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

Autism spectrum disorder (ASD) is an etiologically heterogeneous neurodevelopmental condition that eludes a single explanation or cure. Epidemiological studies reveal risk factors, relevant comorbidities, and behavioral correlates to reach a better understanding of ASD. To contribute such data from an understudied ASD population, this paper presents epidemiological data from a Turkish sample of individuals with ASD (n = 911, 748 boys (82.1%) and 163 girls (17.9%) between 1 and 18 years of age). Average age at diagnosis was 31.06 +/- 11.88 months, and the male-to-female ratio was 4.6:1. Three in 4 individuals with ASD had obsessive behaviors, and 1 in 4 had allergic conditions, inappropriate sexual behaviors, self-harming behaviors, and harmful behaviors towards others. One in 3 received a dietary treatment for at least 3 months; almost half received vitamin supplements; the majority (70%) did not experience constipation; and 2 in 3 were picky eaters. This paper presents data on the age of diagnosis, gender ratios, accompanying behaviors, and dietary interventions in Turkish individuals with ASD, which are topics of current research interest about ASD. Such data from non-Western populations may supplement epidemiological knowledge gained from Western populations to help reach a more comprehensive understanding of this condition with many unknowns. WOS:000658616700001 Q4

Objectives:Autism spectrum disorder is a neurodevelopmental conditiona that manifests with impairments in social interactions and communication and repetitive behaviors and restricted interests. It is known that autism spectrum disorder is accompanied by medical comorbidities, and as the number of accompanying comorbidities increase, the intensity of aberrant behaviors also increases in individuals with autism spectrum disorder. Yet, how subgroups of aberrant behaviors relate to physical complaints with unknown primary etiology in autism spectrum disorder has not yet been investigated. Understanding and solving these physical problems can improve the quality of life of individuals with autism spectrum disorder, as interventions should not only address core autism spectrum disorder symptoms but also all physical complaints affecting an individual’s life. Additionally, an examination of such a relation may help better understand the underlying mechanisms of autism spectrum disorder.Materials and Methods:In this study, in 64 individuals with autism spectrum disorder (11 girls) aged between 6 and 18 years, the relationship between the physical complaints subcategory of Child Behavior Checklist and the severity of autism spectrum disorderaccording to Childhood Autism Rating Scale was examined. Additionally, the relationship between physical complaints and the subgroups of the Aberrant Behavior Checklist was evaluated.Results:A significant positive correlation was found between physical symptoms and autism spectrum disorder severity. Among the five factors of this checklist (irritability, agitation, crying; lethargy, social withdrawal; stereotypic behavior; hyperactivity, non-compliance; inappropriate speech), only hyperactivity/non-compliance and inappropriate speech correlated with physical complaints. This relationship was independent of sociodemographic factors such as child age, parental age, and parental education.Conclusion:These findings indicate that children with autism spectrum disorder who exhibit extreme mobility and disobedience are at risk of physical discomfort. In addition to psychiatric and psychologic examinations, a comprehensive and holistic approach should be adopted for individuals with autism spectrum disorder, especially for those individuals experiencing physical problems.

This chapter presents the design, implementation, and evaluation of a new technique to improve children's algorithmic thinking skills that enable solving problems following clearly defined steps. Gamirithmic teaches children to codify ideas by coming up with solutions to problems in systematic and structured ways via its step-by-step procedure with the increasing complexity of commands in each step. The errors of kindergarten children (3-6 years of age) decreased with each trial, but the time taken did not, suggesting that children took time to process the more complicated commands and come up with algorithmic strategies to solve them, yet made fewer errors even though the steps got more complex, as they got used to engaging this type of thinking. Older children made fewer errors and took less time to complete the new tasks. Gamirithmic teaches technology-related concepts using a technology-independent medium that is less likely to induce behavioral problems associated with screen-based methods.

