Pubmed du 05/08/24

Pubmed du jour

1. Ahmad I, Rashid J, Faheem M, Akram A, Khan NA, Amin RU. Autism spectrum disorder detection using facial images: A performance comparison of pretrained convolutional neural networks. Healthc Technol Lett;2024 (Aug);11(4):227-239.

Autism spectrum disorder (ASD) is a complex psychological syndrome characterized by persistent difficulties in social interaction, restricted behaviours, speech, and nonverbal communication. The impacts of this disorder and the severity of symptoms vary from person to person. In most cases, symptoms of ASD appear at the age of 2 to 5 and continue throughout adolescence and into adulthood. While this disorder cannot be cured completely, studies have shown that early detection of this syndrome can assist in maintaining the behavioural and psychological development of children. Experts are currently studying various machine learning methods, particularly convolutional neural networks, to expedite the screening process. Convolutional neural networks are considered promising frameworks for the diagnosis of ASD. This study employs different pre-trained convolutional neural networks such as ResNet34, ResNet50, AlexNet, MobileNetV2, VGG16, and VGG19 to diagnose ASD and compared their performance. Transfer learning was applied to every model included in the study to achieve higher results than the initial models. The proposed ResNet50 model achieved the highest accuracy, 92%, compared to other transfer learning models. The proposed method also outperformed the state-of-the-art models in terms of accuracy and computational cost.

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2. Alsharif N, Al-Adhaileh MH, Al-Yaari M, Farhah N, Khan ZI. Utilizing deep learning models in an intelligent eye-tracking system for autism spectrum disorder diagnosis. Front Med (Lausanne);2024;11:1436646.

Timely and unbiased evaluation of Autism Spectrum Disorder (ASD) is essential for providing lasting benefits to affected individuals. However, conventional ASD assessment heavily relies on subjective criteria, lacking objectivity. Recent advancements propose the integration of modern processes, including artificial intelligence-based eye-tracking technology, for early ASD assessment. Nonetheless, the current diagnostic procedures for ASD often involve specialized investigations that are both time-consuming and costly, heavily reliant on the proficiency of specialists and employed techniques. To address the pressing need for prompt, efficient, and precise ASD diagnosis, an exploration of sophisticated intelligent techniques capable of automating disease categorization was presented. This study has utilized a freely accessible dataset comprising 547 eye-tracking systems that can be used to scan pathways obtained from 328 characteristically emerging children and 219 children with autism. To counter overfitting, state-of-the-art image resampling approaches to expand the training dataset were employed. Leveraging deep learning algorithms, specifically MobileNet, VGG19, DenseNet169, and a hybrid of MobileNet-VGG19, automated classifiers, that hold promise for enhancing diagnostic precision and effectiveness, was developed. The MobileNet model demonstrated superior performance compared to existing systems, achieving an impressive accuracy of 100%, while the VGG19 model achieved 92% accuracy. These findings demonstrate the potential of eye-tracking data to aid physicians in efficiently and accurately screening for autism. Moreover, the reported results suggest that deep learning approaches outperform existing event detection algorithms, achieving a similar level of accuracy as manual coding. Users and healthcare professionals can utilize these classifiers to enhance the accuracy rate of ASD diagnosis. The development of these automated classifiers based on deep learning algorithms holds promise for enhancing the diagnostic precision and effectiveness of ASD assessment, addressing the pressing need for prompt, efficient, and precise ASD diagnosis.

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3. Berson J, Adams SN. Experiences of caregivers of children with autism during the COVID-19 pandemic: A scoping review. S Afr J Commun Disord;2024 (Jul 18);71(1):e1-e12.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has had a profoundly negative impact on people all over the world, particularly those with disabilities such as autism. However, there are gaps in research understanding the impact of COVID-19 on this population and the support required. AIM: To explore the evidence available on the impact of the COVID-19 pandemic on caregivers of children with autism. METHOD: A scoping review methodology using the Arksey and O’Malley framework was employed. Five electronic databases from March 2020 to December 2022 were reviewed. Two thousand two hundred and six articles were retrieved with primary search terms: caregivers (population), autism (diagnosis) and COVID-19 (context). Following the screening of titles, abstracts and articles, 36 articles were included in the final review. Thematic and content qualitative analysis was completed. RESULTS: Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guided the reporting of the findings. Three main themes were identified: (1) caregiver’s mental health and wellbeing, (2) response to remote health care and support and (3) caregiver resilience. CONCLUSION: The pandemic affected children with autism and their families regarding changes in routine, difficulties with support and emotional states. However, little research has been conducted on the impact in upper-middle-income countries such as South Africa.Contribution: The findings from this review carry practical implications that extend beyond the pandemic, such as political instability or natural disasters that may present similar stressors for children with autism and their families.

