1. Araiba S, Čolić M. Preliminary Practice Recommendations for Telehealth Direct Applied Behavior Analysis Services with Children with Autism. Journal of behavioral education. 2022: 1-35.

This article provides preliminary practice recommendations for telehealth direct applied behavior analysis (ABA) services for children with autism. In the face of COVID-19, there is an immediate need for discussion on how to implement various ABA procedures via telehealth for ABA practitioners. Alongside emerging scientific evidence on the effectiveness of telehealth direct service as well as various service-related guidelines, we provide preliminary practice recommendations that are based on the existing literature on in-person and telehealth ABA procedures. We also discuss these recommendations with case studies of two boys with autism. Social validity measures indicated that families were satisfied with telehealth direct services. Even after the COVID-19 pandemic has resolved itself, telehealth direct ABA service will still be a valuable option for remote and international locations where direct ABA service is limited, and thus, practice recommendations continue to be relevant for all practitioners that use telehealth direct service.

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2. Arun P, Jain S. Use of Smart Phone Among Students with Intellectual and Developmental Disability. Journal of psychosocial rehabilitation and mental health. 2022: 1-6.

Use of Smart phones had created new opportunities for individuals with developmental disabilities for the meaningful engagement in different activities during the pandemic situation. Online learning provides extensive opportunities for individuals during this pandemic situation when everything is closed due to the fear of transmission of COVID-19. Similarly individuals with developmental disabilities are also getting opportunity to learn online through Smartphone. Special educators were conducting online classes with students with developmental disabilities to make them meaningfully engaged during this pandemic situation. 415 students and their parents with developmental disabilities were approached by their special educators on telephone to know if they can use smartphone. This paper reports on use of Smart phones by individuals with developmental disabilities. It was found that they can learn academics like others if there is availability of Smart phones during daytime and proper training and assistance provided by parents or sibling.

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3. Bonomini F, Siniscalco D, Schultz S, Carnovale C, Barthélémy C, Fazzi EM. Editorial: Antioxidants in Autism Spectrum Disorders. Frontiers in psychiatry. 2022; 13: 889865.

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4. Elgueta D, Murgas P, Riquelme E, Yang G, Cancino GI. Consequences of Viral Infection and Cytokine Production During Pregnancy on Brain Development in Offspring. Frontiers in immunology. 2022; 13: 816619.

Infections during pregnancy can seriously damage fetal neurodevelopment by aberrantly activating the maternal immune system, directly impacting fetal neural cells. Increasing evidence suggests that these adverse impacts involve alterations in neural stem cell biology with long-term consequences for offspring, including neurodevelopmental disorders such as autism spectrum disorder, schizophrenia, and cognitive impairment. Here we review how maternal infection with viruses such as Influenza A, Cytomegalovirus, and Zika during pregnancy can affect the brain development of offspring by promoting the release of maternal pro-inflammatory cytokines, triggering neuroinflammation of the fetal brain, and/or directly infecting fetal neural cells. In addition, we review insights into how these infections impact human brain development from studies with animal models and brain organoids. Finally, we discuss how maternal infection with SARS-CoV-2 may have consequences for neurodevelopment of the offspring.

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5. Galizio A, Odum AL. Reinforced behavioral variability in the valproate rat model of autism spectrum disorder. Journal of the experimental analysis of behavior. 2022.

Individuals diagnosed with autism spectrum disorder (ASD) tend to display restricted, repetitive behaviors and deficits in social interaction. Rats exposed to valproate (VPA) in utero have been shown to model symptoms of ASD. In previous research, VPA rats engaged in less social interaction and more repetitive responding than controls. The purpose of the present study was to further investigate behavioral variability in the VPA rat model of ASD by testing VPA and control rats in a reinforced-behavioral-variability operant task. In this procedure, rats emitted sequences of lever presses, some of which produced food. During baseline, food was delivered probabilistically, and variability was not required. Next, rats were exposed either to a variability contingency, in which food was only delivered following sequences that differed sufficiently from previous sequences (i.e., variability required), or to a yoked contingency, in which variability was not required. We hypothesized that VPA rats would behave less variably than controls in this task. However, VPA and control rats responded similarly variably when variability was required. Furthermore, VPA rats behaved slightly more variably than controls during baseline and yoked conditions, when variability was not required. These findings contribute to the complex literature surrounding the VPA rat model of ASD.

