1. Adachi M, Takahashi M, Takayanagi N, Yoshida S, Yasuda S, Tanaka M, Osato-Kaneda A, Saito M, Kuribayashi M, Kato S, Nakamura K. {{Adaptation of the Autism Spectrum Screening Questionnaire (ASSQ) to preschool children}}. {PLoS One}. 2018; 13(7): e0199590.
The Autism Spectrum Screening Questionnaire (ASSQ) is equipped with good properties for screening the broader phenotype of autistic traits, but it is standardized for a limited age range-from 7 to 16 years. To contribute to the early detection of Autism Spectrum Disorder (ASD), particularly in high functioning children with ASD, likely to cause maladjustments during school age, the present study examined psychometric properties to apply the ASSQ to a younger age. We tested parents’ ASSQ ratings for preschool children in clinical (N = 154, average age 60.77 months, range 55-72 months) and community settings (N = 1390, average age 60.53 months, range 57-68 months) in Japan. The results showed, just as in school-aged children, the ASSQ had reliability and validity as a screening instrument for preschool children in community settings. A cut-off of 7 with sensitivity of 0.93 and specificity of 0.84 is recommended for community screening. Still, based on the current study with a clinical group, an optimal cut-off score with high sensitivity and high specificity for parents’ ASSQ ratings could not be established. The clinicians should be reminded that the ASSQ is a screening instrument, not a diagnosing instrument. Also, this result suggest multi-faceted evaluation is necessary in clinical settings, for example, the addition of teachers’ ratings.
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2. Bond EC, Oliphant RYK. {{Pervasive Refusal Syndrome in Autistic Spectrum Disorder}}. {Case reports in psychiatry}. 2018; 2018: 5049818.
Pervasive Refusal Syndrome (PRS) is a rare child psychiatric condition. We describe a case of PRS in a 9-year-old boy with a diagnosis of Autism Spectrum Disorder (ASD) presenting with severe weight loss due to extreme restriction of food and fluids. Other prominent symptoms included total mutism, school refusal, and self-neglect. He was admitted to a specialist Child and Adolescent Mental Health Unit. We discuss the symptoms present in this case and the differential diagnosis of ASD in PRS. Although this differential has briefly been considered one in previous case, there have been no reported cases of PRS with a prior diagnosis of ASD. We explore comorbidity and interaction of the two diagnoses. We discuss the possible impact of ASD as a predisposing factor upon the progression and prognosis of PRS.
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3. El-Saiedi SA, Agha HM, Shaltoot MF, Nassar HH, El Sisi AM, Attia WA, Sedky YM. {{ASD device closure in pediatrics: 3-Dimensional transthoracic echocardiography perspective}}. {Journal of the Saudi Heart Association}. 2018; 30(3): 188-97.
Objective: Real-time three-dimensional echocardiography, using both reconstruction methods and RT3D, has been used as an extra helping tool in several forms of congenital heart diseases. Our aim was to understand the relation of the ASD device to all surrounding structures by 3-dimensional echocardiography (3D). Methods: This prospective study included 37 patients diagnosed as ASD secundum by transthoracic (TTE) and transesophageal echocardiography (TEE) referred for transcatheter closure from October 2013 to July 2016. Follow-up for 1year using 2D and 3D-echocardiography was performed to assess the relations of the device to the surrounding structures. Results: Transcatheter ASD closure and echocardiographic examinations were successfully performed for all patients. By 3D echocardiography, 16 patients (43.24%) had their ASD device close to the aortico-mitral continuity plane without apparent regurgitation, while the rest of our patients (56.75%) the devices were away from this plane. The following variables were significantly different between the two groups; body surface area, atrioventricular rim (AV), device size, left disc size and ratio of left disc to interatrial septum. A cut-off AV rim length not less than 8mm was found optimal to avoid device encroachment on the sensitive surrounding structures. New Formula was constructed to aid in device choice. Conclusion: Use of 3D before and after ASD closure is of value to determine the device relation to the surrounding structures. AV rim by TEE is an important rim to avoid eventual encroachment on the mitral valve and aorta.
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4. Famitafreshi H, Karimian M. {{Overview of the recent advances in pathophysiology and treatment for Autism}}. {CNS & neurological disorders drug targets}. 2018.
