1. Bo J, Acluche F, Lasutschinkow PC, Augustiniak A, Ditchfield N, Lajiness-O’Neill R. Motor networks in children with autism spectrum disorder: a systematic review on EEG studies. Experimental brain research. 2022; 240(12): 3073-87.

Motor disturbance and altered motor networks are commonly reported in individuals with autism spectrum disorder (ASD). It has been suggested that electroencephalogram (EEG) can be used to provide exquisite temporal resolution for understanding motor control processes in ASD. However, the variability of study design and EEG approaches can impact our interpretation. Here, we conducted a systematic review on recent 11 EEG studies that involve motor observation and/or execution tasks and evaluated how these findings help us understand motor difficulties in ASD. Three behavior paradigms with different EEG analytic methods were demonstrated. The main findings were quite mixed: children with ASD did not always show disrupted neuronal activity during motor observation. Additionally, they might have intact ability for movement execution but have more difficulties in neuronal modulation during movement preparation. We would like to promote discussions on how methodological selections of behavioral tasks and data analytic approaches impact our interpretation of motor deficits in ASD. Future EEG research addressing the inconsistency across methodological approaches is necessary to help us understand neurophysiological mechanism of motor abnormalities in ASD.

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2. Calabretta BT, Schneider JL, Iverson JM. Bidding on the go: Links between walking, social actions, and caregiver responses in infant siblings of children with autism spectrum disorder. Autism research : official journal of the International Society for Autism Research. 2022; 15(12): 2324-35.

The development of walking is associated with a shift in how neurotypical infants initiate social interactions. Walking infants are more likely to locate objects in distant places, carry them, and then share those objects by approaching caregivers and using gestures to show or offer their discoveries (i.e., moving bids). The simultaneous organization of the behaviors necessary to generate moving bids requires the coordination of multiple skills-walking, fine motor skills, and gesturing. Infants with an elevated likelihood (EL) for autism spectrum disorder (ASD) exhibit differences and delays in each of these behaviors. This study investigated interconnections between infant walking, social actions, and caregiver responses in 18-month-old EL infants with diverse developmental outcomes (ASD, non-ASD language delay, no diagnosis). We observed 85 infant-caregiver dyads at home during everyday activities for 45 minutes and identified all times when infants walked, instances of walking paired with social action (i.e., approaching the caregiver, approaching while carrying an object, producing a moving bid), and whether caregivers responded to their infants’ social actions. There were no group differences in infants’ production of social actions. Caregiver responses, however, were more clearly modulated by outcome group. While all caregivers were similarly and highly likely to respond to moving bids, caregivers of EL-ASD infants were substantially more likely to respond when their infants simply approached them (with or without an object in hand). Taken together, this research underscores the complexity of EL infant-caregiver interactions and highlights the role that each partner plays in shaping how they unfold.

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3. Camarata SM. Tensions Between Autistic Sociality, Communication, and Social Skills Research: Utilizing the Communication Bill of Rights to Support Autistic People. Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4351-3.

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4. Chien YL, Chen YJ, Tseng WL, Hsu YC, Wu CS, Tseng WI, Gau SS. Differences in white matter segments in autistic males, non-autistic siblings, and non-autistic participants: An intermediate phenotype approach. Autism : the international journal of research and practice. 2022: 13623613221125620.

White matter is the neural pathway that connects neurons in different brain regions. Although research has shown white matter differences between autistic and non-autistic people, little is known about the properties of white matter in non-autistic siblings. In addition, past studies often focused on the whole neural tracts; it is unclear where differences exist in specific segments of the tracts. This study identified neural segments that differed between autistic people, their non-autistic siblings, and the age- and non-autistic people. We found altered segments within the tracts connected to anterior brain regions corresponding to several higher cognitive functions (e.g. executive functions) in autistic people and non-autistic siblings. Segments connecting to regions for social cognition and Theory of Mind were altered only in autistic people, explaining a large portion of autistic traits and may serve as neuroimaging markers. Segments within the tracts associated with fewer autistic traits or connecting brain regions for diverse highly integrated functions showed compensatory increases in the microstructural properties in non-autistic siblings. Our findings suggest that differential white matter segments that are shared between autistic people and non-autistic siblings may serve as potential « intermediate phenotypes »-biological or neuropsychological characteristics in the causal link between genetics and symptoms-of autism. These findings shed light on a promising neuroimaging model to refine the intermediate phenotype of autism which may facilitate further identification of the genetic and biological bases of autism. Future research exploring links between compensatory segments and neurocognitive strengths in non-autistic siblings may help understand brain adaptation to autism.

