Table of Content

10 January 2025, Volume 33 Issue 1

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Expert Consensus

Expert consensus on health management of children with autism spectrum disorder

Specialized Committee on Prevention and Treatment of Autism of China Maternal and Child Health Research AssociationHubei Special Children Rehabilitation Association

2025, 33(1):  1-7.  DOI: 10.11852/zgetbjzz2024-1398

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In recent years, the prevalence of autism spectrum disorders (ASD) has been increasing annually and has become a globally recognized public health issue. Currently, rehabilitation treatment primarily focuses on educational interventions and behavioral modifications, emphasizing core symptom training, while there is insufficient management regarding children's health status. However, the health condition of children with ASD significantly impacts their prognosis. Based on this, Specialized Committee on Prevention and Treatment of Autism of China Maternal and Child Health Research Association has led the establishment of an expert panel to develop this consensus. This consensus aims to provide guidance for medical institutions at all levels, as well as for doctors, rehabilitation therapists, teachers, and parents. It advocates for the adoption of targeted, personalized, and developmentally appropriate health management strategies and family support plans based on the foundation of rehabilitation education and training,so as to support the children with ASD to reach their maximum potential.

Professional Forum

Policy maps and insights related to autism spectrum disorders in mainland of China

WU Lijie

2025, 33(1):  8-12.  DOI: 10.11852/zgetbjzz2024-1472

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The prevalence of autism spectrum disorder(ASD) has increased significantly in recent years. The early onset and long duration of the disease require long-term and intensive rehabilitation, which imposes a great burden of disease on the affected children and their families, and also increases the social cost.The diagnosis and treatment, rehabilitation, schooling, employment as well as social reintegration have become a hot issue of concern to the whole society at present and in the future. The government's policy safeguard is crucial to support the health transition and the well-being ofASD children. In the past decade, the Chinese government has paid more and more attention to this group and developed a series of policies to provide good health services and financial support for ASD children and their families. This paper is to review the national policies related to the ASD group in recent years, describe the policy characteristics, and conduct a policy content analysis based on the World Health Organization's theoretical framework to identify the key areas and potential gaps in China's ASD-related policies so as to provide some thoughts and suggestions for the benefits of stakeholders.

Emphasizing nutritional problems and intervention in children with autism spectrum disorder

YI Mingji, YANG Zhaochuan

2025, 33(1):  13-17.  DOI: 10.11852/zgetbjzz2024-1473

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Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a high prevalence, causing serious harm to physical and mental health in children and parents, as well as some social problems. Notable advancements have been made in early identification, diagnosis, and comprehensive intervention of ASD, but its nutritional issues still warrant further exploration and attention. Researches have found that children with ASD often experience more severe nutritional problems in recent years, which involve breastfeeding, complementary foods and dietary behavior. These nutritional problems impact growth and development of children, and may be related to core symptoms of ASD. Scientific management of these nutritional issues, including behavior intervention, individualized dietary prescriptions and nutritional supplementation, plays an important role in improving the intervention efficacy and prognosis of children with ASD. To better improve the nutritional issues of children with ASD, routine nutritional assessment is recommended during the diagnosis and treatment of ASD, placing increased focus on the causes and risk factors of nutritional problems in children with ASD, and giving comprehensive intervention in their nutritional problems.

Original Articles

Correlation of gut microbiota in children with autism spectrum disorder with food intolerance, inflammatory factors and oxidative stress

ZHANG Yangyang, LI Bolin, FENG Pengya, ZHENG Ruijuan, LI Hang, QIU Chunjing, ZHAO Yonghong, LI Enyao

