1. Al-Mazidi SH, Al-Ayadhi LY. Reply to: « Qualitative Evaluation of α-Synuclein: A Critical Step in Unravelling the Complexities of Autism Spectrum Disorder ». Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2023: 1.

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2. Bradley RS, Staples GL, Quetsch LB, Aloia LS, Brown CE, Kanne SM. Associations Between Parenting Stress and Quality Time in Families of Youth with Autism Spectrum Disorder. Journal of autism and developmental disorders. 2023: 1-12.

Increased stress among parents of youth with ASD has been well-documented. However, research on aspects of the parent-child relationship and subsequent links to parenting stress is limited. We assessed parents (N = 511) of youth with ASD to examine relations between parenting stress and parent-child quality time (amount of quality time, shared enjoyment, synchronicity). Elevated parenting stress was associated with less time spent engaging with youth in shared activities and decreased parent and child enjoyment during shared interactions. Parents with elevated stress reported engaging in shared activities and experiencing synchronicity with their child less often than parents below the clinical threshold. Future research should emphasize longitudinal efforts examining the directionality of this relationship to better inform family-focused intervention.

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3. Brandalise F, Kalmbach BE, Cook EP, Brager DH. Impaired dendritic spike generation in the Fragile X prefrontal cortex is due to loss of dendritic sodium channels. The Journal of physiology. 2023.

Dendritic spike threshold is depolarized in Layer 5 PFC neurons in FX mice Simultaneous somatic and dendritic recording with white noise current injections revealed that larger dendritic stimuli were required to elicit dendritic spikes in FX ET neurons Outside-out patch clamp recording revealed that dendritic sodium conductance density was lower in FX ET neurons ABSTRACT: Patients with Fragile X syndrome, the leading monogenetic cause of autism, suffer from impairments related to the prefrontal cortex including working memory and attention. Synaptic inputs to the distal dendrites of layer 5 pyramidal neurons in the prefrontal cortex have a weak influence on the somatic membrane potential. To overcome this filtering, distal inputs are transformed into local dendritic Na(+) spikes, which propagate to the soma and trigger action potential output. Layer 5 extratelencephalic (ET) PFC neurons project to the brainstem and various thalamic nuclei and are therefore well positioned to integrate task-relevant sensory signals and guide motor actions. We used current clamp and outside-out patch clamp recording to investigate dendritic spike generation in ET neurons from male wild type and Fmr1 knockout (FX) mice. The threshold for dendritic spikes was more depolarized in FX neurons compared to wild type. Analysis of voltage responses to simulated in vivo ‘noisy’ current injections showed that a larger dendritic input stimulus was required to elicit dendritic spikes in FX ET dendrites compared to wild type. Patch clamp recordings revealed that the dendritic Na(+) conductance was significantly smaller in FX ET dendrites. Taken together, our results suggest that the generation of Na(+) -dependent dendritic spikes is impaired in ET neurons of the PFC in FX mice. Considering our prior findings that somatic D-type K(+) and dendritic HCN-channel function is reduced in ET neurons, we suggest that dendritic integration by PFC circuits is fundamentally altered in Fragile X syndrome. Abstract figure legend Loss of dendritic sodium conductance in layer 5 ET neurons in the prefrontal cortex of Fragile X mice. Dendritic sodium channels are critical to the generation of sodium spikes in the dendrites of layer 5 pyramidal neurons in the mouse prefrontal cortex. In L5 PFC neurons of FX mice (red) the threshold for dendritic sodium spikes is depolarized due to a reduced dendritic sodium conductance. This article is protected by copyright. All rights reserved.

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4. Cary E, Pacheco D, Kaplan-Kahn E, McKernan E, Matsuba E, Prieve B, Russo N. Brain Signatures of Early and Late Neural Measures of Auditory Habituation and Discrimination in Autism and Their Relationship to Autistic Traits and Sensory Overresponsivity. Journal of autism and developmental disorders. 2023.

Sensory differences are included in the DSM-5 criteria of autism for the first time, yet it is unclear how they relate to neural indicators of perception. We studied early brain signatures of perception and examined their relationship to sensory behaviors and autistic traits. Thirteen autistic children and 13 Typically Developing (TD) children matched on age and nonverbal IQ participated in a passive oddball task, during which P1 habituation and P1 and MMN discrimination were evoked by pure tones. Autistic children had less neural habituation than the TD comparison group, and the MMN, but not P1, mapped on to sensory overresponsivity. Findings highlight the significance of temporal and contextual factors in neural information processing as it relates to autistic traits and sensory behaviors.

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5. Desaunay P, Guillery B, Moussaoui E, Eustache F, Bowler DM, Guénolé F. Brain correlates of declarative memory atypicalities in autism: a systematic review of functional neuroimaging findings. Molecular autism. 2023; 14(1): 2.

The long-described atypicalities of memory functioning experienced by people with autism have major implications for daily living, academic learning, as well as cognitive remediation. Though behavioral studies have identified a robust profile of memory strengths and weaknesses in autism spectrum disorder (ASD), few works have attempted to establish a synthesis concerning their neural bases. In this systematic review of functional neuroimaging studies, we highlight functional brain asymmetries in three anatomical planes during memory processing between individuals with ASD and typical development. These asymmetries consist of greater activity of the left hemisphere than the right in ASD participants, of posterior brain regions-including hippocampus-rather than anterior ones, and presumably of the ventral (occipito-temporal) streams rather than the dorsal (occipito-parietal) ones. These functional alterations may be linked to atypical memory processes in ASD, including the pre-eminence of verbal over spatial information, impaired active maintenance in working memory, and preserved relational memory despite poor context processing in episodic memory.