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6. Hendriks O, Wei Y, Warrier V, Richards G. Autistic Traits, Empathizing-Systemizing, and Gender Diversity. Archives of sexual behavior. 2022.

Previous research indicates a link between autism and transgender and gender-diverse identities, though the association is not yet fully understood. The current study examined autistic traits (Autism Spectrum Quotient [AQ]), empathizing (Empathizing Quotient-Short [EQ-S]), and systemizing (Systemizing Quotient-Short [SQ-S]) in a sample of 89 adults and aimed to test whether gender-diverse individuals exhibit cognitive profiles consistent with predictions derived from the Extreme Male Brain (EMB) theory. As most research has considered only cisgender people, we recruited a more diverse sample by contacting > 200 UK LGBTQ+ organizations and posting on social media. A range of non-cisgender identities (e.g., transgender male, transgender female, non-binary, genderqueer, transmasculine) and non-heterosexual orientations (e.g., bisexual) were represented, and participants were categorized into one of four groups: (1) assigned female at birth but does not identify as female (transgender AFAB) (n = 32), (2) cisgender female (n = 21), (3) assigned male at birth but does not identify as male (transgender AMAB) (n = 18), and (4) cisgender male (n = 18). After controlling for age and autism diagnostic status, transgender AFAB participants had marginally higher AQ scores, and significantly higher SQ-S and systemizing-relative-to-empathizing (D) scores, compared with the cisgender female group. No such differences were detected between the transgender AMAB and cisgender male groups. Our findings are broadly in line with predictions derived from the EMB theory, though as no transgender AFAB participants reported being heterosexual, it was not possible to determine whether these effects relate specifically to gender identity, to sexual orientation, or to both.

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7. Jiwa MI, Durbin J, Pereira V, Streisslberger E, Steel L, Lunsky Y. « This Is about My Health »: Partnering with Patients and Families to Share Knowledge and Tools about Healthcare Communication for Adults with Intellectual and Developmental Disabilities. Healthcare quarterly (Toronto, Ont). 2022; 24(Sp): 98-104.

This project involved patients with intellectual and developmental disabilities and a family caregiver as advisors on a knowledge translation (KT) effort on healthcare communication. The project demonstrated that with the right supports, patient and family advisors can effectively share their experiences and add a powerful voice to KT activities. Lessons learned included the importance of being creative, responsive and flexible to support the advisors, of recognizing their expertise and of building capacity in multiple advisors to allow for diverse voices and greater flexibility. This work requires adequate time and funding, which needs to be factored into planning.

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8. Li HL, Chen LL, Qian G, Wang WS, Feng XN, Yu MQ, Ren LZ. A Birth Cohort Study of Neurodevelopmental Outcomes from Birth to 2 Years of Age in Preterm Infants under 34 Weeks of Gestation. Journal of healthcare engineering. 2022; 2022: 7496785.

