Effectiveness of serious games in social skills training to autistic individuals: A systematic review

Autism Spectrum Disorder (ASD) is a complex neurological condition that significantly impacts individuals' daily lives and social interactions due to challenges in verbal and non-verbal communication. Game-based tools for psychological support and patient education are rapidly gaining traction. Among these tools, teaching social skills via serious games has emerged as a particularly promising educational strategy for addressing specific characteristics associated with autism. Unlike traditional games, serious games are designed with a dual purpose: to entertain and to fulfill a specific educational or therapeutic goal. This systematic review aims to identify and categorize serious computer games that have been used to teach social skills to autistic individuals and to assess their effectiveness. We conducted a comprehensive search across seven databases, resulting in the identification and analysis of 25 games within 26 studies. Out of the 104 criteria assessed across these studies, 57 demonstrated significant improvement in participants. Furthermore, 22 of these studies reported significant enhancements in at least one measured criterion, with 13 studies observing significant improvements in all assessed outcomes. These findings overwhelmingly support the positive impact of computer-based serious game interventions in teaching social skills to autistic individuals.

Sex differences during development in cortical temporal processing and event related potentials in wild-type and fragile X syndrome model mice

BACKGROUND

Autism spectrum disorder (ASD) is currently diagnosed in approximately 1 in 44 children in the United States, based on a wide array of symptoms, including sensory dysfunction and abnormal language development. Boys are diagnosed ~ 3.8 times more frequently than girls. Auditory temporal processing is crucial for speech recognition and language development. Abnormal development of temporal processing may account for ASD language impairments. Sex differences in the development of temporal processing may underlie the differences in language outcomes in male and female children with ASD. To understand mechanisms of potential sex differences in temporal processing requires a preclinical model. However, there are no studies that have addressed sex differences in temporal processing across development in any animal model of ASD.

METHODS

To fill this major gap, we compared the development of auditory temporal processing in male and female wildtype (WT) and Fmr1 knock-out (KO) mice, a model of Fragile X Syndrome (FXS), a leading genetic cause of ASD-associated behaviors. Using epidural screw electrodes, we recorded auditory event related potentials (ERP) and auditory temporal processing with a gap-in-noise auditory steady state response (ASSR) paradigm at young (postnatal (p)21 and p30) and adult (p60) ages from both auditory and frontal cortices of awake, freely moving mice.

RESULTS

The results show that ERP amplitudes were enhanced in both sexes of Fmr1 KO mice across development compared to WT counterparts, with greater enhancement in adult female than adult male KO mice. Gap-ASSR deficits were seen in the frontal, but not auditory, cortex in early development (p21) in female KO mice. Unlike male KO mice, female KO mice show WT-like temporal processing at p30. There were no temporal processing deficits in the adult mice of both sexes.

CONCLUSIONS

These results show a sex difference in the developmental trajectories of temporal processing and hypersensitive responses in Fmr1 KO mice. Male KO mice show slower maturation of temporal processing than females. Female KO mice show stronger hypersensitive responses than males later in development. The differences in maturation rates of temporal processing and hypersensitive responses during various critical periods of development may lead to sex differences in language function, arousal and anxiety in FXS.

Awareness of Autism Spectrum Disorder Among Population of Kazakhstan

BACKGROUND

In recent years, an abundance of research has substantiated the escalating prevalence of Autism Spectrum Disorder (ASD) on a global scale. The aim to assess the level of awareness regarding ASD among the Kazakhstan population, as well as their readiness to offer help to individuals affected by ASD.

METHODS

A cross-sectional study was conducted encompassing individuals aged 18 years and above, using both the Russian and Kazakh languages. The survey was administered through Google Forms during April to June 2023. The link to survey was disseminated through WhatsApp chats of different social groups, including primary care specialists (general practitioners and nurses), and educators from primary and secondary schools from all 17 regions of Kazakhstan, spanning urban and rural areas. 410 participants took part in the survey in total. Statistical significance will be defined as p-values < 0.05.

RESULTS

Individuals aged 25 and above, who are both educated and employed, exhibit a greater awareness of ASD compared to other demographic groups. A low proportion of respondents (18.3%) demonstrated familiarity with the key symptoms of ASD as well as on its causes. Furthermore, it's noteworthy that the primary resource for acquiring information about ASD was the internet for both of these regions.

CONCLUSION

Low awareness on ASD symptoms and treatment methods was identified in both areas. There is a need to develop activities to increase the public awareness on ASD, including knowledge on early symptoms of ASD and facilities that address the needs of people on the ASD and their families.

Societal Attitudes Towards Autism (SATA): Validation of the Greek Version in the General Population

This study examined the validity of the Greek version of the Societal Attitudes Towards Autism (SATA) scale in a Greek community sample (n = 633) and explored how the demographic variables of the sample modulate knowledge and attitudes regarding people with Autism Spectrum Disorder (ASD). The principal component analysis confirmed the three-dimension model and explained 40.5% of the variance. All Cronbach's alpha values obtained were over 0.70. SATA's subscales were significantly and positively correlated, indicating good internal reliability. Participants presented moderate knowledge about ASD and mediocre positive attitudes towards people with ASD. Gender, age, and educational level significantly affected SATA total scores. Overall, this Greek version of SATA showed acceptable psychometric properties, indicating that can be a reliable scale for use.

Exploring the association between early-life air pollution exposure and autism spectrum disorders in children: A systematic review and meta-analysis

The objective of this meta-analysis is to investigate the association between air pollution and the vulnerability of children to autism spectrum disorders (ASD). A thorough examination and analysis of data obtained from a compilation of 14 studies was undertaken, with a particular emphasis on investigating the effects of nitrogen dioxide (NO2), oxide of nitrogen (NOx), ozone (O3), and particulate matter (PM10 and PM2.5) on individuals diagnosed with ASD. The findings demonstrate a moderate association between exposure to nitrogen dioxide (NO2) and ASD, as indicated by a combined odds ratio (OR) of 1.13 and a 95% confidence interval (CI) spanning from 0.77 to 1.549. O3 shows a combined odds ratio (OR) of 0.82, along with a 95% confidence interval (CI) ranging from 0.49 to 1.14. NOx shows a moderate level of heterogeneity (I² = 75.9%, p = 0.002), suggesting that the impact of NOx on the risk of ASD. There is a statistically significant relationship between exposure to O3 and ASD, although the strength of this relationship is diminished. The findings demonstrated a noteworthy correlation between exposure to PM10 and PM2.5 and the occurrence of ASD. The study found a significant correlation, in relation to PM2.5, with a combined odds ratio (OR) of 1.22 and a 95% confidence interval (CI) ranging from 1.11 to 1.34. The findings have significant implications for the formulation of programs aimed at reducing exposure to harmful chemicals, especially among vulnerable groups such as children.

Parental Experiences of Distance Learning in Families with and without an Adolescent with ADHD/ASD: A Large Qualitative Survey Study

One of the greatest COVID-19-related challenges for children and their families was managing distance learning due to school closures. We also know from previous research that families with a child with a neurodevelopmental disorder such as ADHD or ASD were struggling more than others but also experienced some positive effects. However, few qualitative studies have been conducted. The present study therefore aimed to investigate parental experiences of the negative and positive effects of distance learning during the COVID-19 pandemic in a large sample of families with an adolescent with ADHD and/or ASD and a matched comparison group (n = 682). Data were collected through open-ended questions as part of a larger survey study. Five main themes with different sub-themes were identified for both negative and positive effects: (1) Teaching, (2) Social, (3) Support, (4) Child factors, and (5) Home environment. In addition, the main theme "Technical problems" was identified for negative effects. Families with a child with ADHD/ASD reported negative effects related to "Child factors" and "Support" more frequently than the controls, as well as negative effects related to some aspects of "Teaching" and "Technical problems". Regarding positive effects, significant group differences were primarily found for the theme "Child factors". These findings are discussed both in terms of how to best prepare for possible future pandemics, but also of how to best provide educational support for children with ADHD and/or ASD when schools are open.

