1. Arnhart C, Neale M, Collins C, Chesher T, Coffey S, Rogers TC, Ottwell R, Hartwell M. The Use of Person-Centered Language in Scientific Research Articles Focused on Autism. Journal of developmental and behavioral pediatrics : JDBP. 2022; 43(2): 63-70.

OBJECTIVE: Individuals with developmental conditions, such as autism, experience stigma, which is reflected in derogatory language and labels. To limit stigma associated with disabilities, government agencies and medical organizations have adopted the use of person-centered language (PCL). This study investigated adherence to PCL guidelines among peer-reviewed research publications focused on autism. In addition, we investigated the co-occurrence of stigmatizing language in articles using person-first language (PFL) and identity-first language (IFL) styles. METHODS: We performed a systematic search of PubMed for autism-focused articles from January 2019 to May 2020. Articles from journals with more than 20 search returns were included, and a random sample of 700 publications were screened and examined for inclusion of prespecified, non-PCL terminology. RESULTS: Of the 315 publications, 156 (49.5%) were PCL compliant. Articles frequently used PCL and non-PCL terminology concomitantly, and 10% of publications included obsolete nomenclature. A logistic regression model showed the odds were more likely that publications using IFL were more likely to include other stigmatizing terminology than publications using PFL (odds ratio = 2.03, 95% confidence interval: 1.15-3.58). CONCLUSION: Within medical research, the language to describe individuals and populations needs to be used with intentionality and acknowledges that individuals are more than the diagnosis under study. This may reduce the structural stigma that may be implied otherwise. Our study showed that when PFL is used when addressing individuals with autism, other more stigmatizing language is often avoided and is in line with medical education and clinical practice.

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2. Chetcuti L, Richdale AL, Haschek A, Uljarević M, Lawson LP. Brief Report: Discrete Effortful Control Skills Moderate Relations Between Childhood Behavioural Inhibition and Mental Health Difficulties in Autistic Youth. Journal of autism and developmental disorders. 2022.

Studies of the general population suggest that the risk for mental health difficulties conferred by dispositional behavioural inhibition (BI) may be modified by self-regulation; however, this possibility has not been explored in the context of autism. This study investigated the moderating effects of attentional-, activation-, and inhibitory control on the relationship between childhood BI and anxiety and depression among 47 autistic youths (55% male, M(age) = 19.09 years, SD = 2.23). Childhood BI was associated with anxiety at low but not high levels of attentional- and activation control, and depression at low but not high levels of attentional control. However, there were no moderating effects of inhibitory control. These preliminary findings are partially consistent with those from the general population and point to avenues for future work.

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3. Dutto I, Gerhards J, Herrera A, Souckova O, Škopová V, Smak JA, Junza A, Yanes O, Boeckx C, Burkhalter MD, Zikánová M, Pons S, Philipp M, Lüders J, Stracker TH. Pathway-specific effects of ADSL deficiency on neurodevelopment. eLife. 2022; 11.

Adenylosuccinate lyase (ADSL) functions in de novo purine synthesis (DNPS) and the purine nucleotide cycle. ADSL deficiency (ADSLD) causes numerous neurodevelopmental pathologies, including microcephaly and autism spectrum disorder. ADSLD patients have normal serum purine nucleotide levels but exhibit accumulation of dephosphorylated ADSL substrates, S-Ado, and SAICAr, the latter being implicated in neurotoxic effects through unknown mechanisms. We examined the phenotypic effects of ADSL depletion in human cells and their relation to phenotypic outcomes. Using specific interventions to compensate for reduced purine levels or modulate SAICAr accumulation, we found that diminished AMP levels resulted in increased DNA damage signaling and cell cycle delays, while primary ciliogenesis was impaired specifically by loss of ADSL or administration of SAICAr. ADSL-deficient chicken and zebrafish embryos displayed impaired neurogenesis and microcephaly. Neuroprogenitor attrition in zebrafish embryos was rescued by pharmacological inhibition of DNPS, but not increased nucleotide concentration. Zebrafish also displayed phenotypes commonly linked to ciliopathies. Our results suggest that both reduced purine levels and impaired DNPS contribute to neurodevelopmental pathology in ADSLD and that defective ciliogenesis may influence the ADSLD phenotypic spectrum.

