1. Adiani D, Breen M, Migovich M, Wade J, Hunt S, Tauseef M, Khan N, Colopietro K, Lanthier M, Swanson A, Vogus TJ, Sarkar N. Multimodal Job Interview Simulator for Training of Autistic Individuals. Assist Technol;2023 (Mar 31)

Autistic individuals face difficulties in finding and maintaining employment, and studies have shown that the job interview is often a significant barrier to obtaining employment. Prior computer-based job interview training interventions for autistic individuals have been associated with better interview outcomes. These previous interventions, however, do not leverage the use of multimodal data that could give insight into the emotional underpinnings of autistic individuals’ challenges in job interviews. In this article, the authors present the design of a novel multimodal job interview training platform called CIRVR that simulates job interviews through spoken interaction and collects eye gaze, facial expressions, and physiological responses of the participants to understand their stress response and their affective state. Results from a feasibility study with 23 autistic participants who interacted with CIRVR are presented. In addition, qualitative feedback was gathered from stakeholders on visualizations of data on CIRVR’s visualization tool called the Dashboard. The data gathered indicate the potential of CIRVR along with the Dashboard to be used in the creation of individualized job interview training of autistic individuals.

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2. Almasoud H, Ain G. Parental perspectives on autism services in Saudi Arabia: Decade comparison (2011-2021). Res Dev Disabil;2023 (Mar 28);137:104485.

In 2004, Saudi Arabia began providing services to individuals with Autism Spectrum Disorder (ASD) and their families. There are no studies-based on the researchers’ knowledge-that have aimed to measure the improvement of services provided since 2004. Therefore, this study sought to determine the extent to which services for individuals with ASD have improved from the perspective of parents. The level of improvement was determined by comparing the two time periods (2011 and 2021). This is the first study in the country to assess parental perspectives on this topic at two time points. A questionnaire was administered to 118 parents/caregivers of children with ASD. The questions were designed to determine parents’ perceptions of the quality of support received from public services, level of community awareness concerning ASD, and factors influencing the support required to care for their children. The results established that some of the problems faced in 2011 were still present in 2021, and highlighted improvements in 2021.

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3. AM DM, Olson HA, Johnson KT, Nishith S, Frosch IR, Gabrieli JDE. Personal interests amplify engagement of language regions in the brains of children with and without autism. bioRxiv;2023 (Mar 23)

Behavioral investigations have found that personal interests can profoundly influence language-relevant behaviors; however, the influence of personal interest on language processing in the brain is unknown. We measured brain activation via functional magnetic resonance imaging (fMRI) in 20 children while they listened to personalized narratives written about their specific interests, as well as to non-personalized narratives about a neutral topic. Multiple cortical language regions, as well as select cortical and subcortical regions associated with reward and salience, exhibited greater activation for personally-interesting than neutral narratives. There was also more overlap in activation patterns across individuals for their personally-interesting narratives than neutral narratives, despite the personalized narratives being unique to each individual. These results replicated in a group of 15 children with autism, a condition characterized by both specific interests and difficulties with communication, suggesting that personally-interesting narratives may impact neural language processing even amidst challenges with language and social communication. These findings reveal that engagement with topics that are personally interesting can significantly affect activation in the neocortical and subcortical regions that subserve language, reward, and salience in the brains of children.

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4. Bösebeck F, Worthmann H, Möller C, Konrad C. The social, psychological, and physical impact of COVID-19 restrictions for institutionalized adults with intellectual and developmental disabilities. J Intellect Disabil;2023 (Mar 31):17446295231168293.

During the COVID-19 pandemic, drastic measures to interrupt SARS-CoV-2 infection chains were implemented. In our study we investigated the consequences of pandemic related restrictions on the social, psychological, and physical well-being of institutionalized adults with intellectual and developmental disabilities. Methods: Online survey among professional caregivers in 71 residential groups, caring for 848 residents. Findings: (i.) A lack of participation concerning infection protection measures of the residents, their relatives, and their caregivers; (ii.) A 20% increase in doctor contacts during the pandemic; (iii.) A considerable deterioration in at least one item of the subdomains mood (49%), everyday skills (51%), social interaction (29%), exercise and coordination skills (12%), behavior (11%) and cognition and communication (7%); (iv.) A deterioration of the overall condition in 41%; Summery: Intensive attempts should be made to find individual and less categorical contra-infectious measures without questioning the basic everyday needs of people with intellectual and developmental disabilities.

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5. Bouzy J, Brunelle J, Cohen D, Condat A. Transidentities and autism spectrum disorder: A systematic review. Psychiatry Res;2023 (Mar 27);323:115176.

Transidentity and autism frequently co-occur. Previous reviews have focused mainly on frequencies. Here, we conducted a systematic review to condense all the studies and themes on this co-occurrence and to offer a global view. We followed the PRISMA method and selected 77 articles (including 59 clinical studies) in April 2022. We found 5 main themes (sex ratio, theories, sexual orientation, clinical and social consequences, and care implications) in addition to frequencies. Many theories have been proposed to explain the co-occurrence. One posits that social difficulties related to autism would lead to less identification with gender norms and less pressure to conform to these norms, allowing for greater gender diversity in people with autism. Given their difficulties with social interactions and communication, the announcement of one’s transidentity to one’s social group is often discredited, increasing the risk of suffering and delayed care. Many reports reaffirm the importance of providing specialised care for transgender people with autism. Autism is not a contraindication for gender-affirming treatment. However, some cognitive specificities can affect the planning of care, and transgender people with autism are at high risk of discrimination and harassment. We conclude that there is a need to raise awareness about gender and autism.

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6. Buac M, Ibarra G, Torres R, Onal S, Gladfelter A, Wang Z. The Urgent Need for Neuroscience Research to Consider Culture when Assessing the Development of Gait in Autistic Children: A Scoping Review. J Integr Neurosci;2023 (Mar 23);22(2):51.

