The impact of atypical sensory processing on social impairments in autism spectrum disorder

Age-Related Hearing Loss, Cognitive Decline, and Social Interaction: Testing a Framework

PURPOSE

Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults.

METHOD

We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears.

RESULTS

Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population.

CONCLUSIONS

Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26237060.

The dissociating effects of fear and disgust on multisensory integration in autism: evidence from evoked potentials

Background

Deficits in Multisensory Integration (MSI) in ASD have been reported repeatedly and have been suggested to be caused by altered long-range connectivity. Here we investigate behavioral and ERP correlates of MSI in ASD using ecologically valid videos of emotional expressions.

Methods

In the present study, we set out to investigate the electrophysiological correlates of audiovisual MSI in young autistic and neurotypical adolescents. We employed dynamic stimuli of high ecological validity (500 ms clips produced by actors) that depicted fear or disgust in unimodal (visual and auditory), and bimodal (audiovisual) conditions.

Results

We report robust MSI effects at both the behavioral and electrophysiological levels and pronounced differences between autistic and neurotypical participants. Specifically, neurotypical controls showed robust behavioral MSI for both emotions as seen through a significant speed-up of bimodal response time (RT), confirmed by Miller's Race Model Inequality (RMI), with greater MSI effects for fear than disgust. Adolescents with ASD, by contrast, showed behavioral MSI only for fear. At the electrophysiological level, the bimodal condition as compared to the unimodal conditions reduced the amplitudes of the visual P100 and auditory P200 and increased the amplitude of the visual N170 regardless of group. Furthermore, a cluster-based analysis across all electrodes revealed that adolescents with ASD showed an overall delayed and spatially constrained MSI effect compared to controls.

Conclusion

Given that the variables we measured reflect attention, our findings suggest that MSI can be modulated by the differential effects on attention that fear and disgust produce. We also argue that the MSI deficits seen in autistic individuals can be compensated for at later processing stages by (a) the attention-orienting effects of fear, at the behavioral level, and (b) at the electrophysiological level via increased attentional effort.

Developmental Impacts of Early Sensory Patterns on School-Age Adaptive, Maladaptive, and Participation Outcomes in Autistic and Non-autistic Children

Early sensory differences may cascade into later social-communication difficulties in autism, yet their impacts on broader functional outcomes have remained understudied. This study aimed to conduct a comprehensive investigation into the longitudinal impacts of sensory patterns, including sensory hyperresponsiveness, hyporesponsiveness, and sensory repetitions/seeking behavior, on various school-age outcome domains among a community sample of children with autistic and non-autistic conditions. We prospectively followed 1,517 children with caregiver-reported sensory questionnaires across three timepoints from infancy to school age. A subsample (n = 389; 88 with reported autism diagnosis/concerns) was further assessed with adaptive, maladaptive and participation outcome measures at age 6-7. Structural equation modeling approaches were used to evaluate the multivariate associations between latent growth parameters (i.e., intercepts and slopes) of sensory patterns and school-age outcomes. Increasing sensory hyperresponsiveness was directly associated with poorer adaptive/maladaptive outcomes and indirectly with lower participation in activities with higher functional demands across settings at school age. Elevated sensory hyporesponsiveness was associated with lower adaptive functioning, more externalizing problems, and lower classroom participation. Trajectories of sensory patterns accounted for more unique variances in adaptive functioning and participation in daily life settings with higher functional and environmental demands among autistic children compared to their non-autistic peers.

Reduced Visual Evoked Potential Amplitude in Autistic Children with Co-Occurring Features of Attention-Deficit/Hyperactivity Disorder

Provided the significant overlap in features of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), there is a critical need to identify transdiagnostic markers that could meaningfully stratify subgroups. The objective of this study was to compare the visual evoked potential (VEP) between 30 autistic children, 17 autistic children with co-occurring ADHD presentation (ASD + ADHD), and 21 neurotypical children (NTC). Electroencephalography was recorded while children passively viewed a pattern-reversal stimulus. Mean amplitude of the P1 event-related potential was extracted from a midline occipital channel and compared between groups. P1 mean amplitude was reduced in the ASD + ADHD group compared to the ASD and NTC groups, indicating a distinct pattern of brain activity in autistic children with co-occurring ADHD features.

The Relationship Between Attention, Sensory Processing, and Social Responsiveness Among Adults on the Autism Spectrum

This study evaluated attention, sensory processing, and social responsiveness and the relationship between these constructs among autistic and neurotypical adults. Participants included 24 autistic adults (17-30 years) and 24 neurotypical peers who completed the Test of Everyday Attention, Adolescent/Adult Sensory Profile (AASP), and the Social Responsiveness Scale-2. Autistic individuals showed greater attention, sensory processing, and social responsiveness challenges compared to neurotypical peers. Using mediation models, we showed that the relationship between attention and social responsiveness was mediated by sensory processing, specifically the low registration and sensation-seeking AASP quadrants. The relationship between attention, sensory processing, and social responsiveness suggests that adults with greater attention issues may have greater sensory and social challenges. Specifically, having poor attention may lead to poor sensory processing skills which compound poor social responsiveness. Understanding the relationships between these domains is critical for developing effective interventions and support for autistic adults.

Scene construction ability in neurotypical and autistic adults

LAY ABSTRACT

People with autism spectrum conditions (ASC) have difficulties imagining events, which might result from difficulty mentally generating and maintaining a coherent spatial scene. This study compared this scene construction ability between autistic (N = 55) and neurotypical (N = 63) adults. Results showed that scene construction was diminished in autistic compared to neurotypical participants, and participants with fewer autistic traits had better scene construction ability. ASC diagnosis did not influence the frequency of mentions of the self or of sensory experiences. Exploratory analysis suggests that scene construction ability is associated with the ability to understand our own and other people's mental states, and that these individual-level preferences/cognitive styles can overrule typical group-level characteristics.

Auditory Challenges and Listening Effort in School-Age Children With Autism: Insights From Pupillary Dynamics During Speech-in-Noise Perception

PURPOSE

This study aimed to investigate challenges in speech-in-noise (SiN) processing faced by school-age children with autism spectrum conditions (ASCs) and their impact on listening effort.

METHOD

Participants, including 23 Mandarin-speaking children with ASCs and 19 age-matched neurotypical (NT) peers, underwent sentence recognition tests in both quiet and noisy conditions, with a speech-shaped steady-state noise masker presented at 0-dB signal-to-noise ratio in the noisy condition. Recognition accuracy rates and task-evoked pupil responses were compared to assess behavioral performance and listening effort during auditory tasks.

RESULTS

No main effect of group was found on accuracy rates. Instead, significant effects emerged for autistic trait scores, listening conditions, and their interaction, indicating that higher trait scores were associated with poorer performance in noise. Pupillometric data revealed significantly larger and earlier peak dilations, along with more varied pupillary dynamics in the ASC group relative to the NT group, especially under noisy conditions. Importantly, the ASC group's peak dilation in quiet mirrored that of the NT group in noise. However, the ASC group consistently exhibited reduced mean dilations than the NT group.

CONCLUSIONS

Pupillary responses suggest a different resource allocation pattern in ASCs: An initial sharper and larger dilation may signal an intense, narrowed resource allocation, likely linked to heightened arousal, engagement, and cognitive load, whereas a subsequent faster tail-off may indicate a greater decrease in resource availability and engagement, or a quicker release of arousal and cognitive load. The presence of noise further accentuates this pattern. This highlights the unique SiN processing challenges children with ASCs may face, underscoring the importance of a nuanced, individual-centric approach for interventions and support.

Differentiating early sensory profiles in toddlers at elevated likelihood of autism and association with later clinical outcome and diagnosis

LAY ABSTRACT

Early sensory responsiveness may produce cascading effects on later development, but the relation between sensory profiles and autistic diagnosis remains unclear. In a longitudinal sample of toddlers at elevated likelihood for autism, we aimed to characterize sensory subgroups and their association with clinical outcomes later on. Three sensory subgroups were described and early sensory sensitivity plays a significant role in later development and diagnosis. This study supported the importance of examining different levels of sensory patterns to dissect the phenotypic heterogeneity in sensory processing. As sensory differences are associated with later developmental outcomes, these results may be critical when designing intervention needs and support for children at increased likelihood for neurodevelopmental disorders.

