1. Bulut Ö F, Tanir Y. A Case of Priapism in a Child With Autism Spectrum Disorder, Possibly Due to Risperidone Treatment With Addition of Atomoxetine. Clin Neuropharmacol;2022 (Sep 12)

OBJECTIVES: Risperidone is an effective drug used for the treatment of irritability in children with autism spectrum disorder (ASD). Atomoxetine (ATX) is a well-tolerated drug used in first-line therapy in children with attention-deficit/hyperactivity disorder (ADHD). However, uncommon adverse effects of risperidone and ATX are a concern among mental health professionals. To our knowledge, this is the first case report of priapism after addition of ATX upon existing treatment with risperidone. METHODS: Written informed consent for publication was obtained from the patient and his parents, and their identities were concealed for ethical reasons. RESULTS: Here, we report a case of priapism as an adverse effect of ATX and risperidone treatment in a 7-year-old boy with ASD and comorbid ADHD. In this case, priapism was not observed with risperidone until ATX was added. CONCLUSIONS: Priapism is a condition viewed as a medical emergency. Although risperidone-induced priapism is a rare phenomenon, it is advised for clinicians to consider the drug interactions in treatment of ASD and ADHD in terms of early diagnosis and intervention.

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2. Cooper K, Mandy W, Butler C, Russell A. Phenomenology of gender dysphoria in autism: a multiperspective qualitative analysis. J Child Psychol Psychiatry;2022 (Sep 12)

BACKGROUND: Autistic people are overrepresented in gender clinic settings, but limited evidence is available to guide clinical decision making for this patient group. We aimed to generate a comprehensive understanding of the phenomenology of gender dysphoria in autistic people. METHODS: We conducted a multi-perspectival interpretative phenomenological analysis (IPA), from five different perspectives; autistic young people and adults with experience of gender dysphoria, parents of young people, and clinicians working with autistic people with gender dysphoria in both adult and young person settings (n = 68). RESULTS: IPA analysis resulted in two themes, ‘discovering gender identity’ and ‘the complexities of moving towards gender comfort’. Participants agreed that there was often an interaction between gender dysphoria and features of autism such as sensory sensitivities. There was relative consensus across groups about the need for autism adaptations to be made in gender clinics. Autistic adults were more likely to see autism as an important identity than young people, but both groups were clear that autism did not impair their understanding of gender. In contrast, some parents and clinicians working with young people expressed concern that autism did impact self-understanding. DISCUSSION: While the groups tended to agree on the ways in which particular features of autism can compound gender dysphoria, there were a range of perspectives on the ways in which autism impacted on self-knowledge. CONCLUSION: Recommendations for adaptations when working with autistic people with gender dysphoria are presented.

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3. den Houting J, Higgins J, Isaacs K, Mahony J, Pellicano E. From ivory tower to inclusion: Stakeholders’ experiences of community engagement in Australian autism research. Front Psychol;2022;13:876990.

Autistic people, and other community stakeholders, are gaining increasing recognition as valuable contributors to autism research, resulting in a growing corpus of participatory autism research. Yet, we know little about the ways in which stakeholders practice and experience community engagement in autism research. In this study, we interviewed 20 stakeholders (academics, autistic people, family members/careers, research students, and service providers) regarding their experiences of community engagement in Australian autism research. Through reflexive thematic analysis of interview data, we generated four themes. First, our participants perceived academia as an « ivory tower, » disconnected from community members’ lives and priorities. Second, our participants identified that different stakeholders tended to hold different roles within their research projects: academics typically retained power and control, while community members’ roles tended toward tokenism. Third, our participants spoke of the need to « bridge the gap » between academia and the community, highlighting communication, accessibility, and planning as key to conducting effective participatory research. Lastly, participants emphasized the changing nature of autism research, describing participatory research as « the way of the future. » Our findings reflect both the progress achieved to date, and the challenges that lie ahead, as the field advances toward genuine co-production of autism research.