BACKGROUND: Over the last decade, there has been a steady increase in the number of children diagnosed with autism spectrum disorder (ASD) on a global scale, impacting all racial and cultural groups. This increase in the diagnostic rate has prompted investigation into a myriad of factors that may serve as early signs of ASD. One of these factors includes the biomechanics of gait, or the manner of walking. Although ASD is a spectrum, many autistic children experience differences in gross motor function, including gait. It has been documented that gait is also impacted by racial and cultural background. Given that ASD is equally prevalent across all cultural backgrounds, it is urgent that studies assessing gait in autistic children consider the impact of cultural factors on children’s development of gait. The purpose of the present scoping review was to assess whether recent empirical research studies focusing on gait in autistic children have taken culture into account. METHODS: To do so, we conducted a scoping review following PRISMA guidelines using a keyword searching with the terms autism, OR autism spectrum disorder, OR ASD, OR autis, AND gait OR walking in the following databases: CINAHL, ERIC (EBSCO), Medline, ProQuest Nursing & Allied Health Source, PsychInfo, PubMed, and Scopus. Articles were considered for review if they met all six of the following inclusionary criteria: (1) included participants with a diagnosis of autism spectrum disorder (ASD), (2) directly measured gait or walking, (3) the article was a primary study, (4) the article was written in English, (5) participants included children up to age 18, and (6) the article was published between 2014 and 2022. RESULTS: A total of 43 articles met eligibility criteria but none of the articles took culture into account in the data analysis process. CONCLUSIONS: There is an urgent need for neuroscience research to consider cultural factors when assessing gait characteristics of autistic children. This would allow for more culturally responsive and equitable assessment and intervention planning for all autistic children.

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7. Carter EW, Lanchak ER, Guest L, McMillan ED, Taylor JL, Rowley H. « More Than a Paycheck »: Parent Perspectives on Meaningful Work for Individuals With Intellectual and Developmental Disabilities. Intellect Dev Disabil;2023 (Apr 1);61(2):145-157.

Increasing employment outcomes for individuals with intellectual and developmental disabilities (IDD) remains an enduring emphasis of research, policy, and practice. Parents are often primary partners in the pursuit of meaningful work for their family members with IDD. This qualitative study examined the views of 55 parents regarding the importance of this pursuit and the features of employment that matter most to them. Participants discussed a range of reasons they valued employment for their family members with IDD, including factors that extended beyond a paycheck. Likewise, they described an array of features that they considered to be important to their family member thriving in the workplace (e.g., inclusivity, match with interests, opportunities for growth). We offer recommendations for promoting integrated employment among families and conceptualizing employment outcomes within future research.

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8. Chao SH, Chen PH. Effects of outsider witness practice on a support group for parents of children with autism spectrum disorder. Int J Qual Stud Health Well-being;2023 (Dec);18(1):2196822.

PURPOSE: Providing effective support to parents of children with autism spectrum disorder (ASD) is an important part of clinical work. This study used outsider witnesses in group counselling for parents of children with ASD and explored the mechanism through which the therapeutic effects occurred. METHOD: Parents of children diagnosed with ASD participated in an eight-session group activity. Two outsider witnesses were introduced into some of the sessions. The participants were interviewed to collect their experiences of and reflections on the outsider-witness practice. Texts were analysed using the categorical content approach. RESULTS: The intervention was effective because the participants shifted their subjective experiences to an objective position, leading them to reflect on their previous limited perspectives, thus resulting in self-redefinition. These therapeutic effects may arise due to physical displacement, experience resonance, and externalization of subjective experiences. The results of this study have important implications for parents and practitioners.

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9. Çıtar Dazıroğlu ME, Sağdıçoğlu Celep AG. Determination of Nutrient Intake and Dietary Antioxidant Capacity in Autism Spectrum Disorder: A Case-Control Study. J Autism Dev Disord;2023 (Mar 30)

The aim of this study was to evaluate the nutrient intake and dietary antioxidant capacity of children and adolescents with ASD. The study included 38 children and adolescents with ASD aged 6-18 years and 38 gender and age-matched peers without ASD. Caregivers of participants who met inclusion criteria completed a questionnaire form, three-day food consumption record and antioxidant nutrient questionnaire. There were 26 (68.4%) boys and 12 (31.6%) girls in both groups and mean age of participants with and without ASD was 10.9 ± 4.03 years versus 11.1 ± 4.09 years, respectively. The average intake of carbohydrates, vitamin D, calcium, sodium and selenium was lower in participants with ASD than in participants without ASD (p < 0.05). In both groups, dietary fiber, vitamin D, potassium, calcium and selenium intake insufficiency were high, and there was a significant difference between the two groups in terms of carbohydrate, omega 3, vitamin D and sodium intake insufficiency. Considering the antioxidant intakes of the participants, the median value of dietary antioxidant capacity from food consumption record of participants with and without ASD was 3.2 (1.9) mmol versus 4.3 (1.9) mmol, respectively, whereas the dietary antioxidant capacity from antioxidant nutrient questionnaire was 3.5 (2.9) mmol versus 4.8 (2.7) mmol, respectively (p < 0.05). It is predicted that providing nutritional counseling and regulation of diet, especially keeping the antioxidant capacity of diets high, may be effective in reducing some of the symptoms of ASD.

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10. Dell’Osso L, Chiarantini I, Bonelli C, Cappellato G, Carpita B. A comprehensive perspective of autistic traits and catatonic symptoms in a patient with Fronto-Temporal Dementia and Bipolar Disorder: a case report. BMC Psychiatry;2023 (Mar 30);23(1):216.

BACKGROUND: Fronto-Temporal Dementia (FTD) is a neurodegenerative disorder featuring frontotemporal lobe atrophy which leads to profound changes in behavior and cognition in the affected subjects. Considering that the onset of this type of dementia is typically characterized by the development of affective symptoms, differential diagnosis between FTD and Bipolar Disorder (BD) is particularly difficult. An important overlapping feature between BD and FTD is the presence of catatonic symptoms: Catatonia is extremely frequent in FTD, and, on the other hand, BD is the psychiatric disease with the highest frequency of association with catatonic states. In this framework, it should be noted that also Autism Spectrum conditions have been reported to show high rates of comorbidity and overlapping features with BD. In addition, subjects with autistic traits were reported to show an increased vulnerability towards the development of mood and anxiety disorders, as well as increase the risk of mood episodes with mixed features, suicidal thoughts and catatonic symptoms. CASE PRESENTATION: We reported the case of a patient with a diagnosis of both BD and FTD who showed catatonic symptoms. OBJECTIVES: The aim of this case report is to evaluate the possible role of autistic traits in the illness trajectory of BD and FTD. CONCLUSION: This case confirms the presence of a continuum between psychiatric and neurological conditions, which should be considered as expressions of a same neurobiological system and further investigated in light of an integrative model.

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11. Dey I, Chakrabarty S, Nandi R, Shekhar R, Singhi S, Nayar S, Ram JR, Mukerji S, Chakrabarti B. Autism community priorities in diverse low-resource settings: A country-wide scoping exercise in India. Autism;2023 (Mar 31):13623613231154067.

