1. Alarifi S, Denne L, Alatifi N, Hastings RP. Interventions addressing challenging behaviours in Arab children and adults with intellectual disabilities and/or autism: A systematic review. J Appl Res Intellect Disabil;2024 (Mar);37(2):e13205.

BACKGROUND: Arabs with intellectual disabilities and/or autism may exhibit challenging behaviour that affects them and their caregivers. Early, appropriate intervention may reduce these effects. This review synthesised and critically appraised challenging behaviour intervention research for this population. METHODS: All published empirical research on challenging behaviour interventions for Arabs with intellectual disabilities and/or autism was included. In September 2022, 15 English and Arabic databases yielded 5282 search records. Studies were appraised using the MMAT. Review findings were narratively synthesised. RESULTS: The 79 included studies (n = 1243 participants) varied in design, intervention, and evaluation method. Only 12.6% of interventions were well-designed and reported. Arab interventions primarily targeted children, were applied collectively on small samples, lacked individualised assessment, and were based on an inconsistent understanding of challenging behaviour. CONCLUSION: The evidence base on interventions for Arabs with intellectual disabilities and/or autism and challenging behaviour needs strengthening. Attention should be given to culturally relevant adaptations.

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2. Bailey KM, Rodgers ME, Quinn ED, Thompson S, Nietfeld J, Kaiser AP. Just-in-Time: A Caregiver-Mediated Intervention for Toddlers With Autism. Am J Speech Lang Pathol;2024 (Feb 12):1-17.

PURPOSE: We investigated effects of an adaptive telehealth coaching model on caregiver implementation of enhanced milieu teaching (EMT) with newly diagnosed toddlers with autism. METHOD: Three caregiver-child dyads participated in a multiple-baseline-across-behaviors, single-case design. Caregivers were taught EMT via telehealth using the teach-model-coach-review approach. EMT strategies were taught sequentially in four components corresponding to design tiers. Caregivers reported their needs for support and adaptation via weekly surveys. Primary outcomes were measures of caregiver’s implementation, including (a) a fidelity checklist for wholistic use of EMT and (b) a percentage of correct use of a subset of key EMT strategies (e.g., matched turns, target talk, expansions, play actions, milieu episodes). Generalization and maintenance of caregiver strategy use in uncoached home activities were measured. The number of different words used by children was measured as a secondary, descriptive outcome. Social validity data were collected through ratings and interviews at the end of the study. RESULTS: There was a functional relation between the intervention and caregiver’s implementation of EMT for all dyads. Caregiver’s use of EMT strategies often generalized and maintained post-intervention. Child response to intervention was variable. Social validity data indicated that the model was beneficial to caregivers and children. CONCLUSIONS: An adaptive telehealth coaching model is effective for teaching caregivers of toddlers with autism to implement EMT and potentially helps to bridge the gap between diagnosis and comprehensive intervention. Further exploration of the relation between caregiver fidelity and dosage of active ingredients and child spoken language outcomes is needed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25156223.

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3. Blume J, Miller M, O’Neill D, Mastergeorge AM, Ozonoff S. Utility of the Language Use Inventory in Young Children at Elevated Likelihood of Autism. J Speech Lang Hear Res;2024 (Feb 12);67(2):573-585.

PURPOSE: The aims of this study were (a) to evaluate the convergent validity of the Language Use Inventory (LUI) with measures of autism spectrum disorder (ASD) symptoms, language, and social skills and (b) to assess discriminant validity of the LUI with measures of nonlanguage skills, including daily living skills and motor development. METHOD: This study sample included participants from a longitudinal study (n = 239) of infant siblings with elevated familial likelihood of ASD and lower familial likelihood. Assessment measures completed at 36 months included the LUI, the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), the Mullen Scales of Early Learning, and the Vineland Adaptive Behavior Scales-Second Edition. Bivariate Pearson correlations were estimated between ADOS-2 comparison scores and four language and social skills measures. Additional correlations were estimated between LUI total scores and standard scores from nonlanguage measures. A series of Fisher’s Z transformations were applied to evaluate whether bivariate correlations were significantly different. RESULTS: All four language and social skill measures were moderately to strongly associated with each other and ASD symptom severity scores. The correlation between ADOS-2 comparison scores and LUI total scores was significantly stronger than ADOS-2 correlations with all other measures. CONCLUSIONS: Our findings provide support for the LUI as a feasible, pragmatic language-targeted instrument for inclusion in early developmental evaluations prompted by language concerns. Administration of the LUI may accelerate earlier referral for a comprehensive assessment of ASD symptoms. Given the high correlation with ADOS-2 scores, an LUI total score in a clinical range of concern may encourage a clinician to refer families for a full diagnostic evaluation of ASD.

