1. Cheung PPP, Yu ML, Brown T. Qualitative Evaluation of a Social Cognitive Training Program for Parents of Children with Autism from Hong Kong. Occupational therapy in health care. 2021; 35(3): 286-305.

A key feature of autism spectrum disorder is a dysfunction in social participation. This study aimed to explore the parents’ perceptions and experiences of social cognitive training for their child with autism in the Hong Kong context. Using a qualitative narrative approach, twenty-three parent participants were interviewed using purposive sampling techniques. Data were analyzed using content analysis method. Three themes included: Improvements and changes in children’s social participation across different settings; Challenges in the implementation of and engagement in the social cognitive training; and Parents’ views and suggestions about the training. The findings supported that there were parent perceived improvements in their child’s social skills and social participation. The interviews also revealed generalization of social skills and behaviors across home, school and community settings. The results of this study can inform therapists to design appropriate social cognitive intervention and improve social participation for this population group.

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2. Cuve HC, Murphy J, Hobson H, Ichijo E, Catmur C, Bird G. Are Autistic and Alexithymic Traits Distinct? A Factor-Analytic and Network Approach. Journal of autism and developmental disorders. 2022; 52(5): 2019-34.

Despite the heterogeneity in autism, socioemotional difficulties are often framed as universal. Increasing evidence, however, suggests that socioemotional difficulties may be explained by alexithymia, a distinct yet frequently co-occurring condition. If, as some propose, autistic traits are responsible for socioemotional impairments, then alexithymia may itself be a symptom of autism. We aimed to determine whether alexithymia should be considered a product of autism or regarded as a separate condition. Using factor-analytic and network approaches, we provide evidence that alexithymic and autistic traits are distinct. We argue that: (1) models of socioemotional processing in autism should conceptualise difficulties as intrinsic to alexithymia; and (2) assessment of alexithymia is crucial for diagnosis and personalised interventions.

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3. Devine K, Mojtahedi D. Juror decision-making in cases of rape involving high functioning Autistic persons. International journal of law and psychiatry. 2021; 77: 101714.

Despite a plethora of research examining juror decision-making within cases of rape, very few studies have attempted to examine how the presence of a developmental disorder within a case can impact jurors’ decisions. Research shows that individuals diagnosed with Autism Spectrum Disorder (ASD) are sometimes perceived more negatively (i.e. unempathetic) due to stigmatising beliefs associated with ASD. Thus, the present study sought to examine whether individuals with ASD would be treated differently by jurors in court. Using mock-juror paradigms (N = 204) the present study aimed to explore whether the presence of high-functioning Autism Spectrum Disorder (ASD) amongst either the defendant or claimant influenced juror decisions (guilt verdict, confidence in verdict, and believability towards the defendant and claimant) in cases of rape. The presence of ASD amongst either party failed to have an impact on juror decision-making and final guilt verdicts. However, female participants were more likely to believe the complainant than their male counterparts. Implications of the study and directions for future research are discussed.

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4. Efron D. Potential therapeutic uses of cannabinoids to treat behavioural problems in children and adolescents with developmental disorders. Australian journal of general practice. 2021; 50(6): 352-5.

BACKGROUND: There is a great deal of interest in the potential symptomatic benefits of medicinal cannabis among parents of children and adolescents with developmental disorders. OBJECTIVE: This article provides an overview of what is known about medicinal cannabis as a treatment for paediatric developmental disorders. DISCUSSION: While there is emerging evidence in support of medicinal cannabis for some adult mental health disorders, to date the evidence in children and adolescents is scant. Reports from uncontrolled observational studies suggest that cannabidiol-rich products may be helpful in reducing behavioural problems in autistic youth. Cannabidiol appears to have a relatively benign adverse effect profile and therefore may be worth considering as a treatment option in some cases. Several controlled clinical trials are underway that will provide more definitive information on the therapeutic value of medicinal cannabis in paediatric developmental and behavioural disorders.

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5. Flegenheimer C, Scherf KS. College as a Developmental Context for Emerging Adulthood in Autism: A Systematic Review of What We Know and Where We Go from Here. Journal of autism and developmental disorders. 2022; 52(5): 2075-97.

Autistic individuals often struggle to successfully navigate emerging adulthood (EA). College is an increasingly common context in which individuals learn and hone the necessary skills for adulthood. The goal of this paper is to systematically review and assess the existing research on college as a context of EA development in autistic individuals, particularly in terms of understanding whether and how this context might be critically different for those who are typically developing or developing with other disabilities. Our findings indicate that ASD college students report feeling prepared academically, but exhibit weaknesses in daily living and social skills. Interventions largely focus on social skills, and rarely evaluate outcomes relevant to college success or longer-term emerging adulthood independence. We conclude with hypotheses and recommendations for future work that are essential for understanding and supporting ASD students as they navigate potentially unique challenges in college and their transition to independence during EA.