Self-compassion refers to being kind, understanding, and accepting toward oneself in times of failure, frustration, or negative feelings. Since self-compassion is related to both physical and psychological well-being, measuring and understanding self-compassion in different populations carries importance for their mental well-being and life satisfaction outcomes. One such group is the youth, who experience unique developmental challenges. For this purpose, a Self-Compassion Scale for Youth (SCS-Y) was developed (Neff et al., 2021) and this paper presents its Turkish adaptation. The Turkish translation of SCS-Y was tested on a sample of Turkish youth (N = 450, 61.8% female, Mage= 13.09 ± 1.59, range = 11–15) and was found to have acceptable reliability. The scale showed a similar structure to the original testing on American youth with a bifactor model of a general self-compassion score and six subscale scores, and a two-bifactor model where negative and positive aspects are grouped together. Self-compassion was positively related to resilience and well-being, and negatively related to depression. A serial mediation analysis showed self-compassion to have a direct and positive effect on resilience, and to have an indirect effect on well-being mediated by resilience and depression. Given that the trainable skill of self-compassion is associated with higher resilience, lower depression, and better well-being, the value of this scale and its different adaptations becomes evident, as they enable measuring self-compassion in youth in various populations such as the present Turkish one and guiding the design of future interventions to increase self-compassion, targeted for the specific concerns of the youth.

Background: Sensory problems are a core symptom of autism spectrum disorder (ASD) and tailoring the interventions according to sensory profiles yields better prognosis. Objective: This study profiled the sensory symptoms of children with ASD and their sociodemographic and behavioral correlates. Material and Methods: The sample included 911 Turkish children with ASD (748 male and 163 female) aged between 1-18 years. The study was conducted as an internet survey. Results: Almost all children had a sensory problem in at least one sensory domain. The parents stated that almost half of the children received sensory integration therapy (SIT) and that 3 out of 4 of these children benefited from this method. The rate of receiving SIT for their children with ASD was higher in children of mothers and fathers who had higher education levels. Two out of 3 parents reported that their children have hyperactivity, sleep problems, and food selectivity. Obsessive behaviors were 2 times higher in children with ASD who took non-food objects in their mouths, and almost 7 times more common in children who watched rotating objects. The rates of spinning around themselves, taking nonfood objects in their mouths, and hyperactivity were significantly higher in children who experienced sleep-related problems. Conclusion: This study documents the sensory problems of Turkish children with ASD and how they relate with other behavioral domains, which can be useful for determining the most appropriate therapeutic approaches., Amaç: Duyusal sorunlar, otizm spektrum bozukluğu (OSB)’na sıklıkla eşlik etmektedir. OSB’ye yönelik müdahaleleri bireylerin duyusal profillerine göre adapte etmek daha iyi bir prognoz sağlayabilir. Bu çalışma, OSB’li çocukların duyusal semptomlarını ve bu semptomların onların sosyodemografik ve davranışsal özellikleri ile ilişkilerini incelemiştir. Gereç ve Yöntem: Örnekleme, 1-18 yaşları arasındaki 911 Türk OSB’li (748 erkek ve 163 kız) çocuk dahil edilmiştir. Çalışma, bir internet araştırması olarak gerçekleştirilmiştir. Bulgular: Dahil edilen çocukların neredeyse tamamının en az bir duyusal alanda problem yaşadığı, ebeveynleri tarafından bildirilmiştir. Ebeveynlerin yarısı, çocuklarının duyusal bütünleme terapisi (DBT) aldığını ve alan çocukların 4’te 3’ünün bu yöntemden yararlandığını belirtmiştir. DBT alma oranının, yüksek eğitim düzeyine sahip annelerin ve babaların çocuklarında daha yüksek olduğu görülmüştür. Her 3 ebeveynden 2’si çocuklarında hiperaktivite, uyku sorunu ve gıda seçiciliği durumlarının görüldüğünü bildirmiştir. Ayrıca, obsesif davranışların, ağızlarında yiyecek olmayan cisimleri alan OSB’li çocuklarda 2 kat, dönen cisimleri izleyen çocuklarda ise yaklaşık 7 kat daha fazla görüldüğü belirlenmiştir. Uykuya bağlı problemler yaşayan çocuklarda, kendi etrafında dönme, ağızlarında yiyecek olmayan nesneler alma ve hiperaktivite oranları anlamlı derecede yüksek bulunmuştur. Sonuç: Bu çalışma, OSB’li Türk çocuklarının duyusal sorunlarını ve bu sorunların diğer davranışsal alanlarla ilişkilerini göstermektedir. Böylece, OSB’li bireyler için en uygun terapötik yaklaşımlara yönlendirmelerini sağlamakta fayda sağlayabileceği düşünülmektedir..

