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Guner N, Hayton JA. Parental and Child Sleep: Children with Vision Impairment, Autistic Children, and Children with Comorbid Vision Impairment and Autism. Brain Sci 2024; 14:485. [PMID: 38790463 PMCID: PMC11119615 DOI: 10.3390/brainsci14050485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Parents report associations between children's sleep disturbances and behaviors. Children with neurodevelopmental conditions (e.g., Williams Syndrome and autism) are consistently reported to experience increased sleeping problems. Sleep in children with vision impairment and children with a dual diagnosis of vision impairment and autism remains understudied. METHODS Our exploratory study compared sleep profiles in 52 children (aged 4-12 years) and their parents (n = 37), across four groups: children with vision impairment (VI; n = 9), autism (n = 10), comorbid vision impairment + autism (n = 6), and typically developing children (n = 27). Childhood sleep was measured using the parental report Childhood Sleep Habits Questionnaire and sleep diaries. Children's cognitive functioning was measured using digit span, semantic, and phonemic verbal fluency measures. Parental sleep was measured via the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. RESULTS Clinically disordered sleep was reported in all child groups (p ≤ 0.001), particularly children with VI + autism. Age, not sleep quality/quantity, predicted cognitive task performance in TD and autistic groups, but not in VI and VI + autism groups. The child's diagnosis affected parental sleep, particularly in children with a dual diagnosis of VI + autism. CONCLUSIONS All participants experienced problematic sleep to varying degrees. Those most affected were children and parents in the VI + autism group, suggesting that autism may be the main driver of sleep problems in our sample.
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Affiliation(s)
| | - Jessica Antonia Hayton
- Department of Psychology and Human Development, IOE, UCL’s Faculty of Education and Society, University College London, London WC1H 0AL, UK;
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Longo R, Allegrini F, Gusson E, Morbio R, Di Gennaro G, Gozzi LA, Marchini G, Zoccante L. Visual-motor involvement in autism spectrum disorder: could the stereopsis deficit affect motor coordination? Front Psychiatry 2023; 14:1130185. [PMID: 38034932 PMCID: PMC10687461 DOI: 10.3389/fpsyt.2023.1130185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
PurposeGiven the known difficulty in sensory processing and in motor skills in patients with Autism Spectrum Disorder (ASD), and since visual impairment could interfere with children’s behaviour, early detection and management of visual-motor difficulties are crucial. This exploratory study aims to evaluate the visual-motor status in a cohort of children affected by ASD.MethodsThe records of patients affected by ASD and admitted between 2018 and 2022 to the Pediatric University Hospital of Verona were reviewed. Best Corrected Visual Acuity, cycloplegic refraction, stereopsis, convergence, complete ocular motility, strabismus examination, slit-lamp anterior segment examination and fundus ophthalmoscopy were collected and reviewed.ResultsA total of 253 patients (203 ASD and 50 healthy controls) were included in the study. A higher number of total orthoptic defects were detected in the ASD group, in comparison with the control group. Specifically, a higher percentage of stereopsis deficit and convergence insufficiency was observed.ConclusionIn our cohort of children with ASD stereopsis deficit, convergence insufficiency and refractive errors are the most observed ocular conditions. These findings are consistent with the known alterations of motor skills and sensory processing in ASD. Moreover, our study supports the hypothesis that visual acuity is not compromised in children with ASD. As a result, a complete ophthalmic evaluation is highly recommended in children with ASD, to guarantee early detection and treatment of possible visual-motor defects.
