1. Aishworiya R, Chin HL, Savulescu J. Should newborn genetic testing for autism be introduced?. J Med Ethics;2024 (Dec 3)

This manuscript provides a review of the potential role of newborn genetic testing for autism, and whether the state has an inherent responsibility to facilitate and subsidise this. This is situated within the broader construct of benefits and limitations of genetic testing currently. Potential benefits of such presymptomatic genetic testing include facilitating earlier diagnosis and access to appropriate intervention which can improve the treatment outcome for the child and indirectly benefit caregivers and society by reducing the care needs of the child and adult in future. However, there are several limitations to newborn genetic testing including the variable penetrance of ‘autism-risk’ genes, marked phenotypic heterogeneity of autism, real-world limitations in access to treatment, potential psychological harm to caregivers and financial considerations. We hence argue for facilitation of diagnostic genetic testing instead, especially for parents who seek to have greater understanding of recurrence likelihoods, related to reproductive decision-making. Facilitation of such testing can be in the form of both financial subsidies and infrastructural elements including availability of testing facilities and trained healthcare personnel for individualised pregenetic and postgenetic test counselling.

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2. Alacabey NA, Coşkun D, Çeribaşi S, Ateşşahin A. Correction: Effects of Boron on Learning and Behavioral Disorders in Rat Autism Model Induced by Intracerebroventricular Propionic Acid. Biol Trace Elem Res;2024 (Dec 3)

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3. Bonino AY, Goodwich SF, Mood D. Prevalence and Characteristics of Developmental Disabilities Among Children Who Receive Hearing Health Care. Am J Audiol;2024 (Dec 3):1-12.

PURPOSE: We aim to determine the prevalence and characteristics of developmental disabilities among the clinical population of children who receive hearing health care in the United States. METHOD: Using electronic health records of 131,709 children (0-18 years), we identified those with a diagnosis of attention deficit/hyperactivity disorder, autism spectrum disorder, vision differences, cerebral palsy, chromosomal abnormalities, delayed milestones, Down syndrome, or intellectual disability. We determined prevalence, age of first audiology encounter, age of diagnosis for the developmental disability, and hearing status based on the specific disability and the number of diagnoses. Binomial and multinomial logistic regressions were performed. RESULTS: One in four children had a diagnosed developmental disability. The most common disabilities were delayed milestones (11.3%), vision differences (7.4%), attention-deficit/hyperactivity disorder (6.6%), and autism spectrum disorder (6.2%). Half of the children with developmental disabilities had at least one diagnosis before their first audiology encounter. Children with developmental disabilities were more likely to have a reduced hearing or an unknown hearing status than children without developmental diagnoses. For children with reduced hearing, those with developmental disabilities had higher rates of bilateral configurations and poorer hearing severity levels. CONCLUSIONS: Developmental disabilities are common among children who seek hearing health care. Moreover, developmental disabilities often co-occur with reduced hearing. Further research and advocacy efforts are critical for creating clinical practices that are inclusive of, and equitable for, children with complex and diverse developmental profiles. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.27857847.

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4. Buehler R, Ansorge U, Silani G. Social attention in the wild – fixations to the eyes and autistic traits during a naturalistic interaction in a healthy sample. Sci Rep;2024 (Dec 3);14(1):30102.

Attention to social stimuli is a key component of social behavior and facilitates the development of fundamental social skills. Studies investigating social attention in neurotypical or neurodiverse populations have often relied on screen-based experiments using static images or videos, which lack the sensory richness and reciprocity present in real-life social interactions. This can possibly be attributed to the challenges one encounters when creating naturalistic experiments, such as dealing with dynamically moving areas of interest (AOIs), which require either time-intensive manual coding or restraining of participants. Here, we present findings from an experimental paradigm using unrestrained mobile eye-tracking and a face detection algorithm (MTCNN) to measure fixation rates during a semi-structured, face-to-face interview. Data from N = 62 healthy adult participants was analyzed for gaze behavior and related to participants’ autistic traits. We observed a significant negative correlation between fixation rates on the eye region averaged over the entire interaction and scores on the autism spectrum quotient (AQ) (r = -0.14), indicating participants with high autistic traits fixated less frequently on the eye region. We also compared different types of interview questions (open vs. closed) to explore whether the reduction in fixation rates was more pronounced for specific time intervals during the interview. Lastly, we discuss both possibilities for extensions as well as limitations of the presented paradigm that could serve as inspiration for future research.