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4. Brima T, Beker S, Prinsloo KD, Butler JS, Djukic A, Freedman EG, Molholm S, Foxe JJ. Probing a neural unreliability account of auditory sensory processing atypicalities in Rett Syndrome. medRxiv;2024 (Jan 26)

BACKGROUND: In the search for objective tools to quantify neural function in Rett Syndrome (RTT), which are crucial in the evaluation of therapeutic efficacy in clinical trials, recordings of sensory-perceptual functioning using event-related potential (ERP) approaches have emerged as potentially powerful tools. Considerable work points to highly anomalous auditory evoked potentials (AEPs) in RTT. However, an assumption of the typical signal-averaging method used to derive these measures is « stationarity » of the underlying responses – i.e. neural responses to each input are highly stereotyped. An alternate possibility is that responses to repeated stimuli are highly variable in RTT. If so, this will significantly impact the validity of assumptions about underlying neural dysfunction, and likely lead to overestimation of underlying neuropathology. To assess this possibility, analyses at the single-trial level assessing signal-to-noise ratios (SNR), inter-trial variability (ITV) and inter-trial phase coherence (ITPC) are necessary. METHODS: AEPs were recorded to simple 100Hz tones from 18 RTT and 27 age-matched controls (Ages: 6-22 years). We applied standard AEP averaging, as well as measures of neuronal reliability at the single-trial level (i.e. SNR, ITV, ITPC). To separate signal-carrying components from non-neural noise sources, we also applied a denoising source separation (DSS) algorithm and then repeated the reliability measures. RESULTS: Substantially increased ITV, lower SNRs, and reduced ITPC were observed in auditory responses of RTT participants, supporting a « neural unreliability » account. Application of the DSS technique made it clear that non-neural noise sources contribute to overestimation of the extent of processing deficits in RTT. Post-DSS, ITV measures were substantially reduced, so much so that pre-DSS ITV differences between RTT and TD populations were no longer detected. In the case of SNR and ITPC, DSS substantially improved these estimates in the RTT population, but robust differences between RTT and TD were still fully evident. CONCLUSIONS: To accurately represent the degree of neural dysfunction in RTT using the ERP technique, a consideration of response reliability at the single-trial level is highly advised. Non-neural sources of noise lead to overestimation of the degree of pathological processing in RTT, and denoising source separation techniques during signal processing substantially ameliorate this issue.

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5. de Belen RAJ, Eapen V, Bednarz T, Sowmya A. Using visual attention estimation on videos for automated prediction of autism spectrum disorder and symptom severity in preschool children. PLoS One;2024;19(2):e0282818.

Atypical visual attention in individuals with autism spectrum disorders (ASD) has been utilised as a unique diagnosis criterion in previous research. This paper presents a novel approach to the automatic and quantitative screening of ASD as well as symptom severity prediction in preschool children. We develop a novel computational pipeline that extracts learned features from a dynamic visual stimulus to classify ASD children and predict the level of ASD-related symptoms. Experimental results demonstrate promising performance that is superior to using handcrafted features and machine learning algorithms, in terms of evaluation metrics used in diagnostic tests. Using a leave-one-out cross-validation approach, we obtained an accuracy of 94.59%, a sensitivity of 100%, a specificity of 76.47% and an area under the receiver operating characteristic curve (AUC) of 96% for ASD classification. In addition, we obtained an accuracy of 94.74%, a sensitivity of 87.50%, a specificity of 100% and an AUC of 99% for ASD symptom severity prediction.

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6. Dell’Osso L, Carpita B, Luche RD, Lorenzi P, Amatori G. The Illness Trajectory in Marilyn Monroe’s Psychological Autopsy: From Autism Spectrum Disorder to Borderline Personality Disorder and Bipolar Disorder with Catatonia. Clin Neuropsychiatry;2023 (Dec);20(6):505-510.

