Neuropsychological profile in high functioning autism spectrum disorders

Atypical pattern separation memory and its association with restricted interests and repetitive behaviors in autistic children

LAY ABSTRACT

Memory challenges remain understudied in childhood autism. Our study investigates one specific aspect of memory function, known as pattern separation memory, in autistic children. Pattern separation memory refers to the critical ability to store unique memories of similar stimuli; however, its role in childhood autism remains largely uncharted. Our study first uncovered that the pattern separation memory was significantly reduced in autistic children, and then showed that reduced memory performance was linked to their symptoms of repetitive, restricted interest and behavior. We also identified distinct subgroups with profiles of reduced and increased generalization for pattern separation memory. More than 72% of autistic children showed a tendency to reduce memory generalization, focusing heavily on unique details of objects for memorization. This focus made it challenging for them to identify commonalities across similar entities. Interestingly, a smaller proportion of autistic children displayed an opposite pattern of increased generalization, marked by challenges in differentiating between similar yet distinct objects. Our findings advance the understanding of memory function in autism and have practical implications for devising personalized learning strategies that align with the unique memory patterns exhibited by autistic children. This study will be of broad interest to researchers in psychology, psychiatry, and brain development as well as teachers, parents, clinicians, and the wider public.

New Insights into the Neuropsychological Profile and Intellectual Quotient Variability in Joubert Syndrome Compared to Other Congenital Cerebellar Malformations

The neuropsychological characteristics of the cerebellar cognitive affective syndrome (CCAS) in congenital, non-progressive malformations of the cerebellum have been scarcely investigated, and even less is known for Joubert syndrome (JS), an inherited, non-progressive cerebellar ataxia characterized by the so-called molar tooth sign. The few studies on this topic reported inconsistent results about intellectual functioning and specific neuropsychological impairments. The aim of this research is to examine the neuropsychological profile of JS compared to other congenital cerebellar malformations (CM), considering individual variability of intellectual quotient (IQ) in the two groups. Fourteen patients with JS and 15 patients with CM aged 6-25 years were tested through a comprehensive, standardized neuropsychological battery. Their scores in the neuropsychological domains were inspected through descriptive analysis and compared by mean of MANOVA and ANOVA models, then replicated inserting IQ as covariate. The two groups showed a largely overlapping neuropsychological profile, consistent with CCAS. However, the JS group showed worse performance in visual-spatial memory compared to CM patients, although this difference was mitigated when considering IQ. These findings highlight a divergence between JS and other CM in visual-spatial memory, which might suggest a critical role of the cerebellum in recalling task-relevant memories and might inform rehabilitative interventions.

Mental rotation and language in autism spectrum disorder

Though visuospatial skills are often considered a relative strength in autism spectrum disorder (ASD), unexplained difficulties relative to neurotypical (NT) peers have also been observed. Dissociations between spatial cognition and language skills in ASD may explain these difficulties given that these systems are linked in NT individuals. The current study examined performance on a mental rotation task that systematically varied stimulus features and the degree to which performance was associated with language in ASD relative to NT peers. Participants were children and young adults with ASD and 25 pairwise age- and IQ-matched NT peers (p's>0.53). The mental rotation task involved four conditions: two-dimensional (2D) abstract figures, three-dimensional (3D) abstract figures, 2D common objects, and 3D common objects. Structural language was measured using the grammar subscale from the Test of Language Development: Intermediate adapted for Norwegian. Mixed-effects model results indicated that autistic individuals were less accurate and had slower reaction time across mental rotation task conditions than NT peers. Language was associated with mental rotation accuracy for both groups across conditions, but with reaction time only for the NT group. The current study demonstrated selective associations between language and performance on a classic spatial cognition task in autistic individuals. Namely, there was a dissociation between language and in-the-moment efficiency in the ASD group, and this dissociation may reflect a broader dissociation between visuospatial and language systems.

Cognitive predictors of Social processing in congenital atypical development

According to current accounts of social cognition, the emergence of verbal and non-verbal components of social perception might rely on the acquisition of different cognitive abilities. These components might be differently sensitive to the pattern of neuropsychological impairments in congenital neurodevelopmental disorders. Here, we explored the association between social and non-social cognitive domains by administering subtests of the NEPSY-II battery to 92 patients with Intellectual and Developmental Disability (IDD). Regardless the level of intellectual functioning and presence of congenital brain malformations, results revealed that visuospatial skills predicted emotion recognition and verbal component of Theory of Mind, whereas imitation predicted the non-verbal one. Future interventions might focus on spatial and sensorimotor abilities to boost the development of social cognition in IDD.

Different levels of visuospatial abilities linked to differential brain correlates underlying visual mental segmentation processes in autism

The neural underpinnings of enhanced locally oriented visual processing that are specific to autistics with a Wechsler's Block Design (BD) peak are largely unknown. Here, we investigated the brain correlates underlying visual segmentation associated with the well-established autistic superior visuospatial abilities in distinct subgroups using functional magnetic resonance imaging. This study included 31 male autistic adults (15 with (AUTp) and 16 without (AUTnp) a BD peak) and 28 male adults with typical development (TYP). Participants completed a computerized adapted BD task with models having low and high perceptual cohesiveness (PC). Despite similar behavioral performances, AUTp and AUTnp showed generally higher occipital activation compared with TYP participants. Compared with both AUTnp and TYP participants, the AUTp group showed enhanced task-related functional connectivity within posterior visuoperceptual regions and decreased functional connectivity between frontal and occipital-temporal regions. A diminished modulation in frontal and parietal regions in response to increased PC was also found in AUTp participants, suggesting heavier reliance on low-level processing of global figures. This study demonstrates that enhanced visual functioning is specific to a cognitive phenotypic subgroup of autistics with superior visuospatial abilities and reinforces the need to address autistic heterogeneity by good cognitive characterization of samples in future studies.

Oromotor skills in autism spectrum disorder: A scoping review

Oromotor functioning plays a foundational role in spoken communication and feeding, two areas of significant difficulty for many autistic individuals. However, despite years of research and established differences in gross and fine motor skills in this population, there is currently no clear consensus regarding the presence or nature of oral motor control deficits in autistic individuals. In this scoping review, we summarize research published between 1994 and 2022 to answer the following research questions: (1) What methods have been used to investigate oromotor functioning in autistic individuals? (2) Which oromotor behaviors have been investigated in this population? and (3) What conclusions can be drawn regarding oromotor skills in this population? Seven online databases were searched resulting in 107 studies meeting our inclusion criteria. Included studies varied widely in sample characteristics, behaviors analyzed, and research methodology. The large majority (81%) of included studies report a significant oromotor abnormality related to speech production, nonspeech oromotor skills, or feeding within a sample of autistic individuals based on age norms or in comparison to a control group. We examine these findings to identify trends, address methodological aspects hindering cross-study synthesis and generalization, and provide suggestions for future research.

Do children with and without autism spectrum disorder use different visuospatial processing skills to perform the Rey-Osterrieth complex figure test?

