Table of Content

10 March 2024, Volume 32 Issue 3

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Professional Forum

Communication disorders in children with autism spectrum disorder from speech language pathology perspective

YANG Feng

2024, 32(3):  233-236.  DOI: 10.11852/zgetbjzz2024-0114

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Children with autism spectrum disorder (ASD) face varying degrees of difficulties in communication, language, and social interactions.This article analyzes the basic communication abilities, language development characteristics, and social pragmatic features of ASD children from the perspective of speech pathology, introduces corresponding assessment tools and proposes intervention strategies based on the International Classification of Functioning, Disability, and Health (ICF).Meanwhile, this article emphasizes the adoption of a comprehensive intervention model that involves medical, family, and school components to enhance the communication, language, and social skills of this group comprehensively, with the aim of effectively improving their overall quality of life.

Original Articles

Methylation level of CNR1 in peripheral blood of children with autism spectrum disorder

WANG Feng, LIU Zehui, ZHANG Yilin, TIAN Wenru, YANG Lingyuan, ZOU Mingyang, SUN Caihong

2024, 32(3):  237-241.  DOI: 10.11852/zgetbjzz2023-0686

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Objective To explore the relationship between the methylation level of CNR1 and autism spectrum disorder (ASD), in order to provide a theoretical basis for the etiology of ASD. Methods A case-control study was conducted, recruiting 30 children with ASD from the Child Development and Behavior Research Center of Harbin Medical University and a rehabilitation facility, and 30 matched typically developed children from June 2017 to December 2018. The methylation levels of CNR1 in peripheral blood were measured by the Agena MassArray^® Mass Spectrometry System. A univariate conditional Logistic regression model was used to analyze the potential association between the methylation level of CNR1 and the risk of ASD with adjustment for age, BMI, body fat percentage and body fat. The correlations between the methylation level of CNR1 and the score of Social Responsiveness Scale (SRS) were evaluated by Pearson/Spearman correlation analysis. Results The methylation levels of the average methylation (t=2.224), CpG_3.4 (Z=2.187), CpG_9.10.11 (t=2.308), and CpG_28.29 (t=2.943) of the CNR1 promoter region in ASD children were significantly higher than controls (P<0.05). The methylation levels of the average methylation (OR=1.117, 95%CI: 1.003 - 1.245), CpG_9.10.11 (OR= 1.072, 95%CI:1.006 - 1.142), and CpG_28.29 (OR=1.078, 95%CI: 1.018 - 1.141) of the CNR1 promoter region were positively correlated with the risk of ASD (P<0.05). The methylation level of CpG_28.29 in ASD children was positively correlated with the scores of social motivation in SRS (r=0.421, P＜0.05). Conclusions The methylation levels of CNR1 in peripheral blood are abnormal in ASD children and might be correlated with the risk of ASD and social function. The underlying mechanism needs to be further explored.

Association between screen time and psychological behaviors of preschool children in Lanzhou City

HUANG Lei, NAN Nan, SU Yue, WANG Pengli, WU Xiaoyan, GUO Jinxian

2024, 32(3):  242-247.  DOI: 10.11852/zgetbjzz2023-0396

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Objective To analyze the associations between different types of video screen time and psychological behaviors of preschool children, in order to provide evidence for promoting the development of children's mental health. Methods From February to March 2023, a total of 1 361 parents of children aged 3 - 6 years from 6 kindergartens of Lanzhou were surveyed by cluster sampling method.Parents were surveyed to obtain information about the video use, and the children's Strengths and Difficulties questionnaire (parent version) was used to assess children's psychological and behavioral problems. Results The rate of daily screen time exceeding standard was 36.96% (503/1 361).The screen time was mainly spent in watching TV cartoons, followed by educational APP.The detection rate of abnormal total difficulty score was 11.61% (158/1 361), and the abnormalities of peer communication (32.26%) and prosocial behavior (12.34%) were the most prominent.After adjusting for related factors by multiple Logistic regression analysis, total screen time≥2h/d (OR=1.802) was found to be a risk factor for abnormal total difficulty score; watching TV cartoons≥2h/d was a risk factor for abnormal total difficulty score (OR=2.409) and peer communication (OR=2.222); playing games≥1h/d was a risk factor for abnormal total difficulty score, emotional symptoms, conduct problems, hyperactive behavior, and abnormalities of peer communication, the differences were all statistically significant (P<0.05).However, educational APP screen time<1h/d was a protective factor for abnormal total difficulty score(OR=0.615) and prosocial behavior (OR=0.549), but educational APP screen time≥2h/d was a risk factor for conduct problems (OR=2.302), the differences were all statistically significant (P<0.05). Conclusions The screen time of preschool children in Lanzhou cannot be ignored, and there is a significant correlation between overuse and children's psychological and behavioral problems.Parents and schools should attach importance to the parent-child and peer interaction of preschool children and strengthen the intervention of preschool children's video behavior.

