Epidural labour analgesia and autism spectrum disorder: is the current evidence sufficient to dismiss an association?

2022 ◽  
Author(s):  
Alexander J. Butwick ◽  
Daniel A. Abrams ◽  
Cynthia A. Wong
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Labour Analgesia ◽  
Spectrum Disorder ◽  
Current Evidence

scholarly journals Efficacy and safety of microbiota transfer therapy for the management of autism spectrum disorder in children: a systematic review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 48
Author(s):  
Pablo Daniel Estrella Porter ◽  
Luis Eduardo Guzmán Freire ◽  
Joseth Paulina Adatty Molina ◽  
María Verónica Burneo Raza ◽  
Henry Alejandro Carrión Celi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Intervention Group ◽  
Autism Spectrum ◽  
Nervous System Development ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Level Of Evidence

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with an unclear etiologic mechanism. Following suggestions in the literature of a close relation between the gut microbiota and the central nervous system development, neuroimmune and neuroendocrine systems, new theories and strategies of the management of ASD in children focus on the brain-gut axis via microbiota transfer therapy. Despite the regular appearance in the news, the level of evidence supporting this intervention is unclear and to this date, no systematic review on this issue has been published. Methods: We conducted a systematic literature review of the efficacy and safety of microbiota transfer therapy for the management of ASD in children. MEDLINE via PubMed, LILACS IBECS via BVS, EMBASE via Ovid, Scopus and Cochrane Library were searched on 19th April 2018. Results: One single study published in 2017 was identified. The intervention group included 18 patients and showed significant clinical improvements in the gastrointestinal and ASD-related symptoms. The clinical procedure was reported as safe and well-tolerated with some transitory adverse effects. Conclusions: The causality and correlation of the intervention and the expected outcomes cannot be assumed with current evidence. In addition, recommendations about the effectiveness or safety of microbiota transfer therapy in children with ASD cannot be currently issued. Randomized controlled trials and clinical protocols for the intervention are needed.

scholarly journals Depression in Children and Adolescents with Autism Spectrum Disorder

Children ◽  
2018 ◽  
Vol 5 (9) ◽  
pp. 112 ◽  
Author(s):  
Melissa DeFilippis
Keyword(s):  
Autism Spectrum Disorder ◽  
Children And Adolescents ◽  
Rating Scales ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
High Rate ◽  
Current Evidence ◽  
Comorbid Depression ◽  
Adolescents With Asd ◽  
Higher Functioning

Autism spectrum disorder (ASD) has a high rate of psychiatric comorbidity. The prevalence of comorbid depression seems to correlate with higher functioning forms of ASD and increasing age. Adolescence is a time when youth struggle with identity and interpersonal relationships, and a diagnosis of ASD further complicates this process. Adolescents with ASD may be more aware of the social communication deficits that come with the diagnosis than children with ASD, and it is theorized that higher functioning adolescents may experience this more acutely. While this may be true, the lack of reliable rating and diagnostic scales for depression in individuals with ASD makes it difficult to accurately measure rates of depression among individuals with more severe verbal deficits. While some research has focused on the prevalence of comorbid depression in children and adolescents with ASD and on the associated risk factors, there is very little evidence guiding treatment, including no empirical studies on psychopharmacology for depression in this population. Available evidence exists only in psychosocial approaches to treatment at this time and is mostly limited to adult studies. Current evidence will be presented in this review, including prevalence rates of depression in youth with ASD, various risk and protective factors, the use of diagnostic rating scales, and treatment studies. The lack of evidence supporting various treatment approaches will be highlighted, including challenges specific to the treatment of depression in ASD, which are not addressed in the current treatment studies in typically developing youth with depression.

Down Syndrome and Autism Spectrum Disorder Dual Diagnosis: Important Considerations for Speech-Language Pathologists

2020 ◽  
pp. 1-13
Author(s):  
Theresa M. Versaci ◽  
Laura J. Mattie ◽  
Laura J. Imming
Keyword(s):  
Autism Spectrum Disorder ◽  
Down Syndrome ◽  
Service Delivery ◽  
Dual Diagnosis ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Language Therapy ◽  
Speech Language Pathologists ◽  
Therapy Services

Purpose Individuals with Down syndrome (DS) often receive speech-language therapy services starting in infancy or toddlerhood. When providing speech-language therapy services for children with DS, speech-language pathologists (SLPs) need to consider the impact of other developmental and comorbid disorders that can affect language development, such as the presence of a dual diagnosis of DS and autism spectrum disorder (DS + ASD). The prevalence rate of ASD in DS is ~20%, which is higher than in the general population. Method This clinical focus article aims to provide SLPs with additional knowledge about DS + ASD to improve service delivery and support parents' ability to advocate for their child with confirmed or suspected DS + ASD. This is accomplished by summarizing the current evidence base on the presence of ASD in DS and discussing implications of a DS + ASD diagnosis for clinical practice with SLPs. Conclusions SLPs play a key role in supporting families of those with DS + ASD by advocating and educating. By understanding the unique profiles of strengths and weaknesses of individuals with DS + ASD, SLPs can provide appropriate service delivery (i.e., treatment and intervention approaches) and advocacy for their clients and their families.