Visuospatial organization abilities are closely related to other visuospatial processing skills, such as visuomotor coordination, perceptual abilities, mental rotation, and working memory (WM). One task that enables visuospatial organization abilities to be investigated is the Rey-Osterrieth complex figure test (ROCFT). When examining visuospatial functioning, individuals with autism spectrum disorder (ASD) have proved capable of operating both locally and globally, depending on the sub-domain embraced, with a preference for a locally-oriented processing of visuospatial information. The present research aimed to establish whether different underlying visuospatial skills might account for performance in the ROCFT in children and adolescents with ASD, compared with typically developing (TD), by considering the role of local/global visuospatial processing. The study involved 39 participants who have ASD without intellectual disability, and 57 TD aged 8-16 years. The participants were administered tasks assessing visuospatial organization abilities, manual dexterity, visual perception, mental rotation, spatial-sequential, spatial-simultaneous WM, and visuospatial processing. Our results suggest that manual dexterity and visuospatial processing similarly explain performance in both groups, while differences in visuospatial WM account for the two groups' visuospatial organization abilities. Spatial-simultaneous WM predicted performance in copy and recall conditions in the TD group but not in the ASD group, while spatial-sequential WM only did so in the latter group, reinforcing the tendency of children with ASD towards local bias in the visuospatial organization domain. The implications of these findings are discussed. LAY SUMMARY: The visuospatial organization abilities of children and adolescents with and without autism were compared, considering their underlying visuospatial skills. Visuospatial organization impairments emerged for children with autism, who differed from typically developing children in the underlying visuospatial skills involved. Given the crucial role of visuospatial organization abilities in everyday life, our results could inspire practitioners to develop training interventions that take into account the strengths and weaknesses of individuals with autism.

Risk and protective factors of quality of life for children with autism spectrum disorder and their families during the COVID-19 lockdown. An Italian study

BACKGROUND

The lockdown due to the COVID-19 pandemic has been a difficult period for children with Autism Spectrum Disorder (ASD), and their families.

AIMS

The aim of this study was to investigate the predictors of the quality of life (QoL) of children with ASD and their parents throughout the first lockdown, providing a snapshot of the impact of the pandemic on these families life.

METHOD AND PROCEDURES

A cohort of 243 parents of children with ASD (2-15 years old) completed an original online survey regarding the modification of ASD cores symptoms during lockdown, the type of interventions they had done before and during lockdown and the activities performed by the child. Respondents filled the PedsQL for themselves and their children.

OUTCOME AND RESULTS

The data obtained show a worsening of specific ASD core symptoms during lockdown and their role in predicting parents and children's QoL. Furthermore, protective factors for a better children's QoL as the Telehealth intervention, and some activities done at home during the lockdown as physical activity and play with parents are identified.

CONCLUSIONS

This study identifies the QoL's risk and protective factors for children with ASD and their families. Furthermore, reveals the fundamental role of the parents as children's QoL protective factor, suggesting a higher collaboration between families and health care providers, whilst potentially improving families and children's QoL.

Are Executive Dysfunctions Relevant for the Autism-Specific Cognitive Profile?

Executive functions (EF) have been shown to be important for the understanding of Autism Spectrum Disorder (ASD), but dysfunctions of EF are not autism-specific. The specific role of EF in ASD, its relationship to core autism characteristics, such as mentalizing, needs to be explored. Medline- and PsychINFO databases were searched for studies published between 1990 and 2020 that included measures of EF in ASD and typically developing control persons (TD) in combination with either Theory of Mind (ToM) or Weak Central Coherence (WCC) tasks. A pre-registered meta-analysis and cross-study regression was performed including a total of 42 studies (ASD n = 1,546, TD n = 1,206). Results were reported according to PRISMA guidelines. In all cognitive domains, the ASD group showed significantly reduced performance. Importantly, EF subdomains and ToM were not significantly correlated. This finding rules out a significant association between EF subdomains and ToM and questions the relevance of EF dysfunctions for the autism-specific feature of reduced mentalizing.

A Systematic Review on the Impact of the Social Confinement on People with Autism Spectrum Disorder and Their Caregivers during the COVID-19 Pandemic

The COVID-19 pandemic had imposed a variety of containment measures on the general population for prolonged periods. Confinement has had, and still has, social, economic, educational, health, and psychological consequences on the entire population.

OBJECTIVE

In this article, a systematic search has been performed based on studies carried out since the beginning of the pandemic, regarding the impact of these containment measures on the autism spectrum disorder (ASD) population and their caregivers.

METHOD

We consulted six databases (i.e., PubMed, Medline, Embase, Scopus, Web of Science, and Science Direct) and selected ten studies that met the inclusion criteria. The chosen studies have been classified according to their theoretical focus, methodology, and target population.

RESULTS

We found an increase in stress and a decrease in psychological well-being among individuals diagnosed with ASD (i.e., parents and caregivers). Additionally, in studies focused on children, youth, and adults with ASD diagnosis, the results are contradictory depending on variables such as age, ASD severity, or type of family structure.

CONCLUSIONS

The results show that the consequences of quarantine and social confinement are quite contradictory and depend on variables such as age, ASD severity, and family features.

Automatic classification of autism spectrum disorder in children using cortical thickness and support vector machine

OBJECTIVE

Autism spectrum disorder (ASD) is a neurodevelopmental condition with a heterogeneous phenotype. The role of biomarkers in ASD diagnosis has been highlighted; cortical thickness has proved to be involved in the etiopathogenesis of ASD core symptoms. We apply support vector machine, a supervised machine learning method, in order to identify specific cortical thickness alterations in ASD subjects.

METHODS

A sample of 76 subjects (9.5 ± 3.4 years old) has been selected, 40 diagnosed with ASD and 36 typically developed subjects. All children underwent a magnetic resonance imaging (MRI) examination; T1-MPRAGE sequences were analyzed to extract features for the characterization and parcellation of regions of interests (ROI); average cortical thickness (CT) has been measured for each ROI. For the classification process, the extracted features were used as input for a classifier to identify ASD subjects through a "learning by example" procedure; the features with best performance was then selected by "greedy forward-feature selection." Finally, this model underwent a leave-one-out cross-validation approach.

RESULTS

From the training set of 68 ROIs, five ROIs reached accuracies of over 70%. After this phase, we used a recursive feature selection process in order to identify the eight features with the best accuracy (84.2%). CT resulted higher in ASD compared to controls in all the ROIs identified at the end of the process.

CONCLUSION

We found increased CT in various brain regions in ASD subjects, confirming their role in the pathogenesis of this condition. Considering the brain development curve during ages, these changes in CT may normalize during development. Further validation on a larger sample is required.

A Neuro-Phenomenological Perspective on the Autism Phenotype

In the current paper, we present a view of autism spectrum disorder (ASD) which avoids the typical relational issues, instead drawing on philosophy, in particular Husserlian phenomenology. We begin by following the recent etiological perspectives that suggest a natural predisposition of a part of individuals with ASD towards hypersensitivity and the reduced influence of cognitive priors (i.e., event schemas). Following this perspective, these two characteristics should be considered as a sort of phenomenological a priori that, importantly, could predispose people with ASD towards a spiritual experience, not intended in its religious meaning, but as an attribute of consciousness that consists of being aware of and attentive to what is occurring in the present moment. Potential clinical implications are discussed.