Influence of gestational weight gain and preconception body mass index on overweight and obesity of school-age children

HU Caixia, WU Tianfeng, CHEN Hua, WANG Sen, CHEN Yichen, SHENG Jiayi, SUN Lianghong, QU Xiaobin, ZHOU Yi, BAI Pinqing

2024, 32(3):  248-254.  DOI: 10.11852/zgetbjzz2023-1255

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Objective To understand the prevalence of overweight/obesity among school-age children in Pudong New Area of Shanghai, and to explore the influence of gestational weight gain and pre-pregnancy body mass index (BMI) on weight status of school-age children. Methods From November to December 2020,a stratified cluster sampling method was adopted to select first-grade students from 13 primary schools in Pudong New Area of Shanghai.After matching with the birth monitoring database, 755 students with complete birth information were selected as the study subjects.The relevant information of mothers before and during pregnancy was retrospectively collected, and the effects of pregnancy weight gain combined with pre-pregnancy BMI on overweight/obesity in school-age children were analyzed. Results 1) The prevalence rates of overweight and obesity of first-grade children were 15.89% and 18.41%, respectively.2) Maternal excessive weight gain during pregnancy (OR=1.678) and overweight/obesity before pregnancy (OR=2.315,2.412)were risk factors for overweight/obesity of the offspring at school age(P＜0.05).3) For mothers who were underweight before pregnancy, excessive weight gain during pregnancy was associated with overweight/obesity in school-age children in their offspring (OR=7.436, 95%CI: 1.489 - 37.143,P<0.05).4) Excessive weight gain during pregnancy combined with overweight/obesity before pregnancy significantly increased the risk of overweight/obesity in offspring (OR=3.606, 95%CI: 2.030 - 6.405, P<0.05). Mothers who gained a moderate amount of weight during pregnancy and were emaciated before pregnancy had a significantly lower risk of overweight/obesity in their school-age children (OR=0.217, 95%CI: 0.049 - 0.967, P<0.05). Conclusion Excessive weight gain during pregnancy increases the risk of overweight/obesity in school-age children in their offspring, strengthening pregnancy health education and perinatal care to help pregnant women maintain appropriate weight gain during pregnancy may be an important and novel strategy to prevent childhood obesity.

Relationship between lifestyle and mental health in preschool children

JIN Chunyan, ZHU Zhu

2024, 32(3):  255-260.  DOI: 10.11852/zgetbjzz2023-0933

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Objective To explore lifestyle patterns among Chinese preschool school children by latent class analysis, and to analyze its associations with behavior problems from person-centered perspective,in order to provide theoretical reference for improving children's mental health. Methods A questionnaire survey was conducted among parents of children aged 3 - 6 years old in five kindergartens in Xuzhou city by cluster sampling from April to May 2021.The survey content included the demographic characteristics, rearing environment, life behaviors and behavior problems, which was measured by Strengths and Difficulties Questionnaire(SDQ). Latent class analysis was used to explore latent lifestyle patterns.Unadjusted and adjusted Logistic regression analysis was used to test the associations between latent lifestyle patterns and behavior problems. Results The sample size was 1 190, including 618 (51.9%) boys.Latent class analysis for 7 life behaviors showed that three latent class model was the best one: low-risk group (206, 17.3%), medium-risk group (721, 60.6%) and high-risk group (263, 22.1%).After controlling demographic factors, adjusted Logistic regression model showed that compared to low-risk group, children in high-risk group had more risks of developing hyperactivity (OR=2.129, 95%CI: 1.230 - 3.685), peer problems (OR=2.051, 95%CI: 1.316 - 3.197), and total difficulties (OR=2.081, 95%CI: 1.290 - 3.356). Conclusions Improper dietary balance and irrational structure of daily activities substantially escalate the risk of emotional and behavioral issues in preschool-age children.Helping preschool children form a healthy lifestyle pattern is conducive to preventing behavioral problems.

