1. Ames JL, Burjak M, Avalos LA, Braun JM, Bulka CM, Croen LA, Dunlop AL, Ferrara A, Fry RC, Hedderson MM, Karagas MR, Liang D, Lin PD, Lyall K, Moore B, Morello-Frosch R, O’Connor TG, Oh J, Padula AM, Woodruff TJ, Zhu Y, Hamra GB. Prenatal exposure to per- and polyfluoroalkyl substances and childhood autism-related outcomes. Epidemiology (Cambridge, Mass). 2023.

BACKGROUND: Epidemiologic evidence linking prenatal exposure to per- and polyfluoroalkyl substances (PFAS) with altered neurodevelopment is inconclusive, and few large studies have focused on autism-related outcomes. We investigated whether blood concentrations of PFAS in pregnancy are associated with child autism-related outcomes. METHODS: We included ten cohorts from the National Institutes of Health (NIH)-funded Environmental influences on Child Health Outcomes (ECHO) Program (n=1429). We measured 14 PFAS analytes in maternal blood collected during pregnancy; eight analytes met detection criteria for analysis. We assessed quantitative autism-related traits in children via parent report on the Social Responsiveness Scale (SRS). In multivariable linear models, we examined relationships of each PFAS (natural log-transformed) with SRS scores. We further modeled PFAS as a complex mixture using Bayesian methods and examined modification of these relationships by child sex. RESULTS: Most PFAS in maternal blood were not associated with child SRS T-scores. Perfluorononanoic acid (PFNA) showed the strongest and most consistent association: each 1-unit increase in ln-transformed PFNA was associated with greater autism-related traits (adj-β [95% CI]=1.5 [-0.1, 3.0]). The summed mixture, which included six PFAS detected in >70% of participants, was not associated with SRS T-scores (adj-β [95% highest posterior density interval]=0.7 [-1.4, 3.0]). We did not observe consistent evidence of sex differences. DISCUSSION: Prenatal blood concentrations of PFNA may be associated with modest increases in child autism-related traits. Future work should continue to examine the relationship between exposures to both legacy and emerging PFAS and additional dimensional, quantitative measures of childhood autism-related outcomes.

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2. Cannon J, Eldracher E, Cardinaux A, Irfan F, Bungert L, Li C, O’Brien A, Treves I, Diamond S, Sinha P. Rhythmic and interval-based temporal orienting in autism. Autism research : official journal of the International Society for Autism Research. 2023.

Individuals with autism spectrum disorder (ASD) may show secondary sensory and cognitive characteristics, including differences in auditory processing, attention, and, according to a prominent hypothesis, the formulation and utilization of predictions. We explored the overlap of audition, attention, and prediction with an online auditory « temporal orienting » task in which participants utilized predictive timing cues (both rhythmic and interval-based) to improve their detection of faint sounds. We compared an autistic (n = 78) with a nonautistic (n = 83) group, controlling for nonverbal IQ, and used signal detection measures and reaction times to evaluate the effect of valid temporally predictive cues. We hypothesized that temporal orienting would be compromised in autism, but this was not supported by the data: the boost in performance induced by predictability was practically identical for the two groups, except for the small subset of the ASD group with co-occurring attention deficit hyperactivity disorder, who received less benefit from interval-based cueing. However, we found that the presence of a rhythm induced a significantly stronger bias toward reporting target detections in the ASD group at large, suggesting weakened response inhibition during rhythmic entrainment.

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3. Chee ZJ, Scheeren AM, De Vries M. The factor structure and measurement invariance of the Autism Spectrum Quotient-28: A cross-cultural comparison between Malaysia and the Netherlands. Autism : the international journal of research and practice. 2023: 13623613221147395.

