1. Auvin S. Autism spectrum disorders of patients with epilepsy : The to-be-determined face of the coin. Epilepsy Behav. 2021 : 107838.

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2. Bechi M, Abu-Akel A, Agostoni G, Bosia M, Cocchi F, Spangaro M, Cavallaro R. Functional benefits of co-occurring autistic symptoms in schizophrenia is delimited by symptom severity. Journal of psychiatric research. 2021 ; 137 : 48-54.

BACKGROUND : Impairments in daily functioning characterize both autism spectrum disorder and schizophrenia. Research has shown that a subsample of schizophrenia patients presents autistic symptoms, leading to the hypothesis that their co-occurrence would be associated with a ‘double dose’ of deficit. A growing body of research examined this hypothesis by looking at the joint effect of autistic and positive psychotic symptoms, and yielded contrasting results, ranging from benefits to adverse effects. We hypothesized that the interactive effect of autistic and positive symptoms on functioning in schizophrenia might depend on the patients’ symptom severity. METHOD : In 170 schizophrenia patients, a two-step cluster analysis identified two groups of patients with different levels of autistic and positive symptom severity. Using general linear models, we examined the interactions of groups, autistic and positive symptoms on functioning. RESULTS : Autistic and positive symptoms were interactively associated with better functioning, but only in the symptomatically less severe patients. In contrast, autistic and positive symptoms were independently associated with worse functioning in the symptomatically more severe patients. These associations were observed above and beyond the effects of I.Q. and illness duration. CONCLUSIONS : The findings highlight the complex role played by co-occurring autistic symptoms in schizophrenia, whose beneficial effects on functioning appear to depend on patients’ psychopathological severity. Our findings may help to reconcile the seemingly contrasting results from previous studies, and to understand the heterogeneity of behavior and functional outcomes in schizophrenia. This study underscores the potential utility of routinely assessing autism in schizophrenia, in order to better formulate individualized rehabilitative programs.

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3. Berard M, Rattaz C, Peries M, Loubersac J, Munir K, Baghdadli A. Impact of containment and mitigation measures on children and youth with ASD during the COVID-19 pandemic : Report from the ELENA cohort. Journal of psychiatric research. 2021 ; 137 : 73-80.

BACKGROUND : Containment, involving separation and restriction of movement of people due to the COVID-19 pandemic, and mitigation, also referred to as lockdown, involving closure of schools, universities and public venues, has had a profound impact on people’s lives globally. The study focuses on the effects of containment and mitigation measures, on the behavior of children and youth (CaY) with Autism Spectrum Disorders (ASD). The study primary aim was to examine the impact of these urgent measures on the behaviors, communication, sleep, and nutritional status of the CaY. A secondary aim was to explore risk and protective factors on behavior change including sociodemographic variables, living conditions, ASD symptom severity and continuity of interventions. METHODS : The study sample consisted of 239 ASD subjects, 2-21 years of age, enrolled in the ELENA cohort in France at Stage 3 confinement and mitigation measures announced on March 16, 2020. A parent informant completed the COVID-19 questionnaire. RESULTS : Of the domains examined, challenging behaviors, communicative skills and sleep had the greatest impact ; in terms of risk and protective factors, subject age, ASD severity, single parenthood, daily living skills, and intervention continuity were most likely to impact behaviors ; living conditions were not linked to behavior change. CONCLUSIONS : The findings highlight the topography of behavioral change in CaY with ASD following institution of containment and mitigation measures during the COVID-19 pandemic and help identify risk and protective factors to help better address needs and tailor interventions in the future.

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4. Chang J. Can Caregiver Reports Reflect Dental Treatment Needs of Patients with Intellectual and Developmental Disabilities ?. Oral health & preventive dentistry. 2021 ; 19(1) : 169-77.

