1. Chang Y, Kim B, Youn M. Changes in Children with Autism Spectrum Disorder after Theraplay Application. Soa–ch’ongsonyon chongsin uihak = Journal of child & adolescent psychiatry. 2021; 32(3): 112-7.

OBJECTIVES: This study identified changes in social communication and interaction among children with autism spectrum disorder (ASD) through Theraplay. METHODS: This study included 20 children who were diagnosed with ASD by a child and adolescent psychiatrist and were recommended to undergo Theraplay in 2012-2017. The Marschak interaction method was used to identify and analyze the interactions between parents and their children. The Korean version of the Social Communication Questionnaire (K-SCQ) was used to evaluate symptoms of ASD. The Wilcoxon signed-rank test was used to compare the differences before and after Theraplay. RESULTS: Upon comparing the differences in total K-SCQ scores, there were statistically significant changes (z=-3.269, p=0.001) in children with ASD. Changes were also confirmed in each category, namely social interaction, communication, and limited and repetitive behavior patterns (p=0.011, p=0.025, p=0.039, respectively). CONCLUSION: This study found that Theraplay may cause significant changes in social communication in children with ASD. Further studies are needed to establish the effectiveness of Theraplay in children with ASD.

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2. Chapple M, Worsley JD. Commentary: Considering nomenclature for autism – aligning with the language preferences of the autistic community – a commentary on Kehinde et al. (2021). Child and adolescent mental health. 2021; 26(3): 284-5.

Since the implementation of ‘autism’ as a diagnosable condition in the 1980s, the medical model has continued to dominate how we understand autism. More recently, there has been a rise in understanding autism through the neurodiversity model and the lived experiences of autistic people themselves. However, there is often misalignment between the medical model and the preferences of the autistic community. In particular, there are misalignments around the language we use in society to discuss autism and autistic people. Language misalignments are particularly important, with language playing an important role in conveying understandings of a group within society. This article highlights these nomenclature misalignments, focussing on (1) Asperger syndrome, (2) functioning labels, (3) severity assumptions, (4) the language of disorder and (5) identity-first compared to person-first language. The article discusses the difficulties that might present in healthcare settings as a result of these misalignments.

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3. Cost KT, Zaidman-Zait A, Mirenda P, Duku E, Zwaigenbaum L, Smith IM, Ungar WJ, Kerns C, Bennett T, Szatmari P, Georgiades S, Waddell C, Elsabbagh M, Vaillancourt T. Correction to: « Best Things »: Parents Describe Their Children with Autism Spectrum Disorder Over Time. Journal of autism and developmental disorders. 2021; 51(12): 4575-6.

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4. Degli Espinosa F, Wolff K, Hewett S. A comparison of two teaching procedures to establish generalized intraverbal-tacting in children with autism. Journal of applied behavior analysis. 2021; 54(4): 1468-87.

Previous research has investigated generalized intraverbal-tacting by teaching children with autism to respond using autoclitic frames. The present study compared the effectiveness and efficiency of a Frame and a No Frame procedure across counterbalanced stimulus sets with 4 children with autism. In the Frame condition, children were taught to respond using autoclitic frames (e.g., « Shape square, » « Number two, » « Color green, » « It’s mummy, » « S/he is drinking ») corresponding to the verbal antecedent (« What shape? », « What number? », « What color? », « Who is it? », « What is s/he doing? »). In the No Frame condition, intraverbal-tacting was established without the autoclitic frame. Irrespective of stimuli employed, 2 children acquired intraverbal-tacting only in the Frame condition. The other 2 children acquired intraverbal-tacting in both conditions, with the Frame procedure requiring fewer teaching trials for 1 child and producing greater generalization for the other. Implications for clinical practice and the role of additive intraverbal stimulus control of autoclitic frames are discussed.

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5. Fong VC, Lee BS, Iarocci G. A community-engaged approach to examining barriers and facilitators to accessing autism services in Korean immigrant families. Autism : the international journal of research and practice. 2022; 26(2): 525-37.

