1. Adams JB, Kirby J, Audhya T, Whiteley P, Bain J. Vitamin/mineral/micronutrient supplement for autism spectrum disorders: a research survey. BMC pediatrics. 2022; 22(1): 590.

BACKGROUND: Vitamin and mineral supplements are widely used by children and adults diagnosed with autism spectrum disorder (ASD). Several studies have reported benefits of such supplements in resolving nutritional deficiencies, treating various metabolic problems and improving symptoms and overall quality of life. METHODS: This research survey collected evaluations from 161 people about the effectiveness of ANRC-Essentials Plus (ANRC-EP), a vitamin/mineral/micronutrient supplement designed for children and adults with autism. Although this was an open-label survey, results were compared with a three-month randomized double-blind placebo-controlled study of an earlier version of the supplement. Evaluations included the Parent Global Impressions of Autism (PGIA) and the Overall Benefit/Adverse Effect scale of the National Survey on Treatment Effectiveness for Autism (NSTEA). RESULTS: The participants reported substantially higher Average PGIA Scores than the placebo group in a similar previous study, with an estimated effect size of 0.66. Based on the NSTEA questionnaire, 73% of participants rated the Overall Benefit as Moderate, Good, or Great, with scores that were substantially higher than the NSTEA study found for multi-vitamins, the average of 58 nutraceuticals, and the average of 28 psychiatric and seizure medications. The Overall Adverse Effect score was low (0.25/3.0), similar or slightly higher than other nutraceuticals, and much lower than the average of 28 psychiatric and seizure medications (0.9/3.0). Sub-analysis found that the Overall Benefit of ANRC-EP was not significantly affected by gender, age, autism severity, diet quality, self-limited diet, use of psychiatric or seizure medications, dosage, developmental history, intellectual disability, or seizures. This indicates that ANRC-EP may be beneficial for a wide range of children and adults with ASD. A limitation of this study is the retrospective nature of the survey, and that participants who had good benefits were more likely to respond. CONCLUSIONS: This study found that ANRC-EP had significant benefits for a wide range of symptoms, and low adverse effects.

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2. Adams SN. Feeding and Swallowing Issues in Autism Spectrum Disorders. Neuropsychiatric disease and treatment. 2022; 18: 2311-21.

Children with autism spectrum disorder (ASD) often experience difficulties related to communication and behaviour. However, their feeding issues are most distressing to their families and healthcare professionals as they impact on the children’s adaptive function and health. In comparison to typically developing children, those with ASD experience significantly more feeding difficulties. Children with ASD may display distinctive feeding difficulties and atypical feeding behaviours that include picky eating, limited independent feeding, need for increased feeding times, and a highly restrictive food repertoire. Many of these feeding difficulties continue into childhood, persist in adolescence, and even spill over into adulthood. This proves to be a formidable challenge, as feeding is an essential component for healthy nutrition, growth, and development. This article will highlight how particular food items that are eaten and preferred by affected children may be contributing to their exhibited feeding difficulties. Next, it will be shown how the children’s restrictive diets supplant more healthy food options. When this is combined with the children’s noted reduced physical activity, the consequences are especially serious, as they include not only malnutrition but also give rise to childhood obesity. In sum, it will be demonstrated that feeding difficulties in young children with ASD are not well understood nor managed. The dearth of knowledge about feeding issues in this population affects both assessment choices and, specifically, management practices – aspects that will be elaborated on in this article. Conclusions will include suggested future directions for enhancing and complementing knowledge of these issues for stakeholders.

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3. Amen NE, Eqani S, Bilal K, Ali N, Rajeh N, Adelman D, Shen H, Lohmann R. Molecularly tracing of children exposure pathways to environmental organic pollutants and the Autism Spectrum Disorder Risk. Environmental pollution (Barking, Essex : 1987). 2022; 315: 120381.

