1. Coutelle R, Goltzene MA, Canton M, Campiglia-Sabourin M, Rabot J, Bizet É, Schoenberger M, Berna F, Danion JM. Episodic Autobiographical Memory in Adults With Autism Spectrum Disorder : An Exploration With the Autobiographical Interview. Frontiers in psychiatry. 2020 ; 11 : 593855.

Introduction : The literature has provided contradictory results regarding the status of episodic memory in autism spectrum disorder (ASD). This might be explained by methodological differences across studies. In the present one, the well-recommended Autobiographical Interview was used in which important aspects of episodic memory were assessed, namely, the number and richness of phenomenological memory details, before and after a retrieval support. Method : Twenty-five well-documented adults with ASD without Intellectual Disability (nine women) and 25 control participants were included and asked to recall six specific autobiographical events. The number and richness of details were assessed globally and for five categories of details (perceptual/sensory, temporal, contextual, emotional, and cognitive), firstly before and then after a specific cueing phase consisting in a series of specific questions to elicit more precise memory details. Results : Cumulatively, from the spontaneous recall to the cueing phase, the number of internal details was lower in ASD individuals compared to controls, but this difference was relevant only after the specific cueing procedure and observed only for contextual details. In contrast, no relevant group difference was observed during spontaneous recall. The detail richness was not impaired in ASD throughout the Autobiographical Interview procedure. Conclusion : Our results speak against a clear impairment of episodicity of autobiographical memory in ASD individuals. They thus challenge previous ones showing both a reduced specificity and episodicity of autobiographical memory in this population and call for further studies to get a better understanding on the status of episodic autobiographical memory in ASD.

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2. Cusack RW, Fitzgerald G, Kennedy MW. Late Erosion of Percutaneous ASD Occlusion Device. European journal of case reports in internal medicine. 2020 ; 7(12) : 002202.

Percutaneous closure of atrial septal defects (ASDs) is an ever more common treatment modality in selected patients. Device erosion is a rare but often fatal complication of this therapy, which usually presents early in the post-procedure course. We describe the case of a patient presenting with chest pain and shock in whom early recognition and intervention prevented a negative outcome. Awareness of this potentially lethal complication is important as the population of patients undergoing percutaneous procedures for structural heart disease continues to grow. LEARNING POINTS : As the number of patients undergoing percutaneous atrial septal defect closure increases, so too will the volume presenting with late complications.Early recognition and intervention in cases of device erosion is critical to prevent death.

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3. Davidson D, Hilvert E, Winning AM, Giordano M. Recognition of Emotions from Situational Contexts and the Impact of a Mind Reading Intervention in Children with Autism Spectrum Disorder. Child Psychiatry Hum Dev. 2021.

The present research examined recognition of basic (happy, fear, sad) and self-conscious (pride, embarrassment, guilt) emotions from situational contexts in children with Autism Spectrum Disorder (ASD) and neurotypical children (Study 1). Results showed that children with ASD were less accurate in recognizing fear, embarrassment, and guilt situations than neurotypical children. Additionally, the research explored whether recognition of these emotions from situational contexts could be improved in children with ASD after a 4-week computerized emotion intervention (Study 2). Following the intervention, children showed better recognition of embarrassment and guilt, but no improvement in recognizing fear. In children with ASD, significant negative relations were found between ASD symptomatology and recognition of guilt (Study 1), although ASD symptomatology did not impact the intervention’s efficacy (Study 2). Additional explanations for these findings are provided.

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4. Doaei S, Bourbour F, Teymoori Z, Jafari F, Kalantari N, Abbas Torki S, Ashoori N, Nemat Gorgani S, Gholamalizadeh M. The effect of omega-3 fatty acids supplementation on social and behavioral disorders of children with autism : a randomized clinical trial. Pediatric endocrinology, diabetes, and metabolism. 2021 ; 27(1) : 12-8.

