1. Afsharnejad B, Whitehorne Smith P, Bölte S, Milbourn B, Girdler S. A Systematic Review of Implicit Versus Explicit Social Skills Group Programs in Different Settings for School-Aged Autistic Children and Adolescents. J Autism Dev Disord. 2024.

This systematic review and meta-analysis aimed to identify and evaluate the quality of randomised controlled trials (RCTs), assessing the efficacy of Social Skills Group Programs (SSGPs) for primary and secondary school aged autistic children and adolescents exploring the influence of informant, setting characteristics and teaching strategies as moderating factors for social outcomes. A search of the electronic databases of Medline, ProQuest, CINAHL, Scopus, and Web of Sciences electronic databases was conducted for the period January 1, 2013 until December 31, 2023 for peer-reviewed RCT studies published in English, evaluating the efficacy of SSGPs for school-aged autistic children and adolescents (6-18 years). Included studies were assessed for methodological quality and efficacy using random effect meta-analysis. Informant analysis and moderator analyses were also conducted investigating the influence of informant, setting characteristics and teaching strategy utilised in the SSGPs on the participants social outcomes. Sixty-five studies were included in the systematic review with 49 studies included in the meta-analysis. Although most studies had strong or good methodological quality, a high possibility of publication bias was detected in the meta-analysis. After statistical adjustments for publication bias were made, findings revealed that SSGPs had no effect on the overall outcomes assessed by included studies on school-aged autistic children and adolescents. However, informant analysis revealed small effects reported by self-report, parent-proxy and researchers. Teaching strategies and setting characteristics were not significant moderators for the efficacy of SSGPs on the social outcomes of autistic children and adolescents. This review highlights the need for improvements in measurement frameworks for assessing social skills in autistic children and adolescents.

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2. Ayoub G. Neurodevelopment of Autism: Critical Periods, Stress and Nutrition. Cells. 2024; 13(23).

Autism spectrum disorder (ASD) is a neurodevelopmental disability that presents significant challenges in communication and behavior. ASD prevalence exceeds 2% among eight-year-old children and is at similar levels globally. We propose that critical periods during fetal development and early postnatal years establish the conditions for either neurotypical development or the emergence of autism through mechanisms that influence immune function or delay neuronal development. One critical period is characterized by the requirement for folate, a crucial methyl donor needed for DNA regulation. Insufficient folate availability has been linked to the risk of developing ASD. Another critical period may be affected by oxidative stress or inflammation of the fetal brain, potentially due to inadequate microglial immunity, which can lead to CNS inflammatory changes that disrupt typical neurodevelopment. We suggest that early supplementation with reduced folate and taurine during both the fetal and postnatal stages may be effective in mitigating the severity of ASD symptoms by promoting neurotypical development through these critical neurodevelopmental periods.

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3. Bahji A, Forth E, Nasar A, Waqas A, Hawken ER, Ayub M. Navigating agitation in neurodevelopmental disorders: A comparative study of pharmacotherapies via network meta-analysis in children and adults with autism spectrum disorder or intellectual disabilities. J Psychopharmacol. 2024: 2698811241303654.

IMPORTANCE: Individuals with autism spectrum disorder (ASD) and intellectual disability often experience persistent challenges related to aggressive behaviour and agitation, highlighting the critical need for evidence-based pharmacological interventions among other strategies. Despite previous network meta-analyses (NMAs), the rapidly evolving landscape of treatment options necessitates ongoing and updated assessments. OBJECTIVE: To evaluate the efficacy and tolerability of various pharmacotherapies in managing agitation in children and adults with ASD or intellectual disabilities (ID). METHODS: Employing a systematic review and network meta-analysis methodology, we conducted an exhaustive search across multiple databases for double-blind, randomized controlled trials focusing on pharmacotherapies targeting agitation in these neurodevelopmental disorders. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, our assessment of study quality utilized the Cochrane Risk of Bias Tool to ensure methodological rigour and accuracy in data synthesis. Primary outcomes encompassed measures of reduced agitation, as indicated by treatment response on standardized agitation scales, alongside dropout rates, providing a comprehensive overview of treatment efficacy and tolerability. RESULTS: Our analysis included data from 38 eligible trials, involving 2503 participants across both pediatric and adult populations. Key pharmacological interventions, such as arbaclofen, risperidone plus buspirone, omega-3 fatty acids, risperidone plus palmitoylethanolamide, aripiprazole and risperidone, demonstrated significant efficacy in reducing agitation compared to placebo. Importantly, these treatments were generally well-tolerated, with no significant increase in all-cause dropouts compared to placebo, highlighting their suitability for clinical use in managing agitation in individuals with ASD or ID. CONCLUSIONS: This study underscores the efficacy and tolerability of several pharmacotherapies in managing agitation among children and adults with ASD or ID. Our findings provide robust evidence that specific treatments, such as arbaclofen, risperidone plus buspirone and omega-3 fatty acids, are both effective and well-tolerated, offering valuable therapeutic options for clinicians. The study emphasizes the need for ongoing research to ensure that treatment strategies remain aligned with the evolving clinical landscape, ultimately improving patient outcomes in this challenging population.

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4. Balbuena Madera MA, Garcia Garcia JF, Vargas Cruz A, Aquino Bruno H, González Jasso JG. Paradoxical Infarction? Inferior STEMI With Unexpected Discovery of ASD in an Oncology Patient: A Case of Combined Percutaneous Intervention. Clin Case Rep. 2024; 12(12): e9569.

This case report explores the management of a 56-year-old female oncology patient presenting with acute ST-elevation myocardial infarction (STEMI) and an incidental atrial septal defect (ASD). The patient, with a history of rectal cancer and hypothyroidism, experienced acute chest pain and dyspnea. She was diagnosed with an inferior STEMI and underwent percutaneous coronary intervention (PCI) with the placement of three medicated stents in the right coronary artery. During hospitalization, an echocardiogram revealed a significant ostium secundum ASD. Angiography indicated thrombi, suggesting a potential paradoxical embolism. Percutaneous ASD closure was performed during the same hospital stay, leading to a favorable clinical course without immediate complications. This case highlights the importance of a multidisciplinary approach and comprehensive evaluation in managing complex cardiovascular conditions, particularly in patients with increased thrombotic risk due to malignancy.

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5. Colonnese F, Di Luzio F, Rosato A, Panella M. Enhancing Autism Detection Through Gaze Analysis Using Eye Tracking Sensors and Data Attribution with Distillation in Deep Neural Networks. Sensors (Basel). 2024; 24(23).