Association between parents' participation in accompanying picture book reading and preschool children's emotional regulation ability

MENG Ying, WANG Qian, WANG Liang, ZHANG Ling

2024, 32(3):  261-267.  DOI: 10.11852/zgetbjzz2023-0674

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Objective To analyze the association between preschool children's emotional regulation ability and parents' participation in accompanying picture book reading, in order to provide theoretical reference for improving children's emotional regulation abilility. Methods From September to November 2022, preschool children aged 3 - 6 years from Guangfeng County, Yukan County, Wannian County, Yanshan County and Wuyuan County were selected by random cluster stratified sampling method. Mann-Whitney U test or Kruskal-Wallis Htest were used to analyze the correlation of different levels of children's emotional control ability with different demographic characteristics as well as parents' participation in children's picture book reading. Multivariate Logistic regression model was used to analyze the correlation between parents' involvement in picture book reading and children's emotional control ability. Results Finally 848 valid questionnaires were collected.The average age of children was (4.33±0.95)years old,with 432 boys and 416 girls.Multivariate Logistic regression analysis showed that the temperament control ability(＞P₇₅) of preschool children was positively correlated with mother being the main accompanying caregiver (OR=4.17, 95%CI: 2.13 - 8.17), and negatively correlated with father being the main accompanying caregiver (OR=0.38, 95%CI: 0.21 - 0.70) or both parents being the main accompanying caregivers (OR=0.14, 95%CI: 0.07 - 0.28)(P<0.05). The social confidence (father as the main caregiver OR=3.53, 95%CI:1.62 - 7.66; mother as the main caregiver OR=3.52, 95%CI: 1.66 - 7.45) and anxiety control abilities(father as the main caregiver OR=4.32, 95%CI: 1.85 - 10.09; mother as the main caregiver OR=3.39, 95%CI: 1.49 - 7.73) of preschool children were positively correlated with the type of accompanying caregiver(P<0.05). Additionally, the anxiety control ability (＞P₇₅) of preschool children was negatively correlated with father's accompanying frequency (sometimes OR=0.09, 95%CI: 0.03 - 0.28; often OR=0.19, 95%CI: 0.06 - 0.60) and mother's accompanying duration (<1h/d OR=0.33, 95%CI: 0.12 - 0.91) (P<0.05). Conclusions The frequency and duration of accompanying reading by father or mother are correlated with the emotional regulation ability of preschool children. Parents can moderately participate in picture book reading to promote the development of preschool children's emotional control ability.

Effects of victimization, bullying tolerance on anxiety/depression in adolescentsand moderating role of cognitive emotion regulation strategies

ZHAO Ke, YIN Shaoqing, LIU Hong

2024, 32(3):  268-272.  DOI: 10.11852/zgetbjzz2023-1046

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Objective To explore the relationship of victimization, bullying tolerance and anxiety/depression in adolescents, and to examine the moderating effect of cognitive emotion regulation strategies on the relationship between bullying tolerance and anxiety/depression,in order to provide basis for intervention. Methods From January 2019 to July 2020, 1 768 adolescents were selected into this survey, and completed Bully/Victim Questionnaire, Primary and Secondary School Bullying Tolerance Questionnaire, Cognitive Emotion Regulation Questionnaire and the 28 General Health questionnaires. Results Adolescents' victimization was relatively common and serious, the proportion of verbal bullying, relational bullying, and physical bullying was 57.64% (1 019/1 768), 36.60% (647/1 768), and 22.40% (396/1 768), respectirely. The scores of anxiety and depression of adolescents with different gender (t=2.00), school stage (F=101.38) and academic performance (F=27.91) were statistically significant (P<0.05).Victimization and bullying tolerance had predictive effect on adolescents' anxiety/depression (β=0.14, 0.13, P<0.01).Positive strategies, negative strategies had significant moderating effects on the relationship between bullying tolerance and anxiety/depression(β=-0.10、0.08, P<0.01).The simple slope analysis showed that at high positive strategy level, bullying tolerance had no significant predictive effect on anxiety/depression (P>0.05), while at a low positive strategy level, bullying tolerance had significant predictive effect on anxiety/depression (β=0.28, P<0.01).At a high negative strategy level, bullying tolerance had a significant predictive effect on anxiety/depression (β=0.25, P<0.01), while at a low negative strategy level, bullying tolerance had no significant predictive effect on anxiety/depression (P>0.05). Conclusions Victimization and bullying tolerance positively predict adolescent anxiety/depression.High levels of positive and low levels of negative strategies effectively inhibit the risk of anxiety/depression, while low levels of positive and high levels of negative strategies amplify the risk of anxiety/depression.