2025, 33(1):  18-26.  DOI: 10.11852/zgetbjzz2024-0736

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Objective To analyze the changes in antioxidant enzymes, inflammatory cytokines, intestinal barrier function, and gut microbiota in children with autism spectrum disorder (ASD) and food intolerance (FI), in order to explore the correlation of intestinal flora with the degree of FI, antioxidant enzymes, inflammatory cytokines, and intestinal barrier function in ASD children. Methods A total of 65 ASD children who met the inclusion criteria and were admitted to the Children's Rehabilitation Department of the Fifth Affiliated Hospital of Zhengzhou University from August 2023 to June 2024 were selected in this study. The ASD children were divided into the FI group (35 cases) and the non-FI group (N-FI, 30 cases) based on FI test results. Enzyme-linked immunosorbent assay was used to detect serum inflammatory cytokines interleukin (IL)-6, IL-1β, and IL-10, antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and intestinal mucosal barrier markers D-lactic acid (D-LA), diamine oxidase (DAO), and occludin. 16S rRNA high-throughput sequencing was used to detect the distribution of intestinal flora in patient feces. Results The levels of serum IL-6, IL-1β, D-LA, and DAO in the FI group were significantly higher than those in the N-FI group (t=2.815, 2.622, 2.878, 2.049, P<0.05), while the levels of IL-10, CAT, SOD, and occludin were significantly lower than those in the N-FI group (t=-2.335, -2.812, -2.526, -2.170, P<0.05). At the genus level, the abundances of Faecalibacterium, Halomonas, and Fusicatenibacter in the FI group were significantly higher than those in the N-FI group, while the abundances of Bifidobacterium and Bacteroides were significantly lower. Pearson correlation analysis showed that in the FI group, Bifidobacterium was negatively correlated with egg yolk/egg white IgG antibody levels (r=0.532); [Ruminococcus]_torques_group was positively correlated with milk IgG antibody levels (r=0.760); [Eubacterium]_eligens_group was positively correlated with IL-10 (r=0.662) and SOD (r=0.536), UBA1819 was positively correlated with SOD (r=0.574), [Ruminococcus]_torques_group was positively correlated with D-LA (r=0.692) and IL-1β (r=0.488), and Bifidobacterium was negatively correlated with occludin (r=-0.488,P<0.05). Conclusions There are differences in intestinal flora between ASD children with FI and those without FI, and the abundance of intestinal flora is correlated with FI antibody levels, inflammation, oxidative stress, and intestinal barrier function. Targeting intestinal flora may enhance FI treatment and effectively improve the condition of ASD children.

Causal association between autism spectrum disorder and gut microbiota based on Mendelian randomization analysis

XIAO Lian, LI Xiaofei, WANG Lei

2025, 33(1):  27-33.  DOI: 10.11852/zgetbjzz2024-0638

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Objective To explore the causal relationship between gut microbiota (GM) and autism spectrum disorder (ASD) by Mendelian randomization, in order to provide insight for ASD treatment. Methods GWAS data on gut microbiota from the MiBioGen public database and GWAS data on ASD from the IEU Open GWAS database were utilized. Independent genetic loci significantly associated with the relative abundance of gut microbiota were extracted as instrumental variables (IVs) based on preset thresholds. The effect size odds ratio (OR) and 95%confidence interval (CI) were primarily assessed using the inverse-variance weighted method. The stability and reliability of the results were verified using leave-one-out analysis, heterogeneity tests, and horizontal pleiotropy tests. Results Increased abundances of Dorea (OR=0.811, 95%CI: 0.686 - 0.959), Ruminiclostridium5 (OR=0.812, 95%CI: 0.687 - 0.961), RuminococcaceaeUCG005 (OR=0.776, 95%CI: 0.670 - 0.898), Ruminococcus1(OR=0.831, 95%CI: 0.705 - 0.981), and Sutterella (OR=0.821, 95%CI: 0.684 - 0.987) were associated with a decreased risk of ASD. However, an increase in Turicibacter abundance was associated with an increased risk of ASD (OR =1.140, 95%CI: 1.008 - 1.290). Leave-one-out analysis showed stable results, with no strong influential IVs, and the effects of heterogeneity and horizontal pleiotropy on causal effect estimation could be excluded. Conclusions Among gut microbiota, Dorea, Ruminiclostridium5, RuminococcaceaeUCG005, Ruminococcus1, and Sutterella are protective factors for the occurrence of ASD, and their increased abundances may reduce the incidence of ASD. In contrast, Turicibacter is a risk factor for the occurrence of ASD, and its increased abundance may increase the incidence of ASD.

