1. Andzik NR, Schaefer JM, Christensen VL. The effects of teacher-delivered behavior skills training on paraeducators’ use of a communication intervention for a student with autism who uses AAC. Augmentative and alternative communication (Baltimore, Md : 1985). 2021; 37(1): 1-13.

Special education teachers are often responsible for training their staff how to support children with autism spectrum disorder in their classrooms. In addition to academic and behavioral interventions, paraeducators also need to be prepared to support students with complex communication needs. This study was designed to investigate the effects of a paraeducator-implemented communication intervention in a public school. A multiple probe design across participants was used to evaluate a communication intervention that included providing opportunities to initiate with least-to-most prompting for a 10-year-old student with autism who used an augmentative and alternative communication (AAC) device. Prior to the intervention, the student was rarely observed initiating interactions with her AAC device, and paraeducators were rarely observed offering opportunities to initiate or providing supports to help the student initiate. Following training, data from each paraeducator indicated an increased rate when providing the communication intervention and as a result, the student displayed an increase in the targeted intervention, initiation. Findings from the intervention highlight the need for explicit teaching when promoting initiation among students with autism who use AAC.

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2. Bendik LA, Spicer-White F. The untold perspective: Parents’ experiences of the autism spectrum disorder assessment process when the child did not receive a diagnosis. Autism : the international journal of research and practice. 2021; 25(6): 1761-70.

Autism is diagnosed by a process of child assessment and parental interview. It has been well-documented by parents of children who received a diagnosis of autism, that the process can be lengthy and cause distress for families. Nevertheless, the outcome often compensated for the difficult assessment journey as it enables families to gain access to further information, support and intervention. However, less is known about the assessment process from parents who undertake the same process but at the end are told their child does not meet the diagnostic criteria, meaning no diagnosis is given. We interviewed six parents in North Wales, whose child did not receive a diagnostic of autism following an assessment. During the interview, parents were asked about their experience of the autism assessment process. We found that parents reflected on their experience according to three themes: (1) parents tried to navigate how they could make sense of their child being different despite not receiving a diagnosis; (2) parents referred to the assessment process as a journey, which encompassed many emotional and psychological components and (3) parents discussed what it was like to hear a non-diagnosis outcome, in terms of feeling relieved, confused and raising questions for the child’s future. These findings are important for professionals working in autism assessment services to help improve the assessment process for families, particularly when the assessment does not result in a diagnosis.

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3. Bullard L, Harvey D, Abbeduto L. Exploring the feasibility of collecting multimodal multiperson assessment data via distance in families affected by fragile X syndrome. Journal of telemedicine and telecare. 2021: 1357633×211003810.

INTRODUCTION: Telehealth is an important tool in helping to provide services for hard-to-reach populations. One population that might benefit from telehealth are individuals with fragile X syndrome (FXS). Although FXS is the leading inherited cause of intellectual disability, it is nonetheless a low incidence disorder. Individuals with FXS and their families are involved in research studies, clinical trials and receive interventions – many of which are only offered in a few locations in the United States and thus, not easily accessible to many families. The current project explored the feasibility of using telehealth procedures to collect multimodal behavioural and psychological assessment data from these families. METHODS: Participation in the current study involved online surveys, measures of physiological indices of stress, live interviews and observations of mother-child interactions conducted via distance videoconferencing using the family’s own technology when possible. Across all modes of data collection, we obtained information regarding the feasibility of participating entirely via distance by documenting missing data as well as each mother’s overall impression of participating via distance. RESULTS: Our telehealth procedures were successfully implemented across a wide range of technology platforms with limited difficulty, and we documented little missing data due to technology-related challenges. Perhaps most importantly, however, our sample of mothers reported high satisfaction with participating via distance. DISCUSSION: These findings suggest that a wide range of services and types of assessments may be amenable to telehealth procedures. Further, the findings have immediate applications as the field shifts towards telehealth due to the coronavirus disease 2019 (COVID-19) pandemic.

