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To investigate the effect of multiple factors, including breast-feeding and modes of birth, on gastrointestinal (GI) symptoms of children with autism spectrum disorder (ASD). Methods This was a cross-sectional study. A total of 92 children, aged 2 to 10 years, with a diagnosis of ASD by DSM-5 criteria, along with 84 age-matched typical developing (TD) children as control, were enrolled in this study. The six-item gastrointestinal symptom index (6-GSI) was used for symptomatic survey. The self-made questionnaires were used to collect information on dietary preferences, sleep problems and breast-feeding. Results Constipation from 6-GSI was higher in ASD group than in TD group (P＜0.01). Stratified analysis revealed that total GI symptom scores (P=0.030), fecal odor (P=0.028) and abdominal pain (P=0.022) were higher in ASD children born by c-section than ASD children born vaginally whereas only abdominal pain was higher in TD children born by C-section than TD children born vaginally (P=0.016). ASD children with pick eating had higher scores in diarrhea (P=0.048) and abdominal pain (P=0.013) than those without. ASD children with sleep disorders had higher scores in constipation (P=0.008), diarrhea (P=0.020) and fecal odor (P=0.027) than those without. There was also a significant difference in constipation from 6-GSI between mainly breast-fed children and mainly formula-fed children among all subjects (P=0.026). Conclusion ASD children have more severe constipation than TD children. ASD children with pick eating or with sleep disorders tend to have more GI symptoms, including diarrhea, fecal odor, and abdominal pain, while breastfeeding can alleviate these symptoms.
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Objective To explore the difference in early symptoms between 2-3 years old autism spectrum disorder (ASD) children and healthy children through video analysis,in order to provide evidence for the identification and screening of ASD children.Methods The study involved 25 cases of ASD children who were admitted to Children Development and Behavior Center,the Third Affiliated Hospital,Sun Y at-Sen University,and confirmed with diagnosis standards of Diagnosis and Statistical Manual of Medical Disorder 5th edition (DSM-5) and 21 healthy children recruited in community.Three-minute videos of children in standard procedure were collected.Mter that,all the videos were scored on 5 items by 2 professional evaluators,unaware of diagnostic status.Comparison analysis of video scores between ASD and the healthy controls was made,and the sensitivity and specificity of video analysis were evaluated.Results Response to roll-call score was higher in ASD children [2 (2) scores] than that of the healthy children [0 (0) scores],response to audible object score was higher in ASD children [0(1) scores] than that of the healthy children [0(0) scores],social smiling score was higher in ASD children [1 (1) scores] than that of the healthy children [0 (1) scores],and total score was higher in ASD children [4 (2) scores] than that of the healthy children [2 (0) scores],and the differences were statistically significant (Z =2.272,P =0.000;Z =0.976,P =0.010;Z =1.763,P =0.001;Z =2.355,P =0.000).But,no difference was found in speech and finger pointing (all P ＞ 0.05).The consistency between three-minute video analysis and standard diagnosis was 0.652 (P =0.000),with 80.0％ of sensitivity and 85.7％ of specificity.Conclusions The ASD children perform worse than the healthy children in response to roll-call,response to audible object and social smiling.Three-minute standard video analysis can help to detect the early symptoms of ASD children.This result also demonstrates the potential of video-based analysis used as a ASD screening instrument in 2-3 years old children.
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Objective To explore sex differences in cognitive and behavioral characteristics in children with autism spectrum disorder (ASD) in different age.Methods The study involved 621 children(503 boys,118 girls) diagnosed with ASD from June 2013 to June 2015.Using raw scores to examine cognitive and behavioral characteristics in children with ASD based on the Psycho-Educational Profile-3rd Edition (PEP-3).The subjects were divided into two groups according age:＜4Y group and ≥ 4Y group.The sex differences of cognitive and behavioral characteristics were analyzed in different age groups.Results No sex differences were found in characteristic motor behaviors (CMB) and characteristic verbal behaviors (CVB) raw scores in ＜4Y group(P＞0.05),while girls with ASD had lower raw scores on CMB and CVB raw scores in ＞4Y group((21.56±7.33) vs (24.09±4.80),(9.79±7.05) vs (13.27±5.75) ; P＜0.05)).Girls with ASD had lower raw scores on cognitive verbal/preverbal (CVP),CMB and CVB in ～ 4Y,～5Y,and ～6Y group (P＜0.05).However,there was no sex difference on CVP,CMB and CVB in ～ 3Y and ～ 7Y group (P＞0.05).Conclusions Characteristic verbal and motor behaviors may not be obvious in girls with ASD in early childhood,which may increase the difficulties of early clinical identification.The development of cognitive ability in girls with ASD is far behind that in boys in the crucial 3-5 years old,as well as social reciprocity and characteristic behaviors.It suggests that the behavior characteristics are closely related to cognitive development.