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4. Brady N, Fleming K, Hicks T, Fielding-Gebhardt H, Boorom O. Contextual Variables Associated with Challenging Behaviors in Adolescents with Fragile X Syndrome. J Autism Dev Disord;2024 (Aug 5)

PURPOSE: Our purpose was to report on a novel method of identifying variables associated with challenging behaviors in natural interactions between mothers and their adolescents with Fragile X syndrome (FXS). METHODS: Videotaped interactions of 47 dyads interacting with an iPad game, completing a puzzle, and making a snack and were coded for challenging behaviors by adolescents with FXS, and maternal behaviors that preceded these behaviors. We described the frequencies of adolescent challenging behaviors, then used sequential and survival analyses to identify maternal and adolescent behaviors that preceded self-injurious behavior (SIB) and aggression. RESULTS: Across all the dyads, 109 instances of SIB and 79 instances of aggression were identified during the 30 min of recorded interaction. Most of these challenging behaviors occurred during the iPad activity. The sequential analysis indicated that maternal requests for behavioral compliance frequently preceded both SIB and aggression. Survival analyses revealed that the likelihood of SIB or aggression was increased if the mothers requested behavioral compliance after the child engaged in another challenging behavior. CONCLUSION: Challenging behaviors including SIB and aggression were frequently observed in many participants. The sequential and survival analyses were useful for identifying precursors to these behaviors. Further research is needed to investigate preventative strategies based on the results of sequential and survival analyses.

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5. Carty A, Green R, Goodman CV, McLaughlin JR, Hu H, Lanphear B, Muckle G, Till C. Performance of the Social Responsiveness Scale-2 for the Assessment of Autistic Behaviors in a Sample of Canadian Preschool-Aged Children. J Autism Dev Disord;2024 (Aug 5)

Behavioral traits of autism spectrum disorder (ASD) typically present in early childhood, underscoring the importance of screening tools for the early identification of ASD. The current study compared scores on the Social Responsiveness Scale-Second Edition (SRS-2) Preschool Form between the US standardization sample (n = 247) and a Canadian cohort of preschool-aged children (n = 595) recruited from the Maternal-Infant Research on Environmental Chemicals (MIREC) study. In the MIREC sample, we examined whether ASD-like traits are correlated with sociodemographic characteristics and child intellectual abilities, and how maternal ratings of social skills assessed by the SRS-2 are associated with maternal ratings of general problem behaviors. Mean total SRS-2 raw score was significantly lower in the MIREC sample (mean = 29.7, SD = 15.8) compared to the US standardization sample (mean = 41.9, SD = 26.0). Total raw score in the US standardization sample did not significantly differ between males (mean = 40.6, SD = 23.1) and females (mean = 42.8, SD = 28.7), whereas in the MIREC sample the total raw score was significantly higher among males (mean = 33.0, SD = 17.1) than females (mean = 26.6, SD = 13.9). A significantly larger proportion of the MIREC sample was White, younger in age, and had more educated parents compared to the US standardization sample. ASD-like traits were correlated with lower intellectual abilities, a less enriched home environment, more behavioral problems, and poorer adaptive skills. SRS-2 Preschool Form scores were significantly lower in the Canadian sample compared to the US standardization sample, which may reflect demographic differences between the two groups. Girls may be under-identified when SRS-2 Preschool Form norms are used for screening ASD.

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6. Chen H, Ge S, Yao P, Yang T, Cao X, Sun D. Evaluation of the Quality of Management Guidelines for Children and Adolescents With Autism Spectrum Disorder. Psychol Rep;2024 (Aug 5):332941241269510.