Status of anemia and its association with feeding patterns in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture

MA Xiaolan, WANG Huiling, CAO Ting, MA Xiaorong, XU Juanjuan, HAN Qi, MA Haolan, HE Xiaoyang, MA Jianhua, ZHANG Gexiang

2024, 32(3):  273-279.  DOI: 10.11852/zgetbjzz2023-1146

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Objective To investigate the anemia status of infantsand toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture, Gansu Province, and to comprehensively evaluate the differences in feeding behaviors between anaemic and normal children through the infant and child feeding index (ICFI) and feeding knowledge scores, so as to provide reference for the guidance of infants and young children feeding in ethnic minority areas and the promotion of children's growth and development. Methods Taking infants and young children aged 6 - 24 months in Linxia Prefecture as the study subjects, a multi-stage random sampling method was used to select children who met the requirements from 5 townships and 5 villages in 7 counties in 2019 and 2020.Periphral blood samples were collected to test the level of hemoglobin, so as to determine the anemia status.Meanwhile, physical examination was performed and a questionnaire survey of guardians was conducted to analyze the association betweenanaemia and feeding patterns. Results A total of 3 901 infants and children were included in this study, of whom 729 (18.70%) were anaemic, with a mean ICFI score of 12.56±2.70 and a mean feeding knowledge score of 1.97±1.01.There was no statistically significant association of low feeding knowledge score and low ICFI with anaemia after adjusting for confounders (P＞0.05), Unqualified meat addition in ICFI was a risk factor for anaemia (OR=1.355, P=0.042), while non-bottle feeding in the past 24 hours (OR=0.762, P=0.021), and breastfeeding in the past 24 hours of infants and toddlers aged 12 - 24 months (OR=0.228, P=0.018) were protective factor for anemia in infants and toddlers aged 12 - 24 months. Conclusions The average prevalence of anemia in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture of Gansu Province is high, but the level of infant feeding and the level of feeding knowledge of caregivers are low.Early adherence to breastfeeding, timely addition of supplementary food, and more comsumpution of meat for children are conducive to preventing anemia.

Influencing factors of adaptive ability development of children aged 2 - 6 in China

CUI Jiayin, LI Ruili, WANG Lihong, ZHENG Xiaoguo, YANG Huimin, ZHU Liqi, GUO Shuling, ZHAO Lu, ZHAO Wenhua, YANG Zhenyu, ZHANG Qian, WANG Yuying, XU Tao, CHEN Bowen

2024, 32(3):  280-285.  DOI: 10.11852/zgetbjzz2023-1054

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Objective To investigate the development of adaptability in children aged 2 - 6, and to explore its influencing factors, so as to provide reference for promoting the development of adaptability in young children. Methods Data were from the National Nutrition and Health Systematic Survey for Children in China, and 3 319 children aged 2 - 6 and their parents from 28 sites across 14 provinces were recruited in this study.The Development Scale for Children Aged 0 - 6 years (WS/T 580-2017) was used to measure the developmental quotient of children's adaptive ability, and a survey questionnaire was used to collect relevant information about children and their parents. Results Among 3 319 children aged 2 - 6, the proportion of slightly low or low level of adaptability, moderate adaptability development, good and excellent adaptability development was 7.68%,66.25% and 26.06%, respectively.The proportion of children aged 5 - 6 with good and excellent adaptability was lower in 3-year-old and 4-year-old groups (χ²=59.29, P<0.05).Multiple stepwise linear regression showed that children's gender (β=0.06), gestational age of birth (β=-0.05), only child (β=-0.04), left-behind child (β=-0.04), the main caregiver (β=-0.06), and the education level of parents (β=0.09, 0.10), whether parents actively pay attention to children's emotions (β=-0.06) and whether children play with homemade toys (β=-0.04) were the influencing factors of children's adaptive development quotient.Girls, full-term children, only children, non-left-behind children, children with parents as main caregivers, parents with a high level of education, parents who often take the initiative to pay attention to children's emotions, and children who play with homemade toys had a higher level of adaptability development quotient. Conclusions The development level of adaptability in children aged 2 - 6 in China is mostly above the average level and is related to multiple factors.Targeted intervention work can be carried out on relevant factors in order to promote the development of children's adaptability.