Sensory over-responsivity and atypical neural responses to socially relevant stimuli in autism

Although aversive responses to sensory stimuli are common in autism spectrum disorder (ASD), it remains unknown whether the social relevance of aversive sensory inputs affects their processing. We used functional magnetic resonance imaging (fMRI) to investigate neural responses to mildly aversive nonsocial and social sensory stimuli as well as how sensory over-responsivity (SOR) severity relates to these responses. Participants included 21 ASD and 25 typically-developing (TD) youth, aged 8.6-18.0 years. Results showed that TD youth exhibited significant neural discrimination of socially relevant versus irrelevant aversive sensory stimuli, particularly in the amygdala and orbitofrontal cortex (OFC), regions that are crucial for sensory and social processing. In contrast, ASD youth showed reduced neural discrimination of social versus nonsocial stimuli in the amygdala and OFC, as well as overall greater neural responses to nonsocial compared with social stimuli. Moreover, higher SOR in ASD was associated with heightened responses in sensory-motor regions to socially-relevant stimuli. These findings further our understanding of the relationship between sensory and social processing in ASD, suggesting limited attention to the social relevance compared with aversiveness level of sensory input in ASD versus TD youth, particularly in ASD youth with higher SOR.

Autistic and Non-autistic Children's Pain Perception is Modulated by Their First-Hand Pain Sensitivity and Theory of Mind

The current study examined whether autistic children's perception of others' pain could be modulated by their first-hand pain sensitivity and theory of mind (ToM). We measured the first-hand pain sensitivity, the rating of others' pain intensity, and the performance in the ToM tasks in 43 5- to 8-year-old autistic and 30 neurotypical children. Our results revealed hyposensitivity to first-hand pain, underestimation of others' pain intensity, as well as difficulties in the False Belief subtasks of ToM in autistic children. Furthermore, we detected an interaction between children's first-hand pain sensitivity and ToM in predicting their perception of others' pain. To be specific, for autistic and NT children with normal or hyper-sensitivity to first-hand pain, better performance on ToM predicted higher ratings for others' pain intensity; while for autistic and NT children with hyposensitivity to first-hand pain, ToM did not predict ratings for others' pain intensity. Our study contributes to the understanding of pain perception in young children and provides implications for clinical practices to improve social understanding in autistic children.

Caregivers' Assessment of the Sensory Processing Patterns Exhibited by Children with Autism in the Gulf Region

This study explored the nature, prevalence, and developmental profiles of sensory processing disorders among children with autism spectrum disorder (ASD). The participants comprised 119 children with ASD and 30 typically developing children and their parents. The Child Sensory Profile-2 was used to assess the children's sensory processing characteristics. The children with ASD exhibited elevated sensory processing difficulties. Deficits were observed in all the sensory modalities among the children with ASD, except the visual processing modality. Age-related improvements were observed in most sensory processing domains, although non-significant differences were noted in three domains. These findings should enhance understanding of the sensory challenges faced by children with ASD and contribute to the development of individually tailored, targeted, and age-specific therapeutic interventions.

Proprioception, Emotion and Social Responsiveness in Children with Developmental Disorders: An Exploratory Study in Autism Spectrum Disorder, Cerebral Palsy and Different Neurodevelopmental Situations

Proprioception has long been linked with emotional dysregulation in neurotypical adults. Neuropediatric disorders such as autism spectrum disorder (ASD) and cerebral palsy (CP) are distinct entities and yet both present with deficits and challenges in sensory processing and the regulation of emotions. This study aimed to explore the relationship between proprioception and emotional-social performance in children and to compare proprioception and emotional-social performance in different underlying neurodevelopmental conditions. For this purpose, this cross-sectional study included 42 children with ASD, 34 children with CP and 50 typically developing peers. Proprioceptive acuity, proprioceptive reactive behavior as well as emotion regulation and social responsiveness were assessed. The results show a significant correlation between proprioceptive deficits and emotional difficulties in this pediatric sample, with distinct proprioceptive impairment patterns according to the underlying neurological disorder. Children with CP showed significant emotional knowledge deficits, while children with ASD predominantly showed challenges in social responsiveness. These data thus suggest a differentiated impact of proprioception on emotional-social performance in neurodevelopmental disorders and highlight proprioception as a potential therapeutic target for balancing emotion regulation in children with neurodevelopmental conditions.

Tactile sensory processing deficits in genetic mouse models of autism spectrum disorder

Altered sensory processing is a common feature in autism spectrum disorder (ASD), as recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although altered responses to tactile stimuli are observed in over 60% of individuals with ASD, the neurobiological basis of this phenomenon is poorly understood. ASD has a strong genetic component and genetic mouse models can provide valuable insights into the mechanisms underlying tactile abnormalities in ASD. This review critically addresses recent findings regarding tactile processing deficits found in mouse models of ASD, with a focus on behavioral, anatomical, and functional alterations. Particular attention was given to cellular and circuit-level functional alterations, both in the peripheral and central nervous systems, with the objective of highlighting possible convergence mechanisms across models. By elucidating the impact of mutations in ASD candidate genes on somatosensory circuits and correlating them with behavioral phenotypes, this review significantly advances our understanding of tactile deficits in ASD. Such insights not only broaden our comprehension but also pave the way for future therapeutic interventions.

The anterior cingulate cortex is involved in intero-exteroceptive integration for spatial image transformation of the self-body

Spatial image transformation of the self-body is a fundamental function of visual perspective-taking. Recent research underscores the significance of intero-exteroceptive information integration to construct representations of our embodied self. This raises the intriguing hypothesis that interoceptive processing might be involved in the spatial image transformation of the self-body. To test this hypothesis, the present study used functional magnetic resonance imaging to measure brain activity during an arm laterality judgment (ALJ) task. In this task, participants were tasked with discerning whether the outstretched arm of a human figure, viewed from the front or back, was the right or left hand. The reaction times for the ALJ task proved longer when the stimulus presented orientations of 0°, 90°, and 270° relative to the upright orientation, and when the front view was presented rather than the back view. Reflecting the increased reaction time, increased brain activity was manifested in a cluster centered on the dorsal anterior cingulate cortex (ACC), suggesting that the activation reflects the involvement of an embodied simulation in ALJ. Furthermore, this cluster of brain activity exhibited overlap with regions where the difference in activation between the front and back views positively correlated with the participants' interoceptive sensitivity, as assessed through the heartbeat discrimination task, within the pregenual ACC. These results suggest that the ACC plays an important role in integrating intero-exteroceptive cues to spatially transform the image of our self-body.

"It Helps Make the Fuzzy Go Away": Autistic Adults' Perspectives on Nature's Relationship with Well-being Through the Life Course

Background

While previous work highlights the links between nature and various positive well-being-related outcomes, the experiences of autistic people in nature have received limited empirical research. Our study aimed at gathering autistic adults' perspectives on the relationship between nature and well-being in both childhood and adulthood.

Methods

We used an online survey to capture the views of 127 autistic adults across the United Kingdom. Using reflexive thematic analysis, we analyzed responses to three questions focused on nature experiences in childhood and adulthood and how the participants felt that nature was (or was not) related to well-being. Guided by self-determination theory, we used both inductive and deductive analysis.

Results

We developed three main themes to reflect the nature experiences of autistic adults: choosing to escape into nature, supporting relatedness through connecting in (and to) nature, and nature doesn't judge, but other people do. Compared with many other contexts, nature provides a non-judgmental space through which (in both childhood and adulthood) many, but not all, autistic individuals can meet individual needs and experience autonomy, relatedness, and competence.

Conclusion

This analysis of how autistic adults in the United Kingdom utilize nature to support well-being has implications for how nature can be used in social prescribing as well as in ensuring that existing outdoor spaces, organizations, and activities are supportive of autistic people.

