1. Alharbi A, Bamaga AK, Algarni MA, Abduljabbar MH, Alnemari RM, Althobaiti YS, Alsenani F, Abdelazim AH, Almalki AH. Spectrofluorometric determination of ascorbic acid in the plasma matrix: Exploring correlation with autism spectrum disorder. Anal Biochem;2024 (Aug 21);695:115649.

Ascorbic acid (Vitamin C) is crucial for bodily functions, including collagen synthesis, immune system support and antioxidant defense. Despite autism spectrum disorder’s multifactorial nature involving genetic, environmental and neurological factors, robust evidence exploring the association between ascorbic acid and this disorder is notably lacking. This study introduces an innovative spectrofluorometric method to quantify ascorbic acid in the plasma of healthy children and those with autism spectrum disorder. The method relies on the interaction of ascorbic acid with the fluorescent dye propidium iodide. In acidic conditions, propidium iodide undergoes protonation and selectively binds to the negatively charged ascorbic acid forming an ion-pair complex. This complex alters the molecular structure of propidium iodide inducing chemical fluorescence quenching, that can be utilized for ascorbic acid quantification. The developed method undergoes rigorous validation following ICH guidelines, demonstrating a linear relationship within a concentration range of 4-40 μg/mL, with high precision and accuracy metrics. Analysis of real plasma samples from autistic and healthy children reveals clinically and statistically elevated levels of ascorbic acid in those with autism spectrum disorder.

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2. Alyahyawi A, Barry M, Helal NM. Dental Conscious Sedation for the Treatment of Children With Autism Spectrum Disorder: A Narrative Review. Cureus;2024 (Jul);16(7):e64834.

Conscious sedation has been shown to be a reliable behavior management tool that can be used during dental treatments in children who are less cooperative with dental treatment. The purpose of this study is to review the currently available research on the use of conscious sedation during dental procedures for children diagnosed with autism spectrum disorder (ASD). A web-based search for published articles was conducted. Different electronic databases were searched, including PubMed, Google Scholar, Online Review, and the Cochrane Library database, for papers published until February 2023. Studies providing descriptive protocols for dental conscious sedation for children with ASD were included. The search strategy found two studies that met the included criteria. The use of nitrous oxide in conjunction with oral benzodiazepines was found to be effective in sedating children with ASD. This review highlights the lack of research on sedation techniques for children with ASD. Future studies are needed to determine the specific types of sedative medications, their combinations and dosages, and the best methods for conscious sedation during dental procedures for autistic children.

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3. Baquerizo-Sedano M, Lucero J, Taype-Rondan A. Brief historical account of autism in Peru. Rev Peru Med Exp Salud Publica;2024 (Aug 19);41(2):214-219.

We present a historical account of autism in Peru. Currently, the term « autism spectrum conditions », from the neurodiversity paradigm, is used to describe neurodevelopmental disorders characterized by persistent difficulties in communication, social interaction, and restricted and repetitive behaviors and interests. In Peru, the scientific study of nervous and mental diseases began around 1920 and although the diagnosis of « childhood autism » was proposed in 1959, it only began to spread in the 1980s. Although significant advances were made in the 21st century, Peru still faces many challenges in addressing autism.

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4. Brennan J, Ward OF, Tomeny TS, Davis TE, 3rd. A Systematic Review of Parental Self-Efficacy in Parents of Autistic Children. Clin Child Fam Psychol Rev;2024 (Aug 19)

Parental self-efficacy (PSE) assesses a parent’s expectations and beliefs about their ability to effectively parent their child. PSE has implications for a parent’s well-being, parenting practices, mental health, the parent-child relationship, and child adjustment. While PSE has been extensively examined within the broader parenting literature, the examination of PSE specifically for parents of autistic children has gained increasing attention in recent years. The following systematic review aimed to investigate the role of PSE for parents of autistic children by examining variables that predict PSE or are predicted by PSE in relation to how they align with the broader parenting literature and are unique to autism. Utilizing PRISMA guidelines, peer-reviewed articles were included if (a) participants included caregivers of autistic children, (b) at least one quantitative outcome measure of PSE was utilized, and (c) the role of PSE was examined as an outcome, predictor, or variable in an explanatory model. A total of 53 studies were included in the review and the role of PSE was examined regarding family (e.g., parental characteristics, parent stress, well-being, and support) and child factors (e.g., autism symptomology, problem behaviors, interventions). Several themes emerged including a positive relationship between PSE and support, and a negative relationship between PSE and parenting stress, parent mental health outcomes (e.g., anxiety, depression), and autism symptomology. Findings were compared to the broader parenting and PSE literature to examine how increased considerations and challenges (e.g., child problem behaviors, social impairment, and caregiver strain) associated with raising an autistic child might impact PSE.