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4. Garrido D, Beretta S, Grabrucker S, Bauer HF, Bayer D, Sala C, Verpelli C, Roselli F, Bockmann J, Proepper C, Catanese A, Boeckers TM. Shank2/3 double knockout-based screening of cortical subregions links the retrosplenial area to the loss of social memory in autism spectrum disorders. Mol Psychiatry;2022 (Sep 13)

Members of the Shank protein family are master scaffolds of the postsynaptic architecture and mutations within the SHANK genes are causally associated with autism spectrum disorders (ASDs). We generated a Shank2-Shank3 double knockout mouse that is showing severe autism related core symptoms, as well as a broad spectrum of comorbidities. We exploited this animal model to identify cortical brain areas linked to specific autistic traits by locally deleting Shank2 and Shank3 simultaneously. Our screening of 10 cortical subregions revealed that a Shank2/3 deletion within the retrosplenial area severely impairs social memory, a core symptom of ASD. Notably, DREADD-mediated neuronal activation could rescue the social impairment triggered by Shank2/3 depletion. Data indicate that the retrosplenial area has to be added to the list of defined brain regions that contribute to the spectrum of behavioural alterations seen in ASDs.

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5. Halayem S, Bouden A, Amado IR, Leventhal B. Editorial: Advances in social cognition assessment and intervention in autism spectrum disorder. Front Psychiatry;2022;13:962843.

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6. Ionescu S, Jourdan-Ionescu C. [Autism Spectrum Disorders: What the COVID-19 Pandemic Has Taught Us]. Ann Med Psychol (Paris);2022 (Sep 6)

The article is devoted to the consequences of the pandemic caused by SARS-CoV-2 and more particularly, of the preventive measures adopted during this period on people with autism spectrum disorders (ASD). These people are more at risk (especially in cases of comorbidity with intellectual disability) of being infected and hospitalized longer. This increased risk is explained by the presence of biological risk factors (increased cytokines, decreased melatonin) and by psychological factors related to the clinical picture of ASD. Hesitancy concerning COVID vaccinations is discussed in relation to the erroneously purported link between vaccination and the onset of autism. As expected, the pandemic has had negative effects on the clinical picture of children, adolescents, and adults with ASD: sleep disorders, increased behavioural disorders, more stereotypies, parental distress. Unexpectedly, researchers and clinicians have also highlighted the positive effects of the pandemic, described as the « paradoxical‿ effects (improved communication and relationships, decreased anxiety, being happier because of being more in control over their schedule). The explanation for these effects was related to non-attendance at school and, thus, no bullying, decreased sensory and social overload, increased time spent at home, and solidarity with the autistic community and with the entire community. Finally, the question of the transfer of certain conditions that contributed to the above-mentioned improvements to the post-pandemic period is addressed.

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7. Jaudon F, Thalhammer A, Zentilin L, Cingolani LA. CRISPR-mediated activation of autism gene Itgb3 restores cortical network excitability via mGluR5 signaling. Mol Ther Nucleic Acids;2022 (Sep 13);29:462-480.

Many mutations in autism spectrum disorder (ASD) affect a single allele, indicating a key role for gene dosage in ASD susceptibility. Recently, haplo-insufficiency of ITGB3, the gene encoding the extracellular matrix receptor β3 integrin, was associated with ASD. Accordingly, Itgb3 knockout (KO) mice exhibit autism-like phenotypes. The pathophysiological mechanisms of Itgb3 remain, however, unknown, and the potential of targeting this gene for developing ASD therapies uninvestigated. By combining molecular, biochemical, imaging, and pharmacological analyses, we establish that Itgb3 haplo-insufficiency impairs cortical network excitability by promoting extra-synaptic over synaptic signaling of the metabotropic glutamate receptor mGluR5, which is similarly dysregulated in fragile X syndrome, the most frequent monogenic form of ASD. To assess the therapeutic potential of regulating Itgb3 gene dosage, we implemented CRISPR activation and compared its efficacy with that of a pharmacological rescue strategy for fragile X syndrome. Correction of neuronal Itgb3 haplo-insufficiency by CRISPR activation rebalanced network excitability as effectively as blockade of mGluR5 with the selective antagonist MPEP. Our findings reveal an unexpected functional interaction between two ASD genes, thereby validating the pathogenicity of ITGB3 haplo-insufficiency. Further, they pave the way for exploiting CRISPR activation as gene therapy for normalizing gene dosage and network excitability in ASD.

