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This paper describes a smart tablet-based drawing app to digitally record participants' engagement with the Rey-Osterrieth complex figure (ROCF) task, a well-characterised perceptual memory task that assesses local and global memory. Digitisation of the tasks allows for improved ecological validity, especially in children attracted to tablet devices. Further, digital translation of the tasks affords new measures, including accuracy and computation of the fine motor control kinematics employed to carry out the drawing Here, we report a feasibility study to test the relationship between two neurodevelopmental conditions: autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). The smart tablet app was employed with 39 adult participants (18-35) characterised for autistic and ADHD traits, and scored using the ROCF perceptual and organisational scoring systems. Trait scores and conditions were predictor variables in linear regression models. Positive correlations were found between the attention-to-detail, attention-switching and communication subscales of the autistic trait questionnaire and organisational scores on the ROCF task. These findings suggest that autistic traits might be linked to differential performance on the ROCF task. Novelty and future applications of the app are discussed. [ABSTRACT FROM AUTHOR]

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

This article comprehensively reviews motor impairments in children with autism spectrum disorder (ASD) to: (1) determine the prevalence of motor problems in children with ASD; (2) understand the nature of motor difficulties in ASD and whether they are consistent with developmental coordination disorder (DCD); and (3) determine if the term DCD was used as a co-occurring diagnosis in children with ASD after publication of the DSM-5 in 2013. The following databases were systematically searched: MEDLINE, EMBASE, CINAHL, and PsycINFO from 2010 to December 2021. Articles were included if they: (1) were peer-reviewed and published in a scientific journal; (2) included children with ASD who were between 5 and 12 years; (3) used motor or function measures to assess motor abilities in children with ASD. Studies that included children with intellectual disabilities were excluded. Two independent reviewers reviewed titles, abstracts, and full-text articles for inclusion. Twenty-seven studies met the inclusion criteria and were assessed for quality by two independent reviewers using the Appraisal tool for Cross-Sectional Studies. The majority of articles (92.5%) indicated that 50–88% of children with ASD had significant motor impairments on standardized motor assessments and/or functional questionnaires. The nature of motor and function problems in ASD were consistent with DCD; however, only three out of 20 papers (15%) that were published from 2014 described the motor problems as DCD. One study reported that 15.1% of children with ASD with motor impairments had a co-occurring diagnosis of DCD, suggesting that DCD is under-recognized in this clinical population. [ABSTRACT FROM AUTHOR]

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

The research presents an interactive toy agent leveraging a deep learning approach for treating autistic kids by making them learn Yoga. The objective of the proposed toy is to understand the basic needs of autistic kids and make them socially adaptable to their surrounding environment. Since kids with autism face social insecurities while interacting and communicating with people, we introduce an interactive toy to accompany the kid, making him or her more likely to act as a companion. The toy is orchestrated with IoT and the Deep Learning framework (HARNet) which makes it interactively instruct Yoga Asana to the autistic kid. The motion of the toy is controlled by touch sensors, and interaction is developed through the recognition of Yogo postures performed by the kid. This paper uses snippets of data in the Yoga-82 dataset. The gestures of Yoga asanas are leveraged, and the same is used for modeling HARNet. Empirical evaluations show that HARNet exhibits an accuracy of 98.52% against the Yoga-82 dataset. The cost of the Toy framework is also compared with state-of-the-art research on Humanoid Toys and the economic range of the proposed framework is evident. [ABSTRACT FROM AUTHOR]

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

This research used an alternating treatment design to investigate the relative effectiveness of participant specific social stories delivered using two distinct formats (i.e., technology-based, paper/book), on increasing the frequency of initiations and responses of two adolescents with ASD. Visual analysis of baseline, intervention, maintenance, and generalization data results indicated the intervention increased the frequency of initiations and on-topic responses regardless of delivery format; however, calculation of Percentage of Nonoverlapping Pairs and TAU-U for both formats indicated variable levels of effectiveness for each condition, with ranges of 43–86% and 0.02381–0.76190 respectively. Finally, despite varied results, both participants preferred the technology-based social story format and parents of both participants agreed the social story intervention increased communicative skills. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship that people with high functioning autism have with organizational temporality by considering this operationalization within the framework of humanistic management. To do so, it proposes an analysis based on seven propositions. Autism is a disorder that is still poorly understood and often linked to social depictions that are as unfounded as they are repulsive. It remains an unexplored area of study in the field of management sciences. Existing scholarship has established that people with autism have great difficulty finding and retaining employment. While it is well known that they have weak social skills, their difficulties in relation to time have only been studied in medical research, even though organizational temporality substantially shapes the functioning of teams. The operationalization of autistic temporality as a particular temporality within humanistic management allows for the development of a new conceptual framework based on a consideration of neuro-atypia. This paper begins with a presentation of the theoretical background. It then develops the theoretical model. Implications, limitations and directions for further studies are discussed before concluding. [ABSTRACT FROM AUTHOR]

We recently read the interesting and informative paper entitled "Empathic accuracy and cognitive and affective empathy in young adults with and without autism spectrum disorder" (McKenzie et al. in Journal of Autism and Developmental Disorders 52: 1–15, 2021). This paper expands recent findings from our lab (Ben-David in Journal of Autism and Developmental Disorders 50: 741-756, 2020a; International Journal of Audiology 60: 319–321, 2020b) and a recent theoretical framework (Icht et al. in Autism Research 14: 1948–1964, 2021) that may suggest a new purview for McKenzie et al.'s results. Namely, these papers suggest that young adults with autism spectrum disorder without intellectual disability can successfully recruit their cognitive abilities to distinguish between different simple spoken emotions, but may still face difficulties processing complex, subtle emotions. McKenzie et al. (Journal of Autism and Developmental Disorders 52: 1–15, 2021) extended these findings to the processing of emotions in video clips, with both visual and auditory information. [ABSTRACT FROM AUTHOR]

