BackgroundThe aim of this study was to investigate pre‐, peri‐, and postnatal factors, screen time in a group of patients with autism spectrum disorder (ASD) and age and sex‐matched clinical controls to evaluate risk factors specific to ASD.MethodsThe study included 211 ASD patients (177 boys, 34 girls; mean age 44.3 ± 13.0 months) and 241 (190 boys, 51 girls; mean age 44.6 ± 14.1 months) age and sex group matched clinical controls. Non‐ASD diagnoses were expressive language disorder (n = 135, 56.0%), intellectual disability (n = 15, 6.2%), attention deficit‐hyperactivity disorder (n = 6, 2.4%), oppositional disorder (n = 6, 2.4%), and other behavioral or emotional problems (no diagnosis; n = 79, 32.8%). A sociodemographic data form was used to collect data regarding pre‐, peri‐, and postnatal factors and total daily screen exposure.ResultsAccording to our findings, maternal severe psychological stress and depression during pregnancy, and maternal postpartum depression were more frequent in the ASD group (p = 0.005, p = 0.035, and p = 0.001 respectively). There was a statistically significant difference between groups with regards to maternal any medication use during pregnancy (p = 0.004). The mean duration of daily screen exposure was higher in the ASD group (9.90 ± 5.10 h) compared to non‐ASD children (4.46 ± 3.40 h; p < 0.001). A ROC curve showed that 8.5 h and above total daily screen exposure (AUC = 0.808 [95% CI: 0.769–0.848], p < 0.001; 55% sensitivity, 90.5% specificity) is likely to be associated with increased risk for ASD.ConclusionOur study suggests that prenatal maternal psychological stress, prenatal and postpartum depression, and excess exposure to screen might be related to an increased risk for ASD.

Early diagnosis of autism certainly stands as one of the most important determinants to ensure a better prognosis of the disorder, it is common that the screening programs to ensure this, end up not being implemented in health systems of many countries. This may stem from the disadvantages of classically suggested scale‐based screening (SBS) programs. This study presents a nationwide recognition and referral model for early diagnosis of autism spectrum disorders (ASD), in order to meet the obvious need for new methods. The model consists of interactive video‐based training (IVBAT) of health care workers (HCW), a system where family physicians (FPs) record five probable indicators of autism in their family medicine information system; and is therefore, a practical referral system in which the FP may refer a child with any suggestive finding to a child psychiatrist and may well continue to monitor recently diagnosed cases. The autism teams consist of trained child psychiatrists and coordinators, who delivered trainings to 29,612 FPs and 23,511 nurses countrywide. Of 98.8% FPs were trained throughout the country. Total of 1,863,096 children were reported to have a brief examination of autism signs in Family Medicine Units by trained FPs and nurses. A total of 55,314 (2.96%) these children were deemed at risk for ASD and were referred to child psychiatrists. In the evaluation of 55,314 children by child psychiatrists, 10,087 cases were diagnosed with developmental disorders, while 3226 of children at risk were diagnosed with autism. The results of this study, which reached to the largest sample to date, suggest that some other alternative methods, in addition to SBS should also be tested in order to screen ASD. Lay Summary In this study, a nationwide recognition and referral model for early identification of autism spectrum disorders (ASD) is presented. Scale‐based screening (SBS) is the most recommended model for autism, however, it is clear that most countries can not implement this model in their health system. The results of this study, which reached to the largest sample to date, suggest that SBS may not be the only me for screening ASD and that alternative methods should be tried, as there is an obvious need for exploratory approaches.

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Family building (FB) is a building where residents of different flats are close relatives. Being quite common in metropolitan areas, these unique psychosocial environments remain underexamined. We aimed to research into the interactions within the family and psychosocial features of FBs. One hundred and one children living in FBs and FB-experiences of their parents were assessed by semi-structured interviews using K-SADS-PL. Mothers scored their satisfaction from FB-lifestyle in the scale of 0-100. The sample consisted of 35 girls and 66 boys. Mean age was 108±37.4 months. ADHD and anxiety disorders were the common diagnoses. Eighty-two families lived with paternal relatives. Number of relativeneighbors in the building changed between 2-10. Forty-one mothers scored ≤50 for their satisfaction; 58% believed FBs affected their children's symptoms negatively. Examining the perceived advantages and disadvantages of FBs, 'extreme criticism' and 'social support' were the decisive items to predict mothers' satisfaction levels. Having both positive and negative effects, FB-lifestyle seem to complicate interpersonal relations within the family. This study has revealed some preliminary findings, but further studies are required in the field.

Family building (FB) is a building where residents of different flats are close relatives. Being quite common in metropolitan areas, these unique psychosocial environments remain underexamined. We aimed to research into the interactions within the family and psychosocial features of FBs. One hundred and one children living in FBs and FB-experiences of their parents were assessed by semi-structured interviews using K-SADS-PL. Mothers scored their satisfaction from FB-lifestyle in the scale of 0-100. The sample consisted of 35 girls and 66 boys. Mean age was 108±37.4 months. ADHD and anxiety disorders were the common diagnoses. Eighty-two families lived with paternal relatives. Number of relativeneighbors in the building changed between 2-10. Forty-one mothers scored ≤50 for their satisfaction; 58% believed FBs affected their children’s symptoms negatively. Examining the perceived advantages and disadvantages of FBs, ‘extreme criticism’ and ‘social support’ were the decisive items to predict mothers’ satisfaction levels. Having both positive and negative effects, FB-lifestyle seem to complicate interpersonal relations within the family. This study has revealed some preliminary findings, but further studies are required in the field.