The AQ-28 is a questionnaire measuring autistic traits, that is, traits that are related to Autism Spectrum Conditions, but its reliability in other cultures has not been thoroughly evaluated. We, therefore, tested whether the properties of the AQ-28 are comparable between two countries with different cultures, Malaysia and the Netherlands. A total of 437 Malaysian and 818 Dutch participants completed the AQ-28 online. We measured whether the AQ-28 measures autistic traits similarly in Malaysia and the Netherlands. The AQ-28 measures autistic traits similarly, and the reliability was acceptable and good in the general population of Malaysia and the Netherlands, respectively. However, Malaysians scored higher than Dutch participants. Moreover, 11 AQ-28 items showed cultural bias, indicating that these items are answered/interpreted differently in Malaysia and the Netherlands. Cross-cultural differences in interpreting, reporting, and/or expressing autistic traits highlighted in this study could potentially explain why some items are culturally biased and why Malaysians score higher on these items. The findings of this work imply that cutoff scores derived from one culture should not be generalised to another culture. Moreover, the findings are informative for future development of culturally neutral or appropriate screening and diagnostic tools for autism.

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4. Cheng Y, Bololia L. The Effects of Augmented Reality on Social Skills in Children with an Autism Diagnosis: A Preliminary Systematic Review. Journal of autism and developmental disorders. 2023.

Today, the global prevalence of autism is high and continues to increase dramatically. Effective support and interventions are therefore warranted. Augmented reality (AR), one of the recent modalities of immersive technology, is gaining traction in autism interventions. However, there is currently a lack of reviews on the use of AR in children with autism, and what is more, to the authors’ knowledge, no systematic review to date has been carried out to exclusively examine the effects of AR on basic social skills in children with autism. Therefore, an evidence-based systematic review was conducted to fill the gap and answer the specific research question: Can AR support children with an autism diagnosis towards developing or promoting social skills, such as greetings? The initial search yielded a total of 416 records. After excluding duplicate articles and screening the abstract and full text, 13 studies were included for analysis. A narrative approach was employed to synthesise and evaluate the research findings to substantially explore the effects of AR-based social interventions. The favourable role of AR technology in fostering social skills in children diagnosed with autism was widely recognised in the included studies although multiple methodological limitations were identified in relation to the quality of the included studies. Overall, the promising findings may suggest the effectiveness of AR in improving social skills in children with autism. Nonetheless, this field of research still calls for more high-quality studies relying on rigorous methodologies.

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5. 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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6. Fears NE, Sherrod GMC, Templin TN, Bugnariu NL, Patterson RM, Miller HL. Community-based postural control assessment in autistic individuals indicates a similar but delayed trajectory compared to neurotypical individuals. Autism research : official journal of the International Society for Autism Research. 2023.

Autistic individuals exhibit significant sensorimotor differences. Postural stability and control are foundational motor skills for successfully performing many activities of daily living. In neurotypical development, postural stability and control develop throughout childhood and adolescence. In autistic development, previous studies have focused primarily on individual age groups (e.g., childhood, adolescence, adulthood) or only controlled for age using age-matching. Here, we examined the age trajectories of postural stability and control in autism from childhood through adolescents using standardized clinical assessments. In study 1, we tested the postural stability of autistic (n = 27) and neurotypical (n = 41) children, adolescents, and young adults aged 7-20 years during quiet standing on a force plate in three visual conditions: eyes open (EO), eyes closed (EC), and eyes open with the head in a translucent dome (Dome). Postural sway variability decreased as age increased for both groups, but autistic participants showed greater variability than neurotypical participants across age. In study 2, we tested autistic (n = 21) and neurotypical (n = 32) children and adolescents aged 7-16 years during a dynamic postural control task with nine targets. Postural control efficiency increased as age increased for both groups, but autistic participants were less efficient compared to neurotypical participants across age. Together, these results indicate that autistic individuals have a similar age trajectory for postural stability and control compared to neurotypical individuals, but have lower postural stability and control overall.

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7. 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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8. 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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9. 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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10. Goodwill AM, Low LT, Fox PT, Fox PM, Poon KK, Bhowmick SS, Chen SHA. Meta-analytic connectivity modelling of functional magnetic resonance imaging studies in autism spectrum disorders. Brain imaging and behavior. 2023.

