Autism Spectrum Disorder

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journal1 2018, 26 (4): 349-351. DOI: 10.11852/zgetbjzz2018-26-04-01

Abstract （209）

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Research progress on applied behavioral analysis intervention in autism spectrum disorders

DAI Zhen-zhen, JIANG Zhi-mei, ZHU Jun-li

Chinese Journal of Child Health Care 2021, 29 (6): 623-626. DOI: 10.11852/zgetbjzz2020-0350

Abstract （330）

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder found in early childhood,mainly characterized by social disorder,stereotyped behaviors and restricted interests,all of which limit and impair children's daily life functions.In recent years,there are more and more kinds of interventions for ASD,and applied behavior analysis (ABA) is currently the only form of treatment for ASD endorsed by the US Surgeon General.Its effectiveness has been proven and it is now widely used in the treatment of ASD children.This paper reviews the basic theory,function and effect of ABA compared with other intervention methods.

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Research advances in missed diagnosis and misdiagnosis of autism spectrum disorder in children and adolescents

ZHOU Yu-hang, ZHAO Hong-bo, GUO Lan-min, JIANG Zhi-mei

Chinese Journal of Child Health Care 2021, 29 (4): 409-413. DOI: 10.11852/zgetbjzz2020-0161

Abstract （208）

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Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by social communication disorders of varying severity,repetitive behaviors and a narrow range of interests.ASD has become one of the important causes of mental disability in children and adolescents in China,and early intervention is beneficial to the prognosis of children.However,there are often missed diagnosis and misdiagnosis phenomena in the diagnosis of ASD.Based on previous studies,this review combs the manifestation types and causes of missed diagnosis and misdiagnosis of ASD,and discusses possible countermeasures.

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Principles of monitoring and intervention for micronutrient deficiency in children with autism spectrum disorder

LI Ting-yu, TAN Mei

journal1 2021, 29 (1): 1-4. DOI: 10.11852/zgetbjzz2020-1787

Abstract （236）

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Autism spectrum disorder (ASD) is a common and complex neurodevelopmental disorder for which there is no specific treatment and the clinical practice is mainly based on behavioral interventions,causing a huge economic burden to the families and society.The etiology of ASD is unclear and is recognized as the result of interaction of a complex genetic background with environmental risk factors,resulting in different clinical manifestations of children with ASD.Current evidence suggests that malnutrition,especially micronutrient deficiencies in utero and in early postnatal period,may be associated with the onset and clinical manifestations of ASD.These measures,including ensuring sufficient micronutrients during pregnancy,strengthening micronutrient monitoring for ASD children,and timely and reasonable intervention,may reduce the incidence of ASD and improve the behaviors of children with ASD to some extent.

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Management of family intervention for young children with autism spectrum disorder

XU Xiu

journal1 2021, 29 (1): 5-8. DOI: 10.11852/zgetbjzz2020-2106

Abstract （281）

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder onset in the early stage of development.There is a consensus that early identification,early detection and early intervention of ASD can greatly improve the prognosis of children with ASD.In the early intervention of ASD,the role of family intervention has attracted more and more attention,and has gradually become the research hotspot of early intervention of ASD in the world.This paper discusses the aspects that may be involved in the management and evaluation of family intervention for young children with ASD.

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Review in neurobiological mechanisms of somatosensory disorders in autism spectrum disorder

HU Mei-xin, LI Hui-ping, XU Xiu

Chinese Journal of Child Health Care 2021, 29 (1): 42-46. DOI: 10.11852/zgetbjzz2020-17501

Abstract （173）

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Somatosensory disorder refers to abnormalities in the somatosensory system's perception and processing of stimuli from the skin and deep tissues.It is one of the core symptoms of autism spectrum disorder (ASD),which seriously affects children's social,communication and adaptation skills development and prognosis.There are many studies on somatosensory disorders,but the mechanism between ASD and somatosensory disorders is still unclear.Therefore,this article will review the neurobiological mechanisms of somatosensory disorders and further analyze the known neurobiological mechanisms of ASD combined with somatosensory disorders,thereby providing an idea for understanding the role of somatosensory disorders in the pathogenesis of ASD and for exploring ASD intervention methods.

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Research progresson voltage-gated calcium channel-encoding genes in autism spectrum disorders

JIAO Cui, LIU Tao

journal1 2021, 29 (1): 47-51. DOI: 10.11852/zgetbjzz2020-0945

Abstract （162）

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Autism spectrum disorder (ASD) is a generalized neurodevelopmental disorder with social disorders and narrow interest as common symptoms.Genetic contributions are its main pathogenesis.Research on ASD susceptibility genes is a hot topic in the medical field at home and abroad.Voltage-gated calcium channels (VGCC) are essential for the regulation of neuronal action potential and neurotransmitter release.Currently,all 10 subtypes of the VGCC encoding genes have been found to be associated with ASD.So this review aims to summarize the research progress of the 10 genes encoding VGCC and ASD.