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5. Cardillo R, Marino C, Collini M, Vieno A, Spada MM, Mammarella IC. Browsing problematic social media use in autism spectrum disorder: The role of social anxiety. Addict Behav;2024 (Dec 3);162:108225.

Accessing the Internet is one of the most frequent free-time activities among autistic and non-autistic adolescents. Autistic individuals may experience communicative benefits from using the Internet. However, they may also be at risk of developing Problematic Social Media Use (PSMU). To date, PSMU in autistic adolescents remains underinvestigated, and no research has analyzed the role of emotional correlates. The present study aims to investigate possible differences in terms of PSMU comparing autistic participants to their non-autistic peers, and examine the role of two dimensions of social anxiety (i.e., humiliation/refusal and performance anxiety) as reported by both children and parents in worsening the levels of PSMU. A total of 183 participants (76 on the autism spectrum), aged (8-17 years) participated in the study. Questionnaires on social media use and on social anxiety were administered. Moreover, parents of the participants were asked to complete a questionnaire related to their children’s social anxiety. Results showed similar levels of PSMU across the two groups. However, a different pattern of relationships between PSMU and age, and the two dimensions of social anxiety was observed in autistic adolescents as compared to the non-autistic peers, revealing that individual characteristics and specific social anxiety beliefs might be relevant to understanding PSMU in autism. The clinical and preventive implications of these findings are discussed.

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6. Chowdhury M, Gould M, Ganti L. Advances in Autism: a bibliometric analysis. Health Psychol Res;2024;12:125844.

This paper provides a comprehensive overview of AI treatment research for Autism Spectrum Disorder (ASD) from 2007 to 2023, focusing on global contributions across countries, institutions, authors, and keywords. The United States leads with 164 documents and 4988 citations, highlighting its central role in advancing AI technologies for ASD therapies, followed by significant contributions from China (90 documents, 1190 citations) and India (65 documents, 564 citations). Institutions like Stanford University and McGill University demonstrate substantial research output, while authors such as Dennis Wall are prominent with contributions that make diagnosing Autism much more efficient with the use of AI. Keywords like « Machine learning », « Autism spectrum disorder », and « Children » dominate, reflecting ongoing efforts to leverage technology for ASD interventions. Overall, this analysis underscores a dynamic global effort to enhance ASD treatment methodologies through collaborative research and technological innovations.

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7. Drye M, Banarjee C, Perry L, Viggiano A, Irvin D, Messinger D. Children’s social preference for teachers versus peers in autism inclusion classrooms: An objective perspective. Autism Res;2024 (Dec 3)

In inclusive preschools, children with autism spectrum disorder (ASD) and other developmental disabilities (DD) are less socially engaged with peers than are typically developing (TD) children. However, there is limited objective information describing how children with ASD engage with teachers, or how teacher engagement compares to engagement with peers. We tracked over 750 hours’ worth of children’s (N = 77; N(ASD) = 24, N(DD) = 23, N(TD) = 30; M(age) = 43.98 months) and teachers’ (N = 12) locations and orientations across eight inclusion preschool classrooms to quantify child-teacher and child-peer social preference. Social approach velocity and time in social contact were computed for each child and compared across social partners to index children’s preference for teachers over peers. Children with ASD approached teachers–but not peers-more quickly than children with TD, and children with ASD were approached more quickly by teachers and more slowly by peers than children with TD. Children with ASD spent less time in social contact with peers and did not differ from children with TD in their time in social contact with teachers. Overall, children with ASD showed a greater preference for approaching, being approached by, and being in social contact with teachers (relative to peers) than children with TD. No significant differences emerged between children with DD and children with TD. In conclusion, children with ASD exhibited a stronger preference for engaging with teachers over peers, re-emphasizing the need for classroom-based interventions that support the peer interactions of children with ASD.