BACKGROUND: The tissues and organs of premature infants are immature and easily damaged by external adverse factors, leading to functional development disorders and abnormalities. Besides, the incidence of premature babies in various countries has an increasing trend, with the incidence rate exceeding 10%. OBJECTIVE: This study aims to investigate the neurodevelopment and the incidence of various developmental delays, cerebral palsy, autism spectrum disorder, and audio-visual impairment in premature infants under 34 weeks of gestation from birth to 2 years of age, so as to provide the basis for early intervention of premature infants in the clinic. METHODS: A cohort of premature infants was established using 263 premature infants with a gestational age of 28-33 + 6 weeks who were born alive from March 1, 2018, to February 28, 2019, in four tertiary hospitals in Shenzhen. In addition, 263 full-term infants of the same sex who were born in the same period in the four hospitals were randomly selected and paired in a ratio of 1 : 1 as the control group. The subjects were assessed for neurodevelopment using the Gesell test scale at 6, 12, 18, and 24 months after birth (premature infants were corrected for months). We calculated the neurodevelopmental indicators of children in each month of age and the incidence of various developmental delays, cerebral palsy, autism spectrum disorder, and audio-visual impairment in the two groups. RESULTS: The results of this study showed that the cohort of premature infants with birth gestational age less than 34 weeks had higher adaptive, fine motor, and personal-social energy domain development quotient (DQ) values from the corrected gestational age of 6 months to the corrected gestational age of 24 months after birth compared with the full-term cohort. And it also achieved catch-up growth in neurological development, but the detection rates of neurodevelopmental abnormalities at the corrected gestational age of 12 and 24 months were higher than those in the full-term cohort. CONCLUSION: It is important to reduce the disability rate and degree of premature infants by strengthening the systematic management, early promotion and supervision, as well as early intervention for preterm infants with developmental abnormalities who were born at gestational age less than 34 weeks after birth.

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9. Li J, Chen Z, Zhong Y, Lam HK, Han J, Ouyang G, Li X, Liu H. Appearance-Based Gaze Estimation for ASD Diagnosis. IEEE transactions on cybernetics. 2022; Pp.

Biomarkers, such as magnetic resonance imaging (MRI) and electroencephalogram have been used to help diagnose autism spectrum disorder (ASD). However, the diagnosis needs the assist of specialized medical equipment in the hospital or laboratory. To diagnose ASD in a more effective and convenient way, in this article, we propose an appearance-based gaze estimation algorithm–AttentionGazeNet, to accurately estimate the subject’s 3-D gaze from a raw video. The experimental results show its competitive performance on the MPIIGaze dataset and the improvement of 14.7% for static head pose and 46.7% for moving head pose on the EYEDIAP dataset compared with the state-of-the-art gaze estimation algorithms. After projecting the obtained gaze vector onto the screen coordinate, we apply accumulated histogram to taking into account both spatial and temporal information of estimated gaze-point and head-pose sequences. Finally, classification is conducted on our self-collected autistic children video dataset (ACVD), which contains 405 videos from 135 different ASD children, 135 typically developing (TD) children in a primary school, and 135 TD children in a kindergarten. The classification results on ACVD shows the effectiveness and efficiency of our proposed method, with the accuracy 94.8%, the sensitivity 91.1% and the specificity 96.7% for ASD.

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10. Moffitt JM, Ahn YA, Custode S, Tao Y, Mathew E, Parlade M, Hale M, Durocher J, Alessandri M, Perry LK, Messinger DS. Objective measurement of vocalizations in the assessment of autism spectrum disorder symptoms in preschool age children. Autism research : official journal of the International Society for Autism Research. 2022.

Assessment of autism spectrum disorder (ASD) relies on expert clinician observation and judgment, but objective measurement tools have the potential to provide additional information on ASD symptom severity. Diagnostic evaluations for ASD typically include the autism diagnostic observation schedule (ADOS-2), a semi-structured assessment composed of a series of social presses. The current study examined associations between concurrent objective features of child vocalizations during the ADOS-2 and examiner-rated autism symptom severity. The sample included 66 children (49 male; M = 40 months, SD = 10.58) evaluated in a university-based clinic, 61 of whom received an ASD diagnosis. Research reliable administration of the ADOS-2 provided social affect (SA) and restricted and repetitive behavior (RRB) calibrated severity scores (CSS). Audio was recorded from examiner-worn eyeglasses during the ADOS-2 and child and adult speech were differentiated with LENA SP Hub. PRAAT was used to ascertain acoustic features of the audio signal, specifically the mean fundamental vocal frequency (F0) of LENA-identified child speech-like vocalizations (those with phonemic content), child cry vocalizations, and adult speech. Sphinx-4 was employed to estimate child and adult phonological features indexed by the average consonant and vowel count per vocalization. More than a quarter of the variance in ADOS-2 RRB CSS was predicted by the combination of child phoneme count per vocalization and child vocalization F0. Findings indicate that both acoustic and phonological features of child vocalizations are associated with expert clinician ratings of autism symptom severity. LAY SUMMARY: Determination of the severity of autism spectrum disorder is based in part on expert (but subjective) clinician observations during the ADOS-2. Two characteristics of child vocalizations-a smaller number of speech-like sounds per vocalization and higher pitched vocalizations (including cries)-were associated with greater autism symptom severity. The results suggest that objectively ascertained characteristics of children’s vocalizations capture variance in children’s restricted and repetitive behaviors that are reflected in clinician severity indices.

