Short Term Outcome in Sleep Disturbance Intervention in Children with ASD in a Tertiary Care Hospital in Bangladesh

Aim: The aim of this study was to identify the relationship between sleep patterns and behavioral difficulties in children with ASD using sleep disturbance treatments. Methods: We selected a total 41 children with sleep disorders as study population. The sleep services (behavioral sleep management techniques) were given by the child development center team of Dhaka Shishu Hospital comprising of physician , developmental therapist and psychologist. Children were split into eight groups and two gender divisions based on their age, and they were then studied over a period of 6 months . Sleep disorders were investigated both before and after intervention. Results: The results revealed that the children’s sleep dysfunction improved from before, with the lowest improvement percentage decreasing from 62.9 percent to 51.8 percent and the greatest improvement percentage increasing from 100 percent to 59.2 percent, whereas a sleep problem showed no change at all (sleepwalking). Conclusion: The study has tried and succeeded to an extent to intervene in the sleep dysfunction process of children with ASD in a tertiary care hospital. However, there is still much to learn about the clinical efficacy of these types of behavioral interventions in children with ASD who have sleep disruption.

How Do Children with Autism Spectrum Disorder and Children with Developmental Delays Differ on the Child Behavior Checklist 1.5–5 DSM-Oriented Scales?

The Child Behavior Checklist 1.5–5 (CBCL 1.5–5) is applied to identify emotional and behavioral problems on children with developmental disabilities (e.g., autism spectrum disorder [ASD] and developmental delays [DD]). To understand whether there are variations between these two groups on CBCL DSM-oriented scales, we took two invariance analyses on 443 children (228 children with ASD). The first analysis used measurement invariance and multiple-group factor analysis on the test structure. The second analysis used item-level analysis, i.e., differential item functioning (DIF), to discover whether group memberships responded differently on some items even though underlying trait levels were the same. It was discovered that, on the test structure, the Anxiety Problems scale did not achieve metric invariance. The other scales achieved metric invariance; DIF analyses further revealed that there were items that functioned differently across subscales. These DIF items were mostly about children’s reactions to the surrounding environment. Our findings provide implications for clinicians to use CBCL DSM-oriented scales on differentiating children with ASD and children with DD. In addition, researchers need to be mindful about how items were responded differently, even though there were no mean differences on the surface.

Screen Time, Age and Sunshine Duration Rather Than Outdoor Activity Time Are Related to Nutritional Vitamin D Status in Children With ASD

Objective: This study aimed to investigate the possible association among vitamin D, screen time and other factors that might affect the concentration of vitamin D in children with autism spectrum disorder (ASD).Methods: In total, 306 children with ASD were recruited, and data, including their age, sex, height, weight, screen time, time of outdoor activity, ASD symptoms [including Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule–Second Edition (ADOS-2)] and vitamin D concentrations, were collected. A multiple linear regression model was used to analyze the factors related to the vitamin D concentration.Results: A multiple linear regression analysis showed that screen time (β = −0.122, P = 0.032), age (β = −0.233, P < 0.001), and blood collection month (reflecting sunshine duration) (β = 0.177, P = 0.004) were statistically significant. The vitamin D concentration in the children with ASD was negatively correlated with screen time and age and positively correlated with sunshine duration.Conclusion: The vitamin D levels in children with ASD are related to electronic screen time, age and sunshine duration. Since age and season are uncontrollable, identifying the length of screen time in children with ASD could provide a basis for the clinical management of their vitamin D nutritional status.

Parents perceptions of school nurses roles: The impact of communication on students with autism spectrum disorder

This qualitative study used the nursing grounding theory to describe parents' experiences working with school nurses to elevate their child’s healthcare. Seventeen interviews were conducted with parents/primary caregivers (P/PCG) who had children with autism spectrum disorder (ASD; ages six to ten). Through centering parents’ voices, the investigators were able to identify gaps in P/CG understanding of their school nurses’ roles through thematic analyses. We found that P/CG lacked the understanding of school nurses' roles and how school nurses could aid their child’s healthcare. The oversight of school nurses contributed to miscommunication, which constrained the relationship between the parent and the school nurse. These findings provide insight into the importance of enhancing communication between the parents of children with ASD and school nurses and was the catalyst to why this article was written. When healthcare professionals provide clarity and expertise to parents as to their respective roles, incorporate perspective-taking, and tailor their approaches based on their concerns, it may enhance parents’ experiences with their school nurses. In addition, school nurses should consider various routes of engaging parents so they have a deeper understanding of their responsibilities in enhancing the healthcare of children with ASD.