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8. Fezza JI, Rau S, Clary L, Nimene Johnson O, Fimmel F, Barber J, Kanakatti Shankar R. Spectrum of neuropsychological challenges in Turner syndrome. Front Endocrinol (Lausanne);2024;15:1461103.

INTRODUCTION: Turner syndrome (TS) is associated with significant neuropsychological challenges, and screening is recommended at key transition stages. Our goal was to describe the institutional experience of formal neuropsychological assessments in TS and assess differences by karyotype. METHODS: Data were abstracted by retrospective chart review of completed assessments between January 1, 2019, and October 31, 2022, referred from the newly established multidisciplinary clinic, and descriptive statistical analyses were presented (SAS V9.4). RESULTS: Of 114 patients, 38 (33%) had completed neuropsychological assessment at a median age of 11.3 years (IQR 6.5-14.9). Median full-scale IQ (FSIQ) was lower in those with a 45,X karyotype compared with other karyotypes (p = 0.027) but did not meet statistical significance at the adjusted significance level for multiple comparisons. Lower median non-verbal IQ [performance intelligence quotient (PIQ)] relative to verbal IQ (VIQ) was observed. Diagnoses of attention-deficit hyperactivity disorder (ADHD) (26%) and anxiety disorder (26%) were common followed by specific learning disorder (mathematics; 18%) and autism spectrum disorder (16%). DISCUSSION: The prevalence of neuropsychological abnormalities in our diverse clinic underscores the importance of early and routine neuropsychological testing in TS.

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9. Granana N, Astorino F, Richaudeau A, Costa L, Fernandez de Carrera E, Nanclares V, Sohl K. The Brief Observation of Symptoms of Autism: Validation study in a Latin American sample. Autism;2024 (Dec 3):13623613241291098.

Autism spectrum disorder is a complex condition associated with significant impairments in social communication and behavioral functioning. Diagnosis is dependent on clinician expertise, gathering of developmental history, and observation of specific behaviors. The suggested protocols include tools rendered invalid during the pandemic, which created significant barriers for diagnostic assessments. Furthermore, there are additional barriers in low-income countries in access to screening tools and standardized diagnostic tests for autism spectrum disorders that were only exacerbated during COVID-19. The Brief Observation of Symptoms of Autism instrument was developed to improve access to diagnostic assessment via telehealth during this time. The current study sought to validate the use of the Brief Observation of Symptoms of Autism within two Latin American countries. A sample of 313 children and adults from Argentina and Chile were examined. Results showed valid sensitivity and specificity scores with good fit across modules using two factors (i.e. Social Affect and Restricted, Repetitive Behaviors). Preliminary results of the current study demonstrated that the Brief Observation of Symptoms of Autism is a valid instrument for Latin American population and shows promise to be used beyond the pandemic to ease the diagnostic process. This is a collaborative work with BRINCAR Parent Association, who defined the need in our country to run the validation of Brief Observation of Symptoms of Autism and gave us support as the stakeholders at Lancet Commission.

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10. Jiang J, Zhang L, Wu D, Zhao D, Ying S, Ding S. Lipopolysaccharide induces neuroinflammation in a valproic acid male model of autism. Brain Res Bull;2024 (Nov 30):111154.

