1. Bejarano-Martín Á, Canal-Bedia R, Magán-Maganto M, Hernández Fabián A, Calvarro Castañeda AL, Manso de Dios S, Malmierca García P, Díez Villoria E, Jenaro Río C, Posada de la Paz M. Effect of a Focused Social and Communication Intervention on Preterm Children with ASD: A Pilot Study. Journal of autism and developmental disorders. 2022; 52(4): 1725-40.

While advances in intensive neonatal care have greatly improved survival rates among preterm infants, incidence of neurodevelopmental disorders in this group is still high, with autism spectrum disorder (ASD) being one of the most frequent. To this end, we conducted a social-communication intervention aimed at investigating efficacy in social-communicative skills. Eighteen children (preterm and full-term with ASD and preterm children) aged 18 through 20 months participated in the study. Our findings indicate that most participants in the intervention groups registered significant improvements in terms of socio-communicative skills, cognitive development, and language. Accordingly, these pilot data underscore the need for further research and implementation of early interventions in young preterm children with ASD.

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2. Bertelsen N, Landi I, Bethlehem RAI, Seidlitz J, Busuoli EM, Mandelli V, Satta E, Trakoshis S, Auyeung B, Kundu P, Loth E, Dumas G, Baumeister S, Beckmann CF, Bölte S, Bourgeron T, Charman T, Durston S, Ecker C, Holt RJ, Johnson MH, Jones EJH, Mason L, Meyer-Lindenberg A, Moessnang C, Oldehinkel M, Persico AM, Tillmann J, Williams SCR, Spooren W, Murphy DGM, Buitelaar JK, Baron-Cohen S, Lai MC, Lombardo MV. Imbalanced social-communicative and restricted repetitive behavior subtypes of autism spectrum disorder exhibit different neural circuitry. Communications biology. 2021; 4(1): 574.

Social-communication (SC) and restricted repetitive behaviors (RRB) are autism diagnostic symptom domains. SC and RRB severity can markedly differ within and between individuals and may be underpinned by different neural circuitry and genetic mechanisms. Modeling SC-RRB balance could help identify how neural circuitry and genetic mechanisms map onto such phenotypic heterogeneity. Here, we developed a phenotypic stratification model that makes highly accurate (97-99%) out-of-sample SC = RRB, SC > RRB, and RRB > SC subtype predictions. Applying this model to resting state fMRI data from the EU-AIMS LEAP dataset (n = 509), we find that while the phenotypic subtypes share many commonalities in terms of intrinsic functional connectivity, they also show replicable differences within some networks compared to a typically-developing group (TD). Specifically, the somatomotor network is hypoconnected with perisylvian circuitry in SC > RRB and visual association circuitry in SC = RRB. The SC = RRB subtype show hyperconnectivity between medial motor and anterior salience circuitry. Genes that are highly expressed within these networks show a differential enrichment pattern with known autism-associated genes, indicating that such circuits are affected by differing autism-associated genomic mechanisms. These results suggest that SC-RRB imbalance subtypes share many commonalities, but also express subtle differences in functional neural circuitry and the genomic underpinnings behind such circuitry.

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3. Callanan J, Signal T, McAdie T. What is my child telling me? Reducing stress, increasing competence and improving psychological well-being in parents of children with a developmental disability. Research in developmental disabilities. 2021; 114: 103984.

High levels of stress in parents of children with a developmental disability have been extensively documented. These heightened stress levels seem independent of diagnosis and are better explained by the level of challenging behavior of the children. Furthermore, the relationship between stress level and difficult behavior appears reciprocal. The negative impact of stress on parents’ skill development, response to difficult behavior, sense of competence, well-being and the child’s developmental outcomes have also been thoroughly detailed. The Parent Child Relationally Informed – Early Intervention (PCRI-EI) aims to expand the response repertoires of parents to help address the challenges of parenting a child with a developmental disability, including through reducing parental stress. The current study presents a quasi-experimental assessment of the efficacy of PCRI-EI in reducing stress levels and increasing sense of competency and psychological well-being in a sample of 22 parents of children with a variety of disabilities presenting to a community early childhood development service. Statistically and clinically significant changes in overall stress levels (Parenting Stress Index), psychological well-being (K6) and sense of competence (PSOC) were observed across time.

