Anti-Herpes Zoster Vaccination of Fragile Patients in Hospital Setting: A Nudge Intervention in Italy.

BACKGROUND: A nudge intervention against Herpes Zoster, created and implemented in Italy, is presented in order to administer the Shingrix vaccine on a sample of frail patients, as required by the National Prevention Plan. Individual and contextual factors associated with vaccine adherence were investigated. METHOD: 300 frail adult subjects underwent a full vaccine cycle with recombinant-Shingrix vaccine (RZV vaccine). Hospital Presidia of the Salerno University Hospital Authority, a Hospital Presidium of the Salerno Local Health Authority, and the Public Health Laboratory of the University of Salerno (Campania) participated in the intervention. An ad hoc questionnaire was administered with the following scales: EQ-5D, PSS-10, MSPSS, and representations of HZ and its consequences. RESULTS: Some variables, such as peer support, doctor-patient relationship, level of education, and perception of health, are important in vaccine adherence and information processing. The following factors emerged from the factor analysis: Trust in collective knowledge and collective responsibility (F1); beliefs about virus risk and vaccine function (F2); information about virus and symptomatology (F3); and vaccine distrust (F4). Factor 4 correlates negatively with social support indices (R = -0.363; p < 0.001). There is a significant relationship between factor 3 and satisfaction with national information campaigns (F = 3.376; gdl = 5; p-value = 0.006). CONCLUSIONS: Future vaccination campaigns should be built with the aim of personalizing information and developing contextualized strategies, starting from understanding the stakeholders involved, cultural contexts, and organizational settings.

Perceptions and Expectations of Youth Regarding the Respect for Their Rights in the Hospital.

Information obtained from children themselves regarding the characteristics of the ideal hospital that ensure well-being during a hospital stay is scarce. Here, we report the opinions, perceptions, and expectations of 700 children and adolescents about their experiences, assessed through a mixed-method research approach with age-appropriate questionnaires, three open-ended questions, and an analysis of optional pictorial and textual narratives. Most children indicated that, while they acknowledged the expertise of hospital staff, they also noted several shortcomings, e.g., insufficiently understandable medical information as well as emotional and cognitive support. The continuity of schooling and the right to suffer as little as possible were also critical issues. Adolescents valued in particular the quality of care and services provided, the hospital's adherence to equality and non-discrimination rights, and protection systems but negatively perceived several aspects related to play and participation. Significant differences in the co-occurrences of the most frequently used text terms with the keywords "hospital" and "child/adolescent" between age groups highlight variations in the way patients perceive and articulate their experiences within the hospital setting depending on the cognitive processes linked to age. In drawings, prevailing attention was placed on the physical context of the hospital room, with figures expressing mostly negative emotions. Specifically, in this regard, the main emotion in children was sadness, and, in adolescents, it was fear. Overall, these insights are pivotal in the context of our research objectives as they shed light on the nuanced preferences, needs, and perspectives of children and adolescents during their hospital stays. Recognizing the identified shortcomings, we propose recommendations emphasizing the improvement of medical communication clarity, enhancement of emotional and cognitive support, and the improvement of programs to avoid instructional gaps during hospital stays. Addressing these specific needs is critical for a more comprehensive approach to pediatric healthcare provision.

Gut-Brain Interaction Disorders and Anorexia Nervosa: Psychopathological Asset, Disgust, and Gastrointestinal Symptoms.

BACKGROUND: Gastrointestinal (GI) symptoms are very common in subjects with eating disorders (EDs). This study aimed to (a) investigate the prevalence of gut-brain interaction disorders (DGBIs) in anorexia nervosa (AN) patients, according to ROME IV criteria; and (b) explore AN psychopathological assets and disgust that might impact GI symptoms. METHODS: Thirty-eight female patients consecutively diagnosed with untreated AN (age 19.32 ± 5.59) in an outpatient clinic devoted to EDs underwent Eating Disorder Inventory-3 (EDI-3), Hospital Anxiety and Depression Scale (HADS), Social Phobia Anxiety Scale (SPAS), Body Uneasiness Test (BUT), and Disgust Scale (DS) questionnaires. The presence of DGBIs was evaluated and GI symptoms were assessed using a standardized intensity-frequency questionnaire. RESULTS: A total of 94.7% of our sample met the diagnostic criteria for functional dyspepsia (FD), of which 88.8% presented the postprandial distress syndrome (PDS) subtype and 41.6% presented the epigastric pain syndrome (EPS) subtype. In addition, 52.6% of the sample met the diagnostic criteria for irritable bowel syndrome (IBS), while for functional constipation (FC), prevalence reached 7.9%. All participants presented a pathological score on the disgust scale. Significant correlations were found between several GI symptoms and psychopathological asset and disgust. CONCLUSIONS: AN is a multifactorial disorder. It is necessary to implement studies with an integrated approach, taking into account DGBIs, as well as to monitor the emotional-cognitive structure that acts as a factor in maintaining the disorder.

