Functioning In Autism Research Articles

The Cul3 ubiquitin ligase engages Insomniac as an adaptor to impact sleep and synaptic homeostasis.

Mutations of the Cullin-3 (Cul3) E3 ubiquitin ligase are associated with autism and schizophrenia, neurological disorders characterized by sleep disturbances and altered synaptic function. Cul3 engages dozens of adaptor proteins to recruit hundreds of substrates for ubiquitination, but the adaptors that impact sleep and synapses remain ill-defined. Here we implicate Insomniac (Inc), a conserved protein required for normal sleep and synaptic homeostasis in Drosophila, as a Cul3 adaptor. Inc binds Cul3 in vivo, and mutations within the N-terminal BTB domain of Inc that weaken Inc-Cul3 associations impair Inc activity, suggesting that Inc function requires binding to the Cul3 complex. Deletion of the conserved C-terminus of Inc does not alter Cul3 binding but abolishes Inc activity in the context of sleep and synaptic homeostasis, indicating that the Inc C-terminus has the properties of a substrate recruitment domain. Mutation of a conserved, disease-associated arginine in the Inc C-terminus also abolishes Inc function, suggesting that this residue is vital for recruiting Inc targets. Inc levels are negatively regulated by Cul3 in neurons, consistent with Inc degradation by autocatalytic ubiquitination, a hallmark of Cullin adaptors. These findings link Inc and Cul3 in vivo and support the notion that Inc-Cul3 complexes are essential for normal sleep and synaptic function. Furthermore, these results indicate that dysregulation of conserved substrates of Inc-Cul3 complexes may contribute to altered sleep and synaptic function in autism and schizophrenia associated with Cul3 mutations.

Unlocking autism's complexity: the Move Initiative's path to comprehensive motor function analysis.

The long-standing practice of using manualized inventories and observational assessments to diagnose and track motor function in autism overlooks critical data invisible to the naked eye. This subjective approach can introduce biases and hinder the translation of research into clinical applications that rely on objective markers of brain-body connections. Meanwhile, we are experiencing a digital healthcare revolution, marked by innovations in the collection and analysis of electronic health records, personal genomes, and diverse physiological measurements. Advanced technologies, including current wearable devices, integrate both active and passive (sensor-based) data collection, providing a more comprehensive view of human health. Despite advances in sensors, wearables, algorithms, machine learning, and agentic AI, autism research remains siloed, with many tools inaccessible to affected families and care teams. There is a pressing need to merge these technological advances and expedite their translation into accessible, scalable tools and solutions to diversify scientific understanding. In response, this Perspective introduces the Move Initiative, a coalition spearheaded by the nonprofit 2 m Foundation, composed of self-advocates, families, clinicians, researchers, entrepreneurs, and investors who aim to advance and refine the measurement of movement in autism. Move will make motor screenings more dynamic and longitudinal while supporting continuous assessment of targeted interventions. By fostering cross-disciplinary collaboration, Move seeks to accelerate the integration of the expanding knowledge base into widespread practice. Deep, longitudinal, multi-modal profiling of individuals with Autism Spectrum Disorder offers an opportunity to address gaps in current data and methods, enabling new avenues of inquiry and a more comprehensive understanding of this complex, heterogeneous condition.

Atypical implicit and explicit sense of agency in autism: A complete characterization using the cue integration approach.

There exist indications that sense of agency (SoA), the experience of being the cause of one's own actions and actions' outcomes, is altered in autism. However, no studies in autism have simultaneously investigated the integration mechanisms underpinning both implicit and explicit SoA, the two levels of agency proposed by the innovative cue integration approach. Our study establishes a first complete characterization of SoA functioning in autism, by comparing age- and IQ-matched samples of autistic versus neurotypical adults. Intentional binding and judgments of agency were used to assess implicit and explicit SoA over pinching movements with visual outcomes. Sensorimotor and contextual cues were manipulated using feedback alteration and induced belief about the cause of actions' outcome. Implicit SoA was altered in autism, as showed by an overall abolished intentional binding effect and greater inter-individual heterogeneity. At the explicit level, we observed under-reliance on retrospective sensorimotor cues. The implicit-explicit dynamic was also altered in comparison to neurotypical individuals. Our results show that both implicit and explicit levels of SoA, as well as the dynamic between the two levels, present atypicalities in autism.