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6. Desquenne Godfrey G, Downes N, Cappe E. A Systematic Review of Family Functioning in Families of Children on the Autism Spectrum. Journal of autism and developmental disorders. 2023.

This article aims to review the literature on family functioning in the field of autism. The search was conducted in August 2021 in PubMed, PsycINFO, and PubPsy and sixty-two articles were included. Studies were published in English between 1980 and 2021 and provided quantitative data from validated measures of family functioning in families with an official diagnosis of autism. Results showed that family functioning appeared more problematic for families of autistic children than non-autistic ones. Difficulties were correlated with more caregiver demand and less resources. Interventional results varied. The findings highlight the importance of considering family functioning when providing care for autistic children and their families. Limitations and implications for future research are discussed.Prospero registration number: CRD42022297696.

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7. Drüsedau LL, Götz A, Kleine Büning L, Conzelmann A, Renner TJ, Barth GM. Tübinger Training for Autism Spectrum Disorders (TüTASS): a structured group intervention on self-perception and social skills of children with autism spectrum disorder (ASD). European archives of psychiatry and clinical neuroscience. 2023.

In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants’ self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD.

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8. Fittipaldi S, Armony JL, Migeot J, Cadaveira M, Ibáñez A, Baez S. Overactivation of posterior insular, postcentral, and temporal regions during preserved experience of envy in autism. The European journal of neuroscience. 2023.

Social emotions are critical to successfully navigate in a complex social world because they promote self-regulation of behavior. Difficulties in social behavior are at the core of autism spectrum disorder (ASD). However, social emotions and their neural correlates have been scarcely investigated in this population. In particular, the experience of envy has not been addressed in ASD despite involving neurocognitive processes crucially compromised in this condition. Here, we used an fMRI adapted version of a well-validated task to investigate the subjective experience of envy and its neural correlates in adults with ASD (n = 30) in comparison with neurotypical controls (n = 28). Results revealed that both groups reported similarly intense experience of envy in association with canonical activation in the anterior cingulate cortex and the anterior insula, among other regions. However, in participants with ASD, the experience of envy was accompanied by overactivation of the posterior insula, the postcentral gyrus, and the posterior superior temporal gyrus, regions subserving the processing of painful experiences and mentalizing. This pattern of results suggests that individuals with ASD may use compensatory strategies based on the embodied amplification of pain and additional mentalizing efforts to shape their subjective experience of envy. Results have relevant implications to better understand the heterogeneity of this condition and to develop new intervention targets.

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9. Frazier TW, Dimitropoulos A, Abbeduto L, Armstrong-Brine M, Kralovic S, Shih A, Hardan AY, Youngstrom EA, Uljarević M. The Autism Symptom Dimensions Questionnaire: Development and psychometric evaluation of a new, open-source measure of autism symptomatology. Developmental medicine and child neurology. 2023.

AIM: To describe the development and initial psychometric evaluation of a new, freely available measure, the Autism Symptom Dimensions Questionnaire (ASDQ). METHOD: After development and revision of an initial 33-item version, informants completed a revised 39-item version of the ASDQ on 1467 children and adolescents (aged 2-17 years), including 104 with autism spectrum disorder (ASD). RESULTS: The initial 33-item version of the ASDQ had good reliability and construct validity. However, only four specific symptom factors were identified, potentially due to an insufficient number of items. Factor analyses of the expanded instrument identified a general ASD factor and nine specific symptom factors with good measurement invariance across demographic groups. Scales showed good-to-excellent overall and conditional reliability. Exploratory analyses of predictive validity for ASD versus neurotypical and other developmental disability diagnoses indicated good accuracy for population and at-risk contexts. INTERPRETATION: The ASDQ is a free and psychometrically sound informant report instrument with good reliability of measurement across a continuous range of scores and preliminary evidence of predictive validity. The measure may be a useful alternative to existing autism symptom measures but further studies with comparison of clinical diagnoses using criterion-standard instruments are needed.

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10. Gilhuber CS, Raulston TJ, Galley K. Language and communication skills in multilingual children on the autism spectrum: A systematic review. Autism : the international journal of research and practice. 2023: 13623613221147780.

Both parents and service providers have voiced concerns about the potential negative impact of exposure to multiple languages on the language and communication skills of autistic children. The current literature review summarized research that assessed the language and communication skills of multilingual autistic children in comparison with their autistic and nonautistic peers. After a comprehensive search, 22 relevant publications were identified that met the inclusion criteria of the current review. Thirteen studies used both direct (directly administered screening/diagnostic tools) and indirect language assessments (e.g. parent questionnaires). Receptive and expressive vocabulary was the most frequently assessed language skill. Available research does not support the assumption that bilingualism has negative effects on the language and communication skills of autistic children. The language and communication skills of multilingual autistic children frequently resembled their monolingual autistic peers in both strengths and areas of growth. Preliminary findings indicate that multilingual autistic children may share some advantages of multilingualism with their multilingual nonautistic peers. Studies often excluded participants with intellectual disabilities or complex communication needs, which means that a large population of autistic children is not yet represented in research about the effects of multilingualism.

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11. Hirota T, King BH. Autism Spectrum Disorder: A Review. Jama. 2023; 329(2): 157-68.