Organic pollutants (OPs) including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polycyclic aromatic hydrocarbons (PAHs) have showed neuro-damaging effects, but studies concerning the autism spectrum disorder (ASD) risk are limited. A case-control study with ASD (n = 125) and healthy control (n = 125) children was conducted on the different land use settings across Punjab, Pakistan. Serum concentrations of 26 OCPs, 29 PCB congeners, 11 PBDEs and 32 PAHs were measured. Serum PCB77 (AOR = 2.00; 95% CI: 1.43, 2.18), PCB118 (AOR = 1.49; 95% CI: 1.00, 2.00), PCB128 (AOR = 1.65; 95% CI: 1.01, 1.91), PCB153 (AOR = 1.80; 95% CI: 1.55, 1.93) were significantly higher, but PCB187 (AOR = 0.37; 95% CI: 0.24, 0.49) was significantly lower in the ASD cases when compared to the controls. Serum BDE99 (AOR = 0.48; 95% CI: 0.26, 0.89) was significantly higher in the healthy controls than in the ASD cases. Among the analyzed OCPs, p,p’-DDE (AOR = 1.50; 95% CI: 1.00, 1.85) was significantly elevated in the ASD cases with comparison in the controls. For PAHs, serum dibenzothiophene (AOR = 7.30; 95% CI: 1.49, 35.85) was significantly higher in the ASD, while perylene (AOR = 0.25; 95% CI: 0.06, 1.10) and fluorene (AOR = 0.21; 95% CI: 0.06, 0.72) were significantly higher in the controls. In addition, many of the serum pollutants were significantly associated with GSTT1, GSTM1 (null/present polymorphism) and presented the genotypic variation to respond xenobiotics in children. The children living in proximity to urban and industrial areas had a greater exposure to most of the studied pollutants when compared to the rural children, however children residing in rural areas showed higher exposure to OCPs. This comprehensive study documents an association between environmental exposure risk of several organic pollutants (OPs) from some contaminated environmental settings with ASD risk in children from Pakistan.

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4. Carmo JC, Filipe CN. Disentangling response initiation difficulties from response inhibition in autism spectrum disorder: A sentence-completion task. Frontiers in psychology. 2022; 13: 964200.

It has been proposed that individuals with autism spectrum disorder (ASD) struggle both with response initiation and with response inhibition, both of which are functions of the executive system. Experimental tasks are unlikely pure measures of a single cognitive domain, and in this study we aim at understanding the contributions of response initiation difficulties to possible deficits in inhibitory control in autism. A sample of adults diagnosed with ASD and a control sample participated in this study. To participants it was asked to perform a sentence-completion task with two different condition: Part A-targeting response initiation and Part B-engaging inhibitory processes. Importantly, we have analyzed the B-A latencies that have been proposed for the removal of the response initiation confound effect. Results show that no differences between the groups were found in accuracy measures, either in Part A (ASD: M = 0.78; Controls: M = 0.90) nor Part B (ASD: M = 0.03; Controls: M = 0.02). However, in both conditions autistic participants were significantly slower to respond than the group of participants with typical development (Part A-ASD: M = 2432.5 ms; Controls M = 1078.5 ms; Part B-ASD M = 6758.3 ms; Controls M = 3283.9 ms). Critically, we show that when subtracting the response times of Part A from Part B (B-A latencies) no group differences attributable to inhibitory processes remained (ASD: M = 4325.76; Controls: M = 2205.46). With this study we corroborate the existence of difficulties with response initiation in autism and we question the existence of troubles in inhibition per se.

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5. Chang YC, Shire S, Shih W, Kasari C. Brief Report: An Exploratory Study of Young Dual Language Learners with Autism in a School-Based Intervention. Journal of autism and developmental disorders. 2022.

Due to core challenges in social communication experienced by many young children with autism, children on the spectrum who are also dual language learners (DLLs) may benefit from developmentally-appropriate language supports in school settings. The current study examined whether home language status moderated the effect of a play-based intervention, JASPER, delivered in the classroom, in children with autism. Fifty-nine preschool children with autism received JASPER over eight weeks. Children who received JASPER improved significantly more in their language skills from entry to exit than children in preschool as usual. Home language status moderated the effect of treatment on receptive language where children of diverse linguistic backgrounds made greater gains in receptive language.

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6. Christopoulou M, Drosos K, Petinou K. Recent Advances of Telepractice for Autism Spectrum Disorders in Speech and Language Pathology. Neuropsychiatric disease and treatment. 2022; 18: 2379-89.

