• 文章类型: Journal Article
    目的:自1990年代以来,美国自闭症谱系障碍(ASD)患病率的种族差异已经发生了变化。这篇综述阐述了这种转变的性质和背景,并讨论了潜在的影响因素和未来研究的领域。
    方法:本综述纳入了美国ASD患病率的17项基于人群的流行病学出生队列研究,将种族作为变量。研究是通过PubMed上的关键字搜索确定的。要包括在内,研究需要在患病率估计中包括种族或族裔作为变量,包括至少1000例自闭症患者,并在6月3日之前以英文出版,2023年。
    结果:结果表明,在2010年之前的几乎所有出生队列中,白人儿童的ASD患病率最高。黑人的ASD患病率,西班牙裔,在2010年出生队列中,亚洲/太平洋岛民(API)儿童(分别为22.3,22.5和22.2/1000)的患病率超过了白人儿童(21.2/1000)的患病率,并且在2012年出生队列中继续增加.
    结论:美国ASD患病率存在持续的种族差异,这些差异在2010年后被颠倒了,当时黑人的ASD患病率,西班牙裔,&API儿童超过了白人儿童中的ASD患病率。这种ASD患病率的种族重组的可能驱动因素包括ASD筛查和诊断的变化,健康保险政策的变化,移民政策的变化,和提高少数群体的教育程度。
    OBJECTIVE: Racial differences in prevalence rates of autism spectrum disorder (ASD) have shifted in the United States (US) since the 1990s. This review addresses the nature and context of this shift and discusses potential contributing factors and areas for future research.
    METHODS: Seventeen population-based epidemiological birth cohort studies on ASD prevalence in the US that included race as a variable are included in the review. Studies were identified via a keyword search on PubMed. To be included, studies were required to include race or ethnicity as a variable in the prevalence estimates, include at least 1000 cases with autism, and be published in English by June 3rd, 2023.
    RESULTS: Results suggest that in nearly all birth cohorts prior to 2010, ASD prevalence rates were highest among White children. ASD prevalence rates among Black, Hispanic, and Asian/Pacific Islander (API) children (22.3, 22.5, and 22.2 per 1000, respectively) surpassed prevalence rates among White children (21.2 per 1000) in the 2010 birth cohort and continued to increase in the 2012 birth cohorts.
    CONCLUSIONS: There are persistent racial differences in ASD prevalence in the US, and these differences were inverted after 2010, when ASD prevalence among Black, Hispanic, & API children surpassed ASD prevalence among White children. Possible drivers of this racial repatterning of ASD prevalence include changes in ASD screening and diagnosis, changes to health insurance policy, changes to immigration policy, and increased education attainment by minority groups.
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  • 文章类型: Journal Article
    据报道,自闭症谱系障碍患者的焦虑患病率很高。这篇小型评论评估了现有的研究心率变异性生物反馈,以帮助控制自闭症谱系障碍患者的焦虑症状。对电子数据库进行了彻底搜索,以查找相关文献。与专家和图书馆员的协商有助于按照PICO框架开发搜索词。搜索了五个数据库,使用Covidence软件进行筛查,与PRISMA流程图中概述的过程。最新的审查显示了积极的短期效果,但需要长期随访。未来的调查应考虑设备类型,培训设置,和控制干预措施。独立于生物反馈设备的准确心率变异性评估至关重要。建议使用其他措施,如皮质醇评估和用户反馈,以进行全面评估。这些发现突出了证据基础的进展,并为未来的方向提供了见解。
    There is a reported high prevalence of anxiety in people with autism spectrum disorder. This mini review appraises existing research investigating heart rate variability biofeedback to help manage symptoms of anxiety in people with autism spectrum disorder. A thorough search of electronic databases was conducted to find relevant literature. Consultation with experts and a librarian helped develop search terms following the PICO framework. Five databases were searched, and screening was undertaken using Covidence software, with the process outlined in a PRISMA flowchart. The latest review showed positive short-term effects but there is a need for long-term follow-up. Future investigations should consider device type, training settings, and control interventions. Accurate heart rate variability assessment independent of biofeedback devices is crucial. Additional measures like cortisol assessment and user feedback are recommended for comprehensive evaluation. The findings highlight progress in the evidence base and offer insight to future directions.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)是一种行为定义的复杂神经发育综合征,其特征是持续的社交交流和互动缺陷。经颅磁刺激(TMS)是一种有前途的新兴工具,可通过减少核心和相关症状来干预ASD。已经发表了一些关于基于TMS的ASD治疗的综述,然而,对研究特点的系统回顾,特定的刺激参数,本地化技术,刺激目标,行为结果,自2018年以来,神经图像生物标志物的变化滞后。这里,我们对2018年后在PubMed上发表的文献进行了系统搜索,WebofScience,科学直接。筛选后,最终的系统审查包括17篇文章,组成7项随机对照试验研究和10项开放标签研究。两项研究是双盲的,而其他研究有中度到高度的偏倚风险,归因于对治疗分配的主观和评估者盲化不足.五项研究利用θ脉冲刺激模式,其他人应用低频重复TMS(五项研究),高频率(六项研究),并结合低频和高频刺激(一项研究)。大多数研究人员优先考虑双侧背外侧前额叶作为刺激目标,而顶叶小叶,下顶叶小叶,和后颞上沟也成为新的关注目标。三分之一的研究使用基于解剖磁共振成像的神经导航来定位刺激目标。TMS干预后,在一系列尺度上的明显增强在刻板的行为中很明显,重复行为,和口头社交领域。对过去五年的文献的全面回顾证明了TMS治疗ASD在改善临床核心症状方面的潜力。
    Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by persistent social communication and interaction deficit. Transcranial magnetic stimulation (TMS) is a promising and emerging tool for the intervention of ASD by reducing both core and associate symptoms. Several reviews have been published regarding TMS-based ASD treatment, however, a systematic review on study characteristics, specific stimulating parameters, localization techniques, stimulated targets, behavioral outcomes, and neuroimage biomarker changes is lagged behind since 2018. Here, we performed a systematic search on literatures published after 2018 in PubMed, Web of Science, and Science Direct. After screening, the final systematic review included 17 articles, composing seven randomized controlled trial studies and ten open-label studies. Two studies are double-blind, while the other studies have a moderate to high risk of bias attributing to inadequate subject- and evaluator-blinding to treatment allocation. Five studies utilize theta-burst stimulation mode, and the others apply repetitive TMS with low frequency (five studies), high frequency (six studies), and combined low and high frequency stimulation (one study). Most researchers prioritize the bilateral dorsolateral prefrontal lobe as stimulation target, while parietal lobule, inferior parietal lobule, and posterior superior temporal sulci have also emerged as new targets of attention. One third of the studies use neuronavigation based on anatomical magnetic resonance imaging to locate the stimulation target. After TMS intervention, discernible enhancements across a spectrum of scales are evident in stereotyped behavior, repetitive behavior, and verbal social domains. A comprehensive review of literature spanning the last five years demonstrates the potential of TMS treatment for ASD in ameliorating the clinical core symptoms.
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  • 文章类型: Journal Article
    (1)背景和目标:这篇综述旨在确定有关双语对居住在希腊的自闭症谱系障碍(ASD)儿童的语言技能的可能影响的最新文献。(2)材料和方法:通过选择文章并回顾在同行评审期刊上发表的四项研究,在Scopus和PubMed的数据库中检索文献。本范围审查基于PRISMA范围审查建议的标准,而PCC框架被用作构建明确而有意义的目标和资格标准的指南。(3)结果:审查中包含的出版物涉及各种与语言相关的技能,包括形态学,语法-语用接口,叙事能力,以及接受和表达语言技能。(4)结论:四分之三的研究提供的证据表明,双语ASD儿童与单语同龄人相比并不处于不利地位,而是享受一些好处。在某种程度上,由于双语。然而,审查研究的数量以及研究本身的局限性使该结论具有暂定性。此外,这些发现为言语治疗师制定了指导方针,教育工作者,心理学家,希腊背景下的医生在治疗或教育患有ASD的双语儿童时需要遵循。
    (1) Background and Objectives: This review aims to identify the latest literature on the possible effect of bilingualism on the linguistic skills of children with autism spectrum disorder (ASD) residing in Greece. (2) Materials and Methods: The literature was searched in the databases of Scopus and PubMed by selecting articles and by reviewing four studies published in peer-reviewed journals. This Scoping Review is based on the standards of PRISMA recommendations for scoping reviews, while the PCC framework was used as a guide to construct clear and meaningful objectives and eligibility criteria. (3) Results: The publications included in the review addressed a variety of language-related skills, including morphology, the syntax-pragmatics interface, narrative ability, as well as both receptive and expressive language skills. (4) Conclusions: Three out of four studies provide evidence that bilingual ASD children are not disadvantaged compared to monolingual peers but rather enjoy some benefits, to a certain extent, due to bilingualism. However, the number of the reviewed studies as well as the limitations of the studies themselves render this conclusion tentative. Additionally, the findings set guidelines that speech therapists, educators, psychologists, and doctors in the Greek context need to follow when treating or educating bilingual children with ASD.
