Pubmed du 16/10/19

mercredi 16 octobre 2019

1. Burnham Riosa P, Khan M, Weiss J. Measuring therapeutic alliance in children with autism during cognitive behavior therapy. Clin Psychol Psychother ;2019 (Oct 15)

Therapeutic alliance (TA), or the collaborative relationship between a therapist and client, has been shown to be an important component of intervention success. The objective of this study was to examine the psychometric properties of the Therapy Process Observational Coding System-Alliance Scale (TPOCS-A). The sample consisted of 20 children (19 males) ages 8 to 12 years with autism and their parents (15 mothers, 5 fathers), who completed a cognitive behavioural intervention designed to improve children’s emotion regulation skills. Two trained coders rated early, middle, and late parent and child alliance using the TPOCS-A after watching video recorded therapy sessions. Therapist-reported child involvement, alliance, and adherence was also assessed. Psychometric findings revealed that the TPOCS-A is a reliable and valid measure of therapeutic alliance for children with autism. The implications of examining TA in empirically supported treatments for this population are discussed.

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2. Ersoz Alan B, Gulerman F. [The Role of Gut Microbiota in Autism Spectrum Disorder]. Turk Psikiyatri Derg ;2019 (Fall) ;30(3):210-219.

Human microbiota are colonies of microorganisms located in different parts of the human body with diverse functions. Healthy gut microbiota comprises differing ratios of microoganisms wholly contributing to metabolic and other molecular reactions in a healthy, functioning body. After the demonstration of the bidirectional interaction between the central nervous system and gut microbiota through neuroendocrine, neuroimmune, and autonomic nervous mechanisms, investigations have been started on the microbiota-gut-brain axis in psychiatric disorders. Autism spectrum disorder (ASD), which is a neurodevelopmental disorder of early childhood, is one of these disorders. Most of such studies were cross-sectional and mainly investigated the bacterial species. Changes in gut microbiota composition and the leaky gut syndrome are some of the hypotheses proposed to explain the core symptoms and gastrointestinal (GI) symptoms of ASD. Probiotics, prebiotics, fecal microbiota transplantation, diet have been proposed as treatment options. However, the role of microbiota in diagnosis, followup, and treatment is not yet clear. The bidirectional interaction between central nervous system and intestinal microbiota makes it difficult to establish the cause-effect relationship. The current data on microbiota may be useful to plan patient-specific treatment in autistic children with GI symptoms. This article aims to review the results of the studies on microbiota in animal models and children and discuss the emerging clinical relationship of ASD and gut microbiota.

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3. Frohlich H, Kollmeyer ML, Linz VC, Stuhlinger M, Groneberg D, Reigl A, Zizer E, Friebe A, Niesler B, Rappold G. Gastrointestinal dysfunction in autism displayed by altered motility and achalasia in Foxp1 (+/-) mice. Proc Natl Acad Sci U S A ;2019 (Oct 14)

Gastrointestinal dysfunctions in individuals with autism spectrum disorder are poorly understood, although they are common among this group of patients. FOXP1 haploinsufficiency is characterized by autistic behavior, language impairment, and intellectual disability, but feeding difficulties and gastrointestinal problems have also been reported. Whether these are primary impairments, the result of altered eating behavior, or side effects of psychotropic medication remains unclear. To address this question, we investigated Foxp1 (+/-) mice reflecting FOXP1 haploinsufficiency. These animals show decreased body weight and altered feeding behavior with reduced food and water intake. A pronounced muscular atrophy was detected in the esophagus and colon, caused by reduced muscle cell proliferation. Nitric oxide-induced relaxation of the lower esophageal sphincter was impaired and achalasia was confirmed in vivo by manometry. Foxp1 targets (Nexn, Rbms3, and Wls) identified in the brain were dysregulated in the adult Foxp1 (+/-) esophagus. Total gastrointestinal transit was significantly prolonged due to impaired colonic contractility. Our results have uncovered a previously unknown dysfunction (achalasia and impaired gut motility) that explains the gastrointestinal disturbances in patients with FOXP1 syndrome, with potential wider relevance for autism.

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4. Hoffmann A, Krause SE, Wuu J, Leurgans S, Guter SJ, Jr., Block SS, Salt J, Cook E, Jr., Maino DM, Berry-Kravis E. Vocabulary comprehension in adults with fragile X syndrome (FXS). J Neurodev Disord ;2019 (Oct 16) ;11(1):25.

