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Both the amount "and" responsiveness of adult language input contribute to the language development of autistic and non-autistic children. From parent-child interaction footage, we measured the amount of adult language input, overall parent responsiveness, and six discrete parent responsive behaviours ("imitations, expansions, open-ended questions, yes/no questions, comments" and "acknowledgements") to explore which types of responsiveness predicted autistic preschoolers' language five months later, after controlling for adult language input. We found "expansions" and particularly "imitations" to be more important for later language than overall responsiveness. This study emphasises the need to capture what exactly about parent language input influences child language acquisition, and adds to the evidence that imitating and expanding early language might be particularly beneficial for autistic preschoolers.

The breadth of available non-pharmacological interventions for autistic children, with varying evidence for efficacy summarised in multiple systematic reviews, creates challenges for parents, practitioners, and policymakers in navigating the research evidence. In this article, we report the findings of an umbrella review of 58 systematic reviews of non-pharmacological interventions for autistic children (aged 0-12 years). Positive therapeutic effects were identified for "Behavioural interventions," "Developmental interventions," "Naturalistic Developmental Behavioural Interventions," "Technology-based interventions," and "Cognitive Behaviour Therapy" across several child and family outcomes. Positive effects for certain practices within "Sensory-based interventions" and 'other' interventions were limited to select child and family outcomes. Both inconsistent and null intervention effects were found for "Treatment and Education of Autistic and related Communication-handicapped Children," and "Animal-assisted interventions" across outcomes. The possible influence of child (chronological age, core autism characteristics, and related skills) and delivery (agent, mode, format, and amount) characteristics on intervention effects was rarely examined, and inconsistent where reported. Twenty-seven systematic reviews (47%) were rated as 'high' quality. Few systematic reviews examined children's participation and quality of life or adverse effects. The findings highlight the need for individualised evidence-based decision-making when selecting interventions for autistic children.

Introduction Diabetic retinopathy (DR), diabetic kidney disease (DKD) and distal symmetric polyneuropathy (DSPN) share common pathophysiology and pose an additive risk of early mortality.Research design and methods In adults with type 1 diabetes, 49 metabolites previously associated with either DR or DKD were assessed in relation to presence of DSPN. Metabolites overlapping in significance with presence of all three complications were assessed in relation to microvascular burden severity (additive number of complications—ie, presence of DKD±DR±DSPN) using linear regression models. Subsequently, the same metabolites were assessed with progression to endpoints: soft microvascular events (progression in albuminuria grade, ≥30% estimated glomerular filtration rate (eGFR) decline, or any progression in DR grade), hard microvascular events (progression to proliferative DR, chronic kidney failure, or ≥40% eGFR decline), and hard microvascular or macrovascular events (hard microvascular events, cardiovascular events (myocardial infarction, stroke, or arterial interventions), or cardiovascular mortality), using Cox models. All models were adjusted for sex, baseline age, diabetes duration, systolic blood pressure, HbA1c, body mass index, total cholesterol, smoking, and statin treatment.Results The full cohort investigated consisted of 487 participants. Mean (SD) follow-up was 4.8 (2.9, 5.7) years. Baseline biothesiometry was available in 202 participants, comprising the cross-sectional cohort. Eight metabolites were significantly associated with presence of DR, DKD, and DSPN, and six with additive microvascular burden severity. In the full cohort longitudinal analysis, higher levels of 3,4-dihydroxybutanoic acid (DHBA), 2,4-DHBA, ribonic acid, glycine, and ribitol were associated with development of events in both crude and adjusted models. Adding 3,4-DHBA, ribonic acid, and glycine to a traditional risk factor model improved the discrimination of hard microvascular events.Conclusions While prospective studies directly assessing the predictive ability of these markers are needed, our results strengthen the role of clinical metabolomics in relation to risk assessment of diabetic complications in chronic type 1 diabetes.

The use of both empirically supported and unsupported practices by teachers is common with autistic students. In this study, strategies were used to reduce use of unsupported practices. First, specially-designed information sheets were shared with teachers about the evidence-base of two practices used in schools: one unsupported (sensory integration therapy [SIT]) and one supported (antecedent-based interventions [ABI]). A professional development program was then implemented to improve knowledge and use of ABI. The information sheets significantly reduced teacher support for SIT, however this was not maintained following professional development. Support for ABI remained unchanged across phases. The need for ongoing teacher professional development in replacing use of unsupported practices with more evidence-based approaches is discussed.

Many autistic children have co-occurring behavioural problems influencing core autism symptomology potentially relevant for intervention planning. Parental Expressed Emotion -- reflecting critical, hostile and overprotective comments -- contributes to understanding and predicting behaviour in autistic school-aged children, adolescents and adults and is typically measured using the Five-Minute Speech Sample. However, limitations exist for its use with parents of younger autistic children and so the Autism-Specific Five-Minute Speech Sample was adapted with the goal of better measuring parent Expressed Emotion in the context of childhood autism. The Autism-Specific Five-Minute Speech Sample has not yet been used to explore Expressed Emotion in parents of autistic "preschoolers," nor has the relative predictive utility of the Autism-Specific Five-Minute Speech Sample and Five-Minute Speech Sample been evaluated in the same sample. We compared the two measures from speech samples provided by 51 Australian parents with newly diagnosed autistic preschoolers, including investigating their predictive value for concurrent and subsequent child internalising and externalising behaviour problems. While Autism-Specific Five-Minute Speech Sample Expressed Emotion and Five-Minute Speech Sample Expressed Emotion were associated in this sample, only Autism-Specific Five-Minute Speech Sample codes contributed significant predictive value for concurrent and subsequent child problem behaviour. These preliminary data strengthen the position that the Autism-Specific Five-Minute Speech Sample may better capture Expressed Emotion, than the Five-Minute Speech Sample, among parents of autistic preschool-aged children.