Resting-State Activity in Children: Replicating and Extending Findings of Early Maturation of Alpha Rhythms in Autism Spectrum Disorder

Resting-state alpha brain rhythms provide a foundation for basic as well as higher-order brain processes. Research suggests atypical maturation of the peak frequency of resting-state alpha activity (= PAF) in autism spectrum disorder (ASD). The present study examined resting-state alpha activity in young school-aged children, obtaining magnetoencephalographic (MEG) eyes-closed resting-state data from 47 typically developing (TD) males and 45 ASD males 6.0 to 9.3 years old. Results confirmed a higher PAF in ASD versus TD, and demonstrated that alpha power differences between groups were linked to the shift of PAF in ASD. Additionally, a higher PAF was associated with better cognitive performance in TD but not ASD. Finding thus suggested functional consequences of group differences in resting-state alpha activity.

Salience network connectivity is altered in 6-week-old infants at heightened likelihood for developing autism

Converging evidence implicates disrupted brain connectivity in autism spectrum disorder (ASD); however, the mechanisms linking altered connectivity early in development to the emergence of ASD symptomatology remain poorly understood. Here we examined whether atypicalities in the Salience Network - an early-emerging neural network involved in orienting attention to the most salient aspects of one's internal and external environment - may predict the development of ASD symptoms such as reduced social attention and atypical sensory processing. Six-week-old infants at high likelihood of developing ASD based on family history exhibited stronger Salience Network connectivity with sensorimotor regions; infants at typical likelihood of developing ASD demonstrated stronger Salience Network connectivity with prefrontal regions involved in social attention. Infants with higher connectivity with sensorimotor regions had lower connectivity with prefrontal regions, suggesting a direct tradeoff between attention to basic sensory versus socially-relevant information. Early alterations in Salience Network connectivity predicted subsequent ASD symptomatology, providing a plausible mechanistic account for the unfolding of atypical developmental trajectories associated with vulnerability to ASD.

Sensory sensitivity and intelligence are correlated with nutrient deficiency in children with autism spectrum disorder and intellectual disability

BACKGROUND/OBJECTIVES

Relationship between dietary intake and sensory sensitivity and intelligence in autism spectrum disorder (ASD) is not well described. This study aims to investigate nutrition status in children with ASD and ID and its association with sensory sensitivity and intelligence.

SUBJECTS/METHODS

84 students (34 ASD and 48 ID) in a special education school were recruited. Dietary intakes were evaluated with 3-day food dairy. Sensory sensitivity was measured using short sensory profile (SSP). Wechsler IQ test were performed.

RESULTS

Two out of twenty-four investigated nutrients had an adequate intake rate of over 50%. Four out of ten investigated vitamins had an inadequate intake rate of over 90% and another two over 80%. 75.6% of participants had inadequate energy intake. After adjusting for age, ASD participants had a higher intake of all surveyed nutrients but only the intake of vitamin E and folate were statistically different (p < 0.05) along with a smaller number of inadequate nutrients (p < 0.001). Taste/smell sensitivity, movement sensitivity, underresponsive/seeks sensation, and total sensory sensitivity symptoms severity were slightly higher in ASD group than in ID group (all p < 0.05). After adjusting for IQ and sensory sensitivity score, difference of number of inadequate nutrients between ASD and ID group were not statistically significant (p = 0.193).

CONCLUSIONS

Individuals with ASD had better dietary intake but worse sensory sensitivity compared to those with ID. Sensory sensitivity and intelligence are correlated with nutritional status in individuals with neurodevelopmental disorder.

Vocal Emotion Recognition in Autism: Behavioral Performance and Event-Related Potential (ERP) Response

Autistic youth display difficulties in emotion recognition, yet little research has examined behavioral and neural indices of vocal emotion recognition (VER). The current study examines behavioral and event-related potential (N100, P200, Late Positive Potential [LPP]) indices of VER in autistic and non-autistic youth. Participants (N = 164) completed an emotion recognition task, the Diagnostic Analyses of Nonverbal Accuracy (DANVA-2) which included VER, during EEG recording. The LPP amplitude was larger in response to high intensity VER, and social cognition predicted VER errors. Verbal IQ, not autism, was related to VER errors. An interaction between VER intensity and social communication impairments revealed these impairments were related to larger LPP amplitudes during low intensity VER. Taken together, differences in VER may be due to higher order cognitive processes, not basic, early perception (N100, P200), and verbal cognitive abilities may underlie behavioral, yet occlude neural, differences in VER processing.

English Prosodic Focus Marking by Cantonese Trilingual Children With and Without Autism Spectrum Disorder

PURPOSE

The current study investigated English prosodic focus marking by autistic and typically developing (TD) Cantonese trilingual children, and examined the potential differences in this regard compared to native English-speaking children.

METHOD

Forty-eight participants were recruited with 16 speakers for each of the three groups (Cantonese-speaking autistic [CASD], Cantonese-speaking TD [CTD], and English-speaking TD [ETD] children), and prompt questions were designed to elicit desired focus type (i.e., broad, narrow, and contrastive focus). Mean duration, mean fundamental frequency (F0), F0 range, mean intensity, and F0 curves were used as the acoustic correlates for linear mixed-effects model fitting and functional data analyses in relation to groups and focus conditions (i.e., broad, narrow, and contrastive pre-, on-, and post-focus).

RESULTS

The CTD group had post-focus compression (PFC) patterns via reducing mean duration, narrowing F0 range, and lowering mean F0, F0 curve, and mean intensity for words under both narrow and contrastive post-focus conditions, while the CASD group only had shortened mean duration and lowered F0 curves. However, neither the CTD group nor CASD group showed much of on-focus expansion (OFE) patterns. The ETD group marked OFE by increasing mean duration, mean F0, mean intensity, and higher F0 curve for words under on-focus conditions.

CONCLUSIONS

The CTD group utilized more acoustic cues than the CASD group when it comes to PFC. The ETD group differed from the CASD and CTD groups in the use of OFE. Furthermore, both the CASD and CTD groups showed positive first language transfer in the use of duration and intensity and, potentially, successful acquisition in the use of F0 for prosodic focus marking. Meanwhile, the differences in the use of OFE between the Cantonese-speaking and English-speaking groups, not PFC, might indicate that Cantonese-speaking children acquire PFC prior to OFE.

Chronic Pain in Autistic Youth: Clinical Prevalence and Reflections on Tailoring Evidence-Based Interventions from an Interdisciplinary Treatment Team

Though there is growing awareness of the overrepresentation of autistic patients in chronic pain clinics, potential adaptations for the assessment and treatment of chronic pain in this population have not yet been established. To address this gap, a retrospective review of electronic medical records and discussions by an interdisciplinary pain treatment team were summarized to inform potential biopsychosocial factors affecting the presentation, assessment, and treatment of chronic pain in autistic youth. Our sample included a record review of 95 patients receiving treatment in an interdisciplinary outpatient pediatric pain clinic. Results indicated that 9% (n = 9) of the patients presented to the clinic with a prior diagnosis of autism, but an additional 21% (n = 20) were identified as likely meeting criteria for autism based on the clinical assessment of the developmental history, behaviors observed during the clinical encounter(s), and expert clinical judgment, suggesting that the prevalence rate of autism may be closer to 30% in our outpatient pediatric pain clinic. Over half (52%) of the autistic youth presented to the clinic with widespread pain, 60% identified as female, and 6% identified as gender expansive or transgender. Qualitative insights revealed that most of the autistic patients had co-occurring sensory-processing challenges and difficulty in describing their pain, emotions, and somatic experiences and exhibited cognitive inflexibility and social challenges. We summarize our team's clinical reflections on how autism-relevant biopsychosocial vulnerability factors may contribute to the experience of pain in autistic youth and propose treatment targets and adaptations for the assessment and treatment of pain in this population. Finally, we recommend the need for interventions focused on sensorimotor integration, especially for autistic youth, and describe how pain clinics may be particularly helpful for identifying and supporting autistic females, for whom the potential role of autism in pain experiences had not been considered until receiving treatment in our clinic.