Empirical study on clinical intervention of theory of mind interpretation in children with autism spectrum disorder

ZHANG Lin, SHAO Zhi, XIA Lei, ZHANG Yaru, ZHANG Ting

2025, 33(1):  34-38.  DOI: 10.11852/zgetbjzz2023-1173

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Objective To explore the effectiveness of a multi-component, multi-strategy comprehensive theory of mind (ToM) intervention, in order to provide new clinical ideas and empirical evidence for ToM ability intervention in children with autism spectrum disorder (ASD). Methods From July 2022 to June 2023, 80 children with ASD who underwent rehabilitation training in Children's Autism Rehabilitation Treatment Center of Chongqing Ninth People's Hospital were selected into this study. All children met the diagnostic criteria for ASD in the diagnostic and statistical manual of mental disorders, 5th edition (DSM-5). The participants were divided into experimental group (n=40) and control group (n=40) by a random number method. Children in the control group were given traditional rehabilitation for 6 months, while children in the experimental group received ToM intervention additionally. ToM task scale was used to evaluate the ToM ability of children in the two groups before and after the intervention. Results Intra-group comparison showed that before and after the intervention, the experimental group had a significant improvement in the score of the task of distinguishing belief (t=6.56) and false belief (unexpected content task: t=6.56; unexpected location task: t=6.95) (P<0.05). The control group also showed some improvement, but these changes were not statistically significant (P>0.05). Inter-group comparison showed that before intervention, there was no significant difference in scores of ToM tasks between the experimental group and the control group (P>0.05). However, post-intervention, the experimental group scored higher than the control group in belief discrimination (t=5.37) and false belief tasks (unexpected content task: t=4.98, unexpected location task: t=4.87) with statistical significance (P<0.05). Conclusion An integrated intervention model employing multiple strategies grounded in the multifaceted nature of ToM effectively enhances ToM abilities in children with ASD, highlighting the efficacy of a comprehensive approach in addressing this complex cognitive domain.

Follow-up outcomes and developmental characteristics of children with suspected autism spectrum disorder

LI Huimei, LIU Xiao, DAI Ying, CHENG Qian

2025, 33(1):  39-42.  DOI: 10.11852/zgetbjzz2024-0808

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Objective To follow up the diagnostic outcomes of children with early suspected autism spectrum disorder (ASD) during the preschool period, and to analyze their related developmental characteristics, so as to provide a basis for early diagnosis of ASD. Methods Children who visited the hospital due to language problems and were suspected of having ASD (n=95) or developmental language disorder (DLD) (n=76) between June 2017 and August 2022 were followed up until they were 4 years old. At the initial diagnosis, the Gesell Developmental Scales for infants and young children were used to assess developmental quotient of adaptability, fine motor, gross motor, language, and personal-social dimension. SPSS 26.0 software was used to analyze early developmental characteristics and outcomes in language and social skills. Results 1) Among the 95 children initially suspected of having ASD, 57 (60%) were confirmed to have ASD at age 4, 18 (18.95%) had DLD, 4 (4.21%) had global developmental delay, 12 (12.63%) were typically developed, and 4 (4.21%) had other diagnosis. 2) In the suspected ASD group, there was moderate delay in DQ of language during infancy, mild delays in DQ of personal-social and adaptability for non-verbal development, and borderline DQ of fine motor and gross motor skills. 3) At the follow-up visit, children diagnosed with ASD showed significantly greater improvement in DQ of language compared to DQ of personal-social (t=-2.11, P<0.05), while no significant difference was observed between the improvement in DQ of language and DQ of personal-social dimension among children diagnosed with DLD (t=-0.862, P>0.05). Conclusions Among children suspected of having ASD during infancy, 60% are definitively diagnosed with ASD at the follow-up, indicating high diagnostic stability. Children suspected of having ASD exhibit significant delays in language abilities during infancy, with no significant delays in gross motor or fine motor skills. In preschool children with ASD, the trajectories of language and personal-social skill development differ, with notable improvements in language abilities but persistent delays in personal-social skills, whereas children with DLD show parallel development in both language and personal-social skills.

