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Background and aims Children with autism spectrum condition often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in autism spectrum condition has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs. e-book) and differences in story narration (adult narration vs. in-app narration) would influence narrative comprehension in general, and between groups (autism spectrum condition and a receptive language-matched control group). We were also interested in how task engagement (visual attention and communication) differed between group and conditions and whether task engagement was related to narrative comprehension. Method Forty-two children with autism spectrum condition and 42 typically developing children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children’s behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure). Results Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the typically developing group. Conclusion Overall, this study suggests that children with autism spectrum condition are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in typically developing children. Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.

This paper describes the (Sin Exclusión) Transdisciplinary Autism Assessment and Resources ([S]TAAR) model and presents early metrics tracking efficiency and equity in access to high-quality comprehensive autism evaluations for young children. Retrospective chart reviews over one year (08/2018–08/2019) with n = 173 children were reviewed. Through care coordination with community providers, the model was developed to meet local needs by increasing throughput of children (

Using a mixed methods design, this study aimed to examine the impact of the COVID-19 pandemic on autistic and non-autistic adults. We conducted an online survey with 196 autistic and 228 non-autistic adults from Belgium, the Netherlands and the United Kingdom focusing on their experiences during the first period of the pandemic. Our results indicate rather diverse experiences within the group of autistic participants across all domains of life. In comparison with non-autistic adults, autistic adults reported less negative impact on their social life and more negative impact on health and support services. In the autism group, stress was mainly related to changing and unclear measures. A wide range of coping strategies were described as helpful in reducing stress during the pandemic. ispartof: Journal Of Autism And Developmental Disorders vol:53 issue:1 pages:1-13 ispartof: location:United States status: Published online

Many parents experience grief and loss in response to their child receiving an autism diagnosis in early childhood. However, there is a dearth of research that considers if grief and loss are experienced by parents throughout their child’s adolescence and young adulthood. Further, there is a small but growing body of evidence suggesting that parents of autistic children may be living with ambiguous loss in particular, that is, a loss for which there is no closure or resolution. This case study introduces a peer group intervention utilizing an ambiguous loss framework that school social workers and other clinicians can adopt to support mothers of autistic adolescents who are struggling with ambiguous loss. Through the group process, the mothers developed deeper understanding, self-compassion, and effective coping strategies, resulting in a more resilient approach to the transition process and an enhanced capacity to plan for a meaningful adult life with their autistic child.

A randomized feasibility trial of a parent coaching (PC) intervention was conducted across 16 community agencies in a Canadian province. Parents of toddlers with suspected autism were assigned to either a PC group (n = 24) or an enhanced community treatment (ECT) group (n = 25). PC participants received 24 weeks of coaching support from community service providers trained in the project. Children in both groups also received available community services and supplementary materials. PC children made significantly greater gains in word understanding and PC parents had significantly higher quality of life, satisfaction, and self-efficacy scores. Results are discussed in terms of the challenges of conducting feasibility studies in community settings and the lessons learned in the project. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-021-05390-1.

Hospitals, with many features that can evoke severe behavior in patients with autism spectrum disorder (ASD), often use restraint as a behavior management strategy. Prior research on restraint in patients with ASD has primarily focused on children or specific departments. Twenty-five physicians and medical trainees from an urban teaching hospital participated in discussions about experiences managing severe behavior in patients with ASD across the lifespan. Twenty themes emerged from thematic analysis of participant transcripts. The five most salient themes included: lack of procedural knowledge with restraint implemented by other hospital professionals; alternative strategies to manage severe behavior; negative perceptions of restraint; helpful role of caregivers; and limited experience treating patients with ASD, and critical need for training in function-based management.

Background The goal of this systematic review was to provide an overview of self-report measures of stress in populations on the autism spectrum. In addition, information regarding psychometric properties was discussed as well. Methods Four databases were systematically searched following the PRISMA guidelines and using strict eligibility criteria. Risk of bias assessment was performed using the COSMIN checklist. Results Eight questionnaires were previously used in populations on the autism spectrum, reported over 31 studies. Discussion Future research should focus more on examining psychometric properties of these self-report measures in this population as current evidence is scarce. In addition, it is important to consider which concept of stress one aims to measure as not all questionnaires cover the same aspects of stress. Supplementary information The online version contains supplementary material available at 10.1007/s40489-021-00293-4.

The aim of the present study was to examine the additive effect of elements of cognitive behavioral therapy (CBT) on the video game Mindlight in decreasing anxiety of children with an autism spectrum disorder (ASD). A non-concurrent multiple baseline design with 8 children with ASD in the age of 8-12 was used. CBT did not have the hypothesized additive effect on Mindlight in decreasing anxiety of children with ASD. Instead, multiple participants already experienced a decrease in anxiety during the Mindlight sessions. Yet, several participants did experience a stabilization in anxiety at a low level during the CBT sessions. For now, it can be concluded that CBT does not have an additive effect on Mindlight. ispartof: JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS vol:52 issue:1 pages:150-168 ispartof: location:United States status: published

BackgroundCoronavirus disease 2019 (COVID-19) has had a disproportionate impact on people with intellectual disability (PwID). PwID are at higher risk of mental illness and receive psychotropic prescribing ‘off licence' also, to manage distress behaviour. The lockdown and reduction of multidisciplinary face-to-face appointments had an impact on care delivery, the recourse possibly being psychotropic prescribing. It is imperative to comprehend the influence the pandemic had on psychotropic prescribing patterns to enable future planning.AimsThe aim was to understand the impact of the pandemic by comparing psychotropic prescribing patterns during the England lockdown with the prescribing patterns before lockdown in specialist urban and rural psychiatric services for PwID.MethodData was collected from Cornwall (rural) and London (urban) intellectual disability services in England as a service evaluation project to rationalise psychotropic prescribing. PwID in both services open across January 2020 to January 2021 were included. Baseline patient demographics including age, gender, ethnicity, intellectual disability level and neurodevelopmental and psychological comorbidities were collected. Baseline psychotropic prescribing and subsequent % change for each psychotropic group for the two services was compared using Pearson's chi-square and z-statistic (two tailed) with significance taken at P < 0.05.ResultsThe two centres London (n = 113) and Cornwall (n = 97) were largely comparable but for baseline differences in terms of presence of severe mental illness (37 v. 86, P < 0.001), challenging behaviour (44 v. 57, P < 0.05) and attention-deficit hyperactivity disorder (37 v. 3, P < 0.001). There was an overall increase in psychotropic prescribing during lockdown in urban as compared with rural settings (11% v. 2%).ConclusionsThe pandemic caused an increase in psychotropic prescribing associated with lockdown severity and urban settings. Team structures could have played a role.