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

The artificial intelligence (AI) trend to embrace Autism Spectrum Disorder (ASD) has dramatically transformed the landscape of medical diagnosis. People often exhibit fear and apprehension towards conditions they lack understanding of, and ASD being a complex affliction, poses challenges in comprehending its intricacies. Researchers have harnessed AI applications to improve the precision of disease diagnosis by utilizing Magnetic Resonance Imaging (MRI), Electroencephalography (EEG), genetic, sociodemographic, and medical data. However, the development of AI systems for early diagnosis and triage in healthcare is still in its nascent stages. In particular, studies have revealed a global increase in the prevalence of ASD, with an estimated 1 in 59 children being diagnosed. However, there is a lack of up-to-date information regarding the current status of ASD. This study aims to provide a systematic review of AI applications in early diagnosis and triage for ASD, supplementing the findings of previous studies and offering a comprehensive overview of the evidence. To achieve this, a rigorous literature search method and selection criteria were employed, resulting in the identification of 46 recent contributions on the applications of AI in ASD from various databases, including ScienceDirect (SD), IEEE Xplore digital library (IEEE), Web of Science (WOS), PubMed, and Scopus. The selected papers were categorized into three main categories: ASD triage levels, clinical diagnosis for ASD, and diagnosis based on telemedicine, with further subcategories under the clinical diagnosis category. Theoretical and practical aspects of AI methods used for ASD diagnosis, as well as the presentation utilizing data analytics, were presented. The paper presents a systematic and comprehensive analysis of previous studies, examining the challenges, motivations, and recommendations, thereby paving the way for potential future research. Additionally, the work provides decisive evidence for the use of AI in ASD healthcare diagnosis and triage, offering nine critical analyses of the current state-of-the-art and addressing relevant research gaps. To the best of our knowledge, this study is innovative in exploring the feasibility of using AI in ASD medical diagnosis and triage. It highlights essential pieces of information, including Explainable AI (XAI), Auto machine learning (AutoML), Internet of Things (IoT)-based AI, robot-assisted therapy-based AI, telemedicine, data fusion techniques, and available ASD datasets with different aspects. The analysis of the revised contributions reveals crucial implications for academics and practitioners. The paper also proposes potential methodological aspects to enhance the triage and prioritization of autistic patients using AI applications in the medical sector, as well as addressing theoretical and practical application aspects and five methodology phases using fuzzy Multi-Criteria Decision Making (MCDM) methods in ASD triage and prioritization. [ABSTRACT FROM AUTHOR]

An ability to create good graphic output requires effective transitive movements related to the use of a tool, e.g., a pen. There is evidence that individuals with autism spectrum disorder (ASD) and neurotypicals show differences in graphic skill. Such differences can be due to anomalies in one's transitive movements. One needs to quantify such differences through indices e.g., those related to pen-tip pressure and temporal aspects. To study such indices, researchers are shifting their focus to use of digital medium, e.g., pressure tablets from the pen-and-paper based settings for which acquiring these indices might be a challenge. Though pressure tablets have been used by various research groups for graphic execution by individuals with ASD, none have explored these indices for a spiral drawing task that needs precision of performance and is more difficult than drawing of simple shapes. In our present work, we have designed a digitized dot-guided spiral (DDoS) drawing platform offering clockwise spiral drawing task. We chose the clockwise spiral since individuals with ASD may demonstrate torque i.e., a tendency to draw shapes in the clockwise direction. Results of our study with 20 individuals with ASD and 17 typically developing individuals using DDoS platform indicated that for a clockwise spiral drawing, the pen-tip pressure and temporal indices were differentiated among the two participant groups. The indices offered by DDoS platform can provide information to the caregivers and therapists while assisting in identifying deficits and designing individualized intervention, that can benefit the children. [ABSTRACT FROM AUTHOR]

"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. 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. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to determine whether recommendations made by King & Murphy (Journal of Autism and Developmental Disorders 44:2717–2733, 2014) in their review of the evidence on autistic people in contact with the criminal justice system (CJS) have been addressed. Research published since 2013 was systematically examined and synthesised. The quality of 47 papers was assessed using the Mixed Methods Appraisal Tool. Findings suggest a limited amount of good quality research has been conducted that has focused on improving our understanding of autistic people in contact with the CJS since 2013. Methodological limitations make direct comparisons between autistic and non-autistic offenders difficult. Autistic people commit a range of crimes and appear to have unique characteristics that warrant further exploration (i.e., vulnerabilities, motivations for offending). [ABSTRACT FROM AUTHOR]