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Research progress on the mechanism of vitamin D in autism spectrum disorders

YANG Jing, HU Yan

journal1 2020, 28 (12): 1347-1350. DOI: 10.11852/zgetbjzz2019-1480

Abstract （189）

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder.At present,the pathogenesis of ASD is not clear,and there is no effective treatment.In recent years,many studies have shown that vitamin D plays an important role in brain development and the occurrence and development of ASD.This review combs the progress on the mechanisms of vitamin D in ASD.

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Research advances on the role of vitamin D in autism spectrum disorders

XIA Yang, YANG Shu-fen

journal1 2020, 28 (10): 1122-1125. DOI: 10.11852/zgetbjzz2019-1760

Abstract （146）

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Autism spectrum disorders (ASD) is one of the serious public problems affecting children′s health,characterized by social communication disorder,narrow interest or activity range and repetitive stereotyped behavior.In recent years,increasing studies have shown that the level of vitamin D (Vit D) in ASD children is significantly lower than that of healthy children with the same age,and vitamin D deficiency may be related to the pathogenesis of ASD.This paper reviews the research progress on vitamin D and ASD.

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Review on school performance and social skills development in children with autism spectrum disorders

KONG Mian, GUO Feng-yi

journal1 2020, 28 (10): 1126-1130. DOI: 10.11852/zgetbjzz2019-1305

Abstract （188）

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Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders characterized by barriers to social interaction in varying degrees, and narrow interests and stereotypes. Symptoms appear early in childhood and usually persist throughout the life cycle. In the Second National Disability Survey and Standards published in 2006 in mainland of China, ASD was included in the category of mental disorders, and the Guidelines for the Diagnosis and Treatment of Children with Autism were established. Despite increasing public awareness of ASD in China, most studies are more focused on early diagnosis and comprehensive intervention. Researches regarding the school placement, performance and social skills of ASD children are still at early stage. This review briefly describes the performance and social skills development of ASD children to future support school-age children with autism in China.

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Application of artificial intelligence in autism spectrum disorder rehabilitation

YOU Jia, LI You-jun, CHEN Yan-ni

journal1 2020, 28 (8): 883-886. DOI: 10.11852/zgetbjzz2019-1215

Abstract （323）

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Autism spectrum disorder (ASD) is a series of neurodevelopmental diseases with retarding social-emotional interaction, language and nonlinguistic communication, as well as fellowship with peers, resulting in inferior social development.Conventional diagnostic instruments such as Autism Diagnostic Observation Schedule-Revised (ADOS-R) and Autism Diagnostic Interview (ADI-R) have been used in screening, and methods of Applied Behavior Analysis (ABA), Treatment and Education of Autistic and Communication Handicapped Children (TEACCH), as well as Social Story have been applied in treatments.However, great challenges are still in front of the facts of early accurate diagnosis and workable intervene with ASD.Rapid development of artificial intelligence (AI) has led medicine into a smart age.With the application of AI in medicine, ASD have the potential to be identified timely and accurately, and get progress in treatment in the core symptoms.Meanwhile, AI also makes it possible to better resolve the issues of inadequate medical resources and large treatment costs.This article has reviewed recent literature on AI in ASD and unveiled the research results related to machine learning, virtue reality technology, robot--mediated intervention, and the ethics and prospect of AI in autism rehabilitation.

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Advances on the application of immersive virtual reality technology in the treatment of autism spectrum disorders

CHEN Jing, DU Ya-song

journal1 2020, 28 (5): 543-546. DOI: 10.11852/zgetbjzz2019-0615

Abstract （250）

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The treatment of autism spectrum disorder (ASD) is limited and the burden of this disease is heavy. This paper is aimed to introduce the advances on the application of immersive virtual reality technology in the treatment of ASD,thereby providing new ideas for the treatment of ASD patients.

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Research advances on the genomic biomarkers of autism spectrum disorder

WEI Nian-jin, WANG Yu

journal1 2020, 28 (5): 551-554. DOI: 10.11852/zgetbjzz2019-0762

Abstract （323）

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Autism spectrum disorder (ASD) is a neurodevelopmental disease characterized by impairment social interaction,repetitive behaviors and restricted interest. Recent studies have demonstrated dramatically increasing prevalence of ASD,reaching to 1∶59. However,the etiology and pathogenesis of ASD remain unknown. Early diagnosis and early intervention are crucial to the rehabilitation of ASD. In recent years,researches on biological markers of ASD has made great progress,especially in genomics,including gene mutation,copy number variation,single nucleotide polymorphism and epigenetic. This review will summarize the research progress on genomic biomarkers of ASD.

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Research progress on common comorbidities in children with autism spectrum disorders

ZHOU Yu-nan, ZHAO Hong-bo, JIANG Zhi-mei

journal1 2020, 28 (5): 555-558. DOI: 10.11852/zgetbjzz2019-0996

Abstract （292）

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Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders that occurs in early life. ASD children are often comorbid with ADHD,epilepsy,sleep disorders,gastrointestinal problems,immune abnormalities,anxiety,affective disorders and other diseases. This review focuses on the current research on ADHD,epilepsy,sleep disorders,gastrointestinal problems,respectively and summarized in terms of the epidemiological characteristics,the impact on clinical symptoms and treatment methods of ASD children.

