1. Gentile M, Messineo L, La Guardia D, Arrigo M, Città G, Ayala A, Cusimano G, Martines P, Mendolia G, Allegra M. A Parent-Mediated Telehealth Program for Children with Autism Spectrum Disorder : Promoting Parents’ Ability to Stimulate the Children’s Learning, Reduce Parenting Stress, and Boost Their Sense of Parenting Empowerment. Journal of autism and developmental disorders. 2022.

This study investigates the effectiveness of a 6-month parent-mediated early intervention telehealth program for children with an autism spectrum disorder. The participants comprised a total of 27 parents. The findings showed that participation in the program promotes parents’ empowerment and reduce parental stress and a general improvement in the parents’ ability to stimulate children’s learning. Moreover, the study reveals an effect of parents’ age in mediating the relationship among the parents’ ability, stress, and empowerment levels. These results suggest that an early intervention telehealth program may help parents become aware of how to benefit from interactions with their children, promote their empowerment, and reduce parenting stress.

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2. Ha VS, Whittaker A. « Pray to all four directions »: a qualitative study of syncretic care seeking by Vietnamese families for their children with autism spectrum disorder. Disability and rehabilitation. 2022: 1-12.

PURPOSE: The aim is to understand what therapies and interventions families in a low and middle income (LMIC) country, such as Vietnam resort to in their attempts to seek care for their children with ASD and why they choose these therapies. METHODS: We undertook semi-structured qualitative interviews with 27 parents of children with autism and an online survey of 112 parents as part of a broader ethnographic study over one year augmented with recent interactional observations and a review of social media. RESULTS: There is limited access to formal interventions for families with children with ASD in Vietnam. Rather, families resort to syncretic care using an average of 6.8 different interventions per child. These included: speech therapy; physical therapy; prescribed medicines; and ABA as well as geomancy, special dietary regimes, biochemical testing, stem cell therapies and religious and cultural practices. Despite having low incomes, the families surveyed spent an average USD 345 per month on interventions, many of which are not evidence-based. Desire to care and potentially « cure » their children within a context of stigma associated with ASD drives parents to seek all possible interventions for their children. CONCLUSIONS: There remains a large gap in access to appropriate evidence-based interventions or trained therapists for families. Further information for parents, culturally appropriate guidelines for effective interventions, more trained rehabilitation professionals and regulation is required.IMPLICATIONS FOR REHABILITATIONWithin low and middle income countries (LMIC), such as Vietnam there is a lack of intervention services, difficulties in accessing appropriate specialists, poor quality care and the costs of care.Families seek a range of formal interventions and costly informal therapies as well as culturally specific practices to care for their child/ren and require information on effective therapies.In LMIC training programs to build capacity for allied health professionals need to be implemented on the latest evidence-based therapies.It is important to develop culturally appropriate Vietnamese guidelines to support interventions for children with ASD.

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3. Kaiser K, Villalobos ME, Locke J, Iruka IU, Proctor C, Boyd B. A culturally grounded autism parent training program with Black parents. Autism : the international journal of research and practice. 2022; 26(3): 716-26.

Parent training programs have been well-studied in Autism Spectrum Disorders and shown to increase a parent’s feeling of empowerment, advocacy skills, and treatment enrollment for their child. The majority of parent training interventions have been developed without considering the unique needs of under-represented communities, such as the Black community. Black children with autism are not only misdiagnosed or not diagnosed at all, but are not accessing services equally compared to their White peers. There is an urgent need for culturally adapted interventions in order to decrease the disparity gap. The Color of Autism Foundation developed and ran a parent training program for Black parents of children with autism. The program was grounded in two key features: (1) creating a circle of support for parents to connect and heal from ongoing and historical racial trauma and (2) using parents of Black children with autism as the main facilitators. We believe this increased parent’s ability to engage in the educational aspects of the training. Overall, parents reported high levels of satisfaction with the training were highly engaged (attended an average of five of six sessions) and reported high levels of empowerment. Parents also reported continued mistrust in the medical and research community and a need for more Black providers. Further work should examine the relationship of the parent and provider in autism treatment and study the impact of circles of healing for Black families.

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4. Klein L, D’Urso S, Eapen V, Hwang LD, Lin PI. Exploring polygenic contributors to subgroups of comorbid conditions in autism spectrum disorder. Scientific reports. 2022; 12(1): 3416.

