1. Erratum. A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism. Adapt Phys Activ Q;2023 (Dec 8):1.

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2. Avni E, Ben-Itzchak E, Saban-Bezalel R, Zachor DA. Parents’ and Teachers’ Perspectives of Autism and Co-Morbidity Symptom Severity in Young Children with ASD Over One School Year. J Autism Dev Disord;2023 (Dec 8)

PURPOSE: Only a few studies examined the longitudinal pattern of parent-teacher reports on autism severity and comorbidities in autism spectrum disorder (ASD) and yielded conflicting results. The study’s aims were to compare parents and teachers’ perception of autism, attention deficit hyperactivity disorder (ADHD) and anxiety symptoms severity in children with ASD, at the start (T1) and end (T2) of the school year, to assess changes in their perception over time and to examine correlations between their reports. METHODS: The study included 73 participants, (M = 61), aged 2:10 - 7:6 years (M = 4:10, SD = 1:0), who attended ASD special education classes and were receiving intensive interventions. Parents and teachers completed measures of autism severity and ADHD and anxiety symptoms at T1 and T2. RESULTS: Teachers, in comparison to parents, rated more severe social-communication impairments and inattention symptoms at T1, but not at T2. A significant improvement in teachers’ ratings of autism and inattention symptoms severity was documented at T2. At both time points, parents reported more severe anxiety symptoms. Significant correlations between parents’ and teachers’ reports were noted for autism severity at T1 and T2, but not for inattention and anxiety symptoms severity. CONCLUSION: The study emphasizes the contribution of multiple perspectives for better collaboration between home and school environments. Obtaining accurate information from parents and teachers at the start of the school year may help to identify factors needed for better adjustment at school and to better address difficulties at home.

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3. Butera C, Delafield-Butt J, Lu SC, Sobota K, McGowan T, Harrison L, Kilroy E, Jayashankar A, Aziz-Zadeh L. Motor Signature Differences Between Autism Spectrum Disorder and Developmental Coordination Disorder, and Their Neural Mechanisms. J Autism Dev Disord;2023 (Dec 7)

Autism spectrum disorder (ASD) and Developmental Coordination Disorder (DCD) are distinct clinical groups with overlapping motor features. We attempted to (1) differentiate children with ASD from those with DCD, and from those typically developing (TD) (ages 8-17; 18 ASD, 16 DCD, 20 TD) using a 5-min coloring game on a smart tablet and (2) identify neural correlates of these differences. We utilized standardized behavioral motor assessments (e.g. fine motor, gross motor, and balance skills) and video recordings of a smart tablet task to capture any visible motor, behavioral, posture, or engagement differences. We employed machine learning analytics of motor kinematics during a 5-min coloring game on a smart tablet. Imaging data was captured using functional magnetic resonance imaging (fMRI) during action production tasks. While subject-rated motor assessments could not differentiate the two clinical groups, machine learning computational analysis provided good predictive discrimination: between TD and ASD (76% accuracy), TD and DCD (78% accuracy), and ASD and DCD (71% accuracy). Two kinematic markers which strongly drove categorization were significantly correlated with cerebellar activity. Findings demonstrate unique neuromotor patterns between ASD and DCD relate to cerebellar function and present a promising route for computational techniques in early identification. These are promising preliminary results that warrant replication with larger samples.

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4. Colonnese F, Di Luzio F, Rosato A, Panella M. Bimodal Feature Analysis with Deep Learning for Autism Spectrum Disorder Detection. Int J Neural Syst;2023 (Dec 6):2450005.

Autism Spectrum Disorder (ASD) is a complex and heterogeneous neurodevelopmental disorder which affects a significant proportion of the population, with estimates suggesting that about 1 in 100 children worldwide are affected by ASD. This study introduces a new Deep Neural Network for identifying ASD in children through gait analysis, using features extracted from frames composing video recordings of their walking patterns. The innovative method presented herein is based on imagery and combines gait analysis and deep learning, offering a noninvasive and objective assessment of neurodevelopmental disorders while delivering high accuracy in ASD detection. Our model proposes a bimodal approach based on the concatenation of two distinct Convolutional Neural Networks processing two feature sets extracted from the same videos. The features obtained from the convolutions of both networks are subsequently flattened and merged into a single vector, serving as input for the fully connected layers in the binary classification process. This approach demonstrates the potential for effective ASD detection in children through the combination of gait analysis and deep learning techniques.