Background: Neurodevelopmental conditions such as intellectual disability (ID) and autism spectrum disorder (ASD) can stem from a broad array of inherited and de novo genetic differences, with marked physiological and behavioral impacts. We currently know little about the psychiatric phenotypes of rare genetic variants associated with ASD, despite heightened risk of psychiatric concerns in ASD more broadly. Understanding behavioral features of these variants can identify shared versus specific phenotypes across gene groups, facilitate mechanistic models, and provide prognostic insights to inform clinical practice. In this paper, we evaluate behavioral features within three gene groups associated with ID and ASD – ADNP, CHD8, and DYRK1A – with two aims: (1) characterize phenotypes across behavioral domains of anxiety, depression, ADHD, and challenging behavior; and (2) understand whether age and early developmental milestones are associated with later mental health outcomes. Methods: Phenotypic data were obtained for youth with disruptive variants in ADNP, CHD8, or DYRK1A (N = 65, mean age = 8.7 years, 40% female) within a long-running, genetics-first study. Standardized caregiver-report measures of mental health features (anxiety, depression, attention-deficit/hyperactivity, oppositional behavior) and developmental history were extracted and analyzed for effects of gene group, age, and early developmental milestones on mental health features. Results: Patterns of mental health features varied by group, with anxiety most prominent for CHD8, oppositional features overrepresented among ADNP, and attentional and depressive features most prominent for DYRK1A. For the full sample, age was positively associated with anxiety features, such that elevations in anxiety relative to same-age and same-sex peers may worsen with increasing age. Predictive utility of early developmental milestones was limited, with evidence of early language delays predicting greater difficulties across behavioral domains only for the CHD8 group. Conclusions: Despite shared associations with autism and intellectual disability, disruptive variants in ADNP, CHD8, and DYRK1A may yield variable psychiatric phenotypes among children and adolescents. With replication in larger samples over time, efforts such as these may contribute to improved clinical care for affected children and adolescents, allow for earlier identification of emerging mental health difficulties, and promote early intervention to alleviate concerns and improve quality of life. [ABSTRACT FROM AUTHOR]

There is considerable interest in characterizing cognitive abilities of young children with autism spectrum disorder. Multiple assessment tools are available with many different ways of measuring cognition. In this paper we demonstrate these methods using data from two prior longitudinal studies of autistic toddlers that employed some of the most widely used tools in research to measure early cognition. We emphasize the importance of assessing nonverbal cognition to avoid confounding language and communication impairments with other aspects of cognition. Additionally, we highlight the need for further consideration of adaptive behavior in relation to nonverbal cognition in autistic toddlers. [ABSTRACT FROM AUTHOR]

This article is an investigation of neurodivergent reading practices. It is a collectively written paper where the focus is as much on an autoethnographic exploration of our autistic readings of autism/autistic fiction as it is on the read texts themselves. The reading experiences described come primarily from Yoon Ha Lee's Dragon Pearl (2019) and Dahlia Donovan's The Grasmere Cottage Mystery (2018), which we experience as opposite each other in how they depict their neurodivergent characters and speak to us as autistic readers. Through the article, we describe a formation of neurodivergent (critical) collective readings of autism/autistic fiction. The article contributes to an academic and activistic discourse around neurodivergent reader responses and power relations between neurodivergent and neurotypical readers and authors. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This paper offers an overview of the current status of individuals with autism spectrum disorders (ASD) and developmental disorders (DD) in Oman. A review of demographic and background information about Oman is first presented, followed by an overview of the current status of individuals with autism and developmental disorders, in terms of disability-related legislation, prevalence and diagnosis, as well as treatment and education. In the last section of the paper, major challenges faced in the field are addressed, including lack of autism awareness, lack of healthcare and educational programs or related services, lack of highly qualified professionals to implement evidence-based practices, issues regarding early identification and early intervention, as well as issues pertaining secondary transition, independent living and employment. Corresponding recommendation is proposed at the end of each challenge. [ABSTRACT FROM AUTHOR]

This study tests a handwriting model for children and youth with Autism Spectrum Disorder (ASD) that displays the relationships between handwriting process and product characteristics, and the predictors of these characteristics. Structural Equation Modelling was used to test the model for children and youth with ASD (n = 50) and typically developing peers (n = 50), ages 10 to 15, for a copying and freestyle handwriting task. Findings suggest a generic handwriting model applying to both groups and both handwriting tasks. Unique effects for children and youth with ASD were identified for: (1) high interdependence of handwriting process characteristics, (2) longer pen stroke in air leading to better legibility, and (3) lower scores for executive functions leading to lower scores for legibility. [ABSTRACT FROM AUTHOR]

There is a growing need for standardised familiarisation techniques within the human–robot interaction (HRI) community. This is particularly the case when considering autistic participants, who may have difficulties with the novelty and sensory stimulation associated with meeting a robot. Familiarisation techniques should be considered critical to research, both from an ethical perspective and to achieve research best practice, and are also important in applied settings. In the absence of standardised familiarisation protocols, we conducted a systematic review in accordance with PRISMA guidelines to better understand the range of familiarisation methods used in studies of HRIs with autistic participants. We searched for papers from four different databases: PubMed, Scopus, Web of Science and Science Direct. We identified 387 articles that involved HRIs with autistic participants. The majority did not mention a familiarisation phase (n = 285). A further 52 mentioned including familiarisation but without any description. 50 studies described their familiarisation. Based on a synthesis of these papers, we identified six familiarisation techniques that are commonly used. Using co-production techniques with the autistic community and other participant groups, future studies should validate and critically evaluate the approaches identified in this review. In order to help facilitate improved reporting and critical evaluation of familiarisation approaches across studies we have setup a familiarisation repository. [ABSTRACT FROM AUTHOR]