Telepractice or teletherapy is defined as the means of service delivery via technology-based platforms that allow long-distance interventions across populations, age spans, and geographical locations. Specifically, telepractice capitalizes on communication technologies such as online modules, videoconferencing, and computerized software programs, in servicing populations with communication challenges. Notably, telepractice has emerged as a potentially effective, low-cost, and promising means of conducting and completing online assessment, diagnosis, and intervention sessions for individuals with autism spectrum disorders (ASD). Moreover, telepractice allows the inclusion of parents, caregivers, and educators as potential facilitators in supporting treatment delivery in populations with ASD. This thematic review article aims to highlight and acquaint practitioners and other stakeholders with relatively recent information regarding the advantages and disadvantages of the telepractice service delivery model in ASD. Furthermore, the emergence of the COVID-19 pandemic has impacted service delivery in the field of Health Sciences including speech and language pathology (SLP). Consequently, the need to avoid face-to-face therapy sessions, recommended to SLPs as to all health practitioners, resulted in the call for adaptation and adjustment of service telepractice. This paper attempts to answer this call by suggesting supplementing traditional diagnostic and therapy resources with training modules consisting of online materials and use of animated and specially designed programs in SLP intervention with individuals with ASD. Lastly, the paper includes a discussion of research findings in the field, a conclusion, and a take-home message.

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7. Dekker LP, van der Vegt EJM, Louwerse A, Visser K, van der Ende J, Maras A, Verhulst FC, Greaves-Lord K. Complementing or Congruent? Desired Characteristics in a Friend and Romantic Partner in Autistic versus Typically Developing Male Adolescents. Archives of sexual behavior. 2022.

Ideal friend and romantic partner characteristics related to self-perceived characteristics have been investigated in typically developing (TD) individuals, but not in individuals with autism spectrum disorder (ASD). Considering the autistic symptoms and challenges, investigating these concepts in autistic individuals is relevant. Given the lack of consensus, identity-first (« autistic person ») and person-first (« person with autism ») language are mixed throughout, to cover all preferences. This study explored (1) the association between self-perceived characteristics and desires in a friend/romantic partner, as well as (2) compare two groups (ASD and TD) in their desires for a friend/romantic partner. Two matched groups (ASD and TD) of 38 male adolescents (age 14-19 years) reported on the desire for nine characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, good looking, similar interests, and being rich) in a friend/partner, and to what extent they felt they themselves possessed seven characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, and good looking). Results showed both groups sought a friend and partner similar to themselves on intrinsic characteristics (e.g., trustworthiness), but less similar on extrinsic and social status characteristics (e.g., being less cool and popular). Particularly intrinsic characteristics, more than extrinsic and social status characteristics, were valued in both partners and friends, regardless of group. No significant differences were found between groups concerning to what extent characteristics were desired. Overall, adolescents with ASD desire similar characteristics as TD adolescents in their potential romantic partners and friends. There is some indication that the match between self-perception and desired characteristics is different.

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8. Ge D, Wei H, Wang Y, Li Y, Luo J, Liu X, Hu Y, Chen L, Cheng Q, Li T, Dai Y. Effectiveness of caregiver-mediated intervention: a pilot study for children with neurodevelopmental disorders. Primary health care research & development. 2022; 23: e63.

OBJECTIVES: Caregiver-mediated intervention (CMI), based on parent skills training, is a family-mediated intervention model for children with neurodevelopmental disorders, in particular autism spectrum disorder. This study aimed to evaluate the effectiveness of CMI. METHODS: Thirty-three children (aged 22-69 months from our department) and their caregivers participated in a two-week training course of ten 90-minute lessons. Caregivers were encouraged to try their best to apply intervention skills in both home routines and play routines to encourage the development of cognition, motion, social adaptability, and behavior of children. Demographic information, video-recorded data, and diagnostic scales were collected at two key time points: baseline and post-training (PT – within six months). RESULTS: Three aspects were assessed – primary variables, secondary variables, and correlation analyses. Results showed an improvement in PT in (1) Adult/Child Interaction Fidelity Rating (P < 0.01) and (2) adaptability of Gesell Developmental Scale and stereotyped behaviors and limited interests of Autism Diagnostic Observation Schedule (P < 0.05, P < 0.01). Moreover, a negative correlation occurred between caregiver skill improvement and parent education (P < 0.05), but without correlations with other demographics. CONCLUSIONS: As an efficacious family intervention for both children and their caregivers, CMI is worth being generalized widely.