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6. Garrick A, Lee ML, Scarffe C, Attwood T, Furley K, Bellgrove MA, Johnson BP. An Australian Cross-Sectional Survey of Parents’ Experiences of Emergency Department Visits Among Children with Autism Spectrum Disorder. Journal of autism and developmental disorders. 2022; 52(5): 2046-60.

Parents of children with ASD who had attended an Australian emergency department (ED; n = 421) completed a questionnaire relating to their experiences in the ED, including (1) child’s reason for presentation and existing comorbidities, (2) quality of care during the visit (3) child’s behaviour during visit, e.g. sensory responses to the ED environment, and disruptive behaviours. Children with comorbid ASD and intellectual disability were more likely to present with gastrointestinal issues and seizures, while those with comorbid ASD and oppositional defiant disorder were more likely to present with self-injury. ED staff awareness of ASD-related issues, including communication and expression of pain, were common difficulties for parents. The ED environment (e.g. lights, sounds, waiting areas), exacerbated child anxiety and led to disruptive behaviour.

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7. Lichtlé J, Lamore K, Pedoux A, Downes N, Mottron L, Cappe E. Searching for What Really Matters: A Thematic Analysis of Quality of Life among Preschool Children on the Autism Spectrum. Journal of autism and developmental disorders. 2022; 52(5): 2098-111.

Quality of life (QoL) is an essential measure when assessing health interventions. Most early interventions for preschool children on the spectrum evaluate the effects on autism symptoms. However, researchers increasingly believe that good interventions should also improve the QoL of these children. Domains of QoL among preschool children on the autism spectrum have not previously been researched. We interviewed adults on the spectrum to explore early childhood experiences that made their lives satisfying. Our data revealed four major themes: interests, environmental regularity, sensory differences and social interactions. This study provides the first insights on aspects of life important to pre-schoolers on the spectrum. Findings will contribute to developing items for a measure of QoL among this population.

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8. McKeever L, Cleland J, Delafield-Butt J. Using ultrasound tongue imaging to analyse maximum performance tasks in children with Autism: a pilot study. Clinical linguistics & phonetics. 2021: 1-19.

This study proposes a protocol for assessing speech motor control in children using maximum performance tasks with simultaneous acoustic and ultrasound recording. The protocol was piloted on eight children with autism spectrum disorders and nine typically developing children. Diadochokinesis rate, accuracy, and consistency were elicited using an imitation paradigm where speakers repeat mono-, bi-, and tri-syllabic stimuli at increasing rates. Both traditional measures of rate, accuracy and consistency and an ultrasound tongue-shape analysis of slow versus fast productions were undertaken. Preliminary results suggest that the protocol is feasible with children with communication disorders. Instrumental measures suggest greater variability in tongue movements in the children with autism that is not detected using perceptual measures of accuracy. A subgroup of children with autism showed some evidence of differences in speech motor control. Ultrasound tongue imaging appears to be a useful method for gaining additional insight into speech motor control.

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9. Prescott KE, Ellis Weismer S. Children with ASD and Communication Regression: Examining Pre-Loss Skills and Later Language Outcomes Through the Preschool Years. Journal of autism and developmental disorders. 2022; 52(5): 1956-70.

This study investigated receptive and expressive language outcomes in children with autism spectrum disorder (ASD) with and without a history of language/communication regression, employing three progressively less stringent definitions of regression. Data were derived from a large, longitudinal sample of children with ASD in which regression was assessed at approximately 30 months. Results indicated poorer receptive language and larger discrepancies between receptive and expressive language in the regression group than the group without regression at 44 months but not 66 months. Number of words used before loss predicted receptive language at 44 months. Overall, results suggest that a regression profile in ASD is associated with modest and transient impacts on language outcomes that are no longer discernable at school entry.

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10. Roemer EJ. Beyond the toddler years: A meta-analysis of communicative abilities in siblings of children with autism spectrum disorder. Psychological bulletin. 2021; 147(5): 437-54.