Evaluation of a Peer Mentorship Program for Autistic College Students

The number of autistic students in colleges is growing rapidly. However, their needs are not being met, and graduation rates among this population remain low. This article describes the implementation and evaluation of the Autism Mentorship Initiative (AMI) for autistic undergraduates (mentees), who received 1-on-1 support from upper-level undergraduate or graduate students (mentors) at their university. We examined changes in college adjustment (n = 16) and grade point average among mentees (n = 19) before and after participation in AMI for two or more semesters. We also examined surveys completed by both mentees (n = 16) and mentors (n = 21) evaluating their experiences in AMI. Data from the Student Adaptation to College Questionnaire showed that mentees displayed lower than average social, emotional, and academic adjustment to college compared with neurotypical norms, but participation in AMI resulted in notable gains in all facets of college adjustment. Survey data revealed that both mentors and mentees reported personal, academic, and professional benefits from participating in AMI. However, no improvements in academic achievement of the mentees were found. This study provided preliminary evidence for the benefits of an easily implemented and cost-effective peer mentorship program for autistic students in a college setting.

Lay summary

Why was this program developed?: There are a growing number of autistic students attending college. However, the percentage of autistic students who complete their degree is quite low. We believe that colleges should be offering more support services to address the unique needs of their autistic students.What does the program do?: The Autism Mentorship Initiative (AMI) matches incoming autistic undergraduates with upper-level (third or fourth year) neurotypical undergraduates or graduate students who provide 1-on-1 mentorship. The autistic undergraduates meet regularly with their mentors to discuss personal and professional goals, discuss solutions for problems they are experiencing in college, and discuss ideas for increased integration into college campus life (e.g., joining clubs or attending social events). The neurotypical mentors receive ongoing training from program supervisors about autism and meet regularly with program supervisors to discuss progress with their mentees and troubleshoot issues they may be experiencing with their mentees.How did the researchers evaluate the program?: We evaluated AMI by administering the Student Adaptation to College Questionnaire at multiple time points to examine whether autistic mentees reported improvements in social, emotional, and academic adjustment to college as a result of participating in AMI. In addition to tracking changes in cumulative grade point average (GPA), we also administered program evaluation surveys to determine whether AMI is meeting its core aims and to assess satisfaction with the program from the perspectives of both mentors and mentees.What are the early findings?: While there were no changes in GPA, participation in AMI resulted in notable changes in mentees' academic, social, and emotional adjustment. Both mentors and mentees reported personal, academic, and professional benefits from their participation in AMI.What were the weaknesses of this project?: The sample size was small, so it is questionable whether the findings generalize to a broader autistic student population. In addition, there was no control group, so we cannot be certain that improvements in college adjustment were due to participation in AMI. Moreover, this study only assessed one program at one university in Western Canada, so it is unknown whether this program could be successfully implemented at other universities or in different geographic locations.What are the next steps?: As participation in AMI increases each year, follow-up studies will utilize larger sample sizes. We will seek to obtain control data by examining GPA and college adjustment in autistic students who do not participate in AMI. We will aim to conduct multisite trials to examine whether similar programs can be implemented at other universities.How will this work help autistic adults now and in the future?: We hope that our research will help faculty members and staff from disability support offices to gain ideas and insights in implementing similar-or better-programs at their respective institutions. Our experience is that mentorship programs can be both cost-effective and easily implemented, while offering an invaluable support system to autistic students that may increase the likelihood of degree completion.

The Episodic Memory Profile in Autism Spectrum Disorder: A Bayesian Meta-Analysis

Although autism spectrum disorders (ASD) are commonly characterized by diminished episodic memory, the literature in this area is mixed. We address these inconsistent findings by employing multilevel Bayesian meta-analysis to quantify episodic memory differences between individuals with ASD and typically developing (TD) controls. We used meta-regression to evaluate the effects of test modality (e.g., word list, story recall), delay interval (immediate vs. delayed), retrieval demands (recognition vs. recall), and sensory modality (auditory vs. visual) on episodic memory in ASD. A total of 338 effect sizes from 113 empirical articles, including 5,632 unique participants (ASD = 2,777, TD = 2,855), were included. Results show that the memory deficits associated with ASD were larger for recall (g = -0.52, se = 0.04, 95% CrI [-0.60, -0.43]) compared to recognition (g = -0.25, se = 0.05, 95% CrI [-0.35, -0.14]) and differed based on the testing modality. For example, effect sizes were smallest for words (g = -0.28, se = 0.05, 95% CrI [-0.38, -0.18]), pictures (g = -0.38, se = 0.07, 95% CrI [-0.52, -0.24]), and figure reproduction (g = -0.49, se = 0.11, 95% CrI [-0.70, -0.27]). However, effect sizes for sentences (g = -0.59, se = 0.20, 95% CrI [-1.00, -0.21]), stories (Hedges' g = -0.54, se = 0.08, 95% CrI [-0.69, -0.38]) and staged events (g = -0.75, se = 0.10, 95% CrI [-0.95, -0.55]) were much larger. These findings suggest that ASD is associated with a small to medium reduction in scores on episodic memory tests relative to TD controls.

Node Centrality Measures Identify Relevant Structural MRI Features of Subjects with Autism

Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions characterized by impairments in social interaction and communication and restricted patterns of behavior, interests, and activities. Although the etiopathogenesis of idiopathic ASD has not been fully elucidated, compelling evidence suggests an interaction between genetic liability and environmental factors in producing early alterations of structural and functional brain development that are detectable by magnetic resonance imaging (MRI) at the group level. This work shows the results of a network-based approach to characterize not only variations in the values of the extracted features but also in their mutual relationships that might reflect underlying brain structural differences between autistic subjects and healthy controls. We applied a network-based analysis on sMRI data from the Autism Brain Imaging Data Exchange I (ABIDE-I) database, containing 419 features extracted with FreeSurfer software. Two networks were generated: one from subjects with autistic disorder (AUT) (DSM-IV-TR), and one from typically developing controls (TD), adopting a subsampling strategy to overcome class imbalance (235 AUT, 418 TD). We compared the distribution of several node centrality measures and observed significant inter-class differences in averaged centralities. Moreover, a single-node analysis allowed us to identify the most relevant features that distinguished the groups.

Social Cognition in Neurodevelopmental Disorders and Epilepsy

Introduction: The purpose of our study was to perform a comparative analysis of social cognition in children and adolescents with epilepsy, autism spectrum disorder (ASD), specific learning disorder (SLD) and in typical development (TD) controls. The secondary aim was to relate social cognition to some clinical and demographic characteristics.

Methods: Our work is a transversal observational study. The recruits were 179 children and adolescents aged between 6 and 18 years diagnosed with epilepsy, ASD, or SLD and 32 subjects with TD. All the participants underwent neuropsychological assessment of Emotion Recognition (ER) and Theory of Mind (ToM) skills.