Current and future applications of light-sheet imaging for identifying molecular and developmental processes in autism spectrum disorders

Autism spectrum disorder (ASD) is identified by a set of neurodevelopmental divergences that typically affect the social communication domain. ASD is also characterized by heterogeneous cognitive impairments and is associated with cooccurring physical and medical conditions. As behaviors emerge as the brain matures, it is particularly essential to identify any gaps in neurodevelopmental trajectories during early perinatal life. Here, we introduce the potential of light-sheet imaging for studying developmental biology and cross-scale interactions among genetic, cellular, molecular and macroscale levels of circuitry and connectivity. We first report the core principles of light-sheet imaging and the recent progress in studying brain development in preclinical animal models and human organoids. We also present studies using light-sheet imaging to understand the development and function of other organs, such as the skin and gastrointestinal tract. We also provide information on the potential of light-sheet imaging in preclinical drug development. Finally, we speculate on the translational benefits of light-sheet imaging for studying individual brain-body interactions in advancing ASD research and creating personalized interventions.

Early-Life Digital Media Experiences and Development of Atypical Sensory Processing

Importance

Atypical sensory processing is challenging for children and families, yet there is limited understanding of its associated risk factors.

Objective

To determine the association between early-life digital media exposure and sensory processing outcomes among toddlers.

Design, Setting, and Participants

This multicenter US study used data that were analyzed from the National Children's Study (NCS), a cohort study of environmental influences on child health and development, with enrollment from 2011 to 2014. Data analysis was performed in 2023. The study included children enrolled in the NCS at birth whose caregivers completed reports of digital media exposure and sensory processing.

Exposures

Children's viewing of television or video at 12 months (yes or no), 18 months, and 24 months of age (hours per day).

Main Outcomes and measures

Sensory processing was reported at approximately 33 months of age on the Infant/Toddler Sensory Profile. Quadrant scores (low registration, sensation seeking, sensory sensitivity, and sensation avoiding) were categorized into groups representing typical, high, and low sensory-related behaviors, and multinomial regression analyses were performed.

Results

A total of 1471 children (50% male) were included. Screen exposure at 12 months of age was associated with a 2-fold increased odds of being in the high category of low registration (odds ratio [OR], 2.05; 95% CI, 1.31-3.20), while the odds of being in the low category instead of the typical category decreased for sensation seeking (OR, 0.55; 95% CI, 0.35-0.87), sensation avoiding (OR, 0.69; 95% CI, 0.50-0.94), and low registration (OR, 0.64; 95% CI, 0.44-0.92). At 18 months of age, greater screen exposure was associated with increased risk of high sensation avoiding (OR, 1.23; 95% CI, 1.03-1.46) and low registration (OR, 1.23; 95% CI, 1.04-1.44). At 24 months of age, greater screen exposure was associated with increased risk of high sensation seeking (OR, 1.20; 95% CI, 1.02-1.42), sensory sensitivity (OR, 1.25; 95% CI, 1.05-1.49), and sensation avoiding (OR, 1.21; 95% CI, 1.03-1.42).

Conclusions and Relevance

In this cohort study, early-life digital media exposure was associated with atypical sensory processing outcomes in multiple domains. These findings suggest that digital media exposure might be a potential risk factor for the development of atypical sensory profiles. Further research is needed to understand the relationship between screen time and specific sensory-related developmental and behavioral outcomes, and whether minimizing early-life exposure can improve subsequent sensory-related outcomes.

Effects of Parent-Delivered Traditional Thai Massage on Gait and Heart Rate Variability in Children with Autism: A Randomized Controlled Trial

Aim: To examine the effects of parent-delivered traditional Thai massage (TTM) intervention on heart rate variability (HRV) and gait in children with autism. Methods: This was a two-armed, randomized controlled trial conducted at the Haikou Special Education School in Haikou Province, China, between October 2021 and March 2022. A total of 48 children with autism, aged between 7 and 12 years, were selected from the school and randomly divided into either the parent-delivered TTM group or the control group (no intervention) in a 1:1 ratio. In addition to their regular daily school routines, the TTM group received 16 TTM interventions (twice a week), with each session lasting ∼50 min. HRV and gait parameters were measured at baseline, completion of the 8-week intervention, and 2 months follow-up. Results: The results of this study showed that the TTM intervention had a notable positive effect on HRV, with a significant reduction in low-frequency value (p = 0.001), and increased high-frequency value (p = 0.001), compared with the controls, and the advantages persisted during the follow-up period. However, only the stride length in the TTM group was significantly longer than that in the control group at the post-test (p = 0.039) and follow-up test (p = 0.043), while none of the other parameters of gait comparison showed statistical significance. Conclusions: Parent-delivered Thai massage increased HRV levels and stride length in comparison to the control group, and some effects of the intervention were maintained over the follow-up period. Clinical Trials Registry Identifier ChiCTR2100051355; September 21, 2021.

How Do Children and Adolescents with ASD Look at Animals? A Scoping Review

Autism spectrum disorder (ASD) is characterized by interaction and communication differences, entailing visual attention skill specificities. Interactions with animals, such as in animal-assisted interventions or with service dogs, have been shown to be beneficial for individuals with ASD. While interacting with humans poses challenges for them, engaging with animals appears to be different. One hypothesis suggests that differences between individuals with ASD's visual attention to humans and to animals may contribute to these interaction differences. We propose a scoping review of the research on the visual attention to animals of youths with ASD. The objective is to review the methodologies and tools used to explore such questions, to summarize the main results, to explore which factors may contribute to the differences reported in the studies, and to deduce how youth with ASD observe animals. Utilizing strict inclusion criteria, we examined databases between 1942 and 2023, identifying 21 studies in international peer-reviewed journals. Three main themes were identified: attentional engagement and detection, visual exploration, and behavior. Collectively, our findings suggest that the visual attention of youths with ASD towards animals appears comparable to that of neurotypical peers, at least in 2D pictures (i.e., eye gaze patterns). Future studies should explore whether these results extend to real-life interactions.

Early developmental profiles of sensory features and links to school-age adaptive and maladaptive outcomes: A birth cohort investigation

Sensory-based subtypes among autistic children have been well documented, but little is known about longitudinal sensory subtypes beyond autistic populations. This prospective study aimed to identify subtypes based on trajectories of parent-reported sensory features measured at 6-19 months, 3-4, and 6-7 years of age among a community-based birth cohort (N = 1,517), and to examine their associations with school-age clinical and adaptive/maladaptive outcomes on a subset sample (N = 389). Latent class growth analysis revealed five trajectory subtypes varying in intensity and change rates across three sensory domains. In contrast to an Adaptive-All Improving subtype (35%) with very low sensory features and overall better school-age outcomes, an Elevated-All Worsening subtype (3%), comprised of more boys and children of parents with less education, was associated with most elevated autistic traits and poorest adaptive/maladaptive outcomes. Three other subtypes (62% in total) were generally characterized by stable or improving patterns of sensory features at mild to moderate levels, and challenges in certain outcome domains. Our findings indicate that characterizing children based on early sensory trajectories may contribute to earlier detection of subgroups of children with sensory challenges who are more likely to experience developmental challenges by school age, followed by early targeted interventions for improved long-term outcomes.

Emotion Dysregulation Mediates the Relationship Between Sensory Processing and Behavior Problems in Young Children with Autism Spectrum Disorder: A Preliminary Study

Emotion dysregulation is one of the challenges that children with autism spectrum disorder (ASD) and their families face. It is unclear whether emotion dysregulation plays a mediating role in the relationship between sensory processing patterns and problem behaviors among these children. This study examined the relations between emotion dysregulation, behavioral problems, and sensory processing patterns among fifty-seven young children with ASD. Behavioral problems and sensory processing patterns were moderately to strongly correlated with emotion dysregulation. The relationship between sensory processing patterns and behavioral problems was significant with emotion dysregulation as a mediator. These findings help identify the relationship between emotion dysregulation, sensory processing patterns, and behavioral problems to facilitate the planning of intervention strategies for young children with ASD.

White matter microstructure of children with sensory over-responsivity is associated with affective behavior

BACKGROUND

Sensory processing dysfunction (SPD) is linked to altered white matter (WM) microstructure in school-age children. Sensory over-responsivity (SOR), a form of SPD, affects at least 2.5% of all children and has substantial deleterious impact on learning and mental health. However, SOR has not been well studied using microstructural imaging such as diffusion MRI (dMRI). Since SOR involves hypersensitivity to external stimuli, we test the hypothesis that children with SOR require compensatory neuroplasticity in the form of superior WM microstructural integrity to protect against internalizing behavior, leaving those with impaired WM microstructure vulnerable to somatization and depression.