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4. Elnahas EM, Abuelezz SA, Mohamad MI, Nabil MM, Abdelraouf SM, Bahaa N, Hassan GAM, Aboul-Fotouh S. Novel role of peroxisome proliferator activated receptor-α in valproic acid rat model of autism: Mechanistic study of risperidone and metformin monotherapy versus combination. Progress in neuro-psychopharmacology & biological psychiatry. 2022; 116: 110522.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder of heterogenous etiology exhibiting a challenge in understanding its exact neuro-pathophysiology. Recently, peroxisome proliferator activated receptor (PPAR)-α activation was found to play a fundamental role in neuroprotection and improving autistic-like-behaviors in experimental animal models of ASD through alleviating neuroinflammation, oxidative-stress, astrocyte reactivity, tauopathy in addition to its favorable role in metabolic regulation, thus attracting attention as a possible target in treatment of ASD. This study aimed to investigate the role of PPAR-α, astrocytic dysfunction and tauopathy in ASD and detect the possible neuroprotective effects of metformin (MET), through PPAR-α activation, and risperidone (RIS) either monotherapy or in combination in alleviating autistic-like-changes at behavioral and neurobiological levels in male Wistar rats. Pregnant female Wistar rats received valproic-acid (VPA) to induce autistic-like-behavioral and neurobiological alterations in their offspring. Chronic intra-peritoneal MET (100 mg/kg/day) and RIS (1 mg/kg/day) either monotherapy or in combination started from postnatal day (PND) 24 till PND61 (38 days). Prenatal VPA exposure simulated the autistic core behaviors associated with neurochemical and histopathological neurodevelopmental degenerative changes. Both MET and RIS either monotherapy or in combination were able to reverse these changes. The effect of MET was comparable to RIS. Moreover, MET was able to alleviate the RIS induced weight gain and improve cognitive functions highlighting its promising adjunctive role in alleviating ASD pathophysiology. Our study highlighted the favorable effects of MET and RIS both in monotherapy and in combination in alleviating the autistic-like-changes and proposed PPAR-α activation along with restoring astrocytes homeostasis as promising targets in novel therapeutic strategies in ASD.

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5. Erickson SR, Houseworth J, Esler A. Factors associated with use of medication for behavioral challenges in adults with intellectual and developmental disability. Research in developmental disabilities. 2022; 123: 104182.

BACKGROUND/AIMS: Persons with intellectual or developmental disabilities and who exhibit challenging behaviors are often prescribed medication to control behavior. Little is known about the environmental factors that may be associated with taking these medications. METHODS AND OUTCOMES: This study examined the association between individual and intermediate or environmental factors and the documented use of medication for clients with intellectual or developmental disabilities (IDD) who exhibit challenging behavior, using the 2014-15 National Core Indicators Adult Consumer Survey dataset. RESULTS AND CONCLUSIONS: Individual-level variables associated with a higher likelihood of taking medication for persons with IDD exhibiting challenging behaviors included being of younger age, male gender, having moderate or severe intellectual disability, being ambulatory, communicating verbally, having a behavioral plan, requiring support for behavioral challenges, and having a history of mental illness. Environment-level variables included infrequently eating out and having less everyday choice. This study found that restrictions in opportunities to make choices in their life was associated with a greater likelihood of being on a medication for persons with IDD who exhibit challenging behavior. Living in group home settings also increased the likelihood of medication use. A limitation of the study is a lack of information on why medications were prescribed and whether they were intended to treat the challenging behavior. IMPLICATIONS: This work has important implications for health providers, as addressing malleable social factors may provide an avenue for reducing challenging behaviors without the need for medication.