Serum vitamin K₂ level in children and its correlation with bone mineral density

WANG Peikang, JI Xia, ZHANG Man, ZHANG Xinkai, LIU Xing

2024, 32(3):  286-290.  DOI: 10.11852/zgetbjzz2023-0711

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Objective To analyze the clinical characteristics of serum vitamin K₂ in children and its correlation with bone mineral density, so as to provide reference for the prevention of insufficient bone strength in children. Methods A total of 4 145 children who underwent serum vitamin K₂ testing and physical examination at pediatric outpatient clinics of several municipal and county hospitals in Chongqing from January 2020 to March 2023 were retrospectively selected into this study for serum vitamin K₂-related analysis.Further 844 school-age children who completed serum 25-(OH)D and lumbar bone densitometry measurements were screened to analyze the correlation between vitamin K₂ level and bone mineral density. Results The overall serum vitamin K₂ deficiency rate was 61.6% (2 553/4 145), and the difference in serum vitamin K₂ deficiency rate between different age groups was statistically significant (χ²=39.364, P<0.05).The vitamin K₂ level of children was significantly influenced by season and maternal education level (χ²=45.310,9.990, P<0.05).There were significant differences in age (Z=3.416), gender (χ²=9.218) and serum vitamin K₂ deficiency rate (χ²=5.826) between normal bone mass development group and insufficient bone mass development group (P<0.05).Multivariate Logistic regression analysis suggested that vitamin K₂ deficiency was an independent risk factor for insufficient bone mass development in school-age children (OR=1.37,95%CI:1.03 - 1.83, P=0.030). Conclusions There is a higher serum vitamin K₂ deficiency rate among children, especially infants and school-age children.Decreased bone mineral density in school-age children may be associated with serum vitamin K₂ deficiency.

Review

Advance in exercise intervention enhancing social function in children with autism spectrum disorder

HOU Yaoqi, SONG Xiangqin

2024, 32(3):  291-295.  DOI: 10.11852/zgetbjzz2023-1031

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Autism spectrum disorder (ASD) is a commonly observed neuropsychological behavioral disorder in children.Communication difficulty is one of the typical symptoms, which may restrict building and maintaining of social relationship, cause severe impact on daily life and personal development.While traditional therapeutic approaches offer some effectiveness, they tend to be time-consuming and expensive.In contrast, exercise intervention, a burgeoning treatment strategy, has garnered widespread attention.Neurological studies validate that exercise can rectify brain functional anomalies in ASD patients and bolster their social skills.This paper synthesizes and analyzes existing studies on exercise intervention aimed at improving the social functioning of children with autism, offering a foundational reference for the development of therapeutic and interventional strategies for ASD.

Pharmacogenetic impact on the methylphenidate-hydrocloride treatment in children with attention-deficit hyperactivity disorder

REN Miaomiao, CHEN Li

2024, 32(3):  296-300.  DOI: 10.11852/zgetbjzz2023-0489

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Attention-deficit hyperactivity disorder (ADHD) is one of the most common chronic neurodevelopmental disorders in childhood.It is mainly manifested as inattention, hyperactivity, and impulsivity that are inconsistent with the development level, which may lead to multiple functional impairments and place heavy burdens on individuals, families, and society.Methylphenidate hydrochloride (MPH) is a first-line treatment drug for ADHD, which is widely used in clinical practice.However, some patients have no response to drug treatment and adverse reactions often cause premature termination of treatment.Introducing the concept of pharmacogenetics into MPH treatment may open new avenues for individualized interventions of ADHD.This paper aims to review the impact of pharmacogenetics on MPH treatment in children with ADHD and to provide references for clinical drug treatment and management.

Status of vitamin A, vitamin D and comorbidity of both deficiency in Chinese children

YIN Shian, YANG Zhenyu

2024, 32(3):  301-306.  DOI: 10.11852/zgetbjzz2024-0146

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Vitamin A and vitamin D deficiencies or insufficiencies in children remain global public health problems. The deficiencies of both vitamin A and vitamin D exist in Chinese children, the deficiency of vitamin A is mainly marginal (about 30%) in children aged 0 - 12 years.Vitamin D deficiency and prevalence are common in healthy children aged 0 - 18 years, among which the severe deficiency rate is 2.46%, the deficiency rate is 21.57%, and the marginal deficiency rate is 28.71%.The deficiency rate gradually increases with the increase of age.Since the respective bioactive metabolites of vitamin A and vitamin D, retinoic acid and 1 and 25-dihydroxyvitamin D₃ have hormone-like properties, and both metabolites are synthesized from their vitamin precursors by different tissues and cells in the body, there may be a synergistic effect between both on target cells remotely by binding to nuclear hormone receptors.A high proportion of concurrent vitamin A and vitamin D deficiencies (comorbidities) in malnourished children under 5 years of age in low- and middle-income countries and poor areas will affect the immune response in a highly specific way, in addition to causing growth and developmental disorders (e.g., growth retardation, motor retardation), it also increases susceptibility to infectious diseases (e.g., recurrent respiratory infections, diarrhea), allergic diseases (e.g., asthma, atopic dermatitis), and neurodevelopmental disorders (touretic disorder, autism spectrum disorder).Therefore, children in the period of growth and development may benefit from supplementing with vitamin A and vitamin D.

