1. Amorim R, Catarino S, Miragaia P, Ferreras C, Viana V, Guardiano M. {{The impact of COVID-19 on children with autism spectrum disorder}}. {Revista de neurologia}. 2020; 71(8): 285-91.
INTRODUCTION: Children with autism spectrum disorder (ASD) often experience changing routines as a major challenge. For that reason, the need for adaptation during COVID-19 pandemic may have brought major problems to families with children with this pathology. AIM: To explore how children with ASD and their parents experienced the social isolation during COVID-19 outbreak period. SUBJECTS AND METHODS: We conducted an observational, cross-sectional and analytical study. We applied an anonymous questionnaire that included children’s demographic and clinical characteristics, along with the impact of the COVID-19 outbreak in different aspects of family’s daily life. RESULTS: Out of 99 questionnaires obtained, 43 were related to children with ASD and 56 to control group. Children with ASD predominantly had changes in behavior, while children from control group mostly found no changes. The majority of parents of ASD children reported a negative impact in emotion management against those in control group reporting mostly positive or no impact. Caregivers reported higher mean scores of anxiety levels in themselves than in their children. ASD children and their parents had higher levels of anxiety than healthy ones. In the group with ASD, children that did not maintain routines had higher mean levels of anxiety than children that maintained routines. CONCLUSION: Our results show a potential important psychological impact of the COVID-19 pandemic not only in children with neurodevelopmental disorders but in their caregivers as well. Physicians must be prepared for the post-pandemic surveillance of mental disorders among families.
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2. Casartelli L, Cesareo A, Biffi E, Campione GC, Villa L, Molteni M, Sinigaglia C. {{Vitality form expression in autism}}. {Sci Rep}. 2020; 10(1): 17182.
The notion of « vitality form » has been coined by Daniel Stern to describe the basic features of action, which may reflect the mood or affective state of an agent. There is general consensus that vitality forms substantiate social interactions in children as well in adults. Previous studies have explored children with Autism Spectrum Disorder (ASD)’s ability in copying and recognizing the vitality forms of actions performed by others. In this paper we investigated, for the first time, how children with ASD express different vitality forms when acting themselves. We recorded the kinematics of ASD and typically developing (TD) children while performing three different types of action with two different vitality forms. There were two conditions. In the what condition we contrasted the three different types of action performed with a same vitality form, while in the how condition we contrasted the same type of action performed with two different vitality forms. The results showed a clear difference between ASD children and TD children in the how, but not in the what, condition. Indeed, while TD children distinguished the vitality forms to be expressed by mostly varying a specific spatiotemporal parameter (i.e. movement time), no significant variation in this parameter was found in ASD children. As they are not prone to express vitality forms as neurotypical individuals do, individuals with ASD’s interactions with neurotypical peers could therefore be difficult to achieve successfully, with cascading effects on their propensity to be tuned to their surrounding social world, or so we conjecture. If this conjecture would turn out to be correct, our findings could have promising implication for theoretical and clinical research in the context of ASD.
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3. Chien YL, Chao CC, Wu SW, Hsueh HW, Chiu YN, Tsai WC, Gau SS, Hsieh ST. {{Small fiber pathology in autism and clinical implications}}. {Neurology}. 2020.
OBJECTIVE: To investigate small-fiber innervation of the skin and its relationships with clinicometry of autism and peripheral afferents for contact heat-evoked potential (CHEP) and psychophysical measures of thermal thresholds. METHODS: We recruited 32 men with autism (26.5 ± 5.9 years) and conducted small fiber assessments of (1) skin biopsy with quantifying intraepidermal nerve fiber (IENF) density, (2) CHEP, (3) quantitative sensory testing, and large-fiber physiology of nerve conduction studies. Results were compared with age-matched controls and analyzed with clinical measures of autism. RESULTS: Autism patients showed a lower IENF density than control subjects (5.53 ± 2.09 vs 11.13 ± 3.49 fibers/mm, p < 0.0001). The IENF density was reduced in 17 (53.1%) autism men classified as skin denervation group. On psychophysics, 9 (28%) autism men had elevated thermal thresholds, and the warm threshold of the big toe was negatively correlated with IENF density (p = 0.0073), indicating functional impairments of small-fiber sensory nerves. IENF density was negatively correlated with CHEP amplitude in autism (p = 0.003) in contrast to the pattern of positive correlation in controls, indicating different processing of nociceptive afferent in autism. Clinically, IENF density was related to distinct tactile symptom patterns in the skin denervation vs normal innervation group, respectively. Furthermore, IENF density was associated with autistic symptoms measured by the Autism-spectrum Quotient in a U-shaped model (p = 0.014). CONCLUSIONS: These observations indicated that a substantial portion of autism individuals had small fiber pathology, which was associated with tactile and autistic symptoms, providing structural and physiologic evidence for the involvement of peripheral sensory nerves in autism. Lien vers le texte intégral (Open Access ou abonnement)
4. Downes N, Lichtlé J, Lamore K, Orêve MJ, Cappe E. {{Couples’ Experiences of Parenting a Child After an Autism Diagnosis: A Qualitative Study}}. {J Autism Dev Disord}. 2020.
