1. Açıkel SB, Kara A, Bağcı Z, Can Ü. Serum trimethylamine N-oxide and lipopolysaccharide binding protein levels among children diagnosed with autism spectrum disorder. Int J Dev Neurosci;2023 (Jul 31)

In the literature, there have been several studies available investigating the relationship between autism spectrum disorder and intestinal permeability. In this study, it is aimed to examine the relationship between the levels of trimethylamine N-oxide (TMAO), which is a parameter associated with intestinal permeability, and lipopolysaccharide binding protein (LBP), which is a marker associated with bacterial translocation from the intestine, in patients with autism spectrum disorder (ASD) and healthy controls. Fifty-three children with ASD as the patient group and 30 healthy children as the control group have been included in the study. The diagnostic evaluation has been made according to DSM-5 criteria. According to the obtained results, there has been no significant difference between groups in terms of serum TMAO and LBP levels. Considering the existence of various studies that found different results on ASD and intestinal permeability, it is thought that the studies conducted in this field that did not find statistically different results will also make a contribution to the literature.

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2. Adkins JR, Mulé CM, Linder DE, Must A, Cash SB, Folta SC. Exploring health behaviors and the role of pet dogs in households with autistic children: the DANE study. Front Pediatr;2023;11:1153124.

INTRODUCTION: Autism spectrum disorder (ASD) often presents a unique set of risk factors that impact healthy eating and physical activity. Animal-assisted interventions (AAI) are a promising approach for autistic children. There is growing evidence for the positive impact of AAIs on self-regulation, which is necessary for initiating and maintaining behavioral changes. Pet dogs offer several potential advantages as a vehicle for an AAI focused on health behaviors. However, little is known about the experiences of autistic children and their families with respect to dog ownership and the mechanisms through which such an AAI might operate. METHODS: We conducted interviews with ten parent-child dyads to explore the role of pet dogs in the lives and lifestyle habits of families with an autistic child. Interview guides were designed to explore the relationship between the autistic child and the pet dog and the role of the dog in family life; attitudes and practices related to physical activity and nutrition; and thoughts about intervention strategies. We used a directed qualitative content analysis approach for analysis. RESULTS: Themes indicate a strong bond between the child and the dog, the child’s enjoyment in caring for their dog, and successful integration of dogs within family routines. In contrast, minor themes emerged around the challenges that owning a pet dog posed for families with an autistic child. In terms of nutrition and physical activity, a major theme among children was that healthy eating and exercise were important for both them and their dogs. However, minor themes suggest challenges with healthy eating and exercise and room for improvement for these behaviors. Parents held favorable views toward an intervention that would incorporate the family dog to teach children about nutrition and physical activity, although they expressed some concerns about feasibility. DISCUSSION: This exploratory work suggests that AAIs to improve nutrition and physical activity could build on the strong bond that children have with their pet dogs, but should consider the specific needs of each family, including the needs of the pet dog.

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3. Ahadi H, Abbasi H, Fekar Gharamaleki F. Linguistic and metalinguistic characteristics of Persian-speaking children with autistic spectrum disorders: A systematic review. J Public Health Res;2023 (Jul);12(3):22799036231189068.

Studies of ASD children have mainly focused on pragmatics, but research showed they have problems in other language dimensions. The present systematic review aims to analyze the literature related to linguistic and metalinguistic studies to determine linguistic characteristics and their correlation with reading and writing. After reviewing 43 articles founded, the studies were divided into four main categories: descriptive, comparative, linguistic, and finally nonlinguistic interventional studies. 42% of studies are descriptive, 14% were comparative, and 5% were about the effect of linguistic and metalinguistic training on reading and writing. Studies on the effect of other training on linguistic and metalinguistic skills were about 39% of the studies. They have deficiencies in different linguistic and metalinguistic skills, especially grammar. There were no studies investigating the relationship between linguistic and metalinguistic abilities. The relationship between language and reading skills has been neglected and only one study has examined the correlation between phonological awareness and reading skills. Thus, there is a serious gap in metalinguistic studies. However, it is necessary to study these relationships due to the change in the reading education system from a phonological to a lexical path in schools. The effect of nonlinguistic interventions has been studied more than linguistic ones.