BACKGROUND : Receptive and expressive vocabulary in adult and adolescent males with fragile X syndrome (FXS) have been shown as significantly lower than their chronological age ; however, receptive vocabulary has been considered a strength relative to mental age. This has not been formally examined, however, and data are needed to compare receptive vocabulary with other language skills and with mental age in individuals with FXS. This is especially important as vocabulary measures are sometimes used as a proxy to estimate language ability. METHODS : This preliminary study examined receptive vocabulary, global language, and cognitive skills in 42 adults (33 males and 9 females) with FXS as a portion of the baseline evaluation prior to randomization in a clinical trial of ampakine CX516. The battery of standardized tests addressed receptive vocabulary with the Peabody Picture Vocabulary Test, Third Edition (PPVT-III), receptive and expressive language (termed henceforth as global language) via the Preschool Language Scale, Fourth Edition or the Clinical Evaluation of Language Fundamentals, Third Edition, and non-verbal cognition via the Stanford-Binet Intelligence Scales, Fourth Edition (SB-IV). RESULTS : Results showed (1) significantly higher receptive vocabulary than global language, (2) significantly better receptive vocabulary than non-verbal cognition, (3) equivalent non-verbal cognition and global language, and (4) severity of autism symptomatology was not correlated to receptive vocabulary or global language once non-verbal cognition was removed as factor. The scores from the PPVT-III did not represent the global language skills in our sample of adults with FXS. CONCLUSIONS : Findings from this investigation strongly suggest that the PPVT-III should not be used as a screening tool for language levels or cognitive function in clinical studies since the scores from the PPVT-III were not representative of global language or non-verbal cognitive skills in adults with intellectual disabilities. This finding is critical in order to understand how to evaluate, as well as to treat, language in individuals with FXS. Development of efficient and appropriate tools to measure language, cognition, and behavior in individuals with FXS is essential.

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5. Kadwa RA, Sahu JK, Singhi P, Malhi P, Mittal BR. Prevalence and Characteristics of Sensory Processing Abnormalities and its Correlation with FDG-PET Findings in Children with Autism. Indian J Pediatr ;2019 (Oct 15)

OBJECTIVE : To study the prevalence and characteristics of Sensory processing abnormalities (SPAs) in children with autism and to study if there is any correlation between sensory processing abnormalities with FDG-PET findings in children with severe autism. METHODS : One hundred children, aged 3-12 y, diagnosed as Autistic spectrum disorder ; ASD (DSM-V) and 100 age and sex matched controls were studied. SPAs were detected using Short sensory profile (SSP) questionnaire. Children with progressive neurological diseases, active epilepsy and structural brain abnormalities were excluded. On Childhood Autism rating scale, 30 children had severe and 70 had mild-moderate autism. The pattern of sensory processing abnormalities in children with severe ASD was compared with mild-moderate ASD. FDG-PET scan was done in children with severe autism and correlated with SPAs. RESULTS : All children with severe autism had sensory processing abnormalities as compared to only 40% children with mild-moderate autism. Underresponsiveness/seeking-sensation was affected in all children with severe ASD and 82% had movement sensitivity. In children with mild-moderate ASD, 45% had auditory filtering, 30% had movement sensitivity and 27% had underresponsiveness/seeking-sensation. FDG-PET was abnormal in 17% of children with severe autism. Diffuse cerebral/ temporal lobe hypometabolism, increased bilateral frontal lobe uptake and moderate reduction in parietal lobe (Lt > Rt) was observed. CONCLUSIONS : All patients with severe autism had SPAs. However, they did not correlate with FDG-PET findings.

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6. Kamp-Becker I, Stroth S, Stehr T, Weber L. [Blessing or curse ? The World Wide Web as information source for autism and Asperger Syndrome]. Z Kinder Jugendpsychiatr Psychother ;2019 (Oct 16):1-9.

Blessing or curse ? The World Wide Web as information source for autism and Asperger Syndrome Abstract. Objective : The World Wide Web is today one of the most common methods used for obtaining health-related information, though the quality of the information is sometimes questionable. The present study addresses the quality of the information source internet and the resulting implications and discusses examples related to autism spectrum disorder. Method : We systematically evaluated 96 German websites, with the aim of estimating specific characteristic features, reliability of publications, presentation of information as well as overall website quality. We also analyzed the clinical implications of the presentations. Results : Only 39 % of the websites provided references to scientifically well-founded information, whereas advertisements were found on 53 % of websites. The greatest percentage of false information (17 %) was disseminated concerning therapy. 75 % of the websites provided incomplete information. Only 10 % of websites discussed the impairment or familial burden. The quality of information was insufficient on 30 %, poor on 41 %, and good on only 6 % of the websites. Conclusions : Similar to results available for English-language websites, the quality of German websites providing health-related information can be considered low. Implications concerning confirmation bias, stigma, overidentification, in-group/outgroup, contrast and snowball effects are discussed.