Individuals with autism spectrum disorder (ASD) have heterogeneous comorbid conditions. This study examined whether comorbid conditions in ASD are associated with polygenic risk scores (PRS) of ASD or PRS of comorbid conditions in non-ASD specific populations. Genome-wide single nucleotide polymorphism (SNP) data were obtained from 1386 patients with ASD from the Autism Genetic Resource Exchange (AGRE) study. After excluding individuals with missing clinical information concerning comorbid conditions, a total of 707 patients were included in the study. A total of 18 subgroups of comorbid conditions (‘topics’) were identified using a machine learning algorithm, topic modeling. PRS for ASD were computed using a genome-wide association meta-analysis of 18,381 cases and 27,969 controls. From these 18 topics, Topic 6 (over-represented by allergies) (p = 1.72 × 10(-3)) and Topic 17 (over-represented by sensory processing issues such as low pain tolerance) (p = 0.037) were associated with PRS of ASD. The associations between these two topics and the multi-locus contributors to their corresponding comorbid conditions based on non-ASD specific populations were further explored. The results suggest that these two topics were not associated with the PRS of allergies and chronic pain disorder, respectively. Note that characteristics of the present AGRE sample and those samples used in the original GWAS for ASD, allergies, and chronic pain disorder, may differ due to significant clinical heterogeneity that exists in the ASD population. Additionally, the AGRE sample may be underpowered and therefore insensitive to weak PRS associations due to a relatively small sample size. Findings imply that susceptibility genes of ASD may contribute more to the occurrence of allergies and sensory processing issues in individuals with ASD, compared with the susceptibility genes for their corresponding phenotypes in non-ASD individuals. Since these comorbid conditions (i.e., allergies and pain sensory issues) may not be attributable to the corresponding comorbidity-specific biological factors in non-ASD individuals, clinical management for these comorbid conditions may still depend on treatments for core symptoms of ASD.

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5. Lynch GTF, James SM, Cardon TA, McPherson SM. Sensitivity and specificity of pupillary light reflex measures for ASD using monocular pupillometry. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2022.

INTRODUCTION: Automated hand-held pupillometry demonstrates precision accuracy, offering promise for augmenting ASD screening. METHODS: Monocular pupillometry was examined in children and adolescents (36 ASD; 24 TD). Multiple logistic regression and receiver operating characteristic analysis assessed PLR metrics and diagnostic status. RESULTS: Constriction time (Ct(1)) (ASD: M = 0.69, SD = 0.21; TD: M = 0.82, SD = 0.18; t(58 = 2.37; p = 0.02) and return to baseline (RTB T75) (ASD: M = 2.93, SD = 1.21; TD: M = 2.32, SD = 1.08; t(58) =  - 2.03; p = 0.04) predicted ASD (β =  - 1.31, OR = 0.27; RTB T75, β = 0.156, OR = 1.162). Sensitivity = 74.8%, when RTB ≥ 1.83 s and 69.4% when Ct(1) = 0.785 s. CONCLUSION: Findings suggest monocular pupillometry captures differences detecting ASD.

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6. Reynaud E, Pottelette J, Rabot J, Rolling J, Royant-Parola S, Hartley S, Coutelle R, Schröder CM. Differential effects of COVID-related lockdown on sleep-wake rhythms in adults with autism spectrum disorder compared to the general population. Autism research : official journal of the International Society for Autism Research. 2022.