Perceptions and experiences of culturally and linguistically diverse groups in accessing autism services in Canada are extremely limited. Thus, this study partnered with a community member to explore Korean immigrant parents’ perceptions of barriers and facilitators to accessing autism services in British Columbia, Canada. Interviews were conducted with 20 Korean parents of autistic children. Barriers and facilitators at the system, provider, and family/cultural level were identified. Barriers at the system level included delays and waitlists for services, and ineffective school policies to address child behavioral challenges. At the provider level, barriers included a lack of qualified professionals, negative attitudes, and lack of guidance navigating services. For family/cultural-related barriers, these included language and communication difficulties, out-of-pocket costs, and stigma impeded service access. Facilitators at the system level included family-centered care and prioritization of mental health supports. At the provider level, strengths included culturally competent and bilingual professionals. The family/cultural-related facilitators identified were informal support networks, characteristics of the parent, and connections to cultural community organizations. The findings emphasize the need to understand and consider diverse experiences, preferences, and values in the design and provision of autism services for families and their children.

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6. Ishizuka K, Ishiguro T, Nomura N, Inada T. Autistic traits as predictors of persistent depression. European archives of psychiatry and clinical neuroscience. 2022; 272(2): 211-6.

Persistent depression has been suggested to be associated with autistic traits in people of working age. This study aimed to clarify which autistic characteristics at the initial visit were associated with persistent depression at the 12 week follow-up in a primary care setting. Newly depressed outpatients aged 24-59 years with no history of autism were asked to complete the 50-item autism spectrum quotient (AQ) and the Beck depression inventory (BDI) at baseline and 12 week follow-up (N = 123, males: 48%, age: 37.7 ± 9.15 years). Nearly 40% of participants had an AQ score ≥ 26. Significant differences were observed between the group with remitted depression (N = 43) and those with persistent depression (N = 80) in educational years and AQ « attention switching » and « attention to detail » subscale scores. In addition, a statistically significant decrease in the total AQ and the « communication » and « imagination » scores were observed in the remitted group, while no such change was observed in the group with persistent depression. It remains unclear whether the self-perceived severity of communication and imagination traits in persistent depression was due to the state of persistent depression or a kind of premorbid autistic trait. The results suggest that high levels of autistic traits are frequently present in adults with depression. High « attention switching » and « attention to detail » scores in AQ screening at the first visit might predict the persistence of depressive symptoms after 12 weeks in adults with depression, while total AQ scores, especially for « communication » and « imagination » items, might be state-dependent.

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7. Kenny L, Remington A, Pellicano E. Comparing the Executive Function Ability of Autistic and Non-autistic Adolescents with a Manualised Battery of Neuropsychological Tasks. Journal of autism and developmental disorders. 2021.

Performance on a single executive function (EF) task (e.g., a card sorting task) is often taken to represent ability on the underlying subcomponent of EF (e.g., set shifting) without accounting for the non-specific and non-executive skills employed to complete the task. This study used a manualised battery of EF tasks to derive individual task scores and latent EF scores. Seventy-nine adolescents aged between 11 and 19 years, including 37 autistic and 42 non-autistic participants, matched on cognitive ability, completed the battery. Autistic adolescents had moderate global EF difficulties and had significantly more difficulties on some individual tasks. However, the samples did not differ on any of the specific individual subcomponents of EF (fluency, cognitive control and working memory).

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8. Kichukova T, Petrov V, Popov N, Minchev D, Naimov S, Minkov I, Vachev T. Identification of serum microRNA signatures associated with autism spectrum disorder as promising candidate biomarkers. Heliyon. 2021; 7(7): e07462.

BACKGROUND: MicroRNAs (miRNAs) are short non-coding RNA molecules with a well-recognized role in gene expression mostly at the post-transcriptional level. Recently, dysregulation of miRNAs and miRNA-mRNA interactions has been associated with CNS diseases, including numerous psychiatric disorders. Dynamic changes in the expression profiles of circulating miRNA are nowadays regarded as promising non-invasive biomarkers that may facilitate the accurate and timely diagnosis of complex conditions. METHODS: In this study, we investigated the gene expression patterns of four miRNAs, which were previously reported to be dysregulated in pooled serum samples taken from Autism Spectrum Disorder (ASD) patients and typically developing children. The performance of a diagnostic model for ASD based on these four miRNAs was assessed by a receiver operating characteristic (ROC) curve analysis, which evaluates the diagnostic accuracy of the investigated miRNA biomarkers for ASD. Finally, to examine the potential modulation of CNS-related biological pathways, we carried out target identification and pathway analyses of the selected miRNAs. RESULTS: Significant differential expression for all the four studied miRNAs: miR-500a-5p, miR-197-5p, miR-424-5p, and miR-664a-3p, was consistently measured in the samples from ASD patients. The ROC curve analysis demonstrated high sensitivity and specificity for miR-500a-5p, miR-197-5p, and miR-424-5p. With all miRNA expression data integrated into an additive ROC curve, the combination of miR-500a-5p and miR-197-5p provided the most powerful diagnostic model. On the other hand, the mRNA target mining showed that miR-424-5p and miR-500-5p regulate pools of target mRNA molecules which are enriched in a number of biological pathways associated with the development and differentiation of the nervous system. CONCLUSIONS: The steady expression patterns of miR-500a-5p, miR-197-5p, miR-424-5p, and miR-664a-3p in ASD children suggest that these miRNAs can be considered good candidates for non-invasive molecular biomarkers in the study of ASD patients. The highest diagnostic potential is manifested by miR-500a-5p and miR-197-5p, whose combined ROC curve demonstrates very strong predictive accuracy.