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7. Layne CS, Young DR, Lee BC, Glaze DG, Schwabe A, Suter B. Kinematics associated with treadmill walking in Rett syndrome. Disabil Rehabil ;2019 (Oct 15):1-9.

Background and purpose : Individuals with Rett syndrome suffer from severely impaired cognitive and motor performance. Current movement-related therapeutic programs often include traditional physical therapy activities and assisted treadmill walking routines for those individuals who are ambulatory. However, there are no quantitative reports of kinematic gait parameters obtained during treadmill walking. The purpose of this research was to characterize the kinematic patterns of the lower limbs during treadmill walking as speed was slowly increased. Methods : Seventeen independently ambulatory females diagnosed with a methyl-CpG-binding protein 2 gene mutation walked on a motorized treadmill while joint kinematics were obtained by a camera-based motion capture system and analysis software. Results : Stride times progressively decreased as treadmill speeds increased. There were significant main effects of speed on sagittal knee and hip ranges of motion and hip velocity. There were large joint asymmetries and variance values relative to other ambulatory patient populations, although variance values decreased as walking speed increased. Conclusions : The results indicate that individuals with Rett syndrome can adapt their kinematic gait patterns in response to increasing treadmill speed, but only within a narrow range of speeds. We suggest that treadmill training for ambulatory individuals with Rett syndrome may promote improved walking kinematics and possibly provide overall health benefits. Implications for rehabilitation Walking is an activity that can counter the negative impacts of the sedentary lifestyle of many individuals with disabilities, including those individuals with Rett syndrome. Documentation of the lower limb kinematic patterns displayed during walking by ambulatory females with Rett syndrome can be used by clinicians to evaluate their patients’ gait performance in response to therapeutic and pharmacological interventions designed to promote walking. The ability to adapt to increases in treadmill speed suggests that a training program of treadmill walking may be effective in promoting improved gait performance in individuals with Rett syndrome.

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8. Lee GT, Hu X, Liu Y, Zou C, Cheng X, Zhao Q, Huang J. Increasing Response Diversity to Intraverbals in Children with Autism Spectrum Disorder. J Autism Dev Disord ;2019 (Oct 16)

The purpose of this study was to evaluate the effects of intraverbal prompts on response diversity and novelty in intraverbals posed to children with autism spectrum disorder (ASD). The intraverbal prompts involving function, feature, and class (FFC) of an item were used in the training of three questions requiring multiple responses. Two Chinese boys with ASD (aged 5-6 years) served as participants. A multiple-probe across three behaviors design was employed. The results indicated that the intraverbal prompts effectively increased the number of divergent responses to all three questions. Novel responses emerged at a low level while generalization to similar questions was not observed following the training.

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9. Li Y, Zhu Y, Nguchu BA, Wang Y, Wang H, Qiu B, Wang X. Dynamic Functional Connectivity Reveals Abnormal Variability and Hyper-connected Pattern in Autism Spectrum Disorder. Autism Res ;2019 (Oct 15)

Autism spectrum disorder (ASD) is a general neurodevelopmental disorder associated with altered brain connectivity. However, most connectivity analyses in ASD focus on static functional connectivity, largely neglecting brain activity dynamics that have been reported to provide deeper insight into the underlying mechanisms of brain functions. Therefore, we anticipate that the use of dynamic functional connectivity (DFC) with interaction of clustering measures could help characterize ASD severity and reveal more information. In this study, we applied the sliding-window and k-means clustering methods to perform DFC and clustering analyses in ASD and typically developing (TD) groups. Data from 62 ASD and 63 TD children were acquired from the open-access data set Autism Brain Imaging Data Exchange. Our findings revealed higher DFC variability between the posterior cingulate gyrus (PCC) and middle temporal pole (TPOmid) in subjects with ASD. The connection between the PCC and pars opercularis of inferior frontal gyrus (IFGoper) also presented greater variability in ASD, with the increase depending on ASD symptom severity. Furthermore, clustering analysis showed higher averaged dwell time and probability of transition for globally hyper-connected state in the ASD group, which could be related to connection variability between the PCC and IFGoper. Our results demonstrate that both the PCC and IFGoper play crucial roles in characterizing symptom severity and state configuration in ASD, and brain connectivity dynamics may serve as potential indicators of ASD in future studies. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY : Dynamic functional connectivity (DFC) refers to functional connectivity that changes over a short time. This study found that DFC instability between the posterior cingulate gyrus and pars opercularis of inferior frontal gyrus is associated with abnormal brain pattern configurations and dysfunction of social cognitive processes in autism spectrum disorder (ASD). These findings could contribute to a deeper understanding of the neural mechanisms of ASD and help characterize ASD severity.

