Social Communication Deficits Research Articles

Effects of hyperbaric oxygen therapy on autistic behaviors and GRIN2B gene expression in valproic acid-exposed rats.

Autism is a complex neurodevelopmental condition characterized by deficits in social interaction, communication, and restricted repetitive behaviors. Hyperbaric oxygen therapy (HBOT) has emerged as a potential treatment for autism, although its effects on behavior and gene expression are not well understood. The GRIN2B gene, known for its involvement in encoding a glutamate receptor subunit crucial for neuron communication and associated with autism, was a focus of this study. Using a rat model induced by prenatal exposure to valproic acid, we examined the impact of HBOT on autism-like behaviors and GRIN2B gene expression. Male Wistar rats were categorized into four groups: control, VPA (valproic acid-exposed), VPA+HBOT [2 atmosphere absolute (ATA)], and VPA+HBOT (2.5 ATA). The rats underwent several behavioral tests to assess social behavior, anxiety, stereotype and exploratory behaviors, and learning. Following the behavioral tests, the HBOT groups received 15 sessions of HBOT at pressures of 2 and 2.5 (ATA), and their behaviors were re-evaluated. Subsequently, real-time PCR was employed to measure GRIN2B gene expression in the frontal lobe. Our results indicated that HBOT significantly increased social interaction and exploratory behaviors in VPA-exposed rats, alongside elevated GRIN2B gene expression in their frontal lobe. Our findings imply that HBOT might have a potential role in ameliorating autism-related behaviors in the VPA rat model of autism through potential modulation of GRIN2B gene expression. However, additional research is essential to fully comprehend the underlying mechanisms and refine the HBOT protocol for optimizing its effectiveness in improving autism-related symptoms.

The Use of CGH Arrays for Identifying Copy Number Variations in Children with Autism Spectrum Disorder.

Autism spectrum disorders (ASDs) encompass a broad group of neurodevelopmental disorders with varied clinical symptoms, all being characterized by deficits in social communication and repetitive behavior. Although the etiology of ASD is heterogeneous, with many genes involved, a crucial role is believed to be played by copy number variants (CNVs). The present study examines the role of copy number variation in the development of isolated ASD, or ASD with additional clinical features, among a group of 180 patients ranging in age from two years and four months to 17 years and nine months. Samples were taken and subjected to array-based comparative genomic hybridization (aCGH), the gold standard in detecting gains or losses in the genome, using a 4 × 180 CytoSure Autism Research Array, with a resolution of around 75 kb. The results indicated the presence of nine pathogenic and six likely pathogenic imbalances, and 20 variants of uncertain significance (VUSs) among the group. Relevant variants were more prevalent in patients with ASD and additional clinical features. Twelve of the detected variants, four of which were probably pathogenic, would not have been identified using the routine 8 × 60 k microarray. These results confirm the value of microarrays in ASD diagnostics and highlight the need for dedicated tools.

Architecture of therapeutic environments: therapists' perspective on how design impacts children with autism

Autism Spectrum Disorder is a neurocognitive condition characterised by deficits in social skills, communication, relationships, self-regulation, and sensory sensitivities. Children with autism experience hypersensitivity or hyposensitivity to sensory stimuli. Therapeutic services for children with autism can help minimise adverse behaviours (e.g. aggression, screaming, self-injury, and tantrums) and provide support with education to teach self-help skills for greater independence. This study focuses on the varying sensory stimuli challenges of children with autism and the implementation of thoughtful design strategies that support the therapy process through play, treatment, and sensory experiences. Data were collected through two sets of surveys gathering information about therapeutic and spatial conditions of a therapy centre. The results, representing 272 responses from varying types of therapists and teachers, presents a design solution for an architectural model that responds to the sensory needs of children with autism and can be scaled up, replicated, and customised to be used by architects, interior designers, and therapists in creating new structures or renovation of an existing space. The implementation of these design strategies positively impacts the overall comfort level and wellbeing of children with hypersensitivities and hyposensitivities allowing for a more productive therapy session.