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11. Pangrazzi L, Genovesi S, Balasco L, Cerilli E, Robol C, Zunino G, Piazza S, Provenzano G, Bozzi Y. Immune dysfunction in the cerebellum of mice lacking the autism candidate gene Engrailed 2. Journal of neuroimmunology. 2022; 367: 577870.

Immune system dysfunction has been described in autism spectrum disorder. Here we tested the hypothesis that cerebellar defects are accompanied by immune dysfunction in adult mice lacking the autism-candidate gene Engrailed 2 (En2). Gene ontology analyses revealed that biological processes related to immune function were over-represented in the cerebellar transcriptome of En2(-/-) mice. Pro-inflammatory molecules and chemokines were reduced in the En2(-/-) cerebellum compared to controls. Conversely, pro-inflammatory molecules were increased in the peripheral blood of mutant mice. Our results suggest a link between immune dysfunction and cerebellar defects detected in En2(-/-) mice.

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12. Park Y, Guzick AG, Schneider SC, Fuselier M, Wood JJ, Kerns CM, Kendall PC, Storch EA. Dental Anxiety in Children With Autism Spectrum Disorder: Understanding Frequency and Associated Variables. Frontiers in psychiatry. 2022; 13: 838557.

Dental anxiety seems to be elevated in children with autism spectrum disorder (ASD), and may be associated with feelings of helplessness, loss of control, and sensory overload. Dental anxiety, a primary contributor to dental avoidance, can lead to unwanted long-term oral hygiene consequences. This manuscript characterizes the frequency and correlates of dental anxiety in children with ASD. Specifically, this study examined associations between child-reported dental anxiety and parent-reported autism symptom severity, anxiety symptom severity, sensory sensitivity, and internalizing/externalizing symptom severity. Participants included 76 children without cognitive impairment (age in years M = 9.9, SD = 1.8) who took part in a cognitive behavioral therapy study for children with ASD and co-occurring anxiety disorders. Elevated dental anxiety was found in 68% of participants based on a cut-off score from a dental anxiety measure, with fears related to pain being the most commonly endorsed concern; over half of youth endorsed feeling scared about pinching feelings or having a tooth pulled out at the dentist. No significant correlations between dental anxiety and other variables of interest were found, including overall anxiety severity, ASD symptoms, internalizing and externalizing symptoms, and sensory sensitivities. The findings contextualize the frequency of dental anxiety and its relationship to various variables, which may be useful in tailoring existing treatments to reduce dental anxiety in children with ASD.

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13. Poole D, Casassus M, Gowen E, Poliakoff E, Jones LA. Time perception in autistic adults: Interval and event timing judgments do not differ from nonautistics. Journal of experimental psychology General. 2022.

It has previously been proposed that autistic people have problems with timing which underlie the behavioral and cognitive differences in the condition. However, the nature of this postulated timing issue has not been well specified and the existing experimental literature has generated mixed findings. In the current study, we attempted a systematic investigation of timing processes in autistic adults using scalar expectancy theory as a theoretical framework. Autistic (n = 58) and nonautistic (n = 91) adults matched for age, sex, and full-scale IQ completed a battery of auditory and visual timing tasks measuring basic subsecond duration perception (temporal discrimination thresholds), clock processes (verbal estimation), clock and memory processes (temporal generalization), and event timing (temporal order judgments). Participants also completed suprasecond retrospective duration estimates where the participant was not warned in advanced that they would be required to make a timing judgment, and questionnaires measuring self-reported timing behaviors in daily life. The groups reported differences on questionnaires, but measures of timing performance were comparable overall. In an exploratory analysis, we performed principal components analysis to investigate the relationship between timing judgments and participants’ self-reported social-communicative, sensory, and motor traits. Measures of timing performance were not well correlated with these questionnaire scores. The current study, the largest conducted on time and autism to date, shows no clear evidence for reduced timing performance in autistic adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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14. Qi C, Chen A, Mao H, Hu E, Ge J, Ma G, Ren K, Xue Q, Wang W, Wu S. Excitatory and Inhibitory Synaptic Imbalance Caused by Brain-Derived Neurotrophic Factor Deficits During Development in a Valproic Acid Mouse Model of Autism. Frontiers in molecular neuroscience. 2022; 15: 860275.

