autism

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by qualitative deficits in behavior and social interaction patterns. Recently, cognitive impairments commonly associated with ASD have been well-documented. Neurofeedback (NFB) has been proposed as a potential treatment for individuals with autism, but its effectiveness in improving cognitive issues remains uncertain despite multiple trials. This review aims to summarize the estate of documents regarding the cognitive efficacy of NFB for participants with ASD. 

Materials & Methods:

 Conducting a systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this study scrutinized NFB studies specific to ASD treatment. Its inclusion criteria focused on studies involving individuals with ASD without comorbidities, employing JBI checklists to assess study quality. Utilizing PubMed, Embase, Web of Science, PsycINFO, and Scopus, supplemented by manual paper reviews, we initially identified 474 papers. After deduplication and full-text review, 12 studies were selected for analysis.

Findings revealed that 83% of the chosen studies highlighted a positive impact of NFB on cognition in individuals with ASD. The findings suggest NFB as a promising alternative treatment, demonstrating efficacy in addressing attention, memory, executive function, and speech difficulties. Additionally, six studies indicated sustained long-term effectiveness of NFB in improving cognitive functioning among ASD patients.

This review supports the potential of NFB as a viable intervention for cognitive challenges in ASD. Furthermore, the results hint at broader applications of NFB beyond ASD, suggesting efficacy in addressing conditions like Attention Deficit/Hyperactivity Disorder (ADHD), sleep apnea, depression, and epilepsy.

Individuals with autism spectrum disorder exhibit sexual preferences comparable to those of their typically developing peers; however, their sexuality and sexual maturation are frequently overlooked. This qualitative study was conducted to ascertain parents' experiences of perceived challenges and problems related to the sexual maturation of children with autism spectrum disorder. This qualitative investigation utilized a study population comprising parents of children with autism spectrum disorder who met the inclusion criteria. The study was conducted in two autism education and rehabilitation centers in Khorramabad. Data were collected through semi-structured interviews with 20 parents and analyzed using a conventional content analysis approach. The findings revealed that 17 of the participating parents were female and 3 were male, with the average age of the affected children being 13.40±2.98 years. Seven subcategories were extracted from the study: lack of knowledge regarding sexual maturity of the affected individuals, lack of sexual education skills, concern about vulnerability, fear of social reactions, unclear future of sexual life, confrontation with sexual behaviors, and care deficiencies. Through the merging of similar subcategories, three main categories emerged: educational need, psychological stress, and ineffective actions. The primary challenges faced by parents in addressing the sexual maturity of their adolescent children with autism spectrum disorder stem from insufficient knowledge of autism spectrum disorder and the impact of this developmental condition on various aspects, particularly sexual maturity. Educating parents and children will contribute to improving the reproductive and sexual health of this vulnerable population.

 Working memory, a key component of executive function, is responsible for temporarily storing and manipulating information during cognitive tasks such as perception, learning, and reasoning. Research indicates that children with high-functioning autism spectrum disorder (HF-ASD) often exhibit deficits in working memory. Evidence suggests that transcranial Direct Current Stimulation (tDCS) applied to the prefrontal cortex can enhance working memory in healthy individuals. Given that autism spectrum disorder (ASD) is associated with working memory impairments, tDCS may offer significant benefits for individuals with ASD. The aim of this study was to evaluate the effectiveness of tDCS combined with routine occupational therapy in improving working memory in children with HF-ASD.

 In this study, 20 children with HF-ASD (12 males, 8 females; mean age = 9.5 years) were selected from comprehensive rehabilitation centers and special schools for autism. Participants were evaluated by a child and adolescent psychiatrist and received a definitive diagnosis using the Garez questionnaire and a pervasive developmental disorders screening questionnaire. After meeting the inclusion criteria, participants were randomly assigned to either the experimental or control group. Both groups were assessed using the N-Back test to measure working memory before and after the intervention. The experimental group received tDCS (1.5 mA for 20 minutes over 10 sessions) targeting the left dorsolateral prefrontal cortex (DLPFC) alongside routine occupational therapy, while the control group received sham tDCS with occupational therapy.

 The results demonstrated that tDCS significantly increased the number of correct answers (P = 0.001) and reduced the number of incorrect answers (P = 0.007) in the experimental group compared to the control group.

The findings suggest that tDCS combined with routine occupational therapy has a significant positive effect on working memory in children with HF-ASD, leading to further improvement. This non-invasive and safe intervention may serve as a valuable adjunct to traditional therapies for enhancing cognitive functioning in children with ASD.

