1. Hunter MB, Chin RFM. Impaired social attention detected through eye movements in children with early-onset epilepsy. Epilepsia. 2021; 62(8): 1921-30.

OBJECTIVES: Children with early-onset epilepsy (CWEOE; epilepsy onset before 5 years) exhibit impaired social functioning, but social attention has not yet been examined. In this study we sought to explore visual attention via eye tracking as a component of social attention and examine its relationship with social functioning and Autism Spectrum Disorder (ASD) risk scores. METHODS: Forty-seven CWEOE (3-63 months) and 41 controls (3-61 months) completed two eye-tracking tasks: (1) preference for social versus nonsocial naturalistic scenes, and (2) face region preference task. ASD risk was measured via the Modified Checklist for Autism in Toddlers or Conners Early Childhood Total Score. Social functioning was assessed via the Greenspan Social-Emotional Growth Chart, or Infant-Toddler Social & Emotional Assessment Competence Scale, or Conners Early Childhood Social Functioning Scale, depending on age. Fixation preferences for social scenes and eyes were compared between groups and evaluated by age and social functioning scores. RESULTS: Regression analysis revealed that CWEOE viewed the social scene to a significantly less degree than controls. The greatest difference was found between the youngest CWEOE and controls. Fixation duration was independently and significantly related to social functioning scores. There were no significant differences between CWEOE and controls in the face scanning task, and there was no significant relationship between either task and ASD risk scores. SIGNIFICANCE: CWEOE exhibit task-specific atypical social attention early in the course of the disease. This may be an early marker of impaired social development, and it suggests abnormal social brain development.

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2. Kalstabakken AW, Molitor SJ, Gross AC, Georgieff MK, Boys CJ. Predictive Value of Developmental Assessment in a Neonatal Intensive Care Unit (NICU) Follow-Up Clinic. Journal of pediatric psychology. 2021; 46(7): 814-23.

OBJECTIVE: Neonatal Intensive Care Unit (NICU) Follow-Up programs vary in the duration for which they monitor child development and neurocognitive outcomes. This study explores the early predictive value of a widely used developmental measure for intellectual functioning during early childhood to better inform whether there is value added in continued monitoring. METHODS: Participants were 209 children who had at least two assessments between the ages of 1 and 6 years old as part of NICU Follow-Up clinic. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was administered when children were 1 and 2 years old and the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) was administered when children were 3 years and older. RESULTS: The Bayley-III at 1 year of age was a significant predictor of Bayley-III performance at age 2. Similarly, Bayley-III at ages 1 year and 2 years were significant predictors of WPPSI-IV performance. Strength of prediction was moderate with the majority of variance unexplained. Exploratory analyses examining whether early developmental abilities as assessed on the Bayley-III could identify patients at risk for poorer WPPSI-IV performance indicated appropriate specificity but inadequate sensitivity. CONCLUSIONS: This study supports ongoing assessment of children who were born with perinatal complications into at least early childhood. Assessing development only during the infant and toddler years did not sufficiently identify children who went on to have lower cognitive functioning in preschool and the early school years.

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3. Morris C, Detrick JJ, Peterson SM. Participant assent in behavior analytic research: Considerations for participants with autism and developmental disabilities. Journal of applied behavior analysis. 2021; 54(4): 1300-16.

Obtaining assent from potential research participants is an important component of research for reasons related to ethics compliance, self-determination, and choice. However, unique issues arise when working with populations who cannot assent through traditional means, such as individuals with Autism Spectrum Disorder (ASD) and related developmental disabilities (DD). The purpose of this paper is to review and discuss assent practices within behavior-analytic research to identify strategies that can be used to obtain assent from potential participants with ASD and DDs. We began with a descriptive literature review of behavior-analytic articles that included the term « assent » to identify what practices behavior analysts have used to obtain assent from participants. In short, very few articles that clearly addressed assent procedures were identified. Thus, we propose a model for gaining assent when working with individuals with ASD and DDs.