OBJECTIVE: To systematically assess the quality of management guidelines for children and adolescents with autism spectrum disorder, analyze key management recommendation differences and causes among guidelines, and provide better guideline assessments for clinical workers. METHODS: Clinical guidelines for managing children and adolescents with autism were systematically retrieved from a database. Four reviewers independently evaluated the guidelines using the assessment guideline tool, Appraisal of Guidelines for Research and Evaluation II (AGREE II), and the intra-group correlation coefficient (ICC) was used to measure the consistency of the assessment guidelines among the four reviewers and the differences and reasons for the recommendations and supporting evidence were compared and analyzed. RESULTS: A total of ten management guidelines for children and adolescents with autism spectrum disorder published from 2014 to 2022 were included in this study, with high overall agreement between raters (range of intra-group correlation coefficients: 53.3% ∼ 85.0%), and areas with better median scores and ranges in Protocol II were as follows: domain 1 (scope and purpose, median = 86.1%, 59.7%-98.6%), Domain 4 (clarity of statements, median = 88.2%, 38.9%-100.0%) and domain 6 (independence of editors, median = 71.9%, 0.0%-100.0%). Among the ten guidelines the guidelines published by the Scott Intercollegiate Guidelines Network in 2016 and by the National Institute for health and care excellence in 2021 scored high and were recommended for adoption, 88.7%, 84.9%, respectively. CONCLUSION: There is considerable variation between the quality of guidelines for the management of children and adolescents with autism spectrum disorders.

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7. Cooper D, Frisbie S, Wang S, Ventimiglia J, Gibbs V, Love AMA, Mogavero M, Benevides TW, Hyatt JM, Hooven K, Basketbill I, Shea L. What do we know about autism and policing globally? Preliminary findings from an international effort to examine autism and the criminal justice system. Autism Res;2024 (Aug 5)

Research has demonstrated that autistic individuals have higher rates of police contact, however, research has seldom explored the fundamental reasons for these interactions and how this might vary across international contexts. To remedy this, the Global Autism and Criminal Justice Consortium created and disseminated the Global Criminal Justice Survey. Descriptive statistics of survey respondents with and without police contact were compared to glean differential characteristics. Frequency and type of recent police interactions (within the last 5 years) among autistic individuals were also examined to better contextualize the reasons that autistic individuals encounter police. Study findings indicated that across a global sample (i.e., North America, Scandinavia, Europe, and Oceania) nearly half of all autistic individuals had an interaction with police and that those with a history of police contact were usually older, had higher educational qualifications, and were more likely to have a co-occurring mental health or developmental disorder. Among types of interactions, noncriminal encounters, such as welfare checks, traffic incidents, wandering, and behaviors associated with autism, were most common, followed by autistic individuals alleging a crime was committed against them. These findings offer important directions for future research and for targeted policy responses that can address the unique needs of autistic individuals within the justice system.

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8. Croom K, Rumschlag JA, Molinaro G, Erickson MA, Binder DK, Huber KM, Razak KA. Developmental trajectory and sex differences in auditory processing in a PTEN-deletion model of autism spectrum disorders. Neurobiol Dis;2024 (Aug 5);200:106628.

Autism Spectrum Disorders (ASD) encompass a wide array of debilitating symptoms, including severe sensory deficits and abnormal language development. Sensory deficits early in development may lead to broader symptomatology in adolescents and adults. The mechanistic links between ASD risk genes, sensory processing and language impairment are unclear. There is also a sex bias in ASD diagnosis and symptomatology. The current study aims to identify the developmental trajectory and genotype- and sex-dependent differences in auditory sensitivity and temporal processing in a Pten-deletion (phosphatase and tensin homolog missing on chromosome 10) mouse model of ASD. Auditory temporal processing is crucial for speech recognition and language development and deficits will cause language impairments. However, very little is known about the development of temporal processing in ASD animal models, and if there are sex differences. To address this major gap, we recorded epidural electroencephalography (EEG) signals from the frontal (FC) and auditory (AC) cortex in developing and adult Nse-cre PTEN mice, in which Pten is deleted in specific cortical layers (layers III-V) (PTEN conditional knock-out (cKO). We quantified resting EEG spectral power distribution, auditory event related potentials (ERP) and temporal processing from awake and freely moving male and female mice. Temporal processing is measured using a gap-in-noise-ASSR (auditory steady state response) stimulus paradigm. The experimental manipulation of gap duration and modulation depth allows us to measure cortical entrainment to rapid gaps in sounds. Temporal processing was quantified using inter-trial phase clustering (ITPC) values that account for phase consistency across trials. The results show genotype differences in resting power distribution in PTEN cKO mice throughout development. Male and female cKO mice have significantly increased beta power but decreased high frequency oscillations in the AC and FC. Both male and female PTEN cKO mice show diminished ITPC in their gap-ASSR responses in the AC and FC compared to control mice. Overall, deficits become more prominent in adult (p60) mice, with cKO mice having significantly increased sound evoked power and decreased ITPC compared to controls. While both male and female cKO mice demonstrated severe temporal processing deficits across development, female cKO mice showed increased hypersensitivity compared to males, reflected as increased N1 and P2 amplitudes. These data identify a number of novel sensory processing deficits in a PTEN-ASD mouse model that are present from an early age. Abnormal temporal processing and hypersensitive responses may contribute to abnormal development of language function in ASD.

