1. Arteaga-Henríquez G, Gisbert L, Ramos-Quiroga JA. Immunoregulatory and/or Anti-inflammatory Agents for the Management of Core and Associated Symptoms in Individuals with Autism Spectrum Disorder: A Narrative Review of Randomized, Placebo-Controlled Trials. CNS drugs. 2023.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with a so far poorly understood underlying pathogenesis, and few effective therapies for core symptoms. Accumulating evidence supports an association between ASD and immune/inflammatory processes, arising as a possible pathway for new drug intervention. However, current literature on the efficacy of immunoregulatory/anti-inflammatory interventions on ASD symptoms is still limited. The aim of this narrative review was to summarize and discuss the latest evidence on the use of immunoregulatory and/or anti-inflammatory agents for the management of this condition. During the last 10 years, several randomized, placebo-controlled trials on the effectiveness of (add-on) treatment with prednisolone, pregnenolone, celecoxib, minocycline, N-acetylcysteine (NAC), sulforaphane (SFN), and/or omega-3 fatty acids have been performed. Overall, a beneficial effect of prednisolone, pregnenolone, celecoxib, and/or omega-3 fatty acids on several core symptoms, such as stereotyped behavior, was found. (Add-on) treatment with prednisolone, pregnenolone, celecoxib, minocycline, NAC, SFN, and/or omega-3 fatty acids was also associated with a significantly higher improvement in other symptoms, such as irritability, hyperactivity, and/or lethargy when compared with placebo. The mechanisms by which these agents exert their action and improve symptoms of ASD are not fully understood. Interestingly, studies have suggested that all these agents may suppress microglial/monocyte proinflammatory activation and also restore several immune cell imbalances (e.g., T regulatory/T helper-17 cell imbalances), decreasing the levels of proinflammatory cytokines, such as interleukin (IL)-6 and/or IL-17A, both in the blood and in the brain of individuals with ASD. Although encouraging, the performance of larger randomized placebo-controlled trials, including more homogeneous populations, dosages, and longer periods of follow-up, are urgently needed in order to confirm the findings and to provide stronger evidence.

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2. Konst MJ, Matson JL, Goldin R, Rieske R. Retraction notice to « How does ASD symptomology correlate with ADHD presentations? » [Research in Developmental Disabilities 35/9 (2014) 2252-2259]. Research in developmental disabilities. 2023: 104450.

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3. Livingston LA, Shah P, Happé F. EXPRESS: Linearly Integrating Speed and Accuracy to Measure Individual Differences in Theory of Mind: Evidence from Autistic and Neurotypical Adults. Quarterly journal of experimental psychology (2006). 2023: 17470218231165251.

It has long been theorised that there is a direct link between individual differences in social cognition and behaviour. One of the most popular tests of this theory has involved examination of Theory of Mind (ToM) difficulties in Autism Spectrum Disorder (ASD). However, evidence for associations between ToM and social behaviour is mixed, both when testing the ToM explanation of ASD and when investigating individual differences in ToM in the general population. We argue that this is due to methodological limitations of many ToM measures, such as a lack of variability in task performance, inappropriate non-ToM control tasks, and a failure to account for general mental ability. To overcome these issues, we designed a novel task, which probed individual differences in ToM fluency through mental state attribution in response to cartoons (CarToM). This task, enabling the linear combination of speed and accuracy, was used to quantify ToM ability and its association with self-reported (a)typical social behaviour in adults with and without ASD. In a large sample (N = 237), we found that having an ASD diagnosis and higher autistic traits predicted lower ToM ability, even after accounting for performance on a well-matched non-ToM condition and general mental ability. Overall, our findings provide fresh support for the existence of a link between individual differences in social cognition (specifically, ToM) and behaviour (specifically, ASD/autistic traits). This has implications for social-cognitive theory and research, allowing large-scale, online assessment of individual differences in ToM in clinical groups and the general population.

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4. Maekawa T, Kuroki T, Tanaka M, Ogata K, Yamasaki T, Matsubara T, Tobimatsu S. Effects of spatially filtered fearful faces and awareness on amygdala activity in adults with autism spectrum disorder: A magnetoencephalography study. Neuroscience letters. 2023; 800: 137135.

BACKGROUND: The amygdala is pivotal in emotional face processing. Spatial frequencies (SFs) of visual images are divided and processed via two visual pathways: low spatial frequency (LSF) information is conveyed by the magnocellular pathway, while the parvocellular pathway carries high spatial frequency information. We hypothesized that altered amygdala activity might underlie atypical social communication caused by changes in both conscious and non-conscious emotional face processing in the brain in individuals with autism spectrum disorder (ASD). METHOD: Eighteen adults with ASD and 18 typically developing (TD) peers participated in this study. Spatially filtered fearful- and neutral-expression faces and object stimuli were presented under supraliminal or subliminal conditions, and neuromagnetic responses in the amygdala were measured using 306-channel whole-head magnetoencephalography. RESULTS: The latency of the evoked responses at approximately 200 ms to unfiltered neutral face stimuli and object stimuli in the ASD group was shorter than that in the TD group in the unaware condition. Regarding emotional face processing, the evoked responses in the ASD group were larger than those in the TD group under the aware condition. The later positive shift during 200-500 ms (ARV) was larger than that in the TD group, regardless of awareness. Moreover, ARV to HSF face stimuli was larger than that to the other spatial filtered face stimuli in the aware condition. CONCLUSION: Regardless of awareness, ARV might reflect atypical face information processing in the ASD brain.