PURPOSE : This study aimed to obtain the oral health-related factors of patients with intellectual and developmental disabilities (IDD) from family caregivers and to relate caregiver-perceived risk factors to dental treatment needs of patients. MATERIALS AND METHODS : A total of 120 dyads of patients (mean [SD] age = 29.1 [8.4] years) and their family caregivers (mean [SD] age = 56.5 [9.5] years) were included. Data were obtained from self-administered questionnaires by caregivers and oral examinations by a dentist. Oral health conditions of patients were analysed in different age groups using paired t-tests. Caregiver-perceived oral health conditions of patients and dentist-assessed caries and periodontal disease were compared using Pearson’s chi-squared and Fisher’s exact tests. Relationships between patient factors and treatment needs were analysed using multiple logistic regression. RESULTS : Tooth pain, chewing difficulty, and reasons for the last dental visit were associated with high numbers of decayed teeth (DT) (p < 0.05). Overall oral health condition of patients rated by caregivers was related to high DT and the Community Periodontal Index (CPI) score (p < 0.05). Well-maintained dental care of caregivers was associated with lower numbers of DT and less urgent treatment needs of patients (p < 0.05). CONCLUSION : There were caregiver-perceived factors indicating dental treatment needs of patients with IDD. Proxy reports by caregivers can be used as risk predictors for ongoing dental problems of patients with communication limitations.

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5. Chapin SE, McNaughton D, Light J, McCoy A, Caron J, Lee DL. The Effects of AAC Video Visual Scene Display Technology On the Communicative Turns of Preschoolers with Autism Spectrum Disorder. Assistive technology : the official journal of RESNA. 2021.

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6. Chien YL, Wu CS, Tsai HJ. The Comorbidity of Schizophrenia Spectrum and Mood Disorders in Autism Spectrum Disorder. Autism Res. 2021 ; 14(3) : 571-81.

Individuals with autism spectrum disorder are often diagnosed with at least one or more accompanying disorders. Most studies reported prevalence of the psychiatric comorbidities among these individuals ; however, the incidence of developing comorbidities is unclear. This study used Taiwan’s claims database and aimed to investigate the incidence of developing major psychiatric comorbidities in individuals with autism spectrum disorder and whether the incidence was moderated by gender, autism-spectrum disorder subtypes, and autism-associated neurodevelopmental conditions. A total of 3,837 individuals with autism spectrum disorder (2,929 autistic disorder, 447 Asperger syndrome, 461 pervasive developmental disorder-not otherwise specified) and 38,370 comparison subjects, who were matched by age and gender, were included. The incidences of schizophrenia spectrum, bipolar, and major depressive disorders was examined. The results showed that the incidences of schizophrenia spectrum (9.7 per 1,000 person-year), bipolar disorder (7.0 per 1,000 person-year), and major depressive disorder (3.2 per 1,000 person-year) were significantly higher than the comparison group across all three subtypes of autism-spectrum disorder. Individuals with pervasive developmental disorder-not otherwise specified had higher risk for major depressive disorder than autistic disorder. Females with Asperger syndrome had significant higher risk for schizophrenia spectrum than males. The comorbidity rate dramatically dropped when the autism-associated neurodevelopmental conditions were taken into account. Our findings suggested that the incidences of major psychiatric comorbidities were higher in autism spectrum disorder and influenced by autism subtypes, gender, and autism-associated neurodevelopmental conditions. LAY SUMMARY : We examined whether people with autism spectrum disorder (ASD) have higher incidence of schizophrenia, bipolar disorders, and major depression using a large claims database. The results showed the incidences of these mental illness among individual with ASD were significantly higher than those without ASD. In addition, the incidences were influenced by autism subtypes, gender, and comorbid neurodevelopmental conditions.

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7. Gangi DN, Boterberg S, Schwichtenberg AJ, Solis E, Young GS, Iosif AM, Ozonoff S. Declining Gaze to Faces in Infants Developing Autism Spectrum Disorder : Evidence From Two Independent Cohorts. Child Dev. 2020.

Two independent cohorts (N = 155, N = 126) of infants at high and low risk for autism spectrum disorder (ASD) were followed prospectively between 6 and 36 months of age, when n = 46 were diagnosed with ASD. Gaze to adult faces was coded-during a developmental assessment (Cohort 1) or a play interaction (Cohort 2). Across both cohorts, most children developing ASD showed sharp declines in gaze to faces over time, relative to children without ASD. These findings suggest that declining developmental trajectories may be more common than previously recognized by retrospective methods. Trajectory-based screening methods could potentially identify children in the early stages of symptom onset and allow for early intervention before the full disorder has developed.

