1. Banos O, Comas-González Z, Medina J, Polo-Rodríguez A, Gil D, Peral J, Amador S, Villalonga C. Sensing technologies and machine learning methods for emotion recognition in autism: Systematic review. Int J Med Inform. 2024; 187: 105469.

BACKGROUND: Human Emotion Recognition (HER) has been a popular field of study in the past years. Despite the great progresses made so far, relatively little attention has been paid to the use of HER in autism. People with autism are known to face problems with daily social communication and the prototypical interpretation of emotional responses, which are most frequently exerted via facial expressions. This poses significant practical challenges to the application of regular HER systems, which are normally developed for and by neurotypical people. OBJECTIVE: This study reviews the literature on the use of HER systems in autism, particularly with respect to sensing technologies and machine learning methods, as to identify existing barriers and possible future directions. METHODS: We conducted a systematic review of articles published between January 2011 and June 2023 according to the 2020 PRISMA guidelines. Manuscripts were identified through searching Web of Science and Scopus databases. Manuscripts were included when related to emotion recognition, used sensors and machine learning techniques, and involved children with autism, young, or adults. RESULTS: The search yielded 346 articles. A total of 65 publications met the eligibility criteria and were included in the review. CONCLUSIONS: Studies predominantly used facial expression techniques as the emotion recognition method. Consequently, video cameras were the most widely used devices across studies, although a growing trend in the use of physiological sensors was observed lately. Happiness, sadness, anger, fear, disgust, and surprise were most frequently addressed. Classical supervised machine learning techniques were primarily used at the expense of unsupervised approaches or more recent deep learning models. Studies focused on autism in a broad sense but limited efforts have been directed towards more specific disorders of the spectrum. Privacy or security issues were seldom addressed, and if so, at a rather insufficient level of detail.

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2. Burroughs C, Muscatello RA, Corbett BA. The Role of Everyday Executive Function in Observed Social Symptoms of Autism Spectrum Disorder. J Autism Dev Disord. 2024.

Recent research suggests there may be differences in the social presentations of autistic males and females. Camouflaging is believed to account for some of these differences and executive function (EF) may support compensatory social behaviors. As few studies have explored the role of sex and everyday EF when evaluating specific social difficulties among autistic youth, the present study seeks to address this. The Social Responsiveness Scale-2 (SRS-2) was used to measure types of social difficulties and the Behavioral Rating Inventory of Executive Function-2 (BRIEF-2) served as a measure of everyday EF. Four three-step hierarchical multiple regressions were conducted with SRS-2 social subscales as dependent variables. Autism symptom severity, BRIEF-2 EF Indices (i.e., behavioral, emotional, and cognitive regulation), and sex served as independent variables. Types of EF impairment significantly predicted social symptoms of autism. Behavioral dysregulation predicted all social symptoms assessed, cognitive dysregulation predicted social awareness and communication challenges, and emotion dysregulation predicted social motivation and communication difficulties. Sex significantly predicted social communication and cognition challenges, beyond the contributions of age, IQ, autism severity, and EF impairment. Findings from this study provide evidence for the contribution of EF to observed social symptoms of autism. Results suggest there may be sex-based differences in the relationship between EF and social problems for autistic youth. Implications and future directions are discussed.

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3. Chen L, Du B, Li K, Li K, Hou T, Jia F, Li L. The effect of tDCS on inhibitory control and its transfer effect on sustained attention in children with autism spectrum disorder: An fNIRS study. Brain Stimul. 2024; 17(3): 594-606.

BACKGROUND: Individuals with autism spectrum disorder (ASD) have inhibitory control deficits. The combination of transcranial direct current stimulation (tDCS) and inhibitory control training produces good transfer effects and improves neuroplasticity. However, no studies have explored whether applying tDCS over the dlPFC improves inhibitory control and produces transfer effects in children with ASD. OBJECTIVE: To explore whether multisession tDCS could enhance inhibitory control training (response inhibition), near-transfer (interference control) and far-transfer effects (sustained attention; stability of attention) in children with ASD and the generalizability of training effects in daily life and the class, as reflected by behavioral performance and neural activity measured by functional near-infrared spectroscopy (fNIRS). METHODS: Twenty-eight autistic children were randomly assigned to either the true or sham tDCS group. The experimental group received bifrontal tDCS stimulation at 1.5 mA, administered for 15 min daily across eight consecutive days. tDCS was delivered during a computerized Go/No-go training task. Behavioral performance in terms of inhibitory control (Dog/Monkey and Day/Night Stroop tasks), sustained attention (Continuous Performance and Cancellation tests), prefrontal cortex (PFC) neural activity and inhibitory control and sustained attention in the class and at home were evaluated. RESULTS: Training (response inhibition) and transfer effects (interference control; sustained attention) were significantly greater after receiving tDCS during the Go/No-go training task than after receiving sham tDCS. Changes in oxyhemoglobin (HbO) concentrations in the dlPFC and FPA associated with consistent conditions in the Day/Night Stroop and Continuous Performance test were observed after applying tDCS during the inhibitory control training task. Notably, transfer effects can be generalized to classroom environments. CONCLUSION: Inhibitory control training combined with tDCS may be a promising, safe, and effective method for improving inhibitory control and sustained attention in children with ASD.

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4. Clarke L, O’Neill N, Patel B, Steeman S, Segal G, Merrell SB, Gisondi MA. Trainee advocacy for medical education on the care of people with intellectual and/or developmental disabilities: a sequential mixed methods analysis. BMC Med Educ. 2024; 24(1): 491.

