Adolescent gender diversity: sociodemographic correlates and mental health outcomes in the general population / Akhgar GHASSABIAN in Journal of Child Psychology and Psychiatry, 63-11 (November 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1415-1422 Titre : Adolescent gender diversity: sociodemographic correlates and mental health outcomes in the general population Type de document : texte imprimé Auteurs : Akhgar GHASSABIAN, Auteur ; Anna SULERI, Auteur ; Elisabet BLOK, Auteur ; Berta FRANCH, Auteur ; Manon H.J. HILLEGERS, Auteur ; Tonya WHITE, Auteur Article en page(s) : p.1415-1422 Langues : Anglais (eng) Mots-clés : Child  Infant, Newborn  Humans  Adolescent  Male  Female  Gender Identity  Parents/psychology  Mental Health  Anxiety  Outcome Assessment, Health Care  Gender-variant  autistic traits  general population Index. décimale : PER Périodiques Résumé : BACKGROUND: Gender diversity in young adolescents is understudied outside of referral clinics. We investigated gender diversity in an urban, ethnically diverse sample of adolescents from the general population and examined predictors and associated mental health outcomes. METHODS: The study was embedded in Generation R, a population-based cohort of children born between 2002 and 2006 in Rotterdam, the Netherlands (n=5727). At ages 9-11 and 13-15 years, adolescents and/or their parents responded to two questions addressing children's contentedness with their assigned gender, whether they (a) 'wished to be the opposite sex' and (b) 'would rather be treated as someone from the opposite sex'. We defined 'gender-variant experience' when either the parent or child responded with 'somewhat or sometimes true' or 'very or often true'. Mental health was assessed at 13-15 years, using the Achenbach System of Empirically Based Assessment. RESULTS: Less than 1% of the parents reported that their child had gender-variant experience, with poor stability between 9-11 and 13-15 years. In contrast, 4% of children reported gender-variant experience at 13-15 years. Adolescents who were assigned female at birth reported more gender-variant experience than those assigned male. Parents with low/medium educational levels reported more gender-variant experience in their children than those with higher education. There were positive associations between gender-variant experience and symptoms of anxiety, depression, somatic complaints, rule-breaking, and aggressive behavior as well as attention, social, and thought problems. Similar associations were observed for autistic traits, independent of other mental difficulties. These associations did not differ by assigned sex at birth. CONCLUSIONS: Within this population-based study, adolescents assigned females were more likely to have gender-variant experience than males. Our data suggest that parents may not be aware of gender diversity feelings in their adolescents. Associations between gender diversity and mental health symptoms were present in adolescents. En ligne : http://dx.doi.org/10.1111/jcpp.13588 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490 [article] Adolescent gender diversity: sociodemographic correlates and mental health outcomes in the general population [texte imprimé] / Akhgar GHASSABIAN, Auteur ; Anna SULERI, Auteur ; Elisabet BLOK, Auteur ; Berta FRANCH, Auteur ; Manon H.J. HILLEGERS, Auteur ; Tonya WHITE, Auteur . - p.1415-1422. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1415-1422 Mots-clés : Child  Infant, Newborn  Humans  Adolescent  Male  Female  Gender Identity  Parents/psychology  Mental Health  Anxiety  Outcome Assessment, Health Care  Gender-variant  autistic traits  general population Index. décimale : PER Périodiques Résumé : BACKGROUND: Gender diversity in young adolescents is understudied outside of referral clinics. We investigated gender diversity in an urban, ethnically diverse sample of adolescents from the general population and examined predictors and associated mental health outcomes. METHODS: The study was embedded in Generation R, a population-based cohort of children born between 2002 and 2006 in Rotterdam, the Netherlands (n=5727). At ages 9-11 and 13-15 years, adolescents and/or their parents responded to two questions addressing children's contentedness with their assigned gender, whether they (a) 'wished to be the opposite sex' and (b) 'would rather be treated as someone from the opposite sex'. We defined 'gender-variant experience' when either the parent or child responded with 'somewhat or sometimes true' or 'very or often true'. Mental health was assessed at 13-15 years, using the Achenbach System of Empirically Based Assessment. RESULTS: Less than 1% of the parents reported that their child had gender-variant experience, with poor stability between 9-11 and 13-15 years. In