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5. Fram NR, Alviar C, Lense MD. What scholarship on social timing and autism can learn from each other: A Comment on « The evolution of social timing » by Laura Verga, Sonja A. Kotz, and Andrea Ravignani. Phys Life Rev;2023 (Nov 22);48:19-21.

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6. Gabrielli S, Cristofolini M, Dianti M, Alvari G, Vallefuoco E, Bentenuto A, Venuti P, Mayora Ibarra O, Salvadori E. Co-Design of a Virtual Reality Multiplayer Adventure Game for Adolescents With Autism Spectrum Disorder: Mixed Methods Study. JMIR Serious Games;2023 (Dec 8);11:e51719.

BACKGROUND: Virtual reality (VR) adventure games can offer ideal technological solutions for training social skills in adolescents with autism spectrum disorder (ASD), leveraging their support for multisensory and multiplayer interactions over distance, which may lower barriers to training access and increase user motivation. However, the design of VR-based game environments for social skills training is still understudied and deserves the deployment of an inclusive design approach to ensure its acceptability by target users. OBJECTIVE: We aimed to present the inclusive design process that we had followed to develop the Zentastic VR adventure game to foster social skills training in adolescents with ASD and to investigate its feasibility as a training environment for adolescents. METHODS: The VR game supports multiplayer training sessions involving small groups of adolescents and their therapists, who act as facilitators. Adolescents with ASD and their therapists were involved in the design and in an explorative acceptability study of an initial prototype of the gaming environment, as well as in a later feasibility multisession evaluation of the VR game final release. RESULTS: The feasibility study demonstrated good acceptability of the VR game by adolescents and an enhancement of their social skills from baseline to posttraining. CONCLUSIONS: The findings provide preliminary evidence of the benefits that VR-based games can bring to the training of adolescents with ASD and, potentially, other neurodevelopmental disorders.

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7. Hou W, Li J. Intact or impaired? The understanding of give-and-take interactions in children with autism spectrum disorder. Res Dev Disabil;2023 (Dec 6);144:104642.

BACKGROUND: Understanding and predicting others’ behavior in a dynamic and rapidly changing world is a fundamental aspect of social interactions. However, it remains unclear as to whether children with autism spectrum disorder (ASD) could understand and predict goal-directed social actions. AIMS: To investigate the understanding of give-and-take interactions in children with ASD with the use of eye tracking. METHODS AND PROCEDURES: Experiment 1 and 2 investigated the understanding of giving and taking respectively in 5-to 8-year-old Chinese children with ASD and typically developing children by using the eye-tracking technology. OUTCOMES AND RESULTS: We found that children with ASD could predict actions, but they were less proficient in processing give-and-take interactions. Moreover, children with ASD showed impaired understanding of giving but not taking. CONCLUSIONS: These results indicate that the basic mechanisms of action prediction are intact in children with ASD whereas there may be deficits in the top-down social processing of the giving gesture.

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8. Lan K, Wang XX, Lu Y, Zhang A, Jia M, Lu L, Wei YB, Liu JJ. Comparison of the Clancy Autism Behavior Scale and Autism Behavior Checklist for Screening Autism Spectrum Disorder. J Autism Dev Disord;2023 (Dec 8)

PURPOSE: To make early detection of individuals with autism spectrum disorder (ASD), caregiver-report instruments remain an efficient and adaptable option for the preliminary assessment. This study aimed to compare the psychometric properties of the Clancy Autism Behavior Scale (CABS) and Autism Behavior Checklist (ABC) as screening tools for ASD by caregivers. METHODS: The data were collected from 154 pairs of children and their parents, who sought medical attention for suspected autism at Peking University Sixth Hospital. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index, and area under the receiver operating characteristics curves (AUC) of the CABS and ABC were calculated and compared using recommended cut-off values from initial papers. The optimal cut-off values for CABS and ABC were determined according to the maximum Youden index. RESULTS: The ABC performed better than the CABS in screening autistic persons. Specifically, the ABC demonstrated higher sensitivity than the CABS in identifying children with ASD, while the CABS exhibited superior specificity compared to the ABC. According to the maximum Youden index, the optimal cut-off value was determined to be 13 for CABS and 62 for ABC. CONCLUSION: The ABC exhibits higher sensitivity and overall performance in screening individuals with ASD compared to the CABS. The ABC is more suitable as a screening tool for caregivers in both domestic and clinical settings, while the CABS may be utilized when evaluation time or medical resources are limited due to its shorter completion time and fewer items.