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4. Dell’Osso L, Carpita B, Cremone IM, Gesi C, D’Ermo A, De Iorio G, Massimetti G, Aguglia E, Bucci P, Carpiniello B, Fagiolini A, Roncone R, Siracusano A, Vita A, Carmassi C, Maj M. Autism spectrum in patients with schizophrenia: correlations with real-life functioning, resilience, and coping styles. CNS spectrums. 2021: 1-11.

BACKGROUND: Previous researches highlighted among patients with schizophrenia spectrum disorders (SSD) a significant presence of autistic traits, which seem to influence clinical and functional outcomes. The aim of this study was to further deepen the investigation, evaluating how patients with SSD with or without autistic traits may differ with respect to levels of functioning, self-esteem, resilience, and coping profiles. METHODS: As part of the add-on autism spectrum study of the Italian Network for Research on Psychoses, 164 outpatients with schizophrenia (SCZ) were recruited at eight Italian University psychiatric clinics. Subjects were grouped depending on the presence of significant autistic traits according to the Adult Autism Subthreshold Spectrum (AdAS Spectrum) instrument (« AT group » vs « No AT group »). Other instruments employed were: Autism Spectrum Quotient (AQ), Specific Levels of Functioning (SLOF), Self-Esteem Rating scale (SERS), Resilience Scale for Adults (RSA), and brief-COPE. RESULTS: The « AT group » reported significantly higher scores than the « No AT group » on SLOF activities of community living but significantly lower scores on work skills subscale. The same group scored significantly lower also on SERS total score and RSA perception of the self subscale. Higher scores were reported on COPE self-blame, use of emotional support and humor domains in the AT group. Several correlations were found between specific dimensions of the instruments. CONCLUSION: Our findings suggest the presence of specific patterns of functioning, resilience, and coping abilities among SSD patients with autistic traits.

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5. Dugdale AS, Thompson AR, Leedham A, Beail N, Freeth M. Intense connection and love: The experiences of autistic mothers. Autism : the international journal of research and practice. 2021; 25(7): 1973-84.

For many women, adulthood involves becoming a mother. Knowledge of how motherhood is experienced by autistic women is currently poor. Poor knowledge has a range of negative consequences and can lead to inappropriate support. In this study, nine autistic women were interviewed about their experiences of motherhood. Seven of the nine mothers had an officially diagnosed autistic child, the final two mothers also suspected at least one of their children to be autistic. Systematic in-depth analysis of interview transcripts identified a range of common themes. Participants largely experienced motherhood as joyful, rewarding, and enjoyable, though managing children’s needs had a profound personal impact. Participants reflected on the need for self-care and self-acceptance, resulting in personal growth and adaptation. Participants also spoke of strong bonds, feelings of intense connection, and a range of shared experiences with their children. It was also clear that autistic motherhood is associated with a series of challenges unlikely to be experienced by non-autistic mothers, including the necessity of negotiating misunderstandings from others. The findings demonstrate that, generally, professionals need to be better educated on how autism presents in adulthood, including the fact that autistic women often engage in behaviour to mask their true self. Professionals need to know that there is potential for mismatching between emotional experience and facial expression, that autistic women have sensory needs (especially in pregnancy). Professionals frequently struggle to effectively take the needs and perspectives of autistic mothers into account, resulting in profoundly negative consequences for the mother.

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6. Eugene AR, Eugene B, Masiak M, Masiak JS. Head-to-Head Comparison of Sedation and Somnolence Among 37 Antipsychotics in Schizophrenia, Bipolar Disorder, Major Depression, Autism Spectrum Disorders, Delirium, and Repurposed in COVID-19, Infectious Diseases, and Oncology From the FAERS, 2004-2020. Frontiers in pharmacology. 2021; 12: 621691.