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Affiliation(s)
- Rosa Longo
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Francesca Allegrini
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Elena Gusson
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Roberta Morbio
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Gianfranco Di Gennaro
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona, Italy
| | - Luigi Alberto Gozzi
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona, Italy
| | - Giorgio Marchini
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona, Italy
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3
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Mann A, Aghababaie A, Kalitsi J, Martins D, Paloyelis Y, Kapoor RR. Neurodevelopmental impairments in children with septo-optic dysplasia spectrum conditions: a systematic review. Mol Autism 2023; 14:26. [PMID: 37491272 PMCID: PMC10369759 DOI: 10.1186/s13229-023-00559-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Septo-optic dysplasia (SOD) is a rare condition diagnosed in children with two or more of the following: hypopituitarism, midline brain abnormalities, and optic nerve hypoplasia. Children with SOD experience varied visual impairment and endocrine dysfunction. Autistic-like behaviours have been reported; however, their nature and prevalence remain to be fully understood. The present systematic review aimed to explore the type and prevalence of neurodevelopmental impairments in children with SOD spectrum conditions. METHODS The search was conducted in PubMed, EMBASE, and PsycInfo. Hand-searching reference lists of included studies was conducted. All peer-reviewed, observational studies assessing behavioural and cognitive impairments or autism spectrum disorder (ASD) symptoms in children (< 18 years) with SOD, optic nerve hypoplasia, and SOD-plus were included. Studies were excluded if they did not report standardised measures of neurodevelopmental impairments or ASD outcomes. RESULTS From 2132 screened articles, 20 articles reporting data from a total of 479 children were included in prevalence estimates. Of 14 studies assessing cognitive-developmental outcomes, 175 of 336 (52%) children presented with intellectual disability or developmental delay. A diagnosis of ASD or clinical level of symptoms was observed in 65 of 187 (35%) children across five studies. Only five studies assessed for dysfunction across behavioural, emotional, or social domains and reported impairments in 88 of 184 (48%) of children assessed. LIMITATIONS Importantly, high heterogeneity among the samples in relation to their neuroanatomical, endocrine, and optic nerve involvement meant that it was not possible to statistically assess the relative contribution of these confounding factors to the specific neurodevelopmental phenotype. This was further limited by the variation in study designs and behavioural assessments used across the included studies, which may have increased the risk of information bias. CONCLUSIONS This systematic review suggests that the prevalence of neurodevelopmental impairments in children within the SOD spectrum may be high. Clinicians should therefore consider including formal assessments of ASD symptoms and neurodevelopmental impairments alongside routine care. There is, additionally, a need for further research to define and validate a standardised battery of tools that accurately identify neurodevelopmental impairments in SOD spectrum conditions, and for research to identify the likely causal mechanisms.
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Affiliation(s)
- Amy Mann
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Arameh Aghababaie
- Homerton Healthcare NHS Trust, Homerton University Hospital, London, UK
| | - Jennifer Kalitsi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Child and Family Health Nursing, King's College London, London, UK
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ritika R Kapoor
- Department of Paediatric Endocrinology, Variety Children's Hospital, King's College Hospital NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
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Abu Bakar N, Wan Ibrahim WN, Zulkiflli AR, Saleh Hodin NA, Kim TY, Ling YS, Md Ajat MM, Shaari K, Shohaimi S, Nasruddin NS, Mohd Faudzi SM, Kim CH. Embryonic mercury exposure in zebrafish: Alteration of metabolites and gene expression, related to visual and behavioral impairments. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 256:114862. [PMID: 37004432 DOI: 10.1016/j.ecoenv.2023.114862] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/05/2023] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
The widespread presence of mercury, a heavy metal found in the environment and used in numerous industries and domestic, raises concerns about its potential impact on human health. Nevertheless, the adverse effects of this environmental toxicant at low concentrations are often underestimated. There are emerging studies showing that accumulation of mercury in the eye may contribute to visual impairment and a comorbidity between autism spectrum disorders (ASD) trait and visual impairment. However, the underlying mechanism of visual impairment in humans and rodents is challenging. In response to this issue, zebrafish larvae with a cone-dominated retinal visual system were exposed to 100 nM mercury chloride (HgCl2), according to our previous study, followed by light-dark stimulation, a social assay, and color preference to examine the functionality of the visual system in relation to ASD-like behavior. Exposure of embryos to HgCl2 from gastrulation to hatching increased locomotor activity in the dark, reduced shoaling and exploratory behavior, and impaired color preference. Defects in microridges as the first barrier may serve as primary tools for HgCl2 toxicity affecting vision. Depletion of polyunsaturated fatty acids (PUFAs), linoleic acid, arachidonic acid (ARA), alpha-linoleic acid, docosahexaenoic acid (DHA), stearic acid, L-phenylalanine, isoleucine, L-lysine, and N-acetylputrescine, along with the increase of gamma-aminobutyric acid (GABA), sphingosine-1-phosphate, and citrulline assayed by liquid chromatography-mass spectrometry (LC-MS) suggest that these metabolites serve as biomarkers of retinal impairments that affect vision and behavior. Although suppression of adsl, shank3a, tsc1b, and nrxn1a gene expression was observed, among these tsc1b showed more positive correlation with ASD. Collectively, these results contribute new insights into the possible mechanism of mercury toxicity give rise to visual, cognitive, and social deficits in zebrafish.