Sex differences in autism-like behavior and dopaminergic neurons in substantia nigra of juvenile mice prenatally exposed to valproate.

Autism spectrum disorder (ASD) is characterized by deficits in social interaction and communication and repetitive and restricted behaviors. Sex dimorphism in the brain, including midbrain dopaminergic circuits, can explain differences in social behavior impairment and stereotypic behaviors between male and female individuals with ASD. These abnormal patterns may be due to alterations in dopamine synthesis in the ventral tegmental area (VTA) and substantia nigra (SN). We used an autism-like mouse model by prenatal valproic acid (VPA) exposure. CD1 pregnant female mice were injected with 500mg/kg VPA or 0.9% NaCl as a vehicle on gestational day 12.5. In the offspring, on postnatal day 31, we examined the social and repetitive behaviors and the number of tyrosine hydroxylase (TH)-positive cells in VTA and SN by sex. Male VPA mice showed impaired social behavior and increased repetitive behaviors when compared to male vehicles. In females, we did not find statistically significant differences in social or repetitive behaviors between the groups. Male VPA mice had fewer TH+ cells in the SN than control-vehicle mice. Interestingly, no cellular changes were observed between females. This study supports the notion that sex dimorphism of certain brain regions is involved in the etiopathogenesis and clinical presentation of ASD.

Inclusive learning and development practices for children with autism spectrum disorders and the ICT’s role

Nowadays, the inclusive orientation of education has promoted the inalienable right of all children, including those with autism spectrum disorders (ASD), to be educated in mainstream schools alongside their typically developing (TD) peers. The autism spectrum includes developmental disorders that appear in early childhood and are characterized by qualitative deficits in social communication and adaptive behavior, impeding academic learning and social-emotional development. The aim of this paper is to study those practices that form the conditions for realizing the functional inclusion of ASD children in the traditional classroom. For this reason, through the literature review of modern foreign language scientific articles, an attempt was made to search and study the most widespread and research-documented intervention procedures and techniques, which develop the readiness skills of ASD children, providing them with quality opportunities for active learning and socialization alongside their TD peers. The results showed that when the earlier targeted educational approaches are used in the inclusive classroom, in a structured and predictable learning environment, taking into account their unique characteristics, interests and assessed educational needs, with the support of adequately trained teachers and an interdisciplinary team, in cooperation with the family, their dynamic involvement in the activities of the school program is facilitated. Furthmore, quality interactions with their TD peers are increased and therefore, the appearance of socially acceptable behaviors is promoted, which contributes to their acceptance by their classmates, laying the foundations for their smooth integration into society.

Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (TDCS) in Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disease characterized by deficits in social communication and the presence of restricted, repetitive behaviors or interests, as well as difficulties in emotional regulation. To date, pharmacological approaches are essentially limited to some drugs, such as aripiprazole and risperidone. Drug responses are often partial. Neuromodulation therapies, including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (TDCS) are sometimes used for cognitive, social, behavioral and affective symptoms of ASD. In fact, by targeting specific brain regions, such as the dorsolateral prefrontal cortex (DLPFC), temporoparietal junction (TPJ) and the motor cortex, these therapies can improve the main symptoms of the disease. This work examines the role of TMS and TDCS in ASD. Even though new studies need to be implemented, they have proven to be promising and precise therapeutic strategies for ASD.