Social and non-social deficits in autism spectrum disorders (ASD) persist into adulthood and may share common regions of aberrant neural activations. The current meta-analysis investigated activation differences between ASD and neurotypical controls irrespective of task type. Activation likelihood estimation meta-analyses were performed to examine consistent hypo-activated and/or hyper-activated regions for all tasks combined, and for social and non-social tasks separately; meta-analytic connectivity modelling and behavioral/paradigm analyses were performed to examine co-activated regions and associated behaviors. One hundred studies (mean age range = 18-41 years) were included. For all tasks combined, the ASD group showed significant (p < .05) hypo-activation in one cluster around the left amygdala (peak - 26, -2, -20, volume = 1336 mm(3), maximum ALE = 0.0327), and this cluster co-activated with two other clusters around the right cerebellum (peak 42, -56, -22, volume = 2560mm(3), maximum ALE = 0.049) Lobule VI/Crus I and the left fusiform gyrus (BA47) (peak - 42, -46, -18, volume = 1616 mm(3), maximum ALE = 0.046) and left cerebellum (peak - 42, -58, -20, volume = 1616mm(3), maximum ALE = 0.033) Lobule VI/Crus I. While the left amygdala was associated with negative emotion (fear) (z = 3.047), the left fusiform gyrus/cerebellum Lobule VI/Crus I cluster was associated with language semantics (z = 3.724) and action observation (z = 3.077). These findings highlight the left amygdala as a region consistently hypo-activated in ASD and suggest the potential involvement of fusiform gyrus and cerebellum in social cognition in ASD. Future research should further elucidate if and how amygdala-fusiform/cerebellar connectivity relates to social and non-social cognition in adults with ASD.

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11. Hall CL, Partlett C, Valentine AZ, Pearcey S, Sayal K. Understanding the Impact of Home Confinement on Children and Young People with ADHD and ASD During the COVID-19 Pandemic. Child psychiatry and human development. 2023.

To understand whether the mental health of children and young people (CYP) with and without attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) were differentially affected by COVID-19. We analysed data (n = 6507) from the Co-Space study, a UK web-based longitudinal survey. CYP with ADHD (n = 160;2.5%), ASD (n = 465;7%), and ADHD + ASD (n = 155;2.4%) were compared with a reference group (n = 5727;88%) using parent-completed questionnaires [Strengths and Difficulties Questionnaire (SDQ) & Pandemic Anxiety Scale (PAS)]. Baseline to 1-month follow-up differences were compared using linear regression models. CYP with ADHD and/or ASD had higher scores at baseline than other CYP. At follow-up, CYP with ASD showed small but significant improvements in symptoms (SDQ), compared with the reference group. CYP with ASD experienced a worsening of disease anxiety (PAS) and CYP with ADHD a deterioration in functional impairment. These findings indicate a mixed pattern of pandemic-related impact for CYP with ADHD and/or ASD.

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12. Kainer D, Templeton AR, Prates ET, Jacboson D, Allan ERO, Climer S, Garvin MR. Structural variants identified using non-Mendelian inheritance patterns advance the mechanistic understanding of autism spectrum disorder. HGG advances. 2023; 4(1): 100150.

The heritability of autism spectrum disorder (ASD), based on 680,000 families and five countries, is estimated to be nearly 80%, yet heritability reported from SNP-based studies are consistently lower, and few significant loci have been identified with genome-wide association studies. This gap in genomic information may reside in rare variants, interaction among variants (epistasis), or cryptic structural variation (SV) and may provide mechanisms that underlie ASD. Here we use a method to identify potential SVs based on non-Mendelian inheritance patterns in pedigrees using parent-child genotypes from ASD families and demonstrate that they are enriched in ASD-risk genes. Most are in non-coding genic space and are over-represented in expression quantitative trait loci, suggesting that they affect gene regulation, which we confirm with their overlap of differentially expressed genes in postmortem brain tissue of ASD individuals. We then identify an SV in the GRIK2 gene that alters RNA splicing and a regulatory region of the ACMSD gene in the kynurenine pathway as significantly associated with a non-verbal ASD phenotype, supporting our hypothesis that these currently excluded loci can provide a clearer mechanistic understanding of ASD. Finally, we use an explainable artificial intelligence approach to define subgroups demonstrating their use in the context of precision medicine.