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9. Lee JYS, Whittingham K, Olson R, Mitchell AE. « Their Happiness, Not Neurotypical Success »: Autistic Adults Reflect on the Parenting of Autistic Children. J Autism Dev Disord;2023 (Dec 8)

PURPOSE: Parenting has implications for psychosocial adjustment well into adulthood. While much is known about the parenting behaviors that influence adjustment in autistic children, little is known about how the effects of parenting persist in autistic adults. Further, autistic adults’ perspectives on how they were parented have not been investigated to date. This study aimed to examine autistic adults’ perspectives on their experiences of being parented in childhood and the advice they would like to offer to parents of autistic children in the context of their lived experience. METHODS: Ninety-six Australian autistic adults responded to open-ended questions in a larger survey assessing childhood experiences of being parented, adult attachment, psychological flexibility, and adult adjustment. RESULTS: A total of 10 themes were identified. Autistic adults emphasized the importance of embracing early diagnosis and that the goal of parents should be their child’s happiness rather than « neurotypical » success. They highlighted the importance of unconditional love and understanding of their autistic child, recognizing that autistic children have similar fundamental needs as other children. Participants discussed the importance of structure and predictability in the home to feelings of safety. Parents were encouraged to meet them halfway. Finally, autistic adults reflected on the role of parents in advocacy and parental well-being. Parental neurodivergence was discussed as a possible bane or boon. CONCLUSIONS: Autistic adults emphasized the importance of unconditional acceptance from their parents, with the goal being their child’s happiness. Findings from this study will inform future programs for families of autistic children.

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10. Miyahara K, Tatehana M, Kikkawa T, Osumi N. Investigating the impact of paternal aging on murine sperm miRNA profiles and their potential link to autism spectrum disorder. Sci Rep;2023 (Dec 7);13(1):20608.

Paternal aging has consistently been linked to an increased risk of neurodevelopmental disorders, including autism spectrum disorder (ASD), in offspring. Recent evidence has highlighted the involvement of epigenetic factors. In this study, we aimed to investigate age-related alterations in microRNA (miRNA) profiles of mouse sperm and analyze target genes regulated by differentially expressed miRNAs (DEmiRNAs). Microarray analyses were conducted on sperm samples from mice at different ages: 3 months (3 M), over 12 M, and beyond 20 M. We identified 26 miRNAs with differential expression between the 3 and 20 M mice, 34 miRNAs between the 12 and 20 M mice, and 2 miRNAs between the 3 and 12 M mice. The target genes regulated by these miRNAs were significantly associated with apoptosis/ferroptosis pathways and the nervous system. We revealed alterations in sperm miRNA profiles due to aging and suggest that the target genes regulated by these DEmiRNAs are associated with apoptosis and the nervous system, implying a potential link between paternal aging and an increased risk of neurodevelopmental disorders such as ASD. The observed age-related changes in sperm miRNA profiles have the potential to impact sperm quality and subsequently affect offspring development.

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11. Molani-Gol R, Alizadeh M, Kheirouri S, Hamedi-Kalajahi F. The early life growth of head circumference, weight, and height in infants with autism spectrum disorders: a systematic review. BMC Pediatr;2023 (Dec 8);23(1):619.

BACKGROUNDS: The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association between the early life growth of head circumference (HC), weight, and height with ASD in infants. METHODS: PubMed, Scopus, Science Direct, and Google Scholar databases were searched up to November 2021 using relevant keywords. All original articles are written in English evaluating the early life growth of HC, weight, and height in infants with ASD were eligible for the present review. RESULTS: Totally, 23 articles involving 4959 infants were included in this review. Of 13 studies that evaluated HC of infants at birth, 10 studies (83.33%) showed that the HC at the birth of autistic children was similar to that of the average found in the control group. Among 21 studies that evaluated the HC and weight status in infants, 19 studies (90.47%) showed that autistic children had larger HC and weight than the control group or abnormal acceleration of head growth during infancy. Height growth of infants was investigated in 13 studies, of which 10 cases (76.92%) reported that infants with ASD were significantly longer than control groups. Most of he included studies had a good quality. CONCLUSIONS: The findings suggest that in infants with ASD, without the contribution of birth growth factors and sex of the child, the growth of HC, weight, and height probably was faster than in infants with normal development, in early life. Therefore, these measurements might be useful as initial predictive biomarkers for the risk of developing ASD.

