1. Aaronson B, Estes A, Rogers SJ, Dawson G, Bernier R. The Early Start Denver Model Intervention and Mu Rhythm Attenuation in Autism Spectrum Disorders. Journal of autism and developmental disorders. 2021.

We examined the relationship between the Early start Denver model (ESDM) intervention and mu rhythm attenuation, an EEG paradigm reflecting neural processes associated with action perception and social information processing. Children were assigned to either receive comprehensive ESDM intervention for two years, or were encouraged to pursue resources in the community. Two years after intervention, EEG was collected during the execution and observation of grasping actions performed by familiar and unfamiliar agents. The ESDM group showed significantly greater attenuation when viewing a parent or caregiver executing a grasping action, compared with an unfamiliar individual executing the same action. Our findings suggest that the ESDM may have a unique impact on neural circuitry underlying social cognition and familiarity.

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2. Alemany S, Blok E, Jansen PR, Muetzel RL, White T. Brain morphology, autistic traits, and polygenic risk for autism: A population-based neuroimaging study. Autism research : official journal of the International Society for Autism Research. 2021; 14(10): 2085-99.

Autism spectrum disorders (ASD) are associated with widespread brain alterations. Previous research in our group linked autistic traits with altered gyrification, but without pronounced differences in cortical thickness. Herein, we aim to replicate and extend these findings using a larger and older sample. Additionally, we examined whether (a) brain correlates of autistic traits were associated with polygenic risk scores (PRS) for ASD, and (b) autistic traits are related with brain morphological changes over time in a subset of children with longitudinal data available. The sample included 2400 children from the Generation R cohort. Autistic traits were measured using the Social Responsiveness Scale (SRS) at age 6 years. Gyrification, cortical thickness, surface area, and global morphological measures were obtained from high-resolution structural MRI scans at ages 9-to-12 years. We performed multiple linear regression analyses on a vertex-wise level. Corresponding regions of interest were tested for association with PRS. Results showed that autistic traits were related to (a) lower gyrification in the lateral occipital and the superior and inferior parietal lobes, (b) lower cortical thickness in the superior frontal region, and (c) lower surface area in inferior temporal and rostral middle frontal regions. PRS for ASD and longitudinal analyses showed significant associations that did not survive correction for multiple testing. Our findings support stability in the relationship between higher autistic symptoms and lower gyrification and smaller surface areas in school-aged children. These relationships remained when excluding ASD cases, providing neurobiological evidence for the extension of autistic traits into the general population. LAY SUMMARY: We found that school-aged children with higher levels of autistic traits had smaller total brain volume, cerebellum, cortical thickness, and surface area. Further, we also found differences in the folding patterns of the brain (gyrification). Overall, genetic susceptibility for autism spectrum disorders was not related to these brain regions suggesting that other factors could be involved in their origin. These results remained significant when excluding children with a diagnosis of ASD, providing support for the extension of the relationship between autistic traits and brain findings into the general population.

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3. Arteaga A, Vélez E, Cornejo W, Solarte R, Lobo A, Jaramillo V, Otero J. Epilepsy and electroencephalographic abnormalities in patients with diagnosis of idiopathic autism spectrum disorder in Medellín. International journal of psychological research. 2021; 14(1): 115-20.

The objective of the present study was to make a clinical and electroencephalographic characterization of the electrical findings and types of seizures in patients with idiopathic autism. Pediatric patients of any age, with the diagnosis of idiopathic ASD, contained within the database of the research « Genetic in autism » were included. An electroencephalographic recording with epilepsy protocol was performed in all the patients. 20 pediatric patients were included with an age media of 10.5 years, SD 5.48 years. The median age for the diagnosis of ASD was 53 months, and epileptic seizures were documented in 45%. 66.6% of patients with epileptic events had anti-epileptic treatment, and only 33.3% had achieved seizure control with medication. Interictal abnormal EEG records were found in 8 patients (40%), with 6 of them having epileptic seizures. The abnormal EEG activity was multifocal in 62.5%, focal in 25% and generalized in 12.5% of the cases. The most frequently compromised location was the temporal lobe.