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8. Jesina O, Baloun L, Kudlacek M, Dolezalova A, Badura P. Relationship of Exclusion From Physical Education and Bullying in Students With Specific Developmental Disorder of Scholastic Skills. Int J Public Health;2022;67:1604161.

Objectives: This study aimed to analyze the relationships among exclusion from PE, gender, and bullying in adolescents with specific developmental disorder of scholastic skills (SDDSS) aged 11, 13, and 15 years in Czechia. Methods: In total, the final research sample consisted of 13,953 students (49.4% boys) from the 2013/2014 Health Behaviour in School-aged Children survey. Chi-square tests and regression models stratified by presence of SDDSS diagnosis were used to assess the relationships between non-involvement in PA and bullying. Results: Students diagnosed with SDDSS (12.4% of the sample) were more likely to be excluded from physical education (PE) than students without this diagnosis. This exclusion was associated with higher odds of bullying victimization and perpetration. Our findings further showed that male gender plays a significant role for bullying perpetration for both groups (with and without SDDSS) investigated in the present study. Conclusion: Higher likelihood of aggressive behavior occurs in students who are excluded from PE, including students with SDDSS.

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9. Laroui A, Galarneau L, Abolghasemi A, Benachenhou S, Plantefève R, Bouchouirab FZ, Lepage JF, Corbin F, Çaku A. Clinical significance of matrix metalloproteinase-9 in Fragile X Syndrome. Sci Rep;2022 (Sep 13);12(1):15386.

High plasma matrix metalloproteases-9 (MMP-9) levels have been reported in Fragile X Syndrome in a limited number of animal and human studies. Since the results obtained are method-dependent and not directly comparable, the clinical utility of MMP-9 measurement in FXS remains unclear. This study aimed to compare quantitative gel zymography and ELISA and to determine which method better discriminates abnormal MMP-9 levels of individuals with FXS from healthy controls and correlates with the clinical profile. The active and total forms of MMP-9 were quantified respectively, by gel zymography and ELISA in a cohort of FXS (n = 23) and healthy controls (n = 20). The clinical profile was assessed for the FXS group using the Aberrant Behavior Checklist FXS adapted version (ABC-C(FX)), Adaptive Behavior Assessment System (ABAS), Social Communication Questionnaire (SCQ), and Anxiety Depression and Mood Scale questionnaires. Method comparison showed a disagreement between gel zymography and ELISA with a constant error of - 0.18 [95% CI: - 0.35 to - 0.02] and a proportional error of 2.31 [95% CI: 1.53 to 3.24]. Plasma level of MMP-9 active form was significantly higher in FXS (n = 12) as compared to their age-sex and BMI matched controls (n = 12) (p = 0.039) and correlated with ABC-C(FX) (r(s) = 0.60; p = 0.039) and ADAMS (r(s) = 0.57; p = 0.043) scores. As compared to the plasma total form, the plasma MMP-9 active form better enables the discrimination of individuals with FXS from controls and correlates with the clinical profile. Our results highlight the importance of choosing the appropriate method to quantify plasma MMP-9 in future FXS clinical studies.

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10. Li L, Li H, Zhao Z, Xu S. Comprehensive Intervention and Effect of Martial Arts Routines on Children with Autism. J Environ Public Health;2022;2022:9350841.

Autism in children is a representative disease of pervasive developmental disorder, and there is currently no matching treatment. In the course of treatment, people generally use special education training, but this training mode cannot meet the comprehensive development of children. The traditional treatment mode cannot meet the changing new situation due to its poor adaptability. Martial arts routine movements are the soul of martial arts training, which can lay the foundation for movement training. Based on this, this article takes children with autism as research objects and aims to analyze the comprehensive intervention effect of martial arts routines on autism so as to provide some references for the treatment of children with autism. The article first analyzes the intervention forms of martial arts routine movements and realizes the combination of martial arts routine movements and children’s autism intervention treatment from a theoretical point of view. Then, the article randomly divides the experimental subjects into the experimental group and the control group and conducts an evaluation and analysis of various indicators before and after the training of children with autism. Finally, the article falls back from the experimental results to related theories, aiming to provide a scientific basis for the comprehensive intervention treatment of children with autism. The experimental results showed that the scale evaluation results of the experimental group are different from those of the control group, and various indicators have been improved and improved, including language, perception, and social skills. Among them, the language and behavior of children with autism increased by 19.1%. The perception ability increased by 20.7%, and the social ability increased by 5.9%. The above experiments and analysis fully demonstrated that martial arts routines have a good effect in the intervention and treatment of children with autism, which can well improve the comprehensive quality of patients.