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13. Kaur P, Kaur A. Review of Progress in Diagnostic Studies of Autism Spectrum Disorder Using Neuroimaging. Interdisciplinary sciences, computational life sciences. 2023.

This review article summarizes the recent advances in the diagnostic studies of autism spectrum disorders (ASDs) considering some of the most influential research articles from the last two decades. ASD is a heterogeneous neurodevelopmental disorder characterized by abnormalities in social interaction, communication, and behavioral patterns as well as some unique strengths and differences. The current diagnosis systems are based on autism diagnostic observation schedule (ADOS) or autism diagnostic interview-revised (ADI-R), but biological markers are also important for an effective diagnosis of ASDs. The amalgamation of neuroimaging techniques, such as structural and functional magnetic resonance imaging (sMRI and fMRI), with machine-learning and deep-learning approaches helps throw new light on typical biological markers of ASDs at the early stage of life. To assess the performance of a deep neural network, we develop a light-weighted CNN model for ASD classification. The overall accuracy, precision, and F1-score of the proposed model are 99.92%, 99.93% and 99.92%, respectively. All the neuroimaging studies we have reviewed can be divided into 3 categories, viz. thickness, volume and functional connectivity-based studies. We conclude with a discussion of the major findings of considered studies and promising directions for future research in this field.

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14. Klöbl M, Prillinger K, Diehm R, Doganay K, Lanzenberger R, Poustka L, Plener P, Konicar L. Individual brain regulation as learned via neurofeedback is related to affective changes in adolescents with autism spectrum disorder. Child and adolescent psychiatry and mental health. 2023; 17(1): 6.

BACKGROUND: Emotions often play a role in neurofeedback (NF) regulation strategies. However, investigations of the relationship between the induced neuronal changes and improvements in affective domains are scarce in electroencephalography-based studies. Thus, we extended the findings of the first study on slow cortical potential (SCP) NF in autism spectrum disorder (ASD) by linking affective changes to whole-brain activity during rest and regulation. METHODS: Forty-one male adolescents with ASD were scanned twice at rest using functional magnetic resonance imaging. Between scans, half underwent NF training, whereas the other half received treatment as usual. Furthermore, parents reported on their child’s affective characteristics at each measurement. The NF group had to alternatingly produce negative and positive SCP shifts during training and was additionally scanned using functional magnetic resonance imaging while applying their developed regulation strategies. RESULTS: No significant treatment group-by-time interactions in affective or resting-state measures were found. However, we found increases of resting activity in the anterior cingulate cortex and right inferior temporal gyrus as well as improvements in affective characteristics over both groups. Activation corresponding to SCP differentiation in these regions correlated with the affective improvements. A further correlation was found for Rolandic operculum activation corresponding to positive SCP shifts. There were no significant correlations with the respective achieved SCP regulation during NF training. CONCLUSION: SCP NF in ASD did not lead to superior improvements in neuronal or affective functioning compared to treatment as usual. However, the affective changes might be related to the individual strategies and their corresponding activation patterns as indicated by significant correlations on the whole-brain level. Trial registration This clinical trial was registered at drks.de (DRKS00012339) on 20th April, 2017.

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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. Maltman N, Hilvert E, Friedman L, Sterling A. Comparison of Linguistic Error Production in Conversational Language Among Boys With Fragile X Syndrome + Autism Spectrum Disorder and Autistic Boys. Journal of speech, language, and hearing research : JSLHR. 2023; 66(1): 296-313.

