1. Chung K, Chung E. Randomized controlled pilot study of an app-based intervention for improving social skills, face perception, and eye gaze among youth with autism spectrum disorder. Frontiers in psychiatry. 2023; 14: 1126290.

INTRODUCTION: This pilot study aimed to examine the effectiveness of an app-based intervention (Yface) in 53 children with autism spectrum disorder. Yface is a combined program that improves social skills, facial perception, and eye gaze. METHODS: Children were randomly assigned to one of the two training groups or a waitlist control group. One of the training groups completed the Yface training program lasting for 66 days, while the other training group used a similar app called Ycog, which focuses on cognitive rehabilitation. Questionnaires, computerized tasks, and semi-structured interviews were administered to children and their parents at pre- and post-training sessions. RESULTS: The Yface group showed improvements in face perception and some social skills compared to waitlist controls, and in eye gaze compared to the Ycog group. DISCUSSION: Our results suggest that this app-based intervention is effective in improving targeted social skills and face perception, although their relative effectiveness differs across skill domains.

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2. da Silva AP, Bezerra IMP, Antunes TPC, Cavalcanti MPE, de Abreu LC. Applied behavioral analysis for the skill performance of children with autism spectrum disorder. Frontiers in psychiatry. 2023; 14: 1093252.

INTRODUCTION: Autism spectrum disorder (ASD) has characteristics that have been observed to develop over time, such as the difficulty of affective, sensory, and emotional processing, which trigger some problems during childhood, limiting children’s development. Applied behavior analysis (ABA) is among the therapeutic approaches for ASD, in which treatment can be tailored according to the patient’s objectives. OBJECTIVE: Based on ABA, we aimed to analyze the therapeutic strategy for independence in different skill performance tasks of patients diagnosed with ASD. METHOD: This is a retrospective observational case series study including 16 children diagnosed with ASD who received ABA-based treatment at a therapeutic clinic in Santo Andre city, São Paulo State, Brazil. Individual task performance of different skill domains was registered in the ABA+ affective intelligence(®) software throughout the 12 months (from January 2021 to January 2022) of routine treatment. RESULTS: The evolution of skills was observed between the T0 and T1 intervals, with improved skills over the observed period. CONCLUSION: The strategy based on the ABA methodology improved children’s skill performance over the observed period.

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3. da Silva JF, Honorato MM, Cremaschi RMC, Coelho FMS. Efficacy and tolerance profile of risperidone use in people with autism spectrum disorder in a clinic in Santarém, Pará, Brazil. A retrospective study. Journal of neurosciences in rural practice. 2023; 14(2): 308-12.

OBJECTIVES: This study aimed to obtain the profile of efficacy and tolerance of risperidone in the treatment of people with autism spectrum disorder. MATERIALS AND METHODS: This research was a cross-sectional and retrospective study. The medical records of 100 patients diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were analyzed and measures of central tendency and correlation between variables such as gender, age at diagnosis, symptoms, daily dose, comorbidities, polytherapy, adverse drug effects, and outcome (improvement, worsening, and drug discontinuation) were calculated using Pearson’s R test with a level of statistical significance P < 0.05. RESULTS: The male gender was the most affected, corresponding to 80% of the participants. The mean age at diagnosis was 6.88 ± 6.24 and the mean dose was 1.89 ± 1.68 mg/day. The use of risperidone for patients with aggressiveness, hyperactivity, insomnia, or self-harm improved in 76% of patients and adverse effects were reported in 27% of cases. The presence of self-harm implied lower chances of improvement (P = 0.05/r = -0.20). Adverse effects were strong predictors of discontinuation (P = 0.01/r = 0.39), and epileptic patients were more likely to have them (P = 0.02/r = 0.20). Male gender was associated with dosages lower than 2 mg/day (P = 0.05/r = 0.23). CONCLUSION: Risperidone is a good option in the management of secondary symptoms of ASD, generally requiring low doses and presenting an acceptable profile of adverse effects. The age of diagnosis does not affect the drug's efficiency, but it can make the management of ASD difficult.