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6. Firestein MR, Romeo RD, Winstead H, Goldman DA, Grobman WA, Haas D, Mercer B, Parker C, Parry S, Reddy U, Silver R, Simhan H, Wapner RJ, Champagne FA. Elevated prenatal maternal sex hormones, but not placental aromatase, are associated with child neurodevelopment. Hormones and behavior. 2022; 140: 105125.

Fetal exposure to testosterone may contribute to vulnerability for autism spectrum disorder (ASD). It is hypothesized that placental aromatase prevents fetal exposure to maternal testosterone, however, this pathway and the implications for child neurodevelopment have not been fully explored. We examined the relationships between prenatal maternal testosterone and estradiol at 19.2 ± 1.3 weeks, cord blood testosterone and estradiol at birth, placental aromatase mRNA expression, and neurodevelopment using the Social Communication Questionnaire (SCQ), the Behavioral Assessment System for Children, 3rd Edition (BASC-3), and the Empathizing Quotient for Children (EQ-C) at 4.5-6.5 years of age in a sample of 270 Nulliparous-Mothers-to-be (nuMoM2b) study participants. Maternal testosterone levels were positively associated with SCQ scores, but the association was not significant after adjusting for maternal age at delivery, nor was there a significant interaction with sex. Maternal estradiol levels were negatively associated with BASC-3 Clinical Probability scores among males (n = 139). We report a significant interaction effect of cord blood testosterone and fetal sex on both total SCQ scores and t-scores on the Developmental Social Disorders subscale. Placental aromatase was not associated with any neurodevelopmental or hormone measure, but under conditions of low placental aromatase expression, high maternal testosterone was positively associated with SCQ scores in males (n = 46). No other associations between hormone levels and neurodevelopment were significant. Our findings provide a foundation for further investigation of the mechanisms through which maternal sex hormones and placental steroidogenesis may affect fetal hormone production and neurobehavior.

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7. Hsu YH, Chen CW, Lin YJ, Li CY. Urban-Rural Disparity in the Incidence of Diagnosed Autism Spectrum Disorder in Taiwan: A 10-Year National Birth Cohort Follow-up Study. Journal of autism and developmental disorders. 2022.

Autism spectrum disorder (ASD) is reportedly more prevalent in urban areas partly because of better accessibility and affordability to healthcare. With universal health insurance coverage in Taiwan, a previous study has shown no urban-rural disparity in the utilization rate of a child’s preventive healthcare. Under this circumstance, we followed a birth cohort of 176,273 live births from 2006 to 2015 to detect the differences in ASD incidence between urbanicities. After adjusting for socioeconomic factors, children were 1.28 (95% confidence interval (CI): 1.13-1.44) and 1.54 (95% CI: 1.36-1.75) more likely to acquire ASD in satellite and urban areas compared with those in rural areas, respectively. A gradient association between parental educational attainment and ASD incidence was also noted. Greater ASD incidences in more urbanized areas and more advanced educated parents’ children were detected under a circumstance with low barriers to healthcare.

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8. Ji Y, Lv H, Chen Z, Yu J, Fang S, Li F. Generation of a human induced pluripotent stem cell line (SJTUXHi002-A) from an individual with autism spectrum disorder carrying a heterozygous mutation in GRIA2. Stem cell research. 2022; 60: 102676.

Herein, we report the generation of a human induced pluripotent stem cell (iPSC) line from an autism spectrum disorder (ASD) patient carrying the c.1998delT mutation in GRIA2 gene. The generated iPSC line exhibits normal karyotype, pluripotency markers and was able to differentiate into three germ layers. The iPSC line retained the GRIA2 mutation (c.1998delT), which could provide a valuable resource for investing pathogenic mechanisms underlying ASD and facilitating the development of targeted medicine.

