1. Andreou M, Konstantopoulos K, Peristeri E. Cognitive flexibility in autism: Evidence from young autistic children. Autism Res;2022 (Oct 4)

We examined the cognitive flexibility performance of young autistic children and a group of neurotypical peers. Thirty-six autistic children (72-83 months) and 200 age-matched typically-developing children were assessed on the Children’s Color Trails Test (CCTT), a semantic and a phonemic verbal fluency task. The results showed that the autistic children performed worse than their neurotypical peers in the switching component of the CCTT. In the fluency tests, the autistic group generated overall fewer word items than their neurotypical peers, however, their poorer performance was driven by specific linguistic stimuli in the fluency tasks. The findings suggest that cognitive flexibility for the autistic children was affected in the nonverbal CCTT only, while poor performance in semantic and phonemic fluency seemed to be inherent to the language properties of the verbal fluency tasks. LARY SUMMARY: The current study aims to determine whether the Children’s Color Trails Test (CCTT) and verbal (semantic and phonemic) fluency tasks are appropriate to assess cognitive flexibility in young autistic children. The overall findings showed poor performance for the autistic children in the CCTT. On the other hand, verbal fluency performance seemed to be driven by language features specific to the semantic and the phonemic fluency tasks rather than by difficulties in cognitive flexibility.

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2. Barnard-Brak L, Richman DM, Mutua K, Williamson A. Predictors of employment for adults with intellectual and developmental disabilities participating in a postsecondary transition program in the United States. J Appl Res Intellect Disabil;2022 (Oct 4)

BACKGROUND: Previous research has shown that post-secondary collegiate vocational educational programs often have positive effects on employment outcomes for young adults with intellectual and developmental disabilities. AIMS: Using secondary data of a program in the United States collected over several years, we examined which intervention components of a postsecondary education transition program predicted subsequent employment for young adults with intellectual and developmental disabilities. MATERIALS & METHODS: The sample consisted of 56 individuals that participated in a transition-services collegiate program; Crossing Points, University of Alabama. RESULTS: Results were able to robustly indicate that acquiring job-specific skills was a much better predictor than global measures of intellectual or adaptive behaviour. Additionally, survival curve analyses as an innovative approach to this population showed that there was a positive relation between the number of job-specific training sessions and eventual community employment. DISCUSSION: Results are discussed in relation to a historical parallel movement to expand inclusion of students with intellectual and developmental disabilities in the least restrictive educational setting for primary and secondary public education years. CONCLUSION: In conclusion, the results of the current study suggest positive findings with job-skills training both specific and general.

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3. Elliott T, Floyd James K, Coleman KJ, Skrine Jeffers K, Nau CL, Choi K. Cross-sectional Comparison of Disparities by Race Using White vs Hispanic as Reference Among Children and Youths With Developmental Disabilities Referred for Speech Therapy. JAMA Netw Open;2022 (Oct 3);5(10):e2234453.

IMPORTANCE: Health care research on racial disparities among children and youths has historically used the White race as a reference category with which other racial and ethnic groups are compared, which may inadvertently set up Whiteness as a standard for health. OBJECTIVE: To compare 2 interpretations of an analysis of racial disparities in speech therapy receipt among children and youths with developmental disabilities: a traditional, White-referenced analysis and a Hispanic majority-referenced analysis. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used multiple logistic regression to analyze speech therapy referrals for children, adolescents, and transition age youths in an integrated health care system in Southern California from 2017 to 2020. Eligible participants were children and youths up to age 26 years with 1 or more diagnosed intellectual or developmental disability (eg, autism spectrum disorder, speech or language delay, developmental delay, Down syndrome, and others). EXPOSURES: Child or youth race and ethnicity as reported by parents or caregivers (Asian, Black and African American, Hispanic and Latinx, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, White, multiple, and other). MAIN OUTCOMES AND MEASURES: Receipt of speech therapy within 1 year of referral. RESULTS: A total 66 402 referrals were included; 65 833 referrals (99.1%) were for children under age 17 years, 47 323 (71.3%) were for boys, and 39 959 (60.2%) were commercially insured. A majority of participants were identified as Hispanic (36 705 [55.3%]); 6167 (9.3%) were identified as Asian, 4810 (7.2%) as Black, and 14 951 (22.5%) as White. In the traditional racial disparities model where the reference category was White, referrals of children and youths who identified as Hispanic, Black, Pacific Islander, and other had lower odds of actual receipt of speech therapy compared with referrals for White children and youths (Hispanic: OR, 0.79; 95% CI, 0.75-0.83; Black: OR, 0.72; 95% CI, 0.66-0.78; Pacific Islander: OR, 0.74; 95% CI, 0.57-0.98). When using the majority race group (Hispanic) as the reference category, referrals for children and youths who identified as White (OR, 1.26; 95% CI, 1.20-1.30), Asian (OR, 1.21; 95% CI, 1.12-1.30), and multiracial (OR, 1.35; 95% CI, 1.08-1.71) had higher odds of resulting in actual service receipt in comparison with referrals for Hispanic children and youths. CONCLUSIONS AND RELEVANCE: The cross-sectional study demonstrates the value of decentering Whiteness in interpreting racial disparities research and considering racial differences against multiple referents. Racial disparities researchers should consider investigating multiple between-group differences instead of exclusively using White as the default reference category.