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Affiliation(s)
- Noraini Abu Bakar
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Wan Norhamidah Wan Ibrahim
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Natural Medicines and Product Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Abdul Rahman Zulkiflli
- Natural Medicines and Product Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Nur Atikah Saleh Hodin
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Tae-Yoon Kim
- Department of Biology, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Yee Soon Ling
- Biotechnology Research Institute, Universiti Malaysia Sabah, Jalan UMS, 88400 Kota Kinabalu, Sabah, Malaysia
| | - Mohd Mokrish Md Ajat
- Natural Medicines and Product Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Malaysia
| | - Khozirah Shaari
- Natural Medicines and Product Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Nurrul Shaqinah Nasruddin
- Centre for Craniofacial Diagnostics, Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM), 50300 Kuala Lumpur, Malaysia
| | - Siti Munirah Mohd Faudzi
- Natural Medicines and Product Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Cheol-Hee Kim
- Department of Biology, Chungnam National University, Daejeon 34134, Republic of Korea.
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Galli J, Loi E, Dusi L, Pasini N, Rossi A, Scaglioni V, Mauri L, Fazzi E. Oculocutaneous albinism: the neurological, behavioral, and neuro-ophthalmological perspective. Eur J Pediatr 2023:10.1007/s00431-023-04938-w. [PMID: 37009951 PMCID: PMC10257606 DOI: 10.1007/s00431-023-04938-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Oculocutaneous albinism (OCA) is a group of rare, genetic disorders caused by absent/reduced melanin biosynthesis. The aim of this study was to explore the neurovisual, cognitive, adaptive, and behavioral profile of children affected by OCA, also evaluating any possible effect of the visual acuity deficit on the clinical profile and genotype-phenotype correlations. Eighteen children (9 males, mean age 84 months ± 41; range 18-181 months) with a molecular confirmed diagnosis of OCA were enrolled in the study. We collected data on clinical history, neurodevelopmental profile, neurological and neurovisual examination, and cognitive, adaptive, and emotional/behavioral functioning. A global neurodevelopmental impairment was detected in 56% of the children, without evolving into an intellectual disability. All the patients showed signs and symptoms of visual impairment. Low adaptive functioning was observed in 3 cases (17%). A risk for internalizing behavioral problems was documented in 6 cases (33%), for externalizing problems in 2 (11%), and for both in 5 (28%). Twelve children (67%) showed one or more autistic-like features. Correlation analyses revealed significant associations between the visual acuity level and performance intelligence quotient (p = 0.001), processing speed index (p = 0.021), Vineland total score (p = 0.020), Vineland communication (p = 0.020), and socialization (p = 0.037) domains. No significant correlations were found between genotype and phenotype. CONCLUSION Children with OCA may present a global neurodevelopmental delay that seems to improve with age and emotional/behavioral difficulties, along with the well-known visual impairment. An early neuropsychiatric evaluation and habilitative training are recommended to improve vision-related performance, neurodevelopment, and any psychological difficulties. WHAT IS KNOWN • Children with oculocutaneous albinism show dermatological and ophthalmological problems. • An early visual impairment may have negative implications on motor, emotional, and cognitive processes that would allow the child to organize his or her experiences. WHAT IS NEW • In addition to a variable combination of ocular signs and symptoms, children with oculocutaneous albinism may present an early neurodevelopmental delay and emotional/behavioral difficulties. • An early visual treatment is recommended to improve vision-related performance, neurodevelopment, and any psychological difficulties.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Laura Dusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vera Scaglioni
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lucia Mauri
- Medical Genetics Unit, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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Tzimiris S, Nikiforos S, Kermanidis KL. Post-pandemic pedagogy: Emergency remote teaching impact on students with functional diversity. EDUCATION AND INFORMATION TECHNOLOGIES 2023; 28:1-44. [PMID: 36714441 PMCID: PMC9871427 DOI: 10.1007/s10639-023-11582-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
