Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

While the COVID-19 pandemic is ongoing, early outcome studies indicate severe and pervasive global effects of the pandemic and associated measures to prevent the spread of the virus. General population studies, as well as insight into the outcomes for particular groups, will be necessary in order to mitigate potentially long-term effects as well as to prepare for future epidemics or pandemics. The pandemic conditions have been marked by rapid and abrupt changes and unpredictability which are circumstances that leave the autistic population particularly vulnerable to adverse outcomes following the distinctive features of the diagnosis. Studies are only beginning to delineate the outcomes of the global autism community and the present study adds to these findings by providing a local, multi-perspective, qualitative analysis of the lived experiences of the Swedish autism community. In this study, autistic youth and adults, caregivers of autistic individuals, as well as representatives of Swedish interest organizations were interviewed. Thematic analysis was performed on the population as a whole and patterns of results were formalized according to the International Classification of Function, Disability and Health (ICF-CY). Participants report wide-ranging adverse outcomes of the pandemic relating to mental health and access to support, participation in daily activities and socialization, education, and work as well as parental resources. However, participants also report positive outcomes relating to a reduction in specific social and everyday demands, and normalization of lived experiences. Additionally, interviews outlined some strategies used to cope during pandemic conditions. Implications of these findings are discussed.

Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis

There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63-2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06-1.56), guanfacine (OR = 1.43, 95% CI = 1.12-1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09-1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended.

Perceptual processing links autism and synesthesia: A co-twin control study

Synesthesia occurs more commonly in individuals fulfilling criteria for an autism spectrum diagnosis than in the general population. It is associated with autistic traits and autism-related perceptual processing characteristics, including a more detail-focused attentional style and altered sensory sensitivity. In addition, these characteristics correlate with the degree of grapheme-color synesthesia (consistency of grapheme-color associations) in non-synesthetes. We investigated a predominantly non-synesthetic twin sample, including individuals fulfilling criteria for an autism spectrum diagnosis or other neurodevelopmental disorders (n = 65, 14-34 years, 60% female). We modelled linear relationships between the degree of grapheme-color synesthesia and autistic traits, sensory sensitivity, and visual perception, both within-twin pairs (22 pairs) where all factors shared by twins are implicitly controlled (including 50-100% genetics), and across the entire cohort. We found that the degree of grapheme-color synesthesia was associated with autistic traits within the domain of Attention to Details and with sensory hyper-, but not hypo-sensitivity. These associations were stronger within-twin pairs than across the sample. Further, twins with a higher degree of grapheme-color synesthesia were better than their co-twins at identifying fragmented images (Fragmented Pictures Test). This is the first twin study on the association between synesthesia and autism-related perceptual features and traits. The results suggest that investigating these associations within-twin pairs, implicitly adjusting for potential confounding factors shared by twins, is more sensitive than doing so in non-related individuals. Consistent with previous findings, the results suggest an association between the degree of grapheme-color synesthesia and autism-related perceptual features, while utilizing a different measure for sensory sensitivity. The novel finding of enhanced fragmented picture integration in twins with a higher degree of grapheme-color synesthesia challenges the view of a generally more detail-focused attentional style in synesthesia and might be related to enhanced memory or mental imagery in more synesthetic individuals.