1. Corrigendum for ‘Longitudinal development of manual motor ability in autism spectrum disorder from childhood to mid-adulthood relates to adaptive daily living skills’ by Travers et al. (2017). Dev Sci;2022 (Jun 24):e13299.

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2. Almutairi MM, Nadeem A, Ansari MA, Bakheet SA, Attia SM, Albekairi TH, Alhosaini K, Algahtani M, Alsaad AMS, Al-Mazroua HA, Ahmad SF. Lead (Pb) exposure exacerbates behavioral and immune abnormalities by upregulating Th17 and NF-κB-related signaling in BTBR T(+) Itpr3(tf)/J autistic mouse model. Neurotoxicology;2022 (Jun 26);91:340-348.

Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder that are characterized by abnormal social interaction impairments in communication and repetitive and restricted activities or interests. Even though the exact etiology of ASD remains unknown. Lead (Pb) is a toxin known to harm many organs in the body, it is one of the most ubiquitous metal exposures which is associated with neurological deficits. Previous studies have shown that the exposure to Pb may play a role in ASD. BTBR T(+) Itpr3(tf)/J (BTBR) mouse model is commonly used as a preclinical model for ASD. In this study, we investigated the effects of Pb exposure on sociability, self-grooming and marble burying behaviors tests in BTBR mice. We further examined the effects of Pb on IL-17A- RORγT-, STAT3-, NF-κB p65-, iNOS-, TLR-2- and TLR-4-producing CD45(+) cells in spleen using flow cytometry. We also explored the effects of Pb on IL-17A, RORγT, STAT3, NF-κB p65, and TLR-2 mRNA expression in the brain tissue using RT-PCR analysis. Our results demonstrated that Pb exposure substantially increased repetitive behavior, marble burying and decrease social interactions in BTBR mice. In addition, in spleen cells, Pb exposure exaggerated CD45(+)IL-17A(+), CD45(+)RORγT(+), CD45(+)STAT3(+), CD45(+)NF-κB p65(+), CD45(+)iNOS(+), CD45(+)TLR-2(+) and CD45(+)TLR-4(+) in BTBR mice. We also found that Pb significantly increased IL-17A, RORγT, STAT3, NF-κB p65, and TLR-2 mRNA in the brain tissue. Therefore, Pb exposure exacerbates behavioral and neuroimmune function in BTBR mice, suggesting a potentially strong role for Pb in ASD.

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3. Belek B. ‘A Smaller Mask’: Freedom and Authenticity in Autistic Space. Cult Med Psychiatry;2022 (Jun 26):1-21.

Autscape is an autistic-led conference, organised annually in varying locations around England. Governed by a strict set of rules and regulations, Autscape is a social and spatial setup explicitly devised to accommodate the tendencies, sensitivities, and preferences of people on the autism spectrum. It is a design, in other words-as organisers and participants alike often profess-for an altogether autistic space. The uniqueness of the event, and consequently its value to anthropological theory, lies in the shared imagination of the setting by those who inhabit it as one in which neurotypical masks, otherwise worn daily in keeping with hegemonic society’s expectation of conformity, can finally be removed. I introduce the concept of un-festival as a means of depicting this event, similar to festival in its goals of defiance and inversion, but different from-and in important ways, opposite to-festival in its style and architecture, in the dispositions it encourages and mobilises, and in its potential implications. The un-festival offers a powerful comment on this moment in history, whereby masks are no longer seen as an item that affords freedom, but as one that stifles it. While Autscape participants remain doubtful as to the actual effect of this event on neurotypical society, they do nevertheless express a desire that this project will have some longstanding effects. That once a space has been designed for autistic people that considers their specific needs and tendencies, autism may then finally cease to be interpreted through a neuro-normative prism and freed to be understood in autistic people’s own terms.