After a child is diagnosed with autism, parents’ relationships are impacted as they reorganize their daily lives to support their child’s specific needs. A better understanding of parenting couples’ adaptation is needed to accompany them during this period. This qualitative study explored couples’ experiences after their child’s autism diagnosis. An inductive thematic analysis among ten couple interviews (N = 20) revealed three key themes: emotional experiences, external support, and adaptation. Overall, the quality of couples’ relationships before having a child influenced their relationship after the diagnosis. In general, parents presented complementary coparenting roles, while different opinions about how to raise the child strained their relationship. Helping parents adapt to a diagnosis together could prove to be important for future interventions and research.
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5. Georgiou GP. {{Correction to: Identification of Native Vowels in Normal and Whispered Speech by Individuals with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2020.
The corresponding author of this article wants to add his present affiliation and it appears in this erratum.
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6. Godoy PBG, Shephard E, Milosavljevic B, Johnson MH, Charman T. {{Brief Report: Associations Between Cognitive Control Processes and Traits of Autism Spectrum Disorder (ASD), attention-Deficit/Hyperactivity Disorder (ADHD) and Anxiety in Children at Elevated and Typical Familial Likelihood for ASD}}. {J Autism Dev Disord}. 2020.
Shared difficulties with cognitive control may play a role in co-occurring mental health problems frequently observed in autistic children. We investigated how different cognitive control processes (inhibitory control, conflict resolution, cognitive flexibility) associated with traits of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and anxiety in 7-year-old children at elevated (n = 44) and typical (n = 37) familial likelihood for ASD. Poor inhibitory control was associated with higher ADHD traits. Better inhibitory control and poorer cognitive flexibility predicted higher anxiety traits. Cognitive control processes were not associated dimensionally with autistic traits, though better conflict resolution predicted greater likelihood of meeting diagnostic criteria for ASD in categorical analysis. These findings suggest that different cognitive control alterations are associated with ASD, ADHD and anxiety.
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7. Holingue C, Brucato M, Ladd-Acosta C, Hong X, Volk H, Mueller NT, Wang X, Fallin MD. {{Interaction between Maternal Immune Activation and Antibiotic Use during Pregnancy and Child Risk of Autism Spectrum Disorder}}. {Autism Res}. 2020.
Prenatal exposure to maternal immune activation (MIA) has been implicated as a risk factor for the development of autism spectrum disorder (ASD), though the conditions under which this elevated risk occurs are unclear. Animal literature demonstrates that antibiotic use, which affects the composition of the maternal gut microbiota, modifies the effect of MIA on neurodevelopmental outcomes in the offspring. The aim of this study was to assess whether antibiotic use during pregnancy modifies the association between MIA and subsequent risk of ASD, in a prospective birth cohort with 116 ASD cases and 860 typically developing (TD) child controls. There was no evidence of interaction between fever or genitourinary infection and antibiotic use on the odds of ASD in unadjusted or adjusted analyzes. However, we found evidence of an interaction between flu, specifically in second trimester, and antibiotic use at any point during pregnancy on the odds of ASD in the child. Among women who received an antibiotic during pregnancy, flu in trimester two was not associated with ASD (adjusted odds ratio [aOR] = 0.99 [0.43-2.28]). Among women who were not exposed to an antibiotic at any point during pregnancy, flu in second trimester was significantly associated with increased odds of ASD (aOR = 4.05 [1.14-14.38], P = .03), after adjustment for child sex, child birth year, maternal age, gestational age, C-section delivery, and low birthweight. These findings should be treated as hypothesis-generating and suggest that antibiotic use may modify the influence that MIA has on autism risk in the child. LAY SUMMARY: We looked at whether the association between activation of the immune system during pregnancy and risk of the child developing autism spectrum disorder (ASD) differed among women who did or did not take an antibiotic at any point during pregnancy. We examined 116 children with ASD and 860 without ASD and found that flu in second trimester was associated with increased ASD, but only among women who did not take an antibiotic during pregnancy. No other immune activation exposures seemed to interact with antibiotic use.