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Review of the family-mediated intervention models and effects on children with autism spectrum disorders

GE Dong-mei, DAI Ying

journal1 2020, 28 (2): 167-171. DOI: 10.11852/zgetbjzz2019-0458

Abstract （241）

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With the increasing prevalence rate of autism spectrum disorders (ASD) worldwide,a series of intervention models appear,which create new possibilities for the prognosis of ASD children.Among them,the family-mediated intervention mode has attracted more and more attention,but it is still short of formal and systematic one at home.By reviewing different family-mediated intervention models and effects on ASD children at home and abroad,this review aims to provide some guidance for the domestic family-mediated intervention models in the future.

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journal1 2020, 28 (1): 1-2. DOI: 10.11852/zgetbjzz2019-1865

Abstract （238）

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Research progress on the genetics of autism spectrum disorder

LI Sheng, JIANG Hong, FEI An-xing, ZOU Tian-tian

journal1 2020, 28 (1): 45-47. DOI: 10.11852/zgetbjzz2019-0454

Abstract （224）

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Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders characterized by a deficit in social behaviors,repetitive and stereotyped behaviors.ASD children usually have cognitive and emotional disorders,mainly caused by factors such as early development,genetic and abnormal brain functions.This review combs the advances in genetics of ASD.

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Early prediction of autism spectrum disorders based on eye movement research

LI Fei-rong, CHEN You-qing

journal1 2020, 28 (1): 48-51. DOI: 10.11852/zgetbjzz2019-0273

Abstract （229）

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Autism spectrum disorder(ASD) is generally characterized by social disorders,narrow range of interests,behavioral stereotypes and eye fixation. Abnormal eye fixation is one of the clinical manifestations of ASD and an early biomarker for children with ASD. Eye movement technology has been gradually applied in clinical and related research of ASD. The current early predictions using eye movement technology mainly focus on the gaze time of the face,the eye movement characteristics of visual search and the attention to geometric figures. It is more consistent that the fixation time of the face and eye area is short,the fixation time of the geometric figure is long,and the advantage in visual search can be used as an early predictor of ASD. This review summarizes the early prediction of ASD using eye movement technology in the past few years in order to provide reference for the early detection of ASD.

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Review of methods for assessing mealtime behaviors in children with autism spectrum disorder

ZHANG Peng-fei, LUO Yan

journal1 2019, 27 (12): 1327-1330. DOI: 10.11852/zgetbjzz2019-0880

Abstract （201）

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Due to the characteristics of autism spectrum disorder(ASD), the mealtime behavior of ASD children, compared with healthy contemporaries, often present extreme food selectivity, food refusal and rapid eating.It also includes unusually persistent preference for the traits and texture of certain foods and aggressive, self-injurious, ritual mealtime behaviors.These poor mealtime behaviors affect the intake of nutrients and the development of typical mealtime behaviors in children with autism.If mealtime behavior problems of children with ASD were discriminated and identified in time, it will be beneficial to rehabilitation and growth of children with ASD.A comprehensive, accurate, objective and detailed assessment of mealtime behavior problems can serve as a reference and basis for mealtime behaviors interventions and treatments for children with autism.Therefore, this review summarizes and elaborates on the assessment methods of ASD children's mealtime behaviors.

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Very early intervention with parents as mediators for autism spectrum disorder

KE Xiao-yan

journal1 2020, 28 (1): 3-5. DOI: 10.11852/zgetbjzz2019-1644

Abstract （212）

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Autism spectrum disorder is a neurodevelopmental disorder that seriously affects the development of children.For professional reference,this paper focuses on the research progress of very early intervention for autism spectrum disorder and the importance and necessity of parental involvement.

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Review of the main characteristics and measurement of restricted and repetitive behaviors in autism spectrum disorder

LIAO Shan, LI Meng-qi, DAI Ying

journal1 2020, 28 (1): 41-44. DOI: 10.11852/zgetbjzz2019-0211

Abstract （276）

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Restricted and repetitive behaviors(RRBs) is a common behavior pattern in childhood.In typically developing children,repetitive behavior is the repeated practice of children′s behavior,language and games,with the aim of mastering skills.But in other developmental disorders among children,RRBs is closely related to the abnormal developmental process.The clinical evolution and evaluation of these behaviors in children with different developmental states,especially in children with autism spectrum disorders (ASD),deserve much attention.This review aims to shed light on the problem obove and provide reference for further research by combing the relevant literature.