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5. Doornaert EE, El-Cheikh Mohamad A, Johal G, Allman B, Möhrle D, Schmid S. Not a deficit, just different – Prepulse inhibition disruptions in autism depend on startle stimulus intensities. eNeuro;2024 (Aug 19)

Sensory processing disruptions are a core symptom of autism spectrum disorder (ASD) and other neurological disorders. The acoustic startle response and prepulse inhibition (PPI) are common metrics used to assess disruptions in sensory processing and sensorimotor gating in clinical studies and animal models. However, often there are inconsistent findings on ASD-related PPI deficits across different studies. Here, we used a novel method for assessing changes in startle and PPI in rodents, using the Cntnap2 knockout (KO) rat model for neurodevelopmental disorder/ASD that has consistently shown PPI disruptions in past studies. We discovered that not only sex and prepulse intensity but also the intensity of the startle stimulus, profoundly impacts whether PPI deficits are evident in the Cntnap2 KO rat or not. We show that rats do not universally exhibit a PPI deficit, instead impaired PPI is contingent on specific testing conditions. Notably, at lower startle stimulus intensities, Cntnap2 KO rats not only demonstrated intact PPI but also exhibited evidence of enhanced PPI compared to their wildtype counterparts. This finding emphasizes the importance of considering specific testing conditions when evaluating startle and PPI in the context of ASD and other neuropsychiatric conditions and might explain some of the inconsistencies between different studies.Significance Statement The present study extends traditional approaches to evaluating sensory processing using startle and PPI by showing that startle and PPI disruptions are contingent upon specific testing parameters. Compared to conventional PPI testing where only prepulse levels and interstimulus intervals might vary, we here show that animals consistently reported to have PPI deficits do not have a general sensorimotor gating deficit, but intact, and potentially even enhanced, PPI at lower startle intensities. This has a widespread impact on PPI testing and the interpretation of PPI results, given the broad use in animal models of various neurodevelopmental conditions, alongside the translational relevance to clinical settings.

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6. Estrugo Y, Bar Yehuda S, Bauminger-Zviely N. Motor, cognitive, and socio-cognitive mechanisms explaining social skills in autism and typical development. Autism Res;2024 (Aug 19)

Challenges in social functioning are considered a core criterion for diagnosing autism. Although motor skills, executive functioning (EF), and theory of mind (ToM) abilities independently affect social challenges and are interconnected, these abilities’ shared contribution to the explanation of social functioning in autism remains under-investigated. To address this disparity, we examined the motor, EF, and ToM abilities of 148 autistic and non-autistic youth (ages 6-16 years), evaluating these variables’ impact on social ability and their interconnections. Our mediation model exploring the contribution of motor, EF, and ToM skills explained 85% of the variance in social functioning (Social Responsiveness Scale-SRS-2). Analysis yielded a direct path from study group to SRS-2-social (typically developing-TD > autistic) and two main parallel indirect joint paths: (a) Group ➔ motor ➔ EF ➔ SRS-2-social; and (b) Group ➔ motor ➔ ToM ➔ SRS-2-social. In two secondary indirect paths, autistic children showed lower motor skills, which in turn explained their higher EF and/or ToM impairment, which in turn explained their higher social skills impairment. Put differently, our results suggest that better EF and TOM proficiency may compensate for poorer motor skills. Findings also indicated that the collective impact of motor, EF, and ToM skills on social functioning, along with the mediating role played by EF and ToM on the social-motor linkage, may contribute to understanding individual differences in the social functioning of autistic children. These conclusions call for the inclusion of motor, EF, and ToM activities into daily practices to facilitate social functioning.