OBJECTIVE: A mounting body of literature is showing that, in the clinical and general population, autism spectrum disorder (ASD) or autistic traits (ATs) would appear to be spread along a continuum, reaching the highest levels among individuals affected by other mental disorders, such as borderline personality disorder (BPD) and bipolar disorder (BD). Furthermore, individuals with ASD or ATs appear to be more vulnerable to psychological traumas, with greater likelihood of developing post-traumatic stress disorder (PTSD) and BD. Marilyn Monroe was a famous actress, singer and model, as well as one of the most admired stars of American cinema and a timeless icon. The present report debates the possibility to explore Marilyn Monroe’s case under a neurodevelopmental perspective according to which a ASD favored, on one hand, her worldwide success and, on the other, her mental illness trajectory. METHOD: The analysis is based on the review of her four biographies written by psychiatrists and clinical psychologists, her complete filmography, interviews, filmed material and personal scripts. RESULTS: The present work reconstructed a hypothetical illness trajectory originating from a ASD and culminating in a BD with unspecified catatonia, followed by premature death whose cause has never been clarified. The description of this illness trajectory also confirms the strong impact of psychological traumas on the substrate of ASD vulnerability and its correlation with the development of BPD and BD. CONCLUSIONS: This paper suggests Marilyn Monroe as a possible prototypical case of BPD under a neurodevelopmental perspective that accounts the ASD, as reported in DSM-5-TR (2022), in verbal adult without intellectual impairment, high-functioning autism (HFA), as vulnerability background predisposing to the progression to BPD and BD with unspecified catatonia, triggered by multiple traumas.

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7. Deng PY, Kumar A, Cavalli V, Klyachko VA. Circuit-based intervention corrects excessive dentate gyrus output in the fragile X mouse model. Elife;2024 (Feb 12);12

Abnormal cellular and circuit excitability is believed to drive many core phenotypes in fragile X syndrome (FXS). The dentate gyrus is a brain area performing critical computations essential for learning and memory. However, little is known about dentate circuit defects and their mechanisms in FXS. Understanding dentate circuit dysfunction in FXS has been complicated by the presence of two types of excitatory neurons, the granule cells and mossy cells. Here we report that loss of FMRP markedly decreased excitability of dentate mossy cells, a change opposite to all other known excitability defects in excitatory neurons in FXS. This mossy cell hypo-excitability is caused by increased Kv7 function in Fmr1 knockout (KO) mice. By reducing the excitatory drive onto local hilar interneurons, hypo-excitability of mossy cells results in increased excitation/inhibition ratio in granule cells and thus paradoxically leads to excessive dentate output. Circuit-wide inhibition of Kv7 channels in Fmr1 KO mice increases inhibitory drive onto granule cells and normalizes the dentate output in response to physiologically relevant theta-gamma coupling stimulation. Our study suggests that circuit-based interventions may provide a promising strategy in this disorder to bypass irreconcilable excitability defects in different cell types and restore their pathophysiological consequences at the circuit level.

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8. Glasby J, Miller R, Glasby AM, Ince R, Konteh F. ‘Why are we stuck in hospital?’ Barriers to people with learning disabilities/autistic people leaving ‘long-stay’ hospital: a mixed methods study. Health Soc Care Deliv Res;2024 (Feb);12(3):1-119.