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and repetitive behaviors, often associated with atypical visual attention patterns. In this paper, the Gaze-Based Autism Classifier (GBAC) is proposed, which is a Deep Neural Network model that leverages both data distillation and data attribution techniques to enhance ASD classification accuracy and explainability. Using data sampled by eye tracking sensors, the model identifies unique gaze behaviors linked to ASD and applies an explainability technique called TracIn for data attribution by computing self-influence scores to filter out noisy or anomalous training samples. This refinement process significantly improves both accuracy and computational efficiency, achieving a test accuracy of 94.35% while using only 77% of the dataset, showing that the proposed GBAC outperforms the same model trained on the full dataset and random sample reductions, as well as the benchmarks. Additionally, the data attribution analysis provides insights into the most influential training examples, offering a deeper understanding of how gaze patterns correlate with ASD-specific characteristics. These results underscore the potential of integrating explainable artificial intelligence into neurodevelopmental disorder diagnostics, advancing clinical research by providing deeper insights into the visual attention patterns associated with ASD.

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6. Cominelli G, Lonati C, Pinto D, Rinaldi F, Franco C, Favero G, Rezzani R. Melatonin Attenuates Ferritinophagy/Ferroptosis by Acting on Autophagy in the Liver of an Autistic Mouse Model BTBR T(+)Itpr3(tf)/J. Int J Mol Sci. 2024; 25(23).

Autism spectrum disorders (ASDs) are a pool of neurodevelopment disorders in which social impairment is the main symptom. Presently, there are no definitive medications to cure the symptoms but the therapeutic strategies that are taken ameliorate them. The purpose of this study was to investigate the effects of melatonin (MLT) in treating ASDs using an autistic mouse model BTBR T(+)Itpr3(tf)/J (BTBR). We evaluated the hepatic cytoarchitecture and some markers of autophagy, ferritinophagy/ferroptosis, in BTBR mice treated and not-treated with MLT. The hepatic morphology and the autophagy and ferritinophagy/ferroptosis pathways were analyzed by histological, immunohistochemical, and Western blotting techniques. We studied p62 and microtubule-associated protein 1 light chain 3 B (LC3B) for evaluating the autophagy; nuclear receptor co-activator 4 (NCOA4) and long-chain-coenzyme synthase (ACSL4) for monitoring ferritinophagy/ferroptosis. The liver of BTBR mice revealed that the hepatocytes showed many cytoplasmic inclusions recognized as Mallory-Denk bodies (MDBs); the expression and levels of p62 and LC3B were downregulated, whereas ACSL4 and NCOA4 were upregulated, as compared to control animals. MLT administration to BTBR mice ameliorated liver damage and reduced the impairment of autophagy and ferritinophagy/ferroptosis. In conclusion, we observed that MLT alleviates liver damage in BTBR mice by improving the degradation of intracellular MDBs, promoting autophagy, and suppressing ferritinophagy/ferroptosis.

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7. Conine DE, Dumas LA, Collum SA, Wilson LN, Gayman CM, Keller CE, Marya V. Evaluating a screening-to-intervention model with caregiver training for response to name among children with autism. J Appl Behav Anal. 2024.

Among the developmental milestones related to language and communication in early childhood, one that has been the subject of considerable research is response to name (RTN). Delayed or absent RTN in early childhood is a diagnostic marker for autism spectrum disorder and a target behavior in many early intervention curricula. This article describes two related studies. Study 1 evaluated the efficacy and efficiency of a behavioral screening-to-intervention model for RTN proposed by recent research. Overall, trials to mastery were reduced relative to previous research. Study 2 evaluated the efficacy of using behavioral skills training to teach caregivers to implement a RTN intervention with their child after that intervention was successful in a clinical setting. Generalized improvements in RTN with caregivers sometimes occurred but did not maintain without programmed reinforcement. Subsequent behavioral skills training was associated with increases in both child RTN and caregiver intervention fidelity.

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8. Costescu C, Tufar I, Chezan L, Șogor M, Confederat A. Assessing technology usage in relation to the quality of life of autistic children. Digit Health. 2024; 10: 20552076241304885.

OBJECTIVE: The aim of this study was to investigate the frequency and duration of technology use by autistic children, their primary activities when engaging with technology, and the association between technology use and quality of life. We assumed that technology serves as a means of communication with peers, and it is associated with an improved quality of life. METHODS: The study sample consisted of 61 parents of autistic children aged 5-10 years old. The Quality of Life for Children with Autism Spectrum Disorder Scale was used to measure children’s quality of life based on parent report, and the Technology Use Scale was used to measure the amount of time spent using technology and its purpose. Data collected were analyzed to identify correlations between technology use and quality of life. RESULTS: Findings indicate that autistic children primarily use technology for relaxation purposes and a smaller proportion of children in the sample used technology for socialization. A positive correlation was found between technology use for social interactions and higher parental perceptions of quality of life. These findings suggest that while social use of technology is less frequent, it is associated with improved well-being. CONCLUSIONS: We concluded that technology use among autistic children is predominantly for leisure activities; however, when used for socialization, it is linked to a better perceived quality of life. Future research should further explore the specific benefits and potential risks of technology use for communication and socialization in autistic children. Additionally, the efficacy of technology-based interventions in improving social skills and overall well-being should be evaluated.

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9. Davis AM, Smith E, Yang X, Wright R. Exploring Racial Discrimination, Disability Discrimination, and Perception of the Future Among Black-Identifying Emerging Adults with and without Autism in the United States: A Mixed-Methods Descriptive Study. J Child Adolesc Trauma. 2024; 17(4): 1019-34.

Discrimination experienced by Black emerging adults with autism is rarely studied nor have their experiences been juxtaposed to Black emerging adults without autism. A mixed methods descriptive approach was used to describe responses to open-ended questions collected as part of a larger study of discrimination experienced by Black emerging adults with autism (n = 14) and Black emerging adults without autism (n = 20). Questions focused around racial discrimination, disability discrimination, and perception of the future. Qualitative and quantitative content analysis were applied. Qualitatively- a manifest approach was used, and quantitatively- frequency counts and ratios were identified within themes and subthemes. Four main themes and twelve subthemes were identified. Racial discrimination had two themes: 1) Impact on mental health, and 2) Societal threats, with five subthemes, each reported at higher rates by people without autism (Theme 1 = 5:7, Theme 2 = 3:11). Disability discrimination was only reported on by those with autism, and had one main theme of neurodiverse/autism bias, and three subthemes. Perception of the future contained the theme of emerging life hopes, with four subthemes. Subthemes relating to work/career/family and future unknown were reported more highly by those without autism than with autism (1:8 and 4:7 respectively), while subthemes describing diverse or unique priorities for fulfillment and mental wellness were reported only by those with autism (6:0 and 4:0 respectively). Study findings suggest unique experiences and needs among Black emerging adults with autism, as well as the consequences of anti-blackness and anti-ableism/neurobigotry which can have double impact in their lives, spanning different ages and stages. Results have implications for building resiliency among Black persons with autism and without autism as they transition to adulthood.

