Autism Spectrum Research Articles

Hidden social and emotional competencies in autism spectrum disorders captured through the digital lens

Background/objectivesThe current deficit model of autism leaves us ill-equipped to connect with persons on the spectrum, thus creating disparities and inequalities in all aspects of social exchange in which autistic individuals try to participate. Traditional research models also tend to follow the clinical definition of impairments in social communication and emotions without offering personalized therapeutic help to autistic individuals. There is a critical need to redefine autism with the aim of co-adapting and connecting with this exponentially growing sector of society. Here, we hypothesize that there are social and emotional competencies hidden in the movements’ nuances that escape the naked eye. Further, we posit that we can extract such information using highly scalable means such as videos from smartphones.MethodsUsing a phone/tablet app, we recorded brief face videos from 126 individuals (56 on the spectrum of autism) to assess their facial micro-motions during several emotional probes in relation to their resting state. We extracted the micro-movement spikes (MMSs) from the motion speed along 68 points of the OpenFace grid and empirically determined the continuous family of probability distribution functions best characterizing the MMSs in a maximum likelihood sense. Further, we analyzed the action units across the face to determine their presence and intensity across the cohort.ResultsWe find that the continuous Gamma family of probability distribution functions describes best the empirical face speed variability and offers several parameter spaces to automatically classify participants. Unambiguous separation at rest denotes marked differences in stochastic patterns between neurotypicals and autistic individuals amenable to further separate autistic individuals according to the required level of support. Both groups have comparable action units present during emotional probes. They, however, operate within parameter ranges that fall outside our perceptual umwelt and, as such, do not meet our expectations from prior experiences. We cannot detect them.ConclusionsThis work offers new methods to detect hidden facial features and begin the path of augmenting our perception to include those signatures of the autism spectrum that can enhance our capacity for social interactions, communication, and emotional support to meet theirs.

Stakeholder acceptance of a robot-assisted social training scenario for autistic children compared to a tablet-computer-based approach

Recent studies indicate the potential benefits of robot-assisted therapy (RAT) for children on the autism spectrum (AS), yet acceptance among stakeholders remains unclear due to methodological shortcomings in existing research. This study evaluates stakeholders’ acceptance of a RAT-scenario designed to train emotion recognition and regulation in AS children using Softbank Robotics Pepper, a humanoid robot with an integrated tablet screen, compared to a tablet-based therapy (TBT) control. An online survey of 123 stakeholders (caregivers, professionals, and autistic adults) assessed RAT and TBT using global acceptance, intention to use, and acceptance-related factors (ALMERE model), alongside stakeholders’ concerns. While a larger proportion of stakeholders (58%) showed high global acceptance of RAT, stakeholders preferred TBT across measures and groups (p < .001, Wilk’s Λ = 0.595), potentially due to its established familiarity and easier usability. The intention to use RAT was predicted by perceived usefulness, and, to a smaller extent, perceived ease of use, and affinity for technology, independent of stakeholder group. Concerns mainly addressed the expected effort to implement RAT in therapeutic services. Overall, the results highlight stakeholder acceptance and underscore the need to enhance RAT’s perceived usefulness and ease of implementation, suggesting a user-centered design approach for future deployments.

The Role of a Novel TRIP12 Mutation in Intellectual Disability: A Molecular and Clinical Investigation in Multiplex Family.

Thyroid hormone receptor interactor 12 (TRIP12; MIM #617,752) is an autosomal dominant hereditary disorder involved in the ubiquitin fusion degradation pathway and the regulation of DNA damage-induced chromatin ubiquitination. Positioned on chromosome 2 at position 2q36.3, TRIP12 is a member of the E3 ubiquitin ligase family. This gene plays a vital role in proteasomal degradation by catalyzing substrate ubiquitination and regulating processes such as cell cycle progression, DNA damage repair, and chromatin remodeling. Mutations in TRIP12 can result in intellectual disability (ID), Clark-Baraitser syndrome, and various physical and behavioral abnormalities. The proband, a 32-year-old male, exhibited intellectual disability, delayed speech, and behavioral abnormalities without autistic spectrum disorders. The novel TRIP12 variant was detected through WES and validated by Sanger sequencing in affected family members. In silico tools predicted the deleterious effect of the variant, and protein modeling indicated significant structural changes. RT-qPCR demonstrated increased TRIP12 mRNA levels, suggesting a compensatory mechanism for decreased protein stability. This study examines the role of the TRIP12 gene in the ubiquitin pathway and associated pathologies such as intellectual disability and developmental delay.

