1. Birkeneder SL, Bullen J, McIntyre N, Zajic MC, Lerro L, Solomon M, Sparapani N, Mundy P. The Construct Validity of the Childhood Joint Attention Rating Scale (C-JARS) in School-Aged Autistic Children. J Autism Dev Disord;2023 (Jul 22)

Preliminary evidence from the Childhood Joint Attention Rating Scale (C-JARS; Mundy et al., 2017) suggests symptoms related to diminished joint attention and the spontaneous sharing of experience with others can be assessed with a parent-report measure in children and adolescents with autism. This study was designed to expand on the previous study by examining the validity of both a Social Symptom (SS) and a Prosocial (PS) scale of the C-JARS in a study of school-aged autistic children (n  = 89) with and without co-occurring intellectual disability (ID), as well as an age matched neurotypical sample (n  = 62). Results indicated that both C-JARS scales were sensitive and specific with respect to identifying the diagnostic status of the children. In addition, the PS scale was sensitive to differences in cognitive abilities (IQ) and sex differences in the autism group. These results are consistent with the hypothesis that joint attention and spontaneous sharing of experience symptoms are not only characteristic of preschool children with autism but may also constitute a developmentally continuous dimension of the social phenotype of autism that can be measured in school-aged children.

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2. Bruno G, Chan TA, Zwaigenbaum L, Coombs E, Nicholas D. Indigenous Autism in Canada: A Scoping Review. J Autism Dev Disord;2023 (Jul 22)

Currently there is a severe lack of research on autism and Indigenous people in Canada. This scoping review explores this literature gap and assesses the same literature from an Indigenous perspective. Scoping reviews are an effective means to explore the literature in a specific area, in this case, autism and Indigenous people in Canada. We explored existing literature as it pertains to Indigenous populations and autism in Canada. To support this review, the Indigenous Quality Assessment Tool (QAT) was adapted to appraise the quality of literature. In total, there were a total of 212 articles identified of which 24 met the inclusion criteria: (1) some focus on autism, (2) a component specific to Indigenous people, and (3) specific to Canada. Of the 24 articles and reports, 15 were peer-reviewed and the rest considered grey literature. Most articles focused on program delivery with some literature using primary data (quantitative and/or qualitative). Overall, the quality of the research was appraised as poor, as determined by the QAT. Findings reaffirm the critical need for research that addresses autism in Indigenous communities within Canada and show the importance of having research done in full partnership with, or led by, Indigenous people.

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3. Dückert S, Gewohn P, König H, Schöttle D, Konnopka A, Rahlff P, Erik F, Vogeley K, Schulz H, David N, Peth J. Barriers and needs in mental healthcare of adults with autism spectrum disorder in Germany: a qualitative study in autistic adults, relatives, and healthcare providers. BMC Psychiatry;2023 (Jul 21);23(1):528.

BACKGROUND: Autism refers to a neurodevelopmental condition with characteristic impairments in social interaction and communication, restrictive and repetitive behaviors, as well as difficulties in sensory information processing and daily living skills. Even though symptoms persist from early childhood throughout the lifespan and often require long-term support, there is a lack of mental health services that sufficiently meet the needs of autistic adults. Previous evidence suggested individual, professional and structural barriers to healthcare for autistic adults. Here, using a peer research approach, we sought to systematically investigate barriers and needs in mental healthcare of autistic adults in Germany at the three relevant levels (individual, professional, structural) and from three relevant perspectives (autistic adults, relatives and healthcare providers), in order to obtain specific recommendations for optimized healthcare. METHODS: Maximum variation sampling was used to account for the complexity of the research field. Semi-structured, open-ended interviews were conducted with autistic adults (n = 15) and focus groups with relatives/partners (n = 12), and healthcare providers of several professions (n = 15). Data analysis was performed using the codebook approach of thematic analysis. RESULTS: Poor mental healthcare of autistic adults in Germany was characterized by six central and overarching themes: (i) lack of knowledge about autism, (ii) a need for increased participation/involvement, (iii) consideration of autism-specific needs in treatment, (iv) lack of services, (v) limited access to services, and (vi) improvement of stakeholder collaboration. Themes were similarly reported across participants, emphasizing dissatisfaction in all stakeholders. CONCLUSIONS: We identified major barriers to mental healthcare for autistic adults in Germany that affect autistic adults, but are also of concern to relatives and healthcare providers. Our results point to specific and generic areas for improvement, independent of stakeholder perspectives, which could guide future development of needs- and evidence-based services, recommendations and guidelines of mental healthcare for people with autism across the lifespan. TRIAL REGISTRATION: This study protocol was preregistered at the Open Science Framework ( https://osf.io/5x8pg ).