BACKGROUND: Medical trainees (medical students, residents, and fellows) are playing an active role in the development of new curricular initiatives; however, examinations of their advocacy efforts are rarely reported. The purpose of this study was to understand the experiences of trainees advocating for improved medical education on the care of people with intellectual and/or developmental disabilities. METHODS: In 2022-23, the authors conducted an explanatory, sequential, mixed methods study using a constructivist paradigm to analyze the experiences of trainee advocates. They used descriptive statistics to analyze quantitative data collected through surveys. Participant interviews then yielded qualitative data that they examined using team-based deductive and inductive thematic analysis. The authors applied Kern’s six-step approach to curriculum development as a framework for analyzing and reporting results. RESULTS: A total of 24 participants completed the surveys, of whom 12 volunteered to be interviewed. Most survey participants were medical students who reported successful advocacy efforts despite administrative challenges. Several themes were identified that mapped to Steps 2, 4, and 5 of the Kern framework: « Utilizing Trainee Feedback » related to Needs Assessment of Targeted Learners (Kern Step 2); « Inclusion » related to Educational Strategies (Kern Step 4); and « Obstacles », « Catalysts », and « Sustainability » related to Curriculum Implementation (Kern Step 5). CONCLUSIONS: Trainee advocates are influencing the development and implementation of medical education related to the care of people with intellectual and/or developmental disabilities. Their successes are influenced by engaged mentors, patient partners, and receptive institutions and their experiences provide a novel insight into the process of trainee-driven curriculum advocacy.

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5. Corbett BA, Muscatello RA, McGonigle T, Vandekar S, Burroughs C, Sparks S. Trajectory of depressive symptoms over adolescence in autistic and neurotypical youth. Mol Autism. 2024; 15(1): 18.

BACKGROUND: Adolescence coincides with a dramatic rise in the onset of psychiatric conditions including depression. Depression symptoms may be particularly prevalent and impairing for youth with autism spectrum disorder (ASD). While prior research suggests adolescence is associated with worsening depression symptoms for typically developing (TD) and autistic youth, it is unclear if they follow a similar course. METHOD: The study examined the trajectory of depressive symptoms in autistic and neurotypical youth over a 4-year longitudinal study using linear and logistic mixed effects models. In youth with clinically relevant depressive scores (t-score > 65), moderating factors (i.e., diagnosis, age, puberty, sex) were explored. During Year 1, the sample included 244 youth 10-to-13 years: 140 in the ASD group (36 females) and 104 in the TD group (46 females). RESULTS: Autistic youth had elevated depression scores compared to TD peers (p < 0.001) and females were higher than males in both groups (p = 0.001). There was significant diagnosis by age (p < 0.001) and diagnosis by pubertal stage (p < 0.05) interactions. In the ASD group, elevated depressive scores presented in early adolescence and decreased during middle adolescence and puberty, whereas the TD group showed the opposite trend with an increase in depression symptoms with advancing development. LIMITATIONS: Limitations include an unequal sex distribution (fewer females), non-representative autistic sample (e.g., cognition and race/ethnicity), and potential confound of the COVID-19 pandemic. CONCLUSIONS: Autistic youth present with higher rates of depressive symptoms early in development; yet, approaching middle adolescence and puberty, the symptom trajectory in the autistic youth declines coinciding with an increase in the TD youth. While group trajectories are divergent, they lead to similar levels of depression in late adolescence with higher symptoms in females. Findings suggest a period of quiescence in depressive symptomology influenced by biopsychosocial factors impacting affective profiles.

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6. Cummings KK, Greene RK, Cernasov P, Kan DDD, Parish-Morris J, Dichter G, Kinard JL. Bilingualism Predicts Affective Theory of Mind in Autistic Adults. J Speech Lang Hear Res. 2024: 1-18.

PURPOSE: This study examined the impact of bilingualism on affective theory of mind (ToM) and social prioritization (SP) among autistic adults compared to neurotypical comparison participants. METHOD: Fifty-two (25 autistic, 27 neurotypical) adult participants (ages 21-35 years) with varying second language (L2) experience, ranging from monolingual to bilingual, completed an affective ToM task. A subset of this sample also completed a dynamic eye-tracking task designed to capture differences in time spent looking at social aspects of a scene (SP). Four language groups were compared on task performance (monolingual autism and neurotypical, bilingual autism and neurotypical), followed by analyses examining the contribution of L2 experience, autism characteristics, and social face prioritization on affective ToM, controlling for verbal IQ. Finally, we conducted an analysis to identify the contribution of SP on affective ToM when moderated by autism status and L2 experience, controlling for verbal IQ. RESULTS: The monolingual autism group performed significantly worse than the other three groups (bilingual autism, monolingual neurotypical, and bilingual neurotypical) on the affective ToM task; however, there were no significant differences between the bilingual autism group compared to the monolingual and bilingual neurotypical groups. For autistic individuals, affective ToM capabilities were positively associated with both verbal IQ and L2 experience but did not relate to autism characteristics or SP during eye tracking. Neurotypical participants showed greater SP during the eye-tracking task, and SP did not relate to L2 or autism characteristics for autistic individuals. SP and verbal IQ predicted affective ToM performance across autism and neurotypical groups, but this relationship was moderated by L2 experience; SP more strongly predicted affective ToM performance among participants with lower L2 experience (e.g., monolingual) and had less of an impact for those with higher L2 experience. CONCLUSION: This study provides support for a bilingual advantage in affective ToM for autistic individuals. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25696083.

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7. Dong Q, Cai H, Li Z, Liu J, Hu B. A Multiview Brain Network Transformer Fusing Individualized Information for Autism Spectrum Disorder Diagnosis. IEEE J Biomed Health Inform. 2024; Pp.