METHODS

Children ages 8-12 years old with neurodevelopmental concerns were assessed for SOR using a comprehensive structured clinical evaluation, the Sensory Processing 3 Dimensions Assessment, and underwent 3 Tesla MRI with multishell multiband dMRI. Tract-based spatial statistics was used to measure diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) metrics from global WM and nineteen selected WM tracts. Correlations of DTI and NODDI measures with measures of somatization and emotional disturbance from the Behavioral Assessment System for Children, 3rd edition (BASC-3), were computed in the SOR group and in matched children with neurodevelopmental concerns but not SOR.

RESULTS

Global WM fractional anisotropy (FA) is negatively correlated with somatization and with emotional disturbance in the SOR group but not the non-SOR group. Also observed in children with SOR are positive correlations of radial diffusivity (RD) and free water fraction (FISO) with somatization and, in most cases, emotional disturbance. These effects are significant in boys with SOR, whereas the study is underpowered for girls. The most affected white matter are medial lemniscus and internal capsule sensory tracts, although effects of SOR are observed in many cerebral, cerebellar, and brainstem tracts.

CONCLUSION

White matter microstructure is related to affective behavior in children with SOR.

The Relationship Between Social Skills and Sensory Profile, Emotion Regulation, and Empathizing/Systemizing in Adolescents on the Autism Spectrum

This study aims to evaluate the relationship between social skills and sensory features, emotion regulation, and empathy in adolescents on the autism spectrum. One hundred and twenty-three adolescents were included in the study (50 autistic, 73 typically developing-TD adolescents). The participants filled out the Adolescent/Adult Sensory Profile (AASP) and Emotion Regulation Questionnaire. Parents of the participants completed the Child Empathy and Systemizing Quotient (EQ-C/SQ-C) and Autism-Social Skills Profile (ASSP) scales. Social reciprocity, social participation/avoidance, ASSP total scores, empathy and systemizing scores were lower, and detrimental social behaviors, low registration sensory profile scores were higher in the autism spectrum group. While a difference between genders was observed in sensory sensitivity, sensation avoiding, low registration quadrants and empathy scores, no gender and group interaction was found in any domain. Social skill total scores were correlated to sensation seeking and low registration sensory features, empathy, systemizing, and reappraisal emotion regulation scores. A hierarchical multiple linear regression analysis was conducted controlling for group and gender, sensation seeking (p = .032, β = 0.138), low registration (p = .012, β = - 0.215) of the AASP, and empathy (p < .001, β = 0.555) and systemizing (p = .033, β = 0.138) scores of the EQ/SQ-C was found to significantly predict social skill total scores. Although emotional regulation strategies may play a role, sensory processing features and empathy and systemizing skills seem to be the more significant contributors to social skills during adolescence. Interventions targeting sensory processing and especially improving empathy and systematization skills may positively affect social skills in adolescents on the autism spectrum.

Autistic discussion forums: insights into the topics that clinicians don't know about

Background

User-led autism discussion forums provide a wealth of information about autistic lived experiences, albeit oriented toward those who regularly use computers. We contend that healthcare professionals should read autism discussion forums to gain insight, be informed, and in some cases, to correct assumptions about autistic persons' lives and possibilities. But experts may be dismissive of user-led forums, believing forums to be filled with myths, misinformation, and combative postings. The questions motivating our research were: Do online forums raise issues that are educational for clinicians and other stakeholders? Are forums useful for those who do empirical research?

Method

Content analysis was conducted on 300 posts (62,000 words) from Reddit, Quora, and Wrong Planet. Forums were sampled to reflect broad topics; posts were selected sequentially from the identified forums. The authors read through posts in the Excel sheet, highlighting statements that were the main ideas of the post, to discern both broad categories of topics and more specific topics. We coded content pertinent to classic autism myths and analyzed attitudes towards myths such as 'lack emotion' and 'cannot form relationships.' To document whether forum posts discuss topics that are not widely known outside of elite experts, we compared discussion content to new material about autism contained in the March 2022 DSM 5 Text revision.

Results

Classic autism myths were discussed with examples of when elements of myths may be valid. Posters described cases where parents or therapists believed myths. Experts may believe autism myths due to rapid changes in diagnostic practices and due to their lack of knowledge regarding the characteristics of autistic people who have typical intellectual abilities. We conclude that forums contain high-value information for clinicians because all concepts in the DSM 5 text revision were discussed by posters in the years before the text revision appeared. Ideas that are only slowly becoming part of the research literature are discussed at length in forums. Reading and analyzing forums is useful for both clinicians and scientists. In addition, the relative ease of forum analysis lowers the bar for entry into the research process.

Conserved autism-associated genes tune social feeding behavior in C. elegans

Animal foraging is an essential and evolutionarily conserved behavior that occurs in social and solitary contexts, but the underlying molecular pathways are not well defined. We discover that conserved autism-associated genes (NRXN1(nrx-1), NLGN3(nlg-1), GRIA1,2,3(glr-1), GRIA2(glr-2), and GLRA2,GABRA3(avr-15)) regulate aggregate feeding in C. elegans, a simple social behavior. NRX-1 functions in chemosensory neurons (ADL and ASH) independently of its postsynaptic partner NLG-1 to regulate social feeding. Glutamate from these neurons is also crucial for aggregate feeding, acting independently of NRX-1 and NLG-1. Compared to solitary counterparts, social animals show faster presynaptic release and more presynaptic release sites in ASH neurons, with only the latter requiring nrx-1. Disruption of these distinct signaling components additively converts behavior from social to solitary. Aggregation induced by circuit activation is also dependent on nrx-1. Collectively, we find that aggregate feeding is tuned by conserved autism-associated genes through complementary synaptic mechanisms, revealing molecular principles driving social feeding.

Attitudes to Interpersonal Touch in the Workplace in Autistic and non-Autistic Groups

Unemployment and underemployment have consistently been shown to be higher in autistic adults relative to non-autistic adults. This may be due, in part, to a lack of workplace accommodations being made for autistic people. One factor that may contribute to employment inequalities in autistic people is differences in attitudes towards interpersonal touch. This study acts as a preliminary investigation into whether employed autistic and non-autistic participants differ in their attitudes towards touch in the workplace, and in their loneliness and wellbeing. The current dataset was drawn from a larger online survey (the Touch Test) designed to explore attitudes and experiences towards touch. We found that employed autistic participants had more negative attitudes to general, social and workplace touch relative to non-autistic participants. Autistic participants also experienced greater loneliness and reduced wellbeing. Attachment-related anxiety was the only significant predictor of wellbeing in employed autistic adults. However, attachment-related anxiety, general attitudes to touch and the role of touch in the workplace predicted wellbeing in employed non-autistic adults. With regards to loneliness, general attitudes to touch and the role of touch in the workplace predicted loneliness in autistic participants. We also replicated the finding that a greater proportion of autistic participants were unemployed relative to non-autistic participants. Collectively, this research highlights the importance of considering touch in research investigating employment, and its impact on loneliness and wellbeing, in autistic participants.

Preventive effects of resveratrol against early-life impairments in the animal model of autism induced by valproic acid

Background

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by social interaction deficits and repetitive/stereotyped behaviors. Its prevalence is increasing, affecting one in 36 children in the United States. The valproic acid (VPA) induced animal model of ASD is a reliable method for investigating cellular, molecular, and behavioral aspects related to the disorder. Trans-Resveratrol (RSV), a polyphenol with anti-inflammatory and antioxidant effects studied in various diseases, has recently demonstrated the ability to prevent cellular, molecular, sensory, and social deficits in the VPA model. In this study, we examined the effects of prenatal exposure to VPA and the potential preventive effects of RSV on the offspring.

Method

We monitored gestational weight from embryonic day 6.5 until 18.5 and assessed the onset of developmental milestones and morphometric parameters in litters. The generalized estimating equations (GEE) were used to analyze longitudinal data.

Results

Exposure to VPA during rat pregnancy resulted in abnormal weight gain fold-changes on embryonic days 13.5 and 18.5, followed by fewer animals per litter. Additionally, we discovered a positive correlation between weight variation during E15.5-E18.5 and the number of rat pups in the VPA group.