This paper reports the investigation of Broad Autism Phenotype (BAP) traits and real-world executive function with two samples–parents of children with autism or other (non-autism) developmental disabilities (n = 104) and undergraduates (n = 147). Participants self-reported BAP traits (Broad Autism Phenotype Questionnaire [BAPQ; Hurley et al., 2007]) and real-world-executive functioning (Behavior Rating Inventory of Executive Functioning-Adult [BRIEF-A]). Parents evidencing the BAP demonstrated higher means and percentage of clinically significant range scores (t-score ≥ 65) on all BRIEF-A scales compared to controls. In regression analyses, Shift predicted all BAPQ scores. Inhibit was an additional significant predictor for Total and Pragmatic Language; both Inhibit and Plan/Organize were additional significant predictors for Rigid. Undergraduates evidencing the BAP demonstrated higher means and percentage of clinically significant range scores for five of the twelve BRIEF-A scales: Shift, Emotional Control, Initiate, Plan/Organize, and the Metacognition Index. In regression analyses, Shift was a significant predictor for three BAPQ scores (Total, Aloof, and Rigid); Pragmatic Language was predicted by Working Memory. These findings show the increased likelihood of real-world-executive functioning deficits in the BAP but also demonstrate the variation in skills within this population. Regression results underscore the importance of Shift (i.e., cognitive/behavioral flexibility) in BAP symptomatology, but did not exclusively favor Shift as in prior research. These results provide insight into relations among BAP/executive function constructs and suggest multiple avenues for future research. [ABSTRACT FROM AUTHOR]

At present, there are no brief, freely-available, informant-report measures that evaluate key challenging behaviors relevant to youth with autism spectrum disorder (ASD) or other developmental disabilities (DD). This paper describes the development, refinement, and initial psychometric evaluation of a new 18-item measure, the Open-Source Challenging Behavior Scale (OS-CBS). In a large sample (n = 2004, 169 with ASD, ages 2–17), results of psychometric analyses indicated a clear factor structure (property destruction, aggression, elopement, conduct problems, and self-injury and a general factor with high loadings from all items) based on exploratory structural equation modeling, good scale reliability (α =.66–.83 for subscales, α =.91 total scale), measurement invariance across demographics, and good construct validity. The OS-CBS is a psychometrically-sound instrument for screening and monitoring intervention progress. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) usually show little interest in academic activities and may display disruptive behavior when presented with assignments. Research indicates that incorporating motivational variables during interventions results in improvements in behavior and academic performance. However, the impact of such motivational variables varies between children. In this paper, we aim to address the problem of selecting the right motivator for children with ASD using reinforcement learning by adapting to the most influential factors impacting the effectiveness of the contingent motivator used. We model the task of selecting a motivator as a Markov decision process problem. The states, actions and rewards design consider the factors that impact the effectiveness of a motivator based on applied behavior analysis as well as learners' individual preferences. We use a Q-learning algorithm to solve the modeled problem. Our proposed solution is then implemented as a mobile application developed for special education plans coordination. To evaluate the motivator selection feature, we conduct a study involving a group of teachers and therapists and assess how the added feature aids the participants in their decision-making process of selecting a motivator. Preliminary results indicated that the motivator selection feature improved the usability of the mobile app. Analysis of the algorithm performance showed promising results and indicated improvement of the recommendations over time. [ABSTRACT FROM AUTHOR]

Loneliness is a near-universal experience. It is particularly common for individuals with (so-called) psychopathological conditions or disorders. In this paper, we explore the experiential character of loneliness, with a specific emphasis on how social goods are experienced as absent in ways that involve a diminished sense of agency and recognition. We explore the role and experience of loneliness in three case studies: depression, anorexia nervosa, and autism. We demonstrate that even though experiences of loneliness might be common to many psychopathologies, these experiences nevertheless have distinctive profiles. Specifically, we suggest that: (i) loneliness is often a core characteristic of depressive experience; (ii) loneliness can drive, and even cement, disordered eating practices and anorectic identity in anorexia nervosa; iii) loneliness is neither a core characteristic of autism nor a driver but is rather commonly experienced as stemming from social worlds, environments, and norms that fail to accommodate autistic bodies and their distinctive forms of life. We aim to do justice to the pervasiveness of loneliness in many — if not all — psychopathologies, while also highlighting the need to attend to psychopathology-specific experiences of loneliness, agency, and (non-)recognition. [ABSTRACT FROM AUTHOR]

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

Autism, also known as Autism Spectrum Disorder (or ASD), is a neurological disorder. Its main symptoms include difficulty in verbal/non-verbal communication and rigid/repetitive behavior. These symptoms are often indistinguishable from a normal (control) individual due to which this disorder remains undiagnosed in early childhood, thus leading to a delayed treatment. Since the learning curve is steep during the initial years, an early diagnosis of autism would allow to make an early intervention, which in turn would positively affect the growth of an autistic child. Further, the traditional methods of autism diagnosis require multiple visits to a specialized doctor; however, this process is generally time-consuming. In this paper, we present a learning-based approach to automate autism diagnosis using simple and small action video clips of subjects. This task is particularly challenging because the amount of annotated data available is small, and the variations among samples from the two categories (ASD and control) are generally indistinguishable. This is also evident from poor performance of a baseline binary classifier on this task. To address this, we propose to adopt contrastive feature learning for the first time on this task and demonstrate a significant increase in the prediction accuracy. We further validate this by conducting thorough experimental analyses in both self-supervised and supervised setups on two publicly available datasets. We have also released our codes and pre-trained models for reproducibility. [ABSTRACT FROM AUTHOR]

