OBJECTIVES: To investigate the efficacy and required indicators of Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) in the differential diagnosis of autism spectrum disorder (ASD) and global developmental delay (GDD). METHODS: A total of 277 children with ASD and 415 children with GDD, aged 18-48 months, were enrolled as subjects. CNBS-R2016 was used to assess the developmental levels of six domains, i.e., gross motor, fine motor, adaptive ability, language, social behavior, and warning behavior, and a total of 13 indicators on intelligence age and developmental quotient (DQ) were obtained as the input features. Five commonly used machine learning classifiers were used for training to calculate the classification accuracy, sensitivity, and specificity of each classifier. RESULTS: DQ of warning behavior was selected as the first feature in all five classifiers, and the use of this indicator alone had a classification accuracy of 78.90%. When the DQ of warning behavior was used in combination with the intelligence age of warning behavior, gross motor, and language, it had the highest classification accuracy of 86.71%. CONCLUSIONS Machine learning combined with CNBS-R2016 can effectively distinguish children with ASD from those with GDD. The DQ of warning behavior plays an important role in machine learning, and its combination with other features can improve classification accuracy, providing a basis for the efficient and accurate differential diagnosis of ASD and GDD in clinical practice.
Child ; Humans ; Autism Spectrum Disorder/psychology* ; Diagnosis, Differential ; Machine Learning ; Social Behavior

Anxiety ; etiology ; prevention & control ; Autism Spectrum Disorder ; complications ; therapy ; Caregivers ; psychology ; Child ; Coronavirus Infections ; complications ; Humans ; Pandemics ; Pneumonia, Viral ; complications ; Stress, Psychological ; prevention & control

The Autism Spectrum Rating Scale (ASRS) and the Social Responsiveness Scale (SRS) have been widely used for screening autism spectrum disorder (ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability (ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6-18 years from special education schools, and 402 typically developing (TD) children in the same age span from a community-based population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales (P < 0.05) but higher than TD children (P < 0.05). Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS (area under the curve (AUC) = 0.709, sensitivity = 77.0%, specificity = 52.1%, positive predictive value (PPV) = 82.2%) and the SRS (AUC = 0.742, sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%). The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.
Adolescent ; Age Distribution ; Age Factors ; Autism Spectrum Disorder ; complications ; psychology ; Child ; China ; Female ; Humans ; Intellectual Disability ; etiology ; Male ; Psychiatric Status Rating Scales ; Psychometrics ; Retrospective Studies ; Social Behavior ; Statistics, Nonparametric

OBJECTIVES: This study investigated the effect of social skills training (SST) on facial emotion recognition and discrimination in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). METHODS: Twenty-three children aged 7 to 10 years participated in our SST. They included 15 children diagnosed with ADHD and 8 with ASD. The participants' parents completed the Korean version of the Child Behavior Checklist (K-CBCL), the ADHD Rating Scale, and Conner's Scale at baseline and post-treatment. The participants completed the Korean Wechsler Intelligence Scale for Children-IV (K-WISC-IV) and the Advanced Test of Attention at baseline and the Penn Emotion Recognition and Discrimination Task at baseline and post-treatment. RESULTS: No significant changes in facial emotion recognition and discrimination occurred in either group before and after SST. However, when controlling for the processing speed of K-WISC and the social subscale of K-CBCL, the ADHD group showed more improvement in total (p=0.049), female (p=0.039), sad (p=0.002), mild (p=0.015), female extreme (p=0.005), male mild (p=0.038), and Caucasian (p=0.004) facial expressions than did the ASD group. CONCLUSION: SST improved facial expression recognition for children with ADHD more effectively than it did for children with ASD, in whom additional training to help emotion recognition and discrimination is needed.
Autism Spectrum Disorder* ; Autistic Disorder* ; Checklist ; Child Behavior ; Child* ; Discrimination (Psychology) ; Facial Expression ; Facial Recognition ; Female ; Humans ; Intelligence ; Male ; Parents ; Social Skills*