IMPORTANCE: Autism spectrum disorder (ASD), characterized by deficits in social communication and the presence of restricted, repetitive behaviors or interests, is a neurodevelopmental disorder affecting approximately 2.3% children aged 8 years in the US and approximately 2.2% of adults. This review summarizes evidence on the diagnosis and treatment of ASD. OBSERVATIONS: The estimated prevalence of ASD has been increasing in the US, from 1.1% in 2008 to 2.3% in 2018, which is likely associated with changes in diagnostic criteria, improved performance of screening and diagnostic tools, and increased public awareness. No biomarkers specific to the diagnosis of ASD have been identified. Common early signs and symptoms of ASD in a child’s first 2 years of life include no response to name when called, no or limited use of gestures in communication, and lack of imaginative play. The criterion standard for the diagnosis of ASD is a comprehensive evaluation with a multidisciplinary team of clinicians and is based on semistructured direct observation of the child’s behavior and semistructured caregiver interview focused on the individual’s development and behaviors using standardized measures, such as the Autism Diagnostic Observation Schedule-Second Edition and the Autism Diagnostic Interview. These diagnostic measures have sensitivity of 91% and 80% and specificity of 76% and 72%, respectively. Compared with people without ASD, individuals with ASD have higher rates of depression (20% vs 7%), anxiety (11% vs 5%), sleep difficulties (13% vs 5%), and epilepsy (21% with co-occurring intellectual disability vs 0.8%). Intensive behavioral interventions, such as the Early Start Denver Model, are beneficial in children 5 years or younger for improvement in language, play, and social communication (small to medium effect size based on standardized mean difference). Pharmacotherapy is indicated for co-occurring psychiatric conditions, such as emotion dysregulation or attention-deficit/hyperactivity disorder. Risperidone and aripiprazole can improve irritability and aggression (standardized mean difference of 1.1, consistent with a large effect size) compared with placebo. Psychostimulants are effective for attention-deficit/hyperactivity disorder (standardized mean difference of 0.6, consistent with a moderate effect size) compared with placebo. These medications are associated with adverse effects including, most commonly, changes in appetite, weight, and sleep. CONCLUSIONS AND RELEVANCE: ASD affects approximately 2.3% of children aged 8 years and approximately 2.2% of adults in the US. First-line therapy consists of behavioral interventions, while co-occurring psychiatric conditions, such as anxiety or aggression, may be treated with specific behavioral therapy or medication.

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12. Ilan M, Faroy M, Zachor D, Manelis L, Waissengreen D, Michaelovski A, Avni I, Menashe I, Koller J, Dinstein I, Meiri G. Children with autism exhibit similar longitudinal changes in core symptoms when placed in special or mainstream education settings. Autism : the international journal of research and practice. 2023: 13623613221142394.

Today, children with autism spectrum disorder (ASD) are placed in mainstream or special education settings somewhat arbitrarily with no clear clinical recommendations. Here, we compared changes in core ASD symptoms, as measured by the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) clinical assessment, across ASD preschool children placed in special or mainstream education. Longitudinal changes in ADOS-2 scores did not differ significantly across settings over a 1- to 2-year period. While some children improved in core ASD symptoms, others deteriorated in both settings. This highlights the need to identify specific criteria for establishing meaningful placement recommendations.

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13. Isralowitz EB, Sideris J, Stein Duker LI, Baranek GT, Cermak SA. Comparing sensory processing in children with Down syndrome to a mental age matched sample of children with autism, other developmental disabilities, and typically developing children. Research in developmental disabilities. 2023; 134: 104421.

BACKGROUND: Atypical sensory processing impacts children with intellectual and developmental disabilities (IDD). Research has focused on SP in individuals with autism spectrum disorder (ASD); comparatively, little has been written regarding individuals with Down syndrome (DS) and IDDs. AIMS: We compared patterns of sensory processing in children with DS to children with ASD, other IDDs, and typically developing (TD) peers examining the relationship among different sensory processing measures. METHODS AND PROCEDURES: We analyzed cross-sectional data using two caregiver questionnaires (SP, SEQ) and one observational measure (SPA). Groups were compared on three sensory processing patterns: hyporesponsiveness; hyperresponsiveness; and sensory interests, repetitions, and seeking (SIRS) via ANOVA. We assessed concordance through correlations. OUTCOMES AND RESULTS: Children with DS, IDD, and ASD demonstrated more atypical sensory processing behaviors than TD peers. Children with ASD exhibited the most atypical responses across all measures, significantly more than DS children on all but one subscale. The IDD and DS groups differed on several measures. Measurement concordance was higher between caregiver-report versus observational assessment. CONCLUSIONS AND IMPLICATIONS: Differences between three clinical groups indicate that sensory processing features may differ across clinical populations regardless of cognitive functioning. Lower concordance between caregiver-report and observation measures highlights the need to understand sensory processing expression across different tasks and environments.

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14. Knaus TA, Burns CO, Kamps J, Foundas AL. Action viewing and language in adolescents with autism spectrum disorder. Experimental brain research. 2023.

The mirror neuron system consists of fronto-parietal regions and responds to both goal-directed action execution and observation. The broader action observation network is specifically involved in observation of actions and is thought to play a role in understanding the goals of the motor act, the intention of others, empathy, and language. Many, but not all, studies have found mirror neuron system or action observation network dysfunction in autism spectrum disorder. The objective of this study was to use observation of a goal-directed action fMRI paradigm to examine the action observation network in autism spectrum disorder and to determine whether fronto-parietal activation is associated with language ability. Adolescents with autism spectrum disorder (n = 23) were compared to typically developing adolescents (n = 20), 11-17 years. Overall, there were no group differences in activation, however, the autism spectrum group with impaired expressive language (n = 13) had significantly reduced inferior frontal and inferior parietal activation during action viewing. In controls, right supramarginal gyrus activation was associated with higher expressive language; bilateral supramarginal and left pars opercularis activation was associated with better verbal-gesture integration. Results suggest that action-observation network dysfunction may characterize a subgroup of individuals with autism spectrum disorder with expressive language deficits. Therefore, interventions that target this dysfunctional network may improve expressive language in this autism spectrum subgroup. Future treatment studies should individualize therapeutic approaches based on brain-behavior relationships.