Although widely believed by pediatricians and parents to be safe for use in infants and children when used as directed, increasing evidence indicates that early life exposure to paracetamol (acetaminophen) may cause long-term neurodevelopmental problems. Furthermore, recent studies in animal models demonstrate that cognitive development is exquisitely sensitive to paracetamol exposure during early development. In this study, evidence for the claim that paracetamol is safe was evaluated using a systematic literature search. Publications on PubMed between 1974 and 2017 that contained the keywords "infant" and either "paracetamol" or "acetaminophen" were considered. Of those initial 3096 papers, 218 were identified that made claims that paracetamol was safe for use with infants or children. From these 218, a total of 103 papers were identified as sources of authority for the safety claim. Conclusion: A total of 52 papers contained actual experiments designed to test safety, and had a median follow-up time of 48 h. None monitored neurodevelopment. Furthermore, no trial considered total exposure to drug since birth, eliminating the possibility that the effects of drug exposure on long-term neurodevelopment could be accurately assessed. On the other hand, abundant and sufficient evidence was found to conclude that paracetamol does not induce acute liver damage in babies or children when used as directed. What is Known: • Paracetamol (acetaminophen) is widely thought by pediatricians and parents to be safe when used as directed in the pediatric population, and is the most widely used drug in that population, with more than 90% of children exposed to the drug in some reports. • Paracetamol is known to cause liver damage in adults under conditions of oxidative stress or when used in excess, but increasing evidence from studies in humans and in laboratory animals indicates that the target organ for paracetamol toxicity during early development is the brain, not the liver. What is New: • This study finds hundreds of published reports in the medical literature asserting that paracetamol is safe when used as directed, providing a foundation for the widespread belief that the drug is safe. • This study shows that paracetamol was proven to be safe by approximately 50 short-term studies demonstrating the drug's safety for the pediatric liver, but the drug was never shown to be safe for neurodevelopment. Paracetamol is widely believed to be safe for infants and children when used as directed, despite mounting evidence in humans and in laboratory animals indicating that the drug is not safe for neurodevelopment. An exhaustive search of published work cited for safe use of paracetamol in the pediatric population revealed 52 experimental studies pointing toward safety, but the median follow-up time was only 48 h, and neurodevelopment was never assessed. [ABSTRACT FROM AUTHOR]

Many services can assist autistic people, such as early intervention, vocational services, or support groups. Scholars and activists debate whether such services should be autism-specific or more general/inclusive/mainstream. This debate rests on not only clinical reasoning, but also ethical and social reasoning about values and practicalities of diversity and inclusion. This paper presents qualitative results from a mixed-methods study. An online survey asked autistic adults and parents of autistic people of any age in Canada, the United States, Italy, France, and Germany what types of services they prefer (autism-specific, mixed-disability, or general/inclusive/mainstream). This paper presents the advantages and disadvantages of different service types, identified through inductive thematic coding and organized into higher-level themes focusing on clinical, structural, societal, interpersonal, and personal aspects of services. Autism-specific services were praised for addressing autism needs, helping clinically, and providing interpersonal benefits of others understanding autism; general services were praised for inclusion, helping clinically, community obligations and awareness, and social skills development. Looking at the interaction of these different aspects in respondent narratives nuances debates about autism-specificity, with a complex interplay between clinical, interpersonal, and societal aspects. Clinical and social perspectives are not necessarily separate and opposed, but intertwined based on different understandings of inclusion. Compared to parents, adults focused more on harm/safety issues, enjoyment, and stereotyping among other themes, attending to personal themes. These findings do not identify one best service type, but suggest that determining the right service in a given context may be informed by definitions of and goals about inclusion. [ABSTRACT FROM AUTHOR]

Research on autistic women's experience of parenthood is lacking. In this paper, two studies are presented. Study 1 comprised a small-scale qualitative study with autistic mothers (n = 9) in which their experiences of motherhood were explored using thematic analysis. The findings showed that participants identified a range of strengths, including connection with their children, high knowledge about childhood, a reflective style of parenting, good coping strategies, identifying with their autism diagnosis, and not caring what others thought. They also identified difficulties, including sensory challenges, coping with uncertainty and change, having to socialise, managing exhaustion, and not being taken seriously by professionals involved with their children. Guided by the findings of Study 1, and in collaboration with an advisory panel of autistic mothers, an online survey using mixed methods was completed by education and social professionals (n = 277) to investigate their understanding of, and attitudes towards, autism in women and mothers. Results showed high awareness and positive attitudes towards autism, but low levels of self-efficacy in working with autistic adults. Qualitative content analysis of open-ended questions shed light on challenges and rewards of working with autistic parents. The findings are discussed with reference to the double empathy problem (Milton Disability & Society, 27(6), 883–887, 2012) and implications for training of professionals. [ABSTRACT FROM AUTHOR]

There is growing recognition that parallel processes are central components of supervision and may be a supervisor's primary source of data about a client's and a therapist's unconscious processes and the ongoing therapeutic relationship between them. The term "parallel processes" refers to the process through which unconscious conflict emerges within one dyad (supervisor–supervisee or supervisee–client) and then becomes reflected or re-enacted in another dyad of the triangle. This paper reviews the literature on parallel processes in social work, according to relational theory. Illustrated here are two case examples featuring particular types of unconscious processes generated within the supervision triad (supervisor, student, and client). In one case the process arose in treatment and was re-enacted in a supervision setting, and in the other case it arose in supervision and was re-enacted in treatment sessions. When analyzed within the setting of group supervision for supervisors-in-training these examples demonstrate some of the core components of bidirectional parallel processes in supervision and their application to social work field education. We used the relational approach and its clinical applications to help supervisors understand the student–client relationship, as well as their own involvement in the intricate interactions that develop between client and student and between student and supervisor. The examples also illustrate how the learning process in groups combines clinical and theoretical material to further the professional growth and development of supervisors and their students, with a view to improving the latters' interventions with clients through parallel processes. [ABSTRACT FROM AUTHOR]