It is vital to directly engage with the autism community in order to develop better services and drive the research agenda. While some studies in high-income countries have mapped the priorities of the autism community, there is a severe dearth of such efforts in the global south. Five million autistic individuals are estimated to live in India alone, and there has been little effort to map their priorities. Moreover, studies in high-income countries focused largely on research priorities, and not so much on skills training and interventions. Keeping these needs in mind, we conducted an online survey followed by an in-depth conversation with parents of autistic children and autistic adults drawn from across India. We found that the respondents reported self-help skills to be the most important for training, as they considered it fundamental for every other aspect of life. Speech and language therapy was considered to be the highest intervention priority for this group, highlighting the importance of social communication. Mental health counselling was also considered to be a high priority, but several parents identified it as being more relevant for themselves rather than for their children. Within research, the topmost priority was to understand ways in which the community can better support autistic people. We hope that these findings will help researchers, policymakers and service providers to be able to make well-informed decisions, develop relevant services and shape future research.

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12. Dhinagar NJ, Santhalingam V, Lawrence KE, Laltoo E, Thompson PM. Few-Shot Classification of Autism Spectrum Disorder using Site-Agnostic Meta-Learning and Brain MRI. ArXiv;2023 (Mar 14)

For machine learning applications in medical imaging, the availability of training data is often limited, which hampers the design of radiological classifiers for subtle conditions such as autism spectrum disorder (ASD). Transfer learning is one method to counter this problem of low training data regimes. Here we explore the use of meta-learning for very low data regimes in the context of having prior data from multiple sites – an approach we term site-agnostic meta-learning. Inspired by the effectiveness of meta-learning for optimizing a model across multiple tasks, here we propose a framework to adapt it to learn across multiple sites. We tested our meta-learning model for classifying ASD versus typically developing controls in 2,201 T1-weighted (T1-w) MRI scans collected from 38 imaging sites as part of Autism Brain Imaging Data Exchange (ABIDE) [age: 5.2-64.0 years]. The method was trained to find a good initialization state for our model that can quickly adapt to data from new unseen sites by fine-tuning on the limited data that is available. The proposed method achieved an ROC-AUC=0.857 on 370 scans from 7 unseen sites in ABIDE using a few-shot setting of 2-way 20-shot i.e., 20 training samples per site. Our results outperformed a transfer learning baseline by generalizing across a wider range of sites as well as other related prior work. We also tested our model in a zero-shot setting on an independent test site without any additional fine-tuning. Our experiments show the promise of the proposed site-agnostic meta-learning framework for challenging neuroimaging tasks involving multi-site heterogeneity with limited availability of training data.

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13. Dong HY, Miao CY, Zhang Y, Shan L, Feng JY, Jia FY, Du L. Risk factors for developmental quotients in ASD children: A cross-sectional study. Front Psychol;2023;14:1126622.

OBJECTIVE: To analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD. METHODS: We retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent-child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales-Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD. RESULTS: Vitamin D (β = 0.180, p = 0.002), age (β = -0.283, p = 0.000) and CARS score (β = -0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β =  -0.503, p = 0.000), ADOS-2 severity score (β =  -0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β =  -0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β =  -0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β =  -0.140, p = 0.020), CARS score (β =  -0.342, p = 0.000), ADOS-2 severity score (β = -0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD. CONCLUSION: Vitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.

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14. Farkas K, Pesthy O, Guttengéber A, Weigl AS, Veres A, Szekely A, Komoróczy E, Szuromi B, Janacsek K, Réthelyi JM, Németh D. Altered interpersonal distance regulation in autism spectrum disorder. PLoS One;2023;18(3):e0283761.

Interpersonal distance regulation is an essential element of social communication. Its impairment in autism spectrum disorder (ASD) is widely acknowledged among practitioners, but only a handful of studies reported empirical research in real-life settings, focusing mainly on children. Interpersonal distance in adults with ASD and related autonomic functions received less attention. Here, we measured interpersonal distance along with heart rate variability (HRV) in adults with ASD, and tested the modulatory effects of eye-contact and attribution. Twenty-two adults diagnosed with ASD and 21 matched neurotypical controls participated in our study from October 2019 to February 2020. Our experimental design combined the modified version of the stop distance paradigm with HRV measurement controlling for eye contact between the experimenter and the participant to measure interpersonal distance. Still, we did not detect significant modulatory effect of eye contact and attribution. Our results showed a greater preferred distance in ASD. Moreover, we found lower baseline HRV and reduced HRV reactivity in ASD; however, these autonomic measurements could not predict preferred interpersonal distance. Our study highlights the importance of interpersonal space regulation in ASD: it might be considered that people with ASD need individually variable, presumably greater interpersonal distance. In addition, regardless of the distance they may have reduced autonomic regulatory capacity in social situations. Our results could help shape future experiments with sophisticated designs to grasp the complexity and underlying factors of distance regulation in typical and atypical populations.

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15. Jasmin K, Martin A, Gotts SJ. Atypical connectivity aids conversation in autism. Sci Rep;2023 (Mar 31);13(1):5303.

It is well-established that individuals with autism exhibit atypical functional brain connectivity. However, the role this plays in naturalistic social settings has remained unclear. Atypical patterns may reflect core deficits or may instead compensate for deficits and promote adaptive behavior. Distinguishing these possibilities requires measuring the ‘typicality’ of spontaneous behavior and determining how connectivity relates to it. Thirty-nine male participants (19 autism, 20 typically-developed) engaged in 115 spontaneous conversations with an experimenter during fMRI scanning. A classifier algorithm was trained to distinguish participants by diagnosis based on 81 semantic, affective and linguistic dimensions derived from their use of language. The algorithm’s graded likelihood of a participant’s group membership (autism vs. typically-developed) was used as a measure of task performance and compared with functional connectivity levels. The algorithm accurately classified participants and its scores correlated with clinician-observed autism signs (ADOS-2). In support of a compensatory role, greater functional connectivity between right inferior frontal cortex and left-hemisphere social communication regions correlated with more typical language behavior, but only for the autism group. We conclude that right inferior frontal functional connectivity increases in autism during communication reflect a neural compensation strategy that can be quantified and tested even without an a priori behavioral standard.