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7. Gaziel-Guttman M, Anaki D, Mashal N. The effect of reappraisal on the emotional regulation of shame in young adults with ASD and typical peers. Sci Rep;2024 (Aug 18);14(1):19116.

Young adults with ASD experience shame in social interactions, and if poorly mishandled, it may interfere with their attempts to participate in their social environment. One strategy to reduce shame is cognitive reappraisal, yet the efficacy of this strategy was not examined in ASD. Here, we investigated the effect of reappraisal in reducing feelings of shame in ASD and the thematic contents used. Young adults with high-functioning ASD and typical participants were shown shame-arousing pictures. They imagined themselves as the primary character in each scenario and rated their feelings of shame. Then, they were trained to reappraise shame-arousing pictures less negatively. Finally, they viewed other shame-arousing photos, reappraised them, stated aloud their new interpretations, and rated their feelings. We found lower shame ratings in participants with ASD than in typical participants. In addition, we found a similar reduction in shame ratings after reappraising these pictures in both groups. Qualitative analysis revealed that participants with ASD used fewer positive narratives and more neutral and unrealistic descriptions than their typical peers. These findings highlight shame-regulation abilities in individuals with ASD while pointing to their unique narratives. We recommend that clinical interventions in ASD emphasize generating positive reappraisals of social situations.

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8. Gehdu BK, Gray KL, Cook R. Poor face recognition predicts social anxiety in autism: A short report. Autism;2024 (Aug 18):13623613241272031.

Research has shown that some autistic people have severe difficulties in recognising other people’s faces. However, little is understood about how these difficulties impact the daily life and the mental well-being of autistic people. In this study, we asked 60 autistic adults with varying degrees of face recognition ability to complete two tests of face recognition, a questionnaire about social anxiety and a bespoke survey which asked participants about their experiences of face recognition and social interaction. We found that participants who had poor face recognition reported experiencing higher levels of social anxiety compared to those with average or better face recognition skills. More than half felt that their face recognition difficulties affected their social interactions, and over a third believed it hindered their ability to make friends. These findings suggest that face recognition difficulties may contribute to social anxiety among autistic individuals.

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9. Gouda B, Sinha SN, Sangaraju R, Huynh T, Patangay S, Venkata Mullapudi S, Mungamuri SK, Patil PB, Periketi MC. Extraction, Phytochemical profile, and neuroprotective activity of Phyllanthus emblica fruit extract against sodium valproate-induced postnatal autism in BALB/c mice. Heliyon;2024 (Aug 15);10(15):e34992.

The aim of the present study was to evaluate the effect of the ethyl acetate fraction of amla (EAFA) extract on valproic acid (VPA)-induced postnatal autism in BALB/c mice. Our study revealed that mice treated with VPA on postnatal day 14 (PND14) showed significant abnormal behaviours such as social interaction, social affiliation, anxiety, and motor coordination compared to the control group, while EAFA extract treatment (100 mg/kg) ameliorated these symptoms. Our study highlights the protective effect of EAFA extract on improving behavioural alterations, significantly restoring anti-oxidative enzymes such as GST and GR, and reducing MDA and NO levels. Furthermore, the EAFA-treated group significantly lowered the proinflammatory markers (IL-1β and TNF-α) and the expression of up-regulated 5-HT1D, 5-HT2A, and D2 receptor proteins. Based on histopathological studies, the percentage of neuronal injury in the EAFA-treated group as well as cellular structural changes were reduced using SEM analysis. In conclusion, the present study suggests that treatment with EAFA extract ameliorates VPA-induced autism due to its anti-oxidant and neuroprotective activity.

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10. Jensen de López KM, Thirup Møller H. Prevalence of Autism in Scandinavian Countries (Denmark, Norway, Sweden), and Nordic Countries (Finland, Iceland, the Faroe Islands, and Greenland). Neuropsychiatr Dis Treat;2024;20:1597-1612.