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8. Giroux M, Pélissier-Simard L. Shedding light on autistic traits in struggling learners : A blind spot in medical education. Perspectives on medical education. 2021.

Some highly challenging, seemingly « unsolvable » situations that arise in medical education could be the result of autistic traits (AT) in learners. AT exist in physicians and learners, ranging from profiles compatible with DSM-5’s criteria for autism spectrum disorder (ASD) to more subtle manifestations of ASD’s « broader phenotype. » Often associated with strengths and talents, AT may nonetheless pose significant challenges for learning, teaching, and practising medicine. Since AT remain widely under-recognized and misunderstood by educators, clinicians, and affected individuals alike, they represent a blind spot in medical education. The use of a « neurodiversity lens » to examine challenging situations may help educators consider different pedagogical approaches to address those potentially stemming from AT.This paper aims to raise awareness and understanding of AT-related difficulties in struggling medical learners. To overcome the blind spot challenge and help develop this « neurodiversity lens, » we explore different angles. Beyond any diagnostic consideration, we offer a series of contextual examples, paralleled with explanatory concepts from the field of ASD. We also underline the role of context on functional impact and describe the often ill-defined pattern of challenges encountered, as well as the fertile grounds for interpersonal misunderstandings and disrespect. We propose historical, cultural, and clinical reasons likely contributing to the blind spot. Mindful of the potential risks of prejudice associated with identifying AT-related difficulties, we underline the necessity and feasibility of conciliating diversity and dignity with accountability standards for medical competence.

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9. Helt MS, de Marchena AB, Schineller ME, Kirk AI, Scheub RJ, Sorensen TM. Contagious itching is heightened in children with autism spectrum disorders. Dev Sci. 2021 ; 24(2) : e13024.

The authors tested susceptibility to contagious itching, laughter, and yawning in 55 children with autism spectrum disorder (ASD), ages 8-14, and 106 typically developing (TD) children, ages 5-14. Children with ASD were less likely to yawn or laugh contagiously compared with TD peers, but showed increased susceptibility to contagious itching, under naturalistic conditions. Contagious yawning and laughter were positively correlated with emotional empathy in the TD group. In contrast, contagious itching showed no relationship to empathy, and was positively correlated with autism symptom severity in the ASD group. The authors explore the implications of these findings in terms of psychological theories about ASD.

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10. Hunter JE, McLay LK, France KG, Blampied NM. Sleep and stereotypy in children with autism : effectiveness of function-based behavioral treatment. Sleep medicine. 2021 ; 80 : 301-4.

OBJECTIVES : Children with autism spectrum disorder (ASD) experience high rates of sleep problems, which exacerbate the core symptoms of ASD, including stereotypy (restricted and repetitive behaviors). Conversely, stereotypy can interfere with sleep by actively competing with sleep-facilitative behaviors (eg, lying down quietly). Behavioral interventions informed by functional behavioral assessment (FBA) significantly reduce sleep problems in children with ASD, however, their impact on sleep-interfering stereotypy is not clear. This study investigated the effectiveness of function-based behavioral treatments for sleep problems, including sleep-interfering stereotypy, in children with ASD, the maintenance of these effects, and parents’ satisfaction with the treatment process. METHODS : A non-concurrent multiple baselines across participants design was used to evaluate the effectiveness of function-based, individualized treatments for sleep problems and sleep-interfering stereotypy in three children with ASD. For each participant, stereotypy was automatically maintained and interfered with the initiation and/or re-initiation of sleep. Parents implemented multi-component treatments that included a faded bedtime procedure. RESULTS : Treatment reduced sleep problems in 2/3 participants, and the duration of stereotypy was reduced in all participants. Treatment effects were largely maintained at follow-up, and parent-reported satisfaction was high. CONCLUSION : These results support prior research demonstrating the effectiveness of FBA-informed behavioral treatments for sleep problems in children with ASD. Further, this study shows that these treatments may be effective in reducing sleep-interfering stereotypy. Future research should more thoroughly investigate the bidirectional relationships between sleep and core symptoms of ASD, and address how these relationships are assessed and treated in the sleep context.

