1. Corrigendum to « Self-compassion, mental health, and parenting: Comparing parents of autistic and non-autistic children ». Autism. 2024: 13623613241299946.

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2. Negative effects on oral motor function after submandibular and parotid botulinum neurotoxin A injections for drooling in children with developmental disabilities. Dev Med Child Neurol. 2024.

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3. Ali Raja S, Batool A, Sana M, Khaliq HMH, Choudhry F, Devi D. Exploring the Mechanisms of Neuronal Protection by Glial Cell Line-Derived Neurotrophic Factor in Autism Spectrum Disorder. Cureus. 2024; 16(10): e70913.

BACKGROUND: A complicated neurological disease known as autism spectrum disorder (ASD) is typified by issues with social interaction, communication, and repetitive behavior. The neural protective mechanisms in ASD are thought to be influenced by genetic variables, including the expression of neurotrophic genes such as glial cell line-derived neurotrophic factor (GDNF). OBJECTIVE: The aim was to examine the relationship between neuronal protection and cognitive functioning by crosslinking GDNF gene expression and serum levels in individuals with relation to Mini-Mental State Examination (MMSE) scores in ASD patients. MATERIALS AND METHODS: After getting study approval and informed consent of patients, this case-control study experimental study was conducted for six months between July 2023 and December 2023. The blood samples (5 ml each) were drawn from the study population (n = 140), including 100 ASD patients with a disease course of 30 months based on patients’ reports data and 40 healthy controls from four major clinical and hospital settings in Lahore, Karachi, and Bahawalpur from Pakistan. The analytical procedures included nucleic acid extraction, primer design and optimization, and GDNF-targeted real-time quantitative polymerase chain reaction expression analysis. To measure cognitive and behavioral deficits, enzyme-linked immunosorbent assay-based serum GDNF levels (pg/ml) and MMSE scores were compared, concluding the neuronal protection potential of GDNF. RESULTS: In patients with ASD, lower serum levels of GDNF (9.371 ± 2.388 pg/ml) were linked to more severe behavioral and cognitive deficits confirmed by MMSE scores (13.6 ± 3.5) of ASD patients in comparison with the control group (27.1 ± 2.1). Healthy individuals showed higher relative gene fold expression (11.71) compared to the ASD patients (5.51). CONCLUSION: There is a notable decrease in GDNF gene expression in people with ASD, which raises the possibility that GDNF is important for both cognitive performance and neuronal protection in these people. GDNF may be a useful biomarker for identifying ASD and comprehending its molecular causes, opening the door for focused treatment approaches.

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4. Bortoletto R, Piscitelli F, Basaldella M, Scipioni C, Comacchio C, Fiorino R, Fornasaro S, Barbieri P, Pagliaro D, Sepulcri O, Fabris M, Curcio F, Balestrieri M, Colizzi M. Assessing the biobehavioral effects of ultramicronized-palmitoylethanolamide monotherapy in autistic adults with different severity levels: a report of two cases. Front Psychiatry. 2024; 15: 1463849.

Despite promise of its supplementation as both monotherapy and add-on treatment in autism spectrum disorder (ASD), the biobehavioral effects of Palmitoylethanolamide (PEA) in autistic adults have never been explored so far. We discussed the cases of two autistic adults with different degrees of severity (level 1 and level 2) presenting with symptoms of psychic distress, who were treated with ultramicronized-PEA (um-PEA) 600 mg/day monotherapy for a sustained period of 4 months. The level 1 autistic patient showed improved depressive symptoms and social engagement at a 12-week follow-up, in parallel to a tendency toward reduced inflammatory response and enhanced endocannabinoid (eCB) signaling, partially relapsing after um-PEA discontinuation at four months. Opposedly, the level 2 autistic patient exhibited a generally stable psychosocial functioning for the initial 12 weeks, consistent with basically unchanged immune and eCBs levels, abruptly deteriorating and leading to antipsychotic initiation afterwards. No significant side effects were reported in both cases during the observation period. The two cases suggest that um-PEA could be an effective option for the treatment of psychic distress in level 1 autistic adults, warranting further investigation of its age- and level-specificity and of the biological underpinnings of its therapeutic effect in ASD.

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5. Camillo L, Pozzi M, Bernardo P, Pisano S, Nobile M. Profile of Trofinetide in the Treatment of Rett Syndrome: Design, Development and Potential Place in Therapy. Drug Des Devel Ther. 2024; 18: 5023-40.