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4. Alvarez R, Velthorst E, Pinkham A, Ludwig KA, Alamansa J, Gaigg SB, Penn DL, Harvey PD, Fett AK. Reading the mind in the eyes and cognitive ability in schizophrenia- and autism spectrum disorders. Psychol Med;2023 (Jul 31):1-10.

BACKGROUND: Schizophrenia (SZ) and autism spectrum disorders (ASD) are characterized by difficulties in theory of mind (ToM). We examined group differences in performance on a ToM-related test and associations with an estimated IQ. METHODS: Participants [N = 1227, SZ (n = 563), ASD (n = 159), and controls (n = 505), 32.2% female] completed the Reading the Mind in the Eyes Test (RMET) and assessments of cognitive ability. Associations between IQ and group on RMET were investigated with regression analyses. RESULTS: SZ (d = 0.73, p < 0.001) and ASD (d = 0.37, p < 0.001) performed significantly worse on the RMET than controls. SZ performed significantly worse than ASD (d = 0.32, p = 0.002). Adding IQ to the model, SZ (d = 0.60, p < 0.001) and ASD (d = 0.44, p < 0.001) continued to perform significantly worse than controls, but no longer differed from each other (d = 0.13, p = 0.30). Small significant negative correlations between symptom severity and RMET performance were found in SZ (PANSS positive: r = -0.10, negative: r = -0.11, both p < 0.05). A small non-significant negative correlation was found for Autism Diagnostic Observation Schedule scores and RMET in ASD (r = -0.08, p = 0.34). CONCLUSIONS: SZ and ASD are characterized by impairments in RMET. IQ contributed significantly to RMET performance and accounted for group differences in RMET between SZ and ASD. This suggests that non-social cognitive ability needs to be included in comparative studies of the two disorders.

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5. Bashiri H, Rostamzadeh F, Sabet N, Moslemizadeh A, Rajizadeh MA, Jafari E. Sex-related beneficial effects of exercise on cardiac function and rhythm in autistic rats. Birth Defects Res;2023 (Jul 31)

BACKGROUND: Cardiovascular diseases are prevalent in autistic patients. As exercise is useful in the treatment of medical conditions, this study aimed to identify the effect of low-intensity endurance exercise (LIEE) and moderate-intensity endurance exercise (MIEE) on cardiovascular events in autistic rats. METHODS: Valproic acid (VPA) was administrated once on gestational day 12.5 to pregnant rats to produce autism-like symptoms in offspring. Thirty-day-old offspring were divided into 12 groups: Male-CTL, Male-VPA, Male-CTL + LIEE, Male-CTL + MIEE, Male-VPA + LIEE, Male-VPA + MIEE, Female-CTL, Female-VPA, Female-CTL + LIEE, Female-CTL + MIEE, Female-VPA + LIEE, and Female-VPA + MIEE. LIEE and MIEE were performed 5 days a week for 30 days. Twenty-four hours after the last exercise session, electrocardiogram and hemodynamic and cardiac function indices were recorded. RESULTS: The results indicated that +dp/dt max and contractility index (CI) decreased in the Female-VPA group compared to the Female-CTL group. LIEE increased these parameters in the Female-VPA + LIEE group. However, MIEE normalized CI in the Male-VPA + MIEE compared to the Male-VPA group. Tau increased in the Female-VPA group compared to the Female-CTL group and it decreased in the Female-VPA + MIEE group compared to the Female-VPA group. LIEE and MIEE recovered the reduction of heart rate and the increase in P, R, and T amplitudes in Male-VPA group. LIEE and MIEE increased heart rate variability in the Male-VPA and Female-VPA groups. CONCLUSIONS: The findings showed that LIEE and MIEE alleviated cardiac dysfunction and disturbances in heart rhythm in the autistic offspring. Exercise may be recommended as a routine program for autistic patients to prevent and treat the harmful cardiovascular consequences of autism.

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6. Berry CA, Kwok L, Gofine M, Kaufman M, Williams DA, Terlizzi K, Alvaro M, Neighbors CJ. Utilization and Staff Perspectives on an On-Demand Telemedicine Model for People with Intellectual and Developmental Disabilities Who Reside in Certified Group Residences. Telemed Rep;2023;4(1):204-214.