Objective: Antipsychotic compounds are known to induce sedation somnolence and have expanded clinical indications beyond schizophrenia to regulatory approval in bipolar disorder, treatment-resistant depression, and is being repurposed in infectious diseases and oncology. However, the medical sciences literature lacks a comprehensive association between sedation and somnolence among a wide-range of antipsychotic compounds. The objective of this study is to assess the disproportionality of sedation and somnolence among thirty-seven typical and atypical antipsychotics. Materials and Methods: Patient adverse drug reactions (ADR) cases were obtained from the United States Food and Drug Administration Adverse Events Reporting System (FAERS) between January 01, 2004 and September 30, 2020 for a wide-array of clinical indications and off-label use of antipsychotics. An assessment of disproportionality were based on cases of sedation and somnolence and calculated using the case/non-case methodology. Statistical analysis resulting in the reporting odds-ratio (ROR) with corresponding 95% confidence intervals (95% CI) were conducted using the R statistical programming language. Results: Throughout the reporting period, there were a total of 9,373,236 cases with 99,251 specific ADRs reporting sedation and somnolence. Zuclopenthixol (n = 224) ROR = 13.3 (95% CI, 11.6-15.3) was most strongly associated of sedation and somnolence and haloperidol decanoate long-acting injection (LAI) was not statistically associated sedation and somnolence. Further, among atypical antipsychotic compounds, tiapride and asenapine were the top two compounds most strongly associated with sedation and somnolence. Comprehensively, the typical antipsychotics ROR = 5.05 (95%CI, 4.97-5.12) had a stronger association with sedation and somnolence when compared to atypical antipsychotics ROR = 4.65 (95%CI, 4.47-4.84). Conclusion: We conducted a head-to-head comparison of thirty-seven antipsychotics and ranked the compounds based on the association of sedation and somnolence from ADR data collected throughout 16 years from the FAERS. The results are informative and with recent interests in repurposing phenothiazine antipsychotics in infectious disease and oncology provides an informative assessment of the compounds during repurposing and in psychopharmacology.

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7. Frost KM, Russell K, Ingersoll B. Using qualitative content analysis to understand the active ingredients of a parent-mediated naturalistic developmental behavioral intervention. Autism : the international journal of research and practice. 2021; 25(7): 1935-45.

Although naturalistic developmental behavioral interventions are supported by research for supporting the development of children on the autism spectrum, how they work is not well understood. This study reviewed parent reflection comments in a systematic way to better how one such treatment worked, when delivered by caregivers. Caregivers completed weekly written reflection responses as they learned how to use the treatment techniques. We studied these responses to understand caregiver perspectives on how their children responded to the techniques. The responses were then compared to a theory of how the treatment works. Many responses were consistent with the treatment theory; however, others were not. We found that individual techniques were associated with different child responses, suggesting that general measures of social communication may not measure these specific short-term changes. Our findings point to specific behaviors that may be useful to measure in future research, or useful as indicators of treatment response in clinical practice settings. Overall, qualitative methods may be useful for understanding complex treatment processes.

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8. Hillyer M, Matiz LA, Robbins-Milne L, Friedman S. Who to Test? A Retrospective Study of Lead Testing in High-Risk Children. Clinical pediatrics. 2021; 60(6-7): 267-72.

BACKGROUND: Nearly all pediatric patients in our setting meet high-risk criteria for lead exposure based on screening recommendations and guidelines. Implementation of screening and testing has been inconsistent. OBJECTIVE: To assess the utility and efficacy of performing universal lead testing between ages 1 and 5 at an urban academic pediatric practice. METHODS: Retrospective review of patients with routine lead testing between 2010 and 2015. Key variables included demographics, serum lead level, and behavioral diagnoses. RESULTS: A total of 6597 serum lead levels from 3274 patients were reviewed. Forty-seven samples (0.7%) from 24 patients (0.7%) were elevated. Of the 24 patients with elevated lead, 75% were identified at age 1 or 2. Sixty-seven percent of patients with first elevated lead level at age 3 or older had a diagnosis of developmental delay. CONCLUSION: Routine testing of high-risk patients yielded minimal specificity in identifying elevated lead levels, especially in patients older than 3 years and without developmental delay.