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4. Garner JP, Talbot CF, Del Rosso LA, McCowan B, Kanthaswamy S, Haig D, Capitanio JP, Parker KJ. Rhesus macaque social functioning is paternally, but not maternally, inherited by sons: potential implications for autism. Mol Autism;2023 (Jul 21);14(1):25.

BACKGROUND: Quantitative autistic traits are common, heritable, and continuously distributed across the general human population. Patterns of autistic traits within families suggest that more complex mechanisms than simple Mendelian inheritance-in particular, parent of origin effects-may be involved. The ideal strategy for ascertaining parent of origin effects is by half-sibling analysis, where half-siblings share one, but not both, parents and each individual belongs to a unique combination of paternal and maternal half-siblings. While this family structure is rare in humans, many of our primate relatives, including rhesus macaques, have promiscuous breeding systems that consistently produce paternal and maternal half-siblings for a given index animal. Rhesus macaques, like humans, also exhibit pronounced variation in social functioning. METHODS: Here we assessed differential paternal versus maternal inheritance of social functioning in male rhesus macaque offspring (N = 407) using ethological observations and ratings on a reverse-translated quantitative autistic trait measurement scale. Restricted Maximum Likelihood mixed models with unbounded variance estimates were used to estimate the variance components needed to calculate the genetic contribution of parents as the proportion of phenotypic variance (σ(2)(P)) between sons that could uniquely be attributed to their shared genetics (σ(2)(g)), expressed as σ(2)(g)/σ(2)(P) (or the proportion of phenotypic variance attributable to genetic variance), as well as narrow sense heritability (h(2)). RESULTS: Genetic contributions and heritability estimates were strong and highly significant for sons who shared a father but weak and non-significant for sons who shared a mother. Importantly, these findings were detected using the same scores from the same sons in the same analysis, confirmed when paternal and maternal half-siblings were analyzed separately, and observed with two methodologically distinct behavioral measures. Finally, genetic contributions were similar for full-siblings versus half-siblings that shared only a father, further supporting a selective paternal inheritance effect. LIMITATIONS: These data are correlational by nature. A larger sample that includes female subjects, enables deeper pedigree assessments, and supports molecular genetic analyses is warranted. CONCLUSIONS: Rhesus macaque social functioning may be paternally, but not maternally, inherited by sons. With continued investigation, this approach may yield important insights into sex differences in autism’s genetic liability.

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5. Genc-Tosun D, Kurt O, Cevher Z, Gregori EV. Correction: Teaching Children with Autism Spectrum Disorder to Answer Questions Using an iPad-Based Speech-Generating Device. J Autism Dev Disord;2023 (Jul 22)

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6. Keating CT, Ichijo E, Cook JL. Autistic adults exhibit highly precise representations of others’ emotions but a reduced influence of emotion representations on emotion recognition accuracy. Sci Rep;2023 (Jul 22);13(1):11875.

To date, studies have not yet established the mechanisms underpinning differences in autistic and non-autistic emotion recognition. The current study first investigated whether autistic and non-autistic adults differed in terms of the precision and/or differentiation of their visual emotion representations and their general matching abilities, and second, explored whether differences therein were related to challenges in accurately recognizing emotional expressions. To fulfil these aims, 45 autistic and 45 non-autistic individuals completed three tasks employing dynamic point light displays of emotional facial expressions. We identified that autistic individuals had more precise visual emotion representations than their non-autistic counterparts, however, this did not confer any benefit for their emotion recognition. Whilst for non-autistic people, non-verbal reasoning and the interaction between precision of emotion representations and matching ability predicted emotion recognition, no variables contributed to autistic emotion recognition. These findings raise the possibility that autistic individuals are less guided by their emotion representations, thus lending support to Bayesian accounts of autism.

