Insights into the structure and function of the hippocampus: implications for the pathophysiology and treatment of autism spectrum disorder.

The hippocampus is one of the brain areas affected by autism spectrum disorder (ASD). Individuals with ASD typically have impairments in hippocampus-dependent learning, memory, language ability, emotional regulation, and cognitive map creation. However, the pathological changes in the hippocampus that result in these cognitive deficits in ASD are not yet fully understood. In the present review, we will first summarize the hippocampal involvement in individuals with ASD. We will then provide an overview of hippocampal structural and functional abnormalities in genetic, environment-induced, and idiopathic animal models of ASD. Finally, we will discuss some pharmacological and non-pharmacological interventions that show positive impacts on the structure and function of the hippocampus in animal models of ASD. A further comprehension of hippocampal aberrations in ASD might elucidate their influence on the manifestation of this developmental disorder and provide clues for forthcoming diagnostic and therapeutic innovation.

Impact of maternal immune activation and sex on placental and fetal brain cytokine and gene expression profiles in a preclinical model of neurodevelopmental disorders.

Maternal inflammation during gestation is associated with a later diagnosis of neurodevelopmental disorders including autism spectrum disorder (ASD). However, the specific impact of maternal immune activation (MIA) on placental and fetal brain development remains insufficiently understood. This study aimed to investigate the effects of MIA by analyzing placental and brain tissues obtained from the offspring of pregnant C57BL/6 dams exposed to polyinosinic: polycytidylic acid (poly I: C) on embryonic day 12.5. Cytokine and mRNA content in the placenta and brain tissues were assessed using multiplex cytokine assays and bulk-RNA sequencing on embryonic day 17.5. In the placenta, male MIA offspring exhibited higher levels of GM-CSF, IL-6, TNFα, and LT-α, but there were no differences in female MIA offspring. Furthermore, differentially expressed genes (DEG) in the placental tissues of MIA offspring were found to be enriched in processes related to synaptic vesicles and neuronal development. Placental mRNA from male and female MIA offspring were both enriched in synaptic and neuronal development terms, whereas females were also enriched for terms related to excitatory and inhibitory signaling. In the fetal brain of MIA offspring, increased levels of IL-28B and IL-25 were observed with male MIA offspring and increased levels of LT-α were observed in the female offspring. Notably, we identified few stable MIA fetal brain DEG, with no male specific difference whereas females had DEG related to immune cytokine signaling. Overall, these findings support the hypothesis that MIA contributes to the sex- specific abnormalities observed in ASD, possibly through altered neuron developed from exposure to inflammatory cytokines. Future research should aim to investigate how interactions between the placenta and fetal brain contribute to altered neuronal development in the context of MIA.

Insomnia in children affected by autism spectrum disorder: The role of melatonin in treatment.

The present article explores the connection between insomnia and Autism Spectrum Disorder (ASD), focusing on the efficacy and safety of melatonin treatments as supported by existing research and current guidelines. In this narrative review a group of Italian experts provide an analysis of the various aspects of managing insomnia in children with ASD, highlighting key points that could enhance the quality of life for both patients and their caregivers. This includes the significance of comprehensively understanding the root causes of a child's sleep difficulties for more effective, long-term management. Insomnia, a condition frequently documented in neurodevelopmental disorders such as ASD, greatly affects the lives of patients and caregivers. Recent data show that melatonin-based formulations are effective and safe for treating ASD-related insomnia both short and long term. In particular, prolonged-release melatonin is poised to be the optimal choice for this patient population. This formulation is approved for the treatment of insomnia in children and adolescents aged 2-18 years suffering from ASD and/or Smith-Magenis syndrome, where sleep hygiene measures and behavioral treatments have not been sufficient. In support, emerging research in pediatric settings indicates long-term efficacy and safety, although further research efforts are still needed. Current guidelines recommend managing insomnia and sleep disturbances in ASD using a combination of behavioral and pharmacological methods, primarily melatonin. Recent concerns about accidental melatonin ingestion highlight the need for high purity standards, such as pharmaceutical-grade prolonged-release formulations. The article also summarizes emerging molecular mechanisms from preclinical research, suggesting future therapeutic approaches.

Demographic differences in access to health/therapeutic services over first year of the pandemic: a SPARK COVID-19 impact survey analysis.

