Social Communication Behaviors Research Articles

Enhancing perspective-taking and empathy in children with autism spectrum disorder through asymmetric VR games and peer collaboration

ABSTRACT Children with ASD experience pervasive social cognitive impairments, primarily manifested as challenges in social communication and reciprocal social behavior. These inherent deficits indirectly affect the development, based on the Theory of Mind, and empathy capacity in children with ASD, which are crucial in developing social skills and communicative interaction abilities. Research suggests that children with ASD struggle to judge and interpret the intentions, behaviors, and metaphors involved in social interaction. This impacts their abilities to engage in effective interpersonal communication and social interaction. Therefore, the present study developed a tool called Share VR. This asymmetric VR technology combines peer collaboration and cooperative games to hone the empathetic abilities in children with ASD. The objective is to stimulate the application of their abilities while enhancing their understanding of others’ behavioral intentions. In the experimental verification phase, the study recruited five children with ASD and three typically developing children to participate in Asymmetric VR multiplayer games. The games involved cooperation, competition, and exploration across three different game levels. Further, we used a three-stage experimental validation using a multiple-baseline across subjects design to confirm whether this method effectively enables children with ASD to acquire empathy through peer collaboration, game participation, and cooperative assistance.

Hyperglycemia as a gestational factor associated with Autism Spectrum Disorder: a review of the literature

Introduction: Autism Spectrum Disorder is a neurodevelopmental disorder characterized by deficits in social interaction, communication, and repetitive behaviors. The etiology, which has been the subject of studies, is influenced by a range of factors, including genetic, environmental, and gestational aspects. Methods: This article aims to review the literature, exploring the gestational causes associated with ASD, concentrating on intrauterine hyperglycemia. Results: The analysis reveals a scarcity of empirical studies, highlighting the need for additional research, especially in the Brazilian context. Conclusion: The results show that hyperglycemia during pregnancy can increase the risk of ASD, highlighting the importance of further research in this area.

Prenatal & Perinatal Risk Factors of Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is lifelong neurodevelopmental disorder characterized by impairments in social function, communication, and certain behaviors. The etiology of ASD is unclear & it is believed to be multi-factorial, among those several prenatal & perinatal factors are found to be significant. So, the necessity of this study is to detect the presence of known risk factors of ASD which in turn may help in the early diagnosis and intervention for better long-term outcomes. Objective: To find out prenatal and perinatal risk factors of ASD. Method: A case control study was conducted with 112 cases of ASD and 201 controls of 2-6 years of age. The study was carried out in Center for Neurodevelopment and Autism in Children (CNAC), in the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University and Autism Welfare Foundation (AWF). ASD was diagnosed by DSM-IV TR criteria. Mothers were interviewed and data were collected by semistructured questionnaires. Results: Total 5 risk factors were identified as the risk factors of ASD. They were: advanced paternal age (OR=2.84) and maternal age (OR=1.87); male baby (OR=2.01); environmental stress during pregnancy (OR=1.61) and preterm delivery (OR=1.80). Conclusions: It is concluded that advanced paternal age, maternal age, male baby, environmental stress during pregnancy and preterm delivery are associated with increased risk of ASD. BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 115-121

Tracing Neurogenetic Pathways: SIRT1 Gene's Influence on Autism, Alzheimer's, Type II Diabetes, Dementia, and its role in Neurodevelopmental Dynamics