Individual and Contextual Determinants of Flu Vaccination Adherence: A University Nudge Intervention.

INTRODUCTION: The University of Salerno has implemented a nudge intervention with the aim of promoting vaccine adherence among employees of academia and identifying individual and contextual determinants that influence adherence. METHOD: A purpose-built questionnaire was used during the reference period of October-December 2022 in order to assess levels of state anxiety (STAI-Y1), perceived stress (PSS-10), and public sentiments, which influence vaccination behavior, with consequences for the whole population (VCI). RESULTS: Analysis of the results revealed a difference in mean scores on the PSS: those who have always adhered to the vaccination campaign compared to those who have never been vaccinated perceived higher levels of stress (12.01 vs. 11.33; F = 4.744, p = 0.031); furthermore, there was a relationship between the presence/absence of pathologies and VCI (F = 3,93; df = 1; p = 0.04). CONCLUSIONS: The University of Salerno's nudge intervention made its employees more responsible for protecting the health of the academic community and encouraged good adherence to the flu vaccination campaign. University employees, equipped with high cultural tools, sought information primarily from institutional sources indicated by the university during the free vaccination campaign at the university's vaccine center.

Post-Traumatic Play in Child Victims of Adverse Childhood Experiences: A Pilot Study with the MCAST-Manchester Child Attachment Story Task and the Coding of PTCP Markers.

Background: Play is among the most frequently observed distorted behaviors in victims of Adverse Childhood Experiences (ACEs). Terr's (1981) studies helped to describe this behavioral distortion as post-traumatic child's play (PTCP). This study aimed to evaluate whether child victims of Adverse Childhood Experiences (ACEs) engaging in semi-structured play present the markers of post-traumatic child's play (PTCP) during the administration of the Manchester Child Attachment Story Task (MCAST), whose playful stories activate the attachment system. Methods: The sample comprised 17 child victims of ACEs (mean age = 6.76). Children were evaluated using the Manchester Child Attachment Story Task. Results: The analysis of the play clearly revealed the presence of markers associated with the characteristics of the post-traumatic play described by Terr (1981), namely, repetition, revisiting, hyperarousal, and danger. In particular, the intrusiveness dimension was observed, which can be identified in the post-traumatic play by the presence of recurrent memories, dreams, and dissociative symptoms. Conclusions: Post-traumatic play is characterized by repetition, containing aspects, scenes, or sequences of the traumatic event, expressed explicitly or symbolically.

Negative/Positive Emotions, Perceived Self-Efficacy and Transition to Motherhood during Pregnancy: A Monitoring Study.

BACKGROUND: Several studies have investigated the topic of emotion regulation and self-perception in women during pregnancy, which turns out to be a critical event for the woman approaching psycho-physical changes. The objectives of the study were the evaluation and monitoring, during pregnancy, of emotional states and levels of self-efficacy and the analysis of the representations of self and the child. METHODS: Twenty women (M = 34.60; SD = 4.60) in the 28-week gestation period participated in the research. We performed three administrations (T0-1-2) of an ad hoc questionnaire containing: personal data; Maternal Representations in Pregnancy Interview-IRMAG; Multidimensional Emotion Questionnaire-MEQ; Perceived Self-Efficacy in Complex Situations Scale. RESULTS: Both qualitative and quantitative analyses show that the future mother's strategies and functional resources focus on perceiving herself as effective in the acquired role, despite the pregnancy itself being a highly stressful critical event. Positive emotions tend to increase, just as the frequency, intensity, persistence and regulation of emotion undergo a linear and constant increase with respect to the first and second administration. CONCLUSIONS: Qualitative research has produced significant results with regard to the representations of mothers-to-be as they attempt to cope with states of change during pregnancy with their own personal adaptive resources.

Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents' Representation of the Problem and Management of the Disorder.