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4. Polla DL, Edmondson AC, Duvet S, March ME, Sousa AB, Lehman A, Niyazov D, van Dijk F, Demirdas S, van Slegtenhorst MA, Kievit AJA, Schulz C, Armstrong L, Bi X, Rader DJ, Izumi K, Zackai EH, de Franco E, Jorge P, Huffels SC, Hommersom M, Ellard S, Lefeber DJ, Santani A, Hand NJ, van Bokhoven H, He M, de Brouwer APM. Bi-allelic variants in the ER quality-control mannosidase gene EDEM3 cause a congenital disorder of glycosylation. American journal of human genetics. 2021; 108(7): 1342-9.

EDEM3 encodes a protein that converts Man(8)GlcNAc(2) isomer B to Man(7-5)GlcNAc(2). It is involved in the endoplasmic reticulum-associated degradation pathway, responsible for the recognition of misfolded proteins that will be targeted and translocated to the cytosol and degraded by the proteasome. In this study, through a combination of exome sequencing and gene matching, we have identified seven independent families with 11 individuals with bi-allelic protein-truncating variants and one individual with a compound heterozygous missense variant in EDEM3. The affected individuals present with an inherited congenital disorder of glycosylation (CDG) consisting of neurodevelopmental delay and variable facial dysmorphisms. Experiments in human fibroblast cell lines, human plasma, and mouse plasma and brain tissue demonstrated decreased trimming of Man(8)GlcNAc(2) isomer B to Man(7)GlcNAc(2), consistent with loss of EDEM3 enzymatic activity. In human cells, Man(5)GlcNAc(2) to Man(4)GlcNAc(2) conversion is also diminished with an increase of Glc(1)Man(5)GlcNAc(2). Furthermore, analysis of the unfolded protein response showed a reduced increase in EIF2AK3 (PERK) expression upon stimulation with tunicamycin as compared to controls, suggesting an impaired unfolded protein response. The aberrant plasma N-glycan profile provides a quick, clinically available test for validating variants of uncertain significance that may be identified by molecular genetic testing. We propose to call this deficiency EDEM3-CDG.

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5. Scheerer NE, Birmingham E, Boucher TQ, Iarocci G. Attention capture by trains and faces in children with and without autism spectrum disorder. PloS one. 2021; 16(6): e0250763.

This study examined involuntary capture of attention, overt attention, and stimulus valence and arousal ratings, all factors that can contribute to potential attentional biases to face and train objects in children with and without autism spectrum disorder (ASD). In the visual domain, faces are particularly captivating, and are thought to have a ‘special status’ in the attentional system. Research suggests that similar attentional biases may exist for other objects of expertise (e.g. birds for bird experts), providing support for the role of exposure in attention prioritization. Autistic individuals often have circumscribed interests around certain classes of objects, such as trains, that are related to vehicles and mechanical systems. This research aimed to determine whether this propensity in autistic individuals leads to stronger attention capture by trains, and perhaps weaker attention capture by faces, than what would be expected in non-autistic children. In Experiment 1, autistic children (6-14 years old) and age- and IQ-matched non-autistic children performed a visual search task where they manually indicated whether a target butterfly appeared amongst an array of face, train, and neutral distractors while their eye-movements were tracked. Autistic children were no less susceptible to attention capture by faces than non-autistic children. Overall, for both groups, trains captured attention more strongly than face stimuli and, trains had a larger effect on overt attention to the target stimuli, relative to face distractors. In Experiment 2, a new group of children (autistic and non-autistic) rated train stimuli as more interesting and exciting than the face stimuli, with no differences between groups. These results suggest that: (1) other objects (trains) can capture attention in a similar manner as faces, in both autistic and non-autistic children (2) attention capture is driven partly by voluntary attentional processes related to personal interest or affective responses to the stimuli.