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10. Deoki A, Knapp VM. Teaching an Adult with ASD Independent Toileting Skills. Healthcare (Basel). 2024; 12(23).

Background: Independence with the toilet is an important life skill. Individuals with Autism Spectrum Disorder (ASD) may present with several deficits that impair their ability to independently use the toilet and often individuals with ASD require more support than is provided in typical toilet training methods, including behavioral toilet training methods. This current study is a demonstration of the use of an intensive toilet training procedure with one eighteen-year-old adult male with ASD and below-average levels of adaptive functioning to successfully void in the toilet and reduce accidents. Methods: A package of behavioral toilet training procedures was implemented for 11 weeks in a school setting. This package included intensive toilet training, a urine alarm, a toileting schedule, verbal praise, edible reinforcement, and dry pants checks. School staff were trained to implement this procedure with behavioral skills training (BST). Results: Intensive toilet training was effective in eliminating the number of accidents while increasing the number of successes, thus increasing his independence with toileting. Conclusions: Increasing independence with toileting is an important life skill and can increase the likelihood that an individual would be accepted by an adult services placement.

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11. Drehmer I, Santos-Terra J, Gottfried C, Deckmann I. mTOR signaling pathway as a pathophysiologic mechanism in preclinical models of autism spectrum disorder. Neuroscience. 2024; 563: 33-42.

Autism spectrum disorder (ASD) is a highly prevalent multifactorial disorder characterized by social deficits and stereotypies. Despite extensive research efforts, the etiology of ASD remains poorly understood. However, studies using preclinical models have identified the mechanistic target of rapamycin kinase (mTOR) signaling pathway as a key player in ASD-related features. This review examines genetic and environmental models of ASD, focusing on their association with the mTOR pathway. We organize findings on alterations within this pathway, providing insights about the potential mechanisms involved in the onset and maintenance of ASD symptoms. Our analysis highlights the central role of mTOR hyperactivation in disrupting autophagic processes, neural organization, and neurotransmitter pathways, which collectively contribute to ASD phenotypes. The review also discusses the therapeutic potential of mTOR pathway inhibitors, such as rapamycin, in mitigating ASD characteristics. These insights underscore the importance of the mTOR pathway as a target for future research and therapeutic intervention in ASD. This review innovates by bringing the convergence of disrupted mTOR signaling in preclinical models and clinical data associated with ASD.

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12. Eliassen AH. Stigma, Stereotypes, and Self-Disclosure: Disability and Empowerment in Older Adults on the Autism Spectrum. Gerontologist. 2024.

Older adults on the autism spectrum exhibit a broad array of strengths and limitations. While exceptional abilities may be masked by difficulties in presentation and communication, hidden disabilities can lead to unmet needs for accommodation and support. Critical to the recognition of disabilities is subjects’ readiness to disclose potentially stigmatizing conditions or concerns-weighing the benefits of self-disclosure (e.g., for effective medical care) versus risks (exposure of weaknesses or vulnerabilities). Strategic self-disclosure, based on reading of immediate social contexts, can be problematic for autistic persons who have difficulty processing social cues demarcating situationally appropriate boundaries. Disclosure of autism by older patients in clinical settings can lead to troubled interactions that reinforce stereotypes of aging conflated with disability and educe implicit biases regarding older patients and autistic persons. Future gerontological research and policy initiatives should be designed to empower older autistic adults (and others with lived experience of disability and marginalization) by including them as expert partners in the quest for needed societal change-challenging ableist assumptions embedded in traditional definitions of successful aging, promoting an open awareness context that normalizes the occurrence of disability, and fostering expectations of interdependence (as opposed to helpless dependency or complete independence).

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13. Farmer AL, Febo M, Wilkes BJ, Lewis MH. Environmental Enrichment Attenuates Repetitive Behavior and Alters the Functional Connectivity of Pain and Sensory Pathways in C58 Mice. Cells. 2024; 13(23).

Restricted repetitive behaviors (RRB) encompass a variety of inflexible behaviors, which are diagnostic for autism spectrum disorder (ASD). Despite being requisite diagnostic criteria, the neurocircuitry of these behaviors remains poorly understood, limiting treatment development. Studies in translational animal models show environmental enrichment (EE) reduces the expression of RRB, although the underlying mechanisms are largely unknown. This study used functional magnetic resonance imaging to identify functional connectivity alterations associated with RRB and its attenuation by EE in C58 mice, an animal model of RRB. Extensive differences were observed between C58 mice and C57BL/6 control mice. Higher RRB was associated with altered connectivity between the somatosensory network and reticular thalamic nucleus and between striatal and sensory processing regions. Animals housed in EE displayed increased connectivity between the somatosensory network and the anterior pretectal nucleus and hippocampus, as well as reduced connectivity between the visual network and area prostriata. These results suggest aberrant sensory perception is associated with RRB in C58 mice. EE may reduce RRB by altering functional connectivity in pain and visual networks. This study raises questions about the role of sensory processing and pain in RRB development and identifies new potential intervention targets.

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14. Ferguson EF, Russell KM, Licona SJ, Cai RY, Frazier TW, Vivanti G, Gengoux GW, Hardan AY, Uljarević M. Toward improved understanding and treatment of self-injurious behaviors in autistic individuals with profound intellectual disability. Autism Res. 2024.

Self-injurious behaviors (SIB) commonly occur in autism spectrum disorder (ASD) and span diverse topographies of self-inflicted behaviors ranging from head banging to hitting oneself against hard objects. Despite the high rates of SIB in autistic individuals, relatively little research has focused on psychological factors associated with the development and maintenance of SIB in individuals with autism and moderate-profound intellectual disability (ID). This commentary synthesizes existing literature on SIB and highlights the need for more research focused on psychological correlates and mechanisms in autistic individuals with moderate-profound ID. We highlight the key role of difficulties in emotion regulation (ER) and co-occurring internalizing symptoms in the manifestation of self-harm behaviors in clinical samples and autism. Furthermore, this commentary proposes a framework for understanding the interplay between poor ER and internalizing symptoms in the development and maintenance of SIB in autistic individuals with moderate-profound ID. Specifically, we explore the emergence of SIB in the context of precipitating cues that trigger strong emotions, ER processes and strategy deployment, and co-occurring internalizing symptoms. Future directions and implications for longitudinal research, measurement development, and clinical treatments are discussed.