Characterisation and Management of Children and Young People Referred to a Paediatric Tertiary Post-COVID Service.

Characterisation and Management of Children and Young People Referred to a Paediatric Tertiary Post-COVID Service.

텍스트 마이닝을 활용한 부모교육 연구 동향 분석

This study aims to examine the overall trends in parent education research using text-mining techniques. The research identifies important keywords in parent education research, identifies keyword network structure, and extracts major topics through topic modeling. Python 3.11 was used as a keyword network analysis and topic modeling research tool. Abstracts of 738 journal articles published in South Korea were selected as analysis data. After data preprocessing and morphological analysis, Term Frequency (TF) analysis, Term Frequency-Inverse Document Frequency (TF-IDF) analysis, network analysis, and topic modeling were performed. As a result of latent Dirichlet allocation (LDA)-based topic modeling, eight topics were identified: adolescent protection and changes in family composition, prospective parent education and child abuse prevention, therapeutic interventions using play and art, research trends in parent education and program model development, multicultural families and child language development, autism spectrum, and developmental disabilities, parent growth and development of infants and young children, and faith identity and community formation.

Motor-Communication Skill Link in Minimally Speaking Children on the Autism Spectrum from the U.S. and India.

We aimed to examine the interrelations between motor and communication skills, as well as associations between motor skill subdomains and different communicative functions in minimally speaking children on the autism spectrum, whereas accounting for the child's age, country of residence, educational setting, and communication modalities (covariates). Data from 67 minimally speaking children on the autism spectrum (ages 4-9) from India and the U.S. were analyzed. Motor and communication skills were assessed using the Vineland Adaptive Behavior Scales-Third Edition and the Communication Matrix. Linear regression was used to examine associations between communication and motor skills, and partial correlations were conducted to explore relations between motor skill subdomains and communicative functions. Motor skills were significantly associated with communication skills, independent of covariates. Significant relations were also observed between both motor skill subdomains and refusal functions, as well as between gross motor skills and the obtain function. No significant associations were found between social or information functions and any motor skill subdomain, independent of covariates. The findings underscore the complex and interrelated nature of motor and communication skills. Consideration of both motor and communication skills in intervention approaches may provide insights into ways to support communication development in minimally speaking children on the autism spectrum.

Communities of Practice for Transforming Tacit Knowledge into Explicit Knowledge in Autism Literacy: A Comparative Study of Bolivia, Brazil, Ecuador, and Paraguay

This study examines pedagogical practices for autism literacy across four countries and explores the potential of establishing a communication network to facilitate the effective exchange of knowledge and experiences. By leveraging local cultural strategies, knowledge management, and organizational intelligence, the research aims to transform tacit knowledge—common in languages with phonetic simplicity, such as Latin-based languages—into explicit knowledge, particularly in countries with law-based educational frameworks. The study addresses key challenges in autism learning, including inattention, hyperactivity, impulsivity, anxiety, irritability, tantrums, defiance, and aggression. These difficulties are compounded by the widespread lack of recognition of the heterogeneity within the autism spectrum. Through interviews conducted in the selected countries, this research seeks to answer the following question: To what extent does the transformation of tacit knowledge into explicit knowledge impact autism literacy? The findings suggest that communities of practice play a crucial role in supporting pedagogical approaches, as many educators and caregivers feel overwhelmed and discouraged, often abandoning efforts due to a lack of understanding of literacy concepts, such as writing. Based on these insights, the study proposes the implementation of the phonemic method for literacy, along with a knowledge management portal that integrates learning resources, communities of practice, expert analyses, and semantic web technologies to enhance organizational intelligence in autism education.