A multimodal neural signature of face processing in autism within the fusiform gyrus

Atypical face processing is commonly reported in autism. Its neural correlates have been explored extensively across single neuroimaging modalities within key regions of the face processing network, such as the fusiform gyrus (FFG). Nonetheless, it is poorly understood how variation in brain anatomy and function jointly impacts face processing and social functioning. Here we leveraged a large multimodal sample to study the cross-modal signature of face processing within the FFG across four imaging modalities (structural magnetic resonance imaging (MRI), resting-state functional magnetic resonance imaging, task-functional magnetic resonance imaging and electroencephalography) in 204 autistic and nonautistic individuals aged 7–30 years (case–control design). We combined two methodological innovations—normative modeling and linked independent component analysis—to integrate individual-level deviations across modalities and assessed how multimodal components differentiated groups and informed social functioning in autism. Groups differed significantly in a multimodal component driven by bilateral resting-state functional MRI, bilateral structure, right task-functional MRI and left electroencephalography loadings in face-selective and retinotopic FFG. Multimodal components outperformed unimodal ones in differentiating groups. In autistic individuals, multimodal components were associated with cognitive and clinical features linked to social, but not nonsocial, functioning. These findings underscore the importance of elucidating multimodal neural associations of social functioning in autism, offering potential for the identification of mechanistic and prognostic biomarkers.

Motor, cognitive, and socio-cognitive mechanisms explaining social skills in autism and typical development.

Challenges in social functioning are considered a core criterion for diagnosing autism. Although motor skills, executive functioning (EF), and theory of mind (ToM) abilities independently affect social challenges and are interconnected, these abilities' shared contribution to the explanation of social functioning in autism remains under-investigated. To address this disparity, we examined the motor, EF, and ToM abilities of 148 autistic and non-autistic youth (ages 6-16 years), evaluating these variables' impact on social ability and their interconnections. Our mediation model exploring the contribution of motor, EF, and ToM skills explained 85% of the variance in social functioning (Social Responsiveness Scale-SRS-2). Analysis yielded a direct path from study group to SRS-2-social (typically developing-TD > autistic) and two main parallel indirect joint paths: (a) Group ➔ motor ➔ EF ➔ SRS-2-social; and (b) Group ➔ motor ➔ ToM ➔ SRS-2-social. In two secondary indirect paths, autistic children showed lower motor skills, which in turn explained their higher EF and/or ToM impairment, which in turn explained their higher social skills impairment. Put differently, our results suggest that better EF and TOM proficiency may compensate for poorer motor skills. Findings also indicated that the collective impact of motor, EF, and ToM skills on social functioning, along with the mediating role played by EF and ToM on the social-motor linkage, may contribute to understanding individual differences in the social functioning of autistic children. These conclusions call for the inclusion of motor, EF, and ToM activities into daily practices to facilitate social functioning.

Global Sensory Features are Linked to Executive and Attentional Impairments in Autism Spectrum Disorders.

Sensory features, executive and attentional impairments are frequently reported in individuals with autism spectrum disorders (ASD). However, little is known about their complex relationships. In this study, we aim to examine the executive and attentional difficulties related to distinct sensory profiles. We identified sensory profiles with a Latent Profile Analysis (LPA) based on scores on the Short Sensory Profile (SSP) questionnaire in 95 children with ASD aged 6 to 17years. Executive and attention functions were assessed using the Behavior Rating Inventory of Executive Functions (BRIEF) questionnaire and Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). A three-cluster solution based on raw SSP scores identified a "high'', a "medium" and a "low'' SSP profile. We found a significant relationship between executive functions, attentional skills and the global severity of sensory features, reinforcing findings of previous studies in the literature. A two-cluster solution based on normalized SSP (i.e. equalized for the global severity) identified distinct sensory profiles, mainly discriminated by the score of underresponsive/seeks sensation. We found no significant difference between these two clusters for the BRIEF and ADHD-RS related scores. Our study suggests that the heterogeneity of sensory features in ASD may not be explained by differences in executive and attention functions. Future studies are needed to refine the link between sensory features and executive functions in autism.