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16. Kirby AV, Morgan L, Hilton C. Autism and Mental Health: The Role of Occupational Therapy. Am J Occup Ther;2023 (Mar 1);77(2)

Research has indicated a high prevalence of mental health problems among autistic people, with elevated rates of depression, anxiety, and suicidality. The profession of occupational therapy has its roots in mental health and can offer a unique focus on occupation to support the mental health needs of autistic clients. In this Guest Editorial we introduce articles for this special issue of the American Journal of Occupational Therapy related to autism and mental health and use the Person-Environment-Occupation Model. The articles offer insights into how interactions among person, environment, and occupation factors affect the mental health of autistic populations and demonstrate ways that mental health can be supported through occupational engagement. Opportunities to support the mental health of autistic people include promoting engagement in meaningful activities, supporting individual strengths, and bolstering clients’ sense of self and identification with their autistic identity. Future research is needed to uncover and test interventions to support autistic clients and should reflect cultural humility and participatory approaches. We chose to use identity-first language (rather than person-first language) to describe the autistic community in this Guest Editorial out of respect for common community member preferences and in accordance with recommendations for anti-ableist language use (Bottema-Beutel et al., 2021). Decisions about language for each article in this special issue were made by the respective authors.

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17. Kitamura S, Matsuoka K, Takahashi M, Hiroaki Y, Ishida R, Kishimoto N, Yasuno F, Yasuda Y, Hashimoto R, Miyasaka T, Kichikawa K, Kishimoto T, Makinodan M. Association of adverse childhood experience-related increase in neurite density with sensory over-responsivity in autism spectrum disorder: A neurite orientation dispersion and density imaging study. J Psychiatr Res;2023 (Mar 23);161:316-323.

Sensory over-responsivity (SOR) causes social and daily distress in individuals with autism spectrum disorder (ASD). Compared to typically developed (TD) individuals, ASD individuals are at higher risk of adverse childhood experiences (ACEs), which induce abnormal neuronal development. However, whether or how ACEs are associated with abnormal neural development and SOR in ASD remains to be determined. Forty-five individuals with ASD and 43 TD individuals underwent T1-weighted and neurite orientation dispersion and density imaging; the axonal and dendritic densities were defined as the neurite density index (NDI). Voxel-based analyses were performed to explore the brain regions associated with SOR. The relationships between severity of ACEs and SOR, and NDI in the brain regions were examined. ASD individuals showed a significantly positive association between SOR severity and NDI in the right superior temporal gyrus (STG), which was not found in TD individuals. Severity of ACEs correlated significantly with that of SOR and NDI in the right STG in ASD; ASD individuals having severe SOR showed significantly higher NDI in the right STG than those with mild SOR and TD individuals. In individuals with ASD, NDI in the right STG, but not ACEs, could predict the severity of SOR, which was not shown in TD subjects. Our findings suggest that severe ACEs are involved in excessive neurite density in the right STG in ASD. ACE-associated excessive neurite density in the right STG is critical for SOR in ASD, which may be a therapeutic target in the future.

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18. Li R, Lightbody AA, Lee CH, Bartholomay KL, Marzelli MJ, Reiss AL. Association of Intrinsic Functional Brain Network and Longitudinal Development of Cognitive-Behavioral Symptoms in Young Girls with Fragile X Syndrome. Biol Psychiatry;2023 (Mar 31)

BACKGROUND: Fragile X syndrome (FXS) is an X chromosome-linked, genetic disorder characterized by increased risk for behavioral, social, and neurocognitive deficits. Due to a more severe phenotype relative to females, research has focused largely on identifying neural abnormalities in all-male or mixed-sex participants with FXS. Therefore, very little is known about the neural alterations that contribute to cognitive-behavioral symptoms in females with FXS. This cross-sectional study aimed to elucidate the large-scale resting-state brain networks associated with the multi-domain cognitive-behavioral phenotype in girls with FXS. METHODS: We recruited 38 girls with full mutation FXS (11.58 ± 3.15 years) and 32 girls without FXS (11.66 ± 2.27 years). Both groups were matched on age, verbal IQ, and multi-domain cognitive-behavioral symptoms. Resting-state functional magnetic resonance imaging data were collected. RESULTS: Compared to the control group, girls with FXS showed significantly greater resting-state functional connectivity of the default mode network (DMN), lower nodal strength at the right middle temporal gyrus, stronger nodal strength at the left caudate, and higher global efficiency of DMN. These aberrant brain network characteristics map directly onto the cognitive-behavioral symptoms commonly observed in girls with FXS. An exploratory analysis suggested that brain network patterns at a prior time point (Time 1) were predictive of the longitudinal development of participants’ multi-domain cognitive-behavioral symptoms. CONCLUSIONS: These findings represent the first examination of large-scale brain network alterations in a large sample of girls with FXS, expanding our knowledge of potential neural mechanisms underlying the development of cognitive-behavioral symptoms in girls with FXS.

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19. Loftus T, Mathersul DC, Ooi M, Yau SH. The efficacy of mindfulness-based therapy for anxiety, social skills, and aggressive behaviors in children and young people with Autism Spectrum Disorder: A systematic review. Front Psychiatry;2023;14:1079471.

INTRODUCTION: The purpose of this systematic review was to examine the efficacy of mindfulness-based interventions for improving anxiety, social skills, and aggressive behaviors in children and young people (CYP) with Autism Spectrum Disorder (ASD); summarize the results across clinic, home, and school contexts; and evaluate the quality of these interventions for clinical practice. METHODS: A search of the PsycINFO, Medline (Ovid), Web of Science, and Scopus databases was conducted in June 2021, and no date restrictions were applied. Inclusion criteria were quantitative or qualitative research implementing a mindfulness-based intervention for CYP aged 6-25 years with a diagnosis of ASD, Pervasive Development Disorder, or Asperger’s Syndrome. RESULTS: We identified 23 articles for inclusion including within subject pre- and post-testing, multiple baselines, and randomized control trials, among other research designs. Of these, a quality analysis conducted using an ASD research-specific risk of bias tool found over half (14) were of weak methodological quality, whereas only four and five were found to be of strong and adequate quality, respectively. DISCUSSION: While the results of this systematic review suggest promising evidence for the use of mindfulness-based interventions to improve anxiety, social skills, and aggressive behaviors in CYP with ASD, results should be interpreted with caution due to the limitations resulting from the overall weak quality of the studies.The review protocol was pre-registered on PROSPERO (CRD42021259125) and can be viewed at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259125.

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20. López B, Gregory NJ, Freeth M. Social attention patterns of autistic and non-autistic adults when viewing real versus reel people. Autism;2023 (Mar 30):13623613231162156.