BACKGROUND: Non-emergent medical problems that arise when a usual provider is unavailable can often result in emergency department or urgent care visits, which can be particularly distressing to people with intellectual and developmental disabilities (PIDD). On-demand, synchronous telemedicine may be a promising supplement when immediate care from usual sources is unavailable. Prior research demonstrated that high-quality telemedicine can be effectively delivered to PIDD. The aim of this article is to describe the utilization and staff perspectives on the implementation of the Telemedicine Triage Project (TTP), an innovative model that provides telemedicine consultations for PIDD who reside in state-certified group residences and present with an urgent but non-emergent medical concern when their usual provider is unavailable. METHODS: Call frequency data for calendar years 2020 and 2021 were reviewed. The study team conducted semi-structured interviews, with 19 key informants representing organizational- and agency-level leadership and staff. The interview data were analyzed using a protocol-driven, rapid qualitative methodology. RESULTS: Telemedicine consultations increased from 7953 in 2020 to 15,011 calls in 2021, and call volume peaked between 10 am and 1 pm. Key informants reported high satisfaction with TTP; universal benefits and a few barriers to implementation; and strong interest in maintaining the program beyond the grant period. DISCUSSION: Over the first 2 years of its implementation, the TTP program was widely utilized and proved extremely feasible and acceptable to staff. This model is a promising and highly feasible way to provide equitable access to telemedicine for PIDD by addressing barriers to and disparities in access to health care that affect PIDD.

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7. Chan JK, Cheung TC, Chan CW, Fang F, Lai KY, Sun X, O’Reilly H, Golan O, Allison C, Baron-Cohen S, Leung PW. Enhancing emotion recognition in young autistic children with or without attention-deficit/hyperactivity disorder in Hong Kong using a Chinese App version of The Transporters. Autism;2023 (Jul 31):13623613231187176.

TRIAL REGISTRATION: This study was registered with the German Clinical Trials Register – Deutschen Register Klinischer Studien (DRKS) on 23 December 2018. The Trial Registration Number (TRN) is DRKS00016506. LAY ABSTRACT: The Transporters App is an intervention programme with 15 animated episodes that teach emotion recognition skills to autistic children between 4 and 6 years of age. Each episode contains a story depicting social interactions between characters in the form of a vehicle, with human faces grafted on to each of them. Each episode teaches a specific emotion in a story context. Autistic children watched at least three episodes at home for about 15 min daily for a month, with parental guidance. Its automated, home-based format is cost-saving and readily accessible. This study translated The Transporters to a Cantonese-Chinese version. Results showed a significant improvement in emotion recognition following viewing The Transporters in a group of Hong Kong Chinese autistic children, between 4 and 6 years of age, with and without attention-deficit/hyperactivity disorder (n = 48) relative to a control group (n = 24). A non-autistic group (n = 23) showed that the autistic children scored lower in emotion recognition pre-intervention. Post-intervention, the autistic children had improved in emotion recognition to the level of the non-autistic children. The autistic children in the intervention groups also generalized their learning to novel situations/characters not taught within The Transporters. There was no dosage effect, with the standard recommended number of episodes viewed being sufficient to achieve significant improvement. This study confirms the effectiveness of The Transporters for Chinese autistic children and contributes to the literature/practice by expanding the range of applicability of The Transporters to autistic children with attention-deficit/hyperactivity disorder, which is important given the high rate of co-occurrence between autism and attention-deficit/hyperactivity disorder.

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8. Chien YL, Tai YM, Chiu YN, Tsai WC, Gau SS. The mediators for the link between autism and real-world executive functions in adolescence and young adulthood. Autism;2023 (Jul 31):13623613231184733.

Childhood factors that predict real-world executive function in autism spectrum disorder during the transition into adulthood are largely unknown. This study aimed to identify the predictors for the behavioral and cognitive aspects of real-world executive function in late adolescent and young adult autistic populations. We followed up 289 autistic youth (mean age 11.6 years) and 203 non-autistic controls (10.7 years) to their ages of 16.9 and 15.8, respectively. The Behavior Rating Inventory of Executive Function scale was used to measure the real-world executive function at late adolescence and young adulthood at follow-up. Potential predictors such as autistic symptoms, inattention or hyperactivity symptoms, peer relationship, emotional symptoms, and parenting styles were assessed in childhood at first enrollment. The results showed that childhood inattention, withdrawn behaviors, social communication difficulties, and child-reported emotion and inattention/hyperactivity may predict real-world lower executive function in late adolescence and young adults with autism. When separating executive function into behavioral and cognitive aspects, we found that oppositional behaviors and peer problems were specific predictors for behavioral regulation and cognitive function, respectively. Our findings suggested that treating common predictors in childhood, such as inattention, may potentially improve real-world executive function in autism during the transition into adulthood.