Exploring sulforaphane as neurotherapeutic: targeting Nrf2-Keap & Nf-Kb pathway crosstalk in ASD

Autism spectrum disorders (ASD) are a family of complex neurodevelopmental disorders, characterized mainly through deficits in social behavior and communication. While the causes giving rise to autistic symptoms are numerous and varied, the treatment options and therapeutic avenues are still severely limited. Nevertheless, a number of signalling pathways have been implicated in the pathogenesis of the disease, and targeting these pathways might provide insight into potential treatments and future strategies. Importantly, alterations in inflammation, oxidative stress, and mitochondrial dysfunction have been noted in the brains of ASD patients, and among the pathways involved in these processes is the Nrf2 cascade. This particular pathway has been hypothesized to be involved in inducing both, inflammatory and anti-inflammatory/neuroprotective effects in the brain, sparking an interest in its use in ASD. Sulforaphane, a sulfur-containing phytochemical present mainly in cruciferous plants like broccoli and cabbage, has shown efficacy in activating the Nrf2 signaling pathway, which in turn brings about a protective effect on neuronal cells, especially against mitochondrial dysfunction. Its efficacy against ASD has not yet been evaluated, and in this paper, we attempt to discuss the therapeutic potential of this agent in the therapy of autism, with special emphasis on the role of the Nrf2 pathway in the disorder.

Social Anhedonia Accounts for Greater Variance in Internalizing Symptoms than Autism Symptoms in Autistic and Non-Autistic Youth

PURPOSE

Social anhedonia is a transdiagnostic trait that reflects reduced pleasure from social interaction. It has historically been associated with autism, however, very few studies have directly examined behavioral symptoms of social anhedonia in autistic youth. We investigated rates of social anhedonia in autistic compared to non-autistic youth and the relative contributions of autism and social anhedonia symptoms to co-occurring mental health.

METHODS

Participants were 290 youth (Mage=13.75, Nautistic=155) ranging in age from 8 to 18. Youth completed a cognitive assessment and a diagnostic interview. Their caregiver completed questionnaires regarding symptoms of autism and co-occurring psychiatric conditions.

RESULTS

Autistic youth were more likely to meet criteria for social anhedonia than non-autistic youth. There was a significant positive relationship between age and social anhedonia symptom severity, but there was no association between sex and social anhedonia. Dominance analysis revealed that social anhedonia symptom severity had the strongest association with symptoms of depression and social anxiety, while symptoms of ADHD, generalized anxiety, and separation anxiety were most strongly associated with autism symptom severity.

CONCLUSION

This was the first study to tease out the relative importance of social anhedonia and autism symptoms in understanding psychiatric symptoms in autistic youth. Findings revealed higher rates of social anhedonia in autistic youth. Our results indicate that social anhedonia is an important transdiagnostic trait that plays a unique role in understanding co-occurring depression and social anxiety in autistic youth. Future research should utilize longitudinal data to test the transactional relationships between social anhedonia and internalizing symptoms over time.

The Impact of the COVID-19 Pandemic Quarantine on Adults with Autism Spectrum Disorders and Intellectual Disability: A Longitudinal Study

The impact of the pandemic is being very significant psychologically, especially for people who were already vulnerable in these aspects, such as adults with Autism Spectrum Disorders (ASD) and Intellectual Disability (ID). A longitudinal analysis of motor aspects such as balance and gait, executive functions in daily life, severity of symptoms characteristic of autism, and degree of subjective well-being was performed in 53 adults with ASD and ID. A repeated measures ANOVA was performed and three measures were taken, the first in December 2019, the second in March 2020, and the last in July 2020. The results demonstrated a significant decrease in balance on the latter measure, along with a deterioration in well-being and ASD symptoms in the period of seclusion and an improvement in executive functions after seclusion.

Oral Health and Behavioral Management of Children with Autistic Spectrum Disorder: A 30-year Retrospective Study

PURPOSE

This article aims to determine the oral health status, the dental treatment, the behavioral management techniques, and the follow-up of pediatric autistic spectrum disorder (ASD) patients treated at the Clinic for Pediatric Patients with Disabilities (CPPD) at a public university in Brazil.

METHODS

The medical records of all the patients seen between 1990 and 2020 were evaluated. Data were collected on the autistic patients' medical and dental conditions, treatments, behavior during dental visits, behavioral management techniques used, and the entire follow-up period at the clinic. The Student's t-test and chi-square tests were used to perform the statistical analysis (α = 0.05%).

RESULTS

Sixty-six records of ASD children were analyzed from a total of 656 dental records. The majority were male (80.3%). The mean age was 7.39 ± 2.75 years. All the children had a cognitive deficit, and 62.5% used medication. Most of the children arrived with caries lesions (56.1%), and the mean number of decayed, missed and filled teeth in both the deciduous (dmft-d) and permanent dentition (DMFT) was 2.45 ± 3.13 and 0.87 ± 1.51, respectively. The restorative technique was the most commonly used procedure (54.5%), and protective stabilization was the most frequently used behavioral management technique (18.2%). Of the children who sought treatment, 86.4% were discharged, and 15.2% abandoned the procedure. The majority (those discharged) continued to undergo regular follow-up at the clinic (86%), and the incidence of new caries lesions observed was 33.33% Conclusions: Although our ASD patients had a high frequency of caries and dental treatment needs, we observed good adherence to the treatment, with a low dropout rate, and high discharge rate.

Long-term Memory of Sensory Experiences from the First Pregnancy, its Peri-partum and Post-partum in Women with Autism Spectrum Disorders without Intellectual Disabilities: A Retrospective Study

PURPOSE

To explore the recalled experience of pregnancy and motherhood in women diagnosed with Autism Spectrum Disorders (ASD) without intellectual disabilities, focusing on sensory perceptions and mood.

METHODS

We retrospectively evaluated, through an ad-hoc structured interview, the sensory sensitivity during the pre-partum, the peri-partum, and the post-partum of thirty-three mothers with ASD and thirty-two neurotypical mothers. Participants also underwent a psychometric assessment about autistic traits, general sensory sensitivity, and post-partum depressive symptomatology.

RESULTS

Mothers with ASD recalled a higher sensitivity than the comparison group across the three time-points; however, during the peri-partum their recalled hypersensitivity decreases, and in the post-partum it returned as high as before childbirth. The difference in the length of recall between groups did not statistically influence our results. Higher levels of autistic traits correlated with higher depressive post-partum symptomatology.

CONCLUSIONS

Mothers with ASD seem to recall their experience of pregnancy, childbirth, and post-partum period differently from neurotypical mothers, particularly in terms of hypersensitivity. The correlation with depressive symptoms and the potential role of oxytocin and of long-term memory (encoding and recollection) are discussed. Further exploring these aspects might give fundamental hints to provide tailored support to mothers with ASD during pregnancy and motherhood.

A social robot connected with chatGPT to improve cognitive functioning in ASD subjects

Neurodevelopmental Disorders (NDDs) represent a significant healthcare and economic burden for families and society. Technology, including AI and digital technologies, offers potential solutions for the assessment, monitoring, and treatment of NDDs. However, further research is needed to determine the effectiveness, feasibility, and acceptability of these technologies in NDDs, and to address the challenges associated with their implementation. In this work, we present the application of social robotics using a Pepper robot connected to the OpenAI system (Chat-GPT) for real-time dialogue initiation with the robot. After describing the general architecture of the system, we present two possible simulated interaction scenarios of a subject with Autism Spectrum Disorder in two different situations. Limitations and future implementations are also provided to provide an overview of the potential developments of interconnected systems that could greatly contribute to technological advancements for Neurodevelopmental Disorders (NDD).

