1. Auvichayapat P, Intayot K, Udomchat C, Suphakunpinyo C, Patjanasoontorn N, Keeratitanont K, Tunkamnerdthai O, Jensen MP, Humbert AT, Auvichayapat N. Long-term effects of transcranial direct current stimulation in the treatment of autism spectrum disorder: A randomized controlled trial. Developmental medicine and child neurology. 2022.

AIM: To compare the efficacy of 0, 5, and 20 sessions of transcranial direct current stimulation (tDCS) for reducing symptoms of autism spectrum disorder (ASD). METHOD: Thirty-six male children with ASD (mean age 2 years 3 months, SD 4 months, age range 1 years 6 months-2 years 11 months) were balanced and stratified by age, sex, and baseline severity of ASD, to: (1) a control group that received 20 sessions of sham tDCS; (2) a 5-session tDCS group (5-tDCS) that received 5 sessions of active tDCS followed by 15 sessions of sham tDCS; and (3) a 20-session tDCS group (20-tDCS) that received 20 sessions of active tDCS. All groups participated in the special school activity of Khon Kaen Special Education Center, Thailand. The primary outcome was autism severity as measured by the Childhood Autism Severity Scale. RESULTS: The 5-tDCS and 20-tDCS groups evidenced greater reductions in autism severity than the control group at days 5 and 14, and months 6 and 12. There were no significant differences in the outcome between the 5- and 20-tDCS groups at any time point. Within-group analysis showed clinically meaningful improvements starting at month 6 for the participants in the control group, and clinically meaningful improvements starting on day 5 in both active tDCS groups, all of which were maintained to month 12. INTERPRETATION: The 5- and 20-session tDCS seems to reduce autism severity faster than sham tDCS. These effects maintained at least for 1 year.

Lien vers le texte intégral (Open Access ou abonnement)

2. Binns AV, Casenhiser DM, Shanker SG, Cardy JO. Autistic preschoolers’ engagement and language use in gross motor versus symbolic play settings. Autism & developmental language impairments. 2022; 7: 23969415221115045.

Background and aims: Although adjustment of the environment is recommended as a support strategy in evidence-based interventions for children with autism, the impact of doing so (and the how and why) is not well understood. One essential environmental factor to consider when providing supports for preschool-aged autistic children is the play setting, specifically, the materials available in the child’s play context. The aim of this study was to compare engagement states and number of utterances produced by preschool-aged autistic children within symbolic vs. gross motor play settings. Examining the relationship between gross motor play settings and children’s social engagement and spoken language use is particularly important to explore for autistic children given differences in their sensory processing, motor skill development, and choice of and interaction with toys relative to neurotypical peers. Methods: Seventy autistic children aged 25-57 months were videotaped during natural play interactions with a parent. Children’s social engagement and number of spoken utterances were examined in five minutes each of play with symbolic toys and play with gross motor toys. Continuous time-tagged video coding of the child-caregiver engagement states was conducted, and the child’s frequency of spoken language was identified using language sample analysis. The specific variables examined were; (a) engagement with caregiver, (b) engagement with objects only, (c) unengaged (no evident engagement with objects or people), and (d) total number of spoken utterances. The relationship between play setting (symbolic vs gross motor) and child language and engagement state variables was examined with linear mixed effects modelling. Results: Significant main effects were revealed for the interaction between play setting and autistic children’s engagement. Young autistic children were more likely to engage with caregivers in play environments with gross motor toys (moderate effect) and also were more likely to have periods of unengaged time (not overtly directing their attention to objects or people; small effect) in this setting. Further, when in a setting with symbolic toys, autistic children were more likely to spend their time focusing attention solely on objects (large effect). No interaction was found between play setting and total number of utterances spoken by autistic children. Conclusions and implications: This study confirmed the importance of continued research focused on understanding the relationship between children’s play settings and their social engagement and language use. Although preliminary, findings support the idea that there is an interaction between preschool-aged autistic children’s social engagement and their play settings. Further, our results suggest that there can be value in clinicians differentiating children’s play settings (i.e., gross motor vs symbolic) when assessing and supporting social engagement capacities of young autistic children.

Lien vers le texte intégral (Open Access ou abonnement)

3. Binns AV, Cunningham BJ, Andres A, Oram Cardy J. Current practices, supports, and challenges in speech-language pathology service provision for autistic preschoolers. Autism & developmental language impairments. 2022; 7: 23969415221120768.

BACKGROUND: Speech-language pathology services are among the most frequently accessed services for young autistic children. Therefore, understanding the nature of these services, what challenges these clinicians face, and what supports they value is critical for developing appropriate policies and practices that can maximize positive outcomes for children and families. This study had two primary aims. The first was to examine the self-reported assessment and intervention practices of community-based Speech Language Pathologists (SLPs) and communicative disorders assistants (CDAs; who provide services under the supervision of a SLP) in supporting preschool children with suspected and diagnosed autism. The second aim was to identify barriers and supports (facilitators) to providing services in the community using the Consolidated Framework for Implementation Research (CFIR) as a framework. METHODS: A cross-sectional online survey was used to collect qualitative and quantitative data from clinicians in Ontario Canada who were providing speech and language services to preschool children with suspected or diagnosed autism. Quantitative data were used to describe clinicians » practices, and qualitative data captured their perspectives on barriers and supports to providing services. RESULTS: A total of 258 clinicians participated in the survey. On average, clinicians reported almost half of the preschoolers on their caseload had either diagnosed or suspected autism. There was consistency across the skill development areas assessed by SLPs, and targeted during therapy sessions, with the top four areas targeted being: foundational social communication, language, play and pragmatics. However, there was wide variation in speech and language assessment and intervention practices reported by this sample of clinicians (i.e., service delivery models, tools or programs used, length and duration of therapy services, level of collaboration with other professionals). Clinicians identified several barriers to providing services: limited funding and time, lack of inter-professional collaboration, difficulty accessing services, community messaging about autism services, family readiness and clinician knowledge. Supports (facilitators) included: access to autism-focused professional development, inter- and intra-professional collaboration, and access to additional supports in the community.

Lien vers le texte intégral (Open Access ou abonnement)

4. Binns AV, Smyth R, Andres A, Lam J, Oram Cardy J. Looking back and moving forward: A scoping review of research on preschool autism interventions in the field of speech-language pathology. Autism & developmental language impairments. 2021; 6: 23969415211033171.

BACKGROUND & AIMS: Speech-language pathology services are frequently accessed by families of children who have suspected or diagnosed autism. This is expected given that social communication differences are a core feature of autism. This review looked broadly at the state of research in the field of speech-language pathology and preschool autism interventions in order to identify the types of studies that could be used to inform the practices of speech-language pathologists (SLPs), and to identify gaps in the field so they can be addressed in future research. Specifically, we examined the extent of research conducted on interventions delivered (at least in part) by SLPs to preschool children with suspected or diagnosed autism, identified the range of skill development areas targeted within the studies, and explored the characteristics of the interventions (i.e., theoretical models underlying the programs, service delivery models, treatment dosage). METHODS: A scoping review of articles published between 1980 and 2019 was conducted using the five phases outlined by the Arksey and O’Malley framework: (a) articulating the research question; (b) identifying relevant studies; (c) selecting studies; (d) charting the data; and (e) collating, summarizing, and reporting the results. MAIN CONTRIBUTION/RESULTS: A total of 114 studies met inclusion criteria with most published since 2010 and conducted within North America. Case study or single-subject study designs were the most frequently used. Interventions delivered solely by SLPs and by multiprofessional teams that included SLPs were relatively equally represented. Across the included studies, nine skill development areas were targeted, but interventions targeting social communication, language, and augmentative communication skills made up the vast majority of studies. There was relatively even distribution of interventions informed by child-centered, clinician-directed, and hybrid models. Explicit information detailing intervention characteristics (e.g., treatment dosage, professional training of clinicians delivering the intervention) was poorly reported in many studies. For those studies providing details, there was a great deal of variability in the nature of interventions (e.g., service delivery models, SLPs’ role, dosage). CONCLUSIONS: This review revealed that research in the area of autism interventions delivered, at least in part, by SLPs has markedly increased over the past 10 years. Still, there remains a need for more research, and greater transparency detailing the nature of the interventions being investigated. The research conducted to date captures the versatility of the SLP’s role within preschool autism intervention. Improved reporting and studies with strong methodological rigor focused on capturing the complex and individualized nature of interventions are needed, as are intervention studies aligned with real-world community practice. IMPLICATIONS: This review provides a comprehensive examination of the status of research on preschool interventions delivered to children with suspected or diagnosed autism within the field of speech-language pathology. Several directions for future research are provided, as are suggestions for improving the clinical applicability of results to further the development of effective, evidence-informed policy and practice in speech-language pathology.

Lien vers le texte intégral (Open Access ou abonnement)

5. Camarata SM. Tensions Between Autistic Sociality, Communication, and Social Skills Research: Utilizing the Communication Bill of Rights to Support Autistic People. Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4351-3.