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4. Gosling CJ, Cartigny A, Mellier BC, Solanes A, Radua J, Delorme R. Correction: Efficacy of psychosocial interventions for Autism spectrum disorder: an umbrella review. Mol Psychiatry;2022 (Oct 4)

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5. Iacobucci G. Patients with developmental disability at higher risk of preventable harm in hospitals, study finds. BMJ;2022 (Oct 4);379:o2390.

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6. Lei J, Charman T, Leigh E, Russell A, Mohamed Z, Hollocks MJ. Examining the relationship between cognitive inflexibility and internalizing and externalizing symptoms in autistic children and adolescents: A systematic review and meta-analysis. Autism Res;2022 (Oct 5)

Compared to neurotypical peers, autistic adolescents show greater cognitive inflexibility (CI) which manifests at the behavioral and cognitive level and potentially increases vulnerability for the development of internalizing (INT) and externalizing (EXT) symptoms. This systematic review and meta-analysis explored the association between CI and INT/EXT in autistic adolescents. PubMed, EMBASE, MEDLINE, PsycINFO and Web of Science databases were searched to identify relevant studies until April 2022 (PROSPERO protocol: CRD42021277294). Systematic review included 21 studies (n = 1608) of CI and INT, and 15 studies (n = 1115) of CI and EXT. A pooled effect size using Pearson’s correlation between CI and INT/EXT was calculated and the moderating effects of age, sex, IQ and study quality were investigated using meta-regressions. Sensitivity analyses were completed to investigate the impact of measure variance for CI and co-occurring ADHD on the overall effects. Greater CI is associated with increased INT (nine studies; n = 833; r = 0.39 (moderate effect), 95% confidence interval [0.32, 0.46]) and EXT (six studies; n = 295; r = 0.48 (large effect), 95% confidence interval [0.38, 0.58]). Results withheld when only using parental reports of CI and excluding autistic adolescents with co-occurring ADHD. Increased CI may be a transdiagnostic vulnerability factor that can increase autistic adolescents’ rigid or perseverative patterns of unhelpful cognition and behaviors and reduce their ability to access psychological interventions. Addressing CI may improve autistic children and adolescents’ engagement with psychological therapy for co-occurring mental health difficulties. LAY SUMMARY: This systematic review and meta-analysis explored the relationship between cognitive inflexibility (CI) and symptoms of anxiety, depression and behavioral difficulties in autistic children and adolescents. CI refers to increased rigidity and perseveration in thinking and behavior and was found to be associated with increased mental health symptoms in autistic adolescents. Addressing and targeting individual differences in CI may improve autistic children and adolescents’ engagement with psychological therapy for co-occurring mental health difficulties.

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7. Özdemir Ç, Şahin N, Edgünlü T. Vesicle trafficking with snares: a perspective for autism. Mol Biol Rep;2022 (Oct 5)

Vesicle-mediated membrane traffic is the mechanism fundamental to many biological events, especially the release of neurotransmitters. The main proteins of the mechanism that mediates membrane fusion in vesicle-mediated membrane traffic are N-ethylmaleimide sensitive factor (NSF) supplemental protein (SNAP) receptor (SNAREs) proteins. SNAREs are classified into vesicle-associated SNAREs (vesicle-SNAREs/v-SNAREs) and target membrane-associated SNAREs (target-SNARE/t-SNAREs). Autism spectrum disorders (ASD) are neurodevelopmental disorders characterized by many symptoms, especially complications in social communication and stereotypical behaviours. Defects in synaptogenesis and neurotransmission, oxidative stress, and developmental defects in the early stages of development are defined in the pathogenesis of the disease. SNARE proteins are on the basis of synaptogenesis and neurotransmission. Although the formation mechanisms and underlying causes of the SNARE complex are not fully understood, expression differences, polymorphisms, abnormal expressions or dysfunctions of the proteins that make up the SNARE complex have been associated with many neurodevelopmental diseases, including autism. Further understanding of SNARE mechanisms is crucial both for understanding ASD and for developing new treatments. In this review, the formation mechanisms of the SNARE complex and the roles of various factors involved in this process are explained. In addition, a brief evaluation of clinical and basic studies on the SNARE complex in autism spectrum disorders was made.