COVID-related lockdown led to a radical modification of daily activities and routines which are known to affect sleep. Compared to the general population, participants with autism may be particularly vulnerable to the repercussions of lockdown on sleep, given their intrinsic inflexible adherence to routines and the high overall prevalence of sleep disturbances in this population. The study is a French nation-wide online survey assessing sleep-wake rhythms and behaviors known to affect sleep (daily screen time, daylight exposure, and physical activity), before and during COVID-related lockdown. Respondents were 207 adults with autism (56% female) and 1652 adults of the general population (77% female), with a mean age 35.3 years (SD 11.3). Before lockdown, the adults with autism displayed on average later bedtime and waking hours, lower sleep quality, more evening screen time, less exposure to daylight, and less exercise (all p < 0.01). Lockdown affected all studied measures of sleep and related exposures in a similar way in both groups: poorer self-rated sleep quality as well as a less regular and delayed sleep-wake rhythm, longer screen time in the evening and less exposure to daylight (all p < 0.001). Adults with autism displayed significantly higher levels of sleep and circadian rhythm disturbances and less favorable daily routines known to regulate sleep. While the effect of confinement on sleep and sleep related behaviors was similar in both groups, the results highlight that the pre-existing shift in circadian rhythms and lifestyles in adults with ASD further deteriorated during lockdown. LAY ABSTRACT: COVID-related lockdown led to a radical modification of daily activities and routines known to affect sleep. In a sample of 1800 adults, we observed that, before lockdown, participants with autism displayed significantly higher levels of sleep disturbances and less favorable daily routines known to regulate sleep, compared to the general population. While the deleterious effect of lockdown on sleep was similar in both groups, pre-existing difficulties in adults with autism reached worrying levels during lockdown.

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7. Shalabi M, Khattab NMA, Elheeny AAH. Picture Examination Communication System Versus Video Modelling in Improving Oral Hygiene of Children with Autism Spectrum Disorder: A Prospective Randomized Clinical Trial. Pediatric dentistry. 2022; 44(1): 25-31.

Purpose: The purpose of this study was to compare video modelling (VM) to a Picture Exchange Communication System (PECS) aimed at improving the oral hygiene of children with autism spectrum disorder (ASD). Methods: This prospectively stratified randomized controlled trial was conducted on 50 children with mild and moderate ASD. Children were assigned into two balanced groups. The control group was educated through PECS, and the intervention group was exposed to VM. Oral hygiene was assessed using the Oral Hygiene Index-simplified (OHI-s) on four occasions (at baseline and at three, six, and 12 months). Quantitative data were analyzed using Fisher’s exact test and a t-test at a five percent significance level and 95 percent confidence interval (95% CI), respectively. Spearman’s rank correlation coefficient (r) was used to correlate baseline characteristics in both groups to obtain average OHI-s scores. Results: The VM group showed a statistically significant reduction in average OHI-s scores compared to the PECS group over the follow-up period (P<0.001). At three, six, and 12 months, the OHI-s mean differences were 0.30 (95% CI equals 0.14 to 0.47), 0.58 (95% CI equals 0.39 to 0.77), and 0.57 (95% CI equals 0.30 to 0.84), respectively. For both groups, the severity of ASD was moderately associated with OHI-s scores at 12 months. Conclusion: Video modelling showed superior results in improving the oral hygiene of children with autism spectrum disorder compared to the Picture Exchange Communication System.

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8. Wynn CJ, Josephson ER, Borrie SA. An Examination of Articulatory Precision in Autistic Children and Adults. Journal of speech, language, and hearing research : JSLHR. 2022; 65(4): 1416-25.

PURPOSE: According to the speech attunement framework, autistic individuals lack the ability and/or motivation to « tune up » their speech to the same level of precision as their neurotypical peers. However, previous studies exploring the articulatory patterns of autistic individuals have yielded disparate findings. One reason contrasting conclusions exist may be because studies have relied on perceptual measures of articulation. Here, we use an objective acoustic measure of articulatory precision to explore the articulatory patterns of autistic children and adults. METHOD: This was a retrospective analysis of an existing corpus of 900 recorded speech samples taken from 30 adult and 30 child participants across two different population groups: autistic individuals (autism spectrum disorder [ASD] group) and neurotypical individuals (neurotypical [NT] group). Articulatory precision scores were calculated using an automated metric that compares observed acoustics to the expected acoustics for each phoneme production. Linear mixed-effects models were used to compare the articulatory precision scores across population group (i.e., ASD group vs. NT group) and to see if these differences were moderated by age group (i.e., children vs. adult). RESULTS: The speech of autistic individuals was characterized by reduced articulatory precision relative to their neurotypical peers. This pattern was not significantly moderated by age, indicating it occurred in both the children and adult groups. CONCLUSIONS: Our preliminary findings indicate that imprecise articulation may be a characteristic of the speech of autistic individuals in both childhood and adulthood. These findings are in line with predictions posited by the speech attunement framework. Given the current lack of speech markers for this clinical population and the importance of speech quality in the social integration of autistic individuals, our results advance articulatory precision as a viable and important target for future research.

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