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9. Davis R, Zaki FBM, Sargent L. Autism and bilingualism: A thematic analysis of practitioner perspectives in the United Kingdom. Int J Lang Commun Disord;2023 (Jul 30)

BACKGROUND: At least 25% of autistic children worldwide have the potential to grow up in a bilingual environment. However, many autistic children are being denied opportunities to access additional languages and the cultural, familial and community connections that come with this. There is little evidence identifying the barriers to language learning and access, and no research addressing the perspectives of speech and language therapists (SLTs), who are crucial in supporting parents to make informed choices about bilingualism with their child. AIMS: The aim of this research was to understand the experiences of SLTs working with autistic bilingual children, to understand the main considerations when working with families, and the opportunities and barriers for training, including the sources of information that current practice is based on. METHODS AND PROCEDURES: Twelve SLTs from across the United Kingdom were recruited for this study. All participants were experienced in working with autistic bilingual children and their families (M = 7 years, range 4-23 years). Semi-structured interviews were conducted and focused on the experiences of SLTs regarding familial bilingual experiences, the effect of sociocultural factors of practice, and the extent to which practice is based on current research. OUTCOMES AND RESULTS: Data were analysed using reflexive thematic analysis. Three central themes were identified from the interviews: (1) participants discussed parental uncertainties as to whether they were doing the right thing for their child, (2) while participants were in support of bilingualism, they were not always confident that they were providing the right advice and found it difficult to in keep up to date with relevant, evidence-based research, and (3) participants highlighted a need to shift towards a more inclusive and culturally diverse practice. CONCLUSIONS AND IMPLICATIONS: This is the first qualitative study to understand the perspectives of SLTs working with autistic bilingual children. We identify several key difficulties in supporting access to language learning, and these findings have immediate and longer-term implications for supporting SLTs, and in turn, the children and families they support. WHAT THIS PAPER ADDS: What is already known on the subject Research suggests that autistic children currently have fewer opportunities to maintain bilingualism compared to neurotypical peers. Despite the lack of evidence, many families remain concerned that bilingualism will have a negative impact on their child’s development. To date, little is known about the perspectives of speech and language therapists (SLTs) who play a significant role in supporting the development of autistic bilingual children. This is the first study to provide an in-depth qualitative analysis of the experiences of SLTs working with autistic bilingual children and their families in the United Kingdom. What this study adds The results highlight a number of reoccurring barriers in providing optimal support: first, frequently cited concerns about bilingualism from parents that link to a lack of understanding about autism and the role of SLTs more generally. Second, SLTs do not have confidence in the assessments and tools available and described a lack of emphasis on cultural factors in practice. Many SLTs were concerned about the limited options for resources and interventions available in other languages, which could be challenging for parents who were less proficient or confident communicating in English. Third, SLTs reported having limited opportunities to keep up to date with relevant research to support their decision-making processes. What are the clinical implications of this work? These results have several important implications for practice-they highlight the need for more inclusive practices where possible, a need for more diversity within the profession and further opportunities to be provided with evidence-based advice around good practice. The results also suggest a benefit of providing accessible, evidence-based resources for parents about autism and bilingualism, to ensure that research key findings are reaching families.

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10. Goez H, Nielsen CC, Bryan S, Clark B, Zwaigenbaum L, Yamamoto SS, Osornio-Vargas AR. Autistic regression and exposure to industrial chemicals – Preliminary Observations. Can J Neurol Sci;2023 (Jul 31):1-8.

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11. Huang C, Voglewede MM, Ozsen EN, Wang H, Zhang H. SHANK3 Mutations Associated with Autism and Schizophrenia Lead to Shared and Distinct Changes in Dendritic Spine Dynamics in the Developing Mouse Brain. Neuroscience;2023 (Jul 31);528:1-11.

