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"Autism Spectrum Disorder complications."
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Comorbid conditions among children with autism spectrum disorders
\"This book presents the similarities and intersections between Autism Spectrum Disorders and comorbid conditions in children. It describes the prevalence and magnitude of comorbid conditions occurring in conjunction with ASD that complicate diagnosis and can potentially lead to inappropriate treatment and negative outcomes. It addresses the strengths and limitations of age-appropriate assessment measures as well as activity and motor skill measurement methods. Specific comorbid disorders are examined through the review of core symptoms, prognostic and diagnostic issues and treatment options for children on the ASD spectrum. Featured topics include: challenging behaviors in children with ASD; conditions ranging from feeding and gastrointestinal disorders to epilepsy; developmental coordination disorder (DCD); intellectual disability (ID); methods and procedures for measuring comorbid psychological, medical and motor disorders.\"-- Provided by publisher.
BOOK
Long-Term Efficacy and Safety of Pediatric Prolonged-Release Melatonin for Insomnia in Children with Autism Spectrum Disorder
Objective:
A recent double-blind randomized placebo-controlled study demonstrated 3-month efficacy and safety of a novel pediatric-appropriate prolonged-release melatonin (PedPRM) for insomnia in children and adolescents with autism spectrum disorder (ASD) and neurogenetic disorders (NGD) with/without attention-deficit/hyperactivity disorder comorbidity. Long-term efficacy and safety of PedPRM treatment was studied.
Methods:
A prospective, open-label efficacy and safety follow-up of nightly 2, 5, or 10 mg PedPRM in subjects who completed the 13-week double-blind trial (51 PedPRM; 44 placebo). Measures included caregiver-reported Sleep and Nap Diary, Composite Sleep Disturbance Index (CSDI), caregiver's Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, and quality of life (WHO-5 Well-Being Index).
Results:
Ninety-five subjects (74.7% males; mean [standard deviation] age, 9 [4.24]; range, 2–17.5 years) received PedPRM (2/5 mg) according to the double-blind phase dose, for 39 weeks with optional dose adjustment (2, 5, or 10 mg/day) after the first 13 weeks. After 52 weeks of continuous treatment (PedPRM-randomized group) subjects slept (mean [SE]) 62.08 (21.5) minutes longer (p = 0.007); fell asleep 48.6 (10.2) minutes faster (p < 0.001); had 89.1 (25.5) minutes longer uninterrupted sleep episodes (p = 0.001); 0.41 (0.12) less nightly awakenings (>50% decrease; p = 0.001); and better sleep quality (p < 0.001) compared with baseline. The placebo-randomized group also improved with PedPRM. Altogether, by the end of 39-week follow-up, regardless of randomization assignment, 55/72 (76%) of completers achieved overall improvement of ≥1 hour in total sleep time (TST), sleep latency or both, over baseline, with no evidence of decreased efficacy. In parallel, CSDI child sleep disturbance and caregivers' satisfaction of their child's sleep patterns (p < 0.001 for both), PSQI global (p < 0.001), and WHO-5 (p = 0.001) improved in statistically significant and clinically relevant manner (n = 72) compared with baseline. PedPRM was generally safe; most frequent treatment-related adverse events were fatigue (5.3%) and mood swings (3.2% of patients).
Conclusion:
PedPRM, an easily swallowed formulation shown to be efficacious versus placebo, is an efficacious and safe option for long-term treatment (up to 52 weeks reported here) of children with ASD and NGD who suffer from insomnia and subsequently improves caregivers' quality of life.
Journal Article
A Randomised Controlled Feasibility Trial of Immersive Virtual Reality Treatment with Cognitive Behaviour Therapy for Specific Phobias in Young People with Autism Spectrum Disorder
We examined the feasibility and acceptability of using an immersive virtual reality environment (VRE) alongside cognitive behaviour therapy (CBT) for young people with autism experiencing specific phobia. Thirty-two participants were randomised to treatment or control. Treatment involved one session introducing CBT techniques and four VRE sessions, delivered by local clinical therapists. Change in target behaviour was independently rated. Two weeks after treatment, four treatment participants (25%) and no control participants were responders; at 6 months after treatment, six (38%) treatment and no control participants were responders. At 6 months post-treatment, symptoms had worsened for one treatment and five control (untreated) participants. Brief VRE exposure with CBT is feasible and acceptable to deliver through child clinical services and is effective for some participants.