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9. Kyriacou C, Forrester-Jones R, Triantafyllopoulou P. Clothes, Sensory Experiences and Autism: Is Wearing the Right Fabric Important?. Journal of autism and developmental disorders. 2021.

Tactile defensiveness in autistic individuals is the least investigated sensory modality. The current multi-component, explorative study aimed to understand the experiences of ten autistic adults regarding tactile defensiveness and fabrics, using semi-structured, one-to-one interviews. Participants were asked to discuss the effects of seven provided samples of fabrics and were also asked to bring their ‘favourite’ fabric (s) and express their thoughts about their choices. Using Interpretative Phenomenological Analysis and Content Analysis, the findings showed that some fabrics can impact individuals’ reported wellbeing. Participants’ experiences with several stimuli appeared to have helped them implement coping strategies. By understanding tactile defensiveness, society could move towards increasing autism-friendly approaches with appropriate fabrics. Recommendations for future research, policy and practice are also discussed.

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10. Lee SC, Tsai CH, Lin YC, Li HJ, Jiang DR, Fu IN, Chen KL. Factorial validity of the Theory of Mind Inventory-2 in children with autism spectrum disorder. Autism research : official journal of the International Society for Autism Research. 2021; 14(11): 2424-31.

The Theory of Mind Inventory-2 appears to be a promising measure assessing children’s theory of mind. However, a lack of evidence on its factorial structure interferes with score interpretation. To examine whether the currently-available structures of the Theory of Mind Inventory-2 are robust and replicable, confirmatory factor analysis was conducted in 242 children with autism spectrum disorder aged 3-12 years. Two possible structures were examined: the development-based structure, which reflects children’s developmental stages of theory of mind (early, basic, and advanced), and the content-based structure, which represents children’s social-related functions (emotion recognition, mental state term comprehension, and pragmatics). Four fit indices were adopted simultaneously to examine the model fit of both structures. We found that the development-based structure had a better model fit and was further modified. After modification, the development-based structure showed an improved model fit, but it was not completely acceptable in all fit indices. These findings suggest that the scores of the Theory of Mind Inventory-2 are more appropriate for reflecting children’s developmental stages of theory of mind than the social-related functions in children with autism spectrum disorder. However, the domain scores should be cautiously interpreted because the model fits were not completely acceptable. For further revisions, ambiguous terms (e.g., « want » and « need ») and confusing concepts assessed by the items (e.g., « recognize » and « understand ») could be specified for a better representation of children’s developmental stages of theory of mind. Moreover, further validations are needed. LAY SUMMARY: In children with autism spectrum disorder, the scores of the Theory of Mind Inventory-2 are more appropriate for indicating the developmental stages of theory of mind (early, basic, and advanced) than for indicating the social-related functions (emotion recognition, mental state term comprehension, and pragmatics). However, since the factorial validity was not completely acceptable, the domain scores should be interpreted cautiously. Moreover, further revisions and validations are warranted.

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11. Månsson J, Källén K, Eklöf E, Serenius F, Ådén U, Stjernqvist K. The ability of Bayley-III scores to predict later intelligence in children born extremely preterm. Acta paediatrica (Oslo, Norway : 1992). 2021; 110(11): 3030-9.

AIM: To investigate the ability of the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), scores to predict later Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), performances in a cohort of children born extremely preterm. METHODS: 323 children, born <27 gestational weeks, were tested with the Bayley-III at corrected age 2.5 years and with the WISC-IV at 6.5 years. Regression analyses investigated the association between Bayley-III scores and WISC-IV full-scale intelligence quotient (IQ). The ability of Bayley-III Cognitive Index scores to predict low IQ was evaluated using receiver operating characteristic curves. RESULTS: Bayley-III Cognitive Index scores and IQ had a moderately positive correlation and accounted for 38% of the IQ variance. Using a Bayley-III cut-off score of 70, the sensitivity to detect children with IQ<70 was 18%, and false positive rate was 7%. A Bayley-III cut-off score of 85 corresponded to sensitivity and false positive rates of 44% and 7%, respectively. CONCLUSIONS: Results emphasise the relative importance of Bayley-III Cognitive Index scores as predictors of IQ. An 85 score cut-off for suspecting subnormal IQ is supported. A less conservative threshold would increase identification of true cases yet increase the risk of wrongly diagnosing children.

