Quantitative autistic traits ascertained in a national survey of 22 529 Japanese schoolchildren

Large language models deconstruct the clinical intuition behind diagnosing autism

Efforts to use genome-wide assays or brain scans to diagnose autism have seen diminishing returns. Yet the clinical intuition of healthcare professionals, based on longstanding first-hand experience, remains the gold standard for diagnosis of autism. We leveraged deep learning to deconstruct and interrogate the logic of expert clinician intuition from clinical reports to inform our understanding of autism. After pre-training on hundreds of millions of general sentences, we finessed large language models (LLMs) on >4,000 free-form health records from healthcare professionals to distinguish confirmed versus suspected autism cases. By introducing an explainability strategy, our extended language model architecture could pin down the most salient single sentences in what drives clinical thinking toward correct diagnoses. Our framework flagged the most autism-critical DSM-5 criteria to be stereotyped repetitive behaviors, special interests, and perception-based behaviors, which challenges today's focus on deficits in social interplay, suggesting necessary revision of long-trusted diagnostic criteria in gold-standard instruments.

Temperament Profiles at Age 18 Months as Distinctive Predictors of Elevated ASD- and ADHD-Trait Scores and Their Co-Occurrence at Age 8-9: HBC Study

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) can be traced back to specific early childhood temperament patterns. However, no unique pattern has been identified for their co-occurrence. Given that children with both traits often require more clinical attention, this study aimed to discover such patterns by examining three temperament domains measured during early childhood-Surgency/Extraversion (SE), Negative Affectivity (NA), and Effortful Control (EC)-and their association with group membership defined as being above the cut-off points for either ASD- or ADHD-trait scores or their co-occurrence at school age. We enrolled 814 children from a birth cohort, assessing temperament at 18 months using the Early Childhood Behavior Questionnaire, and ASD- and ADHD-trait scores at ages 8-9 using the Social Responsiveness Scale-2 and ADHD-Rating Scale. Group membership was determined by clinically significant symptoms, defined as + 1 SD after standardizing scores by age and sex. Multinomial regression analyses examined associations between temperament domain scores and group membership (ASD-dominant, ADHD-dominant, co-occurring, neither-ASD-nor-ADHD). The co-occurring group showed a unique temperament profile, with higher scores in both NA and EC (OR in NA = 1.48, 95% confidence interval (CI): 1.11 to 1.96 and OR in EC = 1.61, 95% CI: 1.18 to 2.20), distinct from the patterns shown by the ASD-dominant and ADHD-dominant groups. The combination of high NA and EC scores uniquely characterizes the co-occurring group, highlighting the need for early temperament assessments to identify children potentially requiring clinical attention for both ASD and ADHD traits.

Neural correlates of reading aloud on the autism spectrum

Individuals with autism can show intact decoding (i.e., ability to recognize and pronounce written words accurately). However, reading comprehension (i.e., ability to infer meaning from written text) in autistic individuals is often lower than expected based on age or grade level. Having intact decoding skills despite potentially atypical reading comprehension suggests altered reading pathways in autism, particularly when processing semantics (i.e., word meaning). To test for neural differences in word processing between autistic and non-autistic younger adults, we examined behavioral and neural responses to reading aloud words and pronounceable nonsense words (pseudowords). Additionally, we manipulated word imageability, word frequency, and word and pseudoword spelling-sound consistency as probes for different components (i.e., orthography, phonology and semantics) of the reading system. Behaviorally, the autistic group had a greater reduction in reaction time as word imageability increased. Neurally, pseudoword consistency effects, a probe of spelling-sound mappings without semantics, were only observed in the autistic group, where increased consistency was associated with decreased activity in bilateral intraparietal sulcus. Also compared to the non-autistic group, the autistic group showed greater effects of word consistency, where increasing word consistency was associated with increasing activation in the bilateral posterior superior temporal gyrus and ventral occipitotemporal cortex. Finally, the autistic group showed stronger effects of pseudoword consistency than the non-autistic group, that is increasing pseudoword consistency was associated with decreasing activation in the left ventral occipitotemporal cortex. Together, these results point to differences in how neural resources are used for reading, with more bilateral areas recruited during spelling-sound decoding in autistics to achieve comparable performance to non-autistics.