Female mice prenatally exposed to valproic acid exhibit complex and prolonged social behavior deficits

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized mainly by deficits in social communication and stereotyped and restricted behavior and interests with a male to female bias of 4.2/1. Social behavior in ASD animal models is commonly analyzed in males, and seldomly in females, using the widely implemented three-chambers test procedure. Here, we implemented a novel procedure, the Live Mouse Tracker (LMT), combining artificial intelligence, machine learning procedures and behavioral measures. We used it on mice that were prenatally exposed to valproic acid (VPA) (450 mg/kg) at embryonic day 12.5, a widely recognized and potent ASD model that we had previously extensively characterized. We focused on female mice offspring, in which social deficits have been rarely documented when using the 3-CT procedure. We recorded several parameters related to social behavior in these mice, continuously for three days in groups of four female mice. Comparisons were made on groups of 4 female mice with the same treatment (4 saline or 4 VPA) or with different treatments (3 saline and 1 VPA). We report that VPA females show several types of social deficits, which are different in nature and magnitude in relation with time. When VPA mice were placed in the LMT alongside saline mice, their social deficits showed significant improvement as early as 1 h from the start of the experiment, lasting up to 3 days throughout the duration of the experiment. Our findings suggest that ASD may be underdiagnosed in females. They also imply that ASD-related social deficits can be ameliorated by the presence of typical individuals.

Screening of children attending well baby clinic for risk of autism using modified checklist for autism in toddlers in a pediatric tertiary care Centre in Chennai

Background: Autism spectrum disorder is a common neurodevelopmental disorder with core deficits in social communication, interaction, and restrictive/repetitive behavior. Early intervention provides opportunity for good functional outcome. The study aimed to screen children attending well baby clinic for risk of autism using modified checklist for autism in toddlers (MCHAT) questionnaire. Methods: This descriptive cross-sectional study was conducted on 302 children attending the pediatric well baby clinic. The children aged 16-30 months who met the inclusion criteria were screened for risk of autism using MCHAT. Results: 20 out of 302 children failed the MCHAT screening, 6.6% of the children were found to be at risk of autism. Boys: girls’ ratio was 2:1. Advanced parental age and higher socioeconomic status were found to have significant association with the risk of autism. 70% of children in the at-risk group were first born, 70% of children who failed the MCHAT screen were from a nuclear family. Conclusions: All toddlers attending the well-baby clinic should be screened for autism by pediatricians. MCHAT is a simple easy to use validated tool to screen for autism in a busy pediatric OPD. Timely referral for comprehensive assessment and intervention can help to improve the outcome in children with autism.

Uso do método de Pontos para a Reestruturação de Objetivos Fonéticos e Oro-Musculares (PROMPT) no Transtorno do Espectro Autista: um estudo de caso

ABSTRACT Autism Spectrum Disorder (ASD) is classified by Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a neurodevelopmental disorder, whose characteristics are mainly deficits in social communication and a restricted range of interests. There are several studies about autism, speech, and language in the literature, but few correlate speech and autism. This study aims to carry out a case study that will address autism, speech, and PROMPT (Restructuring Oral Muscular Phonetic Targets) and also to describe the speech improvement in the participant with autism using the method. The target words were defined for the entire intervention according to the System Analysis Observation (SAO) and Motor Speech Hierarchy (MSH), which are parts of the PROMPT evaluation. After the evaluation, the participant was attended for 16 sessions, once weekly, with the objective of improving their speech. After analyzing the data, it was possible to observe improvement in all aspects outlined according to the pre-treatment evaluation of the method such as phonatory control, mandibular control, lip-facial control and lingual control as well as in the sequenced movement although this was not the aim outlined in the evaluation. It was also possible to measure the improvement of an adequate number of words, an adequate number of phonemes, percentages of correct consonants – revised (PCC-R), and intelligibility.