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7. Lao U, Li Y, Bai W, Wang Y, Li Y, Xie Y, Huang X, Zhu H, Zou X. Adaptation and Feasibility of the Mandarin Version of PEERS(®) for Autistic Adolescents. J Autism Dev Disord;2023 (Jul 22)

PURPOSE: The Program for the Education and Enrichment of Relational Skills (PEERS(®)) is a group-based social skills training program for adolescents on the autism spectrum. Although the program has been shown to be effective in improving social skills in autistic adolescents, evidence of its effectiveness from the Mandarin-speaking Chinese population is sparse. The present study used a non-randomized, pre- and post-intervention research design to investigate the feasibility and cultural validity of the program, as well as examine the moderators of intervention outcomes. METHODS: Thirty-three autistic adolescents with intelligence quotient above 70 (M(age) = 13.57, SD(age) = 1.43; Male: Female 25:8) and their parents received 14 concurrent 90-minute sessions. Adolescents’ autistic traits, challenging behaviors, emotional functioning, socio-cognitive process, social environment factors (school support), and caregivers’ well-being were evaluated. RESULTS: The findings suggest that with minor adjustments, the Mandarin version of PEERS(®) was generally acceptable and feasible for autistic adolescents and their parents. PEERS(®) may improve the social skills knowledge, reciprocal communication abilities, and emotional well-being of autistic adolescents. Also, participants with a higher level of school support, and parents with lower perceived subjective well-being at baseline may gain more benefits from PEERS(®). The cultural adaptation and acceptability of the Mandarin Version of PEERS(®) were discussed. CONCLUSION: This feasibility study (Chinese Clinical Trial Registry: ChiCTR2200061417, 2022-06-23, retrospectively registered) provides a basis for further randomized control trials of the Mandarin version of PEERS(®).

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8. Lestarevic S, Kalanj M, Milutinovic L, Grujicic R, Vasic J, Maslak J, Mitkovic-Voncina M, Ljubomirovic N, Pejovic-Milovancevic M. Internal Consistency of the Serbian Translation of the Stanford Social Dimensions Scale and Association to Strengths and Difficulties Questionnaire Scores in Male and Female Individuals on the Autism Spectrum and Non-autistic Individuals. J Autism Dev Disord;2023 (Jul 22)

We aimed to evaluate the internal consistency of Stanford Social Dimensions Scale (SSDS) translated to Serbian and to test it against the Strengths and Difficulties Questionnaire (SDQ). The sample consisted of 200 patients (32% ASD) of the Institute of Mental Health in Belgrade, Serbia (68 females, 132 males, M(age)=9.61, SD(age)=4.06). Internal consistency coefficients were within good/acceptable range for Social Motivation, Affiliation, Recognition and Unusual Approach subscales and below acceptable for Expressive Social Communication subscale. The non-autistic group scored higher on all subscales compared to the ASD group. All SSDS subscales positively correlated with SDQ Prosocial Behaviors scale. The SSDS is a valuable instrument for accessing sociobehavioral phenotype in both individuals on the autism spectrum and non-autistic individuals.

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9. Libster N, Kasari C, Sturm A. Predictors of Sexual Victimization Among Autistic and Non-Autistic College Students. J Autism Dev Disord;2023 (Jul 22)

