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

Objective: To investigate the relationship of pregnancy-related anxiety of pregnant women in second/third trimesters and autism-like behaviors in their offspring at 18 months of age. Methods: Based on a prospective cohort study design, we evaluated the situation of pregnancy-related anxiety of women during second and third trimesters through a Pregnancy-Related Anxiety Questionnaire. Subjects under study were classified into three groups, 1) those with pregnancy- related anxiety during both trimesters, 2) those with pregnancy-related anxiety at one trimester and 3) those without pregnancy-related anxiety in either trimester. When their children were 18 months, autism-like behaviors (ALB) were evaluated, using the part A of Checklist for Autism in Toddlers-23, and then classified into three groups as non-ALB group, minor ALB group and major ALB group. Multi-nominal logistic Regression was used to analyze the relationship of pregnancy-related anxiety with autism-like behaviors. Results: Compared with non-ALB group, children whose mother with pregnancy-related anxiety during both trimesters presented significant higher risk on ALB than children whose mother without pregnancy-related anxiety in these two periods (relative risk, RR=2.43, 95% CI: 1.21-4.86, P=0.012), major factors as pregnant women's IQ and gestational diabetes mellitus, premature delivery and education levels of fosterers on these pregnant women were under control. Our results from the stratified analysis showed: when in the subgroup that mother was the main fosterer of the child, there was an significant increase of risk in children whose mothers with pregnancy-related anxiety during both trimesters (RR=4.22, 95%CI: 1.73-10.32, P=0.002). Conclusion: The association between pregnancy-related anxiety and autism-like behavior was not strong but influenced by the fosterer of the child.
Anxiety/psychology* ; Autistic Disorder/epidemiology* ; China/epidemiology* ; Female ; Humans ; Logistic Models ; Mothers/psychology* ; Pregnancy ; Pregnancy Complications/psychology* ; Pregnancy Trimester, Third ; Pregnancy Trimesters/psychology* ; Pregnant Women/psychology* ; Prospective Studies ; Surveys and Questionnaires

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 analyze the associations between pregnancy-related anxiety and the prevalence of subthreshold autism trait (SAT) in preschool children.

METHODSBaseline data came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). All the participants were enrolled among pregnant women who received prenatal health care in 4 municipal medical centers during Oct. 2008 to Oct. 2010. A total of 5 084 pregnant women were recruited at the beginning and 4 669 singleton live births were included until childbirth. The situation about pregnancy-specific anxiety during trimester and third trimester of women were evaluated by Pregnancy-specific Anxiety Questionnaire (PAQ). Between April 2014 and April 2015, the cohort was followed up again, and the Clancy Autism Behavior Scale (CABRS) filled out by parents was used for telling the SAT children from the healthy children among 3 663 preschool children. Univariate and binary regression model was used to estimate associations between the pregnancy-related anxiety during trimester and third trimester and the subthreshold autism trait in children.

RESULTSDuring the pregnancy, the detected rates of women with pregnancy-specific anxiety in trimester and the third trimester were 25.5%(935/3 663), 13.9%(501/3 592) respectively, and the detected rate of maternal pregnancy-specific anxiety in both periods was 7.7%(278/3 592). There were 290 positive children with SAT and the detection rate was 7.9%. After controlling possible confounding factors including children's genders, place of residence, supplement folic acid during pregnancy, preterm birth, exposure to second-hand smoke during pregnancy, the father (mother) cultural levels, the father (mother) nature of work and family income, the results of multinomial logistic regression analysis showed that maternal pregnancy-specific anxiety in trimester was the risk factor for SAT in preschool children (OR=1.51, 95% CI: 1.11-2.04), and there was no association between maternal pregnancy-specific anxiety in the third trimester and SAT in preschool children (OR=1.36, 95% CI: 0.82-2.22). Compared with the single function of maternal pregnancy-specific anxiety in trimester or the third trimester for SAT in preschool children, maternal pregnancy-specific anxiety in both periods presented a joint action that increasing the risk for SAT (OR=2.02, 95% CI: 1.36-2.98).