The Covid-19 outbreak caused transition from face-to-face teaching to Emergency Remote Teaching (ERT). Due to the hastily and disorganized implementation of ERT considerable difficulties were caused for all the students. Aim of the present study was to investigate (i) parents' views of students with functional diversity regarding ERT during the Covid-19 pandemic and (ii) how their children's functional diversity affected participation in ERT. ERT proved to be an even greater challenge for those students, who faced various learning, psychological and technical problems that further hindered the learning process. In the current research, the views of 12 parents of students with functional diversity were collected with semi-structured interviews. A Modern Greek dataset of qualitative humanistic-linguistic data was created. A novel type of data analysis, combining qualitative descriptive analysis by hand and Artificial Intelligence (AI)-based linguistic analysis was performed on the interview text. Results revealed (i) how those students responded to ERT, (ii) the way that their functional diversity affected their attendance on the online courses and (iii) how their parents evaluate the educational dimension of ERT along with any changes noticed in their children's psychological and emotional state. Parents' evaluations disclosed the overall negative impact of ERT on their children and presented their suggestions for meeting their children's special needs in case of ERT appliance in the future. The current research is considered significant as it investigates ERT impact on K-12 students with functional diversity during the Covid-19 pandemic, based on authentic humanistic data. Our research contributes on (i) the creation of this kind of dataset, as this particular group of students is hard to come by and their collection constitutes a significant contribution and (ii) the two-fold way data analysis methodology, which is novel, combining linguistic and qualitative processes (semantic and sentiment analysis), providing important findings.
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Affiliation(s)
- Spyridon Tzimiris
- Humanistic and Social Informatics Laboratory (HILab), Department of Informatics, Ionian University, 7 Tsirigoti Square, Corfu, Greece
| | - Stefanos Nikiforos
- Humanistic and Social Informatics Laboratory (HILab), Department of Informatics, Ionian University, 7 Tsirigoti Square, Corfu, Greece
| | - Katia Lida Kermanidis
- Humanistic and Social Informatics Laboratory (HILab), Department of Informatics, Ionian University, 7 Tsirigoti Square, Corfu, Greece
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Mother-child interactions among children with visual impairment: Addressing maternal attachment style, depression-anxiety symptoms, and child's behavioral problems. North Clin Istanb 2023; 10:101-107. [PMID: 36910445 PMCID: PMC9996660 DOI: 10.14744/nci.2021.90688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/25/2021] [Accepted: 05/28/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The birth of a visually impaired child leads to stress, disappointment, and medical challenges for the family due to the economic and financial costs, unmet expectations of other family members, and social embarrassment-isolation of the family from society. In these families, mothers are exposed to the stressors more often than other family members, because, in most families, they are the primary caregivers. In this study, we examined the relationship between maternal attachment styles, maternal depression and anxiety levels, and behavioral problems of children with visual impairment. METHODS This is a case-control study. In the study group, there were 35 children with visual impairment, and in the control group, there were 31 healthy children. All mothers completed adult attachment style dimensions scales, beck depression, and anxiety inventories, and the aberrant behaviour checklist. RESULTS Our results demonstrated that children with visual impairment have higher levels of behavior problems including irritability, stereotypic behavior, and inappropriate speech when compared with healthy controls. Contrary to our expectations depression and anxiety, scores of mothers were similar, also, there was not a difference in terms of maternal attachment types. Interestingly, there was a positive relationship between secure attachment and depression among mothers of the visual impairment group. In other words, securely attached mothers were more depressive. On the other hand, there was a positive relationship between anxious/ambivalent attachment and the child's irritability. CONCLUSION The relationship between maternal depression and secure attachment could be a consequence of higher maternal sensitivity due to a child's impairment and should be evaluated in future studies.
