Using the Swedish Medical Birth Registry (MBR), obstetrical and demographic information was retrieved for 250 children with autism or Asperger syndrome who were born in Malmoe, Sweden, and enrolled at the local Child and Youth Habilitation Center. The reference group consisted of all children born in Malmoe during 1980-2005. Obstetric sub-optimality (prematurity, low Apgar scores, growth restriction, or macrosomia) was positively associated with autism but not with Asperger syndrome. Maternal birth outside the Nordic countries was positively associated with autism (adjusted OR: 2.2; 95%CI: 1.6-3.1) and negatively associated with Asperger syndrome (OR: 0.6; 95%CI: 0.3-0.97). The highest risk estimate for autism was found among children to women who were born in sub-Saharan Africa (OR: 7.3), or in East Asia (OR: 3.4).

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ObjectiveTo investigate whether children with Attention Deficit/Hyperactivity Disorder have lower levels of Vitamin D3 at birth than matched controls.MaterialUmbilical cord blood samples collected at birth from 202 children later diagnosed with Attention Deficit/Hyperactivity Disorder were analysed for vitamin D content and compared with 202 matched controls. 25-OH vitamin D3 was analysed by liquid chromatography tandem mass spectrometry.ResultsNo differences in cord blood vitamin D concentration were found between children with Attention Deficit/Hyperactivity Disorder (median 13.0 ng/ml) and controls (median 13.5 ng/ml) (p = 0.43). In a logistic regression analysis, Attention Deficit/Hyperactivity Disorder showed a significant association with maternal age (odds ratio: 0.96, 95% confidence interval: 0.92–0.99) but not with vitamin D levels (odds ratio: 0.99, 95% confidence interval: 0.97–1.02).ConclusionWe found no difference in intrauterine vitamin D levels between children later developing Attention Deficit/Hyperactivity Disorder and matched control children. However, the statistical power of the study was too weak to detect an eventual small to medium size association between vitamin D levels and Attention Deficit/Hyperactivity Disorder.

IntroductionThe last two decades increase in early detection and diagnosing children with autism spectrum disorders (ASD) has challenged child and youth habilitation centers to offer the best and most appropriate treatment and support.Objectives and aimsTo evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with ASD based on principles of behaviour learning and developmental science, implemented in the child's natural setting.MethodThe change in autism symptoms among children participating in CIEI (intervention group, n = 67) was compared with children who received traditional habilitation services only (comparison group, n = 27). Symptom changes were measured as evaluation-ADOS-R-scores, total-, severity-, and module-adjusted-scores (ADOS-MAS), minus the corresponding baseline-scores, divided by the time between baseline and evaluation, and estimated using ANOVA adjusting for confounders. The ADOS-MAS were developed to allow improved communicative functions to be counted in the overall symptom improvement.ResultsChildren in both study groups improved their autism symptoms as measured with the ADOS-MAS, and the improvement was statistically significantly larger among children without any developmental delay (P < .001). When adjustments were made for developmental delay, there was a statistically significant larger improvement of ADOS-MAS among children in the intervention group than in the comparison group (P = 0.047). Similar results were found for ADOS-R-total and ADOS-severity scores (P = 0.023 and P = 0.060. respectively).ConclusionThe results of the current study indicate that the CIEI program significantly improve social and communicative skills among children with autism, and that children with developmental delay could benefit to a similar degree as other children.Disclosure of interestThe authors have not supplied their declaration of competing interest.

BACKGROUND: Preschool children with autism in southern Sweden participated in a comprehensive Naturalistic Developmental Behavioral Intervention (NDBI) program. AIMS: To evaluate the ongoing NDBI program by comparing the pre- and postintervention outcomes in terms of improved autism symptom severity. METHOD: The improvement of Autism Diagnostic Observation Schedule (ADOS-R) test results between baseline and evaluation among children participating in the NDBI program ( n = 67) was compared with the results among children receiving community treatment as usual ( n = 27) using analysis of covariance. RESULTS: The study showed that children in the NDBI group improved their ADOS-R total scores between baseline and evaluation (−0.8 scores per year; 95% CI [−1.2, −0.4]), whereas no improvement was detected in the comparison group (+0.1 scores per year; 95% CI [−0.7, +0.9]). The change in the NDBI group versus the change in the comparison group was statistically significant after adjusting for possible confounders as well. Children in the NDBI group also significantly improved their ADOS severity scores, but the scores were not significantly different from those of the comparison group. CONCLUSIONS: The results from the current naturalistic study must be interpreted cautiously, but they do support earlier studies reporting on improvement of autism symptoms after early intensive interventions. Results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. The results do indicate that children with autism benefit from participating in early comprehensive intensive programs.