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5. Pye K, Jackson H, Iacono T, Shiell A. Economic Evaluation of Early Interventions for Autistic Children: A Scoping Review. Journal of autism and developmental disorders. 2023.

Many autistic children access some form of early intervention, but little is known about the value for money of different programs. We completed a scoping review of full economic evaluations of early interventions for autistic children and/or their families. We identified nine studies and reviewed their methods and quality. Most studies involved behavioral interventions. Two were trial-based, and the others used various modelling methods. Clinical measures were often used to infer dependency levels and quality-adjusted life-years. No family-based or negative outcomes were included. Authors acknowledged uncertain treatment effects. We conclude that economic evaluations in this field are sparse, methods vary, and quality is sometimes poor. Economic research is needed alongside longer-term clinical trials, and outcome measurement in this population requires further exploration.

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6. Rehan ST, Ahmed M, Bukhsh AN, Bari K, Hussain HU, Ullah I, Asghar MS. Heavy migration of flood affectees in Pakistan and increased risk of autism spectrum disorder in children: a call to action. International journal of surgery (London, England). 2023.

Autism spectrum disorder (ASD) refers to various neurodevelopmental disabilities generally seen in kids. Pakistan, being vulnerable to natural disasters, faced one of the most devastating floods in July 2022 due to which many individuals were displaced. This not only affected the mental health of growing children but also the developing fetus of migrant mothers. This report establishes the link between the aftereffects of migration due to floods on children particularly associated with ASD in Pakistan. Flood affected families are devoid of basic necessities and are under a lot of psychological stress. On the other hand, Extensive treatment for autism is complicated, expensive, and provided in proper settings only which is not easily accessible to migrants. Considering all these factors, there are chances that ASD will be more prevalent in future generations of these migrants. Our study calls on respective authorities to take timely action for this growing concern.

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7. Zorzi S, Dalmonego C, De Vreese LP, Gomiero T. Adult Independence Living Measurement Scale: Psychometric validation of a scale to estimate personal skills for independent living in people with intellectual and developmental disabilities. Journal of intellectual disability research : JIDR. 2023.

BACKGROUND: The United Nations has declared that people with disabilities should be enabled to live as independently as possible, since independence is correlated with a better quality of life. Consequently, services need to have common and validated measurement tools for the evaluation of the different levels of personal support needs in order to promote independent living skills. We aimed to create and validate the Adult Independence Living Measurement Scale (AILMS) to estimate personal skills considered tantamount for independent living in adult persons with intellectual and developmental disabilities. METHODS: AILMS is a short informant-rated assessment tool consisting of 19 items (goals) regarding the most important skills related to independent living. AILMS total score is directly proportional to the degree of independence, with scores ranging from 19 to 76. Our validation is a multicentre study attended by 243 subjects, 110 female and 123 males, with a median age of 37 years and with an interquartile range (IQR) of 18 (25th percentile [Q1] 29 years to 75th percentile [Q3] 47 years). All subjects had a diagnosis of intellectual disability associated with various neurodevelopmental disorders or syndromic conditions. RESULTS: The AILMS shows a wide range of scores with a minimum score of 21 and a maximum of 72. We found no floor or ceiling effects for the total score on the AILMS. Cronbach’s α coefficient (= 0.95), based on the 19 AILMS items, indicated high internal consistency. The tool demonstrates a very good agreement even when comparing the results submitted by two different interviewers. It also shows an excellent temporal stability of 1 week, with intraclass correlation coefficients both of 0.97. AILMS total scores do not differ by sex or age, while statistically significant differences are observed between people with different levels of severity of ID. Convergent validity of AILMS was analysed by correlating its total scores with the Italian validated versions of the Support Intensity Scale (SIS-I) and the Alzheimer’s Functional Assessment Tool (AFAST-I) scores. Strong inverse Spearman correlations coefficients (r(s) ) were found both for the Support Need Index of the SIS-I (r(s) = -0.66; P < 0.001) and AFAST-I (r(s) = -0.73; P < 0.001). Scores of support needs in exceptional health disorders of the SIS-I appear unrelated to AILMS total scores (r(s) = -0.01; P = 0.05), confirming the divergent validity of the new scale. Exploratory factor analysis reveals three underlying factors within the AILMS, with factor 1 explaining 51.2% of the total variance (Cronbach's α = 0.92) composed of predominantly nine advanced daily activities. CONCLUSIONS: The AILMS has good psychometric properties and user friendliness and may therefore be a valuable addition to the current informant-rated tools for screening and assessment of independent living skills of individuals with intellectual and developmental disabilities.

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