Functional connectivity (FC) networks, built from analyses of resting-state magnetic resonance imaging (rs-fMRI), serve as efficacious biomarkers for identifying Autism Spectrum Disorders (ASD) patients. Given the neurobiological heterogeneity across individuals and the unique presentation of ASD symptoms, the fusion of individualized information into diagnosis becomes essential. However, this aspect is overlooked in most methods. Furthermore, the existing methods typically focus on studying direct pairwise connections between brain ROIs, while disregarding interactions between indirectly connected neighbors. To overcome above challenges, we build common FC and individualized FC by tangent pearson embedding (TP) and common orthogonal basis extraction (COBE) respectively, and present a novel multiview brain transformer (MBT) aimed at effectively fusing common and individualized information of subjects. MBT is mainly constructed by transformer layers with diffusion kernel (DK), fusion quality-inspired weighting module (FQW), similarity loss and orthonormal clustering fusion readout module (OCFRead). DK transformer can incorporate higher-order random walk methods to capture wider interactions among indirectly connected brain regions. FQW promotes adaptive fusion of features between views, and similarity loss and OCFRead are placed on the last layer to accomplish the ultimate integration of information. In our method, TP, DK and FQW modules all help to model wider connectivity in the brain that make up for the shortcomings of traditional methods. We conducted experiments on the public ABIDE dataset based on AAL and CC200 respectively. Our framework has shown promising results, outperforming state-of-the-art methods on both templates. This suggests its potential as a valuable approach for clinical ASD diagnosis.

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8. Golse B, Yehouetome M. [Being born moderately premature: a risky developmental trajectory]. Soins Pediatr Pueric. 2024; 45(338): 22-5.

Babies born prematurely are frequently prone to developmental disorders, which are all the more severe in babies of low gestational age. However, medium prematurity also generates its own set of difficulties, including sensory, motor, cognitive, behavioral, relational and emotional disorders. It is essential to gain a better understanding of the developmental trajectory of these children and its various ups and downs, in order to support their development as early as possible.

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9. Guo X, Xu C, Chen J, Wu Z, Hou S, Wei Z. Disrupted cognitive and affective empathy network interactions in autistic children viewing social animation. Soc Cogn Affect Neurosci. 2024; 19(1).

Empathy can be divided into two core components, cognitive empathy (CE) and affective empathy (AE), mediated by distinct neural networks. Deficient empathy is a central feature of autism spectrum conditions (ASCs), but it is unclear if this deficit results from disruption solely within empathy networks or from disrupted functional integration between CE and AE networks. To address this issue, we measured functional connectivity (FC) patterns both within and between empathy networks in autistic children (4-8 years, n = 31) and matched typically developing (TD) children (n = 26) using near-infrared spectroscopy during the presentation of an animated story evoking CE and AE. Empathy and social communication ability were also assessed using the Empathy Quotient/Systemizing Quotient (EQ/SQ) and Social Responsiveness Scale, respectively. The results showed that the FC in the AE network of autistic children did not differ from the TD group across conditions; however, the ASC group showed weaker FC in the CE network under the CE condition and weaker FC between networks when processing AE information, the latter of which was negatively correlated with EQ scores in ASC. The empathy defect in ASC may involve abnormal integration of CE and AE network activities under AE conditions.

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10. Harbord J. The visualization of autism: Filming children at the Maudsley Hospital, London, 1957-8. Hist Human Sci. 2024; 37(2): 117-37.

This article examines three films made during the 1950s by Elwyn James Anthony at the psychotic clinic for children at the Maudsley Hospital that marked an important transition in the purpose and practice of visual documentation in a clinical setting: film as a research tool was transitioning from the recording of external signs as indicators of internal subjective states, to the capture of the visual flow of communication between subjects. It is a shift that had a particular impact on the emergent classification of autism, a modality not yet properly separated from the broader term of psychosis, as a non-relational condition whose visual capture demonstrated a void of inter-human communicational exchange. Film was significant not only as a recording apparatus, but as a method of cutting and crafting sequences of movements into brief repetitive motifs. The filmed behaviour of children remained opaque to interpretation, a ‘finding’ that facilitated the modelling of an emergent autism as subjects who were isolated, alienated and automaton-like, inhabiting a separate temporality. The article situates this ‘second’, affectless autism, within a broader context of post-war research into gestures as a language of the body, developed largely through an intellectual network of German émigré psychoanalysts who had fled to the US and UK in the 1930s.

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11. Hyde RJ, Rudolph S. More than meets the eye: A conserved sensorimotor reflex helps unravel the circuit mechanisms of ASD. Neuron. 2024; 112(9): 1375-8.

Animal models are instrumental to understanding the mechanisms underlying autism spectrum disorder, yet translating human behavioral phenotypes remains challenging. Wang et al. leverage a conserved sensorimotor reflex to elucidate synaptic deficits in Scn2a haploinsufficiency and pilot novel rescue strategies.

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12. Ke Y, Zhou X. An affective assessment: incarnate biases in picture captions for autistic children. Int J Dev Disabil. 2024; 70(3): 536-48.

Previous studies have explored cognitive disabilities experienced by autistic children between the ages of 2 and 5 who attend special schools. However, there is still debate regarding the onset, scope, and causes of these problems, particularly when considering incarnate biases that may arise from affective notions. Early affective issues could potentially be a key factor contributing to observing such biases in picture captions. In this study, we employed an affective approach-simultaneous observation and questionnaire-to investigate how incarnate biases impact picture caption activities. Specifically, we looked at the performances of autistic children across four grades: PreK, K1, K2, and K3. We found that autistic children across all grades demonstrated instances of incarnation-biased interpretations in picture captions, although K3 performed better than the other grades. Furthermore, their incarnate biases tended to be negative rather than positive in affection, depending on the level of activity involved. Ultimately, the sources of these incarnate biases may stem from three spheres: school, society, and family. Thus, it is essential to consider these factors when designing educational programs for children with autism. It highlights the potential dangers associated with negative biases in picture captions. Unlike previous studies that focused on identifying discrepancies in picture caption, our research suggests that over time, as we take into account the onset of incarnate biases from the three affective spheres discussed in this study, picture caption may improve among autistic children as their incarnate biases decrease.

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13. Koko M, Kyle Satterstrom F, Warrier V, Martin H. Contribution of autosomal rare and de novo variants to sex differences in autism. medRxiv. 2024.