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9. Kim SY, Crowley S. Understanding perceptions and experiences of autistic undergraduate students toward disability support offices of their higher education institutions. Research in developmental disabilities. 2021; 113: 103956.

BACKGROUND: Autistic undergraduate students are experiencing considerable difficulties on their college campuses. Yet, disability support offices (DSOs), which assume the responsibility of providing support to students with disabilities, often lack the resources to cater to the varied needs of autistic students. AIM: To understand autistic students’ perspectives and experiences with DSOs and the range of support services available from DSOs of higher education institutions in the United States. METHODS: Semi-structured interviews with 27 autistic undergraduate students were conducted to solicit their perceptions about their DSOs. A generic inductive approach was used to qualitatively analyze the participants’ responses. RESULTS: Students expressed both positive and negative experiences with academic and non-academic support, and perceived that DSO staff lacked specific autism knowledge and were often inaccessible. Some students initially decided not to receive DSO accommodations, but many chose to reach out to their DSOs after experiencing academic difficulties. Finally, students’ perceptions of ways for DSOs to support them better highlighted the need for institution-wide efforts to make a cultural shift about disability and acceptance and the need for more individualized services. CONCLUSIONS: Appropriate resources for DSOs and institution-wide efforts are needed to make college campuses both physically and emotionally accessible to autistic students.

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10. Lee D. Knowledge Gaps in Mobile Health Research for Promoting Physical Activity in Adults With Autism Spectrum Disorder. Frontiers in psychology. 2021; 12: 635105.

A growing body of research highlights that adults with autism spectrum disorder (ASD) have poor health outcomes, yet effective health interventions are lacking for this population. While mobile health applications demonstrate potential for promoting physical activity (PA) in adults with ASD, scientific evidence for supporting this tool’s long-term effectiveness on PA behavior change remains inconclusive. This study aimed to provide the latest information on PA research and the prospective role of mobile health applications for promoting PA in adults with ASD. A literature review demonstrated that a few available studies show contradictory results regarding PA levels in adults with ASD, and behavior change techniques and gamification-guided mobile health applications can be promising tactics to leverage autism’s strengths and increase PA in these individuals. Optimizing design decisions based on needs analysis and user feedback is crucial to identifying and developing a sustainable mobile health intervention for PA promotion in adults with ASD.

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11. Levy JA, LaFlamme CW, Tsaprailis G, Crynen G, Page DT. Dyrk1a Mutations Cause Undergrowth of Cortical Pyramidal Neurons via Dysregulated Growth Factor Signaling. Biological psychiatry. 2021; 90(5): 295-306.

BACKGROUND: Mutations in DYRK1A are a cause of microcephaly, autism spectrum disorder, and intellectual disability; however, the underlying cellular and molecular mechanisms are not well understood. METHODS: We generated a conditional mouse model using Emx1-cre, including conditional heterozygous and homozygous knockouts, to investigate the necessity of Dyrk1a in the cortex during development. We used unbiased, high-throughput phosphoproteomics to identify dysregulated signaling mechanisms in the developing Dyrk1a mutant cortex as well as classic genetic modifier approaches and pharmacological therapeutic intervention to rescue microcephaly and neuronal undergrowth caused by Dyrk1a mutations. RESULTS: We found that cortical deletion of Dyrk1a in mice causes decreased brain mass and neuronal size, structural hypoconnectivity, and autism-relevant behaviors. Using phosphoproteomic screening, we identified growth-associated signaling cascades dysregulated upon Dyrk1a deletion, including TrkB-BDNF (tyrosine receptor kinase B-brain-derived neurotrophic factor), an important regulator of ERK/MAPK (extracellular signal-regulated kinase/mitogen-activated protein kinase) and mTOR (mammalian target of rapamycin) signaling. Genetic suppression of Pten or pharmacological treatment with IGF-1 (insulin-like growth factor-1), both of which impinge on these signaling cascades, rescued microcephaly and neuronal undergrowth in neonatal mutants. CONCLUSIONS: Altogether, these findings identify a previously unknown mechanism through which Dyrk1a mutations disrupt growth factor signaling in the developing brain, thus influencing neuronal growth and connectivity. Our results place DYRK1A as a critical regulator of a biological pathway known to be dysregulated in humans with autism spectrum disorder and intellectual disability. In addition, these data position Dyrk1a within a larger group of autism spectrum disorder/intellectual disability risk genes that impinge on growth-associated signaling cascades to regulate brain size and connectivity, suggesting a point of convergence for multiple autism etiologies.