BACKGROUND: Autism spectrum disorders (ASD) are characterized by social skill deficits and behavior impairments. Exposure to valproic acid (VPA) has been linked to ASD in humans and ASD-like behaviors in rodents. Clinical evidence suggests that immunological damage can worsen ASD symptoms in humans. OBJECTIVE: This study aimed to investigate the potential of lipopolysaccharide (LPS) to induce neuroinflammation in a VPA-induced autism male model. MATERIALS: and methods: Pregnant Sprague Dawley rats were injected with 500mg/kg of VPA on gestational day 12.5 to create an ASD rat model in their offspring. Male offspring from VPA-injected group received 10mg/kg of LPS on postnatal day 20. Immunohistochemistry, western blotting, and immunofluorescence were used to assess the expression of NF-κB signaling pathway-related proteins and microglia in the prefrontal cortex and hippocampus. Gene Ontology and pathway enrichment analyses were conducted to predict the function of key synaptic proteins, which were further validated through real-time polymerase chain reaction analysis. RESULTS: The results showed that VPA exposure led to increased locomotor activity, social impairment, and repetitive behaviors in male rats. NF-κB signaling pathway-related proteins were upregulated, and microglial numbers were elevated in the VPA-induced group. Furthermore, synaptic dysfunction was observed in the brains of offspring exposed to VPA. Importantly, LPS administration exacerbated autism-related behaviors in VPA-exposed male rats by promoting NF-κB signaling pathway activation, increasing microglial numbers, and downregulating key synaptic proteins. CONCLUSIONS: This study not only contributed to understanding the importance of the NF-κB signaling pathway, microglia, and synaptic proteins in the progression of ASD, but also identified that LPS induces neuroinflammation in a valproic acid-induced male model of autism.

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11. Lievore R, Mammarella IC. Trait and state mathematics anxiety in autistic and non-autistic school-aged boys. Autism;2024 (Dec 3):13623613241299881.

Autistic children and adolescents may encounter difficulties at school, especially in mathematics, experiencing a pattern of negative feelings, distress, and concerns, which has been called mathematics anxiety. We asked 110 boys (50 autistic, 60 non-autistic) aged between 8 and 16 years old to report their feelings toward mathematics. Specifically, we asked them to fill in a questionnaire on their levels of mathematics anxiety at school and to report their emotional (valence, arousal) and cognitive (perception of competence, worries) responses before and after completing a mathematical task with time pressure. Mathematics anxiety might be an important factor to consider when assessing academic functioning of autistic children and adolescents, to understand whether it can interfere with their school success and well-being. In our sample, no significant group differences emerged for mathematics anxiety experienced at school. However, autistic children and adolescents performed worse in the timed math test than non-autistic peers. Regarding emotional and cognitive factors, lower valence, higher arousal, and higher worries were reported by the autistic participants compared with non-autistic peers. No group differences emerged for perception of competence. Teachers and clinicians should be aware that time pressure could be a negative factor in terms of proficiency and worries in autistic children and adolescents. Furthermore, it is essential to discourage the development of resignation toward academic learning and to improve positive feelings, self-esteem, and self-awareness for a more supportive learning environment.

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12. McLay LK, Schluter PJ, Williams J, Anns F, Monk R, Dacombe J, Hogg G, Tupou J, Ruhe T, Scott T, Woodford E, Thabrew H, Bowden N. Health service utilization among autistic youth in Aotearoa New Zealand: A nationwide cross-sectional study. Autism;2024 (Dec 3):13623613241298352.

Autistic youth generally use healthcare services more often than non-autistic youth. However, we know very little about the factors that can affect health service use and the types of services that are used, and this has not been explored in Aotearoa New Zealand. We analysed data from New Zealand to compare health service use among autistic and non-autistic youth (0 to 24-year-olds). Data were available for 19,479 autistic youth and 1,561,278 non-autistic youth. We compared hospitalizations, specialist visits, emergency department visits and use of different types of medications. In this study, autistic youth were found to have been hospitalized for medical and mental health reasons, more often than non-autistic youth. Autistic youth were also more likely to have attended specialist appointments and to have been given medication. These differences were particularly large for medications commonly used for mental health conditions (e.g. anxiety, depression, attention deficit hyperactivity disorder) or associated symptoms. Autistic youth who also had an intellectual disability were more likely to use healthcare services for physical health conditions, but were less likely to use mental health services, when compared with autistic youth who did not have an intellectual disability. These findings, along with other research, suggest that the healthcare needs of autistic youth are not always being met. Further work is needed to enhance our understanding of co-occurring conditions among autistic youth, including those that result in high rates of health service use, in order to inform the development of healthcare services and training for healthcare professionals to better cater to the needs of autistic youth.