INTRODUCTION : Some studies reported that essential fatty acids deficiencies can be related to autism spectrum disorders (ASD) in children. This study aimed to investigate the effect of omega-3 on social, verbal, and behavioral activities in ASD children. MATERIAL AND METHODS : A double-blind, randomized clinical trial study was conducted on 54 children with autism, who were assigned to the case (n = 28) and control (n = 26) groups. The cases received one capsule of 1000 mg omega-3 daily and the controls received one capsule of 1000 mg medium chain triglyceride daily as placebo for eight weeks. The Gilliam Autism Rating Scale-second edition (GARS-2) was used to assess the severity of autism and food frequency questionnaire (FFQ) was used to assess their dietary intake. All measurements were done at baseline and after the intervention. RESULTS : After adjusting for age, gender, birth weight, BMI, dietary intake, mother’s age, and mother’s BMI, the intervention group had significantly improved stereotyped behaviors (p = 0.02), social communication (p = 0.02), and the GARS score (p = 0.001) after the intervention compared to the control group. No significant change was found in the score of social interaction subscale. CONCLUSIONS : The findings indicate that omega-3 treatment improved autism characteristics including stereotyped behaviors and social communication. Further studies are needed to confirm these findings and to determine the underlying mechanisms.

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5. Fadila, Suman P, Kumar P, Omair F. Clinical Relevance of Methylenetetrahydrofolate Reductase Genetic Testing in Autism : A Case Report of Successful Clinical Outcome. Cureus. 2021 ; 13(1) : e12586.

Autism spectrum disorder is an emerging public health issue. The core features of autism spectrum disorder are persistent impairment in reciprocal social communication and interaction and restricted, repetitive patterns of behavior or interests. We now know that it encompasses disorders previously referred to as early infantile autism, childhood autism, Kanner autism, high-functioning autism, atypical autism, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. While it is agreed that the etiology of autism spectrum disorder is largely unknown, certain environmental and genetic factors may be responsible for the disease. In particular, emerging evidence has suggested the role of C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene as a possible risk factor. We present the case of a two-year-old boy with high risk for autism who was found on advanced investigation to have heterozygous polymorphism for MTHFR. This prompted us to add folic acid to his therapeutic regime. He was treated with high-dose folic acid along with conventional intervention, and went on to make excellent recovery. We conclude that pharmacological intervention has the potential to improve outcome in a subgroup of autistic children.

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6. Gao J, Chen M, Li Y, Gao Y, Li Y, Cai S, Wang J. Multisite Autism Spectrum Disorder Classification Using Convolutional Neural Network Classifier and Individual Morphological Brain Networks. Front Neurosci. 2020 ; 14 : 629630.

Autism spectrum disorder (ASD) is a range of neurodevelopmental disorders with behavioral and cognitive impairment and brings huge burdens to the patients’ families and the society. To accurately identify patients with ASD from typical controls is important for early detection and early intervention. However, almost all the current existing classification methods for ASD based on structural MRI (sMRI) mainly utilize the independent local morphological features and do not consider the covariance patterns of these features between regions. In this study, by combining the convolutional neural network (CNN) and individual structural covariance network, we proposed a new framework to classify ASD patients with sMRI data from the ABIDE consortium. Moreover, gradient-weighted class activation mapping (Grad-CAM) was applied to characterize the weight of features contributing to the classification. The experimental results showed that our proposed method outperforms the currently used methods for classifying ASD patients with the ABIDE data and achieves a high classification accuracy of 71.8% across different sites. Furthermore, the discriminative features were found to be mainly located in the prefrontal cortex and cerebellum, which may be the early biomarkers for the diagnosis of ASD. Our study demonstrated that CNN is an effective tool to build the framework for the diagnosis of ASD with individual structural covariance brain network.

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7. Gerow S, Radhakrishnan S, J SA, McGinnis K, Swensson R. Telehealth parent coaching to improve daily living skills for children with ASD. Journal of applied behavior analysis. 2021.

Children with autism spectrum disorder often display deficits in daily living skills. Behavior analysts can use telehealth, such as videoconferencing technology, to deliver interventions to families of these children. Given the COVID-19 pandemic and the common barriers to accessing behavioral interventions, it is imperative to evaluate the effectiveness and practicality of delivering behavioral interventions via telehealth. This study evaluated the efficacy of a parent-implemented intervention with coaching via telehealth to improve daily living skills. Children ranging in age from 5 to 9 years participated in the study with 1 or 2 of their parents serving as the primary implementer(s). Parents implemented the intervention with fidelity and the intervention yielded increases in independent daily living skill completion for all 4 participants.