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12. Martin-Borreguero P, Gómez-Fernández AR, De La Torre-Aguilar MJ, Gil-Campos M, Flores-Rojas K, Perez-Navero JL. Children With Autism Spectrum Disorder and Neurodevelopmental Regression Present a Severe Pattern After a Follow-Up at 24 Months. Frontiers in psychiatry. 2021; 12: 644324.

This study examined the presence of neurodevelopmental regression and its effects on the clinical manifestations and the severity of autism spectrum disorder (ASD) in a group of children with autism compared with those without neurodevelopmental regression at the time of initial classification and subsequently. Methods and Subjects: ASD patients were classified into two subgroups, neurodevelopmental regressive (AMR) and non-regressive (ANMR), using a questionnaire based on the Autism Diagnostic Interview-Revised test. The severity of ASD and neurodevelopment were assessed with the Childhood Autism Rating Scale Test-2, Strengths and Difficulties Questionnaire, and Pervasive Developmental Disorders Behavior Inventory Parent Ratings (PDDBI) and with the Battelle Developmental Inventory tests at the beginning of the study and after 24 months of follow-up. Fifty-two patients aged 2-6 years with ASD were included. Nineteen were classified with AMR, and 33 were classified with ANMR. Results: The AMR subgroup presented greater severity of autistic symptoms and higher autism scores. Additionally, they showed lower overall neurodevelopment. The AMR subgroup at 24 months had poorer scores on the Battelle Developmental Inventory test in the following areas: Total personal/social (p < 0.03), Total Motor (p < 0.04), Expressive (p < 0.01), and Battelle Total (p < 0.04). On the PDDBI test, the AMR subgroup had scores indicating significantly more severe ASD symptoms in the variables: ritual score (p < 0.038), social approach behaviors (p < 0.048), expressive language (p < 0.002), and autism score (p < 0.003). Conclusions: ASD patients exhibited a set of different neurological phenotypes. The AMR and ANMR subgroups presented different clinical manifestations and prognoses in terms of the severity of autistic symptoms and neurodevelopment.

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13. Noel JP, Paredes R, Terrebonne E, Feldman JI, Woynaroski T, Cascio CJ, Seriès P, Wallace MT. Inflexible Updating of the Self-Other Divide During a Social Context in Autism: Psychophysical, Electrophysiological, and Neural Network Modeling Evidence. Biological psychiatry Cognitive neuroscience and neuroimaging. 2021.

BACKGROUND: Autism spectrum disorder (ASD) affects many aspects of life, from social interactions to (multi)sensory processing. Similarly, the condition expresses at a variety of levels of description, from genetics to neural circuits and interpersonal behavior. We attempt to bridge between domains and levels of description by detailing the behavioral, electrophysiological, and putative neural network basis of peripersonal space (PPS) updating in ASD during a social context, given that the encoding of this space relies on appropriate multisensory integration, is malleable by social context, and is thought to delineate the boundary between the self and others. METHODS: Fifty (20 male/30 female) young adults, either diagnosed with ASD or age- and sex-matched individuals, took part in a visuotactile reaction time task indexing PPS, while high-density electroencephalography was continuously recorded. Neural network modeling was performed in silico. RESULTS: Multisensory psychophysics demonstrates that while PPS in neurotypical individuals shrinks in the presence of others-as to « give space »-this does not occur in ASD. Likewise, electroencephalography recordings suggest that multisensory integration is altered by social context in neurotypical individuals but not in individuals with ASD. Finally, a biologically plausible neural network model shows, as a proof of principle, that PPS updating may be inflexible in ASD owing to the altered excitatory/inhibitory balance that characterizes neural circuits in animal models of ASD. CONCLUSIONS: Findings are conceptually in line with recent statistical inference accounts, suggesting diminished flexibility in ASD, and further these observations by suggesting within an example relevant for social cognition that such inflexibility may be due to excitatory/inhibitory imbalances.