Symptoms severity and physical development of children with autism spectrum disorder of different initial diagnosis ages

MA Liqin, HU Min, LI Aiwen, LIAO Linyan, QIN Yao, ZHAO Yan, DENG Liangqiong

2025, 33(1):  43-48.  DOI: 10.11852/zgetbjzz2024-0461

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Objective To analyze the severity of symptoms,developmental levels and physical development of children with autism spectrum disorder(ASD) of differentinitial diagnosis ages, in order to provide evidence for intervention. Methods A total of 718 children aged 24 to 98 months, who were first diagnosed with ASD from January 2022 to December 2023, were selected as the study subjects and divided into three subgroups. The core symptoms of ASD were assessed by Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS). The Gesell Developmental Scales (GDS) were used to evaluate the developmental level, height for age Z score (HAZ), weight for age Z score (WAZ) and body mass index for age Z score (BAZ) were used to evaluate growth status. Kruskal-Wallis H test, Chi-square test and Spearman correlation analysis were performed to analyze the differences of symptom severity, developmental level and physical development. Results Statistically significant differences were found among thevarious age group in terms of ABC total score, adaptability, gross motor skills, fine motor skills, and personal-social developmental quotient in GDS (H=6.840, 20.226, 35.806, 13.009, 6.295, P<0.05). The age at first diagnosis was negatively correlated with ABC total score, CARS total score, adaptability, gross motor skills, fine motor skills, and personal-social developmental quotient (r=-0.086, -1.117, -0.184, -0.245, -0.154, -0.172, P<0.05), but not correlated with language developmental quotient (P>0.05). There were statistically significant differences in HAZ (H=51.845), WAZ (H=46.156) and the detection rates of growth retardation(χ²=39.710), low body weight(χ²=24.382), wasting(χ²=6.215)and obesity(χ²=16.764) among three subgroups (P<0.05). Specifically, the rates of wasting and obesity in the 72 - 98 months group were higher than those in the 24 - 47 months and 48 - 71 months groups. Conclusions The age of first diagnosis is related to the severity and development level of ASD. Children with ASD at different ages at first diagnosis exhibit deviations in physical growth. Early identification, intervention, and monitoring of physical growth in ASD should be emphasized.

Status quo of screen time and influencing factors of excessive screen time in preschool children from central Gansu Province

HUANG Lei, LI Jiayue, MA Zhengyuan, WANG Pengli, WU Xiaoyan, GAO Yang, GUO Jinxian