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Research advances on pathogenesis and interventions of sleep disorders for children with autism spectrum disorder

ZHAO Qin, SHAO Zhi

journal1 2020, 28 (1): 52-56. DOI: 10.11852/zgetbjzz2019-0471

Abstract （253）

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Sleep disorders are commonly reported comorbidities in children with autism spectrum disorder (ASD),which might not only exacerbate the core symptoms of ASD,but also adversely impact the intervention efficacy.The potential mechanism for sleep disorders of ASD is not clear so far,it might be due to the abnormal sleep regulation,ASD core symptoms,the co-occurring comorbidities,medical conditions,nutritional deficiency,and the medications commonly used.There are no specific therapeutic interventions for sleep problems of ASD currently,and parent education combined with behavioral interventions is recommended.

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Research advances on early interventional programs for children with autism spectrum disorders

MA Chen-huan, WANG Yu

journal1 2020, 28 (1): 57-60. DOI: 10.11852/zgetbjzz2019-0614

Abstract （335）

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Autism spectrum disorder (ASD) is a complex,multidisciplinary neurodevelopmental disorder characterized by social communication disorders,repetitive and stereotyped behaviors,and narrow interests.At present,the prevalence of ASD is on the rise worldwide,and most ASD children have poor prognosis.Early intervention can significantly improve the poor prognosis of ASD children.This paper combs related intervention programs,including applied behavior analysis (ABA),pivotal response treatment (PRT),early start Denver model (ESDM),floortime,treatment and education of autistic and communications handicapped children (TEACCH) as well as social communication,emotional regulation and transactional support (SCERTS).

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Research advances on intestinal microbes and childhood autism spectrum disorders

BAI Mao-fei, WANG Xia

journal1 2019, 27 (9): 986-989. DOI: 10.11852/zgetbjzz2019-0134

Abstract （173）

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Autism spectrum disorders(ASD)is a serious neurodevelopmental disorder,and its core symptoms include the lack of social function,social communication barriers,limitations of interest and stereotyped behavior,caused by the interaction of genetic and environmental factors. Intestinal microorganisms are a large number of microorganisms present in the intestine,which not only affect the ability to digest and absorb,but also affect the brain development and function through the gut-brain axis. Specific probiotics can regulate the balance of human micro-ecology,maintain normal metabolic absorption and immune defense functions. Intestinal microbial disorders in critical stages of infant development may increase the risk of ASD,and affect the development of ASD in children through neuroendocrine,immune,and metabolite pathways. Therefore,probiotics treatment is promising to be a new adjuvant treatment for ASD.

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Discussion on the necessity of routine screening for inborn errors of metabolism in children with autism spectrum disorder

REN Shuang, LI Chen-yang, QIAO Chong, LI Jing

journal1 2019, 27 (4): 397-399. DOI: 10.11852/zgetbjzz2018-1367

Abstract （179）

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Autism spectrum disorder(ASD) is a group of neurodevelopmental disorders,and its etiology is very complicated.Some children with inborn errors of metabolism (IEM) accompanied by ASD or autistic symptoms, can relieve ASD to a certain extent by the treatment of IEM, so IEM is probably one of the causes of ASD.This review discusses whether IEM screening should be routinely carried out in ASD children.

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Research progress on the correlation between intestinal flora and autism spectrum disorder

KUNG Wei-yen, WANG Yu

journal1 2019, 27 (4): 407-410. DOI: 10.11852/zgetbjzz2018-1166

Abstract （158）

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder mainly characterized by social communication disorders, repetitive behaviors and narrow interests.The etiology of ASD is complex, and it focuses on the genetic and environmental factors.As the pathogenesis is unknown, there is no effective treatment.It is found that gastrointestinal diseases and changes of intestinal flora are common in ASD children.Recent studies have shown a two-way interaction between the gut nervous system and the central nervous system, called the microbiota-gut-brain axis.Gut flora regulates brain function through neuroendocrine, immune and intestinal nervous systems and thus affects brain development and behavior.Therefore, the imbalance of intestinal flora may be related to the occurrence of ASD.This article will summarize the effect of intestinal flora on ASD and the progress of related treatment.

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Intervention principles for children with autism and BSR model

ZOU Xiao-bing

journal1 2019, 27 (1): 1-6. DOI: 10.11852/zgetbjzz2018-1611

Abstract （448）

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Autism spectrum disorder(ASD) is mainly characterized by social communication deficits, restricted interests and repetitive patterns of behavior. Research evidences prove sufficiently that early diagnosis and early intervention can improve the prognosis of ASD significantly. According to the national conditions in China, the core mission for ASD intervention must be addressed on improving social communication deficiency, adhered to scientific evidence-based intervention, personalized intervention, and family-community based intervention. Therefore, the author proposes three educational principles for ASD children and the BSR intervention model, which refers to using behavioral management strategy as basic method, using structural teaching as basic framework, and using social communication as basic components.