Randomized Feasibility Pilot of an Executive Functioning Intervention Adapted for Children's Mental Health Settings.

The critical role of executive functioning in autism as well as the co-occurring mental health challenges common among autistic youth support to the immense value of interventions targeting executive functioning for enhancing mental health services for autistic children. The goal of the present study was to conduct a randomized feasibility trial of Unstuck and On Target, an executive functioning intervention, adapted for delivery in children's community mental health setting. Mental health therapists (n = 26) enrolled with participating autistic clients (n = 32) were randomized to receive training in and deliver the adapted Unstuck intervention or to deliver care as usual. We completed masked observational measures of Unstuck strategy use (fidelity) during recorded sessions of participating therapist-client dyads and collected measures of acceptability from participating clients and their caregivers. We also collected measures of pre-post changes in executive functioning and mental health symptoms. Therapists trained in Unstuck demonstrated significantly higher use of Unstuck strategies compared to usual care therapists. Caregivers and autistic clients perceive adapted Unstuck as highly acceptability and helpful. Autistic clients whose therapists were trained in adapted Unstuck demonstrated larger pre-post changes in executive functioning compared to usual care. Across all participating clients, changes in executive functioning were significantly related to changes in mental health symptoms. Finally, clients of therapists trained in adapted Unstuck demonstrated moderate improvements in overall mental health symptoms. The current study provides preliminary evidence of the feasibility and impact of Unstuck and On Target for children's community mental health settings.

Assessing Frontal Lobe Function on Verbal Fluency and Emotion Recall in Autism Spectrum Disorder by fNIRS.

This study applied the functional near-infrared spectroscopy (fNIRS) to investigate frontal activity in autism when performing verbal fluency test and emotion recall task. We recruited 32 autistic adults without intellectual disability and 30 typically-developing controls (TDC). Prefrontal hemodynamic changes were evaluated by fNIRS when the participants performed the verbal fluency test and emotion recall task. fNIRS signals in the prefrontal cortex were compared between autism and TDC. Compared to TDC, autistic adults showed comparable performance on the verbal fluency test but exhibited lower frontal activity on the vegetable category. In the verbal fluency test, left frontal activity in TDC significantly increased in the vegetable category (vs. fruit category). In the emotion recall task, left frontal activity increased significantly in TDC when recalling emotional (vs. neutral) events. This increase of left frontal activity on the more difficult works was not found in autism. Similarly, brain activities were related to test performance only in TDC but not in autism. In addition, more severe social deficits were associated with lower frontal activity when recalling emotional events, independent of autism diagnosis. Findings suggested reduced frontal activity in autism, as compared to TDC, when performing verbal fluency tests. The reduction of left frontal activation in verbal fluency test and emotion recall tasks might reflect on the social deficits of the individual. The fNIRS may potentially be applied in assessing frontal lobe function in autism and social deficits in general population. Trial registration number: NCT04010409.

Atypical pattern separation memory and its association with restricted interests and repetitive behaviors in autistic children.

Memory challenges remain understudied in childhood autism. Our study investigates one specific aspect of memory function, known as pattern separation memory, in autistic children. Pattern separation memory refers to the critical ability to store unique memories of similar stimuli; however, its role in childhood autism remains largely uncharted. Our study first uncovered that the pattern separation memory was significantly reduced in autistic children, and then showed that reduced memory performance was linked to their symptoms of repetitive, restricted interest and behavior. We also identified distinct subgroups with profiles of reduced and increased generalization for pattern separation memory. More than 72% of autistic children showed a tendency to reduce memory generalization, focusing heavily on unique details of objects for memorization. This focus made it challenging for them to identify commonalities across similar entities. Interestingly, a smaller proportion of autistic children displayed an opposite pattern of increased generalization, marked by challenges in differentiating between similar yet distinct objects. Our findings advance the understanding of memory function in autism and have practical implications for devising personalized learning strategies that align with the unique memory patterns exhibited by autistic children. This study will be of broad interest to researchers in psychology, psychiatry, and brain development as well as teachers, parents, clinicians, and the wider public.

The Impact of Microglia on Neurodevelopment and Brain Function in Autism.