Family therapy of suicidal ideation and behavior in adolescents

CHEN Jianling, LIU Yi

2024, 32(3):  307-311.  DOI: 10.11852/zgetbjzz2023-0802

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Suicide is a serious public health problem worldwide.Therefore, effective prevention and intervention of suicidal ideation and behavior is essential.Cognitive behavioral therapy, interpersonal psychotherapy, and supportive psychotherapy have positive effects on improving suicidal ideation and behavior in adolescents.Actually, adolescent workers often work with more than one adolescent, it is often also necessary to work with their families, caregivers and other relevant individuals.This article reviews the intervention methods of family-based effective intervention on suicidal ideation and behavior of adolescents.

Status of parent-child bed sharing and its influences on children

XU Min, SHAN Yanchun, RAN Ni, YANG Zhaochuan, YI Mingji

2024, 32(3):  312-316.  DOI: 10.11852/zgetbjzz2023-0539

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The influence of bed sharing on children's physical and psychological health has been concerned as one of the main types of sleep arrangements.At present, there are significant differences in bed sharing among children of different ages, groups, regions and races.There are also studies on the impact of bed sharing sleep on children's health, on the one hand, it is conducive to breastfeeding, where infants get enough security; on the other hand, it leads to an increase in the incidence of sudden infant death syndrome, and an increase in the number of night awakenings.Therefore, it is important to understand the current research situation of bed sharing and its influences on children, thus to better promote children healthy growth.

Intervention methods and development trends of autism spectrum disorder

ZOU Hong, ZHU Jianfang, LUO Jiayi, LI Dandan, WU Di

2024, 32(3):  317-321.  DOI: 10.11852/zgetbjzz2023-0684

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder, which is manifested by symptoms such as difficulties in social interaction and communication, stereotypical repetitive behaviors, and narrow areas of interests.At present, the intervention methods for ASD mainly include behavioral intervention, pharmacological intervention, physical intervention, exercise intervention, complementary and alternative medicine intervention.With the progress of science and technology and in-depth research, the intervention methods of ASD will develop in the direction of personalized intervention, deep learning technology, gene therapy and neurofeedback technology.These new intervention methods would hopefully improve the treatment effect and the quality of life of patients.

Meta analysis

Meta-analysis of the effect of probiotics on core symptoms of children with autism spectrum disorder

WEI Ran, KONG Rui, GUAN Luyang, WANG Yonglu, YE Kan

2024, 32(3):  322-328.  DOI: 10.11852/zgetbjzz2023-0847

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Objective To evaluate the therapeutic effect of probiotics on core symptoms in patients with autism spectrum disorder (ASD), in order to provide theoretical basis for the treatment and intervention of ASD. Method Articles published from January 2000 to May 2023 on the effect of probiotics on core symptoms in ASD children were retrieved from 7 databases, including Chinese Biomedical Literature Service System (SinoMed), Wanfang Data Knowledge Service Platform, VIP Citation Database, and China National Knowledge Infrastructure (CNKI), PubMed, Embase, and Web of Science.Meta-analysis was performed using RevMan 5.4.Effect size, combine heterogeneity test sensitivity analysis and subgroup analysis were calculated. Result Totally 10 studies with 343 patients were included in this Meta-analysis.Meta-analysis showed that there was statistically significant difference in ASD core symptom score between the intervention group and the control group (SMD=-0.34, 95%CI: -0.55 - -0.12, P<0.05).Subgroup analysis showed that the efficacy of the trial conducted in Asian populations was not significant (SMD=-0.32, 95%CI: -0.63 - 0.00, P=0.05).In Caucasian populations, the therapeutic effect was significant (SMD=-0.35, 95%CI: -0.65 - -0.06, P<0.05).Grouped by age, it was found that the efficacy was not significant in trials involving adults (SMD=-0.12, 95%CI: - 0.57 - 0.33, P=0.61), but significant in trials involving only minors (SMD=-0.40, 95%CI: -0.65 - -0.16, P<0.05).According to the treatment course grouping, the intervention for less than 3 months (SMD=-0.35, 95%CI: -0.66 - -0.03, P<0.05) and more than 3 months (SMD=-0.33, 95%CI: -0.62 - -0.03, P<0.05) showed significant therapeutic efficacy.Grouped by bacterial strains, the efficacy of a single microbial community was not significant (SMD=-0.16, 95%CI: -0.46 - 0.15, P>0.05), while the efficacy of a composite microbial community was significant (SMD=-0.51, 95%CI: -0.81 - -0.21, P<0.05). Conclusions Probiotic therapy is effective in improving the core symptoms of ASD patients, but is influenced by factors such as race, age and probiotic strain. Composite microbiota has better efficacy in Caucasian and underage populations.