This study evaluated the fidelity and effectiveness of a parent coach training program for toddlers at risk for autism spectrum disorder and identified factors required for successful training implementation under real-world conditions. Training addressed four tiers of clinical competence and was delivered to early intervention providers across 23 partner agencies in a large Canadian province. Results indicated that mean trainee fidelity scores were within the range reported in previous community-based training studies but there was considerable variability across trainees. Implementation facilitators included agency learning climate, leadership support, and trainee readiness for change. Implementation barriers included time/caseload demands and challenges related to technology learning and infrastructure. Results have implications for parent coach training in community settings. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-021-05363-4.

Social media can lead to rejection, cyber-bullying victimisation, and cyber-aggression, and these experiences are not fully understood as experienced by autistic adults. To investigate this, 78 autistic adults completed self-report measures of social media use, cyber-bullying victimisation, cyber-aggression, and self-esteem. High levels of social media use were found to be associated with an increased risk of cyber-victimisation; whereas self-esteem was positively correlated with feelings of belonging to an online community and negatively correlated with feelings of being ignored on social network sites and chat rooms. Future studies are needed to further investigate the experience of cyber-bullying victimisation of autistic adults. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-021-05361-6.

The relationship between emotion regulation, social interaction and different types of restricted and repetitive behaviors is poorly understood. In the present study, structural equation modeling based on information about 239 individuals with autism was used to examine whether emotion regulation and social communication were associated with self-injury and stereotyped behaviors. Results showed that poor emotion regulation had a unique association with self-injury while difficulties with social communication was uniquely associated with stereotyped behaviors. Emotion regulation and social communication were strongly associated and self-injury and stereotyped behaviors moderately associated. This implies that these types of behaviors are often expressions of broader negative emotional states in autism. Treatments that help improve coping and social communication strategies may benefit individuals with autism. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.

Interest continues to be high in technology-based interventions for individuals with autism spectrum disorder (ASD). Understanding the preferences and challenges of technology use among individuals with ASD can inform the design of such interventions. Through 18 interviews with parents, we used an iterative inductive-deductive approach to qualitative analysis and explored uses of technology for social skills development among adolescents with ASD. Our findings include parents’ observations about their adolescent’s preferences in types of technology devices and digital content, as well as both positive and negative effects of technology use on mood and behavior. Parents highlighted several avenues of technological preferences and risks that may inform intervention design, enhance user engagement, and capitalize on users’ strengths while buttressing areas for growth. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-021-05315-y.

In this study, we examined trajectories of specific domains of behavior problems (i.e., attention problems, depression/anxiety, and aggressive behavior) from age 6 to 18 in a sample of 55 children with fragile X syndrome. We also examined autism status and early parenting as predictors of subsequent behavioral trajectories. We found that attention problems and aggressive behavior declined steadily from childhood through adolescence whereas anxious/depressed behavior demonstrated relative stability over the same period. Youth with highly flexible mothers displayed more optional trajectories of improvement in attention problems.

Background The rapid movement of mental health services on the internet following the onset of the COVID-19 pandemic has demonstrated the potential advantages of digital delivery and has highlighted the need to learn from prepandemic digital services. Objective The aim of this study is to explore the different elements of interconnected digital mental health and neurodevelopmental services of a well-established provider to the UK National Health Service and how web-based delivery enables young people and their families to access high-quality assessments and interventions in a more timely, flexible, and person-centered manner than in-person delivery. Methods A realist evaluation multiple case–study design was used, with 9 pediatric cases (aged 8-15 years) identified as representative of the services provided by Healios. Presenting concerns included autism and ADHD, anxiety and panic attacks, low self-esteem, anger and self-harm. The research literature was used to define the program theory and six context-mechanism-outcome (CMO) statements. The CMOs formed the basis for the initial data extraction, with novel elements added via an iterative process. Results We identified 10 key elements of web-based services: flexible delivery and timely response, personalized care to the individual, comprehensive care enabled by multiple interconnected services, effective client engagement and productive therapeutic alliances, use of multiple communication tools, client satisfaction with the service, good clinical outcomes, ease of family involvement throughout sessions or from different locations, facilitation of multi-agency working and integration with National Health Services, and management of risk and safeguarding. These elements supported the six CMOs; there was clear evidence that young people and their families valued the responsiveness and flexibility of the web-based mental health service and, in particular, how quickly they were seen. There was also clear evidence of individual needs being met, good therapeutic alliances, and client satisfaction. Multiple communication tools appeared to maximize engagement and working digitally facilitated multi-agency communication and delivery of safe care. The abovementioned factors may be related to the finding of good clinical outcomes, but the methodology of this study does not allow any conclusions to be drawn regarding causality. Conclusions This study demonstrates the effectiveness of interconnected digital mental health and neurodevelopmental services as well as how web-based delivery enables young people and their families to access assessments and interventions in a more timely, flexible, and person-centered manner than in-person delivery. The 10 key elements of web-based service delivery identified through the 9 case studies suggest the potential advantages of web-based work. These elements can inform future research and aid in the delivery of high-quality digital services.

Background This trial tested if a novel therapy, Aligning Dimensions of Interoceptive Experience (ADIE), reduces anxiety in autistic adults. ADIE targets the association of anxiety with mismatch between subjective and behavioral measures of an individual's interoceptive sensitivity to bodily signals, including heartbeats. Methods In this superiority randomized controlled trial, autistic adults (18–65 years) from clinical and community settings in Southern England were randomly assigned (1:1) to receive six sessions of ADIE or an active ‘exteroceptive’ control therapy (emotional prosody identification). Researchers conducting outcome assessments were blind to allocation. ADIE combines two modified heartbeat detection tasks with performance feedback and physical activity manipulation that transiently increases cardiac arousal. Participants were followed-up one-week (T1) and 3-months post-intervention (T2). The primary outcome was Spielberger Trait Anxiety Score (STAI-T) at T2. Outcomes were assessed on an intention-to-treat basis using multiple imputation for dealing with missing values. This trial was registered at International Standard Randomized Controlled Trial Registry, ISRCTN14848787. Findings Between July 01, 2017, and December 31, 2019, 121 participants were randomly allocated to ADIE (n = 61) or prosody (n = 60) intervention groups. Data at T1 was provided by 85 (70%) participants (46 [75%] ADIE; 39 [65%] prosody). Data at T2 was provided by 61 (50%) participants (36 [59%] ADIE; 25 [42%] prosody). One adverse event (cardiac anxiety following ADIE) was recorded. A statistically significant group effect of ADIE on trait anxiety continued at T2 (estimated mean difference 3•23 [95% CI 1•13 to 5•29]; d = 0•30 [95% CI 0•09 to 0•51]; p = 0•005) with 31% of ADIE group participants meeting trial criteria for recovery (compared to 16% in the control group). Interpretation ADIE can reduce anxiety in autistic adults, putatively improving regulatory control over internal stimuli. With little reliance on language and emotional insight, ADIE may constitute an inclusive intervention. Funding: MQ Transforming Mental Health PsyImpact Grant.