Conclusion

VPA exposure led to slight length deficiencies and delays in the onset of developmental milestones. Interestingly, the prenatal RSV treatment not only prevented most of these delays but also led to the early onset of certain milestones and improved morphometric characteristics in the offspring. In summary, our findings suggest that RSV may have potential as a therapeutic intervention to protect against the negative effects of prenatal VPA exposure, highlighting its importance in future studies of prenatal neurodevelopmental disorders.

Association between Autism Spectrum Disorder (ASD) and vision problems. A systematic review and meta-analysis

AIM

To conduct a systematic review and meta-analysis assessing whether vision and/or eye disorders are associated with Autism Spectrum Disorder (ASD).

METHOD

Based on a pre-registered protocol (PROSPERO: CRD42022328485), we searched PubMed, Web of Knowledge/Science, Ovid Medline, Embase and APA PsycINFO up to 5th February 2022, with no language/type of document restrictions. We included observational studies 1) reporting at least one measure of vision in people of any age with a diagnosis of ASD based on DSM or ICD criteria, or ADOS; or 2) reporting the prevalence of ASD in people with and without vision disorders. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Random-effects meta-analyses were used for data synthesis.

RESULTS

We included 49 studies in the narrative synthesis and 46 studies in the meta-analyses (15,629,159 individuals distributed across multiple different measures). We found meta-analytic evidence of increased prevalence of strabismus (OR = 4.72 [95% CI: 4.60, 4.85]) in people with versus those without ASD (non-significant heterogeneity: Q = 1.0545, p = 0.7881). We also found evidence of increased accommodation deficits (Hedge's g = 0.68 [CI: 0.28, 1.08]) (non-significant heterogeneity: Q = 6.9331, p = 0.0741), reduced peripheral vision (-0.82 [CI: -1.32, -0.33]) (non-significant heterogeneity: Q = 4.8075, p = 0.4398), reduced stereoacuity (0.73 [CI: -1.14, -0.31]) (non-significant heterogeneity: Q = 0.8974, p = 0.3435), increased color discrimination difficulties (0.69 [CI: 0.27,1.10]) (non-significant heterogeneity: Q = 9.9928, p = 0.1890), reduced contrast sensitivity (0.45 [CI: -0.60, -0.30]) (non-significant heterogeneity: Q = 9.9928, p = 0.1890) and increased retinal thickness (=0.29 [CI: 0.07, 0.51]) (non-significant heterogeneity: Q = 0.8113, p = 0.9918) in ASD.

DISCUSSION

ASD is associated with some self-reported and objectively measured functional vision problems, and structural alterations of the eye, even though we observed several methodological limitations in the individual studies included in our meta-analyses. Further research should clarify the causal relationship, if any, between ASD and problems of vision during early life.

PROSPERO REGISTRATION

CRD42022328485.

Similar overall expression, but different profiles, of autistic traits, sensory processing, and mental health between young adult males and females

Recent trends suggest that autism is more common in females than traditionally held. Additionally, some argue that females express autistic traits differently than males. Dimensional views of autism could shed light on these issues, especially with regards to understudied behavioral areas, such as sensory processing. We examined autistic traits, sensory processing, anxiety, and related behaviors in a large sample of neurotypical young adult males and females (n = 1,122; 556 female; ages 19-26). Participants completed an online survey containing questionnaires related to the above. Between groups statistical analyses, as well as within groups correlations and mediation analyses containing these constructs were then computed. We also carried out a cluster analysis to establish groups with behavioral similarities and estimate within-cluster male/female ratios. Results showed modest differences in the overall expression of autistic traits and sensory processing, if any, between males and females. Conversely, more detailed examination of survey subtests and mediation analyses revealed differing profiles between these groups. Cluster analysis uncovered a group comprised of both males (69.8%) and females (30.2%) who exhibited elevated degrees of autism-related behaviors, suggesting a higher proportion of females than would be predicted by traditional ratios. Taken together, these findings suggest that males and females may not differ as much as previously thought in their general levels of autistic traits or sensory processing, but may present with distinct profiles of such behaviors. These novel results add to our understanding of autistic traits in females and have the potential to positively influence diagnostic and support practices.

Altered Developmental Trajectory in Male and Female Rats in a Prenatal Valproic Acid Exposure Model of Autism Spectrum Disorder

Early motor and sensory developmental delays precede Autism Spectrum Disorder (ASD) diagnosis and may serve as early indicators of ASD. The literature on sensorimotor development in animal models is sparse, male centered, and has mixed findings. We characterized early development in a prenatal valproic acid (VPA) model of ASD and found sex-specific developmental delays in VPA rats. We created a developmental composite score combining 15 test readouts, yielding a reliable gestalt measure spanning physical, sensory, and motor development, that effectively discriminated between VPA and control groups. Considering the heterogeneity in ASD phenotype, the developmental composite offers a robust metric that can enable comparison across different animal models of ASD and can serve as an outcome measure for early intervention studies.

A Novel Head-Fixed Assay for Social Touch in Mice Uncovers Aversive Responses in Two Autism Models

Social touch, an important aspect of social interaction and communication, is essential to kinship across animal species. How animals experience and respond to social touch has not been thoroughly investigated, in part because of the lack of appropriate assays. Previous studies that examined social touch in freely moving rodents lacked the necessary temporal and spatial control over individual touch interactions. We designed a novel head-fixed assay for social touch in mice, in which the experimenter has complete control to elicit highly stereotyped bouts of social touch between two animals. The user determines the number, duration, context, and type of social touch interactions, while monitoring an array of complex behavioral responses with high resolution cameras. We focused on social touch to the face because of its high translational relevance to humans. We validated this assay in two different models of autism spectrum disorder (ASD), the Fmr1 knock-out (KO) model of Fragile X syndrome (FXS) and maternal immune activation (MIA) mice. We observed higher rates of avoidance running, hyperarousal, and aversive facial expressions (AFEs) to social touch than to object touch, in both ASD models compared with controls. Fmr1 KO mice showed more AFEs to mice of the same sex but whether they were stranger or familiar mice mattered less. Because this new social touch assay for head-fixed mice can be used to record neural activity during repeated bouts of social touch it could be used to uncover underlying circuit differences.SIGNIFICANCE STATEMENT Social touch is important for communication in animals and humans. However, it has not been extensively studied and current assays to measure animals' responses to social touch have limitations. We present a novel head-fixed assay to quantify how mice respond to social facial touch with another mouse. We validated this assay in autism mouse models since autistic individuals exhibit differences in social interaction and touch sensitivity. We find that mouse models of autism exhibit more avoidance, hyperarousal, and aversive facial expressions (AFEs) to social touch compared with controls. Thus, this novel assay can be used to investigate behavioral responses to social touch and the underlying brain mechanisms in rodent models of neurodevelopmental conditions, and to evaluate therapeutic responses in preclinical studies.

Age-Related Differences in Accelerometer-Assessed Physical Activity and Sleep Parameters Among Children and Adolescents With and Without Autism Spectrum Disorder: A Meta-Analysis

Importance

Physical inactivity and sleep disorders are health-related concerns of youth with autism spectrum disorder (ASD) that can persist from childhood and exacerbate core symptoms. However, evidence on group differences in accelerometer-assessed physical activity and sleep parameters among youth with and without ASD is inconclusive and age-specific effects remain unclear.

Objective

To synthesize evidence on group differences in accelerometer-assessed physical activity and sleep parameters and examine the moderating effects of age between children and adolescents with and without ASD.

Data Sources

American Psychological Association PsychInfo, CINAHL Ultimate, ERIC, MEDLINE, SPORTDiscus with Full Text, and Web of Science from inception to February 2023.

Study Selection

Two independent reviewers screened articles for observational research comparing accelerometer-assessed physical activity levels and sleep parameters in children and adolescents with and without ASD.

Data Extraction and Synthesis

After developing a standardized form, relevant data were extracted. Quality was assessed using the McMaster Critical Review Form and rated based on sample, measurement, and analyses. The Preferring Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed.

Main Outcomes and Measures

The primary outcomes were actigraphy-measured MVPA, sleep latency, sleep efficiency, total sleep time, and wake after sleep onset. Data were pooled using a random-effects model. Hedges g was used to express the effect size index. Meta-regression on age was also performed to investigate the potential moderating effects.