Neurodiversity and National Security: How to Tackle National Security Challenges with a Wider Range of Cognitive Talents

National security organizations need highly skilled and intellectually creative individuals who are eager to apply their talents to address the nation's most pressing challenges. In public and private discussions, officials and experts addressed the need for neurodiversity in the national security community. They described missions that are too important and too difficult to be left to those who use their brains only in typical ways. Neurodivergent is an umbrella term that covers a variety of cognitive diagnoses, including (but not exclusive to) autism spectrum disorder, attention deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD), dyslexia, dyscalculia, and Tourette's syndrome. Neurodivergent individuals are already part of the national security workforce. The purpose of this study is to understand the benefits that people with neurodivergence bring to national security; the challenges in recruiting, working with, and managing a neurodiverse workforce; and the barriers in national security workplaces that prevent agencies from realizing the full benefits of neurodiversity. To carry out this research, the authors conducted a review of primary, secondary, and commercial literature; they conducted semistructured interviews and held discussions with government officials, researchers and advocates for the interests of neurodivergent populations, and representatives from large organizations that have neurodiversity employment programs; and they synthesized findings from across these tasks to describe the complex landscape for neurodiversity in large organizations in general and in national security specifically.

Autism Spectrum Disorders in forensic psychiatric investigations-patterns of comorbidity and criminality

Background

There are contradictory research findings regarding whether individuals with Autism Spectrum Disorders (ASDs) are more or less likely to commit crimes. The aims of the current study were to: (1) Describe psychiatric and crime-related characteristics of a large group of offenders with ASD who had undergone a Forensic Psychiatric Investigation (FPI). (2) Identify clinical subgroups among this group of offenders. (3) Investigate associations between the identified clinical subgroups and (a) psychiatric comorbidity (b) types of crimes and (c) criminal responsibility.

Methods

The study cohort consists of all subjects (n = 831) who received an ASD-diagnosis at an FPI between 2002 and 2018 in Sweden. Descriptive and clinical, as well as crime related variables were obtained from the FPIs. Non-parametric (Pearson χ2, Fisher's exact and Mann-Whitney U-test) inferential statistics were used for analyses of between-group differences and effect sizes were reported. A Latent Class Analysis was used to identify homogeneous subgroups (or classes) from categorical characteristics.

Results

The cohort consisted of 708 men and 123 women, aged 18 to 74 yrs. Two-thirds (66.7%) of the cohort had at least one other psychiatric diagnosis, the most prevalent was substance use disorder (SUD). A severe mental disorder, equivalent to lack of criminal responsibility, was most often reported among offenders with a comorbid diagnosis of schizophrenia spectrum disorder. The most common type of crime was violent crime. Three person-oriented clinical subgroups were identified; (1) ASD with few other diagnoses; (2) ASD and very high levels of SUDs, plus moderate levels of other externalizing disorders and psychotic psychopathology and (3) ASD and moderate to high levels of personality disorders (other than ASPD) and SUDs.

Conclusion

Our results highlight the importance of all parts of the CJS to be prepared to handle offenders with ASD, often with high levels of additional psychiatric problems. Traditional approaches in treatment or other psychosocial interventions for ASD may need to be adapted to at least three general clinical profiles- one with mainly neurodevelopmental problems, one with a spectrum of externalizing problems and one with complex personality related difficulties.

Toward an understanding of occupational burnout among employees with autism - the Job Demands-Resources theory perspective

This article aims to gain insight into the phenomenon of occupational burnout among employees with autism based on the theoretical framework of the Job Demands-Resources theory and the literature on employees with autism in the workplace. Firstly, we argue that although the resources and demands of the neurotypical and neurodivergent employees might be different, the theoretical mechanism of occupational burnout formation remains similar among the neurotypical and neurodivergent employees, leading to the similar burnout experience. Next, we distinguish key demands that might drain neurodiverse employees' energy, and spark burnout, and propose a set of resources that might foster their achievement of work goals and mitigate demanding working conditions. We emphasise that the nature of job demands/resources that may cause burnout is not universal but might depend on how employees evaluate them, thus neurotypical and neurodiverse workers who evaluate the same work characteristics differently might complement each other, increasing organisational diversity without losing productivity. Our conceptual elaboration contributes to the theory and practice of healthier workplaces by providing tools and inspiration to managers, policymakers, and all stakeholders interested in creating a diverse and productive workplace. Moreover, our work might spark a much needed debate on occupational burnout among employees with autism and encourage conducting further empirical studies.

A Parental-Report Questionnaire for Language Abilities and Pragmatics in Children and Adolescents with Autism Spectrum Disorders

The aim of this study was to test and validate a parental-report questionnaire, which assesses language abilities and pragmatics, in children with Autism Spectrum Disorders (ASD). We report two experiments: The first served as the initial test and the second sought to provide the first assessment of convergent validity. In total, we recruited 230 parents, where approximately two-thirds had a child with ASD. Results of factor analyses showed a consistent factor structure within each subscale, and the internal consistency was excellent for both sub-scales (Cronbach's alpha >0.90). Convergent validity was assessed by correlating the results of the questionnaire with two sub-scales of the Autism Quotient questionnaire. The correlations were all greater than 0.60. The final version of the questionnaire (following exclusion of problematic items) contains 30 items (12 for language abilities and 18 for pragmatics). We conclude that the questionnaire is a concise and practical instrument for use in a variety of contexts for assessing language functioning and communication in children with ASD.

Investigating the Mechanisms Driving Referent Selection and Retention in Toddlers at Typical and Elevated Likelihood for Autism Spectrum Disorder

It was suggested that children's referent selection may not lay memory traces sufficiently strong to lead to retention of new word-object mappings. If this was the case we expect incorrect selections to be easily rectified through feedback. Previous work suggested this to be the case in toddlers at typical likelihood (TL) but not in those at elevated likelihood (EL) for autism spectrum disorder (ASD) (Bedford et al., ). Yet group differences in lexical knowledge may have confounded these findings. Here, TL (N = 29) and EL toddlers (N = 75) chose one of two unfamiliar objects as a referent for a new word. Both groups retained the word-referent mapping above chance when their choices were immediately reinforced but were at chance after corrective feedback. The same pattern of results was obtained when children observed another experimenter make the initial referent choice. Thus, children's referent choices lay memory traces that compete with subsequent correction; these strong word-object associations are not a result of children actively choosing potential referents for new words.