Promoting Autism Acceptance Through “Understanding Friends on the Autism Spectrum” Webinar for University Students

With the rising prevalence of Autism Spectrum Disorder (ASD), more students with ASD are being educated at the university level in Indonesia. In order to create an inclusive and supportive educational environment, it is crucial to promote autism acceptance among their peers. Autism acceptance promotes understanding and respect for neurodiversity, helping to combat the stigma and discrimination that autistic individuals may face in academic and social settings. This study described university students’ knowledge and perception of ASD after participating in the “Understanding Friends on the Autism Spectrum” webinar. The 2-hour webinar discussed two main topics: getting to know more about ASD and optimizing support for individuals with ASD. Data were gathered from 80 student participants responding to post-event survey questions. The result indicated that the participants had an increased knowledge and acceptance of ASD after the webinar. The practical implications of this study will be discussed.

Cues-Pause-Point Method to Decrease Immediate Echolalia In Adolescents With Autism

Adolescents with autism who show immediate echolalia may experience a communication disorder that increases the likelihood of social failure. This study aims to decrease immediate echolalia in adolescents with autistic spectrum disorder using the Cues-Pause-Point method. This experiment uses multiple baseline designs across content. The participants were 18-year-old and 19-year-old adolescents with autism who were given verbal questions from three content areas: identification, interaction, and facts. The Cues-Pause-Point method was designed to (a) to encourage the participants to remain quiet before, during, and after the presentation of the question and (b) to teach the participants to use environmental cues, which are response cards placed on the table. Their responses were noted and scored by two observers. The resulting data were analyzed using descriptive visual analysis and showed a decrease in the participants’ echolalia percentage. The results show a trend line decrease of immediate echolalia after all subjects get Cues-Pause-Point treatment.

Correlates of self-reported life satisfaction among autistic youth with and without intellectual disability.

Compared to their nonautistic peers, lower levels of life satisfaction have been reported by autistic individuals. It is unclear, however, whether autistic individuals with intellectual disability report similar levels of life satisfaction as autistic individuals without intellectual disability or which characteristics are associated with life satisfaction. This study sought to examine differences in levels of self-reported life satisfaction across those with and without intellectual disability and explore correlates of life satisfaction in a sample of 35 autistic youth with intellectual disability and 99 autistic youth without intellectual disability. No difference in self-reported life satisfaction was detected between autistic youth with and without intellectual disability. Greater self-reported life satisfaction was associated with higher self-determination for autistic youth without intellectual disability. For autistic youth with intellectual disability, greater self-reported life satisfaction was related to more frequent social participation, lower parent stress, and fewer unmet service needs. Unmet service needs and parent stress were significantly stronger correlates of life satisfaction for youth with intellectual disability compared to youth without intellectual disability. Although the sample size of autistic youth with intellectual disability was small, these findings suggest the importance of considering heterogeneity among individuals on the autism spectrum when seeking to understand their well-being.Lay abstractAutistic people report lower life satisfaction compared to people without autism. It is unclear whether autistic people with intellectual disability report similar levels of life satisfaction to autistic people without intellectual disability. In this study, we did not find a difference in levels of life satisfaction for autistic youth with intellectual disability compared to autistic youth without intellectual disability. We also identified factors that might promote better life satisfaction. Higher self-determination was related to higher life satisfaction for autistic youth without intellectual disability. For autistic youth with intellectual disability, more frequent social participation, lower parent stress, and fewer unmet service needs were associated with higher life satisfaction. Unmet service needs and parent stress were more strongly related to life satisfaction for youth with intellectual disability compared to youth without intellectual disability. Our findings suggest that taking a more individualized approach to support the well-being of autistic youth is important.

Household Income, Maternal Allostatic Load During Pregnancy, and Offspring With Autism Spectrum Disorders.