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4. Distefano G, Calderoni S, Apicella F, Cosenza A, Igliozzi R, Palermo G, Tancredi R, Tritto G, Craig F, Muratori F, Turi M. Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder. Frontiers in psychiatry. 2023; 14: 1181466.

BACKGROUND: Sleep disorders are one of the most common problems in children with Autism Spectrum Disorder (ASD). However, they often tend to be underdiagnosed and incorrectly treated in clinical practice. This study aims to identify sleep disorders in preschool children with ASD and to explore their relationship with the core symptoms of autism, the child’s developmental and cognitive level as well as the psychiatric comorbidities. METHODS: We recruited 163 preschool children with a diagnosis of ASD. The Children’s Sleep Habits Questionnaire (CSHQ) assessed sleep conditions. Multiple standardized tests were used to evaluate intellectual abilities, the presence of repetitive behaviors (through the Repetitive Behavior Scale-Revised), as well as the emotional-behavioral problems and the psychiatric comorbidities (through the Child Behavior Checklist -CBCL 1(1/2)-5). RESULTS: The results showed that poor disorders had consistently higher scores in all areas assessed by the CSHQ and on the CBCL across all domains. The correlational analysis showed that severe sleep disorders were associated with higher scores in internalizing, externalizing, and total problems at the CBCL syndromic scales, and in all DSM-oriented CBCL subscales. Moreover, we found that the association between sleep disorders and restricted and repetitive behaviors (RRBs) is explained by the anxiety-related symptoms. CONCLUSION: Based on these findings, the study recommends that screening for sleep problems followed by early intervention should constitute a routine part of clinical practice for children with ASD.

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5. Gangi DN, Aishworiya R, Hill MM, Nguyen DT, Ni R, Parikh C, Solis E, Ozonoff S. Case report: Transient symptoms of autism spectrum disorder in a 2-year-old boy. Clinical case reports. 2023; 11(5): e07345.

Though early ASD diagnosis is highly stable, this case report describes a rare situation in which symptoms resolved without intervention over a 4 month period. We do not recommend delaying diagnosis in symptomatic children who meet criteria but when major behavioral changes are reported after diagnosis, reevaluation may be beneficial.

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6. 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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7. Islam N, Hathaway KL, Anderson BS, Sharp WG, Loechner KJ. Brief Report: Decreased Bone Health in Children with Autism Spectrum Disorder and Avoidant Restrictive Food Intake Disorder. Journal of autism and developmental disorders. 2023.

PURPOSE: Children with autism spectrum disorder (ASD) and food selectivity are at increased risk for nutritional deficiencies which could affect bone health. METHODS: We report on four male patients with ASD and avoidant restrictive food intake disorder (ARFID) with significant bone conditions including rickets, vertebral compression fractures, osteopenia, and slipped capital femoral epiphyses. RESULTS: Each patient was at risk for at least one nutritional deficiency. Two out of four patients had deficiencies in Vitamins A, B12, E, and zinc. Calcium and Vitamin D deficiency were noted in all four. Two out of four patients with Vitamin D deficiency developed rickets. CONCLUSION: Provisional evidence suggests that children with ASD and ARFID are at elevated risk for serious adverse bone health outcomes.

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8. Jiang M, Lu T, Yang K, Li X, Zhao L, Zhang D, Li J, Wang L. Autism spectrum disorder research: knowledge mapping of progress and focus between 2011 and 2022. Frontiers in psychiatry. 2023; 14: 1096769.

BACKGROUND: In recent years, a large number of studies have focused on autism spectrum disorder (ASD). The present study used bibliometric analysis to describe the state of ASD research over the past decade and identify its trends and research fronts. METHODS: Studies on ASD published from 2011 to 2022 were obtained from the Web of Science Core Collection (WoSCC). Bibliometrix, CiteSpace, and VOSviewer were used for bibliometric analysis. RESULTS: A total of 57,108 studies were included in the systematic search, and articles were published in more than 6,000 journals. The number of publications increased by 181.7% (2,623 in 2011 and 7,390 in 2021). The articles in the field of genetics are widely cited in immunology, clinical research, and psychological research. Keywords co-occurrence analysis revealed that « causative mechanisms, » « clinical features, » and « intervention features » were the three main clusters of ASD research. Over the past decade, genetic variants associated with ASD have gained increasing attention, and immune dysbiosis and gut microbiota are the new development frontiers after 2015. CONCLUSION: This study uses a bibliometric approach to visualize and quantitatively describe autism research over the last decade. Neuroscience, genetics, brain imaging studies, and gut microbiome studies improve our understanding of autism. In addition, the microbe-gut-brain axis may be an exciting research direction for ASD in the future. Therefore, through visual analysis of autism literature, this paper shows the development process, research hotspots, and cutting-edge trends in this field to provide theoretical reference for the development of autism in the future.