Ketamine administration in early postnatal life as a tool for mimicking Autism Spectrum Disorders core symptoms

Autism Spectrum Disorders (ASD) core symptoms include deficits of social interaction, stereotyped behaviours, dysfunction in language and communication. Beyond them, several additional symptoms, such as cognitive impairment, anxiety-like states and hyperactivity are often occurring, mainly overlapping with other neuropsychiatric diseases. To untangle mechanisms underlying ASD etiology, and to identify possible pharmacological approaches, different factors, such as environmental, immunological and genetic ones, need to be considered. In this context, ASD animal models, aiming to reproduce the wide range of behavioural phenotypes of this uniquely human disorder, represent a very useful tool. Ketamine administration in early postnatal life of mice has already been studied as a suitable animal model resembling psychotic-like symptoms. Here, we investigated whether ketamine administration, at postnatal days 7, 9 and 11, might induce behavioural features able to mimic ASD typical symptoms in adult mice. To this aim, we developed a 4-days behavioural tests battery, including Marble Burying, Hole Board, Olfactory and Social tests, to assess repetitive and stereotyped behaviour, social deficits and anxiety-like symptoms. Moreover, by using this mouse model, we performed neurochemical and biomolecular analyses, quantifying neurotransmitters belonging to excitatory-inhibitory pathways, such as glutamate, glutamine and gamma-aminobutyric acid (GABA), as well as immune activation biomarkers related to ASD, such as CD11b and glial fibrillary acidic protein (GFAP), in the hippocampus and amygdala. Possible alterations in levels of brain-derived neurotrophic factor (BDNF) expression in the hippocampus and amygdala were also evaluated. Our results showed an increase in stereotyped behaviours, together with social impairments and anxiety-like behaviour in adult mice, receiving ketamine administration in early postnatal life. In addition, we found decreased BDNF and enhanced GFAP hippocampal expression levels, accompanied by elevations in glutamate amount, as well as reduction in GABA content in amygdala and hippocampus. In conclusion, early ketamine administration may represent a suitable animal model of ASD, exhibiting face validity to mimic specific ASD symptoms, such as social deficits, repetitive repertoire and anxiety-like behaviour.

Developing an arabic questionnaire to assess sensory processing disorders among preschool Egyptian children

BACKGROUND

Sensory processing disorder (SPD) is a neurophysiologic disorder in which sensory input is poorly detected, modulated, interpreted and/or to which atypical responses occur. The objective of this study was to validate an Arabic questionnaire for identification of SPD among preschool Arabic-speaking children with Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

METHODS

A newly constructed Arabic questionnaire for assessment of SPD was completed by parents of 100 Egyptian Arabic-speaking children including 40 typically-developing children (control group), 30 children with ASD, and 30 children with ADHD in the age range 3-6 years RESULTS AND CONCLUSION: Sensory processing differences were detected between typically-developing children and children with ASD and ADHD. Significant differences were found in auditory processing, visual processing, oral sensory processing, olfactory processing, total scores and emotional/social response. The current study revealed non-significant differences between ASD and ADHD children as regards auditory, visual, touch, oral sensory, olfactory and total processing scores. On the other hand, ASD children showed higher scores in proprioceptive processing and lower scores in emotional/social response than children with ADHD. The designed Arabic questionnaire is a valid and reliable assessment tool for identification of SPD in preschool Arabic-speaking children.

Prenatal reduction of E14.5 embryonically fate-mapped pyramidal neurons in a mouse model of autism

Although several observations suggest that the constitutive biological, genetic or physiological changes leading to Autism Spectrum Disorders (ASD) start in utero, their early impact on the number and density of neurons in the brain remains unknown. Using genetic fate mapping associated with the iDISCO clearing method we identified and counted a selective population of neocortical and hippocampal pyramidal neurons in the in utero valproate (VPA) mouse model of autism. We report that one day before birth the number of pyramidal neurons born at E14.5 in the neocortex and hippocampus of VPA-mice is smaller than in age-matched controls. VPA also induced a reduction of the neocortical -but not hippocampal- volume one day before birth. Interestingly, VPA-mice present an increase in both neocortical and hippocampal volumes 2 days after birth compared to controls. These results suggest that the VPA-exposed hippocampus and neocortex differ substantially from controls during the highly complex perinatal period, and specially one day before birth, reflecting the early pathogenesis of ASD.

Clinical overlap between functional neurological disorders and autism spectrum disorders: a preliminary study

Functional neurological disorders (FNDs) and autism spectrum disorders (ASDs) share common features in terms of deficits in emotion regulation and recognition, sensory sensitivity, proprioception and interoception. Nevertheless, few studies have assessed their overlap. We recruited 21 patients with FNDs, 30 individuals with ASDs without intellectual disabilities and 45 neurotypical adults (NA). Participants completed: the Autism Quotient (AQ); the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R); and a questionnaire assessing functional neurological symptoms (FNS). ASDs participants also completed the Sensory Perception Quotient-Short Form (SPQ-SF35), assessing sensory sensitivity. In the FNDs sample, no patient scored above the clinical cut-off at the AQ and the 19% scored above the cut-off at the RAADS-R, a prevalence similar to the one we found in NA (15.6%; both p > 0.05). The 86.7% of participants with ASDs reported at least one FNS, a prevalence significantly higher than the NA one (35.6%, p < 0.001). In the ASDs sample, tactile hypersensitivity was found to be a risk factor for functional weakness (OR = 0.74, p = 0.033) and paraesthesia (OR = 0.753, p = 0.019). In conclusions, FNDs individuals did not present autistic traits more than NA, but ASDs individuals presented a higher number of FNSs than NA; this rate was associated with higher sensory sensitivity, especially in the touch domain.

Evaluating the effectiveness of a reverse inclusion Social Skills intervention for children on the Autism Spectrum

Schools need effective, generalizable, and socially valid social skills interventions to better support the social inclusion and peer relationships of their students on the autism spectrum. We evaluated a Pivotal Response Treatment-based, naturalistic social skills intervention implemented daily by school personnel in reverse inclusion school settings with four students on the autism spectrum (K-2nd grade). Using a single-case experimental design, results indicated that the students on the autism spectrum showed increases in the percent of time engaged in cooperative play with peers during the intervention (p = .0026) and moderate changes in social interactions were determined through systematic visual analysis. However, these changes in social behaviors did not generalize to natural inclusive school settings.

Efficacy and Safety of Diet Therapies in Children With Autism Spectrum Disorder: A Systematic Literature Review and Meta-Analysis

Objective

Autism Spectrum Disorder is a neurodevelopmental disorder, with a rapid increase in recognition over the past decade. Interest in alternative therapies is growing annually, such as dietary therapies including gluten-free and/or casein-free diet, and the ketogenic diet. However, there is no consensus on the efficacy and safety of dietary therapy in children with ASD up to now. This study aimed to assess the efficacy and safety of these diet interventions for children with ASD based on a meta-analysis of global data.

Methods

Seven databases (Cochrane Library, PubMed, EMBASE, Web of Science, VIP, CNKI, and Wanfang) were searched according to the established inclusion criteria, from the inception of the databases to August 18, 2021. The Cochrane Bias risk assessment tool was intended to assess the quality of the included studies. Review Manager 5.4 software was used as an efficacy analysis tool of the included studies, taking the core autistic symptoms and scales of ASD as therapeutic efficacy evaluations.

Results

In total, 7 RCTs with 338 participants were finally obtained. All studies assessed the association between core autistic symptoms and therapeutic diet, showing a statistically significant effect (standard mean difference (SMD) of −0.51, 95% confidence interval (Cl): −0.81 to −0.21), in which two studies which followed the GFD diet reported significant reductions in social behaviors (SMD of−0.41, 95% Cl: −0.75 to −0.06), showing no correlation with the length of the interventions (P < 0.05). Two studies were performed in KD diet suggested a significant effect in core symptoms (SMD of −0.67, 95% Cl: −1.04 to −0.31). No statistically significant changes were observed in the GFCF diet, GFD diet, cognition, communication, and stereotypical behaviors subgroups (all P > 0.05).

Conclusion

The results of a meta-analysis suggest that diet therapies can significantly ameliorate core symptoms of ASD, and GFD diets are conducive to improving social behaviors. Although the results suggest the effectiveness of dietary therapy for ASD, limited by the small sample size of RCTs, more well-designed, and high-quality clinical trials are needed to validate the above conclusions.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021277565.

Caring for People with Autism Spectrum Disorder and Cancer

N/a.