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9. Hus Y. Detecting Time Concept Competence in Children with Autism Spectrum and Attention Disorders. Neuropsychiatric disease and treatment. 2022; 18: 2323-48.

The importance of time concept in human existence is « ancient history » celebrated in the biblical book Ecclesiastes. Indeed, our time-sensitive mechanisms are literally carved into our biology and neurology on a molecular level, gifting us with neural clocks. However, time in human consciousness is not the time indicated by physical clocks: time is a subjective reality in our psychological makeup due to the nature of the temporal neural mechanisms and unique properties of physical time. Nonetheless, subjective time requires anchoring to physical time which permeates our language, endeavors, and entire existence, a process hinging on time-related skills such as estimates and measures of passage and duration of time. Moreover, accurate time reading, a critical adaptive life-skill, is imperative for effective function in all societal activities. Because it embodies the complexity of the time construct, it is central to instruction of time concept in primary education. It is often measured in children by clock drawings, a cognitive integrative skill with errors pointing to neuroanatomical differences impacting the integrity of executive function. Time competence in children with atypical neurobiological development and high prevalence, as in autism spectrum disorders (ASD), and attention disorders (ADHD), is often compromised, calling for investigation of its function. This thematic review article aims to: 1) discuss the complexity of time concept and its underlying bio-neurological mechanisms, 2) elucidate difficulties children with ASD and those with ADHD exhibit in temporal development, and 3) demonstrate the use of a set of clinical tools in uncovering temporal competence and ecological executive function in two children with ASD, and a child with ADHD, using a clock drawing task and error analyses; children’s time knowledge questionnaire; a behavior rating parent questionnaire examining ecological executive function, and parent open-ended questions related to their children’s time difficulties. A discussion, directions, and a take-home message round out the article.

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10. Keefer A, Singh V, Jang YS, Alon L, Surmacz M, Holingue C, Mostofsky SH, Vasa RA. Exploring the Symptom Profiles of Intolerance of Uncertainty in Autistic Children. Journal of autism and developmental disorders. 2022.

Intolerance of uncertainty (IU) is a multidimensional construct involving maladaptive responses to uncertainty. IU is strongly associated with autism and anxiety, yet no studies have examined its symptom profile in autistic children. This study compares IU symptom profiles in autistic and NT children and in autistic children with and without anxiety using the Intolerance of Uncertainty Scale for Children. Compared to NT peers, autistic children exhibited heightened IU symptoms in all domains, affective, behavioral, and cognitive; affective symptoms had the highest association with autism. Autistic children with anxiety also exhibited elevated IU symptoms in all domains compared to those without anxiety; behavioral IU symptoms had the highest association with anxiety. IU symptom profiles should be considered in assessment and treatment.

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11. Madaus J, Tarconish E, Langdon SW, Gelbar N. High school and transition experiences of twice exceptional students with autism spectrum disorder: Parents’ perceptions. Frontiers in psychology. 2022; 13: 995356.

Students with autism spectrum disorder (ASD) are accessing college in increasing numbers. Within this cohort are students who are twice exceptional-those who are both academically talented and diagnosed with ASD. Little is known about factors and experiences that impact their successful transition to college. Parents play a critical role in the secondary transition process, but currently, there is a paucity of research that examines their perceptions of this experience. This study presents the results of semi-structured interviews with the parents of 10 college students with ASD who were enrolled in postsecondary institutions in the United States. The parents provided perceptions of their student’s best and most challenging aspects of high school, as well as of the transition preparation the student received. Suggestions were offered in regard to how transition services can be improved for this group of students. Implications for planning and practice are presented.

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12. Matsuba ESM, Prieve BA, Cary E, Pacheco D, Madrid A, McKernan E, Kaplan-Kahn E, Russo N. A Preliminary Study Characterizing Subcortical and Cortical Auditory Processing and Their Relation to Autistic Traits and Sensory Features. Journal of autism and developmental disorders. 2022: 1-18.

This study characterizes the subcortical auditory brainstem response (speech-ABR) and cortical auditory processing (P1 and Mismatch Negativity; MMN) to speech sounds and their relationship to autistic traits and sensory features within the same group of autistic children (n = 10) matched on age and non-verbal IQ to their typically developing (TD) peers (n = 21). No speech-ABR differences were noted, but autistic individuals had larger P1 and faster MMN responses. Correlations revealed that larger P1 amplitudes and MMN responses were associated with greater autistic traits and more sensory features. These findings highlight the complexity of the auditory system and its relationships to behaviours in autism, while also emphasizing the importance of measurement and developmental matching.