Therapeutic potential of CBD in Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by persistent deficits in social communication and interaction, as well as restricted and repetitive patterns of behavior. Despite extensive research, effective pharmacological interventions for ASD remain limited. Cannabidiol (CBD), a non-psychotomimetic compound of the Cannabis sativa plant, has potential therapeutic effects on several neurological and psychiatric disorders. CBD interacts with the endocannabinoid system, a complex cell-signaling system that plays a crucial role in regulating various physiological processes, maintaining homeostasis, participating in social and behavioral processing, and neuronal development and maturation with great relevance to ASD. Furthermore, preliminary findings from clinical trials indicate that CBD may have a modulatory effect on specific ASD symptoms and comorbidities in humans. Interestingly, emerging evidence suggests that CBD may influence the gut microbiota, with implications for the bidirectional communication between the gut and the central nervous system. CBD is a safe drug with low induction of side effects. As it has a multi-target pharmacological profile, it becomes a candidate compound for treating the central symptoms and comorbidities of ASD.

Interactive mirrOring Games wIth sOCial rObot (IOGIOCO): a pilot study on the use of intransitive gestures in a sample of Italian preschool children with autism spectrum disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication, social interaction, and restricted behaviors. The importance of early intervention has been widely demonstrated, and developmental trajectories in ASD emphasize the importance of nonverbal communication, such as intransitive gesture production, as a possible positive prognostic factor for language development. The use of technological tools in the therapy of individuals with ASD has also become increasingly important due to their higher engagement and responsiveness to technological objects, such as robots. We developed a training protocol using the humanoid robot NAO, called IOGIOCO (Interactive mirroring Games wIth sOCial rObot), based on the use of intransitive gestures embedded in naturalistic dialogues, stimulating a triadic interaction between child, robot and therapist. The training was divided into six levels; the first 2 levels were called "familiarization levels," and the other 4 were "training levels". The technological setup includes different complexity levels, from mirroring tasks to building spontaneous interactions. We tested the protocol on 10 preschool children with ASD (aged 2-6 years) for 14 weeks. We assessed them at recruitment (T0), at the end of training (T1), and after 6 months (T2). We demonstrated the tolerability of the protocol. We found that one group (n=4, males and 2 females) reached the training level, while another and group (n=6 males) remained at a familiarization level (mirroring), we analyzed the results for the two groups. In the group that reached the training levels, we found promising results, such as an improvement in the Social Adaptive Domain of the ABAS-II questionnaire between T0 and T2. While current results will need a Randomized Controlled Trial to be confirmed, the present work sets an important milestone in using social robots for ASD treatment, aimed at impacting social and communication skills in everyday life.

Early adversity and family resilience factors in children with autism spectrum disorder: A narrative review

Global estimates indicate that autism is a neurodevelopmental condition that is currently diagnosed in 1 in 100 people across the world. Autistic children can experience deficits in social communication, often linked to difficulties with joint attention and facial emotion recognition. Restrictive repetitive behaviors and interests (RRBIs) are also part of the diagnostic criteria of autism and are associated with lower adaptive skills. Due to social challenges and RRBIs exhibited by autistic children, they may be at higher risk for experiencing social and familial stressors. In non-autistic children, early adversity is predictive of deficits in executive functioning, neurological changes, and poor adult health. However, resilience factors have been identified, which can offset the negative impacts of adversity. In autistic children, these protective factors may have differential downstream influences on children's outcomes due to cognitive and social difficulties. In this narrative review, we report that autistic children are more likely to experience familial and environmental stressors compared to non-autistic children. Resilience factors such as positive parenting, sleep, social relationships, and executive functioning skills were identified as key areas for future research. Lay summary Children with autism are statistically more likely than their peers to be exposed to adverse childhood events including bullying, parental divorce, and poverty. The more severely affected a child is by autism the greater the likelihood they will be exposed to early life stress. This indicates that the most vulnerable children with autism who have limited adaptive skills to promote resilience to stress may have the highest exposure to stressful events during their childhood. In turn, a better understanding of how early adversity impacts children with autism is needed as well to characterize resilience factors that promote optimal outcomes. In this review of the literature, it was found that children with autism may experience more stress from their family and surroundings compared to children without autism. Factors that can help these children cope better were identified, including supportive parenting, getting enough sleep, having friends, and having good problem-solving skills. This research could help parents and teachers better understand how to support children with autism who are experiencing early adversity.

