Abnormal circadian rhythm and cortisol excretion in autistic children: a clinical study
To determine the circadian rhythm alteration of cortisol excretion and the level of corticosteroids in children with different grades of autism severity.
The study included 45 children with different grades of autism severity (low [LFA], medium [MFA], and high functioning autism [HFA]), 15 in each group, and 45 age/sex-matched children with typical development. The urinary levels of free cortisol (at three phases of 24-hour cycle), corticosteroids, vanilylmandelic acid, and 5-hydroxyindole acetic acid were determined.
Alteration in the pattern of cortisol excretion (Phases I, II, and III) was observed in children with LFA (Phase I: 43.8 ± 4.43 vs 74.30±8.62, P = 0.000; Phase II: 21.1±2.87 vs 62±7.68, P < 0.001; Phase III: 9.9 ± 1.20 vs 40 ± 5.73, P < 0.001) and MFA (Phase I: 43.8 ± 4.43 vs 52.6±7.90, P < 0.001; Phase II: 21.1±2.87 vs 27.4±4.05, P < 0.001; Phase III: 9.9 ± 1.20 vs 19 ± 2.50, P < 0.001) compared to the control group. The corticosteroids excretion levels were higher in all the groups of children with autism than in the control group. The level of 5-hydroxyindole acetic acid was significantly higher in children with LFA (8.2±1.48 vs 6.8±0.85, P < 0.001) and MFA (8.2±1.48 vs 7.4± 0.89, P = 0.001) and not significantly higher in children with HFA than in the control group. The changes were correlated with degrees of severity of the disorder.
These data suggest that altered cortisol excretion pattern and high level of corticosteroids in urine may probably be a consequence of altered hypothalamic-pituitary-adrenal axis function, which may contribute to the pathogenesis and affect the severity of autism.
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ABSTRACT: Autism Spectrum Disorder (ASD) is a developmental disability that manifests as impairments in social interaction, communication, and behavior. The objective of this study is to determine if Zen Shiatsu can reduce short- and long-term stress levels in a child with ASD. This is a longitudinal case study of a seven-year-old male with a diagnosis of autism who was given 20-min Zen Shiatsu sessions weekly for six consecutive weeks. Using a five-point stress scale designed for children with autism, the client indicated his stress level before and after each session. In addition, the parent was given the PEDS QL 4.0 Young Child Questionnaire to determine the child's HRQoL (Health Related Quality of Life) prior to Zen Shiatsu treatment to establish a baseline. The parent completed the same questionnaire after six weeks of sessions to compare results. Based on the five-point pictorial stress scale, data collected before and after each Zen Shiatsu session indicated a decrease in stress levels after treatment. The PEDS QL 4.0 showed higher HRQoL scores in all domains, indicating that the child's overall quality of life improved within the six weeks of receiving Zen Shiatsu. Zen Shiatsu, a Japanese modality based on traditional Chinese medicine, provided meaningful and positive benefits for a child with autism. This case study offers preliminary evidence for the possibility of Zen Shiatsu providing a viable complementary therapy for alleviating stress in children with Autism Spectrum Disorder, thereby potentially improving the overall health-related quality of life.International Journal of Therapeutic Massage & Bodywork Research Education & Practice 12/2014; 7(4):23-28. DOI:10.3822/ijtmb.v7i4.246
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