PURPOSE: This study examined predictors of sexual victimization among autistic and non-autistic college students. Specifically, we aimed to determine whether autistic students are more likely than non-autistic students to experience unwanted sexual contact and sexual assault, controlling for co-occurring diagnoses. We also aimed to determine whether students with other disabilities, specifically ADHD, learning disability (LD), and psychological disorders, are more likely than students without these disabilities to experience unwanted sexual contact and sexual assault. METHODS: Autistic students (n=270) and non-autistic students (n=270) who had participated in a nationwide survey were matched on demographic characteristics and co-occurring diagnoses. Logistic regression analyses were conducted to address the research questions and evaluate predictors of unwanted sexual contact and sexual assault. RESULTS: Autistic students were as likely as non-autistic students to have experienced unwanted sexual contact and sexual assault, controlling for co-occurring diagnoses. Regardless of autism diagnostic status, students with ADHD were more likely than students without ADHD to have experienced unwanted sexual contact and sexual assault. CONCLUSIONS: Although autism diagnostic status was not a significant predictor of unwanted sexual contact or sexual assault, other factors associated with increased risk of sexual victimization, such as co-occurring ADHD, are likely to be found in autistic populations. This study highlights the importance of educational, social, and institutional supports to decrease sexual victimization among college students with neurodevelopmental disabilities.

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10. Molcho-Haimovich A, Tikotzky L, Meiri G, Ilan M, Michaelovski A, Schtaierman H, Golan HM, Sadaka Y, Menashe I, Dinstein I. Sleep disturbances are associated with irritability in ASD children with sensory sensitivities. J Neurodev Disord;2023 (Jul 21);15(1):21.

BACKGROUND: Parent reports suggest that 44-84% of children with ASD exhibit sleep disturbances that are of clinical concern. Previous studies have reported that, in children with ASD, the severity of sleep disturbances is associated with the severity of either sensory problems or aberrant behaviors, but none have performed combined analyses with measures of both sensory and aberrant behaviors symptom domains from the same children. METHODS: We examined parent reports of 237 children with ASD, 1.4-8.7 years old, using the child sleep habits questionnaire (CSHQ), sensory profile (SP), and aberrant behaviors checklist (ABC). RESULTS: The analyses revealed that sleep disturbances were most strongly associated with SP sensory sensitivity and ABC irritability scores. Together these scores explained 35% of the variance in total CSHQ scores. Moreover, sensory sensitivity scores moderated the association between irritability and sleep disturbances, indicating that sleep disturbances were significantly associated with irritability only in children with moderate to severe sensory sensitivities. CONCLUSION: We suggest that the three symptom domains may interact and exacerbate each other such that successful intervention in one symptom domain may have positive impact on the others. Further intervention studies testing this hypothesis are highly warranted.

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11. Natri HM, Chapman CR, Heraty S, Dwyer P, Walker N, Kapp SK, Dron HA, Martinez-Agosto JA, Mikkola L, Doherty M. Ethical challenges in autism genomics: Recommendations for researchers. Eur J Med Genet;2023 (Jul 19):104810.

Equitable and just genetic research and clinical translation require an examination of the ethical questions pertaining to vulnerable and marginalized communities. Autism research and advocate communities have expressed concerns over current practices of genetics research, urging the field to shift towards paradigms and practices that ensure benefits and avoid harm to research participants and the wider autistic community. Building upon a framework of bioethical principles, we provide the background for the concerns and present recommendations for ethically sustainable and justice-oriented genetic and genomic autism research. With the primary goal of enhancing the health, well-being, and autonomy of autistic persons, we make recommendations to guide priority setting, responsible research conduct, and informed consent practices. Further, we discuss the ethical challenges particularly pertaining to research involving highly vulnerable individuals and groups, such as those with impaired cognitive or communication ability. Finally, we consider the clinical translation of autism genetics studies, including the use of genetic testing. These guidelines, developed by an interdisciplinary working group comprising autistic and non-autistic individuals, will aid in leveraging the potential of genetics research to enhance the quality of life of autistic individuals and are widely applicable across stigmatized traits and vulnerable communities.

