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15 pages, 669 KB

Open AccessArticle

Impact of NESA Non-Invasive Neuromodulation on Sleep, Behavior, and Sensory Profile in Children with Autism Spectrum Disorder

by Fabiola Molina-Cedrés, Raquel Medina-Ramírez, Aníbal Báez-Suárez, Martín Vílchez-Barrera, Marlene García-Quintana, Andrea Hernandez-Pérez, Irene García-Rodríguez, David Álamo-Arce and Maria del Pilar Etopa-Bitata

Children 2025, 12(12), 1599; https://doi.org/10.3390/children12121599 - 24 Nov 2025

Viewed by 1174

Abstract

Background/Objectives: Autism spectrum disorder is a neurodevelopmental condition affecting up to 1.7% of the global population. Current interventions do not treat the root cause, prompting research into novel treatments like non-invasive neuromodulation. The objective of this study is to examine the use [...] Read more.

Background/Objectives: Autism spectrum disorder is a neurodevelopmental condition affecting up to 1.7% of the global population. Current interventions do not treat the root cause, prompting research into novel treatments like non-invasive neuromodulation. The objective of this study is to examine the use of NESA technology in children with ASD, to determine if it generates changes in their conduct and their central symptoms related to the spectrum. Methods: In this study, twelve children with ASD underwent NESA neuromodulation therapy. We assessed the children’s (CSHQ) and parents’ sleep quality (Pittsburg scale), aberrant behavior (ABC-C), and sensory profile (SP-2). Results: In most cases (66.7%), we observed an improvement in the test results. A comparative analysis of NESA protocols revealed that the optimal programming strategy involves a longer duration of programs 7 and 8 of NESA microcurrents. Conclusions: Given the limited number of patients included in the data set, further investigations are necessary to draw more robust conclusions. This novel form of treatment offers the potential to address autism spectrum disorder by targeting the autonomic nervous system. This approach may influence underlying mechanisms of the autonomic nervous system. The pilot study has opened a new avenue for future research. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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15 pages, 712 KB

Open AccessArticle

Food Pattern, Food Selectivity and Sensory Profile in Autism Spectrum Disorder: An Exploratory Analysis in Chilean Children

by Fernanda Mora, María José Manzur, David Morales-Zepeda, Oscar Flores, Constanza Schwencke and Marcell Leonario-Rodriguez

Children 2025, 12(11), 1560; https://doi.org/10.3390/children12111560 - 17 Nov 2025

Viewed by 784

Abstract

Background/Objectives: Introduction: Food selectivity is highly prevalent in children with autism spectrum disorder (ASD) and is associated with sensory hypersensitivity, particularly in oral, olfactory, and tactile domains. Although international evidence exists, little is known about this phenomenon in Latin American populations. This study [...] Read more.

Background/Objectives: Introduction: Food selectivity is highly prevalent in children with autism spectrum disorder (ASD) and is associated with sensory hypersensitivity, particularly in oral, olfactory, and tactile domains. Although international evidence exists, little is known about this phenomenon in Latin American populations. This study aimed to explore the relationship between sensory hypersensitivity and food selectivity in Chilean children with and without ASD. Methods: A cross-sectional study was conducted with 57 children aged 6–12 years, including 32 with ASD and 25 neurotypical controls. Sensory processing was assessed using the Dunn Sensory Profile 2, while food selectivity was evaluated with the Brief Autism Mealtime Behaviour Inventory (BAMBI) and a Food Frequency Questionnaire (FFQ). Statistical analyses included intergroup comparisons and correlation tests. Results: Children with ASD obtained significantly higher scores across all domains of sensory hypersensitivity (p < 0.001). Selective eating behaviours were more frequent, with texture (78%) and colour (53%) being the most common, and were strongly associated with ritualistic eating (OR 29.39; 95% CI 5.47–136.2; p < 0.0001). BAMBI scores were correlated with oral (p = 0.002), socio-emotional (p = 0.003), and somatic hypersensitivity (p = 0.025). Additionally, children with ASD reported lower intake of vegetables, dairy products, animal proteins, and legumes compared with controls. Conclusions: Food selectivity in Chilean children with ASD is closely related to sensory hypersensitivity, particularly in oral, socio-emotional, and somatic domains. These findings underscore the need for culturally adapted, sensory-based interventions to broaden dietary variety and reduce mealtime difficulties in this population. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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30 pages, 1700 KB