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8. Ruan H, Eungpinichpong W, Wu H, Shen M, Zhang A. Medicine Insufficient Evidence for the Efficacy of Massage as Intervention for Autism Spectrum Disorder: A Systematic Review. Evid Based Complement Alternat Med;2022;2022:5328320.

The efficacy of massage therapy in the treatment of children with autism spectrum disorder (ASD) remains unclear. This study systematically reviewed the impact of massage therapy on children with ASD according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) declaration guidelines. A literature search of the PubMed, Web of Science, Science Direct, Scopus, Google Scholar, and China National Knowledge Infrastructure (CNKI) electronic databases from inception to December 20, 2020, was conducted using the term « autistic/autism » along with one of the following terms, « massages, » and « Tui na. » The risk of bias was assessed using the Cochrane risk of bias Tool. Eight randomized controlled trials examining the impact of massage on children with ASD were included. Interventions combining Qigong massage or Tui na with the control group treatments from once a day to twice a week, for a duration of 15-30 mins, and lasting for six weeks to five months were the main interventions. All reviewed studies reported significant improvement in children with ASD who received massage, especially in the sensory domain, and that massage in combination with control treatment was superior to control treatment alone. However, the overall quality of the available studies is poor with a high degree of heterogeneity. The majority of studies showed a high risk of bias with poor study design, inconsistency in massage protocols, and subjective outcome measures. Assessment bias was a common weakness of these studies. Therefore, there is insufficient evidence to conclude that massage is effective for ASD. Future studies should include large sample sizes, incorporate double-blind designs, employ appropriate outcome measures, and allow for long observation and follow-up periods. Furthermore, consensus must be reached on standardized treatments and additional therapies in order to provide better quality evidence for the treatment of ASD.

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9. Shute KL, Kesler WW, Walker EA. Adventitial bursitis of the dorsal foot presenting as soft tissue masses in patients with autism spectrum disorder. Skeletal Radiol;2022 (Oct 4)

Autism spectrum disorder (ASD) is an increasingly common neurodevelopmental disorder associated with impairments in postural control and repetitive patterns of behavior. Here, we describe two cases of adventitial bursitis of the dorsolateral feet in patients with ASD presenting as mass-like lesions. Both patients habitually sat in the W-position and were treated with ultrasound-guided aspirations with immediate relief of symptoms.

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10. Zhang F, Moerman F, Niu H, Warreyn P, Roeyers H. Atypical brain network development of infants at elevated likelihood for autism spectrum disorder during the first year of life. Autism Res;2022 (Oct 4)

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral features that appear early in life. Although studies have shown that atypical brain functional and structural connectivity are associated with these behavioral traits, the occurrence and initial alterations of brain networks have not been fully investigated. The current study aimed to map early brain network efficiency and information transferring in infants at elevated likelihood (EL) compared to infants at typical likelihood (TL) for ASD in the first year of life. This study used a resting-state functional near-infrared spectroscopy (fNIRS) approach to obtain the length and strength of functional connections in the frontal and temporal areas in 45 5-month-old and 38 10-month-old infants. Modular organization and small-world properties were detected in both EL and TL infants at 5 and 10 months. In 5-month-old EL infants, local and nodal efficiency were significantly greater than age-matched TL infants, indicating overgrown local connections. Furthermore, we used a support vector machine (SVM) model to classify infants with or without EL based on the obtained global properties of the network, achieving an accuracy of 77.6%. These results suggest that infants with EL for ASD exhibit inefficiencies in the organization of brain networks during the first year of life. LAY SUMMARY: The brain networks of 5- and 10-month-old infants are able to support efficient communication of information in the brain. Neural networks of 5-month-old with an elevated likelihood (EL) for autism spectrum disorder (ASD) show an overgrowth in local functional connection, which may not support efficient communication between distant brain regions, while we found no such differences in 10-month-old infants with or without EL for ASD.

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