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Ludwig NN, Jashar DT, Sheperd K, Pineda JL, Previ D, Reesman J, Holingue C, Gerner GJ. Considerations for the identification of autism spectrum disorder in children with vision or hearing impairment: A critical review of the literature and recommendations for practice. Clin Neuropsychol 2022; 36:1049-1068. [PMID: 34889701 PMCID: PMC10072819 DOI: 10.1080/13854046.2021.2002933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE There is higher risk for autism spectrum disorder (ASD) across many pediatric neurological conditions characterized by vision impairment or hearing loss. Early and accurate identification of ASD is imperative in promoting access to appropriate and early evidenced-based intervention; however, differential diagnosis can be particularly challenging in children with sensory impairment given the heterogeneity of ASD combined with the impact of vision impairment or hearing loss/deafness on development and behavior. A neuropsychologist's unique expertise and appreciation of the interplay between sensory and behavioral manifestations can be valuable for making an early and accurate ASD diagnosis in children who are blind/visually impaired or deaf/hard-of-hearing. This article highlights clinical considerations when identifying ASD within the context of vision impairment or hearing loss/deafness. METHOD We discuss clinical considerations for the early identification of ASD in children who are blind/visually impaired and deaf/hard-of-hearing. Information presented in the article is based on a critical review of the literature and the expertise of the author group. CONCLUSION Ongoing development of clinical expertise and evidence-based assessment methods are important when informing the early differential diagnosis of ASD in individuals with sensory impairment. Accurate identification is also vital for the development of targeted interventions across the lifespan.
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Affiliation(s)
- Natasha N Ludwig
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dasal Tenzin Jashar
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.,Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Kelly Sheperd
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.,Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jill L Pineda
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Dani Previ
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jennifer Reesman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Family and Community Interventions, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Calliope Holingue
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gwendolyn J Gerner
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Lau D, Tybor DJ, Perrin E, Sakai C. Time to Diagnosis of Autism Spectrum Disorders in Children with Coexisting Developmental Behavioral Disorders. J Dev Behav Pediatr 2022; 43:245-251. [PMID: 35239608 DOI: 10.1097/dbp.0000000000001047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Our study evaluates whether having an alternate developmental behavioral disorder (DBDs) diagnosis before diagnosis of autism spectrum disorders (ASD) is associated with delays in diagnosis in a nationally representative sample. METHODS Data were obtained from the 2011 National Survey of Pathways to Diagnosis and Services, a survey of children aged 6 to 17 years with ASD, developmental delay, or intellectual disability. A total of 1049 children met inclusion criteria for this study. Of these, 799 children were identified as "late" diagnosis if >12 months elapsed between the age parents reported concerns to a provider and age of ASD diagnosis and 250 as "timely" diagnosis if the gap was ≤12 months. Univariate and multivariate logistic regressions were used to look for association between having an alternate DBDs diagnosed before ASD and "timely" versus "late" ASD diagnosis. RESULTS The mean time elapsed between the age parents reported concerns to a provider and age of ASD diagnosis was 51 months for children with an alternate DBDs diagnosis before receiving ASD diagnosis and 29 months for those diagnosed with alternate DBDs concurrently with ASD. Having alternate DBDs diagnosis before diagnosis with ASD was associated with "late" ASD diagnosis as follows: developmental delay (adjusted odds ratio [aOR,] 3.46; 95% confidence interval [CI], 1.86-6.42; p < 0.001), intellectual disability (aOR, 9.75; 95% CI, 3.0-31.60; p = 0.04), attention-deficit disorder (aOR, 11.07; 95% CI, 3.43-35.71; p < 0.001), depression (aOR, 8.05; 95% CI, 1.07-60.03; p = 0.0495), and behavioral conduct disorder (aOR, 9.9; 95% CI, 3.55-27.62; p < 0.001). CONCLUSION These findings highlight the importance of research to improve the early diagnosis of ASD even in the presence of coexisting developmental behavioral disorders.