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9. Jones MK, Zellner MA, Hobson AN, Levin A, Roberts MY. Understanding Caregiver Satisfaction With a Telediagnostic Assessment of Autism Spectrum Disorder. American journal of speech-language pathology. 2022; 31(2): 982-90.

PURPOSE: In light of the COVID-19 pandemic, it is critical to understand the feasibility and acceptability of the use of telediagnostic assessments in clinical settings. This study aimed to characterize caregiver satisfaction with a telediagnostic assessment of autism spectrum disorder (ASD). METHOD: Twelve families completed a telediagnostic assessment of ASD through Illinois’ Early Intervention program including a caregiver interview, administration of the TELE-ASD-PEDS, and a feedback visit. Following the evaluation, caregivers rated their satisfaction with the telediagnostic assessment. RESULTS: Caregivers reported that the evaluation met their expectations, and they were satisfied with the assessment and feedback visit. However, caregiver satisfaction with the telehealth platform varied, and the majority of caregivers reported a preference for in-person visits. Qualitative analysis of caregiver responses noted the benefits and areas of improvement of telediagnostic assessment. Thematic analysis revealed the strengths of the telediagnostic assessment, including the logistical convenience of the teleassessment, ease of administration, rapport with and expertise of the clinicians, and qualification for intervention services. Although caregivers’ perspectives varied, diagnostic accuracy and the amount of information provided about the diagnosis were reported areas of improvement. CONCLUSIONS: Overall, telediagnostic assessments were well received by families. Caregivers’ preference for in-person visits highlights the need to incorporate caregiver-reported areas of improvement in the development and administration of telediagnostic assessments.

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10. Kranz S, Lukacs J, Bishop J, Block ME. Intergeneration transfer of diet patterns? Parental self-report of diet and their report of their young adult children with ASD. PloS one. 2022; 17(2): e0263445.

Autism Spectrum Disorder (ASD) affects two percent of American children and often results in neophobia, hypersensitivity to foods, and firmly set food preferences, leading to higher proportions of individuals suffering from diet-related chronic diseases. Our objective was to conduct an explorative pilot study to examine parents’ perception of food intake for themselves and their young adult children with ASD. We employed comparative analysis to discover potential pathways to improve diet quality and lower the risk for chronic disease in individuals with ASD. Data from an online survey in n = 493 parent-child dyads on parentally reported intake patterns, food group, and food consumption was analyzed using kappa statistics to determine the level of agreement between reported parental and child intake patterns, body weight status and activity level. Average age was 48 years for parents and 22 years for their children, respectively. Parent-child agreement for obesity was high. We found very strong agreement between the reported diet variety (kappa = 0.82) and changing daily intake (kappa = 0.63) and strong agreement for some vegetable intake patterns (kappa = 0.61 for orange, white, and starchy vegetables) but not in meat intake (no agreement). Results of this study indicate evidence for perceived intergenerational transfer of dietary intake patterns, which may offer effective approaches to change parental diet, to subsequently improve diet quality in young adults with ASD and prevent diet-related chronic diseases in individuals with ASD.

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11. Kwon EY, Cannon JE, Knight VF, Mercer SH, Guardino C. Effects of Social Stories on Increasing Social Interaction and Engagement of Deaf and Hard of Hearing Students with Autism Spectrum Disorder in Inclusive Settings. Journal of autism and developmental disorders. 2022.

d/Deaf or hard of hearing (d/Dhh) students with autism spectrum disorder (ASD) may require specific approaches to promote social inclusion. The purpose of this study was to investigate the effects of reading social stories with American Sign Language vocabulary to students who are d/Dhh with ASD (d/Dhh-ASD) and their peers in inclusive settings, using a non-concurrent multiple baseline design across participants. To examine the effectiveness of the intervention, the frequency of four communicative social behaviors and the duration of social engagement with peers were recorded for each participant during lunchtime and recess. The results did not show an immediate effect across all participants. Implications for promoting social inclusion for students who are d/Dhh-ASD in general education classrooms are discussed.