contrast, 4% of children reported gender-variant experience at 13-15 years. Adolescents who were assigned female at birth reported more gender-variant experience than those assigned male. Parents with low/medium educational levels reported more gender-variant experience in their children than those with higher education. There were positive associations between gender-variant experience and symptoms of anxiety, depression, somatic complaints, rule-breaking, and aggressive behavior as well as attention, social, and thought problems. Similar associations were observed for autistic traits, independent of other mental difficulties. These associations did not differ by assigned sex at birth. CONCLUSIONS: Within this population-based study, adolescents assigned females were more likely to have gender-variant experience than males. Our data suggest that parents may not be aware of gender diversity feelings in their adolescents. Associations between gender diversity and mental health symptoms were present in adolescents. En ligne : http://dx.doi.org/10.1111/jcpp.13588 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490

Associations of toddler mechanical/distress feeding problems with psychopathology symptoms five years later / Diane L. PUTNICK in Journal of Child Psychology and Psychiatry, 63-11 (November 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1261-1269 Titre : Associations of toddler mechanical/distress feeding problems with psychopathology symptoms five years later Type de document : texte imprimé Auteurs : Diane L. PUTNICK, Auteur ; Erin M. BELL, Auteur ; Akhgar GHASSABIAN, Auteur ; Kristen J. POLINSKI, Auteur ; Sonia L. ROBINSON, Auteur ; Rajeshwari SUNDARAM, Auteur ; Edwina YEUNG, Auteur Article en page(s) : p.1261-1269 Langues : Anglais (eng) Mots-clés : Male  Female  Child, Preschool  Humans  Prospective Studies  Cohort Studies  Psychopathology  Attention Deficit and Disruptive Behavior Disorders  Depression/diagnosis  Feeding Behavior  Attention Deficit Disorder with Hyperactivity/diagnosis  Feeding problems  psychopathology Index. décimale : PER Périodiques Résumé : BACKGROUND: Feeding problems are common in early childhood, and some evidence suggests that feeding problems may be associated with psychopathology. Few prospective studies have explored whether toddler feeding problems predict later psychopathology. METHODS: Mothers of 1,136 children from the Upstate KIDS cohort study provided data when children were 2.5 and 8 years of age. Food refusal (picky eating) and mechanical/distress feeding problems and developmental delays were assessed at 2.5 years. Child eating behaviors (enjoyment of food, food fussiness, and emotional under and overeating) and child psychopathology (attention-deficit/hyperactivity (ADHD), oppositional-defiant (OD), conduct disorder (CD), and anxiety/depression) symptoms were assessed at 8 years. RESULTS: Mechanical/distress feeding problems at age 2.5, but not food refusal problems, were associated with ADHD, problematic behavior (OD/CD), and anxiety/depression symptoms at 8 years in models adjusting for eating behaviors at 8 years and child and family covariates. Associations with mechanical/distress feeding problems were larger for ADHD and problematic behavior than anxiety/depression symptoms, though all were modest. Model estimates were similar for boys and girls. CONCLUSIONS: Much of the research on feeding problems focuses on picky eating. This study suggests that early mechanical and mealtime distress problems may serve as better predictors of later psychopathology than food refusal. Parents and pediatricians could monitor children with mechanical/distress feeding problems for signs of developing psychopathology. En ligne : http://dx.doi.org/10.1111/jcpp.13567 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490 [article] Associations of toddler mechanical/distress feeding problems with psychopathology symptoms five years later [texte imprimé] / Diane L. PUTNICK, Auteur ; Erin M. BELL, Auteur ; Akhgar GHASSABIAN, Auteur ; Kristen J. POLINSKI, Auteur ; Sonia L. ROBINSON, Auteur ; Rajeshwari SUNDARAM, Auteur ; Edwina YEUNG, Auteur . - p.1261-1269. