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Self-injury behavior (SIB) is a common problem behavior of children with autism spectrum disorder (ASD), which is characterized by a series of harmful reactions made by themselves causing tissue and physical damages.It seriously affects the physical and mental health in children.An early identification of SIB in children with ASD is helpful to relieve symptoms and improve the prognosis.Aiming to enrich the understanding of SIB in children with ASD and to promote early detection and intervention, this article reviews and summarizes the research on clinical characteristics, influencing factors, evaluation, detection and intervention methods of SIB in children with ASD in recent years.
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ObjectiveTo analyze the research hotspots and frontier trends in the field of early screening tools of autism spectrum disorder (ASD) over the past two decades. MethodsThe literature on early screening tools for ASD was searched in Web of Science core collection database from 2002 to 2022. CiteSpace was used for cluster analysis of keywords, to draw knowledge mapping. Research disciplines were analyzed and comprehensively interpreted. ResultsA total of 115 articles were included. The number of researches on early screening tools for ASD had been increasing over the past two decades. The research disciplines with higher publication volume included pediatrics, neurology and neuroscience, and psychology. A total of 191 keywords were identified, and the LLR keyword clustering analysis yielded eleven clusters. ConclusionModified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) and Brief Infant-Toddler Social and Emotional Assessment (BITSEA) have been subjected to large-scale sample screening and follow-up observation for validity, demonstrating good psychometric properties and high clinical diagnostic value. The development of new early screening tools for ASD, validation of the reliability and validity of different language versions of the M-CHAT-R/F, and research on digital and networked M-CHAT-R/F are current research hotspots. Cultural adaptation of early screening tools for ASD and their application within the developmental monitoring framework may represent frontier research trends.
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and interaction, restricted and repetitive behaviors, interests and activities, and abnormal perception.Obsessive compulsive disorder (OCD) is one of the common comorbid mental diseases of ASD.Accurate identification of the obsessive-compulsive symptoms and OCD comorbidity of ASD and early intervention are essential for the prognosis of patients.However, there are few domestic studies on comorbid OCD in ASD.Based on previous studies abroad, the progress of research on the epidemiology, etiology and neural mechanism, clinical characteristics, evaluation, diagnosis, intervention and treatment of comorbid OCD in ASD was reviewed in this paper.It aims to identify the manifestations of OCD in ASD patients in the early stage and improve the prognosis of patients.
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This review aims to interpret the interventions to improve physical function for children and young people with cerebral palsy, thus providing relevant suggestions.Relevant literatures published before November 2018 were systematically searched in Cochrane library, CINAHL, and Embase MEDLINE using the Grading of Recommendations Assessment, Development and Evaluation method.Consult with international experts and patients to assess evidence and recommend it.Based on 3 systematic reviews, 30 randomized clinical trials, and 5 pre-and post-treatment studies, a total of 13 recommendations were given.The guidelines recommend that, in order to achieve functional stan-dards, intervention measures should include, patient-selected goals, full-task practice in real-life settings, support for family empowerment, and a team approach.The age, ability, and child/family preferences were all needed to be considered.In order to improve walking ability, ground walking and treadmill training can be carried out.Various methods can promote the realization of hand use goals hand use, including the two-hand exercise training, constraint-induced moverment therapy, goal-oriented training and cognitive therapy.In terms of patient self-care, the guideline proposed that, the combination of full-task practice and auxiliary equipment can improve the independence of self-care and reduce the burden of care givers.Leisure goals could be achieved by the combination of the practice of the entire task with strategies to address environmental, personal, and social barriers.The intervention of children and adolescents with cerebral palsy should take into consideration of patient selection and the goal of full-task practice.The child/family preference, age and ability should be considered when clinical workers selecting specific interventions.