Results: All three clinical groups performed significantly worse than controls in ER and ToM. The ASD group achieved significantly lower performance than the other groups; however, the scores of SLD and epilepsy groups were comparable. The ER performances are related to non-verbal intelligence only in the group with epilepsy.

Conclusion: Children and adolescents with focal epilepsy, SLD, or ASD may present a deficit of varying extent in emotion recognition and ToM, compared with TD peers. These difficulties are more pronounced in individuals with ASD, but impairment worthy of clinical attention also emerges in individuals with SLD and epilepsy.

Impact of the COVID-19 Lockdown in Malaysia: An Examination of the Psychological Well-Being of Parent-Child Dyads and Child Behavior in Families With Children on the Autism Spectrum

Background: The COVID-19 pandemic lockdowns have adversely impacted children on the autism spectrum and their families, especially in Malaysia where this population is often marginalized. The current quantitative research aimed to investigate the impact of the Malaysian COVID-19 lockdown on the behavior and psychological distress of children formally diagnosed with an autism spectrum condition (ASC) as well as the psychological distress and well-being of their parents, in comparison with a typically developing (TD) control group. Methods: The children's ages ranged between 5 and 17 years. The sample included 72 ASC parent-child dyads and 62 TD parent-child dyads. The primary caregiver completed an online survey including the following: demographic and diagnostic information; ASC symptoms; children's inattention, hyperactivity/impulsivity, perceived stress, depression, and anxiety; parents' perceived stress, depression, anxiety, and well-being based on their experience pre- and mid-lockdown (March 18th to June 9th 2020) in Malaysia. Results: Among the ASC group, no significant pre- and mid-lockdown change was found in ASC symptoms (p > 0.05). There were no significant gender differences (boys/girls) in all the child scales. The 2 [diagnosis (ASC, TD)] × 2 [lockdown (pre-lockdown, mid-lockdown)] mixed-model ANOVAs revealed main effects of lockdown on children's attention, hyperactivity/impulsivity, anxiety, and parents' perceived stress, depression, and psychological well-being (p < 0.005). There was a main effect of diagnosis in all child and parent variables, except parents' perceived stress (p >0.005). However, there was no significant interaction effect between diagnosis and lockdown (p >0.005). All child behavior (inattention and hyperactivity/impulsivity) and child psychological distress (anxiety, depression, and perceived stress) were significantly correlated in both the ASC and TD groups (p < 0.005). On the other hand, only some of the parent variables were significantly correlated with child variables (p < 0.0045) in the ASC group while none of the parent variables were significantly correlated with the child variables (p > 0.005) in the TD group. Conclusion: The results provide preliminary evidence indicating negative effects of the Malaysian lockdown on both children on the autism spectrum and TD children, as well as their parents. These quantitative results will be triangulated with the qualitative interview data to provide a holistic understanding of the impact of the pandemic, informing translational policy and practice recommendations.

Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review

The psychological impact of the COVID-19 pandemic has been widely discussed during the past few months, with scholars expressing concern about its potential debilitating consequences on youth mental health. Hence, this research aimed to provide a systematic review of the evidence on the COVID-19 pandemic’s impact on youth mental health. We conducted a mixed methods integrated review to identify any empirical study that focused on young people ≤ 18 years old. Eight databases were systematically searched to identify studies of any type of research design. The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD4202019375). Twelve studies deemed eligible for data extraction (n = 12,262). The findings show that COVID-19 has an impact on youth mental health and is particularly associated with depression and anxiety in adolescent cohorts. The quality appraisal indicated that all studies were of low or moderate methodological quality. The COVID-19 pandemic is affecting young people’s lives, and thus generating robust research evidence to inform policy decisions is essential. Hence, the methodological quality of future research should be drastically improved.

An Overview of the Main Genetic, Epigenetic and Environmental Factors Involved in Autism Spectrum Disorder Focusing on Synaptic Activity

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects social interaction and communication, with restricted interests, activity and behaviors. ASD is highly familial, indicating that genetic background strongly contributes to the development of this condition. However, only a fraction of the total number of genes thought to be associated with the condition have been discovered. Moreover, other factors may play an important role in ASD onset. In fact, it has been shown that parental conditions and in utero and perinatal factors may contribute to ASD etiology. More recently, epigenetic changes, including DNA methylation and micro RNA alterations, have been associated with ASD and proposed as potential biomarkers. This review aims to provide a summary of the literature regarding ASD candidate genes, mainly focusing on synapse formation and functionality and relevant epigenetic and environmental aspects acting in concert to determine ASD onset.

Frontoparietal Network in Executive Functioning in Autism Spectrum Disorder

Higher cognitive functions in autism spectrum disorder (ASD) are characterized by impairments in executive functions (EF). While some research attributes this to an overreliance of the prefrontal cortex (PFC), others demonstrate poor recruitment of the PFC in individuals with ASD. In order to assess the emerging consensus across neuroimaging studies of EF in ASD, the current study used a coordinate-based activation likelihood estimation (ALE) analysis of 16 functional magnetic resonance imaging (fMRI) studies, resulting in a meta-analysis of data from 739 participants (356 ASD, 383 typically developing [TD] individuals) ranging from 7 to 52 years of age. Within-group analysis of EF tasks revealed that both TD and ASD participants had significant activity in PFC regions. Analysis of group differences indicated greater activation in ASD, relative to TD participants, in the right middle frontal gyrus and the anterior cingulate cortex, and lesser activation in the bilateral middle frontal, left inferior frontal gyrus, right inferior parietal lobule, and precuneus. Although both ASD and TD participants showed similar PFC activation, there was differential recruitment of wider network of EF regions such as the IPL in ASD participants. The under-recruitment of parietal regions may be due to poor connectivity of the frontoparietal networks with other regions during EF tasks or a restricted executive network in ASD participants which is limited primarily to the PFC. These results support the executive dysfunction hypothesis of ASD and suggests that poor frontoparietal recruitment may underlie some of the EF difficulties individuals with ASD experience. LAY SUMMARY: This study reports a meta-analysis of 16 brain imaging studies of executive functions (EF) in individuals with autism spectrum disorder (ASD). While parts of the brain's EF network is activated in both ASD and control participants, the ASD group does not activate a wider network of EF regions such as the parietal cortex. This may be due to poor EF network connectivity, or a constrained EF network in ASD participants. These results may underlie some of the EF difficulties individuals with ASD experience. Autism Res 2020, 13: 1762-1777. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Psychiatric disorders in children and adolescents during the COVID-19 pandemic

Introduction

The Covid-19 pandemic has generated an unprecedented multimodal (health, occupational, economic, and social) crisis, which will impact developing countries. Confinement as a preventive measure is itself a threat that produces a social impact. Pandemic and confinement have become a psychosocial adversity factor that affects families and their children. During the pandemic, children and adolescents with a psychiatric disorder may experience exacerbation of their symptoms. However, little is known about this, since studies on this population during the pandemic are scarce.

Objective

To review the data available in the current literature on the effect of the pandemic on children and adolescents with a previous psychiatric disorder.

Methods

A literature search was carried out using PubMed, Scielo and, due to the exceptional conditions of the pandemic situation, directly using internet search engines. Both English and Spanish papers were included.