The need for early detection and supportive therapy of Autism Spectrum Disorder (ASD) underlined the influence of screening for ASD in children with epilepsy as well as screening for epilepsy in ASD. This study aimed to explore the prevalence of autism in epileptic children in the northwest of Iran. A case-control study was performed on 80 children aged 16 to 30 months, consisting of 40 with epilepsy as the case group and 40 with febrile seizure as a control group. The case group included children diagnosed with epilepsy, and the control group comprised children with recurrent febrile seizures who were matched by age and sex. Two questionnaires, Ages and Stages Questionnaire (ASQ) and Modified Checklist for Autism in Toddlers (m-CHAT), were utilized for developmental assessment and ASD screening, respectively. An experienced child and adolescent psychiatrist clinically diagnosed autism through relevant DSM-5 criteria. The studied children comprised 22 (55%) males and 18 (45%) females. Based on the M-CHAT screening questionnaire, 19 (47.5%) patients in the case group were positive for ASD. M-CHAT-positive patients were referred to the comprehensive autism center, and of whom, 4 (10%) patients met DSM-5 diagnostic criteria for ASD (definite ASD). In epileptic children with developmental delay, the overall prevalence of definite ASD was 18.2%. The present study showed a high prevalence of autism among epileptic children, especially in developmentally delayed children; this demonstrated the need for autism screening in epileptic patients.

Mothers of children with Autism Spectrum Disorder (ASD) often experience significant social stigma and challenges with distress tolerance, impacting their well-being and parenting effectiveness. This study aimed to evaluate the effectiveness of mindfulness-based parenting training and transdiagnostic therapy in reducing social stigma and improving distress tolerance among these mothers. This study utilized a quasi-experimental, pretest-posttest control group design with three-month follow-up assessments. The target population comprised mothers of children aged 5 to 12 years, diagnosed with ASD, who were attending autism centers in Mashhad during 2024. A convenience sample of 45 mothers was recruited and subsequently randomly allocated to two experimental groups and a single waitlist control group. Data collection instruments included the Social Stigma Scale and the Distress Tolerance Scale. Statistical analyses were conducted using repeated measures analysis of variance (ANOVA), with Bonferroni post-hoc tests employed for pairwise comparisons. Findings demonstrated that both the mindfulness-based parenting intervention and transdiagnostic therapy yielded statistically significant reductions in perceived social stigma and increases in distress tolerance at both the post-test and follow-up assessments when compared to the control group (P<0.001). Additionally, no statistically significant difference was observed in the effectiveness between the two intervention modalities, indicating that they were statistically equivalent in their impact on social stigma and distress tolerance. This research demonstrated that both mindfulness-based parenting and transdiagnostic therapy effectively reduced social stigma and improved distress tolerance in mothers of children with ASD, with sustained benefits observed during follow-up. Clinicians can consider either, or a combined approach, as both yielded equivalent improvements. This allows tailored interventions based on individual needs and preferences.

Autism is one of the most common disorders in children. Children with autism have difficulty with many motor skills. This study aimed to investigate the effect of internal and external attention on gaze behavior and skill learning in children with autism spectrum disorder.

A total of 40 children with autism spectrum disorder were selected to participate in this study. The subjects were randomly divided into two groups: external attention and internal attention. Motor function and gaze control (quiet eye duration) were evaluated before and after observation exercises. Observation exercises included ten viewings of observation clips manipulated in the form of gaze behavior in each attention group (internal/external signs) during observation. To ensure the adherence of the participants’ visual attention to the given instructions, the gaze behavior of these subjects while watching the video clips was examined using eye tracking.

The results showed that the external attention group had better performance and longer quiet-eye duration than the internal attention group (P≤0.05).

Providing educational instructions to promote external attention in the form of gaze facilitates the effects of observational learning for the cognitive-motor improvement of autistic children.

To comprehend the complex interplay between autism symptoms, family well-being, and maternal coping abilities, it is essential to delve into the relationship between these factors. This study aimed to investigate how maternal resilience influences the connection between the severity of autism symptoms and the overall quality of life (QoL) for families with autistic children. A cross-sectional correlational study was designed to investigate the correlation between variables. The study population consisted of mothers of autistic children aged 4 to 12 years residing in Mashhad, Iran. A convenience sample of 372 mothers was recruited from rehabilitation, educational, and therapeutic centers catering to autistic individuals in Mashhad, Iran between January and March 2023. For data analysis, Pearson correlation and SEM were used, with the aid of SPSS and Amos 24. The mean score for the severity of autism symptoms was 160.26 (±11.66). The mean resilience score was 49.98 (±6.55). Also, the mean score for family QoL was 75.33 (±9.81). The results showed significant direct relationships among the severity of autism symptoms, family QoL, autism symptoms, and maternal resilience in mothers of autistic children (P=0.001). Additionally, the study demonstrated that maternal resilience played a significant mediating role in the connection between autism symptoms and family QoL (P=0.001). The study uncovered a negative connection between the severity of autism symptoms and family QoL, suggesting that more pronounced symptoms can negatively impact family well-being. Additionally, the study found a positive link between maternal resilience and family QoL, indicating that fostering resilience in mothers of autistic children can enhance family dynamics.