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11. Itani S, Thanou D. Combining anatomical and functional networks for neuropathology identification : A case study on autism spectrum disorder. Medical image analysis. 2021 ; 69 : 101986.

While the prevalence of Autism Spectrum Disorder (ASD) is increasing, research continues in an effort to identify common etiological and pathophysiological bases. In this regard, modern machine learning and network science pave the way for a better understanding of the neuropathology and the development of diagnosis aid systems. The present work addresses the classification of neurotypical and ASD subjects by combining knowledge about both the structure and the functional activity of the brain. In particular, we model the brain structure as a graph, and the resting-state functional MRI (rs-fMRI) signals as values that live on the nodes of that graph. We then borrow tools from the emerging field of Graph Signal Processing (GSP) to build features related to the frequency content of these signals. In order to make these features highly discriminative, we apply an extension of the Fukunaga-Koontz transform. Finally, we use these new markers to train a decision tree, an interpretable classification scheme, which results in a final diagnosis aid model. Interestingly, the resulting decision tree outperforms state-of-the-art methods on the publicly available Autism Brain Imaging Data Exchange (ABIDE) collection. Moreover, the analysis of the predictive markers reveals the influence of the frontal and temporal lobes in the diagnosis of the disorder, which is in line with previous findings in the literature of neuroscience. Our results indicate that exploiting jointly structural and functional information of the brain can reveal important information about the complexity of the neuropathology.

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12. Jash S, Sharma S. In utero immune programming of autism spectrum disorder (ASD). Human immunology. 2021.

Maladaptation of immune tolerance at the maternal-fetal interface affects balanced maternal-fetal cross-talk and placental health and is associated with adverse pregnancy outcomes. The concept of in utero programming of childhood and adulthood diseases has revolutionized the research on the role of pregnancy in maternal, neonatal, and adult health. However, it is not yet well understood whether dysregulation of uterine immunity contributes to any health consequences during childhood or later in life. Recent observations in mice and humans have strongly supported the notion that uterine immunity during pregnancy determines the health trajectory of the offspring and significantly impacts cognitive function and mental health. Importantly, IL-17a producing Th17 T cells have been projected as the main contributors to heterogeneous pathological and behavioral phenotypes associated with autism spectrum disorder (ASD). However, since normal pregnancy is associated with little or no Th17 cells at the maternal-fetal interface, it is not clear how and when the Th17 T cells are generated and which interventions can ameliorate the ASD-like features in newborns. We propose that infection-associated uterine immune activation within a critical window of development may propel trans-differentiation of Th17 T cells that eventually affect fetal brain development and induce ASD-like behavioral phenotype in the offspring.

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13. Kuhn J, Levinson J, Udhnani MD, Wallis K, Hickey E, Bennett A, Fenick AM, Feinberg E, Broder-Fingert S. What Happens After a Positive Primary Care Autism Screen Among Historically Underserved Families ? Predictors of Evaluation and Autism Diagnosis. J Dev Behav Pediatr. 2021.

OBJECTIVE : Families, pediatric providers, and service systems would benefit from expanded knowledge regarding (1) who is most likely to receive a recommended diagnostic evaluation after a positive primary care-administered autism screen and (2) of those who screen positive, who is most likely to be diagnosed with autism ? METHOD : Participants included 309 predominantly low-income, racial/ethnic minority parents and their child, aged 15 to 27 months, who screened positive on the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F). Generalized estimating equations were used to fit models of predictors for each binary outcome : receiving a diagnostic evaluation and receiving an autism diagnosis on evaluation. RESULTS : Significant predictors of diagnostic evaluation receipt included the parent being older or non-Hispanic and the child having private insurance, lower child communication functioning, or receiving Early Intervention services. Significant predictors of an autism diagnosis on evaluation included male child, lower child communication functioning, screening directly in the parent’s preferred language, White/non-Hispanic parent, and no parent history of mood disorder. CONCLUSION : Children with younger parents, Hispanic ethnicity, relatively higher communication skills, public insurance, and no Early Intervention services were less likely to receive recommended diagnostic care. Reduced likelihood of autism diagnosis after a positive screen in non-White/non-Hispanic subgroups supports previous research indicating issues with M-CHAT-R/F positive predictive power for racial/ethnic minorities. The use of telephonic interpreters to administer screens, as opposed to directly screening in families’ preferred languages, may lead to identification of fewer true autism cases. Thus, multilingual clinical staff capacity may improve positive predictive power of autism screening.