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15. Lee J, Sone B, Rooney T, Roberts MY. The Role of Naturalistic Developmental Behavioral Interventions in Early Intervention for Autistic Toddlers: An Observational Study. American journal of speech-language pathology. 2023: 1-13.

PURPOSE: Naturalistic developmental behavioral interventions (NDBIs) have demonstrated initial promise in facilitating social communication development for autistic toddlers, but their highly structured protocols may be a barrier toward their use by early intervention (EI) providers who must individualize intervention according to family-centered principles. This study aimed to characterize the extent to which EI speech-language pathologists (SLPs) use NDBI strategies, and the range of skills and behaviors addressed during their EI sessions, to contextualize the role of NDBIs within the scope of needs of families with autistic children in EI. METHOD: This observational study included 25 families with an autistic toddler and their EI SLP. One home-based session was recorded for each family, and an observational measure was used to describe SLPs’ NDBI strategy use. Qualitative content analyses were also used to characterize the strategies SLPs recommended to families, and the child skills and behaviors they discussed. RESULTS: SLPs did not implement NDBI strategies with high quality, but they implemented developmental NDBI strategies with significantly higher quality than behavioral NDBI strategies. SLPs discussed many strategies and skills across disciplines within the session. CONCLUSIONS: SLPs may require further training to implement NDBI strategies, but given the breadth and depth of skills addressed during sessions, researchers should investigate and report on the impact of NDBIs on a wider range of communication skills and developmental domains. This will facilitate clinical decision making and make these interventions better aligned with family-centered EI principles. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21834480.

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16. Lewis LF, Stevens K. The lived experience of meltdowns for autistic adults. Autism : the international journal of research and practice. 2023: 13623613221145783.

There is not a lot known about what it feels like for autistic people to have a meltdown. Past research has focused on what meltdowns are like for parents and what meltdowns look like from the outside without understanding what it is like for the person having the meltdown. We asked 32 autistic adults about what it is like for them to have a meltdown. We asked them to tell us about their thoughts and feelings about having a meltdown. Then, we looked for themes in their responses that summarized the meltdown experience. Our findings showed that meltdowns hold different meaning to different people. During a meltdown, we found that most autistics described feeling overwhelmed by information, senses, and social and emotional stress. They often felt extreme emotions, such as anger, sadness, and fear, and had trouble with thinking and memory during the meltdown. Participants described trying to stay in control of themselves, often feeling like they were not themselves during meltdowns. They described the meltdown as a way of letting go of or releasing the extreme emotions they felt. Participants tried to stay away from things or people that might trigger a meltdown or tried to make sure they were alone if they felt a meltdown may be coming as a way of avoiding harm-including harm to their bodies, their emotions, and their relationships. These findings offer an important look into what it is like for autistic adults to have meltdowns from their own point of view.

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17. Nishimura T, Takahashi N, Okumura A, Harada T, Iwabuchi T, Nakayasu C, Rahman S, Uchiyama S, Wakuta M, Nomura Y, Takei N, Senju A, Tsuchiya KJ. Sex Differences in Neurodevelopmental Trajectories in Children with Different Levels of Autistic Traits. Psychiatry and clinical neurosciences. 2023.

AIM: Little is known about early manifestations of autism spectrum disorders (ASD) in females, including those who may be overlooked by the current diagnostic criteria. We longitudinally explored sex differences in the trajectories of cognitive and motor functions and adaptive behaviors in children with different levels of autistic traits. METHODS: The participants were 824 children from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), Japan, who were classified into three autistic trait groups-low, moderate, and high-based on the Social Responsiveness Scale-Second Edition. Cognitive and motor functions were measured at seven time-points from 0.5 to 3.5 years of age using the Mullen Scales of Early Learning. Adaptive behaviors were measured at five time-points from 2.7 to 9 years of age using the Vineland Adaptive Behavior Scales-Second Edition. Trajectories were depicted using latent growth curve modeling. RESULTS: Sex-specific trajectories were observed in the high-autistic-trait group, with only males showing a temporary decline in expressive language around the age of 2 years and a slight improvement thereafter. They also showed a slight improvement around 3 years in the adaptive behavior communication domain but a gradual downward trend later. Females in the high-autistic-trait group showed no distinct manifestation before the age of 3 years but showed a downward trend after 3.5 years in the adaptive behavior communication domain. CONCLUSION: Females and males with higher autistic traits than their same-sex peers, independent of clinical diagnosis, may have different phenotypes in certain neurodevelopmental domains during infancy and early childhood. This article is protected by copyright. All rights reserved.

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18. Palmer M, Carter Leno V, Hallett V, Mueller JM, Breese L, Pickles A, Slonims V, Scott S, Charman T, Simonoff E. Effects of a Parenting Intervention for Emotional and Behavioral Problems in Young Autistic Children Under Conditions of Enhanced Uncertainty: Two-Year Follow-up of a Pilot Randomized Controlled Trial Cohort (ASTAR) During the United Kingdom COVID-19 Pandemic. Journal of the American Academy of Child and Adolescent Psychiatry. 2023.