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13. Mgaieth F, Palmer M, Charman T, Simonoff E. Facing Change and Uncertainty: Lessons Learned from Autistic Children and their Families During the COVID-19 Pandemic. J Autism Dev Disord;2024 (Dec 2)

The COVID-19 pandemic presented a great challenge for individuals around the globe, and particularly for vulnerable populations such as autistic children. This qualitative study explored the experience of autistic children (both verbal and minimally verbal) and their families during the pandemic in August-October 2020 through the lens of 18 parents recruited from an opportunistic follow-up of a randomized controlled trial. Findings revealed that the pandemic was detrimental to the mental health of most parents. School closures, disrupted routines and concerns of the virus were believed by parents to be particularly responsible for increased in their child’s behaviour that challenges and anxiety, resulting in changes in acquired skills and development of tics for some. However, other parents reported that increased one-to-one interaction with their child improved their social interaction and communication. Additionally, families felt more able to cope with the situation when supported by their partner, support services and schools. The findings highlight the challenges and benefits experienced by families with an autistic child during the pandemic. They provide valuable insights into potential areas that warrant attention when preparing for future emergencies. Enhancing our ability to respond to the needs of autistic children and their families, and establishing policies that can support their well-being should be prioritised to effectively address future challenges.

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14. Pickles K, Houdmont J, Smits F, Hill B. ‘Part of the team as opposed to watching from the outside’: Critical incident study of autistic veterinary surgeons’ workdays. Vet Rec;2024 (Dec 2):e4957.

BACKGROUND: Autistic individuals experience differences in sensory processing, communication and executive function, which may affect their experience of the workplace. We investigated UK-based autistic clinical veterinary surgeons’ experiences to establish contributing factors to a good or difficult workday. METHODS: Purposive sampling was used to conduct semi-structured qualitative interviews with 15 autistic veterinary surgeons. A critical incident technique was applied to explore the characteristics of a good and a difficult workday. Reflexive thematic analysis was used to identify recurrent themes and sub-themes in the narratives. RESULTS: Five major themes were identified as contributing to a difficult workday for autistic veterinarians: professional interactions, feeling out of control, the physical environment, role-specific challenges and self-doubt. Four overarching themes were identified as being associated with a good workday: positive interactions, feeling in control, having enough time and a sense of achievement. LIMITATIONS: As this is a qualitative study with a small number of participants, the extent to which these findings reflect the experience of the wider autistic veterinary surgeon community is unclear. CONCLUSION: Strategies to mitigate the effect of the most cited factors leading to difficult workdays, centring around neurodiversity awareness of colleagues and control of work, are likely to be helpful to autistic veterinary surgeons.

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15. Sachse C, Jacob R. Optimizing Dental Care for Adults With Intellectual and Developmental Disabilities: Challenges, Strategies, and Preventative Approaches. Cureus;2024 (Nov);16(11):e72871.

