1. Aran A, Harel M, Ovadia A, Shalgy S, Cayam-Rand D. Mediators of Placebo Response to Cannabinoid Treatment in Children with Autism Spectrum Disorder. Journal of clinical medicine. 2023; 12(9).

The placebo response has a substantial impact on treatment outcome. However, data regarding mediators of the placebo response in children with autism spectrum disorder (ASD) are sparse. This retrospective study investigated possible mediators of the placebo response among participants of a placebo-controlled trial of cannabinoid treatment for behavioral problems in children with ASD (CBA trial, age 5-21 years). We used a specifically designed questionnaire to explore possible mediators of the placebo response in 88 participants of the CBA trial who received a placebo and had valid outcome scores. The parents of 67 participants completed the questionnaire. The placebo response was positively associated with the child’s comprehension of the treatment purpose (p = 0.037). There was also a trend for participants who had a relative aggravation of symptoms before treatment onset to improve following placebo treatment (p = 0.053). No other domains, including parental expectations, previous positive experience with similar treatments (behavioral conditioning), parental locus of control, quality of the patient-physician relationships, and adherence to study medications were associated with placebo-response. This finding suggests that efforts to explain the treatment purpose to children with disabilities may enhance treatment efficacy in clinical practice and decrease differences in the placebo response between study arms. Contrary to our hypothesis, parental expectations regarding cannabinoid treatment were not associated with the placebo response.

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2. Aydin Ü, Gyurkovics M, Ginestet C, Capp S, Greven CU, Palmer J, McLoughlin G. Genetic overlap between midfrontal theta signals and ADHD and ASD in a longitudinal twin cohort. Biological psychiatry. 2023.

BACKGROUND: Cognitive control has been strongly linked to midfrontal theta (4-8 Hz) brain activity. Such control processes are known to be impaired in those with psychiatric conditions, and neurodevelopmental diagnoses, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Temporal variability in theta in particular is associated with ADHD with shared genetic variance underlying the relationship. Here, we investigated the phenotypic and genetic relationships between theta phase variability, theta-related signals (N2, ERN, Pe), reaction time, and ADHD and ASD longitudinally in a large twin study of young adults to investigate the stability of the genetic relationships between these measures over time. METHODS: Genetic multivariate liability threshold models were run on a longitudinal sample of 566 participants (283 twin pairs). Characteristics of ADHD and ASD were measured in childhood and in young adulthood, while EEG was recorded in young adulthood during an arrow flanker task. RESULTS: Cross-trial theta phase variability in adulthood showed large positive phenotypic and genetic relationships with reaction time variability and both childhood and adult ADHD characteristics. Pe amplitude was negatively related phenotypically and genetically to ADHD and ASD at both time points. CONCLUSIONS: We show significant genetic associations between variability in theta signalling and ADHD. In a novel finding, we show that these relationships are stable across time, indicating a core dysregulation of the temporal coordination of control processes in ADHD that persists in those with childhood symptoms. Error processing, indexed by the Pe, was altered in both ADHD and ASD, with a strong genetic contribution.

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3. Hernández-González O, Fresno-Rodríguez A, Spencer-Contreras RE, Tárraga-Mínguez R, González-Fernández D, Sepúlveda-Opazo F. Research Mapping of Trauma Experiences in Autism Spectrum Disorders: A Bibliometric Analysis. Healthcare (Basel, Switzerland). 2023; 11(9).

The number of research related to traumatic experiences in people with autism spectrum disorder (ASD) has grown exponentially, yet there are no bibliometric studies in this field. This article aimed to analyze the literature related to trauma and ASD published in Web of Science (WoS). Papers on trauma and ASD were retrieved from the WoS. Analysis and visualization of selected documents were performed using MS Excel (v16.0), VOS viewer (version 1.6.15), and R package (Biblioshiny, version 2.0). A total of 147 articles were included in this study. The results showed that production has been increasing over the last few years. Among the countries identified, the USA published the largest number of articles. Arvid Nikolai Kildahl, Sissel Berge Helverschou, and Liliana Dell’Osso were the authors with the most number of publications on this topic, and Autism was the most productive journal. The main research topics associated with ASD were post-traumatic stress and traumatic experiences in childhood. This bibliometric study contributes to understanding research trends on trauma and ASD by evaluating relevant publications in the last decades. The results of this bibliometric analysis can serve as a basis and orientation for new studies.

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4. Hotez E, Hudson S. Expanding on « Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care » to Support BIPOC Autistic Postsecondary Students. Journal of autism and developmental disorders. 2023.

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5. Marterosyan J, Gooch J. Neurodivergence and radiology: How medical professionals can optimise the standard of care provided to autistic paediatric patients. Radiography (London, England : 1995). 2023; 29(4): 680-3.

INTRODUCTION: Several studies have been published regarding patients with various neurodevelopmental diagnoses attending hospital appointments, however, few focus on autism and the radiology department. This paper aims to identify how implementing patient-centred strategies and protocols for autistic paediatric patients will benefit the patient pathway and provide a more comfortable experience for those undergoing different scans and procedures within the radiology department. METHODS: Using several electronic databases, articles were collected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and analysed with the Critical Appraisals Skills Programme (CASP). DISCUSSION: A total of 8 articles are discussed and analysed in this review, focussing specifically on patient-centred procedures and practice, costs of healthcare services and how multidisciplinary teamwork compares to applied behavioural analysis. RESULTS: The articles concluded that the current practice of multidisciplinary working is the most beneficial for patients. Furthermore, implementing autism awareness programmes and patient-specific protocols will help reduce anxiety surrounding scans within the radiology department. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Implementing mandatory autism awareness programmes and continuing with the multidisciplinary approach for autistic paediatric patients would provide the best possible patient-centred care.

