Clinical and functional profile of children with autism spectrum disorders

Introduction. Currently, the gain in the number of children patients diagnosed with Autism Spectrum Disorders (ASD) has been recorded. The key feature of the given group is the polysystemic expression, with considerable disruption of the central nervous system, gastrointestinal tract and immune processes. The research of their counteraction and development is essential for determining tactics for ASD patients’ combination treatment.

Aim of the study is to present a clinical and functional patient profile with Autism Spectrum Disorders based on the clinical, medical and social trial.

Materials and methods. We conducted a pilot observational, comparative study within two groups of children (62 ASD patients and 48 healthy children dominated by boys). The examination included receiving complaints, objective assessment by the paediatrician and neurologist, filling in medical records, covering complaints and the results of patients’ objective examination and parents/caretakers surveys.

Results. The study revealed the predominance of complaints about mental disruptions over somatic complaints. Notably, parents/ caretakers indicated the presence of sleep disturbances (up to 22.5%) and specific eating habits (up to 27.4%) in their children. Young patients in the group under consideration exposed signs of allergic diseases chronic intoxication syndromes and micronutrient deficiencies. Nearly one-third of children reported the presence of functional disorders/digestive diseases.

Conclusion. Young patients with Autism Spectrum Disorder are diagnosed with burdened physical status in the form of functional disruptions and diseases. These findings necessitate the paediatrician’s active early detection of organs’ malformation and require somatic systematic monitoring by the psychiatrist and skilled attendance of other medical specialists.

Contribution:
Galova E.A., Chekalova S.A., Blagonravova A.S., Karyakin N.N. — concept and design of the study;
Galova E.A., Chekalova S.A., Kotelnikova O.L., Vorobyova O.V. — collection and processing of the material;
Galova E.A., Chekalova S.A. — statistical processing;
Galova E.A., Chekalova S.A. — writing the text;
Galova E.A., Chekalova S.A. — editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgement. The study was carried out within the framework of the state assignment «Gut microbiota transplantation in children with autism spectrum disorders (ASD)», registration number AAAA-A20-120022590145-1.

Conflict of interest. The authors declare no conflict of interest.

Received: August 05, 2021
Accepted: August 24, 2021
Published: September 16, 2021

1. Terletskaya R.N., Kuzenkova L.M., Vinyarskaya I.V., Lashkova A.N. Current aspects of autism prevalence among children of different age groups. Rossiyskiy pediatricheskiy zhurnal. 2020; 23(1): 21–7. https://doi.org/l0.18821/1560-9561-2020-23-1-21-27 (in Russian)

2. Mazurek M.O., Vasa R.A., Kalb L.G., Kanne S.M., Rosenberg D., Keefer A., et al. Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders. J. Abnorm. Child Psychol. 2013; 41(1): 165–76. http://doi.org/10.1007/s10802-012-9668-x

3. Bozhkova E.D., Balandina O.V., Konovalov A.A. Autism spectrum disorders: state-of-the-art (review). Sovremennye tekhnologii v meditsine. 2020; 12(2): 111–20. http://doi.org/10.17691/stm2020.12.2.14 (in Russian)

4. Simashkova N.V., Makushkin E.V. Autism Spectrum Disorders: Diagnosis, Treatment, Observation. Clinical Guidelines (Treatment Protocol). Moscow; 2015. (in Russian)

5. Ivanov M.V., Simashkova N.V., Kozlovskaya G.V., Makushkin E.V. The epidemiologic study of the risk of autism spectrum disorders in children of 16-24 months in Russia, 2015-2016. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018; 118(5-2): 12–9. http://doi.org/10.17116/jnevro20181185212 (in Russian)

6. Makasheva V.A. Autism morbidity: screening, regional registration. The role of a medical psychologist in the processes of diagnostic and rehabilitation. In: Materials of the All-Russian Scientific-Practical Conference with International Participation «Modern Problems of Clinical Psychology and Personality Psychology» [Materialy Vserossiyskoy nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiem «Sovremennye problemy klinicheskoy psikhologii i psikhologii lichnosti»]. Novosibirsk; 2017: 75–84. (in Russian)

7. World Health Organization. Autism spectrum disorders (ASD); 2019. Available at: https://www.who.int/news-room/q-a-detail/autism-spectrum-disorders-(asd)