BACKGROUND: Transforming care so that people with learning disabilities and/or autistic people can receive support at home rather than in hospital settings is a key priority, but progress has been slow. Despite significant national debate, little previous research has engaged directly with people in hospital, their families or front-line staff to understand the issues from their perspectives. OBJECTIVES: This research seeks to better understand the experiences of people with learning disabilities and/or autistic people in long-stay hospital settings, their families and front-line staff – using this knowledge to create practice guides and training materials to support new understandings and ways of working. DESIGN: Following a structured review of the literature, we sought to work with up to 10 people with learning disabilities and/or autistic people in three case-study sites (2021-22), supplementing this with interviews with family members and commissioners; interviews/focus groups with hospital staff, social workers, advocates and care providers; information from case files; and observations of multidisciplinary meetings. SETTING: Three ‘long-stay’ hospital settings in England. PARTICIPANTS: Twenty-seven people in hospital, together with families, health and social care staff and commissioners. RESULTS: • People in hospital report widespread frustration, feel that hospital environments are not conducive to getting/staying well, and face multiple barriers to leaving hospital. Without someone to fight for them, people struggle to overcome the inertia built into our current systems and processes. • Front-line staff are equally frustrated and describe a complex and seemingly dysfunctional system which they find almost impossible to navigate. • Hospital staff from different professional backgrounds do not have a shared sense of how many people really need to be in hospital or how many people could be cared for in different settings – suggesting that different definitions, world views and professional judgements might be at play. • Hospital staff are frustrated about what they see as the difficulty of discharging people into community services, while community services are equally frustrated about what they see as a risk-averse approach which they feel can lack an up-to-date knowledge of what is possible to achieve in the community. • Despite over a decade of policy attempts to resolve these issues, very significant barriers remain. LIMITATIONS: This research explored the experiences of a small number of people, but has done so in significant depth. The research was undertaken in secure settings, during COVID and in a difficult external policy and practice context, and so has had to be very flexible and empathetic in order to build relationships and make the research possible. Future research could helpfully consider the needs of people from black and minority ethnic communities, the extent to which the experiences of people on forensic pathways are similar to/different from other people’s experiences (including perspectives from the criminal justice system), and what happens to people in the long term after they leave hospital. CONCLUSIONS: Working to make the voices of people with learning disabilities and/or autistic people (as well as the staff who support them) centre stage is complex and sensitive. However, this lived experience/practice knowledge is a crucial resource if we are going to develop better policy and practice solutions in the longer term. STUDY REGISTRATION: This study is registered at www.researchregistry.com (researchregistry6124). FUNDING: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130298) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 3. See the NIHR Funding and Awards website for further award information. Around 2000 people with learning disabilities and/or autistic people are living in hospital. This can be for many years. This is a real problem because hospitals: are not designed to help people to lead ordinary lives; are expensive; can be far away from people’s homes and families; have had a number of abuse scandals. Despite this, there is little research on why people remain stuck in such settings. In particular, previous research often fails to talk directly to people with learning disabilities, their families and staff. Unless we listen to these voices we will not find solutions to these problems. Too many people will therefore remain in hospital unnecessarily. This is sensitive work. It requires skills in working: with people who may not communicate verbally; with people who might be very angry, scared and distressed; where there can be tensions around what is best. We therefore included an experienced team who could carry out such in-depth work in a way that suits the needs of the individual. We also worked with a group of people with learning disabilities and/or autistic people and their families to help us do our work well. We found that: lots of people are still stuck in hospital; they are very frustrated and distressed; hospital is a difficult place to be while you are waiting to leave. Once you are in it is very difficult to get out; health and social care staff are also very frustrated. They find it almost impossible to help people leave hospital; hospital staff and community services find it difficult to work with each other; government has promised to solve this for more than 10 years. However, there are still lots of problems. eng

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9. Grey I, Brennan D, Cody B. Outcomes for children with autism spectrum disorder and their families after two years of school based early intensive behavioural intervention. J Intellect Disabil;2024 (Feb 12):17446295241231039.

The effectiveness of a school based Early Intensive Behavioural Intervention (EIBI) program was assessed over a two-year period for a cohort of 16 pre-school children with autism spectrum disorder (ASD) and their families. Children with a mean age of 40 months, were assessed prior to intervention, after 1 year of intervention, and again after 2 years. Significant improvements were observed on measures of adaptive behaviour, communication ability and challenging behaviour. Parents of children attending the program also reported increased familial quality of life, specifically improved emotional and physical well-being and increased parenting capacity over the duration of the program. The current study suggests that EIBI for young children with ASD can be effective in facilitating improvements in communication ability, reducing challenging behaviours and improving quality of life for families. Children’s pre-intervention adaptive skills appeared to be the strongest predictor of post intervention gains as initial level of adaptive ability was positively related to improved post-intervention outcomes.