BACKGROUND: This study explores the implicit theories by which primary caregivers (PC) of patients diagnosed with anorexia nervosa (AN) understand the eating disorder and interpret their role in treating and managing the problem. METHODOLOGY: In-depth, semi-structured, and open interview questions were used to achieve the study's goals. In total, 19 caregivers, 16 mothers, and three fathers (mean age: 50.74; SD: 5.248) from a public service for the treatment of behavioral disorders in southern Italy were interviewed. A lexical correspondence analysis (LCA) was applied to the verbatim transcripts to identify the main factorial dimensions, which organize similarity and dissimilarity in the collected discourses. RESULTS: The first dimension represents the dialectic between two different models of explanation of the problem, and the second dimension represents the dialectic between two different perspectives on the attribution of responsibility. Overall, the analyses show the difficulties of PC in exploring the emotional dynamics of the problem and the tendency to take out of the family context every possible representation of the role that it can play in the maintenance and evolution of the disorder. CONCLUSIONS: The strategies to prevent and treat AN may benefit from knowledge of the meaning's lenses adopted by the primary caregivers to explain and cope with their daughters' illness.

Anti-SARS-CoV-2 Vaccination Campaign: Risk Perception, Emotional States, and Vaccine Hesitancy in a Sample of Adolescents' Vaccinated Parents in Southern Italy.

BACKGROUND: The international strategic plan for COVID-19 vaccines remains the practical option for the protection of health. However, vaccine hesitancy remains an obstacle to full population vaccination, with rapid developments in COVID-19 vaccines and concerns about efficacy acting as influencing factors. AIM: The present study investigated the perception of vaccine hesitancy among parents of adolescents in order to explore the reasons and related emotional states. METHODS: In January-March 2022, an online questionnaire was administered to a sample of parents who brought their children to the vaccine center of a local health unit, ASL Salerno (Campania, Italy). RESULTS: The participants were 1105 parents (F = 64.6%; mean age = 47.37 years, SD = 7.52) of adolescents (F = 47.6%; mean age = 14.83 years, SD = 1.72). All parents had received the COVID-19 vaccine. Regarding the vaccination schedule, 46.8% believed that children receive more vaccinations than they should; 25.1% believed that it is better to develop immunity rather than get vaccinated; 41.2% believed that their child could have side effects; 29.6% were very concerned that vaccines were unsafe, while 35.3% believed vaccines do not prevent disease; 21.5% were very reluctant about pediatric vaccines; and 23.8% did not trust the information received. CONCLUSIONS: In order to increase vaccination and reduce the prevalence of vaccine hesitancy, it is essential to support the value of vaccination among all parents and make information more accessible and usable through competent pediatricians.

The Multilevel Pathway in MSTs for the Evaluation and Treatment of Parents and Minor Victims of ACEs: Qualitative Analysis of the Intervention Protocol.

BACKGROUND: Adverse childhood experiences (ACEs) may be an important risk factor for the onset of developmental psychopathological disorders. Families involved in ACEs are often the subject of social or welfare policies aimed solely at the victim, without a proper consideration of family functionality. METHODS: We describe the results of an Italian intervention project, which aimed to reinforce both the local networking of the Campania region, and the skills of the operators involved in actions to prevent and combat ACEs. The project was characterized by different phases and two actions, namely: (1) diagnosis and therapy aimed at child victims of ACEs and their families; (2) supervision of the operators of the multidisciplinary specialized teams (MSTs). RESULTS: 99% of the cases under review were characterized by intra-family violence; 34% suffered psychological abuse, 33% neglect, 23% inappropriate care, 4% sexual abuse, 3% excessive care and 3% physical abuse. CONCLUSIONS: Thanks to the interventions carried out, severe and chronic ACE situations were recognized, and processes of de-institutionalization and the construction of life projects were carried out in accordance with the territorial services. This offered child victims and their families an opportunity to restore the conditions of well-being, both for the growth of the individual and the family system.

Chronic Stress and Depression in Periodontitis and Peri-Implantitis: A Narrative Review on Neurobiological, Neurobehavioral and Immune-Microbiome Interplays and Clinical Management Implications.

