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Many individuals with autism spectrum disorder (ASD) experience various degrees of impairment in social interaction and communication, restricted, repetitive behaviours, interests/activities. These impairments make a significant contribution to poorer everyday adaptive functioning. Yet, there are no pharmacological therapies to effectively treat the core symptoms of ASD. Since symptoms of ASD likely emerge from a complex interplay of vulnerabilities, environmental factors and compensatory mechanisms during the early developmental period, pharmacological interventions arguably would have the greatest impact to improve long-term outcomes when implemented at a young age. It is essential therefore, that clinical development programmes of investigational drugs in ASD include the paediatric population early on in clinical trials. Such trials need to offer the prospect of direct benefit (PDB) for participants. In most cases in drug development this prospect is supported by evidence of efficacy in adults. However, the effectiveness of treatment approaches may be age-dependent, so that clinical trials in adults may not provide sufficient evidence for a PDB in children. In this white paper, we consolidate recommendations from regulatory guidelines, as well as advice from the Food and Drug Administration, USA (FDA) and the Committee for Human Medicinal Products (CHMP) consultations on various development programmes on: 1) elements to support a PDB to participants in early paediatric clinical trials in ASD, including single-gene neurodevelopment disorders, 2) aspects of study design to allow for a PDB. This white paper is intended to be complementary to existing regulatory guidelines in guiding industry and academic sponsors in their conduct of early paediatric clinical trials in ASD. [ABSTRACT FROM AUTHOR]

In the last decade there has been a revolution in terms of genetic findings in neurodevelopmental disorders (NDDs), with many discoveries critical for understanding their aetiology and pathophysiology. Clinical trials in single-gene disorders such as fragile X syndrome highlight the challenges of investigating new drug targets in NDDs. Incorporating a developmental perspective into the process of drug development for NDDs could help to overcome some of the current difficulties in identifying and testing new treatments. This paper provides a summary of the proceedings of the 'New Frontiers Meeting' on neurodevelopmental disorders organised by the European College of Neuropsychopharmacology in conjunction with the Innovative Medicines Initiative-sponsored AIMS-2-TRIALS consortium. It brought together experts in developmental genetics, autism, NDDs, and clinical trials from academia and industry, regulators, patient and family associations, and other stakeholders. The meeting sought to provide a platform for focused communication on scientific insights, challenges, and methodologies that might be applicable to the development of CNS treatments from a neurodevelopmental perspective. Multidisciplinary translational consortia to develop basic and clinical research in parallel could be pivotal to advance knowledge in the field. Although implementation of clinical trials for NDDs in paediatric populations is widely acknowledged as essential, safety concerns should guide each aspect of their design. Industry and academia should join forces to improve knowledge of the biology of brain development, identify the optimal timing of interventions, and translate these findings into new drugs, allowing for the needs of users and families, with support from regulatory agencies. [ABSTRACT FROM AUTHOR]

The definition of autism continually changes over time in line with the growth of autism studies and the influences of the neurodiversity movement. The current paper aims to present the ongoing changes in the definition and diagnostic criteria of Autism as well as to introduce the autistic and neurodiversity movement happening globally. It traces back histories of Autism from myths and legends, cases in history possibly related to autism, Kanner’s and Asperger’s pioneered works on autism, and the ongoing transformation of Autism diagnostic criteria presented by all versions of DSM. The contribution of adults with Autism organisations to the DSM-5 diagnostic criteria is highlighted and future studies aimed to confirm the effectiveness of the newly revised criteria of DSM-5-TR are suggested. Subsequently, the current paper also discusses the brief history and principles of the autistic and neurodiversity movements that are growing globally and reviews the evolving definition of autism. The possible impact caused by the changes in the definition on the well-being of individuals with Autism is presented as well as future predictions of Autism’s definition are discussed. [ABSTRACT FROM AUTHOR]

This paper explores the meeting of autism and adolescent developmental processes from a combined psychoanalytic and developmental perspective. Meltzer’s four states of minds or ‘communities’, and the back and forth movements between them during the adolescent period, are described and serve as the theoretical underpinnings for the exploration of adolescent processes in the autistic individual. Motivation, or the desire and emotional capacity to encounter novelty and change, as the engine for movement between the four different states of mind, is also explored. An emphasis is placed on two key characteristics of the autistic experience – sensory/emotional overload and social struggle – and the impact and implications these have on the emotional capacity to cope with the many changes that characterise this transitional period. Clinical examples are used to illustrate the young person’s neurodivergent experience and to encourage clinical techniques that are better adapted to this experience and that hopefully ease the burden placed on these young people to meet neurotypical expectations. The concluding section of this paper will offer some thoughts on the experiences of the parents of autistic adolescents. [ABSTRACT FROM AUTHOR]

Autism is a neurodevelopmental disorder, the prevalence of which has increased dramatically in the United States over the past two decades. It is characterized by stereotyped behaviors and impairments in social interaction and communication. In this paper, we present evidence that autism can be viewed as a PIN1 deficiency syndrome. Peptidyl‐prolyl cis/trans isomerase, NIMA‐Interacting 1 (PIN1) is a peptidyl‐prolyl cis/trans isomerase, and it has widespread influences in biological organisms. Broadly speaking, PIN1 deficiency is linked to many neurodegenerative diseases, whereas PIN1 over‐expression is linked to cancer. Death‐associated protein kinase 1 (DAPK1) strongly inhibits PIN1, and the hormone melatonin inhibits DAPK1. Melatonin deficiency is strongly linked to autism. It has recently been shown that glyphosate exposure to rats inhibits melatonin synthesis as a result of increased glutamate release from glial cells and increased expression of metabotropic glutamate receptors. Glyphosate's inhibition of melatonin leads to a reduction in PIN1 availability in neurons. In this paper, we show that PIN1 deficiency can explain many of the unique morphological features of autism, including increased dendritic spine density, missing or thin corpus callosum, and reduced bone density. We show how PIN1 deficiency disrupts the functioning of powerful high‐level signaling molecules, such as nuclear factor erythroid 2‐related factor 2 (NRF2) and p53. Dysregulation of both of these proteins has been linked to autism. Severe depletion of glutathione in the brain resulting from chronic exposure to oxidative stressors and extracellular glutamate leads to oxidation of the cysteine residue in PIN1, inactivating the protein and further contributing to PIN1 deficiency. Impaired autophagy leads to increased sensitivity of neurons to ferroptosis. It is imperative that further research be conducted to experimentally validate whether the mechanisms described here take place in response to chronic glyphosate exposure and whether this ultimately leads to autism. [ABSTRACT FROM AUTHOR]

What does it mean for all children to be seen as whole and 'appropriate'? How can early childhood educators and families understand a child as capable and whole within the evaluative systems around disability? Through the narrative inquiry of a mother/early childhood teacher, this paper explores the complex entanglements between identity-affirming practices for all children represented in the fourth edition of Developmentally Appropriate Practices, and the relationship with deficit-based evaluations for children with disabilities. This case study explores possibilities for empowered collaborations between early childhood educators and families, resistance to deficit-based identities while navigating evaluations, and the creation of culturally sustaining interventions emerging from shared knowledge of children. The paper looks closely at perspectives and practices that invite critical engagements around evaluation, making space for new possibilities, and new perceptions for supporting all children as 'whole'. [ABSTRACT FROM AUTHOR]