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6. Şengüzel S, Cebeci AN, Ekici B, Gönen İ, Tatlı B. Impact of eating habits and nutritional status on children with autism spectrum disorder. Journal of Taibah University Medical Sciences. 2021; 16(3): 413-21.

OBJECTIVES: Obesity is common among children with Autism Spectrum Disorder (ASD). They suffer more feeding problems than children with normal developmental milestones. Several kinds of diet are recommended for children with ASD. This study determines the frequency of eating disorders and obesity among such children. We investigate the predisposing factors of eating disorders and examine the effects of consumed food on autism scores. METHODS: In this single-centre, cross-sectional study, 46 children with ASD aged between 2 and 10 years were included. Anthropometric measurements were recorded and Brief Autism Mealtime Behavior Inventory (BAMBI), Autism Behavior Checklist (ABC), and Food Frequency Questionnaire (FFQ) forms were filled in by their parents. RESULTS: The rates of being overweight and obese were 10.9% and 28.3%, respectively. Food selectivity was observed in 84.8% of the children, and BAMBI food refusal scores were significantly higher for those aged between 2 and 5 years (p = 0.03). Autism scores and consumption of milk, yoghurt, oily seeds, rice/pasta, and fruits (p < 0.05) were significantly correlated. There were also significant differences between these scores and the frequency of consuming eggs, legumes, and other cereals (p < 0.05). CONCLUSION: Obesity was more common in children with ASD than typically developed children. Despite the high rate of food selectivity, our findings confirmed that food selectivity could be considered independent of obesity. Further, the diet of patients with ASD must include more fruits, yogurt, eggs, legumes, other cereals, less milk, and less rice/pasta.

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7. Shrestha R, Dissanayake C, Barbaro J. Implementing and evaluating Social Attention and Communication Surveillance (SACS) to prospectively identify autism in very young children in Nepal. Research in developmental disabilities. 2021; 115: 104013.

BACKGROUND: Although Autism Spectrum Disorder (ASD) can be identified as early as 12 months and diagnosed by 24 months, the mean age of diagnosis of ASD in Nepal is ∼58 months, with children missing the opportunity for early intervention. AIMS: This study implemented and evaluated a Nepali version of the Social Attention and Communication Surveillance (SACS-N) tool, to identify children between 11-30 months who are at « high likelihood » of ASD in a local community in Nepal. METHODS: Sixty Female Community Health Volunteers (FCHVs) were trained to monitor and identify the early signs of ASD using SACS-N. RESULTS: Overall, 1926 children were monitored with the SACS-N, with 11 children (0.57 %) referred for further assessments at 11-15 months (n = 4), 16-21 months (n = 4), and 22-30 months (n = 3). Of these children, 10 children had a developmental disorder, including ASD and Global Developmental Delay; no information was available on one child who migrated. Hence, the positive predictive value (PPV) of SACS-N for all developmental disorders was 100 %. Of seven children attending a gold standard diagnostic/ developmental assessment, three had ASD (43 % PPV for ASD). The estimated prevalence of ASD ranged between 0.16 % to 0.26 %. CONCLUSION: Community-based developmental monitoring of ASD and other developmental delays by FCHVs is a feasible, cost-effective and sustainable approach to promoting early identification of ASD in Nepal. Further training and awareness of autism is needed for more accurate and increased referral rates using the SACS-N, including regular supervision of FCHVs.

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8. Suliman-Lavie R, Title B, Cohen Y, Hamada N, Tal M, Tal N, Monderer-Rothkoff G, Gudmundsdottir B, Gudmundsson KO, Keller JR, Huang GJ, Nagata KI, Yarom Y, Shifman S. Author Correction: Pogz deficiency leads to transcription dysregulation and impaired cerebellar activity underlying autism-like behavior in mice. Nature communications. 2021; 12(1): 3874.