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5. Dougherty JD, Marrus N, Maloney SE, Yip B, Sandin S, Turner TN, Selmanovic D, Kroll KL, Gutmann DH, Constantino JN, Weiss LA. Can the « female protective effect » liability threshold model explain sex differences in autism spectrum disorder?. Neuron. 2022; 110(20): 3243-62.

Male sex is a strong risk factor for autism spectrum disorder (ASD). The leading theory for a « female protective effect » (FPE) envisions males and females have « differing thresholds » under a « liability threshold model » (DT-LTM). Specifically, this model posits that females require either a greater number or larger magnitude of risk factors (i.e., greater liability) to manifest ASD, which is supported by the finding that a greater proportion of females with ASD have highly penetrant genetic mutations. Herein, we derive testable hypotheses from the DT-LTM for ASD, investigating heritability, familial recurrence, correlation between ASD penetrance and sex ratio, population traits, clinical features, the stability of the sex ratio across diagnostic changes, and highlight other key prerequisites. Our findings reveal that several key predictions of the DT-LTM are not supported by current data, requiring us to establish a different conceptual framework for evaluating alternate models that explain sex differences in ASD.

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6. Erbescu A, Papuc SM, Budisteanu M, Arghir A, Neagu M. Re-emerging concepts of immune dysregulation in autism spectrum disorders. Frontiers in psychiatry. 2022; 13: 1006612.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by communication and social interaction deficits, and by restricted interests and stereotyped, repetitive behavior patterns. ASD has a strong genetic component and a complex architecture characterized by the interplay of rare and common genetic variants. Recently, increasing evidence suggest a significant contribution of immune system dysregulation in ASD. The present paper reviews the latest updates regarding the altered immune landscape of this complex disorder highlighting areas with potential for biomarkers discovery as well as personalization of therapeutic approaches. Cross-talk between the central nervous system and immune system has long been envisaged and recent evidence brings insights into the pathways connecting the brain to the immune system. Disturbance of cytokine levels plays an important role in the establishment of a neuroinflammatory milieu in ASD. Several other immune molecules involved in antigen presentation and inflammatory cellular phenotypes are also at play in ASD. Maternal immune activation, the presence of brain-reactive antibodies and autoimmunity are other potential prenatal and postnatal contributors to ASD pathophysiology. The molecular players involved in oxidative-stress response and mitochondrial system function, are discussed as contributors to the pro-inflammatory pattern. The gastrointestinal inflammation pathways proposed to play a role in ASD are also discussed. Moreover, the body of evidence regarding some of the genetic factors linked to the immune system dysregulation is reviewed and discussed. Last, but not least, the epigenetic traits and their interactions with the immune system are reviewed as an expanding field in ASD research. Understanding the immune-mediated pathways that influence brain development and function, metabolism, and intestinal homeostasis, may lead to the identification of robust diagnostic or predictive biomarkers for ASD individuals. Thus, novel therapeutic approaches could be developed, ultimately aiming to improve their quality of life.

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7. Ganz JB, Pustejovsky JE, Reichle J, Vannest KJ, Foster M, Pierson LM, Wattanawongwan S, Bernal AJ, Chen M, Haas AN, Liao CY, Sallese MR, Skov R, Smith SD. Participant characteristics predicting communication outcomes in AAC implementation for individuals with ASD and IDD: a systematic review and meta-analysis. Augmentative and alternative communication (Baltimore, Md : 1985). 2022: 1-16.

This meta-analysis examined communication outcomes in single-case design studies of augmentative and alternative communication (AAC) interventions and their relationship to participant characteristics. Variables addressed included chronological age, pre-intervention communication mode, productive repertoire, and pre-intervention imitation skills. Investigators identified 114 single-case design studies that implemented AAC interventions with school-aged individuals with autism spectrum disorder and/or intellectual disability. Two complementary effect size indices, Tau(AB) and the log response ratio, were applied to synthesize findings. Both indices showed positive effects on average, but also exhibited a high degree of heterogeneity. Moderator analyses detected few differences in effectiveness when comparing across diagnoses, age, the number and type of communication modes, participant’s productive repertoires, and imitation skills to intervention. A PRISMA-compliant abstract is available: https://bit.ly/30BzbLv.

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8. Hampton S, Allison C, Baron-Cohen S, Holt R. Autistic People’s Perinatal Experiences I: A Survey of Pregnancy Experiences. Journal of autism and developmental disorders. 2022.