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Research progress on zebrafish models of autism spectrum disorder

WANG Yi, LIU Chun-xue, XU Xiu

journal1 2019, 27 (1): 46-50. DOI: 10.11852/zgetbjzz2018-0529

Abstract （176）

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Autism spectrum disorder (ASD) is a set of heterogeneous neurodevelopmental conditions,characterized by social deficits and the presence of repetitive stereotypic behaviors and restricted interests. The biological mechanisms of ASD have not been completely identified. As a fundamental research tool,animal model is comprehensively applied to study genetic basis,neuropathological mechanisms as well as pharmaceutical researches. Zebrafish models have been popularized as typical ASD models based on the advantages of the external fertilization,high fecundity,rapid development,optical transparence of embryos and larvae which allow real-time imaging of developing pathologies,drug screening on a large scale economically. This review thus aims to summarize the achievements of zebrafish for modeling ASD.

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Research progress on the brain development of children with autism spectrum disorders

LIU Jia-ning, CHEN Yan-hui

journal1 2019, 27 (1): 51-55. DOI: 10.11852/zgetbjzz2018-0484

Abstract （170）

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Researches on the structure,neural pathways and neuronal excitability of autism spectrum disorders (ASD) have progressed rapidly in recent years. Studies indicated that abnormalities of brain development in ASD children can be found in early childhood by imaging and elctroencephalogram(EEG) examination,such as abnormalities in the corpus callosum and confusions in the nerve pathways of the white matter.On the other hand,the excitability abnormalities of some neurons is related to the behavioral changes of ASD,and the abnormalities were related to some receptor activities and some signaling pathways. These findings are helpful to explain the pathogenesis mechanism and behavioral manifestation of ASD,and related biological changes could also help to diagnose ASD and provide a breakthrough point for the treatment of ASD.

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Advance on insulin-like growth factor-1 in autism spectrum disorders

HONG Xiao-wen, CHEN Yan-hui

journal1 2019, 27 (1): 56-58. DOI: 10.11852/zgetbjzz2018-1095

Abstract （200）

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The diagnosis of autism spectrum disorder (ASD) is mainly dependent on behavioral symptoms,and most children could not receive accurate diagnosis until 4 years old when the impairment of social interaction presents typically and the best period of intervention has been missed. It is worth noting that scientists have made a lot of theoretical and practical research on the pathological mechanism and drug target of ASD. And more and more studies have shown that the biomarker,insulin-like growth factor-1 (IGF-1),plays an important role in the development and progression in ASD. This review will summarize the role of IGF-1 in ASD in order to elucidate that IGF-1 is expected to be a biomarker of early diagnosis and early prevention of ASD,and to explore the application of IGF-1.

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Effect of caregiver skill training on improving the symptoms of children with autism spectrum disorder and psychological defense mechanism of their parents

WANG Hai-mei, YIN Hua-ying, LI Yan, DONG Qiu-jun, CHEN Jing, AO Dong-qin, LUO Shuang

Chinese Journal of Child Health Care 2023, 31 (2): 141-146. DOI: 10.11852/zgetbjzz2022-0793

Abstract （135）

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Objective To explore the effectiveness of caregiver skill training in improving the symptoms of children with autism spectrum disorder (ASD) and parental psychological defense mechanism, so as to provide evidence for clinical intervention of autistic children. Methods A total of 120 ASD children and their parents who have seen a doctor in a tertiary care children′s hospital in Chongqing from May to November 2021 were selected as the study subjects and were divided into the control group and the intervention group according to the voluntary principle. The control group received conventional intervention, while children and parents in the intervention group received caregiver skills training for 6 weeks, of which online theoretical training lasted for 4 weeks with a frequency of 5 times/week, and offline practical skills training lasted for 2 week with a frequency of 1.5 hours/time, 5 times/week. Before the intervention, at the end of the intervention, and one month after the end of the intervention, the defense ability of parents in the two groups was assessed using the Defense Mechanism Questionnaire (DSQ), the intervention effect of the children in the two groups was evaluated using the Autism Behavior Checklist (ABC) and the infant-junior middle school social adaptive capacity scale(SM). Results At the end of the intervention, the score of immature defense mechanism of parents in the intervention group was 3.79 ± 1.29, which was significantly lower than that in the control group (4.28 ± 1.14) ( t＝-2.281, P <0.05). One month after the end of the intervention, the scores of immature defense mechanism and intermediate defense mechanism of parents in the intervention group were significantly lower than those in the control group ( t=-2.490, -2.196, P <0.05). The score of autism behavior checklist in the intervention group was 55.25±8.89, significantly lower than that in the control group (60.32±9.61) ( t =-2.997, P<0.05), and the time effect was significant ( F=73.54, P <0.05).At the end of the intervention and one month after the end of the intervention, compared with the control group, the number of children with moderate and severe abnormalities in social life ability in the intervention group was significantly reduced ( Z＝-2.119,-3.164, P<0.05). Conclusion Caregiver skill training can effectively improve the immature defense mechanism of parents and reduce the symptoms of ASD children.

