exudates and Autism-Spectrum-Disorder

Caregivers are directly involved in managing the daily basic needs of children with autism spectrum disorder (ASD). The knowledge and attitudes of these caregivers are important to achieving success in their roles. Thus, this study aimed to determine what constitutes good knowledge, attitudes, and associated factors among caregivers toward children with ASD.. A cross-sectional study was conducted among 128 caregivers of children with ASD in Kota Bharu, Kelantan from May to August 2020, using convenience sampling. Validated questionnaires were used to assess the knowledge and attitudes toward children with ASD. The data were analyzed using SPSS version 24. Descriptive statistics and simple and multiple logistic regression analyses were then performed.. The response rate was 100%. The proportion of good knowledge and attitudes toward children with ASD among caregivers was 85.1% and 88.3%, respectively. Factors significantly associated with good knowledge were being female (OR (95% CI) 2.79 [0.99-7.90]) and ASD children being non-first-born children (OR (95% CI) 0.41 [0.15-1.12]). Factors significantly associated with good attitudes were age of 30 years and older (OR (95% CI) 0.13 [0.03-0.62]) and caregiver having other children with other types of learning difficulties (OR (95% CI) 0.15 [0.04, 0.52]).. The proportion of caregivers with good knowledge of ASD and good attitudes toward children with ASD was high. The caregiver's age and sex, the position of the ASD child among the siblings, and the presence of other types of learning disorders in the family need to be considered when managing children with ASD.

Topics: Adult; Autism Spectrum Disorder; Caregivers; Child; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male

The presence of aluminium (Al) in the human body may impact brain neurodevelopment and function, and it is thought to contribute to autism spectrum disease (ASD). The main objective of this study was to assess the association between urinary Al and the development of ASD among Malaysian preschool children in the urban city of Kuala Lumpur.. This was an unmatched case-control study in which children with ASD were recruited from an autism early intervention center and typically developed (TD) children were recruited from government-run nurseries and preschools. Urine samples were collected at home, assembled temporarily at study locations, and transported to the laboratory within 24 h. The Al concentration in the children's urine samples was determined using inductively coupled plasma mass spectrometry (ICP-MS).. A total of 155 preschool children; 81 ASD children and 74 TD children, aged 3 to 6 years, were enlisted in the study. This study demonstrated that ASD children had significantly higher urinary Al levels than TD children (median (interquartile range (IQR): 2.89 (6.77) µg/dL versus 0.96 (2.95) µg/dL) (. A higher urine Al level was discovered to be a significant risk factor for ASD among preschool children in the urban area of Kuala Lumpur, Malaysia.

Topics: Aluminum; Autism Spectrum Disorder; Case-Control Studies; Child, Preschool; Gas Chromatography-Mass Spectrometry; Humans; Malaysia; Male

Sibling relationships remain understudied in typically developing adolescents who have siblings with autism spectrum disorder (ASD). This study explored the lived experiences and perceptions of adolescents who have a brother or a sister with a diagnosis of ASD using semi-structured interviews. Using thematic analysis, the participants reported having difficulties communicating with their siblings. Feeling a mixture of emotions was common when interacting with their siblings with ASD and emotional self-regulation was a typical coping strategy utilized by these adolescents. Despite the challenges, having a sibling with ASD led to closer relationships between the siblings. These findings offer insights into these adolescents' needs and how they may be best supported, informing the practice of speech-language pathology and other health professions.

Topics: Adolescent; Autism Spectrum Disorder; Child; Emotions; Humans; Malaysia; Male; Sibling Relations; Siblings

The autism-spectrum quotient (AQ) measures autistic traits and has been studied in different countries, sometimes with the English version, and sometimes with translated versions. However, the language of the questionnaire might influence non-native English speakers' answering tendency. In the current study we compared the responses on the AQ of multilingual Malaysians (96 participants filled out the AQ in English and Mandarin, and 79 participants filled out English and Bahasa Malaysia). Participants scored higher on the English AQ compared to the Mandarin AQ, whereas there was no difference between the English and Bahasa Malaysia AQ score. Analysis of the response style suggests the same person might display discrepant response styles in different languages, which seems to be related to language proficiency.