AIM: This study aims to identify and describe prevalence rates for ASD in the Scandinavian countries (Denmark, Norway, Sweden), as well as the Nordic countries (Finland, Iceland, the Faroe Islands, and Greenland). METHODS: A systematic review was conducted following PRISMA (2009) guidelines and based on the two databases: APA PsycINFO and MEDLINE (PubMed). RESULTS: A total of 13 studies were included in the analyses. It was not possible to identify ASD prevalence studies for Greenland. However, for the remaining countries descriptive increases in ASD prevalence figures were observed. Increases were evident both in relation to age and birth cohort. Studies varied regarding which age group and cohort prevalence figures were reported. The most reported age group was the 7-12-year-olds. In this group, recent prevalence figures for Denmark ranged from 0.26% to 1.47%, in Norway 0.6%, in Sweden 0.23-0.68%, in Finland 0.22-0.86%, and in Iceland 2.40-3.13%. Iceland stood out in terms of higher prevalence figures compared to the other Scandinavian and Nordic countries. Two studies from the Faroe Islands reported ASD prevalence rates between 0.50% and 0.94% for 7-24-year-olds. These studies were based on nationwide figures, but not from national or official registers. DISCUSSION AND CONCLUSION: This study documented increasing prevalence of ASD in Scandinavian and Nordic countries. Several explanations of aspects that may contribute to the increases were discussed, eg, heightened awareness of ASD and earlier diagnosis. The importance of considering differences in data sources was discussed, with an emphasis on the importance of using national registries when available as this source is the most reliable and valid. The absence of prevalence figures for Greenland may be attributed to structural as well as cultural aspects, eg, two parallel systems assessing ASD, cultural taboos as well as lack of awareness of ASD. Suggestions or how to gain knowledge on ASD prevalence in Greenland is presented.

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11. Keller J, Herle M, Mandy W, Leno VC. The overlap of disordered eating, autism and ADHD: future research priorities as identified by adults with lived experience. Lancet Psychiatry;2024 (Aug 14)

The focus of mental health research in emerging fields should be driven by the priorities of people with relevant lived experience. Autism and ADHD are childhood-onset neurodevelopmental conditions that are associated with a range of health inequalities, including increased risk for eating disorders. The evidence base for how best to support neurodivergent individuals who experience disordered eating is still in its infancy, but research suggests that existing clinical approaches are not currently fit for purpose. In this Personal View, through community consultation with autistic people and people with ADHD who have experienced disordered eating, we present a comprehensive ranked list of research topics that people with lived experience prioritise. These priorities could be clustered into two areas: improving outcomes and identifying causal mechanisms. Within the theme of improving disordered eating outcomes, priorities are the improvement of treatment, the need for neurodiversity training in clinical services, and the identification and minimisation of unintended adverse effects of psychological intervention. Within the theme of identifying causal mechanisms, priorities are the identification of risk factors and a better understanding of the effect of autistic or ADHD neurocognitive profiles as potential contributors to eating disorder vulnerability. The final top ten research priorities are contextualised in terms of how they compare to the existing literature on the overlap between autism or ADHD and eating disorders, and concrete suggestions are made for how to implement these research priorities as testable hypotheses. Research informed by these priorities will build necessary understanding of the reasons behind the increased risk for eating disorders in neurodivergent people, and how to best support people who are affected by disordered eating to live positive and fulfilling lives.

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12. Khandjian EW, Moss T, Rose TM, Robert C, Davidovic L. The fragile X proteins’ enigma: to be or not to be nucleolar. Front Cell Dev Biol;2024;12:1448209.