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Plasma level of folate-related metabolites in children with autism spectrum disorder and its relationship with clinical manifestations

WANG Feng, ZHANG Yu-jue, ZHAO Jing-yi, LIU Ze-hui, ZOU Ming-yang, SUN Cai-hong, XIA Wei

Chinese Journal of Child Health Care 2023, 31 (2): 152-155. DOI: 10.11852/zgetbjzz2021-1907

Abstract （98）

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Objective To explore the relationship between folic acid related metabolites and autism spectrum disorder (ASD), so as to provide theoretical basis for the etiology and pathogenesis of ASD. Methods From June 2017 to December 2018, children who received rehabilitation training in designated rehabilitation institutions for autism in Harbin were collected. Seventy autistic children and seventy matched healthy children were enrolled in this case-control study. The levels of folic acid related metabolites in plasma were measured by liquid chromatography tandem-mass spectrometry (LC-MS/MS), and its association with the clinical phenotype of ASD children was analyzed. Results ASD children had higher plasma levels of cystathionine ( Z=2.59), total glutathione (tGSH) ( t=5.29), homocysteine (Hcy) ( t=2.23), cysteine ( t=11.37), methionine ( t=3.14) compared to healthy control ( P<0.05), but the difference in the levels of adenosine( Z=1.20) and cystine( t=1.75) in plasma between the two groups was not significant ( P>0.05). The level of tGSH in ASD children was positively correlated with the scores of social communication score in Social Responsiveness Scale (SRS) ( r=0.322, P<0.05). Conclusion Abnormal expression of folic acid related metabolites in ASD children is correlated with the scores of clinical phenotypic features of ASD, and the underlying mechanism needs to be further explored.

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Research progress of exosomes in autism spectrum disorder

ZHU Yu-xuan, TIAN Ya-ning, PAN Jue, QIN Yan-nan

Chinese Journal of Child Health Care 2022, 30 (12): 1345-1349. DOI: 10.11852/zgetbjzz2021-1269

Abstract （95）

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Autism spectrum disorder(ASD) is a typical form of pervasive developmental disorder characterized by social interaction and communication disorders,attention deficits,narrow interests,and repetitive/stereotypical behavior patterns. In recent decades,the prevalence rate of autism has been on the rise all over the world and there is a lack of specific treatments. Therefore,it is very urgent to search for sensitive and specific biomarkers and specific treatments. Exosomes are nanoscale vesicles that can be released by most cell types in the central nervous system. Bioactive macromolecules such as RNA,proteins and lipids in exosomes participate in the material exchange and information exchange of various nerve cells, and play an important role in the regulation of nerve development, differentiation,regeneration and synaptic regulation. With the development of molecular biology and the improvement of diagnostic technology,exosomes have gradually become the focus of ASD research due to their advantages of convenient collection,stable structure,easy degradation of macromolecules in exosomes and the ability to pass the blood-brain barrier. It has been reported that exosomes are related to the occurrence and development of ASD,and may be an important source of diagnostic markers for ASD and a new drug treatment carrier. This article reviews the research progress of exosomes in ASD,in order to provide reference for early diagnosis,clinical treatment and prognosis judgment of ASD.

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Research progress of neural network basis on social brain in autism spectrum disorder

YU Han, QU Hang, ZHAO Yi, PAN Yu, WANG Wei

Chinese Journal of Child Health Care 2022, 30 (12): 1350-1353. DOI: 10.11852/zgetbjzz2021-1270

Abstract （152）

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Autism spectrum disorder(ASD) is a heterogeneous neurodevelopmental disorder characterized by impairments in social communication and restricted and repetitive behaviors and interests,with symptom onset during the first few years of life. Over the past two decades,neuroimaging has revealed numerous findings of atypical activity and abnormal connectivity of "social brain" networks,including analysis of faces and gaze by the fusiform face area(FFA),emotional processing in the amygdala,mentalizing in the default mode network(DMN) and imitation and understanding of others′ actions by the regions associated with the mirror neuron system(MNS),yet no consensus view on crucial developmental causes of social communications deficits has emerged. Aside from methodological challenges and studies on the connectivity of individual brain networks,the deeper problem concerns the strong heterogeneity of ASD. This inconsistent finding may be due to changes in diagnostic criteria and the atypical neurodevelopment trajectories of autism at preschool period. Therefore,cohort studies on subtypes of autism and of longitudinal cohort with a large sample are warranted.

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Systematic review of assessment tools of anxiety for children with autism spectrum disorder

LYU Ping-ping, CUI Nai-xue, HAN Jing, HU Meng-zhu, YUE Lei, SHAN Ru-jie

Chinese Journal of Child Health Care 2022, 30 (12): 1358-1363. DOI: 10.11852/zgetbjzz2022-0271

Abstract （99）

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Objective To systematically evaluate the anxiety assessment tools for children with autism spectrum disorder(ASD) at home and abroad, in order to provide evidence for practice and research in this field. Methods Eleven electronic databases were searched. Studies on the development of anxiety assessment tools and/or the testing of psychometric properties for children with ASD were included and evaluated according to the COSMIN standards. Results A total of 31 articles in English language that appraised 16 anxiety assessment tools for ASD children were yielded and included in the systematic review. Among the 16 tools, ten were developed for typically developed children, five were specifically adapted for children with ASD, and one was developed to measure the anxiety of both typically developed children and ASD children. The Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD) demonstrated the best psychometric properties. Conclusions Among the tools in English, ASC-ASD is the most recommended anxiety assessment tool for children with ASD. To our best knowledge, the Chinese version of ASC-ASD is still not found, which can be prioritized for translation and validation.