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4. Azad G, McClain MB, Haverkamp C, Maxwell B, Shahidullah JD. Interagency Collaboration for Pediatric Autism Spectrum Disorder: Perspectives of Community-Based Providers. Journal of interprofessional education & practice. 2021; 24.

BACKGROUND: Interagency collaboration between community and school settings is one mechanism to serve the complex needs of pediatric patients with autism spectrum disorder (ASD). PURPOSE: We surveyed a national sample of community-based providers to examine their perspectives on interagency collaboration with school-based providers when serving pediatric patients with ASD. METHOD: Medical and behavioral/mental health professionals practicing in community settings were recruited. Participants (N = 116) completed an online survey about their interagency collaboration experiences with schools. RESULTS: The majority of the sample reported engaging in interagency collaboration with school-based providers; however, the frequency was limited and was associated with the number of years working in the field. Community-based providers wanted more didactic and hands-on experiences in collaboration. Barriers and facilitators were related to schools’ administration, school personnels’ training in ASD, information exchange, and delineating between identification systems. DISCUSSION AND CONCLUSION: Our findings highlight the importance of leadership support and the need for innovative training experiences to support school-community interagency collaboration.

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5. Bangert K, Moser C, Friedman L, Klusek J. Family as a Context for Child Development: Mothers with the FMR1 Premutation and Their Children with Fragile X Syndrome. Seminars in speech and language. 2021; 42(4): 277-86.

Fragile X syndrome (FXS) is a genetic disorder caused by changes of the FMR1 gene that is passed along among families. A range of developmental processes may be impacted with wide variation in abilities across individuals with FXS. Mothers of children with FXS are often carriers of a « premutation » expansion on the FMR1 gene, which is associated with its own clinical phenotype. These maternal features may increase individual and family vulnerabilities, including increased risk for depression and anxiety disorders and difficulties in social and cognitive ability. These characteristics may worsen with age, and potentially interact with a child’s challenging behaviors and with family dynamics. Thus, families of children with FXS may experience unique challenges related to genetic risk, manifested across both children and parents, that should be considered in therapeutic planning to optimize outcomes for children and their families. In this article, we review core features of the FMR1 premutation as expressed in mothers and aspects of the family environment that interface with developmental outcomes of children with FXS. Recommendations for family-centered support services are discussed.

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6. Barton-Hulsey A, Phinney S, Collins S. Augmentative and Alternative Communication Supports for Language and Literacy in Preschool: Considerations for Down Syndrome and Autism Spectrum Disorder. Seminars in speech and language. 2021; 42(4): 345-62.

Children with Down syndrome and children with autism spectrum disorder have a range of speech abilities during preschool that impacts access to both language and literacy instruction. It is the responsibility of the speech-language pathologist to advocate for and provide intervention using augmentative and alternative communication (AAC) through individualized assessment. This article provides a review of the literature supporting the use of AAC during preschool for both language and literacy development in children with Down syndrome and children with autism spectrum disorder who have limited speech. A small scale exploratory report is discussed to highlight differences in early literacy skills found in children in each group. Implications for AAC intervention during preschool to support both language and literacy are discussed.

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7. Bechis D, Baietto C, Caldarera AM, Vitiello B. Psychopathological profile in children with Prader-Willi syndrome as compared with autism spectrum disorder. Minerva pediatrics. 2021.

BACKGROUND: Children with Prader-Willi syndrome (PWS) can present with social deficits and repetitive behaviours that are also encountered in autism spectrum disorder (ASD). This study aimed at ascertaining possible differences in psychopathology between PWS and ASD, with particular attention to obsessional thinking, repetitive behaviours, and impulsivity. METHODS: 71 children, aged 4-15 years: 24 with PWS, 23 with ASD, and 24 community controls, were assessed on two standardized parent-reported questionnaires: the Child Behaviour Check List (CBCL) and the Autism Spectrum Quotient (AQ). Group differences were tested with one-way ANOVA. RESULTS: ASD had higher CBCL internalizing symptom scores (67.50 + 9.09) than PWS (56.62 + 9.02, Cohen’s d=1.20). On specific CBCL items, PWS had more obsessionality than ASD, which, in turn, showed more impulsivity than PWS. ASD had higher AQ scores than PWS, with small to medium effect sizes (d’s ranging from 0.22 to 0.53). CONCLUSIONS: The PWS phenotype was characterized by intense obsessionality, more marked than in ASD. ASD had greater psychopathology than PWS, especially of the internalizing type. Although limited by the small sample size, this study identifies obsessionality as common feature in PSW. Such symptom, considering the negative impact on daily functioning, requires clinical attention for specific treatment approaches.

