1. Azad GF, Marcus SC, Mandell DS. Partners in School: Optimizing Communication between Parents and Teachers of Children with Autism Spectrum Disorder. Journal of educational and psychological consultation : the official journal of the Association for Educational and Psychological Consultants. 2021; 31(4): 438-62.

Partners in School is a consultation model with the goal of enhancing communication between two of the most important stakeholders in children’s lives – parents and teachers. Using a single-group pre-post design, this preliminary study examined the effect of Partners in School on parent-teacher communication outcomes and the factors associated with these outcomes. Participants were 26 teachers and 49 parents of children with autism spectrum disorder (ASD). Parents and teachers completed surveys before and after participating in Partners in School. Teachers reported an increase in their communication to parents. However, parents did not report an increase in their communication to teachers. Teachers’ self-efficacy, expectations, and intervention fidelity were associated with increased communication to parents. Parental self-efficacy and teacher experience were associated with parents’ reports of communication to teachers. Our findings suggest that family-school consultation services may be used to enhance teachers’ communication with parents.

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2. Elhami Athar M, Ebrahimi A, Karimi S, Esmailzadeh R, Mousavi Asl E, Azizi M, Heidarzadeh S, Siahkamari E, Sharifi A, Ramezani Farani A. Comparison of Autistic Traits Between Iranian Students With Different Ethnic Backgrounds: A Cross-Cultural Study. Frontiers in psychiatry. 2021; 12: 744180.

Autistic traits (ATs) include symptoms associated with autism spectrum conditions (ASCs), which are assumed to be continuously distributed across the general population. Studies have indicated the cultural differences in the expression of ATs. Notwithstanding, our literature review indicated that studies on cross-cultural differences in the expression of ATs included samples from different countries. This is the first study designed to compare the expression of ATs between different ethnicities from the same country. Using the Autism-spectrum Quotient (AQ-28), we examined the possible cultural differences in the expression of autistic traits from four groups of students with different ethnic backgrounds, including Turkish (n = 262), Persian (n = 290), Kurdish (n = 300), and Luri (n = 307) students. Behaviors associated with autistic traits were reported overall higher for males than females. Also, significant cultural differences in autistic traits were found that were different for males and females. Furthermore, while the medical sciences student group scored significantly higher than the humanities group in the Imagination dimension, the humanities group had significantly higher scores in Number/Pattern dimensions than the engineering and medical sciences groups. Altogether, our results provide further support for the idea that the expression of ATs is significantly influenced by culture. A significant limitation of the current study was that groups were not matched with respect to age, percentage of male participants, and fields of studies and that these variables may influence the AQ scores.

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3. Fusaroli R, Grossman R, Bilenberg N, Cantio C, Jepsen JRM, Weed E. Toward a cumulative science of vocal markers of autism: A cross-linguistic meta-analysis-based investigation of acoustic markers in American and Danish autistic children. Autism research : official journal of the International Society for Autism Research. 2022; 15(4): 653-64.

Acoustic atypicalities in speech production are argued to be potential markers of clinical features in autism spectrum disorder (ASD). A recent meta-analysis highlighted shortcomings in the field, in particular small sample sizes and study heterogeneity. We showcase a cumulative (i.e., explicitly building on previous studies both conceptually and statistically) yet self-correcting (i.e., critically assessing the impact of cumulative statistical techniques) approach to prosody in ASD to overcome these issues. We relied on the recommendations contained in the meta-analysis to build and analyze a cross-linguistic corpus of multiple speech productions in 77 autistic and 72 neurotypical children and adolescents (>1000 recordings in Danish and US English). We used meta-analytically informed and skeptical priors, with informed priors leading to more generalizable inference. We replicated findings of a minimal cross-linguistically reliable distinctive acoustic profile for ASD (higher pitch and longer pauses) with moderate effect sizes. We identified novel reliable differences between the two groups for normalized amplitude quotient, maxima dispersion quotient, and creakiness. However, the differences were small, and there is likely no one acoustic profile characterizing all autistic individuals. We identified reliable relations of acoustic features with individual differences (age, gender), and clinical features (speech rate and ADOS sub-scores). Besides cumulatively building our understanding of acoustic atypicalities in ASD, the study shows how to use systematic reviews and meta-analyses to guide the design and analysis of follow-up studies. We indicate future directions: larger and more diverse cross-linguistic datasets, focus on heterogeneity, self-critical cumulative approaches, and open science. LAY SUMMARY: Autistic individuals are reported to speak in distinctive ways. Distinctive vocal production can affect social interactions and social development and could represent a noninvasive way to support the assessment of autism spectrum disorder (ASD). We systematically checked whether acoustic atypicalities highlighted in previous articles could be actually found across multiple recordings and two languages. We find a minimal acoustic profile of ASD: higher pitch, longer pauses, increased hoarseness and creakiness of the voice. However, there is much individual variability (by age, sex, language, and clinical characteristics). This suggests that the search for one common « autistic voice » might be naive and more fine-grained approaches are needed.