Microglia, as one of the main types of glial cells in the central nervous system (CNS), are widely distributed throughout the brain and spinal cord. The normal number and function of microglia are very important for maintaining homeostasis in the CNS. In recent years, scientists have paid widespread attention to the role of microglia in the CNS. Autism spectrum disorder (ASD) is a highly heterogeneous neurodevelopmental disorder, and patients with ASD have severe deficits in behavior, social skills, and communication. Most previous studies on ASD have focused on neuronal pathological changes, such as increased cell proliferation, accelerated neuronal differentiation, impaired synaptic development, and reduced neuronal spontaneous and synchronous activity. Currently, more and more research has found that microglia, as immune cells, can promote neurogenesis and synaptic pruning to maintain CNS homeostasis. They can usually reduce unnecessary synaptic connections early in life. Some researchers have proposed that many pathological phenotypes of ASD may be caused by microglial abnormalities. Based on this, we summarize recent research on microglia in ASD, focusing on the function of microglia and neurodevelopmental abnormalities. We aim to clarify the essential factors influenced by microglia in ASD and explore the possibility of microglia-related pathways as potential research targets for ASD.

Cerebellar Tract of Cognitive Function in Autism and Neurodevelopmental Disorder

The cerebellum is a classical subcortical center for motor control and is an important part of the circuitry that links sensory to motor areas of the brain. It represents 10% of total brain volume but contains more than 50% of its neurons. There is different cerebellar circuitry, among them the cortico cerebellar cortical circuit is very important, any disruption of this circuitry associated with ataxic hemiparesis, dysarthria and clumsy hand syndrome and dysfunctional prefrontal thalamic cerebellar circuitry leads to schizophrenia, cognitive dysmetria. The dentato-rubro-olivary circuit is a bidirectional pathway, forms a feedback loop between the cerebellum and brainstem, and it serves to control spinal cord motor activity, lesion in this triangle is associated with hypertrophic olivary degeneration. There is another circuitry between cerebellam and basal ganglia, which are densely interconnected and control, modify motor activity. Their connections play an important role in pathophysiology of various movement disorders or neurodevelopmental disorders. Parkinsonian tremor results from increased interaction between the basal ganglia and the cerebello- thalamo-cortical circuit. The cerebello-hypothalamo-cerebellar circuit is a bidirectional circuit both directly and indirectly between the cerebellum and hypothalamus, consist of both hypothalamo-cerebellar and cerebello-hypothalamic pathways. The functions of this circuit are so far unknown, but the neurophysiological and neuroimaging studies have demonstrated that this circuit may be involved in feeding, cardiovascular, osmotic, respiratory, micturition, immune, emotion and other nonsomatic regulation. The circuitry between cerebellum with limbic-related brain areas and paralimbic cortices suggests widespread cerebellar influence on behaviors including the experience and expression of emotion, sadness and grief, integrative hypothalamic visceral/sensory functions, pain perception, modulation, and intensity due to noxious stimuli, as well as other nonmotor behaviors. Lesions of this circuitry lead to the cerebellar cognitive affective syndrome both in adults and in children and dysfunction of this circuitry may lead to autism and neurodevelopmental disorder. Cerebellar dysfunction may play a crucial role in the etiology of autism spectrum disorder, schizophrenia, and other cognitive disorders. Although the main function of cerebellum is motor control, but it has some roles in olfactory function. In this paper we have reviewed different descriptive cerebellar circuitry and clinical consequences following their lesions.

The Effect of Caraway Seeds Aqueous Extract on Improving Liver and Kidney Functions in Autism Induced by Valproic Acid in Rats.

The Effect of Caraway Seeds Aqueous Extract on Improving Liver and Kidney Functions in Autism Induced by Valproic Acid in Rats.