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Affiliation(s)
- Deanna Lau
- Division of Developmental-Behavioral Pediatrics, Tufts Children's Hospital, Boston, MA
| | - David J Tybor
- Department of Public Health, Tufts University School of Medicine, Boston, MA
| | - Ellen Perrin
- Division of Developmental-Behavioral Pediatrics, Tufts Children's Hospital, Boston, MA
| | - Christina Sakai
- Division of Developmental-Behavioral Pediatrics, Tufts Children's Hospital, Boston, MA
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Management of Keratoconus in Down Syndrome and Other Intellectual Disability. Cornea 2022; 41:456-461. [PMID: 35244626 DOI: 10.1097/ico.0000000000002793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/03/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to assess an intellectual disability (ID) cohort with keratoconus (KC) regarding ophthalmic (visual acuity and corneal tomography) and systemic characteristics and to describe an appropriate clinical algorithm for investigation and management of KC in this setting. METHODS This was the retrospective cohort study of patients with ID (Down syndrome, autism, and other) in the cornea department of a tertiary referral ophthalmic hospital in Dublin, Ireland. Retrospective chart review was conducted on people with ID undergoing examination under anesthesia or crosslinking under general anesthetic. Key outcome data included corneal examination findings, corneal tomography, visual acuity, and examination findings (eg, type of ID, general anesthetic, and cardiac status). RESULTS Mean age of the 24 patients was 31.9 years (66.7% male). ID type was Down syndrome (66.7%), autism (25%), and other (8.3%). KC was diagnosed in 98% of eyes, with 45.8% having untreatable advanced disease (57.1% of these bilateral), 39.6% amenable to corneal collagen crosslinking (35.7% of these bilateral), and 6.3% having corneal transplantation. Congenital heart defects were present in 37.5% of the Down syndrome group. There were no serious ocular or systemic adverse events. CONCLUSIONS KC is strikingly prevalent in the ID population. Ireland has the highest rate of Down syndrome in Europe (26.3:10,000 live births). This group is rarely suitable for corneal transplantation, and corneal collagen crosslinking is an effective intervention to prevent progression to advanced KC in this already socially restricted group. We propose an algorithm for investigation/treatment and also recommend uniform pediatric KC screening/treatment in ID populations.
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Hofer J, Tillmann J, Salzmann J, Bölte S, Fellinger J, Holzinger D. Screening for autism spectrum disorder in deaf adults with intellectual disability: Feasibility and accuracy of two autism screening instruments. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 122:104167. [PMID: 34998116 DOI: 10.1016/j.ridd.2021.104167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is a lack of autism screening instruments for deaf or hard of hearing (DHH) adults with intellectual disability. AIMS This study examined the diagnostic validity of the Pervasive Developmental Disorder in Mental Retardation Scale and the Diagnostic Behavioral Assessment for autism spectrum disorder - Revised in this rare population. METHODS AND PARTICIPANTS 56 DHH adults with intellectual disability living in three specialized therapeutic communities were examined, 9 of whom met criteria for autism. OUTCOMES AND RESULTS With minimal adaptions regarding item interpretation, both tools showed good diagnostic and high convergent validity. Items probing for difficulties in reciprocal social interaction and restricted interests were discriminant between individuals with and without autism. CONCLUSION These data suggest that both autism screening tools are feasible and psychometrically sound when used with appropriate adaptations for DHH adults with intellectual disability.
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Affiliation(s)
- J Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - J Tillmann
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
| | - J Salzmann
- Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria
| | - S Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institute & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - J Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - D Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Institute of Linguistics, University of Graz, Graz, Austria.
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12
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Chandna A, Ghahghaei S, Foster S, Kumar R. Higher Visual Function Deficits in Children With Cerebral Visual Impairment and Good Visual Acuity. Front Hum Neurosci 2021; 15:711873. [PMID: 34867236 PMCID: PMC8636735 DOI: 10.3389/fnhum.2021.711873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/07/2021] [Indexed: 01/25/2023] Open
Abstract
In clinical practice Cerebral Visual Impairment (CVI) is typically diagnosed by observation of abnormal visually guided behaviors which indicate higher visual function deficits (HVFDs) suggesting abnormal brain development or brain damage in a child with a suitable clinical history. HVFDs can occur even in the presence of good visual acuity and may remain undiagnosed because the good visual acuity does not prompt further investigation. This leads to a lack of understanding of the child's visual perceptual difficulties. In a prospective study, we determined the spectrum of HVFDs in a group of children with history suggestive of brain damage or disruption of brain development and an independent diagnosis of CVI in comparison with typically developing children with a structured 51 question inventory, the Higher Visual Function Question Inventory (HVFQI-51) adapted from the Cerebral Vision Impairment Inventory, CVI-I. Here, we show that the HVFQI-51 can detect a range of HVFDs in children with CVI with good visual acuity and clearly distinguishes these children from typically developing children. HVFDs in our study group could mostly be attributed to dorsal stream visual processing dysfunction though the spectrum varied between children. We report on the inclusion of the "not applicable" response option in analysis providing a picture of HVFDs more in tune with the overall disability of each child. We also propose a subset of 11 questions (Top-11) which discriminate between children with CVI vs. behaviors seen in typical children: this provides both a potential screening tool for initial assessment of HVFDs and a measure of CVI-related impairment, and needs further validation in a secondary independent sample.