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12. Ophir Y, Rosenberg H, Tikochinski R, Dalyot S, Lipshits-Braziler Y. Screen Time and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. JAMA Netw Open;2023 (Dec 1);6(12):e2346775.

IMPORTANCE: Contemporary studies raise concerns regarding the implications of excessive screen time on the development of autism spectrum disorder (ASD). However, the existing literature consists of mixed and unquantified findings. OBJECTIVE: To conduct a systematic review and meta-analyis of the association between screen time and ASD. DATA SOURCES: A search was conducted in the PubMed, PsycNET, and ProQuest Dissertation & Theses Global databases for studies published up to May 1, 2023. STUDY SELECTION: The search was conducted independently by 2 authors. Included studies comprised empirical, peer-reviewed articles or dissertations published in English with statistics from which relevant effect sizes could be calculated. Discrepancies were resolved by consensus. DATA EXTRACTION AND SYNTHESIS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two authors independently coded all titles and abstracts, reviewed full-text articles against the inclusion and exclusion criteria, and resolved all discrepancies by consensus. Effect sizes were transformed into log odds ratios (ORs) and analyzed using a random-effects meta-analysis and mixed-effects meta-regression. Study quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Publication bias was tested via the Egger z test for funnel plot asymmetry. Data analysis was performed in June 2023. MAIN OUTCOMES AND MEASURES: The 2 main variables of interest in this study were screen time and ASD. Screen time was defined as hours of screen use per day or per week, and ASD was defined as an ASD clinical diagnosis (yes or no) or ASD symptoms. The meta-regression considered screen type (ie, general use of screens, television, video games, computers, smartphones, and social media), age group (children vs adults or heterogenous age groups), and type of ASD measure (clinical diagnosis vs ASD symptoms). RESULTS: Of the 4682 records identified, 46 studies with a total of 562 131 participants met the inclusion criteria. The studies were observational (5 were longitudinal and 41 were cross-sectional) and included 66 relevant effect sizes. The meta-analysis resulted in a positive summary effect size (log OR, 0.54 [95% CI, 0.34 to 0.74]). A trim-and-fill correction for a significant publication bias (Egger z = 2.15; P = .03) resulted in a substantially decreased and nonsignificant effect size (log OR, 0.22 [95% CI, -0.004 to 0.44]). The meta-regression results suggested that the positive summary effect size was only significant in studies targeting general screen use (β [SE] = 0.73 [0.34]; t58 = 2.10; P = .03). This effect size was most dominant in studies of children (log OR, 0.98 [95% CI, 0.66 to 1.29]). Interestingly, a negative summary effect size was observed in studies investigating associations between social media and ASD (log OR, -1.24 [95% CI, -1.51 to -0.96]). CONCLUSIONS AND RELEVANCE: The findings of this systematic review and meta-analysis suggest that the proclaimed association between screen use and ASD is not sufficiently supported in the existing literature. Although excessive screen use may pose developmental risks, the mixed findings, the small effect sizes (especially when considering the observed publication bias), and the correlational nature of the available research require further scientific investigation. These findings also do not rule out the complementary hypothesis that children with ASD may prioritize screen activities to avoid social challenges.