Introduction: This analysis examined changes in services received and service recovery one-year post-pandemic compared to pre-pandemic levels in children with ASD aged between 19 months and 17 years in various subgroups based on factors such as age, income, race/ethnicity, geographic location, and sex. Methods: An online, parent report survey was completed by the parents of children with ASD in the SPARK study cohort (N = 6,393). Descriptive statistics, chi-square analyses, and Spearman correlations were performed to study associations between various factors and service access, pre-pandemic and one-year, post-pandemic. Results: One year after pandemic, the lag in service recovery in children with ASD was greatest for PT/OT services followed by SLT. ABA services only recovered in half of the subgroups. In contrast, SES fully recovered and MH and MED services superseded pre-pandemic levels. Across majority of the timepoints, younger children received more SLT, PT/OT, and ABA services whereas older children received more SES, MH, and MED services. Higher income families accessed more SES, SLT, and ABA whereas lower income families received more MH services. White families received less SLT compared to non-white families. Hispanic families received more SLT services compared to non-Hispanic families. Compared to rural families, urban families received more ABA services at baseline which also recovered one year after the pandemic. Certain counterintuitive findings may be attributed to home/remote schooling leading to reduced access to related services. Conclusions: Future research and policy changes are needed to address the American healthcare vulnerabilities when serving children with ASD by enhancing the diversity of healthcare formats for continued service access during future pandemics and other similar crises.

Predicting Social Competence in Autistic and Non-Autistic Children: Effects of Prosody and the Amount of Speech Input.

PURPOSE: Autistic individuals often face challenges perceiving and expressing emotions, potentially stemming from differences in speech prosody. Here we explore how autism diagnoses between groups, and measures of social competence within groups may be related to, first, children's speech characteristics (both prosodic features and amount of spontaneous speech), and second, to these two factors in mothers' speech to their children. METHODS: Autistic (n = 21) and non-autistic (n = 18) children, aged 7-12 years, participated in a Lego-building task with their mothers, while conversational speech was recorded. Mean F0, pitch range, pitch variability, and amount of spontaneous speech were calculated for each child and their mother. RESULTS: The results indicated no differences in speech characteristics across autistic and non-autistic children, or across their mothers, suggesting that conversational context may have large effects on whether differences between autistic and non-autistic populations are found. However, variability in social competence within the group of non-autistic children (but not within autistic children) was predictive of children's mean F0, pitch range and pitch variability. The amount of spontaneous speech produced by mothers (but not their prosody) predicted their autistic children's social competence, which may suggest a heightened impact of scaffolding for mothers of autistic children. CONCLUSION: Together, results suggest complex interactions between context, social competence, and adaptive parenting strategies in driving prosodic differences in children's speech.

Prefrontal Cortex Responses to Social Video Stimuli in Young Children with and without Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting individuals worldwide and characterized by deficits in social interaction along with the presence of restricted interest and repetitive behaviors. Despite decades of behavioral research, little is known about the brain mechanisms that influence social behaviors among children with ASD. This, in part, is due to limitations of traditional imaging techniques specifically targeting pediatric populations. As a portable and scalable optical brain monitoring technology, functional near infrared spectroscopy (fNIRS) provides a measure of cerebral hemodynamics related to sensory, motor, or cognitive function. Here, we utilized fNIRS to investigate the prefrontal cortex (PFC) activity of young children with ASD and with typical development while they watched social and nonsocial video clips. The PFC activity of ASD children was significantly higher for social stimuli at medial PFC, which is implicated in social cognition/processing. Moreover, this activity was also consistently correlated with clinical measures, and higher activation of the same brain area only during social video viewing was associated with more ASD symptoms. This is the first study to implement a neuroergonomics approach to investigate cognitive load in response to realistic, complex, and dynamic audiovisual social stimuli for young children with and without autism. Our results further confirm that new generation of portable fNIRS neuroimaging can be used for ecologically valid measurements of the brain function of toddlers and preschool children with ASD.

Managing social-educational robotics for students with autism spectrum disorder through business model canvas and customer discovery.

