1. Barik K, Watanabe K, Hirosawa T, Yoshimura Y, Kikuchi M, Bhattacharya J, Saha G. Autism Detection in Children using Common Spatial Patterns of MEG Signals. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

Autism exhibits a wide range of developmental disabilities and is associated with aberrant anatomical and functional neural patterns. To detect autism in young children (4-7 years) in an automatic and non-invasive fashion, we have recorded magnetoencephalogram (MEG) signals from 30 autistic and 30 age-matched typically developing (TD) children. We have used a machine learning classification framework with common spatial pattern (CSP)-based logarithmic band power (LBP) features. When comparing the LBP feature to the conventional logarithmic variance (LV) spatial pattern, CSP + LBP (92.77%) has performed better than CSP + LV (90.66%) in the 1-100 Hz frequency range for distinguishing autistic children from TD children. In frequency band-wise analysis using our proposed method, the high gamma frequency band (50-100 Hz) has shown the highest classification accuracy (97.14%). Our findings reveal that the occipital lobe exhibits the most distinct spatial pattern in autistic children over the whole frequency range. This study shows that spatial brain activation patterns can be utilized as potential biomarkers of autism in young children. The improved performance signifies the clinical relevance of the work for autism detection using MEG signals.

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2. Bartroli M, Clotas C, Bosque-Prous M, Espelt A. Short report: Effectiveness of a universal preschool-based program for emotional education in 3- to 5-year-old children with autism spectrum conditions. Autism : the international journal of research and practice. 2023: 13623613231217058.

There are numerous programs and interventions to improve social and emotional skills that expressly target children with autism spectrum conditions. However, there is less knowledge about the impact of universal (directed to all children) school programs of emotional education specifically on these children. In this context, the aim of our study was to evaluate the impact of the « 1,2,3,emoció! » universal school program on them. The results show that children with autism spectrum conditions participating in the program improved their emotional competence more than the ones who did not participate. Therefore, we conclude that the « 1,2,3,emoció! » universal program is effective in children with autism spectrum conditions. This promising outcome gives the opportunity to these children to benefit from group learning in an inclusive school setting, by complementing individual interventions with a universal program.

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3. Calisan Kinter R, Ozbaran B, Inal Kaleli I, Kose S, Bildik T, Ghaziuddin M. The Sensory Profiles, Eating Behaviors, and Quality of Life of Children with Autism Spectrum Disorder and Avoidant/Restrictive Food Intake Disorder. The Psychiatric quarterly. 2023.

Eating disorders frequently accompany autism spectrum disorder (ASD). One such novel eating disorder is avoidant/restrictive food intake disorder (ARFID). This study compares the eating attitudes, quality of life, and sensory processing of typically developing children (TDC), autistic children, and autistic children with ARFID. A total of 111 children aged 4-10 with a diagnosis of ASD and ARFID (n = 37), ASD without ARFID (n = 37), and typical development (n = 37) were recruited. After an interview in which Childhood Autism Rating Scale (CARS) was administered, Child Eating Behavior Questionnaire (CEBQ), Pediatric Quality of Life Inventory (PedsQL), Social Responsiveness Scale (SRS) and Sensory Profile (SP) were completed by caregivers. Autistic children with ARFID had higher scores in CEBQ subscales relating to low appetite and lower scores on the subscales associated with weight gain. Both groups of autistic children scored lower than TDC on all PedsQL subscales and autistic children with ARFID had lower social QL scores than both groups. SRS scores were highest in autistic children with ARFID, followed by autistic and typically developing children. CARS scores were similar in both groups of autistic children, but higher than TDC. Auditory, vision, touch, multi-sensory, oral processing scores; as well as all quadrant scores, were significantly lower in autistic children with ARFID. Oral sensory processing scores were found to be the most significant predictor of ARFID comorbidity in ASD and reliably predicted ARFID in autistic children in the clinical setting. Autistic children with ARFID demonstrate differences in social functioning, sensory processing, eating attitudes, and quality of life compared to autistic and TD children.