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4. Chenausky KV, Norton AC, Tager-Flusberg H, Schlaug G. Auditory-motor mapping training: Testing an intonation-based spoken language treatment for minimally verbal children with autism spectrum disorder. Ann N Y Acad Sci;2022 (Jun 26)

We tested an intonation-based speech treatment for minimally verbal children with autism (auditory-motor mapping training, AMMT) against a nonintonation-based control treatment (speech repetition therapy, SRT). AMMT involves singing, rather than speaking, two-syllable words or phrases. In time with each sung syllable, therapist and child tap together on electronic drums tuned to the same pitches, thus coactivating shared auditory and motor neural representations of manual and vocal actions, and mimicking the « babbling and banging » stage of typical development. Fourteen children (three females), aged 5.0-10.8, with a mean Autism Diagnostic Observation Schedule-2 score of 22.9 (SD = 2.5) and a mean Kaufman Speech Praxis Test raw score of 12.9 (SD = 13.0) participated in this trial. The main outcome measure was percent syllables approximately correct. Four weeks post-treatment, AMMT resulted in a mean improvement of +12.1 (SE = 3.8) percentage points, compared to +2.8 (SE = 5.7) percentage points for SRT. This between-group difference was associated with a large effect size (Cohen’s d = 0.82). Results suggest that simultaneous intonation and bimanual movements presented in a socially engaging milieu are effective factors in AMMT and can create an individualized, interactive music-making environment for spoken-language learning in minimally verbal children with autism.

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5. Doğan S, Çolak A. Social robots in the instruction of social skills in autism: a comprehensive descriptive analysis of single-case experimental designs. Disabil Rehabil Assist Technol;2022 (Jun 26):1-20.

PURPOSE: The rapid technological advances, the traits of individuals with ASD and their interest in technology are promising for the instruction of social skills to individuals with autism spectrum disorder (ASD) using various technological interventions. Robotic interventions are among these. However, although robotics is frequently used with individuals with ASD, there is a limited number of reviews on social skills instruction and methods. The present study aimed to conduct a comprehensive descriptive analysis on single-case experimental designs where social skills were instructed to individuals with ASD and social robots were included as independent variables. MATERIALS AND METHODS: Thirteen single-case experimental designs published in peer-reviewed journals in which social skills were taught to individuals with ASD using social robots were reviewed with a comprehensive descriptive analysis based on five categories: (a) key characteristics, (b) methodological characteristics, (c) findings, (d) data analysis, and (e) key parameters in single-case experimental designs. RESULTS: Social robots are generally effective in the instruction of social skills. Several social skills (e.g., making eye contact, social interaction, simple greetings) were instructed in the studies. Humanoid robots and NAO were used generally. The study data were predominantly analyzed statistically. There were several problems in research based on the basic parameters in single-case experimental designs. CONCLUSIONS: The researches in this study differ in several respects (e.g., results, data analysis, and dependent variable). Thus, there is still a need for several robotics studies in the instruction of social skills. IMPLICATIONS FOR REHABILITATIONThis study will be a guide for teachers who currently use robots in their classrooms but do not know which skills to use in teaching and how to use them functionally, as it shows applied research with robots.The findings of this research will show implementers working with children with ASD that technological tools can be used in rehabilitation environments, and that teachers can take a place in their robots in interventions for children with ASD, giving them a different perspective.It will be seen that the education of children with ASD is not only 1:1 and with humans, but robots can also provide education. In this way, the power of technology in teaching will become clearer. Especially in rehabilitation.Finally, this research will offer new options in teaching especially for teachers who aim at teaching social skills and will give them the opportunity to comprehensively examine the processes of different studies on these subjects.

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6. Godoy PBG, Sumiya FM, Seda L, Shephard E. A systematic review of observational, naturalistic, and neurophysiological outcome measures of nonpharmacological interventions for autism. Braz J Psychiatry;2022 (Jun 24)

OBJECTIVE: Naturalistic and neurophysiological assessments are relevant as outcome measures in autism intervention trials because they provide, respectively, ecologically valid information about functioning and underlying neurocognitive mechanisms. We conducted a systematic review to highlight which specific neurophysiological techniques, experimental tasks, and naturalistic protocols have been used to assess neural and behavioral functioning in autism intervention studies. METHODS: Studies were collected from four electronic databases between October 2019 and February 2020: MEDLINE (via PubMed), PsycINFO, LILACS, and Web of Science, and were included if they used structured observational, naturalistic, or neurophysiological measures to assess the efficacy of a nonpharmacological intervention for ASD. RESULTS: Fourteen different measures were used by 64 studies, with the Autism Diagnostic Observation Schedule the most frequently used instrument. Thirty-seven different coding systems of naturalistic measures were used across 51 studies, most of which used different protocols. Twentyfour neurophysiological measures were used in 16 studies, with different experimental paradigms and neurophysiological components used across studies. CONCLUSIONS: Cross-study variability in assessing the outcomes of autism interventions may obscure comparisons and conclusions about how different behavioral interventions affect autistic social communication and underlying neurophysiological mechanisms.