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8. Borloz E, Villard L, Roux JC. Rett syndrome: think outside the (skull) box. Faculty reviews. 2021; 10: 59.

Rett syndrome (RTT) is a severe X-linked neurodevelopmental disorder characterized by neurodevelopmental regression between 6 and 18 months of life and associated with multi-system comorbidities. Caused mainly by pathogenic variants in the MECP2 (methyl CpG binding protein 2) gene, it is the second leading genetic cause of intellectual disability in girls after Down syndrome. RTT affects not only neurological function but also a wide array of non-neurological organs. RTT-related disorders involve abnormalities of the respiratory, cardiovascular, digestive, metabolic, skeletal, endocrine, muscular, and urinary systems and immune response. Here, we review the different aspects of RTT affecting the main peripheral groups of organs and sometimes occurring independently of nervous system defects.

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9. Bullard L, Abbeduto L. Responsive Parenting as a Target for Telehealth Language Interventions in Fragile X Syndrome: Implications for Scalability and Best Practices. Seminars in speech and language. 2021; 42(4): 287-300.

This review highlights the ways in which telehealth procedures can be implemented to help bridge the research-to-practice gap in supporting developmental outcomes for youth with fragile X syndrome (FXS). We review how the literature to date has informed potential treatment targets in the areas of speech and language development with a focus on understanding and supporting the dyadic relationship between the child and their biological mother, who is also impacted biologically. Notably, parental responsivity is an area that is strongly related to child language outcomes, both early and into adolescence, and thus, it is an important treatment target for subsequent interventions. To date, several parent-implemented interventions have been done in FXS across a broad age range (2-17-year-olds) all showing support not only that parents are successful in learning responsive strategies but also that there are subsequent impacts to child language development. Moreover, these interventions were successfully implemented at a distance through telehealth procedures including video teleconferencing and shared recordings of parent-child interactions. This review also addresses potential moderators of treatment gains. Implications for scaling such interventions in the future as well as best practices for incorporating telehealth procedures into future research and intervention programs are also discussed.

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10. Caron J, Light J, McNaughton D. Effects of a Literacy Feature in an Augmentative and Alternative Communication App on Single Word Reading of Individuals with Severe Autism Spectrum Disorders. Research and practice for persons with severe disabilities : the journal of TASH. 2021; 46(1): 18-34.

The purpose of this study was to investigate the effects of an augmentative and alternative communication (AAC) app with transition to literacy (T2L) software features (i.e., dynamic text and speech output upon selection of a graphic symbol within the grid display), on the acquisition of 12 personally relevant single words for individuals with severe autism spectrum disorder (ASD) who had minimal or no speech. The study implemented a single-subject, multiple-probe, across word sets design with four participants. All four participants in this study demonstrated increased accuracy reading targeted single words and results from this study provide preliminary evidence that the T2L features can positively impact the single word learning of individuals with ASD who have minimal speech and limited literacy skills.

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11. de Giambattista C, Ventura P, Trerotoli P, Margari F, Margari L. Sex Differences in Autism Spectrum Disorder: Focus on High Functioning Children and Adolescents. Frontiers in psychiatry. 2021; 12: 539835.

Autism Spectrum Disorder (ASD) has historically been studied, known, and diagnosed in males. Females tend to remain unidentified, especially those with average intelligence abilities. This sex/gender difference might be partially explained by biological risk factors, but it is probably also bound to methodological issues. The present study aims to examine phenotypic characteristics (cognitive, emotive, socio-communicative, and academic) of a group of 54 females with ASD matched to a group of 55 males with ASD (3-18 years), all without cognitive impairment. Results suggest that there are subtle, yet potentially meaningful, quantitative, and qualitative phenotypic differences between females and males that common screening tests are not always sensitive enough to recognize. Further studies to improve practice and course for the assessment of females, reducing sex/gender-based inequities in ASD care, are required.