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10. Nimmo-Smith V, Heuvelman H, Dalman C, Lundberg M, Idring S, Carpenter P, Magnusson C, Rai D. Anxiety Disorders in Adults with Autism Spectrum Disorder : A Population-Based Study. J Autism Dev Disord ;2019 (Oct 16)

Anxiety is common in children with ASD ; however, the burden of specific anxiety disorders for adults with ASD is under-researched. Using the Stockholm Youth Cohort, we compared anxiety disorder diagnoses among autistic adults (n = 4049), with or without intellectual disability, and population controls (n = 217,645). We conducted additional sibling analyses. Anxiety disorders were diagnosed in 20.1% of adults with ASD compared with 8.7% of controls (RR = 2.62 [95% CI 2.47-2.79]), with greatest risk for autistic people without intellectual disability. Rates of almost all individual anxiety disorders were raised, notably obsessive-compulsive disorder and phobic anxiety disorders. Anxiety disorders were more common in full siblings and half-siblings of people with ASD. The implications of this are explored.

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11. Oudin A, Frondelius K, Haglund N, Kallen K, Forsberg B, Gustafsson P, Malmqvist E. Prenatal exposure to air pollution as a potential risk factor for autism and ADHD. Environ Int ;2019 (Oct 16) ;133(Pt A):105149.

Genetic and environmental factors both contribute to the development of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). One suggested environmental risk factor for ASD and ADHD is air pollution, but knowledge of its effects, especially in low-exposure areas, are limited. Here, we investigate risks for ASD and ADHD associated with prenatal exposure to air pollution in an area with air pollution levels generally well below World Health Organization (WHO) air quality guidelines. We used an epidemiological database (MAPSS) consisting of virtually all (99%) children born between 1999 and 2009 (48,571 births) in the study area, in southern Sweden. MAPSS consists of data on modelled nitrogen oxide (NOx) levels derived from a Gaussian dispersion model ; maternal residency during pregnancy ; perinatal factors collected from a regional birth registry ; and socio-economic factors extracted from Statistics Sweden. All ASD and ADHD diagnoses in our data were undertaken at the Malmo and Lund Departments of Child and Adolescent Psychiatry, using standardized diagnostic instruments. We used logistic regression analyses to obtain estimates of the risk of developing ASD and ADHD associated with different air pollution levels, with adjustments for potential perinatal and socio-economic confounders. In this longitudinal cohort study, we found associations between air pollution exposure during the prenatal period and and the risk of developing ASD. For example, an adjusted Odds Ratio (OR) of 1.40 and its 95% Confidence Interval (CI) (95% CI : 1.02-1.93) were found when comparing the fourth with the first quartile of NOx exposure. We did not find similar associations on the risk of developing ADHD. This study contributes to the growing evidence of a link between prenatal exposure to air pollution and autism spectrum disorders, suggesting that prenatal exposure even below current WHO air quality guidelines may increase the risk of autism spectrum disorders.

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12. Parker ML, Diamond RM, Auwood LH. Exploring Exceptions and Discovering Solutions : A Case Presentation of Autism and the Family. Fam Process ;2019 (Oct 15)

As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence-based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem-focused lens. There is a growing body of research calling for strength-based, relational interventions that build on existing resources to enhance coping, efficacy, and well-being among families affected by ASD. Solution-Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism-associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution-focused approach by modifying commonly used SFBT interventions to address family-driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.

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13. Parsons L, Cordier R, Munro N, Joosten A. A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism. Front Psychol ;2019 ;10:1960.

Purpose : This randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism. Methods : A sample of 71 children with autism were randomized to an intervention-first group (n = 28 analyzed) or waitlist-first (n = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM-2) and the Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention. Results : POM-2 gains were greatest for intervention-first participants (p = 0.031, d = 0.57). Treatment effects were maintained at 3-month follow-up (p < 0.001-0.05, d = 0.49-0.64). POM-2 scores were not significantly different in the clinic and home settings at follow-up. Conclusion : Findings support the combination of play, peer-mediation, video-feedback and parent training to enhance pragmatic language in children with autism.