Physical activity (PA) patterns and health-related physical fitness (HRPF) among children with autism spectrum disorder (ASD), particularly with emphasis on gender differences are less examined. The present study aimed to objectively assess the PA and HRPF of children with ASD and to compare these findings with those of typically developing (TD) children, with a particular focus on gender differences. This descriptive-correlational study was done in Tehran, Iran in 2023. We selected 76 students with ASD (35 girls, Mage=13.63±2.14) and 85 TD children (40 girls, Mage=13.47±2.04) as the study sample through the convenience sampling method. PA and HRPF were assessed using an accelerometer and the Brockport Physical Fitness Test, respectively. Independent t-tests and linear regressions were used to analyze data through SPSS version 26. The ASD group engaged significantly in fewer daily moderate-to-vigorous PA (MVPA) than the TD group (39.93±13.60 vs. 46.87±11.70 minutes per day, respectively, P=0.013). Boys in both ASD and TD groups exhibited significantly higher PA and HRPF as compared with girls (P<0.001 and P=0.040, respectively). As expected, MVPA was correlated with physical fitness in ASD (r=0.298, P<0.001) and TD groups (r=0.432, P<0.001) indicating that participants with higher MVPA were more physically fit. The results emphasized the need of targeted strategies and offerings geared to children and adolescents with ASD to promote an adequate level of PA and health-related physical fitness. Developing specific strategies for children with ASD is vital to promote proper PA and HRPF.

Having a child with autism causes depression, anxiety, and distress in the parents. Accordingly, this study investigates the effect of Benson relaxation response on the anxiety of mothers of children with autism spectrum disorder (ASD). 

It was a quasi-experimental study with pretest-posttest design and a control group. The subjects were 100 mothers with autistic children admitted to Shahid Zolfaghari Autism Support Center located in Tehran, Iran in 2023 who were selected using convenience sampling and were randomly assigned into two intervention and control groups (each with 50 participants). Participants in groups of 5-6 received Benson's relaxation method in eight steps. The steps were repeated until all groups had acquired the required skill. Then the subjects were asked to repeat this intervention twice a day for 30 days. The posttest was done after 30 days of relaxation sessions at home in both groups. The data were collected using the Beck Anxiety Inventory (BAI) and analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of covariance (ANCOVA) and Paired difference t-test) in SPSS software, version 26. The significance level was set at P<0.05). 

The findings showed no statistically significant difference between the mean anxiety scores of the mothers in the intervention group (31.26 ±4.58) and the control group (32.14 ±4.57) before the intervention (p-value > 0.05). However, after the intervention, a statistically significant difference was observed between the mean anxiety scores for the mothers in the intervention group (25.38 ±6.01) and the control group (33.04 ±4.41) (t=5.73; P=0.001). Also after controlling the effect of covariates, the participants’ anxiety scores after the intervention showed a statistically significant difference (F=52.76, p=0.001). 

The Benson relaxation response was effective in reducing the anxiety of mothers of children with ASD. Thus, psychiatric nurses and mental health professionals can use Benson relaxation response along with other treatments to improve the anxiety of mothers of children with ASD.

Autism is a complex neurodegenerative disorder that affects people from birth. Through dietary approaches, sensory integration, rehabilitation training, education and finally medication management, the autistic disorder symptoms can be reduced. Of course, this does not mean that the main features of autism can be treated in general, but with medication control and education, these symptoms can be managed. In the last decade, treatment with herbal medicines has attracted special attention and promising results have been reported in the treatment of various diseases. In this review, it is tried to collect the plants that have been studied for the treatment of autism and herbal medicines with a possible effect on the symptoms of autism in the literature. The results show some few medicinal herbs and natural/ traditional formulations like Gingko biloba, Centella asiatica, Humulus japonicus, Salvia leriifolia, Vitis vinifera, Hazelnut, Ukgansan and Kwakhyangjungkisanhapyukmijihwangtang-gamibang have beneficial effects on different features of autism and could be helpful for the patients. More investigations are needed to prove their efficacy in more clinical studies in the future.

Autism spectrum disorders are a type of developmental disorder that primarily disrupt social interactions and communications. Autism has no treatment, but early diagnosis of it is crucial to reduce these effects. The incidence of autism is represented in repetitive patterns of children’s motion. When walking, these children tighten their muscles and cannot control and maintain their body position. Autism is not only a mental health disorder but also a movement disorder.