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12. de Nocker YL, Toolan CK. Using Telehealth to Provide Interventions for Children with ASD: a Systematic Review. Review journal of autism and developmental disorders. 2021: 1-31.

As the need for accessible interventions for autism spectrum disorder (ASD) grows, empirically supported telehealth interventions become increasingly necessary. With the current COVID-19 public health crisis, in-person interventions have become largely infeasible; therefore, it is crucial that providers have information regarding the effectiveness of telehealth interventions. This systematic review evaluates and synthesizes existing group design research on telehealth ASD interventions. Sixteen articles were evaluated on implementer and child-level intervention outcomes as well as factors that promote equitable access to intervention. Findings suggest that telehealth programs are highly acceptable, comparable to face-to-face interventions, and can be an effective method of training implementers in interventions. Recommendations for future research and for maximizing equitable access to telehealth interventions are presented.

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13. Edelsohn GA, Abright AR. Editorial: Safer Use of Antipsychotics in Youth (SUAY): Should Treatment Be Guided by Symptoms?. Journal of the American Academy of Child and Adolescent Psychiatry. 2022; 61(1): 34-6.

Child and adolescent psychiatrists have company as they wrestle with clinical decision making regarding when it is appropriate to prescribe an antipsychotic. Pediatricians face a similar challenge in trying to determine under what circumstances to prescribe an antibiotic. Both classes of medications are powerful and can be lifesaving, but they are not without the risk of associated adverse events and cumulative exposure. Concerns regarding the widespread use of antipsychotics in children and adolescents have been supported by national trends indicating predominance of prescriptions for conditions (attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, and impulsive aggression)(1,2) other than those approved by the U.S. Food and Drug Administration (psychotic disorders, bipolar disorder with mania, irritability associated with autism spectrum disorder, and tic disorders); the risks of weight gain, diabetes mellitus, and other adverse effects to which youths appear to be more vulnerable than adults(3); and potential disparities related to the absence of race and ethnicity in large administrative datasets.(4) Previous studies of antipsychotic prescribing patterns predate the widespread use of the diagnosis of disruptive mood dysregulation disorder. A recent study found that 58.9% of youths given a diagnosis of disruptive mood dysregulation disorder were prescribed antipsychotics compared with 51% of youths with a diagnosis of bipolar disorder.(5) In this issue of the Journal, Penfold et al.(6) report on a novel approach to antipsychotic prescribing focused on symptoms rather than diagnoses developed as the initial phase of a pragmatic clinical trial, Targeted and Safer Use of Antipsychotics in Youth (SUAY), funded by the National Institute of Mental Health and designed to test the effectiveness of targeted interventions on the use of antipsychotics for youth 4 to 17 years old in large health care systems. We offer some perspectives on differences that distinguish this approach; the process used in its development; and its promise, potential pitfalls, and policy and clinical implications.

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14. Gao H, Ni Y, Mo X, Li D, Teng S, Huang Q, Huang S, Liu G, Zhang S, Tang Y, Lu L, Liang H. Drug repositioning based on network-specific core genes identifies potential drugs for the treatment of autism spectrum disorder in children. Computational and structural biotechnology journal. 2021; 19: 3908-21.

Identification of exact causative genes is important for in silico drug repositioning based on drug-gene-disease relationships. However, the complex polygenic etiology of the autism spectrum disorder (ASD) is a challenge in the identification of etiological genes. The network-based core gene identification method can effectively use the interactions between genes and accurately identify the pathogenic genes of ASD. We developed a novel network-based drug repositioning framework that contains three steps: network-specific core gene (NCG) identification, potential therapeutic drug repositioning, and candidate drug validation. First, through the analysis of transcriptome data for 178 brain tissues, gene network analysis identified 365 NCGs in 18 coexpression modules that were significantly correlated with ASD. Second, we evaluated two proposed drug repositioning methods. In one novel approach (dtGSEA), we used the NCGs to probe drug-gene interaction data and identified 35 candidate drugs. In another approach, we compared NCG expression patterns with drug-induced transcriptome data from the Connectivity Map database and found 46 candidate drugs. Third, we validated the candidate drugs using an in-house mental diseases and compounds knowledge graph (MCKG) that contained 7509 compounds, 505 mental diseases, and 123,890 edges. We found a total of 42 candidate drugs that were associated with mental illness, among which 10 drugs (baclofen, sulpiride, estradiol, entinostat, everolimus, fluvoxamine, curcumin, calcitriol, metronidazole, and zinc) were postulated to be associated with ASD. This study proposes a powerful network-based drug repositioning framework and also provides candidate drugs as well as potential drug targets for the subsequent development of ASD therapeutic drugs.