Besides the well-known systemic factors for periodontal and peri-implant diseases, additional co-factors, such as chronic stress and depression, may also affect disease onset and progression as well as treatment responsiveness. Neurobiological and neurobehavioral pathogenic links between chronic stress and depression, on the one side, and periodontitis and peri-implantitis, on the other side, which have been little investigated and principally related to necrotizing periodontal disease, have been reviewed, along with their putative interconnections with periodontal immune-microbiome balance. Rising evidence suggest that dysregulated neurobiological and neurobehavioral factors, as well as periodontal immune-microbiome unbalance, all related to chronic stress and depression, may crucially interact and thus represent contributing factors in the genesis and worsening not only of necrotizing periodontal lesions, but also of chronic periodontitis and peri-implantitis. Such potential interconnections may be even more relevant in recurrent and aggressive cases of periodontal and peri-implant disease, which are frequently refractory to therapy, and may, if corroborated, coherently pave the way for personalized prevention and treatment strategies, possibly targeting immune-microbiome unbalance and neurobehavioral factors and focusing on neurobiological ones, especially in chronically stressed and depressed subjects with periodontitis and peri-implantitis.

Burnout and Psychological Vulnerability in First Responders: Monitoring Depersonalization and Phobic Anxiety during the COVID-19 Pandemic.

BACKGROUND: It is common knowledge that first responders are among the helping professionals most at risk of burnout and psychological vulnerability. During the COVID-19 pandemic, their mental health has been subjected to various risk factors. METHODS: Data on socio-demographic characteristics, the Maslach Burnout Inventory (MBI) and psychological vulnerability (SCL-90-R) were obtained from 228 subjects (55.3% female; M age = 45.23, SD = 13.14) grouped on the basis of their actual involvement during the emergency phases (82% First Responders and 18% Second Responders). RESULTS: First responders exceeded the MBI clinical cut-off, while SRs did not (χ² ≥ 0.5); specifically, EE = 89.8%, DP = 85.8%, and PA = 82.1%. The FR group showed a higher mean in the global severity index (GSI = 49.37) than did the SRs (=43.95), and the FR group exceeded the clinical cut-off in the SCL-90-R scales of SOM (51.06), ANX (52.40), and PHOB (53.60), while the SF group did so only for the PHOB scale (50.41). The MBI dimensions correlated significantly (p = 0.05) with all investigated clinical scales of the SCL-90-R. CONCLUSIONS: Emergency situations expose first responders to specific risk factors related to work performance and relational aspects, which contribute to increased psychological vulnerability and burnout.

Vaccine Hesitancy and the Green Digital Pass: A Study on Adherence to the Italian COVID-19 Vaccination Campaign.

BACKGROUND: In July 2021, the vaccination campaign in Italy suffered a sudden setback, and the number of vaccine administrations decreased dramatically. On 20 July 2021, the obligation of the Green Digital Pass came into force in order to access work and leisure places, penalizing those who had not been vaccinated. The purpose of this work was to investigate the phenomenon of vaccination hesitancy and the underlying reasons, as well as any changes to the membership following the obligation of the Green Pass. METHODS: A total of 83 subjects (45.8% F; mean age 22.24 ± 4.308) participated in the survey during the post-vaccine observation phase at the Vaccinal Center of the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" (Salerno, Italy). The questionnaire collected anamnestic information, as well as data on state anxiety (STAI-Y), perception of quality of life (SF-12), perception of COVID-19 risks, and vaccine hesitancy. RESULTS: Among participants, 19.3% reported hesitation. The most common concerns about the COVID-19 vaccine concerned safety and efficacy (4.9%) and the obligation of the Green Pass (4.9%). CONCLUSIONS: Findings suggest that delving into the phenomenon of vaccine hesitancy can help to enhance vaccination strategies in order to gain widespread acceptance, a key path to ensuring a quick way out of the current pandemic emergency.

Children on the Autism Spectrum and the Use of Virtual Reality for Supporting Social Skills.

BACKGROUND: Autism spectrum disorders (ASDs) are characterized by differences in socio-pragmatic communication. These conditions are allocated within a "spectrum" of phenotypic variability. Virtual reality (VR) is a useful tool for healthcare intervention and particularly safely advancing social abilities in children with ASD. METHODS: In our study two types of intervention for improving social skills were compared: (i) emotional training obtained by the use of virtual reality (Gr1), (ii) traditional emotional training performed individually with a therapist (Gr2). We aimed to identify the intervention with the shortest acquisition time for the proposed social tasks. RESULTS: Our findings show that both types of intervention had the same acquisition time for the recognition of primary emotions. However, for the use of primary and secondary emotions, the group using VR showed shorter acquisition times. CONCLUSIONS: These findings together with previous preliminary datasuggest that VR can be a promising, dynamic and effective practice for the support of basic and complex social skills of these individuals.

