[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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This study set out to clarify the characteristics of children with Autism Spectrum Disorder (ASD) exhibiting delayed gross motor development in early childhood. The subjects consisted of 17 children with ASD with an DQ or IQ of 70 of more suitable for physical therapy with a chief complaint of delayed motility. The order and timing with which they acquired gross motor development and their observed characteristics were examined based on their medical records. As a result, four patterns were shown in the acquisition of gross motor development: (1) delay in the timing of acquisition overall, (2) reversal of the order of acquisition, (3) delay in the acquisition of sitting position or crawling on hands and knees without any delay in the acquisition of walking, and (4) shuffling. In terms of characteristics, signs of ASD including sensory problems such as hypersensitivity in the hands and feet, rejection of load to sole of foot, obsessiveness, and anxiety around novelty were observed from early childhood, and it was speculated that these had an effect on the delay of motor skill acquisition. From these findings, with children for whom motor development in early childhood is delayed, when observed together with obsessiveness, and anxiety around novelty, incorporating child-oriented relationships that have taken into account the characteristics of ASD from an early stage will be necessary in the context of providing motility support.

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We report the case of a 6-year-old girl who presented with hypoglycemic and dehydration symptoms with acute obsessive compulsive behavior and eating restriction after suffering from streptococcal infection a half year ago.The patient exhibited repeated behavior of wearing clothes in the morning and rituals before eating a week before presentation without triggers. She was admitted to the hospital because her repeated act became extended, resulting in a failure to eat. Dehydration and hypoglycemia appeared. There were no significant findings on brain magnetic resonance imaging or in the tests conducted on the cerebral spinal fluid. After being provided hydration and glucose, the condition of the patient improved, and she was discharged from the hospital. After 18 months, the obsessive compulsive disorder (OCD) symptoms reappeared. Group A Streptococcus was detected via throat culture. Her condition gradually improved with observation in an outpatient clinic without medication for a month. From the clinical course, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections（PANDAS）or Pediatric Acute-onset Neuropsychiatric Syndrome（PANS） as a disease concept encompassing acute onset OCD symptoms without apparent prior infection was suspected. It is desirable to accumulate similar case reports in the future.

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