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7. Han GT, Trevisan DA, Foss-Feig J, Srihari V, McPartland JC. Distinct Symptom Network Structure and Shared Central Social Communication Symptomatology in Autism and Schizophrenia: A Bayesian Network Analysis. J Autism Dev Disord;2022 (Jun 25)

Autism (ASD) and schizophrenia spectrum disorders (SCZ) are neurodevelopmental conditions with overlapping and interrelated symptoms. A network analysis approach that represents clinical conditions as a set of « nodes » (symptoms) connected by « edges » (relations among symptoms) was used to compare symptom organization in the two conditions. Gaussian graphical models were estimated using Bayesian methods to model separate symptom networks for adults with confirmed ASD or SCZ diagnoses. Though overall symptom organization differed by diagnostic group, both symptom networks demonstrated high centrality of social communication difficulties. Autism-relevant restricted and repetitive behaviors and schizophrenia-related cognitive-perceptual symptoms were uniquely central to the ASD and SCZ networks, respectively. Results offer recommendations to improve differential diagnosis and highlight potential treatment targets in ASD and SCZ.

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8. Harris HA, Bowling A, Santos S, Greaves-Lord K, Jansen PW. Child ADHD and autistic traits, eating behaviours and weight: A population-based study. Pediatr Obes;2022 (Jun 24):e12951.

BACKGROUND: Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) have an increased obesity risk. Although these conditions commonly co-occur, shared factors relating to obesity risk are unknown. OBJECTIVES: To examine the shared and unique associations of ADHD and autistic traits with eating behaviours and BMI. METHODS: Children (N = 4134) from the population-based Generation R Study were categorized into subgroups based on parent-reported ADHD and autistic traits scores at 6 years: ADHD(High) , ASD(High) , ADHD+ASD(High) and REF (reference group: ADHD+ASD(Low) ). Multiple linear regressions examined the associations between subgroups and eating behaviours (at 10 years) and BMIz (at 14 years), relative to REF. Mediation analyses tested the indirect effect of subgroup and BMIz through eating behaviours. RESULTS: ADHD + ASD(High) children expressed both food approach (increased food responsiveness and emotional overeating) and avoidant eating behaviours (increased emotional undereating, satiety responsiveness/ slowness in eating and picky eating, and decreased enjoyment in food). ASD(High) children were more food avoidant, while ADHD(High) children had more food approach behaviours and greater BMIz. ADHD(High) and BMIz were indirectly associated with food responsiveness and emotional overeating. CONCLUSIONS: ADHD and autistic trait phenotypes show distinct associations with potential obesity risk factors, and further research is needed to improve targeted early intervention.

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9. Hayes KN, Rossetti KG, Zlomke K, Bcba D. Community support, family resilience, and mental health among caregivers of youth with autism spectrum disorder. Child Care Health Dev;2022 (Jun 25)

BACKGROUND: Caregivers of children with autism spectrum disorder (ASD) has been shown to have unique mental health vulnerabilities that community support may buffer. Positive caregiver mental health can stimulate family resilience behaviors, such as strong communication and problem-solving. Further, community support has been found to be related to caregiver mental health, as well as improved child functioning. The current study aimed to investigate caregiver mental health as a mediator between community support and family resilience in families of a child with an autism spectrum disorder. METHODS: Data obtained from caregivers of 654 children with a reported diagnosis of ASD were utilized from the 2016 National Survey of Children’s Health (NSCH) public database. RESULTS: Community support was positively correlated with family resilience and caregiver mental health. Bivariate correlations indicated significant positive associations between community support and family resilience. Caregiver mental health significantly partially mediated the relationship between community support and family resilience. CONCLUSIONS: The present study provided important insight into fostering caregiver health as a strategy to promote family resilience behaviors. Interventions designed to address family resilience behaviors among families of children with ASD should focus on ways in which to positively impact caregiver mental health.