2025, 33(1):  49-54.  DOI: 10.11852/zgetbjzz2023-0946

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Objective To investigate preschool children's screen time and related influencing factors of excessive screen time in central Gansu Province, so as to provide reference for formulating relevant prevention and control intervention measures and promoting children's health. Methods From February to May 2023, 8 kindergartens were randomly selected in 3 cities (Lanzhou, Baiyin and Linxia) in central Gansu Province by cluster sampling method and 2 188 parents of children aged 3 - 6 years old were surveyed, finally 2 073 valid questionnaires were collected.Multivariate Logistic regression was used to analyze the influencing factors of excessive screen time. Results In the central area of Gansu Province, preschool children spent [1.64(0.83,3.14)]h in video screen every day.The report rate of screen time ≥2h/d in a week was 45.39%, and 64.79% on weekends.Logistic regression analysis showed that ≥4 years old (OR=2.183, 95%CI:1.392 - 3.425), dwelling in Linxia City (OR=1.429, 95%CI:1.030 - 2.017), no restrictions on children's use of electronic products (OR=1.681, 95%CI:1.188 - 2.379), frequent use of electronic products alone (OR=2.212, 95%CI:1.768 - 2.767), and parents' watching TV time ≥1h/d (OR=1.945, 95%CI:1.548 - 2.444) were the risk factors for children's excessive screen time(P＜0.05).Maternal education level above university (OR=0.521, 95%CI:0.360 - 0.753) and using electronic products for education (OR=0.786, 95%CI:0.632 - 0.978) were protective factors for children's excessive screen time. Conclusions In central Gansu Province, the situation of preschool children with excessive video screens is in need of urgent attention, and is closely related to children's age, the literacy level of their parents, and home video screen environment, so targeted education and intervention efforts should be carried out.

Physical and neuropsychological development and quality of life in children with congenital gastrointestinal malformations

WANG Xi, WANG Jianhong, LI Long, LI Qi, LI Xiaomeng, XU Qi, ZHANG Lili, JIN Chunhua, WANG Lin

2025, 33(1):  55-61.  DOI: 10.11852/zgetbjzz2024-1331

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Objective To analyze the comprehensive development of children with congenital gastrointestinal malformations in postoperative period, in order to provide a scientific basis for alerting growth and developmental deviations during clinical long-term follow-up and giving timely and effective interventions. Methods Case data of children with confirmed diagnosis of choledochal cyst, hirschsprung disease and biliary atresia who were hospitalized in the Department of General Surgery of the Children's Hospital affiliated to the Capital Institute of Pediatrics in 2019 to 2020 were collected. At 3 months postoperatively, physical, neurodevelopmental, and quality of life assessments were conducted among children using the Growth Standards for Chinese Children under 7 Years of Age, Children's Neuropsychological Behavioral Examination Scale(2016 version), the Pediatric Quality of Life Inventory Infant Scale or the Pediatric Quality of Life Inventory(version 4.0), respectively. The influencing factors of physical development delay and the status of neurodevelopment and quality of life among children with different gastrointestinal malformations were analyzed. Results A total of 560 children with congenital gastrointestinal malformations were included in this study. Choledochal cyst was the most common type, accounting for 341 cases (60.9%). Hirschsprung disease had the highest complication rate of 37.6%. The detection rates of growth retardation and low body weight were significantly higher in children with hirschsprung disease and biliary atresia compared to choledochal cyst (χ²=26.721、45.082,P<0.05). For children with choledochal cysts, age at surgery less than 3 years old was a risk factor for growth retardation (OR=2.316), while the occurrence of complications (OR=2.410), multiple surgeries (OR=6.427) were risk factors for low body weight; breastfeeding was a protective factor for growth retardation and low body weight(OR=0.321, 0.162). For children with hirschsprung disease, the occurrence of complications(OR=2.428, 2.025) and premature(OR=5.129, 10.319) were risk factors for growth retardation and low body weight, and breastfeeding(OR=0.260, 0.323) was a protective factor for growth retardation and low body weight. Neurodevelopmental delay and impaired quality of life in children with biliary atresia accounted for 30.0% (6/20) and 41.7% (5/12), respectively. The gross motor, adaptability and language development of children with biliary atresia significantly lagged behind those of children with choledochal cyst, hirschsprung disease (P<0.05). Conclusions Children with congenital gastrointestinal malformations exhibit varying degrees of impairment in both physical and neuropsychological development. Therefore, after surgical intervention, greater attention should be paid to the long-term comprehensive development of these children. In response to the potential growth and neuropsychological development issues in children with gastrointestinal malformations, a multidisciplinary integrated diagnosis and treatment platform should be established, collaborating with departments of health care, general surgery, and nutrition to conduct long-term multidisciplinary comprehensive management and prospective follow-up studies on these patients.