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11. Marston E, Cho CC, Pridham K, McPherson AC, Polfuss M. Parenting styles and dimensions in parents of children with developmental disabilities. Res Nurs Health;2022 (Sep 12)

Parenting influences child development. There is limited research, however, related to parenting children who have developmental disabilities. The aims of this study were to: (1) describe the parenting styles and dimensions of parents of children with developmental disabilities and (2) assess differences in parenting styles and dimensions among parents of children with autism spectrum disorder (ASD), Down syndrome (DS), and spina bifida (SB). Secondary data analysis was conducted from a nationwide cross-sectional study of 496 parents of children aged 5-16 years with ASD (n = 180), DS (n = 156), or SB (n = 160). Parent scores indicated high use of the authoritative parenting style and associated parenting dimensions, mid-to-low use of the permissive parenting style, and low use of the authoritarian parenting style and associated dimensions. Variation in parenting styles and dimensions among parents was primarily related to the child’s diagnosis and family income. An unanticipated but positive finding was that parents with lower family incomes had significantly higher scores for the authoritative parenting style. Results from this study can inform future research that might inform clinical practice.

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12. Mohammadkhani R, Ghahremani R, Salehi I, Safari S, Karimi SA, Zarei M. Impairment in social interaction and hippocampal long-term potentiation at perforant pathway-dentate gyrus synapses in a prenatal valproic acid-induced rat model of autism. Brain Commun;2022;4(5):fcac221.

It is well established that prenatal valproic acid exposure in rats leads to autism-like behaviours and social deficits. Long-term potentiation changes in the brain have been proposed as a potential mechanism in the development of autistic behaviour. However, there are controversies regarding the effect of in utero valproic acid exposure on long-term potentiation. This study examined the social interaction and long-term potentiation induction in perforant pathway-dentate gyrus synapses in male offspring of a rat model of autism induced by prenatal exposure to valproic acid. On Embryonic Day 12.5, the pregnant dams received an injection of 500 mg/kg valproic acid (intraperitoneal) to produce the autism model. The sociability test was performed between Postnatal Days 37 and 40. The offsprings were urethane-anaesthetized and placed into a stereotaxic apparatus for surgery, electrode implantation and field potential recording on Postnatal Days 45-55. In the dentate gyrus region, excitatory postsynaptic potential slope and population spike amplitude were measured. Valproic acid-exposed offspring showed significantly impaired social interaction. The birth weight in valproic acid-exposed rats was significantly lower than in control rats. The ability of dentate gyrus synapses to induce long-term potentiation was hampered by valproic acid exposure. The decreasing excitatory postsynaptic potential slope and population spike amplitude of long-term potentiation provide evidence in favour of this notion. It is widely supposed that the hippocampus plays a central role in the process of learning and memory as well as social interaction and social memory. Therefore, deficiencies in hippocampal synaptic plasticity may be responsible, at least in part, for the social interaction deficits in valproic acid-exposed rats.

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13. Nisticò V, Iacono A, Goeta D, Tedesco R, Giordano B, Faggioli R, Priori A, Gambini O, Demartini B. Hypermobile spectrum disorders symptoms in patients with functional neurological disorders and autism spectrum disorders: A preliminary study. Front Psychiatry;2022;13:943098.