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  • 文章类型: Journal Article
    背景:特应性皮炎(AD)儿童患神经发育障碍、注意力缺陷多动障碍(ADHD)和孤独症谱系障碍(ASD)的风险更大,同时全球患病率也在增加。患有这些疾病的儿童似乎在感觉调节方面存在类似的问题,但对潜在病因的研究性研究很少。这项范围界定审查旨在发现知识差距,整理假设并总结有关AD共同病理生理学的可用证据,儿童ADHD和ASD。
    方法:我们的研究将遵循JoannaBriggs方法学出版的方法学手册,并根据系统评价和Meta分析扩展的首选报告项目进行报告。将搜索以下电子数据库,以查找针对患有AD和ADHD和/或ASD症状的儿童的研究:MedlineALLviaOvid,Embase,WebofScience核心合集和Cochrane中央控制试验登记册通过Wiley。
    背景:本审查不需要伦理批准,因为它不会与人类参与者一起进行。我们将只使用已发布的数据。我们的传播策略包括同行评审出版物和会议报告。
    BACKGROUND: Children with atopic dermatitis (AD) are more at risk for the neurodevelopmental disorders attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) with parallel increases in global prevalences. Children afflicted with these conditions appear to share similar problems in sensory modulation but investigational studies on the underlying aetiology are scarce. This scoping review aims to find knowledge gaps, collate hypotheses and to summarise available evidence on the shared pathophysiology of AD, ADHD and ASD in children.
    METHODS: Our study will follow the methodological manual published by the Joanna Briggs Methodology for Scoping Reviews and will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews. The following electronic databases will be searched for studies focused on children with AD and symptoms of ADHD and/or ASD: Medline ALL via Ovid, Embase, Web of Science Core Collection and the Cochrane Central Register of Controlled Trials via Wiley.
    BACKGROUND: This review does not require ethics approval as it will not be conducted with human participants. We will only use published data. Our dissemination strategy includes peer review publication and conference reports.
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  • 文章类型: Journal Article
    自闭症确诊病例的患病率迅速增加,这引起了人们对研究与这些家庭福祉相关的变量的兴趣。本文的目的是回顾与家庭福祉相关的其他变量的最新文献,比如父母的教养方式。我们使用PRISMA检查表和偏见评估进行了系统的审查,目的是分析自闭症的概念,幸福和父母教养方式有关。我们从Scopus等相关数据库中筛选了755个参考文献,Pubmed,PscyInfoEBSCO,WebofScienceandDialnet,2024年5月更新阅读了16篇全文文章和摘要。据确定,权威的父母教养方式,以及那些基于温暖的,建立关系和情感纽带,低表达情绪与家庭幸福呈正相关。另一方面,专制,宽容和过度保护的风格,以及关键,惩罚和培训为主,与幸福感和家庭生活质量呈负相关。
    The prevalence of diagnosed cases of autism has increased rapidly, which has raised interest in studying the variables related to the well-being of these families. The purpose of this paper is to review the recent literature on other variables related to family well-being, such as parenting styles. We conducted a systematic review using the PRISMA check list and bias assessment with the aim of analyzing if the concepts of autism, well-being and parenting style are related. We screened 755 references from relevant databases like Scopus, Pubmed, PscyInfo EBSCO, Web of Science and Dialnet, updated on May 2024. Sixteen full text articles and abstracts were read. It was identified that the authoritative parenting style, as well as those based on warmth, establishing relationships and emotional bonding, and low expressed emotion were positively related to family well-being. On the other hand, authoritarian, permissive and overprotective styles, as well as critical, punishing and training-based, were negatively associated with well-being and quality of family life.
