Introduction: Prevalence of obesity in Autism Spectrum Disorder (ASD) has been reported to be higher than in the general population. Determining prevalence may help increase awareness of obesity in ASD and potentially lead to initiatives to reduce obesity. In order to understand obesity in ASD children, common risk factors were assessed including physical activity, feeding problems and sleep disturbances. Methods: This is a cross-sectional study performed at the Child Development Center at Universiti Kebangsaan Malaysia Medical Center on 151 ASD children aged 2–18 years. Anthropometric and demographic information were obtained and parents completed three questionnaires; Children Sleep Habits Questionnaire (CSHQ), Physical Activity for Older Children Questionnaire (PAQ-C) and Brief Autism Mealtime Behavior Questionnaire (BAMBI). Results: For ASD children in our sample, the prevalence of overweight (BMI ≥85th to <95th percentiles) was 11.3% and the prevalence of obesity (BMI ≥95th percentile) was 21.9%. The overweight/obese ASD children's median age was higher at 8.5 years (IQR 5.81–10.13) compared to the normal/underweight group of 6.33 years (IQR 4.75–7.7) with a p-value of 0.001. The two groups also differed significantly for maternal BMI and paternal age. The median maternal BMI in the overweight/obese group was 26.05 (IQR 23.35–32.25), statistically significantly higher (p = 0.003) than in the non-overweight/obese group, 24.7 (IQR 21–27.9). The median paternal age of 40 years (IQR 37–44) was statistically significantly higher (p = 0.039) in the overweight/obese group, compared to the median paternal age in the non-overweight/obese group of 38 (IQR 35–42). The male overweight/obese children had median PAQ-C score of 2.44 (IQR 2.00–3.00) vs. 2.89 (IQR 2.35–3.53) in the counterpart group with a p-value of 0.01. Using the multiple linear regression stepwise method, three predictors associated with BMI percentiles reached a statistical level of significance; PAQ-C score in males (p < 0.001), the BAMBI domains of Food Refusal (p = 0.001) and Limited Variety of Food (p = 0.001). Conclusions: The prevalence of obesity and overweight is high among Malaysian ASD children and adolescents. Older child age, high maternal BMI, older paternal age, low physical activity, low likelihood of food refusal and high likelihood of food selectivity were found to be risk factors for high BMI in these children.

Introduction: To examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending “high‐risk” schools in Kuala Lumpur.Methods: This is a cross‐sectional study conducted upon 16‐year‐old adolescents attending three high‐risk schools in Kuala Lumpur. A total of 373 students completed self‐administered questionnaires on the sociodemographic variables and externalizing/internalizing syndromes. The number of truant‐days per student during the study period was obtained from the school records.Results: The mean internalizing score, externalizing score and total problem score of those who were truant were found to be significantly higher (P < 0.05) than those who were non‐truant. Multiple logistic regressions showed externalizing syndrome (odds ratio [OR] = 1.044; confidence interval [CI] = 1.012–1.078, P = 0.018) significantly predicts truancy but not the internalizing syndrome. Two other psychosocial factors, namely, having divorced parents (OR = 2.495, CI = 1.058–5.886, P = 0.037) and did not understand or were uncertain of the purpose of schooling (OR = 2.621, CI = 1.265–5.433, P = 0.010) were also showed to be stronger predictors of truancy compared to externalizing/internalizing syndromes.Discussion: Truancy has significant association to externalizing syndrome, in addition to other significant psychosocial variables like parental and schooling factors. This finding indicated the need for comprehensive assessment of students presenting with truant behavior, including the identification of associated psychological and behavioral problems which highlights the roles of mental health professionals in tackling truancy.

To determine the benefits of cochlear implantation in hearing loss children with multiple disabilities (MD) in terms of auditory outcomes, speech performance, and their quality of life. This was a cross sectional study from January 2019 to December 2020 in which thirty-one children with hearing loss and multiple disabilities were evaluated. Their improvement in auditory and speech performances were assessed using Categories of Auditory Performance version II (CAP-II) and the Speech Intelligibility Rating (SIR) scales. The assessment was done at 6-month intervals, with the baseline evaluation done at least six months after activation of the implant. Parents were asked to fill the Parents Evaluation of Aural/Oral Performance of Children (PEACH) diary and Perceived Benefit Questionnaire (PBQ) to evaluate the child's quality of life. All 31 children have Global Developmental Delay (GDD), with 11 having an additional disability. Both mean CAP-II and SIR scores showed significant improvement with increased hearing age (p < 0.05) after 6-month intervals. In addition, 20 out of 31 children (64.5%) have achieved verbal communication after implantation. The mean PEACH score in quiet was significantly better than in noise (p = 0.007) and improved with the increased of hearing age. The majority of parents (96%‒100%) perceived a cochlear implant as beneficial to their child in terms of auditory response, awareness, interaction, communication, and speech development. Cochlear implantation had shown benefits in children with multiple disabilities. Outcome measures should not only focus on auditory and speech performances but the improvement in quality of life. Hence, individualized each case with realistic expectation from families must be emphasized in this group of children. Level 3.

We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease.

Cognitive and behavioral techniques have been found effective in teaching social communication skills to high functioning autism spectrum disorder (HFASD) youth, yet little research has explored their integration into video-based instructions like video modeling (VM) and spherical video-based virtual reality (SVVR). We developed a social communication skills intervention by integrating psychoeducation, deep breathing technique, first-person modeling, third-person modeling and skill rehearsal into VM and SVVR. This preliminary study aimed at evaluating the user experiences of the intervention. Ten HFASD youths and five experts went through 5 sessions of learning social communication skills via VM and skill rehearsals using SVVR. Upon completion, they went through semi-structured interviews about their user experience. Results revealed that psychoeducation was perceived as clear and practical, while the combination of first-person modeling and third-person modeling techniques helped them understand the message from different perspectives. The relaxation technique was deemed helpful, while SVVR skill rehearsal was viewed as realistic and immersive but less interactive. Suggestions for improvement included interactive SVVR features and inclusion of homework and parents’ involvement. Our findings underscore the importance of integrating cognitive and behavioral techniques into VM and SVVR for HFASD intervention, shedding light on their practical application and potential benefits. SVVR emerged as a promising platform for skill rehearsal in social communication training due to its immersive nature. This study contributes valuable insights for future research and practice in utilizing VM and SVVR for social communication skills training in HFASD.