الفهرس 
Autism Spectrum DisordersOnly 14 pages are availabe for public view
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Abstract
A
utism spectrum disorder (ASD) is a widespread neurodevelopmental syndrome which is characterised by communication difficulty, stereotyped and repetitive patterns of behaviour, interests, and activities, as well as difficulties in social interaction. It has steadily increased in prevalence, becoming the most prevalent disorder among psychiatric disabilities.
Various factors have been contributed to ASD, some studies suggested that genetic factors play a significant role in the aetiology of ASD. Other studies linked the development of ASD to environmental factors, they observed that autism pathogenesis is associated with micronutrient deficiency, including vitamin A (VA), vitamin B, and vitamin D (VD). Also, patients with ASD have lower VA levels than normal children or family members.
Vitamin A has a very crucial role in nervous system by influencing the growth, proliferation, and differentiation of neurons in the nervous system; as well as, it can have an impact on cognitive function, learning, memory formation, and brain development, but also it is important for digestive, immunological, and serotonin systems. Therefore, Vitamin A deficiency (VAD) can have a tremendous effect on children neurodevelopment and ASD development as a consequence.
The aim of this study to assess the Vitamin A level in the Egyptian ASD children, as well as the effect of Vitamin A supplementation on ASD symptoms improvement.
This is a two-stage study which the first stage is controlled cross-sectional study, while the second stage is interventional study, clinical trial, open label. We included Children with ASD diagnosed by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria between the age of 1 year to 8 years, as well as healthy controls. Our outcomes were assessing their Vitamin A level at baseline and after Vitamin A supplementation, in addition to ATEC to document improvement following an intervention by comparing the baseline.
We included 30 ASD children and 30 normal children in the control group. The age of the participants was with a mean and sd of 5.33±1.7. according to gender of both groups, we had 76.7% males and 23.3% females. In addition, we observed that 33.3% of ASD patients had a family history of similar cases; either brother, cousin, or uncle. According to Childhood Autism Rating Scale of the patients at baseline, 73.3% had mild to moderate ASD symptoms, while 26.7% had severe symptoms; The overall Mean and SD of the participants was 34.97 ± 3.02. Moreover, we observed a statistical decrease of Vitamin A level in the study group compared to the control group with a mean of 133.85, and 207.43, respectively. Not only that, but about two-thirds of the patients in both groups had low levels of vitamin A, considering that Vitamin A level ≥ 200 was considered normal.
ASD patients with low Vitamin A level had a mean and SD of 51.27±25. this was increased significantly after Vitamin A supplementation to be 81.18±21.652. Additionally, Patients Autism Treatment Evaluation Checklist (ATEC) before vitamin A supplementation was with a Mean and SD of 77.77±22.236. this was decreased significantly after Vitamin A supplementation to be 72.38±19.1, suggesting ASD symptoms improvement of the patients.
As regards to correlation between Vitamin A level and different patients Demographics such as, Age, Gender, and Age of onset at diagnosis, we found no statistically significant relation between them. Not only that, but we found no statistically significant correlation between Vitamin A level and Anthropometric measures, such as Height for age, Weight for age, and Head circumference for age.
However, Vitamin A deficiency is popular in the developing countries including Egypt, yet ASD children had lower Vitamin A levels than normal children. In addition, Vitamin A supplementation seemed to significantly improve autistic symptoms of our patients.
Future research should be conducted to investigate the relation between ASD and different patient’s demographics. Also, two or three doses of Vitamin A supplementation could carry better results regarding autistic symptoms.