Autism Spectrum Disorders (ASD) and schizophrenia are distinct neurodevelopmental disorders that share certain symptoms and genetic components. Both disorders show abnormalities in dendritic spines, which are the main sites of excitatory synaptic inputs. Recent studies have identified the synaptic scaffolding protein Shank3 as a leading candidate gene for both disorders. Mutations in the SHANK3 gene have been linked to both ASD and schizophrenia; however, how patient-derived mutations affect the structural plasticity of dendritic spines during brain development is unknown. Here we use live two photon in vivo imaging to examine dendritic spine structural plasticity in mice with SHANK3 mutations associated with ASD and schizophrenia. We identified shared and distinct phenotypes in dendritic spine morphogenesis and plasticity in the ASD-associated InsG3680 mutant mice and the schizophrenia-associated R1117X mutant mice. No significant changes in dendritic arborization were observed in either mutant, raising the possibility that synaptic dysregulation may be a key contributor to the behavioral defects previously reported in these mice. These findings shed light on how patient-linked mutations in SHANK3 affect dendritic spine dynamics in the developing brain, which provides insight into the synaptic basis for the distinct phenotypes observed in ASD and schizophrenia.

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12. Jia FY, Li TY. Editorial: Etiology and treatment for children and adolescents with autism spectrum disorder. Front Psychiatry;2023;14:1222384.

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13. Karavallil Achuthan S, Stavrinos D, Holm HB, Anteraper SA, Kana RK. Alterations of Functional Connectivity in Autism and Attention-Deficit/Hyperactivity Disorder Revealed by Multi-Voxel Pattern Analysis. Brain Connect;2023 (Aug 22)

Background: Autism and attention-deficit/hyperactivity disorder (ADHD) are comorbid neurodevelopmental disorders that share common and distinct neurobiological mechanisms, with disrupted brain connectivity patterns being a hallmark feature of both conditions. It is challenging to gain a mechanistic understanding of the underlying disorder, because brain connectivity changes in autism and ADHD are heterogeneous. Objectives: The present resting state functional MRI (rs-fMRI) study focuses on investigating the shared and distinct resting state-fMRI connectivity (rsFC) patterns in autistic and ADHD adults using multi-voxel pattern analysis (MVPA). By identifying spatial patterns of fMRI activity across a given time course, MVPA is an innovative and powerful method for generating seed regions of interest (ROIs) without a priori hypotheses. Methods: We performed a data-driven, whole-brain, connectome-wide MVPA on rs-fMRI data collected from 15 autistic, 19 ADHD, and 15 neurotypical (NT) young adults. Results: MVPA identified cerebellar vermis 9, precuneus, and the right cerebellum VI for autistic versus NT, right inferior frontal gyrus and vermis 9 for ADHD versus NT, and right dorsolateral prefrontal cortex for autistic versus ADHD as significant clusters. Post hoc seed-to-voxel analyses using these clusters as seed ROIs were performed for further characterization of group differences. The cerebellum VI, vermis, and precuneus in autistic adults, and the vermis and frontal regions in ADHD showed different connectivity patterns in comparison with NT. Conclusions: The study characterizes the rsFC profile of cerebellum with key cortical areas in autism and ADHD, and it emphasizes the importance of studying the role of the functional connectivity of the cerebellum in neurodevelopmental disorders.

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14. Leighton SC, Rodriguez KE, Nieforth LO, O’Haire ME. Service dogs for autistic children and family system functioning: a constant comparative analysis. Front Psychiatry;2023;14:1210095.

INTRODUCTION: Service dog placements for autistic children are growing in popularity, yet findings to date are mixed. Moreover, no study to date has examined these placements through the lens of a recognized theoretical model. The purpose of this study is twofold: to explore experiences reported by caretakers of autistic children involved in a service dog program, and to contextualize findings within an established theoretical framework. METHODS: A total of n = 50 caretakers of autistic children (n = 38 with and n = 12 without a service dog) were recruited through the national non-profit service dog provider Canine Companions. Participants completed an online survey through Qualtrics which asked open-ended questions about their experiences, both negative and positive. RESULTS: Constant comparative analysis identified two high level themes, nested within a family systems approach framework: (1) Enhancing social functioning of the family system unit and (2) Fostering stability and strength within family system subunits. These themes interacted holistically to foster and reinforce family system resilience. Placements led to greater social inclusion for children and their families, acted as a highly individualized intervention, and decreased experiences of judgement and stigma. Perceived as members of the family, service dogs may coregulate with the autistic child and family members and can be a source of joyful connection within the family. DISCUSSION: Results highlighted the service dog’s influence on the entire family (beyond the autistic child). Implications for service dog organizations suggest it may be helpful to account for family-wide impacts throughout the placement process. High standards on the part of provider organizations may minimize negatives, optimizing outcomes for both humans and canines. Ultimately, findings enrich our understanding of service dog interventions for autistic children.