Relative maternal poverty is a suggested social determinant of autism spectrum disorders (ASDs) in offspring; however, this association may be confounded by the maternal broader autism phenotype (BAP). The biological mechanisms underlying this association are largely understudied. We examined the association between household income during pregnancy and ASDs in offspring, adjusting for confounders including maternal BAP, and explored whether maternal chronic stress, measured by allostatic load (AL) during pregnancy, mediates this association. Data on 59,998 mother-child dyads were obtained from the Japan Environment and Children's Study, a nationwide birth cohort. Household income was categorized into tertiles (< 4 million, 4-6 million, > 6 million JPY) and offspring ASD diagnosis by age four was assessed via guardian's report. Bayesian logistic regression models indicated that mothers from low- and middle-income households had a 58% (95% credible interval [CI]: 28%-98%) and a 37% (95% CI: 12%-70%) higher risk of offspring ASDs, respectively, compared to those from high-income households. AL, defined as three or more out of 10 biomarkers in the highest risk quartile, did not mediate these associations. Low and middle household income during pregnancy was associated with a higher risk of ASD diagnosis, and high AL did not mediate this association.

Autistic traits, alexithymia, and emotion recognition of human and anime faces.

Individuals on the autism spectrum or with elevated autistic traits have shown difficulty in recognizing people's facial emotions. They also tend to gravitate toward anime, a highly visual medium featuring animated characters whose facial emotions may be easier to distinguish. Because autistic traits overlap with alexithymia, or difficulty in identifying and describing feelings, alexithymia might explain the association between elevated autistic traits and difficulty with facial emotion recognition. The present study used a computerized task to first examine whether elevated autistic traits in a community sample of 247 adults were associated with less accurate emotion recognition of human but not anime faces. Results showed that individuals higher in autistic traits performed significantly worse on the human facial emotion recognition task, but no better or worse on the anime version. After controlling for alexithymia and other potentially confounding variables, autistic traits were no longer associated with performance on the facial emotion recognition tasks. However, alexithymia remained a significant predictor and fully mediated the relationship between autistic traits and emotion recognition of both human and anime faces. Findings suggest that interventions designed to help individuals on the autism spectrum with facial emotion recognition might benefit from targeting alexithymia and employing anime characters.

The effect of Smart-Glove exchange-based system vs. PECS® on communication initiation in minimally verbal toddlers with autism spectrum disorder.

The effect of Smart-Glove exchange-based system vs. PECS® on communication initiation in minimally verbal toddlers with autism spectrum disorder.

Connections between executive function and pragmatic skills in Finnish 5–10-year-old children on the autism spectrum and control children

This study explored the performance of children on the autism spectrum (AS) and control children in executive function (EF) tasks and the relationship between EF and pragmatic skills using clinically available measures. 15 Finnish children on the AS (mean age 7;8 years) and 15 control children (mean age 7;7 years) participated in this study. We examined EF domains of working memory (verbal working memory) and inhibitory control of attention (selective auditory and visual attention) using the neuropsychological assessment battery NEPSY-II. Pragmatic skills were assessed by using the Pragma Test and Pragmatic Composite score of the Children’s Communication Checklist-2 (CCC-2). According to the results, the control group performed better in verbal working memory and selective auditory attention subtests, but no between-group difference was observed in selective visual attention. In the control group, verbal working memory was positively associated with the Pragmatic Composite score of the CCC-2. No statistically significant associations were observed in the AS group. Our findings indicate that many, but not all, children on the AS have domain-specific EF difficulties. Our findings also suggest that verbal working memory has a stronger relationship with pragmatic skills in the control group than in the AS group. Clinical implications are discussed.

Evaluation of Taste Acceptance of Three Different Fluoride Varnishes in Children with Autistic Spectrum Disorder: A Randomized Clinical Trial.