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13. Ousley CL, Raulston TJ, Gilhuber CS. Telecoaching for Parents of Young Autistic Children Using Strength-Based Video Feedback. J Autism Dev Disord;2023 (Dec 8)

Parent-implemented Naturalistic Developmental Behavioral Interventions (NDBIs), rooted from applied behavioral and developmental sciences, focus on empowering families by training and coaching natural change agents to embed evidence-based strategies during regular events or contexts (e.g., play time). No research, however, has relied on strength-based video feedback coaching within parent-implemented NDBIs while providing flexibility with self-recorded sessions. We conducted a single case multiple-baseline design across five parent-child dyads to evaluate the effects of a telepractice-based parent-training on five NDBI strategies (i.e., Follow and Imitate, Model Language, Arrange Environment, Wait Time, Reward and Expand), utilizing strength-based video feedback coaching with parents (i.e., two mothers and three fathers) of young autistic children (i.e., ages 2 to 5) on parent strategy use and child social communication. An additional coaching package (i.e., parent self-reflections, goal setting, and joint discussions) was introduced to parents who did not meet a predetermined criterion. Maintenance data were collected 2-, 4-, and 6-weeks after intervention concluded. Visual analyses, nonoverlap calculations, and standardized mean difference effect sizes indicate strong effects for parent strategy use and small, varied effects on child social communication. Maintenance of parent strategy use and child social communication varied, with most remaining at equivalent or higher levels. Parent-implemented interventions that are delivered via telepractice may continue to be successful when coaching is focused on the parents’ strengths, all coaching feedback is provided asynchronously, and families can flexibly record sessions based upon their week’s schedules rather than relying on regularly scheduled meeting times with a coach.

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14. Rogala J, Żygierewicz J, Malinowska U, Cygan H, Stawicka E, Kobus A, Vanrumste B. Enhancing autism spectrum disorder classification in children through the integration of traditional statistics and classical machine learning techniques in EEG analysis. Sci Rep;2023 (Dec 8);13(1):21748.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder hallmarked by challenges in social communication, limited interests, and repetitive, stereotyped movements and behaviors. Numerous research efforts have indicated that individuals with ASD exhibit distinct brain connectivity patterns compared to control groups. However, these investigations, often constrained by small sample sizes, have led to inconsistent results, suggesting both heightened and diminished long-range connectivity within ASD populations. To bolster our analysis and enhance their reliability, we conducted a retrospective study using two different connectivity metrics and employed both traditional statistical methods and machine learning techniques. The concurrent use of statistical analysis and classical machine learning techniques advanced our understanding of model predictions derived from the spectral or connectivity attributes of a subject’s EEG signal, while also verifying these predictions. Significantly, the utilization of machine learning methodologies empowered us to identify a unique subgroup of correctly classified children with ASD, defined by the analyzed EEG features. This improved approach is expected to contribute significantly to the existing body of knowledge on ASD and potentially guide personalized treatment strategies.

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15. Sari NP, Tsompanidis A, Wahab RJ, Gaillard R, Aydin E, Holt R, Allison C, Baron-Cohen S, van IMH, Jansen PW. Is the association between mothers’ autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?. Mol Autism;2023 (Dec 8);14(1):46.

BACKGROUND: Previous studies showed that there is a positive association between mothers’ and children’s autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI). METHOD: The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years). RESULT: Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; β(adjusted) = 0.20, p < 0.01), in early childhood (Generation R; β(adjusted) = 0.19, p < 0.01), and in early adolescence (Generation R; β(adjusted) = 0.16, p < 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (β(adjusted) = 0.03, p < 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight. CONCLUSION: We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.

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16. Serrano L, Vela E, Martín L. Analysis of the Functioning of Families of Children with Autism Spectrum Disorder: A Psychometric Study of the Family APGAR Scale. Int J Environ Res Public Health;2023 (Nov 24);20(23)

Normalised family functioning is a predictor of individual well-being. The diagnosis of a family member with autism spectrum disorder (ASD) can alter the ordinary dynamics of family systems, having a variable impact on family functioning. This research employed a non-probability convenience sampling method to gather a sample of 327 families with and without children diagnosed with ASD. This study has dual objectives: to analyse the psychometric properties of the Spanish version of the Family APGAR Scale and to compare family functioning in families with and without a child with ASD. The results reveal several favourable psychometric properties in the application of the APGAR scale within families of children with ASD. The use of the Family APGAR Scale in the selected sample confirms that the functioning of families with children with ASD can be categorized as mildly dysfunctional, attributed to the inherent challenges in caring for and raising a child with ASD. The presence of ASD within family systems presents a challenge to typical family functioning, with significant differences observed between families with and without children with ASD. This underscores the necessity of implementing effective intervention programs based on empirical evidence to improve the quality of life for individuals with ASD and their families.