Therapists’ Expressions of Agreement in Therapeutic Conversations With Chinese Children With ASD: Strategies, Sequential Positions and Functions

Based on conversations between 10 Chinese children with Autism Spectrum Disorders (ASD) and five therapists in the context of Naturalistic Intervention, this study investigated the therapists’ agreement expressions in this typical setting. The study found that (1) the therapists mainly used four agreement strategies: acknowledgment, positive evaluation, repetition and blending. These four strategies could be used individually or in combination. The first three strategies and their combinations were used frequently during the therapeutic conversation. (2) With the major occurrences in the post-expansion position, the agreement expressions in the therapeutic conversation mainly performed three functions, namely, creating a supportive therapeutic relationship, serving as positive reinforcers and implementing interventions pertinent to communication skills. (3) This study proposed that the therapists’ preferred use of agreement expressions in the intervention process could be explained by the features of Naturalistic Intervention.

Health care providers’ awareness on medical management of children with autism spectrum disorder: cross-sectional study in Russia

Background Autism spectrum disorder (ASD) is a complex developmental range of conditions that involves difficulties with social interaction and restricted/repetitive behaviors. Unfortunately, health care providers often experience difficulties in diagnosis and management of individuals with ASD, and may have no knowledge about possible ways to overcome barriers in ASD patient interactions in healthcare settings. At the same time, the provision of appropriate medical services can have positive effects on habilitative progress, functional outcome, life expectancy and quality of life for individuals with ASD. Methods This online survey research study evaluated the awareness and experience of students/residents (n = 247) and physicians (n = 100) in the medical management of children with ASD. It also gathered the views and experiences of caregivers to children with ASD (n = 158), all based in Russia. Results We have established that the Russian medical community has limited ASD knowledge among providers, and have suggested possible reasons for this. Based on results from online surveys completed by students/residents, non-psychiatric physicians, and caregivers of children diagnosed with ASD, the main problems pertaining to medical management of individuals with ASD were identified. Possible problem solving solutions within medical practice were proposed. Conclusions The results from this study should be considered when implementing measures to improve healthcare practices, and when developing models for effective medical management, due to start not only in Russia but also in a number of other countries.

Early Developmental Signs in Children with Autism Spectrum Disorder: Results from the Japan Environment and Children’s Study

Autism spectrum disorder (ASD) is a developmental disability in early childhood. Early identification and intervention in children with ASD are essential for children and their families. This study aimed to identify the earliest signs of ASD. Using a large cohort including data from 104,062 fetal records in the Japan Environment and Children’s Study, we examined the Ages and Stages Questionnaires® (ASQ-3TM) scores of children with and without ASD. The ASQ-3 comprises five domains: communication, gross motor, fine motor, problem solving, and personal-social. The ASQ-3 scores were obtained at ages 6 months, 1 year, and 3 years. There were 64,501 children with available ASQ-3 data. The number of children diagnosed with ASD was 188 (0.29%) at 3 years of age. The highest relative risk (RR) for any domain below the monitoring score at 6 months was in the communication (RR 1.90, 95% CI 1.29–2.78, p = 0.0041), followed by fine motor (RR 1.50, 95% CI 1.28–1.76, p < 0.0001) domain. A low ASQ-3 score in the communication domain at 6 months was related to an ASD diagnosis at 3 years of age. The ASQ-3 score at 6 months can contribute to the early identification of and intervention for ASD.

Identifying Patterns of Similarities and Differences between Gesture Production and Comprehension in Autism and Typical Development

Production and comprehension of gesture emerge early and are key to subsequent language development in typical development. Compared to typically developing (TD) children, children with autism spectrum disorders (ASD) exhibit difficulties and/or differences in gesture production. However, we do not yet know if gesture production either shows similar patterns to gesture comprehension across different ages and learners, or alternatively, lags behind gesture comprehension, thus mimicking a pattern akin to speech comprehension and production. In this study, we focus on the gestures produced and comprehended by a group of young TD children and children with ASD—comparable in language ability—with the goal to identify whether gesture production and comprehension follow similar patterns between ages and between learners. We elicited production of gesture in a semi-structured parent–child play and comprehension of gesture in a structured experimenter-child play across two studies. We tested whether young TD children (ages 2–4) follow a similar trajectory in their production and comprehension of gesture (Study 1) across ages, and if so, whether this alignment remains similar for verbal children with ASD (Mage = 5 years), comparable to TD children in language ability (Study 2). Our results provided evidence for similarities between gesture production and comprehension across ages and across learners, suggesting that comprehension and production of gesture form a largely integrated system of communication.