Recently, the need for a mental health technology revolution during COVID-19 was noted (1). These authors suggested that interventions should be targeted toward vulnerable groups and adapted to their individual needs (1), and we have expanded this concept here. One vulnerable group that will benefit from such a technology revolution and targeted interventions comprises individuals with Autism Spectrum Disorder (ASD). We discuss how technology can be leveraged to address the specific challenges experienced by these individuals and their families during the pandemic.

Individuals with autism spectrum disorder (ASD) have difficulties in social interactions. The cognitive domains that support these interactions include perceptual decision-making, timing, and error-monitoring, which enable one to appropriately understand and react to the other individual in communicative settings. This study constitutes a comprehensive exploration of decision-making and interval timing in ASD as well as the first investigation of error-monitoring abilities of individuals with ASD regarding their performance in the corresponding domains. We found that children with ASD fared similar to typically developing (TD) children in their first-order task performance in two-alternative forced choice perceptual decision-making and temporal reproduction tasks as well as the secondary tasks (signal detection and free finger tapping tasks). Yet, they had a deficit in error-monitoring in both tasks where their accuracy did not predict their confidence ratings, which was the case for the TD group. The difference between ASD and TD groups was limited to error-monitoring performance. This study attests to a circumscribed impairment in error-monitoring in individuals with ASD, which may partially underlie their social interaction problems. This difficulty in cognitively evaluating one's own performance may also relate to theory of mind deficits reported for individuals with ASD, where they struggle in understanding the mental states and intentions of others. This novel finding holds the potential to inform effective interventions for individuals with ASD that can target this error-monitoring ability to have broad-ranging effects in multiple domains involved in communication and social interaction. Autism Res 2019, 12: 239-248 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Decision-making, timing, and error-monitoring are three of many abilities that underlie smooth social interactions. To date, these domains have been only investigated separately, but given their interactive role in social interactions that are impaired in ASD, we conducted the first study to investigate them together. Children with ASD were as successful as typically developing children in their task performances, but unlike them, were unaware of their errors in both decision-making and timing tasks. This deficit that is limited to error-monitoring can contribute to unraveling the unique cognitive signature of ASD and to formulating interventions with positive implications in multiple domains.

Recent evidence implicates immune alterations and gut microbiota dysbiosis in at least some subpopulations of individuals with autism spectrum disorder (ASD). Immune and gut alterations in ASD have mostly been studied separately, and the reviews and theoretical models up to now have mainly considered the immune system as one of the routes for gut-brain communication. We take a different perspective and consider possible common mechanisms of action for the gut microbiota and inflammation on the neural basis of ASD. We propose these to be their effects on ASD-susceptibility genes, neurodevelopment, and intestinal and blood-brain barrier integrity. We then use these common mechanisms to offer pathways for potentially beneficial effects of early-life probiotics on the neural development in ASD. This new perspective yields a conceptual framework for creating effective preventions for mothers at risk of giving birth to children with ASD. Such a framework may also inform effective interventions targeting these common mechanisms of action, which may be shared in many ASD cases regardless of their different etiological profiles. Probiotics may be one example of such preventions and interventions. Finally, the common mechanisms offered by this perspective can be useful in the search of comprehensive theories that can account for the complete neurobiological and behavioral symptoms of ASD.

Although traditionally it was believed that having advanced Theory of Mind (ToM) abilities led to social competence and prosocial behaviors in children, it has also been shown that some children use their high ToM abilities to strategically manipulate others instead of acting prosocially towards them. It is an important developmental task to understand the factors contributing to this behavioral divergence for children with advanced ToM understanding, which also has significant practical implications for bullying interventions. We contend that this divergence cannot be explained by a lack of moral competence or empathy, but that the existing evidence lends itself better to a motivational explanation. We propose that the direction of social motivation varies across children and the self versus other oriented social motivation determines if children will use their developed morality and empathy competencies in social interactions to act prosocially or instead cognitively divert moral and empathic emotions to avoid negative feelings about manipulating others. We show how self versus other orientation has been used as a legitimate distinction to inform other domains of psychology and conclude by discussing possible correlates and precursors of this difference in the direction of social orientation in children.