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12. Liloia D, Cauda F, Uddin LQ, Manuello J, Mancuso L, Keller R, Nani A, Costa T. Revealing the Selectivity of Neuroanatomical Alteration in Autism Spectrum Disorder via Reverse Inference. Biological psychiatry Cognitive neuroscience and neuroimaging. 2022.

BACKGROUND: Although neuroimaging research has identified atypical neuroanatomical substrates in individuals with autism spectrum disorder (ASD), it is at present unclear whether and to what extent disorder-selective gray matter alterations occur in this spectrum of conditions. In fact, a growing body of evidence shows a substantial overlap between the pathomorphological changes across different brain diseases, which may complicate identification of reliable neural markers and differentiation of the anatomical substrates of distinct psychopathologies. METHODS: Using a novel data-driven and Bayesian methodology with published voxel-based morphometry data (849 peer-reviewed experiments and 22,304 clinical subjects), this study performs the first reverse inference investigation to explore the selective structural brain alteration profile of ASD. RESULTS: We found that specific brain areas exhibit a >90% probability of gray matter alteration selectivity for ASD: the bilateral precuneus (Brodmann area 7), right inferior occipital gyrus (Brodmann area 18), left cerebellar lobule IX and Crus II, right cerebellar lobule VIIIA, and right Crus I. Of note, many brain voxels that are selective for ASD include areas that are posterior components of the default mode network. CONCLUSIONS: The identification of these spatial gray matter alteration patterns offers new insights into understanding the complex neurobiological underpinnings of ASD and opens attractive prospects for future neuroimaging-based interventions.

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13. Lin LZ, Zhan XL, Jin CY, Liang JH, Jing J, Dong GH. The epidemiological evidence linking exposure to ambient particulate matter with neurodevelopmental disorders: A systematic review and meta-analysis. Environmental research. 2022; 209: 112876.

BACKGROUND: There has been increasing attention on the associations between ambient particulate matter (PM) in early-life and neurodevelopmental disorders (NDDs). However, the associations remained unclear when considering different types of NDDs and different sizes of PM, and vulnerable exposure windows during early-life were not identified yet. OBJECTIVE: To synthesize the published literature on the associations between ambient particulate matter (PM) and risk of different types of neurodevelopmental disorders (NDDs) in a systematic review and meta-analysis. METHODS: A systematic search of Medline, Embase, PubMed, Cochrane Library, and Web of Science was performed from inception through 24 January 2022. Two reviewers conducted the study selection, data extraction, and quality appraisal. A random-effects model was used for meta-analyses with two quality-of-evidence assessments (the Grading of Recommendations Assessment, Development, and Evaluation system and the best evidence synthesis system). RESULTS: A total of 6554 articles were screened, of which 31 were included in the review, and 20 provided adequate data for meta-analyses. Exposures to particulate matter of 2.5 μm or less (PM(2.5)) during prenatal periods (OR, 1.32 [95%CI, 1.03-1.69]), the first year after birth (OR, 1.62 [95%CI, 1.22-2.15]) and the second year after birth (OR, 3.13 [95%CI, 1.47-6.67]) were associated with increased risk of autism spectrum disorders (ASD) in children. The quality of evidence for these associations during early postnatal periods was somewhat moderate with limited studies. We found inconsistent evidence when considering other types of NDDs and different sizes of PM. CONCLUSIONS AND RELEVANCE: Current evidence indicated that there might be an association between PM(2.5) exposure and higher risk of ASD, and early postnatal periods appeared to be the critical exposure window. High-quality studies are needed to assess the evidence for other types of NDDs.

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14. Ong SH, Chen ST. Diagnosis of Malnutrition in Children and Adolescents with Identified Developmental Disabilities (IDD) Using Subjective Global Nutrition Assessment (SGNA). Journal of tropical pediatrics. 2022; 68(1).