Social-educational robotics, such as NAO humanoid robots with social, anthropomorphic, humanlike features, are tools for learning, education, and addressing developmental disorders (e.g., autism spectrum disorder or ASD) through social and collaborative robotic interactions and interventions. There are significant gaps at the intersection of social robotics and autism research dealing with how robotic technology helps ASD individuals with their social, emotional, and communication needs, and supports teachers who engage with ASD students. This research aims to (a) obtain new scientific knowledge on social-educational robotics by exploring the usage of social robots (especially humanoids) and robotic interventions with ASD students at high schools through an ASD student-teacher co-working with social robot-social robotic interactions triad framework; (b) utilize Business Model Canvas (BMC) methodology for robot design and curriculum development targeted at ASD students; and (c) connect interdisciplinary areas of consumer behavior research, social robotics, and human-robot interaction using customer discovery interviews for bridging the gap between academic research on social robotics on the one hand, and industry development and customers on the other. The customer discovery process in this research results in eight core research propositions delineating the contexts that enable a higher quality learning environment corresponding with ASD students' learning requirements through the use of social robots and preparing them for future learning and workforce environments.

The relationship between gamma-band neural oscillations and language skills in youth with Autism Spectrum Disorder and their first-degree relatives.

BACKGROUND: Most children with Autism Spectrum Disorder (ASD) have co-occurring language impairments and some of these autism-specific language difficulties are also present in their non-autistic first-degree relatives. One of the possible neural mechanisms associated with variability in language functioning is alterations in cortical gamma-band oscillations, hypothesized to be related to neural excitation and inhibition balance. METHODS: We used a high-density 128-channel electroencephalography (EEG) to register brain response to speech stimuli in a large sex-balanced sample of participants: 125 youth with ASD, 121 typically developing (TD) youth, and 40 unaffected siblings (US) of youth with ASD. Language skills were assessed with Clinical Evaluation of Language Fundamentals. RESULTS: First, during speech processing, we identified significantly elevated gamma power in ASD participants compared to TD controls. Second, across all youth, higher gamma power was associated with lower language skills. Finally, the US group demonstrated an intermediate profile in both language and gamma power, with nonverbal IQ mediating the relationship between gamma power and language skills. LIMITATIONS: We only focused on one of the possible neural contributors to variability in language functioning. Also, the US group consisted of a smaller number of participants in comparison to the ASD or TD groups. Finally, due to the timing issue in EEG system we have provided only non-phase-locked analysis. CONCLUSIONS: Autistic youth showed elevated gamma power, suggesting higher excitation in the brain in response to speech stimuli and elevated gamma power was related to lower language skills. The US group showed an intermediate pattern of gamma activity, suggesting that the broader autism phenotype extends to neural profiles.

Human-derived fecal microbiota transplantation alleviates social deficits of the BTBR mouse model of autism through a potential mechanism involving vitamin B6 metabolism.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by social communication deficiencies and stereotypic behaviors influenced by hereditary and/or environmental risk factors. There are currently no approved medications for treating the core symptoms of ASD. Human fecal microbiota transplantation (FMT) has emerged as a potential intervention to improve autistic symptoms, but the underlying mechanisms are not fully understood. In this study, we evaluated the effects of human-derived FMT on behavioral and multi-omics profiles of the BTBR mice, an established model for ASD. FMT effectively alleviated the social deficits in the BTBR mice and normalized their distinct plasma metabolic profile, notably reducing the elevated long-chain acylcarnitines. Integrative analysis linked these phenotypic changes to specific Bacteroides species and vitamin B6 metabolism. Indeed, vitamin B6 supplementation improved the social behaviors in BTBR mice. Collectively, these findings shed new light on the interplay between FMT and vitamin B6 metabolism and revealed a potential mechanism underlying the therapeutic role of FMT in ASD.IMPORTANCEAccumulating evidence supports the beneficial effects of human fecal microbiota transplantation (FMT) on symptoms associated with autism spectrum disorder (ASD). However, the precise mechanism by which FMT induces a shift in the microbiota and leads to symptom improvement remains incompletely understood. This study integrated data from colon-content metagenomics, colon-content metabolomics, and plasma metabolomics to investigate the effects of FMT treatment on the BTBR mouse model for ASD. The analysis linked the amelioration of social deficits following FMT treatment to the restoration of mitochondrial function and the modulation of vitamin B6 metabolism. Bacterial species and compounds with beneficial roles in vitamin B6 metabolism and mitochondrial function may further contribute to improving FMT products and designing novel therapies for ASD treatment.

Specialization of anterior and posterior hippocampal functional connectivity differs in autism.