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Developmental coordination disorder (DCD) is a childhood-onset condition that primarily affects physical co-ordination.In China, DCD is not well recognized and is under-treated.Knowledge of the evaluation and intervention of DCD among physiotherapists (PT) is limited.In 2020, the Academy of Pediatric Physical Therapy of the American Physical Therapy Association published the Physical Therapy Management of Children with Developmental Coordination Disorder: An Evidence-Based Clinical Practice Guideline.From the perspective of PT, this review aims to make a comprehensive interpretation of the recommendations in the guideline regarding the physical examination and evaluation, physiotherapy planning and implementation, and family education of children at risk or diagnosed with DCD.This article aims to make DCD get more attention from domestic PT through the interpretation of the latest guidelines, and strengthen the knowledge of physiotherapy assessment and management in children with DCD to guide the clinical practice.
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Developmental coordination disorder (DCD) is a developmental disorder that mainly affects children′s motor coordination.The prevalence of DCD in childhood is very high, and it seriously affects the physical and mental health of school-age children.In China, this disease has not yet been fully recognized and understood.There is a lack of standardized and unified diagnostic criteria, and the standardization of relevant clinical assessment tools and the establishment of normative models are insufficient.In addition, the clinical practice and experience of most health professionals in dealing with DCD appear to be limited.Based on international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD issued by the European Academy of Childhood Disability in 2019, the recommendations related to the diagnosis, evaluation and intervention of DCD in the guidelines were compiled and interpreted in the light of the current clinical practice and research in China.The objective of this study is to bring DCD to the attention of more domestic medical experts through the interpretation of this international guideline and to provide preliminary guidance on the clinical diagnosis, assessment, and intervention of DCD.
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Occupational therapy can not only promote the development of motor and cognitive functions in children with developmental or other disabilities, but also improve their self-care ability, learning ability, participation skills and other activities.In 2019, the Aust Occup Ther J published a systematic review on the effects of occupational therapy interventions on disabled children, aiming to summarize the best evidence of occupational therapy and help occupational therapists and families to choose the effective treatment regimens.In this article, the systematic review was interpreted in light of the current status of domestic child occupational therapy, so as to allow clinicians to compare the pros and cons of different treatment methods and improve the efficacy.
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Objective To explore the development and clinical effect of weight_adjustable suit for children with dyskinetic cerebral palsy. Methods Twenty_six cerebral_palsy children with involuntary movement admitted to the Third Hospital Affiliated to Jiamusi University from March to October 2016 were randomly divided into the observa_tion group and the control group,13 cases in each group. The control group was treated with routine rehabilitation trai_ning. The observation group was put on adjustable heavy clothes besides conventional rehabilitation. Before and after treatment,childrenˊs functional independence and gross motor function were assessed and compared by using Wee Punc_tional Independence Measure(Wee_PIM)and Gross Motor Punction Rating Scale(GMPM_88). Results After treat_ment the Wee_PIM score of the control group was(43. 24 ± 5. 58),the GMPM score was(61. 81 ± 9. 46),the Wee_PIM score of the observation group was(50. 21 ± 6. 03),and the GMPM score was(65. 73 ± 10. 17). There were sig_nificant differences between the two groups(P〈0. 05),while the scores of the observation group were significantly higher than those of the control group,and the difference was significant(t﹦2. 582,2. 346,all P〈0. 05). Conclusions The adjustable heavy suit can effectively improve the functional independence and gross motor function of cerebral palsy children with involuntary movement and their comprehensive ability,and it is worth trying clinically.
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Autism spectrum disorders (ASD) is a neurodevelopmental condition characterized by altered social communication,alongside restricted and stereotyped behaviors and interests,bringing a heavy burden to the family and society.International experts develop the International Classification of Functioning,Disability and Health (ICF) core sets for individuals with ASD.The ICF core sets for ASD will be a tool to describe individual functioning comprehensively.