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14. Powell AR, Ames EG, Knierbein EN, Hannibal MC, Mackenzie SJ. Symptom Prevalence and Genotype-Phenotype Correlations in Patients With TANGO2-Related Metabolic Encephalopathy and Arrhythmias (TRMEA). Pediatric neurology. 2021; 119: 34-9.

BACKGROUND: TANGO2-related metabolic encephalopathy and arrhythmias (TRMEA) is a rare, phenotypically heterogeneous, neurological disease affecting children. METHODS: We conducted a chart review of five children with molecularly confirmed TRMEA diagnosed at our institution and compiled pathogenic variant frequency and symptom prevalence from cases previously reported in the literature. RESULTS: Including those patients in our case series, 76 patients with TRMEA have been described. Developmental delay (93%) and/or regression (71%), spasticity (78%), and seizures (57%) are common in TRMEA and frequently precede life-threatening symptoms such as metabolic decompensation with lactic acidosis (83%), cardiomyopathy (38%), and cardiac arrhythmias (68%). Deletion of exons 3 to 9 is the most common pathogenic variant (39% of alleles). The majority of reported intragenic variants (17 of 27) result in disruption of the reading frame, and no clear genotype-phenotype correlations could be identified for those variants wherein the reading frame is maintained, highlighting instead the variable expressivity of the disease. CONCLUSIONS: Patients with TRMEA frequently experience life-threatening complications that are preceded by common neurological symptoms underscoring the need for pediatric neurologists to be familiar with this condition. Additional work pertaining to disease pathophysiology and potential therapeutics is needed.

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15. Qiao Z. A simple and fast ASD-POCS algorithm for image reconstruction. Journal of X-ray science and technology. 2021; 29(3): 491-506.

PURPOSE: The adaptive steepest descent projection onto convex set (ASD-POCS) algorithm is a promising algorithm for constrained total variation (TV) type norm minimization models in computed tomography (CT) image reconstruction using sparse and/or noisy data. However, in ASD-POCS algorithm, the existing gradient expression of the TV-type norm appears too complicated in the implementation code and reduces image reconstruction speed. To address this issue, this work aims to develop and test a simple and fast ASD-POCS algorithm. METHODS: Since the original algorithm is not derived thoroughly, we first obtain a simple matrix-form expression by thorough derivation via matrix representations. Next, we derive the simple matrix expressions of the gradients of TV, adaptive weighted TV (awTV), total p-variation (TpV), high order TV (HOTV) norms by term combinations and matrix representations. The deep analysis is then performed to identify the hidden relations of these terms. RESULTS: The TV reconstruction experiments by use of sparse-view projections via the Shepp-Logan, FORBILD and a real CT image phantoms show that the simplified ASD-POCS (S-ASD-POCS) using the simple matrix-form expression of TV gradient achieve the same reconstruction accuracy relative to ASD-POCS, whereas it enables to speed up the whole ASD process 1.8-2.7 time fast. CONCLUSIONS: The derived simple matrix expressions of the gradients of these TV-type norms may simplify the implementation of the ASD-POCS algorithm and speed up the ASD process. Additionally, a general gradient expression suitable to all the sparse transform-based optimization models is demonstrated so that the ASD-POCS algorithm may be tailored to extended image reconstruction fields with accelerated computational speed.

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16. Sanders JS, Keller S, Aravamuthan BR. Caring for Individuals With Intellectual and Developmental Disabilities in the COVID-19 Crisis. Neurology Clinical practice. 2021; 11(2): e174-e8.