Open AccessArticle

Sensory Processing of Time and Space in Autistic Children

by Franz Coelho, Belén Rando, Mariana Salgado and Ana Maria Abreu

Children 2025, 12(10), 1366; https://doi.org/10.3390/children12101366 - 10 Oct 2025

Cited by 2 | Viewed by 3005

Abstract

Background/Objectives: Autism is characterized by atypical sensory processing, which affects spatial and temporal perception. Here, we explore sensory processing in children with autism, focusing on visuospatial and temporal tasks across visual and auditory modalities. Methods: Ninety-two children aged 4 to 6 [...] Read more.

Background/Objectives: Autism is characterized by atypical sensory processing, which affects spatial and temporal perception. Here, we explore sensory processing in children with autism, focusing on visuospatial and temporal tasks across visual and auditory modalities. Methods: Ninety-two children aged 4 to 6 participated, divided into three groups: autism (n = 32), neurotypical chronological age-matched controls (n = 28), and neurotypical developmental age-matched controls (n = 32). The autism group consisted of high-functioning children (26 boys). The participants completed computer-based tasks requiring spatial and temporal processing. Response accuracy and reaction times were recorded. Results: The autism group demonstrated higher accuracy in temporal tasks (visual and auditory modalities) and comparable accuracy in visuospatial modality, but slower response times in all tasks compared to both neurotypical controls. These results suggest a strategy that prioritizes accuracy over speed, while preserving spatial and temporal processing in autism. Conclusions: These findings suggest that temporal processing, rather than the sensory modality, drives decision-making strategies in children with autism. Our findings highlight the need for interventions aligned with autistic children’s slower but accurate processing style to support social interaction and reduce stress. In a fast-paced digitalized world, autistic children might benefit from slower, balanced, and inclusive, evidence-based approaches that align with their cognitive rhythm and reduce overstimulation. By incorporating these unique strategies, targeted programs can enhance the quality of life and adaptive skills of children with autism, thereby fostering better integration into social and sensory-rich environments. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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18 pages, 563 KB

Open AccessArticle

A Longitudinal Transdisciplinary Approach for Autism Spectrum Disorder

by Aline Kabarite, Glória Maria Marques Ferreira, José Carlos Pitangueira, Rayana de Souza Arimatéa, Renata da Costa Rebello de Mendonça, Roberta Sousa Marcello, Thais Giudice Schulz, Rudimar dos Santos Riesgo and Kamila Castro

Children 2025, 12(9), 1272; https://doi.org/10.3390/children12091272 - 22 Sep 2025

Viewed by 1658

Abstract

Background/Objectives: Autism Spectrum Disorder (ASD) presents complex developmental challenges that require coordinated, individualized interventions. This study aimed to evaluate the effectiveness of a transdisciplinary, family-centered approach in improving clinical and functional outcomes in children and adolescents with ASD. Methods: A longitudinal [...] Read more.