DEVELOPMENT PROFILES OF EXECUTIVE FUNCTIONS IN PRESCHOOL AGE: OBSERVATIONAL STUDY IN GENERALIZED DEVELOPMENT DISORDER

Executive functions (EF) play a fundamental role when it is necessary to implement behaviors aimed at achieving a goal; they are in fact widely studied and described in the literature, especially within neurodevelopment. Matura-tion of executive functions is described as a key component of typical as well as atypical development; their deficit is found in numerous neurodevelopmental and behavioral disorders. There are studies in literature that are intere-sted in the impairment of executive functions in Autism and Generalized Developmental Disorders (DGS). These disorders include a spectrum of clinical pictures characterized by social impairments, communicative impairments, restricted interests and stereotyped behaviors (Valeri, 2006), (APA - Amerian Psychiatric Association, 2013). However, none of these studies concerns the Italian pre-school population nor does it use assessment tools born in the Italian context; the studies in question also find confirmation above all in research conducted on adolescent and adult patients, while studies conducted with pre-school children provide conflicting results (Griffith, et al., 1999). Both in relation to these contradictory results and to the highly adaptive role of this domain for so-cio affective development, learning and quality of life, this study stands as a contribution to the research on exe-cutive function disorders on a sample of children with Generalized Developmental Disorder (DGS) in preschool age (3-6 years), with the aim of providing operational reflections for the best practice for functional assessment in the presence of this disorder, adding useful knowledge to Developmental Neuro and Psychomotor Therapist when drafting his own rehabilitation program. To meet the identified objectives, a sample with a diagnosis of Genera-lized Developmental Disorder (11 subjects) and a control sample, which did not present any neurodevelopmental disorder (39 subjects), were selected. The evaluation tool used is the Battery for the evaluation of executive func-tions in preschool age (FE-PS 2-6; Usai et al. 2017), intentionally selected among the tools developed in the Italian context and specific for the preschool age. The test results, taken from the Battery reference manual, were sub-jected to statistical analysis and subsequently to qualitative analysis, aimed at detecting further aspects of interest on the evolutionary profiles. 2 The research results show a difference in the average performance of the subjects belonging to the DGS group, which appear to be globally lower than those of the subjects belonging to the control group. Particular difficulties are found in all inhibition processes and are above all the characteristics of impulsi-vity and the management of interference. The greatest difficulty in children behavior therefore appears to be pre-sent in their ability to initiate a response and to inhibit actions in the service of general goals to be achieved. This difficulty appears as a dysfunctional characteristic in all the age groups covered by our study, as a constant cha-racteristic at all ages to be considered as a maladaptive functional profile.

Linking functional and structural brain organisation with behaviour in autism: a multimodal EU-AIMS Longitudinal European Autism Project (LEAP) study

Neuroimaging analyses of brain structure and function in autism have typically been conducted in isolation, missing the sensitivity gains of linking data across modalities. Here we focus on the integration of structural and functional organisational properties of brain regions. We aim to identify novel brain-organisation phenotypes of autism. We utilised multimodal MRI (T1-, diffusion-weighted and resting state functional), behavioural and clinical data from the EU AIMS Longitudinal European Autism Project (LEAP) from autistic (n = 206) and non-autistic (n = 196) participants. Of these, 97 had data from 2 timepoints resulting in a total scan number of 466. Grey matter density maps, probabilistic tractography connectivity matrices and connectopic maps were extracted from respective MRI modalities and were then integrated with Linked Independent Component Analysis. Linear mixed-effects models were used to evaluate the relationship between components and group while accounting for covariates and non-independence of participants with longitudinal data. Additional models were run to investigate associations with dimensional measures of behaviour. We identified one component that differed significantly between groups (coefficient = 0.33, padj = 0.02). This was driven (99%) by variance of the right fusiform gyrus connectopic map 2. While there were multiple nominal (uncorrected p < 0.05) associations with behavioural measures, none were significant following multiple comparison correction. Our analysis considered the relative contributions of both structural and functional brain phenotypes simultaneously, finding that functional phenotypes drive associations with autism. These findings expanded on previous unimodal studies by revealing the topographic organisation of functional connectivity patterns specific to autism and warrant further investigation.

The mediators for the link between autism and real-world executive functions in adolescence and young adulthood.