scholarly journals Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Clémence Bougeard ◽  
Françoise Picarel-Blanchot ◽  
Ramona Schmid ◽  
Rosanne Campbell ◽  
Jan Buitelaar
Keyword(s):  
Autism Spectrum Disorder ◽  
Children And Adolescents ◽  
Sleep Disorders ◽  
Hearing Impairment ◽  
Depressive Disorders ◽  
The United States ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Clear Understanding

Objective: Individuals with autism spectrum disorder often present somatic and/or psychiatric co-morbid disorders. The DSM-5 allows for consideration of additional diagnoses besides ASD and may have impacted the prevalence of co-morbidities as well as being limited in capturing the true differences in prevalence observed between males and females. We describe the prevalence of ASD and frequently observed co-morbidities in children and adolescents (<18 years) in the United States and five European countries.Methods: Two systematic literature reviews were conducted in PubMed and Embase for the period 2014–2019 and focusing on the prevalence of ASD and nine co-morbidities of interest based on their frequency and/or severity: Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depressive disorders, epilepsy, intellectual disability (ID), sleep disorders, sight/hearing impairment/loss, and gastro-intestinal syndromes (GI).Results: Thirteen studies on prevalence of ASD and 33 on prevalence of co-morbidities were included. Prevalence of ASD was 1.70 and 1.85% in US children aged 4 and 8 years respectively, while prevalence in Europe ranged between 0.38 and 1.55%. Additionally, current evidence is supportive of a global increase in ASD prevalence over the past years. Substantial heterogeneity in prevalence of co-morbidities was observed: ADHD (0.00–86.00%), anxiety (0.00–82.20%), depressive disorders (0.00–74.80%), epilepsy (2.80–77.50%), ID (0.00–91.70%), sleep disorders (2.08–72.50%), sight/hearing impairment/loss (0.00–14.90%/0.00–4.90%), and GI syndromes (0.00–67.80%). Studies were heterogeneous in terms of design and method to estimate prevalence. Gender appears to represent a risk factor for co-morbid ADHD (higher in males) and epilepsy/seizure (higher in females) while age is also associated with ADHD and anxiety (increasing until adolescence).Conclusion: Our results provide a descriptive review of the prevalence of ASD and its co-morbidities in children and adolescents. These insights can be valuable for clinicians and parents/guardians of autistic children. Prevalence of ASD has increased over time while co-morbidities bring additional heterogeneity to the clinical presentation, which further advocates for personalized approaches to treatment and support. Having a clear understanding of the prevalence of ASD and its co-morbidities is important to raise awareness among stakeholders.

Introduction to the Forum: Literacy in Autism—Across the Spectrum

2021 ◽  
Vol 52 (1) ◽  
pp. 149-152
Author(s):  
Marleen F. Westerveld ◽  
Jessica Paynter
Keyword(s):  
Autism Spectrum Disorder ◽  
At Risk ◽  
Children And Adolescents ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Clinical Implications ◽  
Literacy Assessment ◽  
Speech Language Pathologists ◽  
Children With Asd

Purpose The purpose of this article is to introduce the LSHSS Forum: Literacy in Autism—Across the Spectrum. The articles in this forum provide an overview of the current evidence related to literacy in autism spectrum disorder (ASD) from preschool to adolescence and highlight the high literacy needs of this population. Method This introduction provides an overview of some of the reasons why children with ASD are at risk of persistent literacy difficulties and a summary of the six articles included in this forum. Conclusion More research is clearly needed to better understand which factors contribute to the high literacy needs in this population. For now, based on the best available evidence, the authors in this forum provide clear clinical implications that should be highly useful for speech-language pathologists and other professionals involved in literacy assessment and intervention for children and adolescents on the autism spectrum.

Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses

2020 ◽  
Author(s):  
Md Mahbub Hossain ◽  
Nusrat Khan ◽  
Abida Sultana ◽  
Ping Ma ◽  
E. Lisako J. McKyer ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychiatric Disorders ◽  
Systematic Reviews ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Umbrella Review ◽  
Comorbid Psychiatric Disorders ◽  
Analytic Review ◽  
Meta Analyses