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Affiliation(s)
- Arvind Chandna
- The Smith-Kettlewell Eye Research Institute, San Francisco, CA, United States
- Alder Hey Children’s Hospital, Liverpool, United Kingdom
| | - Saeideh Ghahghaei
- The Smith-Kettlewell Eye Research Institute, San Francisco, CA, United States
| | - Susan Foster
- Alder Hey Children’s Hospital, Liverpool, United Kingdom
| | - Ram Kumar
- Alder Hey Children’s Hospital, Liverpool, United Kingdom
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13
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Matos MBD, Bara TS, Felden ÉPG, Cordeiro ML. Potential Risk Factors for Autism in Children Requiring Neonatal Intensive Care Unit. Neuropediatrics 2021; 52:284-293. [PMID: 33853162 DOI: 10.1055/s-0041-1726401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The etiology of autism spectrum disorder (ASD) is complex and involves the interplay of genetic and environmental factors. AIM We sought to identify potential prenatal, perinatal, and neonatal risk factors for ASD in a unique population of children who had perinatal complications and required care in a neonatal intensive care unit (NICU). METHODS This prospective cohort study included 73 patients discharged from a NICU who received long-term follow-up at the largest children's hospital in Brazil. Potential risk factors were compared between 44 children with a diagnosis of ASD and 29 children without using the Mann-Whitney U test. Proportions were analyzed using the chi-square test. Simple and multiple logistic regression tests were performed. RESULTS Of 38 factors analyzed, the following 7 were associated with ASD: family history of neuropsychiatric disorders (p = 0.049); maternal psychological distress during pregnancy (p = 0.007); ≥ 26 days in the NICU (p = 0.001); feeding tube for ≥ 15 days (p = 0.014); retinopathy of prematurity (p = 0.022); use of three or more antibiotics (p = 0.008); and co-sleeping until up to 2 years of age (p = 0.004). CONCLUSION This study found associations between specific risk factors during critical neurodevelopmental periods and a subsequent diagnosis of ASD. Knowledge of the etiologic factors that may influence the development for ASD is paramount for the development of intervention strategies and improvement of prognoses.
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Affiliation(s)
- Marília Barbosa de Matos
- Department of Neuropediatrics, Children's Hospital Pequeno Príncipe, Waldemar Monastier Hospital, Curitiba, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil.,Faculdades Pequeno Príncipe, Curitiba, Brazil
| | - Tiago S Bara
- Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil.,Faculdades Pequeno Príncipe, Curitiba, Brazil
| | - Érico P G Felden
- Department of Health Sciences, Santa Catarina State University UDESC, Florianópolis, Brazil
| | - Mara L Cordeiro
- Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil.,Faculdades Pequeno Príncipe, Curitiba, Brazil.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, United States
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14
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Holzinger D, Weber C, Bölte S, Fellinger J, Hofer J. Assessment of Autism Spectrum Disorder in Deaf Adults with Intellectual Disability: Feasibility and Psychometric Properties of an Adapted Version of the Autism Diagnostic Observation Schedule (ADOS-2). J Autism Dev Disord 2021; 52:3214-3227. [PMID: 34322824 PMCID: PMC9213306 DOI: 10.1007/s10803-021-05203-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 01/13/2023]
Abstract
This study describes the adaptation of the autism diagnostic observation schedule (ADOS-2) to assess autism spectrum disorder (ASD) in adults with intellectual disability (ID) and hearing loss who communicate primarily visually. This adapted ADOS-2 was applied to residents of specialized therapeutic living communities (n = 56). The internal consistency of the adapted ADOS-2 was excellent for the Social Affect of modules 2 and 3 and acceptable for Restricted and Repetitive Behaviors subscale of module 2, but poor for module 3. Interrater reliability was comparable to standard ADOS-2 modules 1–3. Results suggest that autism symptoms of deaf adults with ID can be reliably identified by an adapted ADOS-2, provided adequate expertise in deafness, ID, ASD and proficiency in signed language by the administrator.
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Affiliation(s)
- D Holzinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria.,Institut für Sprachwissenschaft, Karl-Franzens-Universität Graz, Graz, Austria
| | - C Weber
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Inklusive Pädagogik, Pädagogische Hochschule OÖ, Linz, Austria
| | - S Bölte
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - J Fellinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria.,Abteilung für Sozialpsychiatrie der Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Vienna, Austria
| | - J Hofer
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria. .,Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria. .,Abteilung für Pädiatrie I, Medizinische Universität Innsbruck, Innsbruck, Austria.