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17. Stogiannos N, Pavlopoulou G, Papadopoulos C, Walsh G, Potts B, Moqbel S, Gkaravella A, McNulty J, Simcock C, Gaigg S, Bowler D, Marais K, Cleaver K, Lloyd JH, Dos Reis CS, Malamateniou C. Strategies to improve the magnetic resonance imaging experience for autistic individuals: a cross-sectional study exploring parents and carers’ experiences. BMC Health Serv Res;2023 (Dec 7);23(1):1375.

BACKGROUND: Autistic individuals encounter numerous barriers in accessing healthcare, including communication difficulties, sensory sensitivities, and a lack of appropriate adjustments. These issues are particularly acute during MRI scans, which involve confined spaces, loud noises, and the necessity to remain still. There remains no unified approach to preparing autistic individuals for MRI procedures. METHODS: A cross-sectional online survey was conducted with parents and carers of autistic individuals in the UK to explore their experiences, barriers, and recommendations concerning MRI scans. The survey collected demographic information and experiential accounts of previous MRI procedures. Quantitative data were analysed descriptively, while key themes were identified within the qualitative data through inductive thematic analysis. RESULTS: Sixteen parents/carers participated. The majority reported difficulties with communication, inadequate pre-scan preparation, and insufficient adjustments during MRI scans for their autistic children. Key barriers included an overwhelming sensory environment, radiographers’ limited understanding of autism, and anxiety stemming from uncertainties about the procedure. Recommended improvements encompassed accessible communication, pre-visit familiarisation, noise-reduction and sensory adaptations, staff training on autism, and greater flexibility to meet individual needs. CONCLUSIONS: There is an urgent need to enhance MRI experiences for autistic individuals. This can be achieved through improved staff knowledge, effective communication strategies, thorough pre-scan preparation, and tailored reasonable adjustments. Co-producing clear MRI guidelines with the autism community could standardise sensitive practices. An individualised approach is crucial for reducing anxiety and facilitating participation. Empowering radiographers through autism-specific education and incorporating insights from autistic individuals and their families could transform MRI experiences and outcomes.

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18. Szlamka Z, Hanlon C, Tekola B, Pacione L, Salomone E, Servili C, Hoekstra RA. Correction: Exploring contextual adaptations in caregiver interventions for families raising children with developmental disabilities. PLoS One;2023;18(12):e0295831.

[This corrects the article DOI: 10.1371/journal.pone.0272077.].

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19. Wagner L, Vehorn A, Weitlauf AS, Lavanderos AM, Wade J, Corona L, Warren Z. Development of a Novel Telemedicine Tool to Reduce Disparities Related to the Identification of Preschool Children with Autism. J Autism Dev Disord;2023 (Dec 8)

The wait for ASD evaluation dramatically increases with age, with wait times of a year or more common as children reach preschool. Even when appointments become available, families from traditionally underserved groups struggle to access care. Addressing care disparities requires designing identification tools and processes specifically for and with individuals most at-risk for health inequities. This work describes the development of a novel telemedicine-based ASD assessment tool, the TELE-ASD-PEDS-Preschool (TAP-Preschool). We applied machine learning models to a clinical data set of preschoolers with ASD and other developmental concerns (n = 914) to generate behavioral targets that best distinguish ASD and non-ASD features. We conducted focus groups with clinicians, early interventionists, and parents of children with ASD from traditionally underrepresented racial/ethnic and linguistic groups. Focus group themes and machine learning analyses were used to generate a play-based instrument with assessment tasks and scoring procedures based on the child’s language (i.e., TAP-P Verbal, TAP-P Non-verbal). TAP-P procedures were piloted with 30 families. Use of the instrument in isolation (i.e., without history or collateral information) yielded accurate diagnostic classification in 63% of cases. Children with existing ASD diagnoses received higher TAP-P scores, relative to children with other developmental concerns. Clinician diagnostic accuracy and certainty were higher when confirming existing ASD diagnoses (80% agreement) than when ruling out ASD in children with other developmental concerns (30% agreement). Utilizing an equity approach to understand the functionality and impact of tele-assessment for preschool children has potential to transform the ASD evaluation process and improve care access.