Language profile resemblance between autistic11 The current paper uses “identity-first” language throughout, which is often favored by autistic individuals and their parents (Kenny et al. 2016). children who are language-impaired and children with Developmental Language Disorder (DLD) gives rise to misdiagnosis of the two conditions. Aiming to better understand the underlying causes of language impairments in autism language impaired (ALI) and DLD, the present study adopts a question-statement task to investigate the ability to determine the non-interrogative interpretation of Mandarin wh-words on the basis of syntactic-semantic cues and prosodic cues. The results show that both the ALI and the DLD groups have difficulty using the syntactic-semantic cues to access the non-interrogative interpretations of Mandarin wh-words. However, only the performance of the ALI group correlates with their extralinguistic cognitive ability. Furthermore, the two groups performed differently in using the prosodic cues: the DLD group scores significantly higher than the ALI group on the perception of the prosodic cues. The different linguistic profiles found in the current study suggest that ALI may not simply be a comorbidity of autism and DLD, as has often been proposed. The study’s findings also have the potential to improve diagnostic procedure and to increase accuracy of differential diagnosis in children.The current paper uses “identity-first” language throughout, which is often favored by autistic individuals and their parents (Kenny et al. 2016). [ABSTRACT FROM AUTHOR]

Building on the growing literature examining the multifaceted and complex issues surrounding police interactions with Autistic individuals, this paper examines police officers' training, experiences, and confidence of policing and interacting with autistic individuals. The paper specifically focuses on the Police Service of Northern Ireland (PSNI), which has been completely neglected in the literature to date. The findings are based upon a survey completed by 212 serving PSNI officers across a variety of ranks and years of experience. While there are a range of important findings in relation to training, confidence and available adaptations, the key finding of this paper is that less than one-third of the survey respondents reported receiving training on Autism delivered by the PSNI. Perhaps even more worryingly, less than half of those who had received this training stated that they were 'satisfied' with it. These findings suggest that the PSNI need to urgently reform the training provided to their officers to ensure that all officers receive Autism focused training. The study findings demonstrate that this new training programme should require periodic retraining throughout officers' careers; be designed to provide officers with both the knowledge base and skill set to effectively interact with Autistic individuals in ways that protect their human rights; and be delivered by a specialist organisation or professional, such as Autism NI. [ABSTRACT FROM AUTHOR]

iPad® and paper versions of a receptive vocabulary assessment were administered to 4- to 6-year olds with a diagnosis of autism spectrum disorder (ASD). No differences were found between scores on the two assessments. Standardized testing for children with ASD can be challenging; however, testing using the iPad® may offer a different avenue as it provides visual input that appears to be motivating. Findings suggest iPad® assessments offer an efficient format for itinerant speech-language pathologists (SLPs) and SLPs providing telepractice when creating individualized evaluation plans. [ABSTRACT FROM AUTHOR]

Object personification is the attribution of human characteristics to non-human agents. In online forums, autistic individuals commonly report experiencing this phenomenon. Given that approximately half of all autistic individuals experience difficulties identifying their own emotions, the suggestion that object personification may be a feature of autism seems almost paradoxical. Why would a person experience sympathy for objects, when they struggle to understand and verbalise the emotions of other people as well as their own? An online survey was used to assess tendency for personification in 87 autistic and 263 non-autistic adults. Together, our results indicate that object personification occurs commonly among autistic individuals, and perhaps more often (and later in life) than in the general population. Given that in many cases, autistic people report their personification experiences as distressing, it is important to consider the reasons for the increased personification and identify structures for support. [ABSTRACT FROM AUTHOR]

The paper has a twofold aim. First, it describes the complex process of gaining consent retrospectively for the publication of clinical material after the institution, where therapy was taking place, had closed down. The clinical material was derived from the psychotherapeutic work with an autistic young boy and his family. Details of the complicated process of gaining consent to publish this material are provided. The second aim of this paper is to discuss the important role of 'trust' when asking or granting consent for publication of clinical material. It is argued that trust at different levels (and amongst various people) plays a pivotal role in gaining consent for publication. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this study adds What are the clinical implications of this work? The conceptualisation of autism as a disorder where Theory of Mind (ToM) and pragmatics are fundamentally impaired has prompted a wealth of research on autistic deficits, most of which is characterised by two main assumptions: first, that autistic people would display said deficits, if present, with any conversation partner and in any situation; second, that neurotypical people do not present these deficits, regardless of the conversation partner. However, this is not necessarily reflected in autistic accounts of the way they experience social cognition and pragmatics.The present paper aims to investigate the autistic experience of communication with both autistic and neurotypical people, with a particular focus on their perception of the ability of autistic and neurotypical people to understand their communicative intentions.Participants, 23 adult Italian autistic people without intellectual disability or language disorders, were recruited online. Two virtual focus groups of 2 hours each were conducted, transcribed and analysed through thematic analysis with a descriptive phenomenological approach by two independent researchers.Six themes were developed from the analysis, the most relevant being Autistic–Autistic communication and Autistic ToM. The results, in line with the Double Empathy theory, suggest there seem to be important differences between neurotypical and autistic people's ToM. These appear to make it easier for autistic people to communicate with one another, as well as to create difficulties for neurotypical people to understand autistic people, not just the other way around.These results seem to confirm that challenges in cross‐neurotype communication are better interpreted as mutual miscomprehension and reciprocal differences in ToM rather than deficits on the autistic part. This calls for a reframing of ToM and/or the need for autistic ToM as a construct, of which neurotypical people seem to be lacking. Moreover, these insights should be taken into account for speech and language therapy and clinical practice in general, advocating for a neurodiversity‐informed view of co‐constructed communication as well as for a broader societal change in which therapists can play a crucial role, through participatory approaches or raising awareness in their daily practice. Autism is conceived as characterised by social cognition and communication difficulties, often linked to Theory of Mind (ToM) deficits. However, recent research suggested variations in ToM abilities within the autistic population and proposed alternative theories like the Double Empathy theory. Nevertheless, only a few studies examined how autistic individuals perceive communication across neurotypes. Autistic individuals seem to find it easier to communicate with other autistic people, and they identify specific characteristics of neurotypical communication that hinder successful communication. Moreover, neurotypical people are perceived as having difficulties in autistic ToM, which seems to emerge as a relevant and needed construct in light of the Double Empathy problem. These findings can inform speech and language therapy and clinical practice about the potential gains of raising awareness on the Double Empathy problem and the higher communication ease inside the autistic community, alongside individualised support. Participatory approaches and closer collaboration with the autistic community also seem to be crucial for therapists to help improve communication experiences for autistic individuals. [ABSTRACT FROM AUTHOR]