In recent years, the prevalence of autism spectrum disorder (ASD) has been proliferating rapidly around the world. This paper aims to provide a comprehensive survey of the diagnosis and intervention for autistic children. Two assessment framework are introduced first to provide theoretical support for autistic engineering technologies: international classification of diagnosis (ICD) and international classification of functionalities (ICF). Then autistic diagnosis and intervention techniques are presented respectively with different modalities. Multi-modal sensing strategies for autism assessment are summarized subsequently. Finally the paper is concluded with future directions and challenges. This paper overviews state-of-the-art researches in the field of autistic diagnosis and intervention theory and applications giving priority to ICF based solutions.

Racism and ableism have doubly affected Black families of children with developmental disabilities in their interactions with disability systems of supports and services (e.g., early intervention, mental health, education, medical systems). On average, Black autistic children are diagnosed three years later and are up to three times more likely to be misdiagnosed than their non-Hispanic White peers. Qualitative research provides evidence that systemic oppression, often attributed to intersectionality, can cause circumstances where Black disabled youth are doubly marginalized by policy and practice that perpetuates inequality. School discipline policies that criminalize Black students and inadequate medical assessments that improperly support Black children with developmental and mental health disabilities are examples of systemic oppressions. However, there is evidence to support that attitudes and biases that providers hold about Black children, and their families hold a part in the blame as well. This paper will explore the efforts of two University Centers for Excellence in Developmental Disabilities (UCEDDs) to address disparities in access to diagnostic and higher quality services for Black neurodiverse children in Northern California and Wisconsin. This paper will: (1) Describe programs and projects within each center that support advocacy and peer networking for Black families; (2) Provide first-person accounts from family members that document the UCEDDs’ impact on their respective advocacy journeys; (3) Delineate how each UCEDD partnered with Black families and community stakeholders to develop and plan programs that meet the unique interests and needs of the groups of Black families of autistic children within the cultural contexts of the communities in which they live; (4) Discuss the processes that each UCEDD underwent to evaluate the efficacy of their programs to ensure that they were uplifting principles of cultural and linguistic competence such as community and family engagement; and (5) Offer recommendations to improve current practice and create culturally competent and family-centered supports and services for disability systems and providers across the DD Network and beyond.

Sometimes a division has been made between expressions of knowledge and expressions of emotion, but in the actual instances of interaction, they are deeply intertwined. In this paper we investigate the relationship between these expressions through the notions of affiliation and epistemics. More specifically, we analyze the phenomenon of ‘epistemic calibration’ in response to tellings of personal experience, where recipients fine-tune the strength of their access claims and the degree of their generalizations to be in line with their epistemic statuses in relation to those of the tellers. Drawing on a dataset of Finnish quasi-natural conversations with neurotypical participants and participants diagnosed with Asperger syndrome, we explore how such calibration is done in practice. Our analysis points to different challenges in epistemic calibration, which, we argue, play an important role in influencing the hearing of these responses as less than fully affiliative. Sometimes a division has been made between expressions of knowledge and expressions of emotion, but in the actual instances of interaction, they are deeply intertwined. In this paper we investigate the relationship between these expressions through the notions of affiliation and epistemics. More specifically, we analyze the phenomenon of ‘epistemic calibration’ in response to tellings of personal experience, where recipients fine-tune the strength of their access claims and the degree of their generalizations to be in line with their epistemic statuses in relation to those of the tellers. Drawing on a dataset of Finnish quasi-natural conversations with neurotypical participants and participants diagnosed with Asperger syndrome, we explore how such calibration is done in practice. Our analysis points to different challenges in epistemic calibration, which, we argue, play an important role in influencing the hearing of these responses as less than fully affiliative.

BACKGROUND: There is growing understanding of the potential benefits of a multi-method approach to accurately capture language skills of children on the autism spectrum. Tools such as Language ENvironment Analysis (LENA) provide an efficient means of capturing and analysing early child vocalizations (CVs) and the language learning environment. While developed to capture whole-day recordings of child language in naturalistic settings, there is potential utility in capturing, but little knowledge about, primary LENA metrics-including CVs and conversational turns (CTs)-and novel metrics, such as vocalization ratios (VRs), sampled in clinical practice settings where children are often seen. Moreover, recent research indicates that the novel VR may offer a broad indicator of children's developmental level, beyond just their language abilities, a hypothesis yet to be investigated in a large sample of children for whom the LENA was designed (i.e., pre-schoolers). AIMS: To explore the extent to which primary and novel LENA metrics collected during brief one-to-one clinical interaction was a useful indicator of developmental outcomes for children on the autism spectrum. METHODS & PROCEDURES: Participants were recruited as part of an on-going research programme evaluating early intervention outcomes (n = 99; age 14-47 months). Language samples were collected at intake (T1) using the wearable LENA Digital Language Processors during a one-to-one, play-based assessment with a clinician. Direct (Mullen Scales of Early Learning-MSEL) and parent-report (Vineland Adaptive Behavior Scales-VABS) measures of verbal and non-verbal skills were also collected at intake (T1) and again at exit (T2), approximately 12 months later. OUTCOMES & RESULTS: Few correlations were observed between child measures and CVs, a primary LENA metric. The novel VR metric was associated with concurrent direct assessment (MSEL) (and to a lesser extent parent report; VABS) measures of verbal and non-verbal skills, with moderate positive correlations found between VRs and all directly assessed subscale scores. However, VRs did not uniquely contribute to the prediction of child outcomes when baseline skills were also considered. CONCLUSIONS & IMPLICATIONS: The novel VR may provide an insight into autistic children's overall development in addition to their language ability, suggesting that even when collected in a short recording format, LENA might be a useful component of a multi-method assessment approach. WHAT THIS PAPER ADDS: What is already known on the subject To accurately capture language skills of children on the autism spectrum, multi-method approaches, including natural language sampling, are recommended. Tools such as LENA provide an efficient means of capturing and analysing naturalistic child language and the language learning environment. What this paper adds to existing knowledge This study demonstrates the potential benefits, and limitations, of using LENA to augment assessment of young children on the autism spectrum. Specifically, LENA provides a complementary, and low burden, method for capturing child language samples. What are the potential or actual clinical implications of this work? Novel metrics, such as the VR, collected during brief clinical interactions might be a useful component of a multi-method assessment approach for children on the autism spectrum.

Autism is a neurodevelopmental disorder that affects the everyday life of people who have this lifelong condition. Robots hold great promise for uplifting therapy and care of the affected population. We searched Scopus, Medline, ScienceDirect, Web of Science, and PubMed databases for randomized controlled trials that had evaluated robot use in the therapy of people with autism, to see how effective social robots have been incorporated in autism care. Out of 240 papers initially identified, 19 satisfied the inclusion criteria and were fully evaluated. Overall, 10 different robots were utilized in the trials, out of which, four were non-humanoids. The number of papers with positive results for using robots on the main and secondary parameters was 11 and 5, respectively. Three papers reported that robot groups did not achieve better results than others. Robots in the papers included here were mainly added as the “entertainment agent” to elicit greater engagement from the participants, which is understandable, as robots at this stage might not be ready yet to deliver high-end care.

