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Introduction: Emerging virtual technologies and cognitive rehabilitation methods are two new treatment approaches that can be used to strengthen cognitive functions in Autism Spectrum Disorder (ASD). The main aim of this study was to examine the effect of using virtual reality-based approaches on cognitive disorders of children and adults with ASD.Methods: This systematic review was conducted on scientific papers to determine the effects of virtual reality-based technologies on the cognitive functions of children and adults with ASD. We identified 688 studies related to this topic and filtered them down to 17 articles, and then extracted the effects of interventions on cognitive outcomes.Results: A total of 17 studies met the inclusion criteria, in which 226 persons with ASD had taken place. The sample size in the selected studies ranged from 1 to 56 participants (Median: 8, Q1: 3.5, Q3: 15.5). Four of the studies were case-control studies, ten were pre-test/post-test studies, and three were Randomized Control Trials (RCTs). Results of 16 studies showed significant progress in various cognitive indexes, such as task learning, attention, executive functioning, and daily skills in people with ASD. In most studies, virtual technologies had beneficial effects on reducing cognitive problems, but existing limitations could reduce their effectiveness. These limitations included the cost of virtual reality devices, inappropriate size of software, the weight of devices, potential addiction, intolerance of wearing glasses or headsets by people with autism (especially in children), and the possibility of eye injury.Conclusion: Applying appropriate virtual-based approaches could improve cognitive indexes in people with ASD. However, further studies are needed to investigate the real effects of these technologies in the long run. [ABSTRACT FROM AUTHOR]

Technology offers educators tools that can tailor learning to students' learning styles and interests. Research into the use of socially-assistive robots as a learning support for children on the autism spectrum are showing promising results. However, to date, few schools have introduced these robots to support learning in students on the autism spectrum. This paper reports on a research project that investigated the barriers to implementing socially-assistive robot supported learning, and the expectations, perceived benefits and concerns of school teachers and therapists of students on the autism spectrum and adults on the autism spectrum. First, three focus groups were conducted with six adults on the autism spectrum, and 13 teachers and therapists of students from two autism-specific schools. During the focus groups, there was cautious optimism from participants about the value of socially-assistive robots for teaching support. While the data showed that participants were in favour of trialling socially-assistive robots in the classroom, they also raised several concerns and potential barriers to implementation, including the need for teacher training. In response to their concerns, the second part of the project focussed on developing a software platform and mobile application (app) to support the introduction of robots into autism-specific classrooms. The software platform and app were then trialled in two schools (n = 7 teachers and therapists). Results from focus groups indicated that participants believe socially-assistive robots could be useful for learning support, as the mobile app provides an easy to use tool to support preparing and conducting lessons that would motivate them to trial robots in the classroom. [ABSTRACT FROM AUTHOR]

Informant-report measures for screening symptoms of autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs) are needed for low-resource settings if early identification is to be prioritized because early developmental concerns are likely to be expressed by parents and other caregivers. This paper describes the initial psychometric evaluation of the Nigeria Autism Screening Questionnaire (NASQ). Parents and other caregivers completed the NASQ on 12,311 children ages 1 to 18 in a Nigerian population sample as part of the World Bank National General Household Survey conducted in the country in 2016. Factor analyses indicated a parsimonious three-factor structure with social communication/interaction, repetitive sensory motor, and insistence on sameness dimensions. Measurement invariance was excellent across age and sex. Reliability of the subscales and total scale was good, and item response theory analyses indicated good measurement precision in the range from below average to high scores, crucial for screening, and tracking ASD symptoms. Studies with gold standard ASD diagnostic instruments and clinical confirmation are needed to evaluate screening and diagnostic accuracy. The NASQ appears to be a reliable instrument with a clear factor structure and potential for use in screening and tracking ASD symptoms in future Nigerian samples. [ABSTRACT FROM AUTHOR]

High rates of video game use in Autism Spectrum Disorder (ASD) have often been reported. This might suggest more prevalent video gaming addiction in this population, but elevated video game use could also be explained by restricted interest in video games. We thus reviewed the literature on video game use in ASD to examine the role of vulnerability for video game addiction and the role of restricted interest in video gaming. We conducted a search following PRISMA guidelines. From 511 papers, 15 were included. This review demonstrates that the high rates of video game use in boys and young males with ASD without intellectual disabilities can be predominantly explained by gaming addiction. However, an effect of restricted interest in video games cannot be excluded. Moreover, addictive process and restricted interest may interact. This result raises several issues for differentiating between video game addiction and restricted interest in regard to assessment, overlapping characteristics and interventions. Based on the results, we make recommendations for caregivers and clinicians on the management of problematic video game use in ASD. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorders (ASDs) have some disturbance activities. Usually, they cannot speak fluently. Instead, they use gestures and pointing words to make a relationship. Hence, understanding their needs is one of the most challenging tasks for caregivers, but early diagnosis of the disease can make it much easier. The lack of verbal and nonverbal communications can be eliminated by assistive technologies and the Internet of Things (IoT). The IoT-based systems help to diagnose and improve the patients' lives through applying Deep Learning (DL) and Machine Learning (ML) algorithms. This paper provides a systematic review of the ASD approaches in the context of IoT devices. The main goal of this review is to recognize significant research trends in the field of IoT-based healthcare. Also, a technical taxonomy is presented to classify the existing papers on the ASD methods and algorithms. A statistical and functional analysis of reviewed ASD approaches is provided based on evaluation metrics such as accuracy and sensitivity. [ABSTRACT FROM AUTHOR]

Autistic children experience higher levels of anxiety than their peers. Making appropriate diagnoses of anxiety disorders and providing effective treatment for these children is particularly difficult. Inconsistent evidence suggests that levels of anxiety in autistic children are related to intellectual functioning. We provide the first meta-analysis of this evidence. A systematic search identified 49 papers for review. These papers included measures of anxiety and intelligence quotient in 18,430 autistic children. Studies employing correlations showed evidence of a significant relationship between intelligence quotient and anxiety in autistic children: children with higher intelligence quotient scored higher on measures of anxiety. Studies directly comparing groups of autistic children with and without intellectual disability also supported this conclusion. Most studies employing other designs also supported this finding. Employing a quality assessment framework identified common threats to validity. Many studies used measures of anxiety that were not validated across the samples they measure. This was most notable for those autistic children with an intellectual disability. It is vital that future research determines whether the identified relationship between intelligence quotient and anxiety reflects something important in the mechanism for anxiety in autistic children, or quantifies the lack of sensitivity of our measures of anxiety across different groups. Autistic children often experience higher levels of anxiety than their peers. It can be difficult to diagnose and treat anxiety disorders in autistic children, in part because of the high degree of variability in their underlying abilities and presentations. Some evidence suggests that autistic children with higher intelligence (as measured by intelligence quotient) experience higher levels of anxiety than autistic children with lower intelligence. However, the evidence is inconsistent, with other papers not finding a difference or finding higher levels of anxiety in autistic children with lower intelligence. In this article, we review existing literature to see whether autistic children with higher intelligence quotients have higher anxiety than autistic children with lower intelligence quotients. A systematic search of the literature was conducted which identified 49 papers on the topic. The methods of all the papers were reviewed using an objective quality assessment framework. When combining the data statistically, there was evidence that autistic children with higher intelligence quotients are more anxious than autistic children with lower intelligence quotients. The quality review raised common weaknesses across studies. Most importantly, few studies used measures of anxiety that have been shown to be valid for children with very low intelligence quotients. Similarly, many studies used measures of anxiety that have not been shown to be valid for autistic children. These factors are important because autistic children and those with low intelligence quotient may experience or understand anxiety differently. Future research should use fully validated measures to test whether high intelligence quotient is associated with high levels of anxiety in autistic children. [ABSTRACT FROM AUTHOR]