A synbiotic formulation of Lactobacillus reuteri and inulin alleviates ASD-like behaviors in a mouse model: the mediating role of the gut-brain axis.

Autism Spectrum Disorder (ASD), a complex neurodevelopmental disorder marked by social communication deficits and repetitive behaviors, may see symptom amelioration through gut microbiota modulation. This study investigates the effects of a synbiotic - specifically a probiotic amplified by prebiotic supplementation - on ASD-like mouse model's social deficiencies. This model was established via valproic acid injection into pregnant females. Post-weaning, male progeny received daily synbiotic treatment, a combination of Lactobacillus reuteri (L. reuteri) and inulin, for four weeks. Results indicated that the synbiotic rectified social impairments and attenuated inflammatory cytokine expressions in the brain. Moreover, synbiotic intervention protected gut barrier integrity and altered the gut microbiota composition, enhancing the butyrate-producing Bifidobacterium abundance. The synbiotic elevated metabolites such as butyrate and 3-hydroxybutyric acid (3-HB), alongside upregulated genes associated with 3-HB synthesis in the colon and liver, and brain receptors. Conclusively, the synbiotic combination of L. reuteri and inulin mitigated ASD-related social impairments, partially via their regulatory effect on the gut-brain axis.

Is language impaired in Spanish-speaking children with autism spectrum disorder level 1?

Our main aim was to explore whether children with ASD-Level 1 (ASD-L1) present difficulties in the acquisition of structural language, as little work has been done in this regard so far. As a secondary aim we evaluated the degree to which the potential language impairment in ASD is directly associated with their social communication deficits or it represents a distinct deficit. To further clarify the nature and characteristics of putative language difficulties in ASD-L1, we evaluated language skills in 89 children and preadolescents diagnosed with ASD-L1, and a group of typically developing participants (TD). All of them were between 8 and 13 years old and had similar socioeconomic backgrounds. Children with ASD-L1 obtained lower scores than those in TD group in repeating sentences, in finding the semantic relationships between words, and in applying word structure rules (morphology). Congruently, the core language standard score was lower in the ASD-L1 group, and the proportion of language delay was significantly higher in the ASD-L1 group than in the control group. Language scores were associated with autistic traits; thus, language performance in ASD-L1 is closely related to autistic symptoms. These results are discussed according to the literature on linguistic deficits in ASD-L1 and their relations with phonological working memory.

“When you are a parent of an autistic child, the responsibility is put on you a lot” - Learning from parents’ experiences and expectations of speech and language therapy services for autistic children in Ireland.

Autism is a neurodevelopmental disorder, characterized by deficits in social communication and interaction, restricted interests, and repetitive behaviours. Historically framed within the medical model paradigm, there are increasing calls from the autistic community to reframe autism, using the social model paradigm and embracing neurodiversity. Autistic individuals account for 1-2% of the population and access a variety of services, such as Speech & Language Therapy (SLT), which support autistic individuals' engagement in society. 
 There is a disparity of SLT services available for autistic people in Ireland and parents’ perceptions of services have not been investigated before. We aimed to investigate the parental experiences and expectations of SLT services for autistic children and make recommendations for stakeholders of autism service provision. This presentation is relevant to anyone interested in researching service users’ / parental perceptions and how they can guide the provision of care.
 This research formed a part of a Master’s degree. It was developed by a team of researchers representing SLT and social care services. The initial idea originated from clinical practice, where parents often voiced their concerns and expectations of care. 
 Interpretative Phenomenological Analysis was used as a methodological framework for this study. Participants were parents of autistic children living in the Munster province of Ireland, and they were not previously known to the research team. Individual, semi-structured interviews were carried out to identify participants’ understanding of how they made sense of their experiences. Data was analysed in depth at an individual level before group analysis took place. 
 