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10. Kiarashi Y, Suresha PB, Bahrami Rad A, Reyna MA, Anderson C, Foster J, Lantz J, Villavicencio T, Hamlin T, Clifford GD. Predicting Adverse Behavior in Individuals with Autism Spectrum Disorder Through Off-body Sleep Analysis. medRxiv;2024 (Jan 24)

Poor sleep quality in Autism Spectrum Disorder (ASD) individuals is linked to severe daytime behaviors. This study explores the relationship between a prior night’s sleep structure and its predictive power for next-day behavior in ASD individuals. The motion was extracted using a low-cost near-infrared camera in a privacy-preserving way. Over two years, we recorded overnight data from 14 individuals, spanning over 2,000 nights, and tracked challenging daytime behaviors, including aggression, self-injury, and disruption. We developed an ensemble machine learning algorithm to predict next-day behavior in the morning and the afternoon. Our findings indicate that sleep quality is a more reliable predictor of morning behavior than afternoon behavior the next day. The proposed model attained an accuracy of 74% and a F1 score of 0.74 in target-sensitive tasks and 67% accuracy and 0.69 F1 score in target-insensitive tasks. For 7 of the 14, better-than-chance balanced accuracy was obtained (p-value < 0.05), with 3 showing significant trends (p-value < 0.1). These results suggest off-body, privacy-preserving sleep monitoring as a viable method for predicting nextday adverse behavior in ASD individuals, with the potential for behavioral intervention and enhanced care in social and learning settings.

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11. Li T, Xiong Q, Shi R, Yi L. Autistic and Non-autistic Children’s Pain Perception is Modulated by Their First-Hand Pain Sensitivity and Theory of Mind. Res Child Adolesc Psychopathol;2024 (Feb 12)

The current study examined whether autistic children’s perception of others’ pain could be modulated by their first-hand pain sensitivity and theory of mind (ToM). We measured the first-hand pain sensitivity, the rating of others’ pain intensity, and the performance in the ToM tasks in 43 5- to 8-year-old autistic and 30 neurotypical children. Our results revealed hyposensitivity to first-hand pain, underestimation of others’ pain intensity, as well as difficulties in the False Belief subtasks of ToM in autistic children. Furthermore, we detected an interaction between children’s first-hand pain sensitivity and ToM in predicting their perception of others’ pain. To be specific, for autistic and NT children with normal or hyper-sensitivity to first-hand pain, better performance on ToM predicted higher ratings for others’ pain intensity; while for autistic and NT children with hyposensitivity to first-hand pain, ToM did not predict ratings for others’ pain intensity. Our study contributes to the understanding of pain perception in young children and provides implications for clinical practices to improve social understanding in autistic children.

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12. Netto BB, da Silva EP, de Aguiar da Costa M, de Rezende VL, Bolan SJ, Ceretta LB, Aschner M, Dominguini D, Gonçalves CL. Critical period of exposure to mercury and the diagnostic of autism spectrum disorder: A systematic review. J Neurochem;2024 (Feb 12)

Autism spectrum disorder (ASD) is characterized by repetitive behaviors and deficits in social interaction. Its etiology is not completely clear, but both genetic and environmental factors contribute to and influence its development and course. The increased number of autism cases in recent years has been strongly associated with increased exposure to heavy metals. Mercury (Hg) has gained prominence in the scientific literature as a result of its presence as an urban pollutant and well-described neurotoxicity. This review assessed the relationship between Hg exposure in the pre- and post-natal period and ASD. The systematic review identified observational clinical studies and pre-clinical trials in journals indexed in the PubMed, Embase, ProQuest, and LILACS databases. The aim of this study was to investigate the association between exposure to Hg and ASD and to define the critical period of exposure. A total of 57 articles were selected for this review, with 35 articles (61.40%) identifying a positive association between ASD and Hg, while 22 articles (38.60%) did not find the same outcome. The biological samples most used to analyze Hg body burdens were hair (36.84%) and blood (36.84%). Most case-control studies found an increase in Hg levels in individuals with ASD who were exposed to a polluted environment in the post-natal period. Taken together, the studies suggest that these patients have a deficient detoxification system, and this could worsen the symptoms of the disorder. However, new studies addressing the influence of Hg on the post-natal nervous system and its relationship with ASD should be carried out.

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13. O’Donoghue M, Kennedy N, Forbes J, Murphy CA. Feasible Peer-Mediated Intervention for Autistic Children Using Minimal Speech: A Qualitative Intervention Development Process. Am J Speech Lang Pathol;2024 (Feb 12):1-19.

PURPOSE: Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings. METHOD: A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings. RESULTS: While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation. CONCLUSION: To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/setting), and micro (individual). SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25155770.