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15. Li X, Li J, Zhao S, Liao Y, Zhu L, Mou Y. Magnitude representation of preschool children with autism spectrum condition. Autism;2023 (Jul 31):13623613231185408.

The mathematical abilities of children with autism spectrum condition have been understudied. Magnitude representation (e.g. presenting the number of a collection of objects) is a fundamental numerical ability presented since early infancy and is correlated with children’s later learning of formal mathematics. It remains unclear about whether children with autism spectrum condition differ from their peers without autism spectrum condition in precision of magnitude representations. This study compared preschool children with and without autism spectrum condition in their precision of magnitude representation with an approximate number comparison task, in which children compared two sets of dots without counting and chose the set with more dots. Children with autism spectrum condition exhibited the lower numerical comparison accuracy (i.e. the weaker magnitude representation) than their peers without autism spectrum condition. This difference existed even when multiple general cognitive abilities (working memory, inhibitory control, and nonverbal intelligence) and language abilities were statistically controlled. Moreover, the individual difference of the numerical comparison accuracy was larger in children with autism spectrum condition than without autism spectrum condition. These findings suggest that children with autism spectrum condition are at risk of weaker magnitude representation from an early age, emphasizing the need for specialized mathematics education or interventions to support their learning. In addition, the large variance in the precision of their magnitude representation suggests that individualized mathematics interventions are needed for children with autism spectrum condition.

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16. Lubala TK, Kayembe-Kitenge T, Mubungu G, Lumaka A, Kanteng G, Savage S, Luboya O, Hagerman R, Devriendt K, Lukusa-Tshilobo P. Usefulness of automated image analysis for recognition of the fragile X syndrome gestalt in Congolese subjects. Eur J Med Genet;2023 (Jul 31);66(9):104819.

BACKGROUND: Computer-aided software such as the facial image diagnostic aid (FIDA) and Face2Gene has been developed to perform pattern recognition of facial features with promising clinical results. The aim of this pilot study was to test Face2Gene’s recognition performance on Bantu Congolese subjects with Fragile X syndrome (FXS) as compared to Congolese subjects with intellectual disability but without FXS (non-FXS). METHOD: Frontal facial photograph from 156 participants (14 patients with FXS and 142 controls) predominantly young-adults to adults, median age 18.9 age range 4-39yo, were uploaded. Automated face analysis was conducted by using the technology used in proprietary software tools called Face2Gene CLINIC and Face2Gene RESEARCH (version 17.6.2). To estimate the statistical power of the Face2Gene technology in distinguishing affected individuals from controls, a cross validation scheme was used. RESULTS: The similarity seen in the upper facial region (of males and females) is greater than the similarity seen in other parts of the face. Binary comparison of subjects with FXS versus non-FXS and subjects with FXS versus subjects with Down syndrome reveal an area under the curve values of 0.955 (p = 0.002) and 0.986 (p = 0.003). CONCLUSION: The Face2Gene algorithm is separating well between FXS and Non-FXS subjects.

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17. Lupi E, Tucci F, Casula L, Novello RL, Guerrera S, Vicari S, Valeri G. Early and stable difficulties of everyday executive functions predict autism symptoms and emotional/behavioral problems in preschool age children with autism: a 2-year longitudinal study. Front Psychol;2023;14:1092164.