Early research shows that autistic adults do not attend to faces as much as non-autistic adults. However, some recent studies where autistic people are placed in scenarios with real people reveal that they attend to faces as much as non-autistic people. This study compares attention to faces in two situations. In one, autistic and non-autistic adults watched a pre-recorded video. In the other, they watched what they thought were two people in a room in the same building, via a life webcam, when in fact exactly the same video in two situations. We report the results of 32 autistic adults and 33 non-autistic adults. The results showed that autistic adults do not differ in any way from non-autistic adults when they watched what they believed was people interacting in real time. However, when they thought they were watching a video, non-autistic participants showed higher levels of attention to faces than non-autistic participants. We conclude that attention to social stimuli is the result of a combination of two processes. One innate, which seems to be different in autism, and one that is influenced by social norms, which works in the same way in autistic adults without learning disabilities. The results suggest that social attention is not as different in autism as first thought. Specifically, the study contributes to dispel long-standing deficit models regarding social attention in autism as it points to subtle differences in the use of social norms rather than impairments.

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21. Mayes SD, Calhoun SL, Waschbusch DA. Agreement between mother, father, and teacher ratings of cognitive disengagement syndrome (sluggish cognitive tempo) in children with autism and children with ADHD. Psychol Assess;2023 (Mar 30)

No studies have analyzed differences between mother, father, and teacher ratings of cognitive disengagement syndrome (CDS; formerly sluggish cognitive tempo). The sample included 1,115 children with autism and/or attention-deficit/hyperactivity disorder (ADHD) 4-16 years of age who were rated by mothers on the Pediatric Behavior Scale. Subsets of these children were also rated by fathers and/or teachers, resulting in 896 mother/father, 964 mother/teacher, and 745 father/teacher dyads. The CDS factor comprised four items assessing the core features of CDS: cognitive disengagement (in a fog/confused and stares/preoccupied/in own world) and hypoactivity (sluggish/slow moving/low energy and drowsy/sleepy/not alert). Overall, 37% of teachers, 22% of mothers, and 16% of fathers rated the children as significantly elevated on CDS symptoms. Teacher scores were significantly higher than mother scores, whose scores exceeded those of fathers. Agreement on whether a child had CDS was fair-moderate for mothers and fathers but poor for parents and teachers. Findings of more severe CDS teacher than parent ratings are in marked contrast to the opposite pattern found in studies of anxiety, depression, ADHD, oppositional behavior, conduct problems, autism, bullying, and victimization. Children may display fewer behavior problems at school than at home, and parents may be more aware of their child’s internal state than teachers. However, teachers may be more aware of the cognitive component of CDS that might interfere with functioning in the classroom more so than at home. Cognitive demands in school may reveal and intensify CDS symptoms. Findings highlight the importance of multi-informant ratings in research and clinical practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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22. McCanlies EC, Gu JK, Kashon M, Yucesoy B, Ma CC, Sanderson WT, Kim K, Ludeña-Rodriguez YJ, Hertz-Picciotto I. Parental occupational exposure to solvents and autism spectrum disorder: An exploratory look at gene-environment interactions. Environ Res;2023 (Mar 31):115769.

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23. Mercaldo V, Vidimova B, Gastaldo D, Fernández E, Lo AC, Cencelli G, Pedini G, De Rubeis S, Longo F, Klann E, Smit AB, Grant SGN, Achsel T, Bagni C. Altered striatal actin dynamics drives behavioral inflexibility in a mouse model of fragile X syndrome. Neuron;2023 (Mar 28)

The proteome of glutamatergic synapses is diverse across the mammalian brain and involved in neurodevelopmental disorders (NDDs). Among those is fragile X syndrome (FXS), an NDD caused by the absence of the functional RNA-binding protein FMRP. Here, we demonstrate how the brain region-specific composition of postsynaptic density (PSD) contributes to FXS. In the striatum, the FXS mouse model shows an altered association of the PSD with the actin cytoskeleton, reflecting immature dendritic spine morphology and reduced synaptic actin dynamics. Enhancing actin turnover with constitutively active RAC1 ameliorates these deficits. At the behavioral level, the FXS model displays striatal-driven inflexibility, a typical feature of FXS individuals, which is rescued by exogenous RAC1. Striatal ablation of Fmr1 is sufficient to recapitulate behavioral impairments observed in the FXS model. These results indicate that dysregulation of synaptic actin dynamics in the striatum, a region largely unexplored in FXS, contributes to the manifestation of FXS behavioral phenotypes.

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24. Miner S, McVoy M, Damato E. Evaluation of the Relationship of Sleep Disturbances to Severity and Common Behaviors in Autism Spectrum Disorder. Res Sq;2023 (Mar 23)

Background : Autism spectrum disorder (ASD) is one of the most puzzling disorders of childhood. Recent research of comorbidities that accompany ASD and are commonly attributed to the diagnosis, indicate that they may contribute to the severity of behavioral symptoms of the disorder. Disturbed sleep in all children can decrease cognition, decrease focus, increase performance problems, and alter mood and behavior. Children with ASD experience an increased sensitivity to disturbed sleep that may increase the severity of the disorder. Disturbed sleep patterns, such as increased sleep latency, nighttime waking and early arousal, have been identified in up to 80% of children with ASD. This study explored the relationship of disturbed sleep and the severity of the core ASD symptoms. Methods : Actigraphy and an accompanying sleep diary captured disturbed sleep patterns in 24 children, ages 6-12, with ASD. Participants wore a GT3X actigraphy monitor for 7 nights to collect data on patterns of disturbed sleep. Parents completed a sleep diary and the Autism Spectrum Rating Scale (ASRS) questionnaire. A descriptive analysis was used to report the characteristics of nighttime sleep and sleep efficiency as well as sleep disturbances. Pearson’s r determined the relationships between the number of sleep disturbances and the severity of ASD behavioral scores and diagnostic severity (determined by the ASRS). Results : Of the 24 study participants, almost 92% had one or more sleep disturbances. A positive correlation was present between the number of sleep disturbances and the severity of delays in social and communication symptoms. A moderate effect size was found between the number of sleep disturbances and unusual behaviors in ASD suggests a possible, unanticipated, inverse relationship. Conclusions : Exploring the relationship of disturbed sleep to behavior and symptom severity in children with ASD can provide an understanding of how poor sleep influences ASD symptoms. This study identified distinct differences in ASD symptom severity between and within individual participants and found unique, and unexpected, symptom patterns. This finding supports the need, in research and treatment, to identify comorbidities and symptoms that contribute to individual behavioral profiles and phenotypes of the disorder.