Perception of Health, Mistrust, Anxiety, and Indecision in a Group of Italians Vaccinated against COVID-19.

The objectives of this study were to evaluate the psychological factors of health perception, mistrust, anxiety, fear, and indecision of Italians vaccinated against COVID-19, and conduct an analysis of the relationships between these factors and other variables: sex, vaccine priority ministerial categories, and the type and dose of vaccine. The participants included 1564 subjects who joined the vaccination campaign at the COVID-19 Vaccination Center in Salerno, Italy. A survey was conducted in the reference period March-April 2021 using a brief anamnestic questionnaire. In addition, the following standardized scales were used: the State-Trait Anxiety Inventory (STAI-Y) and the Short Form Health Survey (SF-12). The results showed that, in terms of the type of vaccine received, the interviewees felt more confident in having received the Comirnaty (Pfizer-BioNTech, 23.5%) and Vaxzevria (AstraZeneca, 18.6%) vaccines-feeling less tense (2.1%; Vaxzevria (AstraZeneca) = 3.2%), frightened (1%; Vaxzevria (AstraZeneca) = 1.4%), not at all nervous (61.1%; Vaxzevria (AstraZeneca), 43.6%), and not at all/undecided (67.9%; Vaxzevria (AstraZeneca), 58.6%). Regarding the mood and psychological states considered at the different vaccine administration times, other important differences emerged as the interviewees reported higher levels of tension, nervousness, and fear during the first phase of vaccine administration. Specifically, 40.7% (second dose, 32.7%) felt somewhat tense at the first dose, 26.4% felt frightened (second dose, 21.8%), and 33.8% felt nervous (second dose, 26.8%). The perceived state of health also increased at the end of the vaccination cycle, as, at the second dose, 15.4% of the sample reported an evaluation of "excellent" (first dose, 12.4%).

What does anorexia nervosa mean? Qualitative study of the representation of the eating disorder, the role of the family and treatment by maternal caregivers.

BACKGROUND: Anorexia nervosa is a serious health problem worldwide. The literature widely recognises the roles of the family and caregivers in modulating the onset, development, maintenance and treatment of this disorder. However, few studies have addressed the problem from the perspective of maternal caregivers. AIMS: This study aims to fill this gap by exploring how the meaning given to the term 'eating disorder' influences how mothers communicate with each other about a family member's health problems, how they present symptoms and how this problem is managed. METHOD: A narrative research project was conducted to capture the mothers' experiences of living with a daughter diagnosed with anorexia nervosa. In particular, four semi-structured interviews were conducted to explore the ways in which they made sense of the disorder, their roles in treatment and their daughters' treatment experiences. RESULTS: The results show that the ways in which mothers characterise the disease guide their method of tackling it and the relationship they have with their daughter, as well as how they see their role in the care and treatment process. CONCLUSIONS: Anorexia is experienced as something that is uncontainable, and a dimension of its accommodation characterises the relationship between mothers and daughters receiving treatment for the disorder. Treatment is accompanied by a delegating dimension, and the clinical implications are discussed in this study.

Emotions and Motivations Underlying Adherence to the Anti-COVID-19 Vaccination Campaign: A Survey on a Sample of Italians under 30 Years.

BACKGROUND: In Italy, the under-30 age category was the one that joined the anti-COVID-19 vaccination campaign in an important way. This study investigates the emotional states and motivations underlying joining the anti-COVID-19 vaccination campaign. METHODS: A questionnaire consisting of SF-12, STAI Y, and open questions was administered to investigate the state of health, the state of anxiety, and motivational states of the participants. RESULTS: Of the sample, 80.7% were vaccinated at the first call, deeming the action important to combat the infection. However, 48.2% stated that they were quite worried about the problems related to the pandemic, 37.3% feared being directly infected, and 43.4% were worried about the health of relatives and friends. CONCLUSIONS: The positive impact that the vaccination campaign has had on the under-30 category is very significant for the immunization process, which is of fundamental importance for fighting the pandemic, so the "benefits" outweigh the "risks" related to the COVID-19 vaccine.

Emotional distress, psychosomatic symptoms and their relationship with institutional responses: A survey of Italian frontline medical staff during the Covid-19 pandemic.