No reviews to date have summarized the views of parents on the functional challenges and/or strengths of their children with autism spectrum disorder. We set out to perform a scoping review aiming (a) to identify and collate global results to provide a broad description of parental perspective of functioning research and (b) to summarize these using the International Classification of Functioning Disability and Health–Child and Youth version framework. The International Classification of Functioning Disability and Health provides a language to describe the functional skills of an individual with a health condition in terms of their body structures, body functions, activities and participation, their environmental and personal factors. Given the influence that context has on functioning, and the potential impact of economic status on availability of resources, we were specifically interested to compare perspectives from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English peer-reviewed studies published between 1990 and June 2016. Articles were accessed and summarized using thematic analysis. Meaningful phrases were extracted from key findings and linked to second-level International Classification of Functioning Disability and Health–Child and Youth categories following international linking rules. Thirty-three studies were identified of which only six originated from low/middle-income countries (n = 6/33, 18%). Two studies compared perspectives from low-/middle-income countries and high-income countries (n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health–Child and Youth bio-psychosocial framework while functional themes from low-/middle-income countries were predominantly focused on environmental factors. We propose further research should consider a systematic comparison of high-income and low/middle-income countries across functional categories to get a more accurate impression of the impact of context on functioning. No paper to date has summarized parents' views on the functional challenges and/or strengths of their children with autism spectrum disorder. In this review we set out to perform a scoping review aiming to (a) find and compare existing research from around the globe on parental perception of functioning and (b) summarize results from these papers using the International Classification of Functioning Disability and Health–Child and Youth version framework. Since we know that the place and circumstances we live in can have a significant influence on our functioning in daily life, we were specifically interested in comparing perceptions from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English studies published between 1990 and June 2016. Papers were summarized and key findings were linked to International Classification of Functioning Disability and Health–Child and Youth categories. Thirty-three studies were identified, of which most were conducted in high-income countries (n = 25/33, 76%) with only six studies in low/middle-income countries (n = 6/33, 18%). Two studies compared views from low/middle-income and high-income countries (n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health–Child and Youth framework while functional themes from low-/middle-income countries were mostly focused on environmental factors. It was difficult to directly compare studies from low/middle-income and high-income countries because they investigated and discussed such different parts of functioning. We suggest that future research should use an approach that will allow researchers to directly compare functional categories in order to get a more accurate impression of the impact of context on functioning. [ABSTRACT FROM AUTHOR]

Background: It has been established that people with autism spectrum disorder (ASD) often have difficulties understanding spoken language. Understanding reflexive and clitic pronouns is vital to establishing reference‐based inference, but it is as yet unclear whether such constructions pose specific difficulties for those with ASD. Pronoun interpretation seems be connected to the development of pragmatic abilities, and can therefore be considered a plausible marker in the differential diagnosis between ASD and developmental language disorder (DLD). Aims: To establish whether or not there are differences between ASD and DLD in relation to their understanding of pronoun constructions (both reflexive and clitic). The working hypothesis was that although no differences were expected between groups in relation to automatic (online) pronoun processing, the comprehension of reflexive pronouns would constitute a diagnostic marker between the group with ASD and language disorder and the DLD group. Methods & Procedures: The study carried out two experiments with three clinical groups (two with ASD and different levels of language proficiency and one with DLD) and two control groups with typically developing people (with equivalent language levels), analysing their on‐ and offline processing in pronoun resolution tasks. The first experiment uses an online method (eye‐tracking) to record pronoun processing in real time. The second uses an offline method to analyse comprehension accuracy. Outcomes & Results: The results of the two experiments indicated no differences in the way in which the clinical and control groups resolved the tasks, but a shorter reaction time was observed only in the age‐matched control group in comparison with the ASD group without language disorder in the first experiment, perhaps due to the fact that processing pronouns involves a greater cognitive load among the latter group. Conclusions & Implications: The comprehension of reflexive pronouns cannot be considered a diagnostic marker for distinguishing ASD from DLD. What this paper addsWhat is already known on the subjectPrevious studies have found that the performance of children with ASD in the comprehension of personal pronouns is equivalent to youngest control groups, but poorer regarding the interpretation of reflective pronouns. However, children with DLD do not usually have problems with the use of pronouns, which suggests that their pronoun processing is not affected. As pronoun interpretation seems be connected to the development of pragmatic abilities, it could be considered a plausible marker in the differential diagnosis between ASD and DLD.What this paper adds to existing knowledgeThis paper presents the results of two experiments involving pronoun processing by those with ASD (both with and without language disorder) and those with DLD. The design enables us to analyse the reflexive and clitic pronoun processing in people with ASD and DLD, regardless of their language proficiency. One experiment uses an eye‐tracking methodology that allows us to obtain data about how the pronouns are processed in real time. It represents an attempt to identify language markers that may help distinguish between the two groups and adapt the interventions to the specific problems experienced by each one.What are the potential or actual clinical implications of this work?The results indicate that it is not possible to identify any specific impairment in pronoun processing among the clinical groups (ASD and DLD). [ABSTRACT FROM AUTHOR]

Adaptive behavior skills are often delayed in autism spectrum disorder (ASD), and these behaviors are significantly associated with poor outcomes in adulthood, especially for autistic individuals that have no cognitive and/or language delays. Therefore, despite having the capacity to be self‐sufficient, the vast majority of autistic adults fail to obtain successful levels of employment, independent living, and interpersonal relationships. Given that more than 60% of autistic individuals have intact cognition and language, adaptive behavior skills need to be appropriately assessed as part of the diagnostic process of ASD, and profiles of delays and deficits need to be accommodated throughout development. This paper provides guidelines for conducting adaptive behavior assessments as part of a comprehensive diagnostic evaluation for ASD, which is now considered standard practice. The history and definition of the construct of adaptive behavior are discussed, and considerations for the administration of various measures, interpretation of results, and translation of findings into intervention strategies are provided. Key Points: Adaptive behavior skills are those skills that every individual needs for personal social and self‐sufficiency throughout life.Deficits or delays in adaptive functioning are common across many neurodevelopmental disorders, particularly autism spectrum disorder (ASD).Individuals on the autism spectrum tend to have the greatest delays in adaptive or functional social interaction skills.In ASD, gaps between chronological age and intellectual ability tend to be the greatest for individuals who do NOT have cognitive and/or language impairments, and these gaps tend to widen with age.Delays in adaptive functioning are strongly correlated with poorer adult outcomes in ASD, even for individuals who have no cognitive or language impairment.Adaptive behavior skills are extremely modifiable, meaning that they can change quickly over time, particularly if direct intervention/instruction targets specific adaptive skills.Fostering adaptive skills from the time of ASD diagnosis is critical for optimizing adult outcomes and maximizing any individual's potential for self‐sufficiency.School systems need to embed strategies and supports to teach and hone adaptive skills within educational programs. Waiting until "transition" years is far too late. [ABSTRACT FROM AUTHOR]

The intersection of children identified with autism spectrum disorders (ASD) and children within the foster care system who have experienced trauma can complicate timely assessment and eligibility for special education services, creating health disparities for this group of students. As students with ASD are over three times more likely to be involved in the foster care system than typically developing peers, school psychologists must be equipped to assess for ASD in this population. The complex clinical presentation of students with ASD within foster care contributes to delays in identification and access to special education services. In particular, schools may struggle to disentangle the symptoms of ASD from the consequences of trauma exposure that often accompanies foster care placement. This paper reviews the relation between students in foster care and those with ASD, outlines the similarities and differences in developmental profiles of these students, and provides recommendations for school practitioners associated with assessment practices, prevention strategies to reduce the risk of trauma subsequent foster care placement for students with ASD, as well as needed advocacy efforts and future research. Highlights: The intersection of children identified with autism spectrum disorders (ASD) and children within the foster care system who have experienced trauma can complicate timely assessment and eligibility for special education services, creating health disparities for this group of students.Similarities and differences in developmental profiles of students can assist in differentiating symptoms of ASD from the consequences of trauma exposure that often accompanies foster care placement.Specific assessment guidelines, prevention strategies, advocacy efforts, and research needs are highlighted to further this population of students with both autism and exposure to trauma. [ABSTRACT FROM AUTHOR]

To present interdisciplinary teams (IDTs) as foundational to effective assessment for students with autism spectrum disorder (ASD). This conceptual paper encourages IDTs by (a) presenting practice guidelines and research supporting effective IDTs; (b) describing vital team characteristics; (c) introducing a new model of teaming practices with a clinical case example; and (d) discussing IDT implementation barriers and recommendations specific to professionals supporting students with ASD. IDT members (e.g., school psychologists, teachers, behavior analysts, occupational therapists, speech‐language pathologists) should use assessment results to navigate goal‐setting and intervention planning allowing students with ASD to benefit from several therapeutic and educational approaches. Skilled professionals support a student's educational trajectory, increasing the likelihood of meeting developmental and academic milestones, and, ultimately leading to better life opportunities. Highlights: Interdisciplinary teams are the best practice for students with ASD. They allow a shared vision for student success, remove barriers between disciplines, and promote collaboration among professionals as they work together toward common goals for students.The TRIPOD Model, where Tri‐P represents the three P actions expected of a team: Progress review, Problem‐solving, and Pivot and OD represent the cooperation between disciplines (co‐Operation, Disciplines), is an impactful model for teams supporting students with ASD.Increased ethical guidance, clear communication, and broadened training opportunities are strategies that may allow for more fluid collaboration between disciplines in support of the student with ASD and stakeholders served. [ABSTRACT FROM AUTHOR]