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9. Thompson JL, Plavnick JB, Skibbe LE, Bak MYS, Doher P. Beyond Tier Three: Individualized Levels of Support During Headsprout® Early Reading Instruction for Children with Autism Spectrum Disorder. Journal of autism and developmental disorders. 2022; 52(5): 2132-48.

We previously conducted a series of conceptual replications to parse out which-and to what degree-adaptations and individualized supports were needed for children to access and learn early reading skills using Headsprout®. Here we developed a systematic decision-making process for providing levels of support to individuals with autism who require additional instruction in order to access and/or advance through Headsprout®. Using a series of single-case AB, ABC, and multiple-baseline designs we examined strategies from our previous research and additional strategies iteratively developed during the study on six students with autism, all of whom demonstrated progression through Headsprout® and increased reading skills. We provide practical implications for teachers and suggestions to research these supports with other computer-based programs.

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10. Yang T, Li D, Zhang Y, Zhang L, Li H, Ji GJ, Yang Z, Zhang L, Zhu C, Wang K. Eye Avoidance of Threatening Facial Expressions in Parents of Children with ASD. Neuropsychiatric disease and treatment. 2021; 17: 1869-79.

OBJECTIVE: Previous research found that autism spectrum disorder (ASD) was characterized by eye avoidance of threatening facial expressions. However, it still remains unclear as to whether these abnormalities are present in parents of children with ASD. Our study aimed to investigate the gaze patterns of parents of children with ASD in the threatening facial expressions. METHODS: Thirty-four parents of children with ASD and 35 parents of typically developing (TD) children participated in our study. We investigated the total fixation time of participants when they viewed different facial expression (eg, happy, fearful, angry, sad) videos and examined changes in the fixation duration over time. RESULTS: We observed the following: a) the total fixation time of the parents of children with ASD on the eyes of fearful faces was significantly shorter than that of the normal group, and the difference lasted for five seconds (four to six seconds, eight to nine seconds) throughout the process; and b) The parents of children with ASD avoided the eyes of angry expression faces at around five seconds after the stimulus onset. CONCLUSION: We concluded that parents of children with ASD tended to avoid the eyes of threatening expression faces while viewing the dynamic emotions video.

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11. Yeung SSY, Chan R, Li L, Chan D, Leung J, Leung TF. Eating Behaviors and Diet Quality in Chinese Preschoolers with and without Autism Spectrum Disorder: A Case-Control Study. The Journal of pediatrics. 2021; 237: 258-66.e5.

OBJECTIVES: To compare mealtime behaviors and diet quality in Chinese preschoolers with autism spectrum disorder (ASD) and typically developing preschoolers in Hong Kong. STUDY DESIGN: This case-control study included a community sample of 65 families with preschoolers with ASD aged 3-6 years and 65 families with typically developing preschoolers matched for age and sex. Preschoolers’ eating behaviors were assessed using the Brief Autism Mealtime Behaviour Inventory and the Preschoolers’ Eating Behaviour Questionnaire (CPEBQ). Preschoolers’ usual diet and nutrient intake were assessed using a validated food frequency questionnaire. Diet quality and diversity were generated using the Chinese Children Dietary Index total score and diet variety score. Between-group differences in various scales and dietary variables were examined using multivariate linear or logistics regression models adjusting for baseline demographic differences. RESULTS: Compared with the typically developing group, the ASD group had greater scores in the Brief Autism Mealtime Behaviour Inventory food refusal domain (P < .001), the CPEBQ food fussiness (P = .001) and eating habit (P = .001) domains, and lower CPEBQ exogenous eating score (P = .003) and initiative eating score (P < .001). The Chinese Children Dietary Index total score (P = .001) and diet variety score (P = .005) and intake of soy and soy products (P = .001) were lower in the ASD group compared with the typically developing group. CONCLUSIONS: Preschoolers with ASD showed more eating and mealtime problems, and lower diet quality and diversity than their typically developing counterparts. Our findings highlight the need for regular monitor and early identification of mealtime behavioral and nutrition problems among preschoolers with ASD.

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