PURPOSE: Expressive language impairments are common among school-age boys with fragile X syndrome (FXS) and autistic boys. Given the high co-occurrence of autism spectrum disorder (ASD) among individuals with FXS, cross-condition comparisons can elucidate the specificity of such impairments as they relate to ASD. Language samples can provide fruitful information regarding individuals’ grammatical skills in less structured formats relative to standardized measures. This study examined grammatical errors produced during a conversational language sample among 20 boys with FXS and co-occurring ASD (FXS + ASD) and 19 autistic boys matched on ASD severity. METHOD: Language samples were coded for omissions and errors at the word and utterance levels. Participants’ grammatical errors were also compared to separate mental age-matched and mean length of utterance-matched boys from a reference database. RESULTS: Boys with FXS + ASD and autistic boys produced similar rates of errors across all categories. Relative to their matched comparison groups, boys with FXS + ASD and autistic boys produced significantly more omissions during conversation. CONCLUSIONS: These findings suggest that omissions may be a unique grammatical marker associated with the ASD phenotype. Further examination of omissions across diagnostic groups would aid in clarifying the specificity of omissions in the language phenotype of ASD.

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17. Markfeld JE, Feldman JI, Bordman SL, Daly C, Santapuram P, Humphreys KL, Keçeli-Kaysılı B, Woynaroski TG. Associations Between Caregiver Stress and Language Outcomes in Infants With Autistic and Non-Autistic Siblings: An Exploratory Study. Journal of speech, language, and hearing research : JSLHR. 2023; 66(1): 190-205.

PURPOSE: Caregivers of autistic children present with high stress levels, which have been associated with poorer child outcomes in several domains, including language development. However, prior to this study, it was unknown whether elevated caregiver stress was associated with language development in infant siblings of autistic children (Sibs-autism), who are at increased likelihood of receiving a future diagnosis of autism and/or language impairment compared to infant siblings of non-autistic children. This study explored the degree to which, as well as the mechanisms by which, caregiver stress was linked with later language outcomes of Sibs-autism and infant siblings of non-autistic children (Sibs-NA). METHOD: Participants were 50 infants (28 Sibs-autism; 22 Sibs-NA) aged 12-18 months at the first time point in this study (Time 1). Infants were seen again 9 months later, at 21-27 months of age (Time 2). Caregiver stress was measured via a validated self-report measure at Time 1. Caregiver language input, the putative mechanism by which caregiver stress may influence later language outcomes, was collected via two daylong recordings from digital recording (Language ENvironment Analysis) devices worn by the child at this same time point. Child language outcomes were measured via standardized and caregiver report measures at Time 2. RESULTS: Several models testing hypothesized indirect effects of caregiver stress on later child language outcomes through caregiver language input were statistically significant. Specifically, significant indirect effects suggest that (a) caregivers with increased stress tend to speak less to their infants, and (b) this reduced language input tends to covary with reduced child language outcomes later in life for Sibs-autism and Sibs-NA. CONCLUSIONS: This study provides new insights into links between caregiver stress, caregiver language input, and language outcomes in Sibs-autism and Sibs-NA. Further work is necessary to understand how to best support caregivers and optimize the language learning environments for infants. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21714368.

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18. Perez Liz G, Vela G, Vela A, Maldonado Coronado JR, Sanchez Lizardi P, Robins DL. Autism research capacity building in Northern Mexico: Preliminary evaluation of an ongoing process. Autism : the international journal of research and practice. 2023: 13623613221145787.

To inform improvement of care and public policy, quality research is required. Conducting research projects requires skills and infrastructure. Research capacity building is the process by which individuals and organizations develop greater ability to conduct useful research. However, in the scientific community, research quality and productivity measures are often focused on long-term products, such as publications or grants awarded. Those measures are not helpful when measuring initial stages of research, a common situation in low- and middle-income countries. We used a six-principle framework designed by J. Cooke to assess the progress of an autism research collaborative in northern Mexico. We established 64 criteria across the six principles, and rated them as Not Started, In Progress, or Achieved, based on narratives and process documentation collected for this purpose. Ratings were established for the Years 2018, 2020, and 2022. The principles with the highest Achieved rates were « Linkages, collaborations, and partnerships » (90%), and « Infrastructure » (Principle 6, 70%). Cooke’s research capacity building framework is a useful way to monitor progress of research capacity building and contribute to harmonious development of relevant principles at different levels.

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19. 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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20. Rodrigues JVS, Poli MCF, Petrilli PH, Dornelles RCM, Turcio KH, Theodoro LH. Food selectivity and neophobia in children with autism spectrum disorder and neurotypical development: a systematic review. Nutrition reviews. 2023.