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15. Fink E, Friedman S, Olthof T, van der Meijden S, Goossens F, Begeer S. Exploring the Interpersonal Goals of Autistic and Neurotypical Adolescents Who Bully Others. J Autism Dev Disord. 2024.

The current study examined the association between interpersonal social goals (i.e., agentic and communal goals) and bullying behaviour for autistic adolescents (n = 108, M(age) = 15.25 years, SD = 1.65) and neurotypical adolescents (n = 592, M(age) = 13 years, SD = 0.5). Bullying behaviour was assessed using both self- and peer-reported measures. Agentic and communal social goals were assessed using the child version of the Interpersonal Goal Index. Measurement properties of the Interpersonal Goal Index were first examined, and some features were found to differ across autistic and neurotypical adolescents. Bullying behaviour was associated with agentic goals for neurotypical adolescents whereas communal goals were associated with bullying for autistic adolescents, suggesting a mismatch between social goals and social behaviours for this group. This insight suggests that the dynamics of bullying behaviour differ between neurotypical and autistic adolescents, and highlight the need for the development of autistic-led assessment and support for bullying.

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16. Gunapala KM, Gadban A, Noreen F, Schär P, Benvenisty N, Taylor V. Ascorbic Acid Ameliorates Molecular and Developmental Defects in Human-Induced Pluripotent Stem Cell and Cerebral Organoid Models of Fragile X Syndrome. Int J Mol Sci. 2024; 25(23).

Fragile X Syndrome (FX) is the most common form of inherited cognitive impairment and falls under the broader category of Autism Spectrum Disorders (ASD). FX is caused by a CGG trinucleotide repeat expansion in the non-coding region of the X-linked Fragile X Messenger Ribonucleoprotein 1 (FMR1) gene, leading to its hypermethylation and epigenetic silencing. Animal models of FX rely on the deletion of the Fmr1 gene, which fails to replicate the epigenetic silencing mechanism of the FMR1 gene observed in human patients. Human stem cells carrying FX repeat expansions have provided a better understanding of the basis of epigenetic silencing of FMR1. Previous studies have found that 5-Azacytidine (5Azac) can reverse this methylation; however, 5Azac can be toxic, which may limit its therapeutic potential. Here, we show that the dietary factor Ascorbic Acid (AsA) can reduce DNA methylation in the FMR1 locus and lead to an increase in FMR1 gene expression in FX iPSCs and cerebral organoids. In addition, AsA treatment rescued neuronal gene expression and morphological defects observed in FX iPSC-derived cerebral organoids. Hence, we demonstrate that the dietary co-factor AsA can partially revert the molecular and morphological defects seen in human FX models in vitro. Our findings have implications for the development of novel therapies for FX in the future.

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17. Hill ZR, Flynn CK, Adams JB. Indoxyl Sulfate and Autism Spectrum Disorder: A Literature Review. Int J Mol Sci. 2024; 25(23).

Indoxyl sulfate-a bacterially derived metabolite-has been identified as a toxin that is elevated in children with autism spectrum disorder (ASD). As a neurotoxin, uremic toxin, nephrotoxin, cardiotoxin, osteotoxin, and myotoxin, indoxyl sulfate has been associated with several other conditions, including chronic kidney disease, acute kidney injury, Parkinson’s disease, cognitive disorders, and mood disorders such as anxiety and depression. Indoxyl sulfate is derived from bacterial modification of host tryptophan, and elevated levels of indoxyl sulfate are associated with decreased levels of important neurotransmitters including serotonin, dopamine, and norepinephrine. This article will review what is currently known about indoxyl sulfate in relation to ASD and its comorbidities. A systematic review identified six studies of levels of indoxyl sulfate in children with ASD. All six studies found that indoxyl sulfate was significantly elevated in the urine of children with ASD compared to typically developing children. Through this review, indoxyl sulfate was identified as a toxic microbially derived metabolite that is significantly increased in a subset of children with ASD and may contribute to both core and co-morbid ASD symptoms.

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18. Ishizuka M, Otsuka S, Miyata J, Yoshihara Y, Kubota M, Murai T. Autism-spectrum quotient mediates the relationship between clinical symptoms and quality of life in schizophrenia. Schizophr Res. 2024; 275: 98-106.

BACKGROUND: Social dysfunctions can affect the quality of life (QOL) of patients with schizophrenia. The autism-spectrum quotient (AQ) is a widely used measure of innate autistic traits. However, in patients with schizophrenia, the score may represent the severity of autism-like social dysfunctions as a consequence of symptoms. We tested the hypothesis that AQ would mediate the relationship between clinical symptoms and QOL in patients with schizophrenia, based on the assumption that the AQ measures autism-like social dysfunctions rather than autistic traits in this population. METHODS: We analyzed data from 108 outpatients with schizophrenia. The relationships among the scores on the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Quality of Life Scale (SQLS), and the AQ were examined using structural equation modeling (SEM). RESULTS: Path analyses of the total scale scores revealed partial mediation, but not full mediation or independent effects. However, both the AQ and PANSS scores could be mediators. SEM including the three domain scores of PANSS, the two factors of the AQ, and the three subscale scores of the SQLS showed a good fit of the AQ mediation model, but not the symptom mediation model, supporting our hypothesis. In this final model, the relationship between negative symptoms and QOL was mediated by autism-like social dysfunctions, whereas positive symptoms directly affected QOL. CONCLUSIONS: Our findings advance our understanding of what the AQ measures when applied to patients with schizophrenia and suggest that autism-like social dysfunctions are important treatment targets for improving QOL in this population.

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19. Iwanicki T, Iwanicka J, Balcerzyk-Matić A, Jarosz A, Nowak T, Emich-Widera E, Kazek B, Kapinos-Gorczyca A, Kapinos M, Gawron K, Auguściak-Duma A, Likus W, Niemiec P. Association of CHD8 Gene Polymorphic Variants with the Clinical Phenotype of Autism Spectrum Disorder. J Clin Med. 2024; 13(23).

Background: The CHD8 gene encodes chromodomain helicase DNA-binding protein 8 (CHD8), which is a transcriptional regulator involved in neuron development, myelination, and synaptogenesis. Some CHD8 gene mutations lead to neurodevelopmental syndromes with core symptoms of autism. The aim of this study was to perform an analysis of the family-based association of CHD8 gene polymorphisms with the occurrence and clinical phenotype of autism spectrum disorder (ASD). Methods: We analyzed 210 Caucasian children with ASD and their biological parents. The genotyping of specified polymorphisms, i.e., rs7148741, rs35057134, and rs10467770, was performed using TaqMan-PCR and compared with specific symptoms of ASD. Results: The G allele (rs7148741) was associated with muscle hypotonia as compared with the AA homozygotes. AA homozygosity (rs35057134) predisposed an individual to the use of an incubator, heart rate fluctuations, and the necessity of hospitalization. Moreover, the alleles and genotypes of this polymorphism were characterized by different Apgar scores and distributions. Additionally, CC homozygotes of rs10467770 were more often predisposed to the use of an incubator and hospitalization relative to T allele carriers. The average Apgar score was higher in TT homozygotes. Conclusions: Polymorphisms of the CHD8 gene may determine specific clinical phenotypes of ASD.

