In April 2020, the European Society for Child and Adolescent Psychiatry (ESCAP) Research Academy and the ESCAP Board launched the first questionnaire of the CovCAP longitudinal survey to estimate the impact of COVID-19 on child and adolescent psychiatry (CAP) services in Europe. In this brief report, we present the main findings from the second questionnaire of the survey, one year after the COVID-19 pandemic began to hit Europe (i.e., February/March 2021). While service delivery to patients and their families was affected in a major way (reported by 68%) at the beginning of the pandemic, the majority of respondents (59%) in this second survey only reported a minor impact on care delivery. The use of telemedicine remained widespread (91%) but the proportion of CAP services partially closed or transformed to accommodate COVID-19 patients (59% in 2020) dropped to 20%. On the other hand, the perceived impact on the mental health and psychopathology of children and adolescents dramatically increased from “medium” (> 50%) in 2020 to “strong” or “extreme” (80%) in 2021. Four nosographic entities were particularly impacted: suicidal crises, anxiety disorders, eating disorders and major depressive episodes. Accordingly, this was associated with a substantial increase in the number of referrals or requests for assessments (91% reported an increase in 2021 while 61% reported a decrease in 2020). Finally, heads of the CAP departments expressed strong concerns regarding the management of the long-term consequences of this crisis, especially regarding the provision of care in light of the perceived increase in referrals. Supplementary Information The online version contains supplementary material available at 10.1007/s00787-021-01851-1.

Background Autism spectrum disorders (ASD) affect many children with an estimated prevalence of 1%. Array-comparative genomic hybridization (CGH) offers significant sensitivity for the identification of submicroscopic chromosomal abnormalities and it is one of the most used techniques in daily practice. The main objective of this study was to describe the usefulness of array-CGH in the etiologic diagnosis of ASD. Methods Two-hundred fifty-three patients admitted to a neurogenetic outpatient clinic and diagnosed with ASD were selected for array-CGH (4 × 180K microarrays). Public databases were used for classification in accordance with the American College of Medical Genetics Standards and Guidelines. Results About 3.56% (9/253) of copy number variations (CNVs) were classified as pathogenic. When likely pathogenic CNVs were considered, the rate increased to 11.46% (29/253). Some CNVs apparently not correlated to the ASD were also found. Considering a phenotype–genotype correlation, the patients were divided in two groups. One group according to previous literature includes all the CNVs related to ASDs (23 CNVs present in 22 children) and another with those apparently not related to ASD (10 CNVs present in 7 children). In 18 patients, a next-generation sequencing (NGS) panel were performed. From these, one pathogenic and 16 uncertain significance variants were identified. Conclusion The results of our study are in accordance with the literature, highlighting the relevance of array-CGH in the genetic of diagnosis of ASD population, namely when associated with other features. Our study also reinforces the need for complementarity between array-CGH and NGS panels or whole exome sequencing in the etiological diagnosis of ASD.

Several predictors may influence children's developmental trajectories with Autism Spectrum Disorder (ASD), and parents' concerns may play an important role. This study aimed to investigate developmental trajectories of two groups of children with ASD to understand predictive factors, including parental perception. We examined the clinical features of a sample of 55 children with ASD at 3 and 6 years of age in two moments of evaluation to understand this process. We used the Autism Diagnostic Observation Schedule, (ADOS) in both moments. We selected two groups based on ADOS results at moment two: one group with a worse outcome (ADOS results above 8) and one group with a better outcome (ADOS results below 8 in the second moment). We also selected questions from a questionnaire (elaborated by the authors and used in clinical practice) applied to parents to understand if early parents' concerns may help to predict ASD prognosis. We found a significant association between imitation and playability and the child's prognostic. Also, Interactive Gestures, Beginning of Joint Attention, Reciprocity, and Pleasure in Interaction might help identify positive case evolution. Our findings are significant in early intervention program development, not only with direct intervention with the child but also including the parents' involvement in the intervention.

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