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8. Holm KN, Herren AW, Taylor SL, Randol JL, Kim K, Espinal G, Martiínez-Cerdeño V, Pessah IN, Hagerman RJ, Hagerman PJ. Human Cerebral Cortex Proteome of Fragile X-Associated Tremor/Ataxia Syndrome. Frontiers in molecular biosciences. 2020 ; 7 : 600840.

Background : Fragile X-associated tremor/ataxia syndrome (FXTAS) is an adult-onset neurodegenerative disorder associated with premutation CGG-repeat expansions (55-200 repeats) in the 5′ non-coding portion of the fragile X mental retardation 1 (FMR1) gene. Core features of FXTAS include progressive tremor/ataxia, cognitive decline, variable brain volume loss, and white matter disease. The principal histopathological feature of FXTAS is the presence of central nervous system (CNS) and non-CNS intranuclear inclusions. Objective : To further elucidate the molecular underpinnings of FXTAS through the proteomic characterization of human FXTAS cortexes. Results : Proteomic analysis of FXTAS brain cortical tissue (n = 8) identified minor differences in protein abundance compared to control brains (n = 6). Significant differences in FXTAS relative to control brain predominantly involved decreased abundance of proteins, with the greatest decreases observed for tenascin-C (TNC), cluster of differentiation 38 (CD38), and phosphoserine aminotransferase 1 (PSAT1) ; proteins typically increased in other neurodegenerative diseases. Proteins with the greatest increased abundance include potentially novel neurodegeneration-related proteins and small ubiquitin-like modifier 1/2 (SUMO1/2). The FMRpolyG peptide, proposed in models of FXTAS pathogenesis but only identified in trace amounts in the earlier study of FXTAS inclusions, was not identified in any of the FXTAS or control brains in the current study. Discussion : The observed proteomic shifts, while generally relatively modest, do show a bias toward decreased protein abundance with FXTAS. Such shifts in protein abundance also suggest altered RNA binding as well as loss of cell-cell adhesion/structural integrity. Unlike other neurodegenerative diseases, the proteome of end-stage FXTAS does not suggest a strong inflammation-mediated degenerative response.

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9. Hotez E, Hotez PJ, Rosenau KA, Kuo AA. Prioritizing COVID-19 vaccinations for individuals with intellectual and developmental disabilities. EClinicalMedicine. 2021 : 100749.

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10. Jones J, Blinkhorn A, McQueen M, Hewett L, Mills-Rogers MJ, Hall L, Althagafi L, Hudson C, Gierc M, Wright K, Goettl H, Keogh-Lim D, Rischke-Peddle A, Ayub M. The adaptation and feasibility of dialectical behaviour therapy for adults with intellectual developmental disabilities and transdiagnoses : A pilot community-based randomized controlled trial. J Appl Res Intellect Disabil. 2021.

INTRODUCTION : Preliminary evidence suggests dialectical behaviour therapy (DBT) may be beneficial for persons with intellectual disabilities. This pilot randomized controlled trial aimed to determine the feasibility of adapted DBT for adults with intellectual disabilities and co-morbid psychiatric disorders in the community. METHODS : An adapted DBT programme (aDBT-ID) was delivered to adults with mild-to-moderate intellectual disability (n = 20) and their caregivers (n = 20). A single-blind, mixed-methods design was employed with treatment (n = 10) and control (n = 10). In addition to feasibility, pre-post-measures of emotional regulation, anger and mental health were taken from clients and caregivers. RESULTS : Results suggest it was feasible and beneficial to deliver adapted DBT in the community. Qualitative findings found both participants and caregivers were satisfied with the treatment delivery. No differences between conditions were found. CONCLUSION : This pilot study highlights the feasibility of adapted DBT for individuals with intellectual disabilities and the practicalities of delivering community-based inclusive research.