Background: Autism Spectrum Disorder (ASD) encompasses a range of neurodevelopmental conditions characterized by challenges in social interaction, communication, and repetitive behaviors. Concurrent conditions such as Type II Diabetes Mellitus (DM) and dementia are prevalent comorbidities that exacerbate the cognitive impairments associated with ASD. The SIRT1 gene, known for its role in neuroprotection and longevity, has been implicated in the pathophysiology of these disorders. Objective: To determine the expression of the SIRT1 gene in patients with diabetes and dementia and to investigate its potential as a biomarker for cognitive impairment in these populations. Methods: A cohort of 108 diabetic dementia patients and 32 healthy controls were enrolled. SIRT1 expression levels were quantified using chemiluminescent immunoassay (CLIA) and methylation-specific PCR after bisulfite DNA modification. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and demographic data, along with biochemical parameters such as fasting glucose and HbA1c levels, were analyzed using SPSS version 25. Results: Diabetic dementia patients exhibited significantly lower SIRT1 levels (4.37 ± 1.38 µg/mL) and MMSE scores (12.26 ± 4.56) compared to healthy controls (SIRT1: 11.37 ± 3.64 µg/mL, MMSE: 24.1 ± 3.12). The relative gene expression of SIRT1 in diabetic dementia patients showed a 6.7-fold decrease compared to healthy individuals. Statistical analysis revealed a significant difference in both SIRT1 levels and MMSE scores between the two groups (P<0.05). Conclusion: The underexpression of SIRT1 in diabetic dementia patients and its correlation with lower MMSE scores suggest that SIRT1 could serve as a biomarker for cognitive impairment in this population. The findings advocate for further exploration into SIRT1-targeted interventions, which may improve diagnostics and therapeutic approaches for neurodegenerative conditions associated with ASD.

Improving the social communication skills of preschoolers with autism spectrum disorder: robot-based intervention on Picture Exchange Communication System use

Objectives Children diagnosed with autism spectrum disorder (ASD) often exhibit challenges in social communication. Picture Exchange Communication System (PECS) is effective in enhancing the social skills of children with ASD, and interventions using social robots are potentially beneficial training tools. However, it is uncertain whether robots can facilitate more effective training for children with ASD compared to human therapists. Methods In the present study, we compared the effectiveness of robot-based and human-based interventions on enhancing the social communication behaviors in young children diagnosed with ASD. The feasibility and efficacy of integrating the PECS in robotic systems were evaluated using a single-case design. Eight children with ASD were randomly assigned to either a robot-based group (N = 4) or a human-based group (N = 4). Participants in the two groups underwent phases I–III of the PECS protocol facilitated by either a human therapist or a robot therapist. Changes in social communication behaviors were assessed in each child after intervention using a single-case design. Results Half of the participants in the robot-based intervention group showed significant improvement in both verbal and nonverbal communication behaviors after a two-month PECS intervention. A higher proportion of children in the robot-based intervention group showed significantly enhanced social communication skills encompassing both verbal and nonverbal behaviors than in the human-based intervention group. Conclusions This study demonstrates the effectiveness of robot-based PECS intervention in enhancing verbal and nonverbal communication behaviors in young children with ASD. These findings present novel intervention tools for early intervention educators engaged in supporting children with ASD.

Identification and support of autistic individuals within the UK Criminal Justice System: a practical approach based upon professional consensus with input from lived experience

BackgroundAutism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual’s journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes.MethodsThis consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS.ResultsThe authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS.ConclusionGreater attention needs to be given to this population as they navigate the CJS.

A Scoping Review of Sex/Gender Differences in Social Communication Skills and Behaviors of Autistic Youth—Are Sex/Gender-Specific Interventions Needed?

A Scoping Review of Sex/Gender Differences in Social Communication Skills and Behaviors of Autistic Youth—Are Sex/Gender-Specific Interventions Needed?

The Efficacy of Music Therapy Programs on the Development of Social Communication in Children with Autism Spectrum Disorder: A Systematic Review