Individuals with intellectual and developmental disabilities (IDD) often face numerous barriers to dental care, leading to higher rates of untreated caries and periodontal disease. This editorial explores the challenges associated with dental care for individuals with intellectual disabilities and suggests methods to enhance their dental care. Preventive dental care is crucial for maintaining health. Recommendations, mirroring those for the general population, include brushing and flossing teeth twice daily, biannual dental cleanings, and adopting a diet low in acids and added sugars. Specialized toothbrushes with larger handles have been designed to improve daily cleanings and water flossers may be preferred over traditional flossing. Regular observation of independent tooth brushing habits and daily reminders by caretakers contribute to effective plaque removal. Sealants should be placed routinely for additional cavity protection. Patients with IDD may face challenges in practicing ideal preventive care due to oral sensitivity or motor limitations. Caretakers should discuss these challenges to explore feasible adjustments in dental hygiene routines or utensils. When adjustments are not possible, strict dietary control may improve dental outcomes. Sensitivities related to foods may align with dental care sensitivities, necessitating collaboration with occupational therapists and nutritionists to balance nutritional needs while limiting sugary foods. Dental visits often cause anxiety for individuals with IDD. Studies suggest that conscious sedation, commonly using nitrous oxide, is sufficient for cleanings and minor procedures. Seeking a dentist familiar with caring for patients with IDD can provide additional guidance and care. For those who become edentulous, malnutrition is a common outcome. Dentures are a viable solution, but individuals with IDD may require extra counseling to understand the benefits and risks. Dentures, while effective, pose a choking hazard, which can be mitigated by anchoring with implants or other fixation methods. For those who prefer no reconstructive intervention, dietary adjustments are necessary to meet daily energy and nutritional needs. Many US insurance companies/systems including Medicaid and Medicare do not sufficiently cover dental cleaning or care, adding an additional barrier to care for patients with IDD. Some dental-specific plans support dental care for patients with IDD, but remain an additional financial burden patients face in protecting their dental hygiene.

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16. Smith C, Lautarescu A, Charman T, Crosbie J, Schachar RJ, Iaboni A, Georgiades S, Nicolson R, Kelley E, Ayub M, Jones J, Arnold PD, Lerch JP, Anagnostou E, Kushki A. Harmonizing two measures of adaptive functioning using computational approaches: prediction of vineland adaptive behavior scales II (VABS-II) from the adaptive behavior assessment system II (ABAS-II) scores. Mol Autism;2024 (Dec 3);15(1):51.

BACKGROUND: Very large sample sizes are often needed to capture heterogeneity in autism, necessitating data sharing across multiple studies with diverse assessment instruments. In these cases, data harmonization can be a critical tool for deriving a single dataset for analysis. This can be done through computational approaches that enable the conversion of scores across various instruments. To this end, our study examined the use of analytical approaches for mapping scores on two measures of adaptive functioning, namely predicting the scores on the vineland adaptive behavior scales II (VABS) from the scores on the adaptive behavior assessment system II (ABAS). METHODS: Data from the province of Ontario neurodevelopmental disorders network were used. The dataset included scores VABS and the ABAS for 720 participants (autism n = 547, 433 male, age: 11.31 ± 3.63 years; neurotypical n = 173, 95 male, age: 12.53 ± 4.05 years). Six regression approaches (ordinary least squares (OLS) linear regression, ridge regression, ElasticNet, LASSO, AdaBoost, random forest) were used to predict VABS total scores from the ABAS scores, demographic variables (age, sex), and phenotypic measures (diagnosis; core and co-occurring features; IQ; internalizing and externalizing symptoms). RESULTS: The VABS scores were significantly higher than the ABAS scores in the autism group, but not the neurotypical group (median difference: 8, 95% CI = (7,9)). The difference was negatively associated with age (beta = -1.2 ± 0.12, t = -10.6, p < 0.0001). All estimators demonstrated similar performance, with no statistically significant differences in mean absolute error (MAE) values across estimators (MAE range: 4.96-6.91). The highest contributing features to the prediction model were ABAS composite score, diagnosis, and age. LIMITATIONS: This study has several strengths, including the large sample. We did not examine the conversion of domain scores across the two measures of adaptive functioning and suggest this as a future area of investigation. CONCLUSION: Overall, our results supported the feasibility of harmonization. Our results suggest that a linear regression model trained on the ABAS composite score, the ABAS raw domain scores, and age, sex, and diagnosis would provide an acceptable trade-off between accuracy, parsimony, and data collection and processing complexity.

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17. Sun X, Zhang P, Cheng S, Wang X, Deng J, Zhan Y, Chen J. The value of hippocampal sub-region imaging features for the diagnosis and severity grading of ASD in children. Brain Res;2024 (Nov 30);1849:149369.