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11. Kumazaki H, Muramatsu T, Yoshikawa Y, Haraguchi H, Sono T, Matsumoto Y, Ishiguro H, Kikuchi M, Sumiyoshi T, Mimura M. Enhancing Communication Skills of Individuals With Autism Spectrum Disorders While Maintaining Social Distancing Using Two Tele-Operated Robots. Frontiers in psychiatry. 2020 ; 11 : 598688.

COVID-19 has affected many areas of daily life, including communication and learning. Social distancing is essential to prevent the spread of COVID-19. In these situations, teaching communication skills is essential for helping individuals with autism spectrum disorders (ASD) reach their full potential. To provide communication education while maintaining social distancing, we developed a communication training system using a tele-operated robot. In this system, we prepared a PC and a robot for each participant. The participants were grouped in pairs and communicated with each other through the tele-operated robot. The objective of this study was to test whether this system can maintain motivation for training in individuals with ASD and whether our system was useful for improving communication skills. Participants were randomly assigned to one of two groups : the taking a class by teachers alone (TCT) group or robot-mediated communication exercise (RMC) group. Participants in the TCT group took a class about communication skills from their teacher. Participants in the RMC group, in addition to taking a class by teacher, were grouped in pairs and communicated with each other through the tele-operated robot once a week over 4 weeks (for a total of five sessions). In total, twenty individuals with ASD participated in the study. One-way ANOVA revealed that there were significantly greater improvements in being good at describing their thoughts to others, which was self-rated (F = 6.583 ; p = 0.019), and good at listening to the thoughts or feelings of others, which was rated by themselves (F = 5.635 ; p = 0.029) and their teacher (F = 5.333 ; p = 0.033). As expected, the motivation for training using this system was maintained during a session. Overall, this study revealed that our system was useful for improving communication skills (e.g., listening to the thoughts or feelings of others). Teaching communication skills under pandemic conditions is important, and this study demonstrated the feasibility of communication training using tele-operated robots.

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12. Muharib R, Lang R, Walker VL, Phinney A, Rodriguez M. An Evaluation of Reinforcer Magnitude and Echoic Prompts on Vocal Requesting of Individuals with Autism Spectrum Disorder. Journal of developmental and physical disabilities. 2021 : 1-15.

Individuals with autism spectrum disorder (ASD) often have communication support needs and many rely on augmentative and alternative communication (AAC) systems to communicate. Previous research suggests that AAC use does not preclude the acquisition of spoken language and, in some cases, may facilitate improvements in spoken communication in children with ASD. This study systematically applied echoic prompting and manipulated reinforcer magnitude in an effort to increase the spoken requests of 3 children with ASD, ages 10-12 years, who used iPad-based speech generating devices (SGDs). The spoken language (vocal requests) of all 3 participants increased in frequency and 1 participant began using spoken language exclusively, even when the SGD was an option. Implications for practitioners and directions for future research in this area are discussed.

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13. Napoletani G, Vigli D, Cosentino L, Grieco M, Talamo MC, Lacivita E, Leopoldo M, Laviola G, Fuso A, d’Erme M, De Filippis B. Stimulation of the Serotonin Receptor 7 Restores Brain Histone H3 Acetylation and MeCP2 Corepressor Protein Levels in a Female Mouse Model of Rett Syndrome. Journal of neuropathology and experimental neurology. 2021.

Rett syndrome (RTT) is a rare neurological disorder caused by mutations in the X-linked MECP2 gene, characterized by severe behavioral and physiological impairments for which no cure is available. The stimulation of serotonin receptor 7 (5-HT7R) with its selective agonist LP-211 (0.25 mg/kg/day for 7 days) was proved to rescue neurobehavioral alterations in a mouse model of RTT. In the present study, we aimed at gaining insight into the mechanisms underpinning the efficacy of 5-HT7R pharmacological stimulation by investigating its epigenetic outcomes in the brain of RTT female mice bearing a truncating MeCP2 mutation. Treatment with LP-211 normalized the reduced histone H3 acetylation and HDAC3/NCoR levels, and increased HDAC1/Sin3a expression in RTT mouse cortex. Repeated 5-HT7R stimulation also appeared to strengthen the association between NCoR and MeCP2 in the same brain region. A different profile was found in RTT hippocampus, where LP-211 rescued H3 hyperacetylation and increased HDAC3 levels. Overall, the present data highlight a new scenario on the relationship between histone acetylation and serotoninergic pathways. 5-HT7R is confirmed as a pivotal therapeutic target for the recovery of neuronal function supporting the translational value of this promising pharmacological approach for RTT.