Basic Experimental Articles

Effect of cannabinoid receptor 2 on autism-like behaviors inmice by regulating microglial function

TIAN Wenru, YANG Bilin, HU Jingyi, LIU Shidan, ZOU Mingying, WU Lijie, SUN Caihong

2025, 33(1):  62-70.  DOI: 10.11852/zgetbjzz2024-1205

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Objective To explore the regulatory effect of cannabinoid receptor 2 (CB2R) on microglial function and its impact on autism-like behaviors in mice, in order to provide scientific basis for the etiology of ASD. Methods In vitro experiment, BV2 microglia were divided into control group, LPS group, and AM1241 group. RT-PCR was used to detect mRNA expression levels of inflammatory factors. Western Blot was used to measure the proteins expression of pyroptosis marker. In vivo experiments, the 8-week-old mice were divided into WT group and CB2R knockout mice (CB2R^-/- group). Immunofluorescence staining was used to evaluate the activation of microglia. RT-PCR and western blot were used to detect mRNA and proteins expression levels of pyroptosis marker. Anxiety, restricted and repetitive behaviors, and social function were evaluated by open field, self-grooming, burying marble, and three-chamber test. Results In vitro experiments, compared with the control group, the mRNA levels of pro-inflammatory factors TNF-α, IL-6, and CCL2 in the LPS group were increased, while anti-inflammatory factors Arg-1 and IL-13 were decreased (P<0.05). Compared with the LPS group, the mRNA levels of TNF-α, IL-6, and CCL2 in the AM1241 group were decreased, while Arg-1, IL-10, and IL-13 were increased (P<0.000 1). Compared with the control group, the protein expression of NLRP3, GSDMD, GSDMD-N, caspase-1, and cleaved caspase-1 were significantly increased in the LPS group. After intervention with AM1241, the above protein levels were significantly reduced (P＜0.05). In vivo experiments, compared with the WT group, the CD86⁺/Iba1⁺ ratios in the hippocampal CA1 and CA3 regions were increased, while the CD206⁺/Iba1⁺ ratios were decreased in the CB2R^-/- group (P<0.01). The mRNA expression of NLRP3, GSDMD, caspase-1, IL-1β, and IL-18 in CB2R^-/- group was significantly increased (t=2.20, 3.12, 2.55, 2.54, 2.30, P＜0.05). The protein expression levels of NLRP3, GSDMD, GSDMD-N, caspase-1, and cleaved caspase-1 in CB2R^-/- group were significantly increased (t=7.43, 2.87, 3.86, 3.99, 6.55, P＜0.05). The CB2R^-/- group showed a significant increase in the numbers of moved distance, self-grooming time and marbles buried in mice, a significant decrease in the resting time and social preference index (P<0.05). Conclusion CB2R is involved in regulating the activation and pyroptosis of microglia, affecting neuroinflammatory responses, thereby leading to autism-like behaviors in mice, which suggests that CB2R might be a potential therapeutic target for ASD.

Frontier Express

Realistic examination and countermeasures of screening and intervention for children with autism spectrum disorder in China

YANG Huimin, WANG Lihong, LI Ruili, ZHENG Xiaoguo, ZHU Yanli, ZHANG Xiaoming, CHEN Bowen