Association Between Intellectual Functioning and Autistic Traits in the General Population of Children

Autistic traits are continuously distributed in the general population. The associations between autistic traits and intellectual functioning and/or behavioural difficulties, and the impact of intellectual functioning on behavioural difficulties are unclear. The study aims to describe the distribution of autistic traits in a population-based cross-sectional sample of children. Further aims are to examine the association between intellectual functioning and autistic traits, and between autistic traits and behavioural difficulties. Wechsler scales and ratings of autistic traits and behavioural problems in 874 children aged 7-9 years in the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study were assessed. We found a continuous distribution of autistic traits. Intellectual functioning was negatively associated with autistic traits but not with behavioural difficulties. Behavioural difficulties were associated with autistic traits.

Analysis of Social Performance and Action Units During Social Skills Training: Focus Group Study of Adults With Autism Spectrum Disorder and Schizophrenia

Background

Social communication is a crucial factor influencing human social life. Quantifying the degree of difficulty faced in social communication is necessary for understanding developmental and neurological disorders and for creating systems used in automatic symptom screening and assistive methods such as social skills training (SST). SST by a human trainer is a well-established method. Previous SST used a modified roleplay test to evaluate human social communication skills. However, there are no widely accepted evaluation criteria or social behavioral markers to quantify social performance during SST.

Objective

This paper has 2 objectives. First, we propose applying the Social Performance Rating Scale (SPRS) to SST data to measure social communication skills. We constructed a Japanese version of the SPRS already developed in English and French. Second, we attempt to quantify action units during SST for people with autism spectrum disorder (ASD) or schizophrenia.

Methods

We used videos of interactions between trainers, adults with ASD (n=16) or schizophrenia (n=15), and control participants (n=19) during SST sessions. Two raters applied the proposed scale to annotate the collected data. We investigated the differences between roleplay tasks and participant groups (ASD, schizophrenia, and control). Furthermore, the intensity of action units on the OpenFace toolkit was measured in terms of mean and SD during SST roleplaying.

Results

We found significantly greater gaze scores in adults with ASD than in adults with schizophrenia. Differences were also found between the ratings of different tasks in the adults with schizophrenia and the control participants. Action units numbered AU06 and AU12 were significantly deactivated in people with schizophrenia compared with the control group. Moreover, AU02 was significantly activated in people with ASD compared with the other groups.

Conclusions

The results suggest that the SPRS can be a useful tool for assessing social communication skills in different cultures and different pathologies when used with the modified roleplay test. Furthermore, facial expressions could provide effective social and behavioral markers to characterize psychometric properties. Possible future directions include using the SPRS for assessing social behavior during interaction with a digital agent.

Examining the Effectiveness of Ayres Sensory Integration® Intervention for Children With Developmental Coordination Disorder in Improving Motor Coordination and Daily Activity Function: A Randomized Controlled Trial

Background Ayres Sensory Integration® (ASI) intervention focuses on developing sensory processing abilities to improve motor coordination, executive functions, participation, and satisfaction in everyday activities. No well-designed research studies have addressed clearly the effectiveness of ASI intervention for children with developmental coordination disorder (DCD) even though ASI intervention was effective for children with autism spectrum disorders. Methods and procedures Seventeen children with DCD (aged 4-8.5 years old) were randomly assigned to either an intervention or a control group. ASI intervention was provided to the intervention group twice a week for 10 weeks. In addition to participants' goals in daily activities, sensory integration abilities and motor coordination were assessed before and after the intervention. Outcomes and results The split-plot factorial design demonstrated significant time × group interaction in the total score (F (1, 15) = 7.651, p = 0.014, partial η2= 0.338) and balance score (F (1, 15) = 11.163, p = 0.004, partial η2 = 0.427) of the Movement Assessment Battery for Children-Second Edition (MABC-2), with significant differences in simple main effects before and after intervention for the intervention group. The post-intervention Goal Attainment Scale (GAS) score showed a significant difference in the time × group interaction (F (1, 15) = 15.662, p = 0.001, partial η2 = 0.511) and a simple main effect in the intervention group. Conclusions A short-term, intensive ASI intervention improves motor performance, coordination, and daily activities function in children with DCD.