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14. Kupis L, Goodman ZT, Kircher L, Romero C, Dirks B, Chang C, Nomi JS, Uddin LQ. Altered patterns of brain dynamics linked with body mass index in youth with autism. Autism Res. 2021.

Children with autism spectrum disorder (ASD) have higher rates of overweight and obesity (OWOB) compared with typically developing (TD) children. Brain functional connectivity differences have been shown in both ASD and OWOB. However, only one study to date has examined ASD and OWOB concurrently, so little is known regarding the neural mechanisms associated with the higher prevalence of OWOB and its behavioral impacts in ASD. We investigated co-activation patterns (CAPs) of brain regions identified by independent component analysis in 129 children and adolescents between 6 and 18 years of age (n = 68 ASD). We examined the interaction between body mass index (BMI) and diagnosis in predicting dynamic brain metrics (dwell time, DT ; frequency of occurrence, and transitions between states) as well as dimensional brain-behavior relationships. The relationship between BMI and brain dynamics was moderated by diagnosis (ASD, TD), particularly among the frequency of CAP 4, characterized by co-activation of lateral frontoparietal, temporal, and frontal networks. This pattern was negatively associated with parent-reported inhibition skills. Children with ASD had shorter CAP 1, characterized by co-activation of the subcortical, temporal, sensorimotor, and frontal networks, and CAP 4 DTs compared with TD children. CAP 1 DT was negatively associated with cognitive flexibility, inhibition, social functioning, and BMI. Cognitive flexibility moderated the relationship between BMI and brain dynamics in the visual network. Our findings provide novel evidence of neural mechanisms associated with OWOB in children with ASD. Further, poorer cognitive flexibility may result in increased vulnerability for children with ASD and co-occurring OWOB. LAY SUMMARY : Obesity is a societal epidemic and is common in autism, however, little is known about the neural mechanisms associated with the higher rates of obesity in autism. Here, we find unique patterns of brain dynamics associated with obesity in autism that were not observed in typically developing children. Further, the relationship between body mass index and brain dynamics depended on cognitive flexibility. These findings suggest that individuals with autism may be more vulnerable to the effects of obesity on brain function.

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15. Maietta JE, Kuwabara HC, Cross CL, Flood SM, Kinsora TF, Ross SR, Allen DN. Influence of Autism and Other Neurodevelopmental Disorders on Cognitive and Symptom Profiles : Considerations for Baseline Sport Concussion Assessment. Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists. 2021.

OBJECTIVE : The presence of neurodevelopmental disorders (ND) such as attention-deficit/hyperactivity disorder (ADHD) and learning disorders (LD) have demonstrated effects on Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) performance. No current research has directly examined whether autism spectrum disorder (ASD) has similar effects. The current study compared ImPACT cognitive and symptom profiles in athletes with self-reported ASD to other NDs and healthy controls using case-control matching. METHOD : The current study compared ImPACT baselines of high school athletes with ASD to athletes with other NDs (ADHD, LD, and co-occurring ADHD/LD) and healthy controls on cognitive composites and symptom reporting. Participants included 435 athletes (87 controls, 87 with ASD, 87 with ADHD, 87 with LD, and 87 with ADHD/LD) selected from a larger naturalistic sample. Athletes were matched to the ASD group based on age, sex, and sport using randomized case-matched selection from the larger database. RESULTS : Results revealed that athletes with ASD performed more poorly than healthy controls on the Visual Motor Speed composite. No differences were found for Post-concussion Symptom Scale (PCSS) domain scores. Differences in cognitive and symptom profiles among the athletes with other NDs were also found. CONCLUSIONS : Results elucidate patterns of baseline performance for athletes with ASD, demonstrating that there may not be significant differences between ASD and healthy controls on four of the five ImPACT composites, and no symptom reporting differences. Cognitive and symptom differences found for other NDs should be considered when interpreting baseline performance and for making return-to-play decisions in the absence of baseline assessment.