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14. Ozdemir S, Akin-Bulbul I, Yildiz E. Visual Attention in Joint Attention Bids: A Comparison Between Toddlers with Autism Spectrum Disorder and Typically Developing Toddlers. J Autism Dev Disord;2024 (Feb 12)

Impairments in joint attention are considered core symptoms of autism spectrum disorder (ASD) and are crucial for early assessment and intervention. However, existing information about visual attention during joint attention and its relation to developmental functioning is limited. The current study investigated the visual attention differences between toddlers with ASD and typically developing (TD) toddlers during single and multiple joint attention cue conditions. This study further examined whether visual attention in joint attention Area of Interests (AOIs) is related to cognitive, language, and motor development in participants. Participants included 56 toddlers with ASD and 56 TD toddlers, aged 18-36 months. A passive viewing paradigm was used to assess participants’ visual attention across four different joint attention conditions. Study results showed that toddlers with ASD displayed limited visual attention towards joint attention AOIs, Target, Face, and Target and Face AOIs, in all conditions. As the joint attention cues increased from Condition 1 to Condition 4, toddlers with ASD showed increased visual attention directed towards the Target AOI over the Face AOI. Moreover, increased visual attention on the joint attention AOIs was associated with improved cognitive and language development in toddlers with ASD. This research broadens our understanding of the positive relationships between visual attention to joint attention AOIs and cognitive as well as language development in toddlers with ASD, suggesting that early interventions targeting joint attention may offer promising pathways for treatment.

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15. Palmer SJ, Dvir Y. Trauma and psychosocial adversity in youth with autism spectrum disorder and intellectual disability. Front Psychiatry;2024;15:1322056.

Traumatic experiences contribute significantly to behavioral and mood dysregulation syndromes presenting for treatment to behavioral health settings. Individuals with Autism Spectrum Disorder (ASD), Intellectual Disability (ID) and developmental delay experience traumatic events more frequently than their typically developing peers. However, measures used to identify trauma related disorders and treatment thereof are based on typically developing individuals. Regardless of the baseline characteristics of individuals who experience trauma, trauma exposure is the result of multiple interdependent environmental, social, and familial characteristics. We used the « ecological systems analysis approach » to structure our review of the impact of trauma on those with ASD and ID. In addition, the COVID-19 pandemic which exposed the global population to a collective trauma, has also catalyzed investigations into the challenges faced by members of society most dependent on social services. Children with ASD and ID were among those vulnerable individuals, and the COVID-19 pandemic has allowed researchers to better understand the impact of a collective trauma on those individuals. It is imperative that we understand current research and recommendations for identifying and treating trauma-related disorders in individuals with developmental disorders to best inform clinical practice and directions for future research in this area.

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16. Razaq S, Anwar F. Response to Referral Profile of Developmental Disabilities at a Tertiary Care Hospital in a Resource-limited Country. J Coll Physicians Surg Pak;2024 (Feb);34(2):251-252.

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17. Sandbank M, Bottema-Beutel K, Syu YC, Caldwell N, Feldman JI, Woynaroski T. Evidence-b(i)ased practice: Selective and inadequate reporting in early childhood autism intervention research. Autism;2024 (Feb 12):13623613241231624.

When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better.

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18. Shea L, Villodas ML, Ventimiglia J, Wilson AB, Cooper D. Foster Care Involvement Among Youth With Intellectual and Developmental Disabilities. JAMA Pediatr;2024 (Feb 12)

