1. Angell AM, Lindly OJ, Floríndez D, Floríndez LI, Stein Duker LI, Zuckerman KE, Yin L, Solomon O. Pediatricians’ role in healthcare for Latino autistic children: Shared decision-making versus « You’ve got to do everything on your own ». Autism : the international journal of research and practice. 2023: 13623613231163056.

Latino parents may choose to use complementary health approaches, such as vitamins, supplements, and special diets, for their autistic children. However, they might not tell their pediatrician about their complementary health approach use if they worry that the pediatrician will disapprove or judge them. This fear, along with pediatricians’ lack of autism knowledge, creates barriers to « shared decision-making » between parents and pediatricians. Shared decision-making is a process where families and healthcare providers collaborate and exchange information in order to come to an agreement about treatment options. In our qualitative study with 12 bilingual Latino families of autistic children, we interviewed and observed families to learn about their experiences with both conventional healthcare (their pediatrician) and complementary health approaches. Our study results describe the parents’ different pathways to an autism assessment, a process that is sometimes called the « diagnostic odyssey. » The parents reported that conventional healthcare met their needs for their child’s physical health but not for their child’s developmental challenges. The parents who used complementary health approaches for their autistic children were more frustrated about a lack of autism information from pediatricians than those who did not use complementary health approaches. Finally, we describe two examples of successful shared decision-making between parents and pediatricians. We conclude that pediatricians who are able to talk about complementary health approaches with Latino families may help to facilitate shared decision-making and reduce healthcare disparities for Latino autistic children.

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2. Borre ED, Myers E, Hamilton Lopez M, Kurtzberg J, Shaz B, Troy J, Sanders Schmidler GD. The potential cost-effectiveness of novel cord blood therapies in children with autism spectrum disorder. PloS one. 2023; 18(4): e0282906.

OBJECTIVE: To model the long-term clinical and economic outcomes of potential cord blood therapy in autism spectrum disorder (ASD). STUDY DESIGN: Markov microsimulation of ASD over the lifespan was used to compare two strategies: 1) standard of care (SOC), including behavioral and educational interventions, and 2) novel cord blood (CB) intervention in addition to SOC. Input data reflecting behavioral outcomes included baseline Vineland Adaptive Behavior Scale (VABS-3), monthly VABS-3 changes, and CB intervention efficacy on adaptive behavior based on a randomized, placebo-controlled trial (DukeACT). Quality-adjusted life-years (QALYs) were correlated to VABS-3. Costs for children with ASD ($15,791, ages 2-17 years) and adults with ASD ($56,559, ages 18+ years), and the CB intervention (range $15,000-45,000) were incorporated. Alternative CB efficacy and costs were explored. RESULTS: We compared model-projected results to published data on life-expectancy, mean VABS-3 changes, and lifetime costs. Undiscounted lifetime QALYs in the SOC and CB strategies were 40.75 and 40.91. Discounted lifetime costs in the SOC strategy were $1,014,000, and for CB ranged from $1,021,000-$1,058,000 with CB intervention cost ($8,000-$45,000). At $15,000 cost, CB was borderline cost-effective (ICER = $105,000/QALY). In one-way sensitivity analysis, CB cost and efficacy were the most influential parameters on CB ICER. CB intervention was cost-effective at costs<$15,000 and efficacies ≥2.0. Five-year healthcare payer projected budgetary outlays at a $15,000 CB cost were $3.847B. CONCLUSIONS: A modestly effective intervention designed to improve adaptive behavior in autism can be cost-effective under certain circumstances. Intervention cost and efficacy most affected the cost-effectiveness results and should be targeted to increase economic efficiency.

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3. Bryńska A, Wolak T, Naumczyk P, Srebnicki T, Wolańczyk T. Semantic decisions in adolescents with autism spectrum disorders – functional magnetic resonance imaging study. Psychiatria polska. 2022; 56(5): 1079-92.

