1. Chen S, Fan M, Lee BK, Dalman C, Karlsson H, Gardner RM. Rates of maternal weight gain over the course of pregnancy and offspring risk of neurodevelopmental disorders. BMC Med;2023 (Mar 23);21(1):108.

BACKGROUND: Previous studies have suggested that gestational weight gain (GWG) outside an optimal range increases the risks of neurodevelopmental disorders (NDDs) in offspring including autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit/hyperactivity disorder (ADHD). The sequential development of the fetal brain suggests that its vulnerability may vary depending on the timing of exposure. Therefore, we aimed to investigate the associations of not only gestational age-standardized total GWG (GWG z-scores) but also the rate of GWG (RGWG) in the second and third trimesters with risks of NDDs in offspring. METHODS: In this population-based cohort study, we used maternal weight data from antenatal care records collected for 57,822 children born to 53,516 mothers between 2007 and 2010 in the Stockholm Youth Cohort. Children were followed from 2 years of age to December 31, 2016. GWG z-scores and RGWG (kg/week) in the second and third trimesters were considered as continuous variables in cox regression models, clustered on maternal identification numbers. Nonlinear relationships were accommodated using restricted cubic splines with 3 knots. RGWG were also categorized according to the 2009 US Institute of Medicine (IOM) guidelines for optimal GWG. According to the IOM guidelines, the optimal rate of GWG for the second and third trimesters for underweight, normal weight, overweight, and obese categories were 0.44-0.58, 0.35-0.50, 0.23-0.33, and 0.17-0.27 kg/week, respectively. RESULTS: During a mean follow-up of 5.4 years (until children were on average 7.4 years old), 2205 (3.8%) children were diagnosed with NDDs, of which 1119 (1.9%) received a diagnosis of ASD, 1353 (2.3%) ADHD, and 270 (0.5%) ID. We observed a J-shaped association between total GWG z-score and offspring risk of NDDs, with higher total GWG (GWG z-score = 2) associated with 19% increased risk of any NDD (95% CI = 3-37%) and lower total GWG (GWG z-score = - 2) associated with 12% increased risk of any NDDs (95% CI = 2-23%), compared to the reference (GWG z-score = 0). In the second trimester, lower RGWG (0.25 kg/week) was associated with a 9% increased risk of any NDD diagnosis (95% CI = 4-15%) compared to the median of 0.57 kg/week, with no apparent relationship between higher RGWG and risk of NDDs. In the third trimester, there was no apparent association between lower RGWG and risk of NDDs, though higher RGWG (1 kg/week) was associated with a 28% increased risk of NDD diagnosis (95% CI = 16-40%), compared to the median (0.51 kg/week). When considering categorized RGWG, we found that slow weight gain in the second trimester followed by rapid weight gain in the third trimester most significantly increased the risk of ADHD (HR(adjusted) = 1.55, 1.13-2.13) and ID (HR(adjusted) = 2.53, 1.15-5.55) in offspring. The main limitations of our study are the relatively few years for which detailed GWG data were available and the relatively short follow-up for the outcomes, limiting power to detect associations and misclassifying children who receive an NDD diagnosis later in childhood. CONCLUSIONS: The relationship between maternal weight gain and children’s risk of NDDs varied according to timing in pregnancy, with the greatest risks associated with slow weight gain in the second trimester and rapid weight gain in the third trimester.

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2. Fatehi M, Fatehi L, Mowbray O. Autism spectrum disorder, parent coping, and parent concerns during the COVID-19 pandemic. Child Youth Serv Rev;2023 (Jun);149:106923.

The COVID-19 outbreak beginning in 2019 has created a challenging period for families who have children with autism spectrum disorder (ASD). The purpose of this study was to examine parents’ perceptions about the consequences of the pandemic on their child who has ASD and parents’ concerns and resources during the pandemic. Data was collected between July to November 2020 from U.S. parents who have at least one child with ASD between 3 and 21 years old. An online survey, consisting of 88 items, was developed and distributed online in newsletters and Twitter pages of several ASD organizations, and various caregiving support groups on Facebook. Descriptive analysis showed that during the data collection time (N = 57), 79% of the children had immediate access to electronic devices to utilize online services. Many of the children used remote learning services for less than 2 h (74%) per day. Many children had difficulties following social distance rules. They spent more time in passive activities than active activities. Twenty-five percent of parents reported that they drank alcohol more often during the pandemic. However, parents who participated in support groups consumed less alcohol. Also, child symptom severity was associated with parents taking less times for themselves. These results can assist practitioners in identifying specific difficulties that parents and children with ASD experienced during the pandemic. This work also underlines the parents’ needs for community supports and mental health services.