Qualitative studies of autistic people’s pregnancy experiences have indicated sensory and communication related barriers to accessing adequate prenatal healthcare. However, quantitative work on the topic is scarce. This online survey study explored pregnancy experiences among 417 autistic and 524 non-autistic people. Compared with non-autistic people, autistic people reported heightened sensory and physical experiences during pregnancy and were more likely to experience prenatal depression and anxiety. Autistic people experienced lower satisfaction with prenatal healthcare, including having lower perceptions of their relationships with healthcare professionals and greater difficulties with antenatal classes. This study identifies key adjustments that can be made to prenatal healthcare, including sensory and communication adjustments. The findings highlight the need for greater autism understanding and awareness among professionals.

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9. Holyfield C, O’Neill Zimmerman T. A Scoping Review of Research Evaluating Physiological Information for Individuals With Developmental Disabilities: Augmentative and Alternative Communication Research Considerations. Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4306-26.

PURPOSE: Today, an ever-increasing number of technological advancements are becoming mainstream. As the availability of technological innovations increases, so do opportunities for evaluating any benefits of those innovations in augmentative and alternative communication (AAC) research for individuals with developmental disabilities. One innovation that has become mainstream is the use of noninvasive wearable technology to provide physiological information (e.g., heart rate, skin conductance). Such information could be valuable in AAC research, but more information about its potential feasibility and utility is needed. METHOD: A scoping review was conducted to review and report on existing research that has evaluated (a) physiological information as a communication intervention tool for individuals with developmental disabilities and (b) the relationship between physiological information from individuals with developmental disabilities and behavioral and/or environmental information in real time. RESULTS: Results revealed that, while little communication intervention research has been completed, descriptive research demonstrates that physiological information from individuals with developmental disabilities gathered using wearable technology corresponds meaningfully to observable environmental and behavioral events. CONCLUSIONS: Future AAC research incorporating wearable technology to gather physiological information is warranted. Such research could evaluate potential benefits such as preempting challenging behavior with communication opportunities, signaling readiness for language learning, indicating AAC feature preferences, and expanding methodological approaches.

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10. Hwang IS, Hong SB. Association between body mass index and subcortical volume in pre-adolescent children with autism spectrum disorder: An exploratory study. Autism research : official journal of the International Society for Autism Research. 2022; 15(12): 2238-49.

Conflicting associations exist between autism spectrum disorder (ASD) and subcortical brain volumes. This study assessed whether obesity might have a confounding influence on associations between ASD and brain subcortical volumes. A comprehensive investigation evaluating the relationship between ASD, obesity, and subcortical structure volumes was conducted. Data obtained included body mass index (BMI) and T1-weighted structural magnetic resonance images for children with and without ASD diagnoses from the Autism Brain Imaging Data Exchange database. Brain subcortical volumes were calculated using vol2Brain software. Hierarchical linear regression analyses were performed to explore the subcortical volumes similarly or differentially associated with BMI in children with or without ASD and examine association and interaction effects regarding ASD and subcortical volume impact on the Social Responsiveness Scale and Vineland Adaptive Behavior Scale (VABS) scores. Bilateral caudate nuclei were smaller in children with ASD than in control participants. Significant interactions were observed between ASD diagnosis and BMI regarding the left caudate, right and left putamen, and right and left ventral diencephalon (DC) volumes (β = -0.384, p = 0.010; β = -0.336, p = 0.030; β = -0.317, p = 0.040; β = 0.322, p = 0.010; β = 0.295, p = 0.021, respectively) and between ASD diagnosis and right and left ventral DC volumes regarding the VABS scores (β = 0.434, p = 0.014; β = 0.495, p = 0.007, respectively). However, each subcortical structure volume included in the ventral DC area could not be measured separately. The results identified subcortical volumes differentially associated with obesity in children with ASD compared with typically developing peers. BMI may need to be considered an important confounder in future research examining brain subcortical volumes within ASD.

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11. Iannone LF, Gómez-Eguílaz M, De Caro C. Gut microbiota manipulation as an epilepsy treatment. Neurobiology of disease. 2022; 174: 105897.

Many studies have documented the important role of the gut microbiota (GM) in the regulation of several central nervous system (CNS) processes through the microbiota-gut-brain (MGB) axis. This latter represents the connection between the CNS, the enteric nervous system, the gut and its microbiota through several ascending and descending pathways. The variation of the GM composition is associated with the pathogenesis and/or progression as well as severity of various neuropsychiatric/neurological diseases such as depression, autism spectrum disorder, multiple sclerosis, Parkinson’s, and Alzheimer’s diseases. Recently, changes in the bacterial composition of the GM have also been linked to epilepsy and seizures, with some studies exploring the potential role of GM in the regulation of neuronal hyperexcitability, seizure occurrence and epileptogenesis. Accordingly, there are potential novel treatments which are currently being investigated such as probiotics, prebiotics and symbiotic that may represent innovative therapeutic approaches. The aim of this review is to explore the effect of gut microbiota manipulation as a therapeutic strategy in epilepsy and the methodological challenges to design (translational) clinical trial investigating the gut microbiota.