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9. Dira PMM, Machailo RJ, Scholtz S. Caregivers’ voices: From the world of autism spectrum disorder. Curationis;2024 (Jul 23);47(1):e1-e11.

BACKGROUND: Caring for a child with autism spectrum disorder (ASD) is a challenging and stressful task, especially in countries with limited resources. Additional research is necessary, considering the increasing prevalence of children with ASD, to gain increased knowledge of the complex difficulties faced by caregivers of ASD children and to offer insights into the coping strategies and support networks that parents utilise. OBJECTIVES: The objective of this study was to explore and describe the experiences and coping mechanisms of caregivers of children with ASD in Dr Kenneth Kaunda district, North West province, South Africa. METHOD: Qualitative explorative, contextual and descriptive design with purposive sampling technique and semi-structured interviews were conducted. Data were analysed following the six steps of reflexive thematic analysis. RESULTS: Two themes were identified: Caregivers’ experiences in raising a child with autism, and caregivers’ coping in raising a child with autism. CONCLUSION: The research established caregivers’ experiences and coping mechanisms in raising a child with ASD and the effects on different aspects of their lives including emotional, social and financial aspects, which contribute negatively to their holistic well-being. These impediments warrant the establishment of emotional support groups, empowerment of caregivers and awareness-raising through campaigns to educate the family and the community on the diverse challenges.Contribution: The findings of this study contribute to a deeper understanding of the multifaceted challenges faced by caregivers of children with ASD and provide insights into the support systems and coping mechanisms employed by these caregivers within the socio-ecological context.

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10. Du Toit MN, Eccles R, Westwood K, Graham MA, Van der Linde J. Caregivers’ perspectives of early developmental tele-assessments in challenging circumstances. S Afr J Commun Disord;2024 (Jul 23);71(1):e1-e9.

BACKGROUND: Outbreaks, such as the COVID-19 pandemic in 2020, exacerbate barriers to accessing early childhood developmental care. Tele-assessment may serve as an innovative approach to developmental monitoring to overcome service delivery amidst challenging circumstances. It is vital to collect caregivers’ perspectives of this potential service delivery method to inform clinical decision making. OBJECTIVES: This study aimed to determine caregivers’ perspectives of interview-based early developmental tele-assessment in a South African context. METHOD: Thirty caregivers of children (aged birth – 36 months) completed a caregiver-report developmental assessment via a telecommunications platform, as well as an online questionnaire probing their perspectives on the tele-assessment. RESULTS: Most participants (96.7%, n = 29 out of 30) rated their overall experience of the tele-assessment as positive; however, 53.8% (n = 14 out of 26 that answered the question) indicated that they would additionally still prefer in-person assessment. CONCLUSION: Tele-assessment appears to be a viable approach for caregivers to access developmental care during circumstances such as COVID-19.Contribution: This study provided valuable insight into a novel approach using interview-based early developmental tele-assessment and the perspectives of caregivers thereof.

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11. Frigerio A, Knight T, Rella R, Sinigaglia E, Camussi E, Montali L. Experiences of parenting for autistic children in Australia and Italy: a qualitative cross-cultural comparison. Front Psychol;2024;15:1409234.