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12. Osório JMA, Rodríguez-Herreros B, Richetin S, Junod V, Romascano D, Pittet V, Chabane N, Jequier Gygax M, Maillard AM. Sex differences in sensory processing in children with autism spectrum disorder. Autism research : official journal of the International Society for Autism Research. 2021; 14(11): 2412-23.

Despite the high prevalence of sensory processing difficulties in children with autism spectrum disorder (ASD), little research has focused on the sex differences in sensory processing. Furthermore, there is a lack of knowledge on the female-specific symptoms of ASD, contributing to later referral, diagnosis and intervention. In this study, we examined the sex differences in sensory processing symptoms in large cohorts of ASD children (N = 168; 26 females, 142 males) and typically developing (TD) children (N = 439; 209 females, 230 males). For this, we translated the sensory processing measure (SPM) and SPM – Preschool (SPM-P) Home Forms to French. The SPM/SPM-P are parent/caregiver questionnaires that assess typical behavioral responses to sensory stimuli. Overall, our results showed that the magnitude of the differences in sensory processing between males and females is larger in ASD children relative to TD children, with females showing more severe symptoms in Hearing, as well as Balance and Motion subscales. Additionally, linear discriminant analysis showed that the SPM/SPM-P are good at discriminating TD children from ASD, children with higher accuracy rates for females than for males. These findings are discussed in light of the heterogeneity of sensory processing difficulties present in ASD. Overall, our results suggest that there seem to be female-specific profiles in sensory processing difficulties in ASD. Implications of findings concerning sex differences in sensory processing and their potential for improving identification and diagnosis of ASD females are discussed. LAY SUMMARY: The present study examined sex differences in behavioral responses to sensory stimuli in children with autism spectrum disorder (ASD), and typically developing (TD) children. While there is a small trend for TD males to show more sensory processing atypicalities, female ASD children show significantly more atypical responses compared to their male counterparts. This has important implications for characterizing female autism profiles, and ultimately improving the chance for earlier detection, diagnosis and treatment.

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13. Osumi N, Tatehana M. Transgenerational epigenetic information through the sperm: Sperm cells not just merely supply half of the genome for new life; they also seem to transmit additional information via epigenetic modifications. EMBO reports. 2021; 22(8): e53539.

The biological cause for the increase in Autism Spectrum Disorder may be fathers’ older age and the epigenetic marks it leaves on sperm cells.

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14. Romer K, Vladescu JC, Marano KE, Reeve SA, Sidener TM, Campanaro AM. The influence of observations and ratings on implementation of discrete trial instruction. Journal of applied behavior analysis. 2021; 54(4): 1639-51.

Children diagnosed with autism spectrum disorder are often taught using discrete trial instruction. Because of low trainer-to-staff ratios commonly found in human service settings, research is needed to find an efficient method to train staff to implement discrete trial instruction with little to no in-vivo training by a qualified trainer. One such technique is observing and rating the behavior of another individual. The resulting improvement in the observer’s own behavior is referred to as the observer effect. The purpose of the present study was to assess the effects of conducting behavioral observations and ratings on staff implementation of discrete trial instruction. Staff trainees viewed videos of the implementation of each step, rated the accuracy of implementation, and conducted the procedure with a confederate consumer. The procedure was effective, and the effects extended to novel skills.

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15. Sarda SP, Sarri G, Siffel C. Global prevalence of long-term neurodevelopmental impairment following extremely preterm birth: a systematic literature review. The Journal of international medical research. 2021; 49(7): 3000605211028026.