With the advent of Covid-19, health workers have been under constant physical and psychological pressure. Italy was among the first countries to face the health emergency in a period of great uncertainty about the virus and the ways to treat patients. The present study aims to analyse the levels of emotional distress (ED) and psychosomatic symptoms (PS) of Italian frontline health workers during the Covid-19 emergency, and their relationship with the evaluation of the institutional responses received. A survey was available online during the peak of health system overload. Health workers' ED, PS and perceived overall wellbeing were assessed, along with the perceived adequacy of the emotional support, hygiene and safety measures, and protection received from the national government, regional administration and local hospital. A total of 103 questionnaires were collected [Women: 51.5%; mean age, 41.8 years; SD: ±10,7; high-risk zone: 41.7%]. Correlation analyses were applied to investigate the relationship between the measures of emotional distress and psychosomatic symptoms; ANOVA was applied to compare these measures among groups from different risk zones and with different perceived emotional and safety protection. About half of the health workers showed medium or high scores on emotional exhaustion, exceeded the cut-off for medium, high or very high psychosomatic symptom burdens, felt they have never or rarely been protected by the institutional responses and judged the emotional support received as inadequate; 32% judged the safety and hygiene measures as insufficient. Significant associations were found between measures of ED, PS and perceived change in personal wellbeing. Differences in perceived institutional support and adequacy of hygiene and safety measures related to significant differences in PS and perceived change in personal wellbeing. ED and PS were widely experienced by frontline health workers. Physical and psychological symptoms were amplified by the perceived lack of institutional support. Ensuring PS and hygiene and safety measures is essential to prevent worsening of health and psychosomatic symptoms in frontline health workers.

Online University Counselling Services and Psychological Problems among Italian Students in Lockdown Due to Covid-19.

Introduction: With the advent of Covid-19, Italian university students were overwhelmed by fear of the pandemic and the social restrictions of the lockdown phase, with all didactic activity provided online. These stress factors caused people to experience psychological problems and/or the aggravation of pre-existing mental symptomatology. Psychological support is, therefore, important for the university-student population. Aims: (1) Analyzing the psychological difficulties and mental problems relative to lockdown from Covid-19 of students who asked for help from the Center of Psychological Counseling of the University of Salerno. (2) Describing the online services of the university's psychological counseling treatment. Participants: 266 university students, but only 49 were undergoing psychological treatment during the Covid-19 lockdown at the center. Methods: (1) Semistructured interview; (2) Questionnaire consisting of sociodemographic information and ad hoc questions; and (3) Scl-90-r test. Results and Conclusions: Aim 1: The main results highlight high levels of anxiety and stress, concentration disorders, and psychosomatization. In several cases, there was a reactivation of previous traumas and sleep was found qualitatively compromised. Aim 2: Counseling services included telephone listening activities, online psychological interviews, psychoeducational groups for interventions of anxiety management, and workshops on study methods conducted in small groups. The online counseling intervention, in times of emergency, increased the resilience and identified any psychological problems in order to implement timely management.

Objects as Communicative Mediators in Children With Autism Spectrum Disorder.

In recent years, the socio-material perspective has informed an important interdisciplinary debate concerning the role of the physical world (i.e., the objects) in human psychological development. Several studies in the field of developmental psychology showed positive achievements in explaining the relationship between the subject and the social context through a socio-material approach, in particular in the early development. The importance of objects was also recognized in children with autism spectrum disorder (ASD), showing that these children are characterized by alterations in the use of the objects from early development. Some studies highlighted that objects could be a facilitator in the interactions between children with ASD and peers. However, the role of objects was not sufficiently investigated in interactions between children with ASD and adults. The main purpose of the present study was to investigate in children with ASD the communicative function that the activities with objects assume in the interactions with adults, highlighting the mediator role of objects in these interactions. More generally, this study also aims to highlight the relevance of adopting a socio-material perspective to explore some neglected aspects of the psychological activity of children with ASD. To test this hypothesis, we conducted an extensive exploratory study, collecting data from a sample of 3-year-old (N = 18; F = 3) and 4-year-old (N = 26; F = 3) with ASD. Children were observed in a free-play situation with an adult. They were free to choose an object from a predefined set. Through quantitative data, we have described the general characteristics of the manipulation of objects; through qualitative data, we aimed to capture and describe, in microgenetic sequences, some characteristics of children's activities, defined as socio-material. The analysis of the socio-material activities suggested the role of objects as mediator of the interactions between children with ASD and adults.