OBJECTIVES: Goal: to assess fMRI activation during semantic tasks in adolescents with ASD. METHODS: Material: 44 right-handed male adolescents aged 12-19 (mean 14.3 ± 2.0) – 31 with autism spectrum disorders who met DSM-IV-TR criteria for Asperger’s syndrome and 13 neurotypical adolescents matched according to age and handiness. Method: Functional testing (fMRI) was performed during semantic decisions tasks and phonological decisions in three categories of tasks: concrete nouns, verbs with plural meanings, words describing states of mind, as a control condition. Statistical analyzes were performed at the level of p <0.05 with FWE (family-wise error) correction and p <0.001. RESULTS: Results: lower BOLD signal was demonstrated in many brain areas including precuneus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, regardless of task category and processing method in the ASD group. The smallest differences in semantic processing were found for concrete nouns and the greatest ones for words describing states of mind. CONCLUSIONS: Conclusions: the presence of different activation patterns in the ASD group suggests that far more than just the areas traditionally attributed to language processing, are involved in semantic deficits in ASD.

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4. Bryńska A, Wolak T, Naumczyk P, Srebnicki T, Wolańczyk T. Morphometric evaluations based on Voxel Based Morphometry on adolescents with autism spectrum disorders. Psychiatria polska. 2022; 56(5): 1049-59.

OBJECTIVES: Goal: to evaluate changes in the grey matter volume using the VBM method in a group of adolescents with ASD, who met the criteria for Asperger’s Syndrome. METHODS: Material and methods: Morphometric evaluations based on Voxel Based Morphometry (VBM) were performed on 37 male adolescents aged 12 to 19 (M = 14.3 ± 2.0), with autism spectrum disorders, who met the DSM-IV-TR criteria for Asperger’s Syndrome and 15 neurotypical adolescents matched by age. Significance was set at p<0.007 without FWE correction and p<0.05 with FWE correction. RESULTS: Results: the decrease in the volume of the grey matter was observed in ASD group including the pre- and postcentral gyrus, the superior and middle frontal gyrus, the inferior and superior parietal lobule, the praecuneus, the anterior and posterior cingulate cortex, the fusiform gyrus, the parahippocampal gyrus, the lingual gyrus, the middle occipital region, the cuneus and the angular gyrus, the regions of calcarine sulcus and the cerebellum. The majority of changes was localized bilaterally. CONCLUSIONS: Conclusions: the decrease in the volume of grey matter observed in ASD group can be related functionally with the characteristics of deficits observed in autism spectrum disorders which highlights the role of abnormal organization of numerous CNS structures in the genesis of symptoms observed in cognitive and behavioural domains.

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5. Charbonneau DH, Ketcheson LR. Retracted publications in autism research are mostly concerned with ethical misconduct. Health information and libraries journal. 2023.

BACKGROUND: As the prevalence of autism appears to increase, more research to guide effective diagnosis and intervention practices is needed. Findings disseminated through peer-reviewed publications are critical, but the number of retractions continues to rise. An understanding of retracted publications is imperative to ensure the body of evidence is corrected and current. OBJECTIVES: The objectives of this analysis were to summarize key characteristics of retracted publications in autism research, examine the length of time between publication and retraction, and assess the extent journals are adhering to publishing ethical guidelines for reporting retracted articles. METHODS: We searched five databases through 2021 (PubMed, EMBASE, Scopus, Web of Science, and Retraction Watch). RESULTS: A total of 25 retracted articles were included in the analysis. Ethical misconduct accounted for the majority of retractions rather than scientific error. The shortest time to retraction was 2 months and the longest length was 144 months. DISCUSSION: The time lag between publication and retraction since 2018 has improved considerably. Nineteen of the articles had retraction notices (76%), whereas six articles did not have a notice (24%). CONCLUSION: These findings summarize errors of previous retractions and illuminate opportunities for researchers, journal publishers and librarians to learn from retracted publications.