Reduced multiscale complexity of daily behavioral dynamics in autism spectrum disorder

Aim

Autism spectrum disorder (ASD) is difficult to diagnose objectively due to its heterogeneous and complex manifestations. This study aimed to objectively characterize the behavioral phenotypes of ASD children by exploring the multiscale behavioral dynamics.

Methods

We applied behavioral organization (BO) and multiscale sample entropy (MSE) analyses to physical activity data collected from ASD and typically developing children, using wearable monitors in their daily life. We also examined their correlation with auditory startle response measures and clinical questionnaires, including the Social Responsiveness Scale (SRS) and the Strengths and Difficulties Questionnaire (SDQ).

Results

A significant decrease in MSE at timescales longer than 6 min was observed in ASD children, suggesting decreased irregularity or unpredictability, potentially linked to repetitive behaviors or stereotyped patterns commonly observed in ASD. Additionally, an increase in MSE positively correlated with prepulse inhibition levels, indicating its relationship with sensorimotor gating. Moreover, the observed significant negative correlation with the total difficulty score of SDQ substantiates MSE's potential as an objective metric for assessing general mental health problems associated with ASD.

Conclusion

Multiscale analysis enhances the understanding of ASD's behavioral dynamics, providing valuable metrics for real-world assessments.

Difficulties in perceptual-motor coordination of reaching behavior in children with autism spectrum disorder

Increased risk of injury from collisions with objects is an important issue in children with autism spectrum disorder (ASD). The purpose of the present study was to examine whether impaired perceptual-motor coordination may underlie the high frequency of collisions. Specifically, we hypothesized that collisions are likely to occur frequently in children with ASD due to their difficulty with body-related spatial perception and their inadequate motor planning, due to their detail-focused processing style, i.e., a tendency to focus attention on specific details rather than on the overall context. To evaluate impairment of perceptual-motor coordination in children with ASD, an original action selection task was developed to assess (a) body-related spatial perception and (b) predictive attentional properties for planning the subsequent movements based on the measures of hand movement and gaze behavior. Twenty-six children (13 diagnosed as ASD and 13 with typical development [TD]) completed the task, and their parents completed a questionnaire regarding their child's susceptibility to injury. Results showed that children with ASD displayed inaccurate body-related spatial perception and inadequate motor planning under conditions that induced their detail-focused processing style. In addition, analyses of gaze behavior reflected the characteristics of a detail-focused processing in children with ASD. This was correlated with the severity of ASD and the measure of motor planning. The present findings suggest that difficulty with perceptual-motor coordination, resulting in part from the detail-focused processing style, might contribute to susceptibility to injury in children with ASD. We consider that our evaluation of the difficulty with perceptual-motor of individuals with ASD provides a framework for understanding their high rate of collision-related injuries and could inform strategies for preventing these injuries.

Machine learning's effectiveness in evaluating movement in one-legged standing test for predicting high autistic trait

Introduction

Research supporting the presence of diverse motor impairments, including impaired balance coordination, in children with autism spectrum disorder (ASD) is increasing. The one-legged standing test (OLST) is a popular test of balance. Since machine learning is a powerful technique for learning predictive models from movement data, it can objectively evaluate the processes involved in OLST. This study assesses machine learning's effectiveness in evaluating movement in OLST for predicting high autistic trait.

Methods

In this study, 64 boys and 62 girls participated. The participants were instructed to stand on one leg on a pressure sensor while facing the experimenter. The data collected in the experiment were time-series data pertaining to pressure distribution on the sole of the foot and full-body images. A model to identify the participants belonging to High autistic trait group and Low autistic trait group was developed using a support vector machine (SVM) algorithm with 16 explanatory variables. Further, classification models were built for the conventional, proposed, and combined explanatory variable categories. The probabilities of High autistic trait group were calculated using the SVM model.