Autism is a developmental disorder that manifests itself in early childhood. Autism is characterized by inability to acquire social skills, repetitive behaviors and failure of speech and nonverbal communication development. Recent studies have shown that genetic mutations occur in majority of individuals with autism. These mutations cause a variety of disorders that ultimately lead to brain disorders. It is noteworthy that all mutation do not follow the same pattern. They encompass various kinds of mutations. Autism needs be treated during childhood as untreated patients usually do not progress to the later stages of development. In this regard, many studies have been performed and numerous treatments have been proposed to improve the outcome of this disease. In this review, we have discussed new advancements made in understanding the pathophysiology of autism. Furthermore, we have also discussed new treatments which have been proposed and have successfully translated affected children. Overall, it is concluded that new advances have largely helped these patients.
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5. Farmer CA, Chilakamarri P, Thurm AE, Swedo SE, Holmes GL, Buckley AW. {{Spindle activity in young children with autism, developmental delay, or typical development}}. {Neurology}. 2018; 91(2): e112-e22.
OBJECTIVE: To determine whether spindle activity differs in young children with and without autism. METHODS: We investigated differences in spindle density, duration, and oscillatory features in 135 young children with autism, developmental delay without autism (DD), or typical development (TD) and secondarily assessed the dimensional relationship between spindle density and both cognitive ability and social functioning. RESULTS: Compared to TD, both spindle density (Cohen d 0.93, 95% confidence interval [CI] 0.49-1.37) and duration (Cohen d 0.58, 95% CI 0.15-1.01) were significantly decreased in autism. Spindle density was also significantly reduced in autism compared to DD (Cohen d 0.61, 95% CI 0.13-1.09). Decreased spindle frequency in autism compared to both TD (Cohen d 0.47, 95% CI 0.04-0.90) and DD (Cohen d 0.58, 95% CI 0.10-1.06) did not survive correction. The DD group did not differ significantly from the TD group on any spindle parameter. These results, suggesting a relationship between spindle density and autism but not DD, were further illustrated in exploratory analyses, wherein nonverbal ratio IQ (RIQ) and the Vineland Socialization domain standard score were strongly correlated with spindle density in the full sample (r = 0.33, p Lien vers le texte intégral (Open Access ou abonnement)
6. Kotha SB, AlFaraj NSM, Ramdan TH, Alsalam MA, Al Ameer MJ, Almuzin ZM. {{Associations between Diet, Dietary and Oral Hygiene Habits with Caries Occurrence and Severity in Children with Autism at Dammam City, Saudi Arabia}}. {Open Access Maced J Med Sci}. 2018; 6(6): 1104-10.
AIM: The purpose of the study is to achieve the baseline information of the autistic child’s oral health status about the diet, dietary and hygiene habits. The association of these factors with dental caries were assessed. MATERIAL AND METHODS: The survey was composed of self-administered questionnaires to parents about their children’s’ demographic data followed by questions related to diet, dietary and hygiene habits. This is later followed by oral examination for estimating the decayed, missing and filled [dmft] scores as per WHO norms. The variables are analysed using t-tests and ANOVA. Pearson’s correlation coefficients were calculated for each of the independent variables to examine for autocorrelation. RESULTS: The mean age for the present study is 5.8 years with more predilections of caries in females. The autistic children prefer soft diet and pouch it in oral cavity resulting in increased caries though not significant. Other foods like nuts and pulses confectioneries and soft drinks resulted in increased caries, and our study shows significant relation. Consumption of sugars between meals and increased quantity of sugar per day also increased dental caries with highly significant results in our study. Hygiene habits also made a difference in the occurrence of caries though, in our study, it’s not significant. CONCLUSIONS: The study suggests that the oral health education programs should be conducted for the parents, caregivers and the teachers about the diet, dietary and the hygiene habits and the role they play in maintaining the oral hygiene.
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7. Locke J, Anderson A, Frederick L, Kasari C. {{Understanding Friendship Sex Heterophily and Relational Characteristics to Optimize the Selection of Peer Models for Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2018.
This study used social network analysis to evaluate whether sex heterophily, the degree to which peers are different in sex, between 126 children with autism (ages 5-12 years) and their peers affected social network connectivity. Results indicate that: (1) the quantity and sex of friends were more important in predicting social network connectivity than the relational characteristics of the friends (friendship nominations and social network salience/popularity); and (2) sex heterophily is an important factor in predicting social network connectivity. For males with autism, having friends of the same sex was associated with better social network connectivity; this was not true for females with autism. These findings have important implications for the selection of peer models for elementary-aged children with autism.