This study aims to identify autistic children based on data recorded from their gait patterns using a Kinect sensor. The database used in this study comprises walking information, such as joint positions and angles between joints, of 50 autistic and 50 healthy children. Two groups of features were extracted from the Kinect data in this study. The first one was statistical features of joints’ position and angles between joints. The second group was the features based on medical knowledge about autistic children’s behaviors. Then, extracted features were evaluated through statistical tests, and optimal features were selected. Finally, these selected features were classified by naïve Bayes, support vector machine, k‑nearest neighbors, and ensemble classifier.

The highest classification accuracy for medical knowledge‑based features was 87% with 86% sensitivity and 88% specificity using an ensemble classifier; for statistical features, 84% of accuracy was obtained with 86% sensitivity and 82% specificity using naïve Bayes.

The dimension of the resulted feature vector based on autistic children’s medical knowledge was 16, with an accuracy of 87%, showing the superiority of these features compared to 42 statistical features.

Mothers of children with autism encounter numerous challenges that can greatly impact their caregiving responsibilities. However, spiritual-religious well-being (SWB), being a fundamental aspect of human life, has the potential to alleviate a significant portion of this burden. This study aimed to explore the relationship between spiritual-religious components and care burden among mothers of children with autism.

This cross-sectional descriptive study involved 102 mothers of children with autism who sought assistance at the autism centers affiliated with the Qom University of Medical Sciences in 2022. Convenience sampling was used, and data were collected through questionnaires on demographic characteristics, SWB, and caregiving burden. Descriptive statistics and linear regression analysis were performed using SPSS software, version 22 with a significance level of 0.005.

The participating mothers had an average care burden score of 75.44±22.3 and a SWB score of 196.8±28.3. Linear regression analysis revealed that hope for the future and general religiosity were predictors of care burden in mothers of children with autism.

Mothers of children with autism experience a moderate burden of care, which is influenced by their spiritual and religious well-being. Understanding the spiritual and religious components that impact the caregiving burden can assist therapists in providing solutions to reduce stress and alleviate the burden of care for these mothers.

Autism spectrum disorder (ASD) is a sensory processing, social communication, and occupational performance disorder. Sensory diets can have positive effects on these fields. Current research compared the effectiveness of the sensory diet program with and without teleoccupational therapy on sensory processing patterns, social competency and occupational performance in children with ASD.

The study sample comprised 32 children with ASD 4-10 years old. They were placed in the control and intervention groups. The number of sessions for both groups was 20 30-minute sessions administered over 8 weeks. Through photos, videos, and explanations, sensory problems were described in both groups, the mother presented and implemented activities and environmental adaptations, and the therapist supervised the implementation. This study used three tools—sensory profile 2, social responsive scale 2 and Canadian occupational performance measure.

According to the sensory profile 2, social responsiveness scale, and Canadian occupational performance measure, processing in the areas of auditory, visual, touch, movement, body position, oral, conduct, social-emotional, attentional, sensory seeking, sensory avoiding, sensory sensitive, low registration, social awareness, social cognition, social communication, social motivation, limited interests, repetitive behaviors, and occupational performance in both groups have a significant difference (P<0.05).

It seems that providing a sensory diet program through teleoccupational therapy on sensory processing patterns, social competency, and occupational performance is applicable, as well as face-to-face occupational therapy in children with ASD.

Interventions using ‘hybrid’ remediation/compensatory cognitive interventions may be beneficial to improving the socio-cognitive functioning of children with autism spectrum disorder (ASD). Previous studies have shown that neurocognitive impairments in executive function (EF) and theory of mind (TOM) are specifically associated with ASD. The primary objective of the study is to determine the impact of the remediation and compensatory cognitive intervention on EFs and TOM abilities. The secondary objective is to evaluate TOM and EF behavioral domains due to the remediation and compensatory cognitive intervention. 

A total of 75 children aged 4 to 7 years diagnosed with high-functioning autism and their parents will be recruited to this double-blind, multicenter, multi-arm randomized controlled trial. The primary outcomes are EFs and TOM as measured by the shape school, shape span test, TOM scale, TOM story books, TOM assessment checklist, and EFs assessment checklist. The secondary outcome is EFs and TOM behavioral domains as measured by the TOM behavior checklist and brief-preschool version at baseline (T0), post-test (T1), 1-month follow-up (T2), and 3-month follow-up (T3). Primary and secondary outcomes will be analyzed using repeated measures, such as an analysis of variance and a mixed model. 

This study will assess whether the cognitive intervention program affects not only the neuropsychological functioning of children with ASD but also daily functioning. If the current trial shows that either the remediation or compensatory approaches effectively improve socio-cognitive functioning, the trial would reveal a ‘hybrid’ remediation/compensatory approach.