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4. Godfrey KJ, Espenhahn S, Stokoe M, McMorris C, Murias K, McCrimmon A, Harris AD, Bray S. Autism interest intensity in early childhood associates with executive functioning but not reward sensitivity or anxiety symptoms. Autism : the international journal of research and practice. 2021: 13623613211064372.

Personal interests in autism are a source of joy, pride, and assist with the formation of social relationships. However, highly intense engagement can also interfere with other activities including activities of daily living. Theories have suggested that intense interests relate to executive functioning, reward sensitivity, and anxiety symptoms; but none of these theories have been tested in early childhood. Understanding which behavioral traits relate to intense interests in early childhood could help understand how intense interests may emerge, while also providing clues for how to manage interest intensity and best promote the many benefits of personal interests. We recruited families with autistic and non-autistic children aged 3-6 years. Parents completed questionnaires to assess children’s interest diversity and intensity, executive functioning, reward sensitivity, and anxiety symptoms. We found that for autistic and non-autistic children, greater difficulty shifting attention between activities related to more intense interests. In autistic children only, difficulty with inhibitory control of attention also related to more intense interests. However, reward sensitivity and anxiety symptoms did not relate to interest intensity. Based on these observations, assisting young children with developing executive functioning skills could help with mediating the interference of interests in daily life to ultimately promote the many benefits of personal interests.

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5. Kang J, Zhang Z, Wan L, Casanova MF, Sokhadze EM, Li X. Effects of 1Hz repetitive transcranial magnetic stimulation on autism with intellectual disability: A pilot study. Computers in biology and medicine. 2022; 141: 105167.

OBJECTIVE: To explore whether 1 Hz repetitive transcranial magnetic stimulation (rTMS) has positive effects on brain activity and behavior of autistic children with intellectual disability. METHODS: 32 autistic children with intellectual disability (26 boys and 6 girls) were recruited to participate in this feasibility study. The autistic children were divided randomly and equally into an experimental group and a control group. 16 children (three girls and 13 boys; mean ± SD age: 7.8 ± 2.1 years) who received rTMS treatment twice a week were served as the experimental group, while 16 children (three girls and 13 boys; mean ± SD age: 7.2 ± 1.6 years) with sham stimulation were considered as the control group. Recurrence quantification analysis (RQA) was employed to quantify the nonlinear features of electroencephalogram (EEG) signals recorded during the resting state. Three RQA measures, including recursive rate (RR), deterministic (DET) and mean diagonal length (L) were extracted from the EEG signals to characterize the deterministic features of cortical activity. RESULTS: Significant differences in RR and DET were observed between the experimental group and the control group. We also found discernible discrepancies in the Autism Behavior Checklist (ABC) score pre- and post-rTMS for the experimental group. CONCLUSIONS: 1 Hz repetitive transcranial magnetic stimulation (rTMS) could positively influence brain activity and behavior of autistic children with intellectual disability.

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6. Lacroix A, Dutheil F, Logemann A, Cserjesi R, Peyrin C, Biro B, Gomot M, Mermillod M. Flexibility in autism during unpredictable shifts of socio-emotional stimuli: Investigation of group and sex differences. Autism : the international journal of research and practice. 2021: 13623613211062776.

Flexibility difficulties in autism might be particularly common in complex situations, when shifts (i.e. the switch of attentional resources or strategy according to the situation) are unpredictable, implicit (i.e. not guided by explicit rules) and the stimuli are complex. We analyzed the data of 101 autistic and 145 non-autistic adults, without intellectual deficiency, on two flexibility tasks performed online. The first task involved unpredictable and non-explicit shifts of complex socio-emotional stimuli, whereas the second task involved predictable and explicit shifts of character stimuli. Considering the discrepancies between laboratory results and the real-life flexibility-related challenges faced by autistic individuals, we need to determine which factor could be of particular importance in flexibility difficulties. We point out that the switch cost (i.e. the difference between shift and non-shift condition) was larger for autistic than for non-autistic participants on the complex flexibility task with unpredictable and non-explicit shifts of socio-emotional stimuli, whereas this was not the case when shifts were predictable, explicit and involved less complex stimuli. We also highlight sex differences, suggesting that autistic females have better social skills than autistic males and that they also have a specific cognitive profile, which could contribute to social camouflaging. The findings of this work help us understand which factors could influence flexibility difficulties in autism and are important for designing future studies. They also add to the literature on sex differences in autism which underpin better social skills, executive function, and camouflaging in autistic females.

