petrinovic ◽

Nigel Blackwood

Keyword(s):

Systematic Review ◽

Autism Spectrum Disorder ◽

English Language ◽

Treatment Strategies ◽

Autism Spectrum ◽

Reward Processing ◽

Spectrum Disorder ◽

Social Reward ◽

Social Dysfunction ◽

The Social

AimsEmerging research suggests that aberrant reward processing may underpin much of the social dysfunction we see in psychiatric disorders. Two conditions associated with marked social dysfunction are Autism Spectrum Disorder (ASD) and Psychopathy. However, no review to date has directly contrasted reward processing in both conditions and incorporated literature on social and non-social rewards. This systematic review aims to: (i) identify and compare reward processing abnormalities in ASD and Psychopathy as demonstrated in task-based functional magnetic resonance imaging (fMRI) studies; and (ii) identify correlations between fMRI reward processing abnormalities and manifested symptoms, with a focus on those giving rise to social dysfunction.MethodThe electronic databases PubMed, PsycINFO and EMBASE were searched to identify studies satisfying the following criteria: (i) a validated measure was used to assess ASD or Psychopathy; (ii) the study was published in an English language peer review journal; (iii) the age of participants was 18 years or older; (iv) individuals participated in a reward-based experimental paradigm; and (v) the response to the reward was measure using fMRI.ResultA total of 12 articles were identified that satisfied inclusion criteria. Six studies examined reward processing in ASD and six studies examined reward processing in Psychopathy. All studies in both conditions indicated some degree of abnormal reward-related neural response. The most replicated findings were aberrant responses in the Ventral Striatum (VS). Autism Spectrum Disorder was typified by VS hypoactivation to social and non-social reward, while Psychopathy was associated with VS hyperactivation in response to non-social reward anticipation. No studies were identified of social reward in Psychopathy.ConclusionThe reported fMRI findings correlate with clinical observations in both conditions. Reduced reward response in ASD to a range of social and non-social stimuli would provide a parsimonious account of the social and non-social deficits that characterise the condition. Enhanced responses to the anticipation of reward in Psychopathy provides an account of the ruthless and destructive pursuit of reward-driven behaviours not inhibited by immoral or aversive signals. If, as the literature suggests, reward circuitry dysfunction plays a role in the development and manifestation of symptoms in both conditions, reward processing and its underlying neural circuitry may represent important targets for the development of novel treatment strategies.

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