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20. Komatsu H, Sato Y, Tomimoto K, Onoguchi G, Matsuki T, Hamaie Y, Sakuma A, Ohmuro N, Katsura M, Ito F, Ono T, Matsumoto K, Tomita H. Autistic symptoms and clinical features of individuals at clinical high risk for psychosis and first-episode psychosis. Asian J Psychiatr. 2024; 103: 104345.

INTRODUCTION: Autistic symptoms in schizophrenia are reportedly associated with cognitive and social functions. However, few studies have investigated the association between autistic symptoms and clinical features in individuals with a clinical high risk for psychosis (CHR-P) and first-episode psychosis (FEP). We aimed to determine the association between autistic symptoms and clinical features in a cohort of individuals with CHR-P or FEP. METHODS: This cross-sectional study included 111 participants (CHR-P: 61, FEP: 50). Autistic symptoms were assessed using the Positive and Negative Syndrome Scale for Schizophrenia Autism Severity Scale. We assessed the association between autistic symptoms and global and social functioning, and cognitive function in individuals with CHR-P or EFP. Multiple regression analysis was also performed using age and sex as covariates to determine the association between autistic symptoms and global functioning. RESULTS: The participants with FEP had more severe autistic symptoms than those with CHR-P. The results of bivariate correlation analysis showed a significantly negative association of autistic symptoms with global and cognitive functions in both participants with CHR-P and those with FEP. Multiple regression analysis showed that sex, autistic symptoms, and positive symptoms were significant predictors of overall functioning in those participants. CONCLUSION: These findings suggest that autistic symptoms are associated with lower global functioning with both individuals at CHR-P and those with FEP. Further longitudinal analysis is needed to characterize the association between autistic symptoms and global functioning in CHR-P and FEP.

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21. Ling W, Wang W, Lu D, Liu Q, Jiang G. Unraveling Copper Imbalance in Autism Spectrum Disorder: Mechanistic Insights from the Valproic Acid Mouse Model. ACS Chem Neurosci. 2024.

Abnormal copper (Cu) levels are often closely associated with neurological disorders including neurodevelopmental conditions, such as autism spectrum disorder (ASD). However, the mechanisms underlying the disruption of Cu homeostasis in critical organs, such as the brain, remain unclear. In this study, we elucidated the molecular mechanisms of Cu imbalance in the brain of a valproic acid (VPA) mouse model along with the changes in specific metabolites. Significant alterations occurred in proteins associated with primary Cu-related metabolism in specific regions of the brain (prefrontal cortex, amygdala, cerebellum, and hippocampus), resulting in a direct elevation of Cu ions within the brain tissues (control: 5.05 ± 0.61 μg/g vs model: 6.28 ± 0.81 μg/g, p = 0.015). Furthermore, the brain metabolic profiles revealed significant upregulation of lipids, particularly phospholipid metabolites. Typical neurotransmitters, for example, dopamine (DA) (p < 0.0001) and serotonin (5-HT) (p = 0.02) were upregulated in amygdala. Other small metabolites like glutathione (GSH) (p = 0.0004) also exhibited notable variation in brain. The potential impact of Cu toxicity on the signaling pathways of key metabolites was then evaluated, providing new insights into the role of Cu in metabolism of neurotransmitters in the brain. Our finding sheds molecular aberrations associated with essential element metabolism in the brain, providing new elemental perspectives for understanding the pathogenic mechanisms underlying ASD.

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22. Lopez K. Parent-Mediated Autism Intervention Through a Culturally Informed Lens: Parents Taking Action and Pivotal Response Training with Latine Families. Healthcare (Basel). 2024; 12(23).

Background/Objectives: The prevalence of autism has increased substantially among Latine children; however, few service systems are prepared to provide culturally relevant services. Parents Taking Action (PTA) is a culturally informed parent-mediated psychoeducation program designed to meet the informational needs of Latine families with children with autism. The purpose of this study was to pilot a hybrid model of intervention by including direct parent coaching through pivotal response training (PRT) along with PTA among Latina mothers of children with autism. Methods: Ten Latina mothers of children eight years of age with autism participated in this study. The mothers received PTA from two bilingual trained promotoras (community health workers). PTA provided 14 2 h psychoeducation sessions. The mothers also received four one-hour sessions of PRT from bilingual/bicultural coaches. Results: Paired samples t-tests indicated significant increases in the families’ outcomes, their self-efficacy in using the intervention strategies, and their frequency of using strategies, from pre- to post-test. Conclusions: This study suggests that culturally informed parent-mediated autism intervention coupled with parent coaching positively affects family outcomes among Latine families of children with autism.

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23. Mohammed MA, Alyahya S, Mukhlif AA, Abdulkareem KH, Hamouda H, Lakhan A. Smart Autism Spectrum Disorder Learning System Based on Remote Edge Healthcare Clinics and Internet of Medical Things. Sensors (Basel). 2024; 24(23).

Autism spectrum disorder (ASD) is a brain disorder causing issues among many young children. For children suffering from ASD, their learning ability is typically slower when compared to normal children. Therefore, many technologies aiming to teach ASD children with optimized learning approaches have emerged. With this motivation, this study presents a smart autism spectrum disorder learning system based on remote edge healthcare clinics and the Internet of Medical Things, the objective of which is to offer an online education and healthcare environment for autistic children. Concave and convex optimization constraints, such as accuracy, learning score, total processing time with deadline, and resource failure, are considered in the proposed system, with a focus on different autism education learning applications (e.g., speaking, reading, writing, and listening), while respecting the system’s quality of service (QoS) requirements. All of the autism applications are executed on smartwatches, mobile devices, and edge healthcare nodes during their training and analysis in the system. This study presents the smartwatch autism spectrum data learning scheme (SM-ASDS), which consists of different offloading approaches, training analyses, and schemes. The SM-ASDS algorithm methodology includes partitioning offloading and deep convolutional neural network (DCNN)- and adaptive long short-term memory (ALSTM)-based schemes, which are used to train autism-related data on different nodes. The simulation results show that SM-ASDS improved the learning score by 30%, accuracy by 98%, and minimized the total processing time by 33%, when compared to baseline methods. Overall, this study presents an education learning system based on smartwatches for autistic patients, which facilitates educational training for autistic patients based on the use of artificial intelligence techniques.