Autism spectrum disorders (ASDs) and functional neurological disorders (FNDs) share some clinical characteristics such as alexithymia, sensory sensitivity and interoceptive issues. Recent evidence shows that both the disorders present symptoms compatible with a diagnosis of hypermobile Ehlers-Danlos Syndrome and hypermobile spectrum disorders (hEDS/HSD), a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Here we compared the prevalence of hEDS/HSD-related symptoms in a group of patients with FNDs, of people with ASDs without intellectual disabilities, and a non-clinical comparison group (NC). Twenty patients with FNDs, 27 individuals with ASDs without intellectual disabilities and 26 NC were recruited and completed the Self-reported screening questionnaire for the assessment of hEDS/HSD-related symptoms (SQ-CH). We found that 55% of the patients with FNDs, 44.4% of the individuals with ASDs and 30.8% of NC scored above the cut-off at the SQ-CH; SQ-CH scores of both FNDs and ASDs group were significantly higher than the NC group’s ones. In conclusion, both ASDs and FNDs individuals present hEDS/HSD-related symptoms in a higher number than the general population. Imputable mechanisms include (i) overwhelming of executive functions with consequent motor competence impairment for ASDs individuals, and (ii) exacerbation of FNDs symptoms by physical injury and chronic pain due to abnormal range of joint mobility. Moreover, we speculated that the amygdala and the anterior cingulate cortex circuitry might be responsible for the imbalances at the proprioceptive, interoceptive, and emotional levels.

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14. Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. Nat Rev Psychol;2022 (Sep 5):1-16.

There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives.

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15. Prager BC, Broder SM, Natowicz MR. A picture is worth a thousand words: A proposal to incorporate video into the evaluation of adults with intellectual or developmental disability living outside the home. Front Public Health;2022;10:887714.

Adults with intellectual or developmental disability (IDD) comprise 1-2% of the population worldwide. IDD is a significant risk factor for premature morbidity or mortality. This is likely due in part to preventable health conditions, which are modifiable with the intervention of direct care providers in areas including nutrition, promotion of an active lifestyle and effective identification of health or functional deterioration. Adults with IDD are also at increased risk for neglect or mistreatment, a finding that has been documented across multiple countries and in a variety of care settings. Contributing factors include resource availability, lack of person-centered care, management culture and care worker training. Practical and economical interventions may address the known disparities and challenges facing the large community of adults with IDD. To promote person-centered care, improve record-keeping/documentation, and aid in protecting the health and safety of this vulnerable population, we propose incorporation of a video into the evaluation of adults with IDD living outside the home.

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16. Raghavan K, Dedeepiya VD, Yamamoto N, Ikewaki N, Sonoda T, Iwasaki M, Kandaswamy RS, Senthilkumar R, Preethy S, Abraham SJK. Benefits of Gut Microbiota Reconstitution by Beta 1,3-1,6 Glucans in Subjects with Autism Spectrum Disorder and Other Neurodegenerative Diseases. J Alzheimers Dis;2022 (Sep 6)

BACKGROUND: Aureobasidium pullulans (black yeast) AFO-202 strain-produced beta glucan, Nichi Glucan, has been shown to improve the behavior and sleep pattern along with an increase in α-synuclein and melatonin in children with autism spectrum disorder (ASD). OBJECTIVE: In this randomized pilot clinical study, we have evaluated the gut microbiota of subjects with ASD after consumption of Nichi Glucan. METHODS: Eighteen subjects with ASD were randomly allocated: six subjects in the control group (Group 1): conventional treatment comprising remedial behavioral therapies and L-carnosine 500 mg per day, and 12 subjects (Group 2) underwent supplementation with Nichi Glucan 0.5 g twice daily along with the conventional treatment for 90 days. RESULTS: Whole genome metagenome (WGM) sequencing of the stool samples at baseline and after intervention showed that among genera of relevance, the abundance of Enterobacteriaceae was decreased almost to zero in Group 2 after intervention, whereas it increased from 0.36% to 0.85% in Group 1. The abundance of Bacteroides increased in Group 1, whereas it decreased in Group 2. The abundance of Prevotella increased while the abundance of Lactobacillus decreased in both Group 1 and Group 2. Among species, a decrease was seen in Escherichia coli, Akkermansia muciniphila CAG:154, Blautia spp., Coprobacillus sp., and Clostridium bolteae CAG:59, with an increase of Faecalibacterium prausnitzii and Prevotella copri, which are both beneficial. CONCLUSION: AFO-202 beta 1,3-1,6 glucan, in addition to balancing the gut microbiome in children with ASD and its role in effective control of curli-producing Enterobacteriaceae that leads to α-synuclein misfolding and accumulation, may have a prophylactic role in Parkinson’s and Alzheimer’s diseases as well.