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13. Pradhan A, Chester V, Padhiar K. Classification of Autism and Control Gait in Children Using Multisegment Foot Kinematic Features. Bioengineering (Basel, Switzerland). 2022; 9(10).

Previous research has demonstrated that children with autism walk with atypical ankle kinematics and kinetics. Although these studies have utilized single-segment foot (SSF) data, multisegment foot (MSF) kinematics can provide further information on foot mechanics. Machine learning (ML) tools allow the combination of MSF kinematic features for classifying autism gait patterns. In this study, multiple ML models are investigated, and the most contributing features are determined. This study involved 19 children with autism and 21 age-matched controls performing walking trials. A 34-marker system and a 12-camera motion capture system were used to compute SSF and MSF angles during walking. Features extracted from these foot angles and their combinations were used to develop support vector machine (SVM) models. Additional techniques-S Hapley Additive exPlanations (SHAP) and the Shapley Additive Global importancE (SAGE) are used for local and global importance of the black-box ML models. The results suggest that models based on combinations of MSF kinematic features classify autism patterns with an accuracy of 96.3%, which is higher than using SSF kinematic features (83.8%). The relative angle between the metatarsal and midfoot segments had the highest contribution to the classification of autism gait patterns. The study demonstrated that kinematic features from MSF angles, supported by ML models, can provide an accurate and interpretable classification of autism and control patterns in children.

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14. Schwartz Offek E, Segal O. Comparing Theory of Mind Development in Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Development. Neuropsychiatric disease and treatment. 2022; 18: 2349-59.

BACKGROUND: Theory of mind (ToM) is the ability to recognize, comprehend, and consider oneself’s and others’ mental states and perspectives to predict and explain behaviors and motivations. It is widely accepted that children with autism spectrum disorder (ASD) experience difficulties with ToM. However, there are also findings suggesting that ToM abilities might also be compromised in children with Developmental Language Disorders (DLD). PURPOSE: To assess ToM abilities in three groups of children: 1. ASD with no language difficulties; 2. DLD, known for their language disorder; and 3. TD with no language issues. MATERIALS AND METHODS: A total of 41 preschool children aged 5-to-6 were examined and assigned to one of the three groups based on previous clinical reports and a standardized Hebrew language assessment tool. Nonverbal IQ was established with a standardized test to verify within average range placement (>75 IQ). ToM skills were examined with a Hebrew version of the ToM Task Battery and parent’s questionnaire (ToMI). RESULTS: Children with ASD had significantly lower ToM scores compared to the children with DLD, and TD. The ToM scores of the children with DLD were similar to the scores of the TD children. According to the parents’ questionnaires, both the ASD children and the DLD children had less developed ToM skills compared to their TD peers. CONCLUSION: The present findings suggest that children with ASD have a fundamental difficulty in ToM that is independent of their language abilities. Children with DLD show difficulties in everyday social interactions that involve ToM. It is possible that both ASD and language disorders influence ToM development, suggesting that different developmental routes affect the acquisition of ToM.

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15. Silvestri R, Ipsiroglu OS. Behavioral sleep medicine-The need for harmonization of clinical best practice outcome measures in children and adolescents with intellectual or developmental disabilities and restless sleep. Frontiers in psychiatry. 2022; 13: 1003019.