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8. Kuliński W, Nowicka A. {{EFFECTS OF SENSORY INTEGRATION THERAPY ON SELECTED FITNESS SKILLS IN AUTISTIC CHILDREN}}. {Wiadomosci lekarskie (Warsaw, Poland : 1960)}. 2020; 73(8): 1620-5.
OBJECTIVE: Introduction: Autism is a pervasive developmental disorder characterised by abnormal development in the first two years of life and impairment with respect to the following three areas: social interactions, communication, and behaviour. The disorder is more common in males than females. The aim: The study was conducted to assess the effects of sensory integration therapy on selected fitness skills in autistic children. PATIENTS AND METHODS: Material and methods: The study assessed a group of 20 children (15 boys and 5 girls) aged 3 to 10 years. All children were diagnosed with autism and underwent 2-year therapy. The children showed impaired sensory modulation with abnormal stimulus reception and processing in the tactile, auditory, vestibular (balance), olfactory, and gustatory sensory systems. The study assessed fitness skills and their correlations with sensory integration therapy used in the children. The assessment used the Sensorimotor Development Questionnaire developed by Zbigniew Przyrowski and selected tests from « Obserwacja Kliniczna » as well as history-taking conducted with the parents. The following aspects were analysed: muscle tone, static balance, dynamic balance, jumping on two legs, jumping on one leg, catching and throwing a ball, and self-care activities, such as putting on shoes. RESULTS: Results: Sensory integration therapy contributed to an improvement in motor, sensory, cognitive, emotional, communication, and social development in the study patients. CONCLUSION: Conclusion: The use of sensory integration effectively supports sensory processes in autistic children.
9. Mordaunt CE, Jianu JM, Laufer BI, Zhu Y, Hwang H, Dunaway KW, Bakulski KM, Feinberg JI, Volk HE, Lyall K, Croen LA, Newschaffer CJ, Ozonoff S, Hertz-Picciotto I, Fallin MD, Schmidt RJ, LaSalle JM. {{Cord blood DNA methylome in newborns later diagnosed with autism spectrum disorder reflects early dysregulation of neurodevelopmental and X-linked genes}}. {Genome medicine}. 2020; 12(1): 88.
BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with complex heritability and higher prevalence in males. The neonatal epigenome has the potential to reflect past interactions between genetic and environmental factors during early development and influence future health outcomes. METHODS: We performed whole-genome bisulfite sequencing of 152 umbilical cord blood samples from the MARBLES and EARLI high-familial risk prospective cohorts to identify an epigenomic signature of ASD at birth. Samples were split into discovery and replication sets and stratified by sex, and their DNA methylation profiles were tested for differentially methylated regions (DMRs) between ASD and typically developing control cord blood samples. DMRs were mapped to genes and assessed for enrichment in gene function, tissue expression, chromosome location, and overlap with prior ASD studies. DMR coordinates were tested for enrichment in chromatin states and transcription factor binding motifs. Results were compared between discovery and replication sets and between males and females. RESULTS: We identified DMRs stratified by sex that discriminated ASD from control cord blood samples in discovery and replication sets. At a region level, 7 DMRs in males and 31 DMRs in females replicated across two independent groups of subjects, while 537 DMR genes in males and 1762 DMR genes in females replicated by gene association. These DMR genes were significantly enriched for brain and embryonic expression, X chromosome location, and identification in prior epigenetic studies of ASD in post-mortem brain. In males and females, autosomal ASD DMRs were significantly enriched for promoter and bivalent chromatin states across most cell types, while sex differences were observed for X-linked ASD DMRs. Lastly, these DMRs identified in cord blood were significantly enriched for binding sites of methyl-sensitive transcription factors relevant to fetal brain development. CONCLUSIONS: At birth, prior to the diagnosis of ASD, a distinct DNA methylation signature was detected in cord blood over regulatory regions and genes relevant to early fetal neurodevelopment. Differential cord methylation in ASD supports the developmental and sex-biased etiology of ASD and provides novel insights for early diagnosis and therapy.