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8. Marsack CN, Hopp FP. {{Informal Support, Health, and Burden Among Parents of Adult Children With Autism}}. {The Gerontologist}. 2018.
Background and Objectives: Many adults with autism spectrum disorders require lifelong reliance on caregiver support. As these caregivers age and experience health challenges, social support can be critical. This study seeks to understand if caregiver health moderates the relationship between informal social support and caregiver burden. Research Design and Methods: A total of 320 parents (age 50+ years) of adult children diagnosed with ASD were recruited from autism organizations and support groups and completed a web-based survey. Separate moderation analyses were used to determine if caregiver health was moderating the relationship between informal social support and composite caregiver burden, as well as the separate domains of developmental, time dependence, emotional burden, and impact of caregiving on finances. For each analysis, perceptions of available informal social support were the independent variable, composite and domains of caregiver burden were dependent variables, and parents’ self-reported general health was the moderating variable. Results: Caregiver health had a statistically significant moderating effect when predicting the relationships between informal social support and composite caregiver burden, as well as time dependence burden and impact of caregiving on finances. Discussion and Implications: Increased attention should be focused on supporting the current and future needs of both aging caregivers and their adult children with ASD. Future research on the dynamics of social support, health, and burden is also urgently needed to address the growing number of aging caregivers of adults diagnosed with ASD.
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9. Mazzoni A, Grove R, Eapen V, Lenroot RK, Bruggemann J. {{The promise of functional near-infrared spectroscopy in autism research: What do we know and where do we go?}}. {Social neuroscience}. 2018: 1-14.
Functional near-infrared spectroscopy (fNIRS) is a neuroimaging technique that has been gaining increasing interest as a method to investigate the brain function of individuals on the autism spectrum. It is a non-invasive, portable and relatively motion-tolerant method of measuring haemodynamic activity in the brain. fNIRS can be particularly effective for quantifying brain function in challenging clinical populations. In light of this, there is a growing body of fNIRS literature focusing on individuals on the autism spectrum. The aim of this review is to evaluate and summarise key studies from the literature and discuss their implications for the field. Potential limitations of the fNIRS approach and resolution of these issues based on emerging fNIRS research are also discussed.
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10. Ormstad H, Bryn V, Saugstad OD, Skjeldal O, Maes M. {{Role of the immune system in autism spectrum disorders (ASD)}}. {CNS & neurological disorders drug targets}. 2018.
BACKGROUND: The evidence base supports that multifactorial and complex immune interactions play a role in autism spectrum disorders (ASD), but contradictory findings are also reported. OBJECTIVE: The aim of this selective review was to identify trends in the research literature on this topic, focusing on immunology and other aberrations with respect to the different ASD subtypes. METHODS: This selective review is based on original and review articles written in English and identified in literature searches of PubMed. RESULTS: Several studies have found that the risk of ASD is greater among children whose mothers suffered from autoimmune diseases while pregnant. Moreover, individuals with ASD show increased levels of antibodies that are specific for several specific proteins. Studies also show that mothers of children with ASD have antibodies against fetal brain proteins. There are also reports on associations between increased levels of proinflammatory cytokines and ASD. Finally, infections in mothers during pregnancy are linked to an increased risk of ASD. CONCLUSION: We propose that the large inconsistencies in findings among studies in the field are due to differences in subdiagnoses among the included children with ASD. Well-phenotyped ASD samples are needed to understand the biological and immunological mechanisms underpinning ASD and its subdiagnoses. Future research should apply new strategies to scrutinize the link between ASD and changes in immune responsivity. Important new research avenues are to investigate the associations (a) between different ASD phenotypes and aberrations in (auto)immune pathways and (b) between reduced natural regulatory autoimmune responses during pregnancy, which are in turn associated with increased oxidative and nitrosative stress in maternal blood and putative detrimental effects in the offspring.
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11. Pandey S, Sharma C. {{Perceived Burden in Caregivers of Children with Autism Spectrum Disorder}}. {Journal of Nepal Health Research Council}. 2018; 16(2): 184-9.
