Neonatal Risk Factors for ASD and ADHD and Therapeutic Regimens for their Management in Children and Adolescent
DOI:
https://doi.org/10.32007/jfacmedbagdad.6612026Keywords:
Autism Spectrum Disorder; , Attention Deficit Hyperactivity Disorder; , Neurodevelopment Disorders,, Risk factors;Abstract
Background: Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both neurodevelopmental disorders that affect children early in life. Both conditions have a complicated origin.
Objectives: This study aims to evaluate the neonatal complications linked with ASD and ADHD and to outline the utilization of psychotropic medications in the management of children and adolescents with ASD.
Methods: This study was conducted from January to April 2022 at the National Center for Autism/Medical City Complex in Baghdad. It involved 120 children with neurodevelopmental disorders and 120 control participants. A questionnaire was used to collect the data, which was then analyzed using SPSS 25.
Results: Five perinatal factors have significant associations with child behavioral disorders, as indicated by a P-value of less than 0.05. These factors are Low birth weight (LBW), newborn complications, preterm birth, being the last child, and children delivered via a cesarean section. Additionally, the types of behavioral disorders have significant associations with the use of psychotropic medications. Around 50% of children with both ASD and ADHD, as well as children with ADHD alone, have used psychotropic medications. By comparison, only about 27% of children with ASD have used these medications.
Conclusions: Neonatal risk factors may be linked to neurodevelopmental disorders. Medications are used to manage ASD and ADHD in children and youth.
Received: Nov,, 2022
Accepted: Nov, 2023
Published: Jan..2024
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References
Nijmeijer JS, Hoekstra PJ, Minderaa RB, Buitelaar JK, Altink ME, Buschgens CJM, et al. PDD symptoms in ADHD, an independent familial trait? J Abnorm Child Psychol. 2009;37(3):443–53. https://doi.org/10.1007/s10802-008-9282-0
Okyar E, Görker I. Examining the autistic traits in children and adolescents diagnosed with attention-deficit hyperactivity disorder and their parents. BMC Psychiatry. 2020;20(1):1–11. https://doi.org/10.1186/s12888-020-02703-z
Mulligan A, Anney RJL, O’Regan M, Chen W, Butler L, Fitzgerald M, et al. Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry. 2010;19(3):281–95. https://doi.org/10.1007/s00787-010-0092-x
Baron-Cohen S, Lombardo M V, Auyeung B, Ashwin E, Chakrabarti B, Knickmeyer R. Why are autism spectrum conditions more prevalent in males? PLoS Biol. 2011;9(6):e1001081.
https://doi.org/10.1371/journal.pbio.1001081
Tonge BJ, Bull K, Brereton A, Wilson R. A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: the core components of effective programs, child-focused interventions and comprehensive treatment models. Curr Opin Psychiatry. 2014;27(2):158–65. https://doi.org/10.1097/YCO.0000000000000043
Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatr Assoc. 2013;21(21):591–643. http://www.hakjisa.co.kr/common_file/bbs_DSM-5_Update_October2018_NewMaster.pdf
Schopler E, Van Bourgondien M, Wellman J, Love S. Childhood autism rating scale—Second edition (CARS2): Manual. Los Angeles West Psychol Serv. 2010. https://institutopod.com.br/wp-content/uploads/2019/11/cars-miguel-1-1.pdf
Qiu S, Lu Y, Li Y, Shi J, Cui H, Gu Y, et al. Prevalence of autism spectrum disorder in Asia: A systematic review and meta-analysis. Psychiatry Res. 2020;284:112679. https://doi.org/10.1016/j.psychres.2019.112679
Werling DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol. 2013;26(2):146. https://doi.org/10.1097/WCO.0b013e32835ee548
Baron-Cohen S. The extreme male brain theory of autism. Trends Cogn Sci. 2002;6(6):248–54. https://doi.org/10.1016/S1364-6613(02)01904-6
Arnold AP. Sex chromosomes and brain gender. Nat Rev Neurosci. 2004;5(9):701–8. https://doi.org/10.1038/nrn1494
Singh GK, Kenney MK, Ghandour RM, Kogan MD, Lu MC. Mental Health Outcomes in US Children and Adolescents Born Prematurely or with Low Birthweight. Berk M, editor. Depress Res Treat [Internet]. 2013;2013:570743. Available from: https://doi.org/10.1155/2013/570743
Haglund NGS, Källén KBM. Risk factors for autism and Asperger syndrome: perinatal factors and migration. Autism. 2011;15(2):163–83. https://doi.org/10.1177/1362361309353614
Lozada LE, Nylund CM, Gorman GH, Hisle-Gorman E, Erdie-Lalena CR, Kuehn D. Association of autism spectrum disorders with neonatal hyperbilirubinemia. Glob Pediatr Heal. 2015;2: https://doi.org/10.1177/2333794X15596518
Libbey JE, Sweeten TL, McMahon WM, Fujinami RS. Autistic disorder and viral infections. J Neurovirol. 2005;11(1):1–10.