CONCLUSIONMaternal pregnancy-related anxiety was a risk factor for subthreshold autism trait in preschooler children. Pregnant women should try to keep a good mental state to create a good environment for fetal growth.

Anxiety ; epidemiology ; Autistic Disorder ; epidemiology ; Child ; Child, Preschool ; China ; Cohort Studies ; Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; psychology ; Pregnancy Trimester, Third ; psychology

Autism spectrum disorder (ASD) is characterized by persistent deficits within two core symptom domains: social communication and restricted, repetitive behaviors. Although numerous studies have reported psychopharmacological treatment outcomes for the core symptom domains of ASD, there are not enough studies on fundamental treatments based on the etiological pathology of ASD. Studies on candidate medications related to the pathogenesis of ASD, such as naltrexone and secretin, were conducted, but the results were inconclusive. Oxytocin has been identified as having an important role in maternal behavior and attachment, and it has been recognized as a key factor in the social developmental deficit seen in ASD. Genetic studies have also identified associations between ASD and the oxytocin pathway. As ASD has its onset in infancy, parents are willing to try even experimental or unapproved treatments in an effort to avoid missing the critical period for diagnosis and treatment, which can place their child in an irreversible state. While therapeutic application of oxytocin for ASD is in its early stages, we have concluded that oxytocin would be a promising therapeutic substance via a thorough literature review focusing on the following: the relationship between oxytocin and sociality; single nucleotide polymorphisms as a biological marker of ASD; and validity verification of oxytocin treatment in humans. We also reviewed materials related to the mechanism of oxytocin action that may support its potential application in treating ASD.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Critical Period (Psychology) ; Diagnosis ; Humans ; Maternal Behavior ; Naltrexone ; Oxytocin* ; Parents ; Pathology ; Polymorphism, Single Nucleotide ; Secretin ; Social Change ; Biomarkers

PURPOSE: The study was done to identify the construct validity and reliability of the life transition scale (LTS) for parents who have children with autism. METHODS: Exploratory factor analysis (EFA) and confirmative factor analysis (CFA) were conducted to identify the most adequate measurement model for structural validity. Convergent validity and discriminant validity were also conducted for structural validity. Data were collected from 208 parents through self-reported questionnaires and analyzed with SPSS/WIN 15.0 and AMOS 20.0 version. RESULTS: A four factor-structure was validated (chi2=541.23, p<.001, GFI=.82, RMSEA=.07, IFI=.89, CFI=.89, PNFI=.73, Q (chi2/df)=2.20) at the 3rd order of EFA and CFA, and factors were named as denying, wandering, despairing, and accepting. Both convergent and determinant validity for LTS were 100%. Cronbach's alphas for the reliability of each structure were .77-.90 and .83 for total structure. CONCLUSION: The four structures, 24-item instrument showed satisfactory reliability and validity. LTS has the potential to be appropriate for assessing the transition process of life for parents who have children with autism and provides basic directions for differentiated support and care at each stage.
Adaptation, Physiological ; Adult ; Autistic Disorder/diagnosis/*pathology ; Child ; Child, Preschool ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Parents/*psychology ; Quality of Life ; Questionnaires ; Severity of Illness Index

OBJECTIVETo explore the effect mechanism of electroacupuncture (EA) at Changqiang (GV 1) or Baihui (GV 20) on autism based on molecular biology.

