Common diagnostic tools involve checklists or questionnaires including Autism Diagnostic Observational Schedule (ADOS), and the screening tool for ASD in toddlers and young children (STAT) among others (Huerta and Lord 2012 Vllasaliu et al. However, the role of healthcare professionals in assessing the development and behaviour of children, along with the history provided by the parents or the primary caregiver (as well as teachers) in reporting the child’s usual behaviour and ability, are crucial in diagnosis. For consistency, ASD will be used thereafter.ĭiagnosing ASD in children can be quite challenging due to heterogeneous clinical features expressed by individuals. ASD or “autism” in this context refers to those diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (DSM-V), and/or Autism Diagnostic Observation Schedule (ADOS). In most cases, classical traits of individuals with ASD include delayed speech development, lack of social interaction as well as repetitive behaviours and restricted interest (Levy et al. Globally, approximately 1 in 160 children has ASD equivalent to a median prevalence of 62/10,000 (Elsabbagh et al. Reduced asymmetry between the average 2D:4D ratio of left and right hands observed in ASD males only (not in ASD females) also suggests the importance of considering gender-specific biomarkers for ASD diagnosis.Īutism spectrum disorders (ASD) or autism is a manifestation of developmental abnormalities of the brain (Landrigan 2010 Manning-Courtney et al. There is no association between the median 2D:4D ratio (left or right hands) and ASD in females, which could be due to the small female sample size and/or the possibility of different aetiology for ASD in females. Once validated in a larger sample size, a lowered median 2D:4D ratio on the left hand may be a potential tool to complement ASD diagnosis for males in our study population. There is significant association between a lowered median 2D:4D ratio of the left hand (in males only) and ASD diagnosis. Our study also shows a significant positive correlation and/or a reduced asymmetry between the average 2D:4D ratio of left hands and right hands in ASD males (Pearson’s correlation ( r) = 0.48 95% CI: 0.076–0.75, p = 0.023). For females, there is no association of ASD with the median left hand 2D:4D ratio or the median right hand 2D:4D ratio. Our study shows that the median 2D:4D ratio of left hand in ASD males is significantly lower than those in TD males, after adjusting for ethnicity and age. Logistic regression models were used to explore potential associations between the median 2D:4D ratio and ASD in respective gender, for both left and right hands, independently. Median 2D:4D ratios were measured, compared and analysed between the two groups. We conducted a case–control study comprising 28 ASD and 62 typically developing (TD) children in the case and control group, respectively (age range: 3–11 years old median age: 6 years old). The objective of this study is to explore the association between 2D:4D ratio and ASD in Brunei Darussalam, as a potential tool to complement early ASD diagnosis. Various studies have shown a significant association between a lowered 2D:4D ratio (ratio of second digit/index finger to the fourth digit/ring finger) and ASD, making it one of the potential phenotypic biomarkers for early detection of autism, which is important for early intervention and management. Despite the global increase in the prevalence of autism spectrum disorders (ASD), relevant research studies are lacking in Brunei Darussalam.
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