"I was Confused … and Still am" Barriers Impacting the Help-Seeking Pathway for an Autism Diagnosis in Urban North India: A Mixed Methods Study

Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools.

Sensory Profiles in School-Aged Children with Autism Spectrum Disorder: A Descriptive Study Using the Sensory Processing Measure-2 (SPM-2)

Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum Disorders (ASD) and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. The characterization of the sensory processing in ASD has thus become crucial to identify the sensory and motor features influencing the development of personal autonomy. Objectives: The present study has two aims: (1) to compare the sensory processing between school-aged children with ASD and typically developing peers (TD); (2) to evaluate whether, within the ASD sample, the cognitive level and reported sensory symptoms explain the scores exhibited at the Sensory Processing Measure (SPM-2). Methods: The SPM-2 test was administered to the parents of 105 children with ASD and 70 TD. The ASD group was further subdivided into two groups, namely high and low functioning based on their cognitive level (High Functioning (HF), IQ > 80; Low Functioning (LF), IQ < 80). Results: ASD children exhibited higher scores throughout the SPM-2 total score and its multiple subscales. Within ASD, while HF and LF children did not differ in terms of the SPM-2 total score, a significant difference was found for the hearing, social participation, and balance and motion subscales. Conclusions: Aside from classical knowledge that the ASD population suffers from sensory processing disorders, we revealed that different sensory patterns are associated with high or low cognitive functioning. Beyond its neurobiological interest, such knowledge may be of fundamental importance for individualizing psychoeducational interventions in preschool- and school-aged children and later developmental stages.

Brief Report: Sensory Sensitivity is Associated with Disturbed Eating in Adults with Autism Spectrum Disorders Without Intellectual Disabilities

Aim of the present study was to evaluate the relationship between sensory sensitivity and autistic eating behaviours or Eating Disorders (EDs) symptomatology, in a group of 75 adults with Autism Spectrum Disorders (ASDs) without intellectual disabilities, through a series of self-report questionnaires. We found that, controlling for demographic and clinical features: (i) hypersensitivity in the vision domain predicted higher levels of both EDs symptoms and autistic eating behaviours; (ii) hyposensitivity in the taste domain predicted higher levels of EDs symptoms. This gives preliminary evidence that not only in children diagnosed with ASDs, but even in adult individuals, the threshold of sensory sensitivity is associated with dysfunctional eating behaviours.

A paradoxical psychological impact of COVID-19 among a sample of Italian adults with High Functioning Autism Spectrum Disorder

Background

Since February 2020, many governments of the world ordered strict social distancing rules to try to contain the COVID-19 pandemic, with a reported consequent increase in levels of stress, anxiety and depression in the general population. Aim of this study was to assess the prevalence of the aforementioned psychiatric symptoms across a sample of individuals with High Functioning Autism Spectrum Disorders (HF-ASDs) with respect to a group of neurotypical adults (NA), during the first two months of COVID-19 pandemic in Italy.

Method

45 adults with HF-ASDs and 45NA completed a structured online questionnaire, including; the Depression, Anxiety and Stress Scale – 21 items (DASS-21); the Impact of Event Scale-Revised (IES-R); the Perceived Stress Scale (PSS). We also explored some specific aspects of participants’ psychological well-being through an ad-hoc questionnaire.

Results

Subjects with HF-ASDs scored significantly higher than NA at the DASS-21, the IES-R Total Score and the PSS; NA reported a higher perceived change of their lifestyle during the lockdown than individuals with HF-ASDs, and subjects with HF-ASDs reported to feel more comfortable and less tired during the lockdown period, in relation to the social distancing measures adopted by Italian authorities.

Conclusions

Adults with HF-ASDs presented higher rates of depression, anxiety, stress and PTSD-related symptoms than NA during the first two months of COVID-19 pandemic. However, they also reported to feel subjectively more comfortable and less tired during the lockdown than before, in relation to the social distancing measures.

Predicting ASD Diagnosis in Children with Synthetic and Image-based Eye Gaze Data

As early intervention is highly effective for young children with autism spectrum disorder (ASD), it is imperative to make accurate diagnosis as early as possible. ASD has often been associated with atypical visual attention and eye gaze data can be collected at a very early age. An automatic screening tool based on eye gaze data that could identify ASD risk offers the opportunity for intervention before the full set of symptoms is present. In this paper, we propose two machine learning methods, synthetic saccade approach and image based approach, to automatically classify ASD given children's eye gaze data collected from free-viewing tasks of natural images. The first approach uses a generative model of synthetic saccade patterns to represent the baseline scan-path from a typical non-ASD individual and combines it with the real scan-path as well as other auxiliary data as inputs to a deep learning classifier. The second approach adopts a more holistic image-based approach by feeding the input image and a sequence of fixation maps into a convolutional or recurrent neural network. Using a publicly-accessible collection of children's gaze data, our experiments indicate that the ASD prediction accuracy reaches 67.23% accuracy on the validation dataset and 62.13% accuracy on the test dataset.

Implications of Applying "Clinically Significant Impairment" to Autism Assessment: Commentary on Six Problems Encountered in Clinical Practice

The addition of 'clinically significant impairment' (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, Author, 2013) to the diagnostic criteria for autism in DSM-5 attempts to establish a threshold for the condition. However, the increased prominence of the neurodiversity paradigm and social model of disability runs counter to the idea that characteristics of autism are fundamentally impairing. Consequently, diagnostic criteria for autism are becoming misaligned with the contemporary views of 'disorder' and 'disability'. In this commentary, we outline six clinical issues that arise from this misalignment during diagnostic assessment for autism, and the tension this creates in making diagnostic decisions. We conclude by considering ways the 'clinically significant impairment' criterion could be changed, and the implications this would have on clinical practice, and the concept of autism.

Electroencephalographic Correlate of Mexican Spanish Emotional Speech Processing in Autism Spectrum Disorder: To a Social Story and Robot-Based Intervention

Socio-emotional impairments are key symptoms of Autism Spectrum Disorders. This work proposes to analyze the neuronal activity related to the discrimination of emotional prosodies in autistic children (aged 9 to 11-year-old) as follows. Firstly, a database for single words uttered in Mexican Spanish by males, females, and children will be created. Then, optimal acoustic features for emotion characterization will be extracted, followed of a cubic kernel function Support Vector Machine (SVM) in order to validate the speech corpus. As a result, human-specific acoustic properties of emotional voice signals will be identified. Secondly, those identified acoustic properties will be modified to synthesize the recorded human emotional voices. Thirdly, both human and synthesized utterances will be used to study the electroencephalographic correlate of affective prosody processing in typically developed and autistic children. Finally, and on the basis of the outcomes, synthesized voice-enhanced environments will be created to develop an intervention based on social-robot and Social Story^TM for autistic children to improve affective prosodies discrimination. This protocol has been registered at BioMed Central under the following number: ISRCTN18117434.

Systematic approach to school-based assessments for autism spectrum disorders to reduce inequalities: a feasibility study in 10 primary schools

OBJECTIVES

This was a pilot study to explore whether the Early Years Foundation Stage Profile (EYFSP) carried out by UK teachers within the 'reception' year, combined with the Social Communication Questionnaire (SCQ), can lead to early identification of children with autism spectrum disorders (ASD) and early access to intervention and can reduce inequity in access to assessment and intervention.

DESIGN

Pragmatic prospective cohort.

SETTING

Ten primary schools from the SHINE project in Bradford.

PARTICIPANTS

587 pupils from 10 schools who transitioned from reception to year 1 in July 2017 and had the EYFSP completed were included in the final study.

INTERVENTIONS

The assessment involved a multidisciplinary team of three staff who completed Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule Version 2, classroom observations with an ASD checklist, a teacher-based ASD questionnaire and a final consensus meeting.