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Kanchibhotla D, Gupte P, Harsora P, Kulkarni S. Impact of Prajñā yoga on cognition in adolescents with congenital and adventitious visual impairment. Explore (NY) 2021; 18:313-318. [PMID: 34301513 DOI: 10.1016/j.explore.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 11/04/2022]
Abstract
CONTEXT Numerous scientific studies have investigated the impact of yoga on cognition in children and adults. However, fewer studies have assessed the impact of yogic practices on cognition in children and adolescents with visual impairment. Despite their keen intellectual abilities and advanced linguistic skills, teens with visual impairment often experience difficulties with cognitive control and behavioral regulation. Memory plays an important role in cognition. Besides storing information, memory is also used for recall, defined as the retrieval of information the brain has recently been exposed to, and recognition, defined as the ability to recognize or retrieve the information previously encountered and stored in the brain. OBJECTIVE The objective of the study was to observe the effectiveness of Prajñā Yoga on enhancing the cognition and verbal memory in adolescents with visual impairment. Degree of visual impairment and age of onset of visual impairment were considered while analyzing the study data. DESIGN An open-trial, single arm, pre-post study design was adopted. 273 adolescents with visual impairment were assessed across India using the Rey Auditory Verbal Learning Test (RAVLT), at baseline (before the intervention), immediately after the intervention, and at 40 days after the intervention. RAVLT measures recall and recognition through verbal memory. INTERVENTION Prajñā Yoga (PY) or the Art of Living Intuition Program is a unique intervention, based on ancient techniques of Pranayama, Super Brain Yoga, and Meditation, taught to children & adolescents between the ages 5 and 17. RESULTS The mean scores for Recognition (p=0.011) and Immediate recall (p=0.011) improved significantly after PY for the entire study population, regardless of the degree of visual impairment, gender and age of onset. A significant improvement in mean scores for Delayed Recall was seen after 40 days of daily practice (p = 0.007).
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Affiliation(s)
| | - Poorva Gupte
- Sri Sri Institute for Advanced Research, Bangalore, India
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Battistin T, Mercuriali E, Zanardo V, Gregori D, Lorenzoni G, Nasato L, Reffo ME. Distance support and online intervention to blind and visually impaired children during the pandemic COVID-19. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103816. [PMID: 33271446 PMCID: PMC7682482 DOI: 10.1016/j.ridd.2020.103816] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 05/12/2023]
Abstract
The COVID-19 pandemic imposed dramatic changes to everyone's daily routines, but especially to children with developmental disabilities. The Robert Hollman Foundation decided not to interrupt its service to all the visually impaired children and initiated a Distance Support Project. It was an online process covering all aspects of support for the children and involving audio-video calls, videos and tailored-made multisensory material created specifically for each child. A questionnaire, carried out after the 5-month project duration, was created to collect feedback from parents and professionals to understand the impact this project had on everyone involved. Overall both parents and professionals indicated high levels of satisfaction, but in a significant number of questions parents reported consistently higher levels of satisfaction (p-value <0.001). It was shown that parents felt reassured at this otherwise very difficult time because their children were able to continue their treatment, even if in a very different way. This fact encourages us to consider enriching our existing programmes of support and care, integrating this online approach when necessary. At the same time, it seems clear that the responses of the professionals indicate their belief that the benefits of the traditional ways of working remain of unquestionable importance for children with sight deprivation.
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Affiliation(s)
- Tiziana Battistin
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy.
| | - Elena Mercuriali
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy
| | - Vincenzo Zanardo
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Laura Nasato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Maria Eleonora Reffo
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy
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The Challenging Heterogeneity of Autism: Editorial for Brain Sciences Special Issue "Advances in Autism Research". Brain Sci 2020; 10:brainsci10120948. [PMID: 33297430 PMCID: PMC7762320 DOI: 10.3390/brainsci10120948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
My personal experience as Guest Editor of the Special Issue (SI) entitled "Advances in Autism Research" began with a nice correspondence with Andrew Meltzoff, from the University of Washington, Seattle (WA, USA), which, in hindsight, I consider as a good omen for the success of this Special Issue: "Dear Antonio… [...].
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