Trofinetide is a first-in-class pharmacological treatment proposed for patients with Rett Syndrome. It is a long half-life derivative of glycine-proline-glutamate, the tripeptide normally excided from Insulin-like Growth Factor 1 upon degradation. Due to containing glutamate and glycine in its structure, trofinetide is thought to act through NMDA receptor modulation, thus providing a normalization of neuronal activity and survival. Trofinetide was tested in a series of short and long-term trials, showing good efficacy at improving scores on the Clinical Global Impression-Improvement scale and Rett Syndrome Behavior Questionnaire, with specific effect only on some subscales, ie General Mood subscale and Repetitive Face Movement subscale. No effects were documented on other subscales or on epilepsy, heart and bone -related symptoms. The main adverse effects of trofinetide, severe enough to determine discontinuation, include diarrhea, vomiting, and consequent weight loss. These may be scarcely avoidable, given the need to assume a very large amount of trofinetide per day. Other inherent limitations of use possibly regard the limited duration of drug supplies, as one bottle may last three days only, depending on weight, and the relatively high cost per bottle. Trofinetide has no direct competitors: single symptoms of the Rett Syndrome, for instance, seizures or aggressive behaviors, are currently treated with drugs that have been developed for patients without the Rett Syndrome. This leads to suboptimal efficacy and increased risk of adverse effects. The place in therapy of trofinetide is yet to be determined, based on the results of clinical trials, on its practical usability, and on the windows of opportunity for intervention. Moreover, trofinetide may be curative if given early enough during brain development, or merely symptomatic if given to young adults, and no data exist on this aspect. The place in therapy of trofinetide will require reassessment after competing treatments enter the market.

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6. Choi JW, Bennett DH, Calafat AM, Tancredi DJ, Miller M, Schmidt RJ, Shin HM. Gestational phthalate exposure and behavioral problems in preschool-aged children with increased likelihood of autism spectrum disorder. Int J Hyg Environ Health. 2024; 263: 114483.

BACKGROUND: Experimental studies have shown associations between gestational phthalate exposure and behavioral problems among offspring; however, epidemiological evidence is still mixed. This study aims to investigate whether gestational phthalate exposure is associated with behavioral problems in preschool-aged children. METHODS: Participants include 178 mother-child pairs from MARBLES (Markers of Autism Risk in Babies – Learning Early Signs), a cohort with high familial likelihood of autism spectrum disorder (ASD). We quantified 14 phthalate metabolites in multiple maternal urine samples collected during the 2nd and 3rd trimesters. Preschool behavior problems were assessed using the Child Behavioral Checklist (CBCL), a standardized instrument for evaluating behavior problems of children aged 1.5-5 years. To examine associations of CBCL scores with both individual phthalate biomarker concentrations and their mixture, we used negative binomial regression and weighted quantile sum regression. RESULTS: Overall, maternal phthalate biomarker concentrations were not associated with child behavior problems. Monoisobutyl phthalate (MiBP) concentrations were inversely associated with child anxious/depressed symptoms and somatic complaints. Mono-hydroxy-isobutyl phthalate (MHiBP) and monobenzyl phthalate (MBzP) were also inversely associated with somatic complaints. When assessing trimester-specific associations, more behavior problems were associated with the 2nd trimester biomarker concentrations: mono(3-carboxypropyl) phthalate (MCPP) and monocarboxyisononyl phthalate (MCNP) were positively associated with somatic complaints. All associations became non-significant after false discovery rate correction. No association between a mixture of phthalates and CBCL scores was found. CONCLUSIONS: Our study observed no clear evidence of gestational phthalate exposure on child behavior problems. However, our findings based on the biomonitoring assessment of multiple samples per participant could improve our understanding of gestational phthalate exposure in association with behavior problems in preschool-aged children.

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7. Egawa J, Lemmon VP, Someya T. Editorial: Effects of autism spectrum disorder (ASD) risk genes on phenotypes of each hierarchy. Front Neurol. 2024; 15: 1508494.

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8. Fink JJ, Delaney-Busch N, Dawes R, Nanou E, Folts C, Harikrishnan K, Hempel C, Upadhyay H, Nguyen T, Shroff H, Stoppel D, Ryan SJ, Jacques J, Grooms J, Berry-Kravis E, Bear MF, Williams LA, Gerber D, Bunnage M, Furey B, Dempsey GT. Deep functional measurements of Fragile X syndrome human neurons reveal multiparametric electrophysiological disease phenotype. Commun Biol. 2024; 7(1): 1447.