Topics: Autism Spectrum Disorder; Autistic Disorder; Humans; Language; Malaysia; Multilingualism

The prevalence of Autism Spectrum Disorder (ASD) has been increasing for the past two decades. Parents with autism have been known to be at risk of psychological distress and maladaptation, but many parents were able to overcome this adversity and lead to a good quality of life.. In-depth interviews were conducted among 21 parents of children with ASD. Interviews were transcribed and evaluated using thematic analysis.. The analysis discovered three main themes: acceptance and positive outlook, reaching for helping hands, and understanding autism and finding its solutions.. Although the findings cannot be generalised to other populations with ASD, this study provides a detailed perspective on their unique coping strategies. Insights gained from this study could help health care providers, authorities, and communities to address a specific need and able to advocate relevant support measures to assist them.

Topics: Adaptation, Psychological; Autism Spectrum Disorder; Child; Humans; Malaysia; Psychological Distress; Quality of Life

The main objective of this study was to determine the prevalence of Autism Spectrum Disorder (ASD) in Down Syndrome (DS) children attending the DS clinic at Child Development Centre Universiti Kebangsaan Malaysia Medical Centre (CDC-UKMMC) and to assess the appropriateness of using an M-CHAT as an ASD screener in this population. We traced the karyotype results of our study population from their medical record and compared this to study participant with a dual diagnosis of Down Syndrome- Autism Spectrum Disorder (DS-ASD). Lastly, we assessed the awareness among parents attending our DS follow up clinic regarding the possibility of an ASD diagnosis in DS children.. This a single-centre cross-sectional study among DS children aged 18-60 months who attend the DS follow up clinic in UKMMC. Overall, 24 children were recruited to our study. The accompanying parent was given the Modified Checklist for Autism in Toddlers (M-CHAT) questionnaire and a data collection sheet prior to their consultation. The chromosomal study was traced from their medical case notes. Children that were eligible for the study had their development assessed using the tool Schedule of Growing Skills II. The diagnosis of ASD was determined by the attending paediatrician using The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) criteria.. The prevalence of dual diagnoses DS-ASD in our study population was 4.2%. Using M-CHAT as a screener, 8 children failed the M-CHAT, of whom only one was diagnosed with ASD. None of the children that passed the MCHAT was diagnosed with ASD. Only 17 chromosomal study results were available for analysis, 2 children had mosaic DS whereas the remaining was caused by non-disjunction; the only DS-ASD patient had non-disjunction. Regarding parental awareness of dual diagnoses of ASD and DS, about 60% of the parents attending UKMMC clinic were aware of the possibility of ASD-DS diagnosis.. Our results suggest that ASD prevalence in our DS study population is consistent with those previously reported, and that paediatricians managing DS children should be aware of the dual diagnoses of ASD and DS when managing these patients. Even though, we are unable to make a definitive conclusion regarding the use of M-CHAT in this population of children due to the very small sample size, possibly a multi-centre research in the future may help elucidate this issue.

Topics: Autism Spectrum Disorder; Child Development; Cross-Sectional Studies; Down Syndrome; Humans; Malaysia; Prevalence

Lead (Pb) is a heavy metal which is abundant in the environment and known to cause neurotoxicity in children even at minute concentration. However, the trace elements calcium (Ca), magnesium (Mg), zinc (Zn) and iron (Fe) are essential to children due to its protective effect on neurodevelopment. The primary objective of this study was to assess the role of Pb and trace elements in the development of autism spectrum disorder (ASD) among preschool children. A total of 81 ASD children and 74 typically developed (TD) children aged between 3 and 6 years participated in the study. Self-administered online questionnaires were completed by the parents. A first-morning urine sample was collected in a sterile polyethene urine container and assayed for Pb, Ca, Mg, Zn and Fe using an inductively coupled plasma mass spectrometry (ICP-MS). Comparisons between groups revealed that the urinary Pb, Mg, Zn and Fe levels in ASD children were significantly lower than TD children. The odds of ASD reduced significantly by 5.0% and 23.0% with an increment of every 1.0 μg/dL urinary Zn and Fe, respectively. Post interaction analysis showed that the odds of ASD reduced significantly by 11.0% and 0.1% with an increment of every 1.0 μg/dL urinary Zn and Pb, respectively. A significantly lower urinary Pb level in ASD children than TD children may be due to their poor detoxifying mechanism. Also, the significantly lower urinary Zn and Fe levels in ASD children may augment the neurotoxic effect of Pb.