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25. Neul JL, Benke TA, Marsh ED, Suter B, Silveira L, Fu C, Peters SU, Percy AK, Group R. Top Caregiver Concerns in Rett syndrome and related disorders: data from the US Natural History Study. Res Sq;2023 (Mar 20)

Objective: Recent advances in the understanding of neurodevelopmental disorders such as Rett syndrome (RTT) has enabled development of novel therapeutic approaches that are currently undergoing clinical evaluation or are proposed to move into clinical development. Clinical trial success depends on outcome measures that assess clinical features that are most impactful for affected individuals. To determine the top concerns in RTT and RTT-related disorders we asked caregivers to list the top clinical concerns in order to gain information to guide the development and selection of outcome measures for future clinical trials. Methods: Caregivers of participants enrolled in the US Natural History Study of RTT and related disorders were asked to identify the top 3 concerning problems impacting the affected participant. We generated a weighted list of top caregiver concerns for each of the diagnostic categories and compared results between the disorders. Further, for Classic RTT, caregiver concerns were analyzed by age, clinical severity, and common RTT-causing mutations in MECP2 . Results: The top caregiver concerns for Classic RTT were effective communication, seizures, walking/balance issues, lack of hand use, and constipation. The rank order of the frequency of the top caregiver concerns for Classic RTT varied by age, clinical severity, and specific mutations, consistent with known variation in the frequency of clinical features across these domains. The frequency of caregiver concern for seizures, hand use, and spoken language increased in relation to clinician assessed severity in these clinical domains, showing consistency between clinician assessments and caregiver concerns. Comparison across disorders found commonalities in the top caregiver concerns between Classic RTT, Atypical RTT, MECP2 Duplication Syndrome, CDKL5 Deficiency Disorder, and FOXG1 Syndrome; however, distinct differences in caregiver concerns between these disorders are consistent with the relative prevalence and impact of specific clinical features. Conclusion: The top caregiver concerns for individuals with RTT and the RTT-related disorders reflect the impact of the primary clinical symptoms of these disorders. This work is critical in the development of meaningful therapies, as optimal therapy should address these concerns. Further, outcome measures to be utilized in clinical trials should assess these clinical issues identified as most concerning by caregivers.

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26. Özkan E, Belhan Çelik S, Yaran M, Bumin G. Joint Attention-Based Occupational Therapy Intervention in Preschoolers With Autism Spectrum Disorder: A Randomized Controlled Trial. Am J Occup Ther;2023 (Mar 1);77(2)

IMPORTANCE: A viable occupational therapy program based on joint attention is needed to ensure that children with autism spectrum disorder (ASD) lead lives in which they interact socially. OBJECTIVE: To explore the benefit of a joint attention-based occupational therapy program offered simultaneously with the usual special education program (USEP) compared with USEP alone. DESIGN: Randomized controlled study, including pre-, post-, and follow-up testing. SETTING: Special education and rehabilitation center. PARTICIPANTS: Twenty children with ASD in the study group, M = 4.80 yr (SD = 0.78 yr), and the control group, M = 5.10 yr (SD = 0.73 yr), were included. INTERVENTION: All children received USEP (2 sessions/wk for 12 wk). Joint attention-based occupational therapy was applied to the study group in addition to USEP (3 sessions/wk for 12 wk). OUTCOMES AND MEASURES: The Social Communication Questionnaire (SCQ), Autism Behavior Checklist (ABC), and Motor-Free Visual Perception Test-4 (MVPT-4) were implemented. RESULTS: The study group had a statistically and clinically significant improvement in SCQ, ABC, and MVPT-4 scores after the intervention (p < .001). The control group did not show statistically significant improvement in measurements (p > .05). The mean values of SCQ-Total, ABC-Total, and MVPT-4 variables measured at 3-mo follow-up were significantly different than preintervention (p < .05). CONCLUSIONS AND RELEVANCE: Joint attention-based intervention, including a child-centered approach, can improve social communication, reduce ASD-related behaviors, and improve visual perception. What This Article Adds: This study emphasizes the importance of occupational therapy with a holistic perspective, based on joint attention, in terms of increasing the effectiveness of special education programs attended by children with ASD and reinforcing visual perception, communication, and positive behaviors in children with ASD.

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27. Pan H, Mao Y, Liu P, Li Y, Wei G, Qiao X, Ren Y, Zhao F. Extracting transition features among brain states based on coarse-grained similarity measurement for autism spectrum disorder analysis. Med Phys;2023 (Mar 30)

BACKGROUND: The abnormal brain functional connectivity (FC) of patients with mental diseases is closely linked to the transition features among brain states. However, the current research on state transition will produce certain division deviations in the measurement method of state division, and also ignore the transition features among multiple states that contain more abundant information for analyzing brain diseases. PURPOSE: To investigate the potential of the proposed method based on coarse-grained similarity measurement to solve the problem of state division, and consider the transition features among multiple states to analyze the FC abnormalities of autism spectrum disorder (ASD) patients. METHODS: We used resting-state functional magnetic resonance imaging to examine 45 autism spectrum disorders (ASD) and 47 healthy controls (HC). The FC between brain regions was calculated by the sliding window and correlation algorithm, and a novel coarse-grained similarity measure method was used to cluster the FC networks into five states, and then extract the features both of the state itself and the transition features among multiple states for analysis and diagnosis. RESULTS: (1) The state as divided by the coarse-grained measurement method improves the diagnostic performance of individuals with ASD compared with previous methods. (2) The transition features among multiple states can provide complementary information to the features of the state itself in the ASD analysis and diagnosis. (3) ASD individuals have different brain state transitions than HC. Specifically, the abnormalities in intra- and inter-network connectivity of ASD patients mainly occur in the default mode network, the visual network and the cerebellum. CONCLUSIONS: Such results demonstrate that our approach with new measurements and new features is effective and promising in brain state analysis and ASD diagnosis. This article is protected by copyright. All rights reserved.

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28. Prahl A, Gilson C. Functional Literacy Intervention for Postsecondary Students With Intellectual and Developmental Disabilities: A Pilot Study. Intellect Dev Disabil;2023 (Apr 1);61(2):124-144.

The rapid growth of inclusive higher education opportunities for young adults with intellectual and developmental disabilities (IDD) has contributed to improvements in students’ academics, employment, social, and independent living outcomes. However, many college programs lack a focus on functional literacy, a critical skill for success in adulthood. This study evaluated whether a functional literacy intervention was associated with an increase in the percentage of reading comprehension strategies implemented accurately for college students with IDD. A multiple probe across functional literacy stimuli (e.g., academic assignments, employment emails, social text messages) was replicated across four students. Results indicated an association between the intervention and percentage of strategies implemented accurately. Suggestions for future research and implications for practice are provided.

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29. Prince N, Chu SH, Chen Y, Mendez KM, Hanson E, Green-Snyder L, Brooks E, Korrick S, Lasky-Su JA, Kelly RS. Phenotypically driven subgroups of ASD display distinct metabolomic profiles. Brain Behav Immun;2023 (Mar 31);111:21-29.