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24. Moreno RJ, Ashwood P. An Update on Microbial Interventions in Autism Spectrum Disorder with Gastrointestinal Symptoms. Int J Mol Sci. 2024; 25(23).

In the United States, autism spectrum disorder (ASD) affects 1 in 33 children and is characterized by atypical social interactions, communication difficulties, and intense, restricted interests. Microbial dysbiosis in the gastrointestinal (GI) tract is frequently observed in individuals with ASD, potentially contributing to behavioral manifestations and correlating with worsening severity. Moreover, dysbiosis may contribute to the increased prevalence of GI comorbidities in the ASD population and exacerbate immune dysregulation, further worsening dysbiosis. Over the past 25 years, research on the impact of microbial manipulation on ASD outcomes has gained substantial interest. Various approaches to microbial manipulation have been preclinically and clinically tested, including antibiotic treatment, dietary modifications, prebiotics, probiotics, and fecal microbiota transplantation. Each method has shown varying degrees of success in reducing the severity of ASD behaviors and/or GI symptoms and varying long-term efficacy. In this review, we discuss these microbiome manipulation methods and their outcomes. We also discuss potential microbiome manipulation early in life, as this is a critical period for neurodevelopment.

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25. Petinou K, Vogindroukas I, Christopoulou M. Autism Prevalence Information And Diagnosis Processes In Cyprus, Greece And Malta. Neuropsychiatr Dis Treat. 2024; 20: 2499-505.

The current paper follows the thematic review ‘Autism spectrum disorders without borders: prevalence and diagnosis across the globe’ aiming to highlight and familiarize readers with the challenges and heterogeneity related to the prevalence, and diagnostic processes of Autism Spectrum Disorders (ASD) from a cross-cultural and diverse geopolitical framework with a focus on Cyprus, Malta, and Greece. The study’s goal was twofold: (a) to document the prevalence and diagnostic processes in the aforementioned geographical areas and (b) to highlight similarities and differences in the prevalence and diagnostic process in ASD. The findings revealed similarities across all countries regarding the diagnostic tools implemented in ASD assessment tools and clinical observations. Some differences were observed in documenting prevalence rates due to methodological heterogeneity in the documentation procedures. Although preliminary, the current findings underscore the importance of research-driven investigations that can lead to larger-scale programs necessary for establishing policy-making and stakeholders’ involvement.

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26. Pooley JE. Listen Up: Autistic Youth Need to Be Heard. Pediatrics. 2024.

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27. Posserud MR. Preschool and school-age autism. Tidsskr Nor Laegeforen. 2024; 144(15).

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28. Prynda M, Pawlik AA, Niemczyk W, Wiench R. Dental Adaptation Strategies for Children with Autism Spectrum Disorder-A Systematic Review of Randomized Trials. J Clin Med. 2024; 13(23).

Background: Children with Autism Spectrum Disorder (ASD) often struggle with dental care due to sensory sensitivities and behavioral issues, increasing their risk for oral health problems. Adaptation strategies such as visual aids, video modeling, and sensory-adapted environments aim to improve their dental experiences. Methods: A systematic review of randomized controlled trials (RCTs) was conducted according to PRISMA 2020 guidelines using the PubMed, Scopus, Embase, and Cochrane databases. Of the 1072 records screened, nine RCTs were included in the analysis. Studies included children with ASD under 18 years and compared dental adaptation techniques with traditional care. The risk of bias and study quality were assessed. The quality of evidence for the results was determined using the GRADE tool. Results: Nine RCTs with sample sizes ranging from 25 to 138 participants showed significant improvements in oral hygiene, reduced anxiety, and increased cooperation. Video modeling and sensory-adapted environments were particularly effective in lowering distress during dental visits. Conclusions: Dental adaptation strategies, especially video modeling and sensory-adapted environments, effectively improve oral health outcomes and reduce anxiety in children with ASD. More research is needed to explore the long-term effects and include children with severe ASD.

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29. Raul P, Rowe E, van Boxtel JJA. High neural noise in autism: A hypothesis currently at the nexus of explanatory power. Heliyon. 2024; 10(23): e40842.

Autism is a neurodevelopmental difference associated with specific autistic experiences and characteristics. Early models such as Weak Central Coherence and Enhanced Perceptual Functioning have tried to capture complex autistic behaviours in a single framework, however, these models lacked a neurobiological explanation. Conversely, current neurobiological theories of autism at the cellular and network levels suggest excitation/inhibition imbalances lead to high neural noise (or, a ‘noisy brain’) but lack a thorough explanation of how autistic behaviours occur. Critically, around 15 years ago, it was proposed that high neural noise in autism produced a stochastic resonance (SR) effect, a phenomenon where optimal amounts of noise improve signal quality. High neural noise can thus capture both the enhanced (through SR) and reduced performance observed in autistic individuals during certain tasks. Here, we provide a review and perspective that positions the « high neural noise » hypothesis in autism as best placed to provide research direction and impetus. Emphasis is placed on evidence for SR in autism, as this promising prediction has not yet been reviewed in the literature. Using this updated approach towards autism, we can explain a spectrum of autistic experiences all through a neurobiological lens. This approach can further aid in developing specific support or services for autism.

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30. Røe AB, Jullumstrø S, Eig KB, Lydersen S, Nærland T, Høyland AL. Autism diagnoses in school-age children in southern Trøndelag 2016-2019. Tidsskr Nor Laegeforen. 2024; 144(15).

BACKGROUND: We have previously reported a significantly higher prevalence of autism spectrum disorders in southern Trøndelag among preschool children with mothers from a different national background than Norway. In this study, we wanted to investigate whether, in the same period and in the same geographic area, there was also an excess prevalence among school-age children. Additionally, we wanted to identify psychiatric and developmental comorbidities. MATERIAL AND METHOD: We carried out a retrospective review of the medical records of children between 10 and 16 years of age who had been diagnosed with autism in the period 2016-19. RESULTS: Out of a sample of 125 children, 18 had mothers with a different national background. This gave an incidence rate of 0.18 %, against 0.12 % for children with mothers born in Norway (relative risk 1.5; 95 % confidence interval 0.87 to 2.50, p = 0.11). A total of 74 children had been diagnosed with at least one other developmental disorder or psychiatric condition, most commonly ADHD, before they received the autism diagnosis. In four children, the autism spectrum disorder was accompanied by an intellectual disability. INTERPRETATION: Maternal national background appears to be a less significant factor among school-age children than among preschool children who receive an autism spectrum diagnosis, and age at the time of diagnosis should be specified in studies on autism in children and adolescents. Psychiatric comorbidity and other accompanying developmental disorders may suggest shared aetiological factors or increased vulnerability in cases of undiagnosed autism in children.