Sex is an important factor in understanding the clinical presentation, management, and developmental trajectory of children with neuropsychiatric disorders. While much is known about the clinical and neurobehavioral profiles of males with neuropsychiatric disorders, surprisingly little is known about females in this respect. Animal models may provide detailed mechanistic information about sex differences in autism spectrum disorder (ASD) in terms of manifestation, disease progression, and development of therapeutic options. This review aims to widen our understanding of the role of sex in autism spectrum disorder, by summarizing and comparing behavioral characteristics of animal models. Our current understanding of how differences emerge in boys and girls with neuropsychiatric disorders is limited: Information derived from animal studies will stimulate future research on the role of biological maturation rates, sex hormones, sex-selective protective (or aggravating) factors and psychosocial factors, which are essential to devise sex precision medicine and to improve diagnostic accuracy. Moreover, there is a strong need of novel strategies to elucidate the major mechanisms leading to sex-specific autism features, as well as novel models or methods to examine these sex differences.
Animals ; Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Disease Progression ; Female ; Gonadal Steroid Hormones ; Humans ; Male ; Models, Animal ; Precision Medicine ; Psychology ; Rodentia* ; Sex Characteristics

OBJECTIVETo investigate the characteristics of working memory ability on emotional faces and related event-related potential (ERP) in children with autism spectrum disorder (ASD).

METHODSThe Chinese Facial Affective Picture System was used as test material, and the event-related potential system was used to record the electroencephalographic data when 16 ASD children aged 6-12 years (ASD group) and 14 normal children matched for age (control group) were completing the facial emotion delayed match-to-sample task. The characteristics of P3b component were analyzed for both groups.

RESULTSCompared with the control group, the ASD group had a significantly longer reaction time (1 527 ms vs 1 060 ms; P<0.05) and a significantly lower accuracy rate (76% vs 88%; P<0.01) in the facial emotion delayed match-to-sample task. There was a difference in the amplitude of P3b component during the encoding stage between the two groups. In the ASD group, the P3b component on the left side electrode had a higher amplitude than that on the right side electrode (P<0.05), while the control group had no such characteristics.

CONCLUSIONSThere is a difference in P3b component during the encoding stage between school-aged ASD children and normal children. In ASD children, working memory on emotional faces may depend more on the related neural pathway in the left hemisphere.

Autism Spectrum Disorder ; physiopathology ; psychology ; Child ; Emotions ; Evoked Potentials ; Facial Expression ; Female ; Humans ; Male ; Memory, Short-Term

OBJECTIVETo investigate the features of intelligence development, facial expression recognition ability, and the association between them in children with autism spectrum disorder (ASD).

METHODSA total of 27 ASD children aged 6-16 years (ASD group, full intelligence quotient >70) and age- and gender-matched normally developed children (control group) were enrolled. Wechsler Intelligence Scale for Children Fourth Edition and Chinese Static Facial Expression Photos were used for intelligence evaluation and facial expression recognition test.

RESULTSCompared with the control group, the ASD group had significantly lower scores of full intelligence quotient, verbal comprehension index, perceptual reasoning index (PRI), processing speed index（PSI), and working memory index (WMI) (P<0.05). The ASD group also had a significantly lower overall accuracy rate of facial expression recognition and significantly lower accuracy rates of the recognition of happy, angry, sad, and frightened expressions than the control group (P<0.05). In the ASD group, the overall accuracy rate of facial expression recognition and the accuracy rates of the recognition of happy and frightened expressions were positively correlated with PRI (r=0.415, 0.455, and 0.393 respectively; P<0.05). The accuracy rate of the recognition of angry expression was positively correlated with WMI (r=0.397; P<0.05).

CONCLUSIONSASD children have delayed intelligence development compared with normally developed children and impaired expression recognition ability. Perceptual reasoning and working memory abilities are positively correlated with expression recognition ability, which suggests that insufficient perceptual reasoning and working memory abilities may be important factors affecting facial expression recognition ability in ASD children.

Adolescent ; Autism Spectrum Disorder ; psychology ; Child ; Child Development ; Facial Expression ; Female ; Humans ; Intelligence ; Male

OBJECTIVETo investigate the characteristics of attention in school-age children with mild autism spectrum disorder (ASD), and to provide a basis for clinical treatment.