Fragile X syndrome (FXS) is a neurodevelopmental disorder caused by hypermethylation of expanded CGG repeats (>200) in the FMR1 gene leading to gene silencing and loss of Fragile X Messenger Ribonucleoprotein (FMRP) expression. FMRP plays important roles in neuronal function, and loss of FMRP in mouse and human FXS cell models leads to aberrant synaptic signaling and hyperexcitability. Multiple drug candidates have advanced into clinical trials for FXS, but no efficacious treatment has been identified to date, possibly as a consequence of poor translation from pre-clinical animal models to human. Here, we use a high resolution all-optical electrophysiology platform applied to multiple FXS patient-derived and CRISPR/Cas9-generated isogenic neuronal cell lines to develop a multi-parametric FXS disease phenotype. This neurophysiological phenotype was optimized and validated into a high throughput assay based on the amount of FMRP re-expression and the number of healthy neurons in a mosaic network necessary for functional rescue. The resulting highly sensitive and multiparameter functional assay can now be applied as a discovery platform to explore new therapeutic approaches for the treatment of FXS.

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9. Glauser JD, Nause-Osthoff RC, Elliott AB, Brown SES. A Paradigm for Shared Decision-Making in Pediatric Anesthesia Practice for Children with Autism for the Generalist Clinician. Anesth Analg. 2024.

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10. Grumbach P, Kasper J, Hipp JF, Forsyth A, Valk SL, Muthukumaraswamy S, Eickhoff SB, Schilbach L, Dukart J. Local activity alterations in autism spectrum disorder correlate with neurotransmitter properties and ketamine induced brain changes. medRxiv. 2024.

Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with altered resting-state brain function. An increased excitation-inhibition (E/I) ratio is discussed as a potential pathomechanism but in-vivo evidence of disturbed neurotransmission underlying these functional alterations remains scarce. We compared rs-fMRI local activity (LCOR) between ASD (N=405, N=395) and neurotypical controls (N=473, N=474) in two independent cohorts (ABIDE1 and ABIDE2). We then tested how these LCOR alterations co-localize with specific neurotransmitter systems derived from nuclear imaging and compared them with E/I changes induced by GABAergic (midazolam) and glutamatergic medication (ketamine). Across both cohorts, ASD subjects consistently exhibited reduced LCOR, particularly in higher-order default mode network nodes, alongside increases in bilateral temporal regions, the cerebellum, and brainstem. These LCOR alterations negatively co-localized with dopaminergic (D1, D2, DAT), glutamatergic (NMDA, mGluR5), GABAergic (GABAa) and cholinergic neurotransmission (VAChT). The NMDA-antagonist ketamine, but not GABAa-potentiator midazolam, induced LCOR changes which co-localize with D1, NMDA and GABAa receptors, thereby resembling alterations observed in ASD. We find consistent local activity alterations in ASD to be spatially associated with several major neurotransmitter systems. NMDA-antagonist ketamine induced neurochemical changes similar to ASD-related alterations, supporting the notion that pharmacological modulation of the E/I balance in healthy individuals can induce ASD-like functional brain changes. These findings provide novel insights into neurophysiological mechanisms underlying ASD.

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11. Han TH, Chae KY, Han B, Kim JH, Ha EK, Rhie S, Han MY. Early onset and increasing disparities in neurodevelopmental delays from birth to age 6 in children from low socioeconomic backgrounds. J Neurodev Disord. 2024; 16(1): 60.

OBJECTIVE: To analyze the complex relationship between socioeconomic status (SES) and neurodevelopmental achievements by investigating the temporal dynamics of these associations from birth to age 6. METHODS: This retrospective cohort study was conducted over 6 years using population-based data from the National Health Insurance Service and integrated data from the National Health Screening Program for Infants and Children. Participants were children born between 2009 and 2011 in Korea without neurodevelopmental delays with potential developmental implications. We analyzed results from the Korean Developmental Screening Test, administered at age 6, which covered overall assessment and six domains of gross and fine motor function, cognition, language, sociality, and self-care. The secondary outcome was to determine when neurodevelopmental outcomes began after birth and how these differences changed over time. RESULTS: Of 276,167 individuals (49.2% males), 66,325, 138,980, and 60,862 had low, intermediate, and high SES, respectively. Neurodevelopmental delays observed across all developmental domains were more prevalent in the low-SES group than in the high-SES group. Disparities in neurodevelopment according to these statuses were apparent as early as age 2 and tended to increase over time (interaction, P < 0.001). The cognition and language domains exhibited the most substantial disparities between SES levels. These disparities persisted in subgroup analyses of sex, birthweight, head circumference, birth data, and breastfeeding variables. CONCLUSIONS: Low SES was significantly associated with an increased risk of adverse neurodevelopmental outcomes in preschool children, particularly those affecting cognitive and language domains. These differences manifested in early childhood and widened over time.