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13. Macchia A, Albantakis L, Zebhauser PT, Brandi ML, Schilbach L, Brem AK. Autistic Adults Avoid Unpredictability in Decision-Making. J Autism Dev Disord;2024 (Aug 19)

Decision-making under unpredictable conditions can cause discomfort in autistic persons due to their preference for predictability. Decision-making impairments might furthermore be associated with a dysregulation of sex and stress hormones. This prospective, cross-sectional study investigated decision-making in 32 autistic participants (AP, 14 female) and 31 non-autistic participants (NAP, 20 female) aged 18-64 years. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under ambiguity and under risk with known outcome probabilities, respectively. Cortisol, estradiol, and testosterone serum levels were related to decision-making performance. Groups did not differ in overall IGT and CRT performance, but compared with NAP, AP preferred less profitable card decks with predictable outcomes while avoiding those with unpredictable outcomes. AP required more time to reach decisions compared to NAP. Additionally, AP without comorbid depression performed significantly worse than NAP in the IGT. Estradiol and cortisol concentrations were significant predictors of CRT scores in NAP, but not in AP. The study results imply that AP are ‘risk-averse’ in decision-making under ambiguity as they avoided choice options with unpredictable losses in comparison to NAP. Our findings highlight the intolerance for uncertainty, particularly in ambiguous situations. Thus, we recommend being as transparent and precise as possible when interacting with autistic individuals. Future research should explore decision-making in social situations among individuals with ASD, factoring in person-dependent variables such as depression.

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14. Montoya CN, Ishler KJ, Obeid R, Payner J, Berg KA. « Glimmers of hope and good things »: Positive aspects of caregiving to autistic adolescents and young adults. Autism;2024 (Aug 19):13623613241272050.

We wanted to explore the positive, or rewarding, experiences of caregivers who were caring for older adolescents or young autistic adults. We surveyed 174 caregivers, asking questions about how they dealt with stressors, the support they had from people in their lives, and the different behaviors of the autistic youth they care for. Using an existing measure, as well as an open-ended question, we asked caregivers about the most rewarding aspects of caring for their youth. When examining survey responses, we found that caregivers who reported receiving more help and support from their autistic youth also reported more positive aspects related to caregiving. In response to our study’s open-ended question, caregivers talked about the reward of seeing their youth grow and progress (e.g. learning new skills, reaching new milestones), described positive aspects of the relationship with their youth (e.g. sharing a special bond), and reflected on their own learning and personal growth as caregivers and people. Our findings highlight the positive, or rewarding, aspects of caregiving for autistic adolescents and young adults. This work will inform future work studying positive aspects of caring for autistic individuals and how this may impact caregivers’ psychological well-being.

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15. Nakashima M, Akagi T, Miki T, Nakayama R, Takaya Y, Nakagawa K, Akagi S, Toh N, Nakamura K. Fenestrated GORE® CARDIOFORM ASD occluder for transcatheter atrial septal defect closure in a geriatric patient. J Cardiol Cases;2024 (Aug);30(2):31-34.

An 82-year-old man with a secundum atrial septal defect (ASD) underwent transcatheter closure. The patient had a wide area of aortic and superior rim deficiency, with left ventricular diastolic dysfunction and moderate mitral regurgitation. These findings suggested the risk of both cardiac erosion and increased left atrial pressure after closure. To avoid cardiac erosion, a GORE® CARDIOFORM ASD (GCA) occluder (W.L. Gore & Associates, Flagstaff, AZ, USA) was considered an appropriate device in this patient. However, the possibility of excessively high left atrial pressure due to complete defect closure was a concern. Thus, we created a 4.5-mm fenestration using a surgical punch in the fabric membrane of a 44-mm GCA. The device was deployed in an appropriate position, and no significant elevation of pulmonary capillary wedge pressure was observed. One month after the closure, marked improvement in clinical symptoms and continuous flow through the fenestration were observed. This novel fenestration technique may contribute to expansion of the indications for transcatheter ASD closure in patients who require a GCA owing to an anatomically high risk of erosion accompanied by left ventricular diastolic dysfunction. LEARNING OBJECTIVE: In elderly patients with left ventricular diastolic dysfunction, transcatheter atrial septal defect (ASD) closure is difficult because rapid resolution of an ASD shunt can cause an increase in left atrial pressure. Previous reports described the creation of a fenestration in the closure device. The use of a GORE® CARDIOFORM ASD (GCA) occluder can reduce the erosion risk; however, creating a stable fenestration is difficult. We developed a novel technique to create a stable fenestration in a GCA.