Environmental factors, such as medication during pregnancy, are one of the major causes of autism spectrum disorder (ASD). Valproic acid (VPA) intake during pregnancy has been reported to dramatically elevate autism risk in offspring. Recently, researchers have proposed that VPA exposure could induce excitatory or inhibitory synaptic dysfunction. However, it remains to be determined whether and how alterations in the excitatory/inhibitory (E/I) balance contribute to VPA-induced ASD in a mouse model. In the present study, we explored changes in the E/I balance during different developmental periods in a VPA mouse model. We found that typical markers of pre- and postsynaptic excitatory and inhibitory function involved in E/I balance markedly decreased during development, reflecting difficulties in the development of synaptic plasticity in VPA-exposed mice. The expression of brain-derived neurotrophic factor (BDNF), a neurotrophin that promotes the formation and maturation of glutamatergic and GABAergic synapses during postnatal development, was severely reduced in the VPA-exposed group. Treatment with exogenous BDNF during the critical E/I imbalance period rescued synaptic functions and autism-like behaviors, such as social defects. With these results, we experimentally showed that social dysfunction in the VPA mouse model of autism might be caused by E/I imbalance stemming from BDNF deficits during the developmental stage.

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15. Salhi I, Qbadou M, Gouraguine S, Mansouri K, Lytridis C, Kaburlasos V. Towards Robot-Assisted Therapy for Children With Autism-The Ontological Knowledge Models and Reinforcement Learning-Based Algorithms. Frontiers in robotics and AI. 2022; 9: 713964.

Robots are more and more present in our lives, particularly in the health sector. In therapeutic centers, some therapists are beginning to explore various tools like video games, Internet exchanges, and robot-assisted therapy. These tools will be at the disposal of these professionals as additional resources that can support them to assist their patients intuitively and remotely. The humanoid robot can capture young children’s attention and then attract the attention of researchers. It can be considered as a play partner and can directly interact with children or without a third party’s presence. It can equally perform repetitive tasks that humans cannot achieve in the same way. Moreover, humanoid robots can assist a therapist by allowing him to teleoperated and interact from a distance. In this context, our research focuses on robot-assisted therapy and introduces a humanoid social robot in a pediatric hospital care unit. That will be performed by analyzing many aspects of the child’s behavior, such as verbal interactions, gestures and facial expressions, etc. Consequently, the robot can reproduce consistent experiences and actions for children with communication capacity restrictions. This work is done by applying a novel approach based on deep learning and reinforcement learning algorithms supported by an ontological knowledge base that contains relevant information and knowledge about patients, screening tests, and therapies. In this study, we realized a humanoid robot that will assist a therapist by equipping the robot NAO: 1) to detect whether a child is autistic or not using a convolutional neural network, 2) to recommend a set of therapies based on a selection algorithm using a correspondence matrix between screening test and therapies, and 2) to assist and monitor autistic children by executing tasks that require those therapies.

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16. Tsou HL, Huang YC, Chen CY, Kuo SC, Tzeng NS, Lin JC, Yeh YW. Increased IgG-4 levels in a patient with autism spectrum disorder complicated by autoimmune pancreatitis. Asian journal of psychiatry. 2022; 73: 103111.