Background/Objective: The taste perception of clinical materials used in dental treatment procedures can influence the compliance of autistic children during dental visits due to their heightened anxiety and sensory processing difficulties. This study aimed to evaluate the taste acceptance of different fluoride varnish preparations among children with autism spectrum disorder (ASD) in a clinical setting. Methods: This parallel-arm single-blinded randomized clinical study included autistic children aged 6-14 years, referred to a community dental clinic unit for preventive dental care. Non-verbal behavior, as a measure of taste acceptance, was assessed using the Frankl behavior rating scale. Additionally, subjective taste responses were recorded using a 3-point facial hedonic scale. Data were analyzed using descriptive statistics and the chi-square test. Results: There was no statistically significant difference in non-verbal behavior between the three fluoride varnish groups before application (p = 0.094) or immediately after application (p = 0.718). However, when comparing pre- and post-application responses within each group, Duraphat® showed a significant improvement in non-verbal behavior (p = 0.020), while no significant changes were observed for Profluorid® (p = 0.196) or MI Varnish® (p = 0.704). Subjective taste acceptance, as measured by the 3-point facial hedonic scale, showed no significant differences among the varnish groups (p = 0.406). Conclusions: Flavored fluoride varnishes may improve the compliance of autistic children with preventive oral care procedures. Although no significant differences in taste acceptance were observed among the three varnishes, Duraphat® was associated with a significant improvement in non-verbal positive behavior, suggesting a more favorable response in autistic children.

Neural correlates of reading aloud on the autism spectrum

Individuals with autism can show intact decoding (i.e., ability to recognize and pronounce written words accurately). However, reading comprehension (i.e., ability to infer meaning from written text) in autistic individuals is often lower than expected based on age or grade level. Having intact decoding skills despite potentially atypical reading comprehension suggests altered reading pathways in autism, particularly when processing semantics (i.e., word meaning). To test for neural differences in word processing between autistic and non-autistic younger adults, we examined behavioral and neural responses to reading aloud words and pronounceable nonsense words (pseudowords). Additionally, we manipulated word imageability, word frequency, and word and pseudoword spelling-sound consistency as probes for different components (i.e., orthography, phonology and semantics) of the reading system. Behaviorally, the autistic group had a greater reduction in reaction time as word imageability increased. Neurally, pseudoword consistency effects, a probe of spelling-sound mappings without semantics, were only observed in the autistic group, where increased consistency was associated with decreased activity in bilateral intraparietal sulcus. Also compared to the non-autistic group, the autistic group showed greater effects of word consistency, where increasing word consistency was associated with increasing activation in the bilateral posterior superior temporal gyrus and ventral occipitotemporal cortex. Finally, the autistic group showed stronger effects of pseudoword consistency than the non-autistic group, that is increasing pseudoword consistency was associated with decreasing activation in the left ventral occipitotemporal cortex. Together, these results point to differences in how neural resources are used for reading, with more bilateral areas recruited during spelling-sound decoding in autistics to achieve comparable performance to non-autistics.

A Qualitative Examination of Stakeholder Acceptability of COMPASS in an Australian School Context

Abstract COMPASS is an educational intervention aimed at supporting individualised goal setting for students on the autism spectrum. Although its effectiveness is supported by quantitative data, little qualitative research has explored the perceived benefits and challenges of implementing COMPASS with community consultants. In the present qualitative study, we explored the benefits and challenges of COMPASS from the perspectives of stakeholders including parents/caregivers, teachers, and consultants. Semistructured interviews and focus groups were recorded and analysed using reflexive thematic analysis. Participants felt COMPASS (a) brings the right information to the table, (b) sets the scene for collaboration, and (c) uses a quality tool for data collection. The fourth theme reflected participants’ concerns around how (d) time could be a barrier. The data for this study has implications for the individualised planning process for students on the autism spectrum, a process directly linked to critical student outcomes. Overall, stakeholders spoke positively about student outcomes, which they linked directly to participation in the COMPASS program. The standardised process for individualised planning provided by COMPASS was particularly valued. Results of the study provide further understanding about the COMPASS intervention and offer a direction for future replications of COMPASS.

The Cerebellar Neuropsychiatric Rating Scale.