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31. Salar S, Jorgić BM, Olanescu M, Popa ID. Barriers to Physical Activity Participation in Children and Adolescents with Autism Spectrum Disorder. Healthcare (Basel). 2024; 12(23).

BACKGROUND: Children and adolescents with autism spectrum disorders tend to participate in less physical activity. The purpose of this study was to identify barriers to physical activity participation in children and adolescents with autism spectrum disorder (ASD) based on parental reports. METHODS: The sample comprised 370 children and adolescents with ASD, aged 8-20 years. Simple random sampling was selected. We designed a questionnaire and used the survey method for data collection. Data were analyzed using descriptive and inferential statistics. RESULTS: The results revealed several barriers to physical activity participation: interpersonal barriers were the top priority, followed by friends and peers as well as psychological factors as the second and third priorities. Additionally, family, cognition, management and planning, social and cultural factors, and skills were identified as the fourth through eighth barriers, respectively. CONCLUSIONS: Understanding these barriers is crucial for developing effective school- and community-based strategies to promote physical activity participation.

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32. Seelemeyer H, Gurr C, Leyhausen J, Berg LM, Pretzsch CM, Schäfer T, Hermila B, Freitag CM, Loth E, Oakley B, Mason L, Buitelaar JK, Beckmann CF, Floris DL, Charman T, Banaschewski T, Jones E, Bourgeron T, Murphy D, Ecker C. Decomposing the Brain in Autism: Linking Behavioral Domains to Neuroanatomical Variation and Genomic Underpinnings. Biol Psychiatry Cogn Neurosci Neuroimaging. 2024.

BACKGROUND: Autism is accompanied by highly individualized patterns of neurodevelopmental differences in brain anatomy. This variability makes the neuroanatomy of autism inherently difficult to describe at the group level. Here, we examined inter-individual neuroanatomical differences using a dimensional approach that decomposed the domains of social communication and interaction (SCI), restricted and repetitive behaviors (RRB), and atypical sensory processing (ASP) within a neurodiverse study population. Moreover, we aimed to link the resulting neuroanatomical patterns to specific molecular underpinnings. METHODS: Neurodevelopmental differences in cortical thickness and surface area were correlated with SCI, RRB and ASP domain scores by regression of a General Linear Model in a large neurodiverse sample of N=288 autistic and N=140 non-autistic individuals, aged 6-30, recruited within the EU-AIMS Longitudinal European Autism Project (LEAP). The domain-specific patterns of neuroanatomical variability were subsequently correlated with cortical gene expression profiles via the Allan Human Brain Atlas. RESULTS: Across groups, behavioral variations in SCI, RRB and ASP were associated with interindividual differences in CT and SA in partially non-overlapping fronto-parietal, temporal, and occipital networks. These domain-specific imaging patterns were enriched for genes (i) differentially expressed in autism, (ii) mediating typical brain development, and that are (iii) associated with specific cortical cell types. Many of these genes were implicated in pathways governing synaptic structure and function. CONCLUSIONS: Our study corroborates the close relationship between neuroanatomical variation and interindividual differences in autism-related symptoms and traits within the general framework of neurodiversity, and links domain-specific patterns of neuroanatomical differences to putative molecular underpinnings.

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33. Sheeraz M, Aslam AR, Drakakis EM, Heidari H, Altaf MAB, Saadeh W. A Closed-Loop Ear-Worn Wearable EEG System with Real-Time Passive Electrode Skin Impedance Measurement for Early Autism Detection. Sensors (Basel). 2024; 24(23).

Autism spectrum disorder (ASD) is a chronic neurological disorder with the severity directly linked to the diagnosis age. The severity can be reduced if diagnosis and intervention are early (age < 2 years). This work presents a novel ear-worn wearable EEG system designed to aid in the early detection of ASD. Conventional EEG systems often suffer from bulky, wired electrodes, high power consumption, and a lack of real-time electrode-skin interface (ESI) impedance monitoring. To address these limitations, our system incorporates continuous, long-term EEG recording, on-chip machine learning for real-time ASD prediction, and a passive ESI evaluation system. The passive ESI methodology evaluates impedance using the root mean square voltage of the output signal, considering factors like pressure, electrode surface area, material, gel thickness, and duration. The on-chip machine learning processor, implemented in 180 nm CMOS, occupies a minimal 2.52 mm² of active area while consuming only 0.87 µJ of energy per classification. The performance of this ML processor is validated using the Old Dominion University ASD dataset.

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34. Sullivan AC, Vas AK, Johnson WL. Transition to Adulthood: Executive Functions and Independent Living Skills in Autistic Young Adults. Occup Ther Health Care. 2024: 1-22.

This study investigated differences in independent living skills and executive functioning skills between autistic and neurotypical young adults in addition to how executive functioning skills contribute to independent living skills in autistic young adults. Participants completed the Adaptive Behavior Assessment System as a measure of independent living skills and the Behavioral Rating Inventory of Executive Function Adult version to measure executive functioning abilities. The Weekly Calendar Planning Activity was also used as a novel measure of performance-based executive functioning skills. Results demonstrated that independent living skills and executive functioning skills were significantly lower in autistic adults (p<.001) than neurotypical young adults. The WCPA also indicated deficits in the autistic population as demonstrated by following fewer rules, utilizing fewer strategies, lower accuracy, and lower self-awareness of performance. Within autistic adults, self-reported measures of executive functioning skills robustly correlated with independent living skills. While the Weekly Calendar Planning Activity accuracy correlated strongly with self-reported measures of executive function, the accuracy did not significantly correlate with the ABAS-3 scores suggesting a discrepancy between self-report and performance-based measures of executive functioning skills. Results indicated that the Weekly Calendar Planning Activity shows promise to inform clinical practice by providing a window into how the integration of multiple executive functioning skills impact challenges with everyday living in the adult autistic population.

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35. Talarico M, de Bellescize J, De Wachter M, Le Guillou X, Le Meur G, Egloff M, Isidor B, Cogné B, Beysen D, Rollier P, Fradin M, Pasquier L, Guella I, Hickey SE, Benke PJ, Shillington A, Kumps C, Vanakker O, Gerkes EH, Lakhani S, Romanova I, Kanivets I, Brugger M, Vill K, Caylor RC, Skinner C, Tinker RJ, Stödberg T, Nümann A, Haack TB, Deininger N, Hengel H, Jury J, Conrad S, Mercier S, Yoon G, Tsuboyama M, Barcia G, Gitiaux C, Rio M, Bevot A, Redon S, Uguen K, Wonneberger A, Schulz A, Timmann D, Karlowicz DH, Chatron N, Carnevale A, Mahida S, Õunap K, Kury S, Cabet S, Lesca G. RORA-neurodevelopmental disorder: a unique triad of developmental disability, cerebellar anomalies, and myoclonic seizures. Genet Med. 2024: 101347.