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12. Ibrahimagić A, Patković N, Herwig R. Autism Spectrum Disorders Child Language and Communication Skills and Its Impact on Parental Emotions and Stress. Psychiatria Danubina. 2022; 34(3): 530.

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13. Jarrige D, Haridas S, Bleykasten-Grosshans C, Joly M, Nadalig T, Sancelme M, Vuilleumier S, Grigoriev IV, Amato P, Bringel F. High-quality genome of the basidiomycete yeast Dioszegia hungarica PDD-24b-2 isolated from cloud water. G3 (Bethesda, Md). 2022; 12(12).

The genome of the basidiomycete yeast Dioszegia hungarica strain PDD-24b-2 isolated from cloud water at the summit of puy de Dôme (France) was sequenced using a hybrid PacBio and Illumina sequencing strategy. The obtained assembled genome of 20.98 Mb and a GC content of 57% is structured in 16 large-scale contigs ranging from 90 kb to 5.56 Mb, and another 27.2 kb contig representing the complete circular mitochondrial genome. In total, 8,234 proteins were predicted from the genome sequence. The mitochondrial genome shows 16.2% cgu codon usage for arginine but has no canonical cognate tRNA to translate this codon. Detected transposable element (TE)-related sequences account for about 0.63% of the assembled genome. A dataset of 2,068 hand-picked public environmental metagenomes, representing over 20 Tbp of raw reads, was probed for D. hungarica related ITS sequences, and revealed worldwide distribution of this species, particularly in aerial habitats. Growth experiments suggested a psychrophilic phenotype and the ability to disperse by producing ballistospores. The high-quality assembled genome obtained for this D. hungarica strain will help investigate the behavior and ecological functions of this species in the environment.

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14. Kalemaj Z, Marino MM, Santini AC, Tomaselli G, Auti A, Cagetti MG, Borsello T, Costantino A, Inchingolo F, Boccellino M, Di Domenico M, Tartaglia GM. Salivary microRNA profiling dysregulation in autism spectrum disorder: A pilot study. Frontiers in neuroscience. 2022; 16: 945278.

INTRODUCTION: Autism spectrum disorders (ASD) are the most prevalent neurobiological disorders in children. The etiology comprises genetic, epigenetic, and environmental factors such as dysfunction of the immune system. Epigenetic mechanisms are mainly represented by DNA methylation, histone modifications, and microRNAs (miRNA). The major explored epigenetic mechanism is mediated by miRNAs which target genes known to be involved in ASD pathogenesis. Salivary poly-omic RNA measurements have been associated with ASD and are helpful to differentiate ASD endophenotypes. This study aims to comprehensively examine miRNA expression in children with ASD and to reveal potential biomarkers and possible disease mechanisms so that they can be used to improve faction between individuals by promoting more personalized therapeutic approaches. MATERIALS AND METHODS: Saliva samples were collected from 10 subjects: 5 samples of children with ASD and 5 from healthy controls. miRNAs were analyzed using an Illumina Next-Generation-Sequencing (NGS) system. RESULTS: Preliminary data highlighted the presence of 365 differentially expressed miRNAs. Pathway analysis, molecular function, biological processes, and target genes of 41 dysregulated miRNAs were assessed, of which 20 were upregulated, and 21 were downregulated in children with ASD compared to healthy controls. CONCLUSION: The results of this study represent preliminary but promising data, as the identified miRNA pathways could represent useful biomarkers for the early non-invasive diagnosis of ASD.

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15. Keates N, Waldock KE, Dewar E. Tensions Between Autistic Sociality, Communication, and Social Skills Research: A Response to Bambara (2022) and Camarata (2022). Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4346-50.

PURPOSE: The purpose of this letter to the editor is to further elucidate the arguments Keates (2022) and Beechey (2022) stated in their letters to the editor. Both Bambara (2022) and Camarata (2022) pose comments that require clarifying the original arguments, particularly regarding power and autistic sociality, which we feel will provide further clarity to this highly significant and growing topic within autism research. CONCLUSION: We recommend teaching not autistic people but rather non-autistic individuals about autistic sociality, in order to lower the burden on autistic interlocutors in cross-neurotype interactions and socialization (as per previous literature, Bottema-Beutel et al., 2018). We provide recommendations to address difficulties in cross-neurotype interactions-for example, bridging the neurotype gap through practice or psychosocial interventions for acceptance of autistic people and their system of interpretation, as per Jones et al. (2021).