Autism Spectrum Disorder (ASD) is a heterogeneous condition that includes a broad range of characteristics and associated comorbidities; however, the biology underlying the variability in phenotypes is not well understood. As ASD impacts approximately 1 in 100 children globally, there is an urgent need to better understand the biological mechanisms that contribute to features of ASD. In this study, we leveraged rich phenotypic and diagnostic information related to ASD in 2001 individuals aged 4 to 17 years from the Simons Simplex Collection to derive phenotypically driven subgroups and investigate their respective metabolomes. We performed hierarchical clustering on 40 phenotypes spanning four ASD clinical domains, resulting in three subgroups with distinct phenotype patterns. Using global plasma metabolomic profiling generated by ultrahigh-performance liquid chromatography mass spectrometry, we characterized the metabolome of individuals in each subgroup to interrogate underlying biology related to the subgroups. Subgroup 1 included children with the least maladaptive behavioral traits (N = 862); global decreases in lipid metabolites and concomitant increases in amino acid and nucleotide pathways were observed for children in this subgroup. Subgroup 2 included children with the highest degree of challenges across all phenotype domains (N = 631), and their metabolome profiles demonstrated aberrant metabolism of membrane lipids and increases in lipid oxidation products. Subgroup 3 included children with maladaptive behaviors and co-occurring conditions that showed the highest IQ scores (N = 508); these individuals had increases in sphingolipid metabolites and fatty acid byproducts. Overall, these findings indicated distinct metabolic patterns within ASD subgroups, which may reflect the biological mechanisms giving rise to specific patterns of ASD characteristics. Our results may have important clinical applications relevant to personalized medicine approaches towards managing ASD symptoms.

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30. Rattaz C, Loubersac J, Michelon C, Picot MC, Baghdadli A. Changes in mothers’ and fathers’ stress level, mental health and coping strategies during the 3 years following ASD diagnosis. Res Dev Disabil;2023 (Mar 31);137:104497.

BACKGROUND: ASD in a child affects parental mental health, with elevated levels of stress, anxiety and depression reported in parents. METHOD: In this study, we examined mothers’ and fathers’ stress, anxiety and depression, as well as their coping strategies in a sample of 103 children and adolescents enrolled in the ELENA cohort study in France at diagnosis and three years after diagnosis. RESULTS: Results showed that mothers had higher levels of stress and anxiety / depression than fathers and used more social support coping strategies at diagnosis, which might be explained by increased levels of parental involvement. Mothers’ stress level significantly decreased during the three years following ASD diagnosis but no such decrease was observed in fathers’ stress level. A significant decrease in anxiety and depression was observed for both parents, suggesting that parental distress is particularly elevated during the critical diagnosis period. Results finally yielded a significant decrease in emotion-focused coping strategy in mothers over the three-year period, an ineffective strategy that takes places at the time of diagnosis but then decreases during the period following ASD diagnosis, in relation to the acceptance process. CONCLUSIONS: Implications in terms of addressing the unmet mental health needs of parents and their coping strategies are discussed.

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31. Rooney J, Hodge R, Smith J, Vanstone K, Laugharne R, Shankar R. Survey of parents of children with intellectual disabilities and/or autism who experience chronic constipation. J Appl Res Intellect Disabil;2023 (Mar 30)

BACKGROUND: Constipation is common in children with intellectual disabilities and/or autism, but poorly researched. This study looks to understand parental knowledge, attitudes and management practices towards constipation in children with intellectual disabilities and/or autism. METHODS: A cross-sectional online survey developed with patient facing organisations was circulated to parents of children with intellectual disabilities and/or autism using an exponential and non-discriminatory snowballing method for recruitment. A smaller sample were purposively sampled for their in-depth experiences. RESULTS: Of 68 responses, people were open to discussing constipation and knowledgeable about risk factors. In the qualitative interviews, of 15 parents, they wanted to be treated as an expert in their child’s care. They desired a service that was more responsive when in difficulty. While wanting more information about medication options, parents want a more holistic approach. CONCLUSIONS: Services need more emphasis on holistic management. Listening to parents and treating them as experts is important.

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32. Schlosser RW, Koul R. Advances in augmentative and alternative communication research for individuals with Autism spectrum disorder: moving research and practice forward. Augment Altern Commun;2023 (Mar 30):1-5.

Augmentative and alternative communication (AAC) approaches offer expressive and receptive supports for the segment of the population of individuals with autism spectrum disorder (ASD) who have little or no functional speech. The National Center for Autism Evidence and Practice (NCAEP) declared augmentative and alternative communication (AAC) interventions for individuals with autism an « evidence-based practice. » Following a brief analysis of the breakdown of studies included in NCAEP by dependent variable, we introduce each of the four papers published as part of this special issue on Advances in Augmentative and Alternative Communication Research for Individuals with Autism Spectrum Disorder. In addition to elucidating the contributions and advances of each paper to the research base, including the NCAEP report, we provide a critical commentary as applicable in the hopes of stimulating and guiding further research.

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33. Schmitt LM, Smith EG, Pedapati EV, Horn PS, Will M, Lamy M, Barber L, Trebley J, Meyer K, Heiman M, West KHJ, Hughes P, Ahuja S, Erickson CA. Results of a phase Ib study of SB-121, an investigational probiotic formulation, a randomized controlled trial in participants with autism spectrum disorder. Sci Rep;2023 (Mar 30);13(1):5192.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by core impairments in social communication as well as restricted, repetitive patterns of behavior and/or interests. Individuals with ASD, which includes about 2% of the US population, have challenges with activities of daily living and suffer from comorbid medical and mental health concerns. There are no drugs indicated for the core impairments of ASD. As such, there is a significant need for the development of new medication strategies for individuals with ASD. This first-in-human placebo-controlled, double-blind, crossover study investigated the safety (primary objective) and efficacy of oral SB-121, a combination of L. reuteri, Sephadex® (dextran microparticles), and maltose administered once daily for 28 days in 15 autistic participants. SB-121 was safe and well tolerated. SB-121-associated directional improvements in adaptive behavior measured by Vineland-3 and social preference as measured with eye tracking were noted. These results provide support for further clinical evaluation of SB-121 as a treatment in autistic patients. To evaluate the safety and tolerability of multiple doses of SB-121 in subjects with autism spectrum disorder. Single-center, randomized, placebo-controlled, double-blind, crossover trial. 15 patients with autism spectrum disorder were randomized and analyzed. Daily dosing of SB-121 or placebo for 28 days, followed by approximately a 14 day washout, then 28 days of dosing with other treatment. Incidence and severity of adverse events, presence of Limosilactobacillus reuteri and Sephadex® in stool, and incidence of bacteremia with positive L. reuteri identification. Additional outcomes include changes from baseline on cognitive and behavior tests as well as biomarker levels. Adverse event rates were similar between SB-121 and placebo, with most reported as mild. There were no severe or serious adverse events. No participants had features of suspected bacteremia or notable changes in vital signs, safety laboratory, or ECG parameters from baseline. There was a statistically significant increase from baseline in the Vineland-3 Adaptive Behavior Composite score (p = 0.03) during SB-121 treatment. There was a trend for increased social/geometric viewing ratio following SB-121 treatment compared to placebo. SB-121 was safe and well tolerated. SB-121-associated directional improvements in adaptive behavior measured by Vineland-3 and social preference as measured with eye tracking were noted.Trial registration: clinicaltrials.gov Identifier: NCT04944901.