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12. Hinz JR, Eikeseth FF, Chawarska K, Eikeseth S. A systematic review and meta-analysis of atypical visual attention towards non-social stimuli in preschoolers with autism spectrum disorder. Autism Res. 2024.

Research on attention towards non-social stimuli in preschoolers with autism spectrum disorder (ASD) has increased over the past decade; however, findings have been inconsistent. It has been suggested that stimuli relating to common circumscribed interests (CIs) elicit more attention than non-CI related stimuli. This meta-analysis synthesizes results from 31 studies that compared attention towards non-social stimuli in children with ASD under the age of five with typically developing (TD) controls using eye-tracking. Additional subgroup analysis comparing studies that employed non-social stimuli related to CIs frequently reported in adults with ASD to studies using non-CI related stimuli were conducted. Meta-regressions with age, sex, stimulus dimension, nonverbal DQ, and symptom severity were conducted. Results show small (g = 0.39) but significantly higher attention towards non-social stimuli for the ASD group. However, when studies were split based on stimulus type no significant differences for non-CI related stimuli was found. Meanwhile studies employing CI related stimuli reported significant large effects on attention allocation (g = 0.69). None of the conducted regressions reached significance. The findings show increased non-social attention in children with ASD is driven by CI related content rather than a general non-social attentional bias. The findings and future research directions are discussed.

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13. Kalayci A, Agirbasli D, Serdengecti N, Alay MT, Tarakcioglu MC, Seven M. A new case with coexistence of mosaic 48,XYYY/47,XYY, and CACNA1E variant in autism spectrum disorder. Psychiatr Genet. 2024; 34(6): 134-9.

Autism spectrum disorder (ASD) is a genetically heterogeneous neurobehavioral disorder. The etiology and the inheritance pattern are usually multifactorial. The index case is a 3-year-old male, whose family applied to the child psychiatry outpatient clinic due to failure to speak at 30 months. He had mild dysmorphic features. He is diagnosed with ASD according to DSM-V criteria. Chromosomal analysis revealed mos 48,XYYY[28]/47,XYY[72] karyotype. In FISH analysis, nuc ish (DXZ1x1, DYZ1x3)[44]/(DXZ1x1, DYZ1x2)[156] was detected. WES results displayed a heterozygous missense variant of uncertain significance c.3545G>A in the CACNA1E gene. XYY syndrome is one of the most common sex chromosome aneuploidies, and ASD is detected 20 times more likely than males in general population. To the best of our knowledge, the first case with the coexistence of mosaic 48,XYYY/47,XYY karyotype and CACNA1E variant together may contribute to phenotypic heterogeneity. Further investigation into the functionality of the variant in CACNA1E is needed.

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14. McKinnon K, Bougoure M, Zhuang S, Tan DW, Magiati I. Exploring the construct validity of the Camouflaging Autistic Traits Questionnaire: A factor analytic study. Autism. 2024: 13623613241287964.

Autistic people describe having to mask or ‘camouflage’ their autistic selves to fit into certain social settings. Many researchers have used the CAT-Q to measure the extent to which autistic people engage in camouflaging. However, some researchers have questioned whether the CAT-Q measures camouflaging or whether it measures other related experiences and behaviours associated with social anxiety, fear of being negatively judged or social autistic traits. In our study, we analysed the CAT-Q to check whether it is indeed similar to or different from these related experiences. To do this, we asked 308 autistic adults to complete the CAT-Q and questionnaires about social anxiety, fear of being negatively judged and autistic social features. Then, we put all the CAT-Q items together with the items from each of the other measures in three separate analyses (called factor analyses) to see how the items would group together. These analyses showed us whether camouflaging behaviours are distinguishable and different from, or cluster together with, these other experiences. We found that most of CAT-Q items grouped together separately from the other measures’ items, suggesting that camouflaging differs from these other related experiences. Only some items from one of the CAT-Q subscales clustered together with some social anxiety and autistic items, suggesting these may need to be teased out better in the future. Generally, our findings show that we can use the CAT-Q to measure camouflaging behaviours among autistic people.

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15. McNally Keehn R, Minshawi NF, Tang Q, Enneking B, Ryan T, Martin AM, Paxton A, Monahan PO, Ciccarelli M, Keehn B. Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting. Autism. 2024: 13623613241292850.

Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation.

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16. Mengesha AK, Beyna AT, Kidanu GE, Misker MF, Ayele HS. Assessment of Knowledge and Attitude of General Practitioners Regarding Autism and Associated Factors at Gondar University Hospital, Gondar, Ethiopia. Adv Med. 2024; 2024: 9917927.