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10. Nogay NH, Walton J, Roberts KM, Nahikian-Nelms M, Witwer AN. {{The Effect of the Low FODMAP Diet on Gastrointestinal Symptoms, Behavioral Problems and Nutrient Intake in Children with Autism Spectrum Disorder: A Randomized Controlled Pilot Trial}}. {J Autism Dev Disord}. 2020.
Some research suggests that GI symptoms seen in children with ASD may relate to behavior problems. The objective of this pilot study was to assess the effect of the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet on GI and behavioral problems in children with ASD. At follow-up, the low FODMAP diet group had significant relief in some GI problems compared with both baseline in the group and control group. At baseline and at follow-up, there were no significant differences in behavioral problems between the low FODMAP diet group and the control group. Randomized controlled studies including larger sample sizes are needed to confirm the effects of low FODMAP diets in children with autism who have gastrointestinal problems.
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11. Paola P, Laura G, Giusy M, Michela C. {{Autism, autistic traits and creativity: a systematic review and meta-analysis}}. {Cognitive processing}. 2020.
Psychometric, historiometric and psychiatric studies are controversial on a hypothetical link between psychopathology and creativity. In this study, we will try to contribute to this debate by analysing the case of autism. Is there a relationship between autism and creativity? If so, can we find the same relationship in a watered-down form in subjects with autistic traits? In order to answer these questions, we carried out a systematic literature review of the studies on this topic published in the last 10 years. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We also conducted a meta-analysis of data. We found that in the clinical population there are fewer creative performances than in control groups; nonetheless, it is possible to delineate a medium creative profile of subjects with autism. The average creative profile of people with autism shows that they are inhibited in fluency and flexibility, but that they display a high level of detail and a particularly high level of originality in works either generated during tests or created in private time. In particular, the level of detail reached in the latter condition seems to be higher in the autistic population than in the control groups. Better linguistic skills appear to be linked to better creative performances. Linguistic tests, if compared with visual and performative tests, seem to favour the expression of originality in subjects with autism. Although our data on autistic traits are compatible with the hypothesis that a high level of autistic traits is a watered-down replica of the cognitive profile of subjects with autism, we have no sufficient data to support this hypothesis.
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12. Rehbein T, Herrmann DN. {{Sensory processing in autism spectrum disorders: Insights from the periphery?}}. {Neurology}. 2020.
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13. Reicher D. {{Debate: Remote learning during COVID-19 for children with high functioning autism spectrum disorder}}. {Child and adolescent mental health}. 2020.
The COVID-19 pandemic has illuminated preference of children with autism spectrum disorder of near average to above average intelligence (high functioning autism – HFA) for remote learning. While many children with HFA excel at the academic curriculum, the majority struggle with the so-called hidden curriculum, which includes such things as social rules and societal norms. Explicit teaching of the hidden curriculum is often lacking in mainstream education classes and can be a tremendous stumbling block for children with HFA. The result is often anxiety and depression which can be exacerbated or sometimes even caused by the intense demands for sociability and flexibility required in most mainstream educational settings. Remote learning, while not a legitimate option until now, has provided these children with an opportunity to flourish at home and improve not only their grades but also their mental health. While remote learning or hybrid models may continue to be appropriate for some children, understanding of the hidden curriculum is necessary beyond the school years. Both mental health and academic proficiency will flourish to the degree we are able to make the hidden curriculum more explicit to children with HFA.
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14. Rochat MJ, Distefano G, Maffei M, Toni F, Posar A, Scaduto MC, Resca F, Cameli C, Bacchelli E, Maestrini E, Visconti P. {{Brain Magnetic Resonance Findings in 117 Children with Autism Spectrum Disorder under 5 Years Old}}. {Brain Sci}. 2020; 10(10).