IMPORTANCE: Youth with intellectual and developmental disabilities (I/DD) are more likely to be placed in foster care than other youth. Examining the clinical and sociodemographic characteristics of youth with I/DD in the foster care system is critical for identifying disparities and understanding service needs. OBJECTIVE: To produce a population-level analysis of youth with I/DD in foster care that examines differences in rates of foster care involvement based on race, ethnicity, age, and sex. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study involved all individuals with I/DD 21 years and younger enrolled in Medicaid through foster care in 2016 via data from Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) for all 50 US states and Washington, DC. As a key insurer of I/DD services and foster care, Medicaid claims offer a timely population-level analysis. Youth with I/DD were grouped into diagnostic subgroups: autism spectrum disorder (ASD) only, intellectual disability only, or ASD and ID. The data analysis took place from July 2022 to September 2023. EXPOSURE: TAF data contain Medicaid enrollment information by month with a binary indicator of foster care involvement, and eligibility files identify race, ethnicity, age, and sex. MAIN OUTCOMES AND MEASURES: The period prevalence of foster care involvement was determined among I/DD youth by diagnostic subgroups using an intersectional approach across race, ethnicity, age, and sex. Logistic regression examined associations between risk for foster care involvement and race, ethnicity, age, and sex. RESULTS: A total of 39 143 youth with I/DD had foster care involvement in 2016. Black youth (adjusted odds ratio [aOR], 1.37; 95% CI, 1.28-1.47) and females (aOR, 1.18; 95% CI, 1.1-1.27) had increased likelihood for foster care involvement. The likelihood for foster care involvement increased with age in all groups relative to the age group 0 to 5 years old. CONCLUSIONS AND RELEVANCE: This study found that among youth with I/DD, Black youth and females faced higher risk for foster care involvement, and the likelihood of foster care involvement increased with age. There is an urgent need for research that focuses on addressing system-level factors that drive increased risk. Understanding the specific health needs of Black and female youth with I/DD is critical to ensure the formation, implementation, and monitoring of equitable delivery of health services.

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19. Ukkirapandian K, Elumalai K, Udaykumar KP, Vp S, Rangasmy M. Behavioral and Biochemical Assays for Autism Models of Wistar Rats. Cureus;2024 (Jan);16(1):e52066.

Being a « behavioral disorder, » autism spectrum disorder (ASD) is difficult to manage because its precise etiology is uncertain. In order to better understand the pathophysiology of autism and explore various therapeutic approaches, animal models are developed. Animal models of autism caused by valproate during pregnancy exhibit strong construct validity and reliability. Hence, this study was done among autism-induced rats with the aim of identifying the behavioral and biochemical assays. Pregnant rats were administered sodium valproate on the 12th day of gestation, while control pregnant rats received normal saline. The rats’ offspring that received normal saline during intrauterine life were grouped as control, and the rats’ offspring that received valproate were grouped as autism-induced. From postnatal day (PND) 21, behavioral assessments were done by using the Y maze (repetitive behavior) and the T maze (social behavior). The estimation of antioxidant profile (malondialdehyde {MDA}, glutathione {GSH}, catalase (CAT), and superoxide dismutase {SOD}), proinflammatory markers (tumor necrosis factor {TNF} alpha, transforming growth factor {TGF} beta, interleukin {IL} 6, and IL-1 beta), neurotransmitters (gamma-aminobutyric acid {GABA} and serotonin), and brain-derived neurotrophic factor (BDNF) in the hippocampal region was done. Oxidative stress, increased proinflammatory markers, and increased serotonin were recorded in the autism group. Rats with autism had a significant decrease in GABA and BDNF levels. These biochemical alterations can be correlated with clinical features of autism to diagnose and manage the disorder at the earliest.

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20. Zhang J, Zhang Z, Sun H, Ma Y, Yang J, Chen K, Yu X, Qin T, Zhao T, Zhang J, Chu C, Wang J. Personalized functional network mapping for autism spectrum disorder and attention-deficit/hyperactivity disorder. Transl Psychiatry;2024 (Feb 12);14(1):92.

Autism spectrum disorder (ASD) and Attention-deficit/hyperactivity disorder (ADHD) are two typical neurodevelopmental disorders that have a long-term impact on physical and mental health. ASD is usually comorbid with ADHD and thus shares highly overlapping clinical symptoms. Delineating the shared and distinct neurophysiological profiles is important to uncover the neurobiological mechanisms to guide better therapy. In this study, we aimed to establish the behaviors, functional connectome, and network properties differences between ASD, ADHD-Combined, and ADHD-Inattentive using resting-state functional magnetic resonance imaging. We used the non-negative matrix fraction method to define personalized large-scale functional networks for each participant. The individual large-scale functional network connectivity (FNC) and graph-theory-based complex network analyses were executed and identified shared and disorder-specific differences in FNCs and network attributes. In addition, edge-wise functional connectivity analysis revealed abnormal edge co-fluctuation amplitude and number of transitions among different groups. Taken together, our study revealed disorder-specific and -shared regional and edge-wise functional connectivity and network differences for ASD and ADHD using an individual-level functional network mapping approach, which provides new evidence for the brain functional abnormalities in ASD and ADHD and facilitates understanding the neurobiological basis for both disorders.

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