BACKGROUND: Hippocampal structural changes in Autism Spectrum Disorder (ASD) are inconsistent. This study investigates hippocampal subregion changes in ASD patients to reveal intrinsic hippocampal anomalies. METHODS: A retrospective study from Hainan Children’s Hospital database (2020-2023) included ASD patients and matched controls. We classified ASD participants based on severity, dividing all subjects into four groups: normal, mild, moderate, and severe. High-resolution T1-weighted MRI images were analyzed for hippocampal subregion segmentation and volume calculations using Freesurfer. Texture features were extracted via the Gray-Level Co-occurrence Matrix. The Receiver Operating Characteristic curve was used to evaluate seven random forest predictive models constructed from volume, subregion, and texture features, as well as their combinations following feature selection. RESULTS: The study included 114 ASD patients (98 boys, 2-8 years; 16 girls, 2-6 years; 17 mild, 57 moderate, 40 severe) and 111 healthy controls (HCs). No significant differences in volumes were found between ASD patients and HCs (adjusted P-value >0.05). The seven random forest models showed that single volume and texture features performed poorly for ASD classification; however, integrating various feature types improved AUC values. Further selection of texture, subregion, and volume features enhanced AUC performance across normal and varying severity categories, demonstrating the potential value of specific subregions and integrated features in ASD diagnosis. CONCLUSION: Random forest models revealed that hippocampal volume, texture features, and subregion characteristics are crucial for diagnosing and assessing the severity of ASD. Integrating selected texture and subregion features optimized diagnostic efficacy, while combining texture, subregion, and volume features further improved severity grading effectiveness.

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18. Taferner C, Jahnke-Majorkovits AC, Sevecke K. [Not Available]. Prax Kinderpsychol Kinderpsychiatr;2024 (Nov);73(8):719-736.

Developmental, Behavioral and Emotional Disorders with Onset in Childhood and Adolescence – Changes and Implementation in ICD-11and a Comparison to the DC:0-5 The 11th and latest revision of the International Statistical Classification of Diseases and Related Health Problems, ICD-11, is available and brings significant changes and innovations to the field of child and adolescent psychiatry and psychotherapy. Many of these changes relate to developmental, behavioural and emotional disorders with onset in childhood and adolescence and are particularly important for diagnosis and treatment in (early) childhood. This paper describes the ICD-11 diagnostic criteria for the most important disorders in this age group and highlights structural and substantive changes. A comparison is also made with the diagnostic criteria of the DC:0-5, a classification system for mental health and developmental disorders in infants, toddlers and preschool children.

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19. Talbot CF, Oztan O, Simmons SMV, Trainor C, Ceniceros LC, Nguyen DKK, Del Rosso LA, Garner JP, Capitanio JP, Parker KJ. Nebulized vasopressin penetrates CSF and improves social cognition without inducing aggression in a rhesus monkey model of autism. Proc Natl Acad Sci U S A;2024 (Dec 3);121(49):e2418635121.

Low cerebrospinal (CSF) arginine vasopressin (AVP) concentration is a biomarker of social impairment in low-social monkeys and children with autism, suggesting that AVP administration may improve primate social functioning. However, AVP administration also increases aggression, at least in « neurotypical » animals with intact AVP signaling. Here, we tested the effects of a voluntary drug administration method in low-social male rhesus monkeys with high autistic-like trait burden. Monkeys received nebulized AVP or placebo, using a within-subjects design. Study 1 (N = 8) investigated the effects of AVP administration on social cognition in two tests comparing responses to social versus nonsocial stimuli. Test 1: Placebo-administered monkeys lacked face recognition memory, whereas face recognition memory was « rescued » following AVP administration. In contrast, object recognition memory was intact and did not differ between administration conditions. Test 2: Placebo-administered monkeys did not respond to conspecific social communication cues, whereas following AVP administration, they reciprocated affiliative communication cues with species-typical affiliative responses. Importantly, AVP administration did not increase aggressive responses to conspecific aggressive or affiliative overtures. Study 2 (N = 4) evaluated the pharmacokinetics of this administration method. Following AVP nebulization, we observed a linear increase in cisternal CSF AVP levels, and a quadratic rise and fall in blood AVP levels. These findings indicate that nebulized AVP likely penetrates the central nervous system, selectively promotes species-typical responses to social information, and does not induce aggression in low-social individuals. Nebulized AVP therefore may hold promise for managing similar social symptoms in people with autism, particularly in very young or lower functioning individuals.

