الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition, manifesting in childhood and mainly has two core symptoms: deficits in social communication, and restricted and repetitive patterns of behaviors. The reported prevalence of children with ASD has increased over time. This increase may be attributable to several factors, including broadening in the diagnostic criteria. The etiology of ASD remains unclear. Accordingly, there is no direct and effective medical treatment for this disease, however early identification of young children with ASD is important as early intervention such as behavioral and speech therapies, specialized education and other support services leads to good outcome in ASD especially as regard cognitive development. Developmental screening test is recommended at the 9-, 18-, and 30-month visits and should continue through childhood, including surveillance at the 4- or 5-year visit as development is dynamic in nature and surveillance has limits. Many assessment scales for diagnosis of ASDs as DSM -V criteria, CARS and GARS which based on typical clinical features, examination and history. Cognitive impairment in ASD is a common feature of children with the disorder, a potential predictor of outcome and a predictor of intervention needed. The most commonly used children IQ tests are SB-5 and WISC (Wechsler Intelligence Scale for Children). It is important to pay attention to subtests the verbal score and the non-verbal score which calculated to total score. Children with ASD perform better on PIQ (performance IQ) than on VIQ (verbal IQ) measures. The present study aimed to assess the cognitive strengths and weaknesses of children with autism and the possible effect of age and IQ (Intelligence Quotient) on Stanford-Binet Intelligence Scale, 5th Edition. Such analysis will help us for prompt and early intervention. Our study included 99 cases, their ages ranged from 3 to 18 years, from children attending the pediatric neurology clinic at Assuit children university hospital or admitted in Assuit children university hospital (a tertiary center) from September 2019 to September 2020. All cases included in the study subjected to : Full clinical history including : Age, Sex, Residence, Prenatal history, Neonatal history, Developmental history, Past history, Family history and Present history. Detailed clinical examination including: general examination and full neurological examination. Investigation including: EEG, Neuroimaging, CARS scoring, Stanford-Binet intelligence scale 5th Edition Data management All data processes were done using SPSS software, version 20 and correlation was determined by Pearson correlation. The level of confidence was kept at 95% hence a P value < 0.05 indicated a significant association A predominance of male gender was found in patients with ASD as males to females ratio is (75.8%) : (24.2%) = 3 1 Positive consanguinity is a risk factor as it was present in (30.3%) of patients Positive family history of neuropsychiatric is a risk factor as it was present in (32.2%) of patients Abnormal EEG pattern was found in (33.3%). These abnormal EEG pattern are (75.8%) focal (localized) spike, (21.2%) multiple foci spike and (3%) generalized spike. (19.2%) of patients had atrophic changes in CT brain. The mean and standard deviation (SD) of CARS total scores were 33.52 and 4.32, respectively. The mean and standard deviation (SD) of non-verbal SB-5 were 63.62 and 9.49 , respectively . The mean and standard deviation (SD) of verbal SB-5 was 58.71 and 7.67, respectively The mean and standard deviation (SD) of total SB-5 were 60.64 and 8.76 respectively. The mean of non-verbal IQ was significantly higher than the mean of verbal IQ which indicates a higher PIQ (performance IQ) than VIQ profile in ASD children. There were insignificant differences between males and females as regard CARS and SB-5 scores. Parental consanguinity and family history of neuropsychiatric disease do not affect the severity of ASD. Also patients with or without consanguinity had insignificant differences as regard SB-5 scores. Family history of neuropsychiatric disease had insignificant differences as regard SB-5 scores. EEG abnormalities do not affect the severity of autism. The majority of patients with EEG abnormalities had IQ deficits. Normal CT brain had significantly higher SB-5 scores but insignificant difference as regard CARS There is a positive correlation between age of patients and CARS but a negative correlation between age of patients and SB-5 scores CARS had negative correlation with SB-5 scores. Epilepsy found in (33.3%) of patients. Frequency of convulsions was significantly higher among those with epileptogenic discharge (85%). We advise cognitive testing for all ASD children as it is a more tool help to inform an accurate diagnosis and recommendations, although it is not a routine part of assessment for autism. We advise SB-5 test in ASD children as it includes verbal and non verbal subtests as cognitive profile of ASD children characterized by higher non verbal than verbal IQ. We advise using a validated developmental screening test at the 9-, 18-, and 30-month visits in a primary care. We advise early identification , accurate screening , early treatment and intervention as these leads to better outcomes for ASD children.