Results

For proposed and combined variables, the accuracy, sensitivity, and specificity scores were 1.000. The variables shoulder, hip, and trunk are important since they explain the balance status of children with high autistic trait. Further, the total Social Responsiveness Scale score positively correlated with the probability of High autistic trait group in each category of explanatory variables.

Discussion

Results indicate the effectiveness of evaluating movement in OLST by using movies and machine learning for predicting high autistic trait. In addition, they emphasize the significance of specifically focusing on shoulder and waist movements, which facilitate the efficient predicting high autistic trait. Finally, studies incorporating a broader range of balance cues are necessary to comprehensively determine the effectiveness of utilizing balance ability in predicting high autistic trait.

Developmental process of the understanding of linguistic register in children: A comparison of typically developing children, autistic children, and children with Williams syndrome

Although the developmental process of linguistic register-the appropriate manner of speech as determined by the listener and social situation-has been gradually clarified in typically developing (TD) children, research on the mechanism and developmental process of register acquisition in atypically developing children are insufficient. This study compared the developmental process of understanding linguistic register among TD children, autistic children, and those with Williams syndrome (WS), and examined the contributions of social cognition and motivation to the acquisition of linguistic register. Two experiments were designed to assess the recognition of which linguistic register to use when communicating with different listeners and of the listener's feelings according to the speakers' use of register. The results revealed that the process of understanding register-listener associations was nearly identical among all groups of children and their understanding improved with age. Conversely, their understanding of the effect of register selection on the listener's feelings varied. Importantly, as TD children mature, they become aware that adult listeners may feel negatively when spoken to in an inappropriate register, whereas autistic children and those with WS do not exhibit the same awareness. Thus, our results suggest that atypical social cognition and motivation do not disturb the understanding of register-listener associations. However, social cognition and motivation play important roles in understanding the effect of register selection on the listener's feelings. These findings provide a significant contribution to clarifying the mechanism of linguistic register acquisition.

Sensory processing associated with subcategories of restricted and repetitive behaviors in Japanese children and adolescents with autism spectrum disorder

Background

Restricted and repetitive behavior (RRB) is a core symptom of autism spectrum disorder (ASD). The structure of RRB subcategories and their relationship with atypical sensory processing in Japan are not well understood. This study examined subcategories of the RRB in Japanese children with ASD and explored their relationship with sensory processing.

Methods

A total of 103 children and adolescents with ASD participated in this study, with more than 70% having a co-occurring intellectual disability. First, exploratory factor analysis of the RRB items of the Social Responsiveness Scale second edition (SRS-2) was conducted to identify RRB subcategories. Second, Spearman correlation and multiple regression analysis were run to examine relationships between the RRB subcategories of SRS-2 and subsections of the Short Sensory Profile.

Results

Exploratory factor analysis indicated a two factors solution; repetitive sensory and motor behavior and insistence on sameness. Multiple regression analysis suggested that Movement Sensitivity and Auditory Filtering were associated with insistence on sameness. Furthermore, Underresponsive/Seeks Sensation, Visual/Auditory Sensitivity, and diagnosis of intellectual disabilities were associated with repetitive sensory and motor behavior.

Conclusions

Findings indicate that RRB subcategories are differently related to sensory processing patterns in children with ASD. These results suggested that RRB subcategories are beneficial to consider the relationship between RRB and sensory processing.

Comparison of the Social Responsiveness Scale-2 among Individuals with Autism Spectrum Disorder and Williams Syndrome in Japan

This study examined the similarities/differences between the social phenotypes of Williams syndrome (WS) and autism spectrum disorder (ASD). As cultural norms may affect symptom evaluation, this study administered the Social Responsiveness Scale-2 to Japanese individuals with WS (n = 78, 4.4-44.0 years) and ASD (n = 75, 4.7-55.4 years). The scores for Social Motivation and Social Communication were significantly more severe in the ASD than WS group. Overall, the similarities and differences between the social phenotypes of the syndromes were consistent with the findings of a recent study conducted in the UK, except for the social awareness subscale score. This highlights the importance of cross-cultural investigations of WS and ASD.