Communication is a core challenge for individuals on the autism spectrum, and many autistic individuals experience challenges with language. Prospective studies of younger siblings of children with autism show that siblings not only have an increased likelihood of developing autism themselves, but that even siblings without an autism spectrum diagnosis are more likely to have a language delay as toddlers than their peers without familial history of autism (Marrus et al., 2018). While there is substantial variability in the communicative abilities of siblings of children with autism in toddlerhood, it is not clear how these differences translate beyond the first 3 years of life. The present study used meta-analysis to evaluate a wide range of literature and determine whether siblings of children with autism (Sibs-A) over 48 months of age differ from comparison groups in their language and communication abilities. A total of 26 studies describing 22 cohorts were included. Over 2,000 Sibs-A were compared with neurotypical individuals without familial history of autism or siblings of individuals with another neurodevelopmental disability. Meta-analysis revealed a small but significant effect such that Sibs-A performed lower than comparison peers in overall language and communication. Effects were strongest for expressive language and linguistic processing speed, and there were substantially larger differences for experimenter-administered measures than for parent-report, though findings must be considered in the context of other study characteristics. Suggestions based on this meta-analytic review are provided to guide future research in understanding individual differences in the communicative development and outcomes of Sibs-A. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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11. Roemer EJ, Kushner EH, Iverson JM. Joint Engagement, Parent Labels, and Language Development: Examining Everyday Interactions in Infant Siblings of Children with Autism. Journal of autism and developmental disorders. 2022; 52(5): 1984-2003.

This study examined joint engagement, parent labels, and language development in infants with an elevated (EL) and typical likelihood (TL) for ASD. Parent-child interactions were coded for joint engagement and parent labels at 12 and 18 months, and language skills were assessed later in toddlerhood for 12 EL infants diagnosed with ASD (EL-ASD), 17 EL infants with language delay (EL-LD), 14 EL infants with no diagnosis (EL-ND), and 12 TL infants. Infants spent substantial time in supported joint engagement and received similar rates of input from parents across outcome groups. However, parents of EL-ASD infants increased the rate of labels provided in coordinated joint engagement. While labels positively predicted language for TL infants, the opposite pattern emerged for EL-ASD infants.

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12. Sosnowski DW, Stough CO, Weiss MJ, Cessna T, Casale A, Foran A, Erwinski M, Wilson J, Farber SA, Farber MA. Brief Report: A Novel Digital Therapeutic that Combines Applied Behavior Analysis with Gaze-Contingent Eye Tracking to Improve Emotion Recognition in Children with Autism Spectrum Disorder. Journal of autism and developmental disorders. 2022; 52(5): 2357-66.

This study examined the feasibility, acceptability, and efficacy of a video game-based digital therapeutic combining applied behavior analysis techniques and gaze-contingent eye tracking to target emotion recognition in youth with autism spectrum disorder (ASD). Children aged 4-14 years with ASD were randomized to complete Lookware™ (n = 25) or a control video game (n = 29). Results from a 2 × 2 mixed ANOVA revealed that children in the intervention condition demonstrated significant improvements in emotion recognition from pre- to post-intervention compared to children in the control condition, F(1,52) = 17.48, p < 0.001. Children and staff perceived high feasibility and acceptability of Lookware™. Study results demonstrated the feasibility, acceptability, and preliminary efficacy of Lookware™.

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13. Sulaiman R, Wang M, Ren X. Correction to Exposure to Aluminum, Cadmium, and Mercury and Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis. Chemical research in toxicology. 2021; 34(6): 1693.

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14. Tonhajzerova I, Ondrejka I, Ferencova N, Bujnakova I, Grendar M, Olexova LB, Hrtanek I, Visnovcova Z. Alternations in the Cardiovascular Autonomic Regulation and Growth Factors in Autism. Physiological research. 2021; 70(4): 551-61.

Autism spectrum disorder (ASD) represents a serious neurodevelopmental disorder associated with autonomic nervous system dysregulation. The aim was to study complex cardiovascular autonomic regulation using heart rate variability (HRV) and systolic blood pressure variability (SBPV) linear/non-linear analysis at rest and during orthostasis, and to assess plasma levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in autistic children. Twenty-five ASD boys and 25 age and gender-matched children at the age 7-15 years were examined. After venous blood taking, continuous ECG and blood pressure biosignals were recorded at rest and during orthostasis. Evaluated parameters: RR intervals, high- and low-frequency band of HRV spectral analysis (HF-HRV, LF-HRV), symbolic dynamics parameters 0V%, 1V%, 2LV%, 2UV%, low- and high-frequency band of SBPV (LF-SBPV, HF-SBPV), systolic, diastolic, mean blood pressure, EGF, VEGF plasma levels. RR intervals were significantly shortened and the HF-HRV, LF-SBPV, HF-SBPV parameters were significantly lower at rest, the HF-HRV and LF-SBPV remained lower during orthostasis in autistic children compared to controls (p<0.05). EGF plasma levels were significantly lower in ASD compared to controls (p=0.046). No significant differences were found in remaining parameters. Our study revealed tachycardia, cardiovagal underactivity, and blunted sympathetic vasomotor regulation at rest and during orthostasis in autistic children. Additionally, complex heart rate dynamics are similar in autistic children than controls. Furthermore, EGF was reduced in autistic children without significant correlations with any autonomic parameters. We suggest that the abnormal complex cardiovascular reflex control could contribute to understanding the pathway linking autonomic features and autism.