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4. Chuang TM, Chien YL, Lin SH, Su YK, Liu HH, Chiu YN, Tsai WC, Tseng YL. Social Brain Activation and Connectivity in Autism Spectrum Disorders: An Electroencephalogram Study of Jigsaw Puzzle Solving. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

Autism spectrum disorder requires early detection and treatment. Thus, we developed a method to obtain reliable neurophysiological biomarkers to assist in diagnosing autism. This method includes a simple but typical jigsaw puzzle that allows participants to play and interact with each other. While playing this game, brain signals of the participants were observed and analyzed. The patients with autism were found to have differences in the time range of some event-related potential, such as P300 and N400. Altered patterns of function connectivity were also found in delta frequency bands in the patients while interacting with other people. Working around patients’ capabilities, the jigsaw puzzle game was designed as easy to complete; this caused fewer mismatch conditions. The result suggested that these patterns are promising neurophysiological biomarker to assist doctors in social cognitive assessment in autism.Clinical Relevance-This study demonstrated the possibility of using hyperscanning technique for social cognitive assessment of autism spectrum disorder.

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5. Dhinagar NJ, Santhalingam V, Lawrence KE, Laltoo E, Thompson PM. Few-Shot Classification of Autism Spectrum Disorder using Site-Agnostic Meta-Learning and Brain MRI. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-6.

For machine learning applications in medical imaging, the availability of training data is often limited, which hampers the design of radiological classifiers for subtle conditions such as autism spectrum disorder (ASD). Transfer learning is one method to counter this problem of low training data regimes. Here we explore the use of meta-learning for very low data regimes in the context of having prior data from multiple sites – an approach we term site-agnostic meta-learning. Inspired by the effectiveness of meta-learning for optimizing a model across multiple tasks, here we propose a framework to adapt it to learn across multiple sites. We tested our meta-learning model for classifying ASD versus typically developing controls in 2,201 T1-weighted (T1-w) MRI scans collected from 38 imaging sites as part of Autism Brain Imaging Data Exchange (ABIDE) [age: 5.2 -64.0 years]. The method was trained to find a good initialization state for our model that can quickly adapt to data from new unseen sites by fine-tuning on the limited data that is available. The proposed method achieved an area under the receiver operating characteristic curve (ROC-AUC)=0.857 on 370 scans from 7 unseen sites in ABIDE using a few-shot setting of 2-way 20-shot i.e., 20 training samples per site. Our results outperformed a transfer learning baseline by generalizing across a wider range of sites as well as other related prior work. We also tested our model in a zero-shot setting on an independent test site without any additional fine-tuning. Our experiments show the promise of the proposed site-agnostic meta-learning framework for challenging neuroimaging tasks involving multi-site heterogeneity with limited availability of training data.Clinical Relevance- We propose a learning framework that accommodates multi-site heterogeneity and limited data to assist in challenging neuroimaging tasks.

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6. Iwauchi K, Tanaka H, Nakamura S. Predicting Autistic Traits Using Eye Movement during Visual Perspective Taking and Facial Emotion Identification. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

Autistic traits are broad in severity and difficult to measure quantitatively. Quantitative measurement would be helpful in determining the effectiveness of training and therapy for autistic traits. The development of eye-tracking technology has made it easier to understand autistic traits. Previous works showed that autistic traits can be predicted from eye movements in the facial emotion identification task. It may be possible to measure autistic traits more accurately than the only prediction from facial emotion identification ability. In this study, we used a visual perspective taking task. The results showed that the Social Responsiveness Scale-2 score, which is associated with autistic traits, was predicted at 0.414 in Spearman’s correlation coefficient by using eye movements obtained from the two tasks.

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7. Littman ER, Gavin L, Broda A, Hodges AC, Spector L. Barriers to Receiving Applied Behavior Analysis Services in Children With Autism Spectrum Disorder. Cureus. 2023; 15(11): e48585.

Introduction Applied behavior analysis (ABA) is commonly used to treat children with autism spectrum disorder (ASD). The objective of this study is to evaluate barriers to ABA treatment in ASD. Methods A voluntary 51-question survey, including demographics, socioeconomic status, parental assertiveness/self-advocacy, and parent perceptions, was provided to caregivers of children aged one to eight years old diagnosed with ASD. The survey consisted of a series of yes/no, five-point Likert scale, multiple-choice, and text field questions. Results A total of 540 surveys were completed. The median time since ASD diagnosis was three to five years ago. Respondents were identified as receiving ABA (r-ABA) vs. not receiving ABA (n-ABA). Respondents were from Florida (60%; r-ABA = 61.7%; n-ABA = 57.0%), Pennsylvania (18%; r-ABA = 21.3%; n-ABA = 12.8%), Delaware (17%; r-ABA = 11.7%; n-ABA = 26.8%), and New Jersey (5%; r-ABA = 5.3%; n-ABA = 3.4%) (p < 0.001). Caregiver belief in ABA treatment, empowerment, and comfort level were greater for r-ABA (4.20 ± 0.72; 3.19 ± 0.93; 4.35 ± 0.72) compared to n-ABA (4.06 ± 0.83; 2.90 ± 1.00; 4.03 ± 0.91), respectively (mean ± SD). Conclusion Barriers to accessing ABA services are a multifactorial issue. Location, income, education of the caregiver, time since ASD diagnosis for the child, as well as caregiver empowerment, belief in treatment, and level of comfort in accessing services most likely contribute to children with ASD not receiving ABA. Empowering parents on their impact on their child's treatment may improve ABA use.