Background: The neurodevelopmental conditions known as autism spectrum disorders (ASDs) start in early childhood and last the entirety of a person’s life. They are characterized by distorted social interaction, difficulties communicating, and repetitive, stereotypical behavior. Objective: This study sought to evaluate general practitioners (GPs)’ attitudes and knowledge of ASDs and related factors at Gondar University Hospital. Methods: An institutional-based cross-sectional study design was used. Using a convenience-sample method, three-hundred sixty individuals were chosen for this study. Data were collected using a self-administered questionnaire. The GPs who took part in this survey were characterized by descriptive statistics. The relationship between the dependent variables (knowledge and attitude) and the sociodemographic characteristics was examined using an independent two-sample t-test and Pearson correlation analysis. The Statistical Package for the Social Sciences Version 25 was used for all data analyses. Results: In this study, the GPs had an average age of 31.82 years, with an average of 18 years since graduation and 16 years of practice. Participants’ average overall knowledge and attitude scores on autism were 15.83 (SD = 3.27) and 29.54 (SD = 3.21), respectively, both falling within the moderate range. Using an independent t-test, we found a significant difference (p < 0.001) between the attitudes of male and female GPs regarding autism. The study also identified weakly significant correlations between GPs' age and their attitudes toward autism (r = 0.271⁣(∗∗), p < 0.001) and between years of practice and attitudes (r = 0.105⁣(∗), p=0.046). However, no significant correlations emerged between GPs' knowledge and their age, years since graduation, or years of practice (r = 0.069, p=0.194; r = 0.069, p=0.193; and r = -0.053, p=0.312, respectively). In addition, we observed a weakly significant association (r = 0.004⁣(∗∗), p < 0.001) between GPs' knowledge and their attitudes about autism. Conclusion: Based on their total scores, the participants had a moderate level of knowledge and attitudes toward autism. There was a favorable correlation found between the study subjects' attitudes regarding autism and their age, as well as their practice year. Furthermore, a clear correlation was observed between GPs' attitudes and their understanding of autism.

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17. Moskowitz LJ, Will EA, Black CJ, Roberts JE. The effect of anxiety and autism symptom severity on restricted and repetitive behaviors over time in children with fragile X syndrome. J Neurodev Disord. 2024; 16(1): 61.

BACKGROUND: Restricted and repetitive behaviors (RRBs) are highly prevalent and reduce function in individuals with fragile X syndrome (FXS). As transdiagnostic features of intellectual disability, elevated rates of RRBs in FXS could represent various underlying known co-occurring conditions in FXS such as anxiety or autism spectrum disorder (ASD), yet this distinction has not been investigated. Further, delineating whether RRBs are more indicative of anxiety or ASD in FXS may clarify phenotypic profiles within FXS and improve differential assessment. METHODS: We longitudinally examined the potentially independent or multiplicative effect of ASD and anxiety symptom severity on RRBs in 60 children with FXS. Anxiety was measured using the Child Behavior Checklist (CBCL), ASD severity was measured using the Childhood Autism Rating Scale (CARS), and RRBs were measured using the Repetitive Behavior Scale – Revised (RBS-R). We estimated a series of moderated regression models with anxiety and ASD symptoms at the initial assessment (Time 1) as predictors of RRBs at the outcome assessment two years later (Time 2), along with an anxiety-by-ASD interaction term to determine the potential multiplicative effect of these co-occurring conditions on RRBs. RESULTS: Results identified a significant interaction between ASD and anxiety symptom severity at the initial assessment that predicted elevated sensory-motor RRBs two years later. Increased sensory-motor RRBs were predicted by elevated ASD symptoms only when anxiety symptom severity was low. Likewise, increased sensory-motor RRBs were predicted by elevated anxiety symptoms only when ASD symptom severity was low. Interestingly, this relationship was isolated to Sensory-Motor RRBs, with evidence that it could also apply to total RRBs. CONCLUSIONS: Findings suggest that ASD and anxiety exert independent and differential effects on Sensory-Motor RRBs when at high severity levels and a multiplicative effect when at moderate levels, which has important implications for early and targeted interventions.

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18. Rios GG, Jonsdottir U, Cooper F, Vyas N, Gurnurkar S. Hypocalcaemia owing to severe vitamin D deficiency in two children with autism spectrum disorder and food allergy. Paediatr Int Child Health. 2024: 1-5.