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4. Casseus M, Cheng J. Children with Cerebral Palsy and Unmet Need for Care Coordination. Journal of developmental and behavioral pediatrics : JDBP. 2021; 42(8): 605-12.

OBJECTIVE: To examine the physical and functional health of children with cerebral palsy (CP) and determine the prevalence and correlates of unmet need for health care coordination among this population. METHODS: We analyzed data from the 2016 to 2018 National Survey of Children’s Health (n = 102,341). Bivariate and multivariable analyses were conducted to compare the prevalence of chronic health conditions, functional disabilities, and care coordination among children with and without CP. Multivariable logistic regression models were used to estimate the adjusted odds ratio of comorbid conditions, functional disabilities, and unmet need for care coordination. Associations between select sociodemographic factors and unmet need for care coordination were assessed. RESULTS: Children with CP had significantly higher prevalence of all the comorbid conditions and functional disabilities examined. The most prevalent health conditions among children with CP were allergies (34.2%), anxiety (26.5%), and asthma (25.1%). Notably, children with CP had higher odds of autism spectrum disorder (adjusted odds ratio [aOR] = 2.97; 95% confidence interval [CI] 1.40-6.30) and mental health conditions (aOR = 3.65; 95% CI 2.15-6.21). More than half (53.8%) of children with CP had unmet need for care coordination. They also had higher odds of unmet need for care coordination than children without CP (aOR = 2.63; 95% CI 1.69-4.10). CONCLUSION: Children with CP have high prevalence of chronic health conditions and are also more likely to have unmet need for care coordination. Given the complexity of CP, our study supports the need for robust efforts to ensure that all children with CP have effective care coordination.

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5. Frazier TW, Uljarevic M, Ghazal I, Klingemier EW, Langfus J, Youngstrom EA, Aldosari M, Al-Shammari H, El-Hag S, Tolefat M, Ali M, Al-Shaban FA. Social attention as a cross-cultural transdiagnostic neurodevelopmental risk marker. Autism research : official journal of the International Society for Autism Research. 2021; 14(9): 1873-85.

The primary objectives of this study were to evaluate the structure and age-related stability of social attention in English and Arabic-speaking youth and to compare social attention between children with autism spectrum disorder (ASD), other developmental disabilities (DD), and typically-developing controls. Eye-tracking data were collected from US (N = 270) and Qatari (N = 242) youth ages 1-17, including children evaluated for possible ASD. Participants viewed 44 stimuli from seven social paradigms. Fixation was computed for areas of interest within each stimulus. Latent variable models examined the structure of social attention. Generalized estimating equation models examined the effect of age, sex, culture, and diagnostic group on social attention. The best-fitting model included a general social attention factor and six specific factors. Cultural differences in social attention were minimal and social attention was stable across age (r = 0.03), but females showed significantly greater social attention than males (d = 0.28). Social attention was weaker in DD (d = -0.17) and lowest in ASD (d = -0.38) relative to controls. Differences were of sufficient magnitude across areas-of-interest to reliably differentiate DD from controls (AUC = 0.80) and ASD-only from all other cases (AUC = 0.76). A social attention dimension that represents an early-life preference for socially salient information was identified. This preference was cross-culturally consistent and stable across development but stronger in females and weaker in DD, especially ASD. Given rapid and easy-to-collect remote eye tracking administration, social attention measurement may be useful for developmental monitoring. Acquisition of population norms, analogous to height/weight/head circumference, might enhance early screening and tracking of neurodevelopment. LAY SUMMARY: This research found that social attention is a single dimension of behavior that represents a strong preference for social stimuli, is consistent across cultures, stable across age, and stronger in females. Children with developmental disabilities had lower levels of social attention than neurotypical children and children with autism spectrum disorder had the lowest levels of social attention.

