1. Allahdad M, Gluyas E, Spain D, Blainey S, Doswell S, Onyejiaka A. Implementing ‘Transforming Care’ – The first two years of a pilot service for autistic adults experiencing mental health crisis warranting psychiatric admission. Res Dev Disabil;2024 (Mar 1);147:104700.

BACKGROUND: Autistic adults are at increased risk of mental health difficulties; however Adult Mental Health Services (AMHS) often struggle to offer appropriate support to this group. Within England, Government initiatives, such as the ‘Transforming Care’ programme which included ‘Building the Right Support’ (NHS England, 2015) have promoted the need for AMHS to consider how they can better provide autism-informed support to autistic adults. AIMS/METHODS: Here, we describe the first two years of work of the Transforming Care in Autism (TCA) Team; a specialist service that supports autistic adults, without a moderate or severe intellectual disability or presenting significant risk to others, experiencing a mental health crisis. The service model is described, and descriptive data is presented over the two years of the service operation. RESULTS: Between February 2019 and February 2021, 110 referrals were received; 52 (47%) were accepted. Support offered to autistic adults included psychoeducation, psychological interventions, family-focused interventions, and consultation with professionals about specific individuals. Seventy autism training sessions were delivered to professionals working in medical health settings, AMHS, social care and residential services. CONCLUSIONS/IMPLICATIONS: Developing more autism-informed community and inpatient AMHS is vital for improving care. Further research about the experiences and needs of autistic adults using AMHS is needed, along with improved awareness of autism and provision of tailored intervention within these settings. LAY ABSTRACT: Autistic people have mental health problems more often than people who are not autistic. When autistic people need help from mental health services, often these services do not know how to help autistic people. The Government says mental health services must do more to help autistic people. In this paper we write about a new team, called the Transforming Care in Autism team. In its first two years the team was asked to help 110 people and worked with 52 of them. Help included talking to autistic people about how autism affects them and offering therapy. We also worked with families and professionals supporting autistic adults and offered 70 training sessions. More work is needed to make sure mental health services work well with autistic people. We also need to ask autistic people about their experiences of getting help from mental health services.

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2. Bandyopadhyay S, Peddi S, Sarma M, Samanta D. Decoding autism: Uncovering patterns in brain connectivity through sparsity analysis with rs-fMRI data. J Neurosci Methods;2024 (Feb 29):110100.

BACKGROUND: In the realm of neuro-disorders, precise diagnosis and treatment rely heavily on objective imaging-based biomarker identification. This study employs a sparsity approach on resting-state fMRI to discern relevant brain region connectivity for predicting Autism. NEW METHOD: The proposed methodology involves four key steps: (1) Utilizing three probabilistic brain atlases to extract functionally homogeneous brain regions from fMRI data. (2) Employing a hybrid approach of Graphical Lasso and Akaike Information Criteria to optimize sparse inverse covariance matrices for representing the brain functional connectivity. (3) Employing statistical techniques to scrutinize functional brain structures in Autism and Control subjects. (4) Implementing both autoencoder-based feature extraction and entire feature-based approach coupled with AI-based learning classifiers to predict Autism. RESULTS: The ensemble classifier with the extracted feature set achieves a classification accuracy of 84.7% ±0.3% using the MSDL atlas. Meanwhile, the 1D-CNN model, employing all features, exhibits superior classification accuracy of 88.6% ±1.7% with the Smith 2009 (rsn70) atlas. COMPARISON WITH EXISTING METHOD(S): The proposed methodology outperforms the conventional correlation-based functional connectivity approach with a notably high prediction accuracy of more than 88%, whereas considering all direct and noisy indirect region-based functional connectivity, the traditional methods bound the prediction accuracy within 70% to 79%. CONCLUSIONS: This study underscores the potential of sparsity-based FC analysis using rs-fMRI data as a prognostic biomarker for detecting Autism.

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3. Bettencourt C, Garret-Gloanec N, Pellerin H, Péré P, Bertamini G, Squillante M, Roos-Weil F, Ferrand L, Pernel AS, Apter G, Chetouani M, Cortese S, Cohen D. Promoting emotional and behavioral interventions in ASD treatment: Evidence from EPIGRAM, A naturalistic, prospective and longitudinal study. Res Dev Disabil;2024 (Mar 2);147:104688.