OBJECTIVE: Neurodevelopmental impairment (NDI) is a major complication of extreme prematurity. This systematic review was conducted to summarize the worldwide long-term prevalence of NDI associated with extreme prematurity. METHODS: Embase and MEDLINE databases were searched for epidemiologic and observational/real-world studies, published in English between 2011 and 2016, reporting long-term prevalence of NDI (occurring from 1 year) among extremely preterm infants born at gestational age (GA) ≤28 weeks. RESULTS: Of 2406 articles identified through searches, 69 met the protocol NDI definition (24 North America, 25 Europe, 20 Rest of World). Prevalence of any severity NDI in North America was 8%-59% at 18 months to 2 years, and 11%-37% at 2-5 years; prevalence of moderate NDI in Europe was 10%-13% at 18 months to 2 years, 3% at 2-5 years, and 9%-19% at ≥5 years; prevalence of any NDI in Rest of World was 15%-61% at 18 months to 2 years, and 42% at 2-5 years (no North America/Rest of World studies reported any NDI at ≥5 years). A trend toward higher prevalence of NDI with lower GA at birth was observed. CONCLUSIONS: Extreme prematurity has a significant long-term worldwide impact on neurodevelopmental outcomes.

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16. Wei Q, Machalicek W, Zhu J. Treatment Acceptability for Interventions Addressing Challenging Behavior Among Chinese Caregivers of Children with Autism Spectrum Disorder. Journal of autism and developmental disorders. 2021.

The present study evaluated treatment acceptability for behavioral interventions addressing challenging behaviors with Chinese caregivers of children with autism spectrum disorder. Factors influencing treatment acceptability (i.e., severity of challenging behavior and Chinese child-rearing values) were investigated. Caregivers of children aged 2-12 years (N = 216) participated in this survey study. Results suggest that caregivers found positive strategies including noncontingent reinforcement and positive reinforcement the most acceptable; punishment-based strategies were rated as the least acceptable. Furthermore, positive punishment was perceived as more acceptable for severe challenging behavior. Caregivers who endorsed training were more likely to find positive strategies acceptable, whereas those who endorsed shaming were more likely to rate punishment-based strategies as more acceptable. Implications for future research and culturally competent behavioral treatments in Chinese context are provided.

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17. Yang HX, Zhou HY, Zheng H, Wang Y, Wang YY, Lui SSY, Chan RCK. Individuals with Autistic Traits Exhibit Heightened Alexithymia But Intact Interoceptive-Exteroceptive Sensory Integration. Journal of autism and developmental disorders. 2021.

Interoceptive accuracy has been widely measured using the Heartbeat Tracking Test (HTT). We devised the novel paradigm of Interoception-Exteroception Synchronicity Judgement (IESJ) task to assess participants’ interoceptive accuracy, exteroceptive accuracy, and the balancing score which reflected the ability to allocate attentions between interoceptive and exteroceptive signals. This study administered the behavioural paradigms of the HTT and the IESJ as well as other self-report scales to 119 typically-developing youths. Individuals with lower autistic traits (n = 30) showed comparable interoceptive accuracy, exteroceptive accuracy, and balancing scores as their higher autistic traits counterparts (n = 33). Taken together, the high autistic traits subgroup exhibited higher levels of alexithymia but not empathy or interoception than the low autistic traits subgroup.

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18. Zhang Q, Wu R, Zhu S, Le J, Chen Y, Lan C, Yao S, Zhao W, Kendrick KM. Facial emotion training as an intervention in autism spectrum disorder: A meta-analysis of randomized controlled trials. Autism research : official journal of the International Society for Autism Research. 2021; 14(10): 2169-82.

A large number of computer-based training programs have been developed as an intervention to help individuals with autism spectrum disorders (ASD) improve their facial emotion recognition ability, as well as social skills. However, it is unclear to what extent these facial emotion training programs can produce beneficial, long-lasting, and generalizable results. Using standard meta-analytic techniques, we investigated the effects of facial emotion training including generalization and maintenance restricted to randomized control trial studies comprising a total of 595 individuals with ASD. Our findings revealed that the intervention resulted in a robust improvement in emotion recognition for individuals receiving training compared with controls. However, while there was also some evidence for generalization of training effects, the small number of studies which conducted follow-ups and assessed social skills reported that improvements were not maintained and there was no evidence for general improvement in social skills. Overall, the analysis revealed a medium effect size in training improvement indicating that facial emotion training may be an effective method for enhancing emotion recognition skills in ASD although more studies are required to assess maintenance of effects and possible general improvements in social skills. LAY SUMMARY: Facial emotion training as an intervention may be a potential way to help improve emotion recognition in autism spectrum disorder (ASD), however robust empirical support for its efficacy has not been sufficiently established. Here, we conducted a meta-analysis of previous studies to summarize the effects of facial emotion training on ASD. Our results show that the training produces a robust improvement in subsequent emotion recognition, while maintenance and generalization effects still need further investigation. To date, no experimentally verified improvements in social skills have been reported.

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