Structural and functional differences in the hippocampus have been related to the episodic memory and social impairments observed in autism spectrum disorder (ASD). In neurotypical individuals, hippocampal-cortical functional connectivity systematically varies between anterior and posterior hippocampus, with changes observed during typical development. It remains unknown whether this specialization of anterior-posterior hippocampal connectivity is disrupted in ASD, and whether age-related differences in this specialization exist in ASD. We examined connectivity of the anterior and posterior hippocampus in an ASD (N = 139) and non-autistic comparison group (N = 133) aged 5-21 using resting-state functional magnetic resonance imaging (MRI) data from the Healthy Brain Network (HBN). Consistent with previous results, we observed lower connectivity between the whole hippocampus and medial prefrontal cortex in ASD. Moreover, preferential connectivity of the posterior relative to the anterior hippocampus for memory-sensitive regions in posterior parietal cortex was reduced in ASD, demonstrating a weaker anterior-posterior specialization of hippocampal-cortical connectivity. Finally, connectivity between the posterior hippocampus and precuneus negatively correlated with age in the ASD group but remained stable in the comparison group, suggesting an altered developmental specialization. Together, these differences in hippocampal-cortical connectivity may help us understand the neurobiological basis of the memory and social impairments found in ASD.

Replicative Study of the Impacts of Applied Behavior Analysis on Target Behaviors in Individuals With Autism Using Repeated Measures.

Background  The effectiveness of interventions based on applied behavior analysis (ABA) for individuals with autism has been well documented in numerous meta-analyses, systematic reviews, and cost-benefit analyses. However, an observed 'efficacy-effectiveness gap' exists, which can be attributed to various factors. This third replication study, therefore, has significant implications for the field. By assessing the impact of ABA treatment, specifically involving discrete trial training and mass trials, within a naturalistic environment, the study provides valuable insights that can inform and improve the delivery of ABA treatments in real-world settings. Methods  The study was conducted using a repeated measures research design. Retrospective chart review data were collected from 62 individuals with autism, age (M=8.65, SD=4.53), all of whom were level two autistic and required moderate support in communication, socialization, and daily life. These individuals received ABA treatment over five months. The study measured cumulative target behaviors using a repeated measures design, which allowed for the identification of statistically significant differences across 12 time points. This robust methodology ensures the validity and reliability of the study's findings. Results  Mixed repeated measures analysis of variance (ANOVA) indicated statistical significance (sphericity assumed), F(11,495) = 55.432, p < 0.001 (time). Multiple comparisons using bootstrapped paired t-tests showed p < 0.05 on time points 1-8 and non-significance (p > 0.05) on time points 9-12. There was a significant interaction effect (sphericity assumed) with time x (age category), F(44,495) = 2.338, p < 0.001. Interaction contrasts indicated statistically significant differences over time, mainly within the one-year to four-year-old, five to eight-year-old, and most in the nine to 12-year-old age groups. There was some significance within the 13- to 16-year-old age group and no significance within the 17- to 26-year-old age group. Conclusions  Over five months, individuals with autism who underwent ABA treatments demonstrated a statistically significant enhancement in general target behaviors. This finding is crucial as it underscores the effectiveness of ABA treatments in a naturalistic environment. Moreover, the study's discovery of a significant interaction between time and age in these behaviors provides valuable insights into the impact of age on treatment outcomes. Extensive large-N studies of general ABA broad effectiveness and repeated measures designs are lacking and can lead to further research to improve quality and outcomes. These findings contribute to the body of empirical evidence and emphasize the importance of replicative efficacy studies in ensuring the reliability of research findings.

The Effects of Applied Behavior Analysis on Verbal Behavior With Autistic Individuals Using the Verbal Behavior Milestones Assessment and Placement Program (VBMAPP) and the Assessment of Basic Language and Learning Skills (ABLLS).