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1261-1269 Mots-clés : Male  Female  Child, Preschool  Humans  Prospective Studies  Cohort Studies  Psychopathology  Attention Deficit and Disruptive Behavior Disorders  Depression/diagnosis  Feeding Behavior  Attention Deficit Disorder with Hyperactivity/diagnosis  Feeding problems  psychopathology Index. décimale : PER Périodiques Résumé : BACKGROUND: Feeding problems are common in early childhood, and some evidence suggests that feeding problems may be associated with psychopathology. Few prospective studies have explored whether toddler feeding problems predict later psychopathology. METHODS: Mothers of 1,136 children from the Upstate KIDS cohort study provided data when children were 2.5 and 8 years of age. Food refusal (picky eating) and mechanical/distress feeding problems and developmental delays were assessed at 2.5 years. Child eating behaviors (enjoyment of food, food fussiness, and emotional under and overeating) and child psychopathology (attention-deficit/hyperactivity (ADHD), oppositional-defiant (OD), conduct disorder (CD), and anxiety/depression) symptoms were assessed at 8 years. RESULTS: Mechanical/distress feeding problems at age 2.5, but not food refusal problems, were associated with ADHD, problematic behavior (OD/CD), and anxiety/depression symptoms at 8 years in models adjusting for eating behaviors at 8 years and child and family covariates. Associations with mechanical/distress feeding problems were larger for ADHD and problematic behavior than anxiety/depression symptoms, though all were modest. Model estimates were similar for boys and girls. CONCLUSIONS: Much of the research on feeding problems focuses on picky eating. This study suggests that early mechanical and mealtime distress problems may serve as better predictors of later psychopathology than food refusal. Parents and pediatricians could monitor children with mechanical/distress feeding problems for signs of developing psychopathology. En ligne : http://dx.doi.org/10.1111/jcpp.13567 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts / Heather E. VOLK in Journal of Autism and Developmental Disorders, 56-5 (May 2026)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 56-5 (May 2026) . - p.2023-2034 Titre : Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts Type de document : texte imprimé Auteurs : Heather E. VOLK, Auteur ; Diogo FORTES, Auteur ; Rashelle MUSCI, Auteur ; Amanda KIM, Auteur ; Theresa M. BASTAIN, Auteur ; Carlos A. CAMARGO, Auteur ; Lisa A. CROEN, Auteur ; Dana DABELEA, Auteur ; Cristiane S. DUARTE, Auteur ; Anne L. DUNLOP, Auteur ; Kennedy GACHIGI, Auteur ; Akhgar GHASSABIAN, Auteur ; Irva HERTZ-PICCIOTTO, Auteur ; Kathi C. HUDDLESTON, Auteur ; Robert M. JOSEPH, Auteur ; Daniel KEATING, Auteur ; Rachel S. KELLY, Auteur ; Young Shin KIM, Auteur ; Rebecca J. LANDA, Auteur ; Leslie D. LEVE, Auteur ; Kristen LYALL, Auteur ; Jessie B. NORTHRUP, Auteur ; Thomas O’CONNOR, Auteur ; Sally OZONOFF, Auteur ; Anna ROSS, Auteur ; Rebecca J. SCHMIDT, Auteur ; Julie B. SCHWEITZER, Auteur ; Lauren C. SHUFFREY, Auteur ; Coral SHUSTER, Auteur ; Emily VANCE, Auteur ; Scott T. WEISS, Auteur ; Greta WILKENING, Auteur ; Robert O. WRIGHT, Auteur Article en page(s) : p.2023-2034 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems. En ligne : https://doi.org/10.1007/s10803-024-06670-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=587 [article] Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts [texte imprimé] / Heather E. VOLK, Auteur ; Diogo FORTES, Auteur ; Rashelle MUSCI, Auteur ; Amanda KIM, Auteur ; Theresa M. BASTAIN, Auteur ; Carlos A. CAMARGO, Auteur ; Lisa A. CROEN, Auteur ; Dana DABELEA, Auteur ; Cristiane S. DUARTE, Auteur ; Anne L. DUNLOP, Auteur ; Kennedy GACHIGI, Auteur ; Akhgar GHASSABIAN, Auteur ; Irva HERTZ-PICCIOTTO, Auteur ; Kathi C. HUDDLESTON, Auteur ; Robert M. JOSEPH, Auteur ; Daniel KEATING, Auteur ; Rachel S. KELLY, Auteur ; Young Shin KIM, Auteur ; Rebecca J. LANDA, Auteur ; Leslie D. LEVE, Auteur ; Kristen LYALL, Auteur ; Jessie B. NORTHRUP, Auteur ; Thomas O’CONNOR, Auteur ; Sally OZONOFF, Auteur ; Anna ROSS, Auteur ; Rebecca J. SCHMIDT, Auteur ; Julie B. SCHWEITZER, Auteur ; Lauren C. SHUFFREY, Auteur ; Coral SHUSTER, Auteur ; Emily VANCE, Auteur ; Scott T. WEISS, Auteur ; Greta WILKENING, Auteur ; Robert O. WRIGHT, Auteur . - p.2023-2034. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 56-5 (May 2026) . - p.2023-2034 Index. décimale : PER Périodiques Résumé : Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems. En ligne : https://doi.org/10.1007/s10803-024-06670-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=587

Determinants of neonatal brain-derived neurotrophic factor and association with child development / Akhgar GHASSABIAN in Development and Psychopathology, 29-4 (October 2017)  