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Objective To investigate the epidemiological characteristics of cerebral palsy(CP)in children aged 1-6 years in China,including the incidence,prevalence,type of CP,etiology,prevention and rehabilitation status. Methods The survey was carried out by standard questionnaires,multi-center collaboration,stratified-cluster ran-dom sampling method.The surveyed adopted the following principles:streets in the city and villages in the rural areas, and the number of the urban and rural children was the same,and the proportion of children in each age group was balanced.The investigation areas included provinces and autonomous regions,including Heilongjiang,Beijing,Henan, Shandong,Shanxi,Shaanxi,Anhui,Hunan,Guangxi,Guangdong,Chongqing and Qinghai,and 323 858 children were in-vestigated.Results The incidence of CP was 2.48‰(155/62 591 cases),and the prevalence was 2.46‰(797/323 858 cases)(1-6 years old).The prevalence varied in different regions,in which the highest prevalence was 5. 40‰(54/9 998 cases)in Qinghai province,and the lowest prevalence was 1.04‰(47/45 133 cases)in Shandong province.The prevalence of the males(2.64‰,461/174 391 cases)was higher than that of the females(2.25‰, 336/149 467 cases),and the difference was statistically significant(P<0.05).The types of CP were spastic type (58.85%,469/797 cases),mixed type(13.17%,105/797 cases),dyskinetic(9.79%,78/797 cases),hypotonic (8.28%,66/797 cases),ataxia(6.25%,52/797 cases)and rigid(3.39%,27/797 cases)respectively in 797 CP children.The first three risk factors for CP were long -term exposure to harmful physical factors during pregnancy, whether there were birth defects among the three generations of relatives of the children,such as children's peers, parents or grandparents,whether there were birth defects among the children's peers,parents or grandparents,and neonatal jaundice or persistent jaundice.Among 797 CP children,79.67% of the children with CP were timely detected and treated in the local hospitals,while the other 19.93% of them were not timely treated.The places which could give them timely detection and early diagnosis and treatment were general hospitals(42.97%),Maternity and Infant Hospitals (27.03%)and Children's Hospitals(20.31%). The main rehabilitation methods for 797 children with CP were 34.58% in the hospitals or rehabilitation centers,31.61% in the communities(including at home),33.80% mainly in the medical institution,and in the communities they could also receive partially rehabilitation services. Conclusions The prevalence of CP in China is coincident with international levels.The prevalence rate of CP in males is higher than that in females.The types of CP distribution are accorded with international distribution characteristics.There were still some children with CP who could not receive timely detection and treatment.Rehabilitation at the medical institutions is the chief way and proper rehabilitation guidance should be carried out in the communities.
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Objective To explore the effects of hand-arm bimanual intensive training (HABIT) in group on functional independence and quality of life of children with hemiplegic cerebral palsy. Methods From November, 2015 to September, 2016, 20 children with hemiplegic cerebral palsy were randomly divided into control group (n=10) and experimental group (n=10). Both groups received routine occupational therapy, and the experimental group received HABIT in group one hour per day additionally, for eight weeks. They were assessed with the Carroll Upper Extremities Functional Test (UEFT), Functional Independence Measure Children's Edition (WeeFIM) and Chinese Version Pe-diatric Quality of Life Inventory (PedsQLTM) 3.0 Cerebral Palsy Module respectively before and after treatment. Results After treatment, the scores of UEFT, WeeFIM and the PedsQLTM3.0 improved in both groups (t>3.970, P2.306, P<0.05). Conclusion HABIT in group could improve the fine function of upper extremity and hands coordina-tion of children with hemiplegic cerebral palsy, and enhance the functional independence and quality of life.
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Objective To explore the relationship between autism spectrum disorder (ASD) and gastrointestinal problems. Methods 172 ASD children were investigated with self-made questionnaire from July, 2014 to Augest, 2015. The frequencies of motor behaviors, vocal behaviors and behavioral problems, and the intensity of the behavioral problems in the period with or without gastrointestinal symptoms were compared. Results The frequencies of motor behaviors (F=67.4, P<0.001), vocal behaviors (F=43.6, P<0.001) and behavioral prob-lems (F=79.4, P<0.001), and the intensity of the behavioral problems (F=65.7, P<0.001) were all more in the period with gastrointestinal symptoms than without gastrointestinal symptoms. Conclusion There are more behavioral problems in the ASD children with the presence of gastrointestinal symptoms;while the behavioral symptoms may be a indicator of gastrointestinal problems in children with ASD.