Ecological accounts of responsible agency claim that moral feedback is essential to the reasons-responsiveness of agents. In this paper, we discuss McGeer's scaffolded reasons-responsiveness account in the light of two concerns. The first is that some agents may be less attuned to feedback from their social environment but are nevertheless morally responsible agents – for example, autistic people. The second is that moral audiences can actually work to undermine reasons-responsiveness if they espouse the wrong values. We argue that McGeer's account can be modified to handle both problems. Once we understand the specific roles that moral feedback plays for recognizing and acting on moral reasons, we can see that autistics frequently do rely on such feedback, although it often needs to be more explicit. Furthermore, although McGeer is correct to highlight the importance of moral feedback, audience sensitivity is not all that matters to reasons-responsiveness; it needs to be tempered by a consistent application of moral rules. Agents also need to make sure that they choose their moral audiences carefully, paying special attention to receiving feedback from audiences which may be adversely affected by their actions. [ABSTRACT FROM AUTHOR]

Challenges in social communication is one of the core symptom domains in autism spectrum disorder (ASD). Novel therapies are under development to help individuals with these challenges, however the ability to show a benefit is dependent on a sensitive and reliable measure of treatment effect. Currently, measuring these deficits requires the use of time-consuming and subjective techniques. Objective measures extracted from natural conversations could be more ecologically relevant, and administered more frequently—perhaps giving them added sensitivity to change. While several studies have used automated analysis methods to study autistic speech, they require manual transcriptions. In order to bypass this time-consuming process, an automated speaker diarization algorithm must first be applied. In this paper, we are testing whether a speaker diarization algorithm can be applied to natural conversations between autistic individuals and their conversational partner in a natural setting at home over the course of a clinical trial. We calculated the average duration that a participant would speak for within their turn. We found a significant correlation between this feature and the Vineland Adaptive Behaviour Scales (VABS) expressive communication score (r = 0.51, p = 7 × 10–5). Our results show that natural conversations can be used to obtain measures of talkativeness, and that this measure can be derived automatically, thus showing the promise of objectively evaluating communication challenges in ASD. [ABSTRACT FROM AUTHOR]

The non-autistic majority often judges people on the autism spectrum through the prism of numerous stereotypes, prejudices, cognitive biases, or, generally speaking, non-rational beliefs. This causes problems in autistic people's everyday lives, as they often feel stigmatized, marginalized, and they internalize deficit-laden narratives about themselves. Unfortunately, experts, including health or law professionals, are not entirely immune to these non-rational beliefs, which affect their decision-making processes. This primarily happens when a mix of background knowledge, overconfidence, and haste co-occur. The resulting decisions may impact autistic people, e.g., by determining eligibility for the state's therapeutical and financial support. This paper shows how simplified reasoning and inference may influence experts' (medical examiners or court expert witnesses) decision-making processes concerning autistic people. It also proposes particular clues and strategies that could help experts cope with this risk and avoid making biased decisions. [ABSTRACT FROM AUTHOR]

Some children with autism spectrum disorders (ASD) demonstrate unusual islets of abilities or "splinter skills" that represent relative strengths in their development. In this paper we present a clinical case of an 11-year-old Russian boy with ASD who spontaneously acquired the English language. While the child demonstrated language deficits in both English and Russian, the discrepancy between the languages was paradoxical given the lack of exposure to English language. This case study brings into question the importance of a language environment for children with ASD. Alternative pathway to language acquisition is discussed. We hypothesize that that incidental second language acquisition in children with ASD resulting from media exposure could become more frequent with the availability of the Internet. [ABSTRACT FROM AUTHOR]

In this article, I argue that rhythm is a key concept in understanding autism. The article builds on fieldwork conducted amongst autistic children at two specialized institutions in Denmark, as well as interviews with parents of autistic children, some of whom were also autistic themselves. The paper draws on Lefebvre's theory of 'rhythmanalysis' and treats rhythm as a 'way of being'. Viewing autism as a rhythm by using locutions expressed by my interlocutors, such as staccato, schematic, robotic, desynchronized, not tuning in and dissonant, illustrates the many ways to perceive social interaction as rhythmic. I add to this the concept of syncopation, to describe some of the most common features associated with autism, pointing to a non-pathological way of being irregular or offbeat. This 'non-pathologizing language' communicates both the challenges and contributions of social interactions between autistic people and their friends and family members. [ABSTRACT FROM AUTHOR]

Many scientific papers reported that an unbalanced gut microbiota could lead to or worsen neurodevelopmental disorders (NDD). A dysbiosis may then be observed in the course of development and mark a dysfunction within what is called the gut-brain axis. The aim of this systematic review is to investigate potential evidence of dysbiosis in children and young adults with NDD compared to controls. Using the PRISMA guidelines we systematically reviewed studies that compared the gut microbiota in NDD participants (with an age inferior to thirty) to the gut microbiota of controls, regardless of the data analysis methods used. The MEDLINE, Scopus and PsycINFO databases were searched up to September 2018. 31 studies with a total sample size of 3002 ASD (Autism Spectrum Disorder) and 84 ADHD (Attention Deficit Hyperactivity Disorder) participants were included in this systematic review. Independent data extraction and quality assessment were conducted. The quality of the studies was rated from low to high. Population characterization and experimental methods were highly heterogeneous in terms of the data available, selection of criteria, and dysbiosis measurement. A dysbiosis was reported in 28 studies in terms of either diversity, bacterial composition or metabolome dysfunction. Due to heterogeneity, a quantitative synthesis was not applicable. In this paper, we discuss the different biases to understand the complexity of microbiota and neurodevelopmental disorders to provide leads for future cohort studies looking to answer the questions raised by the trillions of microorganisms that inhabit key body niches. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASD) is a neurodevelopmental disorder that causes repetitive stereotyped behavior and social difficulties, early diagnosis and intervention are beneficial to improve treatment effect. Although multi-site data expand sample size, they suffer from inter-site heterogeneitys, which degrades the performance of identitying ASD from normal controls (NC). To solve the problem, in this paper a multi-view ensemble learning network based on deep learning is proposed to improve the classification performance with multi-site functional MRI (fMRI). Specifically, the LSTM-Conv model was firstly proposed to obtain dynamic spatiotemporal features of the mean time series of fMRI data; then the low/high-level brain functional connectivity features of the brain functional network were extracted by principal component analysis algorithm and a 3-layer stacked denoising autoencoder; finally, feature selection and ensemble learning were carried out for the above three brain functional features, and a classification accuracy of 72% was obtained on multi-site data of ABIDE dataset. The experimental result illustrates that the proposed method can effectively improve the classification performance of ASD and NC. Compared with single-view learning, multi-view ensemble learning can mine various brain functional features of fMRI data from different perspectives and alleviate the problems caused by data heterogeneity. In addition, this study also employed leave-one-out cross validation to test the single-site data, and the results showed that the proposed method has strong generalization capability, in which the highest classification accuracy of 92.9% was obtained at the CMU site. [ABSTRACT FROM AUTHOR]