Clinical Research

Eating behaviors and sleep problems in children with autism spectrum disorder and their correlation factors

XU Ke, ZHOU Qin, WU Minglei, SONG Li, KE Xiaoyan

2024, 32(3):  329-333.  DOI: 10.11852/zgetbjzz2023-0970

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Objective To investigate the distribution of sleep and eating behavior problems in children with autism spectrum disorder (ASD), and to analyze their correlations with clinical characteristics,in order to provide basis for fwture mechanism research and clinical intervention. Methods A total of 211 ASD children aged 2 - 7 were enrolled into this study from outpatient department from January to June 2023, and 91 typically developed children matched with age and sex were enrolled into control group.Autism Behavior Checklist (ABC), Children's Sleep Habits Questionnaire (CSHQ) and a self-made questionnaire were used to assess children's autistic behavior, sleep problems and eating behaviors. Chi-square test, t test, non-parametric test and multinomial Logistic regression analysis were performed to analyze the relationship between sleep problems and eating behaviors in children with ASD. Results The prevalence rates of sleep problems and food selectivity were significantly higher in children with ASD than those in control group (χ²=6.876、17.299,P<0.05).The total score of CSHQ of ASD children (48.55±6.07) was significantly higher than that of control group (45.24±5.33)(t=4.494,P<0.05).ASD children were more likely to report bedtime resistance, sleep onset delay, sleep duration, night waking, parasomnias and sleep disordered breathing than control group (P<0.05).The total score of CSHQ was significantly higher in ASD children with aberrant eating behaviors, and the difference was statistically significant in food selectivity (type selectivity, texture selectivity and pica) (Z=2.803, P<0.05).Multinomial Logistic regression indicated that the occurrence of sleep onset delay was positively affected by body and object use (OR=1.063), and negatively affected without food texture selectivity (OR=0.524) and pica (OR=0.343). Conclusions ASD children have a higher risk of sleep problems and aberrant eating behaviors than the typically developed children.Moreover,ASD children with aberrant eating behaviors have more severe sleep problems.The influencing factors of sleep onset delay include body and object use, food texture selectivity and pica.

Suicide attitude, ideation and their relationship with family environment in adolescents with depression

ZHAO Juanjuan, XIONG Zuping, WANG Kun, TANG Xinlong

2024, 32(3):  334-338.  DOI: 10.11852/zgetbjzz2023-1047

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Objective To investigate the suicidal attitude, ideation of adolescent patients with depression, and to analyze their relationships with family environment,in order to provide evidence for the clinical treatment of adolesent depression and to reduce the suicide rate. Methods Totally 376 adolescentsdiagnosed with depression in Lu'an area from March 2019 to October 2021 were selected as the case group, and 376 normal adolescents were selected as the control group.The suicide attitude questionnaire (QSA), Beck scale for suicide ideation (BSS) and family environment scale (FES-CV) were used to investigate the suicide attitude, suicidal ideation and family environmentof adolescents in two groups. Logistic regression analysis was used to analyze the influencing factors of suicide attitude and ideation of adolescent depression patients.Pearson correlation test was used to analyze the correlations between suicidal attitude, ideation and family environment of adolescent patients with depression. Results The scores of QSA and BSS in the case group were significantly higher than those in the control group(t=43.352, 96.527, P＜0.001).The scores of intimacy, emotional expression, knowledge and entertainment in FES-CV of the case group were lower than those of the control group(t=25.487, 14.573, 22.160, 18.906), the score of contradiction was higher than that of the control group (t=30.311),and the differences were statistically significant (P＜0.001).Logistic regression analysis showed that age of 20 - 25 years old (OR=2.016,2.261), severe illness (OR=2.115, 2.192), dwelling in city (OR=2.442, 2.557) were all risk factors for suicidal attitude and ideation in adolescent depression patients (P<0.05).The scores of QSA and BSS in the case group were negatively correlated with the scores of intimacy, emotional expression, knowledge and entertainment in FES-CV (QSA: r=-0.891,-0.933,-0.788,-0.698, BSS: r=-0.901,-0.832,-0.725,-0.637, P<0.05), but they were positively correlated with the score of contradiction (r=0.848, 0.883, P<0.05). Conclusions The suicidal attitude, ideation of adolescents with depression are higher than those of normal adolescents. Age, illness and growth environment are all influencing factors for suicidal attitudes and ideation in adolescent depression patients, of which the suicide attitude, ideation of patients are closely related to family environment.