PRIMARY OUTCOME MEASURE

National Institute for Health and Care Excellence guideline-compliant clinical diagnosis of ASD.

SECONDARY OUTCOME MEASURES

Age of diagnosis, demographic data and feasibility parameters.

RESULTS

Children with low scores on the EYFSP were more likely to score above the SCQ threshold of 12, indicating potential autism (50% compared with 19% of children with high scores on the EYFSP (p<0.001)). All children scoring above the SCQ threshold received a full autism assessment; children who scored low on the EYFSP were more likely to be diagnosed with autism (and other developmental issues) compared with those who did not.

CONCLUSIONS

We identified nine new children with a diagnosis of ASD, all from ethnic minorities, suggesting that this process may be addressing the inequalities in early diagnosis found in previous studies. All children who scored above the SCQ threshold required support (ie, had a neurodevelopmental disorder), indicating the EYFSP questionnaire captured 'at-risk' children.

Comprehension of the Presupposition Trigger Ye "Also" by Mandarin-Speaking Preschoolers With and Without Autism Spectrum Disorders

Individuals with autism spectrum disorders (ASD) have been reported to be widely impaired in their understanding of linguistic expressions that rely on elements of the context or norms of communication. The accurate interpretation of sentences conveying presuppositions often relies on such content, however, little previous research has investigated the ASD population’s understanding of these sentences. The present study attempts to remedy this by exploring the understanding that Mandarin-speaking preschoolers with ASD and their typically developing (TD) peers have of sentence containing the presupposition trigger ye “also”. We used a Picture Selection Task and found that Mandarin-speaking preschool children with ASD performed significantly worse than their TD peers with regard to their understanding of the presuppositional content of sentences containing this presupposition trigger. Additionally, in contrast with previous results, TD preschoolers’ understanding of this presupposition trigger was found to be adult-like. We attribute this to an improved experimental design.

Maternal treatment with oral intestinal alkaline phosphatase mitigates high fat diet-induced cognitive disorders in offspring mice

Intestinal alkaline phosphatase (IAP) is an endogenous enzyme that promotes gastrointestinal homeostasis by detoxifying inflammatory mediators, tightening the gut barrier and promoting a healthy microbiome. Oral IAP administration was efficacious in ameliorating diabetes in a high fat diet (HFD)-induced murine model. In humans, maternal obesity and diabetes during pregnancy have been associated with an increased risk of autism spectrum disorders (ASD). In mice, HFD-induced maternal obesity leads to offspring with cognitive deficiency. Here we investigated whether IAP administration to obese dams could ameliorate autism-like disorders in mice. Using a HFD murine model, we recapitulated that maternal obesity leads to male offspring with social deficits as shown by the three chamber test and reciprocal social interaction analyses. Notably, oral delivery of IAP to dams improved those deficiencies. In addition, a jumping behavior was noted in pups from obese dams, which was rescued by maternal IAP treatment. Our findings suggest that maternal treatment with IAP can relieve some ASD-like symptoms in offspring mice.

Association between peripheral blood levels of C-reactive protein and Autism Spectrum Disorder in children: A systematic review and meta-analysis

INTRODUCTION

In the past five years, a growing number of studies have tried to illustrate the association between the peripheral blood level of C-reactive protein (CRP) and Autism Spectrum Disorders (ASD). However, the results have been inconsistent. To assess whether abnormal CRP in peripheral blood was associated with ASD, we conducted a systematic review and meta-analysis.

METHODS

A systematic literature search was performed using the Embase, PubMed, Web of Knowledge, PsycINFO, and Cochrane databases through August 27, 2019. Reference lists were also checked by hand-searching. Clinical studies exploring CRP concentration in the peripheral blood of autistic children and healthy controls were included in our meta-analysis. Overlapping samples were excluded. We pooled obtained data using a fixed- or random-effect model based on a heterogeneity test with Comprehensive Meta-Analysis software and STATA software. Standardized mean differences were converted to Hedges' g statistic in order to obtain the effect size adjusted for sample size. Subgroup analyses, sensitivity analyses, meta-regression, and publication bias tests were also undertaken.

RESULTS

Nine studies with 592 ASD children and 604 healthy children were included in our meta-analysis. Significantly elevated CRP levels in peripheral blood were found in ASD children compared with healthy controls (Hedges' g = 0.527, 95% CI: 0.224-0.830, p = 0.001). Subgroup analyses based on sample types and ethnicity also showed similar results, except for the plasma subgroup. There was also a significant association between peripheral CRP concentration and ASD after removing the studies identified by Galbraith plots. The results of the sensitivity analysis revealed that no single study could reverse our results. Meta-regression analyses revealed that the gender of autistic children had a moderating effect on the outcome of the meta-analysis. In addition, no obvious publication bias was found in the meta-analysis.

CONCLUSIONS AND RELEVANCE

In our study, peripheral CRP levels were significantly elevated in autistic children compared with healthy children. These results may provide us some new insights about ASD.

Autism Spectrum Disorders in Greece: Nationwide Prevalence in 10-11 Year-Old Children and Regional Disparities

Autism spectrum disorders (ASD) constitute a public health concern with increasing prevalence worldwide. We aimed to estimate prevalence and age at diagnosis in Greece, where no large-scale prevalence study has ever been conducted. Aggregate data were collected on ASD diagnoses by gender and calendar year of diagnosis up to 2019, for children born in 2008 and 2009, from the Centers for Educational and Counseling Support, which evaluate children to receive special educational support in school. Coverage was 87.1% of centers and 88.1% of schoolchildren born in 2008–9. ASD prevalence overall was 1.15% (1.83% males, 0.44% females; ratio 4.14:1), ranging from 0.59% to 1.50% in Greece’s 13 regions. In five regions, prevalence differed significantly between centers. Overall, only 3.8% of diagnoses were made before the fourth year after birth and 42.7% before the sixth year, with considerable variation between regions. Approximate mean age at diagnosis was six years and one month, and about three months earlier for girls than for boys. Our results provide evidence-based information to guide service planning and development at national and regional levels. Particular attention should be paid to smoothing out inequalities regarding service accessibility and provision. Emphasis should be given to earlier identification and diagnosis of ASD.

Strengthening Behavior and Social Functioning Among Persons with Autism Spectrum Conditions Using Artificial Intelligence and Behavioral Activation: Protocol for the Well-Being and Health for Loved onEs with ASD (WHOLE) Psychosocial Pilot Randomized Controlled Trial

Although a proportion of families and communities in low resource settings continue to provide care to loved ones with autism spectrum conditions, many of the affected persons remain undiagnosed and without access to proven therapies due to high treatment cost and cultural pressures, in particular. Use of conversational agents on mobile phones in combination with behavior activation home care may provide an innovative, culturally appropriate and affordable platform for strengthening behavior and social functioning outcomes, in addition to an opportunity for participation of the persons with autism spectrum conditions in the intervention development process. We aim to assess the effectiveness of an intervention that incorporates artificial intelligence conversational agent technologies and behavioral activation therapy techniques.

Problems in treatment and training of autistic children growing up in China: A follow-up case report

INTRODUCTION

Currently, interventions for children with autism spectrum disorders (ASD) in China are mainly carried out by professionals in rehabilitation institutions and special schools. However, when autistic children are older, they do not receive effective training and treatment, and there is no specific place in society to accommodate autistic adults. Mental hospitals are usually their ultimate home.

CASE PRESENTATION

We report a 22-year-old male with ASD. The manifestation and/or intervention from the age of 3 years to now were recorded. He has been hospitalized in the closed ward of a mental hospital since 2015.