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16. Napoletani G, Vigli D, Cosentino L, Grieco M, Talamo MC, Lacivita E, Leopoldo M, Laviola G, Fuso A, d’Erme M, De Filippis B. Stimulation of the Serotonin Receptor 7 Restores Brain Histone H3 Acetylation and MeCP2 Corepressor Protein Levels in a Female Mouse Model of Rett Syndrome. Journal of neuropathology and experimental neurology. 2021 ; 80(3) : 265-73.

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

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17. Ramírez-López A, Pastor A, de la Torre R, La Porta C, Ozaita A, Cabañero D, Maldonado R. Role of the endocannabinoid system in a mouse model of Fragile X undergoing neuropathic pain. Eur J Pain. 2021.

BACKGROUND : Neuropathic pain is a complex condition characterized by sensory, cognitive and affective symptoms that magnify the perception of pain. The underlying pathogenic mechanisms are largely unknown and there is an urgent need for the development of novel medications. The endocannabinoid system modulates pain perception and drugs targeting the cannabinoid receptor type 2 (CB2) devoid of psychoactive side effects could emerge as novel analgesics. An interesting model to evaluate the mechanisms underlying resistance to pain is the fragile X mental retardation protein knockout mouse (Fmr1KO), a model of fragile X syndrome that exhibits nociceptive deficits and fails to develop neuropathic pain. METHODS : A partial sciatic nerve ligation was performed to wild-type (WT) and Fmr1KO mice having (HzCB2 and Fmr1KO-HzCB2, respectively) or not (WT and Fmr1KO mice) a partial deletion of CB2 to investigate the participation of the endocannabinoid system on the pain-resistant phenotype of Fmr1KO mice. RESULTS : Nerve injury induced canonical hypersensitivity in WT and HzCB2 mice, whereas this increased pain sensitivity was absent in Fmr1KO mice. Interestingly, Fmr1KO mice partially lacking CB2 lost this protection against neuropathic pain. Similarly, pain-induced depressive-like behaviour was observed in WT, HzCB2 and Fmr1KO-HzCB2 mice, but not in Fmr1KO littermates. Nerve injury evoked different alterations in WT and Fmr1KO mice at spinal and supra-spinal levels that correlated with these nociceptive and emotional alterations. CONCLUSIONS : This work shows that CB2 is necessary for the protection against neuropathic pain observed in Fmr1KO mice, raising the interest in targeting this receptor for the treatment of neuropathic pain. SIGNIFICANCE : Neuropathic pain is a complex chronic pain condition and current treatments are limited by the lack of efficacy and the incidence of important side effects. Our findings show that the pain-resistant phenotype of Fmr1KO mice against nociceptive and emotional manifestations triggered by persistent nerve damage requires the participation of the cannabinoid receptor CB2, raising the interest in targeting this receptor for neuropathic pain treatment. Additional multidisciplinary studies more closely related to human pain experience should be conducted to explore the potential use of cannabinoids as adequate analgesic tools.

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18. Salgado-Cacho JM, Moreno-Jiménez MDP, de Diego-Otero Y. Detection of Early Warning Signs in Autism Spectrum Disorders : A Systematic Review. Children (Basel, Switzerland). 2021 ; 8(2).