Lien vers le texte intégral (Open Access ou abonnement)

6. Cohn EG, McVilly KR, Harrison MJ, Stiegler LN. Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism. Autism & developmental language impairments. 2022; 7: 23969415221091928.

BACKGROUND AND AIMS: Echolalia, the repetition of speech, is highly prevalent in school aged children with Autism. Prior research has found that individuals with echolalia use their repetitions to engage in communicatively functional speech, in the absence of self-generated speech. Educators are the natural audience for a wide vary of echoed utterances across environments and in differing contexts. The objectives of this paper were three-fold: (1) to systematically investigate how researchers identify and ascribe communicative function to echoed utterances; (2) to gather and evaluate the evidence that might assist teachers to identify and better understand echoed utterances as being communicatively purposeful; and (3) to provide teachers with evidence-informed response strategies they can use to assist their students on their journey towards more self-generated speech. MAIN CONTRIBUTION: Prior research in the field of echolalia has generally been segmented into opposing viewpoints. A paucity of work in the echolalia field has meant that there is limited work that has sought to view how a communicative function to echolalia has been ascribed from across multiple disciplines and fields. As such, there is limited literature to guide the practice of classroom educators. This review combines communicative models from across various disciplines with the view to supporting classroom educators by providing guidance on how they might assist their students with echolalia. This review represents the first contribution to the research literature in this area. CONCLUSIONS AND IMPLICATIONS: Research into echolalia did not originally emanate from the field of education; however, anecdotes from classroom educators were cited as the primary impetus for the creation of some of the communicatively functional models. We found that although there are many techniques that researchers have used to attribute a communicative function to echolalia, some of these can be easily employed by educators in their practice. By adopting these techniques, educators are placed in a position that may assist with the identification of communicative echolalia; subsequently they are better placed to acknowledge and respond to their students.

Lien vers le texte intégral (Open Access ou abonnement)

7. Delehanty A, Wetherby AM. Coordinated social communication in toddlers with and without autism spectrum disorder during a home observation. Autism & developmental language impairments. 2022; 7: 23969415221121089.

BACKGROUND & AIMS: Social communication and language skills have been found to be important predictors of long-term outcomes in individuals with autism spectrum disorder (ASD). However, the development of coordinated social communication (i.e., gestures and sounds or words) remains relatively understudied in young children with ASD and developmental delays (DD). This study used a prospective, longitudinal design and granular observational coding to document the coordination of gestures, sounds, and words in a large, heterogeneous sample of toddlers identified with ASD, DD, or typical development (TD) during a naturalistic home observation. Specific aims were: (1) to compare rates per minute and proportions of coordinated child communicative acts across groups; (2) to examine concurrent relationships between coordinated communication and measures of social communication and autism symptoms; and (3) to examine prospective relationships between coordinated communication, receptive and expressive language skills, and autism symptoms collected at 3 years of age. METHODS: At a mean age of 20.3 months (SD = 2.0), 211 children (n(ASD) = 121; n(DD) = 46; n(TD) = 44) participated in everyday activities with a parent during an hourlong home observation. Rates per minute and proportions of gestures, sounds and words, as well as temporally overlapping gesture + sound, gesture + word, and gesture + phrase combinations, were compared using one-way ANOVA. Pearson product moment correlations between coordinated communicative acts and measures of social communication, language, and autism symptoms were examined. RESULTS: On average, children with ASD used sounds and gesture + sounds at significantly lower rates than DD and TD groups, who did not differ. Children with ASD and DD coordinated gesture + single words and gesture + phrases at significantly lower rates than the TD group. Groups did not differ with respect to the rate per minute at which they used gestures alone. Children with TD used a smaller proportion of sounds alone and higher proportions of words and phrases, with and without coordinated gestures, than ASD and DD groups. Children with ASD and DD used a significantly higher proportion of gestures alone than children with TD. Rates per minute and proportions of single words and gesture + words had significant correlations with measures of social communication, language skills, and autism symptoms. CONCLUSIONS: Results suggest that a significantly lower rate per minute of sounds and gesture + sound combinations was a distinguishing feature of ASD in our sample. Further, limited use of single words and gesture + single words was observed in children ASD and DD. Significant prospective relationships between single words and gesture + words with language skills measured over a year later underscores the importance of acquiring these forms. IMPLICATIONS: Results support the idea that clinicians should include opportunities to observe and encourage coordinated social communication while screening and assessing young children for DD and ASD in the home environment. The significant associations between rate of single words and gesture + word combinations with language development over a year later have implications for incorporating intervention targets that encourage the use of gesture-speech combinations.

Lien vers le texte intégral (Open Access ou abonnement)

8. Deng X, Zhang J, Liu R, Liu K. Classifying ASD based on time-series fMRI using spatial-temporal transformer. Computers in biology and medicine. 2022; 151(Pt B): 106320.

As the prevalence of autism spectrum disorder (ASD) increases globally, more and more patients need to receive timely diagnosis and treatment to alleviate their suffering. However, the current diagnosis method of ASD still adopts the subjective symptom-based criteria through clinical observation, which is time-consuming and costly. In recent years, functional magnetic resonance imaging (fMRI) neuroimaging techniques have emerged to facilitate the identification of potential biomarkers for diagnosing ASD. In this study, we developed a deep learning framework named spatial-temporal Transformer (ST-Transformer) to distinguish ASD subjects from typical controls based on fMRI data. Specifically, a linear spatial-temporal multi-headed attention unit is proposed to obtain the spatial and temporal representation of fMRI data. Moreover, a Gaussian GAN-based data balancing method is introduced to solve the data unbalance problem in real-world ASD datasets for subtype ASD diagnosis. Our proposed ST-Transformer is evaluated on a large cohort of subjects from two independent datasets (ABIDE I and ABIDE II) and achieves robust accuracies of 71.0% and 70.6%, respectively. Compared with state-of-the-art methods, our results demonstrate competitive performance in ASD diagnosis.

Lien vers le texte intégral (Open Access ou abonnement)

9. Duan L, Liu J, Yin H, Wang W, Liu L, Shen J, Wang Z. Dynamic changes in spatiotemporal transcriptome reveal maternal immune dysregulation of autism spectrum disorder. Computers in biology and medicine. 2022; 151(Pt B): 106334.

Maternal immune activation (MIA) during pregnancy is known to be an environmental risk factor for neurodevelopment and autism spectrum disorder (ASD). However, it is unclear at which fetal brain developmental windows and regions MIA induces ASD-related neurodevelopmental transcriptional abnormalities. The non-chasm differentially expressed genes (DEGs) involved in MIA inducing ASD during fetal brain developmental windows were identified by performing the differential expression analysis and comparing the common DEGs among MIA at four different gestational development windows, ASD with multiple brain regions from human patients and mouse models, and human and mouse embryonic brain developmental trajectory. The gene set and functional enrichment analyses were performing to identify MIA dysregulated ASD-related the fetal neurodevelopmental windows and brain regions and function annotations. Additionally, the networks were constructed using Cytoscape for visualization. MIA at E12.5 and E14.5 increased the risk of distinct brain regions for ASD. MIA-driven transcriptional alterations of non-chasm DEGs, during the coincidence brain developmental windows between human and mice, involving ASD-relevant synaptic components, as well as immune- and metabolism-related functions and pathways. Furthermore, a great number of non-chasm brain development-, immune-, and metabolism-related DEGs were overlapped in at least two existing ASD-associated databases, suggesting that the others could be considered as the candidate targets to construct the model mice for explaining the pathological changes of ASD when environmental factors (MIA) and gene mutation effects co-occur. Overall, our search supported that transcriptome-based MIA dysregulated the brain development-, immune-, and metabolism-related non-chasm DEGs at specific embryonic brain developmental window and region, leading to abnormal embryonic neurodevelopment, to induce the increasing risk of ASD.

Lien vers le texte intégral (Open Access ou abonnement)

10. Eshraghi AA, Memis I, Wang F, White I, Furar E, Mittal J, Moosa M, Atkins CM, Mittal R. Genetic ablation of metabotropic glutamate receptor 5 in rats results in an autism-like behavioral phenotype. PloS one. 2022; 17(11): e0275937.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in communication, and social skills, as well as repetitive and/or restrictive interests and behaviors. The severity of ASD varies from mild to severe, drastically interfering with the quality of life of affected individuals. The current occurrence of ASD in the United States is about 1 in 44 children. The precise pathophysiology of ASD is still unknown, but it is believed that ASD is heterogeneous and can arise due to genetic etiology. Although various genes have been implicated in predisposition to ASD, metabotropic glutamate receptor 5 (mGluR5) is one of the most common downstream targets, which may be involved in autism. mGluR5 signaling has been shown to play a crucial role in neurodevelopment and neural transmission making it a very attractive target for understanding the pathogenesis of ASD. In the present study, we determined the effect of genetic ablation of mGluR5 (Grm5) on an ASD-like phenotype using a rat model to better understand the role of mGluR5 signaling in behavior patterns and clinical manifestations of ASD. We observed that mGluR5 Ko rats exhibited exaggerated self-grooming and increased marble burying, as well as deficits in social novelty. Our results suggest that mGluR5 Ko rats demonstrate an ASD-like phenotype, specifically impaired social interaction as well as repetitive and anxiety-like behavior, which are correlates of behavior symptoms observed in individuals with ASD. The mGluR5 Ko rat model characterized in this study may be explored to understand the molecular mechanisms underlying ASD and for developing effective therapeutic modalities.