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16. Rajagopalan SS, Zhang Y, Yahia A, Tammimies K. Machine Learning Prediction of Autism Spectrum Disorder From a Minimal Set of Medical and Background Information. JAMA Netw Open;2024 (Aug 1);7(8):e2429229.

IMPORTANCE: Early identification of the likelihood of autism spectrum disorder (ASD) using minimal information is crucial for early diagnosis and intervention, which can affect developmental outcomes. OBJECTIVE: To develop and validate a machine learning (ML) model for predicting ASD using a minimal set of features from background and medical information and to evaluate the predictors and the utility of the ML model. DESIGN, SETTING, AND PARTICIPANTS: For this diagnostic study, a retrospective analysis of the Simons Foundation Powering Autism Research for Knowledge (SPARK) database, version 8 (released June 6, 2022), was conducted, including data from 30 660 participants after adjustments for missing values and class imbalances (15 330 with ASD and 15 330 without ASD). The SPARK database contains participants recruited from 31 university-affiliated research clinicals and online in 26 states in the US. All individuals with a professional ASD diagnosis and their families were eligible to participate. The model performance was validated on independent datasets from SPARK, version 10 (released July 21, 2023), and the Simons Simplex Collection (SSC), consisting of 14 790 participants, followed by phenotypic associations. EXPOSURES: Twenty-eight basic medical screening and background history items present before 24 months of age. MAIN OUTCOMES AND MEASURES: Generalizable ML prediction models were developed for detecting ASD using 4 algorithms (logistic regression, decision tree, random forest, and eXtreme Gradient Boosting [XGBoost]). Performance metrics included accuracy, area under the receiver operating characteristics curve (AUROC), sensitivity, specificity, positive predictive value (PPV), and F1 score, offering a comprehensive assessment of the predictive accuracy of the model. Explainable AI methods were applied to determine the effect of individual features in predicting ASD as secondary outcomes, enhancing the interpretability of the best-performing model. The secondary outcome analyses were further complemented by examining differences in various phenotypic measures using nonparametric statistical methods, providing insights into the ability of the model to differentiate between different presentations of ASD. RESULTS: The study included 19 477 (63.5%) male and 11 183 (36.5%) female participants (mean [SD] age, 106 [62] months). The mean (SD) age was 113 (68) months for the ASD group and 100 (55) months for the non-ASD group. The XGBoost (termed AutMedAI) model demonstrated strong performance with an AUROC score of 0.895, sensitivity of 0.805, specificity of 0.829, and PPV of 0.897. Developmental milestones and eating behavior were the most important predictors. Validation on independent cohorts showed an AUROC of 0.790, indicating good generalizability. CONCLUSIONS AND RELEVANCE: In this diagnostic study of ML prediction of ASD, robust model performance was observed to identify autistic individuals with more symptoms and lower cognitive levels. The robustness and ML model generalizability results are promising for further validation and use in clinical and population settings.

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17. Santiago CFG, Lelis DF, Ferreira GFS, Pinto AL, Caldeira IP, Ribeiro NG, Forechi L, Baldo TOF, Baldo MP. Mental health in mothers of children with autism spectrum disorder: a cross-sectional study. Women Health;2024 (Sep);64(8):636-647.

The increased prevalence of autism spectrum disorder (ASD) has placed a significant emotional and psychological burden on mothers. We explored the association between the severity of ASD symptoms in children and the mental health of their mothers during the COVID-19 pandemic. Our study included 1,924 mothers of children with ASD, enrolled in a web-based cross-sectional survey over 85 consecutive days to gather clinical and sociodemographic data. The severity of ASD symptoms was obtained according to the children’s age. Using the Depression, Anxiety, and Stress Scales (DASS-21) scale, we found that 35.8 percent of mothers experienced both anxiety and depression. A high education level and a high family income reduced the chance of concurrent anxiety and depression. Conversely, unemployment, a child using psychiatric medication, and higher severity of ASD symptoms increased the chance. Notably, the severity of the ASD symptom was the sole predictor of maternal co-occurring anxiety and depression across all age groups (<3 years aOR = 2.04, 95%CI 1.07-3.89; 3-5 years aOR = 2.76, 95%CI 1.67-4.56; ≥ 6 years aOR = 1.61, 95%CI 1.04-2.50). Recognizing the challenges associated with ASD leads to greater acceptance and tailored interventions, ultimately improving the overall well-being of both individuals with ASD and their mothers.