Results

The information found is presented in the following sections: family and children during the pandemic, evaluation of mental disorders in children and young people during the pandemic, pre-existing psychiatric disorders during the pandemic, and telepsychiatric care. Specific information is presented on attention deficit hyperactivity disorder, autism spectrum disorder, intellectual disability, anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder. The current pandemic due to COVID-19 and confinement are a psychosocial adversity that threatens the stability of the family. Such a stressor can cause exacerbation of symptoms of a previous mental disorder. Children and adolescents with psychiatric disorders are a vulnerable population and require specialised care. Telepsychiatry is becoming a modality with multiple advantages.

Assessment of Changes over Time of Lipid Profile, C-Reactive Protein Level and Body Mass Index in Teenagers and Young Adults on Different Diets Belonging to Autism Spectrum Disorder

Background: Numerous scientific studies on patients with autism spectrum disorder (ASD) suggest a significant role of inflammation processes or lipid disorders in this spectrum of neurodevelopmental disorders. Unfortunately, there is a lack of assessments of changes over time regarding level of lipids and inflammatory markers in people diagnosed with ASD using different diets. The aim of this study was to evaluate changes in lipid profile, high sensitivity C-reactive protein (hs-CRP) and body mass index (BMI) in individuals diagnosed with ASD and healthy controls. Variables were assessed at two time points (2015/17 and 2017/20) for each subject. Methods: After applying the selection criteria, for the first assessment period, 96 participants were qualified (the group consisted of 59 males with ASD and 37 healthy volunteers, i.e., age-matched control group—CG). The final assessment included 93 participants (57 from ASD group and 36 from CG). Subjects were on low-fat diet (LFD), gluten–casein-free diet (GF–CF) and regular diet (RD), respectively. All members of CG were on regular diet. A fasting lipid profile and hs-CRP level were analyzed. BMI and percentiles were calculated. Eating habits were checked by analyzing data from questionnaires. Principal component analysis (PCA) was used separately for every assessment. The Mann–Whitney U test was used to compare the medians of variables in the scheme of pairwise comparisons between control and ASD groups on different diets for separate assessment, while differences over time between variables were tested by Wilcoxon signed-rank test. Results: Statistically significant differences between BMI, CRP, triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), non-HDL-C and TC/HDL ratio were found in ASD group in comparison to healthy volunteers (increased BMI, CRP and TC/HDL and decreased HDL-C for all types of diets, increased TG in the group of LFD and RD individual and increased non-HDL-C in the group of GF–CF and RD individuals) during the first assessment period. The second assessment over time also showed increased levels of TC, non HDL-C and TC/HDL and decreased level of HDL-C for all ASD individuals regardless of diets used, while BMI and CRP increased only for individuals on LFD and RD. No statistically significant correlations between age of participants and other variables comparing with CG were found. Conclusions: Our studies suggest that targeted, individualized nutritional pattern and periodic screening for lipid and immune disorders would be beneficial for teenagers and adults diagnosed with ASD.

A comparison of local-global visuospatial processing in autism spectrum disorder, nonverbal learning disability, ADHD and typical development

BACKGROUND

Research on visuospatial functioning has revealed cognitive challenges for children with autism spectrum disorder (ASD), nonverbal learning disability (NLD) and attention deficit hyperactivity disorder (ADHD). These disorders are characterized by some overlapping symptoms, making their diagnosis a challenge.

AIMS

The study aims to clarify the role of visuospatial abilities in their neuropsychological profiles by investigating different visuospatial domains and their interplay with the local-global processing.

METHOD AND PROCEDURES

Participants (N = 150) with ASD, NLD, or ADHD were compared with typically-developing (TD) children on visuospatial processing speed, visuo-perceptual abilities, visuo-constructive abilities, and visuospatial working memory. Generalized mixed-effects models were performed and receiver operating characteristic curves were estimated to express the usefulness of a local-global processing index in discriminating groups.

OUTCOMES AND RESULTS

The NLD group was impaired in all domains; children with ADHD revealed a heterogeneous profile, with greater impairments in visuospatial processing speed; ASD and TD groups were comparable. The local-global processing index had predictive power in discriminating among groups in visuo-constructive task.

CONCLUSIONS AND IMPLICATIONS

The study of visuospatial abilities of children with ASD, NLD and ADHD might help to understand strengths and weaknesses in their neuropsychological profile and to differentiate between them. Clinical implications of these findings are discussed.

Human Figure Drawings in Children with Autism Spectrum Disorders: A Possible Window on the Inner or the Outer World

Background: Tests based on human figure drawings (HFD) have captured the attention of clinicians and psychologists for a long time. The aim of the present study was to evaluate the performance of HFD of children with autism spectrum disorders (ASDs) relative to typically developing (TD) controls. Methods: All children were asked to draw three human figures (man, woman, self-portrait) and were evaluated with a neuropsychological battery. HFD were scored according to the Maturity Scale, and correlative approaches testing maturity against neuropsychological scores were applied. Results: ASDs presented marked deficits in maturity. No significant correlation emerged for both groups between maturity and the theory of mind test. On the contrary, positive and significant correlations between maturity and the affect recognition test (AR) were found, with group-specific patterns. In TD, this result regarded drawings of others, but not self-portraits, while an opposite pattern emerged for ASD, whose sole maturity in self-portraits significantly correlated with the AR scores. Conclusion: These findings suggest that the use of HFD tests with individuals with autism may not be used in clinical practices. However, in basic research, HFDs could be used to highlight dependencies between drawing performance and neuropsychological features, thus possibly providing hints on the functioning of autism.

Behavioral and Autonomic Responses in Treating Children with High-Functioning Autism Spectrum Disorder: Clinical and Phenomenological Insights from Two Case Reports

In this study, we aimed to evaluate the process applied in subjects with Autism Spectrum Disorder (ASD) to elaborate and communicate their experiences of daily life activities, as well as to assess the autonomic nervous system response that subtend such a process. This procedure was evaluated for the first time in two eight-year-old girls with high-functioning ASDs. The subjects performed six months of training, based on the cognitive–motivational–individualized (c.m.i.^®) approach, which mainly consisted in building domestic procedures and re-elaborating acquired experiences through drawing or the use of icons made by the children. Together with behavioral observations, the response of the autonomic nervous system during such re-elaboration was recorded. A change in communicative and interactive competences was observed, moving from a condition of spontaneity to one in which the girls were engaged in relating their experiences to a parent. Autonomic response highlighted how, in communicating their own experiences, they achieved a state of cognitive activation, which enabled a greater communicative and emotional connection with the interlocutor. This is a proof-of-concept study on the application of the c.m.i.^®, which needs to be extensively validated in the clinical setting.