Results

Collectively, 1757 studies were initially identified. Among 104 articles that were assessed, 28 were included, comprising moderate-to-vigorous physical activity (MVPA), 4 sleep parameters, and 73 independent effect sizes. A total of 28 studies were included in analysis, comprising 805 children and adolescents with ASD and 1573 without ASD (age range, 5.1-16.9 years). Compared with peers without ASD, children and adolescents with ASD had a small-to-moderate difference in MVPA (g = -0.450; 95% CI, -0.622 to -0.277), total sleep time (g = -0.332; 95% CI, -0.574 to -0.090), sleep efficiency (g = -0.424; 95% CI, -0.645 to -0.203), and a moderate difference in sleep latency (g = 0.514; 95% CI, 0.351 to 0.677) measured by actigraphy. Children and adolescents with ASD experienced an age-related decline in moderate-to-vigorous physical activity (β = -0.049 [95% CI, -0.097 to -0.001]; P = .045), indicating that younger children with ASD showed a smaller difference in MVPA compared with their peers without ASD. Moderating effects of age on sleep parameters were not significant.

Conclusions and Relevance

The findings of this meta-analysis suggested that children and adolescents with ASD had lower MVPA and worse sleep than peers without ASD, and the difference in MVPA varied with age. These findings reinforce the need for public health initiatives aimed at reducing these group disparities.

Deletions of Cacna2d3 in parvalbumin-expressing neurons leads to autistic-like phenotypes in mice

Autism spectrum disorder (ASD) is a series of highly inherited neurodevelopmental disorders. Loss-of-function (LOF) mutations in the CACNA2D3 gene are associated with ASD. However, the underlying mechanism is unknown. Dysfunction of cortical interneurons (INs) is strongly implicated in ASD. Parvalbumin-expressing (PV) INs and somatostatin-expressing (SOM) INs are the two most subtypes. Here, we characterized a mouse knockout of the Cacna2d3 gene in PV-expressing neurons (PVCre;Cacna2d3f/f mice) or in SOM-expressing neurons (SOMCre;Cacna2d3f/f mice), respectively. PVCre;Cacna2d3f/f mice showed deficits in the core ASD behavioral domains (including impaired sociability and increased repetitive behavior), as well as anxiety-like behavior and improved spatial memory. Furthermore, loss of Cacna2d3 from a subset of PV neurons results in a reduction of GAD67 and PV expression in the medial prefrontal cortex (mPFC). These may underlie the increased neuronal excitability in the mPFC, which contribute to the abnormal social behavior in PVCre;Cacna2d3f/f mice. Whereas, SOMCre;Cacna2d3f/f mice showed no obvious deficits in social, cognitive, or emotional phenotypes. Our findings provide the first evidence suggesting the causal role of Cacna2d3 insufficiency in PV neurons in autism.

Headache in Individuals with Neurodevelopmental Disorders

PURPOSE OF REVIEW

Migraine is a common condition affecting an estimated billion people across the world. The incidence in individuals with neurodevelopmental disorders or intellectual disabilities like those seen in severe autism spectrum disorder (ASD) is unknown. This is likely due to the limited capacity to communicate the specifics of pain. The expression of pain with maladaptive behaviors, such as self-injurious behavior (SIB), has been described and can alert the clinician to the presence of untreated pain. This review article serves to educate the reader about clinical and treatment considerations when managing headaches in individuals with severe or non-verbal neurodevelopmental disorders given their communication challenges. It will include some clinical experiences and the gaps in our current knowledge.

RECENT FINDINGS

A comprehensive literature review was conducted using scientific databases, including PubMed, Medline, and Google Scholar. Only 1 article addressed the consideration for headaches in this population. The search was conducted using a combination of the following keywords: headache, intellectual disabilities, autism, pain, and behavior. Headache pain is likely underestimated and represents a disservice to this population of people. The consideration for headache pain should be explored when maladaptive behaviors are otherwise unexplainable. Further studies are needed in the area.

Autistic Traits and College Adjustment

This study evaluated the association of autistic traits (RAADS-14) with academic and social outcomes among college students using data from an online survey (N = 2,736). In the academic domain, the total trait score and all subscale scores (mentalizing deficits, social anxiety, sensory reactivity) were associated with course failure and academic difficulties independent of an autism diagnosis; the total score and mentalizing deficits also predicted lower grade point average (GPA). In the social domain, the total trait score and subscale scores were associated with lower odds of having a confidant, lower friendship quality, and higher odds of social exclusion. Subgroup analyses revealed that autistic traits had more consistently negative associations with social outcomes for students without an autism diagnosis than for students with a diagnosis. Associations were also more often significant for women than men. These results support the development of programs and services for students with autistic traits regardless of diagnostic status.

Differentiated, rather than shared, strategies for time-coordinated action in social and non-social domains in autistic individuals

Autism spectrum disorder (ASD) is a neurodevelopmental condition with a highly heterogeneous adult phenotype that includes social and non-social behavioral characteristics. The link between the characteristics assignable to the different domains remains unresolved. One possibility is that social and non-social behaviors in autism are modulated by a common underlying deficit. However, here we report evidence supporting an alternative concept that is individual-centered rather than deficit-centered. Individuals are assumed to have a distinctive style in the strategies they adopt to perform social and non-social tasks with these styles presumably being structured differently between autistic individuals and typically-developed (TD) individuals. We tested this hypothesis for the execution of time-coordinated (synchronized) actions. Participants performed (i) a social task that required synchronized gaze and pointing actions to interact with another person, and (ii) a non-social task that required finger-tapping actions synchronized to periodic stimuli at different time-scales and sensory modalities. In both tasks, synchronization behavior differed between ASD and TD groups. However, a principal component analysis of individual behaviors across tasks revealed associations between social and non-social features for the TD persons but such cross-domain associations were strikingly absent for autistic individuals. The highly differentiated strategies between domains in ASD are inconsistent with a general synchronization deficit and instead highlight the individualized developmental heterogeneity in the acquisition of domain-specific behaviors. We propose a cognitive model to help disentangle individual-centered from deficit-centered effects in other domains. Our findings reinforce the importance to identify individually differentiated phenotypes to personalize autism therapies.

Symmetry Detection in Autistic Adults Benefits from Local Processing in a Contour Integration Task

Symmetry studies in autism are inconclusive possibly due to different types of stimuli used which depend on either local or global cues. Therefore, this study compared symmetry detection between 20 autistic and 18 non-autistic adults matched on age, IQ, gender and handedness, using contour integration tasks containing open and closed contours that rely more on local or global processing respectively. Results showed that the autistic group performed equally well with both stimuli and outperformed the non-autistic group only for the open contours, possibly due to a different strategy used in detecting symmetry. However, there were no group differences for the closed contour. Results explain discrepant findings in previous symmetry studies suggesting that symmetry tasks that favour a local strategy may be advantageous for autistic individuals. Implications of the findings towards understanding visual sensory issues in this group are discussed.

Exploring cognitive individuality and the underlying creativity in statistical learning and phase entrainment

Statistical learning starts at an early age and is intimately linked to brain development and the emergence of individuality. Through such a long period of statistical learning, the brain updates and constructs statistical models, with the model's individuality changing based on the type and degree of stimulation received. However, the detailed mechanisms underlying this process are unknown. This paper argues three main points of statistical learning, including 1) cognitive individuality based on "reliability" of prediction, 2) the construction of information "hierarchy" through chunking, and 3) the acquisition of "1-3Hz rhythm" that is essential for early language and music learning. We developed a Hierarchical Bayesian Statistical Learning (HBSL) model that takes into account both reliability and hierarchy, mimicking the statistical learning processes of the brain. Using this model, we conducted a simulation experiment to visualize the temporal dynamics of perception and production processes through statistical learning. By modulating the sensitivity to sound stimuli, we simulated three cognitive models with different reliability on bottom-up sensory stimuli relative to top-down prior prediction: hypo-sensitive, normal-sensitive, and hyper-sensitive models. We suggested that statistical learning plays a crucial role in the acquisition of 1-3 Hz rhythm. Moreover, a hyper-sensitive model quickly learned the sensory statistics but became fixated on their internal model, making it difficult to generate new information, whereas a hypo-sensitive model has lower learning efficiency but may be more likely to generate new information. Various individual characteristics may not necessarily confer an overall advantage over others, as there may be a trade-off between learning efficiency and the ease of generating new information. This study has the potential to shed light on the heterogeneous nature of statistical learning, as well as the paradoxical phenomenon in which individuals with certain cognitive traits that impede specific types of perceptual abilities exhibit superior performance in creative contexts.