Lien vers le texte intégral (Open Access ou abonnement)

11. Garnett R, Davidson B, Eadie P. Parent perceptions of a group telepractice communication intervention for autism. Autism & developmental language impairments. 2022; 7: 23969415211070127.

BACKGROUND & AIMS: Estimates suggest that one in 59 children receive a diagnosis of autism and that early intervention can be effective if applied consistently and intensively. Parent implemented intervention can increase intervention consistency and intensity however, availability of providers, geographical factors, time constraints, and parental stress levels can all act as barriers to service access. Limitations in understanding elements that support family engagement can also impact participation in intervention. Telepractice can increase availability of intervention services and decrease the time and costs associated with face-to-face delivery. Research focused on children with autism has shown that telepractice is acceptable to parents. Despite positive findings for telepractice services with individual clients, limited research has been conducted on telepractice services for parent groups; parent perceptions and preferences regarding intervention; and service delivery methods. This research aimed to investigate parent perceptions of a group intervention programme for autism; the telepractice approach; parent and child outcomes; and parental stress. The purpose of the investigation was to build an understanding of parent’s intervention preferences to inform future service offerings, increase choice, and support participation. METHODS: Eleven parents of preschool children with autism participated in a telepractice delivered group training programme called Hanen More Than Words (HMTW). The intervention is traditionally delivered face to face and teaches strategies to facilitate social-communication development in young children.Quantitative and qualitative measures were used to evaluate parent perceptions of the telepractice HMTW intervention. Data were collected via the Parenting Stress Index, HMTW programme evaluation forms, and online parent survey.Quantitative data was analysed using descriptive statistics. Pre- and post-intervention comparisons of parenting stress were conducted using paired T-Tests. Open comment field responses were analysed qualitatively using a directed content analysis. RESULTS: Parents reported high levels of satisfaction with telepractice delivered HMTW across intervention and post programme evaluations. Interactive learning opportunities, group participation, video coaching, individualisation of service, and programme facilitation were identified as key supports to learning.Parents perceived increased insight into the interaction, learning, and behaviour of themselves and their children. They reported positive changes in strategy implementation and confidence. Parents also perceived improvements in their children’s communication, responsiveness, interaction, and play following intervention. Parental stress measurements from pre- to post intervention, were not significantly different. CONCLUSIONS: Telepractice may reduce service barriers and improve access, particularly with the efficiency of a group delivery approach. Utilising technology to deliver group intervention was acceptable to parents and perceived to have positive outcomes for both parent and child. Further investigation into parent perceptions of intervention types and delivery approaches, could facilitate a broader understanding of family needs with respect to service access and engagement. IMPLICATIONS: Expansion of telepractice offerings can increase efficiencies and service choice for families and providers. Limitations in service availability and barriers to service access and engagement, confirm the importance of pursuing ongoing service improvements and evaluating the preferences of service users. Development of standardised tools to measure and compare parent perceptions across intervention types and service delivery approaches would be beneficial.

Lien vers le texte intégral (Open Access ou abonnement)

12. Granak S, Tuckova K, Kutna V, Vojtechova I, Bajkova L, Petrasek T, Ovsepian SV. Developmental dynamics of the impact of constitutive mTORC1 hyperactivity and environmental enrichment on structural synaptic plasticity and behaviour in a rat model of autism spectrum disorder. The European journal of neuroscience. 2022.

Autism spectrum disorder (ASD) is a neurodevelopmental condition causing a range of social and communication impairments. Although the role of multiple genes and environmental factors has been reported, the impact of the interplay between genes and environment on the onset and progression of the disease remains elusive. We housed wild-type (Tsc2+/+) and tuberous sclerosis 2 deficient (Tsc2+/-) Eker rats (ASD model) in individually ventilated cages or enriched conditions and conducted a series of behavioural tests followed by the histochemical analysis of dendritic spines and plasticity in three age groups (days 45, 90, and 365). The elevated plus-maze test revealed a reduction of anxiety by enrichment, while the mobility of young and adult Eker rats in the open field was lower compared to wild-type. In the social interaction test, an enriched environment reduced social contact in the youngest group and increased anogenital exploration in 90- and 365-day-old rats. Self-grooming was increased by environmental enrichment in young and adult rats and decreased in aged Eker rats. Dendritic spine counts revealed an increased spine density in the cingulate gyrus in adult Ekers irrespective of housing conditions, whereas spine density in hippocampal pyramidal neurons was comparable across all genotypes and groups. Morphometric analysis of dendritic spines revealed age-related changes in spine morphology and density which were responsive to animal genotype and environment. Taken together, our findings suggest that under TSC2 haploinsufficiency and mTORC1 hyperactivity, the expression of behavioural signs and neuroplasticity in Eker rats can be differentially influenced by the developmental stage and environment.

Lien vers le texte intégral (Open Access ou abonnement)

13. Haghighatfard A, Yaghoubi Asl E, Bahadori RA, Aliabadian R, Farhadi M, Mohammadpour F, Tabrizi Z. FOXP2 down expression is associated with executive dysfunctions and electrophysiological abnormalities of brain in Autism spectrum disorder; a neuroimaging genetic study. Autism & developmental language impairments. 2022; 7: 23969415221126391.

BACKGROUND AND AIMS: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by language impairment, and challenges with social interaction, communication, and repetitive behaviors. Although genetics are a primary cause of ASD, the exact genes and molecular mechanisms involved in its pathogenesis are not completely clear. The FOXP2 gene encodes a transcription factor that is known for its major role in language development and severe speech problems. The present study aimed to evaluate the role of FOXP2 in ASD etiology, executive functions, and brain activities. METHODS: In the present study, we recruited 450 children with ASD and 490 neurotypical control children. Three domains of executive functions (working memory, response inhibition, and vigilance) were assessed. In addition, five-minute eyes closed electroencephalography was obtained from some of the children with ASD and neurotypical children. DNA sequence and expression level of FOXP2 in blood samples of children with ASD and the control group were evaluated by using sequencing and Real-time PCR, respectively. RESULTS: The results showed no mutations but a significant down expression of FOXP2 genes in children with ASD vs. neurotypical children. Several cognitive and executive function deficiencies were detected in children with ASD. Low alpha and gamma bands in the frontal lobe and high theta bands in the occipital lobe were revealed in children with ASD. We also found several correlations between FOXP2 expression levels and clinical assessments. CONCLUSIONS: Our finding revealed the down expression of FOXP2, which could be considered as a biomarker for ASD as well as cognitive and executive dysfunction. Based on brain mapping data, FOXP2 may be related to the theta wave abnormality of children with ASD. FOXP2 may be considered a target of novel treatment to improve memory and executive functions. IMPLICATIONS: Our findings highlight the role of FOXP2 mRNA level in ASD etiology, executive functions, and brain wave frequencies.

Lien vers le texte intégral (Open Access ou abonnement)

14. Heyworth M, Brett S, den Houting J, Magiati I, Steward R, Urbanowicz A, Stears M, Pellicano E. « It just fits my needs better »: Autistic students and parents’ experiences of learning from home during the early phase of the COVID-19 pandemic. Autism & developmental language impairments. 2021; 6: 23969415211057681.

BACKGROUND AND AIMS: The COVID-19 pandemic has caused unprecedented disruption to people’s lives, especially for families, whose children have been taken out of schools during lockdown restrictions and required to learn from home. Little is known, however, about the perceived impact of the lockdown restrictions on the educational experiences of autistic children and young people – a group whose conventional schooling experiences are already often challenging. In this study, we sought to (1) understand these experiences from the perspectives of autistic young people and their parents, and (2) identify the underlying sources of positive experiences at this challenging time, in order to inform the ways in which autistic children might flourish at school in more normal times. METHODS: Ninety-one Australian participants, including 16 autistic young people aged 12-18 years, 32 autistic parents and 43 non-autistic parents of autistic young people aged 3-18 years, took part in semi-structured interviews about their experiences of life during the initial phase of the COVID-19 pandemic. The interviews were subjected to reflexive, thematic analysis to identify themes and subthemes for each research question. RESULTS: Overall, our participants initially found the transition to learning from home extremely challenging, with parents reporting that the support received from schools was far from adequate. After that initial period of transition, however, many autistic children reported flourishing at home both educationally and personally. For these children and families, we identified three key ingredients essential to this flourishing, including: (i) the importance of connected, trusting relationships (‘people’); (ii) the sensory and social safety of home (‘place’); and (iii) the flexibility to pace and structure learning to suit the individual child (‘time’). CONCLUSIONS: While the initial COVID-19 lockdown presented many challenges to children learning at home, there were aspects of this otherwise-unsettling situation that enabled children to thrive and from which we can learn for the future. IMPLICATIONS: These findings have important implications for understanding how and when autistic children might thrive in institutional educational settings once the pandemic subsides, focusing on the relationships between teachers and students, the nature of the physical learning environment and the need for greater flexibility in planning the school day.