BACKGROUND: Children with identified developmental disabilities (IDD) experience a higher risk of growth retardation. Anthropometric indicator is one common objective measurement used to determine malnutrition in those children. A comprehensive nutritional assessment tool should be introduced to offer a more robust approach in understanding their nutritional problems. OBJECTIVE: To determine the use of Subjective Global Nutrition Assessment (SGNA) as a nutrition assessment tool for children with IDD in comparison to the anthropometric indicators. METHODS: This cross-sectional study was conducted in local community settings. IDD included in this study were autism spectrum disorder (ASD), Down syndrome (DS) and cerebral palsy (CP). SGNA and anthropometry measurements including weight, height, mid-upper arm circumference and triceps skinfolds were performed on 93 children with IDD (40 ASD, 26 DS and 27 CP) aged 5-18 years. Cohen’s Kappa, sensitivity, specificity and its 95% confidence interval were calculated between SGNA and anthropometric indicators for the agreement in determining malnutrition status of the children. RESULTS: SGNA identified a lower prevalence of malnutrition in children with IDD in comparison to the use of anthropometric indicators. SGNA obtained a moderate-to-fair agreement (above 80% agreement, except height-for-age parameter) and sensitivity (25.71-59.09%) against the use of a single anthropometric indicator in identifying the malnutrition status of the children. CONCLUSIONS: The use of SGNA as an adjunct to body mass index-for-age as an anthropometric measurement for diagnosing malnutrition in children and adolescents with IDD is recommended.

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15. Xiao Y, Alkire D, Moraczewski D, Redcay E. Developmental differences in brain functional connectivity during social interaction in middle childhood. Developmental cognitive neuroscience. 2022; 54: 101079.

The transition from childhood to adolescence is marked by significant changes in peer interactions. However, limited research has examined the brain systems (e.g., mentalizing and reward networks) involved in direct peer interaction, particularly during childhood and early adolescence. Here, we analyzed fMRI data from 50 children aged 8-12 years while they participated in a task in which they chatted with a peer (Peer) or answered questions about a story character (Character). Using a beta-series correlation analysis, we investigated how social interaction modulates functional connectivity within and between mentalizing and reward networks and whether this modulation changes with age. We observed effects of social interaction on functional connectivity were modulated by age within the mentalizing and reward networks. Further, greater connectivity within and between these networks during social interaction was related to faster reaction time to the Peer versus Character condition. Similar effects were found in the salience and mirror neuron networks. These findings provide insights into age-related differences in how the brain supports social interaction, and thus have the potential to advance our understanding of core social difficulties in social-communicative disorders, such as autism spectrum disorder.

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16. Zaheer J, Kim H, Ko IO, Jo EK, Choi EJ, Lee HJ, Shim I, Woo HJ, Choi J, Kim GH, Kim JS. Pre/post-natal exposure to microplastic as a potential risk factor for autism spectrum disorder. Environment international. 2022; 161: 107121.

In common with the increase in environmental pollution in the past 10 years, there has also been a recent increase in the prevalence of autism spectrum disorder (ASD). In this regard, we hypothesized that exposure to microplastics is a potential risk factor for ASD. To evaluate the validity of this hypothesis, we initially examined the accumulation of polyethylene (PE) in the brains of mice and then assessed the behavioral effects using mouse models at different life stages, namely, prenatal, post-weaning, puberty, and adult models. Based on typical behavioral assessments of autistic traits in the model mice, we established that ASD-like traits were induced in mice after PE feeding. In addition, we examined the induction of ASD-like traits in response to microplastic exposure using positron emission tomography, magnetic resonance spectroscopy, quantitative real-time polymerase chain reaction, microarray, and microbiome analysis. We believe these findings provide evidence in microplastics as a potential risk factor for ASD.

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