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8. Rynkiewicz A, Zheng S, Lacroix A. Special considerations for assessing and caring for autism in girls and women. Current opinion in psychiatry. 2023.

PURPOSE OF REVIEW: As the specificities of autistic women are increasingly recognized, this review aims to highlight emerging areas of research. These areas primarily focus on measurement bias of diagnostic tools, the physical and mental health of autistic women, and the unique aspects of the lives of autistic women, both personally and professionally across all life stages. RECENT FINDINGS: Conventional diagnostic tools struggle to capture the specificities of autism in females, but more sensitive instruments like the GQ-ASC (Girls’ Questionnaire for Autism Spectrum Conditions), later also referred to as Q-ASC (Questionnaire for Autism Spectrum Conditions) in the scientific literature, show better performances. Autistic women face particular challenges, including an increased risk of physical and mental health problems throughout their lives as women (puberty, motherhood, menopause). Autistic women also encounter specific difficulties in their employment that require greater consideration. SUMMARY: The findings of this review identify research areas that need to be developed to better understand and support autistic girls and women and to enhance clinical practice for them.

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9. Samanta A, Sarma M, Samanta D. ALERT: Atlas-Based Low Estimation Rank Tensor Approach to Detect Autism Spectrum Disorder(). Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

In response to a stimulus, distinct areas of the human brain are activated. Also, it is known that the regions interact with one another. This functional connectivity is helpful to diagnose any neurological abnormality, such as autism spectrum disorder (ASD). This work proposes an approach to construct a functional connectivity network from fMRI image data. For obtaining a functional connectivity network, the time series component of fMRI data is used and from it correlation matrix is calculated showing the degree of interaction among the brain regions. To map the different regions of a brain, the brain atlas is considered. This essentially yields a low-rank tensor approximation of the functional connectivity matrix. A 2D convolutional deep neural network model is built to categorize topological similarity in the functional connectivity matrices related to ASD and typically developing control. The proposed approach has been tested with ABIDE dataset of fMRI data for autism spectrum disorder. Several brain atlases have been considered in the experiment. With a majority voting concept on the results from the atlases, the proposed technique reveals an ASD detection accuracy of 84.79%, which is significantly comparable to the state of the art techniques.Clinical Relevance- ASD is one of the least understood neurological disorders that has been recently recognized to have major sociological consequences on an affected individual’s life. A symptom-based diagnosis is in practice. However, this requires prolonged behavioural examinations under the supervision of a highly skilled multidisciplinary team. An early and cost-effective detection using an fMRI image is considered an appropriate, comprehensive, and advanced treatment plan.

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10. Tost A, Bachiller A, Garcia-Cazorla A, Medina-Rivera I, Romero S, Mananas MA. Electroencephalographic assessment in patients with Rett syndrome during cognitive stimulation by means of eye tracking technology and alternative and augmentative communication systems. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

Rett syndrome (RTT) is considered a rare disease despite being the leading genetic disorder to cause severe intellectual disability in women. There is no cure for RTT, so the treatment is symptomatic and supporting, requiring a multidisciplinary approach. Occupational therapy can help girls and their families to improve communication, being one of the main concerns when verbal language and intentional hand movement are impaired or lost. This paper presents a pilot study of cognitive training through the combined use of eye-tracking technology (ETT) and augmentative and alternative communication (AAC) using the Peabody Picture Vocabulary Test (PPVT-IV). The objective was to evaluate brain activation by means of electroencephalography (EEG) during the stimulation of non-verbal communication. EEG data were recorded during an eyes-open resting state (EO-RS) period and during cognitive stimulation via AAC activity. To assess their effect, both signals were compared at the spectral level, focusing on frequency, brain symmetry and connectivity. During the task, a redistribution of power towards fast frequency bands was observed, as well as an improvement in the brain symmetry index (BSI) and functional synchronicity through increased coherence. Therefore, the results of the spectral analysis showed a possible deviation from the pathological pattern, manifesting a positive effect in the use of non-verbal cognitive stimulation activities. In conclusion, it was observed that it is possible to establish a cognitive training system that produces brain activation and favors communication and learning despite intentional language loss.Clinical Relevance- This manifests a method of cognitive training that would induce brain activation in RTT patients with absence of intentional communication. The evaluation system through spectral analysis could complement the standardized protocols to asses communication that are based on verbal and motor production.