OBJECTIVE: Most young autistic children display emotional and behavioral problems (EBPs). There is evidence that behavioral parenting interventions (BPIs) reduce these. The COVID-19 pandemic and associated lockdowns can be seen as a natural experiment to test the longer-term effect of BPIs under conditions of increased uncertainty. METHOD: Opportunistic follow-up (n = 49) of a pilot randomized controlled trial (RCT) cohort (n = 62 autistic children aged 6-11 years; originally randomized to a 12-week group BPI [Predictive Parenting; n = 31] or an attention control [Psychoeducation; n = 31]) was conducted during COVID-19-related lockdowns. Measures of parent-reported child irritability and parenting stress were collected at 3 time points (baseline: mean age = 6.7 years; primary endpoint: mean age = 7.1 years, ∼5 months after randomization; and COVID-19 follow-up: mean age = 8.8 years, ∼2 years after randomization). We tested the magnitude of intervention effects using point estimates of differences in child irritability and parenting stress between arms at primary endpoint and COVID-19 follow-up, covarying for baseline scores. We used area under the curve (AUC) analyses to obtain overall estimates of the average intervention effect across all 3 timepoints. Semi-structured qualitative interviews were conducted with a subsample of parents (n = 18). RESULTS: A small but significant intervention effect was found from baseline to COVID-19 follow-up in favor of Predictive Parenting on parent-reported child irritability (d = -0.33, 95% CI = -0.65, -0.01) and parenting stress (d = -0.31, 95% CI = -0.59, -0.03). No overall mean intervention effect for these measures as estimated by the AUC analyses (which takes into account the nonsignificant effect at primary endpoint) was found. Interview feedback on the both interventions was positive, and parents reported using strategies from Predictive Parenting during COVID-19-related restrictions. CONCLUSION: This opportunistic follow-up study at a time of stress indicates the need for careful consideration of how and when to measure the effects of BPIs in autistic child populations. Future trials should consider both the most appropriate endpoint and in what context effects may be more likely to be seen. CLINICAL TRIAL REGISTRATION INFORMATION: Autism Spectrum Treatment and Resilience (ASTAR); https://www.isrctn.com; 91411078.

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19. Pang S, Luo Z, Dong W, Gao S, Chen W, Liu N, Zhang X, Gao X, Li J, Gao K, Shi X, Guan F, Zhang L, Zhang L. Integrin β1/FAK/SRC signal pathway is involved in autism spectrum disorder in Tspan7 knockout rats. Life science alliance. 2023; 6(3).

TSPAN7 is related to various neurological disorders including autism spectrum disorder (ASD). However, the underlying synaptic mechanism of TSPAN7 in ASD is still unclear. Here, we showed that Tspan7 knockout rats exhibited ASD-like and ID-like behavioral phenotypes, brain structure alterations including decreased hippocampal and cortical volume, and related pathological changes including reduced hippocampal neurons number, neuronal complexity, dendritic spines, and synapse-associated proteins. Then, we found that TSPAN7 deletion interrupted the integrin β1/FAK/SRC signal pathway that was followed by the down-regulation of PSD95, SYN, and GluR1/2, which are key synaptic integrity-related proteins. Furthermore, reactivation of SRC restored the expression of synaptic integrity-related proteins in primary neurons of TSPAN7 knockout brains. Taken together, our results suggested that TSPAN7 knockout caused ASD-like and ID-like behaviors in rats and impaired neuronal synapses possibly through the down-regulation of the integrin β1/FAK/SRC signal pathway, which might be a new mechanism on regulation of synaptic proteins expression and on ASD pathogenesis by mutated TSPAN7. These findings provide novel insights into the role of TSPAN7 in psychiatric diseases and highlight integrin β1/FAK/SRC as a potential target for ASD therapy.

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20. Pezzimenti F, Durrani E, Zheng S, Adams RE, Bishop SL, Taylor JL. Perspectives on Employer-Initiated Terminations Among Young Adults on the Autism Spectrum. Journal of autism and developmental disorders. 2023.

Job instability is high among autistic adults, with employer-initiated terminations a common reason for job loss. The current study used qualitative methods to code reasons that autistic adults identified for their employer-initiated termination. From 315 autistic individuals ages 18-35 who completed an online survey, 93 (29.5%) reported having been terminated from a job. These individuals were asked about the reasons for their termination and responses were coded into thematic categories. Common reasons included work performance, social difficulties, attendance, and mental health challenges. Adults were more likely to attribute terminations to internal causes (related to the individual) than to external causes (environment-related). A good fit between workplace, individual preferences, skills, and abilities is likely key to promoting job continuity for autistic adults.

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21. Pham C, Bacon EC, Grzybowski A, Carter-Barnes C, Arias S, Xu R, Lopez L, Courchesne E, Pierce K. Examination of the impact of the Get SET Early program on equitable access to care within the screen-evaluate-treat chain in toddlers with autism spectrum disorder. Autism : the international journal of research and practice. 2023: 13623613221147416.

Delays in autism spectrum disorder identification and access to care could impact developmental outcomes. Although trends are encouraging, children from historically underrepresented minority backgrounds are often identified at later ages and have reduced engagement in services. It is unclear if disparities exist all along the screen-evaluation-treatment chain, or if early detection programs such as Get SET Early that standardize, these steps are effective at ameliorating disparities. As part of the Get SET Early model, primary care providers administered a parent-report screen at well-baby examinations, and parents designated race, ethnicity, and developmental concerns. Toddlers who scored in the range of concern, or whose primary care provider had concerns, were referred for an evaluation. Rates of screening and evaluation engagement within ethnic/racial groups were compared to US Census data. Age at screen, evaluation, and treatment engagement and quantity was compared across groups. Statistical models examined whether key factors such as parent concern were associated with ethnicity or race. No differences were found in the mean age at the first screen, evaluation, or initiation or quantity of behavioral therapy between participants. However, children from historically underrepresented minority backgrounds were more likely to fall into the range of concern on the parent-report screen, their parents expressed developmental concerns more often, and pediatricians were more likely to refer for an evaluation than their White/Not Hispanic counterparts. Overall results suggest that models that support transparent tracking of steps in the screen-evaluation-treatment chain and service referral pipelines may be an effective strategy for ensuring equitable access to care for all children.