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14. Oren A, Dromi E, Goldberg S, Mimouni-Bloch A. Pragmatic Profiles of Toddlers With Autism Spectrum Disorder at the Onset of Speech. Frontiers in neurology. 2020 ; 11 : 612314.

Using speech to communicate pragmatic functions is challenging among individuals with Autism Spectrum Disorder (ASD). Given the role language plays in developing everyday skills, we traced the unique pragmatic profile of early words, seeking comparison to typically developing (TD) toddlers at similar lexical stages. Twenty-four mother-toddler dyads participated (9 ASD and 15 TD). Dyads were video recorded when toddlers reached a productive lexicon of 40-70 words. These recordings were captured three times during naturalistic interaction and at two consecutive visits with a 2-month interval. Seven thousand three hundred seventy-six productions were analyzed and classified into four communicative intentions (Declaratives, Requests, Objections, and Non-Communicative speech). ASD toddlers were delayed in the emergence of words compared to TD toddlers, with a greater within-group variability (median 28 months, IQR 24.5-35, median 17 months, IQR 17-18, respectively, p < 0.001). In both groups, the most common communicative intention was Declarative. However, the percentage of Declaratives was higher among TD toddlers across visits compared to ASD toddlers. In both groups, most productions were directed toward the communicative partner, but ASD toddlers used Non-Communicative speech more often than TD peers. Non-Communicative speech gradually decreased over time. We conclude that while TD toddlers begin to talk with an already-established knowledge of the main communicative functions of words, ASD toddlers seem to have only a partial understanding and gradually improve communicative use as they expand their lexicon. These findings bear theoretical and practical implications for early intervention in ASD. We suggest that communicative profiles are affected by individual characteristics and by the interaction style.

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15. Palumbo D, Stanghellini G, Mucci A, Ballerini M, Giordano GM, Lysaker PH, Galderisi S. Autism Rating Scale : A New Tool for Characterizing the Schizophrenia Phenotype. Frontiers in psychiatry. 2021 ; 12 : 622359.

Social dysfunctions (SD) are frequently observed in subjects with schizophrenia. Some of these dysfunctions are also observed in other neuropsychiatric disorders such as autism spectrum disorders (ASD), major depression, bipolar disorder, or Alzheimer disease. Recently, a characterization of a specific type of SD in schizophrenia has been proposed, with the concept of dis-sociality, which form the core aspect of « Schizophrenic Autism » (SA). The present study aimed to explore the presence in people with schizophrenia of SA, independent of other autistic traits, which can be often found in schizophrenia and other neurodevelopmental disorders. We used a structured interview-the Autism Rating Scale (ARS), an instrument devised to detect and measure SA. Fifty-one outpatients affected by schizophrenia (26 remitted, SCZ-r) and 28 affected by bipolar disorder type 1, with psychotic features, in the euthymic phase (BD-e) were recruited. Before assessing the specificity for schizophrenia of SA, we tested the internal consistency, the convergent and divergent validity of the ARS in the schizophrenia sample. Specificity was assessed by examining potential differences in ARS scores between SCZ-r and BD-e subjects. ARS showed good internal consistency, as well as convergent and divergent validity. ARS items were more frequently of moderate severity in SCZ-r than in BD-e subjects. This scale can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, and opens up the possibility of identifying a different type of SD in schizophrenia, independent of autistic traits and negative symptoms, which might benefit from different treatments.

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16. Prosperi M, Turi M, Guerrera S, Napoli E, Tancredi R, Igliozzi R, Apicella F, Valeri G, Lattarulo C, Gemma A, Santocchi E, Calderoni S, Muratori F, Vicari S. Sex Differences in Autism Spectrum Disorder : An Investigation on Core Symptoms and Psychiatric Comorbidity in Preschoolers. Frontiers in integrative neuroscience. 2020 ; 14 : 594082.