Topics: Autism Spectrum Disorder; Case-Control Studies; Child; Child, Preschool; Humans; Lead; Malaysia; Trace Elements

Emotion Regulation Checklist (ERC) has been used globally and translated to several languages, including Brazilian Portuguese, Italian and Persian. The aim of this study is to translate and validate ERC to the Malay language and to measure the reliability and validity of the translated version of this scale among Malaysian parents.. This study involved forward and back translation method. The translated questionnaire was then pretested and piloted among 10 parents and 50 participants, respectively. The procedure was repeated using the same questionnaire to evaluate the test-retest reliability.. The ERC-Malay (ERC-M) has excellent qualitative and quantitative measurements in both item-level content validation index (I-CVI) and scale-level content validation index (S-CVI). In addition, the ERC-M demonstrated good internal consistency from Cronbach's alpha and test-retest reliability based on the Intraclass Correlation Coefficient (ICC) in all domains.. ERC-M can potentially be used as a tool to evaluate emotion for the population with emotional dysregulation issue, such as autism spectrum disorder.

Topics: Autism Spectrum Disorder; Checklist; Cross-Cultural Comparison; Emotional Regulation; Humans; Language; Malaysia; Reproducibility of Results; Surveys and Questionnaires

Topics: Autism Spectrum Disorder; Autistic Disorder; Child; Child Development Disorders, Pervasive; Friends; Humans; Malaysia; Social Skills

Many parents have experienced difficulties in parenting children with autism. We, therefore, consider a more in-depth understanding that is necessary to explore the challenges facing parents and families to provide a better outcome for both. We interviewed 21 parents of 24 children with autism spectrum disorder (ASD) to qualitatively explore the challenges they experienced through a phenomenological framework. Four main aspects emerged as challenges to the parents: inadequate knowledge, psychological distress and stigma, lack of support, and barriers to services. These four themes reflect a lack of balance between the needs of caregivers and the services and resources or support available in the community to meet those needs. Our study contributes to an understanding of how parents perceive challenges, making it easier to take necessary action to meet their needs and ease their burden of stress. A concerted effort is needed to coordinate services across all disciplines to address these challenges.

Topics: Autism Spectrum Disorder; Autistic Disorder; Caregivers; Child; Humans; Malaysia; Parenting

Children with Autism Spectrum Disorder (ASD) of different levels of symptom severity may exhibit a wide range of behaviours and characteristics. There is a limited nutrition-related study on children with ASD of different severity in Malaysia.. This cross-sectional study aims to determine the association between sociodemographic factors, parental factors, and lifestyle factors with autism severity in children with ASD.. A total of 224 children with ASD were included in this study. Their mothers completed a self-administered questionnaire on sociodemographic characteristics, autism severity, parenting style, parental feeding practices, parenting stress, child's sleep habits and eating behaviours.. As high as 78.1 % of the children with ASD demonstrated a high level of autism severity. Multiple linear regression showed that father's employment status (B = 6.970, 95 % CI = 3.172, 10.768, p < 0.001) and perceived child weight (B = 3.338, 95 % CI = 1.350, 5.327, p = 0.001) predicted autism severity.. Children with ASD in this study had a high level of autism severity. Regular anthropometric measurements by healthcare professionals should be conducted at the autism intervention centres. It is important to have multidisciplinary collaboration in future research to develop customised guidelines for parents with autistic children.

Topics: Adult; Autism Spectrum Disorder; Autistic Disorder; Body Weight; Child; Child, Preschool; Employment; Fathers; Feeding Behavior; Feeding Methods; Female; Humans; Linear Models; Malaysia; Male; Maternal Behavior; Mothers; Parenting; Severity of Illness Index; Sleep; Stress, Psychological

This study explored the relationship between self-perceived stigmatization (affiliate stigma), stress and quality of life among parents of children with autism spectrum disorder (ASD).. Participants (N = 110) filled-in the Affiliate Stigma Scale, the Caregiver Burden Inventory and the CarerQOL scale.. Parents reported low scores on stigma and fair levels of stress and quality of life, indicating that parents do not feel stigmatized by affiliation with a child with ASD nor are they stressed from affiliate stigma. After controlling for demographic factors, both the relationships of affiliate stigma with stress and with quality of life were weak, indicating that stigma may have little to no effect on stress and quality of life.. Cultural and religious beliefs may play a part in the acceptance of a child's condition, resulting in less impact of stigma on the parents.