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17. Rubal S, Abhishek M, Rupa J, Phulen S, Kumar R, Kaur G, AmitRaj S, Jain A, Prakash A, Alka B, Bikash M. Homotaurine ameriolates the core ASD symptomatology in VPA rats through GABAergic signalling: Role of GAD67. Brain Res Bull;2022 (Sep 13)

Dysregulated GABAergic signaling is reported in Autism Spectrum disorder (ASD). In the present study, we evaluated a GABA structural mimicker homotaurine (HT) via in-silico docking and investigated the therapeutic efficacy of this drug to ameliorate ASD symptoms in the valproic acid (VPA) rat model of ASD. For the in-vivo study, animals were divided into two groups [Normal control (NC, 0.9% saline; i.p) and disease control (VPA 600mg/kg; i.p)] on gestational day (GD) 12.5. Male pups from VPA-exposed mothers were further divided into five groups (n=6 in each group): disease control (DC, no-further treatment), standard treatment (risperidone (RES) 2.5mg/kg; i.p, consecutively from PND 23-43), HT (10, 25 and 50mg/kg; i.p, consecutively from PND 23-43). In in-silico studies, the binding pattern of homotaurine to GABA-A receptor was found similar to GABA with Tyr205, Glu155, Tyr157, Arg6, and Thr 130 as shared residues. In the in-vivo phase, the early developmental parameters (from PND 7-23) and behavioral parameters (from PND 43-54) were assessed. The offspring of the VPA exposed group exhibited significant (p<0.05) developmental delays, behavioral deficits [decreased sociability and social novelty (three-chamber sociability test), spatial memory (Morris water maze), increased stereotypy (self-grooming)], increased oxidative stress (decreased GSH, SOD, Catalase, and increased MDA), increased pro-inflammatory (IL-1β, 6, TNF-α) and decreased anti-inflammatory (IL-10) cytokines, Purkinje cell loss in the cerebellum and pyknosis in PFC (H/E, Nissil staining) and decreased GAD67 expression in the cerebellum (RT-PCR & immunohistochemistry). Compared to the DC, HT treatment (50mg/kg) was able to ameliorate the aberrant core behavioral deficits, decreased oxidative stress, decreased pro-inflammatory and increased anti-inflammatory cytokine profile with preservation of the Purkinje cell density in the cerebellum, decreased pyknosis in the prefrontal cortex and normalised the expression of GAD67. Thus, HT can be a useful therapeutic agent in ASD and requires further clinical evaluation.

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18. Salleh NS, Tang LY, Jayanath S, Lim Abdullah K. An Explorative Study of Affiliate Stigma, Resilience, and Quality of Life Among Parents of Children with Autism Spectrum Disorder (ASD). J Multidiscip Healthc;2022;15:2053-2066.

PURPOSE: Children diagnosed with ASD usually have impaired social functions, exhibit repetitive, stereotyped and self-stimulatory behaviors, which make them prone to be stigmatized by the public. However, stigma not only affects those with stigmatization characteristics such as children with ASD but also tends to include other people related to them including parents. This is called affiliate stigma. However, affiliate stigma is unlikely to occur if public awareness is high. Considering that awareness of ASD is still comparatively low in this region and that, as a review of the literature showed, there have been limited studies on stigma and ASD conducted in South-East Asia, particularly in Malaysia, this study is of great significance, especially in the context of the East and other developing countries. The aim of this study was to explore parents’ experiences of caring and perceptions of affiliate stigma, resilience and quality of life (QoL) when caring for a child with ASD. METHODS: This paper is part of the sequential explanatory mixed-methods study in which, after a cross-sectional study of 144 parents, a qualitative approach was used to explore parents’ experiences of caring and their perceptions of affiliate stigma, resilience, and QoL. Participants were recruited when they were accompanying their children to therapy at two tertiary public hospitals in one of the north-eastern states of Malaysia. Eleven parents of children with ASD aged 2-12 years participated. Qualitative data analysis followed Braun and Clarke’s methodology of thematic analysis. RESULTS: Four themes were identified: the meaning of QoL, ASD and life adjustment, perceived stigma, and resilience. CONCLUSION: This is the first Southeast Asian study on parent-perceived affiliate stigma, resilience, and QoL in the context of ASD. These findings can inform healthcare personnel and policymakers into day-to-day parenting realities and therefore an effort to coordinate support services across all disciplines could be made to improve outcomes for both parents and children.