Findings regarding sex differences in autism spectrum disorder (ASD), as far as core symptoms and psychiatric comorbidities (PC) are concerned, are inconsistent, inconclusive, or conflicting among studies. The lower prevalence of ASD in females than in males and the age and intelligence quotient (IQ) heterogeneity among samples made it difficult to investigate these differences. This case-control study tries to deepen the impact of sex differences on core symptoms of autism and PC in 214 preschoolers with ASD (mean age, 45.26) without impairment in non-verbal IQ (nvIQ ≥70). A total of 107 ASD females (mean age, 44.51 ± 13.79 months) were matched one by one with 107 males (mean age, 46.01 ± 13.42 months) for chronological age (±6 months) and nvIQ (±6 points). We used the Autism Diagnostic Observation Schedule 2 (ADOS-2) and the Child Behavior Checklist (CBCL) 1.5-5 to explore autism severity and PC. The results highlight that ASD females did not significantly differ from ASD males regarding the severity of autism. Statistically significant lower levels of emotionally reactive (p = 0.005, η(2) = 0.04), anxious-depressed (p = 0.001, η (2) = 0.05), internalizing problems (p = 0.04, η (2) = 0.02), and DSM-Oriented Scales anxiety problems (p = 0.02, η (2) = 0.04) in ASD females than in ASD males were also detected. Our findings of no difference in the autism severity and lower internalizing problems in females than males with ASD extend the knowledge of autism in females during preschool years. Compared to other similar studies on this topic, we can state that these results are not supported by differences in nvIQ between sexes nor by the presence of cognitive impairment. It confirms the need for clinicians to consider sex differences when describing autism psychopathology.

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17. Sakuta S, Hashimoto M, Ikeda M, Koyama A, Takasaki A, Hotta M, Fukuhara R, Ishikawa T, Yuki S, Miyagawa Y, Hidaka Y, Kaneda K, Takebayashi M. Clinical features of behavioral symptoms in patients with semantic dementia : Does semantic dementia cause autistic traits ?. PLoS One. 2021 ; 16(2) : e0247184.

OBJECTIVE : To investigate the behavioral characteristics of semantic dementia (SD) using an instrument originally developed for patients with autism spectrum disorder. METHODS : The behavioral symptoms of 20 patients with SD and 20 patients with Alzheimer’s disease (AD) in both the preclinical state and the dementia state were evaluated using the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS). RESULTS : The SD group showed high prevalence in four behaviors related to stereotypy and social impairment : eating very few food items, selfishness, difficulty in recognizing others’ feeling and thoughts, and interpreting language literally. Scores on the PARS short version, which is sensitive for diagnosis of autism spectrum disorder, were significantly higher in the dementia state than in the preclinical state in both the SD (11.5 ± 6.0 and 1.7 ± 2.5, respectively ; t (19) = 6.7, p < 0.001) and AD (6.9 ± 4.6 and 1.7 ± 2.0, respectively ; t (19) = 5.1, p < 0.001) groups. PARS short version scores after dementia onset increased in both the SD and AD groups, although the increase was significantly larger in the SD group (F = 5.6, p = 0.023). Additionally, a significantly higher rate of patients exceeded the cutoff score for autism diagnosis in the dementia state in the SD group (75%) than in the AD group (40% ; χ2 = 5.0, p = 0.025). PARS scores in the dementia state were significantly correlated with illness duration (r = 0.46, p = 0.04) and Mini-Mental State Examination scores (r = -0.75, p < 0.001) in the SD group only. CONCLUSIONS : Although SD and autism spectrum disorder are etiologically distinct diseases, patients with semantic dementia behave like those with autism spectrum disorder. Our findings suggest the symptomatic similarity of the two disorders.

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18. Tsuchiya KJ, Hakoshima S, Hara T, Ninomiya M, Saito M, Fujioka T, Kosaka H, Hirano Y, Matsuo M, Kikuchi M, Maegaki Y, Harada T, Nishimura T, Katayama T. Diagnosing Autism Spectrum Disorder Without Expertise : A Pilot Study of 5- to 17-Year-Old Individuals Using Gazefinder. Frontiers in neurology. 2020 ; 11 : 603085.