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9. Johnson NL, Fial A, Van Hecke AV, Whitmore K, Meyer K, Pena S, Carlson M, Koth KA. A Scoping Review of Diagnosis of Autism Spectrum Disorder in Primary Care. Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners. 2023.

INTRODUCTION: This scoping review was performed to collect, examine, and present literature on interventions promoting the diagnosis of Autism Spectrum Disorder (ASD) in U.S. primary health care settings. METHOD: The literature searched was from 2011-2022, in the English language, in PubMed, CINAHL, Psych INFO, Cochrane, and Web of Science, for persons with autism or ASD aged ≤ 18 years. RESULTS: Six studies met the search criteria, including a quality improvement project, a feasibility study, a pilot study, and three primary care provider (PCP) intervention trials. Measured outcomes included: accuracy of diagnosis (n = 4), practice change maintenance (n = 3), time to diagnosis (n = 2), specialty clinic appointment wait time (n = 1), PCP comfort making ASD diagnosis (n = 1), and increased ASD diagnosis (n = 1). DISCUSSION: Results inform future implementation of PCP ASD diagnosis for the most obvious cases of ASD and research evaluating PCP training, using longitudinal measures of PCP knowledge of ASD and intention to diagnose.

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10. Moore L, Larkin F, Foley S. Mental Health Professionals’ Experiences of Adapting Mental Health Interventions for Autistic Adults: A Systematic Review and Thematic Synthesis. Journal of autism and developmental disorders. 2023.

Autistic adults experience high rates of metal health difficulties and face significant barriers to accessing appropriate mental health care. Empirical research and recent professional guidelines emphasise the importance of modifying standard mental health interventions to best meet the needs of autistic adults. This systematic review explored mental health professionals’ experiences of adapting mental health interventions for autistic adults. A systematic search was conducted on CINAHL, PsychINFO, PubMed, Scopus, and Web of Science in July 2022. The findings from 13 identified studies were synthesised using thematic synthesis. Three major analytical themes were generated, the unique experience of adapting interventions for autistic clients, factors which facilitate successful adaptations, and challenges to adapting interventions. Each theme contained a number of subsequent sub-themes. Professionals view the process of adapting interventions to be a highly individualised process. A range of personal traits, professional experiences, and systemic, service-based issues were identified in facilitating or challenging this individualised process. Further research regarding adaptations with different intervention models and increased supportive resources are required to enable professionals to successfully adapt interventions for autistic adult clients.

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11. O’Flanagan S, Nicolson R. Training in the Psychiatry of Developmental Disabilities. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent. 2023; 32(2): 68.

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12. Piskorowski RA, Chevaleyre V. Hippocampal area CA2: interneuron disfunction during pathological states. Frontiers in neural circuits. 2023; 17: 1181032.

Hippocampal area CA2 plays a critical role in social recognition memory and has unique cellular and molecular properties that distinguish it from areas CA1 and CA3. In addition to having a particularly high density of interneurons, the inhibitory transmission in this region displays two distinct forms of long-term synaptic plasticity. Early studies on human hippocampal tissue have reported unique alteration in area CA2 with several pathologies and psychiatric disorders. In this review, we present recent studies revealing changes in inhibitory transmission and plasticity of area CA2 in mouse models of multiple sclerosis, autism spectrum disorder, Alzheimer’s disease, schizophrenia and the 22q11.2 deletion syndrome and propose how these changes could underly deficits in social cognition observed during these pathologies.