Autism is four times more prevalent in males than females. To study whether this reflects a difference in genetic predisposition attributed to autosomal rare variants, we evaluated the sex differences in effect size of damaging protein-truncating and missense variants on autism predisposition in 47,061 autistic individuals, then compared effect sizes between individuals with and without cognitive impairment or motor delay. Although these variants mediated differential likelihood of autism with versus without motor or cognitive impairment, their effect sizes on the liability scale did not differ significantly by sex exome-wide or in genes sex-differentially expressed in the cortex. Although de novo mutations were enriched in genes with male-biased expression in the fetal cortex, the liability they conferred did not differ significantly from other genes with similar loss-of-function intolerance and sex-averaged cortical expression. In summary, autosomal rare coding variants confer similar liability for autism in females and males.

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14. Langhorne S, Uglik-Marucha N, Broadhurst C, Lieven E, Pearson A, Vitoratou S, Leadbitter K. The Knowledge of Autism Questionnaire-UK: Development and Initial Psychometric Evaluation. J Autism Dev Disord. 2024.

Tools to measure autism knowledge are needed to assess levels of understanding within particular groups of people and to evaluate whether awareness-raising campaigns or interventions lead to improvements in understanding. Several such measures are in circulation, but, to our knowledge, there are no psychometrically-validated questionnaires that assess contemporary autism knowledge suitable to the UK context. We aimed to produce a brief measure to assess between-respondent variability and within-respondent change over time. A pool of questionnaire items was developed and refined through a multi-stage iterative process involving autism experts and a lay sample. Attention was paid to face validity, clarity, consensus on correct responses, and appropriate difficulty levels. Initial validation data was obtained from a lay sample of 201 people. Difficulty and discrimination ability were assessed using item response theory and low-performing items were removed. Dimensionality was evaluated with exploratory factor analysis, which revealed a one-factor structure of the questionnaire. Further items were removed where they did not load strongly on their main factor. This process resulted in a final 14-item questionnaire called the Knowledge of Autism Questionnaire-UK. Internal consistency was satisfactory, and the final questionnaire was able to distinguish between parents of autistic people and those without an affiliation to autism. The KAQ-UK is a new, freely-available measure of autism knowledge that could be used to assess between-respondent variability and within-respondent change over time. Further evaluation and validation of its measurement properties are required.

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15. Liu F, Qiu K, Wang H, Dong Y, Yu D. Decreased wrist rotation imitation abilities in children with autism spectrum disorder. Front Psychiatry. 2024; 15: 1349879.

INTRODUCTION: While meaningless gross motor imitation (GMI) is a common challenge for children diagnosed with autism spectrum disorder (ASD), this topic has not attracted much attention and few appropriate test paradigms have been developed. METHODS: The current study proposed a wrist rotation imitation (WRI) task (a meaningless GMI assignment), and established a WRI ability evaluation system using low-cost wearable inertial sensors, which acquired the simultaneous data of acceleration and angular acceleration during the WRI task. Three metrics (i.e., total rotation time, rotation amplitude, and symmetry) were extracted from those data of acceleration and angular acceleration, and then were adopted to construct classifiers based on five machine learning (ML) algorithms, including k-nearest neighbors, linear discriminant analysis, naive Bayes, support vector machines, and random forests. To illustrate our technique, this study recruited 49 ASD children (aged 3.5-6.5 years) and 59 age-matched typically developing (TD) children. RESULTS: Findings showed that compared with TD children, those with ASD may exhibit shorter total rotation time, lower rotation amplitude, and weaker symmetry. This implies that children with ASD might exhibit decreased WRI abilities. The classifier with the naive Bayes algorithm outperformed than other four algorithms, and achieved a maximal classification accuracy of 88% and a maximal AUC value of 0.91. Two metrics (i.e., rotation amplitude and symmetry) had high correlations with the gross and fine motor skills [evaluated by Gesell Developmental Schedules-Third Edition and Psychoeducational Profile-3 (PEP-3)]. While, the three metrics had no significant correlation with the visual-motor imitation abilities (evaluated by the subdomain of PEP-3) and the ASD symptom severity [evaluated by the Childhood Autism Rating Scale (CARS)] . DISCUSSION: The strengths of this study are associated with the low-cost measurement system, correlation between the WRI metrics and clinical measures, decreased WRI abilities in ASD, and high classification accuracy.

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16. Loureiro F, Ringold SM, Aziz-Zadeh L. Interoception in Autism: A Narrative Review of Behavioral and Neurobiological Data. Psychol Res Behav Manag. 2024; 17: 1841-53.

While exteroceptive sensory processing is a hallmark of autism spectrum disorder, how interoceptive processing may impact and contribute to symptomatology remains unclear. In this comprehensive narrative review on interoception in autism, we discuss: 1) difficulties with assessing interoception; 2) potential interoceptive differences; 3) interactions between neural systems for interoception, attention, sensorimotor processing, and cognition; and 4) potential differences in neural circuits involved in interoception. In general, there are mixed findings on potential interoception differences in autism. Nevertheless, some data indicate differences in integration of interoceptive and exteroceptive information may contribute to autism symptomatology. Neurologically, interoceptive processing in autism may be impacted by potential differences in the development, morphometry, and connectivity of key interoceptive hubs (vagal processing, brainstem, thalamus, insula), though much work is needed on this topic.

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17. Malik Z. Developmental disability and obesity: Oral health implications across the lifespan. Spec Care Dentist. 2024.

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18. Maw KJ, Beattie G, Burns EJ. Cognitive strengths in neurodevelopmental disorders, conditions and differences: A critical review. Neuropsychologia. 2024; 197: 108850.