METHODSA total of 20 school-age children with mild ASD were enrolled, and the intermediate visual and auditory continuous performance test (IVA-CPT) was used to assess their attention. A total of 20 children with attention deficit hyperactivity disorder (ADHD) and 40 healthy children were enrolled as controls.

RESULTSCompared with the normal control group, the ASD group showed significantly lower scores of full scale attention quotient, full scale response control quotient, visual/auditory full scale response control quotient, visual/auditory prudence quotient, auditory perseverance quotient, visual consistency quotient, visual/auditory vigilance quotient, visual attention quotient, visual speed quotient, number of correct visual/auditory reactions, and visual mean reaction time of the second and third phases (P<0.05). Compared with the ADHD group, the ASD group showed significantly higher scores of full scale response control quotient and auditory consistency quotient (P<0.05), as well as significantly lower scores of visual vigilance quotient and visual speed quotient (P<0.05).

CONCLUSIONSSchool-age children with mild ASD have attention deficit mainly manifested as the defect in the ability to focus attention, which is similar to the defect in children with ADHD, but ASD children have a lower degree of attention control impairment compared with children with ADHD. The defect in the ability to focus visual attention is more severe than that in the ability to focus auditory attention, while there is no significant difference between the defects in visual and auditory attention control.

Adolescent ; Attention ; Attention Deficit Disorder with Hyperactivity ; psychology ; Autism Spectrum Disorder ; psychology ; Child ; Female ; Humans ; Male

OBJECTIVES: This study aimed to investigate the differences in the facial emotion recognition and discrimination ability between children with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). METHODS: Fifty-three children aged 7 to 11 years participated in this study. Among them, 43 were diagnosed with ADHD and 10 with ASD. The parents of the participants completed the Korean version of the Child Behavior Checklist, ADHD Rating Scale and Conner's scale. The participants completed the Korean Wechsler Intelligence Scale for Children-fourth edition and Advanced Test of Attention (ATA), Penn Emotion Recognition Task and Penn Emotion Discrimination Task. The group differences in the facial emotion recognition and discrimination ability were analyzed by using analysis of covariance for the purpose of controlling the visual omission error index of ATA. RESULTS: The children with ADHD showed better recognition of happy and sad faces and less false positive neutral responses than those with ASD. Also, the children with ADHD recognized emotions better than those with ASD on female faces and in extreme facial expressions, but not on male faces or in mild facial expressions. We found no differences in the facial emotion discrimination between the children with ADHD and ASD. CONCLUSION: Our results suggest that children with ADHD recognize facial emotions better than children with ASD, but they still have deficits. Interventions which consider their different emotion recognition and discrimination abilities are needed.
Autism Spectrum Disorder ; Autistic Disorder* ; Checklist ; Child Behavior ; Child* ; Discrimination (Psychology)* ; Facial Expression ; Female ; Humans ; Intelligence ; Male ; Parents

OBJECTIVETo explore the relationship between the behavior phenotypes of patients with autism spectrum disorder (ASD) and their parents through family study.

METHODSForty-five core families with ASD and 30 control families from Chengdu area were examined using Autism Spectrum Quotient (AQ). Descriptive statistical analysis, correlation analysis, and Logistic regression analysis were used to investigate the effect of various factors, especially genetic factors that may affect the pathogenesis of ASD.

RESULTSThe social skills factor and communication factor of the father's AQ scale, as well as the mother's age of childbearing and AQ social skills factor are related to whether children with ASD (R were 0.46, 0.39, 0.39 and 0.36, P<0.05). The communication factor of the parents' AQ and mother's attention to detail factor are related to whether children will show developmental anomaly before the age of 36 months (R were 0.55, 0.51 and 0.54, P<0.05). The social skill problems of parents and father's communication problems are risk factors for children with autism.

CONCLUSIONASD may be influenced by both genetic and environmental factors. The autistic behavior phenotype of parents is a risk factor for ASD and is associated with developmental anomalies of early childhood.

Adult ; Autism Spectrum Disorder ; diagnosis ; genetics ; psychology ; Child ; Child Behavior ; psychology ; Child, Preschool ; Communication ; Female ; Humans ; Infant ; Interviews as Topic ; Logistic Models ; Male ; Parents ; psychology ; Phenotype ; Social Behavior ; Surveys and Questionnaires