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13. Roy A, Jahan F. Emotion regulation and social responsiveness in adults with autism spectrum disorder. Journal of neurosciences in rural practice. 2023; 14(2): 276-9.

OBJECTIVES: This study aimed to find out the relationship between emotion regulation (ER) and its domains with social responsiveness (SR) to investigate ER and its domains as predictors of SR. MATERIALS AND METHODS: A sample of 60 male and female adults diagnosed by a professional with autism spectrum disorder (ASD) was studied with ER and its domains of RI or Cognitive Reappraisal, SI or Expressive Suppression and SR as variables. Tools used were Social Responsiveness Scale-2 (Adult, Relative/Other online form) and Emotion Regulation Questionnaire (ERQ). RESULTS: ERQ domain of Cognitive Reappraisal or RI was found to be negatively correlated with Social Responsiveness or SR but positively correlated with Expressive Suppression or SI domain with Pearson’s r value of -0.662 for RI and of 0.275 for SI. Furthermore, RI and SI variables were found to be significantly negatively correlated with each other. Multiple regression analysis results showed R to be 0.666 and predictor variables explained 44.4% of the variance in the data since R square was found to be 0.444. The model was found to be a significant predictor of the variable SR, F (2, 57) = 22.76, P = 0.000. CONCLUSION: The present study found that ASD adults with high or good SR engage in less cognitive reappraisal (RI) ER strategy and more in expressive suppression (SI) strategy of ER. Multiple regression analysis results suggest a good and strong relationship suggesting our model is a relatively good predictor of the outcome.

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14. Secci I, Petigas L, Cuenod A, Klauser P, Kapp C, Novatti A, Armando M. Case report: Treatment-resistant depression, multiple trauma exposure and suicidality in an adolescent female with previously undiagnosed Autism Spectrum Disorder. Frontiers in psychiatry. 2023; 14: 1151293.

High rates of co-occurring depression are commonly reported in youth with Autism Spectrum Disorder (ASD), especially in individuals without intellectual disability (ID). Depression in ASD undermines adaptive behavior and is associated with a higher risk of suicidality. Females with ASD may be particularly vulnerable due to their greater use of camouflaging strategies. Indeed, in comparison to males, ASD is underdiagnosed in females, despite higher rates of internalizing symptoms and suicidality. Trauma exposure may also play a role in the development of depressive symptoms in this population. Moreover, evidence for effective treatments of depression in autistic youth are lacking, with ASD individuals frequently experiencing low efficacy and side effects. We present the case of an adolescent female with previously undiagnosed ASD without ID, admitted for active suicidal plans and a treatment-resistant depression (TRD), occurred after a COVID-19 lockdown in the context of cumulative exposure to stressful life events. Comprehensive clinical assessments performed at intake confirmed severe depression with suicidality. Intensive psychotherapy and different changes in medications were carried out (SSRI, SNRI, SNRI + NaSSA, SNRI + aripiprazole), all of which were ineffective, with persistent suicidal thoughts, often requiring intensive individual monitoring. The patient was finally successfully treated with lithium augmentation of fluoxetine, with no side effects. During hospitalization she was also evaluated by an ASD specialized center, where a diagnosis of ASD was made according to the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) scores, as well as to clinical judgment of a senior psychiatrist. The present case report shows that clinicians should not overlook undiagnosed autism as a possible cause of TRD, especially in females without ID, where higher rates of under diagnosis may be in part related to their greater use of camouflage. It also suggests that ASD underdiagnosis and resulting unmet needs may be involved in vulnerability to stressful experiences, depression, and suicidality. Furthermore, it shows the complexity of providing care to TRD in youth with autism, suggesting that an augmentation therapy with lithium, a commonly recommended therapeutic strategy for refractory depression in typically developing samples, may also be effective in this population.

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15. Yingling ME, Ruther MH, Dubuque EM. Correction to: Geographic Access to Registered Behavior Technicians among Children with Autism Spectrum Disorder. Behavior analysis in practice. 2023; 16(2): 510.

[This corrects the article DOI: 10.1007/s40617-022-00729-1.].

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