Childhood factors that predict real-world executive function in autism spectrum disorder during the transition into adulthood are largely unknown. This study aimed to identify the predictors for the behavioral and cognitive aspects of real-world executive function in late adolescent and young adult autistic populations. We followed up 289 autistic youth (mean age 11.6 years) and 203 non-autistic controls (10.7 years) to their ages of 16.9 and 15.8, respectively. The Behavior Rating Inventory of Executive Function scale was used to measure the real-world executive function at late adolescence and young adulthood at follow-up. Potential predictors such as autistic symptoms, inattention or hyperactivity symptoms, peer relationship, emotional symptoms, and parenting styles were assessed in childhood at first enrollment. The results showed that childhood inattention, withdrawn behaviors, social communication difficulties, and child-reported emotion and inattention/hyperactivity may predict real-world lower executive function in late adolescence and young adults with autism. When separating executive function into behavioral and cognitive aspects, we found that oppositional behaviors and peer problems were specific predictors for behavioral regulation and cognitive function, respectively. Our findings suggested that treating common predictors in childhood, such as inattention, may potentially improve real-world executive function in autism during the transition into adulthood.

Investigating the Face Inversion Effect in Autism Across Behavioral and Neural Measures of Face Processing

Face processing is foundational to human social cognition, is central to the hallmark features of autism spectrum disorder (ASD), and shapes neural systems and social behavior. Highly efficient and specialized, the face processing system is sensitive to inversion, demonstrated by reduced accuracy in recognition and altered neural response to inverted faces. Understanding at which mechanistic level the autistic face processing system may be particularly different, as measured by the face inversion effect, will improve overall understanding of brain functioning in autism. To synthesize data from the extant literature to determine differences of the face processing system in ASD, as measured by the face inversion effect, across multiple mechanistic levels. Systematic searches were conducted in the MEDLINE, Embase, Web of Science, and PubMed databases from inception to August 11, 2022. Original research that reported performance-based measures of face recognition to upright and inverted faces in ASD and neurotypical samples were included for quantitative synthesis. All studies were screened by at least 2 reviewers. This systematic review and meta-analysis was conducted according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Multiple effect sizes were extracted from studies to maximize information gain and statistical precision and used a random-effects, multilevel modeling framework to account for statistical dependencies within study samples. Effect sizes were calculated as a standardized mean change score between ASD and neurotypical samples (ie, Hedges g). The primary outcome measure was performance difference between upright and inverted faces during face recognition tasks. Measurement modality, psychological construct, recognition demand, sample age, sample sex distribution, and study quality assessment scores were assessed as moderators. Of 1768 screened articles, 122 effect sizes from 38 empirical articles representing data from 1764 individual participants (899 ASD individuals and 865 neurotypical individuals) were included in the meta-analysis. Overall, face recognition performance differences between upright and inverted faces were reduced in autistic individuals compared with neurotypical individuals (g = -0.41; SE = 0.11; 95% credible interval [CrI], -0.63 to -0.18). However, there was considerable heterogeneity among effect sizes, which were explored with moderator analysis. The attenuated face inversion effect in autistic individuals was more prominent in emotion compared with identity recognition (b = 0.46; SE = 0.26; 95% CrI, -0.08 to 0.95) and in behavioral compared with electrophysiological measures (b = 0.23; SE = 0.24; 95% CrI, -0.25 to 0.70). This study found that on average, face recognition in autism is less impacted by inversion. These findings suggest less specialization or expertise of the face processing system in autism, particularly in recognizing emotion from faces as measured in behavioral paradigms.

Language Abilities are Associated with Both Verbal and Nonverbal Intelligence in Children on the Autism Spectrum

ABSTRACT Intellectual abilities factor into levels of functioning used to characterize autism. Language difficulties are highly prevalent in autism and may impact performance on measures of intellectual abilities. As such, nonverbal tests are often prioritized in classifying intelligence in those with language difficulties and autism. However, the relationship between language abilities and intellectual performance is not well characterized, and the superiority of tests with nonverbal instructions is not well established. The current study evaluates verbal and nonverbal intellectual abilities in the context of language abilities in autism and the potential benefit of tests with nonverbal instructions. Participants were 55 children and adolescents on the autism spectrum who underwent a neuropsychological evaluation as part of a study examining language functioning in autism. Correlation analyses were performed to examine relations between expressive and receptive language abilities. Language abilities (CELF−4) were significantly correlated with all measures of both verbal (WISC-IV VCI) and nonverbal intelligence scores (WISC-IV PRI and Leiter-R). There were no significant differences between nonverbal intelligence measures with verbal or nonverbal instructions. We further discuss the role of assessment of language abilities in interpreting results of intelligence testing in populations with higher prevalence of language difficulties

Neural Correlates of Audiovisual Speech Processing in Autistic and Non-Autistic Youth.