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11. Vitor-Vieira F, Patriarcha PP, Rojas VCT, Parreiras SS, Giusti FCV, Giusti-Paiva A. Influence of Maternal Immune Activation on Autism-like Symptoms and Coping Strategies in Male Offspring. Physiology & behavior. 2023: 114432.

Maternal immune activation (MIA) caused by exposure to pathogens or inflammation during critical periods of gestation increased susceptibility to neurodevelopmental disorders, including autism, in the offspring. In the present work, we aimed to provide characterization of the long-term consequences on anxiety-like behavior and cardiovascular stress response of MIA in the offspring. This study aimed to evaluate the effect of MIA by lipopolysaccharide (LPS) in adult male offspring. In our study, the animals were subjected to a range of behavioral and physiological tests, including the elevated plus maze, social interaction, cat odor response, open field behavior, contextual fear conditioning, and cardiovascular responses during restraint stress. In the offspring of MIA, our study unveiled distinct anxious behaviors. This was evident by fewer entries into the open arms of the maze, diminished anti-thigmotaxis in the open field, and a decrease in social interaction time. Moreover, these rats showed heightened sensitivity to cat odor, exhibited prolonged freezing during fear conditioning, and presented elevated 22Hz ultrasonic vocalizations. Notably, during restraint stress, these animals manifested an augmented blood pressure response, and this was associated with an increase in c-fos expression in the locus coeruleus compared to the control group. These findings collectively underline the extensive behavioral and physiological alterations stemming from MIA. This study deepens our understanding of the significance of maternal health in predisposing offspring to neurobehavioral deficits and psychiatric disorders.

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12. Wang J, Zhang L, Li T, Liu W, Xue H, Liu S, Ming D. Atypical scanning strategies of emotional faces for individuals with high autistic traits. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

Autism has become one of the primary diseases causing disability in children, and the incidence has risen rapidly in recent years. The preclinical study on individuals with high autistic traits is extremely important to reduce genetic risks of autism because high autistic traits is the susceptibility marker of autism. However, few studies explored the face scanning pattern of people with high autistic traits in typical developing populations. In this study, we designed a facial emotion recognition experiment including four emotions (happy, neutral, sad, angry) and three angles (0°, 45°, 90°) , and informed the participants to identify the facial emotion. Forty-two college students with typical development were recruited and divided into high autistic traits (HAT) group and low autistic traits (LAT) group by the Autism-Spectrum Quotient, and we collected the eye movement data using eye-tracking technology when they performed the task. The response time, recognition accuracy, AOI based proportional fixation time and pupil diameter were computed and analyzed for both groups. HATs showed significantly lower recognition accuracy and lower pupil diameter than LATs when recognizing negative emotions (P<0.05) , indicating HATs kept poor autonomic nervous arousal. What ' s more, the proportional fixation time of HATs were significantly more in mouth area but less in eye area than that of LAT group (P<0.05) , revealed HATs had an atypical emotional faces scanning strategies that paid less attention to eyes and more attention to mouth. Our research provides a feasible objective biomarker for screening high autistic traits population.

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13. Yoo S, Jang Y, Hong SJ, Park H, Valk SL, Bernhardt BC, Park BY. Atypical structural connectome asymmetry and associations with network communication in autism spectrum disorder. Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual International Conference. 2023; 2023: 1-4.

Autism spectrum disorder is a common neurodevelopmental condition showing connectome disorganization in sensory and transmodal cortices. However, alterations in the inter-hemispheric asymmetry of structural connectome are remained to be investigated. Here, we studied structural connectome asymmetry in individuals with autism using dimensionality reduction techniques and assessed its topological underpinnings by associating with network communication measures. We found that the sensory and heteromodal association regions showed significant between-group differences in inter-hemispheric asymmetry between individuals with autism and neurotypical controls. In addition, the network communication ability was particularly altered between visual and limbic areas. Our findings provide insights for understanding structural connectome alteration in autism and its topological underpinnings.Clinical Relevance- This study provides insights into the understanding of atypical macroscale structural connectome organization in individuals with autism.