This paper provides clinical guidance supported by the literature on conducting diagnostic evaluations for young children suspected of having autism spectrum disorder (ASD). Authors provided a summary of clinical recommendations and evidence-based strategies for providing diagnostic evaluations for young children suspected of having ASD that are supported by the existing literature. ASD is a complex condition that typically presents in the first couple years of a child's life. While many children can be accurately diagnosed by age 2, the majority of children are diagnosed much later. This article provides recommendations for evidence-based clinical practices to support accurate early identification and diagnosis in young children with autism. Recommended practices and measures for screening, comprehensive diagnostic evaluation, and differential diagnosis of ASD in early childhood are discussed. Early identification of ASD is important to promote improved outcomes related to early intervention. There are a variety of tools and practices available to support neuropsychologists in providing accurate early diagnosis and appropriate developmental monitoring for children suspected of ASD and related neurodevelopmental conditions. There is a need for continued efforts regarding awareness of ASD in early childhood and targeted training in ASD for neuropsychologists and other disciplines who support families of young children with disabilities. [ABSTRACT FROM AUTHOR]

Despite the evidence of an increased stress, the knowledge on couple interactions in parents of children with Autism Spectrum Disorder (ASD) is still scarce. In this paper we examine the associations between parental stress, social support, positive and negative couple interactions, and relationship satisfaction in parents of children with ASD. The sample included 89 participants who met the criteria of being in a relationship, i.e. living in the same household with a partner, and parenting a child with a diagnosis of ASD. Questionnaires were administered through kindergartens, primary schools and centers for autism. Path analysis showed a significant indirect effect of parental stress on relationship satisfaction via more negative interactions, more co-parenting conflicts, and less positive interactions. The results also suggest an important role of social support: high parental stress was associated with negative interactions in couples with weak social support, whereas the same association was not substantial for couples with strong social support. Enhancing parent's intimate relationships should be included in planning support services. Programs should address the issues of positive and negative couple interactions and forms of effective social support. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide an overview of the most relevant contributions regarding the application of so-called third generation interventions of cognitive behavioral therapy, such as mindfulness and ACT (Acceptance and Commitment Therapy), in the context of therapy for autism spectrum disorders. In particular, our attention is focused on the application of these interventions aimed at caregivers of individuals with autism spectrum disorder who have not reached the mature age. To this end, a search was conducted on the contributions published between 2005 and 2020 through the main search engines: it led to a final number of 8 revised articles. At present, the scarce availability of reliable results does not allow to arrive at a structured, valid and reliable model of intervention; nevertheless, having ascertained the potential benefit that emerged from the few studies conducted, it is possible to deduce that the line of research undertaken may create a protocol of proven effectiveness for the future. [ABSTRACT FROM AUTHOR]

The Protocadherin-10 (PCDH10) gene is associated with autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and major depression (MD). The PCDH10 protein is a homophilic cell adhesion molecule that belongs to the d2-protocadherin family. PCDH10 is highly expressed in the developing brain, especially in the basolateral nucleus of the amygdala (BLA). However, the role of PCDH10 in vivo has been debatable: one paper reported that a Pcdh10 mutant mouse line showed changes in axonal projections; however, another Pcdh10 mutant mouse line was reported to have failed to detect axonal phenotypes. Therefore, the actual roles of PCDH10 in the brain remain to be elucidated. We established a new Pcdh10 KO mouse line using the CRISPR/Cas9 system, without inserting gene cassettes to avoid nonspecific effects, examined the roles of PCDH10 in the brain, and studied the behavioral consequences of Pcdh10 inactivation. Here, we show that Pcdh10 KO mice do not show defects in axonal development. Instead, we find that Pcdh10 KO mice exhibit impaired development of excitatory synapses in the dorsal BLA. We further demonstrate that male Pcdh10 KO mice exhibit reduced anxiety-related behaviors, impaired fear conditioning, decreased stress-coping responses, and mildly impaired social recognition and communication. These results indicate that PCDH10 plays a critical role in excitatory synapse development, but not axon development, in the dorsal BLA and that PCDH10 regulates anxiety-related, fear-related, and stress-related behaviors. Our results reveal the roles of PCDH10 in the brain and its relationship to relevant psychiatric disorders such as ASD, OCD, and MD. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is theoretically characterized by alterations in functional connectivity between brain regions. Many works presented approaches to determine informative patterns that help to predict autism from typical development. However, most of the proposed pipelines are not specifically designed for the autism problem, i.e. they do not corroborate with autism theories about functional connectivity. In this paper, we propose a framework that takes into account the properties of local connectivity and long range under-connectivity in the autistic brain. The originality of the proposed approach is to adopt elimination as a technique in order to well emerge the autistic brain connectivity alterations, and show how they contribute to differentiate ASD from controls. Experimental results conducted on the large multi-site Autism Brain Imaging Data Exchange (ABIDE) show that our approach provides accurate prediction up to 70% and succeeds to prove the existence of deficits in the long-range connectivity in the ASD subjects brains. [ABSTRACT FROM AUTHOR]

The assessment of autism spectrum disorder (ASD) is based on semi-structured procedures addressed to children and caregivers. Such methods rely on the evaluation of behavioural symptoms rather than on the objective evaluation of psychophysiological underpinnings. Advances in research provided evidence of modern procedures for the early assessment of ASD, involving both machine learning (ML) techniques and biomarkers, as eye movements (EM) towards social stimuli. This systematic review provides a comprehensive discussion of 11 papers regarding the early assessment of ASD based on ML techniques and children's social visual attention (SVA). Evidences suggest ML as a relevant technique for the early assessment of ASD, which might represent a valid biomarker-based procedure to objectively make diagnosis. Limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Autistic individuals often struggle to successfully navigate emerging adulthood (EA). College is an increasingly common context in which individuals learn and hone the necessary skills for adulthood. The goal of this paper is to systematically review and assess the existing research on college as a context of EA development in autistic individuals, particularly in terms of understanding whether and how this context might be critically different for those who are typically developing or developing with other disabilities. Our findings indicate that ASD college students report feeling prepared academically, but exhibit weaknesses in daily living and social skills. Interventions largely focus on social skills, and rarely evaluate outcomes relevant to college success or longer-term emerging adulthood independence. We conclude with hypotheses and recommendations for future work that are essential for understanding and supporting ASD students as they navigate potentially unique challenges in college and their transition to independence during EA. [ABSTRACT FROM AUTHOR]

Phenomenological approaches suggest that the bodily presence of others has a profound influence on the experience of social spaces. This intimate relationship is particularly evident in mental disorders. Investigations into the nature of intersubjectivity in various pathologies indicate that modifications to the capacity for social perception play a key role in determining the manners in which the social space is experienced and felt. This paper aims to examine the interviewing relation of social perception and the experience of space and its consequences in autism spectrum disorder (ASD). This is done through a phenomenologically informed analysis of the functioning of social perception in ASD. Our account proposes that the atypical socio-perceptual patterns exhibited by people with autism significantly reduce the capacity to grasp the context of the situation, which facilitates and intensifies negative feelings that are intertwined with the experience of social spaces. This novel understanding draws on the idea that ASD involves a fundamental difficulty to establish a gestalt perception of social scenes. The evidence we discuss suggests that this anomaly in the operation of social perception also modulates the experience of the social space. Failing to perceive the wholeness of the situation means that people with autism often experience the social space as unfamiliar, confusing, uncertain, and unsafe, rather than feeling familiar and understood in the embodied presence of others. As a result, autistic subjects may experience difficulty evaluating the outcomes of hazardous circumstances, which poses a risk to their well-being, particularly in borderline situations. This suggestion is elaborated through the tragic occurrences that led to the killing of Eyad al-Hallaq, a 32-year-old Palestinian with autism. [ABSTRACT FROM AUTHOR]

• Correlation-based analysis of speech- and fine-motor signals helps discriminate between verbal individuals with ASD and neurotypical controls. • Handwriting time series reveal higher complexity in ASD participants. • Speech feature time series indicate lower complexity in ASD participants. • Correlation-based speech-based analysis explains variance in expressive vocabulary scores. Autism spectrum disorder (ASD) is a neurodevelopmental disorder often associated with difficulties in speech production and fine-motor tasks. Thus, there is a need to develop objective measures to assess and understand speech production and other fine-motor challenges in individuals with ASD. In addition, recent research suggests that difficulties with speech production and fine-motor tasks may contribute to language difficulties in ASD. In this paper, we explore the utility of an off-body recording platform, from which we administer a speech- and fine-motor protocol to verbal children with ASD and neurotypical controls. We utilize a correlation-based analysis technique to develop proxy measures of motor coordination from signals derived from recordings of speech- and fine-motor behaviors. Eigenvalues of the resulting correlation matrix are inputs to Gaussian Mixture Models to discriminate between highly-verbal children with ASD and neurotypical controls. These eigenvalues also characterize the complexity (underlying dimensionality) of representative signals of speech- and fine-motor movement dynamics, and form the feature basis to estimate scores on an expressive vocabulary measure. Based on a pilot dataset (15 ASD and 15 controls), features derived from an oral story reading task are used in discriminating between the two groups with AUCs > 0.80, and highlight lower complexity of coordination in children with ASD. Features derived from handwriting and maze tracing tasks led to AUCs of 0.86 and 0.91, however features derived from ocular tasks did not aid in discrimination between the ASD and neurotypical groups. In addition, features derived from free speech and sustained vowel tasks are strongly correlated with expressive vocabulary scores. These results indicate the promise of a correlation-based analysis in elucidating motor differences between individuals with ASD and neurotypical controls. [ABSTRACT FROM AUTHOR]