Autism spectrum disorder (ASD) in children is characterized by difficulties in social communication and restricted repetitive behavior patterns. Music therapy appears to have beneficial effects in the area of social interaction and communication. The aim of this systematic literature review is to investigate the effectiveness of music therapy programs on the development of social communication among preschool- and school-aged children with ASD. For this purpose, a detailed study of the relevant literature that has been published in the last decade in peer-reviewed scientific journals was conducted. Web of Science, Springer Link, PsyINFO, and ERIC databases were searched, and according to the eligibility and exclusion criteria, 12 studies were finally selected from the 167 initially found. From the analysis of the results, the following categories were defined to contribute to enhancing social communication: (a) improvisational music therapy; (b) joint attention and eye contact; (c) therapeutic relationship, synchronization, and attunement; (d) imitation; (e) understanding and interaction; (f) family-centered music therapy; and (g) language and socioemotional adjustment. The results of the review were mixed, as music therapy appeared to have a positive effect on improving the social communication of children with ASD, but a general conclusion could not be drawn about the degree of its effectiveness compared to the standard treatments that children usually receive. In the future, further research in this field, especially on the improvisational music Therapy technique, is recommended. Moreover, an increased focus on the development of a common methodological practice regarding the sample selection process and measurement tools is suggested.

Social Communication Traits in Typical Hispanic Infants and Toddlers for Use in Autism Screening

The Centers for Disease Control and Prevention recommend that the first Autism Spectrum Disorder (ASD) screening of development and behavior for all children can be completed as early as 9 months of age. To address this recommendation this study was aimed at describing the gestural and oral receptive and expressive social communicative behavior of typical Puerto Rican Hispanic children, using skills in the Early Social-Communication Scales (ESCS). Twenty Puerto Rican infants and toddlers, 10-14 months of age, were studied. Each participant was examined and observed (using video-audio recordings), by a trained speech-language pathology graduate student and a speech-language pathologist of the FILIUS Center. One clinician elicited while the other observed each child’s responses to the ESCS items. At the end, the recorded sessions were analyzed and discussed by the two observers to assign values to observed abilities on a scale of from 1 to 5 for each skill (1= does not execute; 5=very frequent execution). The strongest indicators of typical social communication in these Hispanic infants and toddlers demonstrate that, at that very early age, infants and toddlers are driven to interact with a stranger when accompanied by their mothers as a confirmation of their empathic dispositions. These strong indicators of social communication in typical Hispanic infants and toddlers can be observed by health professionals to identify difficulties in interaction skills as signs to refer children at-risk of autism.

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.

Sex-specific modulation of safety learning in Shank2-deficient mice

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impaired perceptual processing and social communication, intellectual disabilities, and repetitive behaviors. Interestingly, while not a core symptom, anxiety disorders frequently co-occur in individuals with ASD and deficits in safety learning have been described in patients with anxiety-related disorders. Because genetic factors, such as SHANK deficiency (loss-of-function mutations), have been linked to ASD, the aim of the present study was to investigate whether Shank2 deficiency interferes with associative fear and safety signal learning. To first investigate trait anxiety, male and female Shank2-deficient mice were exposed to a light-dark box test. Mice were then submitted to a combination of contextual fear conditioning and single-cue safety conditioning. The results show that Shank2 deficiency increases trait anxiety but reduces contextual fear learning. In male but not female Shank2-deficient mice, reduced single-cued safety learning was observed. This safety learning deficit was not caused by altered anxiety levels, increased locomotor activity, or reduced contextual fear since these changes were also observed in female Shank2-deficient mice. Concluding, our data indicate that the observed safety learning deficits in Shank2-deficient male mice could contribute to the emotional symptoms observed in ASD and the high comorbidity with anxiety-related disorders.

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.

Enhancing Social Responsiveness in Autism: The Impact of Art Therapy

This study aimed to evaluate the effectiveness of art therapy in enhancing social responsiveness among individuals with autism spectrum disorder (ASD). Given the challenges faced by individuals with ASD in social interaction, communication, and repetitive behaviors, art therapy has been proposed as a promising therapeutic intervention to ameliorate these challenges. A randomized controlled trial (RCT) design was employed, involving 40 participants with ASD, aged between 8 and 16 years. Participants were randomly assigned to either an experimental group that received a structured art therapy program or a control group that received no intervention. The art therapy program consisted of 10 sessions, each lasting 75 minutes, designed to encourage social interaction, emotional expression, and the development of social skills. The Social Responsiveness Scale, Second Edition (SRS-2), was administered at baseline, immediately post-intervention, and at a three-month follow-up to assess changes in social responsiveness. Analysis of variance (ANOVA) with repeated measurements indicated a significant improvement in social responsiveness scores for the experimental group compared to the control group (p < 0.01). The Bonferroni post-hoc test revealed significant improvements in social responsiveness from baseline to post-test and follow-up in the experimental group, with no significant difference observed between post-test and follow-up scores, indicating the sustainability of the intervention's effects. The findings suggest that art therapy is an effective intervention for enhancing social responsiveness among individuals with ASD. The structured art therapy program provided a beneficial impact on participants' social skills and behaviors, with improvements sustained over the three-month follow-up period. This study contributes to the evidence base supporting the use of art therapy in therapeutic interventions for individuals with ASD, highlighting its potential to improve social interaction and communication skills.