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Difference in fecal intestinal flora instructure and short chain fatty acids between children with autism spectrum disorder and healthy children

ZHANG Yu, LU Hong-yan, TANG Wei, HAO Xiao-bo

Chinese Journal of Child Health Care 2022, 30 (12): 1390-1394. DOI: 10.11852/zgetbjzz2021-1015

Abstract （105）

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Objective To investigate the difference in fecal intestinal flora instructure and short chain fatty acids between children with autism spectrum disorder (ASD) and healthy children, so as to provide new clues for the prevention and treatment of ASD from the perspective of intestinal flora. Methods A total of 25 ASD childrendiagnosed in the Department of Pediatrics, Afficiated Hospital of Jiangsu University were enrolled in the ASD group from January to November 2019. Meanwhile 24 healthy children with typical growth and development who took physical examination were selected as control group. Their feces samples were collected. 16SrRNA sequencing was used to analyze the structure of the intestinal microflora, and gas chromatography was used to detect the content of short-chain fatty acids in feces. Results Compared with the control group, ASD children had a significant decrease in the abundance (Chao index and Ace index) and diversity (Shannon index) of intestinal flora ( t=2.917, 2.890, 3.353, P＜0.05), an increase in the abundance of Firmicutes and Proteus and a decrease in the abundance of Bacterioidetes at the phylum level( t=3.180, 5.761, 5.970, P＜0.05). At the genus level, ASD children had a significant decrease in the abundance of Bacterioides, Bifidobacterium, Blautia and Streptococcus, a significant increase in the abundance of Clostridium and Sutterella ( Z=2.440, 3.100, 3.620, 3.500, 4.200, 4.054, P＜0.05). Compared with the control group, the levels of acetic acid, propionic acid and total short chain fatty acids in ASD group were significantly increased, while the butyric acid was significantly decreased( t=3.040, 3.220, 2.560, 4.100, P<0.05). Spearman correlation analysis showed Bifidobacterium was negatively correlated with propionic acid and total short chain fatty acids( r=－0.422,－0.412, P＜0.05). Conclusions There are significant changes in the structure of intestinal flora and the content of short chain fatty acids in feces of ASD children. The increase of the content of propionic acid and the total short chain fatty acids caused by the decrease of Bifidobacterium may be related to ASD.

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Comparison of contingency discrimination training between 4- to 8-year-old children with autism spectrum disorder and normal children

SHEN Shi-hui, MA Chen-huan, WANG Yu, CHEN Jin-jin

Chinese Journal of Child Health Care 2022, 30 (11): 1177-1180. DOI: 10.11852/zgetbjzz2022-0087

Abstract （121）

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Objective To compare the difference in contingency discrimination training between children with autism spectrum disorder (ASD) and normal children, in order to provide suggestions for the intervention of ASD children. Methods A total of 22 children diagnosed with ASD in the Department of Children's Health Care of Shanghai Children's Hospital and 24 normal children matched with age and intelligence quotient (IQ) were selected into this study from July 2020 to October 2021. Children in both groups took contingency discrimination training, and the difference was compared. Results The score of positive and negative contingency discrimination training under motivational manipulation between ASD children and normal children had no significant difference ( Z=1.35,1.63 , P＞0.05). ASD children scored significantly lower in positive and negative contingency discrimination training with external visualization signs than normal children ( Z=2.83, 5.04, P＜0.05). And for ASD children, the score of positive contingency discrimination training with external visualization signs was significantly different with that of negative contingency discrimination training with external visualization signs ( Z=3.17, P＜0.05). Conclusion ASD children have lower contingency discrimination training with external visualization signs than normal children. In addition, ASD children have lower negative contingency discrimination training with external visualization signs than positive contingency discrimination training with external visualization signs. Therefore, it is recommended that training related to contingency discrimination training with external visualization signs should be added to the rehabilitation training of ASD children.

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Comparison of clinical application between Autism Diagnostic Observation Schedule Second Edition Module-1 and Children Autism Rating Scale in children with autism spectrum disorder

WU Man-hong, XU Ning, CHANG Yan-qun, WEN Jian, LOU Yu-yan, HUANG Shuang-miao

Chinese Journal of Child Health Care 2022, 30 (11): 1181-1184. DOI: 10.11852/zgetbjzz2022-0613