CONCLUSION

This report typically present the current problems in treatment and training of autistic children growing up in China. Life-long rehabilitation training is important for every patient with ASD. Relevant policies and resources in China should be optimized in terms of medical treatment and health care, education and training, social assistance, social security, labor employment, and social culture.

The need for and barriers to using assistive technologies among individuals with Autism Spectrum Disorders in China

A large number of people in China have been affected by Autism Spectrum Disorders (ASDs). However, different factors associated with current barriers to accessing external support by ASD individuals in China have been identified. Assistive technologies are believed to help address the barriers. To obtain an in-depth understanding of the need and barriers of Chinese individuals with ASD in using assistive technologies, this study surveyed parents of ASD children, ASD professionals, as well as technology developers in the field. This study found that people in China have lower awareness and utilization of assistive technologies but similar demands for technologies when compared to those in the United Kingdom. Monitoring and informing systems, therapeutic recommendation systems and social skill training applications are major forms of assistive technologies desired by the participants in the interviews. Concerns about affordability, public exposure, confidentiality breaches and possible side-effects are considered as barriers that may prevent ASD individuals in China from using assistive technologies. The paper further discussed potential orientations of assistive technology development in China. Considering Chinese individuals may suffer intense stigma and heavy financial burden on mental disabilities, affordable mobile applications that help reduce the stigma would be more acceptable by Chinese ASD individuals.

Molecular Biomarkers Predictive of Sertraline Treatment Response in Young Children With Autism Spectrum Disorder

Sertraline is one among several selective serotonin reuptake inhibitors (SSRIs) that exhibited improvement of language development in Autism Spectrum Disorder (ASD); however, the molecular mechanism has not been elucidated. A double blind, randomized, 6-month, placebo-controlled, clinical trial of low-dose sertraline in children ages (3–6 years) with ASD was conducted at the UC Davis MIND Institute. It aimed at evaluating the efficacy and benefit with respect to early expressive language development and global clinical improvement. This study aimed to identify molecular biomarkers that might be key players in the serotonin pathway and might be predictive of a clinical response to sertraline. Fifty eight subjects with the diagnosis of ASD were randomized to sertraline or placebo. Eight subjects from the sertraline arm and five from the placebo arm discontinued from the study. Furthermore, four subjects did not have a successful blood draw. Hence, genotypes for 41 subjects (20 on placebo and 21 on sertraline) were determined for several genes involved in the serotonin pathway including the serotonin transporter-linked polymorphic region (5-HTTLPR), the tryptophan hydroxylase 2 (TPH2), and the Brain-Derived Neurotrophic Factor (BDNF). In addition, plasma levels of BDNF, Matrix metallopeptidase 9 (MMP-9) and a selected panel of cytokines were determined at baseline and post-treatment. Intent-to-treat analysis revealed several primary significant correlations between molecular changes and the Mullen Scales of Early Learning (MSEL) and Clinical Global Impression Scale – Improvement (CGI-I) of treatment and control groups but they were not significant after adjustment for multiple testing. Thus, sertraline showed no benefit for treatment of young children with ASD in language development or changes in molecular markers in this study. These results indicate that sertraline may not be beneficial for the treatment of children with ASD; however, further investigation of larger groups as well as longer term follow-up studies are warranted.

Parent-reported feeding and swallowing difficulties of children with Autism Spectrum Disorders (aged 3 to 5 years) compared to typically developing peers: a South African study

BACKGROUND

Research on aspects of neurodevelopment such as feeding and swallowing difficulties in children with Autism Spectrum Disorders (ASD) is limited in low and middle income countries such as South Africa.

METHOD

A descriptive comparative group design was used to investigate feeding and swallowing difficulties of young children with ASD in comparison to typically developing peers. The Brief Autism Mealtime Behavioural Inventory (BAMBI) was used.

RESULTS

Findings indicated a significant difference in the severity of feeding and swallowing difficulties between the two groups. Difficulties such as food selectivity, sensory processing difficulties, oral-motor difficulties and symptoms of dysphagia were identified. The findings added to the existing global literature on feeding and swallowing difficulties in young children with ASD but provide a unique first perspective on these difficulties in South African children with ASD.

CONCLUSION

Findings also highlighted the use of the BAMBI as an adjunct clinical tool to encourage comprehensive parental report during feeding assessment in this population. Cultural adaptation of the BAMBI for future use in African countries should be considered. A better local understanding of the parental perspective on the multidimensional nature of the feeding and swallowing difficulties displayed by young children with ASD was obtained.

Received Cradling Bias During the First Year of Life: A Retrospective Study on Children With Typical and Atypical Development

A population-level left cradling bias exists whereby 60-90% of mothers hold their infants on the left side. This left biased positioning appears to be mutually beneficial to both the mother and the baby's brain organization for processing of socio-emotional stimuli. Previous research connected cradling asymmetries and Autism Spectrum Disorders (ASD), entailing impairment in socio-communicative relationships and characterized by an early hypo-lateralization of brain functions. In this explorative study, we aimed to provide a contribution to the retrospective investigations by looking for early behavioral markers of neurodevelopmental disorders such as ASD. We hypothesized that an atypical trajectory in maternal cradling might be one of the possible signs of an interference in mother-infant socio-emotional communication, and thus of potential neurodevelopmental dysfunctions. To this aim, we examined photos depicting mother-child early cradling interactions by consulting family albums of 27 children later diagnosed with ASD and 63 typically developing children. As regards the first half of the first year of life, no differences were shown between maternal cradling-side preferences in typical and ASD groups, both exhibiting the left-cradling bias in the 0-3 months period, but not in the 3-6 months period. However, our results show dissimilar patterns of cradling preferences during the second half of the first year of life. In particular, the absence of left-cradling shown in typical mothers was not observed in ASD mothers, who exhibited a significant left-cradling bias in the 6-12 months age group. This difference might reflect the fact that mother-infant relationship involving children later diagnosed with ASD might remain "basic" because mothers experience a lack of social activity in such children. Alternatively, it may reflect the overstimulation in which mothers try to engage infants in response to their lack of responsiveness and social initiative. However, further investigations are needed both to distinguish between these two possibilities and to define the role of early typical and reversed cradling experiences on neurodevelopment.

An overview of autism in the elderly

The overall improvement in quality of health care in many countries across the globe will likely see an increase in the number of elderly patients with ASDs (Autism Spectrum Disorders) and will result in a need for extra and more adaptive educational, occupational, social, and environmental supports. An earlier diagnosis will auger well for better long-term outcomes in ASD. Therefore, better and more evidence based screening and diagnostic tools are needed. The lack of research and studies surrounding ASD in the elderly raises many real concerns about the wellbeing of those diagnosed with ASD as adults as they enter old age. This review will help provide information on prevalence, available screening tools and diagnostic instruments along with symptoms and manifestations, patients' quality of life related issues and current interventions. We will also highlight research needs and help create a clearer understanding of ASD and the challenges patients and professionals face and are confronted with.