BACKGROUND: Autism Spectrum Disorder is a lifelong developmental disorder that affects children and results in deficit in social interaction, communication and display of unusual pattern of behavior. Though caregiving is a normal parental duty, providing intensive care to a child with long-term problem is burdensome and impacts both physical and mental health of caregivers. The aim of this study was to obtain a picture of burden among caregivers raising children with Autism Spectrum Disorder. METHODS: We conducted a descriptive cross-sectional study to assess the burden of caregiving among sixty one parents of children with Autism Spectrum Disorder in the Kathmandu Valley, Nepal, using purposive sampling technique. The burden perceived by caregivers was assessed using standard tool Zarit Burden Interview-22. RESULTS: Average burden score was 41.49+/-12.25 which indicates that caregivers experienced moderate to severe range of burden. Level of education, anxiety and depression was found to be significantly associated with burden of caregiving. CONCLUSIONS: The study concluded that the burden of caregiving is most remarkably associated with emotional status and social life of the caregivers.
12. Pereira AM, Campos BM, Coan AC, Pegoraro LF, de Rezende TJR, Obeso I, Dalgalarrondo P, da Costa JC, Dreher JC, Cendes F. {{Differences in Cortical Structure and Functional MRI Connectivity in High Functioning Autism}}. {Frontiers in neurology}. 2018; 9: 539.
Autism spectrum disorders (ASD) represent a complex group of neurodevelopmental conditions characterized by deficits in communication and social behaviors. We examined the functional connectivity (FC) of the default mode network (DMN) and its relation to multimodal morphometry to investigate superregional, system-level alterations in a group of 22 adolescents and young adults with high-functioning autism compared to age-, and intelligence quotient-matched 29 healthy controls. The main findings were that ASD patients had gray matter (GM) reduction, decreased cortical thickness and larger cortical surface areas in several brain regions, including the cingulate, temporal lobes, and amygdala, as well as increased gyrification in regions associated with encoding visual memories and areas of the sensorimotor component of the DMN, more pronounced in the left hemisphere. Moreover, patients with ASD had decreased connectivity between the posterior cingulate cortex, and areas of the executive control component of the DMN and increased FC between the anteromedial prefrontal cortex and areas of the sensorimotor component of the DMN. Reduced cortical thickness in the right inferior frontal lobe correlated with higher social impairment according to the scores of the Autism Diagnostic Interview-Revised (ADI-R). Reduced cortical thickness in left frontal regions, as well as an increased cortical thickness in the right temporal pole and posterior cingulate, were associated with worse scores on the communication domain of the ADI-R. We found no association between scores on the restrictive and repetitive behaviors domain of ADI-R with structural measures or FC. The combination of these structural and connectivity abnormalities may help to explain some of the core behaviors in high-functioning ASD and need to be investigated further.
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13. Rogozin IB, Gertz EM, Baranov P, Poliakov E, Schaffer AA. {{Genome-wide changes in protein translation efficiency are associated with autism}}. {Genome biology and evolution}. 2018.
We previously proposed that changes in the efficiency of protein translation are associated with autism spectrum disorders (ASDs). This hypothesis connects environmental factors and genetic factors because each can alter translation efficiency. For genetic factors, we previously tested our hypothesis using a small set of ASD-associated genes, a small set of ASD-associated variants, and a statistic to quantify by how much a single nucleotide variant (SNV) in a protein coding region changes translation speed. In this study, we confirm and extend our hypothesis using a published set of 1800 autism quartets (parents, one affected child and one unaffected child) and genome-wide variants. Then, we extend the test statistic to combine translation efficiency with other possibly relevant variables: ribosome profiling data, presence/absence of CpG dinucleotides, and phylogenetic conservation. The inclusion of ribosome profiling abundances strengthens our results for male-male sibling pairs. The inclusion of CpG information strengthens our results for female-female pairs, giving an insight into the significant gender differences in autism incidence. By combining the single-variant test statistic for all variants in a gene, we obtain a single gene score to evaluate how well a gene distinguishes between affected and unaffected siblings. Using statistical methods, we compute gene sets that have some power to distinguish between affected and unaffected siblings by translation efficiency of gene variants. Pathway and enrichment analysis of those gene sets suggest the importance of Wnt signaling pathways, some other pathways related to cancer, ATP binding, and ATP-ase pathways in the etiology of ASDs.
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14. Sagiv SK, Harris MH, Gunier RB, Kogut KR, Harley KG, Deardorff J, Bradman A, Holland N, Eskenazi B. {{Erratum: « Prenatal Organophosphate Pesticide Exposure and Traits Related to Autism Spectrum Disorders in a Population Living in Proximity to Agriculture »}}. {Environmental health perspectives}. 2018; 126(7): 079001.
[This corrects the article DOI: 10.1289/EHP2580.].