Preliminary observations on the associations between sensory processing abnormalities and event-related potentials in adults with autism spectrum disorder

Aim

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is thought to involve a variety of neurophysiological characteristics. Event-related potentials (ERPs) reflect cognitive functions in the brain's cognitive processing. In this study, we investigated differences in P300 and N100 of ERPs between ASD and typically developing groups and focused on the relationship between the components of ERPs and measures of autistic traits and sensory processing characteristics.

Methods

ERPs were measured in 96 subjects in the ASD group and 62 subjects in the age- and sex-adjusted typically developing group. Correlations between each component and the scores of the Autism-Spectrum Quotient Japanese version (AQ-J) and the Adolescent and Adult Sensory Profile (AASP) were also evaluated.

Results

The ASD group showed a significant decrease in the amplitude of N100 at C3. Furthermore, a negative correlation was found between lower amplitude at C3 of N100 and low registered sensory scores in both groups.

Conclusion

Our findings imply that the N100 amplitude at C3 could be a potential indicator for examining the neurophysiological traits of ASD; however, these results should be interpreted with caution due to their preliminary nature. These tentative insights into sensory processing anomalies may be discernible in specific subsets of the ASD population, providing a foundation for future investigative pathways.

A Sense of Belonging and Help Seeking: Examining Factors Related to the Mental Health of High School Students with High Autistic Traits without Diagnosis

Certain individuals are clinically undiagnosed for Autism Spectrum Disorder (ASD) but exhibit strong ASD characteristics. This study examined the differences between a control group and a "high autistic traits" group involving individuals who scored 9 or higher on the Autism-Spectrum Quotient-16 Japanese Version, based on their sense of belonging, help-seeking style, and relationship with mental health. The participants were 608 Japanese public high school students. Of them, 129 (21.2%) and 479 (78.8%) were in the high autistic traits and control groups, respectively. A multiple regression analysis was performed using the General Health Questionnaire (GHQ) as the dependent variable for the groups. The analysis revealed no differences between the two groups regarding grade, gender, physical illness, insomnia, or mental health status; however, they differed regarding avoidant help-seeking style and teacher acceptance. Moreover, avoidant help-seeking scores in the high autistic traits group and teacher acceptance showed a significantly positive and significantly negative association with GHQ, respectively. The results indicated that children with autistic traits internally suppress them, experiencing distress. Teachers are aware that these students seek support from them, but the students seem reluctant to ask them for help. This can negatively impact the mental health of children with high autistic traits.

Caregiver-child interaction as an effective tool for identifying autism spectrum disorder: evidence from EEG analysis

BACKGROUND

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects individuals across their lifespan. Early diagnosis and intervention are crucial for improving outcomes. However, current diagnostic methods are often time-consuming, and costly, making them inaccessible to many families. In the current study, we aim to test caregiver-child interaction as a potential tool for screening children with ASD in clinic.

METHODS

We enrolled 85 preschool children (Mean age: 4.90 ± 0.65 years, 70.6% male), including ASD children with or without developmental delay (DD), and typical development (TD) children, along with their caregivers. ASD core symptoms were evaluated by Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule-Calibrated Severity Scores (ADOS-CSS). Behavioral indicators were derived from video encoding of caregiver-child interaction, including social involvement of children (SIC), interaction time (IT), response of children to social cues (RSC), time for caregiver initiated social interactions (GIS) and time for children initiated social interactions (CIS)). Power spectral density (PSD) values were calculated by EEG signals simultaneously recorded. Partial Pearson correlation analysis was used in both ASD groups to investigate the correlation among behavioral indicators scores and ASD symptom severity and PSD values. Receiver operating characteristic (ROC) analysis was used to describe the discrimination accuracy of behavioral indicators.