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6. Mottron L, Gagnon D. Prototypical autism: New diagnostic criteria and asymmetrical bifurcation model. Acta psychologica. 2023; 237: 103938.

The current « autism spectrum » DSM 5 diagnostic criteria and autism standardized diagnostic instruments promote considerable heterogeneity or clinical indecision and may be detrimental to the advancement of fundamental research on autism mechanisms. To increase clinical specificity and reorient research towards core autistic presentations, we propose new diagnostic criteria for prototypical autism during the age of 2- to 5-years. We include autism within other non-dominant, familiarly aggregated phenomena sharing asymmetrical developmental bifurcations, such as twin pregnancy, left handedness, and breech presentation/delivery. Following this model, nature, trajectory, and positive/negative signs structure of autism would result from the polarized problem of whether or not language and information is processed in a socially biased manner. Prototypical autism would follow a canonical developmental trajectory by which a gradual decline in social bias in the processing of incoming information, overtly beginning at the end of the first year, bifurcates into a prototypical autistic presentation in the second half of the second year of life. This bifurcation event is followed by a plateau, in which these atypicalities show maximal stringency and distinctiveness, and then ultimately, in most cases, by partial normalization. During the plateau period, the orientation towards, and processing of, information is considerably modified, with an absence of bias for social information, contrasting with a high level of interest in complex, unbiased information, independently of its social or non-social nature. Integrating autism into asymmetrical developmental bifurcations would explain the absence of deleterious neurological and genetic markers and the presence of familial transmission in canonical autistic presentations.

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7. Noel JP, Angelaki DE. A theory of autism bringing across levels of description. Trends in cognitive sciences. 2023.

Autism impacts a wide range of behaviors and neural functions. As such, theories of autism spectrum disorder (ASD) are numerous and span different levels of description, from neurocognitive to molecular. We propose how existent behavioral, computational, algorithmic, and neural accounts of ASD may relate to one another. Specifically, we argue that ASD may be cast as a disorder of causal inference (computational level). This computation relies on marginalization, which is thought to be subserved by divisive normalization (algorithmic level). In turn, divisive normalization may be impaired by excitatory-to-inhibitory imbalances (neural implementation level). We also discuss ASD within similar frameworks, those of predictive coding and circular inference. Together, we hope to motivate work unifying the different accounts of ASD.

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8. Yan T, Hou Y, Liang L. Family Socioeconomic Status and Parental Involvement in Chinese Parents of Children with Autism Spectrum Disorder: A Moderated Mediation Model. Healthcare (Basel, Switzerland). 2023; 11(9).

Parental involvement benefits children with autism spectrum disorder (ASD) in multiple developmental areas. We conducted the present study to examine the role of parenting stress and ASD symptom severity in the relationship between family socioeconomic status (SES) and parental involvement. A total of 165 Chinese parents of children with ASD participated in this study. Mediation analyses indicated that family SES was positively related to parental involvement; parenting stress partially mediated the relationship between family SES and parental involvement. The analyses also found that ASD symptom severity moderated the influence of parenting stress on parental involvement. Specifically, the decreased parenting stress improved parental involvement when ASD symptom severity was low. The findings enhanced our understanding of the mechanism underlying the relationship between family SES and parental involvement among parents facing considerable child-rearing challenges. Implications for devising evidenced-based interventions to promote parental involvement for low SES children with ASD are discussed.

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9. Zheng S, Fang J, Bai G, He X, Hua M, Zhu B, Chen W, Dong W, Wang L, Huang X, Wang H, Shao J. The association between parental risks and childhood development: findings from a community-based survey in East China. BMC public health. 2023; 23(1): 878.

BACKGROUND: Nurturing care is necessary for optimal early childhood development. This study aimed to investigate the prevalence of parental risks in rural East China and assess their impacts on early development in children younger than three years old. METHODS: This community-based cross-sectional survey was conducted among 3852 caregiver-child pairs in Zhejiang Province from December 2019 to January 2020. Children aged 0 to 3 years were recruited from China’s Early Childhood Development Program (ECD). Local child health care providers conducted face-to-face interviews with the primary caregivers. Demographic information of the participants was collected by questionnaire. Each child was screened for parental risk through the Parental Risk Checklist designed by the ECD program. The Ages and Stages Questionnaire (ASQ) was used to identify children with potential developmental delays. Multinomial logistic regression model and linear trend test were applied to assess the association between parental risks and suspected developmental delays. RESULTS: Among the 3852 children included in the analyses, 46.70% had at least one parental risk and 9.01% presented suspected developmental delays in any domain of ASQ. Parental risk was statistically associated with the overall suspected developmental delay in young children (Relative Risk Ratio (RRR): 1.36; 95% confidence interval (CI): 1.08, 1.72; P = 0.010) after adjusting potential confounders. Compared with children with no parental risk, children exposed to 3 or more parental risks had 2.59, 5.76, 3.95, and 2.84 times higher risk of the suspected developmental delay in overall ASQ, communication, problem-solving, and personal-social domain, respectively (P values < 0.05). The linear trend tests found that the more parental risks, the higher possibility of developmental delay (P values < 0.05). CONCLUSIONS: Parental risks are prevalent among children under three years in rural East China, which may increase the risk of developmental delays in children. Meanwhile, parental risk screening can be used to recognize poor nurturing care in primary health care settings. Targeted interventions are warranted to improve nurturing care for optimal early childhood development.

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