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17. Walhout SJ, van Zanten J, DeFuentes-Merillas L, Sonneborn CK, Bosma M. Patients With Autism Spectrum Disorder and Co-occurring Substance Use Disorder: A Clinical Intervention Study. Substance abuse : research and treatment. 2022; 16: 11782218221085599.

BACKGROUND: The prevalence of substance use disorders (SUD) in individuals with autism spectrum disorders (ASD) appears to be higher than previously described. Attention has been drawn to developing new treatment approaches for this patient population, as they appear to do less well with traditional addiction treatment. There is very little research addressing treatment outcome. This study aims to introduce and evaluate a manualized group treatment intervention developed specifically for patients with ASD and co-occurring SUD. METHODS: We developed a group treatment based on cognitive behavioural therapy (CBT) and evaluated outcome measures at the end of treatment and 3-month follow-up. Fifty-seven patients with ASD and co-occurring SUD were included of which 30 completed the group intervention, 27 of them also participated at 3-month follow-up. RESULTS: The findings suggest that group treatment can work for patients with ASD and co-occurring SUD. Lower levels of alcohol use (t = 3.61, P = .002, d = 0.75), craving (t = 2.65, P = .013, d = 0.51), passive coping styles (t = 2.32, P = .030, d = 0.48), depression (t = 3.48, P = .002, d = 0.67), anxiety (t = 3.02, P = .006, d = 0.58), and stress (t = 2.62, P = .015, d = 0.51) symptoms were reported after completing the group intervention, with even stronger effects at 3 months follow-up. CONCLUSIONS: The present study shows promising results of a tailor-made group intervention in a heterogeneous patient population with ASD and co-occurring SUD with positive effects on both symptoms of ASD and SUD.

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18. Yang XY, Wang YY, Zhou YP, He J, Mei MJ, Zhang MN, Wang B, Zhou WJ, Luo MH, Wang QH, Li ZY, Xu Y, Lu Q, Zou LP. Postnatal Cytomegalovirus Infection May Increase the Susceptibility of Tuberous Sclerosis Complex to Autism Spectrum Disorders. Microbiology spectrum. 2022: e0186421.

Autism spectrum disorder (ASD), a highly hereditary and heterogeneous neurodevelopmental disorder, is influenced by genetic and environmental factors. Tuberous sclerosis complex (TSC) is a common syndrome associated with ASD. Cytomegalovirus (CMV) infection is an environmental risk factor for ASD. The similarities in pathological and mechanistic pathways of TSC and CMV intrigued us to investigate whether CMV and TSC interacted in ASD’s occurrence. We detected CMV IgG seroprevalence of 308 TSC patients from our prospective cohort (September 2011 to March 2021) and 93 healthy children by magnetic particle indirect chemiluminescence immunoassay. A total of 206 TSC patients enrolled were divided into ASD and non-ASD groups, and the relationship between ASD and CMV seroprevalence was analyzed. Nested PCR and Western blot were used to detect CMV DNAs and proteins in cortical malformations of seven TSC patients with and without ASD. No difference was found in CMV seroprevalence between TSC patients and healthy children (74.0% versus 72.0%, P = 0.704). Univariate analysis showed the seroprevalence in TSC patients with ASD was higher than that in TSC patients without ASD (89.2% versus 75.1%, P = 0.063), and multifactorial analysis showed that CMV seroprevalence was a risk factor for ASD in TSC patients (OR = 3.976, 95% CI = 1.093 to 14.454). Moreover, CMV was more likely to be detected in the cortical malformations in TSC patients with ASD but not in those without ASD. The findings demonstrated that CMV may increase the susceptibility of TSC to ASD. IMPORTANCE CMV is an environmental risk factor for ASD, but its role in syndromic autism with known genetic etiology has been rarely studied. The pathogenesis of ASD is related to the interaction between environmental and genetic factors. This study demonstrated that CMV can contribute to the occurrence of ASD related to TSC, a common genetic syndrome associated with ASD. Our findings provided support for the theory of gene-environment interaction (G × E) in pathogenesis of ASD and a new perspective for the prevention and therapy for TSC related ASD.

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