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7. McKowen J, Woodward D, Yule AM, DiSalvo M, Rao V, Greenbaum J, Joshi G, Wilens TE. Characterizing autistic traits in treatment-seeking young adults with substance use disorders. The American journal on addictions. 2022; 31(2): 108-14.

BACKGROUND AND OBJECTIVES: Recent work highlights an increase in the overlap of autism spectrum disorder (ASD) and substance use disorder (SUD). Little is known about the presence of ASD symptoms in SUD-treatment-seeking populations. METHODS: The informant-rated Social Responsiveness Scale-2 (SRS-2) was completed at intake to an outpatient SUD clinic for youth aged 16-26 (N = 69). Comparisons were made between those with elevated SRS-2 scores on demographic, psychiatric, and substance use variables. RESULTS: Parents of sixty-nine patients with SUD completed the SRS-2. Fourteen (20%) (average age 18.7 ± 2.5) had elevated SRS-2 Total T-scores (≥66) and 55 (average age 18.1 ± 2.8) had non-clinical SRS-2 Total T-scores. There were few differences between groups; however, those with elevated SRS-2 Total T-scores were more likely to have a stimulant use disorder (odds ratio [OR] = 7.59, 95% confidence interval [CI] = 0.77, 101.88; p = 0.05) or an opioid use disorder (OR = 5.02, 95% CI = 0.59, 43.27; p = 0.08) than patients with normal SRS-2 Total T-scores as well as alcohol use in the week prior to intake. DISCUSSION AND CONCLUSIONS: A significant proportion of treatment-seeking SUD outpatients suffer from clinically elevated autistic traits. These findings highlight the importance of assessing for autistic traits in SUD treatment settings yet additional research is needed to determine if these findings are specific to the presence of ASD or secondary to sequelae of specific SUD presentations. SCIENTIFIC SIGNIFICANCE: This study is, to our knowledge, the first to have examined the prevalence, morbidity, or clinical characteristics, associated with ASD symptoms in a SUD-specific population.

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8. Shibuya M, Nitta Y, Kimura Y, Kamekura N, Fujisawa T. Utility of a Structured Teaching Approach, Rehearsal, and Training for Patients With Autism Spectrum Disorder to Avoid Physical Restraint During Induction of Anesthesia. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 2022; 37(2): 210-3.

PURPOSE: We aimed to determine whether the use of a structured teaching approach, rehearsing, and training (SRT) for anesthesia induction in patients with autism spectrum disorder (ASD) could reduce the need for physical restraint. DESIGN: Retrospective observational study METHODS: We retrospectively analyzed 63 patients (4 to 40 y old) with ASD who underwent general anesthesia for dental treatment. Patients were divided into SRT (n = 22) and non-SRT (n = 41) groups. In the SRT group, patients were presented with a visual guide based on a structured teaching approach at the pre-anesthetic consultation. The guide comprised photographs of the places, tools, and processes that the patient would experience prior to anesthesia induction. Patients then practiced these processes (rehearsal). Patients in the non-SRT group were administered anesthesia in a conventional manner without SRT. FINDINGS: The percentage of patients needing physical restraint was significantly lower in the SRT (3/22, 13%) than in the non-SRT group (21/41, 51%, P < .001). CONCLUSIONS: The SRT method reduces the need for physical restraint in patients with ASD during anesthesia induction.

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9. Wang Q, Lu H, Feng S, Song C, Hu Y, Yi L. Investigating intra-individual variability of face scanning in autistic children. Autism : the international journal of research and practice. 2021: 13623613211064373.

Atypical face scanning is suggested to be related to social interactions and communicative deficits in autistic children. We systematically examined whether autistic and non-autistic children used consistent scanning patterns when performing different tasks and scanning different types of faces. We found that autistic children scanned faces more variably than non-autistic children: While non-autistic children used more consistent scanning patterns, autistic children’s scanning patterns changed frequently when watching different faces. Autistic children’s variable face scanning patterns might delay and impair face processing, resulting in a social interaction deficit. What’s more, variable scanning patterns may create an unstable and unpredictable perception of the environment for autistic children. Developing in such an unstable environment might motivate autistic children to retract from the environment, avoid social interaction, and focus instead on the performance of repetitive behavior. Therefore, studying face scanning variability might represent a new avenue for understanding core symptoms in autistic people.

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