People with intellectual and developmental disabilities (IDD) and autism are often marginalized and further traumatized because of behaviours that are difficult (challenging) for care providers and services to manage. These behaviours are similar in many ways to responses of our autonomic nervous system when triggered by danger and life threat – namely fight-flight-freeze (FFF) and shutdown survival responses. This discussion paper, drawing on polyvagal theory understanding, explores these similarities further from Outside-In (i.e., as observed and reported by others such as carers and clinicians) and Inside-Out perspectives (i.e., as described by people with IDD and autism engaging in these behaviours). Polyvagal theory, developed by Dr. Stephen Porges, explains how the sympathetic nervous system and the dorsal branches of the vagus nerve are involved in FFF and shutdown survival responses; the ventral branches of the vagus nerve are involved in the capacity for social engagement and in the experience of feeling safe. In our paper, the experience of feeling safe is investigated and triggers that alert the nervous system to danger and threat are identified. Being safe and feeling safe diminishes autonomic nervous system reactivity and automatic survival responses. We conclude that imbuing a safe experience for people with IDD and autism (from their perspective), through optimal health and supportive emotional and physical environments adapted to unique needs, will diminish autonomic nervous system reactivity and dysregulation, which in turn will diminish consequent distress behaviours that services and care providers find difficult. Being safe and feeling safe, are key to both treatment and prevention of emotional and behavioural distress and difficult behaviours.

“Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Although the primary aim is to argue that autonomy is, in part, embodied, we also outline general principles for the future development of a full-on theory of embodied autonomy. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law.

AIM This narrative review aimed to analyse the methodologies used by quantitative studies to evaluate their evidence for the association between gender diversity and autism spectrum conditions (ASC) in child and adolescent population samples. METHOD A systematic search was conducted for papers published between 2010 and 2020. RESULTS Fifteen papers met the inclusion criteria; all reported associations between their defined versions of gender diversity and ASC. Gender diversity was characterised as "dysphoria", "variance", and/or "diverse", and was correlated across ASC categories of "symptoms", "traits", or "empathising and systemising styles of thinking". Multiple diagnostic criteria and/or nonspecific, adult administrated measures were used to quantify youth gender experiences and ASCs. CONCLUSION Interpretations of the findings are discussed in relation to critical appraisal of methodologies used including data collection and deduction, the characteristics of the sample population, the usage of comparison groups, and the overall quality of statistical reporting amongst others.

Purpose The aim of this paper is to share the details of a multidisciplinary approach, which includes occupational therapy, and to review the factors that should be considered in the evaluation and treatment of children with autism spectrum disorders (ASD) who are excessively selective in their food choices. Issues in this area are complex and often related to several complementary domains (medical, nutritional, psychosocial, sensorimotor, etc.). However, feeding disorders are frequently assessed and treated from a single discipline and important issues are missed or confounded. Design/methodology/approach A team of experienced clinicians in the field of paediatric feeding disorders gathered the knowledge and experience they acquired from working with individuals with ASD as well as with individuals with other neurodevelopmental diagnosis. A review of current literature in paediatric feeding disorders was used to document and explicate the multifactorial nature of feeding disorders in children with ASD and justify the need for a multidisciplinary approach to issues in this area. Findings Feeding disorders in children with ASD are linked to multiple sensory, motor, behavioural, nutritional and gastrointestinal comorbidities. A multidisciplinary approach is needed and increasingly recommended. However, multidisciplinary teams, specialised in the care of children with ASD and feeding issues, continue to be difficult to locate and access for families. The authors sought to highlight the signs of feeding problems in children with ASD from different domains and share a model of a multidisciplinary approach that can lead to more successful interventions. Originality/value The detailed description of the domains linked to feeding issues and the clinical descriptions provided throughout the paper create a roadmap for other clinicians aiming to set up similar teams.

This paper proposes that one of the underlying causes of Autism Spectrum Disorder is the presence of a High-Pass Filter Effect applied to cognitive perception. Such an effect causes an enhancement of local details at the expense of global patterns. In particular, the High-Pass Filter Effect induces a disadvantage pertaining to mastering contextual fields (fields in which local features are noisy and information is distributed in adjacent perceptual pieces and in the relationship between them; for instance, interpersonal communication). Furthermore, in some cases, the High-Pass Filter Effect produces an advantage with respect to mastering detailed fields (fields in which information is intrinsic in modular, precise pieces of information; for example, computer science).In this paper, the High-Pass Filter Effect is explained, two secondary effects are described, (Peripheral Functionality Blindness and Prioritization by Specificity), and then a few examples of the way in which these effects induce the symptoms of Autism Spectrum Disorder are reported.

Camouflaging may be characterized as a set of actions and strategies more or less consciously adopted by some autistic people to navigate the neurotypical social world. Despite the increased interest that this phenomenon has garnered, its nature remains elusive and in need of conceptual clarification. In this paper, we aim to put forward an inclusive view of camouflaging that does justice to its complexity while also reflecting the heterogeneity of autism as a condition. First, we offer an overview of the main characterizations of camouflaging. This overview shows that current characterizations fail to paint a cohesive picture, and that different accounts emphasize different aspects of the phenomenon. Second, we explore the analogy between camouflaging and passing, which we take to be illuminating to describe some forms of camouflaging, while probably obscuring the study of others. Third, we extend the discussion about camouflaging to currently understudied groups across the autistic spectrum – i.e., children, and adults with linguistic and/or intellectual disabilities. We argue that camouflaging in such groups may differ from what the current literature describes as typical instances of camouflaging. We conclude by revisiting the nature of camouflaging in light of such understudied groups, and we offer some suggestions on how to move research forward. We are grateful to Elena Castroviejo, Inge-Marie Eigsti, Marta Jorba, and Teresa Roversi for their valuable feedback on earlier versions of this paper. Conversations with Itziar Arbina and Oiane Musitu from the Landaberde Daycare Center were important in the development of our ideas concerning camouflaging in adults with verbal and intellectual difficulties. Earlier versions of this material were discussed at the Philosophy of Psychiatry Work in Progress at Lancaster University and at Lindy Lab seminars at the University of the Basque Country (UPV/EHU). We would also like to thank two anonymous referees of this journal for their constructive, encouraging, and engaging suggestions throughout the revision process.

The paper presents the results of Educational computer's game application for social skills training by recognizing and naming emotions in children with Autism spectrum disorder (ASD). The educational computer game was developed on the basis of the ability model of Emotional intelligence. The main target of the game is to develop skills in children with ASD for emotional recognition, understanding and naming using story-based (plot) pictures and emoticons. The educational computer game was incorporated in the e-learning platform Moodle. The paper presents a case of a child with ASD and the results from a repeated application of the game. An analysis was made of the upgrading the skills for recognizing the emotions by counting the mistakes, searching for additional information, correct and false attempts in the individual modules of the game as well as the time for completing the tasks. Additionally, a survey for the parents was applied to collect information about the behavior of the child, his interest in the game and his motivation. The results show the need for short instruction, use of simple words and the game's positive effect on recognizing emotions.