Having a diagnosis of Down syndrome (DS) is associated with intellectual disability (ID), pervasive developmental disorders and Alzheimer's dementia (AD). The association between these conditions has not been well evaluated. This paper looks to examine the current evidence pertaining to the relationship between dementia in people with DS and severity of ID and the presence of pervasive developmental disorders. A scoping review using PRISMA guidance was undertaken. Medline, Cochrane database, NHS evidence, Trial registers and Open Grey were searched in December 2018 and an updated search was completed in July 2020. Three search strategies were used to retrieve articles relating to DS, dementia, pervasive developmental disorders (including autism, autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD)) and severity of ID. Studies were included if they met the pre-defined inclusion criteria of investigating an association between autism/ASD, ADHD, or severity of ID and the development of dementia in people with DS. Studies were excluded if they did not include primary data, if the population included non-Down causes of ID, or if no specific outcome measure related to comorbid autism/ASD, ADHD, or severity of ID and dementia in people with a diagnosis of DS were reported. There were no exclusions related to study design. Papers were assessed for quality using the Mixed Methods Appraisal Tool (MMAT). The search identified 15 papers, publishing results from 12 studies, relating to severity of ID, DS and dementia. No papers were identified relating to pervasive developmental disorders, DS and dementia. There is limited evidence on how severity of ID impacts on the presentation, diagnosis, management or prognosis of dementia in people with DS. However, no evidence was found on comorbid pervasive developmental disorders, DS and dementia. This paper has identified multiple areas for future research. There is an urgent need for longitudinal studies into the presentation, development and progression of dementia in people with DS ensuring the severity of ID and comorbid pervasive developmental conditions are captured regularly to understand their influence on the dementia etiology and outcome. [ABSTRACT FROM AUTHOR]

Purpose: The paper presents conclusions from a comparative analysis of the medical and court documentation of a 5-year-old patient on the autism spectrum. The goal of the research was to identify potential cognitive errors made by the evaluating court experts. Case description: During the meeting of the County Committee for the Assessment of Disability, the patient was denied a proper disability certificate taking into account his actual level of impaired functioning. The patient's family appealed against the decision and had court experts appointed to re-assess the case. The documentation created in this process served as the material for the analysis presented in this paper. Comment: The study analyses the risk of cognitive errors that may occur in the assessments issued by court experts appointed to evaluate the level of patient's disability. This is due to the fact that such evaluations are often based, among other things, on a stereotypical perception of ASD-people or personal susceptibility to certain heuristics. Self-advocacy and neuro-diversity movements have been campaigning to change the assessment-issuing system for years but have been unsuccessful. Exposing the cognitive errors that can be found in expert assessments in a full-scale study might constitute an important step towards improving the current state of affairs. [ABSTRACT FROM AUTHOR]

Introduction: Early adolescence is a time of increased social interaction with peers. Social competence is related to pretend play ability in younger children, but a lack of pretend play ability in childhood may also be associated with social challenges in early adolescence. Adolescents who find social situations challenging experience alienation from peers resulting in lowered self‐regard. This paper presents an exploratory study comparing an Implicit group intervention (age‐appropriate play based group (PB)) to an Explicit group intervention Cognitive Behavioural Therapy (CBT) to increase social ability in adolescents. Methods: Six adolescents, three female and three male, were in the Implicit group (PB; mean age 12.3 years, SD = 1.21). Six male adolescents were in the Explicit group (CBT; mean age 13.3 years, SD = 1.03). All participants were assessed pre‐ and post the 8‐week intervention for social competence, cognitive flexibility and narrative ability. The Implicit group (PB) was assessed through an age appropriate play assessment. Seven participants had a formal diagnosis, including autism spectrum disorder, and all were in mainstream high schools. Results: The Explicit group (CBT) showed a medium effect for social engagement, total social skills, emotional engagement and a large effect for a decrease in flexible thinking. The Implicit group (PB) showed a large impact for narrative ability with increases in ability to sequence events, initiation and creation of plot, understanding character roles and total movie score, with medium effects for generation of problems, precise vocabulary and use of symbols. The Implicit group (PB) maintained cognitive flexibility, and decreased in social self‐scoring which showed medium effects for externalising and internalising. Conclusion: This paper contributes to evidence that the choice of social skills intervention impacts different skill sets. For neuro‐diverse adolescents, the cognitive intervention impacted social and emotional engagement and the play‐based intervention impacted a wider range of abilities related to narrative social interaction. [ABSTRACT FROM AUTHOR]

A psychiatric evaluation was conducted on an adolescent with autism spectrum disorder, who had committed serious crimes. This paper includes the evaluation result and a discussion. At the age of 16, he was charged with the attempted murder of two girls. The motive was the pursuit of sexual excitement. He was diagnosed for autism spectrum disorder, categorized into the aloof type based on Wing & Gould subtypes. He was also diagnosed for conduct disorder according to operational diagnostic criteria, as well as sexual perversion and inversion. The adolescent had a strong aloof type tendency, which encouraged his individual actions and did not hinder him from narrowing his one-sided interests. Regarding his family environment, his parents had not paid much attention to his behaviour. His problematic behaviour that was created and promoted by personal factors was then further fueled by parental neglect, and as a result, the attempted murders took place. This paper mainly focuses on the significant influence of the aloof type of autism spectrum disorder on the likelihood of committing crimes and the importance of attentive environment for adolescents to prevent problematic behaviour. A clinical question has arisen, in which the aloof type of autism spectrum disorder may be a risk factor for crimes, hence further studies are needed. In conclusion, psychiatric evaluation of adolescents should not only consider their accountability but the circumstances surrounding their nurturing environments. [ABSTRACT FROM AUTHOR]

Applied behavior analysis (ABA) is a common treatment for individuals with autism spectrum disorder (ASD). In a recent volume of this journal, Sanvodal-Norton and Shkedy (2019) published a criticism of behavior analysis including the professionals and entire field as a discipline—of demonstrating unethical behavior, creating prompt dependency in the learners, destroying internal motivation, and refusing to collaborate with new and other treatment philosophies. The current paper is a response to the these claims by providing several examples of peer-reviewed studies that contradicts the authors' arguments, and summarizing the information of the included study's findings by and other objective. The primary purpose of this paper is to demonstrate that, contrary to the perspectives of Sanvodal-Norton and Shkedy (2019), ABA is scientific approach that identifies environmental variables that influence socially significant behaviors and develop strategies to cause behavior change that is practical and applicable, improve educational outcomes, and provide real-life support for parents and families who are seeking treatment for their loved one with ASD. In doing so, this paper will demonstrate that ABA is an efficacious approach that is supported by numerous scientific studies in the peer-reviewed literature [ABSTRACT FROM AUTHOR]

Autism, now called Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder that presents in early life and affects both genders, all races and all regions of the globe. Since its early recognition by Leo Kanner in 1943, autism has received enormous attention from researchers, and understandable concern from parents and caregivers. However, since that year and until the present day, controversies continue around its nosology, nature, causation, diagnosis, and management. The terminology is still changing. New hypotheses are continuously developing, and yet no consensus about its management has been achieved. Advances in neuroscience and progress in genetic studies raise hopes of finding biomarkers that may explain its pathophysiology, develop more solid clinical diagnostic criteria, and provide more effective therapeutic approaches. Until such development arises, much of the current knowledge of autism remains controversial. The current paper provides an overview covering the evolution of the nosology and other parameters of autism since its first delineation by Kanner, the founder of child psychiatry in the United States. The paper also aims to better understand how autism is recognized and defined within the many editions and revisions of the popular classification systems of mental disorders namely, the American Psychiatric Society (APA), the Diagnostic and Statistical Manual of Mental Disorder (DSM), the World Health Organization (WHO), and the International Classification of Diseases (ICD), particularly the chapters on mental, behavioral and neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