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20. Wang M, Ma Z, Wang Y, Liu J, Guo J. A multi-view convolutional neural network method combining attention mechanism for diagnosing autism spectrum disorder. PLoS One;2023;18(12):e0295621.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition whose current psychiatric diagnostic process is subjective and behavior-based. In contrast, functional magnetic resonance imaging (fMRI) can objectively measure brain activity and is useful for identifying brain disorders. However, the ASD diagnostic models employed to date have not reached satisfactory levels of accuracy. This study proposes the use of MAACNN, a method that utilizes multi-view convolutional neural networks (CNNs) in conjunction with attention mechanisms for identifying ASD in multi-scale fMRI. The proposed algorithm effectively combines unsupervised and supervised learning. In the initial stage, we employ stacked denoising autoencoders, an unsupervised learning method for feature extraction, which provides different nodes to adapt to multi-scale data. In the subsequent stage, we perform supervised learning by employing multi-view CNNs for classification and obtain the final results. Finally, multi-scale data fusion is achieved by using the attention fusion mechanism. The ABIDE dataset is used to evaluate the model we proposed., and the experimental results show that MAACNN achieves superior performance with 75.12% accuracy and 0.79 AUC on ABIDE-I, and 72.88% accuracy and 0.76 AUC on ABIDE-II. The proposed method significantly contributes to the clinical diagnosis of ASD.

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21. Wang T, Zhang S, Luo M, Lu M, Wei L, Zhou X, Wang H, Xu D. Prenatal caffeine exposure induces autism-like behaviors in offspring under a high-fat diet via the gut microbiota-IL-17A-brain axis. Ecotoxicol Environ Saf;2023 (Dec 8);269:115797.

Prenatal caffeine exposure (PCE) is a significant contributor to intrauterine growth retardation (IUGR) in offspring, which has been linked to an increased susceptibility to autism spectrum disorder (ASD) later in life. Additionally, a high-fat diet (HFD) has been shown to exacerbate ASD-like behaviors, but the underlying mechanisms remain unclear. In this study, we first noted in the rat model of IUGR induced by PCE that male PCE offspring exhibited typical ASD-like behaviors post-birth, in contrast to their female counterparts. The female PCE offspring demonstrated only reduced abilities in free exploration and spatial memory. Importantly, both male and female PCE offspring displayed ASD-like behaviors when exposed to HFD. We further observed that PCE + HFD offspring exhibited damaged intestinal mucus barriers and disturbed gut microbiota, resulting in an increased abundance of Escherichia coli (E. coli). The induced differentiation of colonic Th17 cells by E. coli led to an increased secretion of IL-17A, which entered the hippocampus through peripheral circulation and caused synaptic damage in hippocampal neurons, ultimately resulting in ASD development. Our strain transplantation experiment suggested that E. coli-mediated increase of IL-17A may be the core mechanism of ASD with a fetal origin. In conclusion, PCE and HFD are potential risk factors for ASD, and E. coli-mediated IL-17A may play a crucial role in fetal-originated ASD through the gut-brain axis.

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22. Yamasue H. Is the efficacy of oxytocin for autism diminished at higher dosages or repeated doses?: Potential mechanisms and candidate solutions. Peptides;2023 (Dec 8):171133.

No approved pharmacological intervention currently exists to address the core symptoms of autism spectrum disorder, a prevalent neurodevelopmental condition. However, there is a growing body of empirical evidence highlighting oxytocin’s modulatory effects on social and communicative behaviors. Numerous single-dose trials have consistently demonstrated the efficacy of oxytocin in ameliorating behavioral and neural measurements associated with the core symptoms of autism spectrum disorder. Nevertheless, prior investigations involving the repeated administration of oxytocin have yielded disparate findings concerning its effectiveness, particularly in relation to clinical measures of the core symptoms of autism spectrum disorder. Recent studies have also raised the possibility of diminishing efficacy of oxytocin over time, particularly when higher or recurrent dosages of oxytocin are administered. This review article aims to provide an overview of previous studies examining this issue. Furthermore, it aims to discuss the potential mechanisms underlying these effects, including the interaction between oxytocin and vasopressin, as well as potential strategies for addressing the challenges mentioned. This review’s overall objective is to provide insights into the potential development of innovative therapeutics to mitigate the core symptoms of autism spectrum disorder, representing potential breakthroughs in the treatment of this complex neurodevelopmental condition.

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