Emotion recognition and analysis is the process of identifying emotions and feelings of a person. Emotion analysis process is accurate in identifying expression in normal people in a single attempt. Emotion analysis is difficult in case of Autism Spectrum Disorder (ASD) children which are suffering with communication problems and speech problems. This paper proposed an optimized deep learning model with multi label classification for predicting ASD and NoASD with emotion analysis in children of age group 1 to 10 years. The kaggle dataset [1] of 1857 ASD children and 1850 Typically Developed (TD) children are used in this paper. Proposed model performance is tested on Yale Expression Dataset [2], CAFE children dataset [3] and also tested on social media dataset of autism parents group. The model is implemented by extracting face landmarks and is used to predict ASD and NoASD as first classification label and emotion is detected based on landmarks by computing internal and external distances by feature wise. Convolutional Neural Networks (CNN) is used to work with extracted face landmarks by using optimization methods, dropout, batch normalization and parameter updating. The proposed model is applied to predict 6 emotions irrespective of 4 general emotions with better accuracy.

Background & aimsHow can non-autistic adults facilitate social learning with children on the spectrum? A new theoretical understanding of autism is currently emerging that has made this question more relevant than ever. At the intersection of two growing research areas in the field of autism, the borderland that separates the experience of social interaction between neurotypes is increasingly mapped out. By integrating anthropological research on autistic sociality and the neurocognitive framework of predictive processing, this paper explores the question: If autistic people experience the world in a fundamentally different way, what is a meaningful strategy for supporting them in developing their socialities?MethodsThe paper reports an in-depth analysis of a 2-min sequence in which a non-autistic adult facilitates a collaboration game between three autistic children (8–12 years). The data comes from a participatory research project that develops a new pedagogical approach to social learning based on open-ended construction play. The analytical strategy is informed by conversation analysis.ResultsWe find that the facilitation supports the children in accomplishing social interaction and collaboration, but it also in several instances gives rise to misunderstandings between the children. Whereas the facilitator aims to support the children's direct verbal communication about the construction task, we observe that the children use a broad repertoire of non-direct communication strategies that enables them to coordinate and align their shared process. We find that the children's actions with their hands in the construction task count as turns in the communication. Regarding the play-based learning environment, we find that the children are engaged in the shared construction task and that they competently navigate social tension when it arises without the facilitator's help.ConclusionWe conclude that the misunderstandings between the children created by the facilitation from a non-autistic adult emerge from a discrepancy of attention in the situation. The facilitator focuses on the words, but the children focus on the task. Even though this discrepancy is not necessarily a result of different neurotypes, we find that it emerges from the social dynamics of facilitation by non-autistic adults that is key in many social intervention settings. Furthermore, we conclude that the play-based learning environment enables the facilitator to support the children without directly instructing them in their social behavior. This appears to give the children an opportunity to acquire complex social experiences through their collaboration.ImplicationsThe interaction dynamics in the data clip is shaped by the non-autistic adult's expectations of the children's interaction. This made us wonder whether we can establish a learning environment that begins from the learners’ perspectives instead. The analysis caused us to change the facilitation strategy that we employ in our project. It is our hope that our approach will inspire reflection and curiosity in researchers and practitioners who develop social interventions targeting autistic people. Structured abstract Background & aims: How can non-autistic adults facilitate social learning with children on the spectrum? A new theoretical understanding of autism is currently emerging that has made this question more relevant than ever. At the intersection of two growing research areas in the field of autism, the borderland that separates the experience of social interaction between neurotypes is increasingly mapped out. By integrating anthropological research on autistic sociality and the neurocognitive framework of predictive processing, this paper explores the question: If autistic people experience the world in a fundamentally different way, what is a meaningful strategy for supporting them in developing their socialities? Methods: The paper reports an in-depth analysis of a 2-min sequence in which a non-autistic adult facilitates a collaboration game between three autistic children (8–12 years). The data comes from a participatory research project that develops a new pedagogical approach to social learning based on open-ended construction play. The analytical strategy is informed by conversation analysis. Results: We find that the facilitation supports the children in accomplishing social interaction and collaboration, but it also in several instances gives rise to misunderstandings between the children. Whereas the facilitator aims to support the children's direct verbal communication about the construction task, we observe that the children use a broad repertoire of non-direct communication strategies that enables them to coordinate and align their shared process. We find that the children's actions with their hands in the construction task count as turns in the communication. Regarding the play-based learning environment, we find that the children are engaged in the shared construction task and that they competently navigate social tension when it arises without the facilitator's help. Conclusion: We conclude that the misunderstandings between the children created by the facilitation from a non-autistic adult emerge from a discrepancy of attention in the situation. The facilitator focuses on the words, but the children focus on the task. Even though this discrepancy is not necessarily a result of different neurotypes, we find that it emerges from the social dynamics of facilitation by non-autistic adults that is key in many social intervention settings. Furthermore, we conclude that the play-based learning environment enables the facilitator to support the children without directly instructing them in their social behavior. This appears to give the children an opportunity to acquire complex social experiences through their collaboration. Implications: The interaction dynamics in the data clip is shaped by the non-autistic adult's expectations of the children's interaction. This made us wonder whether we can establish a learning environment that begins from the learners’ perspectives instead. The analysis caused us to change the facilitation strategy that we employ in our project. It is our hope that our approach will inspire reflection and curiosity in researchers and practitioners who develop social interventions targeting autistic people.

An unbiased, widely accepted estimate of the rate of occurrence of new cases of autism over time would facilitate progress in understanding the causes of autism. The same may also apply to other disorders. While incidence is a widely used measure of occurrence, birth prevalence—the proportion of each birth year cohort with the disorder—is the appropriate measure for disorders and diseases of early childhood. Studies of autism epidemiology commonly speculate that estimates showing strong increases in rate of autism cases result from an increase in diagnosis rates rather than a true increase in cases. Unfortunately, current methods are not sufficient to provide a definitive resolution to this controversy. Prominent experts have written that it is virtually impossible to solve.This paper presents a novel method, time-to-event birth prevalence estimation (TTEPE), to provide accurate estimates of birth prevalence properly adjusted for changing diagnostic factors. It addresses the shortcomings of prior methods. TTEPE is based on well-known time-to-event (survival) analysis techniques. A discrete survival process models the rates of incident diagnoses by birth year and age. Diagnostic factors drive the probability of diagnosis as a function of the year of diagnosis. TTEPE models changes in diagnostic criteria, which can modify the effective birth prevalence when new criteria take effect. TTEPE incorporates the development of diagnosable symptoms with age. General-purpose optimization software estimates all parameters, forming a non-linear regression. The paper specifies all assumptions underlying the analysis and explores potential deviations from assumptions and optional additional analyses.A simulation study shows that TTEPE produces accurate parameter estimates, including trends in both birth prevalence and the probability of diagnosis in the presence of sampling effects from finite populations. TTEPE provides high power to resolve small differences in parameter values by utilizing all available data points.