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@#Objective To analyze the concept of Peabody Developmental Motor Scale-Fine Motor (PDMS-FM). Methods Concept con-tained in each item of PDMS-FM was discussed and determined by 3 rehabilitation physicians or therapists. They were linked to the catego-ries of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) by 2 rehabilitation physi-cians according to the linking rules after discussion. Third party intervened informally if there was a disagreement. Results Ninety-eight items from the PDMS-FM linked to 21 categories of the 3rd level within 13 categories of the 2nd level, belong to b1 Mental Functions, b7 Neuromusculoskeletal and Movement-related Functions, d1 Learning and Applying Knowledge, d4 Activities and d5 Self-care, a total of 5 categories of the 1st level. Eighty items linked to d4, and 40 items linked to d1. Conclusion PDMS-FM mainly focuses on the activities, es-pecially Carrying, Moving and Handling Objects and Basic Learning of Learning and Applying Knowledge.
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As the urgent need of both clinic and research,the identification of hypertonia subtypes is becoming more and more important. Hypertonia assessment tool is a standardized discriminative measure with good reliability and validity. Hypertonia assessment tool can identify paediatric hypertonia subtypes. For its easily learning,it can be easily generalized in clinician.
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Cerebral palsy (CP) is the most common activity limitition of children, their movement and posture impairments persist throughout whole life.In recent years, CP has been significantly increasing with the improved survival rate of newborns.This may lead to a great burden and costs to both the family and the society.A variety of risk factors have been proposed to be associated with CP.However, recent abroad researches indicate that genetic factors may predispose to CP of newborns and initial results of related researches infer that several susceptibility genes may contribute to CP's development, masqueraders have a great impact on CP's clinical symptoms.Now, the recent publications related to virulence genes and masqueraders of CP are reviewed.
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Objective To explore the mental health and personality traits of the parents of cerebral palsy children. Methods 128 parents of cerebral palsy children and other 128 parents of healthy children were investigated with the Symptom Check List-90 (SCL-90), Eysenck Personality Questionnaire (EPQ). Results The scores of SCL-90 were more in the parents of cerebral palsy children, especially in the factors of somatization, obsession, depression, anxiety, and paranoid (P<0.01). The personality traits characterized as introversion (P<0.05) and neu-roticism (P<0.01). The multiple regression showed that some factors of SCL-90 were related with the personality of neuroticism. Conclu-sion The mental health of the parents of children with cerebral palsy are poor, which may be related with the personality of neuroticism.
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Objective To observe the expression of FAS/FASL in brain of autism model rats induced by sodium valproate,and study the role of FAS/FASL in pathogenesis of autism.Methods Female wistar rats were given a single intraperitoneal injection of sodium valproate(VPA,600 mg/kg) on 12.5 d after pregnancy,and their offspring were used as the experimental group;while the other pregnancy rats were given the same dose of normal saline,and their offspring were used as the control group.The growth,social and non-social behaviors,repetitive stereotyped movements of both groups were observed and tested.The expressions of FAS/FASL in brain of both groups on 1 d,7 d,l4 d,28 d,56 d and 90 d after birth were observed and compared by means of immunohistochemistry and image analysis.Results Compared with the control group,the rats in experimental group had stunted growth,a decrease in social behavior,an increase in non-social behavior,with repetitive stereotyped movements increased,and there were significant differences (all P ＜0.05) ;FAS/FASL expression was less on 1 d after birth,and it was growing gradually with age in days,and expression reached the peak on 28 d and then began to decrease.Compared with the control group,all day-old rats' FAS and FASL expression in the experimental group were significantly raised (all P ＜ 0.05).In experimental group,the brain FAS/FASL IOD values on 28 d after the birth reached the maximum,and 90 d after the birth reached the minimum.In the control group brain FAS/FASL IOD values on 14 d after the birth reached the maximum,and 1 d after the birth reached the minimum.Conclusions The apoptotic cell of autism model rats' brain neure is increasing firstly and then decreasing by FAS/FASL apoptotic pathway,and reach apoptosis peak on 28d.