Ethnographic researchers have long relied upon observation as a powerful means to learn about social relations. This paper discusses research observation that was conducted as a part of an institutional ethnography (IE) investigating how people use the language and ideas of neurodiversity across different settings. While our research protocol initially called for ethnographic observation to take place at in-person events in Southern Ontario, our approach needed to be re-formulated with the switch to online events during the COVID-19 pandemic. After the shift to online-only spaces, a total of 52 sessions at 7 online events related to neurodiversity or autism were observed by a team of 5 researchers: these events were no longer geographically restricted but were officially "hosted" by institutions in Canada, the US, and the UK. This paper reflects upon the challenges and opportunities we encountered as we conducted observations in digital spaces, including our experiences of navigating the "chat" feature. We discuss the need to analyze the format as well as the content of online events, and present findings on how neurodiversity appeared in these social spaces. Finally, we consider the implications of this research for people who are conducting ethnographic observation in an increasingly online world. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Parental input plays a central role in typical language acquisition and development. In autism spectrum disorder (ASD), characterized by social communicative and language difficulties, parental input presents an important avenue for investigation as a target for intervention. A rich body of literature has identified which aspects of grammatical complexity and lexical diversity are most associated with child language ability in both typical development and autism. Yet, the majority of these studies are conducted with English‐speaking children, thus potentially overlooking nuances in parental input derived from cross‐linguistic variation.To examine the differences in verbal parental input to Bulgarian‐ and English‐speaking children with ASD. To examine whether aspects of verbal parental input found to be concurrent predictors of English‐speaking children's expressive language ability are also predictors of the expressive language of Bulgarian‐speaking children with ASD.We compared parental input to Bulgarian‐speaking (N = 37; 2;7–9;10 years) and English‐speaking (N = 37; 1;8–4;9 years) children with ASD matched on expressive language. Parent–child interactions were collected during free play with developmentally appropriate toys. These interactions were transcribed, and key measures of parental input were extracted.English‐speaking parents produced more word tokens and word types than Bulgarian‐speaking parents. However, Bulgarian parents produced more verbs in relation to nouns and used more statements and exclamations but asked fewer questions than English‐speaking parents. In addition, child age and parents’ use of questions were significant concurrent predictors of child expressive vocabulary.This is one of the first studies to conduct a cross‐linguistic comparison of parental input in ASD. The differences found emphasize the need to further study parental input to Bulgarian children and adapt naturalistic parent‐mediated interventions to the local language and its specific characteristics. A rich body of literature has identified the specific aspects of grammatical complexity, lexical diversity, and question‐asking that are concurrently and longitudinally associated with the language ability of children with typical development and of children with ASD. Yet, the majority of these studies are conducted with English‐speaking children. The present study finds that there are specific differences in verbal parental input to Bulgarian‐ and English‐speaking children with autism in terms of lexical composition and question‐asking. Bulgarian parents used more verbs than nouns, and the opposite pattern was found for English‐speaking parents. In addition, Bulgarian parents asked fewer questions but used more statements and exclamations. Nevertheless, parental question use was significantly correlated with children's language ability across both groups, suggesting that question‐asking should be further examined as a potential target for parent‐mediated language interventions for Bulgarian children with autism. Most language and social communication interventions for autism are designed and piloted with English‐speaking children. These interventions are often simply translated and used in different countries, with different populations and in different contexts. However, considering that one of the defining characteristics of autism is language difficulty, more studies should examine (1) how these language difficulties manifest in languages other than English, and (2) what characterizes verbal parental input in these other contexts. Such research investigations should inform future language and social communication interventions. The present study emphasizes the cross‐linguistic differences between Bulgarian‐ and English‐speaking parents’ verbal input to their children with autism. [ABSTRACT FROM AUTHOR]

Purpose: Three deaths at Cawston Park Hospital shed a bright light on Norfolk's services for people with learning disabilities and autism, including those operated by the company that ran the hospital. The purpose of this paper is to review Norfolk County Council's current position from the unique aspect of a senior manager wihtin the system. Design/methodology/approach: This paper reviews the unique perspective of a social worker from within the system. Findings: The process of making change included engagement and action concerning such thorny challenges as the pressures on community services; the undervaluing of care-giving as a career; and the continuing admissions to specialist mental health services at a time when hospital discharges are being expedited. Originality/value: Norfolk's investment in improving its services involves the adoption of a human rights approach; a capital programme to facilitate new developments; nurturing care-giving as a career; and bringing a clearer evidence base to this work programme. [ABSTRACT FROM AUTHOR]

Some researchers suggest difficulties synchronising with a partner could underpin the social differences associated with Autism Spectrum Condition, potentially acting as a marker for autism. Social Motor Synchrony (SMS) is one aspect of synchrony that could augment observational diagnostic procedures. However, the full breadth of literature examining SMS in autism has not been systematically reviewed. A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines yielded 29 papers meeting inclusion criteria. Of 21 studies including a comparison group, all indicated weaker SMS between two autistic partners and in mixed-neurotype partnerships compared with two non-autistic partners. Papers involving mixed-neurotype pairs without a comparison group showed higher than chance SMS and demonstrated an increase in SMS over time following rhythm-based interventions. Although research so far demonstrates weaker SMS in pairs involving an autistic partner compared with non-autistic pairs, we identified several limitations which may have influenced SMS in autistic people and their partners. Further work is needed with autistic partnerships, more natural and preferred tasks within comfortable settings and partnerships, and more work to identify the basis of synchrony differences. We set out implications for design of further research. When two people interact, they often fall into sync with one another by moving their bodies at the same time. Some say autistic people are not as good as non-autistic people at moving at the same time as a partner. This has led some researchers to ask whether measuring synchrony might help diagnose autism. We reviewed the research so far to look at differences in Social Motor Synchrony (SMS) (the way we move together) between autistic people and people they interact with. The research suggests that interactions involving an autistic partner (either two autistic partners, or an autistic and non-autistic partner) show lower synchrony than a non-autistic pair. However, we recognised elements in the research so far that may have affected SMS in interactions involving an autistic person. One way SMS may have been affected in research so far might be the way interactions have been set up in the research studies. Few papers studied interactions between two autistic people or looked at synchrony in comfortable environments with autistic-preferred tasks. The studies also do not explain why synchrony might be different, or weaker, in pairs involving autistic partners. We use these limitations to suggest improvements for future research. [ABSTRACT FROM AUTHOR]

Background: Neurodiversity is increasingly discussed in relation to autism research and practice. However, there is a lack of scholarship concerning the neurodevelopmental condition of Developmental Language Disorder (DLD) and the neurodiversity movement. While this movement may hold opportunities for the DLD community, the application of the concept of neurodiversity to DLD research and practice needs consideration, as DLD and autism have very different levels of public and professional awareness and understanding. Aims: In this article, we discuss what the concept of neurodiversity and the associated neurodiversity movement could mean for DLD research and practice. We aim to critique some assumptions that may arise from the application of neurodiversity principles (or assumed principles) to the field of DLD. Methods: This is a discussion paper, drawing on the personal experiences and reflections of the author team. Main Contributions: We make the case for why DLD should be included in discussions about neurodivergence and outline considerations for doing so, and why some issues and applications may be particular to DLD. We outline points of similarity and contrast with autism in relation to our understanding of neurodiversity. We consider the issues around diagnosis and terminology and urge practitioners to continue to diagnose DLD using currently agreed terminology, so as not to undermine recent awareness efforts. We note that a neurodiversity‐informed perspective challenges us to offer interventions that operate at the level of our environments, not just at the level of an individual. Indeed, neurodiversity offers a platform to argue for better rights and more inclusive spaces in mental health settings, education and work for children and adults with DLD. Conclusions: DLD should be considered from a neurodiversity‐informed perspective, and it is our hope that this will lead to neurodiversity‐affirming practice that will afford young people with DLD better understanding from members of the public and the professionals who work with them. Further work is needed to better support children, young people and adults with DLD to have a voice in the neurodiversity movement. WHAT THIS PAPER ADDS: What is already known on the subject: Neurodiversity approaches are increasingly being taken up in research and practice in relation to autism, meaning that our understanding of autism and how autistic people are supported is increasingly drawing on the principles of neurodiversity. However, autism is not the only neurodivergent population. Developmental Language Disorder (DLD) is another neurodevelopmental condition; however, relative to autism, DLD has lower awareness amongst professionals and the public. There has been no scholarship that has examined DLD through the lens of neurodiversity, or considered the application of neurodiversity‐affirming approaches to DLD. What this paper adds to existing knowledge: In this paper, we examine what the neurodiversity movement means for DLD research and practice. In particular, we consider what neurodiversity in the field of autism might teach us about the application of neurodiversity in the field of DLD, and highlight where we believe there are important differences between the two populations. We reflect on what neurodiversity means for intervention, diagnosis, terminology and championing the need for accessibility, especially with regard to mental health support, education and employment. What are the potential or actual clinical implications of this work?: Neurodiversity highlights the need to consider interventions at the level of an individual's environment (e.g., how can we make this space more inclusive?) as well as interventions operating at the level of the individual themselves (e.g., interventions focusing on an individual's language skills). We challenge the notion that neurodiversity‐affirming approaches mean not diagnosing DLD or changing DLD's terminology: we argue that this is not in the spirit of the original neurodiversity movement, but also that for a condition with such low public awareness, these actions could do more harm than good for families affected by DLD. We call for more in‐depth scholarship and discussion around the application of neurodiversity approaches to DLD and argue that the neurodiversity movement offers an important opportunity to raise better awareness and understanding of DLD in multiple sectors, including (but not limited to) mental health, education and employment. [ABSTRACT FROM AUTHOR]