RESULTS

Compared to TD group, both ASD groups demonstrated significant lower scores of SIC, IT, RSC, CIS (all p values < 0.05), and significant higher time for GIS (all p values < 0.01). SIC scores negatively correlated with CARS (p = 0.006) and ADOS-CSS (p = 0.023) in the ASD with DD group. Compared to TD group, PSD values elevated in ASD groups (all p values < 0.05), and was associated with SIC (theta band: p = 0.005; alpha band: p = 0.003) but not IQ levels. SIC was effective in identifying both ASD groups (sensitivity/specificity: ASD children with DD, 76.5%/66.7%; ASD children without DD, 82.6%/82.2%).

CONCLUSION

Our results verified the behavioral paradigm of caregiver-child interaction as an efficient tool for early ASD screening.

The Association of Autistic Traits on Cognitive Emotion Regulation Strategies in a Non-clinical Sample

Individuals with high autistic traits have difficulty in regulating their negative emotions. However, few studies clarify the relationship between autistic traits and cognitive emotion regulation strategies. This study examined the association between adaptive and maladaptive strategies in cognitive emotion regulation and autistic traits using a non-clinical sample. Two hundred and thirty-four participants completed the Japanese version of the Social Responsiveness Scale-2 (Adult Self-Report version) and the Japanese version of the Cognitive Emotion Regulation Questionnaire. The results showed that autistic traits were negatively associated with the use of adaptive subordinate strategies for cognitive emotion regulation. By contrast, autistic traits were positively associated with the use of maladaptive subordinate strategies of cognitive emotion regulation. The cognitive and emotional characteristics of autism spectrum disorder, such as perspective taking and executive function, contextualize these results. These findings can help guide not only our understanding of the relationship between autistic traits and cognitive emotion regulation but also develop interventions aimed at facilitating the use of adaptive cognitive emotion regulation strategies and preventing the use of maladapted strategies in individuals with high autistic traits.

School Social Capital Mediates Associations Between ASD Traits and Depression Among Adolescents in General Population

Though autism spectrum disorder (ASD) traits are associated with depression, it is unclear if school social capital mediates their association. We examined whether school social capital mediates the association between ASD traits and depression, and moderation effect of sex on the mediation effect among adolescents in a general population sample (1750 males, 1779 females; equivalent 12-15 years old). The results of this study indicate that ASD traits are associated with depression among adolescents, and that this association is partly mediated by school social capital. Furthermore, the results of the moderated mediation analysis suggest that lower level of school social capital can lead to more increase level of depression for females than for males.

Prototypical autism: New diagnostic criteria and asymmetrical bifurcation model

The current "autism spectrum" DSM 5 diagnostic criteria and autism standardized diagnostic instruments promote considerable heterogeneity or clinical indecision and may be detrimental to the advancement of fundamental research on autism mechanisms. To increase clinical specificity and reorient research towards core autistic presentations, we propose new diagnostic criteria for prototypical autism during the age of 2- to 5-years. We include autism within other non-dominant, familiarly aggregated phenomena sharing asymmetrical developmental bifurcations, such as twin pregnancy, left handedness, and breech presentation/delivery. Following this model, nature, trajectory, and positive/negative signs structure of autism would result from the polarized problem of whether or not language and information is processed in a socially biased manner. Prototypical autism would follow a canonical developmental trajectory by which a gradual decline in social bias in the processing of incoming information, overtly beginning at the end of the first year, bifurcates into a prototypical autistic presentation in the second half of the second year of life. This bifurcation event is followed by a plateau, in which these atypicalities show maximal stringency and distinctiveness, and then ultimately, in most cases, by partial normalization. During the plateau period, the orientation towards, and processing of, information is considerably modified, with an absence of bias for social information, contrasting with a high level of interest in complex, unbiased information, independently of its social or non-social nature. Integrating autism into asymmetrical developmental bifurcations would explain the absence of deleterious neurological and genetic markers and the presence of familial transmission in canonical autistic presentations.