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16. Li LG, Fu HG, Zhao YH, Zhao PJ, Meng QK, Zheng RJ, Li EY. A Meta-Analysis on the Impact of Prenatal and Early Childhood Antimicrobial Use on Autism Spectrum Disorders. The Annals of pharmacotherapy. 2022: 10600280221130280.

OBJECTIVE: To investigate the impact of prenatal and early childhood antimicrobial use on autism spectrum disorders (ASD). DATA SOURCES: We searched PubMed and Embase databases for relevant studies from inception to August 2022. STUDY SELECTION AND DATA EXTRACTION: Peer-reviewed, observational studies were all acceptable. Raw data were extracted into a predefined worksheet and quality analysis was performed using the Newcastle-Ottawa Scale. DATA SYNTHESIS: Nineteen studies were identified in the meta-analysis. Prenatal antimicrobial exposure was not associated with ASD (P = 0.06 > 0.05), whereas early childhood antimicrobial exposure was associated with an increased odds ratio of ASD (OR = 1.17, 95% CI = [1.08-1.27], P value < 0.001). The sibling-matched analysis, with a very limited sample size, suggested that neither prenatal (P = 0.47 > 0.05) nor early childhood (P = 0.13 > 0.05) antimicrobial exposure was associated with ASD. Medical professionals may need to take the possible association into consideration when prescribing an antimicrobial in children. CONCLUSIONS: Early childhood antimicrobial exposure could increase the incidence of ASD. In future studies, it would be necessary to control for confounding factors, such as genetic factors, parenteral age at birth, or low birthweight, to further validate the association.

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17. McChesney N, Barth JL, Rumschlag JA, Tan J, Harrington AJ, Noble KV, McClaskey CM, Elvis P, Vaena SG, Romeo MJ, Harris KC, Cowan CW, Lang H. Peripheral Auditory Nerve Impairment in a Mouse Model of Syndromic Autism. The Journal of neuroscience : the official journal of the Society for Neuroscience. 2022; 42(42): 8002-18.

Dysfunction of the peripheral auditory nerve (AN) contributes to dynamic changes throughout the central auditory system, resulting in abnormal auditory processing, including hypersensitivity. Altered sound sensitivity is frequently observed in autism spectrum disorder (ASD), suggesting that AN deficits and changes in auditory information processing may contribute to ASD-associated symptoms, including social communication deficits and hyperacusis. The MEF2C transcription factor is associated with risk for several neurodevelopmental disorders, and mutations or deletions of MEF2C produce a haploinsufficiency syndrome characterized by ASD, language, and cognitive deficits. A mouse model of this syndromic ASD (Mef2c-Het) recapitulates many of the MEF2C haploinsufficiency syndrome-linked behaviors, including communication deficits. We show here that Mef2c-Het mice of both sexes exhibit functional impairment of the peripheral AN and a modest reduction in hearing sensitivity. We find that MEF2C is expressed during development in multiple AN and cochlear cell types; and in Mef2c-Het mice, we observe multiple cellular and molecular alterations associated with the AN, including abnormal myelination, neuronal degeneration, neuronal mitochondria dysfunction, and increased macrophage activation and cochlear inflammation. These results reveal the importance of MEF2C function in inner ear development and function and the engagement of immune cells and other non-neuronal cells, which suggests that microglia/macrophages and other non-neuronal cells might contribute, directly or indirectly, to AN dysfunction and ASD-related phenotypes. Finally, our study establishes a comprehensive approach for characterizing AN function at the physiological, cellular, and molecular levels in mice, which can be applied to animal models with a wide range of human auditory processing impairments.SIGNIFICANCE STATEMENT This is the first report of peripheral auditory nerve (AN) impairment in a mouse model of human MEF2C haploinsufficiency syndrome that has well-characterized ASD-related behaviors, including communication deficits, hyperactivity, repetitive behavior, and social deficits. We identify multiple underlying cellular, subcellular, and molecular abnormalities that may contribute to peripheral AN impairment. Our findings also highlight the important roles of immune cells (e.g., cochlear macrophages) and other non-neuronal elements (e.g., glial cells and cells in the stria vascularis) in auditory impairment in ASD. The methodological significance of the study is the establishment of a comprehensive approach for evaluating peripheral AN function and impact of peripheral AN deficits with minimal hearing loss.