Introduction  Applied behavior analysis (ABA) is a fundamental practice-based intervention for treating autism spectrum disorder (ASD). Few studies have directly measured and evaluated the effects of ABA on verbal behaviors, mainly using the Verbal Behavior Milestones Assessment and Placement Program (VBMAPP) and the Assessment of Basic Language and Learning Skills (ABLLS) as outcome measures. This study aims to fill this gap by examining the relationship between ABA interventions and the enhancement of verbal skills, as measured by the VBMAPP and the ABLLS, in a convenience sample of individuals with ASD.  Materials and methods At The Oxford Centers (TOCs) in Brighton and Troy, Michigan, USA, 33 individuals with autism received treatment from January 2018 to July 2021, spanning 43 months. A pretest-posttest design was employed to retrospectively examine any impacts between ABA interventions and alterations in verbal scores among individuals with ASD. Depending on developmental age, all subjects underwent two verbal assessments with a six-month interval in-between. Twelve children were administered the VBMAPP, while 21 were given the ABLLS. Results Paired t-tests for pretest and posttest VBMAPP subscales resulted in statistically significant effects (p<0.05) for (VBMAPP - Mand), (VBMAPP - Tact), (VBMAPP - Listener Responding), (VBMAPP - Visual Perceptual Skills and Matching-to-Sample), (VBMAPP -Independent Play), (VBMAPP - Social Play), (VBMAPP - Motor Imitation), (VBMAPP - Spontaneous Vocalization), (VBMAPP - Intraverbal), (VBMAPP - Group Behavior), and (VBMAPP - Linguistic Structure). As measured by Cohen's d, effect sizes were moderate to mostly high (-0.623 to -1.688). There were non-significant results (p>0.05) for (VBMAPP - Listener Responding by Feature, Function, and Class) and (VBMAPP - Echoic). Paired t-tests for pretest and posttest ABLLS subscales resulted in statistically significant effects (p<.05) for all ABLLS scales: (ABLLS - Receptive Language), (ABLLS - Requests), (ABLLS - Labeling), (ABLLS - Intraverbals), (ABLLS - Spontaneous Vocalizations), (ABLLS - Syntax Grammar), (ABLLS - Social Interactions), and (ABLLS - Generalized Responding). As measured by Cohen's d, effect sizes were moderate to mostly high (-0.656 to -1.372). Conclusions  The administration of ABA treatments had a noteworthy influence, with statistically significant impacts on improving verbal behaviors on 11 of the 13 VBMAPP scales and all of the ABLLS scales. As measured by Cohen's d, effect sizes were moderate to high for both scales. These findings underscore the importance and effectiveness of ABA interventions in enhancing verbal skills in children with ASD. However, it's crucial to note that further confirmatory studies are required to verify the reliability of these original findings, emphasizing the ongoing need for research in this field.

Shared and Specific Neural Correlates of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder: A Meta-Analysis of 243 Task-Based Functional MRI Studies.

OBJECTIVE: To investigate shared and specific neural correlates of cognitive functions in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), the authors performed a comprehensive meta-analysis and considered a balanced set of neuropsychological tasks across the two disorders. METHODS: A broad set of electronic databases was searched up to December 4, 2022, for task-based functional MRI studies investigating differences between individuals with ADHD or ASD and typically developing control subjects. Spatial coordinates of brain loci differing significantly between case and control subjects were extracted. To avoid potential diagnosis-driven selection bias of cognitive tasks, the tasks were grouped according to the Research Domain Criteria framework, and stratified sampling was used to match cognitive component profiles. Activation likelihood estimation was used for the meta-analysis. RESULTS: After screening 20,756 potentially relevant references, a meta-analysis of 243 studies was performed, which included 3,084 participants with ADHD (676 females), 2,654 participants with ASD (292 females), and 6,795 control subjects (1,909 females). ASD and ADHD showed shared greater activations in the lingual and rectal gyri and shared lower activations in regions including the middle frontal gyrus, the parahippocampal gyrus, and the insula. By contrast, there were ASD-specific greater and lower activations in regions including the left middle temporal gyrus and the left middle frontal gyrus, respectively, and ADHD-specific greater and lower activations in the amygdala and the global pallidus, respectively. CONCLUSIONS: Although ASD and ADHD showed both shared and disorder-specific standardized neural activations, disorder-specific activations were more prominent than shared ones. Functional brain differences between ADHD and ASD are more likely to reflect diagnosis-related pathophysiology than bias from the selection of specific neuropsychological tasks.

Prenatal exposure to valproic acid reduces synaptic δ-catenin levels and disrupts ultrasonic vocalization in neonates.