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6. Gisbert Gustemps L, Lugo Marín J, Setien Ramos I, Ibañez Jimenez P, Romero Santo-Tomás O, Jurado Luque MJ, Ballester Navarro P, Esteve Cruella A, Díez Villoria E, Canal Bedia R, Ramos Quiroga JA. Sleep disturbances in autism spectrum disorder without intellectual impairment: relationship with executive function and psychiatric symptoms. Sleep medicine. 2021; 83: 106-14.

The autism spectrum disorder (ASD) is a neurodevelopmental condition, frequently accompanied by medical and psychiatric pathology. One of the most commonly found problems associated with ASD is sleep disturbances, which are estimated to affect approximately 80% of the people with ASD, not only during childhood but also in the adolescence and adult stages. Nevertheless, the relationship of these sleep difficulties with autism severity, as well as other associated impairments such as executive functioning and psychiatric disorders (eg, depression), has not yet been widely studied. The main objective of the present study was to explore the relationship between sleep disturbances, subjective measures of executive function, and psychiatric pathology in the ASD population. To reach that goal, a group of 89 participants with ASD (44 children/adolescents and 45 adults) was recruited and evaluated with self-reported measures of executive function performance and psychiatric pathology tests. Multivariate analysis showed a significant association between sleep disturbances and psychiatric symptoms in both ASD groups, with greater sleep disturbances predicting more severe psychiatric pathology. No significant association was found with executive function in any group. Limitations included a small sample size and lack of objective measures. Sleep problems seem to be associated with the severity of psychiatric pathology throughout the lifespan, increasing the chance of developing psychiatric symptoms when they were present. Improving sleep quality in ASD at all ages may result in preventing and/or decreasing psychiatric pathology in this population.

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7. Ludyga S, Pühse U, Gerber M, Kamijo K. How children with neurodevelopmental disorders can benefit from the neurocognitive effects of exercise. Neuroscience and biobehavioral reviews. 2021; 127: 514-9.

Exercise is an integral part of children’s lives, and research in educational settings has found that regular engagement promises improvements in executive function (i.e. top-down control of goal-directed behavior). Based on recent advances in understanding the moderators and the neurocognitive mechanisms of these effects, we highlight a potential application of exercise in the treatment of executive dysfunction. Even though different neurodevelopmental disorders are characterized by a heterogeneity in core symptoms, children affected by these disorders often face common executive function deficits. So far, exercise has not been recognized as an alternative or additional treatment for this specific cognitive impairment. The limited experimental evidence in children with neurodevelopmental disorders provides a first indication that regular exercise engagement benefits executive function. However, we identified key research questions that need to be answered before a prescription of exercise to children with executive dysfunction can be encouraged in clinical practice.

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8. Meral BF. Parental Views of Families of Children with Autism Spectrum Disorder and Developmental Disorders During the COVID-19 Pandemic. Journal of autism and developmental disorders. 2022; 52(4): 1712-24.

The COVID-19 pandemic, the infection caused by the novel coronavirus detected in December 2019 by World Health Organization (WHO), has detrimentally impacted human life in a variety of areas. Many concepts including outbreak, pandemic, and quarantine have been an inseparable part of our lives. This kind of dialectic change naturally affects persons with autism spectrum disorder (ASD) and developmental disorders (DD) and their families. The present study using a mixed-method evaluation aims to reveal the impacts of the COVID-19 pandemic on the family functioning of children specifically with ASD in Turkey. This study promises a holistic understanding of how the lockdown depending on the COVID -19 pandemic affects families and their children with ASD with positive and negative sides.

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9. Núñez C, Stephan-Otto C, Arca G, Agut T, Arnaez J, Cordeiro M, Benavente-Fernández I, Boronat N, Lubián-López SP, Valverde E, Hortigüela M, García-Alix A. Neonatal arterial stroke location is associated with outcome at 2 years: a voxel-based lesion-symptom mapping study. Archives of disease in childhood Fetal and neonatal edition. 2022; 107(1): 45-50.