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22. Renuka P, Singh S, Rathore M. Picture exchange communication system as a behavior modification technique for oral health assessment in autistic children. The Journal of clinical pediatric dentistry. 2022; 46(6): 11-6.

OBJECTIVE: The aim of this study was to establish a modality for behavioral intervention for dental management in autistic children using Picture Exchange Communication System (PECS). STUDY DESIGN: A prospective interventional study was carried out on 30 autistic children in the age range of 4-18 years diagnosed with mild to moderate grades of autism to evaluate the effectiveness of PECS in improving oral health over a period of 6 months. RESULTS: PECS Phases showed a gradual rise from first to third visit, which was statistically highly significant (p < 0.001). Oral Hygiene Index-Simplified (OHI-S) scores improved significantly from first visit and second visit. Definitely substantial correlation was seen between PECS and OHI-S. CONCLUSION: Gradual decrease was observed in OHI-S scores over a period of 6 months, indicating an improvement in the oral hygiene status of autistic children. Gradual progress in Phases of PECS proved to increase cognitive ability of autistic children towards understanding the dental setup related PECS cards.

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23. Rimmer C, Philibert-Lignières G, Iarocci G, Quintin EM. The Contribution of Perceptual Reasoning Skills to Phonological Awareness for School Age Autistic Children. Journal of autism and developmental disorders. 2023.

This study aimed to investigate the phonological awareness (PA) skills of school age autistic children (age range = 6-12) in two parts: (1) comparing their performance on a PA task to non-autistic children with groups matched on chronological age, verbal and non-verbal cognitive skills, and (2) exploring the role of cognitive skills and autism characteristics on PA skills. Results revealed that the groups did not differ in their PA skills (study 1) and that perceptual reasoning skills are associated with the PA skills of autistic participants (study 2). Results highlight the role of non-verbal cognitive skills in literacy development for autistic children and suggest that their perceptual reasoning abilities likely contribute a great deal when learning to read.

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24. Roberts MY, Stern YS, Grauzer J, Nietfeld J, Thompson S, Jones M, Kaat AJ, Kaiser AP. Teaching Caregivers to Support Social Communication: Results From a Randomized Clinical Trial of Autistic Toddlers. American journal of speech-language pathology. 2023; 32(1): 115-27.

BACKGROUND: Studies of early caregiver-mediated interventions targeting social communication of young autistic children have yielded variable child outcomes. This study examined the effects of combining two caregiver-mediated interventions on caregiver strategy use and child social communication and language outcomes. METHOD: This was a multisite parallel randomized controlled trial. Participants included 120 caregivers and their autistic children between 24 and 36 months of age. Dyads were randomly assigned to receive a hybrid intervention that combined Enhanced Milieu Teaching (EMT) and Joint Attention, Symbolic Play, Engagement, and Regulation (JASPER) or to a behavior management control condition, each delivered over 6 months. Caregivers in the JASP-EMT group received twice-weekly, in-home, and hour-long sessions. Outcomes were measured at baseline, the end of intervention (T1), and 6 months later (T2) and included a naturalistic language sample procedure, standardized measures, and caregiver report measures. This trial was registered at clinicaltrials.gov (NCT02595697). RESULTS: Child outcomes did not differ between conditions at T1 or T2 for child primary (social communication) or secondary (language, play, and autism symptoms) outcomes. Relative to control group caregivers, intervention group caregivers demonstrated significantly higher use of JASP-EMT strategies at T1 and T2, with the exception of two strategies (Responsiveness and Matched Responsiveness), which were used significantly more by control group caregivers. Neither autism severity nor baseline caregiver responsiveness moderated outcomes. Post hoc analyses revealed significant correlations between specific strategies and all child outcomes. CONCLUSIONS: Twice-weekly caregiver-mediated intervention that taught caregivers of autistic children to use social communication support strategies did not yield significant child outcomes. Future studies should examine possible sources for the lack of main effects including unexpected differences in linguistic features of caregiver input, changes in control group caregiver behavior, and insufficient intervention dosage. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21714278.

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25. Santhanam SP. An Interactive and Neurodiversity-Affirming Approach to Communication Supports for Autistic Students Through Videogaming. Language, speech, and hearing services in schools. 2023: 1-20.

PURPOSE: Videogaming offers an interactive, enjoyable, and socially valid context for interaction between autistic and non-autistic students in schools. In this tutorial, I describe an approach that supports communication and peer interaction through group-based videogaming. This approach creates an opportunity for autistic and non-autistic students to engage in a meaningful and enjoyable activity and to promote acceptance and appreciation of communication differences. METHOD: This tutorial includes development, planning, essential components, goal writing, and a list of resources and directions to implement the videogaming-based group intervention in middle and high school settings. This tutorial is grounded in a supports-based, anti-ableist, neurodiversity framework that embraces a difference-based view of autistic communication. Cost-effectiveness and ease of implementation make this intervention feasible for school settings. CONCLUSIONS: Ableist practices are pervasive in academic and clinical settings. There is an urgency within the field of speech-language pathology to address misconceptions regarding autism and autistic individuals, increase the understanding and appreciation of diversity in autistic communication, and eliminate practices that may promote autistic masking. These can be achieved by developing supports that value the preferences and experiences of autistic individuals and honor their strengths. Videogaming is one context that supports social communication. It does not hinge upon normative communication as a benchmark. Increased contact and exposure to autistic peers through fun and engaging game-based interactions help reduce stigma and prejudice toward autistic students.