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Objective To investigate the autistic symptoms or autistic trait in the children with attention deficit hyperactivity disorder(ADHD) for facilitating the development of appropriate interventions.Methods Sixty-two 6-12-year-old high-functioned autism spectrum disorder (ASD),ADHD and typically developing (TD) children were assessed respectively using Chinese-version social responsiveness scale (SRS),and ADHD core symptoms were assessed in the ADHD children at the same time.Results ASD group＞ADHD group＞ TD group on the SRS total raw score and the five dimensions scores as well(P＜0.01).ASD,ADHD and TD group scored respectively 92.43±19.17,65.66±19.86 and 38.40±10.68 on the SRS total scale.The SRS total raw score of ADHD group exceeded the TD group for 2.55 standard deviant (SD) and with social communication (2.00 SD) and autistic mannerism (2.71 SD) deviating the most.22.58％ (14 out of 62) children with ADHD scored above the threshold on the SRS total raw score which was significantly higher than that in the TD group(P＜0.01).There were nonsignificant differences in the ADHD core symptoms between ADHD± children (with the SRS total raw score ≥85)and ADHD-children(with the SRS total raw score＜85) (P＞0.01).Conclusion Children with ADHD appear more ASD symptoms than the TD children and a considerable proportion of them reach the SRS diagnostic cut-off point.
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Objective To compare the intelligence quotient (IQ) between children with Asperger syndrome (AS) and children with attention deficit hyperactivity disorder (ADHD) in order to provide reliable evidence for differential diagnosis.Methods The intelligence of 141 children with AS,154 children with ADHD and 102 normal control (NC) children aged 6-13 years old examined by the China-Wechsler Intelligence Scale for Children was analyzed,and the diagnoses of AS and ADHD was made according to the Fourth edition of the Diagnostic and Statistical Manual of Mental Disorder.Results The proportions of children at low level of IQ (borderline and mental retardation range) in children with AS and with ADHD group were both significantly higher than those of NC group.The proportions of children at top level of IQ (superior and very superior range) in ADHD group were significantly lower than those of AS and NC groups.In the AS group,higher proportions of verbal IQ (VIQ) at top level and performance IQ (PIQ) at low level were found.The average VIQ,PIQ and full IQ (FIQ) of the AS,ADHD and NC groups were (102.55 ± 17.27,91.31 ± 16.01,97.10 ± 15.88),(95.39 ±13.49,94.16 ± 12.92,94.40 ± 12.78) and (104.06 ± 13.66,103.05 ±11.80,103.91 ± 12.92),respectively.The VIQ,PIQ and FIQ in ADHD group were lower than those in NC group significantly(P ＜ 0.01);compared with NC group,the PIQ and FIQ in AS group were significantly lower (P ＜ 0.01),while the VIQ was not significantly different(P ＞0.05).The AS and ADHD group scored both lower than the NC groupin the subtests ofcomprehension, coding, picture completion andpicture arrangement (P ＜ 0.01).The difference values between VIQ and PIQ in the AS,ADHD and TD group were(11.23 ± 17.29),(1.23 ± 13.10) and (1.00 ± 10.91),respectively,among which only the value in AS group was statistically significant (P ＜ 0.01) but not in ADHD and NC group(P ＞0.05).The proportion of children having a VIQ-PIQ difference value more than 15 in AS group was 54.60％ (77/141 cases),which was significantly higher than that in ADHD [22.07％ (34/154 cases)] and NC groups [13.72％ (14/102 cases)] (P ＜ 0.01),while the latter 2 value had no statistical difference (P ＞ 0.05).The differences among scores on the three Kaufman factors were significant in AS group (P ＜ 0.01) but not in ADHD and NC groups(P ＞ 0.05).Conclusions Compared with ADHD and normal control children,there are some unique intelligence profiles in children with AS,which show VIQ and PIQ separation,imbalance intelligence structure as well as strengths and weaknesses coexisting.Furthermore,children with ADHD and AS children share common features in some subtests scores.
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Objective To investigate the changes of the serum sex steroids levels in prepuberal children with autism,and analyze the possible clinical implications.Methods The serum sex steroids,including folliclestimulating hormone(FSH),luteotropic hormone(LH),testosterone(T),estradiol(E2),progesterone(P),dehydroepiandrosterone sulfate(DHEA-S) and androstenedione were measured in 44 autistic children(35 boys and 9girls,47.5 ± 18.9 months) and 44 normal children(35 boys and 9 girls,45.0 ± 18.7 months),using chemiluminescence immunoassay.Results ①The progesterone levels in autism group were significantly lower than control group((＜ 0.48,2.08) nmoL/L vs (＜ 0.48,6.95) nmol/L,Z =-3.564,P ＜ 0.01),but no statistical differences were observed in other sex steroids levels(P＞ 0.05).②The progesterone levels in ＜ 48 months autism group showed no significant differences from ≥48 months autism group (Z =0.150,P ＞ 0.05).There were no statistical differences in progesterone level between the boys and girls of the autism group(Z=1.972,P＞0.05).Conclusion The progesterone levels are lower in autistic children,and they are not associated with the children's age or gender.This study indicates that the progesterone levels are closely associated with autism.