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12. Patti MA, Ning X, Hosseini M, Croen LA, Joseph RM, Karagas MR, Ladd-Acosta C, Landa R, Messinger DS, Newschaffer CJ, Nguyen R, Ozonoff S, O’Shea TM, Schmidt RJ, Trevino CO, Lyall K. A Comparative Analysis of the Full and Short Versions of the Social Responsiveness Scale in Estimating an Established Autism Risk Factor Association in ECHO: Do we Get the Same Estimates?. J Autism Dev Disord;2023 (Jul 22)

PURPOSE: Prior work developed a shortened 16-item version of the Social Responsiveness Scale (SRS), a quantitative measure of social communication and autism spectrum disorder (ASD)-related traits. However, its properties for use in risk factor estimation have not been fully tested compared to the full SRS. We compared the associations between gestational age (previously established risk factor for ASD) and the 65-item « full » and 16-item « short » versions of the SRS to test the shortened version’s ability to capture associations in epidemiologic analyses of ASD risk factors. METHODS: We used data from participants in the Environmental influences on Child Health Outcomes (ECHO) Program (n = 2,760). SRS scores were collected via maternal/caregiver report when children were aged 2.5-18 years. We compared estimates of associations between gestational age and preterm birth between the full and short SRS using multivariable linear regression, quantile regression, and prediction methods. RESULTS: Overall, associations based on full and short SRS scores were highly comparable. For example, we observed positive associations between preterm birth with both full ([Formula: see text]=2.8; 95% CI [1.7, 4.0]) and short ([Formula: see text]=2.9; 95% CI [1.6, 4.3]) SRS scores. Quantile regression analyses indicated similar direction and magnitude of associations across the distribution of SRS scores between gestational age with both short and full SRS scores. CONCLUSION: The comparability in estimates obtained for full and short SRS scores with an « established » ASD risk factor suggests ability of the shortened SRS in assessing associations with potential ASD-related risk factors and has implications for large-scale research studies seeking to reduce participant burden.

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13. Pesthy O, Farkas K, Sapey-Triomphe LA, Guttengéber A, Komoróczy E, Janacsek K, Réthelyi JM, Németh D. Intact predictive processing in autistic adults: evidence from statistical learning. Sci Rep;2023 (Jul 22);13(1):11873.

Impairment in predictive processes gained a lot of attention in recent years as an explanation for autistic symptoms. However, empirical evidence does not always underpin this framework. Thus, it is unclear what aspects of predictive processing are affected in autism spectrum disorder. In this study, we tested autistic adults on a task in which participants acquire probability-based regularities (that is, a statistical learning task). Twenty neurotypical and 22 autistic adults learned a probabilistic, temporally distributed regularity for about 40 min. Using frequentist and Bayesian methods, we found that autistic adults performed comparably to neurotypical adults, and the dynamics of learning did not differ between groups either. Thus, our study provides evidence for intact statistical learning in autistic adults. Furthermore, we discuss potential ways this result can extend the scope of the predictive processing framework, noting that atypical processing might not always mean a deficit in performance.

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14. Ting FN, Kiing JSH, Li WW, Chan YH, Loo JHY, Kang YQ. Prevalence and Profiles of Late-Onset Hearing Loss in Preschool Children with Autism Spectrum Disorder Who Passed Newborn Hearing Screening in a South East Asian Population. J Autism Dev Disord;2023 (Jul 22)

Prevalence of hearing loss in children with autism spectrum disorder (ASD) is uncertain, as it is more challenging to assess hearing function in children with developmental difficulties (DD). We aimed to determine the prevalence and profiles of hearing loss in preschool children with ASD in a Southeast-Asian population who passed newborn hearing screening. A retrospective study of preschool children with DD (ASD, Global Developmental Delay (GDD), and Speech and Language Delay (SLD)) attending the Child Development Unit (CDU) at our hospital was performed. Three hundred and thirty-three children (ASD: n = 129; GDD: n = 110; and SLD: n = 94) underwent hearing assessments. Of these, 10.8% of children (n = 36, comprising 15 with ASD, 12 with GDD and 9 with SLD) had confirmed hearing loss. Hearing loss was predominantly bilateral in children with ASD and GDD; in those with SLD, unilateral and bilateral hearing loss were equally common. Conductive hearing loss occurred as frequently as sensorineural hearing loss in children with ASD and SLD, but was the dominant subtype in those with GDD. Moderate to severe hearing loss (n = 2) was noted only in children with ASD. Children with ASD and GDD required significantly more audiology visits and procedures to obtain conclusive hearing test results, compared to those with SLD. The need to identify hearing loss and monitor for resolution is particularly important in vulnerable populations with communication deficits, such as in those with ASD.