ДИФФЕРЕНЦИРОВАННЫЙ ПОДХОД В ОКАЗАНИИ ПОМОЩИ ДЕТЯМ С РАССТРОЙСТВАМИ АУТИСТИЧЕСКОГО СПЕКТРА

Autism spectrum disorders (ASD) are neurological and developmental disorders characterized by difficulties with social communication and repetitive interests and/or behaviors that begin before age of 3 years. The exact etiology of ASD remains unknown today. According to literature reviews, several factors may predispose to the development of these entities, which, according to scientific publications, can be both genetic and environmental factors. A problematic area remains the timely provision of highly qualified assistance in the management and treatment of such patients [1]. It is important that the child with ASD and his family have the support of a multidisciplinary team to help overcome current situations and problems. The aim of the work: to emphasize the advantages of a multidisciplinary approach in accompanying children with autism spectrum disorders. The authors describe some epidemiological data on autism spectrum disorders using the example of Minsk.

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.

Children's and Parents' Factors That Affect Parenting Stress in Preschool Children With Developmental Disabilities or Typical Development.

This study compared parenting stress in preschool children with developmental disabilities (DD) or typical development (TD). We also investigated children's factors that affect parenting stress. A total of 196 preschool children participated in the study (aged 54.8±9.2 months). There were 79 children with DD (59 with autism spectrum disorder, 61 with intellectual disability, 12 with language disorder) and 117 with TD. The high parenting stress and the low parenting stress groups were divided based on the Total Stress of Korean Parenting Stress Index Fourth Edition (K-PSI-4) with an 85-percentile cutoff score. Pearson's correlation analysis was conducted to calculate the correlation between K-PSI-4 and the children's or parents' measures. The difference in parenting stress between DD and TD was significant in the Total Stress of K-PSI-4 (p<0.001). The Total Stress scale of K-PSI-4 represented a modest to strong correlation with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Our results showed that caregivers of children with DD reported higher parenting stress than those with TD. Parenting stress was strongly associated with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Among the children's factors, especially social communication, attention problems, and aggressive behavior had association with caregivers' higher parenting stress. These findings suggest the need for early intervention for parenting stress in caregivers by assessing child characteristics, including social cognition, awareness, communication, and inattention and hyperactivity, in the evaluation of children with DD.

Autism spectrum disorders and the gastrointestinal tract: insights into mechanisms and clinical relevance.

Autism spectrum disorders (ASDs) are recognized as central neurodevelopmental disorders diagnosed by impairments in social interactions, communication and repetitive behaviours. The recognition of ASD as a central nervous system (CNS)-mediated neurobehavioural disorder has led most of the research in ASD to be focused on the CNS. However, gastrointestinal function is also likely to be affected owing to the neural mechanistic nature of ASD and the nervous system in the gastrointestinal tract (enteric nervous system). Thus, it is unsurprising that gastrointestinal disorders, particularly constipation, diarrhoea and abdominal pain, are highly comorbid in individuals with ASD. Gastrointestinal problems have also been repeatedly associated with increased severity of the core symptoms diagnostic of ASD and other centrally mediated comorbid conditions, including psychiatric issues, irritability, rigid-compulsive behaviours and aggression. Despite the high prevalence of gastrointestinal dysfunction in ASD and its associated behavioural comorbidities, the specific links between these two conditions have not been clearly delineated, and current data linking ASD to gastrointestinal dysfunction have not been extensively reviewed. This Review outlines the established and emerging clinical and preclinical evidence that emphasizes the gut as a novel mechanistic and potential therapeutic target for individuals with ASD.