 Five themes emerged during group analysis: 
 1) The journey of parenting an autistic child, 
 2) The journey of experiencing services for autistic children, 
 3) The journey of navigating SLT services, 
 4) The journey of evolving therapeutic relationships and desirable clinical qualities,
 5) The journey of evolving parental expectations of changes to services for autistic children.
 Parents’ understanding of SLT services for autism was fraught with doubts about the public health system and the financial burden of accessing private services. Parents’ searches for services revealed significant wait times and barriers to access supports. Parents desired speech and language (SLTs) with clinical experience and understanding of parents’ roles in SLT. The need for reduced waiting periods for services and compassionate support for families of autistic children was also reported.
 Findings provide insight into parents’ evolving expectations and suggested changes for services for autistic children, which are important for autism service providers. Future research should focus on autistic individuals’ and SLTs experiences of SLT services for autism.

Neuropathological insights from SHANK3 mutant animal models

SHANK3 is a protein primarily found in the postsynaptic density (PSD) of excitatory synapses in the brain. Heterozygous mutations in the shank3 gene have been linked to autism spectrum disorder (ASD) and intellectual disability. There are various animal models carrying mutant SHANK3 that have provided valuable insights into the pathogenesis of ASD. In this review, we will discuss these animal models, with a specific focus on the neuropathology observed in shank3 mouse and monkey models. These models are particularly important as they share closer similarities to humans and are capable of more accurately recapitulating the neuropathological features observed in individuals with ASD. Mice with mutations in the shank3 gene exhibit deficits in social behavior, communication, and repetitive behaviors, which are core features of ASD and support the link between SHANK3 and ASD. However, studies of monkey models with SHANK3 targeting by CRISPR/Cas9 have demonstrated that, unlike mice with completely knocked-out shank3 genes, the monkey model with complete deletion of SHANK3 displays a reduction in the number of neuronal cells. This review discusses the species-specific neuropathology in SHANK3/shank3 knockout mice and monkeys. The differences in neuropathology in SHANK3/shank3 mutant mouse and monkey models suggest that non-human primate models are highly valuable for investigating the mechanism of neurodegeneration that may selectively occur in primate brains.

Intermittent Hypobaric Hypoxia Ameliorates Autistic-Like Phenotypes in Mice.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent deficits in social communication and stereotyped behaviors. Although major advances in basic research on autism have been achieved in the past decade, and behavioral interventions can mitigate the difficulties that individuals with autism experience, little is known about the many fundamental issues of the interventions, and no specific medication has demonstrated efficiency for the core symptoms of ASD. Intermittent hypobaric hypoxia (IHH) is characterized by repeated exposure to lowered atmospheric pressure and oxygen levels, which triggers multiple physiological adaptations in the body. Here, using two mouse models of ASD, male Shank3B -/- and Fmr1 -/y mice, we found that IHH training at an altitude of 5,000 m for 4 h per day, for 14 consecutive days, ameliorated autistic-like behaviors. Moreover, IHH training enhanced hypoxia inducible factor (HIF) 1α in the dorsal raphe nucleus (DRN) and activated the DRN serotonergic neurons. Infusion of cobalt chloride into the DRN, to mimic IHH in increasing HIF1α expression or genetically knockdown PHD2 to upregulate HIF1α expression in the DRN serotonergic neurons, alleviated autistic-like behaviors in Shank3B -/- mice. In contrast, downregulation of HIF1α in DRN serotonergic neurons induced compulsive behaviors. Furthermore, upregulating HIF1α in DRN serotonergic neurons increased the firing rates of these neurons, whereas downregulation of HIF1α in DRN serotonergic neurons decreased their firing rates. These findings suggest that IHH activated DRN serotonergic neurons via upregulation of HIF1α, and thus ameliorated autistic-like phenotypes, providing a novel therapeutic option for ASD.

Day-to-day spontaneous social behaviours is quantitatively and qualitatively affected in a 16p11.2 deletion mouse model.