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15. Hadidi AT. Response to Letter to the Editor re  »Ano-Scrotal Distance (ASD) is it a marker for the severity of chordee?. Journal of pediatric urology. 2021; 17(5): 671.

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16. Hamner T, Shih E, Ichord R, Krivitzky L. Children with perinatal stroke are at increased risk for autism spectrum disorder: Prevalence and co-occurring conditions within a clinically followed sample. The Clinical neuropsychologist. 2021: 1-12.

OBJECTIVE: Children with perinatal stroke are at increased risk for developmental language disorders, learning difficulties, and other mental health conditions. However to date, autism (ASD) prevalence in this group has not been reported. Given that early identification of ASD is essential to promoting optimal outcomes, our goal was to establish prevalence of ASD in children with perinatal stroke. METHOD: A prospectively enrolled, single-center stroke registry maintained at our institution since 2005 was queried for all potentially eligible patients with a history of perinatal stroke. Information regarding stroke features, ASD diagnosis/concern, intellectual disability/global developmental delay, cerebral palsy/hemiparesis, epilepsy, and language disorder were collected via retrospective chart review from electronic health records. RESULTS: 311 children were identified, of which 201 complete records were analyzed. Twenty-three cases were formally diagnosed with ASD (11.4%). First concerns were noted in toddlerhood (Mage = 2.66 years), yet the average age of diagnosis was 6.26 years. Children with ASD were more likely to have earlier diagnoses of intellectual disability/global developmental delay or a mixed receptive-expressive language disorder (ps < .001) but did not differ on CP/hemiplegia or epilepsy diagnoses. Risk for ASD increased with accumulating diagnoses. DISCUSSION: Children with perinatal stroke have an increased prevalence of ASD (11.4%) than in the general population. ASD concerns arise at a similar age as the general population, yet ASD is diagnosed almost two years later than the general population and 3.60 years after first concerns present. Co-occurring neurological conditions are common. Clinicians must be aware of increased prevalence and implement screening as part of routine care for all pediatric patients with perinatal stroke.

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17. Hassrick EM, Shih W, Nuske HJ, Vejnoska SF, Hochheimer S, Linares DE, Ventimiglia J, Carley K, Stahmer AC, Smith T, Mandell D, Kasari C. Disrupted Care Continuity: Testing Associations between Social Networks and Transition Success for Children with Autism. Social sciences. 2021; 10(7).

Children with autism situated in lower income families often receive intensive educational interventions as their primary form of treatment, due to financial barriers for community interventions. However, the continuity of care can be disrupted by school transitions. The quality of social relationships during the transition to a new school among parents, school staff and community providers, called the team-around-the-child (TAC), can potentially buffer a child with autism from the adverse effects caused by care disruptions. Qualities of social relationships, including trust and collaborative problem solving, can be measured using social network analysis. This study investigates if two different types of TAC relationships, defined as (1) the level of trust among team members and (2) the degree of collaborative problem solving among team members, are associated with perceived successful transitions for children with autism from lower income families. Findings suggested that TAC trust is significantly associated with the outcome of transition success for children with autism immediately post-transition.

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18. John S, Jaeggi AV. Oxytocin levels tend to be lower in autistic children: A meta-analysis of 31 studies. Autism : the international journal of research and practice. 2021; 25(8): 2152-61.