CONTEXT: Individuals with autism spectrum disorder (ASD) have common eating problems, including food refusal, dietary restrictions, and behavioral problems during eating. OBJECTIVE: The aim of this systematic review was to find more clear evidence on the relationship between food selectivity or food neophobia (FN) and ASD in children up to age 14 years. The PECO-based question was: Are food selectivity and FN behaviors more prevalent in children with ASD than in children with neurotypical development (NTD)?, in which the P is children, E is ASD, C is children with NTD, and O is food selectivity and FN. DATA SOURCES: Clinical studies in the databases PubMed, Embase and Web of Science, comparing children with ASD and those with NTD, were reviewed from October 1966 to October 2021. STUDY SELECTION AND DATA EXTRACTION: A total of 122 studies were analyzed for summary reading, and only 17 of these were included in the descriptive qualitative analysis. In 9 studies, the analysis of food selectivity was performed via a questionnaire. RESULTS: The results showed that children with ASD are more selective than those with NTD. Four studies evaluated FN through scales; however, only 2 found higher levels of FN in the ASD group than in children with NTD. The sensory profile was measured using questionnaires in 9 studies, and we found that altered sensory processing is more common in children with ASD. CONCLUSION: Children with ASD present greater food selectivity than children with NTD. However, the occurrence of FN was higher in only 50% in which FN was investigated, which points to a need for studies that compare FN between siblings with ASD and those with NTD in the same family nucleus. In addition, atypical oral sensitivity seems to be a sensory characteristic most related to eating disorders. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021247880.

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21. 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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22. Smith H, Black MH, Thompson C, Falkmer M, Falkmer T, Girdler S, Milbourn B. Exploration of caregiver experiences of reported first signs of Autism. Child: care, health and development. 2023.

This study explored caregiver-reported first signs of Autism and caregiver experiences of reporting these signs to health professionals using a multiple methods approach. Phase one included secondary analysis of a survey of caregivers, while phase two consisted of focus groups of caregivers of children on the autism spectrum. Survey data indicated that most children were aged 12-18 months when first signs were noticed, with first signs noticed earlier in females than males. Children were age 2-6 years when caregivers sought advice and received a diagnosis. Uncertainty and a lack of information often left caregivers feeling frustrated and under-supported when seeking advice and diagnosis. Despite first signs being recognised early by caregivers, barriers to information and seeking help and support resulted in significant delays in receiving a diagnosis.

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23. Teixeira OFB, Xavier SPL, Félix NDC, Silva J, Abreu R, Miranda KCL. Repercussions of the COVID-19 pandemic for people with autism and their family members: A scoping review. Revista latino-americana de enfermagem. 2022; 30: e3729.

OBJECTIVE: to map the diverse scientific evidence available about the repercussions of the COVID-19 pandemic for people with Autism Spectrum Disorder and their family members. METHOD: a scoping review conducted in the following databases: MEDLINE, CINAHL, SciELO, SCOPUS, EMBASE and Wiley Online Library, in August and September 2021. The protocol of this review was registered at the Open Science Framework under DOI 10.17605/OSF.IO/JYTVD. The data were analyzed and synthesized in a narrative way. RESULTS: a total of 46 publications identified indicate that the pandemic period brought about countless repercussions for the population with autism and their family members when experiencing serious difficulties in the changes or irregularities of the scheduled routines and limited access to education, therapies and social support. CONCLUSION: the diverse evidence suggests that the COVID-19 pandemic intensified the inequalities already experienced by individuals with autism and their family members, with negative consequences in the emotional, psychological, behavioral and social aspects, interfering with the quality of life and mental health of this population segment. Future studies on individuals with autism and their families during public health crisis periods are of fundamental importance for planning psychiatric, psychosocial and educational interventions.

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24. Wang D, Pruett JR, Jr. Computational approaches to address data challenges in intellectual and developmental disabilities research. Journal of neurodevelopmental disorders. 2023; 15(1): 2.

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25. 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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