Lien vers le texte intégral (Open Access ou abonnement)

15. Holyfield C, O’Neill Zimmerman T. A Scoping Review of Research Evaluating Physiological Information for Individuals With Developmental Disabilities: Augmentative and Alternative Communication Research Considerations. Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4306-26.

PURPOSE: Today, an ever-increasing number of technological advancements are becoming mainstream. As the availability of technological innovations increases, so do opportunities for evaluating any benefits of those innovations in augmentative and alternative communication (AAC) research for individuals with developmental disabilities. One innovation that has become mainstream is the use of noninvasive wearable technology to provide physiological information (e.g., heart rate, skin conductance). Such information could be valuable in AAC research, but more information about its potential feasibility and utility is needed. METHOD: A scoping review was conducted to review and report on existing research that has evaluated (a) physiological information as a communication intervention tool for individuals with developmental disabilities and (b) the relationship between physiological information from individuals with developmental disabilities and behavioral and/or environmental information in real time. RESULTS: Results revealed that, while little communication intervention research has been completed, descriptive research demonstrates that physiological information from individuals with developmental disabilities gathered using wearable technology corresponds meaningfully to observable environmental and behavioral events. CONCLUSIONS: Future AAC research incorporating wearable technology to gather physiological information is warranted. Such research could evaluate potential benefits such as preempting challenging behavior with communication opportunities, signaling readiness for language learning, indicating AAC feature preferences, and expanding methodological approaches.

Lien vers le texte intégral (Open Access ou abonnement)

16. Jones R, Zane ER, Grossman RB. Like, it’s important: The frequency and use of the discourse marker like in older autistic children. Autism & developmental language impairments. 2022; 7: 23969415221129132.

BACKGROUND & AIMS: Discourse markers, such as well or like, serve a variety of functions to support conversational reciprocity: filling pauses, aiding word-finding, and modulating turn-taking by holding the conversational floor. Previous research shows that autistic individuals use discourse markers less frequently than non-autistic (NonAu) peers; however, the discourse marker like has not been included in that research, despite its ubiquitous use by NonAu individuals, and despite the fact that like serves important pragmatic functions that are not encoded by any other discourse marker. Specifically, like signals to the listener that the content of upcoming speech is 1) Important/new; 2) Loose/approximate; 3) Reformulative; or 4) Quotative. The current study addresses this gap in the literature by comparing the frequency of discourse marker like use between older autistic and non-autistic children as well as exploring patterns of usage between the four like functions. METHODS: Twenty-one 10-to-17-year-old children on the autism spectrum and 20 NonAu peers-statistically matched on age, sex, IQ and language scores-engaged in a semi-structured interview with a researcher. Uses of discourse-marker like were identified from written transcripts of interviews and each use was categorized into one of the four functions. RESULTS: There were no significant differences in like frequencies between groups, nor were there differences in relative proportions of functions used by each group. CONCLUSIONS: Research consistently indicates that autistic individuals use discourse markers significantly less often than their NonAu counterparts, but the findings from our study suggest that this pattern does not persist to all such markers. This group of older autistic children use like as often as their peers and use it to signify similar information about upcoming speech to their listener.

Lien vers le texte intégral (Open Access ou abonnement)

17. Kawai M, Buck C, Chick CF, Anker L, Talbot L, Schneider L, Linkovski O, Cotto I, Parker-Fong K, Phillips J, Hardan A, Hallmayer J, O’Hara R. Sleep architecture is associated with core symptom severity in autism spectrum disorder. Sleep. 2022.

OBJECTIVE: While caregiver-reported sleep disturbances are common in children and adolescents with autism spectrum disorder (ASD), few studies have measured objective sleep in ASD compared to controls, and their findings are mixed. We investigated 1) differences in sleep architecture, specifically slow-wave sleep (SWS) and rapid eye movement sleep (REM), between ASD and typically developing controls (TD); and 2) if any observed differences in sleep were associated with core ASD symptoms. METHODS: We used ambulatory polysomnography (PSG) in 53 participants with ASD (ages 6 to 18) and 66 age-matched TD in their home sleeping environment. The primary outcome measures were SWS and REM sleep. Core behavioral ASD symptoms were assessed using the Autism Diagnostic Interview-Revised (ADI-R). Spectral power bands during sleep, and additional behavioral measures, were examined in exploratory analyses. RESULTS: Compared to TD, participants with ASD exhibited a higher SWS ratio and lower REM ratio. Within the ASD group, higher SWS was associated with more severe symptoms on the Restricted, Repetitive, and Stereotyped Behaviors subscale of the ADI-R. No association was observed between REM ratio and any ASD symptom. CONCLUSIONS: Increased SWS and reduced REM sleep ratio differentiated ASD from TD. However, only increased SWS was associated with more severe core ASD symptoms. Increased SWS may reflect neuronal immaturity specific to ASD in this age group. These findings may inform the underlying mechanisms of clinical symptoms observed in children and adolescents with ASD.

Lien vers le texte intégral (Open Access ou abonnement)

18. Keates N, Waldock KE, Dewar E. Tensions Between Autistic Sociality, Communication, and Social Skills Research: A Response to Bambara (2022) and Camarata (2022). Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4346-50.

PURPOSE: The purpose of this letter to the editor is to further elucidate the arguments Keates (2022) and Beechey (2022) stated in their letters to the editor. Both Bambara (2022) and Camarata (2022) pose comments that require clarifying the original arguments, particularly regarding power and autistic sociality, which we feel will provide further clarity to this highly significant and growing topic within autism research. CONCLUSION: We recommend teaching not autistic people but rather non-autistic individuals about autistic sociality, in order to lower the burden on autistic interlocutors in cross-neurotype interactions and socialization (as per previous literature, Bottema-Beutel et al., 2018). We provide recommendations to address difficulties in cross-neurotype interactions-for example, bridging the neurotype gap through practice or psychosocial interventions for acceptance of autistic people and their system of interpretation, as per Jones et al. (2021).

Lien vers le texte intégral (Open Access ou abonnement)

19. Kilanko A, Obi-Azuike C, Adaralegbe N, Eze-Njoku C, Urhi A, Agbor C, Ayisire OE, Eche VC, Soomro F, Kaur G, Babalola F, Oyeleye-Adegbite OC, Aladum B, Popoola HA, Anugwom GO. The Correlation Between Autistic Childhood Disorders and the Development of Anxiety and Depression in Adults: A Systematic Review. Cureus. 2022; 14(10): e30093.

Children with autism spectrum disorder significantly suffer from other mental conditions, including anxiety and depression, compared to the general population. This continues to have a significant effect till adulthood. This study aimed at determining if there is a correlation between autism disorder in childhood and the development of anxiety and depression in adulthood and if behavioral therapy for children with this disorder reduces the likelihood of developing anxiety and depression as an adult.  Three major databases were searched: EMBASE, Google Scholar, and PubMed, using specific search terms. Studies were selected according to population, exposure, comparison, condition or outcome(s) of interest, study design, and context. Overall, there are five articles relevant to this systematic review synthesis; all were observational studies. Our study shows psychiatric disorders like anxiety and depression could be related to autism spectrum disorder and early behavioral intervention could be beneficial and reduce the need for anxiety and depression medication.

Lien vers le texte intégral (Open Access ou abonnement)

20. Klaiman C, White S, Richardson S, McQueen E, Walum H, Aoki C, Smith C, Minjarez M, Bernier R, Pedapati E, Bishop S, Ence W, Wainer A, Moriuchi J, Tay SW, Deng Y, Jones W, Gillespie S, Klin A. Expert Clinician Certainty in Diagnosing Autism Spectrum Disorder in 16-30-Month-Olds: A Multi-site Trial Secondary Analysis. Journal of autism and developmental disorders. 2022: 1-16.