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19. Shtayermman O, Fletcher J. Predictors of Suicide Attempts of Individuals with Autism and Their Siblings. Nurs Res Pract;2022;2022:9157365.

The occurrence of mood- and anxiety-related conditions among family members of individuals diagnosed with autism spectrum disorder (ASD) increases the risk of suicide attempts and has also created assessment and treatment issues for clinicians and parents. Recorded rates of mental health disorders comorbid with suicide attempts among individuals on the spectrum range from 29% to 52%. The purpose of this study was to investigate the presence of predictors of suicide attempts among sibling dyads (pairs of siblings in which one sibling is on the autism spectrum). Growing evidence in the literature indicates a link between a diagnosis of autism and mental health. A web-based survey was used to collect data from individuals on the spectrum and their siblings. A sample of 144 individuals was finalized for the analyses. Logistic regression analysis was conducted to assess the predictors of suicide attempts in the sample. Depression, anxiety, sexual orientation, and marital status were all used as predictors in the logistic regression analyses. Both levels of anxiety and sexual orientation were found to be significant predictors for suicide attempts. Recommendations for future research, assessment, and treatment are presented.

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20. Thabtah F, Spencer R, Abdelhamid N, Kamalov F, Wentzel C, Ye Y, Dayara T. Autism screening: an unsupervised machine learning approach. Health Inf Sci Syst;2022 (Dec);10(1):26.

Early screening of autism spectrum disorders (ASD) is a key area of research in healthcare. Currently artificial intelligence (AI)-driven approaches are used to improve the process of autism diagnosis using computer-aided diagnosis (CAD) systems. One of the issues related to autism diagnosis and screening data is the reliance of the predictions primarily on scores provided by medical screening methods which can be biased depending on how the scores are calculated. We attempt to reduce this bias by assessing the performance of the predictions related to the screening process using a new model that consists of a Self-Organizing Map (SOM) with classification algorithms. The SOM is employed prior to the diagnostic process to derive a new class label using clusters learnt from the independent features; these clusters are related to communication, repetitive traits, and social traits in the input dataset. Then, the new clusters are compared with existing class labels in the dataset to refine and eliminate any inconsistencies. Lastly, the refined dataset is utilised to derive classification systems for autism diagnosis. The new model was evaluated against a real-life autism screening dataset that consists of over 2000 instances of cases and controls. The results based on the refined dataset show that the proposed method achieves significantly higher accuracy, precision, and recall for the classification models derived when compared to models derived from the original dataset.

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21. Xu L, Fields NL, Greer JA, Tamplain PM, Bricout JC, Sharma B, Doelling KL. Socially assistive robotics and older family caregivers of young adults with Intellectual and Developmental Disabilities (IDD): A pilot study exploring respite, acceptance, and usefulness. PLoS One;2022;17(9):e0273479.

INTRODUCTION: The need for caregiver respite is well-documented for the care of persons with IDD. Social Assistive Robotics (SAR) offer promise in addressing the need for caregiver respite through ‘complementary caregiving’ activities that promote engagement and learning opportunities for a care recipient (CR) with IDD. This study explored the acceptability and usefulness of a SAR caregiver respite program responsive to feedback from both young adults with IDD and their older family caregivers (age 55+). METHOD: Young adults with IDD and caregiver dyads (N = 11) were recruited. A mixed methods research design was deployed in three phases: Phase I with four focus groups to inform the program design; Phase II for program demonstration and evaluation with pre- and post-surveys; and Phase III with post-program interviews for feedback and suggestions. RESULTS: Both young adults with IDD and their caregivers scored favorably the social presence of, social engagement, and satisfaction with robot Pepper. Though there was no significant improvement of caregiving burden/stress as well as well-being of the young adults with IDD based on surveys, results from interviews suggested that the SAR may offer physical/emotional respite to caregivers by providing companionship/friendship as well as promoting independence, safety/monitoring, and interactive engagement with children. DISCUSSION: SAR has potential in providing respite for older family caregivers. Future studies need a longer program design and larger sample size to develop a promising intervention and test its feasibility and efficacy.

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