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18. Shang C, Xie W, Zeng J, Osman N, Sun C, Zou M, Wang J, Wu L. E-Health Family Interventions for Parents of Children With Autism Aged 0-6 Years: A Scoping Review. Psychiatry Investig;2024 (Aug 20)

OBJECTIVE: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in infancy. Early intervention is critical to improve the prognosis for these children. E-health interventions have tremendous potential. This review aimed to determine the status and effectiveness of family interventions for parents of children aged 0-6 years with ASD in the context of e-health. METHODS: The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Web of Science, and China National Knowledge Infrastructure were searched from inception to June 2022. The searches were limited to children with ASD of the age range between 0 and 6 years. We collated the available information and used descriptive statistics to analyze the synthesized data. RESULTS: Our initial search identified 3,672 articles, of which 30 studies met the inclusion criteria. The 30 articles selected were released between 2012 and 2022. All articles are in English. Most articles reviewed were from high-income countries (27/30, 90.0%), especially from the United States (16/30, 53.3%). Four major themes emerged from the 30 studies that matched the inclusion criteria, as follows: 1) type of e-health interventions, 2) duration of interventions, 3) clinical aspects of e-health interventions, and 4) evidence for intervention effectiveness, looking into the positive, negative, and mixed findings of previous studies. CONCLUSION: These findings suggest that a wide variety of e-health interventions may actually help support both children with ASD aged 0-6 years and their parents.

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19. Shinomiya S. The role of administrative categories in the globalisation of a psychiatric concept: Case studies of autism in Japan. Soc Sci Med;2024 (Aug 10);357:117223.

This paper explores how what I call ‘administrative categories’ have been adopted by the Japanese government and experts in autism support and what roles these categories have played in local settings. Since support practices for children and adults with autism began in the 1950s in Japan, the Japanese government and people engaging in autism support have used Japanese-specific administrative categories, instead of relying on a medical concept of autism, such as ‘severe moving disabilities’ (SMD), ’emotional disturbance’, and ‘extremely disruptive behavioural disorders’ (EDBD). To understand the emergence of these three autism-related administrative categories in Japan, historical materials published from the 1950s to the 1990s by Japanese authors (doctors, psychologists, teachers, educationalists, welfare workers, government officials, and parents) and interview data with 19 leading experts of autism in Japan were collected and analysed thematically. The analysis revealed that the governmental ministries aimed to focus on establishing administrative support by avoiding engaging in aetiological debates among doctors, and to describe the political agenda more vividly. Administrative categories filled the gap between local interests and international medical concepts, enabling the concept of autism to be rooted in Japan’s administrative systems. Three roles of administrative categories were identified: i) separation from medicine, ii) describing local problems, and iii) claimsmaking to wider actors and the public. I concluded that looking purely at medical and specifically diagnostic concepts limits our understanding of the formation of practices regarding disabilities, and thus more focus should be placed on categorisation practices outside of medicine. In addition, to the literature on the globalisation of Euro-American psychiatric concepts, this study contributes to our knowledge of a form of locality that has not been central in the exploration of the influence of globalisation on local settings and the relationships between the local and the global.

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20. Wu YX, Li MJ, Liu Y, Guo M, Lan MN, Zheng HJ. ASPG and DAD1 are potential placental-derived biomarkers for ASD-like symptom severity levels in male/female offspring. Placenta;2024 (Aug 14);155:78-87.