Differential diagnosis of young children with suspected autism spectrum disorder (ASD) is challenging, and clinician uncertainty about a child’s diagnosis may contribute to misdiagnosis and subsequent delays in access to early treatment. The current study was designed to replicate and expand a recent report in this Journal (McDonnell et al. in J Autism Dev Disord 49:1391-1401, https://doi.org/10.1080/15374416.2020.1823850 , 2019), in which only 60% of diagnoses were made with complete certainty by clinicians evaluating 478 toddlers and preschool children referred for possible ASD to specialized clinics. In this study, secondary analyses were performed on diagnostic, demographic and clinical data for 496 16-30-month-old children who were consecutive referrals to a 6-site clinical trial executed by specialized centers with experienced clinicians following best-practice procedures for the diagnosis of ASD. Overall, 70.2% of diagnoses were made with complete certainty. The most important factor associated with clinician uncertainty was mid-level autism-related symptomatology. Mid-level verbal age equivalents were also associated with clinician uncertainty, but measures of symptomatology were stronger predictors. None of the socio-demographic variables, including sex of the child, was significantly associated with clinician certainty. Close to one third of early diagnoses of ASD are made with a degree of uncertainty. The delineation of specific ranges on the ADOS-2 most likely to result in clinician uncertainty identified in this study may provide an opportunity to reduce random subjectivity in diagnostic decision-making via calibration of young-child diagnostic thresholds based on later-age longitudinal diagnostic outcome data, and via standardization of decision-making in regard to clinical scenarios frequently encountered by clinicians.

Lien vers le texte intégral (Open Access ou abonnement)

21. Koizumi M, Kojima M. Syntactic development and verbal short-term memory of children with autism spectrum disorders having intellectual disabilities and children with down syndrome. Autism & developmental language impairments. 2022; 7: 23969415221109690.

BACKGROUND AND AIMS: Previous studies suggest that syntactic development in children with intellectual disabilities (ID) is positively correlated with verbal short-term memory (VSTM). This study investigated the characteristics of syntactic development and their relationships of VSTM in children with ID based on type. METHODS: The participants were children with ID (N = 34), including 14 children with autism spectrum disorders (ASD), 20 with Down syndrome (DS), with chronological ages from 8 years 10 months to 18 years 4 months and nonverbal mental ages (MA) of over 4 years, and typically developing (TD) children (N = 21) with chronological ages from 5 years 0 months to 5 years 10 months. They were assessed using VSTM, syntactic comprehension, and expression tasks. RESULTS: The results showed that both the ASD and DS groups performed significantly lower on the syntactic comprehension task and the syntactic expression task than the TD group with the same nonverbal MA in the complex aspect of grammatical structure. In the VSTM task, the ASD group showed significantly lower performance in sentence and story repetition tasks than the TD group of the same nonverbal MA. The DS group showed significantly lower performance in forward digit span, and word, nonword, sentence, and story repetition tasks than the TD group of the same nonverbal MA. CONCLUSIONS: These results suggest that children with ASD have difficulty in understanding and remembering linguistic information with complex semantic structures, and children with DS have a small capacity for VSTM, affecting their syntactic development.

Lien vers le texte intégral (Open Access ou abonnement)

22. Lee NR, McQuaid GA, Grosman HE, Jayaram S, Wallace GL. Vocational Outcomes in ASD: An Examination of Work Readiness Skills as well as Barriers and Facilitators to Employment Identified by Autistic Adults. Journal of autism and developmental disorders. 2022: 1-14.

Little is known about work readiness skills among autistic adults. This study sought to address this by examining work readiness skills and their relation to vocational outcomes among 281 autistic young adults. It also examined perceived barriers and facilitators to employment as articulated by a subset of autistic adults. Results revealed a variegated work readiness profile. Stronger work readiness skills (particularly work style/adaptability) were associated with more favorable vocational outcomes. Autistic participants articulated both barriers and facilitators to employment related to the autism phenotype, job search/work readiness, and workplace education. These findings indicate the need for research on phenotype-driven vocational rehabilitation strategies as well as workplace psychoeducation/accommodations to support vocational outcomes for autistic adults.

Lien vers le texte intégral (Open Access ou abonnement)

23. Lin KR, Wisman Weil L, Thurm A, Lord C, Luyster RJ. Word imageability is associated with expressive vocabulary in children with autism spectrum disorder. Autism & developmental language impairments. 2022; 7: 23969415221085827.

BACKGROUND & AIMS: Throughout typical development, children prioritize different perceptual, social, and linguistic cues to learn words. The earliest acquired words are often those that are perceptually salient and highly imageable. Imageability, the ease in which a word evokes a mental image, is a strong predictor for word age of acquisition in typically developing (TD) children, independent of other lexicosemantic features such as word frequency. However, little is known about the effects of imageability in children with autism spectrum disorder (ASD), who tend to have differences in linguistic processing and delayed language acquisition compared to their TD peers. This study explores the extent to which imageability and word frequency are associated with early noun and verb acquisition in children with ASD. METHODS: Secondary analyses were conducted on previously collected data of 156 children (78 TD, 78 ASD) matched on sex and parent-reported language level. Total expressive vocabulary, as measured by the MacArthur Bates Communicative Development Inventory (MB-CDI), included 123 words (78 nouns, 45 verbs) that overlapped with previously published imageability ratings and word input frequencies. A two-step hierarchical linear regression was used to examine the relationship between word input frequency, imageability, and total expressive vocabulary. An F-test was then used to assess the unique contribution of imageability on total expressive vocabulary when controlling for word input frequency. RESULTS: In both the TD and ASD groups, imageability uniquely explained a portion of the variance in total expressive vocabulary size, independent of word input frequency. Notably, imageability was significantly associated with noun vocabulary and verb vocabulary size alone, with imageability explaining a greater portion of the variance in total nouns produced than in total verbs produced. CONCLUSIONS: Imageability was identified as a significant lexicosemantic feature for describing expressive vocabulary size in children with ASD. Consistent with literature on TD children, children with ASD who have small vocabularies primarily produce words that are highly imageable. Children who are more proficient word learners with larger vocabularies produce words that are less imageable, indicating a potential shift away from reliance on perceptual-based language processing. This was consistent across both noun and verb vocabularies. IMPLICATIONS: Our findings contribute to a growing body of literature describing early word learning in children with ASD and provide a basis for exploring the use of multisensory language learning strategies.

Lien vers le texte intégral (Open Access ou abonnement)

24. Liu M, Ma Z. Correction: A systematic review of telehealth screening, assessment, and diagnosis of autism spectrum disorder. Child and adolescent psychiatry and mental health. 2022; 16(1): 85.

Lien vers le texte intégral (Open Access ou abonnement)

25. Liu T, Schultz BG, Dai D, Liu C, Lense MD. Parent-Child Nonverbal Engagement During Read Versus Sung Book-Sharing in Preschoolers with and without ASD. Psychology of music. 2022; 50(6): 1721-39.

Providing natural opportunities that scaffold interpersonal engagement is important for supporting social interactions for young children with Autism spectrum disorder (ASD). Musical activities are often motivating, familiar, and predictable, and may support both children and their interaction partners by providing opportunities for shared social engagement. We assessed multiple facets of nonverbal social engagement – child and caregiver visual attention and interpersonal movement coordination – during musical (song) and non-musical (picture) book-sharing contexts in caregiver-child dyads of preschoolers with (n = 13) and without (n = 16) ASD. Overall, children with ASD demonstrated reduced visual attention during the book sharing activity, as well as reduced movement coordination with their caregivers, compared to children with typical development. Children in both diagnostic groups, as well as caregivers, demonstrated greater visual attention (gaze toward the activity and/or social partner) during song books compared to picture books. Visual attention behavior was correlated between children and caregivers in the ASD group but only in the song book condition. Findings highlight the importance of considering how musical contexts impact the behavior of both partners in the interaction. Musical activities may support social engagement by modulating the behavior of both children and caregivers.

Lien vers le texte intégral (Open Access ou abonnement)

26. Luyster RJ, Zane E, Wisman Weil L. Conventions for unconventional language: Revisiting a framework for spoken language features in autism. Autism & developmental language impairments. 2022; 7: 23969415221105472.

BACKGROUND AND AIMS: Autism has long been characterized by a range of spoken language features, including, for instance: the tendency to repeat words and phrases, the use of invented words, and « pedantic » language. These observations have been the source of considerable disagreement in both the theoretical and applied realms. Despite persistent professional interest in these language features, there has been little consensus around terminology, definitions and developmental/clinical interpretation. MAIN CONTRIBUTION: This review paper updates and expands an existing framework for unconventional language in autism to include a broader range of non-generative (echolalia and self-repetition) and generative (idiosyncratic phrases, neologisms and pedantic language) features often observed in the language of individuals on the autism spectrum. For each aspect of the framework, we review the various definitions and measurement approaches, and we provide a summary of individual and contextual correlates. We also propose some transitional language features that may bridge non-generative and generative domains (e.g., mitigated echolalia and gestalt language). CONCLUSIONS: This updated framework offers a unified taxonomy and nomenclature that can facilitate further investigation and interpretation of unconventional language in autism. IMPLICATIONS: There are important implications of this work for our understanding of the complex interplay between autism and language development. Equally important are the clinical ramifications that will guide evidence-based practice in assessment and intervention for individuals on the autism spectrum.