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3. Favole I, Davico C, Marcotulli D, Sodero R, Svevi B, Amianto F, Ricci FS, Arduino GM, Vitiello B. Sleep disturbances and emotional dysregulation in young children with autism spectrum, intellectual disability, or global developmental delay. Sleep Med;2023 (Mar 8);105:45-52.

OBJECTIVE: Sleep disturbance and emotional dysregulation (ED) are common and often functionally impairing in young children with neurodevelopmental disorders (NDD). This study investigated the relationship between sleep disturbance and ED in a sample of preschoolers with ASD, intellectual disability, or global developmental delay, and examined possible predictors of their persistence over time. METHODS: All children under 6 years of age clinically referred between July 2018 and May 2022 to two neuropsychiatric specialized centers for NDD received a comprehensive diagnostic evaluation, including the Child Behavior Checklist 1.5-5 (CBCL), the Autism Diagnostic Observation Schedule-2 (ADOS-2), and standardized tests of cognitive and global development. Sleep disturbances were assessed with the CBCL-sleep score, and ED with the CBCL Attention, Aggression, and Anxious/Depressed scales (CBCL-AAA). A reassessment of sleep and ED was conducted after 6 months or longer, including the Child Sleep Habits Questionnaire (CSHQ). Multivariate analyses and mixed linear regression models were conducted. RESULTS: A total of 136 children, 75.7% male, median age 38.27 months, IQR 15.39, 41.2% with global developmental disorder (GDD) or intellectual disability (ID) participated in the study. Of them, 64.7% were diagnosed with autism spectrum disorder (ASD) and 35.3% with other NDD (w/o ASD). Sleep disturbances (CBCL-Sleep) and ED (CBCL-AAA) were positively correlated (p < 0.001), after accounting for age, ID/GDD and autism symptom severity, in both the entire sample and separately in each diagnostic group (ASD and NDD w/o ASD). Seventy-five children (55%) were reassessed a mean 17.2 months afterwards. There was persistence of the positive correlation between sleep problems and ED (p < 0.001) in both the entire sample and each diagnostic group. The longitudinal mixed linear model showed that ED at follow-up was predicted by baseline sleep problems (p = 0.008), ED (p < 0.001), and ASD severity (p = 0.015). CONCLUSIONS: Sleep disturbances are significantly associated with ED in young children with NDD, either with or without ASD, both cross-sectionally and prospectively over time. Sleep problems represent an important comorbidity and a potential treatment target for improving emotional stability in NDD.

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4. Gu S, Katyal A, Zhang Q, Chung W, Franciosi S, Sanatani S. The Association Between Congenital Heart Disease and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Pediatr Cardiol;2023 (Mar 25)

Congenital heart disease (CHD) is linked to an increased incidence of neurodevelopmental impairments in young patients. Given the number of published studies on this topic, a synthesis of the literature is timely and needed. We performed a systematic review and meta-analysis of the medical literature to assess the evidence linking CHD to incidence of autism spectrum disorder (ASD). A systematic review of studies on CHD and ASD in PubMed, Cochrane and Institute for Scientific Information (ISI) from 1965 to May 2021 was conducted. Quantitative estimates of association between CHD and ASD were extracted from eligible studies for the meta-analysis. Pooled estimates were obtained using a random effect models fit by a generalised linear mixed model. We screened 2709 articles and 24 articles were included in this review. Among the 24 studies, there was a total of 348,771 subjects (12,114 CHD, 9829 ASD and 326,828 controls). Seven of 24 studies were eligible for the meta-analysis, which included information on a total of 250,611 subjects (3984 CHD, 9829 ASD, and 236,798 controls). The summary estimate indicated that having CHD is associated with almost double the odds of ASD compared with patients without CHD (OR 1.99, 95% CI 1.77-2.24, p < 0.01). Early developmental delay, perinatal factors, and genetics were potential risk factors and etiologies for the onset of ASD symptoms in CHD patients. Having CHD is associated with an increased risk of presenting with a diagnosis or symptoms suggestive of ASD.