Information and Communication Technologies have transformed our lives in different social areas, facilitating interpersonal relationships thanks to technological tools. In the specific case of people with disabilities, Assistive Technologies (ATs) break down barriers and increase opportunities to become active members of society with equal opportunities. This paper presents a systematic mapping study that analyzes the current state-of-the-art of ATs proposed in the literature to support the empowering of people with disability. Specifically, this paper focuses on (1) describing a global vision of the scientific literature published in the last 20 years about ATs in the computer science field and (2) identifying research needs, gaps, and trends. For this purpose, an in-depth analysis of 389 primary studies is presented. The information obtained from the mapping process is also constrained. Concretely, 35 ATs versus 22 disabilities are compared, obtaining striking peaks for some disabilities described in the discussion. Finally, the findings show that several areas have been covered only lightly, revealing interesting future directions and challenges for junior researchers. • ATs have the potential to break down barriers for people with disabilities, enabling them to participate more fully in society. This implies a need for rehabilitation programs to incorporate ATs into their strategies to enhance social inclusion. • Given the transformative role of ICT, rehabilitation programs should focus on helping people with disabilities develop the necessary technological skills to utilize ATs effectively. • This work highlights the diversity of ATs and disabilities, suggesting a need for personalized rehabilitation plans that match specific ATs to individual disabilities. • Rehabilitation professionals should be trained to assess and recommend appropriate ATs for each case. Rehabilitation programs should consider incorporating cutting-edge ATs and staying involved in research to contribute to future developments to cover gaps and challenges identified. [ABSTRACT FROM AUTHOR]

The Repetitive Behaviours Questionnaire for Adults (RBQ-2A) measures two factors of restricted and repetitive behaviours (RRBs) associated with autism. However, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides four criteria for RRBs: repetitive motor behaviours, insistence on sameness, restricted interests, and interest in sensory aspects of the environment (or atypical sensitivity). The current paper aimed to examine whether the RBQ-2A is a psychometrically sound measure of these four factors. Study 1 had university students (N = 368) complete the RBQ-2A and other related measures online and revealed that the RBQ-2A can assess the factors highlighted in the DSM-5 and that these four factors comprise a general RRB construct. Study 2 had individuals disclosing a diagnosis of autism (N = 283) complete the RBQ-2A and other related measures online and supported that this four-factor structure provided good psychometric properties. While the current paper provides findings for an online autistic population, further research is needed to generalize these findings to autistic individuals less likely to partake in online studies (e.g., those with intellectual or language disabilities). Overall, the results suggest that the RBQ-2A reliably and validly assesses RRBs. [ABSTRACT FROM AUTHOR]

This document provides a summary of several research papers published in the American Journal of Psychiatry. The papers cover topics related to schizophrenia, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). The research findings indicate low levels of recovery and remission in individuals with schizophrenia spectrum disorders compared to other psychoses. A meta-analysis of neuroimaging data reveals shared and distinct patterns of brain activation in individuals with ASD and ADHD. Another study uses a mega-analytic approach to identify functional connectivity alterations in youth with ADHD. These findings contribute to our understanding of the etiology and pathophysiology of these disorders and may guide the development of new treatments. [Extracted from the article]

The plan of the paper is to study autism spectrum disorder (ASD) in children as complex conditions that affect cognitive, emotional, social, and physical health. Broadly tracing the medical journey of the condition, it addresses the challenges faced by parents as they make sense of, and navigate their way through the appearance of early symptoms, impediments in correct diagnosis, acceptance, and adapt to live with the condition. The paper attempts to understand autism in medical and neurological terms, as well as the challenges faced by children and parents through the case study of Kyari (meaning a flower bed), a lone centre providing accessible autism care in about 150 km around Moradabad (west UP, India), which has been instrumental in raising an awareness of autism and has a reach that is unprecedented in the city in bringing sensitive autism intervention. It further comprehensively studies the symptoms of ASD, and the role of augmentative and alternative communication, behaviour modification, and the work of organisations like the Centre for Autism, CBSE mandate for inclusive education as applied in the case and Indian government policy for autism. [ABSTRACT FROM AUTHOR]

While the needs and care for children on the autism spectrum have been widely investigated, the intervention and services available to autistic adults have been overlooked for a long time. This survey paper reviewed 32 articles that described and evaluated assistive technologies that have been developed and evaluated through a complete circle of interactive product design from ideation, prototype, and user evaluation. These assistive technologies aim to improve independence and living quality in autistic adults. We extracted information from the perspective of requirement gathering, technology designing, and effectiveness of evaluation in the design cycle. We found a general lack of requirements-driven design, and the evaluation process was not standardized either. The lack of requirement gathering results in designs purely based on existing literature without targeting actual user needs. Our synthesis of included paper contributes to developing iterative design considerations in assistive technologies for autistic adults. We also suggest that assistive technologies for autistic adults shift some attention from assisting only autistic adults who require at least substantial support to embracing also those who have been living independently but rather have difficulties in social interaction. Assistive technologies for them have the potentials to help them consolidate and enhance their experiences in independent living. [ABSTRACT FROM AUTHOR]

The notion that autistic individuals suffer from empathy deficiencies continues to be a widespread assumption, including in many areas of philosophy and cognitive science. In response to this, Damian Milton has proposed an interactional approach to empathy, namely the theory of the double empathy problem. According to this theory, empathy is fundamentally dependent on mutual reciprocity or salience rather than individual, cognitive faculties like theory of mind. However, the theory leaves open the question of what makes any salient interaction empathic in the first place. The aim of this paper is to integrate core tenets of the theory of the double empathy problem specifically with classical, phenomenological descriptions of empathy. Such an integration provides further conceptual refinement to the theory of the double empathy problem while recognizing its core tenets, but it also introduces important considerations of neurodiversity to classic, phenomenological descriptions of empathy. Points of interest: Dominant autism research continues to claim that autistic individuals lack empathy in some form or other. Critics of such claims argue that empathy is a two-way street where problems can emerge because of different people's social experiences and expectations. In philosophy, the tradition known as phenomenology has long studied empathy by examining how empathy is experienced. Insights from phenomenology further clarify when and how empathy can break down between autistic and non-autistic people. By including autistic and other diverse perspectives, phenomenological studies of empathy stand to benefit significantly in nuance and depth. [ABSTRACT FROM AUTHOR]

The practice of self-diagnosing, amplified by the spread of psychiatric knowledge through social media, has grown rapidly. Yet, the motivations behind this trend, and, critically, its psychological repercussions remain poorly understood. Self-ascribing a psychiatric label always occurs within a broader narrative context, with narratives serving as essential interpretive tools for understanding oneself and others.In this paper, we identify four principal motivators for people pursuing self-diagnosis, pertaining to 1. waiting time and cost of mental health resources, 2. recognition, 3. identity formation, and 4. destigmatization. We compare these motivators against the backdrops of psychiatric narratives, including DSM-based (operationalism), bio-medical, and Neurodiversity narratives, to evaluate the psychological implications of self-ascriptions. We show that while self-ascription aligns with many motivations, it also carries the risk of essentialism across all analyzed narratives, which can over-simplify and sometimes misrepresent people’s attempts to find meaning through psychiatric labels. Essentialism makes narratives less comprehensive, responsive, and resourceful.We contend that self-ascriptions are not inherently problematic; instead, they show the need for greater focus and understanding in psychiatric practices and the importance of incorporating people’s experiences and perspectives in clinical settings. However, both the narratives and the social climate from which they emerge may need adjustments to make self-ascriptions meaningful, comprehensive, and resourceful tools. [ABSTRACT FROM AUTHOR]