The paper offers an innovative exploration of the mediating role of psychological capital (PsyCap) in the relations between future orientation and self-advocacy among high-functioning adults on the autism spectrum. We posited that PsyCap, a composite of hope, self-efficacy, resilience, and optimism, serves as a crucial mediator of future orientation and self-advocacy. The sample comprised 40 high-functioning adults on the autism spectrum. Future orientation, self-advocacy, and PsyCap were significantly correlated among young adults with ASD. PsyCap was a mediator of the relations between future orientation and self-advocacy. The findings contribute to the understanding of psychological factors influencing self-advocacy and future orientation and have practical implications for interventions aimed at enhancing PsyCap to improve self-advocacy and future orientation in individuals with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Purpose: Puberty a period of transition from childhood to adulthood, poses problems that are difficult to manage for typically developing adolescents, but even more difficult for adolescents with autism. It is vital that girls with autism spectrum disorder (ASD), like their typically developing peers, are able to manage these physiological processes in a healthy way and learn self-care and hygiene behaviours without being dependent on others. Given the contribution of mothers to the menstrual hygiene and self-care skills of adolescent girls, this study aims to explore the views of mothers.The study is a case study designed in the qualitative research model. The research was carried out with the participation of 10 mothers met the necessary criteria and agreed to take part in the study voluntarily. The data obtained were subjected to descriptive and thematic analysis. Codes, sub-themes and main themes were created.The research identifies the themes of self-care and menstrual hygiene, preparations made during menstruation, behavioral problems in adolescents, the person who carries out hygiene and self-care, and situations that tire/strain mothers during menstruation.At the end of the research, it was concluded that the adolescent girls with ASD are mostly unable to perform their self-care and hygiene adequately, and that the mothers do nothing to prepare their daughters for adolescence. It was also concluded that the most stressful situation for mothers during adolescence is usually the difficulty their daughters have in using sanitary pads, cleaning armpits and genital hair, and bathing.Methods: Puberty a period of transition from childhood to adulthood, poses problems that are difficult to manage for typically developing adolescents, but even more difficult for adolescents with autism. It is vital that girls with autism spectrum disorder (ASD), like their typically developing peers, are able to manage these physiological processes in a healthy way and learn self-care and hygiene behaviours without being dependent on others. Given the contribution of mothers to the menstrual hygiene and self-care skills of adolescent girls, this study aims to explore the views of mothers.The study is a case study designed in the qualitative research model. The research was carried out with the participation of 10 mothers met the necessary criteria and agreed to take part in the study voluntarily. The data obtained were subjected to descriptive and thematic analysis. Codes, sub-themes and main themes were created.The research identifies the themes of self-care and menstrual hygiene, preparations made during menstruation, behavioral problems in adolescents, the person who carries out hygiene and self-care, and situations that tire/strain mothers during menstruation.At the end of the research, it was concluded that the adolescent girls with ASD are mostly unable to perform their self-care and hygiene adequately, and that the mothers do nothing to prepare their daughters for adolescence. It was also concluded that the most stressful situation for mothers during adolescence is usually the difficulty their daughters have in using sanitary pads, cleaning armpits and genital hair, and bathing.Results: Puberty a period of transition from childhood to adulthood, poses problems that are difficult to manage for typically developing adolescents, but even more difficult for adolescents with autism. It is vital that girls with autism spectrum disorder (ASD), like their typically developing peers, are able to manage these physiological processes in a healthy way and learn self-care and hygiene behaviours without being dependent on others. Given the contribution of mothers to the menstrual hygiene and self-care skills of adolescent girls, this study aims to explore the views of mothers.The study is a case study designed in the qualitative research model. The research was carried out with the participation of 10 mothers met the necessary criteria and agreed to take part in the study voluntarily. The data obtained were subjected to descriptive and thematic analysis. Codes, sub-themes and main themes were created.The research identifies the themes of self-care and menstrual hygiene, preparations made during menstruation, behavioral problems in adolescents, the person who carries out hygiene and self-care, and situations that tire/strain mothers during menstruation.At the end of the research, it was concluded that the adolescent girls with ASD are mostly unable to perform their self-care and hygiene adequately, and that the mothers do nothing to prepare their daughters for adolescence. It was also concluded that the most stressful situation for mothers during adolescence is usually the difficulty their daughters have in using sanitary pads, cleaning armpits and genital hair, and bathing.Conclusion: Puberty a period of transition from childhood to adulthood, poses problems that are difficult to manage for typically developing adolescents, but even more difficult for adolescents with autism. It is vital that girls with autism spectrum disorder (ASD), like their typically developing peers, are able to manage these physiological processes in a healthy way and learn self-care and hygiene behaviours without being dependent on others. Given the contribution of mothers to the menstrual hygiene and self-care skills of adolescent girls, this study aims to explore the views of mothers.The study is a case study designed in the qualitative research model. The research was carried out with the participation of 10 mothers met the necessary criteria and agreed to take part in the study voluntarily. The data obtained were subjected to descriptive and thematic analysis. Codes, sub-themes and main themes were created.The research identifies the themes of self-care and menstrual hygiene, preparations made during menstruation, behavioral problems in adolescents, the person who carries out hygiene and self-care, and situations that tire/strain mothers during menstruation.At the end of the research, it was concluded that the adolescent girls with ASD are mostly unable to perform their self-care and hygiene adequately, and that the mothers do nothing to prepare their daughters for adolescence. It was also concluded that the most stressful situation for mothers during adolescence is usually the difficulty their daughters have in using sanitary pads, cleaning armpits and genital hair, and bathing. [ABSTRACT FROM AUTHOR]

People with autism spectrum disorder (ASD) often have cognitive impairments. Effective connectivity between different areas of the brain is essential for normal cognition. Electroencephalography (EEG) has been widely used in the detection of neurological diseases. Previous studies on detecting ASD with EEG data have focused on frequency-related features. Most of these studies have augmented data by splitting the dataset into time slices or sliding windows. However, such approaches to data augmentation may cause the testing data to be contaminated by the training data. To solve this problem, this study developed a novel method for detecting ASD with EEG data. This study quantified the functional connectivity of the subject's brain from EEG signals and defined the individual to be the unit of analysis. Publicly available EEG data were gathered from 97 and 92 subjects with ASD and typical development (TD), respectively, while they were at rest or performing a task. Time-series maps of brain functional connectivity were constructed, and the data were augmented using a deep convolutional generative adversarial network. In addition, a combined network for ASD detection, based on convolutional neural network (CNN) and long short-term memory (LSTM), was designed and implemented. Based on functional connectivity, the network achieved classification accuracies of 81.08% and 74.55% on resting state and task state data, respectively. In addition, we found that the functional connectivity of ASD differed from TD primarily in the short-distance functional connectivity of the parietal and occipital lobes and in the distant connections from the right temporoparietal junction region to the left posterior temporal lobe. This paper provides a new perspective for better utilizing EEG to understand ASD. The method proposed in our study is expected to be a reliable tool to assist in the diagnosis of ASD. • This study constructed TSM-BFCs by combining the temporal information in EEG signals with the individual taken as the unit of analysis. • A CNN–LSTM model for ASD detection that leverages the temporal and spatial features of EEG signals was designed. [ABSTRACT FROM AUTHOR]

Both naturalistic developmental behavioral interventions (NDBIs) and augmentative and alternative communication (AAC) have been shown to support the language development of children with a diagnosis of autism spectrum disorder and minimal speech. However, little research has addressed the impact of incorporating AAC systems within NDBIs. This systematic review was conducted to assess the relative impact of NDBI procedures with and without AAC on the language development of children on the autism spectrum with minimal speech. Relevant studies were located through systematic database searching, targeted review of relevant journals, and ancestral search of references from identified and associated papers. Relevant study characteristics were coded for all included studies, as well as determining certainty of evidence and calculating effect sizes for language variables. All procedures followed the systematic review guidelines set by the Cochrane Collaboration. A total of 29 relevant studies were included within this review, covering both single-case and group design research. Three studies were identified that directly compared NDBI and AAC interventions. NDBIs had a strong impact on language across study types (i.e., with and without AAC), though both aggregate and comparative effect sizes were notably larger when AAC was included within NDBI procedures, as compared to NDBIs without AAC. Results suggest that combining AAC with NDBI procedures may lead to better language outcomes than NDBIs alone for children on the autism spectrum with minimal speech. [ABSTRACT FROM AUTHOR]