We examined the potential benefits of neuroimaging measurements across the first 5 years of life in detecting early comorbid or etiological signs of autism spectrum disorder (ASD). In particular, we analyzed the prevalence of neuroradiologic findings in routine magnetic resonance imaging (MRI) scans of a group of 117 ASD children younger than 5 years old. These data were compared to those reported in typically developing (TD) children. MRI findings in children with ASD were analyzed in relation to their cognitive level, severity of autistic symptoms, and the presence of electroencephalogram (EEG) abnormalities. The MRI was rated abnormal in 55% of children with ASD with a significant prevalence in the high-functioning subgroup compared to TD children. We report significant incidental findings of mega cisterna magna, ventricular anomalies and abnormal white matter signal intensity in ASD without significant associations between these MRI findings and EEG features. Based on these results we discuss the role that brain MRI may play in the diagnostic procedure of ASD.
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15. Troisi J, Autio R, Beopoulos T, Bravaccio C, Carraturo F, Corrivetti G, Cunningham S, Devane S, Fallin D, Fetissov S, Gea M, Giorgi A, Iris F, Joshi L, Kadzielski S, Kraneveld A, Kumar H, Ladd-Acosta C, Leader G, Mannion A, Maximin E, Mezzelani A, Milanesi L, Naudon L, Marzal LNP, Pardo PP, Prince NZ, Rabot S, Roeselers G, Roos C, Roussin L, Scala G, Tuccinardi FP, Fasano A. {{Genome, Environment, Microbiome and Metabolome in Autism (GEMMA) Study Design: Biomarkers Identification for Precision Treatment and Primary Prevention of Autism Spectrum Disorders by an Integrated Multi-Omics Systems Biology Approach}}. {Brain Sci}. 2020; 10(10).
Autism Spectrum Disorder (ASD) affects approximately 1 child in 54, with a 35-fold increase since 1960. Selected studies suggest that part of the recent increase in prevalence is likely attributable to an improved awareness and recognition, and changes in clinical practice or service availability. However, this is not sufficient to explain this epidemiological phenomenon. Research points to a possible link between ASD and intestinal microbiota because many children with ASD display gastro-intestinal problems. Current large-scale datasets of ASD are limited in their ability to provide mechanistic insight into ASD because they are predominantly cross-sectional studies that do not allow evaluation of perspective associations between early life microbiota composition/function and later ASD diagnoses. Here we describe GEMMA (Genome, Environment, Microbiome and Metabolome in Autism), a prospective study supported by the European Commission, that follows at-risk infants from birth to identify potential biomarker predictors of ASD development followed by validation on large multi-omics datasets. The project includes clinical (observational and interventional trials) and pre-clinical studies in humanized murine models (fecal transfer from ASD probands) and in vitro colon models. This will support the progress of a microbiome-wide association study (of human participants) to identify prognostic microbiome signatures and metabolic pathways underlying mechanisms for ASD progression and severity and potential treatment response.
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16. van der Cruijsen R, Boyer BE. {{Explicit and implicit self-esteem in youth with autism spectrum disorders}}. {Autism}. 2020: 1362361320961006.
Having a stable and good self-esteem is important for maintaining a good mental health. However, having low self-esteem is a risk factor for developing depressive, anxious, or uncooperative/aggressive symptoms. While many individuals with an autism spectrum disorder have these symptoms, there is a lack of studies on self-esteem in this group. We studied self-esteem of youth with autism spectrum disorder and the connection to their co-occurring symptoms. To do this, different self-esteem profiles were investigated, including explicit self-esteem (how someone says their self-esteem is after reflecting on it), implicit self-esteem (how someone’s self-esteem is on a task that does not give them time to reflect on it), and the difference between both (high explicit with low implicit self-esteem or low explicit with high implicit self-esteem). Our results show that youth with autism spectrum disorder report lower self-esteem than youth without autism spectrum disorder when they have reflected on it (explicit self-esteem). And parents of children with autism spectrum disorder report that their children have even lower self-esteem. Implicit self-esteem was the same for youth with and without autism spectrum disorder. Furthermore, we found that within youth with autism spectrum disorder, there was a negative relationship between explicit self-esteem and depressive symptoms, and between implicit self-esteem and externalizing behavior. Taken together, youth with autism spectrum disorder are at risk for developing low self-esteem and when they do they have a higher risk of developing co-occurring problems. Therefore we stress that it is important to measure and improve the self-esteem of youth with autism spectrum disorder, so they develop less co-occurring problems and have a higher quality of life.