Autistic people often camouflage, i.e. they adopt certain behaviors in order to fit in in neurotypical environments. Autobiographical accounts suggest that autistic trans people experience camouflaging in a unique, more complex and often heightened way than cis autistic people, and this has not been studied. They have autistic traits to mask, as well as gendered traits, in a hostile neuronormative and cisnormative world. This intersection of experience is worthy of exploration, not least because this group of people are typically misunderstood and silenced, as well as being particularly at risk of the mental distress that can come from camouflaging. In this paper I discuss autistic trans people’s accounts of camouflaging and begin a preliminary phenomenological analysis. I draw primarily from Simone de Beauvoir’s concept of “doubling”, whereby (cis) women experience being both oneself and the image of oneself, under patriarchal objectification. One can argue that autistic people are similarly “doubled” when camouflaging, experiencing their neurodivergent selves as well as their more neurotypical presentation. Going beyond de Beauvoir, it can be further argued that many trans people experience “tripling” and therefore that trans autistic people experience being at least “quadrupled” if not “quintupled”. [ABSTRACT FROM AUTHOR]

Autistic adults are at increased risk of both mental and physical health difficulties, and yet can face barriers to accessing healthcare. A meta-ethnographic approach was used to conduct a review of the existing literature regarding autistic adults' experiences of accessing healthcare. Four databases were systematically searched for qualitative and mixed-method studies reporting on the experiences of autistic adults without a co-occurring learning disability accessing adult healthcare services within the United Kingdom. Fifteen studies met the inclusion criteria, and seven steps were used to systematically extract the data and then generate novel themes. Three superordinate themes were identified: Professionals' lack of knowledge can be damaging, Need to reduce processing demands and Adaptation to improve engagement. This review highlights the wide-reaching damaging impact misdiagnosis, inadequate or inappropriate treatment, overwhelming environments and inaccessible systems can have on the well-being and ability of autistic adults to engage with treatment. The lack of autism knowledge and understanding experienced in interactions with healthcare professionals, along with autistic adult's own communication and sensory processing differences, demonstrates the need for widely delivered training co-produced with autistic adults alongside bespoke and person-centred adaptations. Autistic adults are more likely to experience mental and physical health difficulties, and yet can find it difficult to get the support that they need. A meta-ethnographic approach was used to review the existing research on autistic adults' experiences of accessing healthcare. Four databases were searched for qualitative and mixed-method studies which looked at the experiences of autistic adults who did not also have a learning disability when using healthcare services in the United Kingdom. Fifteen papers met the criteria to be included, and seven steps were used to analyse the information and develop new themes. Three main themes were identified: Professionals' lack of knowledge can be damaging, Need to reduce processing demands and Adaptation to improve engagement. This review highlights how damaging misdiagnosis, inappropriate treatment, overwhelming environments and systems that are difficult to access can have on the well-being of autistic adults. Limited knowledge and understanding about autism knowledge among healthcare professionals along with autistic adult's own communication and sensory differences indicate that there is a need for improved training developed with autistic adults and adaptations. [ABSTRACT FROM AUTHOR]

Prospective memory helps us to remember to perform tasks in the future. Prospective memory can be either time or event based. The goal of this study was to determine time- and event-based prospective memory in autistic adults across the life span. Autistic (n = 82) and non-autistic (n = 111) adults, aged between 30 and 86 years, performed the lab-based Amsterdam Breakfast Task, and several naturalistic prospective memory tasks. Preregistered analyses (AsPredicted #34249) were performed using classical frequentist as well as Bayesian statistics. On none of the prospective memory tasks, group differences were observed. Our results show no effect of age on naturalistic tasks, but age did affect our lab-based measure, indicative of the age paradox often described in non-autistic adults. Moreover, we found evidence for a parallel age-related effect of lab-based and naturalistic prospective memory in autistic and non-autistic individuals. What is already known : Prospective memory is an important function for daily living. It is the cognitive function that helps you remember that you are meeting your friend for coffee at 2 pm tomorrow, or that you need to take your vitamins after breakfast. This cognitive function is particularly important in autistic adults, but how prospective memory is associated with increasing age, we currently do not know. What this paper adds : Although performance on experimental tasks that measure prospective memory decreases with age, this pattern is similar in autistic and non-autistic adults. No age effects were found for tasks that were performed outside the lab. Autistic adults and non-autistic adults perform similarly on prospective memory, and this performance remains similar when autistic and non-autistic adults age. Implications for practice, research, or policy : While our results show that prospective memory decreased with increasing age, our results do point to parallel development of prospective memory in autistic and non-autistic adults. This finding serves as a reassurance for those individuals concerned that older autistic individuals might show quicker cognitive decline. [ABSTRACT FROM AUTHOR]

Purpose: Autistic camouflaging is a collection of strategies used to hide autistic characteristics. It can have serious consequences on autistic people's mental health and needs to be addressed and measured in clinical practice. The purpose of this study is to evaluate the psychometric properties of the French adaptation of the Camouflaging Autistic Traits Questionnaire. Methods: 1227 participants (744 autistic, 483 non-autistic) answered the French version of the CAT-Q in an online survey or on paper. Confirmatory factor analysis, measurement invariance testing, internal consistency analysis (McDonald's ω), and convergent validity with the DASS-21 depression subscale were conducted. Test-rest reliability was assessed on a sample of 22 autistic volunteers using intraclass correlation coefficient. Results: A good fit was found for the original three-factor structure as well as a good internal consistency, excellent test-retest reliability and highly significant convergent validity. Measurement invariance testing indicates however that the meaning behind items is different for autistic vs. non-autistic people. Conclusion: The French version of the CAT-Q can be used in clinical settings to assess camouflaging behaviors and intent to camouflage. Further research is needed to clarify the camouflage construct and whether reported measurement noninvariance are due to cultural differences or a true difference in what camouflaging might mean for non-autistic people. [ABSTRACT FROM AUTHOR]

Background: Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer‐to‐peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs. Methods: The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project. Findings: The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions. Conclusions: From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours which leads to better health outcomes. Accessible Summaries: People with learning disabilities are 10 times more likely than other people to have a problem with their eyes but less likely to get the eye care they need.This paper explains how people with a learning disability and/or autism are employed to tell other people with learning disabilities and/or autism, their supporters, health and care professionals and people who plan services about how important it is to get regular eye care. This job is an 'Eye Care Champion'.We share what the eye care champions did in their role, what worked well and what did not.We discuss how what we have learnt can help other people with learning disabilities and/or autism work as eye care champions and perhaps as champions for other areas of healthcare. [ABSTRACT FROM AUTHOR]

Background: Neurodevelopmental conditions frequently co‐occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred to as autism) and intellectual disability, and (2) behavioural and socio‐emotional problems and the level of clinician‐rated functioning for young males and females. Methods: In this cross‐sectional study, diagnostic information, caregiver‐rated behavioural and socio‐emotional data (as conceptualised by the Strengths and Difficulties Questionnaire) and clinician‐rated functioning scores (as conceptualised by the Children's Global Assessment Scale) were extracted from electronic patient records for 2768 young people aged 3–17 years (mean = 11.55, SD = 3.46). All data were extracted at baseline, that is, at the time the young person was diagnosed with attention deficit hyperactivity disorder, autism and/or an intellectual disability. Ordinal regression analyses tested associations between the number of neurodevelopmental conditions met (i.e. 1, 2 or 3) and behavioural and socio‐emotional outcomes and functioning. Results: After controlling for age and biological sex, the number of neurodevelopmental conditions was associated with higher levels of inattention/hyperactivity and peer problems, lower levels of prosocial behaviour and poorer clinician‐rated functioning. Although these findings were consistent for males, a cumulative association was not identified for females, except for clinician‐rated functioning. Conclusions: For young people, the presence of multiple neurodevelopmental conditions may have a cumulative impact across domains, but this may differ between males and females. [ABSTRACT FROM AUTHOR]