Background/Objectives: Autism Spectrum Disorder (ASD) presents complex developmental challenges that require coordinated, individualized interventions. This study aimed to evaluate the effectiveness of a transdisciplinary, family-centered approach in improving clinical and functional outcomes in children and adolescents with ASD. Methods: A longitudinal study was conducted with 53 participants aged 2 to 16 years, all with confirmed ASD diagnoses. Assessments were performed at baseline, 6 months, and 12 months. Participants received personalized, evidence-based interventions provided by a multidisciplinary team working within a transdisciplinary model. Therapies were delivered individually and in groups, with flexible intervention phases tailored to each participant’s evolving needs. Outcomes were measured using the Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), and the Aberrant Behavior Checklist (ABC). Results: Clinical and functional improvements were observed over the 12-month period. Most participants reached high functional levels by the end of the study. Caregivers reported notable reductions in support needs, while therapist ratings confirmed more moderate improvements. Decreases in behavioral challenges, sensory difficulties, and sleep disturbances were observed, alongside gains in adaptability and functional play. Greater family involvement was associated with more favorable outcomes. Conclusions: A transdisciplinary, family-centered intervention model was beneficial in supporting developmental progress in children and adolescents with ASD. The findings highlight the importance of flexible, team-based care and emphasize the critical role of family engagement in achieving positive long-term outcomes. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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13 pages, 219 KB

Open AccessArticle

Acceptability and Pilot Validation of the Diagnostic Autism Spectrum Interview (DASI-2) Compared with Clinical and ADOS-2 Outcomes

by Susan Jane Young, Nóra Kollárovics, Bernadett Frida Farkas, Tímea Torzsa, Rebecca Cseh, Gyöngyvér Ferenczi-Dallos and Judit Balázs

Children 2025, 12(8), 1025; https://doi.org/10.3390/children12081025 - 4 Aug 2025

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Abstract

Background/Objectives: There is a growing need for autism spectrum disorder (ASD) assessment tools that are diagnostically aligned, clinically usable, and accessible across diverse service contexts. The Diagnostic Autism Spectrum Interview—Version 2 (DASI-2) is a freely available, semi-structured clinical interview mapped directly to DSM-5 [...] Read more.

Background/Objectives: There is a growing need for autism spectrum disorder (ASD) assessment tools that are diagnostically aligned, clinically usable, and accessible across diverse service contexts. The Diagnostic Autism Spectrum Interview—Version 2 (DASI-2) is a freely available, semi-structured clinical interview mapped directly to DSM-5 and ICD-11 criteria. This pilot study aimed to adapt DASI-2 into Hungarian and explore the (1) acceptability of DASI-2 administration, (2) agreement with prior clinical ASD diagnoses, and (3) relationship between DASI-2 observational ratings and ADOS-2 classifications. Methods: Following a multistep translation procedure, DASI-2 was administered to seven children previously assessed for ASD in a multidisciplinary Hungarian clinical setting. The assessment included a parent interview, direct assessment with the child or young person, and completion of the DASI observational record (OR1–OR4). DASI diagnostic outcomes were compared with prior clinical decisions, and OR scores were analyzed in relation to ADOS-2 classifications. Results: All participants completed the DASI-2 interview in full. Agreement with prior clinical diagnosis was found in six of seven cases (κ = 0.70, indicating substantial agreement). When exploring the one non-aligned case, the divergence in diagnostic outcome was due to broader contextual information considered by the initial clinical team which influenced clinical opinion. The five participants diagnosed with ASD showed substantially higher DASI observational scores (mean = 15.26) than the two who were not diagnosed (mean = 1.57), mirroring ADOS-2 severity classifications. Conclusions: These findings support the acceptability and preliminary validity of DASI-2. Its inclusive structured observational record may provide a practical complement to resource-intensive tools such as the ADOS-2; however, further validation in larger and more diverse samples is needed. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

20 pages, 664 KB

Open AccessArticle

Differences and Relationships Between Sensory Profile and Repetitive Behavior in Autism

by María-Dolores Cárcel-López and Mercedes Ferrando-Prieto

Children 2025, 12(4), 504; https://doi.org/10.3390/children12040504 - 14 Apr 2025

Viewed by 4132

Abstract

Repetitive behaviors are actions that are performed consistently and repeatedly, often without an obvious functional purpose. These types of behaviors are common and diverse in individuals with Autism Spectrum Disorder (ASD) and can influence daily life, making social integration difficult for individuals who [...] Read more.