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6. Cleary M, West S, Thapa DK, Kornhaber R. Putting Cats on the Spectrum: A Scoping Review of the Role of Cats in Therapy and Companionship for Autistic Adults and Children. Issues in mental health nursing. 2023: 1-12.

This scoping review brings together existing studies on the use of cats in animal-assisted interventions, as assistance animals and as companion animals for autistic people. A systematic search across PubMed, CINAHL and Scopus in September 2022 identified 13 articles from 12 studies meeting the selection criteria with analysis revealing two key findings, cat-assisted therapeutic interventions, and cats as companion animals. There were five themes that emerged: the characteristics and behaviours of cats that make them suitable for inclusion in homes with autistic people; the bond between the cat and the autistic person; the use of cats as human-substitutes; the multiple ways in which cats improved the lives and social functioning of autistic people; and, some noted drawbacks or considerations of cat ownership. The review generates a comprehensive knowledge base upon which to promote feline therapy in autism and to advocate for further targeted research.

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7. Cortes Cavalcante J, Faria Sales M, Sousa Junior RR, Souto DO, Vale Gonçalves R, Camargos ACR, Leite HR. Analysis of the Brazilian-Portuguese Content on Autism Spectrum Disorder Available on YouTube Videos. Physical & occupational therapy in pediatrics. 2023: 1-15.

AIMS: Information about Autism Spectrum Disorder (ASD) is available in different videos on YouTube. However, these videos might present inaccurate or outdated information. The aims of this study were to 1) identify characteristics of Brazilian-Portuguese videos about ASD (i.e., type of content, number of views, likes, and dislikes); 2) analyze the content of informative videos about ASD, by assessing their trustworthiness and overall quality; and 3) investigate the most popular topics of informative videos about ASD over time. METHODS: This is a cross-sectional study that investigated Brazilian-Portuguese ASD content on YouTube. Videos were selected by two examiners and categorized as experiential or informative. The Discern checklist and the Global Quality Score (GQS) were used to analyze the trustworthiness and quality of informative videos. RESULTS: In total, 216 videos were analyzed, of which 19.5% and 85% were classified as experiential and informative, respectively. The majority of informative videos presented moderate trustworthiness and quality. Videos about ASD clinical aspects were the most popular. CONCLUSION: YouTube offers a large number of experiential and informative videos on ASD. However, some of these videos fail to present reliable and additional sources of information for stakeholders. Efforts to promote knowledge translation about ASD on YouTube are necessary.

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8. Cupaioli FA, Mosca E, Magri C, Gennarelli M, Moscatelli M, Raggi ME, Landini M, Galluccio N, Villa L, Bonfanti A, Renieri A, Fallerini C, Minelli A, Marabotti A, Milanesi L, Fasano A, Mezzelani A. Author Correction: Assessment of haptoglobin alleles in autism spectrum disorders. Scientific reports. 2023; 13(1): 6321.

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9. Girianelli VR, Tomazelli J, Silva C, Fernandes CS. Early diagnosis of autism and other developmental disorders, Brazil, 2013-2019. Revista de saude publica. 2023; 57: 21.