BACKGROUND: Prognostic factors from naturalistic treatment studies of children with Autism Spectrum Disorder (ASD) remain largely unknown. We aimed to identify baseline and treatment-related prognostic predictors at 1-year follow-up after Integrative Care Practices (ICPs). METHODS: Eighty-nine preschool children with severe ASD were given ICP combining nine therapeutic workshops based on children’s needs. Participants were assessed at baseline and during 12 months follow-up with the Psycho-educational Profile-3-R, Children Autism Rating Scale, Parental Global Impression, and the Autistic Behaviors Scale. We assessed prognostic predictors using multivariable regression models and explored treatment ingredients influencing outcome using Classification and Regression Trees (CART). RESULTS: Multivariable models showed that being a child from first generation immigrant parents predicted increased maladaptive behaviors, whereas play activities had an opposite effect; severity of ASD symptoms and impaired cognitive functions predicted worse autism severity at follow-up; and lower play activities predicted worse parent impression. Regarding treatment effects, more emotion/behavioral interventions predicted better outcomes, and more communication interventions predicted lower autism severity, whereas more education and cognitive interventions had an opposite effect. CART confirmed that more hours of intervention in the emotion/behavioral domain helped classifying cases with better outcomes. More parental support was associated with decreased maladaptive behaviors. Sensorimotor and education interventions also significantly contributed to classifying cases according to outcomes but defined subgroups with opposite prognosis. CONCLUSION: Children who exhibited the best prognosis following ICPs had less autism severity, better cognition, and non-immigrant parents at baseline. Emotion/behavior interventions appeared key across all outcomes and should be promoted.

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4. Kovacheva E, Gevezova M, Maes M, Sarafian V. The MCs – Cytokines axis in ASD. Neuropharmacology;2024 (Feb 29):109890.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disturbance, diagnosed in early childhood. It is associated with varying degrees of dysfunctional communication and social skills, repetitive and stereotypic behaviors. Regardless of the constant increase in the number of diagnosed patients, there are still no established treatment schemes in global practice. Many children with ASD have allergic symptoms, often in the absence of mast cell (MC) positive tests. Activation of MCs may release molecules related to inflammation and neurotoxicity, which contribute to the pathogenesis of ASD. The aim of the present paper is to enrich the current knowledge regarding the relationship between MCs and ASD by providing PPI network analysis-based data that reveal key molecules and immune pathways associated with MCs in the pathogenesis of autism. Network and enrichment analyzes were performed using receptor information and secreted molecules from activated MCs identified in ASD patients. Our analyses revealed cytokines and key marker molecules for MCs degranulation, molecular pathways of key mediators released during cell degranulation, as well as various receptors. Understanding the relationship between ASD and the activation of MCs, as well as the involved molecules and interactions, is important for elucidating the pathogenesis of ASD and developing effective future treatments for autistic patients by discovering new therapeutic target molecules.

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5. O’Neill SJ, Smyth S. Using off-the-shelf solutions as assistive technology to support the self-management of academic tasks for autistic university students. Assist Technol;2024 (Mar 3);36(2):173-187.

Having the skills to self-manage the demands of academic life in third-level education is critical to the successful completion of courses taken there. Independent study behavior is an aspect of university life that pervades all topics but one that requires the self-management of time in relation to study goals. Individuals with additional educational needs, such as autism, often have difficulty self-managing independent study. This may result in students failing to meet the standards required for successful course completion. The current study (n = 2) used a range bound changing criterion design to evaluate the effects of a behavioral intervention that included assistive technology in the form of a smartphone and wearable smartwatch. The intervention aimed to increase the duration of independent study behavior among university students with autism. The intervention combined self-management (goal setting, self-monitoring, self-recording) together with assistive tech. to prompt engagement in, and recording of, independent study behavior. Findings showed the intervention to be effective at increasing independent study duration for autistic adults attending third-level education.

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6. Yu ACL, McAllister R, Mularoni N, To CKS. Brief Report: Atypical Temporal Sensitivity in Coarticulation in Autism: Evidence from Sibilant-Vowel Interaction in Cantonese. J Autism Dev Disord;2024 (Mar 2)

PURPOSE: Atypicalities in the prosodic aspects of speech are commonly considered in clinical assessments of autism. While there is an increasing number of studies using objective measures to assess prosodic deficits, such studies have primarily focused on the intonational and rhythmic aspects of prosody. Little is known about prosodic deficits that are reflected at the segmental level, despite the strong connection between prosody and segmental realization. This study examines the nature of sibilant-vowel coarticulation among male adult native speakers of Cantonese with autism and those without. METHODS: Fifteen Cantonese-speaking autistic (ASD) adults (mean age = 25 years) and 23 neuro-typical (NT) adults (mean age = 20 years) participated. Each participant read aloud 42 syllables with a sibilant onset in carrier phrase. Spectral means and variance, skewness and kurtosis were measured, and regressed by vocalic rounding (rounded vs. unrounded), cohort (ASD vs. NT), sibilant duration, and articulation rate. RESULTS: While neurotypical participants exhibit sibilant-vowel coarticulation that are sensitive to variation in sibilant duration, autistic participants show no sensitivity to segmental temporal changes. CONCLUSION: These findings point to the potential for atypicalities in prosody-segment interaction as an important characteristic of autistic speech.

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