Sex differences in neurodevelopmental trajectories in children with different levels of autistic traits

AIM

Little is known about early manifestations of autism spectrum disorders (ASD) in females, including those who may be overlooked by the current diagnostic criteria. We longitudinally explored sex differences in the trajectories of cognitive and motor functions and adaptive behaviors in children with different levels of autistic traits.

METHODS

The participants were 824 children from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), Japan, who were classified into three autistic trait groups-low, moderate, and high-based on the Social Responsiveness Scale-Second Edition. Cognitive and motor functions were measured at seven time-points from 0.5 to 3.5 years of age using the Mullen Scales of Early Learning. Adaptive behaviors were measured at five time-points from 2.7 to 9 years of age using the Vineland Adaptive Behavior Scales-Second Edition. Trajectories were depicted using latent growth curve modeling.

RESULTS

Sex-specific trajectories were observed in the high-autistic-trait group, with only males showing a temporary decline in expressive language around the age of 2 years and a slight improvement thereafter. They also showed a slight improvement around 3 years in the adaptive behavior communication domain but a gradual downward trend later. Females in the high-autistic-trait group showed no distinct manifestation before the age of 3 years but showed a downward trend after 3.5 years in the adaptive behavior communication domain.

CONCLUSION

Females and males with higher autistic traits than their same-sex peers, independent of clinical diagnosis, may have different phenotypes in certain neurodevelopmental domains during infancy and early childhood.

Characteristics of students who require elementary school counselors' support owing to developmental disorders

Awareness and support for developmental disorders are increasing in Japan. In the education field, support from school counselors for students with developmental disorders and their roles and responsibilities in elementary schools are on the rise. However, identifying and addressing specific conditions and developmental disorders that require school counselors' attention are not clearly planned. Therefore, this study explored the characteristics of students who require elementary school counselors' support owing to developmental disorders. The participants included 17 school counselors who were experienced in working at elementary schools. Through semi-structured interviews, 30 cases were discussed, examined, and categorized based on "case characteristics," "classification of the main complaint," "basic information on the diagnosis," and "type of support." The analysis included detailed viewpoints of 13 school counselors, a code frequency table, and contrast tables, focusing on the main complaint and diagnosis. Regarding the children whose main complaint was "school refusal," eight out of nine cases were in the fourth grade or above, with several cases of suspected developmental disorders or autism spectrum disorder. The number of children with comorbid attention-deficit hyperactivity disorder, including suspected cases, seemed to be higher, especially in Grades 3-5. The study highlighted the importance of assessing students' developmental characteristics related to the main complaint in the background of a secondary problem. Furthermore, early detection and interventions should be conducted in the first and second grades.

Investigating and comparing the psychometric properties of the Chinese Mandarin version of social responsiveness scale-2 and its shortened version in preschool-age children with autism spectrum disorder

We aimed to investigate and compare the psychometric properties of the Chinese Mandarin Social Responsiveness Scale-2 (SRS-2) and its shortened version. The study assessed 670 children with autism spectrum disorder (ASD) aged 30-54 months and 138 typical developmental (TD) children of the same age in mainland China. Our item reliability test revealed that only 36 items of the 65 items in the Chinese Mandarin SRS-2 (Preschool) met the reliability criteria. Moreover, the shortened version of SRS-2 (Preschool) with four subscales and 30 items maintained strong correlations (r = 0.961) with the Chinese Mandarin SRS-2 (Preschool), and demonstrated improved psychometric performance on the 4-week test-retest reliability (intraclass correlations was 0.70), internal consistency (Cronbach's alpha 0.71-0.91), construct validity, and convergent validity with the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, and Child Behavior Checklist. Receiver operating characteristics (ROC) analyses showed excellent and comparable discriminant validity of the shortened version with an area under the curve of 0.992. Our data suggested a cutoff ≥ 22.5 for the shortened version, with good accuracy in screening autism symptoms (sensitivity=96.9 %, specificity=94.2 %). Our findings demonstrated that the shortened version of SRS-2 (Preschool) was a reliable and valid instrument for identifying preschoolers with ASD in mainland China.