Purpose: An increasing number of scholarly publications on autism spectrum disorder (ASD) have urged researcher interest in this topic; however, there is still a lack of quantitative analysis. Therefore, this study aims to cover the knowledge gap between the amount of literature published on ASD research on architectural and designers' perspectives compared to the medical and psychological fields. The study has analyzed global research output on ASD from a designer's perspective to recognize this gap related to designing the physical environment. Methodology: The bibliometric method was employed to analyze the published literature from 1992–to 2021. 812 papers were downloaded from the Web of Science for analysis based on annual growth of literature, prolific authors, authorship pattern, organizations, countries, international collaboration, and subject development by keywords and thematic map analyses. Various bibliometric and scientometric software was used to analyze the data, namely Bibexcel, Biblioshiny, and VOS viewer. Results: The812 research papers were published in 405 sources. 2019 appeared as a productive year (NP=101), and 2014 received the highest number of citations (TC=6634). Researchers preferred to publish as journal articles (NP=538; TC=24922). The University of Toronto, Canada, was identified as a productive institution with 42 publications and 5358 citations. The USA was the leading producing country with 433 publications, and most of the researchers published in the journal "Scientific Reports" (NP=16). The word autism (NP=257) and architecture (NP=165) were more frequently used keywords. Conclusion: The study identified a massive gap in the development of literature in ASD for architecture design and built environment perspective, the most important and trending keywords are missing, and the analyses also showed a lack of subject development. The authors have suggested areas and keywords for further research to fulfill the gap in the future.

Purpose This meta-synthesis of the literature critically reviews how Photovoice has been used in qualitative research with people on the autism spectrum whose difficulties in communication often restrain their accessibility to and participation in research. It focuses specifically on ways that researchers used Photovoice to enable people on the autism spectrum to participate in research about them and present first-hand accounts of their lives. Methods The authors conducted a meta-synthesis of qualitative research studies. Nine research databases including subject specific databases for public health, psychology and social work were searched in January and August 2020 to identify the studies that used Photovoice to explore the experiences and perspectives of people on the autism spectrum. Of the 94 identified papers, 11 met requirements for inclusion in the review. Data was extracted from these papers to describe the steps of Photovoice used by the researchers in their studies with participants on the autism spectrum. Results Researchers in the reviewed papers conducted the major stages of Photovoice methodology developed by Wang and Burris (1997) to accomplish their studies, including engagement, data collection, data analysis, and outcome dissemination with participants on the autism spectrum. The meta-synthesis of the literature also identified that researchers made modifications to Photovoice methodology to fit in with purposes of their studies and, more importantly, to facilitate communication and enhance meaningful participation of people on the autism spectrum in research. Conclusion Photovoice can facilitate engagement of people on the autism spectrum in research.Future studies using Photovoice should include visual cues and verbal prompts to support communication of participants and become inclusive for people who are on the autism spectrum and with non-verbal abilities by offering them more alternatives of communication.

Families of young children diagnosed with autism around the spring of 2020 were especially vulnerable as Covid-19 pandemic-related restrictions interrupted the delivery of their specialized early intervention services. This paper examined 34 families' perceptions of the impact of this situation in Quebec on their child and their family using a mixed-methods design. Parents reported largely detrimental effects on their access to, and relationships with, service providers and their child's transition to school. They noted negative changes in several domains of child development. The need to combine childcare responsibilities with telework was also a source of stress. This situation resulted in family adjustment challenges and in the exacerbation of pre-existing vulnerabilities. However, parents also remarked on their family's ability to adapt and mobilize resources.

The language used to refer to autism has been a topic of ongoing debate. Research in English-speaking countries indicated an overall preference for identity-first language (‘autistic person’) among autistic adults rather than person-first language (‘person with autism’). We examined terminology preference in Dutch autistic adults ( n = 1026; 16–84 years; 57% women) and parents of autistic children ( n = 286) via an online survey. A majority of self-reporting adults with autism (68.3%) and parents (82.5%) demonstrated a person-first language preference. A younger age, higher IQ and more autistic traits predicted a relatively stronger identity-first language preference in autistic adults. We conclude that language and culture may impact terminology preference of adults with autism and parents. For now, we advocate to use a mix of person-first language and identity-first language in academic papers to cover the full range of preferences. Lay abstract There are different words to describe people with an autism diagnosis. For instance, we can put the person before autism (e.g. ‘person with autism’), or we can put autism before the person (e.g. ‘autistic person’). Previous research showed that autistic adults in English-speaking countries generally liked it better when autism is placed before the person. Yet, people also greatly differ in the words they like and dislike. In this study, we examined word preference in Dutch autistic adults ( n = 1026; 16–84 years; 57% women) and parents of autistic children ( n = 286). Via an online questionnaire, we asked our participants to select one term for autistic people that they liked best. The results showed that most adults with autism (68.3%) and parents (82.5%) preferred to put the person before autism. Younger adults, with a higher intelligence, and with more autistic traits, were a bit more likely to put autism before the person. We conclude that there are large differences in the words that people prefer. Because we found different results in our Dutch participants compared to participants in English-speaking countries, we think that the Dutch language or culture may also play a role in word preference. For now, we advise autism researchers to use both person-first and autism-first language.

Background Open research broadly refers to a set of practices that aim to increase transparency, rigor, reproducibility and inclusivity of research. Participatory research refers to incorporating the views and sharing power with the autism community to decide what research gets done, how it is done and how it is implemented. There is growing interest in both open and participatory practices in autism research. To date, however, these practices have tended to be considered separately. Method In this paper, we outline the value of both open and participatory approaches to the autism research field, highlighting key points of overlap. Results We propose three core principles underpinning open and participatory autism research: (1) the need for adequate expertise and infrastructure to facilitate high quality research, (2) the need for a greater degree of accessibility at all stages of the research process, and (3) the need to foster trusting relationships between the autistic and research communities. Conclusion There are various challenges and opportunities of adopting open and participatory principles in autism research. We hope our principles support researchers to embed these approaches more fully within their work.