Journal Article
Gut to brain interaction in Autism Spectrum Disorders: a randomized controlled trial on the role of probiotics on clinical, biochemical and neurophysiological parameters
Background
A high prevalence of a variety of gastrointestinal (GI) symptoms is frequently reported in patients with Autism Spectrum Disorders (ASD). The GI disturbances in ASD might be linked to gut dysbiosis representing the observable phenotype of a “gut-brain axis” disruption. The exploitation of strategies which can restore normal gut microbiota and reduce the gut production and absorption of toxins, such as probiotics addition/supplementation in a diet, may represent a non-pharmacological option in the treatment of GI disturbances in ASD. The aim of this randomized controlled trial is to determine the effects of supplementation with a probiotic mixture (Vivomixx®) in ASD children not only on specific GI symptoms, but also on the core deficits of the disorder, on cognitive and language development, and on brain function and connectivity. An ancillary aim is to evaluate possible effects of probiotic supplementation on urinary concentrations of phthalates (chemical pollutants) which have been previously linked to ASD.
Methods
A group of 100 preschoolers with ASD will be classified as belonging to a GI group or to a Non-GI (NGI) group on the basis of a symptom severity index specific to GI disorders. In order to obtain four arms, subjects belonging to the two groups (GI and NGI) will be blind randomized 1:1 to regular diet with probiotics or with placebo for 6 months. All participants will be assessed at baseline, after three months and after six months from baseline in order to evaluate the possible changes in: (1) GI symptoms; (2) autism symptoms severity; (3) affective and behavioral comorbid symptoms; (4) plasmatic, urinary and fecal biomarkers related to abnormal intestinal function; (5) neurophysiological patterns.
Discussion
The effects of treatments with probiotics on children with ASD need to be evaluated through rigorous controlled trials. Examining the impact of probiotics not only on clinical but also on neurophysiological patterns, the current trial sets out to provide new insights into the gut-brain connection in ASD patients. Moreover, results could add information to the relationship between phthalates levels, clinical features and neurophysiological patterns in ASD.
Trial registration
ClinicalTrials.gov Identifier:
NCT02708901
. Retrospectively registered: March 4, 2016.
Journal Article
The Effect of Karate Techniques Training on Communication Deficit of Children with Autism Spectrum Disorders
This investigation examined the long term effect of Karate techniques training on communication of children with autism spectrum disorders (ASD). Thirty school aged children with ASD were randomly assigned to an exercise (n = 15) or a control group (n = 15). Participants in the exercise group were engaged in 14 weeks of Karate techniques training. Communication deficit at baseline, post-intervention (week 14), and at 1 month follow up were evaluated. Exercise group showed significant reduction in communication deficit compared to control group. Moreover, reduction in communication deficit in the exercise group at one month follow up remained unchanged compared to post-intervention time. We concluded that teaching Karate techniques to children with ASD leads to significant reduction in their communication deficit.
Journal Article
HD-tDCS effects on social impairment in autism spectrum disorder with sensory processing abnormalities: a randomized controlled trial
This study examined the effects of high-definition transcranial direct current stimulation (HD-tDCS) on social impairment in children with autism spectrum disorder (ASD), focusing on those with and without sensory processing abnormalities. A randomized double-blind sham-controlled trial involved 72 children with ASD, divided into three groups based on sensory integration status. A post-hoc analysis of 51 children aged 4–8 years who received true HD-tDCS was conducted, categorizing them into hypo-tactile, hyper-tactile, and typical tactile sensitivity groups. Therapeutic efficacy was compared across these groups. (1) The randomized cntrolled Trial: The typical sensory integration group showed significant improvements in social awareness (
t
= 5.032,
p
< 0.000) and autistic mannerisms (
t
= 3.085,
p
= 0.004) compared to the sensory integration dysfunction group. (2)The result of the post-hoc analysis: The hypo-tactile and typical tactile sensitivity groups exhibited notable improvements in social awareness, cognition, communication, autistic mannerisms, and total SRS scores. In contrast, the hyper-tactile group only had a significant reduction in social communication (
t
= 2.385,
p
= 0.022) post-intervention. HD-tDCS effectively improved social impairment symptoms in children with ASD, particularly those with typical sensory integration and either typical or hypo-tactile responsiveness.
Journal Article