INTRODUCTION: An early evaluating system for autism spectrum disorder (ASD) severity is crucial. Questionnaire survey is challenging for accurately assessing the severity levels for ASD in children. METHODS: Offspring with ASD-like phenotypes were induced by treating pregnant mice with Poly (I:C) at GD12.5 and the placentae corresponding to the offspring were obtained by caesarean. The autism severity composite score (ASCS) for offspring was calculated through behavioral tests. HE staining and immunohistochemistry were used to observe the morphology of placenta. Candidate biomarkers were identified by weighted protein co-expression network analysis (WPCNA) combined with machine learning and further validated by ELISA. Sperman’s was used to analyze the correlation between biomarkers and metabolome. RESULTS: The placental weight and mean vascular area of male offspring with ASD-like phenotypes were significantly decreased compared with typical mice. According to the WPCNA, four modules were identified and significantly correlated with ASCS of offspring. Two biomarkers (ASPG and DAD1) with high correlation with ASCS in offspring were identified. DISCUSSION: VEGF pathway may contribute to sexual dimorphism in placental morphology within mice with ASD-like phenotypes in term. The placental ASPG and DAD1 levels could reflect ASD-like symptom severity levels in male/female mice offspring.

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21. Yi YJ, Heidari Matin N, Brannan D, Johnson M, Nguyen A. Design Considerations for Virtual Reality Intervention for People with Intellectual and Developmental Disabilities: A Systematic Review. Herd;2024 (Aug 18):19375867241271434.

OBJECTIVES: This systematic review aims to explore virtual reality (VR) applications for rehabilitation purposes among people with intellectual and developmental disabilities (IDD), identify their effects on rehabilitation outcomes, explore themes to consider in VR intervention design, and provide guidance for designers and researchers in creating therapeutic environments using VR technology. BACKGROUND: VR has gained increasing attention in healthcare settings to assist in achieving rehabilitation goals for people with IDD. VR is particularly advantageous since it simulates the real world while providing controllable, safe, and versatile environments. It is necessary to expand the current body of knowledge on VR intervention’s outcomes by synthesizing further information on VR application characteristics as well as identifying design considerations regarding feasibility, usability, safety, and other aspects that will benefit future VR intervention design and research. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framed the current review. Multiple databases were searched to identify studies published between 2001 and 2023. The review qualitatively organized VR environment design considerations according to three themes: feasibility, usability, and safety. RESULTS: This review included 27 articles and included 868 participants. The overall findings indicated that VR interventions are promising in enhancing rehabilitation outcomes among people with IDD, such as physical, cognitive, emotional, and functional independence domains. CONCLUSION: This review provides design recommendations to create effective, usable, and safe VR interventions for individuals with IDD. The suggested design implications should be applied with the awareness that VR is a relatively emerging technology with rapidly evolving features.

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22. Yu Y, Yang X, Hu G, Tong K, Wu J, Yu R. Risk cycling in diabetes and autism spectrum disorder: a bidirectional Mendelian randomization study. Front Endocrinol (Lausanne);2024;15:1389947.

OBJECTIVE: The relationship between diabetes mellitus (DM) and autism spectrum disorder (ASD) remains controversial. This study aimed to analyze the causal relationship between different types of DM and ASD by bidirectional Mendelian randomization (MR). METHODS: Single nucleotide polymorphisms for type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM), and ASD were obtained from genome-wide association studies. Subsequently, inverse variance weighted, MR-Egger, and weighted median were used to test the exposure-outcome causality. Finally, MR-Egger’s intercept, Cochran’s Q, and leave-one-out method were used to assess horizontal pleiotropy, heterogeneity, and sensitivity of the results, respectively. RESULTS: The positive analysis showed that T2DM was associated with an increased risk of ASD, whereas neither T1DM nor GDM was associated with the risk of ASD. The reverse analysis showed that ASD was associated with an increased risk of T2DM, while it was not associated with the risk of either T1DM or GDM. MR-Egger intercept showed no horizontal pleiotropy (p > 0.05) for these results. Cochran’s Q showed no heterogeneity expect for the results of T1DM on the risk of ASD, and leave-one-out sensitivity analysis showed these results were robust. CONCLUSION: This MR analysis suggests that T2DM and ASD are reciprocal risk factors and that they may create an intergenerational risk cycling in female patients. Aggressive prevention and treatment of T2DM and ASD help to break the trap of this risk cycling. Additionally, this study does not support a causal relationship between T1DM and ASD, as well as GDM and ASD. And more studies are needed in the future to continue to explore the interactions and underlying mechanisms between different types of DM and ASD.

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