Topics: Adult; Asian People; Autism Spectrum Disorder; Child; Female; Humans; Malaysia; Male; Middle Aged; Parents; Quality of Life; Self Concept; Social Stigma; Stress, Psychological; Young Adult

Parents' use of complementary health approaches (CHA) for children with autism spectrum disorder (ASD) are common despite the uncertain evidence of its benefit. Parents often adopt CHA due to dissatisfaction with conventional treatment. This study aimed to examine parents' satisfaction with ASD treatment and their perception of progress in their child's development. Parents' use of CHA among children with ASD and the factors related were also evaluated.. Self-administered questionnaires were completed by 48 parents of children with ASD at a single tertiary referral hospital in Malaysia. Correlation analysis was used to explore associations between parental satisfaction scores, perception of progress scores and use of CHA.. Use of CHA was reported by parents for 35.4% of children with ASD in the sample. Parents who were less satisfied with conventional treatment and parents who perceived poorer progress in their child's development were more likely to use CHA. Strong positive relationship was found between parent satisfaction with ASD treatment scores and parent perception of progress scores, which indicates that parents who were satisfied with treatment were more likely to perceive greater progress in their child's development. Improvement in child's progress was most appreciated by parents in their child's behavior (85.5%), social skills (83.3%) and motor skills (77.1%).. The use of CHA was common among children with ASD. Parents were more likely to practice CHA when they were less satisfied with conventional treatment and perceived poorer progress. A larger multicenter study is required to further explore the practice of CHA among children with ASD throughout Malaysia.

Topics: Adolescent; Adult; Autism Spectrum Disorder; Child; Child Behavior; Child, Preschool; Complementary Therapies; Cross-Sectional Studies; Female; Humans; Infant; Malaysia; Male; Middle Aged; Parents; Personal Satisfaction; Social Skills; Surveys and Questionnaires; Treatment Outcome

To explore socio-demographics and clinical characteristics of children with Autism Spectrum Disorder (ASD) at Child Development Clinic (CDC), Penang Hospital.. A record review study of 331 children with ASD attending CDC, Penang Hospital from September 2013 to April 2017.. Out of 331 children with ASD, 82.5% were males, 17.5% females, with male to female ratio of 4.7:1. Mean age at consultation was 5 years and 6 months (SD 31.68 months) with age range from 19 months to 18 years and 4 months. 85.8% were term infants with normal birth weight. History of speech regression was noted in 14.8%, epilepsy and genetic disorders in 9.4% and 5.7% respectively. Sleep problems was reported in 29.3%, dietary issues 22.1%, challenging behaviour 24.2% and ADHD 14.2%. Mean age of the father and mother at birth was 33.6 and 31.6 years respectively.. In this study, we report a higher male to female ratio and mean age at referral with some similar rates of neurodevelopmental and medical comorbidities and relatively younger parental age with higher parental education levels.

Topics: Adolescent; Adult; Autism Spectrum Disorder; Child; Child Development; Child, Preschool; Female; Follow-Up Studies; Hospitals; Humans; Infant; Malaysia; Male; Mass Screening; Middle Aged; Parents; Pilot Projects; Prevalence; Retrospective Studies; Sex Distribution; Sex Factors; Socioeconomic Factors

Caregivers of children with autism spectrum disorder (ASD) experience increased stress and more significant negative caregiving consequences than those with typically developing children. There is a lack of studies specifically focusing on stress among caregivers with ASD children in Asian countries. The current study examines levels of perceived stress and factors associated with it among caregivers in Kelantan, Malaysia.. In a cross-sectional study, the Malay version of the Perceived Stress Scale (PSS) was administered to 227 caregivers of children with ASD. The caregivers were recruited from ASD databases in four tertiary hospitals in Kelantan and a meeting was set up during the child's follow-up in the clinic. Multiple linear regression analyses were applied to determine the predictors of perceived stress.. The mean total perceived stress score was 20.84 (4.72). This was considered higher than average. Higher perceived stress was significantly predicted among caregivers who live far from the health institution, caregivers who do not own transportation to bring the child to the treatment center, and caregivers who have an ASD child with a learning disability.. Caregivers of an ASD child perceived significant stress while taking care of their children. Institutions should alleviate the factors that were predicted to increase the caregivers' perceived stress to improve the quality of the lives of children and ASD families as a whole.