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  • 文章类型: Journal Article
    在美国被诊断为自闭症的黑人/非洲裔美国人经常经历与服务相关的差异,包括无法获得高质量的自闭症和相关护理(例如行为干预),并且不太可能在整个生命周期中持续接受治疗。虽然支持自闭症患者的干预措施通常被设计为通用的,人们担心,由于对接受干预的黑人儿童或家庭的需求缺乏反应,这些干预措施不适合黑人/非裔美国人的人群,可能会降低总体影响.当前的系统评价总结了针对黑人自闭症社区开发的干预措施的研究,包括患有自闭症的黑人儿童和他们的照顾者。经过全面的,系统搜索,确定了8篇符合研究纳入标准的同行评审出版物.大多数干预措施都是为自闭症儿童的黑人照顾者量身定制的。自闭症研究人员展示了以文化上敏感的方式吸引黑人护理人员的不同策略;然而,需要对这些干预措施进行更多的研究,以评估其有效性。此外,在文化上适应黑人/非裔美国自闭症患者的干预措施仍然有限。文化适应清单框架是一种新颖的方法,有望成为适应干预措施以满足不同文化群体需求的标准。文化反应是制定干预措施的一个重要方面,这些干预措施可以为美国的多样性范围产生最佳结果,并且是实现公平的自闭症研究实践的重要一步。
    UNASSIGNED: Black/African American people in the United States who have a diagnosis of autism often experience service-related disparities, including not having the same access to high-quality autism and related care (e.g. behavioral interventions), and are less likely to have sustained treatment engagement across their lifespan. While interventions to support autistic people are typically designed to be universal, there is concern that these interventions not being tailored to the Black/African American population could reduce the overall impact due to a lack of responsiveness to the needs of the Black children or families who receive the intervention. The current systematic review summarized research on interventions developed for the Black autism community, including Black children with autism and their caregivers. After a comprehensive, systematic search, eight peer-reviewed publications were identified that met the study\'s inclusion criteria. The majority of the interventions were tailored to Black caregivers of children with autism. Autism researchers demonstrate different strategies for engaging Black caregivers in culturally responsive ways; however, more research into these interventions is needed in order to assess their effectiveness. In addition, there are still limited interventions adapted to be culturally responsive to Black/African American autistic people. The Cultural Adaptation Checklist framework is a novel approach with promise to become the standard for adapting interventions to meet the needs of culturally diverse groups. Cultural responsiveness is an important facet in the development of interventions that produce optimal outcomes for the range of diversity in the United States and is an important step to achieving equitable autism research practices.
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  • 文章类型: Journal Article
    目的:评估怀孕期间使用大麻与后代长期神经精神病理学风险之间的关系。
    方法:MEDLINE,EMBASE,和Cochrane图书馆数据库进行了系统搜索,直到2024年1月22日,没有语言或日期限制。
    方法:如果研究报告了母亲在怀孕期间使用大麻用于医疗或娱乐用途的后代的任何长期神经精神结局的定量数据,则有资格纳入研究。通过任何途径和任何三个月,与怀孕期间放弃使用大麻的妇女的后代相比。所有观察性研究设计均包括在分析中。
    方法:根据PRISMA和MOOSE指南进行系统评价和荟萃分析。数据由两名审阅者独立提取。以下后代结果值得关注:注意力缺陷/多动障碍(ADHD),自闭症谱系障碍(ASD),抑郁症,焦虑,精神病,以及大麻和其他物质的使用。与未接触大麻的女性相比,在怀孕期间暴露于大麻的女性的后代中,每种神经精神结局的赔率比(OR)和95%置信区间(CI)进行了汇总。使用随机效应模型汇集数据。
    结果:18项符合条件的观察性研究纳入了系统评价,17个被纳入最终的定量分析,代表534,445名与会者。在调整了混杂因素后,ADHD的合并OR为1.13(95%CI1.01-1.26);对于ASD,合并OR为1.04(95%CI0.74-1.46);对于精神病性症状,汇总OR为1.29(95%CI0.97-1.72);对于焦虑,合并OR为1.34(95%CI0.79-2.29);对于抑郁症,合并OR为0.72(95%CI0.11-4.57);对于后代使用大麻,合并OR为1.20(95%CI1.01-1.42).
    结论:产前大麻暴露与ASD风险增加无关,精神病症状,焦虑,或者后代的抑郁症。然而,它可能会略微增加多动症的风险,并使后代容易食用大麻。尽管有这些发现,怀孕期间使用大麻需要谨慎。进一步的研究势在必行,特别是考虑到近年来大麻的效力越来越高。
    OBJECTIVE: To evaluate the association between cannabis use during pregnancy and the risk for long-term neuropsychiatric pathology in the offspring.
