Management and treatment of autism spectrum disorders

2020 ◽  
pp. 289-298
Author(s):  
Emily Simonoff
Keyword(s):  
Best Practice ◽  
Sleep Problems ◽  
Autism Spectrum ◽  
Intellectual Ability ◽  
Evidence Based ◽  
Hyperactivity Disorder ◽  
Self Injury ◽  
Chronic Disorder ◽  
Core Symptoms ◽  
Restricted And Repetitive Behaviours

Autism spectrum disorder (ASD) is a chronic disorder beginning early in development and comprising lifelong impairments in social communication and restricted and repetitive behaviours and interests. The manifestations of these core symptoms frequently vary across individuals, especially with differences in intellectual ability, and may change with age. In addition, people with ASD have high rates of co-occurring psychiatric disorders, including attention-deficit/hyperactivity disorder, anxiety and depression, tics/Tourette’s syndrome, and sleep problems. They frequently exhibit behaviours that challenge others, including aggression, self-injury, and high levels of irritability. Hence, their treatment and management requires a comprehensive approach to core and co-occurring symptoms. Management should include evidence-based approaches from health and also ASD-specific support from education, employment, social care, and the wider community. There is insufficient evidence to guide best practice, and more research on interventions is urgently required.

Disorder-specific alterations of tactile sensitivity in neurodevelopmental disorders

2020 ◽  
Author(s):  
Jason He ◽  
Ericka Wodka ◽  
Mark Tommerdahl ◽  
Richard Edden ◽  
Mark Mikkelsen ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Autism Spectrum ◽  
Typically Developing ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Children With Asd ◽  
Tactile Detection ◽  
Spectrum Disorders ◽  
Sensory Processes ◽  
Core Symptoms

Alterations of tactile processing have long been identified in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, the extent to which these alterations are disorder-specific, rather than disorder-general, and how they relate to the core symptoms of each disorder, remains unclear. We measured and compared tactile detection, discrimination and order judgment thresholds between a large sample of children with ASD, ADHD, ASD + ADHD combined and typically developing controls. The pattern of results suggested that while difficulties with tactile detection and order judgement were more common in children with ADHD, difficulties with tactile discrimination were more common in children with ASD. Strikingly, subsequent correlation analyses found that the disorder-specific alterations suggested by the group comparisons were also exclusively related to the core symptoms of each respective disorder. These results suggest that disorder-specific alterations of lower-level sensory processes exist and are specifically related to higher-level clinical symptoms of each disorder.

scholarly journals Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder—A Review of the Literature

2020 ◽  
Vol 10 (4) ◽  
pp. 219
Author(s):  
Beata Rzepka-Migut ◽  
Justyna Paprocka
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Sleep Disorders ◽  
Attention Deficit ◽  
Sleep Problems ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Melatonin Treatment ◽  
Hyperactivity Disorder ◽  
Wide Range

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with disturbed melatonin secretion profile and sleep problems. The growing incidence of ASD and ADHD inspires scientists to research the underlying causes of these conditions. The authors focused on two fundamental aspects, the first one being the presentation of the role of melatonin in ASD and ADHD and the second of the influence of melatonin treatment on sleep disorders. The authors present the use of melatonin both in the context of causal and symptomatic treatment and discuss melatonin supplementation: Dosage patterns, effectiveness, and safety. Sleep disorders may have a different clinical picture, so the assessment of exogenous melatonin efficacy should also refer to a specific group of symptoms. The review draws attention to the wide range of doses of melatonin used in supplementation and the need to introduce unified standards especially in the group of pediatric patients.

scholarly journals Sleep problems in children with autism spectrum disorder: a multicenter survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyu Chen ◽  
Ting Yang ◽  
Jie Chen ◽  
Li Chen ◽  
Ying Dai ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Daytime Sleepiness ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Onset Delay ◽  
Multicenter Survey ◽  
Core Symptoms