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34. Uscătescu LC, Kronbichler M, Said-Yürekli S, Kronbichler L, Calhoun V, Corbera S, Bell M, Pelphrey K, Pearlson G, Assaf M. Intrinsic neural timescales in autism spectrum disorder and schizophrenia. A replication and direct comparison study. Schizophrenia (Heidelb);2023 (Mar 30);9(1):18.

Intrinsic neural timescales (INT) reflect the duration for which brain areas store information. A posterior-anterior hierarchy of increasingly longer INT has been revealed in both typically developed individuals (TD), as well as persons diagnosed with autism spectrum disorder (ASD) and schizophrenia (SZ), though INT are, overall, shorter in both patient groups. In the present study, we aimed to replicate previously reported group differences by comparing INT of TD to ASD and SZ. We partially replicated the previously reported result, showing reduced INT in the left lateral occipital gyrus and the right post-central gyrus in SZ compared to TD. We also directly compared the INT of the two patient groups and found that these same two areas show significantly reduced INT in SZ compared to ASD. Previously reported correlations between INT and symptom severity were not replicated in the current project. Our findings serve to circumscribe the brain areas that can potentially play a determinant role in observed sensory peculiarities in ASD and SZ.

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35. Wagner L, Banchik M, Okada NJ, McDonald N, Jeste SS, Bookheimer SY, Green SA, Dapretto M. Associations between thalamocortical functional connectivity and sensory over-responsivity in infants at high likelihood for ASD. Cereb Cortex;2023 (Mar 31)

Despite growing evidence implicating thalamic functional connectivity atypicalities in autism spectrum disorder (ASD), it remains unclear how such alterations emerge early in human development. Because the thalamus plays a critical role in sensory processing and neocortical organization early in life, its connectivity with other cortical regions could be key for studying the early onset of core ASD symptoms. Here, we investigated emerging thalamocortical functional connectivity in infants at high (HL) and typical (TL) familial likelihood for ASD in early and late infancy. We report significant thalamo-limbic hyperconnectivity in 1.5-month-old HL infants, and thalamo-cortical hypoconnectivity in prefrontal and motor regions in 9-month-old HL infants. Importantly, early sensory over-responsivity (SOR) symptoms in HL infants predicted a direct trade-off in thalamic connectivity whereby stronger thalamic connectivity with primary sensory regions and basal ganglia was inversely related to connectivity with higher order cortices. This trade-off suggests that ASD may be characterized by early differences in thalamic gating. The patterns reported here could directly underlie atypical sensory processing and attention to social vs. nonsocial stimuli observed in ASD. These findings lend support to a theoretical framework of ASD whereby early disruptions in sensorimotor processing and attentional biases early in life may cascade into core ASD symptomatology.

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36. Wang H, Zhu Z, Liu Z, Yuan Y, Xu X, Liu L, Wen J, Xia X, Zhang Y, He J. Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin. Front Pediatr;2023;11:1138717.

BACKGROUND: Acute thrombus in atrial septal defect occluders is a rare complication that requires aggressive, effective, and safe management. Tirofiban, a platelet glycoprotein IIb/IIIa receptor antagonist, is widely used for the management of thromboembolic diseases, such as coronary heart disease and stroke. To date, there is no report using the GPIIb/IIIa receptor antagonist tirofiban for the management of ASD closure-related thrombosis in children. CASE PRESENTATION: Herein, we reported a case of a 5-year-old girl with ASD who presented with acute thrombus on the left disc of the occluder device immediately after transcatheter closure of ASD. The thrombus was successfully dissolved 24 h after a combined infusion of heparin and tirofiban, followed by 1 months of aspirin and clopidogrel and 5 months of aspirin alone. No thromboembolism or hemorrhage events occurred during follow-up for more than 2 years. CONCLUSION: The continuous infusion of GPIIb/IIIa receptor antagonist tirofiban combined with heparin may have beneficial effects for the management of thrombosis during ASD closure procedure.

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37. Wright B, Kingsley E, Cooper C, Biggs K, Bursnall M, Wang HI, Chater T, Coates E, Teare MD, McKendrick K, Gomez de la Cuesta G, Barr A, Solaiman K, Packham A, Marshall D, Varley D, Nekooi R, Parrott S, Ali S, Gilbody S, Le Couteur A. I-SOCIALISE: Results from a cluster randomised controlled trial investigating the social competence and isolation of children with autism taking part in LEGO(®) based therapy (‘Play Brick Therapy’) clubs in school environments. Autism;2023 (Mar 29):13623613231159699.

Autism is characterised by keen interests and differences in social interactions and communication. Activities that help autistic children and young people with social skills are commonly used in UK schools. LEGO(®) based therapy is a new activity that provides interesting and fun social opportunities for children and young people and involves building LEGO(®) models together. This study looked at LEGO(®) based therapy for the social skills of autistic children and young people in schools. It was a randomised controlled trial, meaning each school was randomly chosen (like flipping a coin) to either run LEGO(®) based therapy groups in school over 12 weeks and have usual support from school or other professionals, or only have usual support from school or other professionals. The effect of the LEGO(®) based therapy groups was measured by asking children and young people, their parents/guardians, and a teacher at school in both arms of the study to complete some questionnaires. The main objective was to see if the teacher’s questionnaire answers about the children and young people’s social skills changed between their first and second completions. The social skills of participants in the LEGO(®) based therapy groups were found to have improved in a small way when compared to usual support only. The study also found that LEGO(®) based therapy was not very costly for schools to run and parents/guardians and teachers said they thought it was good for their children and young people. We suggest further research into different potential benefits of LEGO(®) based therapy.

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