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5. Guo L, Jiang ZM, Zhan YJ, Pan W, Wu QW, Song FX, Zhou X, Zhou XY, Liu LJ, Wang JT. Neuro death through autophagy via the acetylation of FoxO1 by SIRT2 in the hippocampus of mice in a autism spectrum disorder mice model. J Cell Physiol;2023 (Mar 24)

Autism Spectrum Disorder (ASD) is a series of complex neurodevelopmental disorders, which can affect children’s social, behavioral and communication abilities. A member of the Sirtuins family of NAD+dependent deacetylases called SIRT2 could regulate the inflammation progress during stress, but the relevant mechanism has not been clearly defined. In the present study, the ASD model of wild type and SIRT2 knock out mice was established to evaluate the impact on the homeostasis of neurons in the hippocampus using western blotting, immunofluorescence and Nissl staining. The results showed that the amplification of neuronal richness was significantly decreased and neuroinflammation increased in the hippocampus following ASD due to autophagy, caused by enhancing the acetylation of FoxO1 using SIRT2 gene deletion and indicating this should be the target for ASD or other psychological stress treatment. This article is protected by copyright. All rights reserved.

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6. Hou Y, Yan T, Deng M, Li Y, Zhang J. The development and validation of a questionnaire on parental involvement in the transition from kindergarten to primary school for children with developmental disabilities in China. Res Dev Disabil;2023 (Mar 22);136:104494.

BACKGROUND: At present, there is a lack of valid and reliable instruments that can measure parental involvement in the transition from kindergarten to primary school of children with developmental disabilities (DD) in China. AIM: This study seeks to develop and validate the questionnaire on Parental Involvement in Transition from Kindergarten to Primary School (PITKPS) for children with DD in China. METHODS: A total of 241 parents of children with DD participated in Study 1, and another 247 parents participated in Study 2. In study 1, we used item analysis and exploratory factor analysis to screen items and explore the factor structure of the PITKPS questionnaire. In study 2, three types of validity were examined: construct validity; convergent and discriminative validity; and criterion-related validity. Internal consistency was used to measure reliability. RESULTS: The final version of the PITKPS questionnaire comprised 37 items that examined six factors. Confirmatory factor analysis supported the use of the six-factor model, and the results indicated that the questionnaire had good reliability and validity. CONCLUSIONS: The PITKPS questionnaire can be used as a valid tool to assess the involvement of Chinese parents in the transition from kindergarten to primary school of children with DD.

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7. Ma Z, Fu W, Gu P, Siting H, Liujing Y, Zhou W. Parental Perception of the Importance of Friendship and Other Educational Outcomes in Children with Autism Spectrum Disorder in China. J Autism Dev Disord;2023 (Mar 24)

This study examined parental perception of the importance of friendship and five other educational outcomes from 101 Chinese parents of children with autism spectrum disorders between the ages of 3 and 12 years. Results showed Chinese parents considered friendship less important than social skills, emotional development, and physical skills and motor development. Unlike the results from previous studies, Chinese parents ranked friendship as the second least important outcome. Children’s age rather than educational setting impacted parental perceptions. The findings suggested cultural contexts may have influenced parental perceptions of the importance of different educational outcomes, and future research on the influence of cultural contexts is warranted.

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8. McKernan EP, Russo N. Investigating the Structure of the CESD-R and DASS-21 Across Adults with Low and High Levels of Autistic Traits. J Autism Dev Disord;2023 (Mar 24)

The current study examined factorial invariance of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) and the Depression Anxiety Stress Scales-21 (DASS-21) using a convenience sample of 434 adults surveyed though Amazon Mechanical Turk. Participants were sorted into two groups based on their score on the Autism-Spectrum Quotient. Results indicated that the CESD-R did not demonstrate configural invariance. The DASS-21 demonstrated evidence of scalar invariance, indicating cross-group equality in factor loadings and factor intercepts. Findings suggest that the DASS-21 measures symptoms of depression, anxiety, and stress consistently across individuals with high and low levels of ASD-related traits, whereas the CESD-R may not be valid when assessing symptoms of depression in those with a high level of ASD-related traits.

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9. Yi L, Yang X. Are lay abstracts published in Autism readable enough for the general public? A short report. Autism;2023 (Mar 25):13623613231163083.

Research papers are sometimes hard to follow. Lay abstracts give a short account of research papers. However, it is unclear whether lay abstracts are readable to the lay people. This study examined the readability of 570 abstracts and lay abstracts published between 2020 and 2022 in the journal Autism. We found that that lay abstracts are easier to read than abstracts but are harder to read than news reports. The findings suggest that lay abstracts, on average, are hard to read for the lay people. We propose that the journal and its authors may invite reviewers from outside the research community to test whether a lay abstract is readable.

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