In behavioral medicine, sleep disorders, insomnia in particular, may be considered comorbidities and precipitating factors to intellectual or developmental disabilities (IDD). Nevertheless, sleep alterations have often been neglected in favor of daytime features and symptoms, albeit simple behavioral nighttime observations may disclose hypermotor features that characterize restless sleep. The root of most hypermotor restlessness is linked to central iron deficiency. The latter is often exacerbated by vitamin D deficiency (VDD), which interferes with both dopaminergic and serotonergic mechanisms. In this way, an imbalance affecting daytime behavior and mood is created. Several sleep-related motor disorders such as bruxism, periodic and aperiodic leg movements, Restless Legs Syndrome (RLS), and Restless Sleep Disorder (RSD) are commonly seen in Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). However, they are rarely diagnosed and often overlooked in affected children and adolescents. As a result, not only are these disorders not adequately addressed therapeutically, but their symptoms may be worsened by the side-effects of drugs used to contain disruptive daytime behavior, such as antipsychotics and antidepressants. In children with IDDs, obesity, inactivity and metabolic effects of antipsychotics often lead to Sleep Disordered Breathing (SDB), which is currently understood as an inflammatory state leading to « hyperactive » lethargy and further alterations of the hypoxic chain and vitamin D levels. Endorsing simple routine blood tests, including inflammatory markers such as C-reactive protein, ferritin, transferrin, and vitamin D levels, may favorably complement caregiver observations and ambulatory sleep recordings, leading to a sleep disorder diagnosis and consequent therapy. In fact, the treatment of SDB, RLS, and RSD has been copiously demonstrated to favorably impact vigilance, behavior, social competence, and academic skills in healthy and, to a greater extent, in IDD children. Thus, consulting and deliberating the root causes of functional and categorical diagnoses within a clinical framework may engender a more precise diagnosis and further benefit pediatric daytime and nighttime management of hyperactive behaviors.

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16. Song X, Hu Q, Xu X, Pan W. Protein kinase C beta relieves autism-like behavior in EN2 knockout mice via upregulation of the FTO/PGC-1α/UCP1 axis. Journal of biochemical and molecular toxicology. 2022: e23236.

Increasing evidence suggests that disruption of neuron activity contributes to the autistic phenotype. Thus, we aimed in this study to explore the role of protein kinase C beta (PKCβ) in the regulation of neuron activity in an autism model. The expression of PKCβ in the microarray data of autism animal models was obtained from the Gene Expression Omnibus database. Then, mice with autism-like behavior were prepared in EN2 knockout ((-/-) ) mice. The interaction between PKCβ on fat mass and obesity-associated protein (FTO) as well as between PGC-1α and uncoupling protein 1 (UCP1) were characterized. The effect of FTO on the N(6) -methyladenosine (m6A) modification level of proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) was assayed. Following transfection of overexpressed PKCβ and/or silenced UCP1, effects of PKCβ and UCP1 in autism-like behaviors in EN2(-/-) mice were analyzed. Results showed that PKCβ was downregulated in EN2(-/-) mouse brain tissues or neurons. PKCβ promoted the expression and stability of FTO, which downregulated the m6A modification level of PGC-1α to promote its expression. Moreover, PGC-1α positively targeted the expression of UCP1. PKCβ knockdown enhanced sociability and spatial exploration ability, and reduced neuron apoptosis in EN2(-/-) mouse models of autism, which was reversed by UCP1 overexpression. Collectively, PKCβ overexpression leads to activation of the FTO/m6A/PGC-1α/UCP1 axis, thus inhibiting neuron apoptosis and providing neuroprotection in mice with autism-like behavior.

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17. Storch EA, Schneider SC, Olsen SM, Ramirez AC, Berry LN, Goin-Kochel RP, McNeel M, Candelari AE, Guzick AG, Cepeda SL, Weinzimmer S, Voigt RG, Quast T, Goodman WK, Salloum A. Stepped-Care Cognitive Behavioral Therapy in Children on the Autism Spectrum with Co-occurring Anxiety. Journal of autism and developmental disorders. 2022: 1-16.

This trial examined stepped-care cognitive-behavioral treatment (CBT) among 96 autistic youth with co-occurring anxiety. Step 1 included an open trial of parent-led, therapist-guided bibliotherapy. Step 2 was family-based CBT for those who did not respond to Step 1 or maintenance for those who did. Eighteen participants (28%) who completed Step 1 responded. Responders reported significantly lower pre-treatment anxiety, internalizing symptoms, and functional impairment than non-responders. After Steps 1 and 2, 80% of completers (55% intent-to-treat) were responders. Anxiety, impairment, and ASD-related impairments significantly improved. Youth in maintenance experienced faster improvement through post-treatment, though there were no group differences at 3-month-follow-up. A stepped approach may help some individuals in Step 1, particularly those who are less anxious.

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18. Tatzer E, Maleczek W, Waldhauser F. An assessment of what Hans Asperger knew about child euthanasia in Vienna during the Nazi occupation. Acta paediatrica (Oslo, Norway : 1992). 2022.