Abstract Background High prevalence of sleep problems have been reported in children with Autism Spectrum Disorder (ASD). This study aims to investigate the sleep conditions of ASD children in China, and explore the relationship between the common sleep problems and core symptoms and developmental levels. Methods Using a cross-sectional design, we included 2 to 7-year-old children from 13 cities in China: 1310 with ASD and 1158 with typically-developing (TD) children. The neurodevelopmental level was evaluated with the revised Children Neuropsychological and Behavior Scale (CNBS-R2016). ASD were diagnosed with DSM-5 and Child Autism Rating Scale (CARS). the Social Responsiveness Scale (SRS), the Autism Behavior Checklist (ABC) and the communication warning behavior sub-scale in CNBS-R2016 valued autism behaviors. The children’ s sleep habits questionnaire (CSHQ) assessed sleep conditions. Results The prevalence of sleep disorders in ASD children was significantly higher than that in TD (67.4% vs. 51%, p < 0.01), and among them the four dimensions with the highest prevalence of sleep problems were bedtime resistance (25.6%), sleep anxiety (22.7%), sleep onset delay (17.9%) and daytime sleepiness (14.7%). ASD children with sleep onset delay or sleep anxiety had higher ABC, SRS scores and higher scores on communication warning behavior with sleep anxiety, with daytime sleepiness had higher ABC, SRS and CARS scores, and with bedtime resistance had higher SRS total scores. Differences in the neurodevelopmental level were not significant. Conclusion Children with ASD have a higher prevalence of sleep problems. Bedtime resistance, anxiety, sleep onset delay and daytime sleepiness may be related to the core symptoms, but not be related to the developmental level in ASD children. In the clinic, sleep assessment should be included in the routine of ASD visits, and during the intervention, sleep hygiene education is as important as the treatment of biological factors. Trial registration The study was approved by the ethics committee of the Children’s Hospital of Chongqing Medical University, Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194).

Evidence-Based Practices for Teaching Learners on the Autism Spectrum

2020 ◽  
Author(s):  
Amanda A. Webster
Keyword(s):  
Best Practice ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Structured Learning ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Early 21St Century ◽  
Inclusive School ◽  
Child Centered ◽  
Teachers And Parents

The rising number of students diagnosed with autism spectrum disorder (ASD) in schools, and the unique characteristics of these students, has led many educators and parents to question the types of programs and strategies that are most effective in supporting them to achieve within school climates and curriculum of the early 21st century. Moreover, educators and parents must sort through the plethora of information and reports of interventions and treatments claiming to treat or cure autism in order to determine what strategies will best support their children or students. A number of studies have focused on determining the evidence base of specific practices for students on the autism spectrum. However, only a few have investigated the applicability of these strategies in inclusive school environments or specifically employed strategies to address academic needs. This has created a research-to-practice gap for educators working with students on the autism spectrum in inclusive school settings. More promising are studies which have highlighted elements of effective practice in education programs. An analysis of this research reveals four principles of best practice for schools and educators working with students on the autism spectrum: provision of a supportive and structured learning environment for staff and students; consistent provision of child-centered and evidence-based curriculum and instruction; multidisciplinary engagement and collaboration; and meaningful communication and collaboration between families and schools. These principles provide a framework for teachers and parents to work alongside students on the autism spectrum to plan, implement and evaluate strategies that can be embedded and implemented in the class program and are effective in supporting the specific needs of individual students on the autism spectrum.

scholarly journals Disorder-specific alterations of tactile sensitivity in neurodevelopmental disorders

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jason L. He ◽  
Ericka Wodka ◽  
Mark Tommerdahl ◽  
Richard A. E. Edden ◽  
Mark Mikkelsen ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Autism Spectrum ◽  
Typically Developing ◽  
Tactile Discrimination ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Children With Asd ◽  
Tactile Detection ◽  
Sensory Processes ◽  
Core Symptoms

AbstractAlterations of tactile processing have long been identified in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, the extent to which these alterations are disorder-specific, rather than disorder-general, and how they relate to the core symptoms of each disorder, remains unclear. We measured and compared tactile detection, discrimination, and order judgment thresholds between a large sample of children with ASD, ADHD, ASD + ADHD combined and typically developing controls. The pattern of results suggested that while difficulties with tactile detection and order judgement were more common in children with ADHD, difficulties with tactile discrimination were more common in children with ASD. Interestingly, in our subsequent correlation analyses between tactile perception and disorder-specific clinical symptoms, tactile detection and order judgment correlated exclusively with the core symptoms of ADHD, while tactile discrimination correlated exclusively with the symptoms of ASD. When taken together, these results suggest that disorder-specific alterations of lower-level sensory processes exist and are specifically related to higher-level clinical symptoms of each disorder.