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26. Schwartzman JM, Williams ZJ, Paterson AV, Jacobs AX, Corbett BA. Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT. Autism : the international journal of research and practice. 2023: 13623613221143587.

Autistic youth and adults are more likely to experience psychiatric symptoms (e.g. depression, anxiety) and to use psychiatric services than non-autistic people, yet research on evidence-based approaches to enhance psychiatric care for autistic people is limited. Measurement-based care is an evidence-based approach to psychotherapy that improves outcomes for clients, clinicians, and organizations by routinely administering and evaluating measures to clients. Despite this, research on measurement-based care systems for autistic clients is sparse. To address this gap, we developed an autism-adapted measurement-based care (MBC-AUT) system for and with autistic people and pilot tested the system in an outpatient psychiatry clinic to investigate the preliminary feasibility, acceptability, benefits, and barriers to this system for clients and clinicians. Findings suggested that the MBC-AUT system was a feasible and acceptable system for the first 18 autistic youth, their caregivers, and autistic adults to use the system. In semi-structured interviews, clients and clinicians discussed the benefits of the MBC-AUT system to various therapeutic processes, as well as several important barriers to the use of the system. We offer potential solutions to address these barriers and to reduce client and clinician burden, and propose future directions for this line of research to increase access to more autistic people. As autistic clients continue to seek psychological services amid social landscapes of increasing complexity (e.g. COVID-19 pandemic), efforts to enhance the delivery of psychotherapy for this population are critical.

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27. Sivathasan S, Dahary H, Burack JA, Quintin EM. Basic emotion recognition of children on the autism spectrum is enhanced in music and typical for faces and voices. PloS one. 2023; 18(1): e0279002.

In contrast with findings of reduced facial and vocal emotional recognition (ER) accuracy, children on the autism spectrum (AS) demonstrate comparable ER skills to those of typically-developing (TD) children using music. To understand the specificity of purported ER differences, the goal of this study was to examine ER from music compared with faces and voices among children on the AS and TD children. Twenty-five children on the AS and 23 TD children (6-13 years) completed an ER task, using categorical (happy, sad, fear) and dimensional (valence, arousal) ratings, of emotions presented via music, faces, or voices. Compared to the TD group, the AS group showed a relative ER strength from music, and comparable performance from faces and voices. Although both groups demonstrated greater vocal ER accuracy, the children on the AS performed equally well with music and faces, whereas the TD children performed better with faces than with music. Both groups performed comparably with dimensional ratings, except for greater variability by the children on the AS in valence ratings for happy emotions. These findings highlight a need to re-examine ER of children on the AS, and to consider how facilitating strengths-based approaches can re-shape our thinking about and support for persons on the AS.

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28. Smith IN, Dawson JE, Eng C. Comparative Protein Structural Network Analysis Reveals C-Terminal Tail Phosphorylation Structural Communication Fingerprint in PTEN-Associated Mutations in Autism and Cancer. The journal of physical chemistry B. 2023.

PTEN (phosphatase and tensin homolog deleted on chromosome 10) is a tightly regulated dual-specificity phosphatase and key regulator of the PI3K/AKT/mTOR signaling pathway. PTEN phosphorylation at its carboxy-terminal tail (CTT) serine/threonine cluster negatively regulates its tumor suppressor function by inducing a stable, closed, and inactive conformation. Germline PTEN mutations predispose individuals to PTEN hamartoma tumor syndrome (PHTS), a rare inherited cancer syndrome and, intriguingly, one of the most common causes of autism spectrum disorder (ASD). However, the mechanistic details that govern phosphorylated CTT catalytic conformational dynamics in the context of PHTS-associated mutations are unknown. Here, we utilized a comparative protein structure network (PSN)-based approach to investigate PTEN CTT phosphorylation-induced conformational dynamics specific to PTEN-ASD compared to PTEN-cancer phenotypes. Results from our study show differences in structural flexibility, inter-residue contacts, and allosteric communication patterns mediated by CTT phosphorylation, differentiating PTEN-ASD and PTEN-cancer phenotypes. Further, we identified perturbations among global metapaths and community network connections within the active site and inter-domain regions, indicating the significance of these regions in transmitting information across the PSN. Together, our studies provide a mechanistic underpinning of allosteric regulation through the coupled interplay of CTT phosphorylation conformational dynamics in PTEN-ASD and PTEN-cancer mutations. Importantly, the detailed atomistic interactions and structural consequences of PTEN variants reveal potential allosteric druggable target sites as a viable and currently unexplored treatment approach for individuals with different PHTS-associated mutations.

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29. van Andel DM, Sprengers JJ, Königs M, de Jonge MV, Bruining H. Effects of Bumetanide on Neurocognitive Functioning in Children with Autism Spectrum Disorder: Secondary Analysis of a Randomized Placebo-Controlled Trial. Journal of autism and developmental disorders. 2023.

We present the secondary-analysis of neurocognitive tests in the ‘Bumetanide in Autism Medication and Biomarker’ (BAMBI;EUDRA-CT-2014-001560-35) study, a randomized double-blind placebo-controlled (1:1) trial testing 3-months bumetanide treatment (≤ 1 mg twice-daily) in unmedicated children 7-15 years with ASD. Children with IQ ≥ 70 were analyzed for baseline deficits and treatment-effects on the intention-to-treat-population with generalized-linear-models, principal component analysis and network analysis. Ninety-two children were allocated to treatment and 83 eligible for analyses. Heterogeneous neurocognitive impairments were found that were unaffected by bumetanide treatment. Network analysis showed higher modularity after treatment (mean difference:-0.165, 95%CI:-0.317 to - 0.013,p = .034) and changes in the relative importance of response inhibition in the neurocognitive network (mean difference:-0.037, 95%CI:-0.073 to - 0.001,p = .042). This study offers perspectives to include neurocognitive tests in ASD trials.