INTRODUCTION: Longitudinal studies of autistic children show that autism symptoms and emotional/behavioral problems vary and change over time. However, the factors that affect this variability remain far from certain and very little is known about what take place in the preschool period and the role of executive functions (EF). METHODS: Here, we test the influence of stable difficulties in everyday executive functioning (EEF) during early childhood across 2 years on autistic symptoms and emotional and behavioral problems. Twenty-nine autistic children (24 males and 5 females) were assessed twice within the space of 2 years. At baseline (M = 29 months, SD =5.6 months), participants were assessed for EEF, cognitive development, autistic symptoms, and emotional/behavioral problems. At follow-up, we repeated the same assessment except for cognitive development. RESULTS: The group with stable difficulties (across 2 years) in EEF during early childhood showed a worsening in the severity of autistic symptoms and emotional and behavioral problems compared with children without EEF difficulties (p < 0.05), and these effects cannot be attributable to cognitive development. DISCUSSION: Our results suggest that early and stable EEF plays the role of a modifier by interacting with the core domains of autism, in particular with the social affect domain (SA CSS), influencing social cognition and exacerbating or lessening symptom expression and emotional behavioral problems. These short-term longitudinal and preliminary findings underscore the importance of EEF as necessary target for early intervention in children with autism.

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18. Malow BA, Mazurek M, Stobbe G, Agrawal MM, Loftin R, Caudel D, Hess A, Westphal A, Smith J, Shouse J, Cheak-Zamora N, Sohl K. ECHO autism adult healthcare: Training community clinicians to provide quality care for autistic adults. Autism Res;2023 (Aug);16(8):1619-1629.

Autistic adults experience significant unmet healthcare needs, with opportunities for improvement in both the systems and the practitioners who serve this population. Primary care physicians/practitioners (PCPs) are a natural choice to provide comprehensive care to autistic adults but often lack experience in serving this population. This pilot study developed and tested an Extension for Community Healthcare Outcomes (ECHO) Autism model adapted from our previous work, focused specifically on training PCPs in best-practice care for autistic adults. The project was informed directly by the perspectives and preferences of autistic adults, caregivers, and PCPs. Two consecutive cohorts of PCPs participated in ECHO Autism Adult Healthcare sessions. Each cohort met 1 h twice a month for 6 months, with 37 PCPs (n = 20 in Cohort 1, and n = 17 in Cohort 2) participating. Based on findings from the first cohort, adjustments were made to refine the session preparation, curriculum, conduct of the ECHO, resources, and evaluation. After participation in the ECHO Autism program, PCP self-efficacy and satisfaction improved, while the number of perceived barriers did not change. Knowledge did not improve significantly in Cohort 1, but after adjustments to the training model, participants in Cohort 2 showed significant knowledge gains. While attention to systems of care is critical to addressing barriers in healthcare in the autistic population, the ECHO Autism Adult Healthcare model is feasible and holds promise for improving PCP satisfaction and self-efficacy in working with autistic adults.

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19. Michel L, Ricou C, Bonnet-Brilhault F, Houy-Durand E, Latinus M. Correction: Sounds Pleasantness Ratings in Autism: Interaction Between Social Information and Acoustical Noise Level. J Autism Dev Disord;2023 (Jul 31)

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20. Rios K, Burke M. Exploring correlates among Latino/a parents of young children with intellectual and developmental disabilities. Autism Res;2023 (Aug);16(8):1527-1532.

Parents of children with intellectual and developmental disabilities (IDD), including autism, experience stress in part due to child and parent characteristics. Although there is significant research about the correlates of parent stress, less is known about stress among Latino/a parents of children with IDD. The purpose of this study was to explore the correlates of empowerment, type of disability, stress, and special education knowledge among 61 Latino/a parents of children with IDD. Findings revealed a positive, significant correlation between empowerment and special education knowledge. Parents of children with autism reported significantly greater special education knowledge and stress. Implications for the future research including the need for longitudinal research are discussed.

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21. Samuel D, O’Malley F, Brink FW, Crichton KG, Duffy B, Letson MM, Michaels NL. Characterizing child maltreatment fatalities among child victims with disabilities in the United States, 2010-2019. Child Abuse Negl;2023 (Oct);144:106354.