Repetitive behaviors are actions that are performed consistently and repeatedly, often without an obvious functional purpose. These types of behaviors are common and diverse in individuals with Autism Spectrum Disorder (ASD) and can influence daily life, making social integration difficult for individuals who experience them and thus becoming a source of distress. Research show that, in most individuals with ASD, sensory processing tends to be affected. It has been suggested that, in children with ASD, sensory processing disorders can cause them to experience their environment in an exaggerated or diminished way, and this affects their behavior. Repetitive behaviors may emerge as a way to regulate the level of stimulation and achieve a state of sensory balance. Objectives: The aim of this investigation is to study differences and relationships between the sensory profile and repetitive behavior in autism. Methods: A total of 48 students, aged 4 to 26 years (M = 14.39; SD = 7.24), participated. The Bodfish Repetitive Behavior Scale and Sensory Profile 2 by Dunn were used as instruments of measure. Results: Results show that the student groups differ only in some variables, with Level 3 students being the most affected. In this sense, Level 3 students present with higher self-injury, greater tactile and movement processing difficulties, and higher registration (passive response and a high threshold of perception). Hyper-reactivity shows a weak prediction power over insistence of sameness, while hypo-reactivity showed none. Conclusions: Correlations between repetitive behavior and sensory processing were weak and of low magnitude, which contradicts the previous literature. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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Review

Jump to: Research

20 pages, 600 KB

Open AccessReview

Feeding Management in Autistic Children During Early Childhood: A Scoping Review

by Noe Jorquera Tobar, Vannia Jara Mella, Daniela Wachholtz Martorell, Samanta Valdés-Thomas, Verónica Vidal Velasco, Evelyn Farías Vargas, Alejandra M. Wiedeman and Marcela Vizcarra Catalán

Children 2025, 12(12), 1699; https://doi.org/10.3390/children12121699 - 16 Dec 2025

Viewed by 396

Abstract

Autistic children often experience eating difficulties due to sensory processing, food selectivity, and other eating behaviors. As a result, the feeding process can be particularly challenging for caregivers and professionals in healthcare and educational settings. This scoping review describes interventions that address feeding [...] Read more.

Autistic children often experience eating difficulties due to sensory processing, food selectivity, and other eating behaviors. As a result, the feeding process can be particularly challenging for caregivers and professionals in healthcare and educational settings. This scoping review describes interventions that address feeding difficulties, focused on improving food acceptance and reducing challenging eating-related behavior in autistic children under 6 years. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) guidelines. We searched the PubMed, Web of Science (WOS), and PsycINFO databases, as well as manually examined reference lists, to identify relevant articles. Nineteen studies were selected by two independent reviewers for inclusion in the review. Among the selected studies, a variety of effective feeding strategies were categorized into three groups: applied behavior analysis (ABA)-based interventions, a combination of ABA-based strategies with others, and emerging strategies beyond ABA. These interventions have been reported to increase the acceptance of foods and reduce challenging mealtime behaviors of autistic children. Future research should focus on developing comprehensive interventions to improve the quality of life of autistic children, their families, and their communities. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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21 pages, 1643 KB

Open AccessReview

The Autistic Toe Walking: A Narrative Review for Interventions and Comparison with Idiopathic Toe Walking

by Luiz Renato Agrizzi de Angeli, Bárbara Lívia Corrêa Serafim and Julio Javier Masquijo

Children 2025, 12(9), 1198; https://doi.org/10.3390/children12091198 - 8 Sep 2025

Viewed by 3493

Abstract

Background/Objectives: Idiopathic toe walking (ITW) is a diagnosis of exclusion in children who demonstrate a persistent toe-walking gait without an identifiable underlying neuromuscular or orthopedic pathology. The classification of toe-walking behavior (TWB) in children with Autism Spectrum Disorder (ASD) remains an area of [...] Read more.