Atypical eye gaze is an established clinical sign in the diagnosis of autism spectrum disorder (ASD). We propose a computerized diagnostic algorithm for ASD, applicable to children and adolescents aged between 5 and 17 years using Gazefinder, a system where a set of devices to capture eye gaze patterns and stimulus movie clips are equipped in a personal computer with a monitor. We enrolled 222 individuals aged 5-17 years at seven research facilities in Japan. Among them, we extracted 39 individuals with ASD without any comorbid neurodevelopmental abnormalities (ASD group), 102 typically developing individuals (TD group), and an independent sample of 24 individuals (the second control group). All participants underwent psychoneurological and diagnostic assessments, including the Autism Diagnostic Observation Schedule, second edition, and an examination with Gazefinder (2 min). To enhance the predictive validity, a best-fit diagnostic algorithm of computationally selected attributes originally extracted from Gazefinder was proposed. The inputs were classified automatically into either ASD or TD groups, based on the attribute values. We cross-validated the algorithm using the leave-one-out method in the ASD and TD groups and tested the predictability in the second control group. The best-fit algorithm showed an area under curve (AUC) of 0.84, and the sensitivity, specificity, and accuracy were 74, 80, and 78%, respectively. The AUC for the cross-validation was 0.74 and that for validation in the second control group was 0.91. We confirmed that the diagnostic performance of the best-fit algorithm is comparable to the diagnostic assessment tools for ASD.

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19. van Dijk MWG, Buruma ME, Blijd-Hoogewys EMA. Correction to : Detecting Feeding Problems in Young Children with Autism Spectrum Disorder. J Autism Dev Disord. 2021.

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20. Ye Q, Liu L, Lv S, Cheng S, Zhu H, Xu Y, Zou X, Deng H. The Gestures in 2-4-Year-Old Children With Autism Spectrum Disorder. Front Psychol. 2021 ; 12 : 604542.

Deficits in gestures act as early signs of impairment in social interaction (SI) and communication in children with autism spectrum disorder (ASD). However, the pieces of literature on atypical gesture patterns in ASD children are contradictory. This investigation aimed to explore the atypical gesture pattern of ASD children from the dimensions of quantity, communicative function, and integration ability ; and its relationship with social ability and adaptive behavior. We used a semi-structured interactive play to evaluate gestures of 33 ASD children (24-48 months old) and 24 typically developing (TD) children (12-36 months old). And we evaluated the social ability, adaptive behavior, and productive language of ASD and TD children by using the Adaptive Behavior Assessment System version II (ABAS-II) and Chinese Communication Development Inventory (CCDI). No matter the total score of CCDI was corrected or not, the relative frequency of total gestures, behavior regulation (BR) gestures, SI gestures, and joint attention (JA) gestures of ASD children were lower than that of TD children, as well as the proportion of JA gestures. However, there was no significant group difference in the proportion of BR and SI gestures. Before adjusting for the total score of CCDI, the relative frequency of gestures without vocalization/verbalization integration and vocalization/verbalization-integrated gestures in ASD children was lower than that in TD children. However, after matching the total score of CCDI, only the relative frequency of gestures without vocalization/verbalization integration was lower. Regardless of the fact that the total score of CCDI was corrected or not, the relative frequency and the proportion of eye-gaze-integrated gestures in ASD children were lower than that in TD children. And the proportion of gestures without eye-gaze integration in ASD children was higher than that in TD children. For ASD children, the social skills score in ABAS-II was positively correlated with the relative frequency of SI gesture and eye-gaze-integrated gestures ; the total score of ABAS-II was positively correlated with the relative frequency of total gestures and eye-gaze-integrated gestures. In conclusion, ASD children produce fewer gestures and have deficits in JA gestures. The deficiency of integrating eye gaze and gesture is the core deficit of ASD children’s gesture communication. Relatively, ASD children might be capable of integrating vocalization/verbalization into gestures. SI gestures and the ability to integrate gesture and eye gaze are related to social ability. The quantity of gestures and the ability to integrate gesture with eye gaze are related to adaptive behavior. Clinical Trial Registration : www.ClinicalTrials.gov, identifier ChiCTR1800019679.

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