In the typically developing population, social touch experiences are influenced by several factors, including the biological sex of toucher and receiver, the body area wherein the touch is delivered and the social context in which the tactile exchange occurs. However, it is currently unexplored how social touch experiences of autistic adults are modulated by these factors. We sought to address this by utilizing a self-report body-painting task. Our main results show that autistic, compared with non-autistic, adults reported lower levels of pleasantness, erogeneity and appropriateness, specifically in intimate and friendly social contexts and in body areas typically touched in these situations. Importantly, sex played a major role in group differences. For instance, although autistic females reported, across social contexts, less pleasantness than both non-autistic females and autistic males, they experienced similar levels of appropriateness in the professional social context, usually deemed as touch-appropriate. Our findings provide new support to the hypothesis that social touch is experienced and possibly conceptualized differently by autistic compared with non-autistic adults. Moreover, by identifying the factors that influence social touch processing in autistic adults, our results might aid the development of support for autistic individuals seeking help in the spheres of social and intimate touch. What is already known about the topic? At least in neurotypical individuals, social touch represents an important channel for emotional communication associated with social bonding and pain/anxiety modulation. Autistic adults report to avoid social touch more and to have different tactile sensitivity than their non-autistic comparisons. What this paper adds? Few studies specifically investigated social touch in autistic individuals, and none of them examined the role of participants' sex, social context in which social touch occurs, and specific body areas being touched. In our study, adult participants reported how pleasant, erogenous and appropriate they would consider touches delivered by another person over their entire body in intimate (date), friendly (dance class) and professional (physiotherapy-massage session) social contexts. Autistic adults reported social touch to be less pleasant, erogenous and appropriate specifically in intimate and friendly social contexts and in body areas typically touched in these situations. Importantly, autistic females seem more at risk to experience unpleasant social touch as, although they considered it more unpleasant than non-autistic females and autistic males, they did consider it similarly appropriate in professional social contexts where touch is normed to be socially appropriate. Implications for practice, research or policy Our results might improve awareness and understanding about autistic adults' different, and often more discomforting, experience of social touch and thus help consider and respect it during everyday social interactions. Our results might also benefit future research investigating, for instance, the neural underpinnings of social touch differences in autism or aiming at developing support for autistic individuals seeking help in the diverse spheres of social touch. [ABSTRACT FROM AUTHOR]

Niche construction theory highlights the active role of organisms in modifying their environment. A subset of these modifications is the developmental niche, which concerns ecological, epistemic, social and symbolic legacies inherited by organisms as resources that scaffold their developmental processes. Since in this theory development is a situated process that takes place in a culturally structured environment, we may reasonably ask if implicit cultural biases may, in some cases, be responsible for maladaptive developmental niches. In this paper we wish to argue for an affirmative answer. In order to do so, we first propose to conceptualize implicit bias as embodied perceptual habits, and then proceed to show that these habits are at least partially responsible for maladaptive developmental niches of children with Down syndrome and autism. With this framework we thus hope to bring together two fields of research that haven't been explicitly connected: implicit bias and niche construction theory. Linking these two theories may bring benefits both to implicit bias researchers, who can extend this concept to characterize other sets of processes as biased, as well as to niche construction theorists, who will have a useful theoretical tool to diagnose maladaptive features of niches brought about by sociocultural biases. [ABSTRACT FROM AUTHOR]

An overview of Applied Behavior Analysis (ABA) and Autism Spectrum Disorder (ASD) in the Middle East was published by Kelly and colleagues in 2016. The focus of the review was to explore clinical services, educational opportunities, and published research in the six countries of the Gulf Cooperation Council, namely the Kingdom of Bahrain, the State of Kuwait, the Sultanate of Oman, the State of Qatar, the Kingdom of Saudi Arabia, and the United Arab Emirates. The objective of the current paper was to provide an update on the current status of ABA and ASD in the Gulf region, with a focus on successes, challenges, and recommendations for future directions. [ABSTRACT FROM AUTHOR]

This systematic review investigated how studies have measured gender dysphoria (GD) in autistic samples and the impact of using different measures on study results. The literature search identified 339 relevant papers, with 12 of them meeting the inclusion criteria. Results showed that seven different measures of GD characteristics have been used with autistic samples and that the studies consistently reported a greater number of GD characteristics and a greater severity of GD in autistic compared to non-autistic samples. Methodological common practices were found in recruiting participants from clinical settings rather than the general population, having more autistic males than females in the samples, for studies being conducted in Europe, North America, and Oceania, and using single-item measures of GD for samples of autistic children. Issues were identified with study designs and measures of GD, suggesting a need for a more standardized multi-item self-report measure of GD for use in clinical and non-clinical samples across different ages and cultures. [ABSTRACT FROM AUTHOR]

Summary: Sleep problems are common in neurological conditions for which ketogenic dietary therapies (KDTs) are recognised as an effective intervention (drug‐resistant epilepsy, autism spectrum disorder, and migraine). Given the composite framework of action of ketogenic dietary therapies, the prevalence of sleep disturbance, and the importance of sleep regulation, the present scoping review aimed at identifying and mapping available evidence of the effects of ketogenic dietary therapies on sleep. A comprehensive web‐based literature search was performed retrieving publications published to June 2023 using PubMed and Scopus, yielding to 277 records. Twenty papers were finally selected and included in the review. Data were abstracted by independent coders. High variability was identified in study design and sleep outcome evaluation among the selected studies. Several changes in sleep quality and sleep structure under ketogenic dietary therapies were found, namely an improvement of overall sleep quality, improvement in the difficulty falling asleep and nighttime awakenings, improvement in daytime sleepiness and an increase of REM sleep. The relevance and possible physiological explanations of these changes, clinical recommendations, and future directions in the field are discussed. [ABSTRACT FROM AUTHOR]

The assumption that primal phantasmatic activity stems from bodily functions is widely accepted in developmental and psychoanalytic thinking. This article attempts to give more specific meaning to this abstract assumption. It examines the influence of sensory, perceptual, and motor capacities on the consolidation of typically differentiated erotogenic experiences relevant to pre-Oedipal and Oedipal organisations. It then proceeds to examine the impact of innate deficiencies in these capacities on the development of phantasmatic organisation in children on the autistic spectrum who often manifest atypical erotogenic organisation. Additionally, it pays attention to non-symbolic therapeutic communication and the unconscious transference-countertransference relationship stemming from such a problematic matrix. The paper is clinically derived from a description of the early-Oedipal organisation of a child with low cognitive and functional capacities and proceeds to the manifestations of the Oedipal constellation of a high-functioning autistic child. [ABSTRACT FROM AUTHOR]

The author presents the issue of the development of internal space, as a function of the relationship of intimacy and synchrony with the caregiver, with the purpose of rendering more tolerable the experience of space outside the body. This paper argues that if this relationship does not stabilise by the end of the first year of life, an absence of representation of an internal space in the unidimensional realm might ensue. The psychoanalytic treatment of autistic children offers windows to certain developmental challenges associated with the representation of both internal and external spaces, the consequent development of dimensionality and its deviations. The case of a young autistic child in the first year of her four-session-a-week analysis is described as an illustration of the child's struggle to overcome precipitation anxiety around the experience of falling by using her movements in the external space. The child's autistic defences and deficits at first functioned to keep her in a liquid state, and later denied gravity by means of repetitive movements of her body while exploring the space of the analyst's room. Her mouth was experienced as a hole to be completely blocked with either food or a pacifier, preventing exchanges with the analyst. Her subsequent compulsive use of strings in activities revealed at the same time the search for links, and her difficulty connecting and establishing communication. At the end, the analyst realised an archaic equivalence between their room and body, as a 'concrete transference', revealing the child's attachment and motivation to explore it, which could be interpreted as an affective link between the analyst and patient. [ABSTRACT FROM AUTHOR]