Public ISBD [article]  inDevelopment and Psychopathology > 29-4 (October 2017) . - p.1499-1511 Titre : Determinants of neonatal brain-derived neurotrophic factor and association with child development Type de document : texte imprimé Auteurs : Akhgar GHASSABIAN, Auteur ; Rajeshwari SUNDARAM, Auteur ; Nikhita CHAHAL, Auteur ; Alexander C. MCLAIN, Auteur ; Erin M. BELL, Auteur ; David LAWRENCE, Auteur ; Edwina H. YEUNG, Auteur Article en page(s) : p.1499-1511 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Using a population-based birth cohort in upstate New York (2008–2010), we examined the determinants of brain-derived neurotrophic factor (BDNF) measured in newborn dried blood spots (n = 2,637). We also examined the association between neonatal BDNF and children's development. The cohort was initially designed to examine the influence of infertility treatment on child development but found no impact. Mothers rated children's development in five domains repeatedly through age 3 years. Socioeconomic and maternal lifestyle determinants of BDNF were examined using multivariable linear regression models. Generalized linear mixed models estimated odds ratios for neonatal BDNF in relation to failing a developmental domain. Smoking and drinking in pregnancy, nulliparity, non-White ethnicity/race, and prepregnancy obesity were associated with lower neonatal BDNF. Neonatal BDNF was not associated with failure for developmental domains; however, there was an interaction between BDNF and preterm birth. In preterm infants, a higher BDNF was associated with lower odds of failing any developmental domains, after adjusting for confounders and infertility treatment. This result was particularly significant for failure in communication. Our findings suggest that BDNF levels in neonates may be impacted by maternal lifestyle characteristics. More specifically, lower neonatal BDNF might be an early marker of aberrant neurodevelopment in preterm infants. En ligne : http://dx.doi.org/10.1017/s0954579417000414 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=313 [article] Determinants of neonatal brain-derived neurotrophic factor and association with child development [texte imprimé] / Akhgar GHASSABIAN, Auteur ; Rajeshwari SUNDARAM, Auteur ; Nikhita CHAHAL, Auteur ; Alexander C. MCLAIN, Auteur ; Erin M. BELL, Auteur ; David LAWRENCE, Auteur ; Edwina H. YEUNG, Auteur . - p.1499-1511. Langues : Anglais (eng) in Development and Psychopathology > 29-4 (October 2017) . - p.1499-1511 Index. décimale : PER Périodiques Résumé : Abstract Using a population-based birth cohort in upstate New York (2008–2010), we examined the determinants of brain-derived neurotrophic factor (BDNF) measured in newborn dried blood spots (n = 2,637). We also examined the association between neonatal BDNF and children's development. The cohort was initially designed to examine the influence of infertility treatment on child development but found no impact. Mothers rated children's development in five domains repeatedly through age 3 years. Socioeconomic and maternal lifestyle determinants of BDNF were examined using multivariable linear regression models. Generalized linear mixed models estimated odds ratios for neonatal BDNF in relation to failing a developmental domain. Smoking and drinking in pregnancy, nulliparity, non-White ethnicity/race, and prepregnancy obesity were associated with lower neonatal BDNF. Neonatal BDNF was not associated with failure for developmental domains; however, there was an interaction between BDNF and preterm birth. In preterm infants, a higher BDNF was associated with lower odds of failing any developmental domains, after adjusting for confounders and infertility treatment. This result was particularly significant for failure in communication. Our findings suggest that BDNF levels in neonates may be impacted by maternal lifestyle characteristics. More specifically, lower neonatal BDNF might be an early marker of aberrant neurodevelopment in preterm infants. En ligne : http://dx.doi.org/10.1017/s0954579417000414 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=313

Infant brain structures, executive function, and attention deficit/hyperactivity problems at preschool age. A prospective study / Akhgar GHASSABIAN in Journal of Child Psychology and Psychiatry, 54-1 (January 2013)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 54-1 (January 2013) . - 96-104 Titre : Infant brain structures, executive function, and attention deficit/hyperactivity problems at preschool age. A prospective study Type de document : texte imprimé Auteurs : Akhgar GHASSABIAN, Auteur ; Catherine M. HERBA, Auteur ; Sabine J. ROZA, Auteur ; Paul GOVAERT, Auteur ; Jacqueline J. SCHENK, Auteur ; Vincent W.V. JADDOE, Auteur ; Albert HOFMAN, Auteur ; Tonya WHITE, Auteur ; Frank C. VERHULST, Auteur ; Henning TIEMEIER, Auteur Article en page(s) : 96-104 Langues : Anglais (eng) Mots-clés : Brain  corpus callosum  executive function  Attention Deficit/Hyperactivity Disorder Index. décimale : PER Périodiques Résumé : Background: Neuroimaging findings have provided evidence for a relation between variations in brain structures and Attention Deficit/Hyperactivity Disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the prospective association between brain structures measured during infancy and executive function and