In this paper, we present a systematic review of the applications of (1) Extended Reality (XR), (2) Augmented Reality (AR), and (3) Virtual Reality (VR) technologies to enhance emotion recognition and emotion expression in people with Autism Spectrum Disorder (ASD). ASD can affect various abilities, and poses challenges to the recognition of emotions in others, which is often referred to as "social blindness". Treating this condition typically requires intensive one-on-one or small-group therapy sessions, which can be costly and limited in terms of availability. With the growing number of diagnoses of ASD, concerns have risen regarding a potential "lost generation" that may face difficulties in fulfilling its potential. Through this comprehensive review, we aim to provide an overview of innovative approaches that use XR technologies to improve the learning experience of individuals with ASD. [Display omitted] • Review revealed high interest in XR technologies and wellbeing. • XR technologies significantly improved emotion skills learning. • XR applications greatly enhance user motivation. • A user-centered approach is crucial for maximizing learning efficiency. • Further long-term studies and gamification are needed to sustain motivation. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD) must be present early in development, but may not fully manifest until social demands exceed capacities. In the absence of adequate biological or brain imaging markers to detect and diagnose autism, diagnosis relies on clinical judgment based on observation of symptoms. Many tools have been developed in English-speaking countries (questionnaires for parents, symptom checklists for professionals, observation systems, etc.). Screening in countries with other languages requires cultural and linguistic adaptation of these instruments. This paper presents the adaptation of the ADEC (Autism Detection in Early Childhood).Methods: The original version of the ADEC was translated and culturally and linguistically adapted to the characteristics of the population of Guayaquil (Ecuador).Participants: A pilot study was conducted with a sample of 613 children aged 18–48 months. Results: Cronbach’s alpha values (0.89) indicate high internal consistency. The correlation between the MCHAT-R/F follow-up interview and the ADEC (mean r = 0.93) indicates high construct validity. In terms of predictive validity, using the original cut-off points of the ADEC, they show excellent diagnostic ability. The sensitivity and specificity results (sensitivity 1.00; specificity 0.92; positive predictive value 0.83; negative predictive value 0.99) are even better than those obtained in a similar study in the Mexican population. Conclusions: Considering that the MCHAT R/F is a parent-reported instrument, the Guayaquil Spanish version of the ADEC (ADEC-GU) seems to be a suitable instrument to be used in a complementary way as a second-level screening instrument for autism, before resorting to a full diagnostic process. [ABSTRACT FROM AUTHOR]

In the context in which it was demonstrated that humanoid robots are efficient in helping children diagnosed with autism in exploring their affective state, this paper underlines and proves the efficiency of a previously developed machine learning-based mobile application called PandaSays, which was improved and integrated with an Alpha 1 Pro robot, and discusses performance evaluations using deep convolutional neural networks and residual neural networks. The model trained with MobileNet convolutional neural network had an accuracy of 56.25%, performing better than ResNet50 and VGG16. A strategy for commanding the Alpha 1 Pro robot without its native application was also established and a robot module was developed that includes the communication protocols with the application PandaSays. The output of the machine learning algorithm involved in PandaSays is sent to the humanoid robot to execute some actions as singing, dancing, and so on. Alpha 1 Pro has its own programming language—Blockly—and, in order to give the robot specific commands, Bluetooth programming is used, with the help of a Raspberry Pi. Therefore, the robot motions can be controlled based on the corresponding protocols. The tests have proved the robustness of the whole solution. [ABSTRACT FROM AUTHOR]

BACKGROUND: Autism Spectrum Disorder (ASD) is characterized by difficulties in social communication, social interactions, and repetitive behaviors. The earlier the diagnosis, the sooner the intervention therapy can begin, thus, making early diagnosis an important research goal. Technological innovations have tremendous potential to assist with early diagnosis and improve intervention programs. There is a limited understanding of the Wearable Technologies (WTs) currently available for autistic individuals, and how they measure functioning in this population. OBJECTIVE: The aim of this review is to identify advancement in wearable technologies used to monitor behavioral and physiological responses in the intervention of children with ASD. METHODS: A literature search was performed for English language articles and conference papers indexed in Science direct, PubMed, Web of science, Google scholar, ERIC, ProQuest and Cochrane in last five years (2017–2021), resulting in eighteen studies being reviewed. RESULTS: Wearable technology present a potential solution that can support and complement existing interventions. WTs measured a range of physiological and behavioural functions to objectively measure stereotypical motor movements, social function, communication, and emotion regulation in autistic youth in the context of a range of environments and activities. CONCLUSIONS: Advancement in technology that include behavioral and physiological response monitoring with wearable sensors provide the opportunity to acquire new understanding of the internal components of observable behavior of children with ASD. This could lead to better individualization of treatment and greater treatment effectiveness. [ABSTRACT FROM AUTHOR]

Physical activity (PA) has shown promise in addressing social, behavioural, and motor concerns in children with Autism Spectrum Disorder (ASD). In this paper, the experience of a seven-year-old girl ("Sophie") with ASD and other psychological disorders was examined as she participated in a 10-week PA program. Her motor and social skills were evaluated before and after the program via the Movement Assessment Battery for Children and the Social Responsiveness Scale. PA and social interactions were analyzed based on video recordings, interviews, and focus groups. Sophie demonstrated some improvements in her motor and social skills after the PA program, in addition to gaining PA and social interactions. Sophie also gained self-confidence as she was supported by the instructor and volunteer, and acceptance as she was included in an environment with other children of varying ages and abilities. Sophie's progress exemplifies the far-reaching effects of PA when offered in an accepting environment with adequate support. [ABSTRACT FROM AUTHOR]

Frontal lobe volume has been extensively researched in individuals with Autism spectrum disorder (ASD), though findings are yet to be summarised to explain the developmental trends of frontal lobe volume. The aim of the present study is to consolidate all existing frontal lobe volume and age data of autistic individuals below 30 years of age, and compare this data to non-autistic (N-ASD) controls. Following a systematic review, frontal lobe volume data were obtained from seven papers. Raw data, or the means and standard deviations of frontal lobe volume, and age, were obtained from the studies giving 372 autistic and 190 N-ASD participants. Data were plotted and analysed. Findings revealed that regression lines of fit for ASD (R2 Linear = 0.33; R2 Quadratic = 0.52) and N-ASD (R2 Linear = 0.14; R2 Quadratic = 0.39) were significantly different by diagnosis (linear p = 0.002, quadratic p = 0.02) with quadratic models providing significantly better fit within ASD (p < 0.001) and N-ASD (p < 0.001). Additional analyses revealed that frontal lobe volume was greater in autistic individuals than N-ASD between two and four years (F(1,31) = 12.965, p < 0.005, η2 = 0.291). In the present study, there were distinct developmental trends for frontal lobe volume between ASD and N-ASD. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders are a group of neurodevelopmental disorders associated with deficits in social, communication and behavioural functions. It is estimated that 1-2% of the global population is affected by autism spectrum disorders, with girls and women still representing a highly underestimated group of autistic patients. Patients with autism spectrum disorder require comprehensive care and often have difficulty accessing high-quality healthcare services due to the shortage of well-trained specialists. Extension for Community Healthcare Outcomes (ECHO) Autism is a global program that allows autism spectrum disorder experts to share their knowledge and skills with professionals in local communities. The ECHO project is a mentoring model in which an interdisciplinary team of experts plays a supreme role and provides practical information to specialists in local communities. ECHO Autism is not a form of telemedicine but a telementoring model, where specialised knowledge is delivered to local specialists. Experts teach how to investigate and diagnose autism spectrum disorder as well as how to deal with co-occurring conditions in these patients. ECHO Autism is useful in meeting the complex needs of patients with autism spectrum disorders from their childhood to late adulthood. It provides the best possible care for these patients and their families, expands practical knowledge and awareness of the disorder, while reducing the inequalities that often occur in rural and neglected communities. The ECHO Autism model is disseminated globally due to its flexibility in adapting to local and regional differences in social norms and constructs. The model is now for the first time introduced in the field of medicine in Europe, with Poland being the first country to adopt it. The aim of this paper is to briefly present the ECHO Autism model and to announce its development in Poland. [ABSTRACT FROM AUTHOR]

The gut–brain axis refers to the bidirectional connection and communication between the gastrointestinal tract and the central nervous system. This paper explores two routes for this communication that have hitherto remained under-examined: epigenetics and redox signaling and their implications for autism spectrum disorder (ASD). The gut microbiota may induce epigenetic changes in the gut and potentially in the brain through their fermentation products. Instead of through other conceptualizations of them acting as neurotransmitters, gut microbial products may act as epigenetic agents, which are supported by the effects of gut bacterial-derived metabolites on gene regulation and expression. In addition to their epigenetic effects, gut bacterial-derived communicative agents can also influence host signaling by contributing to and even substituting host reactive oxygen species (ROS) production. These ROS can act as second messengers and exert oxidative activity on proteins to influence immune, inflammatory, and other signaling processes. ROS and epigenetic mechanisms may have interactive effects as well. ROS, in addition to their role in signaling pathways and cellular redox alterations, also influence redox-sensitive transcription factors, thereby having an effect on gene expression. Specifically, ROS are involved in the activation of transcription factors, chromatin remodeling, and histone/protein deacetylation. These two proposed mechanisms correspond with the recent findings related to ASD, where a cofactor that is shown to be lower in ASD has antioxidative properties, responds to epigenetic modulation, and increases via microbiota interventions. The current evidence reviewed here suggests the need to update models of the gut–brain communication to include these two mechanisms. Such a modeling can also contribute to understanding the unknowns of host metabolism and physiology in ASD and afford potential therapeutic avenues for this as well as other psychiatric and physiological conditions. [ABSTRACT FROM AUTHOR]