Autistic feature as a presentation of Inborn Errors of Metabolism

Autism spectrum disorder (ASD) is a category of neurodevelopmental disorders characterized by social and communication impairment and restricted or repetitive behaviors. The pathogenesis of ASD is not well understood and it's proved that genetic is strongly associated with ASD in 5 to 25% of cases. Inborn errors of metabolism(IEMs), defined by a vast array of disorders that are caused by specific enzyme deficiencies or transport protein defects, is as frequent as in 1 in 800 births. IEMs can manifest several psychiatric or behavioral manifestations such as self-injuriesincreased activity and aggression, personality changes, paranoia, depression, catatonia, and psychosis. IEMs underlie autistic symptoms in less than 5% of cases. The literature on the association between ASD and respiratory chain abnormalities is growing, including complex III/IV deficiency and MELAS (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes) syndrome, as well as glucose-6-phosphate dehydrogenase deficiency. Google Scholar, Pubmed, and SCOPUS databases were searched using a combination of the following keywords: "autism spectrum disorder", "autism spectrum", "autistic feature" and "inborn error of metabolism", " IEM", "congenital error of metabolism". Initially, 655 articles were found and our expert and methodologist altogether selected 187 articles based on the titles, relevance, and text language. After reading full texts, 37 studies were selected for review. We think it's best to consider IEMs in children with syndromic ASD and/or if there is a strong familial history of autism or parental consanguineous marriage.

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.

Conserved and divergent expression dynamics during early patterning of the telencephalon in mouse and chick embryos

The mammalian and the avian telencephalon are nearly indistinguishable at early embryonic vesicle stages but differ substantially in form and function at their adult stage. We sequenced and analyzed RNA populations present in mouse and chick during the early stages of embryonic telencephalon to understand conserved and lineage-specific developmental differences. We found approximately 3000 genes that orchestrate telencephalon development. Many chromatin-associated epigenetic and transcription regulators show high expression in both species and some show species-specific expression dynamics. Interestingly, previous studies associated them to autism, intellectual disabilities, and mental retardation supporting a causal link between their impaired functions during telencephalon development and brain dysfunction. Strikingly, the conserved up-regulated genes were differentially enriched in ontologies related to development or functions of the adult brain. Moreover, a differential enrichment of distinct repertoires of transcription factor binding motifs in their upstream promoter regions suggest a species-specific regulation of the various gene groups identified. Overall, our results reveal that the ontogenetic divergences between the mouse and chick telencephalon result from subtle differences in the regulation of common patterning signaling cascades and regulatory networks unique to each species at their very early stages of development.

Using technology-based learning tool to train facial expression recognition and emotion understanding skills of Chinese pre-schoolers with autism spectrum disorder

Objectives: Given the pervasiveness of emotional and behavioral deficits of individuals with Autism Spectrum Disorders (ASD), there is a pressing need for effective interventions to address their difficulties on Facial Expression Recognition and Emotion Understanding (FER/EU). Qunatiandi, a structured, app-based intervention program that is designed for Chinese children with ASD was utilized in this study. Three young children (two girls and one boy; age M = 4.94 years) completed an 8-week one-on-one intervention in a rehabilitation center setting. It was hypothesized that the three children would show greater progress in their FER/EU. Methods: In this study, a modified multiple probe across the program phases design was used; the dependent variable was the percentage of unprompted correct receptive identification responses for FER/EU tests during instruction and probes. Data were taken during baseline, the endpoint of instruction sessions, and a maintenance stage followed by intervention termination. Results: Findings of the study revealed that all participants demonstrated significant improvements in social acuity, gains were mostly achieved on emotion distinguishing and understanding (above 80% of accuracy). A similar scoring pattern was also found in the maintenance probe phase. Conclusion: The study is one of only a few early intervention projects to improve FER/EU skills for children with ASD using an app-based intervention. The results demonstrated that children with ASD can experience increases in emotion distinguishing and understanding skills. Maintenance probe results showed that the interventional effect can be maintained for a period of time after intervention.

Autism spectrum disorder (ASD) - biomarkers of oxidative stress and methylation and transsulfuration cycle

Autism spectrum disorder (ASD) affects people from all regions of the globe, regardless of nationality, living standards or social group. Currently, it is assumed that ASD pathogenesis is multifactorial because there is no one specific cause of the disorder. According to literature, ASD may result from genetic defects, metabolic disorders or exposure to environmental factors. There is a number of hypotheses that attempt to explain the intensity of emotional and behavioral symptoms or the increased sensory threshold that is characteristic of ASD. It is suggested that neurological changes may be due to oxidative stress occurring in early brain tissue development and reduced antioxidative barrier. Due to the abnormalities in the synthesis of neurotransmitters, often occurring in ASD, autism is investigated for disorders of vital biochemical processes of methylation and transsulfuration. Finding a biomarker for a disturbed oxidative-reduction equilibrium, methylation pathway pathology, or other reason could be an important diagnostic tool and the base for individual treatment for patients with varying degrees of severity. This work provides a review of the potential biological indicators for ASD taking into account the occurrence of oxidative stress and the methylation and transsulfuration cycles.

The Impacts of a Reading-to-Dog Programme on Attending and Reading of Nine Children with Autism Spectrum Disorders

Simple Summary

The purpose of this research was to compare reading motivation and attitude, as well as reading and cognitive skills, of school-age children diagnosed with Autism Spectrum Disorders (ASD) who attended a 10 session reading programme with and without the presence of a dog. Children who read to a dog had 100% attendance at sessions over the course of the programme versus 75% (range 25–100%) of children attending reading sessions without a dog. In addition, after the programme, they were significantly more motivated and willing to read at home, as perceived by their parents. However, there were no significant differences in scores on reading and cognitive tests either within each group or between groups. Based on these results, we can conclude that reading to a dog can have positive effects on an ASD child’s motivation and attitude toward reading. More research is needed to better understand if it can also have positive effects on children with ASD’s overall reading and cognitive abilities.

Abstract

Poor knowledge is available on the effectiveness of reading to dogs in educational settings, particularly in children with Autism Spectrum Disorders (ASD). In this study, we test the hypothesis that reading to a dog improves propensity towards books and motivation to read after the end of the programme, as well as reading and cognitive skills in children with ASD. The study is a prospective, randomized controlled trial, consisting of testing and re-testing after a 10 sessions reading programme with and without the presence of a dog. Nine Children with ASD (6–11 years old) were randomly assigned to a control (CG, reading without a dog, n. 4) or experimental group (EG, reading to a dog, n. 5). Children’s attendance at reading sessions was recorded at each session. Parents’ perceptions were evaluated at the end of the programme to detect changes in children’s attitudes and motivation toward reading. Psychologist-administered validated reading (Cornoldi’s MT2 reading test; test of reading comprehension, TORC; metaphonological competence test, MCF) and cognitive tests (Wechsler intelligence scale for children Wisc IV, Vineland) to all children, at baseline and at the end of the reading programme. Compared with CG children, children in the EG group participated more frequently in the reading sessions, and they were reported to be more motivated readers at home after the programme. However, there were no differences on reading and cognitive tests’ scores either within each group of children or between groups. Further studies are warranted in order to understand whether and how incorporating dogs into a reading programme is beneficial to Children with ASD at the socio-emotional and cognitive level.

PREDICTING AUTISM DIAGNOSIS USING IMAGE WITH FIXATIONS AND SYNTHETIC SACCADE PATTERNS

Signs of autism spectrum disorder (ASD) emerge in the first year of life in many children, but diagnosis is typically made much later, at an average age of 4 years in the United States. Early intervention is highly effective for young children with ASD, but is typically reserved for children with a formal diagnosis, making accurate identification as early as possible imperative. A screening tool that could identify ASD risk during infancy offers the opportunity for intervention before the full set of symptoms is present. In this paper, we propose two machine learning methods, synthetic saccade approach and image based approach, to automatically classify ASD given the scanpath data from children on free viewing of natural images. The first approach uses a generative model of synthetic saccade patterns to represent the baseline scan-path from a typical non-ASD individual and combines it with the input scanpath as well as other auxiliary data as inputs to a deep learning classifier. The second approach adopts a more holistic image based approach by feeding the input image and a sequence of fixation maps into a state-of-the-art convolutional neural network. Our experiments indicate that we can get 65.41% accuracy on the validation dataset.