OBJECTIVE: To investigate the factors associated with the early diagnosis of autism and other types of pervasive developmental disorder (PDD) in children treated at the Psychosocial Care Center for Children and Adolescents of the Unified Health System, from 2013 to 2019,in Brazil. METHODS: An exploratory cross-sectional study, based on data from the Record of Outpatient Health Actions (RAAS) of the first appointment of children aged 1 to 12 years. The gross (RRg) and adjusted (RRa) relative risks and respective 95% confidence intervals (95%CI) were estimated using the Poisson regression model with robust variance estimation. RESULTS: Of the 22,483 children included in the study, the majority were male (81.9%), lived in the same municipality where they were diagnosed (96.8%) and in the Southeast region (57.7%). Early diagnosis was higher for childhood autism (RRg = 1.48; 95%CI 1.27-1.71) , PDD without subtype designation (RRg = 1.55; 95%CI 1.34-1.80), other PDD (RRg = 1.48; 95%CI 1.21-1.81) and PDD not otherwise specified (RRg = 1.44; 95%CI 1.22-1.69) than for atypical autism. Children residing in the same municipality where the diagnosis was made had a higher rate of early diagnosis (RRg = 1.31; 95%CI 1.10-1.55) than the others; as well as those referred by primary care (RRg = 1.51; 95%CI 1.37-1.68) and by spontaneous demand (RRg = 1.45; 95%CI 1.31-1.61) than those from other types of referral. Early diagnosis was higher from 2014 and lower in the North region than in the other regions. In the multiple analysis, the magnitude of RRa was similar to that of RRg. CONCLUSIONS: Early identification of autism and other PDD has improved in Brazil, but it still represents about 30% of the diagnoses made. The variables included in the model were significant, but still explain little of the early diagnosis of children with autism and other PDD.

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10. Hasler M, Fideli Ü S, Susi A, Hisle-Gorman E. Examining the relationship between autism spectrum disorder and neural tube defects. Congenital anomalies. 2023.

Folate and vitamin B(12) deficiencies have been strongly associated with neural tube defects, preliminary research suggests folate and B(12) deficiency may also be associated with autism spectrum disorder (ASD). We examined the association between neural tube defects and ASD as a further avenue to examine the hypothesis that ASD is related to maternal folate and B(12) deficiency during pregnancy. A retrospective case-control study was performed using the Military Health System Data Repository. Cases and matched controls were followed from birth until at least 6 months after their first autism diagnosis. International Classification of Diseases, 9th Revision, codes were used to identify neural tube defects in the health records. A total of 8760 cases between the ages of 2 and 18 years were identified. The prevalence of any neural tube defect was 0.11% in children without ASD and 0.64% in children with ASD. Children with autism were over 6 times as likely to have a neural tube defect. The increased odds of neural tube defect in children diagnosed with ASD, found through our methodology, supports prior studies. Although additional studies are needed to elucidate the relationship between ASD and maternal folate and vitamin B(12) deficiency during pregnancy this study supports their use during pregnancy.

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11. Hughes MM, Shaw KA, DiRienzo M, Durkin MS, Esler A, Hall-Lande J, Wiggins L, Zahorodny W, Singer A, Maenner MJ. The Prevalence and Characteristics of Children With Profound Autism, 15 Sites, United States, 2000-2016. Public health reports (Washington, DC : 1974). 2023: 333549231163551.

OBJECTIVES: Autism spectrum disorder (autism) is a heterogeneous condition that poses challenges in describing the needs of individuals with autism and making prognoses about future outcomes. We applied a newly proposed definition of profound autism to surveillance data to estimate the percentage of children with autism who have profound autism and describe their sociodemographic and clinical characteristics. METHODS: We analyzed population-based surveillance data from the Autism and Developmental Disabilities Monitoring Network for 20 135 children aged 8 years with autism during 2000-2016. Children were classified as having profound autism if they were nonverbal, were minimally verbal, or had an intelligence quotient <50. RESULTS: The percentage of 8-year-old children with profound autism among those with autism was 26.7%. Compared with children with non-profound autism, children with profound autism were more likely to be female, from racial and ethnic minority groups, of low socioeconomic status, born preterm or with low birth weight; have self-injurious behaviors; have seizure disorders; and have lower adaptive scores. In 2016, the prevalence of profound autism was 4.6 per 1000 8-year-olds. The prevalence ratio (PR) of profound autism was higher among non-Hispanic Asian/Native Hawaiian/Other Pacific Islander (PR = 1.55; 95 CI, 1.38-1.73), non-Hispanic Black (PR = 1.76; 95% CI, 1.67-1.86), and Hispanic (PR = 1.50; 95% CI, 0.88-1.26) children than among non-Hispanic White children. CONCLUSIONS: As the population of children with autism continues to change, describing and quantifying the population with profound autism is important for planning. Policies and programs could consider the needs of people with profound autism across the life span to ensure their needs are met.