Data collection is an important component of evidence-based behavioral interventions for children with autism, but many one-to-one aides (i.e., behavioral support staff) do not systemically collect quantitative data that are necessary for best-practice client progress monitoring. Data collection of clients' behaviors often involves labor-intensive pen-and-paper practices. In addition, the solitary nature of one-to-one work limits opportunities for timely supervisor feedback, potentially reducing motivation to collect data. We incorporated principles from behavioral economics and user-centered design to develop a phone-based application, Footsteps, to address these challenges. We interviewed nine one-to-one aides working with children with autism and seven supervisors to ask for their app development ideas. We then developed the Footsteps app prototype and tested the prototype with 10 one-to-one aides and supervisors through three testing cycles. At each cycle, one-to-one aides rated app usability. Participants provided 76 discrete suggestions for improvement, including 29 new app features (e.g., behavior timer), 20 feature modifications (e.g., numeric type-in option for behavior frequency), four flow modifications (e.g., deleting a redundant form), and 23 out-of-scope suggestions. Of the participants that tested the app, 90% rated usability as good or excellent. Results support continuing to develop Footsteps and testing its impact in a clinical trial. [ABSTRACT FROM AUTHOR]

Designing new objectively diagnostic methods of autism spectrum disorder (ASD) are burning questions. Dynamic functional connectivity (DFC) methodology based on fMRI data are an effective lever to investigate changeability evolution of signal synchronization in macroscopic neural activity patterns. Embracing the network dynamics concepts, this paper introduces changeability index ( C -score)which is focused on time-varying aspects of FCs, and develops a new framework for researching the roots of ASD brains at resting states in holism significance. The important process is to uncover noticeable regions and subsystems endowed with antagonistic stance in C -scores of between atypical and typical DFCs of 30 healthy controls (HCs) and 48 ASD patients. The abnormities of edge C-scores are found across widespread brain cortex in ASD brains. For whole brain regional C-scores of ASD patients, orbitofrontal middle cortex L, inferior triangular frontal gyrus L, middle occipital gyrus L, postcentral gyrus L, supramarginal L, supramarginal R, cerebellum 8 L, and cerebellum 10 Rare endowed with significantly different C -scores.At brain subsystems level, C-scores in left hemisphere, right hemisphere, top hemisphere, bottom hemisphere, frontal lobe, parietal lobe, occipital lobe, cerebellum sub systems are abnormal in ASD patients. The ASD brains have whole-brain abnormity on widespread regions. Through the strict evidence-based study, it was found that the changeability index (C-score) is a meaningful biological marker to explore cortical activity in ASD. [ABSTRACT FROM AUTHOR]

Brain functional connectivity network (FCN) based on resting-state functional magnetic resonance imaging (rs-fMRI) has been widely used to identify neuropsychiatric disorders such as autism spectrum disorder (ASD). Most existing FCN-based methods only estimate the correlation between brain regions of interest (ROIs), without exploring more informative higher-level interactions among multiple ROIs which could be beneficial to disease diagnosis. To fully explore the discriminative information provided by different brain networks, a cluster-based multi-view high-order FCN (Ho-FCN) framework is proposed in this paper. Specifically, we first group the functional connectivity (FC) time series into different clusters and compute the multi-order central moment series for the FC time series in each cluster. Then we utilize the correlation of central moment series between different clusters to reveal the high-order FC relationships among multiple ROIs. In addition, to address the phase mismatch issue in conventional FCNs, we also adopt the central moments of the correlation time series as the temporal-invariance features to capture the dynamic characteristics of low-order dynamic FCN (Lo-D-FCN). Experimentalresults on the ABIDE dataset validate that: 1) the proposed multi-view Ho-FCNs is able to explore rich discriminative information for ASD diagnosis; 2) the phase mismatch issue can be well circumvented by using central moments; and 3) the combination of different types of FCNs can significantly improve the diagnostic accuracy of ASD (86.2%). [ABSTRACT FROM AUTHOR]

The text discusses the growing incidence of autism in the world, presents an understanding of autism from the point of view of analytical psychology, and reflects on the treatment of autistic patients. Today, it is understood that autism is part of a continuum of characteristics on a spectrum with biological and congenital causes. It is a non-specific picture resulting from multiple causations of non-linear factors. Autism is a neuro-developmental disorder characterized by a triad of symptoms: persistent deficits in social communication and social interaction, and restricted and repetitive patterns of behaviours, interests, or activities. Autism spectrum disorder must be considered as a clinical entity, with current clearly defined characteristics. It is an extremely complex condition, which requires multidisciplinary approaches aiming at the possibility of prognosis and effective therapeutic approaches. This paper explores how a disturbance may occur from the intra-uterine phase, in which matriarchal experiences do not constellate. The structuring function of the patriarchal organization can then become dominant, and people with autism need understanding and help to organize their world and learn to live in it. As they don't have the capacity to structure consciousness through the matriarchal archetype, they rely entirely on the structuring and organizing capacity of the Father archetype. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a collection of neuro-developmental disorders associated with social, communicational, and behavioral difficulties. Early detection thereof is necessary to mitigate the adverse effects of this disorder by initiating special education in schools and rehabilitation centers. Two methods are available for diagnosing and rehabilitating ASD. The first is the manual method (i.e., an observation- or interview-based approach), in which the disorder is diagnosed through observation or by interviewing a parent or caregiver. This method is time-consuming, subjective, and mostly comprises the examination of behavioral symptoms. The other method involves automatic diagnosis using traditional machine learning (ML)- and modern deep learning (DL)-based approaches that rely on image analysis. Indeed, the amount of research literature concerned with the evaluation of the usefulness of DL-based methods that process images or video data to diagnose ASD to improve patients' lives has increased significantly. This paper presents a systematic review of the DL-based approach involving the analysis of images or videos in autism research. The review covers studies that were published from 2017 to June 2023 and were indexed in PubMed, IEEE Xplore, ACM Digital Library, and Google Scholar. The results are reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A total of 130 studies were included in the analysis. Eligible papers were categorized based on the different features extracted as input for the DL-based approach. Existing well-known public and private datasets that include images or videos for autism research are extensively reviewed and discussed in this systematic review. In addition, different rehabilitation strategies that have been shown to be highly beneficial for ASD individuals are included. Finally, various challenges presented by the automated detection, classification, and rehabilitation of ASD are discussed. The review concludes that the use of DL for the precise and affordable diagnosis of autism is increasing substantially. Our findings are expected to significantly benefit researchers, therapists, psychologists, and relevant stakeholders to advance ASD screening, monitoring, and diagnosis with the aid of a DL-based approach that entails image or video analysis. [ABSTRACT FROM AUTHOR]