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17. Yu YT, Li HJ, Tsai CH, Lin CH, Lai SS, Chen KL. {{Cool Executive Function and Verbal Comprehension Mediate the Relation of Hot Executive Function and Theory of Mind in Children with Autism Spectrum Disorder}}. {Autism Res}. 2020.
Impaired executive function (EF), verbal comprehension, and theory of mind (ToM) may contribute to social difficulties in children with autism spectrum disorder (ASD). The linkage between cool (cognitive) EF and ToM has been widely investigated, but the relations between hot (affective) EF and ToM remain largely unknown. The roles of cool EF and verbal comprehension have not been previously explored together to address hot EF-ToM relations. This study applied mediation analysis to investigate the mediating effects of cool EF and verbal comprehension to further elaborate the link between hot EF and ToM in children with ASD and average intellectual abilities. A total of 97 children with ASD aged from 6 to 12 years participated in this study. Children’s cool EF, hot EF, and verbal comprehension were, respectively, measured with the computerized Dimensional Change Card Sort task, Children’s Gambling Task, and the verbal comprehension index of the Wechsler Intelligence Scale for Children-fourth edition. Children’s ToM was assessed with the Theory of Mind Task Battery. Partial correlation coefficients indicated that hot EF was significantly related with ToM with age controlled for. The results of the mediation analysis showed that cool EF and verbal comprehension mediated the linkage between hot EF and ToM. These findings highlight not only the connections between hot EF and ToM but also the importance of cool EF and verbal comprehension on hot EF-ToM relations in clinical assessments and interventions for school-aged children with ASD and average intellectual abilities. LAY SUMMARY: Relatively few studies have investigated the hot (affective) executive function (EF)-theory of mind (ToM) relations in children with autism spectrum disorder (ASD). This study discovered that hot EF was significantly related to ToM, while cool (cognitive) EF and verbal comprehension mediated the relationship between hot EF and ToM. Therefore, the influence of cool EF and verbal comprehension on hot EF-ToM relations should be considered in studies involving children with ASD.
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18. Zıvralı Yarar E, Howlin P, Charlton R, Happé F. {{Age-Related Effects on Social Cognition in Adults with Autism Spectrum Disorder: A Possible Protective Effect on Theory of Mind}}. {Autism Res}. 2020.
Impaired social cognition has been suggested to underlie the social communication difficulties that define autism spectrum disorder (ASD). In typical development, social cognition may deteriorate in older age, but age effects in ASD adults have been little explored. In the present study, we compared groups of younger and older adults with and without ASD (n = 97), who completed a set of social cognition tasks assessing theory of mind (ToM), and self-report measures of empathy and alexithymia. While typically developing (TD) younger adults outperformed elderly TD and younger ASD participants, younger and older ASD adults did not differ in their ToM performance, and the elderly ASD and TD groups performed equivalently. By contrast, ASD adults reported lower empathy scores and higher levels of alexithymia symptoms compared to TD adults regardless of age. The difference between ASD and TD groups in self-reported empathy scores was no longer significant when alexithymia was covaried (with the exception of the Perspective Taking subscore). Results suggest a possible age-protective effect on ToM in the ASD group. In addition, empathy difficulties appear to be associated with alexithymia rather than ASD per se. Possible interpretations are discussed, and future directions for autism aging research are proposed. LAY SUMMARY: People with autism spectrum disorder (ASD) have difficulties with social understanding. Some age-related studies in typical development have shown a decline in social understanding in older age. We investigated whether a similar pattern is present in adults with ASD. We found that understanding what someone is thinking was not worse in older versus younger autistic adults. Also, we reported further evidence suggesting that emotional empathy difficulties were related to difficulties with understanding one’s own emotions rather than with autism itself.