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12. Kasari C, Shire S, Shih W, Landa R, Levato L, Smith T. Spoken language outcomes in limited language preschoolers with autism and global developmental delay: RCT of early intervention approaches. Autism research : official journal of the International Society for Autism Research. 2023.

Preschool autistic children with significant global developmental delays and very limited language skills are at high risk for remaining minimally verbal at entry into primary school. This study compared two early intervention models for improving social communication and spoken language outcomes in 164 children who received intervention in their community preschool program for 6 months, with a six-month follow-up. The primary outcome measure was a standardized language assessment, and secondary measures focused on social communication. Results indicated children on average made 6 months gain in language development in the active 6 months of intervention with no difference between intervention models. Children who initiated joint attention more frequently, or who had higher receptive language at baseline made more progress if assigned to receive JASPER, a naturalistic developmental behavioral intervention. Children who received Discrete Trial Training made greater spoken language progress from exit to follow-up. These findings suggest that progress can be made in autistic children who have very little spoken language and who receive targeted early interventions. Individual trajectories vary and depend in part on initial abilities in social communication and receptive language. Future research might consider methods to systematically personalize approaches to fit child characteristics and family preference. LAY SUMMARY: This study compared two different early intervention approaches for teaching spoken language to minimally verbal, globally delayed autistic preschoolers. Children were given an hour of therapy daily for 6 months and then reassessed 6 months later. The majority of the 164 participants were from historically excluded populations (low income and minority), and therapy was delivered in school community settings by expert clinicians. Results indicated that the participants made significant progress regardless of intervention approach: 6 months gain in standardized language scores over 6 months, but slower progress during the period after therapy ended. Children who initiated joint attention more frequently, or who had higher language understanding at baseline made more progress if assigned to receive JASPER, a naturalistic developmental behavioral intervention. Children who received Discrete Trial Training made greater language progress during 6-month period after therapy ended. These findings suggest that progress can be made in children with ASD who have very little spoken language and who receive targeted early interventions.

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13. Katumba KR, Tann CJ, Webb EL, Tenywa P, Nampijja M, Seeley J, Greco G. The economic burden incurred by families caring for a young child with developmental disability in Uganda. PLOS global public health. 2023; 3(4): e0000953.

Each year, nearly 30 million children globally are at risk of developmental difficulties and disability as a result of newborn health conditions, with the majority living in resource-constrained countries. This study estimates the annual cost to families related to caring for a young child with developmental disability in Uganda. Nested within a feasibility trial of early care and support for young children with developmental disabilities, this sub-study estimated the cost of illness, the cost of paternal abandonment of the caregiver and the affordability of care by household. Seventy-three caregivers took part in this sub-study. The average annual cost of illness to families was USD 949. The main cost drivers were the cost of seeking care and income lost due to loss of employment. Households caring for a child with a disability spent more than the national average household expenditure, and the annual cost of illness for all households was more than 100% of the national GDP per capita. In addition, 84% of caregivers faced economic consequences and resorted to wealth-reducing coping strategies. Families caring for a child with severe impairment incurred USD 358 more on average than those with mild or moderate impairment. Paternal abandonment was common (31%) with affected mothers losing an average of USD 430 in financial support. Caring for a young child with developmental disability was unaffordable to all the study households. Programmes of early care and support have the potential to reduce these financial impacts. National efforts to curb this catastrophic health expenditure are necessary.

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14. Khan S, Naeem A. MTHFR Deficiency in Biological Siblings Diagnosed With Autism and Attention-Deficit Hyperactivity Disorder (ADHD): A Report of Two Cases. Cureus. 2023; 15(3): e36294.