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15. Sharp WG, Postorino V, McCracken CE, Berry RC, Criado KK, Burrell TL, Scahill L. {{Dietary Intake, Nutrient Status, and Growth Parameters in Children with Autism Spectrum Disorder and Severe Food Selectivity: An Electronic Medical Record Review}}. {Journal of the Academy of Nutrition and Dietetics}. 2018.
BACKGROUND: Food selectivity is common in children with autism spectrum disorder (ASD). The clinical characteristics, however, of severe food selectivity in children with ASD is not well documented. OBJECTIVE: This study examined the demographic characteristics, anthropometric parameters, risk of nutritional inadequacy, dietary variety, and problematic mealtime behaviors in a sample of children with ASD with severe food selectivity. DESIGN: The study involved a cross-sectional electronic medical record review. Data extraction followed a systematic protocol for data extraction. PARTICIPANTS/SETTING: Children (age 2 to 17 years) with ASD, severe food selectivity, and complete nutritional data who received a multidisciplinary evaluation at a specialty feeding clinic in the southeastern United States between January 2014 and January 2016. Criteria for severe food selectivity used in this clinical practice required complete omission of one or more food groups (eg, fruit, vegetable, protein, grain, dairy) or consuming a narrow range of items on a weekly basis (eg, five or fewer total food items). MAIN OUTCOME MEASURES: Analyses examined demographic characteristics, dietary preferences, risk for nutritional inadequacies, anthropometric parameters, and problematic mealtime behaviors. RESULTS: Of the 279 patients evaluated during the 24-month period, 70 children with ASD and severe food selectivity met inclusion criteria. Caregivers reported 67% of the sample (n=47) omitted vegetables and 27% omitted fruits (n=19). Seventy-eight percent consumed a diet at risk for five or more inadequacies. Risk for specific inadequacies included vitamin D (97% of the sample), fiber (91%) vitamin E (83%), and calcium (71%). Children with five or more nutritional inadequacies (n=55) were more likely to make negative statements during meals (P<0.05). Severe food selectivity was not associated with compromised growth or obesity. CONCLUSION: Children with ASD and severe food selectivity may be at increased risk for nutritional inadequacies. Future research should examine causes, consequences, and remediation of severe food selectivity in this population. Lien vers le texte intégral (Open Access ou abonnement)
16. Steward R, Crane L, Mairi Roy E, Remington A, Pellicano E. {{« Life is Much More Difficult to Manage During Periods »: Autistic Experiences of Menstruation}}. {J Autism Dev Disord}. 2018.
Although menarche and menstruation are perceived to be overwhelmingly negative events for developmentally-disabled women, women’s health issues remain under-researched in autism. Here, we conducted a preliminary investigation of the experiences of post-menarcheal autistic (n = 123) and non-autistic (n = 114) respondents to a brief online survey. Although autistic respondents reported many overlapping issues and experiences with non-autistic respondents, they also highlighted distinct-and sometimes-distressing-issues relating to menstruation, especially a cyclical amplification of autistic-related challenges, including sensory differences and difficulties with regulating emotion and behavior, which had a significant, negative impact on their lives. These initial findings call for systematic research on the potential causes, correlates and consequences of menstrual-related problems in autistic individuals-across the spectrum and the lifespan.
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17. Van Cleave J, Holifield C, Neumeyer AM, Perrin JM, Powers E, Van L, Kuhlthau KA. {{Expanding the Capacity of Primary Care to Treat Co-morbidities in Children with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2018.
We examined barriers and facilitators to expanding primary care’s capacity to manage conditions associated with autism spectrum disorder (ASD). We conducted semi-structured interviews with specialists, primary care providers (PCPs), primary care staff, and parents of children with ASD, discussing health/behavior problems encountered, co-management, and patient/family experience. Participants endorsed primary care as the right place for ASD-associated conditions. Specialists advising PCPs, in lieu of referrals, efficiently uses their expertise. PCPs’ ability to manage ASD-associated conditions hinged on how behavioral aspects of ASD affected care delivery. Practices lacked ASD-specific policies but made individual-level accommodations and broader improvements benefitting children with ASD. Enhancing access to specialty expertise, particularly around ASD-associated behaviors, and building on current quality improvements appear important to expanding primary care.
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18. Van Herwegen J, Ashworth M, Palikara O. {{Parental views on special educational needs provision: Cross-syndrome comparisons in Williams Syndrome, Down Syndrome, and Autism Spectrum Disorders}}. {Res Dev Disabil}. 2018; 80: 102-11.