Topics: Adaptation, Psychological; Adolescent; Adult; Autism Spectrum Disorder; Caregivers; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Middle Aged; Psychometrics; Stress, Psychological

This study determined the accuracy of Modified Checklist for Autism in Toddlers (M-CHAT) in detecting toddlers with autism spectrum disorder (ASD) and other developmental disorders (DD) in community mother and child health clinics. We analysed 19,297 eligible toddlers (15-36 months) who had M-CHAT performed in 2006-2011. Overall sensitivities for detecting ASD and all DD were poor but better in the 21 to <27 months and 27-36-month age cohorts (54.5-64.3%). Although positive predictive value (PPV) was poor for ASD, especially the younger cohort, positive M-CHAT helped in detecting all DD (PPV = 81.6%). This suggested M-CHAT for screening ASD was accurate for older cohorts (>21 months) and a useful screening tool for all DD.

Topics: Autism Spectrum Disorder; Checklist; Child, Preschool; Cohort Studies; Community Health Centers; Developmental Disabilities; Female; Humans; Infant; Malaysia; Male; Mass Screening; Retrospective Studies

A Malay version of Parent Satisfaction Scale (PSS-M) is needed to investigate the factors contributing to the Malay caregivers' satisfaction with health care management for children with autism spectrum disorder (ASD). The aim of the study is to translate and validate the questionnaire to assess the caregivers' satisfaction on health care services.. A cross-sectional study was conducted among 110 caregivers of children with ASD aged between 2 and 17 years old that received treatment at two tertiary care centres in Kelantan. Permission to use the original version of the PSS questionnaire was obtained. The original English version of the PSS was translated into a Malay version following the 10 steps proposed by an established guideline. Pre-testing of the PSS was carried out with 30 caregivers before confirmatory factor analysis (CFA) was established using 110 caregivers. They were asked to assess their understanding of the questionnaire. The one-dimensional questionnaire consists of 11 items, including staff attitudes, availability of staff, supportiveness, and helpfulness. The 5-point Likert scale provided ratings from 1 (strongly disagree) to 5 (strongly agree). Confirmatory factor analysis was performed using a robust maximum likelihood estimator.. The analysis showed model fit data with good reliability.. The PSS-M shows overall model fitness based on specific indices, with good construct validity and excellent absolute reliability to determine the satisfaction level of caregivers of children with ASD with respect to health care services.

Topics: Adult; Autism Spectrum Disorder; Caregivers; Child; Factor Analysis, Statistical; Female; Health Services; Humans; Likelihood Functions; Malaysia; Male; Parents; Personal Satisfaction; Reproducibility of Results; Surveys and Questionnaires; Translations

Minimal information is known about the three-dimensional (3D) ground reaction forces (GRF) on the gait patterns of individuals with autism spectrum disorders (ASD). The purpose of this study was to investigate whether the 3D GRF components differ significantly between children with ASD and the peer controls. 15 children with ASD and 25 typically developing (TD) children had participated in the study. Two force plates were used to measure the 3D GRF data during walking. Time-series parameterization techniques were employed to extract 17 discrete features from the 3D GRF waveforms. By using independent t-test and Mann-Whitney U test, significant differences (p<0.05) between the ASD and TD groups were found for four GRF features. Children with ASD demonstrated higher maximum braking force, lower relative time to maximum braking force, and lower relative time to zero force during mid-stance. Children with ASD were also found to have reduced the second peak of vertical GRF in the terminal stance. These major findings suggest that children with ASD experience significant difficulties in supporting their body weight and endure gait instability during the stance phase. The findings of this research are useful to both clinicians and parents who wish to provide these children with appropriate treatments and rehabilitation programs.

Topics: Autism Spectrum Disorder; Biomechanical Phenomena; Child; Female; Gait; Humans; Imaging, Three-Dimensional; Malaysia; Male; Neurologic Examination; Postural Balance; Statistics as Topic; Walking