INTRODUCTION: Parents vary in their gradual adaptation to the demands of caring for an autistic child. Their experiences can be positive, negative, or a combination of both, depending on the severity of the cases and various personal and social factors. Cross-cultural comparisons can aid in understanding how contextual factors, such as the availability of social and health services, and cultural factors, such as family relationships and the distribution of care burden, may influence the caregiving experience. However, there is a limited amount of cross-cultural research on this topic, which is almost exclusively quantitative. AIMS AND METHODS: From an ecocultural perspective, our interview-based study aimed to explore the experiences of Australian (15) and Italian (11) parents of autistic children living in their respective countries. RESULTS: The analysis identified three main themes. Life through autism, autism through life: coexisting with an unexpected life partner, Parenting autistic children: reorganization of parents’ subjectivity and familiar dynamics, and The unseen side of disability: autism communities between inclusion and segregation. DISCUSSION: Our comparative approach reveals both commonalities and differences between the two groups of participants. The similarities support features previously identified in the literature: the emotional and physical burden on parents and the positive impact on parental identity. The differences relate to the diagnostic process, interactions with health professionals, the impact of autism on family dynamics and parental perspectives, and the role assigned to siblings. Despite facing similar challenges, these differences reveal how Italian and Australian parents articulate different understandings linked to social and cultural differences.

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12. Ghasemi MR, Sadeghi H, Hashemi-Gorji F, Mirfakhraie R, Gupta V, Ben-Mahmoud A, Bagheri S, Razjouyan K, Salehpour S, Tonekaboni SH, Dianatpour M, Omrani D, Jang MH, Layman LC, Miryounesi M, Kim HG. Exome sequencing reveals neurodevelopmental genes in simplex consanguineous Iranian families with syndromic autism. BMC Med Genomics;2024 (Aug 5);17(1):196.

BACKGROUND AND OBJECTIVE: Autosomal recessive genetic disorders pose significant health challenges in regions where consanguineous marriages are prevalent. The utilization of exome sequencing as a frequently employed methodology has enabled a clear delineation of diagnostic efficacy and mode of inheritance within multiplex consanguineous families. However, these aspects remain less elucidated within simplex families. METHODS: In this study involving 12 unrelated simplex Iranian families presenting syndromic autism, we conducted singleton exome sequencing. The identified genetic variants were validated using Sanger sequencing, and for the missense variants in FOXG1 and DMD, 3D protein structure modeling was carried out to substantiate their pathogenicity. To examine the expression patterns of the candidate genes in the fetal brain, adult brain, and muscle, RT-qPCR was employed. RESULTS: In four families, we detected an autosomal dominant gene (FOXG1), an autosomal recessive gene (CHKB), and two X-linked autism genes (IQSEC2 and DMD), indicating diverse inheritance patterns. In the remaining eight families, we were unable to identify any disease-associated genes. As a result, our variant detection rate stood at 33.3% (4/12), surpassing rates reported in similar studies of smaller cohorts. Among the four newly identified coding variants, three are de novo (heterozygous variant p.Trp546Ter in IQSEC2, heterozygous variant p.Ala188Glu in FOXG1, and hemizygous variant p.Leu211Met in DMD), while the homozygous variant p.Glu128Ter in CHKB was inherited from both healthy heterozygous parents. 3D protein structure modeling was carried out for the missense variants in FOXG1 and DMD, which predicted steric hindrance and spatial inhibition, respectively, supporting the pathogenicity of these human mutants. Additionally, the nonsense variant in CHKB is anticipated to influence its dimerization – crucial for choline kinase function – and the nonsense variant in IQSEC2 is predicted to eliminate three functional domains. Consequently, these distinct variants found in four unrelated individuals with autism are likely indicative of loss-of-function mutations. CONCLUSIONS: In our two syndromic autism families, we discovered variants in two muscular dystrophy genes, DMD and CHKB. Given that DMD and CHKB are recognized for their participation in the non-cognitive manifestations of muscular dystrophy, it indicates that some genes transcend the boundary of apparently unrelated clinical categories, thereby establishing a novel connection between ASD and muscular dystrophy. Our findings also shed light on the complex inheritance patterns observed in Iranian consanguineous simplex families and emphasize the connection between autism spectrum disorder and muscular dystrophy. This underscores a likely genetic convergence between neurodevelopmental and neuromuscular disorders.

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13. Ha YW, Kim TH, Kang DR, Park KS, Shin DC, Cho J, Kim C. Estimation of Attributable Risk and Direct Medical and Non-Medical Costs of Major Mental Disorders Associated With Air Pollution Exposures Among Children and Adolescents in the Republic of Korea, 2011-2019. J Korean Med Sci;2024 (Aug 5);39(30):e218.

BACKGROUND: Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents. METHODS: We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011-2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution. RESULTS: A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 μm [PM(10)]), 3.7% (PM(2.5)), and 2.2% (sulfur dioxide [SO(2)]). The PAF of PM(10) was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM(10) and SO(2) decreased during the study period. CONCLUSION: This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM(10,) PM(2.5), and SO(2) attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.