AIM: Hans Asperger is probably best known for Asperger syndrome. However, he has been accused of knowingly and willingly participating in the National Socialist Child Euthanasia programme by referring patients to the Am Spiegelgrund children’s home in Vienna. This later became notorious for euthanising disabled children. We investigated those allegations. METHODS: Clinicians and historians examined original documents and transcripts related to Asperger’s referrals from the Viennese Therapeutic Pedagogy Unit, and corresponding Am Spiegelgrund admissions, up to 25 March 1943, when he was drafted. RESULTS: Asperger referred 13 children to Am Spiegelgrund. Eleven survived and apparently received adequate care that allowed them to achieve positive developments, but two girls died. Asperger referred these two girls during June and October 1941, before most of the deaths at Am Spiegelgrund occurred and before its euthanasia programme became public knowledge. Our detailed investigation of the medical records, Unit referral practices and Am Spiegelgrund provided no evidence that Asperger knew about the euthanasia programme at the time of the referrals. One death was probably due to euthanasia, but the other was less clear. CONCLUSION: There was no evidence that Asperger knew about the euthanasia programme when he referred two patients who died at Am Spiegelgrund.

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19. Thérien VD, Degré-Pelletier J, Barbeau EB, Samson F, Soulières I. Differential neural correlates underlying mental rotation processes in two distinct cognitive profiles in autism. NeuroImage Clinical. 2022; 36: 103221.

Enhanced visuospatial abilities characterize the cognitive profile of a subgroup of autistics. However, the neural correlates underlying such cognitive strengths are largely unknown. Using functional magnetic resonance imaging (fMRI), we investigated the neural underpinnings of superior visuospatial functioning in different autistic subgroups. Twenty-seven autistic adults, including 13 with a Wechsler’s Block Design peak (AUTp) and 14 without (AUTnp), and 23 typically developed adults (TYP) performed a classic mental rotation task. As expected, AUTp participants were faster at the task compared to TYP. At the neural level, AUTp participants showed enhanced bilateral parietal and occipital activation, stronger occipito-parietal and fronto-occipital connectivity, and diminished fronto-parietal connectivity compared to TYP. On the other hand, AUTnp participants presented greater activation in right and anterior regions compared to AUTp. In addition, reduced connectivity between occipital and parietal regions was observed in AUTnp compared to AUTp and TYP participants. A greater reliance on posterior regions is typically reported in the autism literature. Our results suggest that this commonly reported finding may be specific to a subgroup of autistic individuals with enhanced visuospatial functioning. Moreover, this study demonstrated that increased occipito-frontal synchronization was associated with superior visuospatial abilities in autism. This finding contradicts the long-range under-connectivity hypothesis in autism. Finally, given the relationship between distinct cognitive profiles in autism and our observed differences in brain functioning, future studies should provide an adequate characterization of the autistic subgroups in their research. The main limitations are small sample sizes and the inclusion of male-only participants.

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20. Vogindroukas I, Stankova M, Chelas EN, Proedrou A. Language and Speech Characteristics in Autism. Neuropsychiatric disease and treatment. 2022; 18: 2367-77.

The aim of this paper is to provide information regarding diversity in speech and language profiles of individuals with Autism Spectrum Disorders (ASD) and try to classify these profiles according to the combination of the communication difficulties. Research findings confirm the existence of heterogeneity of communication challenges in ASD across the lifespan. A lot of children with ASD experience communication challenges and strengths across all language sub-systems including pragmatics, grammar, semantics, syntax, phonology, and morphology in both oral and written language, while some children with autism demonstrate exceptional language abilities incl. linguistic creativity. Communication issues vary on a continuum of severity so that some children may be verbal, whereas others remain non-verbal or minimally-verbal. The diversity of profiles in speech and language development stem from either the presence of comorbid factors, as a core symptom of autistic behavior without comorbidity or both, with the development of complex clinical symptoms. Difficulties with the semantic aspect of language affect the individual’s skills in abstract thinking, multiple meanings of words, concept categorization, and so on. Finally, the coexistence of ASD with other communication difficulties such as a Language Disorder, Apraxia of Speech, Speech Sound Disorders or/and other neurodevelopmental disorders raises the need for examining more carefully the emergence of new clinical profiles and clinical markers useful in performing differential diagnosis and different intervention.