Lien vers le texte intégral (Open Access ou abonnement)

27. Mihaylova MS, Bocheva NB, Stefanova MD, Genova BZ, Totev TT, Racheva KI, Shtereva KA, Staykova SN. Visual noise effect on reading in three developmental disorders: ASD, ADHD, and DD. Autism & developmental language impairments. 2022; 7: 23969415221106119.

BACKGROUND AND AIMS: Developmental disorders such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and Developmental Dyslexia (DD) are reported to have more visual problems, oral language difficulties, and diminished reading skills in addition to their different diagnostic features. Moreover, these conditions also have increased internal noise and probably an impaired ability of external noise filtering. The aim of the present study was to compare the reading performance of these groups in the presence of external visual noise which disrupts the automatic reading processes through the degradation of letters. METHODS: Sixty-four children and adolescents in four groups, ASD, ADHD, DD, and TD, participated in the study. Two types of stimuli were used – unrelated words and pseudowords. The noise was generated by exchanging a fixed number of pixels between the black symbols and the white background distorting the letters. The task of the participants was to read aloud the words or pseudowords. The reading time for a single letter string, word or pseudoword, was calculated, and the proportion of errors was assessed in order to describe the reading performance. RESULTS: The results obtained showed that the reading of unrelated words and pseudowords differs in the separate groups of participants and is affected differently by the added visual noise. In the no-noise condition, the group with TD had the shortest time for reading words and short pseudowords, followed by the group with ASD, while their reading of long pseudowords was slightly slower than that of the ASD group. The noise increase evoked variations in the reading of groups with ASD and ADHD, which differed from the no-noise condition and the control group with TD. The lowest proportion of errors was observed in readers with TD. The reading performance of the DD group was the worst at all noise levels, with the most prolonged reading time and the highest proportion of errors. At the highest noise level, the participants from all groups read the words and pseudowords with similar reading speed and accuracy. CONCLUSIONS: In reading words and pseudowords, the ASD, ADHD, and DD groups show difficulties specific for each disorder revealed in a prolonged reading time and a higher proportion of errors. The dissimilarity in reading abilities of the groups with different development is most evident when the accuracy and reading speed are linked together. IMPLICATIONS: The use of noise that degrades the letter structure in the present study allowed us to separate the groups with ASD, ADHD, and DD and disclose specifics in the reading process of each disorder. Error type analysis may provide a basis to improve the educational strategies by appropriately structuring the learning process of children with TD, ASD, ADHD, and DD.

Lien vers le texte intégral (Open Access ou abonnement)

28. Petersson-Bloom L, Holmqvist M. Strategies in supporting inclusive education for autistic students-A systematic review of qualitative research results. Autism & developmental language impairments. 2022; 7: 23969415221123429.

BACKGROUND AND AIM: Strategies to modify and adjust the educational setting in mainstream education for autistic students are under-researched. Hence, this review aims to identify qualitative research results of adaptation and modification strategies to support inclusive education for autistic students at school and classroom levels. METHOD: In this systematic review, four databases were searched. Following the preferred PRISMA approach, 108 studies met the inclusion criteria, and study characteristics were reported. Synthesis of key findings from included studies was conducted to provide a more comprehensive and holistic understanding. MAIN CONTRIBUTION: This article provides insights into a complex area via aggregating findings from qualitative research a comprehensive understanding of the phenomena is presented. The results of the qualitative analysis indicate a focus on teachers’ attitudes and students’ social skills in research. Only 16 studies were at the classroom level, 89 were at the school level, and three studies were not categorized at either classroom or school level. A research gap was identified regarding studies focusing on the perspectives of autistic students, environmental adaptations to meet the students’ sensitivity difficulties, and how to enhance the students’ inclusion regarding content taught and knowledge development from a didactic perspective. CONCLUSIONS AND IMPLICATIONS: Professional development that includes autism-specific understanding and strategies for adjusting and modifying to accommodate autistic students is essential. This conclusion may direct school leaders when implementing professional development programs. A special didactical perspective is needed to support teachers’ understanding of challenges in instruction that autistic students may encounter.

Lien vers le texte intégral (Open Access ou abonnement)

29. Ravaei A, Rubini M. Folate in maternal rheumatoid arthritis-filial autism spectrum disorder continuum. Reproductive toxicology (Elmsford, NY). 2022; 115: 29-35.

Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease that affects women three times more than men. Epidemiological studies found that the incidence of Autism Spectrum Disorder (ASD), a neurological and developmental disorder, in children born to mothers suffering from RA is higher compared with the control population. Considering that the pathogenesis of ASD could be traced back to pregnancy and in uterine conditions, and the evidence of reduced folate levels in the brain of ASD-affected children, we aimed to study the role of folate, as an important nutritional factor during pregnancy, in associating maternal RA to ASD development in the offspring. Folate balance during RA could be influenced twice, initially during the immune activation associated with disease onset, and later during the treatment with anti-folate drugs, with a potential consequence of folate deficiency. Maternal folate deficiency during pregnancy could increase homocysteine levels, oxidative stress, and global DNA hypomethylation, all known risk factors in ASD pathogenesis. These effects could be intensified by genetic polymorphisms in the folate system, which were also found as genetic risk factors for both RA and ASD. The available evidence suggests that folate level as an important factor during RA, pregnancy and ASD could have pathological and therapeutical significance and should be carefully monitored and investigated in the RA-pregnancy-ASD axis.

Lien vers le texte intégral (Open Access ou abonnement)

30. Silver K, Parsons S. Perspectives of autistic adults on the strategies that help or hinder successful conversations. Autism & developmental language impairments. 2022; 7: 23969415221101113.

BACKGROUND & AIMS: There is increasing recognition of the importance of challenging deficit-focused, medical model approaches to supporting autistic people in daily life, however there is a lack of inclusion of autistic perspectives to inform approaches that may empower autistic people in conversations. METHODS: This multiple case study used a participatory approach to explore the conversation experiences and exchange in dyads of five autistic and five non-autistic adults over four to 12 months. The study was grounded in the perspectives of autistic people through a series of semi-structured interviews, observations, reflective conversations, and diary records. RESULTS: The findings focus on autistic participants’ existing knowledge of conversations that they reported could be useful to them, including the communication environment, and type and structure of talk. The study also helped participants to identify and use previously unrecognised metacognitive abilities (what they already knew about conversations) within naturalistic interactive contexts. CONCLUSIONS: These findings provide novel insights as to how the ‘interactional expertise’ of non-autistic people could be strengthened to enable the effective contribution of the voices of autistic people in everyday conversations. IMPLICATIONS: The identification and use of successful conversation strategies identified by autistic adults gave them a greater sense of empowerment within the conversation based on their accounts of their experiences. Understanding these strategies has valuable implications for staff training, for working with families and for learning by autistic adults.

Lien vers le texte intégral (Open Access ou abonnement)

31. Srinivasan S, Patel S, Khade A, Bedi G, Mohite J, Sen A, Poovaiah R. Efficacy of a novel augmentative and alternative communication system in promoting requesting skills in young children with Autism Spectrum Disorder in India: A pilot study. Autism & developmental language impairments. 2022; 7: 23969415221120749.

Background & aims: The study assessed the efficacy of a novel, child-friendly, socio-culturally sensitive, icon-based Augmentative and Alternative Communication (AAC) system called Jellow Communicator, in teaching requesting skills to young children with Autism Spectrum Disorder (ASD) in a special school in Mumbai, India. Jellow is a comprehensive AAC system with a lexicon and pictorial library designed using a participatory, user-centric design process. The content of Jellow has been developed bearing in mind the socio-cultural and linguistic diversity of India. Jellow is available in low-tech (flashcards, booklet) and high-tech (Android and iOS app and desktop application) versions. Methods: The quasi-experimental longitudinal study involved seventeen 3.5-12-year-old children with ASD with communication challenges. Children were taught to use the Jellow AAC system to request for preferred items, as part of their regular speech therapy sessions. Each child received one-on-one training sessions with a licensed speech therapist twice a week over a 3-month duration, with each session lasting around 20-30 min. A systematic training protocol adapted from the original Picture Exchange Communication System (PECS) was developed to train children to use the Jellow system, progressing from flashcards to the app version of Jellow. Behavioral training strategies such as modeling, least-to-most prompting, differential reinforcement, and behavior chain interruption were used to facilitate requesting behaviors. The speech therapist assessed children’s developmental level across multiple domains at pretest and posttest. We coded 3 videos per child, i.e., one early, one mid, and one late training session each, to assess changes in children’s stage of communication, spontaneous requesting abilities, level of attention during training trials, and average time to completion for requesting trials. In addition, caregivers filled out questionnaires to assess training-related changes in children’s adaptive functioning levels as well as the psychosocial impact of the Jellow AAC system on children’s quality of life. Results: Children significantly improved their stage of communication, and a majority of children transitioned from flashcards to using the Jellow app to request for preferred items. Children also increased the proportion of spontaneous requests over the course of training. Caregivers reported a positive perceived psychosocial impact of the Jellow AAC system on their child’s self-esteem, adaptability, and competence. Conclusions: The findings from our pilot study support the use of the novel, socio-culturally adapted, Jellow Communicator AAC system for teaching requesting skills to young children with ASD who use multiple communication modalities. Future studies should replicate our findings with a larger group of participants using a randomized controlled trial design. Implications: This is the first experimental study to systematically assess the effects of an indigenously-developed comprehensive AAC system adapted to the sociocultural and linguistic landscape of India. Our study results provide support for the use of the cost-effective Jellow Communicator AAC system in facilitating requesting skills in children with ASD who use multiple communication modalities. Clinicians can use low-tech and high-tech versions of Jellow to promote communication skills in children with ASD.