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14. Kearly A, Hluchan M, Brazeel C, Lane JT, Oputa J, Baio J, Cree RA, Cheng Q, Wray A, Payne C, Gerling J, Pham T, Ekart S. Health Service Utilization Patterns Among Medicaid Enrollees With Intellectual and Developmental Disabilities Before and During the COVID-19 Pandemic: Implications for Pandemic Response and Recovery Efforts. J Public Health Manag Pract;2024 (Aug 5)

OBJECTIVES: To assess the impact of COVID-19 on health service utilization of adults with intellectual and developmental disabilities (IDDs) through an analysis of Medicaid claims data. DESIGN: Retrospective cohort study of Medicaid claims. SETTING AND PARTICIPANTS: Medicaid members aged 25 to 64 years from January 1, 2018, to March 31, 2021, from the states of Louisiana, Pennsylvania, and Wyoming. INTERVENTION: We analyzed data from two 12-month time periods (pre-COVID-19 and during COVID-19) and assessed the potential impact of the COVID-19 pandemic on health service utilization and service intensity for 3 cohorts: (1) IDD with preexisting mental health diagnoses, (2) IDD without mental health diagnoses, and (3) all other Medicaid members. MAIN OUTCOME MEASURE: Health service utilization determined by specific claims data classifications. RESULTS: The analysis showed reduced utilization for nonmental health service types with differing utilization patterns for IDD with preexisting mental health diagnoses, IDD without mental health diagnoses, and all other Medicaid members. Change in utilization varied, however, for mental health service types. Measures of service intensity showed decreased numbers of members utilizing services across most service types and increased Medicaid claims per person across most mental health service categories but decreased Medicaid claims per person for most nonmental health services. CONCLUSIONS: Results suggest a need for mental health services among all Medicaid members during the COVID-19 pandemic. By anticipating these needs, communities may be able to expand outreach to Medicaid members through enhanced case management, medication checks, and telemedicine options.

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15. Rosinda SJ, Hoekstra PJ, Hadders-Algra M, de Bildt A, Heineman KR. Predictive validity of the Standardized Infant NeuroDevelopmental Assessment (SINDA) to identify 4-5 year-old children at risk of developmental delay in a low-risk sample. Early Hum Dev;2024 (Sep);196:106097.

BACKGROUND: Early detection of developmental problems is important as it allows for early intervention. Previous studies, in high-risk infants, found high predictive values of atypical scores on the Standardized Infant NeuroDevelopmental Assessment (SINDA) for later neurodevelopmental disorders (i.e., cerebral palsy, intellectual disability). AIMS: The present study explored SINDA’s predictive values to identify risk of developmental delay at 4-5 years. STUDY DESIGN: Cohort study. SUBJECTS: 786 low-risk Dutch children (367 boys; median gestational age: 40 (27-42) weeks; mean birth weight: 3455 (SD 577) grams). OUTCOME MEASURES: The SINDA was assessed at 2-12 months and risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4-5 years. SINDA’s predictive values were determined for five ASQ domains and the total ASQ score for children at risk of marked (all ASQ domains deviant) and any (one or more ASQ domains deviant) developmental delay. RESULTS: Presence of one atypical SINDA scale score showed low to moderate sensitivities (12-88 %, depending on the SINDA scale and ASQ domain involved), moderate to high specificities (66-94 %), low positive predictive values (PPVs; 3-16 %), and high negative predictive values (NPVs; 95-100 %) for children at risk of marked and any developmental. Presence of multiple atypical SINDA scale scores predicted deviant ASQ domains slightly better (sensitivities = 11-62 %, specificities = 90-98 %, PPVs = 6-30 %, and NPVs = 95-100 %). CONCLUSIONS: In low-risk infants, SINDA’s predictive value is low for detecting children at risk of marked and any developmental delay at 4-5 years, as reflected by the low sensitivities. One of the explanations is the relatively low prevalence of developmental delay in low-risk populations. This might have consequences for the application of the SINDA in general healthcare settings (e.g. child health clinics), but further studies are needed to draw this conclusion.

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16. Sivayokan B, King C, Mali I, Payne M, Strating H, Warnes E, Bossmann SH, Plakke B. Aerobic exercise improves cognitive flexibility and modulates regional volume changes in a rat model of autism. Behav Brain Res;2024 (Aug 5);471:115136.