attention deficit/hyperactivity problems assessed at preschool age. Methods: In the Generation R Study, the corpus callosum length, the gangliothalamic ovoid diameter (encompassing the basal ganglia and thalamus), and the ventricular volume were measured in 784 6-week-old children using cranial postnatal ultrasounds. Parents rated executive functioning at 4 years using the Behavior Rating Inventory of Executive Function-Preschool Version in five dimensions: inhibition, shifting, emotional control, working memory, and planning/organizing. Attention Deficit/Hyperactivity Problems were assessed at ages 3 and 5 years using the Child Behavior Checklist. Results: A smaller corpus callosum length during infancy was associated with greater deficits in executive functioning at 4 years. This was accounted for by higher problem scores on inhibition and emotional control. The corpus callosum length during infancy did not predict Attention Deficit/Hyperactivity Problem at 3 and 5 years, when controlling for the confounders. We did not find any relation between gangliothalamic ovoid diameter and executive function or Attention Deficit/Hyperactivity Problem. Conclusions: Variations in brain structures detectible in infants predicted subtle impairments in inhibition and emotional control. However, in this population-based study, we could not demonstrate that early structural brain variations precede symptoms of ADHD. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2012.02590.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=186 [article] Infant brain structures, executive function, and attention deficit/hyperactivity problems at preschool age. A prospective study [texte imprimé] / Akhgar GHASSABIAN, Auteur ; Catherine M. HERBA, Auteur ; Sabine J. ROZA, Auteur ; Paul GOVAERT, Auteur ; Jacqueline J. SCHENK, Auteur ; Vincent W.V. JADDOE, Auteur ; Albert HOFMAN, Auteur ; Tonya WHITE, Auteur ; Frank C. VERHULST, Auteur ; Henning TIEMEIER, Auteur . - 96-104. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 54-1 (January 2013) . - 96-104 Mots-clés : Brain  corpus callosum  executive function  Attention Deficit/Hyperactivity Disorder Index. décimale : PER Périodiques Résumé : Background: Neuroimaging findings have provided evidence for a relation between variations in brain structures and Attention Deficit/Hyperactivity Disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the prospective association between brain structures measured during infancy and executive function and attention deficit/hyperactivity problems assessed at preschool age. Methods: In the Generation R Study, the corpus callosum length, the gangliothalamic ovoid diameter (encompassing the basal ganglia and thalamus), and the ventricular volume were measured in 784 6-week-old children using cranial postnatal ultrasounds. Parents rated executive functioning at 4 years using the Behavior Rating Inventory of Executive Function-Preschool Version in five dimensions: inhibition, shifting, emotional control, working memory, and planning/organizing. Attention Deficit/Hyperactivity Problems were assessed at ages 3 and 5 years using the Child Behavior Checklist. Results: A smaller corpus callosum length during infancy was associated with greater deficits in executive functioning at 4 years. This was accounted for by higher problem scores on inhibition and emotional control. The corpus callosum length during infancy did not predict Attention Deficit/Hyperactivity Problem at 3 and 5 years, when controlling for the confounders. We did not find any relation between gangliothalamic ovoid diameter and executive function or Attention Deficit/Hyperactivity Problem. Conclusions: Variations in brain structures detectible in infants predicted subtle impairments in inhibition and emotional control. However, in this population-based study, we could not demonstrate that early structural brain variations precede symptoms of ADHD. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2012.02590.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=186

Infant muscle tone and childhood autistic traits: A longitudinal study in the general population / Fadila SERDAREVIC in Autism Research, 10-5 (May 2017)  

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Neighborhood opportunity and residential instability: associations with mental health in middle childhood / Diane L. PUTNICK in Journal of Child Psychology and Psychiatry, 66-7 (July 2025)  

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Structure, longitudinal invariance, and stability of the Child Behavior Checklist 11/2-5's Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Disorder scale: Findings from Generation R (Rotterdam) / Leslie A. RESCORLA in Autism, 23-1 (January 2019)  

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