Oxytocin is a hormone that mediates interpersonal relationships through enhancing social recognition, social memory, and reducing stress. It is released centrally into the cerebrospinal fluid, as well as peripherally into the blood, where it can easily be measured. Some studies indicate that the oxytocin system with its social implications might be different in people with autism spectrum disorder. With summarizing evidence of 31 studies, this meta-analysis suggests that children with autism spectrum disorder have lower blood oxytocin levels compared to neurotypical individuals. This might not be the case for adults with autism spectrum disorder, where we could not find a difference. Our findings motivate further exploration of the oxytocin system in children with autism spectrum disorder. This could lead to therapeutic options in treating autism spectrum disorder in childhood.

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19. K RB, Duvall SW, Armstrong K, Hall TA. Survey of training experiences and clinical practice in assessment for autism spectrum disorder by neuropsychologists. The Clinical neuropsychologist. 2021: 1-18.

OBJECTIVE: The primary purpose of this study is to better understand current practices in the assessment of autism spectrum disorder (ASD) by neuropsychologists. METHODS: A 21-item survey regarding ASD assessment beliefs and practices was sent via email through neuropsychology listservs. The survey was accessed by 445 licensed psychologists who identified as neuropsychologists. A total of 367 surveys were deemed usable for data analysis. Descriptive statistics were used to characterize the full sample. Exploratory analyses were conducted between groups of interest, including primary population served (pediatric, adult, or lifespan), primary practice setting (medical center vs. private practice) and years in practice (< 5 years, 5 to 14 years, or 15+ years). RESULTS: Respondents were well-distributed across age range, years in practice, primary practice setting, and primary practice location. Almost all respondents (most of whom self-identified as pediatric-focused clinicians) believe that neuropsychologists should be able to competently rule in or out ASD and most received training in ASD assessment. Approximately 40% of respondents endorsed wanting more training in ASD assessment to increase their competence and confidence in making this differential diagnosis. Minimal differences in ASD beliefs and assessment practices were seen across years of practice or primary practice setting. Pediatric and lifespan clinicians had similar experience with ASD assessment practices, and both generally differed from adult clinicians. CONCLUSIONS: Our findings suggest many respondents desire further specialty ASD training for neuropsychologists. Additionally, the large majority of respondents indicated that future neuropsychologists should receive training in ASD assessment during graduate school, internship and/or post-doctoral fellowship.

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20. Lim TSH, Tan MY, Aishworiya R, Kang YQ, Koh MY, Shen L, Chong SC. Correction to: Factors Contributing to Psychological Ill#Effects and Resilience of Caregivers of Children with Developmental Disabilities During a Nation#wide Lockdown During the COVID#19 Pandemic. Journal of autism and developmental disorders. 2021: 1.

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21. Lovell M. Commentary: Autism spectrum disorder and intellectual disability – an evolving landscape of clinical terminology – a commentary on Kehinde et al. (2021). Child and adolescent mental health. 2021; 26(3): 288-9.

Diagnoses and words used are important. Terminology in autism spectrum disorders and intellectual disabilities is constantly changing in either diagnostic systems or everyday language. There are different pressures for terminological change from clinical, academic and societal perspectives. Clinically, the words are aligning in the 2 major diagnostic systems. This poses dilemmas for those with lived experience as well as professionals as to what words to use and when. An agreed set of words to use for diagnoses will improve understanding, respect and ensure needs are met appropriately.

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22. Mattie LJ, Hadley PA. Characterizing the Richness of Maternal Input for Word Learning in Neurogenetic Disorders. Seminars in speech and language. 2021; 42(4): 301-17.

Promoting language abilities, including early word learning, in children with neurogenetic disorders with associated language disorders, such as Down syndrome (DS) and fragile X syndrome (FXS), is a main concern for caregivers and clinicians. For typically developing children, the quality and quantity of maternal language input and maternal gesture use contributes to child word learning, and a similar relation is likely present in DS and FXS. However, few studies have examined the combined effect of maternal language input and maternal gesture use on child word learning. We present a multidimensional approach for coding word-referent transparency in naturally occurring input to children with neurogenetic disorders. We conceptualize high-quality input from a multidimensional perspective, considering features from linguistic, interactive, and conceptual dimensions simultaneously. Using case examples, we highlight how infrequent the moments of word-referent transparency are for three toddlers with DS during play with their mothers. We discuss the implications of this multidimensional framework for children with DS and FXS, including the clinical application of our approach to promote early word learning for these children.