Individuals with intellectual and developmental disabilities (IDDs) are among our most medically vulnerable neurologic patient population. As such, they are at particular risk of psychosocial and medical harm during the coronavirus disease 2019 (COVID-19) pandemic. Here, we highlight strategies to decrease potential infectious exposures and ensure continued optimal neurologic care for individuals with IDD during the COVID-19 pandemic. Finally, in a climate of potential medical resource restriction, we offer some suggestions for advocacy on behalf of individuals with IDD.

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17. Wei QH, Xie XF, Dai JJ, Yu Y, Zhang Y, Cheng Q. [Value of autism screening checklists in the early identification of autism spectrum disorder]. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics. 2021; 23(4): 343-9.

OBJECTIVE: To evaluate the value of autism screening checklists in the early identification of autism spectrum disorder (ASD). METHODS: A total of 2 571 children who attended the Children’s Hospital of Chongqing Medical University and completed autism screening and diagnostic test were enrolled as subjects, among whom 2 074 were diagnosed with ASD, 261 were diagnosed with global developmental delay (GDD), 206 were diagnosed with developmental language disorder (DLD), and 30 had normal development. The sensitivity, specificity, and optimal threshold value of the Modified Checklist for Autism in Toddlers (M-CHAT) and the Autism Behavior Checklist (ABC) for the early identification of ASD were evaluated by the receiver operating characteristic (ROC) curve. RESULTS: The M-CHAT had a high sensitivity of 88.3% but a low specificity of 36.0% for the identification of ASD. Its sensitivity decreased with age, and was maintained above 80% for children aged 16 to < 48 months. The ABC had a high specificity of 87.3% but a low sensitivity of 27.2%, with an optimal cut-off value of 47.5 based on the ROC curve analysis. The multivariate linear regression model based on a combination of the M-CHAT and ABC for screening of ASD showed a specificity of 85.8% and a sensitivity of 56.6%. CONCLUSIONS: The M-CHAT has a high sensitivity and a low specificity in the identification of ASD, with a better effect in children aged 16 to < 48 months. The ABC has a high specificity and a low sensitivity. The multiple linear regression model method based on the combined M-CHAT and ABC to screen ASD appears to be effective. Publisher: Abstract available from the publisher. chi.

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18. Wong PP, Wai VC, Chan RW, Leung CN, Leung PW. Autism-Spectrum Quotient-Child and Autism-Spectrum Quotient-Adolescent in Chinese population: Screening autism spectrum disorder against attention-deficit/hyperactivity disorder and typically developing peers. Autism : the international journal of research and practice. 2021; 25(7): 1913-23.

The Autism-Spectrum Quotient is a 50-item questionnaire developed to assess autistic symptoms in adults, adolescents and children. Its original version and others in different countries are known to be effective tools in identifying individuals with autism spectrum disorder. This study examined whether the Hong Kong Chinese versions of the Autism-Spectrum Quotient-Child and Autism-Spectrum Quotient-Adolescent were effective in identifying autism spectrum disorder children and adolescents. On top of comparing them with their typically developing peers, this study also included a group of children/adolescents with attention deficit/hyperactivity disorder, a disorder with similar social difficulties as autism spectrum disorder. Results showed that both the Autism-Spectrum Quotient questionnaires were effective in differentiating the autism spectrum disorder group from the typically developing and attention-deficit/hyperactivity disorder groups, separately and jointly. On the contrary, they could not identify the attention-deficit/hyperactivity disorder group from the typically developing group so that they were not misclassifying attention-deficit/hyperactivity disorder as autism spectrum disorder. These findings supported that both the Autism-Spectrum Quotient-Child and Autism-Spectrum Quotient-Adolescent were not general measures of child and adolescent psychopathology, but could claim to be specific measures of autism spectrum disorder. Such capability would enormously enhance their utility in clinical practice for identifying autism spectrum disorder children/adolescents from their typically developing peers and from those with attention-deficit/hyperactivity disorder. This is because, the latter is a common neurodevelopmental disorder frequently presented to child psychiatric clinics alongside with autism spectrum disorder.

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