Comprehensive intervention for reducing stigma of autism spectrum disorders: Incorporating the experience of simulated autistic perception and social contact

Stigma of autism spectrum disorders (ASD) is a crucial factor leading to a lower quality of life for individuals with ASD. This research evaluated an intervention effect for the stigma through an experience of simulated autistic visual perception and video-based social contact. The intervention was conducted as an experiential workshop for the ASD simulator. Participants (N = 217; 156 women, 61 men; a mean age of 41.3) voluntarily attended the workshop. In the workshop, they received a short lecture on autistic perception, a simulated experience using the ASD simulator, a narrative video of individuals with ASD, and a group discussion. They completed the multidimensional attitudes scale, which was developed to measure four attitudes toward ASD: negative affect, calm, cognitions, and behaviors. The attitudes were measured three times: the period of registration with the workshop, during participation in the workshop, and six weeks after the workshop. With regard to the measure during participation in the workshop, attendees responded to the attitudes at the beginning or end of the workshop, to confirm whether attitudes changes were attributed to the effectiveness of the intervention or artifacts resulting from participation in the workshop. A significant reduction was observed in negative affective attitudes at the end of the workshop and persisted even six weeks afterward, even though not observed in calm, cognitive, and behavioral attitudes. Our findings suggest that implementation of our intervention can bring about reduction of the stigma associated with ASD. Further studies with a random sampling method are needed to validate its generalizability and elaborate the components of the intervention.

Fine-grained topographic organization within somatosensory cortex during resting-state and emotional face-matching task and its association with ASD traits

Sensory atypicalities are particularly common in autism spectrum disorders (ASD). Nevertheless, our knowledge about the divergent functioning of the underlying somatosensory region and its association with ASD phenotype features is limited. We applied a data-driven approach to map the fine-grained variations in functional connectivity of the primary somatosensory cortex (S1) to the rest of the brain in 240 autistic and 164 neurotypical individuals from the EU-AIMS LEAP dataset, aged between 7 and 30. We estimated the S1 connection topography ('connectopy') at rest and during the emotional face-matching (Hariri) task, an established measure of emotion reactivity, and accessed its association with a set of clinical and behavioral variables. We first demonstrated that the S1 connectopy is organized along a dorsoventral axis, mapping onto the S1 somatotopic organization. We then found that its spatial characteristics were linked to the individuals' adaptive functioning skills, as measured by the Vineland Adaptive Behavior Scales, across the whole sample. Higher functional differentiation characterized the S1 connectopies of individuals with higher daily life adaptive skills. Notably, we detected significant differences between rest and the Hariri task in the S1 connectopies, as well as their projection maps onto the rest of the brain suggesting a task-modulating effect on S1 due to emotion processing. All in all, variation of adaptive skills appears to be reflected in the brain's mesoscale neural circuitry, as shown by the S1 connectivity profile, which is also differentially modulated during rest and emotional processing.

The prevalence and developmental course of auditory processing differences in autistic children

Auditory processing differences, including hyper- or hyposensitivity to sound, aversions to sound, and difficulty listening under noisy, real-world conditions, are commonly reported in autistic individuals. However, the developmental course and functional impact of these auditory processing differences are unclear. In this study, we investigate the prevalence, developmental trajectory, and functional impact of auditory processing differences in autistic children throughout childhood using a longitudinal study design. Auditory processing differences were measured using the Short Sensory Profile, a caregiver questionnaire, in addition to adaptive behaviors and disruptive/concerning behaviors at 3, 6, and 9 years of age. Our results showed that auditory processing differences were reported in greater than 70% of the autistic children in our sample at all three timepoints, maintained a high prevalence through 9 years of age, and were associated with increased disruptive/concerning behaviors and difficulty with adaptive behaviors. Furthermore, in our sample of children, auditory processing differences at age 3 years predicted disruptive/concerning behaviors and difficulty with adaptive behaviors at age 9 years. These findings warrant further investigations of the potential benefit of incorporating measures of auditory processing during routine clinical evaluations as well as interventions targeting auditory processing differences in autistic children.

Stretch marks: a visible expression of connective's involvement in autism spectrum disorders

In autism spectrum disorders (ASDs) in the pediatric population, skin manifestations are generally attributable to the concomitance of allergic forms or to accidental, self-inflicted or abusive lesions. However, clinical evidence has highlighted the presence of an increasing number of abdominal stretch marks, probably caused by the increase in the number of obesity cases in the pediatric population, in general, and therefore also among children with ASD. Stretch marks are often attributed to obesity, as they have an incidence of more than 50% in obese individuals. In the first part of this article we hypothesized that in addition to obesity there are other factors, such as a structural alteration on the skin in people with ASD, which can contribute/aggravate the phenomenon of stretch marks. Despite the high frequency with which stretch marks are found in children with ASD, this aspect has never been studied, the structure of the skin of children with ASD is not known. Furthermore, it is not known whether this structure is different from that of subjects without ASD. In the second part of the article, we hypothesized the mechanisms of the negative impact of simple abdominal stretch marks on the symptomatic picture of children with ASD. The presence of stretch marks, altered tactile perception, altered sensitivity to clothing fabrics can be a combination that influences development and determines negative consequences in the neurological picture of a child with ASD, as it is already known that the altered sensory perception in children with ASD contributes to the deterioration of social behavior. Furthermore, the presence of stretch marks may play a role in the postural and motor defects of children with ASD.

Validation of the German Glasgow Sensory Questionnaire and replication of sensory processing differences in students with higher and lower Autism-Spectrum Quotient

BACKGROUND

The Glasgow Sensory Questionnaire (GSQ) gives insight into sensory processing differences (hypo- and hyper-sensitivity across modalities), which is a clinically defining characteristic of autism spectrum disorder (ASD). Because there is no validated German version of this instrument, this study aimed at validating the German GSQ. Further, a replication of the GSQ's sensory processing differences was intended.

METHODS

University students of Technische Universität or Universitätsklinikum in Dresden, Germany, were recruited via email distribution or the university homepage and 297 German-speaking students completed the online survey, comprising the German GSQ, Autism-Spectrum Quotient (AQ) and Symptom-Checklist (SCL-90). For validation of the German GSQ, confirmatory factor analyses followed by exploratory factor analyses were applied.

RESULTS

The German GSQ has moderate to low validity, good to acceptable reliability, and a different internal structure from the original GSQ. Replicating the sensory processing differences in students with higher and lower AQ was not successful.

CONCLUSIONS

Results indicate that the GSQ, developed especially for individuals with ASD, is less informative for the general population if there are not enough individuals with higher AQ scores in the sample.

People with higher autistic traits show stronger binding for color-shape associations

Non-synesthetes exhibit a tendency to associate specific shapes with particular colors (i.e., circle-red, triangle-yellow, and square-blue). Such color-shape associations (CSAs) could potentially affect the feature binding of colors and shapes, thus resulting in people reporting more binding errors in the case of incongruent, rather than congruent, colored-shape pairs. Individuals with autism spectrum disorder (ASD) exhibit atypical sensory processing and impaired multisensory integration. Here, we examined whether autistic traits (Autism-Spectrum Quotient; AQ) influence the strength of color-shape associations, as evidenced by the occurrence of binding errors in incongruent minus congruent conditions. Participants took part in an experiment designed to reveal binding errors induced by incongruent and congruent colored-shape pairs, and completed the Japanese version of the AQ score. The results revealed a significant correlation between AQ scores and occurrence of binding errors when participants were presented with the circle-red and triangle-yellow CSAs: That is, individuals with higher autistic traits tend to make more binding errors in incongruent minus congruent colored-shape pairs, indicating a stronger binding of circle-red and triangle-yellow associations. These results therefore suggest that autistic traits play a role in forming color-shape associations, shedding light on the nature of both color-shape associations and autistic perception.