Methylenetetrahydrofolate reductase is a critical enzyme that has been associated with several complex psychiatric mental health illnesses. The enzyme can be detected by bloodwork or a cheek swab and, once identified as lacking in individuals, can be treated by over-the-counter supplementation with folate. Due to a provider’s limited information and/or the cost to cover the test, the deficiency is not regularly tested for, and, therefore, is missed and not treated. There are very limited studies that demonstrate the benefits of supplements in conjunction with psychotropic medications. This study discusses the case of two biological siblings diagnosed with attention-deficit hyperactivity disorder and autism, who presented with this unique deficiency and had improvement of symptoms once starting the supplement with their traditional psychopharmacological treatment.

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15. Micheletti M, Brukilacchio BH, Hooper-Boyle H, Basiru T, Brinster MI, Ravenscroft S, Shahidullah JD. Evaluating the Efficiency and Equity of Autism Diagnoses via Telehealth During COVID-19. Journal of autism and developmental disorders. 2023.

Given existing barriers to a timely autism diagnosis, this study compares the efficiency and equity of diagnoses conducted in-person vs. telehealth in a developmental behavioral pediatrics setting. The transition to telehealth was prompted by the COVID-19 pandemic. Eleven months of clinic data in electronic medical records were retrospectively analyzed for children diagnosed with autism in-person (N = 71) vs. telehealth (N = 45). Time to autism diagnosis, patient demographics, and deferred diagnoses did not significantly differ across visit types. However, privately insured patients and families living farther from the clinic had a longer time to diagnosis via telehealth vs. in-person. Results of this exploratory study highlight the feasibility of telehealth evaluations for autism and which families may benefit from additional support to ensure a timely diagnosis.

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16. Moser M, Müllner C, Ferro P, Albermann K, Jenni OG, von Rhein M. The role of well-child visits in detecting developmental delay in preschool children. BMC pediatrics. 2023; 23(1): 180.

BACKGROUND: Early detection of developmental delay (DD) in preschool children is crucial for counselling parents, initiating diagnostic work-up, and starting early intervention (EI). METHODS: We conducted a register study of all preschool children referred for EI in the Canton of Zurich, Switzerland, in 2017 (N = 1,785) and used an online survey among primary care physicians (PCPs, N = 271) to evaluate the care service of DD children. RESULTS: PCPs accounted for 79.5% of all referrals by physicians and had correctly referred over 90% of the children in need of EI at an average age of 39.3 months (SD 8.9). In the survey, which represents 59.2% of all pediatricians and 11.3% of all general practitioners in the Canton, PCPs reported performing a mean of 13.5 (range 0-50, SD 10.7) well-child visits per week to preschool children and estimated well-child visits to be the most frequent type of consultation (66.7%) for the identification of DD. Parents’ hesitancy in accepting further evaluation or support were reported by 88.7%. CONCLUSIONS: Most preschool children with DD are identified in well-child visits. These visits represent an ideal opportunity for early detection of developmental impairment and initiation of EI. Carefully addressing parents’ reservations could reduce the rate of refusal, thus improving early support for children with DD.

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17. Munz M, Bharioke A, Kosche G, Moreno-Juan V, Brignall A, Rodrigues TM, Graff-Meyer A, Ulmer T, Haeuselmann S, Pavlinic D, Ledergerber N, Gross-Scherf B, Rózsa B, Krol J, Picelli S, Cowan CS, Roska B. Pyramidal neurons form active, transient, multilayered circuits perturbed by autism-associated mutations at the inception of neocortex. Cell. 2023.