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@#Objective To investigate the relationship between RELN gene single nucleotide polymorphism (SNP) and childhood autism in Jiamusi, Heilongjiang. Methods Polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) was used to determine allele and genotype of SNP (exon 6) of RELN in 30 children with autism and 30 normal children. Autism Behavior Checklist (ABC) was used to evaluate the children. Results There was a significant difference in the distribution of the allelic frequencies and genotype in exon 6 between these groups (P<0.05). There was a significant difference in the communication factors between patients with genotype of A/A and A/G or A/A and G/G (P<0.05), as well as in the total scores of ABC between A/G and G/G (P<0.05). Conclusion The SNP of RELN (exon 6) associated with the childhood autism. There is a more serious communication disorder in children with genotype of G/G, A/G than that of A/A.
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@#Objective To explore the level of polyunsaturated fatty acids (PUFAs) in blood plasma and its relation with the behavior ofchildren with autism. Methods High performance liquid chromatography was used to measure the level of free PUFAs of blood plasma in30 autistic children and 20 healthy children. Conner's Parent Rating Scale (parents) and the Repetitive Behavior Scale-Revised (RBS-R) RatingScale were used to evaluate the behavior of the children, and the relationship between the PUFAs level and abnormal behavior in the childrenwas also analyzed. Results The level of α-linolenic acid (ALA), docosahexenoic acid (DHA) and total n-3 PUFAs were lower in autisticchildren than in healthy children (P<0.05), especially lower in DHA (P<0.01). There was no significant difference in n-3 PUFAs betweentwo groups (P>0.05); There were negatively correlations between the level of DHA and total n-3 PUFAs in blood plasma and impulsion-hyperactivity,hyperactivity index, learning, anxiety, stereotypic behavior, self-injurious behavior, compulsions, ritualistic behavior and samenessbehavior. Conclusion The level of n-3 PUFAs in blood plasma of autistic children was lower than the healthy children and the level ofPUFAs were correlated with the behavior of autistic children.
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Objective To study the reliability and validity of the Chinese version of the dynamic occupational therapy cognitive assessment for children (DOTCA-Ch).Methods The English version of the DOTCA-Ch was translated into Chinese. One hundred and nine students from the city of Jiamusi were assessed with the Chinese Binet intelligence test and the DOTCA-Ch. Intra-class correlation coefficients (ICCs) were used in inter-rater and intra-rater reliability assessments. Cronbach's alpha coefficient was used to assess internal consistency. Factor analysis was used to assess construct validity. Pearson correlation coefficients were used in assessing criterion-related validity. Results The total ICC of the DOTCA-Ch was 0. 892. Cronbach's alpha coefficients for the subtests were orientation 0. 713 ; spatial perception 0. 793 ; praxis 0. 850 ; visuomotor construction 0. 844 and thinking operations 0. 630. The ICC for intra-rater reliability was 0. 991 and for inter-rater reliability it was 0. 989. Using the Binet intelligence test as a benchmark, the Pearson correlation coefficient between the IQ values and the total DOTCA-Ch scores was 0. 872 for 6 year-olds, but 0. 870 for 11 and 12 yearolds. Factor analysis revealed an acceptable set of 5 common factors. Their cumulative contribution was 67％.Conclusions The Chinese version of the DOTCA-Ch is reliable and valid. It can be used as an effective measuring tool to evaluate children's cognitive functioning.