Assumptions: This article is part of a wider study on adults with autism. The main assumption of the series of studies is concerned with listening to and hearing the voices of those most affected – those with a diagnosis of autism. The material, which is based on the experiences of people with autism, allows us to present views on the role of the teacher – the creator of the educational space. Thus far, we have presented the experiences and comments of teachers and therapists; now we can listen to the voices of not only students and parents, but people with autism. The research problem was to present the educational experiences described by autistic people in a paper on pedeutology. The aim of the study was to investigate the opinions on education held by people with autism. Method. This study employed the netnographic method and involved a group of people with a diagnosis of autism who met online and agreed to participate. Results. Reaching out to a large group made it possible to analyze their statements by ranking and creating meaning bundles. Conclusions. The first conclusion is that there is a difference in the approach to the teaching/learning process. This is due to symptoms that are specific to autism, as well as to the different educational and therapeutic approaches. The second conclusion is related to the use of punishment that, in addition to forbidden forms (such as physical punishment), often evolve into psychological and social punishment, such as isolation, marginalization, or a lack of interest. It seems to be equally important to draw attention to the ineffective attempts to impose recognized normative forms of functioning (often referred to as a violation), as well as treating these people as not fully intellectually capable, which is not a condition (intellectual disability can co-occur in a few cases [see Casanova et al., 2000]).

Acknowledgements: The authors would like to acknowledge critical assistance provided by Dr Ekaterina Ostashchenko, former postdoctoral researcher at the University of Cambridge and now a lecturer in psychology at Manchester Metropolitan University, with expertise in psycholinguistics and social cognition in autism. Dr Ostashchenko checked sections of this paper drawn from the Russian-language literature and also reviewed Russian transliteration. Thanks are due to Richard Turner at Green Templeton College Library and librarians at the Bodleian Library, University of Oxford, for helping locate articles written by Sukhareva in journals which have since ceased publication. The authors also acknowledge Thomas Maisel at the University of Vienna archives, Kathy Lafferty and Becky Schulte of the Spencer Research Library, University of Kansas, and Christopher Henry, Christine Ruggere, and Will Bryant of the Welch Medical Library at Baltimore’s John Hopkins University for their help in addressing enquiries and locating archive material. Thanks are due to Professor Jimmy Potash and Professor James Harris, both of John Hopkins University, for directing our attention to important material concerning autism history., Grunya Efimovna Sukhareva's seminal role in being the first to publish a clinical description of autistic traits in 1925, before both Kanner and Asperger, has been revealed relatively recently. Nevertheless, Sukhareva's work is little known and largely unrecognised beyond Russia. Amidst calls for greater recognition of her pivotal contribution in the genesis of autism conceptualisation and categorisation, this article provides a biographical and historical background. Sukhareva's wide-ranging psychiatric work is adumbrated and her pioneering efforts in conceptualising both schizophrenia and autism are elucidated. The article reflects on possible explanations for the belated and incomplete recognition of Sukhareva's role. The current article indicates how Sukhareva's work was ahead of its time in reflecting modern criteria for autism diagnoses and in its focus on female case studies. Sukhareva's somewhat precarious position as a foremost psychiatrist condemned in the Stalinist years for being anti-Marxist is explicated. The article outlines further directions for academic research on Sukhareva's work and contributions.

This paper uses a microanalysis of naturally occurring interactions to uncover how pre-school-aged autistic and non-autistic children organize their participation in pretend play. The analysis draws on video recordings of children and a teacher during two playing time sessions in an inclusive nursery school. It explores differences in the embodied practices with which the children attempt to gain access to play material and take possession of it. Findings show how children use environmental resources (e.g. space, objects) for their purposes while adapting to relevant situative contingencies; they also suggest that autistic children can be thorough observers of unfolding interactions who possess the ability to transform and adopt their own embodied practices. Comparative analysis thus provides empirical support for the potential achievements of inclusive education.

The dominant discourse surrounding neurodevelopmental conditions such as autism and ADHD emphasizes biological explanations. Neurodevelopmental conditions are conceived as different types of brains, the result of different types of genes. This way of thinking is present both in medical research and in clinical practice. Indeed, it is widely acknowledged that the idea of having a biological diagnosis helps people see beyond blame and guilt. It aids acceptance. However, simplistic approaches to biology risks neglecting the experiences and stories of autistic people in favor of finding etiological causes. At the same time, there is growing awareness that risks, functioning, and resilience are not solely defined by genes and brains but have a cultural and experiential component as well. Furthermore, atypical cognitive trajectories are not straightforwardly associated with poor outcomes. In this paper we describe the concept of developmental diversity as an alternative to more categorical approaches to neurodevelopmental conditions. We explore how dynamic models of life offer possibilities to look at neurodevelopmental conditions differently: rather than seeing autistic people as people with fundamental flaws in their genes or software faults in their brains that have to be explained, autism appears as a phenomenon that exists in interaction with the context, as a meaningful reaction to the environment. We explore what it would mean for research to go from a diagnosis-based approach to a developmental diversity approach that will define wellbeing and functioning in a more granular way across developmental trajectories. We argue that this would mean incorporating lived experiences into biological research and going beyond genes-environment dichotomies. Next to yielding a more complete picture on the phenomenon of autism, we describe how an approach that takes developmental diversity as a starting point offers a new way to look at existing challenges of autism research, such as how to deal with the significant overlap between diagnosis. Our hypothesis is that thinking with developmental diversity rather than categorical difference both represents an opportunity for a more inclusive society, and fundamentally can alter the way we perform research. As such, it is in line with requests of neurodiversity and disability movements. ispartof: FRONTIERS IN PSYCHIATRY vol:13 ispartof: location:Switzerland status: published

According to current data, nutritional condition in neonates, particularly the length of nursing, has an important role in the etiology of autism spectrum disorder (ASD) and/or attention deficient hyper active disorder (ADHD). We wanted to conduct a systematic review and meta-analysis of relevant studies that found a relationship between ASD/ADHD and breastfeeding status. In December 2022, ten computerized databases and a manual search of reference lists were utilized to locate relevant papers.

Autism spectrum disorder is one of pervasive developmental disorders, characterized by persistent challenges in many social communication and social interaction domains, including gestural communication. An area of special importance for autistic individuals is the ability to gesture when knowledge status is asymmetrical between interlocutors. Successful communication in such a case requires autistic individuals to take the interlocutor’s perspective and adapt their gestures accordingly. Previous research has well documented autistic children’s perspective taking challenges manifested in verbal communication while very few studies investigated their gestural communication. So the present study will investigate whether high functioning autistic children are comparable to typically developing children in designing their gesture by taking the interlocutor’s perspective. A drawing instruction task was used. In this task, children described pictures presented on iPad or laptop to the interlocutor. The interlocutor could not see the screen but was required to replicate the pictures on paper based on children’s instruction. Both parties had no constraints on communicative behaviors. It thus provides a natural sample to investigate children’s gesture behaviors.

Psychiatrists such as Michael Fitzgerald, Christopher Gillberg and Yoshiki Ishisaka diagnosed Ludwig Wittgenstein posthumously with Autism Spectrum Disorder (ASD). Taking this diagnosis into account, the present paper discusses how Wittgenstein's philosophy reveals his cognitive difficulties. Wittgenstein's grammatical inquiries are particularly investigated here, highlighting his misunderstandings concerning the use of words – specially, his misunderstandings concerning analogies, which he tended to interpret literally.