Individuals with autism spectrum disorder (ASD) often exhibit limited food preferences and sensory sensitivity. Co-existing food allergies in this population can further limit their already restricted diets, increasing the risk of nutritional deficiencies. Two children with ASD and food allergies presented with non-specific symptoms and were found to have hypocalcaemia secondary to severe vitamin D deficiency. The report highlights the importance of a greater degree of suspicion of vitamin D deficiency in children with co-existing ASD and food allergies. Non-specific symptoms related to hypocalcaemia can be difficult to evaluate in non-verbal patients. A thorough dietary history is an essential part of the care of children with ASD. It is proposed that limited diets should be screened for common nutritional deficiencies.

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19. Sarwahi V, Rahman E, Eigo K, Galina J, Hasan S, Ko A, Lo Y, Amaral T, Djukic A, Santiago M, Schneider J. Perioperative Considerations in Patients with Rett Syndrome as Compared to Those with Cerebral Palsy. Spine (Phila Pa 1976). 2024.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: This study aimed to compare perioperative outcomes of Rett syndrome and Cerebral palsy patients undergoing posterior spinal fusion for neuromuscular scoliosis. SUMMARY OF BACKGROUND DATA: Surgical correction in the treatment of scoliosis for patients with Rett syndrome (RS) has been shown to increase survival rate. Cerebral palsy (CP) patients, like RS patients, are often nonverbal, nonambulatory, with frequent surgical complications. METHODS: Retrospective review of 36 RS and 80 CP patients undergoing PSF from 2005-2023. Data and x-ray measurements were collected pre- and post-operatively. Sub-analysis was performed comparing non-ambulatory patients (GMFCS IV-V). Wilcoxon-Rank Sum, Fisher’s Exact, and Chi-square tests were utilized. RESULTS: The primary outcome measure, complication rates, was similar between the groups (P=0.09). Preoperative Cobb angle, levels fused, fixation points, and LOS were similar (P>0.05). EBL was significantly higher in CP patients as was rate of transfusion (P=0.001) and surgical time (P=0.001). Postoperative Cobb angle (P=0.002) was significantly higher for CP patients. There was no significant difference between CP and RS patients in both preoperative (P=0.383) and postoperative (P=0.051) coronal decompensation. Nonambulatory status was associated with increased odds of having a postoperative complication (OR=6.17, 95% C.I. 1.36 – 28.04). Sub-analysis of non-ambulatory RS and CP patients revealed significantly higher postoperative Cobb (P=0.008), EBL (P=0.019) and surgical time (P=0.017) in CP patients compared to RS patients. There were no significant differences in preoperative Cobb, levels fused, fixation points, hospital stay, or complication rate (P>0.05). CONCLUSION: RS patients are shown to have better outcomes to CP patients in terms of surgical, perioperative, and radiographic variables. Ambulatory status was identified as an independent risk factor for complications.

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20. Smith AM, Adler SR, Prelock P, Sibold J, Westervelt K, Wolever RQ. Integrative Health and Wellness Coaching: A Call to Action to Address a Research Gap for Individuals with Intellectual and Developmental Disabilities. J Integr Complement Med. 2024.

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21. Takeda T, Makinodan M, Toritsuka M, Iwata N. Impacts of adverse childhood experiences on individuals with autism spectrum disorder. Curr Opin Neurobiol. 2024; 89: 102932.

Individuals with autism spectrum disorder (ASD) are more likely to experience adverse childhood experiences (ACEs) compared with typically developing (TD) individuals, which predisposes them to an elevated risk of mental health issues. This review elucidates the profound impact of ACEs on individuals with ASD by synthesizing findings from a plethora of epidemiologic and biological studies, encompassing genetics, epigenetics, and neuroimaging. Despite the limited number of studies explicitly focusing on this intersection, the extant literature consistently demonstrates that ASD individuals are disproportionately affected by ACEs, leading to significant deterioration in mental health and brain function. Furthermore, the nature and extent of the effects of ACEs appear to diverge between ASD and TD populations, underscoring the necessity for tailored clinical and research approaches. Understanding these complex and intertwined interactions is imperative for advancing both clinical practice and research, with the goal of mitigating the adverse outcomes associated with ACEs in ASD individuals.

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22. Xiong Y, Hu X, Cao J, Shang L, Yao Y, Niu B. Development of gross motor skills in children under the age of 3 years: a decision tree approach. Front Public Health. 2024; 12: 1421173.