Due to the exponential increase of autism spectrum disorders’ prevalence in Western countries, it is necessary to improve early detection and intervention to enhance developmental milestones. This systematic review identified the most effective screening instrument, which can be used at an early age and which identifies the maximum number of autism cases. We identified several instruments with adequate predictive properties-the Autism Parent Screen for Infants (APSI), Battelle Development Inventory, second edition (BDI-2) ; Brief Infant-Toddler Social and Emotional Assessment (BITSEA) ; First Year Inventory (FYI) ; Infant-Toddler Checklist/Communication and Symbolic Behavior Scales Developmental Profile (ITC/CSBS-DP) ; Program of Research and Studies on AUTISM (PREAUT-Grid) ; Checklist for Early Signs of Developmental Disorders (CESDD) ; Social Attention and Communication Study (SACS) ; and the Screening Tool for Autism in Toddlers and Young Children (STAT)-that can be applied from 12 months of age in Western countries. The ITC/CSBS-DP has been proposed for universal screening from 12 months of age onwards, complemented by the Modified Checklist for Autism in Toddlers, Revised/Revised with Follow-Up (M-CHAT-R/F), which can be used from 15 months of age onwards. This strategy could improve early detection in at-risk children within the current health system, thus allowing for early intervention.

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19. Scheerer NE, Boucher TQ, Iarocci G. Alexithymia is related to poor social competence in autistic and nonautistic children. Autism Res. 2021.

Alexithymia is characterized by difficulties identifying and describing one’s own emotions and the emotions of others. These challenges with understanding emotions in people with alexithymia may give rise to difficulties with social interactions. Given that alexithymia frequently co-occurs with autism spectrum disorder (ASD), and that both populations have difficulties with social interactions, it is of interest to determine whether alexithymia can help to parse some of the heterogeneity in social competence in autistic and nonautistic individuals. The caregivers of 241 children (6-14 years old), including 120 autistic, and 121 nonautistic, rated their child’s social competence using the Multidimensional Social Competence Scale (MSCS), autism traits using the Autism Spectrum Quotient (AQ), and alexithymia traits using the Children’s Alexithymia Measure (CAM). Regression analyses indicated that age, IQ, sex, AQ, and CAM scores accounted for 40.2% of the variance in autistic children’s, and 68.2% of the variance in nonautistic children’s, parent-reported social competence. Importantly, after controlling for age, IQ, sex, and AQ scores, CAM scores alone accounted for an additional 16.2% of the variance in autistic children’s, and 17.4% of the variance in nonautistic children’s social competence. These results indicate that higher alexithymia traits predict lower levels of social competence, suggesting that increased difficulty in identifying and describing one’s own emotions and the emotions of others is associated with poorer social competence. Furthermore, CAM scores were found to partially mediate the relationship between autistic traits and social competence, suggesting that comorbid alexithymia traits may be partially responsible for poor social competence in individuals with high autistic traits. This research contributes to the understanding of the factors associated with the development of social competence and highlights alexithymia as a potential target for identification and intervention to improve social competence. LAY SUMMARY : Alexithymia is a condition where people find it hard to think and talk about their (and others’) feelings. About 50% of autistic people have alexithymia. This might be why they have social and emotional difficulties. Parents answered questions about alexithymia and social difficulties their children have. Children with more alexithymia problems had poorer social skills. Thus, alexithymia may be related to social problems faced by autistic and nonautistic children.

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20. Widyawati Y, Scholte RHJ, Kleemans T, Otten R. Positive parenting and its mediating role in the relationship between parental resilience and quality of life in children with developmental disabilities in Java Island, Indonesia. Res Dev Disabil. 2021 ; 112 : 103911.

BACKGROUNDS : Developmental disabilities exert severe physical, cognitive and social-emotional consequences, such as low quality of life, not only on children but also on their families. However, the extent of the effect of such consequences on quality of life is partially dependent on how parents address the situation. AIMS : The study aimed to examine whether positive parenting mediates the link between parental resilience and quality of life of children with a developmental disability in Indonesia. METHODS AND PROCEDURES : Data were derived from a three-wave longitudinal study on 497, 224 and 209 families in waves one, two and three, respectively. The study determined parental resilience by assessing the knowledge of parents about the characteristics of their child, perceived social support and positive perception of parenting. Quality of life consisted of five aspects : material well-being, communication and influence, socio-emotional well-being, development and activity. Positive parenting was assessed through observed levels of support, encouragement and praise. CONCLUSIONS AND IMPLICATIONS : The results demonstrated that positive parenting mediated the impact of positive perception of parenting on quality of life. This finding implies that positive perception and positive parenting should be encouraged when families with children with developmental disabilities receive care or support.

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