Neurodevelopmental disorders are traditionally characterised by a range of associated cognitive impairments in, for example, sensory processing, facial recognition, visual imagery, attention, and coordination. In this critical review, we propose a major reframing, highlighting the variety of unique cognitive strengths that people with neurodevelopmental differences can exhibit. These include enhanced visual perception, strong spatial, auditory, and semantic memory, superior empathy and theory of mind, along with higher levels of divergent thinking. Whilst we acknowledge the heterogeneity of cognitive profiles in neurodevelopmental conditions, we present a more encouraging and affirmative perspective of these groups, contrasting with the predominant, deficit-based position prevalent throughout both cognitive and neuropsychological research. In addition, we provide a theoretical basis and rationale for these cognitive strengths, arguing for the critical role of hereditability, behavioural adaptation, neuronal-recycling, and we draw on psychopharmacological and social explanations. We present a table of potential strengths across conditions and invite researchers to systematically investigate these in their future work. This should help reduce the stigma around neurodiversity, instead promoting greater social inclusion and significant societal benefits.

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19. McConnell K, Keenan C, Storey C, Thurston A. Video-based interventions promoting social behavioural skills for autistic children and young people: An evidence and gap map. Campbell Syst Rev. 2024; 20(2): e1405.

BACKGROUND: Video-based interventions (VBIs) are an approach that can be used to promote social behavioural skills for autistic children and young people. Despite an abundance of literature in this area, previous evidence syntheses are limited by their exclusive search strategies and eligibility criteria. Therefore, there is a lack of comprehensive evidence syntheses to provide insight on whether these interventions work, for whom, and in what circumstances. Evidence and Gap Maps (EGMs) are used to collate vast literature on a broad topic area such as this, highlighting areas for synthesis, and identifying gaps for future research. OBJECTIVES: To identify, map and synthesise existing primary research on VBIs promoting social behavioural skills for autistic children and young people, creating a live, searchable and publicly available EGM. SEARCH METHODS: Searches were conducted in electronic databases (n = 8), web search engines, and other repositories including published papers and grey literature. The search strategy was developed around two concepts including (1) terms related to autism, and (2) terms related to VBIs. Searches were conducted in May 2021. SELECTION CRITERIA: All primary studies evaluating the effectiveness of VBIs in promoting social behaviours for autistic children and young people aged 3-18 were included in the EGM. DATA COLLECTION AND ANALYSIS: Search results were imported into Eppi-Reviewer where duplicates of identical studies were removed. Titles and abstracts were then screened by two independent reviewers. Potentially eligible full texts were located and also screened by two reviewers. Data were then extracted on study design, participant characteristics, type of intervention, type of outcome, and country of study, by one of three reviewers. EPPI-Mapper was used to create the interactive EGM. MAIN RESULTS: The current EGM contains 438 studies reporting on 394 single subject research designs, 25 randomised controlled trials, 15 non-randomised group designs, and 8 pretest-posttest designs. Included studies evaluated VBIs in all male (n = 238), mixed gender (n = 172) or all female (n = 17) samples. VBIs employed included video modelling (n = 273), video self-modelling (n = 82), point-of-view modelling (n = 61), video prompting (n = 57), video feedback (n = 12) and computer-based video instruction (n = 4). The most frequently used models were adults (n = 191) and peers (n = 135). In relation to social outcomes, almost half evaluated social engagement (n = 199) with limited studies looking at safety (n = 9) and community (n = 7) skills. AUTHORS’ CONCLUSIONS: This EGM provides a valuable resource for policy-makers, practitioners, researchers, funders and members of the public to access evidence on VBIs promoting social behavioural skills in autistic children and young people. The map has identified areas of sufficient research where evidence can undergo synthesis. In addition, important gaps in the evidence were highlighted and suggest further research is warranted in all female samples and less frequently evaluated types of VBIs and social outcomes. Evidence included in this EGM will be further explored via systematic review and meta-analysis on control group designs.

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20. McDonald DQ, DeJardin E, Sariyanidi E, Herrington JD, Tunç B, Zampella CJ, Schultz RT. Predicting Autism from Head Movement Patterns during Naturalistic Social Interactions. Proc 2023 7th Int Conf Med Health Inform ICMHI 2023 (2023). 2023; 2023: 55-60.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized in part by difficulties in verbal and nonverbal social communication. Evidence indicates that autistic people, compared to neurotypical peers, exhibit differences in head movements, a key form of nonverbal communication. Despite the crucial role of head movements in social communication, research on this nonverbal cue is relatively scarce compared to other forms of nonverbal communication, such as facial expressions and gestures. There is a need for scalable, reliable, and accurate instruments for measuring head movements directly within the context of social interactions. In this study, we used computer vision and machine learning to examine the head movement patterns of neurotypical and autistic individuals during naturalistic, face-to-face conversations, at both the individual (monadic) and interpersonal (dyadic) levels. Our model predicts diagnostic status using dyadic head movement data with an accuracy of 80%, highlighting the value of head movement as a marker of social communication. The monadic data pipeline had lower accuracy (69.2%) compared to the dyadic approach, emphasizing the importance of studying back-and-forth social communication cues within a true social context. The proposed classifier is not intended for diagnostic purposes, and future research should replicate our findings in larger, more representative samples.

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21. Međaković J, Čivljak A, Zorčec T, Vučić V, Ristić-Medić D, Veselinović A, Čivljak M, Puljak L. Perceptions on support, challenges and needs among parents and caregivers of children with developmental disabilities in Croatia, North Macedonia and Serbia: a cross-sectional study. BMC Pediatr. 2024; 24(1): 297.