Umbilical Cord Stem Cell Stem Cell Therapy For Rare Genetic Disease Prader-Willi Syndrome

This abstract summarises the studies on the use of umbilical cord stem cells to treat Prader-Willi syn- drome. Among the various stem cells found in the umbilical cord, hematopoietic and mesenchymal stem cells may create bioactive molecules that aid in tissue repair and regeneration, control immunological responses, and give birth to a variety of cell types. Because of this, they present a feasible option for treating the multidisciplinary character of PWS. Preclinical research on PWS animal models has shown promising outcomes, with umbilical cord stem cell transplantation improving metabolic disorders, hy- hypothalamic function, and general behavior. It has been investigated if immunological regulation, trophic support, and paracrine signaling are among the factors that promote stem cell therapeutic potential. Several clinical studies employing umbilical cord stem cells to treat PWS are now underway, and the findings should aid in assessing the advantages and disadvantages of using this approach on patients. The preliminary evidence is encouraging, since some trial participants improved in hyperphagia, mus- cular tone, and cognitive ability. Although the use of umbilical cord stem cells as a PWS treatment has shown some promise, further study is required to determine its long-term safety, optimal dose, and ongoing effectiveness. A variety of key elements, such as ethical issues, regulatory frameworks, and the availability of standardized stem cell products, will have a considerable impact on the future development of this treatment technique. SD is a disease known as a neurodevelopmental problem represented through problems with social communication, sensor sensitivity, and repetitive behaviors. Despite years of study, therapy options for autism spectrum disorder (ASD) remain relatively limited. As regenerative medicine has improved, stem cell treatment has been investigated as a novel therapeutic option for the underlying neurological disorders that underpin ASD. The development, possible methods, and potential uses of stem cell treatment for autistic children are discussed in this article.

Improving Parental Stress and Child ASD Severity through the Japanese Parent Mentorship Program: A Research Protocol

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition which often begins in early childhood and can involve a spectrum of persistent challenges with social communication, restricted interests, and repetitive behaviours. Literature in western and non-western countries has demonstrated that parents of children with ASD experience elevated stress relative to parents of neurotypical children. Despite the health-related burdens presented by raising children with ASD, little clinical and research emphasis is placed on reducing parental stress. Furthermore, much of the limited work on parent-centered interventions been conducted in the U.S., and few similar interventions have been developed for the Japanese population. Methods: The Japanese Parent Mentorship Program (JPM) seeks to modify a pre-existing social support intervention (the Colorado Parent Mentorship Program developed for parents of ASD children in the U.S.) to Japanese parents by incorporating dialogue about the culturally relevant stressors, social acceptability, maternal burden, saving the face, and parent-child attachment. To test the efficacy of the JPM at reducing parental stress, a randomized control trial will be conducted with mothers of ASD children who were born and are living in Japan for a minimum of five years. Results: Enrolment into the JPM will be associated with decreased parental stress post-intervention. The social support provided in the JPM will also be a protective moderator on the relationship between parental stress and ASD severity by weakening the overall association between parental stress and ASD severity. Discussion: The JPM can improve health outcomes for parents and their children with ASD by decreasing parental stress and consequently, ASD severity, leading to numerous indirect and positive implications on their physical, emotional, and social well-being. As prompted by the JPM, cultural competence in ASD management, is associated with positive outcomes such as such as increased likelihood of treatment continuation, increased strength of perceived therapeutic alliance and increased perceived treatment benefit. Conclusion: This research contributes to a major gap in the cross-cultural literature about parental stress and ASD. This work can be used to inform intervention strategies in Japan and researchers can emulate this design towards a global shift of providing culturally competent interventions for all.