Gestational exposure to valproic acid (VPA) is a risk factor for autism spectrum disorder (ASD). Rodents exposed to VPA in utero display common features of ASD, including volumetric dysregulation in higher-order cognitive regions like the medial prefrontal cortex (mPFC), the anterior cingulate cortex (ACC), and the hippocampus. Exercise has been shown in elderly populations to boost cognition and to buffer against brain volume losses with age. This study employed an adolescent treadmill exercise intervention to facilitate cognitive flexibility and regional brain volume regulation in rats exposed to VPA during gestation. It was found that exercise improved performance on extra-dimensional shifts of attention on a set-shifting task, which is indicative of improved cognitive flexibility. Exercise decreased frontal cortex volume in females, whereas in males exercise increased the ventral hippocampus. These findings suggest that aerobic exercise may be an effective intervention to counteract the altered development of prefrontal and hippocampal regions often observed in ASD.

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17. Stefanou ME, Dundon NM, Bestelmeyer PEG, Biscaldi M, Smyrnis N, Klein C. The dissociating effects of fear and disgust on multisensory integration in autism: evidence from evoked potentials. Front Neurosci;2024;18:1390696.

BACKGROUND: Deficits in Multisensory Integration (MSI) in ASD have been reported repeatedly and have been suggested to be caused by altered long-range connectivity. Here we investigate behavioral and ERP correlates of MSI in ASD using ecologically valid videos of emotional expressions. METHODS: In the present study, we set out to investigate the electrophysiological correlates of audiovisual MSI in young autistic and neurotypical adolescents. We employed dynamic stimuli of high ecological validity (500 ms clips produced by actors) that depicted fear or disgust in unimodal (visual and auditory), and bimodal (audiovisual) conditions. RESULTS: We report robust MSI effects at both the behavioral and electrophysiological levels and pronounced differences between autistic and neurotypical participants. Specifically, neurotypical controls showed robust behavioral MSI for both emotions as seen through a significant speed-up of bimodal response time (RT), confirmed by Miller’s Race Model Inequality (RMI), with greater MSI effects for fear than disgust. Adolescents with ASD, by contrast, showed behavioral MSI only for fear. At the electrophysiological level, the bimodal condition as compared to the unimodal conditions reduced the amplitudes of the visual P100 and auditory P200 and increased the amplitude of the visual N170 regardless of group. Furthermore, a cluster-based analysis across all electrodes revealed that adolescents with ASD showed an overall delayed and spatially constrained MSI effect compared to controls. CONCLUSION: Given that the variables we measured reflect attention, our findings suggest that MSI can be modulated by the differential effects on attention that fear and disgust produce. We also argue that the MSI deficits seen in autistic individuals can be compensated for at later processing stages by (a) the attention-orienting effects of fear, at the behavioral level, and (b) at the electrophysiological level via increased attentional effort.

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18. Worringer E, Rowland K. Acetaminophen use during pregnancy was not linked to autism, ADHD, or intellectual disability in offspring. Ann Intern Med;2024 (Aug);177(8):Jc95.

Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children’s risk of autism, ADHD, and intellectual disability. JAMA. 2024;331:1205-1214. 38592388.

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19. Xu L, Shen X, Ma W, Li H. Picturing immediate echolalia within the context of autism: Examining its formats, actions and patterns under conversation analysis. Clin Linguist Phon;2024 (Aug 5):1-24.

Echolalia, a prevalent feature of Autism Spectrum Disorders (ASD), has been extensively debated among behaviourists and developmental researchers for decades, long segmenting clinical work within the context of autism. This qualitative study aimed to explore the interactive underpinnings of immediate echolalia naturally occurring in dyadic conversation between autistic individuals and clinicians, employing turn-by-turn and sequence-by-sequence analysis within the framework of Conversation Analysis (CA). The results revealed that varying the complete-incomplete-transformed format, echolalia helped participants a) express their emotions, b) automatically associate conversation, c) organise their response, d) maintain conversational reciprocity, and e) assist with request initiation. Within the context of echolalia, the dynamics of conversation exhibited blocking, diverting, or affiliating patterns. The current study provides insights into the interactive traits of immediate echolalia and underscores the potential utility for clinical therapists to employ the echoic sources in clinical intervention.