Lien vers le texte intégral (Open Access ou abonnement)

32. Stabile M, Eigsti IM. Lexical Alignment and Communicative Success in Autism Spectrum Disorder. Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4300-5.

PURPOSE: Typical speakers tend to adopt words used by their conversational partners. This « lexical alignment » enhances communication by reducing ambiguity and promoting a shared understanding of the topic under discussion. Lexical alignment has been little studied to date in autism spectrum disorder (ASD); furthermore, it has been studied primarily via structured laboratory tasks that may overestimate performance. This study examined lexical alignment in ASD during discourse and explored associations with communicative success and executive function. METHOD: Thirty-one autistic and nonautistic adolescents were paired with a study-naïve research assistant (RA) to complete a social communication task that involved taking turns verbally instructing (guiding) the partner to navigate on a map. Lexical alignment was operationalized as the proportion of shared vocabulary produced by guides on successive maps. Task accuracy was operationalized as the pixels contained within the intended and drawn routes. RESULTS: Results indicated that autistic adolescents had greater difficulty describing navigational routes to RAs, yielding paths that were less accurate. Alignment was reduced in autistic participants, and it was associated with path accuracy for nonautistic, but not autistic, adolescents. The association between lexical alignment and executive function missed significance (p = .05); if significant, the association would indicate that greater executive function difficulty was associated with reduced lexical alignment. CONCLUSIONS: These findings provide preliminary evidence of reduced lexical alignment in ASD in an unstructured discourse context. Moreover, positive associations between lexical alignment and task performance in the neurotypical group raise the possibility that interventions to promote the use of shared vocabulary might support better communication. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21313719.

Lien vers le texte intégral (Open Access ou abonnement)

33. Stenning A. Misfits and ecological saints: strategies for non-normative living in autistic life writing. Disability studies quarterly. 2022; 42(1).

Lien vers le texte intégral (Open Access ou abonnement)

34. Stogios N, Hahn MK, Lunsky Y, Desarkar P, Agarwal SM. Addressing Metabolic Comorbidity in Individuals With Intellectual and Developmental Disability on Antipsychotics: A Clinical Case Series. Journal of clinical psychopharmacology. 2022.

PURPOSE/BACKGROUND: Individuals with intellectual and developmental disabilities (IDDs) are at increased risk for serious metabolic comorbidities, which is further exacerbated by the high rate of antipsychotic use in this population. There is currently a lack of literature on effective treatment options for antipsychotic-induced weight gain and metabolic abnormalities in IDD. This case series reports on the clinical use of metformin in patients with IDD on antipsychotics. METHODS/PROCEDURES: We conducted a retrospective review of patients in a novel clinical service at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada for adults with IDD experiencing antipsychotic-related weight gain and other metabolic aberrations. Charts were reviewed for weight and other metabolic outcome measures before and after commencing metformin treatment. FINDINGS/RESULTS: In 11 patients referred to this clinic, the mean weight loss while on metformin treatment was 11.1 kg, with over 50% of the sample achieving clinically meaningful weight loss of >7%. Additional adaptive changes were observed for fasting glucose, glycated hemoglobin, triglyceride, and high-density lipoprotein cholesterol levels. IMPLICATIONS/CONCLUSIONS: In line with its use in severe mental illness, metformin may be a safe, effective, and accessible treatment option for patients with IDD experiencing metabolic adverse effects of antipsychotic medication. Further research and randomized controlled trials are needed to examine the efficacy of metformin in this population.

Lien vers le texte intégral (Open Access ou abonnement)

35. Sturrock A, Guest H, Hanks G, Bendo G, Plack CJ, Gowen E. Chasing the conversation: Autistic experiences of speech perception. Autism & developmental language impairments. 2022; 7: 23969415221077532.

BACKGROUND AND AIMS: Humans communicate primarily through spoken language and speech perception is a core function of the human auditory system. Among the autistic community, atypical sensory reactivity and social communication difficulties are pervasive, yet the research literature lacks in-depth self-report data on speech perception in this population. The present study aimed to elicit detailed first-person accounts of autistic individuals’ abilities and difficulties perceiving the spoken word. METHODS: Semi-structured interviews were conducted with nine autistic adults. The interview schedule addressed interviewees’ experiences of speech perception, factors influencing those experiences, and responses to those experiences. Resulting interview transcripts underwent thematic analysis. The six-person study team included two autistic researchers, to reduce risk of neurotypical ‘overshadowing’ of autistic voices. RESULTS: Most interviewees reported pronounced difficulties perceiving speech in the presence of competing sounds. They emphasised that such listening difficulties are distinct from social difficulties, though the two can add and interact. Difficulties were of several varieties, ranging from powerful auditory distraction to drowning out of voices by continuous sounds. Contributing factors encompassed not only features of the soundscape but also non-acoustic factors such as multisensory processing and social cognition. Participants also identified compounding factors, such as lack of understanding of listening difficulties. Impacts were diverse and sometimes disabling, affecting socialising, emotions, fatigue, career, and self-image. A wide array of coping mechanisms was described. CONCLUSIONS: The first in-depth qualitative investigation of autistic speech-perception experiences has revealed diverse and widespread listening difficulties. These can combine with other internal, interpersonal, and societal factors to induce profound impacts. Lack of understanding of such listening difficulties – by the self, by communication partners, by institutions, and especially by clinicians – appears to be a crucial exacerbating factor. Many autistic adults have developed coping strategies to lessen speech-perception difficulties or mitigate their effects, and these are generally self-taught due to lack of clinical support. IMPLICATIONS: There is a need for carefully designed, adequately powered confirmatory research to verify, quantify, and disentangle the various forms of listening difficulty, preferably using large samples to explore heterogeneity. More immediate benefit might be obtained through development of self-help and clinical guidance materials, and by raising awareness of autistic listening experiences and needs, among the autistic community, communication partners, institutions, and clinicians.

Lien vers le texte intégral (Open Access ou abonnement)

36. Tevis C, Matson JL, Callahan M. Developmental Functioning of Toddlers At-Risk for Autism With and Without Down Syndrome. Developmental neurorehabilitation. 2022: 1-9.

PURPOSE: Due to the difficulties in differentiating between impairments associated with intellectual disability and ASD symptomology, DS often leads to delayed or misdiagnoses of ASD. METHOD: An ANOVA was run to investigate the effects of ASD risk and DS on overall developmental functioning across three groups: ASD+, DS-, and DS+ (n = 138). A MANOVA was run to investigate the differences of group on five developmental subdomains. RESULTS: The results revealed significant group differences in the overall developmental functioning and each developmental subdomain. Children in the DS+ group demonstrated significantly lower overall developmental functioning, as well as lower adaptive, cognitive, motor, and communication skills compared to their peers; however, children in the DS- group demonstrated significantly better social skills compared to their peers in the ASD+ group. DISCUSSION: These findings support the need for early screening and identification of ASD among those with DS.

Lien vers le texte intégral (Open Access ou abonnement)

37. Uddin MN, Manley K, Lawrence DA. Altered meningeal immunity contributing to the autism-like behavior of BTBR T (+) Itpr3 (tf) /J mice. Brain, behavior, & immunity – health. 2022; 26: 100563.

Autism spectrum disorder (ASD) is a complicated neurodevelopmental disorder, which is categorized by deficiency of social contact and communication, and stereotyped forms of performance. Meningeal immunity conditions the immune reflection and immune defense in the meningeal area involving meningeal lymphatic organization, glymphatic structure, immune cells, and cytokines. The development of meningeal immunity dysfunction might be the leading cause for many neural diseases including ASD. The inbred mouse strain BTBRT + Itpr3tf/J (BTBR) shows multiple ASD-like behavioral phenotypes, thus making this strain a widely used animal model for ASD. In our previous study, we reported an altered peripheral immune profile in BTBR mice. Herein, we are investigating immunological and neural interactions associated with the aberrant behavior of BTBR mice. BTBR mice have an increased level of immune cell deposition in the meninges along with a higher level of CD4(+) T cells expressing CD25 and of B and myeloid cells expressing more MHCII than C57BL/6 (B6) mice, which have normal behaviors. BTBR mice also have higher levels of autoantibodies to dsDNA, Aquaporin-4, NMDAR1, Pentraxin/SAP and Caspr2 than B6 mice, which may affect neural functions. Interestingly, the T regulatory (Treg) cell population and their function was significantly reduced in the meninges and brain draining lymph nodes, which may explain the increased level of activated B and T cells in the meninges of BTBR mice. A low level of Treg cells, less IL-10 production by Treg, and activated T and B cells in meninges together with higher autoantibody levels might contribute to the development of autism-like behavior through neuroinflammation, which is known to be increased in BTBR mice.