Background/Objectives: Idiopathic toe walking (ITW) is a diagnosis of exclusion in children who demonstrate a persistent toe-walking gait without an identifiable underlying neuromuscular or orthopedic pathology. The classification of toe-walking behavior (TWB) in children with Autism Spectrum Disorder (ASD) remains an area of debate, with some considering it a part of the broader ITW spectrum, while others view it as a distinct entity. Children with TWB associated with ASD (Autistic Toe Walking—ATW) present unique clinical challenges. This subgroup exhibits a higher prevalence of toe walking, and their gait patterns are often associated with underlying neurodevelopmental differences, frequently leading to increased resistance to conventional treatment approaches and higher rates of persistence and recurrence. This narrative review aims to summarize the available evidence on interventions for ATW, highlight differences compared to ITW and discuss implications for clinical practice. Methods: A literature search was performed, including articles that addressed interventions for toe walking in children with ASD. Results: The literature is limited and heterogeneous. Identified interventions include physiotherapy, orthoses, botulinum toxin injections, serial casting, and surgical procedures. Evidence of effectiveness is scarce, with most studies consisting of small case series. ATW differs from classic ITW in some aspects of pathophysiology and clinical presentation. Treatment decisions should balance potential benefits with risks, particularly regarding repeated anesthesia exposure during casting versus earlier surgical options. Conclusions: Evidence for managing ATW is limited. While comparisons to ITW may be useful, clinicians must recognize that they present distinct characteristics. Future research should focus on standardized definitions and controlled trials to guide management. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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24 pages, 1516 KB

Open AccessReview

Nutritional Factors and Therapeutic Interventions in Autism Spectrum Disorder: A Narrative Review

by Carlos A. Nogueira-de-Almeida, Liubiana A. de Araújo, Fábio da V. Ued, Andrea A. Contini, Maria E. Nogueira-de-Almeida, Edson Z. Martinez, Ivan S. Ferraz, Luiz A. Del Ciampo, Carla C. J. Nogueira-de-Almeida and Mauro Fisberg

Children 2025, 12(2), 202; https://doi.org/10.3390/children12020202 - 8 Feb 2025

Cited by 4 | Viewed by 10659

Abstract

Objective: To explore recent findings on how nutritional, gastrointestinal, social, and epigenetic factors interact in autism spectrum disorder, highlighting their implications for clinical management and intervention strategies that could improve development and quality of life of affected children. Sources: Studies published from [...] Read more.

Objective: To explore recent findings on how nutritional, gastrointestinal, social, and epigenetic factors interact in autism spectrum disorder, highlighting their implications for clinical management and intervention strategies that could improve development and quality of life of affected children. Sources: Studies published from 2000 to 2024 in the PubMed, Web of Science, Scopus, Scielo, Lilacs, and Google Scholar databases were collected. The process for the review adhered to the Search, Appraisal, Synthesis, and Analysis framework. Summary of the findings: Children with autism spectrum disorder have restrictive eating habits and often exhibit food selectivity with either hyper- or hypo-sensory characteristics. This review provides an overview of the literature on diagnosis and intervention strategies for selectivity in autism spectrum disorder, including the involvement of family members in meals, sharing a healthy diet and positive relationship with food, and the importance of exploring visual, olfactory, and tactile experiences of food and introducing new foods through play activities to expand the food repertoire. Modifications in the microbiota and gastrointestinal disorders may also be present in autism spectrum disorder and are presented due to their frequent nutritional repercussions. The medium and long-term implications of food preferences and behavior issues for nutritional status are also discussed, given the tendency for children with autism spectrum disorder to consume low-quality and energy-dense foods, leading to nutritional problems. Conclusions: Children with autism spectrum disorder have feeding difficulties, especially selectivity, gastrointestinal problems, changes in the microbiota and can evolve with micronutrient deficiencies, malnutrition and obesity. This review describes the evidence for possible targets for interventions aiming to improve nutritional health for children with autism spectrum disorder. Full article

(This article belongs to the Special Issue Children with Autism Spectrum Disorder: Diagnosis and Treatment)

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