BACKGROUND: The early years of life are critical for gross motor development (GMD). This study utilized decision tree modeling to examine the influences on gross motor development in children under the age of 3 years and to rank the key factors affecting their development. METHODS: Based on randomized stratified sampling, 9,507 children aged 0-3 years in Shenzhen were included in this study. The Ages and Stages Questionnaires (ASQ) were utilized for the assessment of gross motor development. The chi-square test was used to compare groups, and variables were screened using univariable and multivariable regression analyses. Decision tree modeling was employed to rank the importance of statistically significant variables. RESULTS: The research found a prevalence of gross motor developmental delay of 1.41% among the respondents. The accuracy of the decision tree model is 70.96%. The results demonstrated a strong correlation between seven variables affecting the gross motor development of children, which were ranked based on importance: age, whether to provide supplementary food, average time spent interacting with children, family type, feeding method, mode of delivery, and birth order. CONCLUSION: The risk of gross motor developmental delay increases with age. Furthermore, supplementary food and interacting with other children are critical factors in improving children’s GMD delay. It is therefore imperative to enhance the monitoring of children’s gross motor skills through regular developmental assessments that detect potential GMD delays. Moreover, family type, feeding method, mode of delivery, and birth order were also predictive factors of GMD delay.

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23. Yaar E, Gal E, Bedell G, Lamash L. SPAN-ASD: Pilot implementation to promote functional goals of autistic adolescents and young adults. Res Dev Disabil. 2024; 155: 104864.

PURPOSE: This concurrent embedded-design study evaluated the initial efficacy of the Social Participation and Navigation (SPAN-ASD) remote intervention for autistic adolescents and young adults (AYA) in achieving personal goals and enhancing self-efficacy. The study also explored participants’ experiences through follow-up interviews. METHODS: Twelve autistic AYA (9 male; 12-20 years, M = 16.2, SD = 3.3) completed baseline data using demographic, Daily Routine and Autonomy (DRA), and Child and Adolescent Scale of Participation (CASP) questionnaires, and set two goals. The Canadian Occupational Performance Measure (COPM) and SPAN Self-Efficacy Scale (SPAN-SES) assessed Goal 1 at baseline, preintervention, and postintervention, and Goal 2 at postintervention and follow-up. We applied Friedman’s and Wilcoxon’s tests to evaluate time differences and calculated effect sizes. Semi-structured interviews explored participants’ perceptions, with thematic analysis identifying key themes. RESULTS: Postintervention, Goal 1 performance and satisfaction improved significantly (p <.01) with large effect sizes (respectively, Z = -2.92, r = -.59; Z = -2.86, r = -.58). Goal 2 also showed significant improvement (p <.05) in performance (Z = -2.5, r = -.51) and satisfaction (Z = -2.08, r = -.43). SPAN-SES scores showed no significant differences; medium effect sizes (>.30) suggested increased self-efficacy in setting and planning goals and decreased ability to review plans. Thematic analysis revealed three themes: facilitating personal change, using metacognitive strategies, and perspectives on the SPAN-ASD intervention. CONCLUSION: SPAN-ASD improves functional goal achievement and self-efficacy in goal-setting and planning for autistic AYA. Future research should explore its potential for promoting autonomy.

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24. Yao TT, Chen L, Du Y, Jiang ZY, Cheng Y. MicroRNAs as Regulators, Biomarkers, and Therapeutic Targets in Autism Spectrum Disorder. Mol Neurobiol. 2024.

The pathogenesis of autism spectrum disorder (ASD) is complex and is mainly influenced by genetic and environmental factors. Some research has indicated that environmental aspects may interplay with genetic aspects to enhance the risk, and microRNAs (miRNAs) are probably factors in explaining this link between heredity and the environment. MiRNAs are single-stranded noncoding RNAs that can regulate gene expression at the posttranscriptional level. Some research has indicated that miRNAs are closely linked to neurological diseases. Many aberrantly expressed miRNAs have been observed in autism, and these dysregulated miRNAs are expected to be potential biomarkers and provide new strategies for the treatment of this disease. This article reviews the research progress of miRNAs in autism, including their biosynthesis and function. It is found that some miRNAs show aberrant expression patterns in brain tissue and peripheral blood of autistic patients, which may serve as biomarkers of the disease. In addition, the article explores the novel role of exosomes as carriers of miRNAs with the ability to cross the blood-brain barrier and unique expression profiles, offering new possibilities for diagnostic and therapeutic interventions in ASD. The potential of miRNAs in exosomes as diagnostic markers for ASD is specifically highlighted, as well as the prospect of using engineered exosome-encapsulated miRNAs for targeted therapies.

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25. Yenkoyan K, Grigoryan A, Kutna V, Shorter S, O’Leary VB, Asadollahi R, Ovsepian SV. Cerebellar impairments in genetic models of autism spectrum disorders: A neurobiological perspective. Prog Neurobiol. 2024; 242: 102685.

