1. Adams D, Stainer M, Simpson K, Paynter J, Westerveld M. Profiles and Longitudinal Growth Trajectories of Teacher-Rated Academic Skills and Enablers in Autistic Children and Adolescents. Journal of autism and developmental disorders. 2023.

In non-autistic children, academic skills are associated with academic enablers (motivation, engagement, study/interpersonal skills), but few studies have explored these in autistic children. This study identified profiles of academic skills and enablers in autistic students and explored the trajectory of each profile over time. Teachers completed the Academic Competences Evaluation Scales for autistic children in primary and secondary educational settings annually for 5 years. Latent profile analysis identified six profiles in the primary/younger cohort and seven in the secondary/older cohort. Whilst some profiles showed relative stability across skills and enablers, others profiles were more variable. The profiles remained stable and significantly different from each other over time, with no profile × time interactions identified. Autistic children may show variability across their academic skills and enablers. This highlights the importance of understanding each individual student and their profile of strengths and challenges when planning supports.

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2. Beversdorf DQ, Ferguson B, Hunter S, Hirst K, Lolli B, Bellesheim KR, Barton AU, Muckerman J, Takahashi N, Selders K, Holem R, Sohl K, Dyke P, Stichter J, Mazurek M, Kanne S. Randomized controlled trial of propranolol on social communication and anxiety in children and young adults with autism spectrum disorder. Psychopharmacology. 2023.

RATIONALE: Autism spectrum disorder (ASD) is characterized by impaired social communication and is also frequently characterized by co-occurring anxiety. Propranolol is widely utilized to treat performance and public speaking anxiety. Single-dose psychopharmacological challenge studies suggested benefits using propranolol for verbal tasks and social interaction. OBJECTIVE: We conducted a double-blinded, placebo-controlled trial of the β-adrenergic antagonist propranolol in ASD for social interaction, anxiety, and language. METHODS: Seventy-four participants with ASD, age 7-24 years, were enrolled and randomized to a 12-week course of propranolol or placebo, with blinded assessments at baseline, 6 weeks, and 12 weeks. The primary outcome was the General Social Outcome Measure-2 (GSOM-2) for social interaction, and secondary outcomes were the Clinician Global Clinical Impression-Improvement (CGI-I) ratings independently conducted for social interaction, anxiety, and language at 6 weeks and 12 weeks. RESULTS: Sixty-nine participants completed the 12-week visit. No significant effect of drug was found for the GSOM-2 or the CGI-I for social interaction or language. CGI-I for anxiety showed greater improvement with propranolol at the 12-week time point (p = 0.045, odds ratio = 2.58 (95% CI = 1.02-6.52). Expected decreases in heart rate and blood pressure were observed with propranolol, and side effects were uncommon. CONCLUSIONS: Propranolol did not impact social interaction measures or language, but there were indications of a beneficial effect for anxiety. This will need confirmation in a larger multicenter trial, monitoring markers or characteristics to identify those participants most likely to respond to propranolol for anxiety, and determine whether there is a subset of participants that are responsive for other previously reported outcomes.

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3. Horvath S, Arunachalam S. Assessing receptive verb knowledge in late talkers and autistic children: advances and cautionary tales. Journal of neurodevelopmental disorders. 2023; 15(1): 44.