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15. Tsuboyama M, Liu J, Kaye H, DiBacco M, Pearl PL, Rotenberg A. Transcranial Magnetic Stimulation in Succinic Semialdehyde Dehydrogenase Deficiency: A Measure of Maturational Trajectory of Cortical Excitability. Journal of child neurology. 2021; 36(13-14): 1169-76.

BACKGROUND: Succinic semialdehyde dehydrogenase deficiency (SSADHD) is a disorder of GABA degradation with use-dependent downregulation of postsynaptic GABA(A/B) receptors. We aim to measure the resulting cortical excitation: inhibition ratio using transcranial magnetic stimulation. METHODS: In this single-center observational study, 18 subjects with SSADHD and 8 healthy controls underwent transcranial magnetic stimulation. Resting motor threshold, cortical silent period, and long-interval intracortical inhibition were measured in both groups. Resting motor threshold in focal epilepsy patients from an institutional transcranial magnetic stimulation database were also included. RESULTS: SSADHD subjects had higher resting motor threshold than healthy controls but lower relative to focal epilepsy patients. Resting motor threshold decreased with age in all groups. Cortical silent period was longer in SSADHD subjects than in healthy controls. No difference was detected in long-interval intracortical inhibition between the 2 groups. CONCLUSION: Findings suggest abnormal corticospinal tract physiology in SSADHD, but with preserved developmental trajectory for corticospinal tract maturation. Defining features of these transcranial magnetic stimulation metrics in SSADHD will be better elucidated through this ongoing longitudinal study.

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16. Wang Q, Kong Y, Wu DY, Liu JH, Jie W, You QL, Huang L, Hu J, Chu HD, Gao F, Hu NY, Luo ZC, Li XW, Li SJ, Wu ZF, Li YL, Yang JM, Gao TM. Impaired calcium signaling in astrocytes modulates autism spectrum disorder-like behaviors in mice. Nature communications. 2021; 12(1): 3321.

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder. The mechanisms underlying ASD are unclear. Astrocyte alterations are noted in ASD patients and animal models. However, whether astrocyte dysfunction is causal or consequential to ASD-like phenotypes in mice is unresolved. Type 2 inositol 1,4,5-trisphosphate 6 receptors (IP3R2)-mediated Ca(2+) release from intracellular Ca(2+) stores results in the activation of astrocytes. Mutations of the IP3R2 gene are associated with ASD. Here, we show that both IP3R2-null mutant mice and astrocyte-specific IP3R2 conditional knockout mice display ASD-like behaviors, such as atypical social interaction and repetitive behavior. Furthermore, we show that astrocyte-derived ATP modulates ASD-like behavior through the P2X2 receptors in the prefrontal cortex and possibly through GABAergic synaptic transmission. These findings identify astrocyte-derived ATP as a potential molecular player in the pathophysiology of ASD.

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17. Williams ZJ, McKenney EE, Gotham KO. Investigating the structure of trait rumination in autistic adults: A network analysis. Autism : the international journal of research and practice. 2021; 25(7): 2048-63.

Autistic adults are substantially more likely to develop depression than individuals in the general population, and recent research has indicated that certain differences in thinking styles associated with autism may play a role in this association. Rumination, the act of thinking about the same thing over and over without a functional outcome, is a significant risk factor for depression in both autistic and non-autistic adults. However, little is known about how different kinds of rumination relate to each other and to depressive symptoms in the autistic population specifically. To fill this gap in knowledge, we recruited a large online sample of autistic adults, who completed questionnaire measures of both the tendency to ruminate and symptoms of depression. By examining the interacting network of rumination and depression symptoms, this study was able to identify particular aspects of rumination-such as thinking repetitively about one’s guilty feelings or criticizing oneself-that may be particularly important in maintaining these harmful thought patterns in autistic adults. Although further study is needed, it is possible that the symptoms identified as most « influential » in the network may be particularly good targets for future interventions for mood and anxiety disorders in the autistic population.

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