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23. Ros-Castelló V, Latorre A, Álvarez-Linera J, Martinez-Castrillo JC, Bhatia KP, Pareés I. Dystonia in a Female Fragile X Premutation Carrier. Movement disorders clinical practice. 2021; 8(5): 797-9.

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24. Taverna EC, Huedo-Medina TB, Fein DA, Eigsti IM. The interaction of fine motor, gesture, and structural language skills: The case of autism spectrum disorder. Research in autism spectrum disorders. 2021; 86.

Motor skill differences have been consistently reported in individuals with ASD. Associations between motor skill and social communication skills have been reported in both typical development (TD) and autism spectrum disorder (ASD). The current study extends these findings to characterize performance on a fine motor imitation task, probing skills as a predictor of social and communicative functioning, and co-speech gesture use. These research questions were addressed by a secondary analysis of data collected during a previous study characterizing a cohort of individuals who were diagnosed with ASD in early childhood but lost the autism diagnosis (LAD) by the time of adolescence. Fine motor imitation skills were compared between 14 individuals with LAD, 15 individuals with autism spectrum disorder (ASD), and 12 typically developing (TD) individuals. LAD and TD groups had more advanced fine motor imitation skills than the ASD group, and abilities were significantly associated with ASD symptoms and amount of gesture use (though there was a counterintuitive interaction between group and fine motor skill in the LAD and TD groups only, in which lower motor skills predicted more ASD symptoms; this relationship was of a small effect size and is likely driven by the compressed range of fine motor skills in these two groups). Findings suggest that fine motor skills normalize along with social communication skills and restricted and repetitive behaviors and interests in individuals who lose the ASD diagnosis, and that individuals with better fine motor abilities produce more co-speech gesture.

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25. Toscano CVA, Barros L, Lima AB, Nunes T, Carvalho HM, Gaspar JM. Neuroinflammation in autism spectrum disorders: Exercise as a « pharmacological » tool. Neuroscience and biobehavioral reviews. 2021; 129: 63-74.

The worldwide prevalence of ASD is around 1%. Although the pathogenesis of ASD is not entirely understood, it is recognized that a combination of genetic, epigenetics, environmental factors and immune system dysfunction can play an essential role in its development. It has been suggested that autism results from the central nervous system derangements due to low-grade chronic inflammatory reactions associated with the immune system activation. ASD individuals have increased microglial activation, density, and increased proinflammatory cytokines in the several brain regions. Autism has no available pharmacological treatments, however there are pedagogical and psychotherapeutic therapies, and pharmacological treatment, that help to control behavioral symptoms. Recent data indicate that exercise intervention programs may improve cognitive and behavioral symptoms in children with ASD. Exercise can also modify inflammatory profiles that will ameliorate associated metabolic disorders. This review highlights the involvement of neuroinflammation in ASD and the beneficial effects of physical exercise on managing ASD symptoms and associated comorbidities.

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26. Webster PJ, Wang S, Li X. Review: Posed vs. Genuine Facial Emotion Recognition and Expression in Autism and Implications for Intervention. Frontiers in psychology. 2021; 12: 653112.

Different styles of social interaction are one of the core characteristics of autism spectrum disorder (ASD). Social differences among individuals with ASD often include difficulty in discerning the emotions of neurotypical people based on their facial expressions. This review first covers the rich body of literature studying differences in facial emotion recognition (FER) in those with ASD, including behavioral studies and neurological findings. In particular, we highlight subtle emotion recognition and various factors related to inconsistent findings in behavioral studies of FER in ASD. Then, we discuss the dual problem of FER – namely facial emotion expression (FEE) or the production of facial expressions of emotion. Despite being less studied, social interaction involves both the ability to recognize emotions and to produce appropriate facial expressions. How others perceive facial expressions of emotion in those with ASD has remained an under-researched area. Finally, we propose a method for teaching FER [FER teaching hierarchy (FERTH)] based on recent research investigating FER in ASD, considering the use of posed vs. genuine emotions and static vs. dynamic stimuli. We also propose two possible teaching approaches: (1) a standard method of teaching progressively from simple drawings and cartoon characters to more complex audio-visual video clips of genuine human expressions of emotion with context clues or (2) teaching in a field of images that includes posed and genuine emotions to improve generalizability before progressing to more complex audio-visual stimuli. Lastly, we advocate for autism interventionists to use FER stimuli developed primarily for research purposes to facilitate the incorporation of well-controlled stimuli to teach FER and bridge the gap between intervention and research in this area.