Functional and molecular alterations in the cerebellum are among the most widely recognised associates of autism spectrum disorders (ASD). As a critical computational hub of the brain, the cerebellum controls and coordinates a range of motor, affective and cognitive processes. Despite well-described circuits and integrative mechanisms, specific changes that underlie cerebellar impairments in ASD remain elusive. Studies in experimental animals have been critical in uncovering molecular pathology and neuro-behavioural correlates, providing a model for investigating complex disease conditions. Herein, we review commonalities and differences of the most extensively characterised genetic lines of ASD with reference to the cerebellum. We revisit structural, functional, and molecular alterations which may contribute to neurobehavioral phenotypes. The cross-model analysis of this study provides an integrated outlook on the role of cerebellar alterations in pathobiology of ASD that may benefit future translational research and development of therapies.

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26. Zhou Q, Chen J, Ma J, Jiao W, Liang Z, Du R, Pan Y, Liu L, Qian Q, Sun S, Ji Y, Zhang Z. Relationship between global warming and autism spectrum disorder from 1990 to 2019. BJPsych Open. 2024; 10(6): e198.

BACKGROUND: Despite mounting evidence linking neurological diseases with climate change, the link between autism spectrum disorder (ASD) and global warming has yet to be explored. AIMS: To examine the relationship between the incidence of ASD and global warming from 1990 to 2019 and estimate the trajectory of ASD incidence from 2020 to 2100 globally. METHOD: We extracted meteorological data from TerraClimate between 1990 and 2019. To estimate the association between global ASD incidence and temperature variation, we adopted a two-stage analysis strategy using a generalised additive regression model. Additionally, we projected future ASD incidence under four representative shared socioeconomic pathways (SSPs: 126, 245, 370 and 585) by bootstrapping. RESULTS: Between 1990 and 2019, the global mean incidence of ASD in children under 5 years old was 96.9 per 100 000. The incidence was higher in males (147.5) than in females (46.3). A 1.0 °C increase in the temperature variation was associated with a 3.0% increased risk of ASD incidence. The association was stronger in boys and children living in a low/low-middle sociodemographic index region, as well as in low-latitude areas. According to the SSP585 scenario, by 2100, the children living in regions between 10 and 20° latitude, particularly in Africa, will experience a 68.6% increase in ASD incidence if the association remains. However, the SSP126 scenario is expected to mitigate this increase, with a less than 10% increase in incidence across all latitudes. CONCLUSIONS: Our study highlights the association between climate change and ASD incidence worldwide. Prospective studies are warranted to confirm the association.

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27. Zou M, Zhang Y, Du C, Yang B, Guo P, Liang H, Zhang Y, Tian W, Yang L, Liu D, Wu L, Sun C. Augmentation of Endogenous 2-Arachidonoylglycerol Mitigates Autistic Behaviors of BTBR Mice. Mol Neurobiol. 2024.

The lipid-based endocannabinoid (eCB) system regulates a host of developmental, physiological, and pathological processes in the mammalian brain, and recent studies have suggested that dysfunction of eCB system may contribute to the neuropathology of autism spectrum disorder (ASD). However, specific contributions to ASD-related developmental, cognitive, and behavioral phenotypes remain largely unexplored. The current study was designed to investigate if enhancing eCB signaling by blocking 2-arachidonoylglycerol (2-AG) hydrolase can mitigate ASD-like behaviors in a mouse model, and if such effects are associated with suppression of inflammatory signaling, oxidative stress, or neuronal apoptosis. Intraperitoneal injection of the 2-AG hydrolase monoacylglycerol lipase (MAGL) JZL184 (4, 16, or 40 mg/kg) elevated 2-AG and reversed eCB system metabolic enzymes and receptors expression deficits in BTBR T + ltpr3tf/J (BTBR) mouse model of ASD. Moreover, the hyperactivity, excessive stereotypy, impaired social behavior, and cognitive deficits characteristic of this animal model were significantly improved by JZL184. Concomitantly, JZL184 administration reversed the abnormal pro- and anti-inflammatory cytokine concentrations measured in the hippocampus of BTBR mice. In addition, JZL184 reversed the observed overexpression of pro-apoptotic Bax and underexpression of anti-apoptotic Bcl-2 in BTBR mice and enhanced neuronal numbers in hippocampal CA1 and CA3 regions. We also found that the behavioral test battery influenced eCB concentrations independently of JZL184 treatment. Collectively, these findings suggest that augmenting eCB signaling can mitigate ASD-related phenotypes by suppressing neuroinflammation and neuronal apoptosis.

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