BACKGROUND: Parents/caregivers of children with developmental disabilities (CDD) have a wide range of support needs and there are various interventions available. Support, challenges, and needs among parents/caregivers of CDD likely vary in different geographical settings. This study aimed to analyze the perceptions of support, challenges, and needs among parents/caregivers of CDD in Croatia, North Macedonia, and Serbia. METHODS: We conducted a cross-sectional study in March-April 2023 within the Erasmus + SynergyEd project. The eligible participants were parents and caregivers of CDD in Croatia, North Macedonia, and Serbia, who filled out a modified Caregiver Needs Survey online. RESULTS: Among 953 participants, 542 (57%) were from Croatia, 205 (21%) were from North Macedonia and 206 (22%) were from Serbia. The most common diagnosis of participants’ children was autism spectrum disorder (26%). The child most often received the first diagnosis at the median of 2 years, diagnosed by a team of professionals. More than half (58%) of children attended preschool and public school, while 22% did not attend any schooling. Additional support from the state/city/county was received by 66% of CDD. Most participants declared not participating in association/organization for family support. Participants mostly (68%) used experts who work with the child as a source of information about their child’s condition, followed by the Internet (53%). In the last 12 months, 60% of participants had difficulties with the availability of services in their area or problems getting appointments. The biggest problem in getting support was ensuring the child’s basic rights were protected. Participants stated that ensuring greater rights for CDD was the greatest need for their families. CONCLUSION: Parents/caregivers of CDD in Croatia, North Macedonia, and Serbia faced multiple challenges, but most of them were satisfied with the services provided to their children. Future efforts to develop policies and services related to CDD should consider the opinions of their parents/caregivers and disparities in access to services.

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22. Modirrousta A, Harris YR. Parental strategies to promote theory of mind development in autistic children of color. Front Psychol. 2024; 15: 1347504.

INTRODUCTION: Autism Spectrum Disorder is characterized by an impaired ability to take other people’s perspectives, which is known as theory of mind. However, little is known about how theory of mind exhibits itself in autistic children of color and how parents foster their child’s developmental skills in communities of color. METHODS: Two interviews were created to assess how parents appraise their child’s developmental skills and help their child grow: a perspective-teaching interview and a general developmental skills interview. Four families participated in the study; three children were African American or mixed, while one had an Asian mother. Parents were asked how their child exhibited various developmental skills and how they helped their child with those milestones. RESULTS: Parents pointed at similar delays in theory of mind and other developmental skills, such as turn-taking and reading faces. They also provided similar strategies to teach those abilities, such as modeling and reinforcements. Several insights and common themes were found regarding autistic behaviors their children expressed and how those affected their parenting experiences. DISCUSSION: These findings allow for a better understanding of parents’ experiences raising autistic children of color; future research could expand on their stories and create interventions tailored to these underrepresented communities.

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23. Morais S, d’Almeida OC, Caldeira S, Meneses S, Areias G, Girão V, Bettencourt C, Pereira DJ, Macedo A, Castelo-Branco M. Executive function in schizophrenia and autism in adults shares common components separating high and low performance groups. Front Psychiatry. 2024; 15: 1381526.

The profile of executive function (EF) in adults with Schizophrenia (SCZ) and autism spectrum disorder (ASD) remains unclear. This study aims to ascertain if distinct EF patterns can be identified between each clinical condition by comparing the neuropsychological profile of adults with SCZ and ASD, for whom the differential diagnosis is still highly challenging. Forty-five individuals (15 SCZ, 15 ASD, 15 controls) matched for age, sex, education level, and handedness underwent intelligence evaluation and neuropsychological testing for working memory, inhibition, planning and set-shifting, and verbal fluency subdomains. Principal component analysis (2D-PCA) using variables representing 4 domains was employed to identify patterns in neuropsychological profiles. The ASD group had lower scores on the Digits Forward subtest compared to the SCZ group (7.2 ± 2.1 vs. 9.3 ± 1.9, p = 0.003; Cohen’s d: 1.05). ASD also performed significantly worse on the Stroop Word Test compared to the control group (77.7± 17.9 vs. 98.0 ± 12.7, p = 0.009; Cohen’s d: 1.31). No significant differences were observed between ASD and SCZ on other EF measures. The larger contributors for the dimensions in 2D-PCA were the Digits Forward subtest and Stroop Word Test. Still, there was substantial overlap between the clinical groups. This study suggests a high degree of similarity of EF between SCZ and ASD. Through four EF measures, the discrimination of low and high-functioning EF groups spanning both diagnostic categories may help to identify the individuals who could better benefit from cognitive rehabilitation strategies.

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24. O’Sharkey K, Mitra S, Paik SA, Chow T, Cockburn M, Ritz B. Trends in the Prevalence of Autism Spectrum Disorder in California: Disparities by Sociodemographic Factors and Region Between 1990-2018. J Autism Dev Disord. 2024.

Autism Spectrum Disorders (ASD) prevalence has risen globally, with regional variation and sociodemographic disparities affecting diagnosis and intervention. This study examines ASD trends from 1990 to 2018 in California (CA), focusing on sociodemographic factors that may inform policy/interventions. Using CA Department of Public Health birth records (1990-2018) and Developmental Services ASD cases (1994-2022), we analyzed diagnosis incidence by age 4 or 8, stratified by sociodemographic and regional factors. From 1990 to 2018, for each birth year the cumulative incidence of ASD by 4 and 8 years of age in CA increased while the diagnosis age decreased. Distinct patterns emerged over these three decades. Children born to White and Asian and Pacific Islander (API) mothers, or to mothers with higher education or living in high socioeconomic status (SES) neighborhoods exhibited higher ASD cumulative incidences throughout the 1990s and early 2000s. However, in the mid-2000s, ASD incidence in children born to Black or Hispanic mothers, with low education, or living in low SES neighborhoods surpassed that of White/API children or those living in high SES neighborhoods. Black or Hispanic children now have the highest ASD cumulative incidence, even though age at first diagnosis remains lowest in high SES regions, for the highly educated, and for White/API children. ASD cumulative incidence in CA from 1990 to 2018 exhibited demographic reversals with higher rates in children born to Black or Hispanic mothers or lower SES neighborhoods. Black and Hispanic children still have delayed age at diagnosis compared to White/API children.