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18. Mishra A, Singla R, Kumar R, Sharma A, Joshi R, Sarma P, Kaur G, Prajapat M, Bhatia A, Medhi B. Granulocyte Colony-Stimulating Factor Improved Core Symptoms of Autism Spectrum Disorder via Modulating Glutamatergic Receptors in the Prefrontal Cortex and Hippocampus of Rat Brains. ACS chemical neuroscience. 2022; 13(20): 2942-61.

Chronic neuroinflammation-induced anomalous glutamate receptor activation has been identified as one of the important factors in the pathogenesis of autism spectrum disorder (ASD). Thus, the current study was designed to elucidate the neuroprotective effect of the granulocyte colony-stimulating factor (G-CSF), a haemopoietic growth factor, an anti-inflammatory, and a neuroprotectant to decipher the underlying mechanism(s) in the valproic acid (VPA)-induced experimental model of ASD. Experimentally, the ASD rat model was induced by a single dose of VPA (600 mg/kg; i.p.) on gestation day 12.5 to the pregnant female rats. After birth, pups were treated with vehicle, normal saline 0.9% i.p., risperidone (2.5 mg/kg; i.p.), and G-CSF (10, 35, and 70 μg/kg; i.p.) from postnatal day (PND) 23 to 43. All the groups were subjected to various developmental and behavior tests from birth. The rats were sacrificed on PND 55, and their brain was excised and processed for biochemical parameters (oxidative stress, inflammatory markers, BDNF), histological examination (H&E, Nissl staining), NMDA, and AMPA receptor expression by immunohistochemistry, western blot, and real-time polymerase chain reaction evaluation. Also, the possible interaction of the G-CSF with NMDA and AMPA receptors was evaluated using the in-silico method. The results of the study showed that in VPA-exposed rats, postnatal treatment of G-CSF rescued all the behavioral abnormalities, oxidative stress, and inflammatory parameters in a dose-dependent manner while risperidone did not show any significant results. The in-silico analysis showed the direct interaction of G-CSF with NMDA and AMPA receptors. The upregulated expression of NMDA and AMPA both in the prefrontal cortex as well as hippocampus was alleviated by G-CSF thereby validating its anti-inflammatory and excitoprotective properties. Thus, G-CSF demonstrated neuroprotection against the core symptoms of autism in the VPA-induced rodent model, making it a potential candidate for the treatment of ASD.

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19. Persichetti AS, Shao J, Gotts SJ, Martin A. Maladaptive Laterality in Cortical Networks Related to Social Communication in Autism Spectrum Disorder. The Journal of neuroscience : the official journal of the Society for Neuroscience. 2022; 42(48): 9045-52.

Neuroimaging studies of individuals with autism spectrum disorders (ASDs) consistently find an aberrant pattern of reduced laterality in brain networks that support functions related to social communication and language. However, it is unclear how the underlying functional organization of these brain networks is altered in ASD individuals. We tested four models of reduced laterality in a social communication network in 70 ASD individuals (14 females) and a control group of the same number of tightly matched typically developing (TD) individuals (19 females) using high-quality resting-state fMRI data and a method of measuring patterns of functional laterality across the brain. We found that a functionally defined social communication network exhibited the typical pattern of left laterality in both groups, whereas there was a significant increase in within- relative to across-hemisphere connectivity of homotopic regions in the right hemisphere in ASD individuals. Furthermore, greater within- relative to across-hemisphere connectivity in the left hemisphere was positively correlated with a measure of verbal ability in both groups, whereas greater within- relative to across-hemisphere connectivity in the right hemisphere in ASD, but not TD, individuals was negatively correlated with the same verbal measure. Crucially, these differences in patterns of laterality were not found in two other functional networks and were specifically correlated to a measure of verbal ability but not metrics of other core components of the ASD phenotype. These results suggest that previous reports of reduced laterality in social communication regions in ASD is because of the two hemispheres functioning more independently than seen in TD individuals, with the atypical right-hemisphere network component being maladaptive.SIGNIFICANCE STATEMENT A consistent neuroimaging finding in individuals with ASD is an aberrant pattern of reduced laterality of the brain networks that support functions related to social communication and language. We tested four models of reduced laterality in a social communication network in ASD individuals and a TD control group using high-quality resting-state fMRI data. Our results suggest that reduced laterality of social communication regions in ASD may be because of the two hemispheres functioning more independently than seen in TD individuals, with atypically greater within- than across-hemisphere connectivity in the right hemisphere being maladaptive.