https://doi.org/10.1080/13550280590900553
Rennie JM, Hagmann CF, Robertson NJ. Outcome after intrapartum hypoxic ischaemia at term. In: Seminars in Fetal and Neonatal Medicine. Elsevier; 2007. p. 398–407. https://doi.org/10.1016/j.siny.2007.07.006
Kroll J, Froudist-Walsh S, Brittain PJ, Tseng C-EJ, Karolis V, Murray RM, et al. A dimensional approach to assessing psychiatric risk in adults born very preterm. Psychol Med. 2018;48(10):1738–44. https://doi.org/10.1017/S0033291717003804
Nawaz FA, Sultan MA. Low Birth Weight Prevalence in Children Diagnosed with Neurodevelopmental Disorders in Dubai. Glob Pediatr Heal. 2021;8:2333794X211031782. https://doi.org/10.1177/2333794X211031782
Ugur C, Tonyali A, Goker Z, Uneri OS. Birth order and reproductive stoppage in families of children with autism spectrum disorder. Psychiatry Clin Psychopharmacol [Internet]. 2019 Oct 2;29(4):509–14. Available from: https://doi.org/10.1080/24750573.2018.1457489
Gardener H, Spiegelman D, Buka SL. Prenatal risk factors for autism: comprehensive meta-analysis. Br J psychiatry. 2009;195(1):7–14. https://doi.org/10.1192/bjp.bp.108.051672
Zhang T, Sidorchuk A, Sevilla-Cermeño L, Vilaplana-Pérez A, Chang Z, Larsson H, et al. Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: a systematic review and meta-analysis. JAMA Netw open. 2019;2(8):e1910236–e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236
Gialloreti LE, Benvenuto A, Benassi F, Curatolo P. Are caesarean sections, induced labor and oxytocin regulation linked to Autism Spectrum Disorders? Med Hypotheses. 2014;82(6):713–8. https://doi.org/10.1016/j.mehy.2014.03.011
Husarova VM, Lakatosova S, Pivovarciova A, Babinska K, Bakos J, Durdiakova J, et al. Plasma oxytocin in children with autism and its correlations with behavioral parameters in children and parents. Psychiatry Investig. 2016;13(2):174. https://doi.org/10.4306/pi.2016.13.2.174
Shabila NP. Trends and changes in cesarean delivery rates in Iraq: findings from the multiple indicator cluster surveys, 2011–2018. J Matern Neonatal Med. 2021;1–6. https://doi.org/10.1080/14767058.2021.1910664
Hyman SL, Levy SE, Myers SM, Kuo DZ, Apkon S, Davidson LF, et al. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1). https://doi.org/10.1542/9781610024716-part01-ch002
Alghuraibawi NA. Survey on different intervention modalities used for Iraqi children with ASD in clinical population. J Posit Sch Psychol. 2022;6(3):7654–60.https://journalppw.com/index.php/jpsp/article/view/4693
Pierce K, Courchesne E, Bacon E. To screen or not to screen universally for autism is not the question: Why the task force got it wrong. J Pediatr. 2016;176:182–94. https://doi.org/10.1016/j.jpeds.2016.06.004
Alsayouf HA, Talo H, Biddappa ML, De Los Reyes E. Risperidone or aripiprazole can resolve autism core signs and symptoms in young children: case study. Children. 2021;8(5):318. https://doi.org/10.3390/children8050318
Siegel M, Beaulieu AA. Psychotropic medications in children with autism spectrum disorders: a systematic review and synthesis for evidence-based practice. J Autism Dev Disord. 2012;42(8):1592–605. https://doi.org/10.1007/s10803-011-1399-2
Hirsch LE, Pringsheim T. Aripiprazole for autism spectrum disorders (ASD). Cochrane database Syst Rev. 2016 Jun;2016(6):CD009043. https://doi.org/10.1002/14651858.CD009043.pub3
Nguyen M, Tharani S, Rahmani M, Shapiro M. A review of the use of clonidine as a sleep aid in the child and adolescent population. Clin Pediatr (Phila). 2014;53(3):211–6. https://doi.org/10.1177/0009922813502123
Ming X, Gordon E, Kang N, Wagner GC. Use of clonidine in children with autism spectrum disorders. Brain Dev. 2008;30(7):454–60. https://doi.org/10.1016/j.braindev.2007.12.007
LeClerc S, Easley D. Pharmacological therapies for autism spectrum disorder: a review. Pharm Ther. 2015;40(6):389. PMID: 26045648
Spencer D, Marshall J, Post B, Kulakodlu M, Newschaffer C, Dennen T, et al. Psychotropic medication use and polypharmacy in children with autism spectrum disorders. Pediatrics. 2013;132(5):833–40. https://doi.org/10.1542/peds.2012-3774
References
Nijmeijer JS, Hoekstra PJ, Minderaa RB, Buitelaar JK, Altink ME, Buschgens CJM, et al. PDD symptoms in ADHD, an independent familial trait? J Abnorm Child Psychol. 2009;37(3):443–53. https://doi.org/10.1007/s10802-008-9282-0
Okyar E, Görker I. Examining the autistic traits in children and adolescents diagnosed with attention-deficit hyperactivity disorder and their parents. BMC Psychiatry. 2020;20(1):1–11. https://doi.org/10.1186/s12888-020-02703-z
Mulligan A, Anney RJL, O’Regan M, Chen W, Butler L, Fitzgerald M, et al. Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry. 2010;19(3):281–95. https://doi.org/10.1007/s00787-010-0092-x
Baron-Cohen S, Lombardo M V, Auyeung B, Ashwin E, Chakrabarti B, Knickmeyer R. Why are autism spectrum conditions more prevalent in males? PLoS Biol. 2011;9(6):e1001081.