Our separateness from the other is the 'basic agony', the 'original heartbreak' of the human condition, according to Frances Tustin's thinking. The ways we deal with this heartbreak form the foundation through which relationships, self-experience and wellbeing are built and developed. The following paper describes a child's journey, from omnipotent encapsulation, through the extremes of heartbreak – the child's, as well as his parents' and the therapist's – to liveliness and hope. Tustin teaches us the meaning and experience of encapsulation, the delicate balance between 'hard' and 'soft' needed in the therapeutic stance, the extremes of despair, hurt, cruelty and heartbreak that are met with along the way, as well as the possibility of hope even in dire situations. Holding on, survival and faith, as well as hope-against-hope, which is the resistance to despair in situations of hopelessness, are needed in order for this broken heart to be somewhat mended and allowed to flourish and to grow. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented that focuses on issues related to learning disabilities, including participation of people with learning disabilities in end-of-life care research, attitudes of support workers towards the affective and sexual lives of people with intellectual disabilities, and challenges concerning attention-deficit/hyperactivity disorder that is often misdiagnosed in people with learning disabilities.

This paper represents a sociological approach to autism spectrum disorder that critiques the terms neurodiverse and it obverse, neurotypical, because they promote a cognitive approach that mystifies what is actual and real about human activity in everyday life. It is in dynamic interactional practices rather than putative cognitive states that human diversity is manifest or observable. The empirical part of the paper, following Bleuler, defines and examines “autistic talk” as a turning away from the ordinary social world or commonsense “reality,” and engaging self‐oriented practices and orientations. However, the range of participants who produce such talk is not confined to those on the putative autism spectrum. Rather, that range encompasses the entire human span. If so, then a question is raised about what autism is as a “condition,” which term individualizes social difficulties rather than appreciating that they are always about diverse social actions‐in‐interaction. [ABSTRACT FROM AUTHOR]

Background Aims Methods and procedures Outcomes and results Conclusions and implications What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? In typically developing (TD) children, gesture emerges around 9 months of age, allowing children to communicate prior to speech. Due to the important role gesture plays in the early communication of autistic and TD children, various tasks have been used to assess gesture ability. However, few data exist on whether and how tasks differentially elicit gesture, particularly for samples of racially and ethnically diverse autistic children.In this study, we explored if task (a naturalistic parent–child interaction [NPCI]; structured assessment of child communication) differentially elicited rate or type of gesture production for young autistic children.This secondary analysis included baseline data from 80 racially and ethnically diverse autistic children aged 18–59 months who participated in one of two larger studies. Video recordings of NPCIs and an assessment of child communication with standardised administration procedures were collected at baseline. Child gesture rate (number of gestures produced per 10 min) and type were extracted from these recordings and analysed.The structured assessment elicited more gestures than the NPCI. In terms of gesture type, points, gives, and reaches accounted for 76% of child gestures. Points (which are developmentally more advanced than reaches and gives) were produced at the highest rates within book exploration. Distal points (which are more developmentally advanced than proximal or contact points) were produced at the highest rates when children were tempted to request.Our findings indicate elicitation tasks differentially elicit type and rate of gesture for young autistic children. To assess the gesture production of young autistic children, a structured task designed to elicit child requests will probe the developmental sophistication of the child's gesture repertoire, eliciting both the most gestures and the most developmentally advanced gestures. Because of the importance of gesture in early communication for autistic and typically developing children, various tasks have been used to assess it. However, little is known about whether tasks differentially elicit type or rate of gesture for young autistic children from diverse racial and ethnic backgrounds. Elicitation tasks differentially elicit type and rate of gesture for young autistic children in the early stages of gesture. We recommend a structured task designed to elicit child requests to assess the developmental sophistication of a child's gesture repertoire. [ABSTRACT FROM AUTHOR]

This paper considers current workforce issues facing psychological professionals working in NHS services, examining the challenges, and identifying opportunities to better meet the needs of autistic people and people with an intellectual disability (PwID) across the lifespan. The aim of this paper is to identify and publicly articulate the need for a coherent approach to guide the practice of psychological professionals when helping autistic people and/or PwID. It should be noted that the scope of the paper is limited to autism and intellectual disability. In addressing these broad groups and their co-occurring conditions and needs, we anticipate that many principles could be applied to other neurodevelopmental conditions. We also note the significant potential challenges in linking intellectual disability and autistic populations, hence have attempted – in drawing together a working group to write this paper – to ensure representation from a range of psychological professionals including those in policy, leadership, and training roles, those working in specialist or generic mental health services and undertaking clinical research across the lifespan. Objectives: ■ To help define and support clear action so that all sectors welcome and adequately support people with neurodevelopmental differences, including autistic people and/or PwID. ■ To play a role in the development, planning and evaluation of new psychological professions roles such as the Clinical Associates in Psychology (CAPS) and Education Mental Health Practitioners (EMHPs). ■ To reflect on the obstacles to recruiting to autism and learning disability services and to propose approaches to developing a sustainable psychological workforce in these areas. ■ To recognise where good examples of education and training programmes exist to address training, confidence and competence for all psychological professionals working with those who may be autistic and/or have an ID, and consider how to establish a more consistent approach to education, training and CPD across the workforce. ■ To engage in policy discussions around the current gaps, such as the demand for diagnostic assessments and support which significantly outstrips capacity, whilst highlighting unrealised opportunities, through for example, a systematic approach to training. ■ To advocate for the need for the voice of autistic people and PwID and their families/carers which is often absent from the design and offer of help. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to place on record the impact made on government policy and research by Autism Cymru, a small charity that existed in Wales between 2001 and 2014. The success of Autism Cymru resulted directly from philanthropic funding, applied with strategic vision and genuine ambition. Design/methodology/approach: A retrospective, chronological viewpoint highlighting the creative process, drawing upon records held by the charity. Findings: Autism Cymru initiated the concept and played a crucial role in steering the development of government policy for autism in Wales between 2001 and 2011. The charity also drove forward the initiative, which led to the establishment of the Wales Autism Research Centre at Cardiff University in 2010. This paper demonstrates that with astute philanthropic support, small learning disability/autism charities can elicit structural and sustainable change at the national level, leading to wide-ranging benefits for the communities they represent. Originality/value: The strategic approach taken over 20 years ago in Wales by Autism Cymru, which led to the Welsh Government's ASD Strategic Action Plan for Wales (Welsh Government, 2011), set in place a national policy model, which was then followed by The Scottish Strategy for Autism and the Northern Ireland Autism Strategy (Department of Health, 2013>; Scottish Government, 2011). The insightful and tenacious method used by Autism Cymru remains relevant today, demonstrating that any small charity supported by shrewd philanthropic funding can punch well above its weight by taking a planned, ambitious and strategic approach to policy, research and practice. [ABSTRACT FROM AUTHOR]

Purpose: This paper is a commentary that aims to address themes arising from the article by Morgan titled "Wales and Autism: The Impact of Philanthropy Matched with Ambition". Design/methodology/approach: This opinion piece considers the broader impact of stakeholder engagement in the field of autism, including how the dissemination of evidence-based support could be made more accessible for autistic people, their families and carers and philanthropists. Findings: This paper highlights the link between stakeholder engagement and meaningful change in policy and practice in the field of autism. It highlights the need for philanthropists to invest in evidence-based support but highlights the difficulty in identifying and accessing such support. This piece supports the use of evidence and gap maps (EGMs) to increase the accessibility of autism research and evidence. Originality/value: While stakeholder engagement is encouragingly rising in this field, most of the evidence is held in academic journals, which are behind paywalls and, therefore, inaccessible to many autistic people, their families, carers and associated professionals. Displaying evidence using EGMs provides an accessible way for autistic people and those who support them to identify possible avenues of support quickly and allows philanthropists to direct research funding to areas of high priority. [ABSTRACT FROM AUTHOR]