Abstract （152）

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Objective To compare the diagnostic value between Autism Diagnostic Observation Schedule Second Edition(ADOS-2) Module-1 and Children Autism Rating Scale (CARS) for children with autism spectrum disorder (ASD), in order to provide reference for clinical application. Methods From January 2019 to March 2022, a total of 104 children who firstly visited and diagnosed in the Department of Neurological Rehabilitation, Guangdong Women and Children Hospital were enrolled in this study, including 60 ASD children (ASD group:30 cases of high function and 30 cases of low function,), 24 children with global developmental delay (GDD) and 20 normal children (non-ASD group). All children were assessed by ADOS-2 Module-1 and CARS. The consistency of diagnostic results between the two scales and the criteria of American Diagnostic and Statistical Manual of Mental Disorders-5(DSM-5) was evaluated, and the sensitivity and specificityof the two scales in the diagnosis of ASD were compared. Results 1) The consistency between ADOS-2 module 1 and DSM-5 was good ( Kappa=0.862),as well as between ADOS-2 module 1 and CARS ( Kappa=0.695).The consistency was medium between CARS and DSM-5 ( Kappa=0.509), 2) The sensitivity of ADOS-2 module 1 was significantly better than that of CARS ( χ²=13.333, P<0.001). There was no significant difference in the sensitivity and specificity between diagnosing children with IQ≥70 and children with IQ <70( P>0.05). The sensitivity of CARS in the diagnosis of children with IQ <70 was significantly better than that of children with IQ≥70 ( χ²=7.500, P=0.006), but the specificity was not statistically significant ( P>0.05). Conclusions ADOS-2 module-1 and CARS are both important tools to assist in the diagnosis of ASD, and ADOS-2 module-1 has higher sensitivity and specificity in the early diagnosis of ASD children. In clinical work, it is recommended to lower the diagnostic threshold of CARS for children with IQ ≥ 70 in order to improve the diagnostic sensitivity of CARS and reduce the rate of missed diagnosis.

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Effects of endocannabinoid system on autistic behavior in valproic acid-induced rats

PENG Zhen, LIU Yu, ZENG Yi-yuan, LUO Gui-bao, CHENG Li-xia, LI Yin-chu, ZHANG Yu-jue, ZOU Ming-yang

Chinese Journal of Child Health Care 2022, 30 (11): 1191-1197. DOI: 10.11852/zgetbjzz2021-1865

Abstract （99）

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Objective To investigate the effect of altered 2-arachidonoylglycerol(2-AG) levels on autistic behaviors in VPA-induced rats(ASD model), so as to provide evidence for identifying the etiology of ASD. Methods The rats were divided into CON group, VPA group(ASD), acute JZL184 injection group [VPA+40 mg/kg JZL184 group(VPA+40AJ)], chronic JZL184 injection group [including VPA+1 mg/kg JZL184 group(VPA+1RJ), VPA+3 mg/kg JZL184 group(VPA+3RJ) and VPA+10 mg/kg JZL184 group(VPA+10RJ) ]. The ASD-like behavior of rats in each group was assessed. The levels of endocannabinoids(eCBs) in the hippocampus of rats were detected by liquid chromatography-mass spectrometry. Western blot was used to test the expression levels of related receptors and metabolic enzymes in eCB system. Results The levels of 2-AG and AEA in VPA group were significantly lower than those in CON group( P<0.05). After JZL184 intervention, the levels of 2-AG in VPA+3RJ group and VPA+10RJ group significantly increased( P<0.05). Compared with the CON group, the number of buried marbles, self-grooming time and spontaneous activities increased significantly in VPA group, and the sociability index and the social preference index decreased( P<0.05). After JZL184 intervention, the number of buried marbles, self-grooming time and spontaneous activities decreased, and the sociability index and the social preference index in VPA+40AJ group increased significantly, the self-grooming time of the rats in VPA+1RJ group decreased. After JZL184 intervention, the number of buried marbles, self-grooming time and spontaneous activities decreased, and the social preference index of the rats in VPA+3RJ group increased significantly. The number of buried marbles and self-grooming time decreased, and the social preference index of the rats in VPA+10RJ group increased significantly( P<0.05).The protein expressions of CB1R, DAGL, MAGL and FAAH in VPA group were significantly higher than those in CON group( P<0.05).After JZL184 intervention, the protein expressions of DAGL and MAGL of the rats in VPA+3RJ group were significantly down-regulated, and MAGL in VPA+10RJ group were also significantly down-regulated( P<0.05). Conclusions Low eCBs signal is associated with autistic behaviors in VPA-induced rats, and boosting 2-AG levels can improve repetitive and stereotypical behaviors, hyperactivity and social functions in ASD rats.

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Influencing factors of developmental regression in children with autism spectrum disorder

ZHOU Ping, CHEN Li

Chinese Journal of Child Health Care 2022, 30 (11): 1208-1211. DOI: 10.11852/zgetbjzz2021-0483

Abstract （111）

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Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized as heterogeneous clinical manifestations.Developmental regression, regarded as a specific subtype in ASD, is getting more and more attention.However, the influencing factors of regression are not clear.It is generally believed that it is a kind of developmental disorder caused by genetics, environment and their interaction.This review aims to summarize the influencing factors increasing risk of regressive autism from the perspective of environment and genetics, thereby providing references for the recognition and interventions in early childhood.

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