The complexities of including students with autism in schools throughout Australia has resulted in the increased necessity for collaboration between stakeholders. For included students with autism, secondary school presents a variety of subjects, teachers and peers that have the potential to increase anxiety levels compared to their primary experience. Communication between important stakeholders is critical in alleviating issues for students with autism before they escalate. In this paper, researchers report and reflect on the implementation of a co-design process as a rigorous practice-based research methodology that provided an empathy focussed platform to explore possibilities in designing a prototype digital solution to support students with autism. The project was designed to identify communication issues associated with the secondary experience of students with autism and to create solutions via the development of a rapid prototype communication app. Findings from this project suggest that involving diverse stakeholders in co-designing and exploring possibilities in complex school environments had two benefits: stakeholders had the opportunity to see the challenge from other parties' perspectives, and the process promoted creativity and flexibility in generating people-based solutions. [ABSTRACT FROM AUTHOR]

Research has repeatedly shown the positive effects of early diagnosis and intervention in improving the quality of life and symptom trajectory of individuals with autism spectrum disorder (ASD). Immigrant and racial/ethnic minority children are diagnosed with ASD at significantly older ages, and have access to interventions later than their White peers. Recent efforts to address diagnostic disparities have focused on universal ASD screening in pediatric primary care. However, little is known about immigrant families' experiences with ASD screening and with navigating subsequent referrals after receiving a positive ASD screen. In the current study, we explored cultural influences on: mothers' perceptions of child development and disability, communication with pediatric healthcare providers, and perceived benefits of Early Intervention services. We interviewed 26 mothers (14 US-born and 12 immigrant—representing twelve different nationalities) of children who screened positively for ASD in primary care but did not receive an ASD diagnosis after a formal evaluation (i.e., false positive ASD screen). Mothers completed semi-structured qualitative interviews that explored their perceptions of child development, experiences with the ASD screening and developmental evaluation process, and experiences with developmental services. Data were stratified by U.S. nativity and analyzed using applied thematic analysis. Immigrant mothers described different ways of monitoring child development than US-born mothers, and described a mismatch between their own views and the child development frameworks used in the U.S. Due to this mismatch, immigrant parents may be less likely to raise concerns to their pediatricians, and therefore may particularly benefit from routine screening. This paper uses data from a supplemental study to a larger clinical trial. The clinical trial registration number is NCT02359084. Highlights: Immigrant families view child development as a process that unfolds uniquely for each child, therefore, monitoring development through milestones can be a new idea for culturally diverse families. Immigrant children with elevated risk for ASD may be at higher risk for later identification of developmental delays if they are not screened at their well-child visits. Culturally and linguistically accessible explanations of child development and disabilities can help immigrant families throughout the ASD screening process. Immigrant families emphasize benefiting from family navigation and logistical support during the developmental evaluation process. [ABSTRACT FROM AUTHOR]

In this paper, we report on a participatory oral history study documenting the lives of late-diagnosed autistic adults in Australia. We interviewed 26 autistic adults about their life history and the impact of late diagnosis. All were diagnosed after the age of 35, growing up in an era when autism was not well known. Using reflexive thematic analysis, we uncovered a rich body of reflections on shared Autistic identity and identified three major themes within that data set: 'conceptualising the Autistic family', 'creating Autistic community', and 'contesting Autistic identity'. Overall, the study provides insights into the active creation of shared Autistic identity and the importance of Autistic community to these late-diagnosed autistic adults. [ABSTRACT FROM AUTHOR]

Genetic and environmental factors increase autism spectrum disorder (ASD) incidence, and this has led to the generation of corresponding animal models, with some showing strong construct and face validity. This short review focuses on results we have recently obtained with environmental and genetic mouse models of ASD and that are the valproic acid, the poly I:C and the Shank 3 models. This has allowed us to provide a comparative description of these widely used animal models providing an interesting perspective as to the pros and cons of each one of them, in our experimental settings. In these papers, we focused on motor and gait disorders which are currently not included in the diagnosis criteria, but which may provide new insights to ASD pathophysiology potentially leading to innovative therapies for a disease that currently has none. In all these models, we reported behavioral, cellular and molecular alterations related to the cerebellum. Motor and gait deficits were observed to various degrees in animal models and, when strongly present, they were correlated to the severity of social deficits as well as to the number of cerebellar Purkinje cells. Additionally, we also reported that, like in humans, males are more severely affected than females in these ASD models. These findings, along with an increasing body of literature, open new hopes in the ASD field pointing to brain regions, such the cerebellum, that are at the crossroads between cognitive, social and motor deficits. Targeting these brain regions and their underlying pathways and synaptic connections may prove of significant benefits. [ABSTRACT FROM AUTHOR]