Psychosocial and Behavioral Impact of COVID-19 in Autism Spectrum Disorder: An Online Parent Survey

The 2019 coronavirus disease (COVID-19) outbreak could result in higher levels of psychological distress, especially among people suffering from pre-existing mental health conditions. Young individuals with autism spectrum disorders (ASD) are particularly at risk due to their vulnerability to unpredictable and complex changes. This study aimed to investigate the impact of the COVID-19 pandemic on ASD individuals, whether any pre-pandemic sociodemographic or clinical characteristics would predict a negative outcome, and to narratively characterize their needs. Parents and guardians of ASD individuals filled out an online survey consisting of 40 questions investigating socio-demographic and clinical characteristics of their children, impact of the COVID-19 outbreak on their wellbeing and needs to deal with the emergency. Data were available on 527 survey participants. The COVID-19 emergency resulted in a challenging period for 93.9% of families, increased difficulties in managing daily activities, especially free time (78.1%) and structured activities (75.7%), and, respectively, 35.5% and 41.5% of children presenting with more intense and more frequent behavior problems. Behavior problems predating the COVID-19 outbreak predicted a higher risk of more intense (odds ratio (OR) = 2.16, 95% confidence interval (CI) 1.42–3.29) and more frequent (OR = 1.67, 95% CI 1.13–2.48) disruptive behavior. Even though ASD children were receiving different types of support, also requiring specialist (19.1%) or emergency (1.5%) interventions in a relatively low proportion of cases, a number of needs emerged, including receiving more healthcare support (47.4%), especially in-home support (29.9%), as well as interventions to tackle a potentially disruptive quarantine (16.8%). The COVID-19 outbreak has undoubtedly resulted in increased difficulties among ASD individuals.

Self-Reported Autistic Traits Using the AQ: A Comparison between Individuals with ASD, Psychosis, and Non-Clinical Controls

The term "autism" was originally coined by Eugen Bleuler to describe one of the core symptoms of schizophrenia. Even if autism spectrum disorder (ASD) and schizophrenia spectrum disorders (SSD) are now considered two distinct conditions, they share some clinical features. The present study aimed to investigate self-reported autistic traits in individuals with ASD, SSD, and non-clinical controls (NCC), using the Autism-Spectrum Quotient (AQ), a 50-item questionnaire. The study was conducted in the Psychiatry Unit of Policlinico "G. Rodolico", Catania, Italy. The AQ was administered to 35 adults with ASD, 64 with SSD, and 198 NCC. Overall, our data showed that the ASD sample scored significantly higher than NCC. However, no significant differences were detected between individuals with ASD and SSD. Notably, the three groups scored similarly in the subscale "attention to detail". AQ showed good accuracy in differentiating ASD from NCC (AUC = 0.84), while discriminant ability was poor in the clinical sample (AUC = 0.63). Finally, AQ did not correlate with clinician-rated ADOS-2 scores in the ASD sample. Our study confirms that symptoms are partially overlapping in adults with ASD and psychosis. Moreover, they raise concerns regarding the usefulness of AQ as a screening tool in clinical populations.

Handle the Autism Spectrum Condition During Coronavirus (COVID-19) Stay At Home period: Ten Tips for Helping Parents and Caregivers of Young Children

COVID-19 has become pandemic [...].

Handle the Autism Spectrum Condition During Coronavirus (COVID-19) Stay At Home period: Ten Tips for Helping Parents and Caregivers of Young Children

COVID-19 has become pandemic [...].

Assessments of Amino Acids, Ammonia and Oxidative Stress Among Cohort of Egyptian Autistic Children: Correlations with Electroencephalogram and Disease Severity

OBJECTIVE

The current study aimed to assess the profiles of plasma amino acids, serum ammonia and oxidative stress status among autistic children in terms of electroencephalogram findings and clinical severity among the cohort of autistic Egyptian children.

PATIENTS AND METHODS

The present study included 118 Egyptian children categorized into 54 children with autism who were comparable with 64 healthy controls. Clinical assessments of cases were performed using CARS in addition to EEG records. Plasma amino acids were measured using high-performance liquid chromatography (HPLC), while, serum ammonia and oxidative stress markers were measured using colorimetric methods for all included children.

RESULTS

The overall results revealed that 37.04% of cases had abnormal EEG findings. Amino acid profile in autistic children showed statistically significant lower levels of aspartic acid, glycine, β-alanine, tryptophan, lysine and proline amino acids with significantly higher asparagine amino acid derivative levels among autistic patients versus the control group (p˂0.05). There were significantly higher serum ammonia levels with significantly higher total oxidant status (TOS) and oxidative stress index (OSI) values among the included autistic children vs controls (p˂0.05). There were significantly negative correlations between CARS with aspartic acid (r=-0.269, P=0.049), arginine (r= - 0.286, p= 0.036), and TAS (r= -0.341, p= 0.012), and significantly positive correlations between CARS with TOS (r=0.360, p= 0.007) and OSI (r= 0.338, p= 0.013).

CONCLUSION

Dysregulated amino acid metabolism, high ammonia and oxidative stress were prevalent among autistic children and should be considered in autism management. Still EEG records were inconclusive among autistic children, although may be helpful in assessment autism severity.

Psychiatric disorders in children and adolescents during the COVID-19 pandemic

INTRODUCTION

The Covid-19 pandemic has generated an unprecedented multimodal (health, occupational, economic, and social crisis, which will impact developing countries. Confinement as a preventive measure is itself a threat that produces a social impact. Pandemic and confinement have become a psychosocial adversity factor that affects families and their children. During the pandemic, children and adolescents with a psychiatric disorder may experience exacerbation of their symptoms. However, little is known about this, since studies on this population during the pandemic are scarce.

OBJECTIVE

To review the data available in the current literature on the effect of the pandemic on children and adolescents with a previous psychiatric disorder.

METHODS

A literature search was carried out using PubMed, Scielo and, due to the exceptional conditions of the pandemic situation, directly using internet search engines. Both English and Spanish papers were included.

RESULTS

The information found is presented in the following sections: family and children during the pandemic, evaluation of mental disorders in children and young people during the pandemic, pre-existing psychiatric disorders during the pandemic, and telepsychiatric care. Specific information is presented on attention deficit hyperactivity disorder, autism spectrum disorder, intellectual disability, anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder. The current pandemic due to COVID-19 and confinement are a psychosocial adversity that threatens the stability of the family. Such a stressor can cause exacerbation of symptoms of a previous mental disorder. Children and adolescents with psychiatric disorders are a vulnerable population and require specialised care. Telepsychiatry is becoming a modality with multiple advantages.

A cross-task comparison on visuospatial processing in autism spectrum disorders

This study aimed to draw a cross-task comparison on visuospatial processing in autism spectrum disorder without intellectual disability. Participants with autism spectrum disorder were matched with typically developing individuals on general intelligence and perceptual reasoning index. The two groups were subsequently compared on visuospatial processing speed, visuo-perceptual, visuo-constructive, and visuospatial working memory tasks. Our results revealed similar performances between autism spectrum disorder and typically developing individuals on measures of visuospatial processing speed and visuospatial working memory. The autism spectrum disorder group showed slower reaction times than the typically developing group in the visuo-perceptual task, when stimuli were characterized by a minimum level of perceptual cohesiveness, revealing weaker spatial integration abilities. Concerning the visuo-constructive domain, no differences between the autism spectrum disorder and the typically developing group emerged for the unsegmented condition, revealing that our participants with autism spectrum disorder were similar to the typically developing group in the local analysis of the stimuli. The discussion takes into account the role of individual differences on visuospatial intelligence, task requirements, and cognitive domains to clarify the visuospatial processing skills of individuals with autism spectrum disorder.