    METHODS: MEDLINE, EMBASE, and Cochrane library databases were systematically searched until January 22, 2024, with no language or date restrictions.
    METHODS: Studies were eligible for inclusion if they reported quantitative data on any long-term neuropsychiatric outcome in offspring whose mothers used cannabis during pregnancy for medical or recreational use, by any route and at any trimester, in comparison to offspring of women who abstained from cannabis use during pregnancy. All observational study designs were included in the analysis.
    METHODS: A systematic review and meta-analysis were performed according to the PRISMA and MOOSE guidelines. The data was extracted independently by two reviewers. The following offspring outcomes were of interest: attention-deficit/ hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression, anxiety, psychotic disorders, as well as cannabis and other substance use. Odds ratios (OR) and 95% confidence intervals (CI) were pooled for each neuropsychiatric outcome in the offspring of women exposed to cannabis during pregnancy compared with non-exposed. Data were pooled using random-effects models.
    RESULTS: Eighteen eligible observational studies were included in the systematic review, and seventeen were included in the final quantitative analysis, representing 534,445 participants. After adjusting for confounders, the pooled OR for ADHD was 1.13 (95% CI 1.01-1.26); for ASD, the pooled OR was 1.04 (95% CI 0.74-1.46); for psychotic symptoms, the pooled OR was 1.29 (95% CI 0.97-1.72); for anxiety, the pooled OR was 1.34 (95% CI 0.79-2.29); for depression, the pooled OR was 0.72 (95% CI 0.11-4.57); and for offspring\'s cannabis use the pooled OR was 1.20 (95% CI 1.01-1.42).
    CONCLUSIONS: Prenatal cannabis exposure is not associated with an increased risk of ASD, psychotic symptoms, anxiety, or depression in offspring. However, it may slightly elevate the risk of ADHD and predispose offspring to cannabis consumption. Despite these findings, caution is warranted regarding cannabis use during pregnancy. Further research is imperative, especially given the increasing potency of cannabis in recent years.
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  • 文章类型: Journal Article
    共同发生的智力/发育障碍(IDD)和超重/肥胖(OW/OB)是IDD精神病学护理的重要考虑因素。OW/OB与自闭症谱系障碍(ASD)和/或IDD的合并症诊断之间的关系在现有文献中仍未得到充分描述。这项研究的目的是探索这些共同发生的诊断。提高对相关合并症的了解可以指导临床医生采取干预措施,以最大程度地减少与OW/OB相关的并发症。我们对DSM-5定义的患有IDD或ASD的心灵感应诊所的成年患者进行了回顾性审查。ICD-10诊断为IDD或ASD,人口统计,BMI,合并症,并记录当前用药情况。二元逻辑回归用于估计每个预测指标与超重(体重指数(BMI)≥25kg/m2)和肥胖(BMI≥30kg/m2)的结果之间的关联。这412名成年人的肥胖患病率为52.4%(95%CI47.5,57.3)。IDD严重程度与每个结果的几率之间存在显著的负相关关系(p<.001)。80.3%的患者正在积极接受抗抑郁药治疗。服用抗抑郁药的患者患肥胖症的几率为两倍(校正OR2.03,95%CI1.23,3.41,p=.006)。这些发现为预防OW/OB及其相关医学后遗症提供了紧迫感。与普通人群相比,该样本中的肥胖患病率更高。IDD严重程度与OW/OB之间的反比关系值得进一步研究检查年龄,照顾者的参与,并作为潜在的修饰符获得护理。
    Co-occurring intellectual/developmental disability (IDD) and overweight/obesity (OW/OB) is an important consideration of IDD psychiatric care. The relationship between OW/OB and comorbid diagnoses of Autism Spectrum Disorder (ASD) and/or IDD remains inadequately described in existing literature. The purpose of this study is to explore these co-occurring diagnoses. Improved understanding of associated comorbidities can guide clinicians toward interventions to minimize complications associated with OW/OB. We conducted a retrospective review of adult patients of a telepsychiatry clinic with IDD or ASD defined by DSM-5. ICD-10 diagnosis of IDD or ASD, demographics, BMI, comorbidities, and current medications were recorded. Binary logistic regression was used to estimate associations between each predictor and the outcomes overweight (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2). Prevalence of obesity in these 412 adults was 52.4% (95% CI 47.5, 57.3). There was a significant inverse relationship between IDD severity and the odds of each outcome (p < .001). 80.3% of patients were being actively treated with an antidepressant. Patients taking an antidepressant had twice the odds of obesity (adjusted OR 2.03, 95% CI 1.23, 3.41, p = .006). These findings provide a sense of urgency for prevention of OW/OB and its associated medical sequelae. Prevalence of obesity was higher in this sample compared to the general population. The inverse relationship between IDD severity and OW/OB warrants further research examining age, caregiver involvement, and access to care as potential modifiers.