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14. Romagnoli G, Leone A, Sansoni J, Tofani M, De Santis R, Valente D, Galeoto G. Occupational Therapy’s efficacy in children with Asperger’s syndrome : a systematic review of randomized controlled trials. Clin Ter ;2019 (Sep-Oct) ;170(5):e382-e387.

This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger’s syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were : LEGO therapy, Social Use of Language Programme, Let’s Face It ! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT’s benefits and limitations in AS patients.

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15. Rose V, Paynter J, Vivanti G, Keen D, Trembath D. Predictors of Expressive Language Change for Children with Autism Spectrum Disorder Receiving AAC-Infused Comprehensive Intervention. J Autism Dev Disord ;2019 (Oct 16)

Comprehensive interventions for children with autism spectrum disorder (ASD) often incorporate augmentative and alternative communication (AAC) ; however, variability in outcomes exists even among children who access similar intervention. This study investigated predictors of expressive language change for 48 children with ASD aged 31 to 67 months receiving AAC-infused intervention. The relationships between participants’ initial responses to AAC and expressive language change were examined. Commonly reported predictors (IQ, chronological age, ASD symptomatology) did not significantly predict expressive language change. AAC factors (visual attention, object play, word learning) entered at Step 2 of a hierarchical multiple regression, explained an additional 42% of the variance. The findings provide preliminary data on child characteristics associated with expressive language changes within AAC-infused comprehensive interventions.

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16. Sadeghiyeh T, Dastgheib SA, Mirzaee-Khoramabadi K, Morovati-Sharifabad M, Akbarian-Bafghi MJ, Poursharif Z, Mirjalili SR, Neamatzadeh H. Association of MTHFR 677C>T and 1298A>C polymorphisms with susceptibility to autism : A systematic review and meta-analysis. Asian J Psychiatr ;2019 (Sep 23) ;46:54-61.

Several studies have investigated association of MTHFR 677C > T and 1298A > C polymorphisms with risk of autism, but they have reported controversial and inconclusive results. The present meta-analysis was designed to evaluate association of MTHFR 677C > T and 1298A > C polymorphisms with risk of autism. A comprehensive literature search was done in PubMed, EMBASE, and CNKI databases to identify all eligible publications up to April 01, 2019. Finally, 25 case-control studies including 18 studies on MTHFR 677C > T and 7 studies on MTHFR 1298A > C polymorphism were selected. Overall, a significant association was found between MTHFR 677C > T and an increased risk of autism under all five genetic models (T vs. C : OR = 1.483, 95% CI 1.188-1.850, p </= 0.001 ; TT vs. CC : OR = 1.834, 95% CI 1.155-2.913, p = 0.010 ; TC vs. CC : OR = 1.512, 95% CI 1.101-2.078, p = 0.011 ; TT + TC vs. CC : OR = 1.632, 95% CI 1.261-2.113, p C and autism risk. Stratified analyses showed that MTHFR 677C > T and 1298A > C polymorphisms are involved in genetic susceptibility of autism by ethnicity. Results of this meta-analysis indicated that MTHFR 677C > T polymorphism may be associated with increased risk of autism in overall and by ethnicity, while MTHFR 1298A > C was reported to be significantly associated with the risk of autism only in Caucasians. MTHFR polymorphisms could be used as a diagnostic marker for autism with respect to ethnicity background.

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17. Valencia K, Rusu C, Quinones D, Jamet E. The Impact of Technology on People with Autism Spectrum Disorder : A Systematic Literature Review. Sensors (Basel) ;2019 (Oct 16) ;19(20)

People with autism spectrum disorder (ASD) tend to enjoy themselves and be engaged when interacting with computers, as these interactions occur in a safe and trustworthy environment. In this paper, we present a systematic literature review on the state of the research on the use of technology to teach people with ASD. We reviewed 94 studies that show how the use of technology in educational contexts helps people with ASD develop several skills, how these approaches consider aspects of user experience, usability and accessibility, and how game elements are used to enrich learning environments. This systematic literature review shows that the development and evaluation of systems and applications for users with ASD is very promising. The use of technological advancements such as virtual agents, artificial intelligence, virtual reality, and augmented reality undoubtedly provides a comfortable environment that promotes constant learning for people with ASD.

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