PURPOSE: Using eye-tracking, we assessed the receptive verb vocabularies of age-matched late talkers and typically developing children (experiment 1) and autistic preschoolers (experiment 2). We evaluated how many verbs participants knew and how quickly they processed the linguistic prompt. Our goal is to explore how these eye-gaze measures can be operationalized to capture verb knowledge in late talkers and autistic children. METHOD: Participants previewed two dynamic scenes side-by-side (e.g., « stretching » and « clapping ») and were then prompted to find the target verb’s referent. Children’s eye-gaze behaviors were operationalized using established approaches in the field with modifications in consideration for the type of stimuli (dynamic scenes versus static images) and the populations included. Accuracy was calculated as a proportion of time spent looking to the target, and linguistic processing was operationalized as latency of children’s first look to the target. RESULTS: In experiment 1, there were no group differences in the proportion of verbs known, but late talkers required longer to demonstrate their knowledge than typically developing children. Latency was predicted by age but not language abilities. In experiment 2, autistic children’s accuracy and latency were both predicted by receptive language abilities. CONCLUSION: Eye gaze can be used to assess receptive verb vocabulary in a variety of populations, but in operationalizing gaze behavior, we must account for between- and within-group differences. Bootstrapped cluster-permutation analysis is one way to create individualized measures of children’s gaze behavior, but more research is warranted using an individual differences approach with this type of analysis.

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4. Khalifa GF, Alzubaidi BY, Bamarouf DA, Alsaedi YB, Alayyafi OH, Ramadan MM. Perspective of adults in Saudi Arabia toward complementary and alternative medicine use for autism spectrum disorder: a cross-sectional study. BMC complementary medicine and therapies. 2023; 23(1): 454.

BACKGROUND: Autism Spectrum Disorder (ASD) is a high-prevalence neurodevelopmental disorder characterized by communicational, social, and behavioral challenges. Complementary and alternative medicine (CAM) is a group of practices and products that fall outside the realm of conventional medicine practiced worldwide. Traditional CAM is a health practice that comes from a particular culture, such as the use of Zamzam water and black seeds in Saudi Arabia. CAM comprises widely utilized practices in Saudi Arabia for children of various ages and adults. In many cases, CAM is used to treat ASD. The aim of this study is to investigate the perspectives of adults in Saudi Arabia toward CAM for treating ASD. METHODS: A cross-sectional study was conducted by distributing an online questionnaire to adults in different regions of Saudi Arabia. RESULTS: A total of 4,311 adults participated in this study; 66.8% were females and 33.2% were male. Half of the participants reported that they knew about ASD (54.7%). More than half of the participants indicated that CAM-including art therapy (69.0%), physical exercise (67.0%), and limiting the use of electronic (55.4%)-could help in ASD management. Around half of the respondents indicated a belief that traditional treatment cannot help in treating ASD (53.9%). Only 20.0% of the respondents thought that ASD could be entirely treated using CAM therapies. The most common source of knowledge about CAM was social media and the internet (58.6%). CONCLUSIONS: The majority of participants in this study did not believe that ASD could be treated entirely using CAM. In addition, fewer than half of the participants believed that CAM therapies could improve different aspects of ASD, such as behavioral issues. The study highlighted the need for awareness among residents of Saudi Arabia regarding specific treatments for ASD.

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5. Perzolli S, Bentenuto A, de Falco S, Venuti P. Language of mothers and fathers in interaction with their autistic children. Frontiers in psychiatry. 2023; 14: 1254563.

INTRODUCTION: Verbal language is one of the most immediate and significant means parents have to express affect and information to their children. Parental speech directed to children has been thoroughly examined in typical development. However, the characteristics of parental speech directed to children with neurodevelopmental disorders are far less well documented, and no recent studies have been carried out that involve autistic(1) children and their fathers. Therefore, the present study aims to analyze and compare maternal and paternal speech directed to young autistic children, focusing on fathers’ elements of speech in comparison with maternal language. METHODS: N = 88 dyads participated in this study. 44 autistic children (41 males and 3 females) (chronological age: M = 40.01 months; SD = 11.96) in interaction with their fathers (paternal age M = 41.84 years; SD = 7.02) and the same 44 children in interaction with their mothers (maternal age M = 37.37 years; SD = 5.45). The language was verbatim transcribed using ELAN software (ELAN Version 6.4, 2022) and coded with an observational tool (Penman) for analyzing functions and referents of speech after reaching a satisfactory level of agreement between two independent transcribers. RESULTS: No differences emerged considering the affective aspects of speech. However, mothers seem to direct more informative salient statements (W = 1,259; p = 0.02) and call the child’s attention more often than fathers (W = 1,253.5; p = 0.02). Regarding referents of informative speech, fathers focused more on the child’s internal states rather than mothers (W = 727; p = 0.04). DISCUSSION: These results reveal that fathers seem to display a relationship-based approach focused on a non-intrusive style with few demands while talking with their children, providing a complementary role to mothers that allows complete and harmonious stimulation of all areas of child development.