Cortical circuits are composed predominantly of pyramidal-to-pyramidal neuron connections, yet their assembly during embryonic development is not well understood. We show that mouse embryonic Rbp4-Cre cortical neurons, transcriptomically closest to layer 5 pyramidal neurons, display two phases of circuit assembly in vivo. At E14.5, they form a multi-layered circuit motif, composed of only embryonic near-projecting-type neurons. By E17.5, this transitions to a second motif involving all three embryonic types, analogous to the three adult layer 5 types. In vivo patch clamp recordings and two-photon calcium imaging of embryonic Rbp4-Cre neurons reveal active somas and neurites, tetrodotoxin-sensitive voltage-gated conductances, and functional glutamatergic synapses, from E14.5 onwards. Embryonic Rbp4-Cre neurons strongly express autism-associated genes and perturbing these genes interferes with the switch between the two motifs. Hence, pyramidal neurons form active, transient, multi-layered pyramidal-to-pyramidal circuits at the inception of neocortex, and studying these circuits could yield insights into the etiology of autism.

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18. Persson M, Reichenberg A, Andersson Franko M, Sandin S. Maternal type 1 diabetes, pre-term birth and risk of autism spectrum disorder-a prospective cohort study. International journal of epidemiology. 2023; 52(2): 377-85.

BACKGROUND: It has been suggested that maternal type 1 diabetes (T1D) increases the risk of autism spectrum disorder (ASD) in the offspring. However, it is unclear whether this risk is mediated by pre-term birth, affecting around one-third of pregnancies with T1D, and whether maternal levels of glycated haemoglobin (HbA1c) impact the risk. METHODS: A cohort of 1.4 million Swedish children born between 1998 and 2015, and their parents. Maternal T1D and HbA1c before or in early pregnancy, gestational and ASD diagnoses were obtained from Swedish national registers. Relative risk (RR) and 95% CIs of ASD were estimated by hazard ratios (HRs) from Cox regression or RR from log-binomial regression. RESULTS: Of 1 406 650 children, 8003 (0.6%) were born to mothers with T1D, 24 941 (1.8%) were diagnosed with ASD and 81 915 (5.8%) were born pre-term. The risk of ASD was increased in offspring of mothers with T1D was HR = 1.40 (1.21-1.61). The RR for each +5-mmol/mol excess HbA1c was estimated at HR = 1.03 (0.97-1.10). The T1D effect on ASD mediated through pre-term birth was estimated at RR = 1.06 (1.05 to 1.08), corresponding to 22% (16% to 41%) of the total effect. T1D in pregnancy was associated with increased ASD risk in the offspring. Twenty percent of the total effect was accounted for by pre-term birth. HbA1c was not associated with ASD risk, beyond the risk associated by the T1D diagnosis itself. CONCLUSION: Awareness of ASD in the offspring of mothers with T1D may be warranted, especially considering the additional effect of pre-term birth.

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19. Taylor LG, Primucci M, Irwin JD, Teachman G, Tucker P. The Uses and Effectiveness of Occupational Therapy Physical Activity Interventions in Young Children with Developmental Disabilities: A Systematic Review. Physical & occupational therapy in pediatrics. 2023: 1-22.

BACKGROUND: Physical activity (PA) is often used to support the development of young children (<5 years) with disabilities. The effectiveness of PA as an occupational therapy (OT) treatment approach in this population has not yet been systematically examined. AIMS: This research aimed to explore the uses and effectiveness of OT PA interventions on developmental indicators in young children with developmental disabilities. METHODS: A systematic review of peer-reviewed publications (from 2000 onward) across six electronic databases was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to assess study quality. Narrative synthesis (vote counting and structured reporting of effects) was employed to summarize the findings. RESULTS: Eight studies with heterogenous interventions were included. Evidence demonstrated positive trends of participation in the PA interventions on physical, cognitive, and social-emotional indicators, with significance varying. There was no association between interventions and communication indicators or negative effects related to participation in the interventions. Overall, the studies were low-quality when judged by GRADE. CONCLUSIONS: PA may be a promising avenue for OT interventions among young children with developmental disabilities. Rigorous research is needed to determine the magnitude of effect PA has on developmental indicators.

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