<p>With ever-increasing prevalence of various mental disorders worldwide, a comprehensive evaluation of the prevalence of co-occurring psychiatric disorders among individuals with autism spectrum disorder (ASD) is needed to strengthen the knowledge base. This umbrella review aims to summarize the current evidence on the prevalence of comorbid psychiatric disorders among people with ASD. A systematic search of 12 major databases and additional sources was conducted. Any systematically conducted narrative, qualitative, or meta-analytic review reporting the prevalence of psychiatric disorders among people with ASD with no age or geographical restriction were included. From a total of 2755 records, 26 articles representing 14 systematic reviews and 12 meta-analyses met the criteria of this review. The synthesized findings reveal a high burden of comorbid psychiatric disorders among people with ASD, including anxiety disorders, depressive disorders, bipolar and mood disorders, schizophrenia spectrum, suicidal behavior disorders, attention-deficit/hyperactivity disorder, disruptive, impulse-control and conduct disorders amongst diverse age groups, with a majority in younger participants. Most studies were conducted in developed nations, with limited evidence from low and middle-income countries. These synthesized findings provide high-quality evidence for clinical and policy-level decision-making from a global overview of the status of comorbid psychiatric disorders among people with ASD.</p>

Oral health status of children and adolescents with autism spectrum disorder: A systematic review of case-control studies and meta-analysis

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1047-1066 ◽  
Author(s):  
Phoebe PY Lam ◽  
Rennan Du ◽  
Simin Peng ◽  
Colman PJ McGrath ◽  
Cynthia KY Yiu
Keyword(s):  
Autism Spectrum Disorder ◽  
Health Status ◽  
Oral Health ◽  
Children And Adolescents ◽  
Oral Health Status ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Tooth Decay ◽  
Oral Diseases

Children and adolescents with autism spectrum disorder are thought to be more vulnerable to oral diseases than typically developing individuals due to cariogenic dietary habits, self-injurious behaviors, and increased barriers to dental care services. This review aimed to summarize current evidence comparing the oral health status of people diagnosed with and without autism spectrum disorder. Study selection and screening, data extraction, risk of bias assessment, and quality-of-evidence evaluation was conducted using the Grading of Recommendations Assessment Development and Evaluation approach and performed independently by two reviewers. A total of 16 studies were found eligible for qualitative synthesis and 15 were included in quantitative analysis. When comparing children and adolescents diagnosed with and without autism spectrum disorder, significantly higher prevalence of bruxism was identified. Individuals diagnosed with autism spectrum disorder were also found to have significantly lower salivary pH. However, no statistically significant differences in terms of caries prevalence and severity, oral hygiene and periodontal status, prevalence of malocclusion, dental traumatic injuries, as well as salivary flow rate and buffering capacity were found. The quality of evidence of each outcome was graded as very low mainly due to the overall high risk of bias, considerable heterogeneity, and imprecision. Lay Abstract Children and adolescents diagnosed with Autism Spectrum Disorder (ASD) are thought to be more vulnerable to oral diseases than typically-developing individuals. This is due to their increased barriers to dental care services, self-harm behaviors and dietary habits that may favor tooth decay. In this review, we summarized the current evidence comparing the oral health status of children and adolescents diagnosed with and without ASD. After a systematic search in the literature, we found that the salivary pH of individuals diagnosed with ASD was significantly lower, but the results were not clinically significant that can increase their risks to tooth decay. We also found weak evidence suggesting a higher percentage of children and adolescents diagnosed with ASD having the habit of tooth grinding compared with their neurotypical counterparts. When comparing salivary flow rate, tooth decay, gum diseases, tooth malalignment and tooth trauma; no significant differences were found between the two groups. The findings did not suggest ASD as a predisposing factor to oral diseases: other factors including sugary diet and inadequate oral hygiene may play a more important role. We also call for further research to establish more concrete association between ASD and oral diseases.

scholarly journals Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Shoumitro Deb ◽  
Meera Roy ◽  
Rachel Lee ◽  
Madiha Majid ◽  
Bharati Limbu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Evidence ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomised Controlled

Background Although widely used, the current evidence for the efficacy of antidepressant and anti-anxiety medications for people with autism spectrum disorder (ASD) is limited and conflicting. Aims We carried out a systematic review and meta-analysis of randomised controlled trials that assessed the effectiveness of these medications in people with ASD. Method We searched the following databases: Cochrane Library, Medline, EMBASE, CINAHL, PsycINFO, ERIC, DARE and ClinicalTrials.gov. Additionally, we hand-searched 11 relevant journals. We used the Cochrane risk-of-bias tool and Jadad score to assess the quality of each included study. We carried out a meta-analysis using a random effects model. Results We included 15 randomised controlled trials (13 on antidepressants and two on anti-anxiety medications) for a total of 958 people with ASD. Data showed contradictory findings among the studies, with larger studies mostly showing a non-significant difference in outcomes between the treatment and the placebo groups. Meta-analysis of pooled Yale-Brown Obsessive Compulsive Scale and Clinical Global Impression Scale data from nine studies (60%) did not show any statistically significant inter-group difference on either of the outcome measures. The adverse effects reported were mild and, in most studies, their rates did not show any significant inter-group difference. Conclusions Given the methodological flaws in the most included studies and contradictory findings, it is difficult to draw any definitive conclusion about the effectiveness of either antidepressant or anti-anxiety medications to treat either ASD core symptoms or associated behaviours. Robust, large-scale, randomised controlled trials are needed to address this issue.

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