Lien vers le texte intégral (Open Access ou abonnement)

38. Venker CE, Neumann D, Aladé F. Visual perceptual salience and novel referent selection in children with and without autism spectrum disorder. Autism & developmental language impairments. 2022; 7: 23969415221085476.

BACKGROUND & AIMS: Many young children with autism spectrum disorder (ASD) demonstrate striking delays in early vocabulary development. Experimental studies that teach the meanings of novel nonwords can determine the effects of linguistic and attentional factors. One factor that may affect novel referent selection in children with ASD is visual perceptual salience-how interesting (i.e., striking) stimuli are on the basis of their visual properties. The goal of the current study was to determine how the perceptual salience of objects affected novel referent selection in children with ASD and children who are typically developing (TD) of similar ages (mean age 3-4 years). METHODS: Using a screen-based experimental paradigm, children were taught the names of four unfamiliar objects: two high-salience objects and two low-salience objects. Their comprehension of the novel words was assessed in low-difficulty and high-difficulty trials. Gaze location was determined from video by trained research assistants. RESULTS: Contrary to initial predictions, findings indicated that high perceptual salience disrupted novel referent selection in the children with ASD but facilitated attention to the target object in age-matched TD peers. The children with ASD showed no significant evidence of successful novel referent selection in the high-difficulty trials. Exploratory reaction time analyses suggested that the children with autism showed « stickier » attention-had more difficulty disengaging (i.e., looking away)-from high-salience distracter images than low-salience distracter images, even though the two images were balanced in salience for any given test trial. CONCLUSIONS AND CLINICAL IMPLICATIONS: These findings add to growing evidence that high perceptual salience has the potential to disrupt novel referent selection in children with ASD. These results underscore the complexity of novel referent selection and highlight the importance of taking the immediate testing context into account. In particular, it is important to acknowledge that screen-based assessments and screen-based learning activities used with children with ASD are not immune to the effects of lower level visual features, such as perceptual salience.

Lien vers le texte intégral (Open Access ou abonnement)

39. Yamamoto SH, Alverson CY. From high school to postsecondary education, training, and employment: Predicting outcomes for young adults with autism spectrum disorder. Autism & developmental language impairments. 2022; 7: 23969415221095019.

BACKGROUND AND AIMS: The fastest growing group of students with disabilities are those with Autism Spectrum Disorder (ASD). States annually report on post-high school outcomes (PSO) of exited students. This study sought to fill two gaps in the literature related to PSO for exited high-school students with ASD and the use of state data and predictive modeling. METHODS: Data from two states were analyzed using two predictive analytics (PA) methods: multilevel logistic regression and machine learning. The receiver operating characteristic curve (ROC) analysis was used to assess predictive performance. RESULTS: Data analyses produced two results. One, the strongest predictor of PSO for exited students with ASD was graduating from high school. Two, machine learning performed better than multilevel logistic regression in predicting PSO engagement across the two states. CONCLUSION: This study contributed two new and important findings to the literature: (a) PA models should be applied to state PSO data because they produce useful information, and (b) PA models are accurate and reliable over time. IMPLICATIONS: These findings can be used to support state and local educators to make decisions about policies, programs, and practices for exited high school students with ASD, to help them successfully transition to adult life.

Lien vers le texte intégral (Open Access ou abonnement)

40. Yen TL, Huang TN, Lin MH, Hsu TT, Lu MH, Shih PY, Ellegood J, Lerch J, Hsueh YP. Sex bias in social deficits, neural circuits and nutrient demand in Cttnbp2 autism models. Brain : a journal of neurology. 2022.

Autism spectrum disorders caused by both genetic and environmental factors are strongly male-biased neuropsychiatric conditions. However, the mechanism underlying the sex bias of autism spectrum disorders remains elusive. Here, we use a mouse model in which the autism-linked gene Cttnbp2 is mutated to explore the potential mechanism underlying the autism sex bias. Autism-like features of Cttnbp2 mutant mice were assessed via behavioral assays. C-FOS staining identified sex-biased brain regions critical to social interaction, with their roles and connectivity then validated by chemogenetic manipulation. Proteomic and bioinformatic analyses established sex-biased molecular deficits at synapses, prompting our hypothesis that male-biased nutrient demand magnifies Cttnbp2 deficiency. Accordingly, intakes of branched-chain amino acids (BCAA) and zinc were experimentally altered to assess their effect on autism-like behaviors. Both deletion and autism-linked mutation of Cttnbp2 result in male-biased social deficits. Seven brain regions, including the infralimbic area of the medial prefrontal cortex (ILA), exhibit reduced neural activity in male mutant mice but not in females upon social stimulation. ILA activation by chemogenetic manipulation is sufficient to activate four of those brain regions susceptible to Cttnbp2 deficiency and consequently to ameliorate social deficits in male mice, implying an ILA-regulated neural circuit is critical to male-biased social deficits. Proteomics analysis reveals male-specific downregulated proteins (including SHANK2 and PSD-95, two synaptic zinc-binding proteins) and female-specific upregulated proteins (including RRAGC) linked to neuropsychiatric disorders, which are likely relevant to male-biased deficits and a female protective effect observed in Cttnbp2 mutant mice. Notably, RRAGC is an upstream regulator of mTOR that senses branched-chain amino acids (BCAA), suggesting that mTOR exerts a beneficial effect on females. Indeed, increased BCAA intake activates the mTOR pathway and rescues neuronal responses and social behaviors of male Cttnbp2 mutant mice. Moreover, mutant males exhibit greatly increased zinc demand to display normal social behaviors. Mice carrying an autism-linked Cttnbp2 mutation exhibit male-biased social deficits linked to specific brain regions, differential synaptic proteomes and higher demand for BCAA and zinc. We postulate that lower demand for zinc and BCAA are relevant to the female protective effect. Our study reveals a mechanism underlying sex-biased social defects and also suggests a potential therapeutic approach for autism spectrum disorders.

Lien vers le texte intégral (Open Access ou abonnement)

41. Zaydlin M, Cara VM, Bez Y, Coffey BJ. Difficult-to-Treat Aggression in a Child with Autism Spectrum Disorder: Did We Miss Something? Bipolar Disorder As a Comorbid Psychiatric Condition in Autism Spectrum Disorder. Journal of child and adolescent psychopharmacology. 2022; 32(9): 500-4.

Lien vers le texte intégral (Open Access ou abonnement)

42. Zhuang Q, Zheng X, Yao S, Zhao W, Becker B, Xu X, Kendrick KM. Oral Administration of Oxytocin, Like Intranasal Administration, Decreases Top-Down Social Attention. The international journal of neuropsychopharmacology. 2022; 25(11): 912-23.

BACKGROUND: The neuropeptide oxytocin (OXT) modulates social cognition by increasing attention to social cues and may have therapeutic potential for impaired social attention in conditions such as autism spectrum disorder. Intranasal administration of OXT is widely used to examine the drug’s functional effects in both adults and children and is assumed to enter the brain directly via this route. However, OXT can also influence brain function through increased blood concentrations, and we have recently shown that orally (lingual) administered OXT also modulates neural responses to emotional faces and may be better tolerated for therapeutic use. Here, we examine whether 24 IU OXT administered orally can facilitate social attention. METHODS: In a randomized, placebo-controlled pharmacologic study, we used a validated emotional antisaccade eye-tracking paradigm to explore the effects of oral OXT on bottom-up and top-down attention processing in 80 healthy male participants. RESULTS: Our findings showed that in terms of top-down attention, oral OXT increased errors for both social (angry, fearful, happy, sad, and neutral emotion faces) and nonsocial stimuli (oval shapes) in the antisaccade condition but increased response latencies only in the social condition. It also significantly reduced post-task state anxiety, but this reduction was not correlated with task performance. A comparison with our previous intranasal OXT study using the same task revealed that both routes have a similar effect on increasing antisaccade errors and response latencies and on reducing state anxiety. CONCLUSIONS: Overall, our findings suggest that oral administration of OXT produces similar effects on top-down social attention control and anxiety to intranasal administration and may therefore have therapeutic utility.

Lien vers le texte intégral (Open Access ou abonnement)