2025, 33(1):  71-76.  DOI: 10.11852/zgetbjzz2024-1079

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Autism spectrum disorder(ASD) is a neurodevelopmental disorder characterized by unclear etiology and a lack of effective treatments. Early screening and intervention represent viable strategies for mitigating the adverse consequences.Through literature research and policy analysis, this study examines the current status of assessment and intervention for ASD children in China based on the Lancet report "Future Care and Clinical Research on Autism" published in 2021, providing important evidence to promote the standardized development of early identification, assessment, and intervention forASD children in China. Our findings indicate that policies and guidelines for screening and intervention of ASD children have improved gradually, service models have been established, and scientific research has been strengthened. However, there remains significant scope for enhancement in the social support environment, the screening and intervention service system, the standardization of assessment tools, and cross-sectoral cooperation.In resporse to current situation and problems, the following countermeasures are proposed: improving the social environment to foster the social integration of autistic children; refining the service system to establish a screening and intervention model tailored to Chinese characteristics; standardizing assessment tools to enhance the quality of autism screening and diagnosis; and strengthening cross-sectoral cooperation to regulate the autism screening intervention network.

Review

Association of vitamins and trace elements level with autism spectrum disorder

ZHAO Tingting, SUN Hao, ZHANG Panpan, XIAO Xuwu

2025, 33(1):  77-82.  DOI: 10.11852/zgetbjzz2023-1194

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Autism spectrum disorders (ASD) is a complex neurodevelopmental disorder, and its etiology remains unclear. Some studies have suggested that children with ASD may have abnormal levels of vitamins and trace elements in their bodies, and supplementing the corresponding vitamins and trace elements can improve the clinical symptoms of ASD children to some extent. However, the specific mechanisms are still unknown. From the metabolic and physiological perspectives of vitamins and trace elements,this review combs relevant researches from domestic and international sources on the correlation between ASD and vitamins and trace elements. It further discusses the potential mechanisms of how these vitamins and trace elements act in ASD, aiming to provide new perspectives and directions for the clinical treatment.

Advances in the treatment of autism spectrum disorder by fecal microbiota transplantation

WANG Lihong, YU Lianhu, CAO Aihua

2025, 33(1):  83-87.  DOI: 10.11852/zgetbjzz2023-1151

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interactions and communications together with repetitive and restrictive behaviors.The pathogenesis of ASD is complex and heterogeneous.Genetic and environmental factors are associated with the development of ASD.Current researches proposed gut microbiota dysbiosis may be an important trigger in the development of ASD,so the exploration of significant differences in the gut microbiota and metabolomics between individuals with ASD and typically developed individuals may have great significance for understanding the pathogenesis of ASD and clinical diagnosis and treatment.Behavioral interventions are the mainstay of ASD treatment,but their efficacy is limited.Recently,treatments based on the theory of correcting gut microbiota disturbance and restoring intestinal homeostasis have emerged,among which fecal bacteria transplantation is the most representative.In this review,the progress of gut microbiota dysbiosis and metabolomic changes in the occurrence and development of ASD is summarized,and the current research status of fecal microbiota transplantation intervention in ASD population is elucidated,so as to provide new insights for future fecal microbiota transplantation research.

Advances in acceptance commitment therapy in autism spectrum disorder

CHEN Jiayi, ZHANG Quanzhi, WANG Chaoyue, YIN Jinxia

2025, 33(1):  88-91.  DOI: 10.11852/zgetbjzz2023-1157

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder with unclear etiology and pathogenesis,which negatively affects physical and mental health of both patients and their caregivers.Co-morbidities of mental disorders are common in the ASD population,and the high cost of ASD treatment and long recovery period make ASD parents face many pressures and challenges,leading to parenting burnout,anxiety,depression and other psychological problems in parents,causing negative impact on the physical and mental health of parents with ASD,parent-child interactions,and the quality of the child's care and healthy development.Currently,the treatment of ASD is mainly based on behavioral and educational training,which requires families to pay a lot of economic and time costs,but the treatment and rehabilitation training for children show a slower effect.In recent years,a positive psychology approach centered on acceptance and commitment therapy (ACT) can be a useful addition to treating the core symptoms of ASD and the mental health of parents.Yoga,tai chi,and other mind-body exercises are widely used to relieve fatigue,reduce stress,and ameliorate negative psychological issues.Given the issues and challenges facing the field of ASD research,interventions that combine ACT with other mind-body treatments may become a new paradigm for future mental health research in the field of ASD.