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21. Xie T, Ma H, Wang L, Du Y. Can Enactment and Motor Imagery Improve Working Memory for Instructions in Children with Autism Spectrum Disorder and Children with Intellectual Disability?. Journal of autism and developmental disorders. 2022.

This study explored the impacts of enactment and motor imagery on working memory for instructions in children with autism spectrum disorder (ASD), children with intellectual disability (ID) and typically developing (TD) children. The participants were asked to hear (hearing condition), imagine enacting (motor imagery condition) and actually enact (enactment condition) instruction sequences and then recall them orally. Compared with the hearing condition, all groups performed better in the enactment condition, with the greatest advantage exhibited by the TD group; however, only the TD children performed better in the motor imagery condition. In summary, enactment has a weaker facilitating effect on ASD children and ID children than on TD children, and motor imagery is ineffective in the former two groups.

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22. Zhou B, Xu Q, Li H, Zhang Y, Li D, Dong P, Wang Y, Lu P, Zhu Y, Xu X. Motor impairments in Chinese toddlers with autism spectrum disorder and its relationship with social communicative skills. Frontiers in psychiatry. 2022; 13: 938047.

OBJECTIVE: Motor impairments are prevalent in children with autism spectrum disorder (ASD) and persistent across age. Our current study was designed to investigate motor deficits in Chinese toddlers with ASD and to explore the relationships between motor deficits and social communication skills. METHODS: For this cross-sectional study, we recruited a total of 210 Chinese toddlers with ASD aged between 18 and 36 months in the study during December 2017 to December 2020. Griffiths Developmental Scales-Chinese (GDS-C), Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and Communication and Symbolic Behavior Scales Developmental Profile-Infant-Toddler Checklist (CSBS-DP-ITC) were administered in these toddlers to evaluate their development, social communicative skills, and autism severity. We compared the developmental and social communicational profiles of ASD toddlers in different gross and fine motor subgroups, and explored potential associated factors. The univariate generalized linear model tested the relationship of fine and gross motor skills and social communicative skills. RESULTS: The prevalence of gross and fine motor deficits were 59.5 and 82.5%, respectively, which are almost equivalent in boys and girls. The motor impairments tended to be more severe with age in toddlers. After adjusting for age, sex, non-verbal development quotient (DQ) and restricted, repetitive behaviors, severer gross motor impairments were significantly related to higher comparison score of ADOS-2 and higher social composite score of CSBS-DP-ITC, without interactions with other variables. Meanwhile, lower fine motor skills were associated with more deficits of social communication and higher severity of ASD, also depending on non-verbal DQ. In the lower non-verbal DQ subgroup, both fine motor deficits and restricted repetitive behaviors (RRBs) might have effects on autism symptomology. CONCLUSION: Motor impairments are common in Chinese toddlers with ASD. Toddlers with weaker gross and fine motor skills have greater deficits in social communicative skills. Gross motor impairment might be an independent predictor of the severity of autism and social communication skills, while the effect of fine motor deficits might be affected by non-verbal DQ and RRBs of toddlers with ASD. We provide further justification for the inclusion of motor impairments in the early intervention for toddlers with ASD.

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23. Zhou B, Yan X, Yang L, Zheng X, Chen Y, Liu Y, Ren Y, Peng J, Zhang Y, Huang J, Tang L, Wen M. Effects of arginine vasopressin on the transcriptome of prefrontal cortex in autistic rat model. Journal of cellular and molecular medicine. 2022; 26(21): 5493-505.

Our previous studies have also demonstrated that AVP can significantly improve social interaction disorders and stereotypical behaviours in rats with VPA-induced autism model. To further explore the mechanisms of action of AVP, we compared the PFC transcriptome changes before and after AVP treatment in VPA-induced autism rat model. The autism model was induced by intraperitoneally injected with VPA at embryonic day 12.5 and randomly assigned to two groups: the VPA-induced autism model group and the AVP treatment group. The AVP treatment group were treated with intranasal AVP at postnatal day 21 and for 3 weeks. The gene expression levels and function changes on the prefrontal cortex were measured by RNA-seq and bioinformatics analysis at PND42 and the mRNA expression levels of synaptic and myelin development related genes were validated by qPCR. Our results confirmed that AVP could significantly improve synaptic and axon dysplasia and promote oligodendrocyte development in the prefrontal cortex in VPA-induced autism models by regulating multiple signalling pathways.

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