BACKGROUND: There has been little research on child maltreatment-related fatalities among children with disabilities. Despite being a minority of children in the United States, children with disabilities experience higher rates of victimization. OBJECTIVE: To characterize fatalities due to child maltreatment among children with disabilities in the United States. METHODS: Data from the National Violent Death Reporting System from 2010 to 2019 were analyzed to describe child maltreatment-related deaths among children with disabilities aged birth to 17 years. RESULTS: There were 106 fatalities meeting the study criteria. The average age of the victims was 5.9 years old and 74.6 % were male. The most frequent suspected perpetrators of maltreatment-related fatalities were biological mothers (35.2 %), and most perpetrators were White (55.7 %). Analyses showed a statistically significant relationship between fatalities caused by neglect and diagnoses of attention deficit hyperactivity disorder, autism spectrum disorder, cerebral palsy, and/or traumatic brain injury. Overall, physical abuse and/or neglect resulting in a fatality among children with disabilities were significantly correlated with the relationship of the perpetrator to the victim. CONCLUSIONS: Children with disabilities who died as a result of abuse were more likely to have autism spectrum disorder, a developmental disability, or other physical impairment, with physical abuse being the most prevalent type of abuse that resulted in death. To decrease the likelihood of abuse of disabled children, healthcare practitioners and caseworkers should work together to create strategies to help caregivers cope with the financial, mental, and physical stress that comes with raising children with disabilities.

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22. Shirwaikar RD, Sarwari I, Najam M, M SH. Has Machine Learning Enhanced the Diagnosis of Autism Spectrum Disorder?. Crit Rev Biomed Eng;2023;51(1):1-14.

Autism spectrum disorder (ASD) is a complex neurological condition that limits an individual’s capacity for communication and learning throughout their life. Although symptoms of Autism can be diagnosed in individuals of different ages, it is labeled as a developmental disorder because symptoms typically start to show up in the initial 2 years of childhood. Autism has no single known cause but multiple factors contribute to its etiology in children. Because symptoms and severity of ASD vary in every individual, there could be many causes. Detection of ASD in the early stages is crucial for providing a path for rehabilitation that enhances the quality of life and integrates the ASD person into the social, family, and professional spheres. Assessment of ASD includes experienced observers in neutral environments, which brings constraints and biases to a lack of credibility and fails to accurately reflect performance in terms of real-world scenarios. To get around these limitations, the conducted review offers a thorough analysis of the impact on the individual and the ones living around them and most recent research on how these techniques are implemented in the diagnosis of ASD. As a result of improvements in technology, assessments now include processing unconventional data than can be collected from measurements arising out of laboratory chemistry or of electrophysiological origin. Examples of these technologies include virtual reality and sensors including eye-tracking imaging. Studies have been conducted towards recognition of emotion and brain networks to identify functional connectivity and discriminate between people with ASD and people who are thought to be typically developing. Diagnosis of Autism has recently made substantial use of long short term memory (LSTM), convolutional neural network (CNN) and its variants, the random forest (RF) and naive Bayes (NB) machine learning techniques. It is hoped that researchers will develop methodologies that increase the probability of identification of ASD in its varied forms and contribute towards improved lifestyle for patients with ASD and those affected by the pathology.

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23. Xie J, Zhang W, Shen Y, Wei W, Bai Y, Zhang G, Meng N, Yue X, Wang X, Zhang X, Wang M. Abnormal spontaneous brain activity in females with autism spectrum disorders. Front Neurosci;2023;17:1189087.

OBJECTIVES: To date, most studies on autism spectrum disorder (ASD) have focused on sample sets that were primarily or entirely composed of males; brain spontaneous activity changes in females remain unclear. The purpose of this study was to explore changes in the brain spontaneous neural activity in females with ASD. METHODS: In this study, resting-state functional magnetic resonance images (rs-fMRI) of 41 females with ASD and 41 typically developing (TD) controls were obtained from the ABDIE database. The amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of the two groups were calculated to detect the regional brain activity. A two independent sample t-test was used to analyze differences between the ASD and TD groups and a p-value <0.05 was considered statistically significant after false discovery rate (FDR) correction. Pearson correlation analysis was conducted between social responsiveness scale (SRS) scores and the local activity of significantly different brain regions. RESULTS: Compared with the typically developing (TD) group, the values of ALFF and ReHo were significantly increased in the left superior temporal gyrus (STG), while the values of ReHo were significantly decreased in the left superior frontal gyrus (SFG), left middle occipital gyrus (MOG), bilateral superior parietal lobule (SPL), and bilateral precuneus in the females with ASD group. Correlation analysis showed that the ReHo of the right precuneus was positively correlated to the total SRS, social communication, and autistic mannerisms. CONCLUSION: Spontaneous activity changes in females with ASD involved multiple brain regions and were related to clinical characteristics. Our results may provide some help for further exploring the neurobiological mechanism of females with ASD.

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