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25. Pardo-Salamanca A, Rosa-Martínez E, Gómez S, Santamarina-Siurana C, Berenguer C. Parenting Stress in Autistic and ADHD Children: Implications of Social Support and Child Characteristics. J Autism Dev Disord. 2024.

High levels of parenting stress have been detected in mothers of children with Autism (ASD) and children with attention deficit hyperactivity disorder (ADHD) comparing with mothers of typically developing (TD) children. The current study explored the implications of social support (confidant and affective support) and child characteristics (emotional, behavioral and sleep problems) on parenting stress in ASD and ADHD. Furthermore, the differences between mothers of children with autism, ADHD and TD on the studied variables were examined.A total of 120 mothers of 30 TD children, 47 with ASD without intellectual disability and 43 with ADHD collaborated in the study. Significant differences were found between clinical and TD groups in parenting stress, social support, and child characteristics.Correlation analysis in the group with ADHD revealed that parental stress correlated significantly with social support and with children’s emotional problems. In the ASD group, parental stress also correlated significantly with children’s sleep and behavioral problems. Moreover, multiple regressions showed that confidant support was a significant predictor of parenting stress in both clinical groups.The findings provide new insights to consider social support as a fundamental part of treatments for parenting stress in mothers of children with ASD and ADHD.

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26. Reza Naghdi M, Ahadi R, Motamed Nezhad A, Sadat Ahmadi Tabatabaei F, Soleimani M, Hajisoltani R. The neuroprotective effect of Diosgenin in the rat Valproic acid model of autism. Brain Res. 2024: 148963.

BACKGROUND AND AIM: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with two core behavioral symptoms restricted/repetitive behavior and social-communication deficit. The unknown etiology of ASD makes it difficult to identify potential treatments. Valproic acid (VPA) is an anticonvulsant drug with teratogenic effects during pregnancy in humans and rodents. Prenatal exposure to VPA induces autism-like behavior in both humans and rodents. This study aimed to investigate the protective effects of Diosgenin in prenatal Valproic acid-induced autism in rats. METHOD: pregnant Wister female rats were given a single intraperitoneal injection of VPA (600 mg/kg, i.p.) on gestational day 12.5. The male offspring were given oral Dios (40 mg/kg, p.o.) or Carboxymethyl cellulose (5 mg/kg, p.o.) for 30 days starting from postnatal day 23. On postnatal day 52, behavioral tests were done. Additionally, biochemical assessments for oxidative stress markers were carried out on postnatal day 60. Further, histological evaluations were performed on the prefrontal tissue by Nissl staining and Immunohistofluorescence. RESULTS: The VPA-exposed rats showed increased anxiety-like behavior in the elevated plus maze (EPM). They also demonstrated repetitive and grooming behaviors in the marble burying test (MBT) and self-grooming test. Social interaction was reduced, and they had difficulty detecting the novel object in the novel object recognition (NOR) test. Also, VPA-treated rats have shown higher levels of oxidative stress malondialdehyde (MDA) and lower GP(X), TAC, and superoxide dismutase (SOD) levels. Furthermore, the number of neurons decreased and the ERK signaling pathway upregulated in the prefrontal cortex (PFC). On the other hand, treatment with Dios restored the behavioral consequences, lowered oxidative stress, and death of neurons, and rescued the overly activated ERK1/2 signaling in the prefrontal cortex. CONCLUSION: Chronic treatment with Dios restored the behavioral, biochemical, and histological abnormalities caused by prenatal VPA exposure.

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27. Suresh H, Morgan BR, Mithani K, Warsi NM, Yan H, Germann J, Boutet A, Loh A, Gouveia FV, Young J, Quon J, Morgado F, Lerch J, Lozano AM, Al-Fatly B, Kühn AA, Laughlin S, Dewan MC, Mabbott D, Gorodetsky C, Bartels U, Huang A, Tabori U, Rutka JT, Drake JM, Kulkarni AV, Dirks P, Taylor MD, Ramaswamy V, Ibrahim GM. Postoperative cerebellar mutism syndrome is an acquired autism-like network disturbance. Neuro Oncol. 2024; 26(5): 950-64.

BACKGROUND: Cerebellar mutism syndrome (CMS) is a common and debilitating complication of posterior fossa tumor surgery in children. Affected children exhibit communication and social impairments that overlap phenomenologically with subsets of deficits exhibited by children with Autism spectrum disorder (ASD). Although both CMS and ASD are thought to involve disrupted cerebro-cerebellar circuitry, they are considered independent conditions due to an incomplete understanding of their shared neural substrates. METHODS: In this study, we analyzed postoperative cerebellar lesions from 90 children undergoing posterior fossa resection of medulloblastoma, 30 of whom developed CMS. Lesion locations were mapped to a standard atlas, and the networks functionally connected to each lesion were computed in normative adult and pediatric datasets. Generalizability to ASD was assessed using an independent cohort of children with ASD and matched controls (n = 427). RESULTS: Lesions in children who developed CMS involved the vermis and inferomedial cerebellar lobules. They engaged large-scale cerebellothalamocortical circuits with a preponderance for the prefrontal and parietal cortices in the pediatric and adult connectomes, respectively. Moreover, with increasing connectomic age, CMS-associated lesions demonstrated stronger connectivity to the midbrain/red nuclei, thalami and inferior parietal lobules and weaker connectivity to the prefrontal cortex. Importantly, the CMS-associated lesion network was independently reproduced in ASD and correlated with communication and social deficits, but not repetitive behaviors. CONCLUSIONS: Our findings indicate that CMS-associated lesions may result in an ASD-like network disturbance that occurs during sensitive windows of brain development. A common network disturbance between CMS and ASD may inform improved treatment strategies for affected children.

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28. Wang H, Jing H, Yang J, Liu C, Hu L, Tao G, Zhao Z, Shen N. Identifying autism spectrum disorder from multi-modal data with privacy-preserving. Npj Ment Health Res. 2024; 3(1): 15.