Valproic acid (VPA) is an effective and commonly prescribed drug for epilepsy and bipolar disorder. However, children born from mothers treated with VPA during pregnancy exhibit an increased incidence of autism spectrum disorder (ASD). Although VPA may impair brain development at the cellular level, the mechanism of VPA-induced ASD has not been completely addressed. A previous study has found that VPA treatment strongly reduces δ-catenin mRNA levels in cultured human neurons. δ-catenin is important for the control of glutamatergic synapses and is strongly associated with ASD. VPA inhibits dendritic morphogenesis in developing neurons, an effect that is also found in neurons lacking δ-catenin expression. We thus hypothesize that prenatal exposure to VPA significantly reduces δ-catenin levels in the brain, which impairs glutamatergic synapses to cause ASD. Here, we found that prenatal exposure to VPA markedly reduced δ-catenin levels in the brain of mouse pups. VPA treatment also impaired dendritic branching in developing mouse cortical neurons, which was partially reversed by elevating δ-catenin expression. Prenatal VPA exposure significantly reduced synaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor levels and postsynaptic density 95 (PSD95) in the brain of mouse pups, indicating dysfunctions in glutamatergic synaptic transmission. VPA exposure also significantly altered ultrasonic vocalization (USV) in newly born pups when they were isolated from their nest. Moreover, VPA-exposed pups show impaired hypothalamic response to isolation, which is required to produce animals' USVs following isolation from the nest. Therefore, these results suggest that VPA-induced ASD pathology can be mediated by the loss of δ-catenin functions.

Parents' perceptions of the impact of the novel coronavirus (COVID-19) on the eating behaviors and routines of children with autism spectrum disorders (ASD).

Background: Restricted interests and repetitive behavior are characteristics of autism spectrum disorder (ASD). The likelihood that persons with ASD will respond adversely to unfamiliar situations is great. The novel coronavirus outbreak has resulted in disruptions to all aspects of routine and behavior. Hence, this study proposed to investigate the impact of the outbreak on the eating behavior and routines of children with ASD in Saudi Arabia through the perceptions of their parents. Method: A cross-sectional study with a quantitative approach was utilized to obtain data from 150 parents of children with ASD aged ≤18 years in Saudi Arabia. The data collected included demographic data of the parents, the ASD status of the family, impact of COVID-19 to the family, eating behavior of the children with ASD, and daily routines of the children with ASD. Moreover, parents were able to provide comments regarding their children's eating behavior or daily routines. Results: The study found that changes in the eating behavior of children with ASD were found to differ significantly (p<0.05) based on the number of children with ASD, the age of the children with ASD, the gender of the children with ASD, and the severity of their ASD symptoms. Moreover, changes to dinner-time routines were found to differ significantly (p<0.05) based on the age of the children with ASD. Also, changes to morning routines were found to differ significantly (p<0.05) based on the age of the children with ASD, their gender, and the severity of their ASD symptoms. Additionally, impact of COVID-19 to the family had a significant impact to eating behavior and daily routines of the children with ASD. Conclusion: This study found that the eating behavior and daily routines of children with ASD in Saudi Arabia have been considerably worsened and changed. The study recommends the collaboration of multidisciplinary teams and parents to modify or design interventions that help to change their eating behavior and routine can be implemented in the home. It also recommends the provision of virtual helplines to aid parents of children with ASD in such cases.

The Effectiveness of Sensory-Motor Integration Exercises on Social Skills and Motor Performance in Children with Autism.

PURPOSE: The current study aims to investigate the effectiveness of sensory-motor integration exercises on social skills and motor performance in children with autism spectrum disorder (ASD). METHODS: This is a quasi-experimental study with a pre-test-post-test design and with a control group. The statistical population of this research included all children with ASD aged 9-11 years old in Babolsar city in 2022, among whom 30 were selected through convenient sampling from the transplant center of Babolsar, and were randomly assigned into two experimental and control groups. Then, the experimental group received the treatment program in 12 sessions. The data collection instrument included Gresham and Elliott's social skills questionnaire (Gresham FM, Elliott SN (1993) Social skills intervention guide: systematic approaches to social skills training. Spec Serv Sch 8(1):137-158) and Ulrich's motor performance test (Ulrich B, Ulrich D (1985) The role of balancing ability in performance of fundamental motor skills in 3-, 4-, and 5-year-old children. Motor Dev: Curr Select Res 1:87-97). Data analysis was conducted using covariance analysis in SPSS21. RESULTS: The multivariate covariance analysis test showed that there is a significant difference between the experimental and control groups in the variable of social skills and motor performance, respectively (P < 0.001). CONCLUSION: According to the research findings, it can be concluded that sensory-motor integration exercises can be used as an appropriate intervention in promoting and improving social skills and motor performance of children with autism spectrum. Results of this study can be helpful for therapists and educators who deal with autistic children.

A Descriptive Study on the Impacts of Hyperbaric Oxygen Therapy on Autistic Individuals Using Parent Testimonies.