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20. Schuchard J, Kaplan-Kahn EA, Carle AC, Holmes LG, Law K, Miller JS, Parish-Morris J, Forrest CB. Using percentiles in the interpretation of Patient-Reported Outcomes Measurement Information System scores: Guidelines for autism. Autism research : official journal of the International Society for Autism Research. 2022; 15(12): 2336-45.

The objectives of this study were to (1) demonstrate the application of percentiles to advance the interpretation of patient-reported outcomes and (2) establish autism-specific percentiles for four Patient-Reported Outcomes Measurement Information System (PROMIS) measures. PROMIS measures were completed by parents of autistic children and adolescents ages 5-17 years as part of two studies (n = 939 parents in the first study and n = 406 parents in the second study). Data from the first study were used to develop autism-specific percentiles for PROMIS parent-proxy sleep disturbance, sleep-related impairment, fatigue, and anxiety. Previously established United States general population percentiles were applied to interpret PROMIS scores in both studies. Results of logistic regression models showed that parent-reported material hardship was associated with scoring in the moderate-severe range (defined as ≥75th percentile in the general population) on all four PROMIS measures (odds ratios 1.7-2.2). In the second study, the percentage of children with severe scores (defined as ≥95th percentile in the general population) was 30% for anxiety, 25% for sleep disturbance, and 17% for sleep-related impairment, indicating a high burden of these problems among autistic children. Few children had scores at or above the autism-specific 95th percentile on these measures (3%-4%), indicating that their scores were similar to other autistic children. The general population and condition-specific percentiles provide two complementary reference points to aid interpretation of PROMIS scores, including corresponding severity categories that are comparable across different PROMIS measures.

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21. Singhi P, Malhi P. Early Diagnosis of Autism Spectrum Disorder: What the Pediatricians Should Know. Indian journal of pediatrics. 2022.

Autism is a spectrum disorder marked by considerable heterogeneity and characterized by impairments in the social communication domain along with the presence of restricted and repetitive behaviors or interests. Comprehensive autism evaluation generally consists of assessments by a multidisciplinary team. Having multiple specialists in the evaluation team aids in diagnosis and in chalking out a comprehensive management plan. Diagnosis is generally based on detailed developmental history, clinical judgment, and the use of standardized diagnostic instruments. Differential diagnosis is complicated as many of the mental health and neurodevelopmental conditions that routinely coexist with autism also have some symptoms that overlap with autism. Several barriers are linked to delay in diagnosis including lack of comfort in diagnosing autism by primary care providers, delayed referrals, the inability of parents to raise critical developmental concerns, confusion of autism with other conditions, and health system that is not responsive to the needs of the underserved communities. The etiology of autism spectrum disorder (ASD) is complex and still not completely understood; it involves genetics, neurobiology, and environmental exposures, leading to a diverse presentation of behaviors and symptoms. There is an imperative need to start therapeutic interventions as soon as a diagnosis of autism is suspected rather than wait for a definitive diagnosis. Early diagnosis is vital as timely intervention can lead to better outcomes for children and their families.

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22. Stabile M, Eigsti IM. Lexical Alignment and Communicative Success in Autism Spectrum Disorder. Journal of speech, language, and hearing research : JSLHR. 2022; 65(11): 4300-5.

PURPOSE: Typical speakers tend to adopt words used by their conversational partners. This « lexical alignment » enhances communication by reducing ambiguity and promoting a shared understanding of the topic under discussion. Lexical alignment has been little studied to date in autism spectrum disorder (ASD); furthermore, it has been studied primarily via structured laboratory tasks that may overestimate performance. This study examined lexical alignment in ASD during discourse and explored associations with communicative success and executive function. METHOD: Thirty-one autistic and nonautistic adolescents were paired with a study-naïve research assistant (RA) to complete a social communication task that involved taking turns verbally instructing (guiding) the partner to navigate on a map. Lexical alignment was operationalized as the proportion of shared vocabulary produced by guides on successive maps. Task accuracy was operationalized as the pixels contained within the intended and drawn routes. RESULTS: Results indicated that autistic adolescents had greater difficulty describing navigational routes to RAs, yielding paths that were less accurate. Alignment was reduced in autistic participants, and it was associated with path accuracy for nonautistic, but not autistic, adolescents. The association between lexical alignment and executive function missed significance (p = .05); if significant, the association would indicate that greater executive function difficulty was associated with reduced lexical alignment. CONCLUSIONS: These findings provide preliminary evidence of reduced lexical alignment in ASD in an unstructured discourse context. Moreover, positive associations between lexical alignment and task performance in the neurotypical group raise the possibility that interventions to promote the use of shared vocabulary might support better communication. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21313719.