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10. Northrup JB, Goodwin MS, Peura CB, Chen Q, Taylor BJ, Siegel MS, Mazefsky CA. Mapping the time course of overt emotion dysregulation, self-injurious behavior, and aggression in psychiatrically hospitalized autistic youth: A naturalistic study. Autism Res;2022 (Jun 25)

Challenges with emotion dysregulation, self-injurious behavior (SIB), and aggression are common in autistic individuals. Prior research on the relationships between these behaviors is limited mainly to cross-sectional correlations of parent-report data. Understanding how emotion dysregulation, SIB, and aggression present and relate to one another in real-time could add to our understanding of the context and function of these behaviors. The present study examined the real-time occurrence and temporal relationships between these behaviors in 53 psychiatrically hospitalized autistic youth. Over 500 hours of behavioral observation occurred during everyday activities in the hospital. Start and stop times for instances of overt emotion dysregulation, SIB, and aggression were coded live using a custom mobile phone app. Results indicated large individual variability in the frequency and duration of these behaviors and their co-occurrence. Both SIB and aggression co-occurred with overt emotion dysregulation at above-chance levels, suggesting a role for emotional distress in the occurrence of these behaviors. However, there was substantial variability within and between individuals in co-occurrence, and SIB and aggression often (and for some individuals, almost always) occurred without overt emotion dysregulation. Relatedly, cross-recurrence quantitative analysis revealed that SIB and aggression preceded emotion dysregulation more often than emotion dysregulation preceded SIB and aggression. Future research, perhaps using ambulatory psychophysiological measures, is needed to understand whether emotion dysregulation may sometimes be present but not easily observed during SIB and aggression.

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11. Porter K, Foli KJ. Egocentric norm in health-based decision making of patients on the autistic spectrum. Nurs Forum;2022 (Jun 25)

BACKGROUND: Individuals diagnosed with autism spectrum disorder (ASD) without intellectual disability (ID) may have advanced mental reasoning; however, symptomology may vary within the population. Possible symptomology includes communication problems, difficulty relating to people, things, and events, and sensory sensitivity. Current concepts in determining health behavior are not applicable to the ASD without ID population. AIM: The aim of this analysis is to define the concept of egocentric norm in the context of health-based decisions of adults diagnosed with ASD without ID and to support improved nursing practice with this population. DESIGN: The Walker and Avant approach was used. Model, borderline, and contrary cases are offered. DATA SOURCE: Literature search yielded 47 peer reviewed papers that were included in the analysis. REVIEW METHODS: Uses of the concept were reviewed, following the Walker and Avant approach. RESULTS: Egocentric norm is defined as an individual’s ability to perceive, adapt, and respond to information and potential consequences of personal health behavior based on self-evaluation and the immediate environment with limited regard to peer and family influence. CONCLUSIONS: The new concept of egocentric norm may account for the unique dynamics presented by adults with ASD without ID, which may impact health behaviors and actions.

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12. Winterberg AV, Jones E, Ding L, Hill LM, Varughese AM. Adaptive Care for Perioperative Patients With Developmental Disabilities: An Exploration of Interventions and Family Experience. J Pediatr Health Care;2022 (Jun 26)

INTRODUCTION: Patients with developmental disabilities commonly experience psychological distress during health care visits. There is limited research describing which individualized interventions are being implemented to promote optimal care in the perioperative area. METHOD: In this prospective observational study of 60 patients with developmental diagnoses, aged 3-21 years, we recorded adaptive care plan (ACP) interventions and assessed family experience. RESULTS: Patients receiving ACPs had diverse diagnoses, including autism spectrum and 10 other unique syndromes. Most patients received previsit planning (90%), adaptations to standard protocols (60%), child life specialist preparation (67%), procedural support (90%), and were given fast-acting anxiolytics before anesthesia induction (68%). Families reported that ACPs were important for managing a child’s stress (94%) and promoting safety (92%). DISCUSSION: ACPs promote safe, productive health care encounters for patients with various diagnoses, ages, and coping abilities. Families find ACPs important for stress management and promoting safety.

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