https://doi.org/10.1371/journal.pbio.1001081
Tonge BJ, Bull K, Brereton A, Wilson R. A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: the core components of effective programs, child-focused interventions and comprehensive treatment models. Curr Opin Psychiatry. 2014;27(2):158–65. https://doi.org/10.1097/YCO.0000000000000043
Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatr Assoc. 2013;21(21):591–643. http://www.hakjisa.co.kr/common_file/bbs_DSM-5_Update_October2018_NewMaster.pdf
Schopler E, Van Bourgondien M, Wellman J, Love S. Childhood autism rating scale—Second edition (CARS2): Manual. Los Angeles West Psychol Serv. 2010. https://institutopod.com.br/wp-content/uploads/2019/11/cars-miguel-1-1.pdf
Qiu S, Lu Y, Li Y, Shi J, Cui H, Gu Y, et al. Prevalence of autism spectrum disorder in Asia: A systematic review and meta-analysis. Psychiatry Res. 2020;284:112679. https://doi.org/10.1016/j.psychres.2019.112679
Werling DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol. 2013;26(2):146. https://doi.org/10.1097/WCO.0b013e32835ee548
Baron-Cohen S. The extreme male brain theory of autism. Trends Cogn Sci. 2002;6(6):248–54. https://doi.org/10.1016/S1364-6613(02)01904-6
Arnold AP. Sex chromosomes and brain gender. Nat Rev Neurosci. 2004;5(9):701–8. https://doi.org/10.1038/nrn1494
Singh GK, Kenney MK, Ghandour RM, Kogan MD, Lu MC. Mental Health Outcomes in US Children and Adolescents Born Prematurely or with Low Birthweight. Berk M, editor. Depress Res Treat [Internet]. 2013;2013:570743. Available from: https://doi.org/10.1155/2013/570743
Haglund NGS, Källén KBM. Risk factors for autism and Asperger syndrome: perinatal factors and migration. Autism. 2011;15(2):163–83. https://doi.org/10.1177/1362361309353614
Lozada LE, Nylund CM, Gorman GH, Hisle-Gorman E, Erdie-Lalena CR, Kuehn D. Association of autism spectrum disorders with neonatal hyperbilirubinemia. Glob Pediatr Heal. 2015;2: https://doi.org/10.1177/2333794X15596518
Libbey JE, Sweeten TL, McMahon WM, Fujinami RS. Autistic disorder and viral infections. J Neurovirol. 2005;11(1):1–10.