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  • 文章类型: Journal Article
    鉴于对自闭症谱系障碍(ASD)的补充治疗策略的兴趣日益增加,本研究旨在全面分析动物辅助活动和治疗(AAAT)对各种ASD症状的影响.
    对数据库的细致搜索,包括Scopus和PubMed,为ASD收集AAAT的相关研究。这一过程导致选择了45项研究,包括1,212名参与者。然后对所选择的研究进行荟萃分析以评估AAAT在减轻核心ASD症状中的功效。
    荟萃分析显示,由于AAAT,一些核心ASD症状得到了显着改善。值得注意的是,社会交往有所改善(MD=-4.96,95%CI[-7.49,-2.44]),易怒(MD=-2.38,95%CI[-4.06,-0.71]),多动症(MD=-4.03,95%CI[-6.17,-1.89]),和不同的单词使用技能(MD=20.48,95%CI[7.41,33.55])。然而,社会意识(MD=-1.63,95%CI[-4.07,0.81]),社会认知(MD=-3.60,95%CI[-9.36,2.17]),社交行为(MD=-0.73,95%CI[-2.55,1.09]),社会动机(MD=-1.21,95%CI[-2.56,0.13]),嗜睡(MD=-1.12,95%CI[-3.92,1.68]),和定型行为(MD=-0.23,95%CI[-1.27,0.80])没有显著改善。
    该研究证明了AAAT在改善ASD某些核心症状方面的潜力,比如社交,烦躁,多动症,和单词使用技巧。然而,AAAT在其他ASD症状领域的有效性仍不确定。该研究受到缺乏长期随访数据和现有研究中存在高风险偏倚的限制。因此,虽然研究结果表明了AAAT在特定领域的前景,建议谨慎在所有ASD症状中推广其疗效。
    UNASSIGNED: Given the rising interest in complementary therapeutic strategies for autism spectrum disorder (ASD), this research aims to provide a comprehensive analysis of the impact of animal-assisted activities and therapies (AAAT) on various ASD symptoms.
    UNASSIGNED: A meticulous search of databases, including Scopus and PubMed, was conducted to gather relevant research on AAAT for ASD. This process led to the selection of 45 studies encompassing 1,212 participants. The chosen studies were then subjected to a meta-analysis to evaluate the efficacy of AAAT in alleviating core ASD symptoms.
    UNASSIGNED: The meta-analysis revealed significant improvements in several core ASD symptoms due to AAAT. Notably, there were improvements in social communication (MD = -4.96, 95% CI [-7.49, -2.44]), irritability (MD = -2.38, 95% CI [-4.06, -0.71]), hyperactivity (MD = -4.03, 95% CI [-6.17, -1.89]), and different word usage skills (MD = 20.48, 95% CI [7.41, 33.55]). However, social awareness (MD = -1.63, 95% CI [-4.07, 0.81]), social cognition (MD = -3.60, 95% CI [-9.36, 2.17]), social mannerisms (MD = -0.73, 95% CI [-2.55, 1.09]), social motivation (MD = -1.21, 95% CI [-2.56, 0.13]), lethargy (MD = -1.12, 95% CI [-3.92, 1.68]), and stereotypical behaviors (MD = -0.23, 95% CI [-1.27, 0.80]) did not significantly improve.
    UNASSIGNED: The study demonstrates the potential of AAAT in improving certain core symptoms of ASD, such as social communication, irritability, hyperactivity, and word usage skills. However, the effectiveness of AAAT in other ASD symptom domains remains uncertain. The research is limited by the absence of long-term follow-up data and a high risk of bias in existing studies. Therefore, while the findings indicate the promise of AAAT in specific areas, caution is advised in generalizing its efficacy across all ASD symptoms.
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