The application of deep learning models to precision medical diagnosis often requires the aggregation of large amounts of medical data to effectively train high-quality models. However, data privacy protection mechanisms make it difficult to perform medical data collection from different medical institutions. In autism spectrum disorder (ASD) diagnosis, automatic diagnosis using multimodal information from heterogeneous data has not yet achieved satisfactory performance. To address the privacy preservation issue as well as to improve ASD diagnosis, we propose a deep learning framework using multimodal feature fusion and hypergraph neural networks for disease prediction in federated learning (FedHNN). By introducing the federated learning strategy, each local model is trained and computed independently in a distributed manner without data sharing, allowing rapid scaling of medical datasets to achieve robust and scalable deep learning predictive models. To further improve the performance with privacy preservation, we improve the hypergraph model for multimodal fusion to make it suitable for autism spectrum disorder (ASD) diagnosis tasks by capturing the complementarity and correlation between modalities through a hypergraph fusion strategy. The results demonstrate that our proposed federated learning-based prediction model is superior to all local models and outperforms other deep learning models. Overall, our proposed FedHNN has good results in the work of using multi-site data to improve the performance of ASD identification.

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29. Wang Y, Guo D, Wang M, Hu M, Zhu D, Yu Q, Li Z, Zhang X, Ding R, Zhao M, He P. Correction: Community-based integrated care for patients with diabetes and depression (CIC-PDD): study protocol for a cluster randomized controlled trial. Trials. 2024; 25(1): 295.

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30. Wu T, Yin X, Xu L, Yu J. Using dynamic spatio-temporal graph pooling network for identifying autism spectrum disorders in spontaneous functional infrared spectral sequence signals. J Neurosci Methods. 2024: 110157.

BACKGROUND: Autism classification work on fNIRS data using dynamic graph networks. Explore the impact of the dynamic connection relationship between brain channels on ASD, and compare the brain channel connection diagrams of ASD and TD to explore potential factors that influence the development of autism. METHOD: Using dynamic graph construction to mine the dynamic relationships of fNIRS data, obtain spatio-temporal correlations through dynamic feature extraction, and improve the information extraction capabilities of the network through spatio-temporal graph pooling to achieve classification of ASD. RESULT: A classification effect with an accuracy of 97.2% was achieved using a short sequence of 1.75s. The results showed that the dynamic connections of channel 5 and 19, channel 12 and 25, and channel 7 and 34 have a greater impact on the classification of autism. Comparison with previously used method(s): Compared with previous deep learning models, our model achieves efficient classification using short-term fNIRS data of 1.75s, and analyzes the impact of dynamic connections on classification through dynamic graphs. CONCLUSION: Using Dynamic Spatio-Temporal Graph Pooled Neural Networks (DSTGPN), dynamic connectivity between brain channels was found to have an impact on the classification of autism. By modelling the brain channel relationship maps of ASD and TD, hyperlink clusters were found to exist on the brain channel connections of ASD.

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31. Zarokanellou V, Papagiannopoulou E, Gryparis A, Siafaka V, Tafiadis D, Ntre V, Ziavra N. Healthcare Students’ Perceptions and Attitudes Towards Peers with Autism Spectrum Disorders. J Autism Dev Disord. 2024.

PURPOSE: The present study investigates healthcare students’ affective, behavioral, and cognitive attitudes toward hypothetical peers with autism spectrum disorder (ASD) and the effect of the ASD label on their attitudes. METHODS: The MAS scale for ASD persons in the postsecondary education (Matthews et al., 2015) was translated and adapted in Greek according to the guidelines of World Health Organization (2016). Participants (n = 444) were randomly divided into three equal groups and completed their demographic information. Each participant read the three vignettes of the Greek-adapted MAS scale describing a communicative interaction with one hypothetical fellow student with autistic characteristics in three different social situations but in each group, the vignette’s character was labeled differently (High-functioning, typical college student, and no-label). RESULTS: Students in the High-functioning group demonstrated more positive affective, behavioral, and cognitive attitudes toward the vignette characters than students in the no-label condition. Furthermore, students in the typical student group reported more rejective behaviors toward the vignette characters than students in the high-functioning group, implying that atypical behavior evokes rejection and stigmatization, while the label did not. Male students presented more positive cognitive attitudes across study groups in comparison to female students, while previous contact with individuals with ASD did not seem to impact significantly attitudes. CONCLUSION: The findings of the study indicate that knowledge of an ASD diagnosis leads to greater acceptance and have important implications for future research, disability policy makers, and university support services.

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32. Zhang Z, Zhu Q, Gao T, Gan K, Wang F, Guan L, Ke X. Cross-Cultural Generalizability of the First Year Inventory for Early ASD Screening in China. J Autism Dev Disord. 2024.

The First Year Inventory (FYI) is a parent report screening measure, aimed at identifying the risk of autism spectrum disorder (ASD) in 12-month-old infants. This study aimed to investigate the utility of FYI within the Chinese community and develop a short version, encompassing both a low-risk sample and a high-risk sample comprising infants with older siblings diagnosed with ASD. Parents of 53 high-risk (HR) infants and 519 low-risk (LR) infants, aged 11 to 13 months, were recruited. After comparing response distributions across Chinese and American samples, a new factorial structure was developed according to the factor analyses. The construct validity and internal consistency of the two FYI versions were examined. The implementation of FYI in the HR sample was also assessed. Noteworthy disparities in response distribution were observed between the Chinese and American samples. Both FYI 2.0 and the FYI short version demonstrated moderate construct validity and internal consistency, with the FYI short version exhibiting better predictive ability in the HR sample. Significant lower risk scores was observed in the HR sample compared to the LR sample. These findings substantiate the applicability and validity of the Chinese short version of FYI. Future research should include follow-up assessments with the Chinese sample to evaluate cutoff scores, considering the cutoff between sensitivity and specificity and the sample?s characteristics.

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