Purpose: To make early detection of individuals with autism spectrum disorder (ASD), caregiver-report instruments remain an efficient and adaptable option for the preliminary assessment. This study aimed to compare the psychometric properties of the Clancy Autism Behavior Scale (CABS) and Autism Behavior Checklist (ABC) as screening tools for ASD by caregivers.The data were collected from 154 pairs of children and their parents, who sought medical attention for suspected autism at Peking University Sixth Hospital. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index, and area under the receiver operating characteristics curves (AUC) of the CABS and ABC were calculated and compared using recommended cut-off values from initial papers. The optimal cut-off values for CABS and ABC were determined according to the maximum Youden index.The ABC performed better than the CABS in screening autistic persons. Specifically, the ABC demonstrated higher sensitivity than the CABS in identifying children with ASD, while the CABS exhibited superior specificity compared to the ABC. According to the maximum Youden index, the optimal cut-off value was determined to be 13 for CABS and 62 for ABC.The ABC exhibits higher sensitivity and overall performance in screening individuals with ASD compared to the CABS. The ABC is more suitable as a screening tool for caregivers in both domestic and clinical settings, while the CABS may be utilized when evaluation time or medical resources are limited due to its shorter completion time and fewer items.Methods: To make early detection of individuals with autism spectrum disorder (ASD), caregiver-report instruments remain an efficient and adaptable option for the preliminary assessment. This study aimed to compare the psychometric properties of the Clancy Autism Behavior Scale (CABS) and Autism Behavior Checklist (ABC) as screening tools for ASD by caregivers.The data were collected from 154 pairs of children and their parents, who sought medical attention for suspected autism at Peking University Sixth Hospital. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index, and area under the receiver operating characteristics curves (AUC) of the CABS and ABC were calculated and compared using recommended cut-off values from initial papers. The optimal cut-off values for CABS and ABC were determined according to the maximum Youden index.The ABC performed better than the CABS in screening autistic persons. Specifically, the ABC demonstrated higher sensitivity than the CABS in identifying children with ASD, while the CABS exhibited superior specificity compared to the ABC. According to the maximum Youden index, the optimal cut-off value was determined to be 13 for CABS and 62 for ABC.The ABC exhibits higher sensitivity and overall performance in screening individuals with ASD compared to the CABS. The ABC is more suitable as a screening tool for caregivers in both domestic and clinical settings, while the CABS may be utilized when evaluation time or medical resources are limited due to its shorter completion time and fewer items.Results: To make early detection of individuals with autism spectrum disorder (ASD), caregiver-report instruments remain an efficient and adaptable option for the preliminary assessment. This study aimed to compare the psychometric properties of the Clancy Autism Behavior Scale (CABS) and Autism Behavior Checklist (ABC) as screening tools for ASD by caregivers.The data were collected from 154 pairs of children and their parents, who sought medical attention for suspected autism at Peking University Sixth Hospital. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index, and area under the receiver operating characteristics curves (AUC) of the CABS and ABC were calculated and compared using recommended cut-off values from initial papers. The optimal cut-off values for CABS and ABC were determined according to the maximum Youden index.The ABC performed better than the CABS in screening autistic persons. Specifically, the ABC demonstrated higher sensitivity than the CABS in identifying children with ASD, while the CABS exhibited superior specificity compared to the ABC. According to the maximum Youden index, the optimal cut-off value was determined to be 13 for CABS and 62 for ABC.The ABC exhibits higher sensitivity and overall performance in screening individuals with ASD compared to the CABS. The ABC is more suitable as a screening tool for caregivers in both domestic and clinical settings, while the CABS may be utilized when evaluation time or medical resources are limited due to its shorter completion time and fewer items.Conclusion: To make early detection of individuals with autism spectrum disorder (ASD), caregiver-report instruments remain an efficient and adaptable option for the preliminary assessment. This study aimed to compare the psychometric properties of the Clancy Autism Behavior Scale (CABS) and Autism Behavior Checklist (ABC) as screening tools for ASD by caregivers.The data were collected from 154 pairs of children and their parents, who sought medical attention for suspected autism at Peking University Sixth Hospital. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index, and area under the receiver operating characteristics curves (AUC) of the CABS and ABC were calculated and compared using recommended cut-off values from initial papers. The optimal cut-off values for CABS and ABC were determined according to the maximum Youden index.The ABC performed better than the CABS in screening autistic persons. Specifically, the ABC demonstrated higher sensitivity than the CABS in identifying children with ASD, while the CABS exhibited superior specificity compared to the ABC. According to the maximum Youden index, the optimal cut-off value was determined to be 13 for CABS and 62 for ABC.The ABC exhibits higher sensitivity and overall performance in screening individuals with ASD compared to the CABS. The ABC is more suitable as a screening tool for caregivers in both domestic and clinical settings, while the CABS may be utilized when evaluation time or medical resources are limited due to its shorter completion time and fewer items. [ABSTRACT FROM AUTHOR]

This paper reported the quality of life (QoL) of 260 Malaysian parents with autism spectrum disorder (ASD) and factors which influencing it. About half of these parents reported to having good QoL. The factors identified in the double ABCX model showed that perceived social support and sense of coherence (SOC) were mediated by coping strategies and had a positive direct and indirect effect on parents' QoL. These finding reiterate the importance of social support, coping skills, and strong SOC reflection skills in influencing the QoL of parents with ASD child. We therefore suggest parents to utilize the widely available social and organization supports to gain good QoL, which is also important for the wellbeing of their child. [ABSTRACT FROM AUTHOR]

Daily living skill deficits commonly co-occur in individuals with autism spectrum disorder (ASD). These deficits in adolescence are associated with poor outcomes, in both employment and independent living skills as adults. Currently, there are no interventions that directly target daily living skill acquisition in adolescents with ASD without an intellectual disability to facilitate a successful transition to adulthood. In this paper, we discuss the development, refinement, and initial efficacy studies of Surviving and Thriving in the Real World (STRW), a 14-session group treatment for both adolescents with ASD and their parent/caregiver that promotes attainment of critical daily living skills. We summarize initial feasibility studies that have been instrumental in the iterative development of STRW. The structure, core treatment elements, and content of STRW are described in detail. Lastly, we discuss the transition of the in-person STRW intervention to STRW-telehealth, which allows for adolescents with ASD to work on daily living skills in their own home with support from a therapist. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide an overview of the most relevant contributions regarding the application of so-called third generation interventions of cognitive behavioral therapy, such as mindfulness and ACT (Acceptance and Commitment Therapy), in the context of therapy for autism spectrum disorders. In particular, our attention is focused on the application of these interventions aimed at caregivers of individuals with autism spectrum disorder who have not reached the mature age. To this end, a search was conducted on the contributions published between 2005 and 2020 through the main search engines: it led to a final number of 8 revised articles. At present, the scarce availability of reliable results does not allow to arrive at a structured, valid and reliable model of intervention; nevertheless, having ascertained the potential benefit that emerged from the few studies conducted, it is possible to deduce that the line of research undertaken may create a protocol of proven effectiveness for the future. [ABSTRACT FROM AUTHOR]

Avoidant Restrictive Food Intake Disorder (ARFID) is a Feeding and Eating Disorder newly added to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, which presents with high prevalence rates in community and clinical settings. Given its recent diagnostic recognition, validated and standardized treatments for this population are lacking. In addition, given the complexity, heterogeneity of symptoms, and high rates of psychiatric comorbidities in the ARFID population, new models of care are required. The current therapy model combines two evidence-based treatments - Family Based Treatment (FBT) and the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) - for young patients with ARFID plus Autism Spectrum Disorder (ASD), which allows clinicians to personalize care based on each patient's unique presenting needs. This paper presents two distinct cases which showcase the use of the FBT+UP for ARFID approach for treating comorbid ARFID and ASD in a clinical setting. Case 1 demonstrates the application and reliance on FBT, while Case 2 draws upon UP to facilitate behavioural change in the patient. Case backgrounds, presenting problems, and treatment approaches combining the two evidence-based treatments are presented and discussed. The cases demonstrate the unique challenges of treating young patients with comorbid ARFID and ASD, along with the proposed benefits of the combined approach with this population. [ABSTRACT FROM AUTHOR]

Background: Despite high levels of prenatal alcohol exposure in the UK, evidence on the prevalence of fetal alcohol spectrum disorders (FASD) is lacking. This paper reports on FASD prevalence in a small sample of children in primary school. Methods: A 2‐phase active case ascertainment study was conducted in 3 mainstream primary schools in Greater Manchester, UK. Schools were located in areas that ranged from relatively deprived to relatively affluent. Initial screening of children aged 8–9 years used prespecified criteria for elevated FASD risk (small for age; special educational needs; currently/previously in care; significant social/emotional/mental health symptoms). Screen‐positive children were invited for detailed ascertainment of FASD using gold standard measures that included medical history, facial dysmorphology, neurological impairment, executive function, and behavioral difficulties. Results: Of 220 eligible children, 50 (23%) screened positive and 12% (26/220) proceeded to Phase 2 assessment. Twenty had a developmental disorder, of whom 4 had FASD and 4 were assessed as possible FASD. The crude prevalence rate of FASD in these schools was 1.8% (95% CI: 1.0%, 3.4%) and when including possible cases was 3.6% (2.1%, 6.3%). None of these children had previously been identified with a developmental diagnosis. Conclusions: FASD was found to be common in these schools and most of these children's needs had not previously been identified. A larger, more definitive study that uses a random sampling technique stratified by deprivation level to select schools is needed to make inferences regarding the population prevalence of FASD. [ABSTRACT FROM AUTHOR]

The experimental protocol presented in this paper aims to explore the potential agency of cinematic dispositive and moving images as part of the therapeutic process, in particular of the strategic approach, in supporting children and adolescents with Autism Spectrum Disorder (HFASD Level 1, DSM-5) and their families. The protocol illustrates the methodological integration of the Strategic Psychotherapy approach, parent training, and the following audiovisual techniques: Therapeutic Filmmaking; Cinematherapy; Documentary Videotherapy. This methodological integration guarantees a narrative and patient-centered-approach, in which the participants (children and families) are actively involved in the creative therapeutic process. The research protocol described aims to (a) enhancing social, relational skills and self-representation in youths with ASD; (b) helping the family system to manage stress and to improve educational strategies to promote positive children's behavior and psychological well-being. [ABSTRACT FROM AUTHOR]