Amac: Otizm spektrum bozuklugu, dunya capinda yayginligi giderek artan fakat sebepleri hala tamamen bilinmeyen, norogelisimsel bir farkliliktir. Otizmli bireyler, sosyal beceri ve iletisim zorluklari yasarlar; tekrar eden ve kisitlayici ilgi alanlari ile davranislar gosterirler. Otizmin bilinen bir tedavisi veya otizmin butun unsurlarini aciklayabilen kapsamli bir model henuz yoktur. Yontem: Son yillarda bircok hastaligin rejeneratif tedavisinde oldukca yaygin olarak kullanilan kok hucrelerden, uyarilmis pluripotent kok hucre (UPKH), otizmin sebeplerinin daha iyi anlasilmasi icin umut vaat edicidir. Bulgular: UPKH’ler ile yurutulen otizm modellemeleri, otizme neden olan mekanizmalarin anlasilmasi, bozukluklarin duzeltilmesi ve kisiye ozel tedavilerin gelistirilmesi icin cesitli firsatlar sunmaktadir. Sonuc: Bu derleme, UPKH’lerin su ana kadar otizmdeki kullanim alanlarini, avantajlarini ve UPKH modellemeleri ile elde edilen bulgulari incelemektedir.

Changing teacher willingness to teach inclusive classes is critical in achieving optimal outcomes for students with autism spectrum disorder (ASD). The present study investigated the mechanisms underlying the effects of a teacher training in special education strategies for students with ASD on mainstream school teachers' behavioral intentions toward inclusive education. Specifically, the role of attitudes and autism self-efficacy were explored as mediators in this process. The sample comprised 763 mainstream school teachers from eleven cities in Northeastern Turkey who participated in an intensive training that included special education strategies for students with ASD, evidence-based special education applications, and inclusive education practices. Statistical mediation analyses revealed that the training increased teachers' willingness to teach inclusive classes and intention to implement special education techniques in the regular education classroom through increasing their autism self-efficacy. However, though attitudes toward inclusive education was a significant predictor of both willingness to teach inclusive classes and intent to use special education techniques, the training did not improve attitudes. Based on these findings, additional strategies or components to change attitudes toward inclusive education were recommended to be integrated into the teacher training programs on special education strategies for inclusive education.

We propose an unprecedented intervention for individuals with autism spectrum disorder (ASD) and their parents: the social living complex. Unlike existing social skills interventions, peer-mediated interventions here are not limited to the school/experiment duration and setting. Whereas other supported living services house adults with ASD only, here children with ASD and their families live and interact with typically developing (TD) individuals. Another novelty is support groups for parents of children with ASD, who report feeling higher levels of stress than parents of TD children and children with other disabilities, feeling isolated, and not receiving social support. This complex will enable the practice and generalization of schooled skills in the lives of children with ASD and foster an accepting, autism-friendly community.

Konuşma güçlüğü çeken bireylerin iletişim kurmalarına yardımcı olanAlternatif Destekleyici İletişim (ADİ) teknikleri, mobil cihazlarda yer almayave yaygın olarak kullanılmaya başlamıştır. ADİ yöntemlerinin konuşma zorluklarıyaşayan bireylerin hayatlarını kolaylaştırdığı daha önce yapılan çalışmalarlagösterilmiştir. Özellikle otizm spektrum bozukluğu (OSB) için faydalarısıklıkla dile getirilen ADİ uygulamalarının gerçek hayatta nasıl kullanıldığınıyansıtan verilerin sunulduğu bir çalışma henüz bulunmamaktadır. Bu çalışmanınamacı, OSB’ye sahip bireylerin okulda gördükleri eğitime ek olarak sunulan birADİ sisteminin kullanım verilerini incelemek ve bu tür uygulamalarıngeliştirilmesi adına faydalı olmaktır. Bu çalışmada, mobil cihazları çocuklariçin evde eğitim platformuna dönüştüren Otsimo uygulamasında bulunan ADİmodülünden toplanan anonim veriler analiz edilerek raporlanmıştır. Mevcut seslendirmeyöntemlerinden elde edilen veriler incelenmiş, en çok kullanılan kelimelersunularak bu kelimelerin sık kullanımına yol açabilecek olası sebeplerbelirtilmiştir. Bu analizlerin sonucunda elde edilen veriler üzenden iletişimbozukluğu yaşayan bireylerin günlük hayatlarını kolaylaştırabilmek ve ADİuygulamalarını geliştirmek adına öneriler sunulmuştur., Augmentative and Alternative Communication(AAC) is a technique that helps individuals with speech problems tocommunicate. They help individuals with autism spectrum disorder (ASD) who havelanguage difficulties express themselves. AAC tools have started appearing inmobile platforms and are becoming more widespread. Though some research pointsto the advantages of AAC tools for special needs populations, no studies haveyet presented or analyzed data about real life utilization of these tools bytargeted individuals. The aim of this study was to analyze the data collectedfrom the AAC module in Otsimo, an application that turns mobile devices intoeducational platforms for children with ASD, and to present suggestions for theimprovement of AAC modules based on this data. The words that were used themost were determined for different utilization methods and possible reasons fortheir high utilization were listed. Then, recommendations were made in order tofacilitate the creation of more user-friendly AAC tools to assist and improvethe life qualities of individuals with communication disorders and otherdisorders with implicated language problems such as ASD.