METHODSThe autism model was established by intraperitoneal injection of sodium valproate (VPA) in Wistar pregnant rats. Forty young rats with autism were selected and randomly divided into a model group, a non-acupoint group, an electroacupuncture at "Changqiang" (GV 1) (EAGV 1 for short) group and an electroacupuncture at "Baihui" (GV 20) (EAGV 20 for short) group. Another 10 normal young rats were selected as a blank group. In the EAGV 1 group, acupuncture was applied at Houhai [as Changqiang (GV 1)], then EA apparatus was connected with continuous wave, 2 Hz, 20 min, once a day for consecutive 20 days. The same EA manipulation as EAGV 1 group was used in the EAGV 20 group where "Baihui" (GV 20) was selected and non-acupoint group where non-acupoint in the right rib was selected. Blank group and model group were reared under the same conditions without any intervention. The escape latency and the ratio of swimming distance in platform quadrant to total swimming distance in each group were observed by using Morris water maze, and the PSD-95 protein expression in hippocampal CA 1 was measured by immunohistochemical techniques.

RESULTSCompared with the blank group, the escape latency in the model group and the non-acupoint group lengthened (both P < 0.05), the ratio of swimming distance in platform quadrant to total swimming distance was decreased (both P < 0.05), the PSD-95 protein expression was decreased (P < 0.05). Compared with the model group, the escape latency in the EAGV 1 group and the EAGV 20 group were decreased (both P < 0.05), the ratio of swimming distance in platform quadrant to total swimming distance was increased, the PSD-95 protein expression was increased (both P < 0.05). But the escape latency, the ratio of swimming distance in platform quadrant to total swimming distance and the PSD-95 protein expression had no significant difference between EAGV 1 group and EAGV 20 group (P > 0.05).

CONCLUSIONElectroacupuncture at Changqiang (GV 1) or Baihui (GV 20) can respectively improve learning and memory ability of rats with autism, which has no significant difference and the mechanism of action may be related to regulation of the PSD-95 protein expression.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Autistic Disorder ; genetics ; metabolism ; psychology ; therapy ; Disks Large Homolog 4 Protein ; Electroacupuncture ; Female ; Hippocampus ; metabolism ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Learning ; Male ; Membrane Proteins ; genetics ; metabolism ; Memory ; Rats ; Rats, Wistar

OBJECTIVETo observe the effect difference of behavior training with head needling retention and behavior training after acupuncture for autism children.

METHODSSixty qualified autism children were divided randomly into simultaneous head needling retention and behavior training group (trial group) and behavior training after acupuncture treatment group (control group) with 30 case in each group. Retention needles on the head with simultaneous behavior training was applied for the trial group. The main acupoints included Sishen Xue, Dingshen Sanxue (3 points for mental tranquilization), Nao Sanxue (3 points for the function of brain), Shou Zhisanxue (3 points for mental activities on hand) and Zozhi Sonxue (3 points for mental activities on foot). Other points were combined according to conditions of patients. Needles on the 4 extremities were withdrawn first after 30 minutes, needles on head were remained during behavior training. While behavior training was applied to the control group when acupuncture treatment was completely accomplished. Treatments were applied once a day to both groups. And 3 months was taken as one observation cycle. Estimation was made on therapeutic effect and developing level of autism children with CARS and PEP.

RESULTSThe total effective rate of the trial group was 83.3% (25/30), better than 66.7% (20/30) of the control group (P < 0.05). The CARS scores of both groups declined after the treatment. And the score of trail group was lower than the control group (all P < 0.05). While the PEP scores of both groups increased, and the score of trail group was higher than the control group (all P < 0.05). The increasing level of scores of cognitive understanding and cognitive expression were all better than the control group (all P < 0.05).

CONCLUSIONThe effect of behavior training with head needle retention on autism children is better than behavior training after acupuncture treatment, especially in enhancing cognition understanding and cognition expression.

Acupuncture Points ; Acupuncture Therapy ; Autistic Disorder ; psychology ; therapy ; Behavior Therapy ; Child ; Child, Preschool ; Female ; Humans ; Male

Autistic Disorder ; complications ; psychology ; Child ; Child Development ; Communication ; Down Syndrome ; complications ; physiopathology ; psychology ; Follow-Up Studies ; Humans ; Interpersonal Relations ; Male ; Play and Playthings ; Singapore ; Social Behavior ; Stress, Psychological ; psychology