Association between sleep problems and psychological behavioral in disabled children in Beijing

ZHANG Boning, XIAYIDANMU Abudusaimaiti, ZHU Huiping, GAO Qi

2024, 32(3):  339-343.  DOI: 10.11852/zgetbjzz2023-1197

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Objective To examine the association between psychological behavioral problems and sleep problems in disabled children in Beijing,in order to provide reference for reducing the sleep problems of disabled children. Methods From September 2017 to February 2018,children with disabilities aged 6 to 17 years were selected by random sampling,and were investigated by a self-designed questionnaire to get their demographic characteristics.Pediatric Symptom Checklist-17 (PSC-17) was used to assess psychological and behavioral problems.The relationship between psychological behavior and sleep problems was analyzed by binary Logistic regression. Result Totally 650 children with disabilities were included in the study.The detection rates of sleep problems was significantly different in children with different genders,different school styles,different types of disabilities and different grades of disabilities (χ²=3.984,4.437,12.925,18.104,P＜0.001). There was statistically significant difference in the detection rate of sleep problems between children with and without psychological and behavioral problems (χ²=30.722,P＜0.001).Psychological and behavioral problems were the main risk factors for sleep problems of disabled children (OR=2.540,95%CI:1.740 - 3.709).The risk of sleep problems in day students with disabilities was 1.577 times as high as that of boarders with disabilities. Conclusions Psychological and behavioral problems of disabled children are related to sleep problems.Improving psychological and behavioral status can effectively prevent their sleep problems.

Status quo and its influencing factors of social anxiety in school-age children with attention deficit hyperactivity disorder

LI Mengtao, DAI Mengqin, LUO Yaojing, ZHAO Xiaoyan

2024, 32(3):  344-348.  DOI: 10.11852/zgetbjzz2023-0613

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Objective To investigate the current situation of social anxiety in children with attention deficit hyperactivity disorder (ADHD), and to analyze the factors influencing social anxiety in ADHD children, in order to provide reference for improving the clinical management of ADHD children. Methods A total of 206 school-age children with ADHD were selected from the Children's Psychology Clinic of Mianyang Central Hospital from January 2020 to January 2023. The relevant clinical data of the children were collected through the general data questionnaire. Children's Social Anxiety Scale (SASC) was used to assess social anxiety, and the Social Response Scale (SRS) was used to assess social ability. The Chinese version of Swanson,Nolan and Pelham Rating Scale Ⅳ(SNAP-Ⅳ) was used to assess core symptoms. Multivariate Logistic regression analysis was used to determine influencing factors of social anxiety in children with ADHD. Results There were 128(62.14%) cases detected with social anxiety among 206 children with ADHD. The score of SASC was 14.02±4.06. The proportions of girls (χ²=6.057), comorbid autism spectrum disorder(ASD) (χ²=4.929), and main caregivers with junior high school education or below (χ²=13.345), the total score of SRS(t=5.842) and SNAP-Ⅳ(t=7.848) and the scores of all dimensions were significantly higher than those in the non-anxious group (P<0.05). Multivariate Logistic regression analysis showed that higher SRS total score(OR=5.217,95%CI: 2.309 - 11.791), higher SNAP-Ⅳ total score(OR=4.150,95%CI: 1.974 - 8.722), girls(OR=2.268, 95%CI: 1.423 - 3.616), primary caregivers with junior high school education or below (OR=1.527,95%CI: 1.162 - 2.005), and comorbid ASD (OR=1.551,95%CI: 1.209 - 1.990) were risk factors for social anxiety in ADHD children (P<0.05). Conclusions Children with ADHD have a higher prevalence rate of social anxiety. Cognitive behavioral therapy and psychological intervention should be strengthened for high-risk children to improve social ability and reduce the risk of social anxiety.