BACKGROUND: The current study examined parents’ views about their child’s educational provision for children with Williams syndrome (WS), Down syndrome (DS), and Autism Spectrum Disorders (ASD). AIMS: This cross-syndrome comparison explored the specific and general difficulties that parents of children with neurodevelopmental disorders experience about their child’s educational provision. METHODS AND PROCEDURES: Parents of children aged 4-18;11 years old, including 99 with WS, 88 with DS, and 82 with ASD completed a survey. OUTCOMES AND RESULTS: Children with DS were more likely to access mainstream settings and 1-to-1 support compared to those with WS and ASD. Parental satisfaction was lowest for those with ASD but all parents mentioned concerns about professionals’ knowledge of how to support children with special educational needs and disabilities (SEND). There were also group differences for access to specialist support but overall access to occupational therapy and mental health was low. CONCLUSIONS AND IMPLICATIONS: In contrast to previous studies, educational provision and satisfaction with educational provision are syndrome-specific. These results also highlight the need for training and raising awareness about the specific needs of children with neurodevelopmental disorders. In addition, our findings suggest improved communication between parents and the school is required about the type of support children with SEND are receiving.
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19. Wei HT, Hsu JW, Huang KL, Bai YM, Su TP, Li CT, Lin WC, Tsai SJ, Pan TL, Chen TJ, Chen MH. {{Timing of the Diagnoses of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Taiwan}}. {J Autism Dev Disord}. 2018.
ADHD comorbidity has been associated with delayed diagnosis of ASD, but no study has investigated this association in an Asian country. Children with ASD were included and divided into three groups: ADHD before ASD, ADHD same/after ASD, and ASD only. Timing of ASD and ADHD diagnoses were assessed. The logistic regression model was performed to investigate the likelihood of being diagnosed with ASD after 6 years of age between three groups. ADHD before ASD (OR 10.93) group was more likely to being diagnosed with ASD after 6 years of age compared with ADHD same/after ASD (OR: 1.37) and ASD only groups. ADHD comorbidity would delay the diagnosis of ASD in the general clinical settings in Taiwan.
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20. Yau CH, Ip CL, Chau YY. {{The therapeutic effect of scalp acupuncture on natal autism and regressive autism}}. {Chinese medicine}. 2018; 13: 30.
Background: Autism spectrum disorders (ASD) is a common disease and the incidence has been rising constantly. Acupuncture is one of the most widely used complementary and alternative medicine therapies. Despite studies had been done on the effectiveness of acupuncture on ASD children, how factors such as chronological age and the onset pattern influence the effectiveness of the therapy remains unclear. The aim of this retrospective study is to know how symptomatology of ASD alters upon the introduction of scalp acupuncture and how do age and onset type affect the effectiveness of the therapy. Methods: ASD children aged 2-11 years old were invited to join the study. In the course of the investigation, they received a total of 30 sessions of scalp acupuncture therapy. They were then evaluated to compare the performance on various aspects before and after the treatment. The influence on the therapeutic effect by factors including chorological age and onset pattern were further taken into consideration and analyzed. In addition, investigation on the relationship between allergies and onset pattern of ASD was performed by statistically analyzing the received epidemiologic data from the participants. Results: 68 children with ASD participated in the study. It is found that the significant effective rate of scalp acupuncture on ASD is 97%. Scalp acupuncture can improve verbal communication problems the most while noise sensitivity improves the least. The therapeutic effectiveness decreases with increasing age and children with natal autism benefit more from acupuncture than those with regressive autism. In the latter part of the study, we observe a positive correlation between the family history of allergy and onset pattern. Conclusion: Scalp acupuncture is an effective treatment for alleviating the symptomatology of ASD. The therapeutic effectiveness is expected to be higher for those patients with natal or early onset of the disorder, and at a younger age when they receive the therapy. The study result helps to formulate an ideal regimen for ASD patients and allow therapists and parents to make appropriate expectation towards the therapeutic outcome of acupuncture. Early intervention of scalp acupuncture therapy recommended. The relationship between the family history of allergic disorder and the onset type of ASD hints that the etiologies of natal and regressive ASD are discrete. It shows a great significance in differentiating the onset pattern in carrying out clinical assessments or researches on ASD patients.Trial registration This retrospective study was approved by the Committee on the Use of Human and Animal Subjects in Teaching and Research, Hong Kong Baptist University on 4th Aug 2017. The retrospectively registered number is HASC/Student/17-18/0115.