https://doi.org/10.1080/13550280590900553
Rennie JM, Hagmann CF, Robertson NJ. Outcome after intrapartum hypoxic ischaemia at term. In: Seminars in Fetal and Neonatal Medicine. Elsevier; 2007. p. 398–407. https://doi.org/10.1016/j.siny.2007.07.006
Kroll J, Froudist-Walsh S, Brittain PJ, Tseng C-EJ, Karolis V, Murray RM, et al. A dimensional approach to assessing psychiatric risk in adults born very preterm. Psychol Med. 2018;48(10):1738–44. https://doi.org/10.1017/S0033291717003804
Nawaz FA, Sultan MA. Low Birth Weight Prevalence in Children Diagnosed with Neurodevelopmental Disorders in Dubai. Glob Pediatr Heal. 2021;8:2333794X211031782. https://doi.org/10.1177/2333794X211031782
Ugur C, Tonyali A, Goker Z, Uneri OS. Birth order and reproductive stoppage in families of children with autism spectrum disorder. Psychiatry Clin Psychopharmacol [Internet]. 2019 Oct 2;29(4):509–14. Available from: https://doi.org/10.1080/24750573.2018.1457489
Gardener H, Spiegelman D, Buka SL. Prenatal risk factors for autism: comprehensive meta-analysis. Br J psychiatry. 2009;195(1):7–14. https://doi.org/10.1192/bjp.bp.108.051672
Zhang T, Sidorchuk A, Sevilla-Cermeño L, Vilaplana-Pérez A, Chang Z, Larsson H, et al. Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: a systematic review and meta-analysis. JAMA Netw open. 2019;2(8):e1910236–e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236
Gialloreti LE, Benvenuto A, Benassi F, Curatolo P. Are caesarean sections, induced labor and oxytocin regulation linked to Autism Spectrum Disorders? Med Hypotheses. 2014;82(6):713–8. https://doi.org/10.1016/j.mehy.2014.03.011
Husarova VM, Lakatosova S, Pivovarciova A, Babinska K, Bakos J, Durdiakova J, et al. Plasma oxytocin in children with autism and its correlations with behavioral parameters in children and parents. Psychiatry Investig. 2016;13(2):174. https://doi.org/10.4306/pi.2016.13.2.174
Shabila NP. Trends and changes in cesarean delivery rates in Iraq: findings from the multiple indicator cluster surveys, 2011–2018. J Matern Neonatal Med. 2021;1–6. https://doi.org/10.1080/14767058.2021.1910664
Hyman SL, Levy SE, Myers SM, Kuo DZ, Apkon S, Davidson LF, et al. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1). https://doi.org/10.1542/9781610024716-part01-ch002
Alghuraibawi NA. Survey on different intervention modalities used for Iraqi children with ASD in clinical population. J Posit Sch Psychol. 2022;6(3):7654–60.https://journalppw.com/index.php/jpsp/article/view/4693
Pierce K, Courchesne E, Bacon E. To screen or not to screen universally for autism is not the question: Why the task force got it wrong. J Pediatr. 2016;176:182–94. https://doi.org/10.1016/j.jpeds.2016.06.004
Alsayouf HA, Talo H, Biddappa ML, De Los Reyes E. Risperidone or aripiprazole can resolve autism core signs and symptoms in young children: case study. Children. 2021;8(5):318. https://doi.org/10.3390/children8050318
Siegel M, Beaulieu AA. Psychotropic medications in children with autism spectrum disorders: a systematic review and synthesis for evidence-based practice. J Autism Dev Disord. 2012;42(8):1592–605. https://doi.org/10.1007/s10803-011-1399-2
Hirsch LE, Pringsheim T. Aripiprazole for autism spectrum disorders (ASD). Cochrane database Syst Rev. 2016 Jun;2016(6):CD009043. https://doi.org/10.1002/14651858.CD009043.pub3
Nguyen M, Tharani S, Rahmani M, Shapiro M. A review of the use of clonidine as a sleep aid in the child and adolescent population. Clin Pediatr (Phila). 2014;53(3):211–6. https://doi.org/10.1177/0009922813502123
Ming X, Gordon E, Kang N, Wagner GC. Use of clonidine in children with autism spectrum disorders. Brain Dev. 2008;30(7):454–60. https://doi.org/10.1016/j.braindev.2007.12.007
LeClerc S, Easley D. Pharmacological therapies for autism spectrum disorder: a review. Pharm Ther. 2015;40(6):389. PMID: 26045648
Spencer D, Marshall J, Post B, Kulakodlu M, Newschaffer C, Dennen T, et al. Psychotropic medication use and polypharmacy in children with autism spectrum disorders. Pediatrics. 2013;132(5):833–40. https://doi.org/10.1542/peds.2012-3774
Kim Y-H. How can pediatricians treat neurodevelopmental disorders. Clin Exp Pediatr. 2021;64(1):1.https://doi.org/10.3345/cep.2020.00507
Rasmussen L, Bilenberg N, Thomsen Ernst M, Abitz Boysen S, Pottegård A. Use of Psychotropic Drugs among Children and Adolescents with Autism Spectrum Disorders in Denmark: A Nationwide Drug Utilization Study. J Clin Med. 2018 Oct;7(10). https://doi.org/10.3390/jcm7100339
Houghton R, Ong RC, Bolognani F. Psychiatric comorbidities and use of psychotropic medications in people with autism spectrum disorder in the United States. Autism Res. 2017;10(12):2037–47. https://doi.org/10.1002/aur.1848
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