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20. Yim G, Roberts A, Lyall K, Ascherio A, Weisskopf MG. Multigenerational association between smoking and autism spectrum disorder: findings from a nationwide prospective cohort study. Am J Epidemiol;2024 (Aug 5);193(8):1115-1126.

Animal studies have shown that exposure to cigarette smoke during pregnancy can induce neurobehavioral anomalies in multiple subsequent generations. However, little work has examined such effects in humans. We examined the risk of grandchild autism spectrum disorder (ASD) in association with grandmother’s smoking during pregnancy, using data from 53 562 mothers and grandmothers and 120 267 grandchildren in Nurses’ Health Study II. In 1999, Nurses’ Health Study II participants with children reported on their mothers’ smoking. Grandchildren’s ASD diagnoses were reported by the mothers in 2005 and 2009. Among grandmothers, 13 383 (25.0%) smoked during pregnancy, and 509 (0.4%) grandchildren were diagnosed with ASD. The adjusted odds ratio for ASD for grandmother smoking during pregnancy was 1.52 (95% CI, 1.06-2.20). Results were similar with direct grandmother reporting in 2001 of her smoking during pregnancy from the Nurses’ Mothers Cohort Study subgroup (n = 22 167 grandmothers, n = 49 917 grandchildren) and were stronger among grandmothers who smoked ≥15 cigarettes per day during pregnancy (adjusted odds ratio = 1.93 [95% CI, 1.10-3.40]; n = 1895 grandmothers, n = 4212 grandchildren). Results were similar when we adjusted for mother’s smoking during pregnancy. There was no association with grandfather’s smoking as reported by the grandmother. Our results suggest a potential persistent impact of gestational exposure to environmental insults across 3 generations.

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21. Yu R, Hafeez R, Ibrahim M, Alonazi WB, Li B. The complex interplay between autism spectrum disorder and gut microbiota in children: A comprehensive review. Behav Brain Res;2024 (Sep 13);473:115177.

Autism spectrum disorder (ASD) is characterized by defects in social communication and interaction along with restricted interests and/or repetitive behavior. Children with ASD often also experience gastrointestinal (GI) problems in fact incidence of GI problems in ASD is estimated up to 80 percent. Intestinal microbiota, which is a collection of trillions of microorganisms both beneficial and potentially harmful bacteria living inside the gut, has been considered one of the key elements of gut disorders. The goal of this review is to explore potential link between gut microbiota and ASD in children, based on the recently available data. This review discusses recent advances in this rapidly expanding area of neurodevelopmental disorders, which focuses on what is known about the changes in composition of gut bacteria in children with ASD, exploration of possible mechanisms via which gut microbiota might influence the brain and thus lead to appearance of ASD symptoms, as well as potential treatments that involve modulation of gut flora to improve symptoms in children with ASD, i.e., probiotics, postbiotics or changes in the diet. Of course, it’s important to keep in mind inherent difficulties in proving of existence of causal relationships between gut bacteria and ASD. There are significant gaps in understanding of the mechanism of gut-brain axis and the mechanisms that underlie ASD. Standardized approaches for research in this area are needed. This review would provide an overview of this exciting emerging field of research.

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22. Zhang X, Song XK, So WC. The Development of Gesture Skills in Chinese Autistic Children: The Predictive Roles of Age and Language Ability. J Speech Lang Hear Res;2024 (Aug 5);67(8):2583-2599.

PURPOSE: Gesture delay in autistic infants and toddlers has been widely reported. The developmental trajectory of gesture production during early childhood is understudied. Thus, little is known about the possible changes of gesture production over time. The present study aimed to document the development of gesture production in autistic children and examine whether child-based factors (chronological age and initial language skills) predicted gesture development. METHOD: A total of 33 Chinese-speaking autistic children (M(age) = 56.39 months, SD = 8.54 months) played with their parents at four time points over a 9-month period. Their speech was transcribed, and their gestures were coded from parent-child interaction. Multilevel modeling analysis was used to investigate the development of gesture and its associated factors. RESULTS: The total number of gestures produced by autistic children decreased over time. Among different factors, children’s initial age significantly and negatively predicted children’s gesture production, while initial language positively predicted children’s gesture production. CONCLUSIONS: Gesture delay persists in preschool age. The decline in gesture production was associated with children’s age and initial language ability. These findings shed light on the difficulties surrounding gesture use in autistic children.

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