PURPOSE: RORA encodes the RAR-related orphan receptor-α (RORα), playing a pivotal role in cerebellar maturation and function. Here, we report the largest series of individuals with RORA-related-neurodevelopmental disorder (RORA-NDD). METHODS: Forty individuals (30 unrelated; 10 siblings from 4 families) carrying RORA pathogenic/likely pathogenic variants were collected through an international collaboration. RESULTS: The 33 variants (29 de novo, 4 inherited, one shared), identified by genome/exome sequencing (n=21), chromosomal-microarray-analysis (n=7) or gene panels (n=4), included frameshift (n=18/33), missense (n=9/33) and stop-codon (n=6/33). Developmental disability (n=32/37), intellectual disability (n=22/32), and cerebellar signs (n=25/34) were the most striking clinical features. Cerebellar symptoms were divided into early-onset, late-onset and progressive subgroups. Cerebellar hypoplasia, atrophy, or both (n=16/25) were more frequent in individuals with missense variants in the DNA-binding-domain (DBD). Epilepsy (n=18/38), with prominent myoclonic seizure types (n=11/18), was classified in: i) genetic generalized epilepsy (n=10/18) with a syndromic diagnosis identifiable for six: epilepsy with eyelid myoclonia (n=5/6), epilepsy with myoclonic absence (n=1/6); ii) developmental and epileptic encephalopathy (n=5/18); and iii) unclassified (n=3/18). A participant with rapid deterioration of visual acuity and cone/rod dystrophy was reported. CONCLUSION: Missense variants in DBD correlate to a more severe cerebellar phenotype. The RORA-NDD triad comprises developmental disability, cerebellar features and a spectrum of myoclonic epilepsy.

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36. Wright B, Blackwell JE, Bell KJ, Teige C, Mandefield L, Wang HI, Welch C, Scantlebury A, Watson J, McMillan D, Standley E, Attwell L, Carrick H, Taylor A, Taylor O, Hodkinson R, Edwards H, Pearson H, Parrott S, Marshall D, Varley D, Hargate R, McLaren A, Hewitt C. Autism Spectrum Social Stories in Schools Trial 2 (ASSSIST-2): a pragmatic randomised controlled trial of the Social Stories™ intervention to address the social and emotional health of autistic children in UK primary schools. Child Adolesc Ment Health. 2024.

BACKGROUND: Autistic children can experience mental health, social and emotional difficulties. Carol Gray’s Social Stories™ are a highly personalised intervention that provide social information in a short individually tailored story. METHODS: A multi-site pragmatic cluster randomised controlled trial to evaluate the clinical and cost-effectiveness of Social Stories™ alongside care as usual in autistic children aged 4-11 years. The primary outcome was the Social Responsiveness Scale-2 completed by teachers 6 months post-randomisation, analysed on an intention-to-treat basis. TRIAL REGISTRATION: ISRCTN11634810. RESULTS: Eighty-seven schools, including 249 children, were randomised (intervention 44 schools with 129 children, and usual care 43 schools with 120 children). After 6 months, a reduction of 1.61 points was found on the Social Responsiveness Scale-2 in the intervention group (95% CI -4.18 to 0.96, p = .220) and for those who attended at least six sessions a reduction of 3.37 points (CACE 95% CI -6.65 to -0.10, p = .043). Children in the intervention group met their individual socio-emotional goal more frequently than children receiving usual care alone and this was statistically significant. No statistically significant differences were found in other secondary outcomes including anxiety, depression, general health or parental stress. CONCLUSIONS: Social Stories™ represent a low-cost, low-burden intervention. Benefits are seen in individual socio-emotional goals but without clinically evident impact on social responsiveness, anxiety, depression, parental stress or general health.

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37. Zhao Y, Zhao L, Yang F, Tao C, Tang W, Cheng W, Zhang Y, Bu L. Assessing visual motor performance in autistic children based on Kinect and fNIRS: A case study. Neuroscience. 2024; 563: 10-9.

In recent years, the incidence rate of children with autism has shown a significant upward trend. Rehabilitation training is an important part of recovery or improvement in autism children. However, during autism rehabilitation training, the methods that can visually reflect and objectively evaluate its effects are seldom considered. Therefore, this study aimed to objectively evaluate the rehabilitation impact of visual-motor skills training in children with autism via quantitative measures. In this study, vision sensors and functional near-infrared spectroscopy were used to monitor and analyze visual motor training task of 20 autism children. These children were divided into high- and low-score groups according to the autism behavior checklist (ABC). Results showed significant differences between the high- and low-score groups in the brain regions of the left and right temporal lobe, right motor cortex, and left occipital lobe; the difference in functional connectivity was greatest when the left hand was moving at the green light (p < 0.05). The differences in speed, acceleration, and angle between the high- and low-score groups were mainly reflected in left-hand movement. Moreover, analysis of multimodal data showed that visual motor training had a positive effect on brain activation and functional connectivity, and increasing the frequency of left-hand training and using more green light were beneficial to the improvement of brain function. These findings can be used as basis to help optimize rehabilitation programs and improve rehabilitation effectiveness.

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38. Zisk AH, Eddy B, Donaldson AL, Cannalonga S, Strickland O, Corbin E, Schall JHT. School-Based Professionals’ Knowledge of Autistic Speech and Augmentative and Alternative Communication Decision Making. Semin Speech Lang. 2024; 45(5): 524-42.

Autistic adults report communication access barriers related to the prioritization of speech over all other forms of communication. Our participatory research team, including autistic adults who use augmentative and alternative communication (AAC) both part- and full-time, designed and administered a 35-question online survey to examine school-based professionals’ knowledge, training, and practices related to AAC and autism. The current study reports a portion of the larger data set specific to participants’ definitions of speech terms related to autistic speech. A total of 567 participants completed the survey. Thematic analysis of participants’ responses to speech definitions revealed multiple themes, including a focus on speech without implying or suggesting other forms of communication, speech production (mechanics), communication functions (intentionality), deficits, and definitions that were exclusionary in nature (e.g., identifying what the term did not define). Quantitative analysis of definitions of autistic speech revealed the need for increased exposure to these internal speech states for professionals working with autistic children. Increasing school-based professionals’ knowledge, including community-sourced knowledge, related to autism and AAC, can improve access to AAC for speaking autistic students who may benefit from AAC.

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