The triad of cerebellar ataxiology is the cerebellar motor, vestibular, and cerebellar cognitive affective / Schmahmann syndrome (CCAS). The CCAS affective component comprises 5 domains: Attentional control, Emotional control, Autism spectrum, Psychosis spectrum, and Social Skill Set, each with hypermetric / overshoot and hypometric / undershoot poles reflecting the dysmetria of thought and universal cerebellar transform theories. There is no validated screening instrument to assess neuropsychiatric impairments in patients with cerebellar disorders. To examine the psychometric properties of our Cerebellar Neuropsychiatric Rating Scale (CNRS) that explores these symptoms and behaviors in patients with cerebellar disorders, 21 adults with ataxia completed the CNRS and other validation measures: the Behavior Rating Inventory of Executive Function-Adult Version Informant Report, Adult Behavior Checklist, Older Adult Behavior Checklist, Neuropsychiatric Inventory Questionnaire. We examined CNRS internal consistency using Cronbach's alpha, assessed item to subscale correlations, studied ceiling and floor effects, and convergent construct validity between CNRS and validity measure subscales. Internal consistency was α > 0.70 for each of the five domains. Subscale structure was generally confirmed: 86% of correlations between CNRS and validity subscales were significant. There were no ceiling effects. Item to subscale correlations indicated adequate reliability for total scale and subdomains. NPI-Q and CNRS scores were correlated, and 86.4% (19/22) of conceptually related subscales were significant. The CNRS is a reliable and valid measure of cerebellar neuropsychiatry. Further development can refine the instrument and shed light on the patient experience of their affective dysregulation and its clinical meaningfulness.

A Pilot Investigation of Accommodations for the Gross Motor Assessment of Boys on the Autism Spectrum

Motor skill assessments are often modified to meet the needs of children on the autism spectrum. Yet, accom-modations to standardized motor skill testing have not been established and little consensus exists regarding the most appropriate or effective testing accommo-dations. Therefore, the purpose of this study was to ex-amine two accommodations to motor skill assessments: (1) an acclimation period and (2) visuals (i.e., pictures, videos). Using a sample of 10 boys on the autism spec-trum between the ages of 5 to 12 (M = 8.86, SD = 2.2), the impact of accommodations on motor skill perfor-mance, duration of assessment, and task comprehen-sion was analyzed visually. A descriptive analysis of the data suggests that, regardless of visual support, using accompanying visuals may help improve a child’s comprehension of requested motor tasks; moreover, al-lowing for acclimation to the testing environment may decrease the overall assessment time. Within this anal-ysis, neither an added visual cue nor an acclimation period impacted the assessed performance.

Does Attending Mainstream School Improve the Social Inclusion of Children on the Autism Spectrum and their Parents? A Cross-Sectional Study in China.

This study investigated whether attending mainstream school is associated with improved social inclusion among children on the autism spectrum and their parents. The cross-sectional study took place from July to August 2023 at 30 rehabilitation centers for children on the autism spectrum in Hunan Province, China. Participants included 860 children aged 3-14 years, with autism history receiving outpatient rehabilitation services, and their primary caregiver parents aged 23-54 years. Social inclusion among children on the autism spectrum was evaluated using the Chinese version of the social inclusion subscale of the KidsLife-ASD Scale. Parental social inclusion was assessed using the Chinese version of the Social Inclusion Scale. Linear mixed models were used to explore the association between attending mainstream school and social inclusion. Among children on the autism spectrum, 36.2% attended mainstream school. These children showed significantly higher levels of social inclusion compared to non-attenders. Subgroup analysis based on the severity of autism symptoms revealed that the significant association remained in both the mild and moderate/severe subgroups, being more pronouced in the mild subgroup (Pfor interaction<0.001). Parents of children attending mainstream school reported greater social inclusion levels than those whose children did not; however, after adjusting for severity of autism symptoms and other factors, this association became non-significant. Our study demonstrates a positive association between attending mainstream school and social inclusion for children on the autism spectrum, highlighting the critical role of mainstream school education in fostering social opportunities and providing diverse learning resources. It also underscores the need for targeted support strategies for parents.