Introduction Hyperbaric oxygen therapy (HBOT) has been influential in treating many physical and psychological ailments, including the symptoms of autism. This current study aims to evaluate HBOT parents' goals and exit interviews describing the positive, negative, or no impacts experienced from the HBOT dives, asking the question, "Are your child's symptoms improving?" Methods Between January 2020 and July 2023, a Class B monoplace hyperbaric chamber (Sechrist 3300H, Sechrist Industries, Inc., Anaheim, California, United States) was used to administer HBOT sessions to patients with autism. Medical-grade oxygen was pressurized to 1.5-2.0 atmospheres absolute at a rate of 1-2 psi/min, with an average oxygen percentage of 100%, for up to five sessions per week. Retrospective descriptive data and patient information through parent testimonials were collected through a chart review of 30 children and one adult with autism who experienced HBOT sessions. Data were presented through exit interviews describing how parents felt about their child's progress toward goals. Four raters rated parent testimonies on a 5-point Likert scale (1 = Much worse, 2 = Somewhat worse, 3 = Stayed the same, 4 = Somewhat improved, and 5 = Much improved), and an inter-rater reliability estimate using interclass correlation (2) (r = 0.831) was derived, indicating excellent agreement between raters. Results Parents/caregivers provided testimony in an exit interview with a registered nurse after the individual with autism received an entire course of HBOT dives. Descriptive statistics resulted in Rater #1 (M = 4.19, median = 4, SD = 0.654): 87.1% of Rater #1 ratings were Somewhat improved and Much improved; Rater #2 (M = 4.23, median = 4, SD = 0.717): 83.9% of Rater #2 ratings were Somewhat improved and Much improved; Rater #3 (M = 4.23, median = 4, SD = 0.560): 93.5% of Rater #3 ratings were Somewhat improved and Much improved; and Rater #4 (M = 4.26, median = 4, SD = 0.631): 90.3% of Rater #4 ratings were Somewhat improved and Much improved. One-way ANOVA resulted in F (3,123) = 0.052, p = 0.984, which indicated a nonstatistically significant mean difference between rater groups. Conclusions The current study assessed HBOT parents'/caregivers' goals and exit interviews, describing the effects experienced from the complete course of HBOT dives on their children/individuals. A majority of parents/caregivers declared that their condition had "Much improved" or "Somewhat improved," based on the 5-point Likert scale. Based on parents'/caregivers' testimonies, HBOT was demonstrated as a safe and effective intervention, and side effects were primarily mild and did not lead to treatment discontinuation. As a result of this analysis, we recommend continued use of HBOT for treatment.

Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework.

Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.

Associations of neighborhood greenspace, and active living environments with autism spectrum disorders: A matched case-control study in Ontario, Canada.

BACKGROUND: Increasing evidence links early life residential exposure to natural urban environmental attributes and positive health outcomes in children. However, few studies have focused on their protective effects on the risk of autism spectrum disorder (ASD). The aim of this study was to investigate the associations of neighborhood greenspace, and active living environments during pregnancy with ASD in young children (≤6 years). METHODS: We conducted a population-based matched case-control study of singleton term births in Ontario, Canada for 2012-2016. The ASD and environmental data was generated using the Ontario Autism Spectrum Profile, the Better Outcomes Registry & Network Ontario, and Canadian Urban Environmental Health Research Consortium. We employed conditional logistic regressions to estimate the odds ratio (OR) between ASD and environmental factors characterizing selected greenspace metrics and neighborhoods conducive to active living (i.e., green view index (GVI), normalized difference vegetation index (NDVI), tree canopy, park proximity and active living environments index (ALE)). RESULTS: We linked 8643 mother-child pairs, including 1554 cases (18%). NDVI (OR 1.034, 0.944-1.024, per Inter Quartile Range [IQR] = 0.08), GVI (OR 1.025, 95% CI 0.953-1.087, per IQR = 9.45%), tree canopy (OR 0.992, 95% CI 0.903-1.089, per IQR = 6.24%) and the different categories of ALE were not associated with ASD in adjusted models for air pollution. In contrast, living closer to a park was protective (OR 0.888, 0.833-0.948, per 0.06 increase in park proximity index), when adjusted for air pollution. CONCLUSIONS: This study reported mixed findings showing both null and beneficial effects of green spaces and active living environments on ASD. Further investigations are warranted to elucidate the role of exposure to greenspaces and active living environments on the development of ASD.