In response to Vivanti's 'Ask The Editor...' paper [Journal of Autism and Developmental Disorders, 50(2), 691–693], we argue that the use of language in autism research has material consequences for autistic people including stigmatisation, dehumanisation, and violence. Further, that the debate in the use of person-first language versus identity-first language should centre first and foremost on the needs, autonomy, and rights of autistic people, so in to preserve their rights to self-determination. Lastly, we provide directions for future research. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a neurodevelopment disorders, which is very difficult to diagnose at early stages of life, and is a complex spectrum disorder, involving many persistent challenges with lack of social interactions, eye contact and facial expressions. Facial features of children having ASD are different from typically developing (TD) children, which is a major clue for early detection of autism using demographics of facial features. In this paper, a novel framework for early detection of autism has been developed, using a semi-supervised approach that consists ConvNeXt-T model and clustering of image embedding vectors. State-of-the-art ConvNeXt-T model is trained for autism dataset, and after that, image embedding clusters are created based on cosine similarity threshold. By doing this, model's classification layer and embedding generation layers are trained for the subject data. The proposed framework provides embeddings and autism classifier from the trained model, where cluster embeddings can be used in semi-supervised classification. Hence, after training process, inference architecture has two modes: (i) classification using ConvNeXt-T and (ii) classification using embedding clusters. The classification accuracy of framework using ConvNeXt-T is 89.5%, where clustering accuracy using cosine similarity of image embedding is 93%. Most of the other techniques in this area focus only on classification using deep neural networks. The proposed framework is also providing classification based on embedding clusters and can work on unlabelled dataset. Moreover, the proposed framework is based on server–client architecture, which allows easy usability and integration without multi acceleration devices and extra resource consumption. A single image of child is required to detect autism using the proposed framework in real-life scenario. [ABSTRACT FROM AUTHOR]

Detecting the attention of children with autism spectrum disorder (ASD) is of paramount importance for desired learning outcome. Teachers often use subjective methods to assess the attention of children with ASD, and this approach is tedious and inefficient due to disparate attentional behavior in ASD. This study explores the attentional behavior of children with ASD and the control group: typically developing (TD) children, by leveraging machine learning and unobtrusive technologies such as webcams and eye-tracking devices to detect attention objectively. Person-specific and generalized machine models for face-based, gaze-based, and hybrid-based (face and gaze) are proposed in this paper. The performances of these three models were compared, and the gaze-based model outperformed the others. Also, the person-specific model achieves higher predictive power than the generalized model for the ASD group. These findings stress the direction of model design from traditional one-size-fits-all models to personalized models. [ABSTRACT FROM AUTHOR]

Mainstream media is a common source of information on mental health, and its portrayal of mental disorders can influence public perceptions and stigmatisation. Recently, autism has received increased attention in mainstream media. This scoping review aims to contribute to the existing literature on the portrayal of autism and its stigmatising effect by mapping the characteristics and range of records that describe the representation of autism in mainstream media with a focus on non-fiction media (newspapers and social media) and fiction media (movies & TV, and literature). We extracted 31 articles from PubMed and PsychInfo, as well as conducting secondary searches, covering articles published between 2010 and 2022, with a time frame of media from 1988 to 2022. Most of the articles focused on newspapers and movies & TV. Our findings suggest that while the portrayal of autism in media varies, stigmatisation is most prominent in newspapers and movies & TV, often with a negative tone and stereotypical portrayal such as savantism. One possible reason for this could be the lack of representation of experts by experience in these media outlets. In contrast, our review found that literature often has a more diverse and positive representation, and social media tends to have a more supportive tone. Our recommendation is that autistic individuals should be included in the content creation process. Furthermore, future research should focus on newer forms of media, particularly social media, where self-representation is more common, and investigate how this affects the portrayal and stigmatisation of autism. [ABSTRACT FROM AUTHOR]

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 (< 4 years old) evaluated by a transdisciplinary team. Team-based processes included pre-visit triage, synchronous evaluation procedures, case conferencing, huddles, and care coordination. The model led to increased patient throughput, reductions in waitlist and time to diagnosis, and improved provider satisfaction. Improvements in access to care were equitable across patient race, ethnicity, language, and insurance type. [ABSTRACT FROM AUTHOR]

This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good.60–.79 to excellent ≥.80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings. [ABSTRACT FROM AUTHOR]

Biofeedback systems have shown promising clinical results in regulating the autonomic nervous system (ANS) of individuals. However, they typically offer a "one-size-fits-all" solution in which the personalization of the stimuli to the needs and capabilities of its users has been largely neglected. Personalization is paramount in vulnerable populations like children with autism given their sensory diversity. Ambient intelligence (AmI) environments enable creating effective adaptive mechanisms in biofeedback to adjust the stimuli to each user's performance. Yet, biofeedback models with adaptive mechanisms are scarce in the AmI literature. In this paper, we propose an adaptive model to support biofeedback that takes the user's physiological data, user's adherence to therapy, and environmental data to personalize its parameters and stimuli. Based on the proposed model, we present EtherealBreathing, a biofeedback system designed to help children with autism practice box breathing. We used the data from 20 children with autism using EtheralBreating without adaptation mechanisms to feed an adaptive model that automatically adapts the visual and audible stimuli of EtherealBreathing according to changes in each user's physiological data. We present two scenarios showing how EtherealBreathing is capable of personalizing the stimuli, difficulty level, or supporting the therapist decisions. Results are promising in terms of performance and personalization of each user model, showing the importance of personalization for AmI technology. Finally, we discuss challenges and opportunities in using adaptive models to support biofeedback in AmI environments. [ABSTRACT FROM AUTHOR]