Research progress on improving inhibitory control function in children andadolescents with autism spectrum disorder through exercise intervention

HOU Yaoqi, WANG Yan, DENG Jiaqi, SONG Xiangqin

2025, 33(1):  92-96.  DOI: 10.11852/zgetbjzz2024-0037

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This article aims to explore the effect and potential mechanisms of exercise intervention on the inhibitory control function of children and adolescents with autism spectrum disorder (ASD), and systematically review experimental studies on the effect of exercise intervention on the inhibitory control function of children and adolescents with ASD in recent years. Research has shown that exercise intervention can significantly improve the inhibitory control ability of children and adolescents with ASD, and the forms of exercise intervention are diverse, ranging from traditional martial arts to ball games, as well as emerging methods combining virtual reality technology. Exercise intervention can promote physiological changes in the brain by improving cardiovascular function, reshaping brain structure, altering cerebral blood flow, and increasing neurotrophic factor concentration, thereby enhancing inhibitory control ability.

Characteristics of language disorders in children with autism spectrum disorder and rehabilitation intervention mode to improve their language ability

LI Lifang, LI Jing, ZHANG Changjie

2025, 33(1):  97-102.  DOI: 10.11852/zgetbjzz2024-0274

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Lack of social communication is one of the main manifestations of autism spectrum disorder (ASD). A significant part of the reason for the lack of social communication skills in children with ASD is due to their language disorders. This paper reviews and analyzes the characteristics of language disorders in children with ASD from the perspectives of pre-linguistic skills, phonology, semantics, syntax, and pragmatics. By organizing and analyzing relevant literature, this paper summarizes rehabilitation intervention models that can enhance language and social communication abilities in children with ASD. The review of the literature concludes that in the process of rehabilitation intervention for children with ASD, adopting intervention models that improve pre-linguistic skills, phonology, semantics, syntax, and pragmatics can effectively enhance the language abilities of children with ASD. This paper reviews literature and concludes that the rehabilitation intervention mode can improve the language ability of children with ASD by improving the pre-language ability, phonology, semantic, syntax and morphology, and pragmatics abilities.

Meta Analysis

Visualization analysis of international knowledge network mapping of the autismspectrum disorder-gut-brain axis in the last decade based on CiteSpace

TIAN Yanping, LI Wei, LI Qinghong, WU Jiana, LAI Yanmei, JIANG Xue, LYU Zhihai

2025, 33(1):  103-111.  DOI: 10.11852/zgetbjzz2024-0438

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Objective To use CiteSpace visualization mapping software to outline the existing research structure in the international field of autism spectrum disorder(ASD)-gut-brain axis, so as to identify and predict research hotspots and their evolving trends in this area. Methods Using the Web of Science database as the source of literature, documents related to ASD-gut-brain axis published between 2013 and 2023 were recorded. CiteSpace software was used to conduct visual analysis of the related literature records, and to draw and interpret the related knowledge map in terms of countries, institutions, authors, co-citations and keywords. Results The average annual number of foreign publications from 2013 to 2023 was 52.3. The most productive collaborating countries were the United States, China, and Italy. The most productive collaborating institutions included University College Cork in Ireland, the University of California in the USA, and Harvard University in the USA. The most productive research team was represented by the group led by Dinan TG. Hotspot keywords included gut microbiota, irritable bowel syndrome, short-chain fatty acids, sodium butyrate, and akkermansia muciniphila. It was predicted that the mechanism of neurodevelopmental regulation of ASD by gut flora through the gut-brain axis and the study of gut microbiome-targeted therapies for ASD will be the research hotspots in the near future. Conclusions The research field of autism-gut-brain axis, although started late, is developing more rapidly. This paper points out potential collaborative authors and institutions and predicts research hotspots, aiming to provide a reference for related studies in this field.