An Exploration of Physical and Phenotypic Characteristics of Bangladeshi Children with Autism Spectrum Disorder

Abstract

This study explored the physical and clinical phenotype of Bangladeshi children with autism spectrum disorder (ASD). A total 283 (68 females) children were referred for screening. Assessments were conducted using a semi-structured clinical interview along with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Overall, 209 (45 females) children reached the ADOS-2 algorithmic cutoff for ASD. A trend for greater weight and head circumference was observed in children with ASD versus non-ASD. Head circumference was significantly (p<0.03) larger in ASD males compared with non-ASD males. A trend was also observed for symptom severity, higher in females than males (p=0.06), with further analyses demonstrating that social reciprocity (p<0.01) and functional play (p<0.03) were significantly more impaired in ASD females than males. Response to Reviewers:Reviewer 1 comment 1.No additional comments on the manuscript. However, I suggest that in the future, when these authors submit manuscripts for peer review and they are asked to respond to comments from reviewers, that the authors specifically note the changes that have been made in the manuscript so it is easier for peer reviewers to identify the revisions. For example, instead of stating in the response to the reviewer's comment, "We have added a sentence to clear the number of participants," the authors should state the exact sentence that was added and where it was added in the Methods section. When the authors don't help the peer reviewers by stating exactly what was revised and where it was revised in the manuscript, it makes it extremely challenging for the peer reviewers to re-review the manuscript and appreciate the changes that have been made in response to the reviewer's comments.Response: We are very grateful to the reviewer for the thoughtful comments and efforts toward improving our manuscript. In future we will definitely note the specific changes made in the manuscript.Reviewer 2 comments 1.The first sentence of Discussion could read, "This study set out to examine the characteristics of a consecutive series of children referred to a developmental clinic in Bangladesh for ASD assessment, including only those who were nonverbal or speaking mainly in single words (i.e., those administered Module 1 of the ADOS-2)."Response: Thanks and the first sentence of the Discussion section has been changed according to suggestion.2.Table 2, 3, and 4 should be integrated -there is a lot of data that is redundant across these tables.Response: We have integrated Table 3, and 4 and presented the data in Table 3 only. 3.Figure 2 Y axis should mention domain rather than relying on the figure note. Response: We have mentioned domain in Figure 2 Y axis.

Dietary intake in children on the autism spectrum is altered and linked to differences in autistic traits and sensory processing styles

“…Pham et al ( 2020 ) similarly found lower BMIs among children on the spectrum with taste aversions. Other studies examining the link between autism‐linked traits as measured by the ADOS and obesity however have either not found a relationship with weight (Hill et al, 2015 ; Zuckerman et al, 2014 ) or contrary to our findings found autistic traits were associated with greater obesity (Rahaman et al, 2021 ). These contradictory results suggest that previously identified associations between obesity and autistic traits may be mediated by sample specific differences in sensory sensitivities which influence dietary intakes or other factors such as the use of medications associated with weight gain as a side effect.…”

Correlation analysis of maternal condition during pregnancy with head circumference and autism spectrum disorder: A propensity score-matched study

“…Any disruption in the steps of cortical expansion can result in abnormalities such as microcephaly or macrocephaly. [ 21 ] Rahaman et al [ 22 ] identified a trend toward increased HC in Bangladeshi children with ASD, while men with ASD exhibited significantly larger HC than men without ASD. Individuals with larger HC tended to have more severe ASD core characteristics.…”

Construction of copy number variation landscape and characterization of associated genes in a Bangladeshi cohort of neurodevelopmental disorders

“…In a well-characterized NDD cohort, a gold-standard observational assessment tool ADOS-2 confirmed 73.85% (209/283) as ASD cases and the remaining 26.15% (74/283) as broader NDD cases ( Rahaman et al, 2020 ). Here, the diagnosis of NDDs was mostly carried out by observing the clinical conditions of the patients and using psychological assessment tools (DSM-IV and ADOS/ADOS2) ( Rahaman et al, 2020 ). Due to the overlapping and complex clinical presentation of NDDs, it is difficult to confirm NDD diagnosis by psychological assessment.…”

“…In Bangladesh, child mental health is considered a significant health problem, with around 5 million Bangladeshi children and adolescents having psychiatric disorders (Mullick and Goodman, 2005). In a well-characterized NDD cohort, a gold-standard observational assessment tool ADOS-2 confirmed 73.85% (209/ 283) as ASD cases and the remaining 26.15% (74/283) as broader NDD cases (Rahaman et al, 2020). Here, the diagnosis of NDDs was mostly carried out by observing the clinical conditions of the patients and using psychological assessment tools (DSM-IV and ADOS/ADOS2) (Rahaman et al, 2020).…”