Spatial language difficulties reflect the structure of intact spatial representation: Evidence from high-functioning autism

Previous studies have shown that the basic properties of the visual representation of space are reflected in spatial language. This close relationship between linguistic and non-linguistic spatial systems has been observed both in typical development and in some developmental disorders. Here we provide novel evidence for structural parallels along with a degree of autonomy between these two systems among individuals with Autism Spectrum Disorder, a developmental disorder with uneven cognitive and linguistic profiles. In four experiments, we investigated language and memory for locations organized around an axis-based reference system. Crucially, we also recorded participants' eye movements during the tasks in order to provide new insights into the online processes underlying spatial thinking. Twenty-three intellectually high-functioning individuals with autism (HFA) and 23 typically developing controls (TD), all native speakers of Norwegian matched on chronological age and cognitive abilities, participated in the studies. The results revealed a well-preserved axial reference system in HFA and weakness in the representation of direction within the axis, which was especially evident in spatial language. Performance on the non-linguistic tasks did not differ between HFA and control participants, and we observed clear structural parallels between spatial language and spatial representation in both groups. However, there were some subtle differences in the use of spatial language in HFA compared to TD, suggesting that despite the structural parallels, some aspects of spatial language in HFA deviated from the typical pattern. These findings provide novel insights into the prominence of the axial reference systems in non-linguistic spatial representations and spatial language, as well as the possibility that the two systems are, to some degree, autonomous.

Developing set-shifting improvement tasks (SSIT) for children with high-functioning autism

BACKGROUND

Children with autism spectrum disorder (ASD) experience set-shifting deficit as a part of executive function, which can lead to cognitive and behavioural flexibility deficits and/or restricted behaviours. Despite the increasing body of research on this cognitive deficit, set-shifting training has not been exclusively studied in ASD.

AIMS

In this study, a training condition [set-shifting improvement tasks (SSIT)] was developed to improve set-shifting ability; afterwards, the possible effects of these tasks were investigated.

METHODS AND PROCEDURES

With the aim of improving set-shifting ability in children with autism, a training program (SSIT), involving a computer game (Tatka, a puzzle game produced by our research team) with some home-based tasks (for generalisation purposes), was developed. Then, in a quasi-experimental design, the effects of SSIT tasks were studied on children (n = 13, 5-7 years old) with high-functioning autism. Outcome measures (pre-training, post-training and a 6-week follow-up) were assessed using Modified Wisconsin Card Sorting Test, Bender-Gestalt Test and Behavioural Flexibility Rating Scale.

RESULTS AND OUTCOMES

A significant change was observed in both cognitive (Bender Gestalt, ηp2=0.84 ; WCST; =p20.87 ) and behavioural flexibilities ( ηp2=0.79 ) and also in repetitive behaviours ( ηp2=0.45 ). Furthermore, the result remained stable to some extent for about 1 month after the training condition.

CONCLUSIONS AND IMPLICATIONS

Developing the SSIT is just an initial step in the major target of creating cognitive rehabilitation tools to be used by clinicians and parents for children diagnosed with ASD and should be understood as a supplement, rather than an alternative, to the main treatments such as applied behaviour analysis. Future research with larger samples are needed to confirm whether this intervention is effective for children with ASD.

Contextual priors do not modulate action prediction in children with autism

Bayesian accounts of autism suggest that this disorder may be rooted in an impaired ability to estimate the probability of future events, possibly owing to reduced priors. Here, we tested this hypothesis within the action domain in children with and without autism using a behavioural paradigm comprising a familiarization and a testing phase. During familiarization, children observed videos depicting a child model performing actions in diverse contexts. Crucially, within this phase, we implicitly biased action-context associations in terms of their probability of co-occurrence. During testing, children observed the same videos but drastically shortened (i.e. reduced amount of kinematics information) and were asked to infer action unfolding. Since during the testing phase movement kinematics became ambiguous, we expected children's responses to be biased to contextual priors, thus compensating for perceptual uncertainty. While this probabilistic effect was present in controls, no such modulation was observed in autistic children, overall suggesting an impairment in using contextual priors when predicting other peoples' actions in uncertain environments.

Processing Speed is Impaired in Adults with Autism Spectrum Disorder, and Relates to Social Communication Abilities

Autism spectrum disorder (ASD) is characterized by a variety of social and non-social behavioral deficits. One potential mechanism that could unify this diverse profile of behaviors is slower processing speed. Seventy-six high-functioning adults with ASD were compared to 64 matched controls on standardized measures of processing speed. Participants with ASD were significantly slower on all measures, and on the composite score from the three tests (d's > .65). ASD participants with slower processing speeds scored higher on the ADOS Communication and Reciprocal Social Interaction scale (r = .34). These findings provide evidence of slower processing speeds in adults with ASD, and that this may be contributing to impairments in social communication skills. Interventions that improve processing speed might improve social communication abilities in ASD.

Executive functions in children with dyslexia

INTRODUCTION

This study aimed to verify whether children with dyslexia have difficulties in executive functions (shifting, working memory, inhibition).

METHODS

A sample of 47 children (ages 8-13 years) participated in the study: 24 who were dyslexic and 23 controls with typical development. A battery of neuropsychological tests was used.

RESULTS

Results revealed executive function difficulties among the dyslexic children when compared with controls, encompassing selective attention modulation processes, shifting, and inhibitory control. These difficulties appeared to be affected by phonological working memory deficits, typically associated with dyslexia.

CONCLUSION

Our findings support the consensus among scholars regarding the central involvement of phonological skill dysfunctions in dyslexia.

Clinical considerations for the inclusion of individuals with autism spectrum disorder in clinical trials

Diagnoses of autism spectrum disorder (ASD) have increased considerably over the past 20 years. Because of this rise and the inherent complexity of ASD, there is a need for an increased number of scientifically valid basic and clinical research studies addressing this disorder. This manuscript serves as an introduction to the clinical presentation of ASD as well as the unique challenges and modifications required to conduct clinical research with this population. This includes detailing the current diagnostic criteria, process of receiving an ASD diagnosis, information on assessment measures, and special considerations when developing research. It is the hope that this information will provide researchers interested in conducting clinical trials with those with ASD with baseline information and considerations when developing their research topics and methodology.

Less differentiated facial responses to naturalistic films of another person's emotional expressions in adolescents and adults with High-Functioning Autism Spectrum Disorder

BACKGROUND

Reduced facial expressivity (flat affect) and deficits in nonverbal communicative behaviors are characteristic symptoms of autism spectrum disorder (ASD). Based on the important interpersonal functions of facial emotional responsiveness the present study aimed at a comprehensive and differentiated analysis of perceptible facial behavior in response to another person's naturalistic, dynamic facial expressions of emotion.