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14. Zamstein O, Sheiner E, Binyamin Y, Pariente G, Wainstock T. Examining the relationship between autism spectrum disorder in children whose mother had labour epidural analgesia for their birth: A retrospective cohort study. European journal of anaesthesiology. 2023.

BACKGROUND: Controversy exists regarding the association between autism spectrum disorder (ASD) in children whose mother had labour epidural analgesia for their birth, as the few existing investigations have reported mixed findings. OBJECTIVE: This study aims to evaluate the possibility of an association in our heterogeneous population. DESIGN: A retrospective population-based cohort study. SETTING: Vaginal deliveries that took place between the years 2005 and 2017 at Soroka University Medical Center, a tertiary referral hospital in Israel, and a follow-up on the incidence of ASD in the children. PATIENTS: A hundred and thirty-nine thousand, nine hundred and eighty-one labouring patients and their offspring. MAIN OUTCOME MEASURES: The incidence of children diagnosed with ASD (both hospital and community-based diagnoses) was compared based on whether their mothers had received labour epidural analgesia during their labour. A Kaplan-Meier survival curve compared cumulative incidence of ASD. A Cox proportional hazards model was used to control for relevant confounders. RESULTS: Labour epidural analgesia was administered to 33 315 women. Epidural analgesia was more common among high-risk pregnancy groups (including pregnancies complicated with diabetes mellitus, hypertensive disorders, intrauterine growth restriction, and oligohydramnios; P < 0.001). In a Cox proportional hazards model, the association between epidural analgesia during labour and ASD in the children lost statistical significance following adjustment for confounders such as maternal age, gestational age, hypertensive disorders, diabetes mellitus, and ethnicity [adjusted hazard ratio = 1.13, 95% confidence interval (CI), 0.96 to 1.34, P = 0.152]. CONCLUSION: In our population, after adjusting for confounders, epidural analgesia is not independently associated with autism spectrum disorder in the children. These findings enhance our knowledge regarding the safety of epidural analgesia and enable patients to make informed decisions about their pain relief techniques during labour.

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15. Zhang P, Wang X, Xu Y, Zhao X, Zhang X, Zhao Z, Wang H, Xiong Z. Association between interpregnancy interval and risk of autism spectrum disorder: a systematic review and Bayesian network meta-analysis. European journal of pediatrics. 2023.

Although the risk of autism spectrum disorder (ASD) has been reported to be associated with interpregnancy intervals (IPIs), their association remains debatable due to inconsistent findings in existing studies. Therefore, the present study aimed to explore their association. PubMed, Embase, Web of Science, and the Cochrane Library were systematically retrieved up to May 25, 2022. An updated search was performed on May 25, 2023, to encompass recent studies. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Our primary outcome measures were expressed as adjusted odds ratios (ORs). Given various control measures for IPI and diverse IPI thresholds in the included studies, a Bayesian network meta-analysis was performed. Eight studies were included, involving 24,865 children with ASD and 2,890,289 children without ASD. Compared to an IPI of 24 to 35 months, various IPIs were significantly associated with a higher risk of ASD (IPIs < 6 months: OR = 1.63, 95% CI 1.53-1.74, n = 5; IPIs of 6-11 months: OR = 1.50, 95% CI 1.42-1.59, n = 4; IPIs of 12-23 months: OR = 1.19, 95% CI 1.12-1.23, n = 10; IPIs of 36-59 months: OR = 0.96, 95% CI 0.94-0.99, n = 2; IPIs of 60-119 months: OR = 1.15, 95% CI 1.10-1.20, n = 4; IPIs > 120 months: OR = 1.57, 95% CI 1.43-1.72, n = 4). After adjusting confounding variables, our analysis delineated a U-shaped restricted cubic spline curve, underscoring that both substantially short (< 24 months) and excessively long IPIs (> 72 months) are significantly correlated with an increased risk of ASD. Conclusion: Our analysis indicates that both shorter and longer IPIs might predispose children to a higher risk of ASD. Optimal childbearing health and neurodevelopmental outcomes appear to be associated with a moderate IPI, specifically between 36 and 60 months. What is Known: • An association between autism spectrum disorder (ASD) and interpregnancy intervals (IPIs) has been speculated in some reports. • This association remains debatable due to inconsistent findings in available studies. What is New: • Our study delineated a U-shaped restricted cubic spline curve, suggesting that both shorter and longer IPIs predispose children to a higher risk of ASD. • Optimal childbearing health and neurodevelopmental outcomes appear to be associated with a moderate IPI, specifically between 36 and 60 months.

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