Autism spectrum disorders affect more than 1% of the population, impairing social communication and increasing stereotyped behaviours. A micro-deletion of the 16p11.2 BP4-BP5 chromosomic region has been identified in 1% of patients also displaying intellectual disabilities. In mouse models generated to understand the mechanisms of this deletion, learning and memory deficits were pervasive in most genetic backgrounds, while social communication deficits were only detected in some models. To complement previous studies, we itemized the social deficits in the mouse model of 16p11.2 deletion on a hybrid C57BL/6N × C3H.Pde6b+ genetic background. We examined whether behavioural deficits were visible over long-term observation periods lasting several days and nights, to parallel everyday-life assessment of patients. We recorded the individual and social behaviours of mice carrying a heterozygous deletion of the homologous 16p11.2 chromosomic region (hereafter Del/+) and their wild-type littermates from both sexes over two or three consecutive nights during social interactions of familiar mixed-genotype quartets of males and of females, and of same-genotype unfamiliar female pairs. We observed that Del/+ mice of both sexes increased significantly their locomotor activity compared to wild-type littermates. In the social domain, Del/+ mice of both sexes displayed widespread deficits, even more so in males than in females in quartets of familiar individuals. In pairs, significant perturbations of the organisation of the social communication and behaviours appeared in Del/+ females. Altogether, this suggests that, over long recording periods, the phenotype of the 16p11.2 Del/+ mice was differently affected in the locomotor activity and the social domains and between the two sexes. These findings confirm the importance of testing models in long-term conditions to provide a comprehensive view of their phenotype that will refine the study of cellular and molecular mechanisms and complement pre-clinical targeted therapeutic trials.

Precision microbial intervention improves social behavior but not autism severity: A pilot double-blind randomized placebo-controlled trial

Autism spectrum disorder (ASD) is characterized by the presence of restricted/repetitive behaviors and social communication deficits. Because effective treatments for ASD remain elusive, novel therapeutic strategies are necessary. Preclinical studies show that L.reuteri selectively reversed social deficits in several models for ASD. Here, in a double-blind, randomized, placebo-controlled trial, we tested the effect of L.reuteri (a product containing a combination of strains ATCC-PTA-6475 and DSM-17938) in children with ASD. The treatment does not alter overall autism severity, restricted/repetitive behaviors, the microbiome composition, or the immune profile. However, L.reuteri combination yields significant improvements in social functioning that generalized across different measures. Interestingly, ATCC-PTA-6475, but not the parental strain of DSM-17938, reverses the social deficits in a preclinical mouse model for ASD. Collectively, our findings show that L.reuteri enhances social behavior in children with ASD, thereby warranting larger trials in which strain-specific effects should also be investigated.

Intensive Interaction as an intervention approach in children with autism spectrum disorder: a systematic review

As a neurodevelopmental condition, autism spectrum disorder (ASD) is characterised by pervasive social interaction and communication deficits. This review aimed to identify and synthesise the latest literature about the effectiveness of the Intensive Interaction approach in children with ASD. The review was conducted according to the PRISMA guidelines. The total number of children with ASD was 28, aged from 4 to 14 years old, with 27 males and only one female. The studies addressed intervention goals related to non-verbal and intentional communication, behavioural difficulties, joint attention, and parent-child interaction. The findings from the studies indicated that children with ASD had a positive outcome from the involvement in the Intensive Interaction approach. Regrettably, the constraints imposed by the methodology and design employed in the studies, coupled with the limited sample sizes (two of the studies consisted of a single case), preclude forming any definitive conclusions about the impacts of Intensive Interaction. However, the evidence is at least sufficient to support the assertions put forth by the authors. Despite the encouraging evidence of the effectiveness of the Intensive Interaction approach, multiple factors contribute as barriers to this issue, including the inherent challenges associated with conducting high-quality research that adheres to rigorous methodological standards.