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6. Petti T, Gupta M, Fradkin Y, Gupta N. Management of sleep disorders in autism spectrum disorder with co-occurring attention-deficit hyperactivity disorder: update for clinicians. BJPsych open. 2023; 10(1): e11.

AIMS: To update and examine available literature germane to the recognition, assessment and treatment of comorbid autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD) and sleep disruption, with a predominant focus on children, adolescents and emerging adults. BACKGROUND: Considerable overlaps exist among ASD, ADHD and sleep disruption. Literature and guidance for clinicians, administrators, policy makers and families have been limited, as such deliberations were rarely considered until 2013. METHOD: This narrative review of the literature addressing sleep disruption issues among those with ASD, ADHD and comorbid ASD and ADHD involved searching multiple databases and use of reverse citations up to the end of September 2022. Emphasis is placed on secondary sources and relevant data for clinical practice. RESULTS: Complex clinical presentations of ASD/ADHD/sleep disruption are frequently encountered in clinical practice. Prior to 2013, prevalence, clinical presentation, pathophysiology, prognosis, other sleep-related factors and interventions were determined separately for each disorder, often with overlapping objective and subjective methods employed in the process. High percentages of ADHD and ASD patients have both disorders and sleep disruption. Here, the extant literature is integrated to provide a multidimensional understanding of the relevant issues and insights, allowing enhanced awareness and better care of this complex clinical population. Database limitations are considered. CONCLUSIONS: Assessment of ASD symptomatology in youth with ADHD, and the reverse, in cases with disrupted sleep is critical to address the special challenges for case formulation and treatment. Evidence-based approaches to treatment planning and multi-treatment modalities should consider combining psychosocial and biological interventions to address the complexities of each case.

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7. Valenti M, Mazza M, Arduino GM, Keller R, Le Donne I, Masedu F, Romano G, Scattoni ML. Diagnostic assessment, therapeutic care and education pathways in persons with autism spectrum disorder in transition from childhood to adulthood: the Italian National Ev.A Longitudinal Project. Annali dell’Istituto superiore di sanita. 2023; 59(4): 304-12.

INTRODUCTION: The transition from childhood to adulthood is one of the main critical points in the network of services for taking care of people with autism spectrum disorder (ASD). Within the framework of the national research programs on autism, an exploratory longitudinal multicentre study was conducted. This research program, called « Ev.A Project (Developmental and Adult Age) », was proposed by the Italian National Institute of Health (Istituto Superiore di Sanità, ISS) and the aim was the development and testing of a diagnostic, therapeutic, assistance and educational pathway (PDTAE) for autism. AIM: The present study aimed to evaluate two impact outcomes of the care protocol: the response obtained by the ASD person, and the perception of the change in the family context. METHODS: Participants underwent an initial clinical evaluation and then after one year. Over the course of the year, participants undertook a program of intervention. The measures of adaptive functioning, need for support, psychiatric symptomatology and family quality of life were used for the outcome assessment. Linear mixed models were constructed for each measure to estimate the explanatory/predictive behavior of the intensity of the interventions, adjusted for the participant’s level of symptom severity. RESULTS: The results estimate a main effect of Intervention Group (b=-27.22, p<0.001) and severity level (b=-41.87, p<0.001) on the adaptive functioning of the ASD person, but no effect on performance on the dimension of Family Quality of Life (b=0.523, p=0.455). CONCLUSIONS: The most significant predictor of the impact on the ASD person is the activation of the service network, which must take into account the level of severity of the presented symptoms.

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