People with different needs and abilities continue to be marginalized by society, including by church communities. One of these groups is people on the autism spectrum. Disability theology seeks to point to the dignity of every human being as an imago Dei, and as a gift of God. In search of perspectives that will contribute to a clearer understanding of this truth and the overcoming of prejudice and marginalization, this paper analyzes the phenomenon of creativity. This is a phenomenon that is important in many disciplines, and thus underlies the theology of creation, philosophical and everyday thinking. Furthermore, empirical studies examine the relationship between autism and creativity. Their results emphasize the exceptional talent and creativity of as many as a third of the members of this group. Building on these insights, the article promotes creativity as a field of relationship between God the Creator and all people, with each individual called by God to creatively shape themselves and the world in which they live. By focusing the theological view on the marginalized group of people on the autism spectrum and emphasizing the necessity of the whole body of Christ, we are not stressing the importance of the product and usefulness of the individual’s creativity but the belief that all humans are equally called to co-create God’s plan, regardless of the possibilities and obstacles the individual faces.

This paper aims to capture in/exclusion processes in one transgender person’s life, a person who is also diagnosed with autism. We do this through Staunæs’ (2005) concept of troubling subjectivities, which helps us to explore how one specific person, Vera, ‘does’ or negotiates her identities as a neurodiverse transgender woman. We pay particular attention to how the two categories of transgender and autism intersect and which in/exclusion processes they set in motion. In this way, we unfold how identifying as transgender and having been diagnosed with autism spectrum disorder shape Vera’s life. Specifically, we aim to unveil how these two social categories shape her degree of agency in her private social relations and in institutional settings of both education and healthcare. This is important to explore for two reasons: a) the intersections of multiple social categories change the conditions under which someone is allowed to do their particular personhood in different social settings, and b) research shows that a significant number of transgender people also inhabit the clinical category of autism. We show, that while Vera is able to perform identities related to the categories of transgender and autism in personally empowering ways, she is at the same time obstructed by what we refer to as identity overwork. That is, others’ positioning of Vera as ‘troubled’, repeatedly requires her response, on multiple social levels and in various contexts.

Purpose An electroencephalography (EEG) examination may cause psychological stress in children with autism that can interfere with the examination results. The objective information on the presence or absence of psycho-emotional stress in patients can help interpret electroencephalograms. This paper aimed to demonstrate the potential of noninvasive objective diagnostics of emotional stress in autistic children undergoing an EEG examination based on analysis of saliva. Design/methodology/approach This study involved 19 children with autism spectrum disorder (ASD) (ICD-10 F84.0); the mean age was seven years. During EEG examination of the children, behavioral parameters were assessed. The activity of cytochrome P450 reductase (CYPOR) in saliva was measured before and after the EEG procedure using lucigenin-enhanced nicotinamide adenine dinucleotide phosphate-stimulated chemiluminescence assay. Findings Significant differences in CYPOR activity were found between the children who were distressed during an EEG examination and the children without behavioral disturbances (Mann–Whitney test, p = 0.002). Thus, the EEG examination resulted in an increase in CYPOR activity in saliva cells, which may prove the stressful effect of this procedure on autistic children. Originality/value The chemiluminescent indices reflecting the activity of microsomal CYPOR in cells presenting in saliva correlate with the absence or presence of psychological stress in children; this phenomenon can be explained by an increased metabolism of the stress hormone, cortisol, by the cytochrome P450 microsomal system. Furthermore, the proposed method is completely safe, noninvasive, rapid (recording time is 20 min), inexpensive and promising for an objective assessment of psycho-emotional stress in autistic children undergoing medical examinations.

Autism spectrum disorders (ASD) are defined as neurodevelopmental disorders, which are highly variable in nature and do not form a uniform picture, either in terms of symptomatology or depth of the disturbance. Diagnosis of ASD is made for children who show signs of impairment in social interaction, communication and cognitive skills. The exact cause of autism spectrum disorders has not been determined to date. Although there is no cure for ASD, a variety interventions have been proposed. The most commonly used restrictive dietary intervention is the gluten-free casein-free diet (GFCF), which is based on the opioid excess theory. This paper summarizes and discusses research on the core elements of the opioid excess theory in ASD: increased levels of opioid peptides in body fluids in ASD patients, increased intestinal permeability, altered peptidase activity and the effectiveness of GFCF diet in alleviating symptoms of ASD. Furthermore, we discuss the difficulties and their causes in conducting research with ASD patients. The assumptions of the opioid excess theory have neither been definitively confirmed nor disproved. Research in this area should continue, taking into account the highest possible quality standards and the specific needs and abilities of patients with ASD and their families.

There is a variety of scoping review studies regarding the use of Brain-computer interface (BCI) for people with disabilities including people with motor disabilities. There was no scoping review for the autism population to our knowledge. The aim of this scoping review is to provide an overview of available studies using BCI for the autism population. The data will be extracted from multiple datasets and will be managed using Covidence. The abstracts will be triaged based on inclusion and exclusion criteria by two coders. then, the data will be extracted from included full papers. The results will be analyzed and reported based on guiding questions and research variables. The implication for researchers and clinicians will be provided.

The most persistent oral health disparities in the United States impact children from racial and ethnic minoritized groups and children diagnosed as autistic. This paper aims to describe barriers to oral care as depicted by Black/African American (B/AA) parents of autistic children to further explore how and why oral health disparities persist in this population. A purposeful sample of eleven caregivers of autistic children, ages 4 to 14 years, who identified as B/AA were interviewed twice for approximately 60–90 min each. Thematic analysis utilizing a narrative approach was employed. Three themes emerged from the data concerning the barriers that affect oral health experiences: (a) difficulty in maintaining good oral health practices, (b) challenges with access to care and resources, and (c) poor patient-provider relationships. Due to the limited research that examines the intersection of autism, B/AA culture, and oral health practices, this study provides a rich picture of the barriers families face when obtaining oral care. Many families raised issues that other parents of autistic children also identified. B/AA caregivers have demonstrated that despite their own negative dental experiences, they understand the value of good oral care practices and are willing to pursue oral care for their children.

Researchers’ understanding of the meaning of non-verbal behaviours in autism determines, to varying degrees, what practitioners, educators and family members do about these behaviours. There is a lack of consensus in our current understanding of non-verbal behaviours, private and inner speech, and echolalia in children with autism spectrum disorder, as well as a lack of consistency and rigour in terminological use. Even more importantly, there is a lack of rigorous multidimensional lines of evidence to support current views of the meaning of non-verbal behaviours or private and inner speech in autistics. This position paper supports recommendations from a growing number of autism experts for behavioural phenomenological analyses of these complex behaviours, in order to explore the potential communicative intent underlying non-verbal behaviours in children with autism spectrum disorder.