Developmental vulnerability in children often impacts social, educational, and health outcomes that then determine a child's developmental trajectory into adolescence and adulthood. It is widely accepted that early detection of vulnerability and implementation of targeted educational support can optimise children's outcomes, particularly when implemented via a holistic, cross-institutional approach with community and multi-stakeholder engagement. However, developing and sustaining community collaboration on the scale necessary to achieve such an outcome is challenging, and communities seeking to do so may be able to learn from others where such outcomes have been achieved. It is in this context that we describe the formation and activities of the Griffith University-Nerang Alliance (GU-NA) collaboration, a co-designed community-wide endeavour aimed at ensuring every child has a healthy and successful start to school in Nerang and surrounding suburbs in southeast Queensland, Australia. Using the Knowledge-To-Action Framework, we reflect on the process for establishing and sustaining the collaboration focussing on supporting children's transition to school, including challenges and lessons learned. We highlight the importance of a systematic, co-designed approach to collaboration, and share processes and lessons learned with the view to supporting similar collaborations in other communities.

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

Parents from individualist cultures (those focused on autonomy of individuals; that is, Australian) may view their autistic children differently compared to parents from collectivist cultures (where community needs are valued over an individual's, that is, South-East Asian cultures). As most research on autism and parenting has been undertaken in Western individualist cultures, knowledge of parenting beliefs and mental health within collectivist cultures is lacking. We compared the mental health, quality of life, well-being and parenting sense of competency between families raising an autistic child from two groups: 97 Australian parents and 58 parents from South-East Asian backgrounds. Children from both groups were receiving the same community-based early intervention. No group differences were found on the measures of mental health but, when compared to Australian parents, parents from South-East Asian backgrounds reported higher well-being and less impact on their quality of life resulting from their child's autism-specific difficulties. Furthermore, a positive association between well-being and quality of life was only observed for South-East Asian parents. Hence, the views of, and responses to, disability for South-East Asian parents may act as a protective factor promoting well-being. This novel research indicates that culture plays a role in parenting autistic children and highlights the need to accurately capture cultural background information in research.

Extensive research has shown elevated mental health difficulties among parents of children with autism compared to other parents. Although several studies have explored factors related to mental health among parents of children with autism, the factors that influence and promote well-being remain poorly characterised. Parents of young, newly diagnosed autistic children may also be particularly vulnerable to stressors that impact mental health and well-being. We examined child-, parent-, and family/socioeconomic factors associated with concurrent mental health and well-being among 136 parents of young children with autism, aged 13-48 months. Parental mental health was predicted by both trait negative emotionality and reported child autism symptoms, while well-being was predicted by parent factors alone, including trait extraversion and mindfulness. Broader child characteristics and family/socioeconomic contextual factors made no significant contribution in regression models. While the mental health and well-being of parents with young autistic children are associated with one another, unique predictors seem to exist. That well-being was uniquely predicted by a modifiable parent characteristic -- mindfulness -- suggests the potential for early supports to bring direct benefits for parents, in the context of raising a young child with autism.

A challenge facing metabolomics in the analysis of large human cohorts is the cross-laboratory comparability of quantitative metabolomics measurements. In this study, 14 laboratories analyzed various blood specimens using a common experimental protocol provided with the Biocrates AbsoluteIDQ p400HR kit, to quantify up to 408 metabolites. The specimens included human plasma and serum from male and female donors, mouse and rat plasma, as well as NIST SRM 1950 reference plasma. The metabolite classes covered range from polar (e.g., amino acids and biogenic amines) to nonpolar (e.g., diacyl- and triacyl-glycerols), and they span 11 common metabolite classes. The manuscript describes a strict system suitability testing (SST) criteria used to evaluate each laboratory's readiness to perform the assay, and provides the SST Skyline documents for public dissemination. The study found approximately 250 metabolites were routinely quantified in the sample types tested, using Orbitrap instruments. Interlaboratory variance for the NIST SRM-1950 has a median of 10% for amino acids, 24% for biogenic amines, 38% for acylcarnitines, 25% for glycerolipids, 23% for glycerophospholipids, 16% for cholesteryl esters, 15% for sphingolipids, and 9% for hexoses. Comparing to consensus values for NIST SRM-1950, nearly 80% of comparable analytes demonstrated bias of

Children with Autism Spectrum Disorder (ASD) may have additional needs in the classroom, resulting from delays in their development of critical school readiness skills, which include following directions and attending to tasks. Consequently, empirically supported strategies targeting these skills have been developed, yet there is evidence to suggest they are not being utilised. The aim of this study was to address this research-practice gap, by working with teachers to identify factors that contribute to their decisions to select and implement these strategies. Using a qualitative methodology and purposive sampling, 13 Australian educators were interviewed to determine factors that influence their selection of strategies to use with children with ASD, including information sources they utilised. Teachers reported that individual characteristics of the children, their own professional experience, and the need for strategies to work within their settings strongly influenced their decision-making. Further, in their efforts to make good decisions surrounding the support of students with ASD, teachers not only accessed supports provided by their school but in some cases sought out additional resources. This study helps to identify the practical considerations that influence the knowledge and use of empirically supported strategies by mainstream teachers.