OBJECTIVE: In contrast to motor impairments, the association between lesion location and cognitive or language deficits in patients with neonatal arterial ischaemic stroke remains largely unknown. We conducted a voxel-based lesion-symptom mapping cross-sectional study aiming to reveal neonatal arterial stroke location correlates of language, motor and cognitive outcomes at 2 years of age. DESIGN: Prospective observational multicentre study. SETTING: Six paediatric university hospitals in Spain. PARTICIPANTS: We included 53 patients who had a neonatal arterial ischaemic stroke with neonatal MRI and who were followed up till 2 years of age. MAIN OUTCOME MEASURES: We analysed five dichotomous clinical variables: speech therapy (defined as the need for speech therapy as established by therapists), gross motor function impairment, and the language, motor and cognitive Bayley scales. All the analyses were controlled for total lesion volume. RESULTS: We found that three of the clinical variables analysed significantly correlated with neonatal stroke location. Speech therapy was associated with lesions located mainly at the left supramarginal gyrus (p=0.007), gross motor function impairment correlated with lesions at the left external capsule (p=0.044) and cognitive impairment was associated with frontal lesions, particularly located at the left inferior and middle frontal gyri (p=0.012). CONCLUSIONS: The identification of these susceptible brain areas will allow for more precise prediction of neurological impairments on the basis of neonatal brain MRI.

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10. Purser HRM, Van Herwegen J, Ranzato E, Thomas MSC. The role of context in verbal humor processing in autism. Journal of experimental child psychology. 2021; 209: 105166.

Difficulties in processing humor have been associated with individuals with autism. The current study investigated whether humor comprehension and appreciation could be augmented in children with autism by providing contextual support suggesting that humor was to be expected. A verbally presented riddle task was used in which participants were assessed for their subjective ratings and comprehension of the materials. They were also filmed to record any smiling or laughing. Both riddles and control stimuli were presented with supporting verbal context and also without it. The results showed that (a) the greater subjective appreciation of riddles than of control stimuli was dependent on the provision of context for the participants with autism and that (b) context statistically equated these ratings of riddles between participants with autism and matched typically developing controls. However, context had no effect on comprehension or affective response. The results of the current study demonstrate that children with autism are, even in the most conservative interpretation, able to use verbal context to recognize verbal humor. This lays the foundation of possible interventions based on training sensitivity to context.

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11. Wang S, Liu H, Cheng B, Wu Q, Li L, Yang T, Hou N, Li T. Vitamin A supplementation ameliorates motor incoordination via modulating RORα in the cerebellum in a valproic acid-treated rat autism model with vitamin A deficiency. Neurotoxicology. 2021; 85: 90-8.

Motor dysfunctions are common comorbidities among autism spectrum disorder (ASD) patients. Abnormal cerebellar development throughout critical periods may have an effect on motor functions and result in motor impairments. Vitamin A (VA) plays a crucial role in the developing process of the nervous system. The correlation of VA deficiency (VAD) and ASD with motor dysfunctions, however, is not clear. Therefore, we built rat models with different VA levels based on the valproic acid (VPA)-treated autism model. ASD rats with VAD showed aggravated motor coordination abnormalities, Purkinje cell loss and impaired dendritic arborization of Purkinje cells compared to ASD rats with normal VA levels (VA normal, VAN). Additionally, the expression levels of retinoid-related orphan receptor α (RORα) and retinoic acid receptor α (RARα) were lower in the cerebellum of ASD rats with VAD than in those of ASD rats with VAN. VA supplementation (VAS) effectively improved motor coordination and cerebellar Purkinje cell abnormalities in ASD rats with VAD. Furthermore, the results of chromatin immunoprecipitation (ChIP) assays confirmed that the enrichment of RARα was detected on the RORα promoter in the cerebellum and that VAS could upregulate the binding capacity of RARα for RORα promoters. These results showed that VAD in autism might result in cerebellar impairments and be a factor aggravating a subtype of ASD with motor comorbidities. The therapeutic effect of VAS on motor deficits and Purkinje neuron impairments in autism might be due to the regulation of RORα by RARα.

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