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20. Yoon S, Penzes P. Roles of ANK2/ankyrin-B in neurodevelopmental disorders: Isoform functions and implications for autism spectrum disorder and epilepsy. Curr Opin Neurobiol;2024 (Dec 3);90:102938.

The ANK2 gene, encoding ankyrin-B, is a high-confidence risk factor for neurodevelopmental disorders (NDDs). Evidence from exome sequencing studies have repeatedly implicated rare variants in ANK2 in autism spectrum disorder. Recently, the functions of ankyrin-B isoforms on neuronal phenotypes have been investigated using a number of techniques including electrophysiology, proteomic screens and behavioral analysis using animal models with loss of distinct Ank2 isoforms or with targeted loss of Ank2 in different cell types and time points during brain development. ANK2 variants and their pathophysiology could provide valuable insights into the molecular mechanisms underlying NDDs. In this review, we focus on recently reported studies to help understand the pathological mechanisms of ANK2 loss and how it may facilitate the development of treatments for NDDs in the future.

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21. Yuan G, Zhu Z, Guo H, Yang H, Zhang J, Zhang K, Zhang X, Lu X, Du J, Shi H, Jin G, Hao J, Sun Y, Su P, Zhang Z. Screen Time and Autism Spectrum Disorder: A Comprehensive Systematic Review of Risk, Usage, and Addiction. J Autism Dev Disord;2024 (Dec 3)

The relationship between autism spectrum disorder (ASD) and screen time (ST) has been extensively studied; but the evidence remains inconsistent, and a comprehensive quantitative synthesis of this association is lacking. This study aims to provide a robust quantitative assessment of the relationship between ASD and ST by consolidating and analyzing available evidence to offer a more precise understanding of this complex association. This systematic review followed PRISMA 2020 statement, and applied a quality assessment tool for quantitative studies to identity best available evidence. A comprehensive search was conducted in PubMed, Web of Science, Embase, and Scopus, covering literature published from January 1, 2006 to June 12, 2024. In total, 30 studies involving 356,666 participants met the inclusion criteria. The findings revealed a significant association between screen exposure in preschool children and the development of ASD, with a longer duration of screen exposure correlating with an increased likelihood of being diagnosed with autism. Furthermore, autistic people tend to have longer daily screen use and are at a higher risk of screen addiction compared to non-autistic individuals. These findings emphasize the importance of limiting ST for preschoolers and autistic people. However, the level of evidence supporting these conclusions is very low. Future studies should focus on controlling for confounding factors, using more objective measures, and further investigate the relationship between screen engagement styles (active or passive), screen use patterns (screen devices and content), and ASD.

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22. Zarhin D, Asher N. Orchestrating rhythms in autism care: enacting parental expertise in and through time. Health Sociol Rev;2024 (Dec 2):1-17.

This article delves into the underexplored relationship between lay expertise and temporality by analysing semi-structured interviews with parents who treat their autistic children using complementary and alternative medicine (CAM). The analysis indicates that time and temporalities play a significant role in how parents construct and enact their expertise. Faced with uncertainty, urgency, and inadequate support from medical and educational systems, parents assumed crucial responsibilities in managing their children’s therapies. Over time, they acquired knowledge and skills, ultimately claiming expertise in caring for their children, making therapy decisions and administering treatments. Parents engaged in complex time work as they attempted to orchestrate everyday, developmental, therapeutic, and social rhythms, alternating their focus between future and present. They endeavoured to synchronise their children’s rhythms with those of peers by using CAM therapies not yet adopted into conventional medicine, which they perceived as slow and outdated. This study contributes novel insights into autism care, temporalities of care, and the under-examined nexus between lay expertise and temporality.

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