8. Dolgikh V.V., Starovoytova T.E., Pogodina A.V., Mikhnovich V.I., Rychkova L.V. Somatic health of children with autism. Pediatriya. Zhurnal im. G.N. Speranskogo. 2014; 93(5): 150–3. (in Russian)

9. Donierova F.A. Somatic and neurological status of children with autism. Molodoy uchenyy. 2017; 154(20): 189–92. (in Russian)

10. Ivanova D.V., Semina I.I., Ziganshin A.U. Somatic disorders in autism as one of the factors of behavioral and social interaction disorders. Kazanskiy meditsinskiy zhurnal. 2019; 100(4): 689–94. http://doi.org/10.17816/kmj2019-689 (in Russian)

11. Fung T.C., Olson C.A., Hsiao E.Y. Interactions between the microbiota, immune and nervous systems in health and disease. Nat. Neurosci. 2017; 20(2): 145–55. http://doi.org/10.1038/nn.4476

12. Adams J.B., Johansen L.J., Powell L.D., Quig D., Rubin R.A. Gastrointestinal flora and gastrointestinal status in children with autism-comparisons to typical children and correlation with autism severity. BMC Gastroenterol. 2011; (11): 22. http://doi.org/10.1186/1471-230X-11-22

13. Chaidez V., Hansen R.L., Hertz-Picciotto I. Gastrointestinal problems in children with autism, developmental delays or typical development. J. Autism Dev. Disord. 2014; 44(5): 1117–27. http://doi.org/10.1007/s10803-013-1973-x

14. Coury D.L., Ashwood P., Fasano A., Fuchs G., Geraghty M., Kaul A. et al. Gastrointestinal conditions in children with autism spectrum disorder: developing a research agenda. Pediatrics. 2012; 130(Suppl.2): 160–8. http://doi.org/10.1542/peds.2012-0900N

15. Bavykina I.A., Zvyagin A.A., Gusev K.Yu., Panina O.A. Disturbances of food behavior in children with autism spectrum disorders. Lechashchiy vrach. 2019; (3): 72. (in Russian)

16. McElhanon B.O., McCracken C., Karpen S., Sharp W.G. Gastrointestinal symptoms in autism spectrum disorder: a meta-analysis. Pediatrics. 2014; 133(5): 872–83. http://doi.org/10.1542/peds.2013-3995

17. Holingue C., Newill C., Lee L., Pasricha P.J., Fallin M.D. Gastrointestinal symptoms in autism spectrum disorder: a review of the literature on ascertainment and prevalence. Autism Res. 2018; 11(1): 24–36. http://doi.org/10.1002/aur.1854

18. Frazier T.W., Strauss M., Klingemier E.W., Zetzer E.E., Hardan A.Y., Eng C., et al. A meta-analysis of gaze differences to social and nonsocial information between individuals with and without autism. J. Am. Acad. Child Adolesc. Psychiatry. 2017; 56(7): 546–55. http://doi.org/10.1016/j.jaac.2017.05.005

19. Muhle R., Trentacoste S.V., Rapin I. The genetics of autism. Pediatrics. 2004; 113(5): e472–e486. http://doi.org/10.1542/peds.113.5.e472

20. Bilder D., Pinborough-Zimmerman J., Miller J., McMahon W. Prenatal, perinatal and neonatal factors associated with autism spectrum disorders. Pediatrics. 2009; 123(5): 1293–300. http://doi.org/10.1038/pr.2018.23

21. Campbell D.J., Chang J., Chawarska K. Early generalized overgrowth in autism spectrum disorder: prevalence rates, gender effects, and clinical outcomes. J. Am. Acad. Child Adolesc. Psychiatry. 2014; 53(10): 1063–73.e5. http://doi.org/10.1016/j.jaac.2014.07.008

22. Gardener H., Spiegelman D., Buka S.L. Perinatal and neonatal risk factors for autism: a comprehensive meta-analysis. Pediatrics. 2011; 128(2): 344–55. http://doi.org/10.1542/peds.2010-1036

23. Wu S., Wu F., Ding Y., Hou J., Bi J., Zhang Z. Advanced parental age and autism risk in children: a systematic review and meta-analysis. Acta Psychiatr. Scand. 2017; 135(1): 29–41. http://doi.org/10.1111/acps.12666