Individuals with autism spectrum disorder (ASD) have difficulties in social interactions. The cognitive domains that support these interactions include perceptual decision-making, timing, and error-monitoring, which enable one to appropriately understand and react to the other individual in communicative settings. This study constitutes a comprehensive exploration of decision-making and interval timing in ASD as well as the first investigation of error-monitoring abilities of individuals with ASD regarding their performance in the corresponding domains. We found that children with ASD fared similar to typically developing (TD) children in their first-order task performance in two-alternative forced choice perceptual decision-making and temporal reproduction tasks as well as the secondary tasks (signal detection and free finger tapping tasks). Yet, they had a deficit in error-monitoring in both tasks where their accuracy did not predict their confidence ratings, which was the case for the TD group. The difference between ASD and TD groups was limited to error-monitoring performance. This study attests to a circumscribed impairment in error-monitoring in individuals with ASD, which may partially underlie their social interaction problems. This difficulty in cognitively evaluating one's own performance may also relate to theory of mind deficits reported for individuals with ASD, where they struggle in understanding the mental states and intentions of others. This novel finding holds the potential to inform effective interventions for individuals with ASD that can target this error-monitoring ability to have broad-ranging effects in multiple domains involved in communication and social interaction. Autism Res 2019, 12: 239-248 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Decision-making, timing, and error-monitoring are three of many abilities that underlie smooth social interactions. To date, these domains have been only investigated separately, but given their interactive role in social interactions that are impaired in ASD, we conducted the first study to investigate them together. Children with ASD were as successful as typically developing children in their task performances, but unlike them, were unaware of their errors in both decision-making and timing tasks. This deficit that is limited to error-monitoring can contribute to unraveling the unique cognitive signature of ASD and to formulating interventions with positive implications in multiple domains.

There is a well-established relationship between theory of mind (ToM) and executive function (EF) during the preschool years. However, less is known about the concurrent and longitudinal relations between EF and specific tasks tapping different aspects of ToM. The current study investigated the ToM-EF relationship across 1 year in 3- to 5-year-old Turkish children using the ToM battery of Wellman and Liu (2004), which measures understanding of diverse desires (DD), diverse beliefs (DB), knowledge access (KA), contents false belief (CFB), explicit false belief (EFB), and hidden emotion (HE). This battery has not yet been used in its entirety to test the predictive relations between ToM and EF. We used peg tapping and day-night tasks to measure EF. Our sample comprised 150 Turkish preschool children (69 girls) aged 36-60 months at Time 1 (T1) and 49-73 months at Time 2 (T2). Using the ToM composite with all six tasks, when child's age, receptive language, and T1 ability level (EF or ToM) were controlled, T1 EF significantly predicted T2 ToM, whereas Tl ToM did not predict 12 EF. Among DD, DB, KA, false belief understanding (FBU: the composite score of CFB and EFB), and HE, only KA and FBU were significantly associated with EF at T1 and T2. Further regression analyses showed that KA did not have a predictive relationship with EF. Instead, FBU drove the predictive EF-ToM relationship across time. Thus, in Turkish children, earlier EF predicts later ToM, but especially the FBU component, in this well-validated battery. (C) 2017 Published by Elsevier Inc.