Background: Narrative discourse, or storytelling, is used in daily conversation and requires higher‐level language and social communication skills that are not always captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) have difficulties with both social communication and language skills, and narrative discourse analysis offers an ecologically relevant approach to assessing those challenges. Aims: This study investigated narrative discourse in individuals with autism and FASD, as well as an age‐ and sex‐matched comparison group. Methods and Procedures: Narratives from 45 adolescents and adults, 11 with autism, 11 with FASD and 23 age‐ and sex‐matched comparison participants were elicited using a wordless storybook. They were then transcribed orthographically, formatted to the Systematic Analyses of Language Transcript (SALT) convention and scored based on the SALT Narrative Scoring Scheme (NSS), a standardised language analysis protocol. In addition to the NSS total score, which assesses the overall structure and cohesion of the narratives produced, local and global measures of language ability were also employed. The local language measures included the number of mental state and temporal relation terms produced, while the global language measures included mean length of utterance, total different words, total words, total utterances, rate of speech, the number of mazes (e.g., repetitions, 'um', 'uh' or self‐corrections) per total word and the NSS total score. Outcomes and Results: Using the SALT Language Sample Analysis tool, our results revealed that on global language measures, group differences were found on rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. The autism group produced significantly more mazes per total word and scored higher on the NSS conflict/resolution category score compared to the FASD and comparison groups. Both the autism and FASD groups spoke at a lower rate than the comparison group. On local language measures of narrative production, all groups were comparable, on average. Conclusions and Implications: While many aspects of narrative discourse in the autism and FASD groups were similar to each other and to the comparison group, we observed group differences on global measures of narrative production and significant individual variability within groups, suggesting that narrative abilities considered at an individual level may provide important clinical information for intervention planning. Future research should also consider additional variables that influence narrative discourse, such as motivation, distractibility or decision‐making of individual participants. What this paper adds: What is already known on the subject: Narrative discourse, or storytelling, is used in daily conversational interactions and reveals higher‐level language skills that may not be well captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) show difficulty with pragmatic and expressive language skills. What this paper adds to existing knowledge: We found that many aspects of the narratives produced by the adolescents/young adults in the autism and FASD groups were comparable to each other and to the neurotypical group. However, the groups differed on three global measures of narrative production: rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. Also, significant variability was observed within groups, suggesting that narrative abilities should be considered at an individual level as opposed to their clinical groups. What are the potential or actual clinical implications of this work?: This study showed that narrative discourse is an appropriate task that can be added to routine clinical assessments of language abilities in autistic adolescents/young adults as well as those with FASD or typical development and has the potential to reveal higher‐level, real‐world language skills. An important clinical implication of this study is that narrative language abilities should be considered at an individual level and individual‐tailored interventions based on ability level due to the variability observed across individuals. [ABSTRACT FROM AUTHOR]

Hereditary and sporadic cerebellar ataxias represent a vast and still growing group of diseases whose diagnosis and differentiation cannot only rely on clinical evaluation. Brain imaging including magnetic resonance (MR) and nuclear medicine techniques allows for characterization of structural and functional abnormalities underlying symptomatic ataxias. These methods thus constitute a potential source of radiological biomarkers, which could be used to identify these diseases and differentiate subgroups of them, and to assess their severity and their evolution. Such biomarkers mainly comprise qualitative and quantitative data obtained from MR including proton spectroscopy, diffusion imaging, tractography, voxel-based morphometry, functional imaging during task execution or in a resting state, and from SPETC and PET with several radiotracers. In the current article, we aim to illustrate briefly some applications of these neuroimaging tools to evaluation of cerebellar disorders such as inherited cerebellar ataxia, fetal developmental malformations, and immune-mediated cerebellar diseases and of neurodegenerative or early-developing diseases, such as dementia and autism in which cerebellar involvement is an emerging feature. Although these radiological biomarkers appear promising and helpful to better understand ataxia-related anatomical and physiological impairments, to date, very few of them have turned out to be specific for a given ataxia with atrophy of the cerebellar system being the main and the most usual alteration being observed. Consequently, much remains to be done to establish sensitivity, specificity, and reproducibility of available MR and nuclear medicine features as diagnostic, progression and surrogate biomarkers in clinical routine. [ABSTRACT FROM AUTHOR]

The study explores the role of the Eye to I© intervention model in facilitating advancement through social stages of play in which skills contribute to the quality of social interaction and communication in children with autism. Data were collected on 11 participants, ages of 2–6 years, formally diagnosed with autism, receiving Eye to I© Social Communication therapy at Potentials Therapy Center, New Delhi, India. Eye to I© is developed in-house at Potentials and is further discussed in the paper. All participants attended a form of group intervention. A mixed-method design included quantitative measures administered pre and post intervention (Communication DEALL Developmental Checklist, Communication Matrix) and video coding of Social Communication sessions. Qualitative measures were semi-structured parent interviews conducted at the end of intervention. Thematic analysis and quantitative statistical analysis results show that by the end of the Eye to I© intervention period children engaged in social stages of play of greater developmental complexity and showed increased scores in assessments of social skills as well as generalization of skills. This suggests that skill acquisition necessary to directly support two diagnostic criteria areas of autism as per DSM-V; i.e., communication and social interaction occurred during the period of intervention. [ABSTRACT FROM AUTHOR]

In 2008 a community-academic partnership was formed between the School District of Philadelphia and our university-based team, Philadelphia Autism Instructional Methods Support. Through this partnership, we conducted a large-scale randomized trial of autism interventions in public schools, which indicated concerns related to implementation fidelity despite high-quality consultation to an evidence-based curriculum. Since the conclusion of the initial study, we have sustained this partnership to continue providing access to evidence-based care for autistic students. In this paper, we describe our iterative process of adapting consultation for autism support teachers, present findings regarding the impact of these services on teacher implementation fidelity, and map elements of our model onto well-established sustainment strategies for implementing change. In sharing this model, we hope to provide a blueprint for organizations conducting similar work and for those interested in empirically testing or applying strategies for sustainment of EBPs in school settings. [ABSTRACT FROM AUTHOR]

Abstract\nPoints of InterestThis paper examines autistic adults’ narratives and accounts of their experiences. It focuses on exploring how autistic individuals interpret and respond to stigma and negative attitudes surrounding autism. Thematic analysis of qualitative data obtained from interviews and focus groups reveals how autistic persons reconstruct their self-perception and definition of autism in response to stigma and societal attitudes. Further, the analysis reveals the prevalent use of social camouflaging among autistic adults to manage and cope with their stigmatized identities. This research contends that the dual approach that appeared among participants of advocating for autism acceptance while masking and concealing autism, reflects a continuous balancing act between avoiding stigma and its harmful consequences and striving to fit in, gain acceptance, engage in social interaction and relationships. Reframing autism as positive and reporting decreased motivation for camouflaging and increased self-acceptance, demonstrate stigma resistance and the agency and power possessed by autistic people.This article looks into how autistic adults describe their daily and social experiences.Specifically, it examines the impact of stigma on autistic individuals’ understanding of autism as well as explains how autistic people deal with stigmatic views and negative reactions to autism.The data collected for this study is based on interviews and focus groups conducted with autistic adults.The study highlights the use of masking, where autistic individuals hide their autism to avoid stigma and its negative consequences while seeking social acceptance and engaging socially.By exploring how autism intersects with various social identities, the study reveals how autistic individuals navigate societal challenges, highlighting the diverse experiences and perspectives within the autistic community and the complexity of the autism experience. [ABSTRACT FROM AUTHOR]