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23. Stankovic M, Stojanovic A, Ignjatovic A, Elsabbagh M, Gonzalez M, Yusuf A, Ibrahim A, Shikako-Thomas K, Stojanov J, Stankovic M. The Challenges of Caregivers of Children with Autism Spectrum Disorders Comorbidity during the COVID-19 Pandemic in Serbia. Psychiatria Danubina. 2022; 34(3): 587-94.

BACKGROUND: Children with Autism Spectrum Disorders (ASD) experience significantly higher prevalence of other mental disorders, which amplifies their need for overall support. The outbreak of novel coronavirus (COVID-19) resulted in restrictions and limited access to different services with great challenge for families and children with ASD. SUBJECTS AND METHODS: We used an electronic SurveyMonkey questionnaire to examine the experiences of 114 caregivers of children with ASD. We compared: (a) level of support by the child’s school, changes in child behavior, and priority needs for families of ASD and ASD with comorbidities (ASD+) children, during pandemic, and (b) developmental history and diagnosis for ASD and ASD+ children before the pandemic. RESULTS: Our research shows significant behavioral difficulties in the population with ASD and ASD+ that arose in the field of altered living conditions and overall functioning during the COVID-19 pandemic. Statistically significant results comparing ASD to ASD+ children we found in area of getting additional help and support before the outbreak of the pandemic (47.1% vs 16.0%, p=0.002), as well as in worsening of sleep problems, statistically significant more common in children with ASD+ (ASD+ 47.7% vs. ASD 25.7%, p=0.046). CONCLUSIONS: Our findings can contribute to the faster development and implementation of protocols for dealing with situations such as pandemics, related to the vulnerable population of children with ASD and their caregivers.

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24. Wieckowski AT, Zuckerman KE, Broder-Fingert S, Robins DL. Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers. Autism research : official journal of the International Society for Autism Research. 2022; 15(12): 2216-22.

Formal autism diagnosis from a specialist trained in autism assessment is customary prior to a child accessing early, intensive autism-specific services. However, long wait lists for diagnostic evaluations and limited specialty workforce have created substantial delays. Additionally, lengthy multidisciplinary evaluations are costly to insurers, inconvenient to families, and disproportionally impact under-resourced families. Diagnostic delays can impede access to intervention services. These barriers, combined with evidence regarding the importance of receiving early, autism-specific treatment, demand new approaches enabling access to autism specific services before comprehensive evaluation. Pediatric primary care providers (PCPs) are often the only health care professionals with whom a family interacts during early childhood and can play a crucial role in helping children with autism symptoms access services. Many strategies for autism diagnosis in primary care are being developed and tested; however, they have yet to be broadly adopted by PCPs, primarily due to critical implementation barriers in primary care settings. There is also not enough evidence on the accuracy of PCPs’ diagnostic impressions without extensive specialty support, resulting in PCP hesitancy in diagnosing ASD, as well as family and service provider hesitancy in accepting a PCP autism diagnosis. In this commentary, we explore the acute need for shortening waitlists for autism evaluations through a tiered diagnostic approach, in which PCPs can rule in or rule out autism in children, for whom diagnosis is clear, and refer more complex cases for specialist evaluations, and explore implementation challenges to this approach.

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25. Yuan HL, Lai CYY, Wong MNK, Kwong TC, Choy YS, Mung SWY, Chan CCH. Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review. Children (Basel, Switzerland). 2022; 9(10).

Individuals with autism spectrum disorder (ASD) often exhibit sensory over-responsivity (SOR), which is characterized by an overwhelmingly negative reaction to or avoidance of sensory stimulation. Despite the detrimental effects of SOR on people’s personal and social lives, the knowledge of and interventions for the issue remain limited. This paper collates and reviews studies on SOR and information on the potential for effective interventions for people with ASD. This review reveals evidence that SOR has a close relationship with anxiety, depression, insomnia, and family life impairment and an underlying mechanism related to SOR. Four interventions and their theoretical bases in sensory-motor processing are discussed in this paper, namely, physical activity (PA), sensory integration therapy (SIT), mindfulness-based cognitive therapy (MBCT), and cognitive behavioral therapy (CBT). These interventions focus on establishing coping strategies for regulating the emotional response to sensory information, and they have been found to be effective and to have the potential to help children with ASD reduce their SOR behaviors. This paper provides guidance for selecting appropriate interventions and for further investigation of more effective interventions in the future.

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