Autistic youth demonstrate differences in processing multisensory information, particularly in temporal processing of multisensory speech. Extensive research has identified several key brain regions for multisensory speech processing in non-autistic adults, including the superior temporal sulcus (STS) and insula, but it is unclear to what extent these regions are involved in temporal processing of multisensory speech in autistic youth. As a first step in exploring the neural substrates of multisensory temporal processing in this clinical population, we employed functional magnetic resonance imaging (fMRI) with a simultaneity-judgment audiovisual speech task. Eighteen autistic youth and a comparison group of 20 non-autistic youth matched on chronological age, biological sex, and gender participated. Results extend prior findings from studies of non-autistic adults, with non-autistic youth demonstrating responses in several similar regions as previously implicated in adult temporal processing of multisensory speech. Autistic youth demonstrated responses in fewer of the multisensory regions identified in adult studies; responses were limited to visual and motor cortices. Group responses in the middle temporal gyrus significantly interacted with age; younger autistic individuals showed reduced MTG responses whereas older individuals showed comparable MTG responses relative to non-autistic controls. Across groups, responses in the precuneus covaried with task accuracy, and anterior temporal and insula responses covaried with nonverbal IQ. These preliminary findings suggest possible differences in neural mechanisms of audiovisual processing in autistic youth while highlighting the need to consider participant characteristics in future, larger-scale studies exploring the neural basis of multisensory function in autism.

Pathways to adaptive functioning in autism from early childhood to adolescence.

Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. This study examines longitudinal and contemporaneous associations of adaptive functioning in autistic youth across a wide ability range. Parent-reported autism symptoms, co-occurring emotional, behavioral and attention deficit hyperactivity disorder (ADHD) symptoms, and IQ were assessed in early childhood (M age 7 years; T1) and 6 years later in adolescence (M age 13 years; T2) in 179 autistic youth. Adaptive functioning was assessed at T2. Structural equation modeling estimated pathways to adaptive functioning from autism, and psychiatric symptoms at T1 and T2, testing whether associations were driven by continuity of behaviors from T1 to T2 or their contemporaneous effect at T2, or both, controlling for T1 IQ. Lower adaptive functioning at T2 was associated with higher T1 and T2 ADHD symptoms (β=-0.14, and β=-0.21) but not behavioral nor emotional symptoms at either timepoint. Lower adaptive functioning at T2 was also associated with lower T1 IQ (β=0.43) and higher social communication symptoms (β=-0.37) at T2 but not T1, but the relationship with ADHD symptoms remained. Paths were not moderated by sex or IQ. Increased symptoms of ADHD, both in early childhood and contemporaneously, were associated with reduced adaptive functioning in adolescence. Co-occurring ADHD may be a modifiable risk factor for adaptive function impairments and should be routinely assessed and when present evidence-based treatments initiated which may benefit adaptive functioning outcomes. LAY SUMMARY: Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. In a community sample higher attention deficit/hyperactivity disorder (ADHD) symptoms, but not emotional or behavioral symptoms, in both early childhood and contemporaneously were associated with lower adaptive functioning in autistic adolescents. Co-occurring ADHD may be a modifiable risk factor for adaptive function difficulties in autism.

Social Deficits or Interactional Differences? Interrogating Perspectives on Social Functioning in Autism.

Social dysfunction is a key characteristic of autism. Determining and treating autism-related social deficits have been challenging. The medical model views interpersonal difficulties in autism as a localized set of deficits to be managed, whereas the neurodiversity movement calls for the accommodation of differences by the larger community. One common assumption underlying these perspectives is a misalignment in social behaviors between autistic individuals and neurotypicals. This paper reviews and interrogates current perspectives on social functioning in autism to uncover the intricacies of such a notion. Even though extant literature has alluded to a misalignment in social behaviors between autistic and neurotypical individuals, it is uncertain where this disparity lies. Implications for future research and practice are discussed.