METHODS

In a group of 21 adolescent and adult individuals with High-Funtioning autism spectrum disorder (HF-ASD) and in 21 matched healthy controls we examined perceptible facial responses using the whole range of action units of the Facial Action Coding System (FACS) while participants were watching films displaying continuous, dynamic real-life facial expressions of four universal emotions (cheerfulness, anger, sadness, anxiety). The duration of the 80 s films was in the typical range of casual face-to-face interactions.

RESULTS

Overall, the number of congruent facial muscle movements while watching the emotion-laden stimulus films did not differ in the two groups. However, the comprehensive FACS analysis indicated that participants with HF-ASD displayed less differentiated facial responses to the watched emotional expressions.

CONCLUSIONS

The unusual or awkward patterns of facial emotional responses in ASD may hamper the recognition of affect in other people as well as the interaction partner's sense of interpersonal resonance, and thereby lead to social disadvantage in individuals with ASD.

Olfactory Processing in Male Children with Autism: Atypical Odor Threshold and Identification

Sensory issues are of great interest in ASD diagnosis. However, their investigation is mainly based on external observation (parent reports), with methodological limitations. Unobtrusive olfactory assessment allows studying autism neurosensoriality. Here, 20 male children with high-functioning ASD and 20 matched controls were administered a complete olfactory test battery, assessing olfactory threshold, identification and discrimination. ASD children show lower sensitivity (p = 0.041), lower identification (p = 0.014), and intact odor discrimination (p = 0.199) than controls. Comparing olfactory and clinical scores, a significant correlation was found in ASD between olfactory threshold and the CBCL social problems (p = 0.011) and aggressive behavior (p = 0.012) sub-scales. The pattern featuring peripheral hyposensitivity, high-order difficulties in odor identification and regular subcortical odor discrimination is discussed in light of hypo-priors hypothesis for autism.

Relations Between Executive Functions, Social Impairment, and Friendship Quality on Adjustment Among High Functioning Youth with Autism Spectrum Disorder

High functioning adolescents with Autism Spectrum Disorder (ASD) often have adjustment difficulties, specifically loneliness and depression. To better understand contributing factors, the current study evaluated associations between several Executive Function (EF) domains, social impairment, and friendship quality on depressive symptoms and loneliness in this population. Participants included 127 high functioning ASD adolescents and a parent/caregiver. Results indicated significant levels of parent-reported EF impairment which were positively correlated with increased levels of loneliness and depressive symptoms. Social impairment was identified as a significant mediator between all studied EF domains and adjustment, while friendship quality only partially mediated the relation between emotional control and loneliness. These results have implications for treatments focusing both on social skills and adjustment in adolescents with ASD.

Adult Autism Subthreshold Spectrum (AdAS Spectrum) in parents of pediatric patients with epilepsy: Correlations with post-traumatic stress symptoms

Increasing literature has shown the usefulness of a dimensional approach to mental disorders, particularly when exploring subjects exposed to traumatic experiences such as a severe illness in one's child. Recent evidence suggests an increased vulnerability in subjects with autism spectrum symptoms to develop post-traumatic stress symptoms. The aim of the present study was to evaluate the presence of adult autism subthreshold spectrum in a sample of parents of children with epilepsy and its impact on post-traumatic stress spectrum symptoms in the same study sample. Results revealed noteworthy correlations between post-traumatic stress symptoms and adult autism subthreshold spectrum (AdAS Spectrum) only in the subgroup of the fathers. In particular, were evidenced correlations between AdAS Spectrum domain of rumination and narrow interests and some TALS-SR nuclear domains: reaction to traumatic events, reexperiencing and arousal. These findings corroborate the hypothesis that subthreshold autistic features may influence the possible psychopathological reaction to trauma.

Narratives of mothers of children with autism spectrum disorders: focus on eating behavior

OBJECTIVE

To investigate the eating behavior of individuals with autism through their mothers' narratives.

METHODS

The study of narratives was used to report on the narrators' experiences. Data on the eating habits of individuals with autism were collected using semi-structured interviews held individually with the mothers. The interviews were recorded, transcribed and codified using the NVivo software program.

RESULTS

Eighteen mothers of boys/young men with autism participated in the study. Analysis yielded three major categories: eating patterns, the family's attitudes to the child's eating habits, and food-related behavior.

CONCLUSION

Results show that autism-related factors may affect the child's food choices. Environmental factors, particularly the parents' behavior, may also play a decisive role, both in reinforcing the child's food choices and in encouraging a healthier and more diversified diet. Professionals should instruct parents regarding their decisive role in reinforcing or discouraging inappropriate mealtime behavior in children with autism.

The association between theory of mind, executive function, and the symptoms of autism spectrum disorder

It has been strongly argued that atypical cognitive processes in autism spectrum disorder (ASD) contribute to the expression of behavioural symptoms. Comprehensive investigation of these claims has been limited by small and unrepresentative sample sizes and the absence of wide-ranging task batteries. The current study investigated the cognitive abilities of 100 adolescents with ASD (mean age = 15 years 6 months), using 10 tasks to measure the domains of theory of mind (ToM) and executive function (EF). We used structural equation modelling as a statistically robust way of exploring the associations between cognition and parent-reported measures of social communication and restricted and repetitive behaviours (RRBs). We found that ToM ability was associated with both social communication symptoms and RRBs. EF was a correlate of ToM but had no direct association with parent-reported symptom expression. Our data suggest that in adolescence ToM ability, but not EF, is directly related to autistic symptom expression. Autism Res 2018, 11: 95-109. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

The behaviours that are common to autism spectrum disorder (ASD) have been linked to differences in thinking ability. We assessed autistic adolescents and found that social communication difficulties and the presence of restricted and repetitive behaviours related to difficulties in understanding other peoples' minds (theory of mind). In contrast, these behaviours were not associated with the general thinking abilities involved in planning and executing tasks (executive function).

Evolving Definitions of Autism and Impact on Eligibility for Developmental Disability Services: California Case Example

When establishing eligibility for developmental disability (DD) services, definitions of specific diagnostic conditions, such as autism, impact policy. Under the Medicaid home and community-based waiver program, states have discretion in determining specific program or service eligibility criteria, the nature of supports to be provided, and the number of individuals to be served. Individuals with DD, their families, and advocates have pushed to expand eligibility and improve the quality of services and supports received. This article uses a California legal case to explore the impact on individuals seeking eligibility for DD services when states rely on evolving diagnostic criteria for autism spectrum disorder. Recommendations are made for a more equitable and consistent approach to disability eligibility determination.

Executive Function, Social Emotional Learning, and Social Competence in School-Aged Boys With Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is an aetiologically complex neurodevelopmental disorder characterized by deficits in social functioning. Children with ASD display a wide range of social competence and more variability in social domains as compared with either communication or repetitive behaviour domains. There is limited understanding of factors that contribute to the heterogeneity of social abilities in ASD. A modified version of McKown and colleagues’ social competence model was used to examine social competence in 49 8- to 13-year-old boys with ASD without cognitive disability. The relations between executive function (EF), social emotional learning (SEL), and parent reports of child social competence were examined. Results showed that EF but not SEL predicted parent-reported child social competence. Although many interventions target SEL skills, these findings support specifically targeting EF in both assessment and interventions of school-aged children with ASD.