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30. van ‘t Wout F, Jarrold C. To What Extent is the Contribution of Language to Learning via Instructions Modulated by the Expression of Autism Traits?. Journal of autism and developmental disorders. 2023.

Language plays a fundamental role in enabling flexible, goal-directed behaviour. This study investigated whether the contribution of language to instruction encoding is modulated by the expression of autism traits, as measured by the Autism Spectrum Quotient (ASQ) questionnaire. Participants (N = 108) completed six choice reaction time tasks, with each task consisting of six stimulus-response mappings. During an instruction phase preceding each task, participants performed either a verbal, non-verbal or no distractor task. Participants made more errors in the verbal distractor task condition, but this detrimental effect did not differ significantly between the high (top 33%) and low (bottom 33%) ASQ groups. Hence, the contribution of language to instruction encoding does not appear to be modulated by the expression of autism traits.

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31. Weitlauf AS, Miceli A, Vehorn A, Dada Y, Pinnock T, Harris JW, Hine J, Warren Z. Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care. Journal of autism and developmental disorders. 2023.

PURPOSE: Despite advances in screening and awareness, Black and multiracial families continue to experience challenges when seeking an autism diagnosis for their children. METHODS: We surveyed 400 Black and multiracial families of young children with autism from an existing research database in the United States about their retrospective diagnostic experiences. We gathered quantitative and qualitative data and engaged in iterative coding to understand timing and content of first concerns, families’ experiences of care providers and systems, and the impact of race and culture on accessing care. RESULTS: Families provided examples of early developmental concern and described provider, systemic, and cultural barriers and facilitators to care. Families also provided insight into the influence of culture and made recommendations on how the medical system could better care for Black and multiracial families of children with autism. CONCLUSIONS: Results add to a growing body of literature supporting the need for culturally sensitive and accessible care related to developmental monitoring, diagnosis, and follow-up care for Black and multiracial children.

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32. Woodbury-Smith MR, Westphal A, Loftin R. Editorial: Training in Autism Among First Responders. Journal of autism and developmental disorders. 2023.

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33. Yasumitsu-Lovell K, Thompson L, Fernell E, Eitoku M, Suganuma N, Gillberg C. Pre-/perinatal reduced optimality and neurodevelopment at 1 month and 3 years of age: Results from the Japan Environment and Children’s Study (JECS). PloS one. 2023; 18(1): e0280249.

Neurodevelopmental disorders (NDDs) in children are associated with a complex combination of genetic and/or environmental factors. Pre-/perinatal events are major known environmental suboptimal factors, and their individual and combined contributions vary. This study investigated the association between pre-/perinatal reduced optimality and child development observed by parents at 1 month, as well as NDDs at 3 years of age (i.e., motor delay, intellectual disability, developmental language disorder, and autism spectrum disorder), in the context of the Japan Environment and Children’s Study. The study also assessed whether child development at 1 month predicted NDDs at 3 years of age. Associations between 25 pre-/perinatal factors and (a) developmental concerns at 1 month of age and (b) NDDs at 3 years were analyzed (n = 71,682). Binomial regression models were used to investigate risk ratios of the developmental outcome at each time point for total pre-/perinatal reduced optimality scale scores, as well as for individual pre-/perinatal factors of the reduced optimality scale. Finally, we assessed the ability of parental observations of offspring development at 1 month to predict NDDs at 3 years. Total reduced optimality scores were positively associated with 1-month developmental concerns and 3-year NDDs, with higher scores (i.e., a reduction in optimality) associated with an increased risk of both NDDs and earlier parental concerns. Neonatal transportation, epidural analgesia, advanced maternal age, cesarean section delivery, Apgar score ≤8, and hyperbilirubinemia were identified as individual risk factors for 3-year NDDs, overlapping with 14 risk factors for 1-month developmental concerns except Apgar score ≤8. Among six developmental items assessed at 1 month of age, concerns about gross motor function and difficulty holding/trouble calming down had the strongest associations with later-diagnosed motor delay and autism spectrum disorder, respectively. Five perinatal factors and advanced maternal age were associated with NDD at 3 years of age, as were early parental developmental concerns regarding their offspring’s overall development, indicating the importance of careful follow-up of offspring born with pre-/perinatal reduced optimality. The results also implicated early parental concerns, as early as 1 month, may also be a useful indicator of later NDD status.

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34. Zarokanellou V, Gryparis A, Papatheodorou P, Tatsis G, Tafiadis D, Papadopoulos A, Voniati L, Siafaka V. Societal Attitudes Towards Autism (SATA): Validation of the Greek Version in the General Population. Journal of autism and developmental disorders. 2023.

This study examined the validity of the Greek version of the Societal Attitudes Towards Autism (SATA) scale in a Greek community sample (n = 633) and explored how the demographic variables of the sample modulate knowledge and attitudes regarding people with Autism Spectrum Disorder (ASD). The principal component analysis confirmed the three-dimension model and explained 40.5% of the variance. All Cronbach’s alpha values obtained were over 0.70. SATA’s subscales were significantly and positively correlated, indicating good internal reliability. Participants presented moderate knowledge about ASD and mediocre positive attitudes towards people with ASD. Gender, age, and educational level significantly affected SATA total scores. Overall, this Greek version of SATA showed acceptable psychometric properties, indicating that can be a reliable scale for use.

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