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27. Zhang M, Zhou Y, Jiang Y, Lu Z, Xiao X, Ning J, Sun H, Zhang X, Luo H, Can D, Lu J, Xu H, Zhang YW. Profiling of Sexually Dimorphic Genes in Neural Cells to Identify Eif2s3y, Whose Overexpression Causes Autism-Like Behaviors in Male Mice. Frontiers in cell and developmental biology. 2021; 9: 669798.

Many neurological disorders exhibit sex differences and sex-specific therapeutic responses. Unfortunately, significant amounts of studies investigating molecular and cellular mechanisms underlying these neurological disorders use primary cell cultures with undetermined sexes; and this may be a source for contradictory results among different studies and impair the validity of study conclusion. Herein, we comprehensively compared sexual dimorphism of gene expression in primary neurons, astrocytes, and microglia derived from neonatal mouse brains. We found that overall sexually dimorphic gene numbers were relatively low in these primary cells, with microglia possessing the most (264 genes), neurons possessing the medium (69 genes), and astrocytes possessing the least (30 genes). KEGG analysis indicated that sexually dimorphic genes in these three cell types were strongly enriched for the immune system and immune-related diseases. Furthermore, we identified that sexually dimorphic genes shared by these primary cells dominantly located on the Y chromosome, including Ddx3y, Eif2s3y, Kdm5d, and Uty. Finally, we demonstrated that overexpression of Eif2s3y increased synaptic transmission specifically in male neurons and caused autism-like behaviors specifically in male mice. Together, our results demonstrate that the sex of primary cells should be considered when these cells are used for studying the molecular mechanism underlying neurological disorders with sex-biased susceptibility, especially those related to immune dysfunction. Moreover, our findings indicate that dysregulation of sexually dimorphic genes on the Y chromosome may also result in autism and possibly other neurological disorders, providing new insights into the genetic driver of sex differences in neurological disorders.

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28. Zimmermann JT, Meuser S, Hinterwimmer S, Vogeley K. Preserved Perspective Taking in Free Indirect Discourse in Autism Spectrum Disorder. Frontiers in psychology. 2021; 12: 675633.

Perspective taking has been proposed to be impaired in persons with autism spectrum disorder (ASD), especially when implicit processing is required. In narrative texts, language perception and interpretation is fundamentally guided by taking the perspective of a narrator. We studied perspective taking in the linguistic domain of so-called Free Indirect Discourse (FID), during which certain text segments have to be interpreted as the thoughts or utterances of a protagonist without explicitly being marked as thought or speech representations of that protagonist (as in direct or indirect discourse). Crucially, the correct interpretation of text segments as FID depends on the ability to detect which of the protagonists « stands out » against the others and is therefore identifiable as implicit thinker or speaker. This so-called « prominence » status of a protagonist is based on linguistic properties (e.g., grammatical function, referential expression), in other words, the perspective is « hidden » and has to be inferred from the text material. In order to test whether this implicit perspective taking ability that is required for the interpretation of FID is preserved in persons with ASD, we presented short texts with three sentences to adults with and without ASD. In the last sentence, the perspective was switched either to the more or the less prominent of two protagonists. Participants were asked to rate the texts regarding their naturalness. Both diagnostic groups rated sentences with FID anchored to the less prominent protagonist as less natural than sentences with FID anchored to the more prominent protagonist. Our results that the high-level perspective taking ability in written language that is required for the interpretation of FID is well preserved in persons with ASD supports the conclusion that language skills are highly elaborated in ASD so that even the challenging attribution of utterances to protagonists is possible if they are only implicitly given. We discuss the implications in the context of claims of impaired perspective taking in ASD as well as with regard to the underlying processing of FID.

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