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15. Vinayagam R, Tanner C, Harley D, Karatella S, Brooker K. « My Autism is Linked with Everything »: at the Crossroads of Autism and Diabetes. J Autism Dev Disord;2023 (Jul 22)

Autistic adults experience stark health disparities and difficulties accessing health care. Their realities of managing complex health conditions are unknown. Our research explored the experience of Autistic adults self-managing diabetes. Interviews with Autistic adults with diabetes and their support people were thematically analysed to identify three key themes. The Autistic experience influenced diabetes self-management, including autism-unique challenges and strengths. Participants prioritised avoiding Autistic burnout over diabetes self-management; mitigating the psychosocial pressures of neurotypical systems took precedence. Health professionals often separated autism and diabetes subsequently overlooking key factors impacting diabetes self-management. To better meet the needs of Autistic adults, diabetes care and health management more broadly should be considered within the context of autism, including supports for self-management during Autistic burnout.

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16. Wang S, Li F, Wang F, Liao X, Li J, Guo X, Deng W. Comorbidity and Characteristics of Autism Spectrum Disorders and ADHD in Children: A Clinically-Based Study. J Atten Disord;2023 (Jul 22):10870547231187166.

OBJECTIVE: We examined the characteristics and heritability of Autism Spectrum Disorder (ASD) and ADHD through a twin study. METHOD: Our sample included 44 twins, with at least one twin diagnosed with ASD. Among the participants, 30 had ASD, and 18 of them also had coexisting ADHD. RESULTS: We observed higher concordance rates for ASD in monozygotic twins compared to dizygotic twins (67% vs. 25%), indicating a genetic influence on ASD. Inattentive symptoms of ADHD were more prevalent in monozygotic twins. The ASD + ADHD group exhibited significantly higher Social Responsiveness Scale scores, indicating greater social difficulties compared to the ASD and typical development groups. Twin analyses revealed that shared genetic factors accounted for 72.25% of the variance in both ASD and ADHD symptoms. CONCLUSIONS: Our findings suggest that the comorbidity of ASD and ADHD may indicate increased severity and can be explained by shared genetic factors underlying both conditions.

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17. Young K, Harris B, Hall-Lande J, Esler A. The Intersection of Systemic, Child, and Evaluation Factors in the Prediction of Autism Special Education Eligibility; Examining the Role of Race and Ethnicity. J Autism Dev Disord;2023 (Jul 22)

Though there is evidence autism identification has been inequitable for populations who are culturally and linguistically minoritized, there is limited research that explains the issue of disproportionality and factors contributing to its occurrence, especially within an educational setting. To explore contributors to racial/ethnic disparities in autism special education eligibility, the current investigation evaluated child and evaluation characteristics as they relate to the absence of autism eligibility. Data were obtained from the Autism and Developmental Disabilities Monitoring (ADDM) Network Study and included children with behavioral characteristics consistent with autism and educational evaluation records. Despite documented characteristics consistent with autism, only 72% of the sample received educational services under autism eligibility. To characterize children without autism eligibility, hierarchical logistic regression was used to evaluate factors documented in evaluation records predicting the absence of autism eligibility. Factors influencing autism eligibility included behavioral characteristics documented, evaluation components completed, intellectual ability, and clinical diagnoses present. There was no unique contribution of race/ethnicity in predicting the absence of autism eligibility when accounting for these previous predictors, but many of these predictors differed by racial/ethnic group. Disproportionality in autism may be the manifestation of inequitable evaluation experiences, including experiencing less comprehensive evaluations, and not receiving an autism specific assessment. Though race/ethnicity did not uniquely contribute to the absence of autism eligibility above and beyond those combined factors, it is important to evaluate and reduce inequities experienced within the autism identification process for populations who are culturally and linguistically minoritized.

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