scholarly journals Melatonin Use in Pediatrics: Evaluating the Discrepancy in Evidence Based on Country and Regulations Regarding Production

2021 ◽  
Vol 26 (1) ◽  
pp. 4-20
Author(s):  
Michelle Skrzelowski ◽  
Amanda Brookhaus ◽  
Leticia A. Shea ◽  
Daniel J. Berlau
Keyword(s):  
United States ◽  
Autism Spectrum Disorder ◽  
Clinical Trials ◽  
Pediatric Population ◽  
The United States ◽  
Autism Spectrum ◽  
Evidence Based ◽  
Hyperactivity Disorder ◽  
Safety Regulations ◽  
The World

Melatonin manufacturers in the United States have begun producing melatonin products specifically targeted for use in the pediatric population. This paper aims to critically evaluate the evidence available regarding the use of melatonin in children based on where the clinical trials are performed and the regulations regarding the production of melatonin in that country. Melatonin is regulated differently around the world with the least amount of regulation placed on OTC supplements in the United States. The majority of studies evaluating melatonin use in the pediatric population are conducted with children who have comorbidities, such as autism spectrum disorder or attention-deficit/hyperactivity disorder. Evidence supporting the use of US formulations of melatonin in the otherwise healthy pediatric population is non-existent. Based on the lack of safety regulations in place in the United States and the lack of evidence regarding US melatonin products, they should be used sparingly in the otherwise healthy pediatric population, if they are used at all.

scholarly journals Sleep problems in attention-deficit/hyperactivity disorder and autism spectrum disorder: Sex differences and parental stress

2020 ◽  
Vol 291 ◽  
pp. 113099
Author(s):  
Elisa D'Agati ◽  
Roberta Abate ◽  
Leonardo Emberti Gialloreti ◽  
Carmen Napolitano ◽  
Valentina Postorino ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Sex Differences ◽  
Attention Deficit ◽  
Parental Stress ◽  
Sleep Problems ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Hyperactivity Disorder

scholarly journals Cannabinoids for People with ASD: A Systematic Review of Published and Ongoing Studies

2020 ◽  
Vol 10 (9) ◽  
pp. 572
Author(s):  
Laura Fusar-Poli ◽  
Vito Cavone ◽  
Silvia Tinacci ◽  
Ilaria Concas ◽  
Antonino Petralia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Problem Behaviors ◽  
Cannabis Sativa ◽  
Sleep Problems ◽  
Medical Condition ◽  
Emotional Responses ◽  
Autism Spectrum ◽  
Associated Symptoms ◽  
Common Medical Condition ◽  
Core Symptoms

The etiopathogenesis of autism spectrum disorder (ASD) remains largely unclear. Among other biological hypotheses, researchers have evidenced an imbalance in the endocannabinoid (eCB) system, which regulates some functions typically impaired in ASD, such as emotional responses and social interaction. Additionally, cannabidiol (CBD), the non-intoxicating component of Cannabis sativa, was recently approved for treatment-resistant epilepsy. Epilepsy represents a common medical condition in people with ASD. Additionally, the two conditions share some neuropathological mechanisms, particularly GABAergic dysfunctions. Hence, it was hypothesized that cannabinoids could be useful in improving ASD symptoms. Our systematic review was conducted according to the PRISMA guidelines and aimed to summarize the literature regarding the use of cannabinoids in ASD. After searching in Web of KnowledgeTM, PsycINFO, and Embase, we included ten studies (eight papers and two abstracts). Four ongoing trials were retrieved in ClinicalTrials.gov. The findings were promising, as cannabinoids appeared to improve some ASD-associated symptoms, such as problem behaviors, sleep problems, and hyperactivity, with limited cardiac and metabolic side effects. Conversely, the knowledge of their effects on ASD core symptoms is scarce. Interestingly, cannabinoids generally allowed to reduce the number of prescribed medications and decreased the frequency of seizures in patients with comorbid epilepsy. Mechanisms of action could be linked to the excitatory/inhibitory imbalance found in people with ASD. However, further trials with better characterization and homogenization of samples, and well-defined outcomes should be implemented.

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