Modulation effects of the intact motor skills on the relationship between social skills and motion perceptions in children with autism spectrum disorder: A pilot study

BACKGROUND

An individual with autism spectrum disorder (ASD) has social skill, motor skill, and motion perception deficits. However, the relationship among them was not clarified. Therefore, this study aimed to evaluate the effects of motor skills on social skills and motion perception.

METHODS

Five typically developed children and fourteen children with ASD participated in our study. The N200 component, a brain activity indicating motion perception, was induced in mid-temporal (MT/V5) brain area by watching a random dot kinematograph, and was recorded using a scalp electroencephalogram. Furthermore, the social responsiveness scale (SRS) indicating the social skill deficit, the developmental coordination disorder questionnaire (DCDQ) estimating the developmental coordination disorder (DCD), and the movement assessment battery for children second edition (MABC-2) indicating motor skills were recorded in the children with ASD. A hierarchical multiple regression analysis was conducted to examine the modulation effects of motor skills on the relationship between social skills and motion perception. The dependent variable was the N200 latency, and the independent variables were SRS, MABC-2, and combined MABC-2 and SRS.

RESULTS

The N200 latency was more delayed in children with ASD relative that in typically developed children. Intact balance ability modulated the relationship between social skills and N200 latency in children with ASD. Within the high balance ability, when the social skills worsened, the N200 latency was shortened.

CONCLUSIONS

This is the first report that intact motor skills could modulate the relationship between social skills and motion perception.

Internalizing problems and suffering due to sensory symptoms in children and adolescents with and without autism spectrum disorder

Sensory symptoms are common in autism spectrum disorder (ASD). Previous studies have shown a positive correlation between sensory symptoms and internalizing problems; however, the role of the suffering due to sensory symptoms is not well understood. In the present study, we hypothesized that the relationship between sensory symptoms and internalizing problems in children is mediated by children’s and surrounding people’s suffering due to sensory symptoms. Parents of 113 students aged 6–15 years with and without ASD completed questionnaires about their children’s autistic traits, sensory symptoms, suffering due to sensory symptoms, and internalizing problems. The results showed that autistic traits and sensory symptoms were distributed as a continuum throughout children with and without ASD. Therefore, we investigated the relationship among variables in children with and without ASD attending regular classes. Structural equation modeling indicated that those who scored higher on sensory symptoms demonstrated greater suffering due to sensory symptoms as predictors of internalizing problems. Our findings provide evidence for developing a support system that specifically reduces suffering due to sensory symptoms, especially for students in regular classes.

Emotional and behavioral problems in Japanese preschool children with subthreshold autistic traits: findings from a community-based sample

BACKGROUND

Recently, there has been a growing recognition that autistic traits exist along a continuum beyond diagnostic categories and that even subclinical symptoms may be associated with an increased risk for the psychosocial well-being and mental health of children. However, as yet, there has been little research on whether preschool children with autism spectrum disorder (ASD) symptoms, who do not meet the diagnostic criteria for ASD, are more likely to experience difficulties. To address this deficit this study examined whether young children with subthreshold autistic traits have an increased risk for emotional/behavioral difficulties.

METHODS

Data were analyzed from 1057 Japanese preschool children aged 5-years old collected during the first wave of the Tama Children's Survey (TCS) cohort study. Parent-reported autistic traits were assessed with the Social Responsiveness Scale (SRS), while they provided information on their child's emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ). Logistic regression analysis was used to examine associations.

RESULTS

Preschool children with mild-to-moderate autistic traits, corresponding to subclinical autism were significantly more likely to score above the clinical thresholds for emotional/behavioral problems compared to children with fewer autistic traits. Follow-up diagnostic assessments and analyses of 72 children from the cohort confirmed these findings and showed that these children with subthreshold autistic traits also had a significantly lower intelligence quotient (IQ) as measured by the Wechsler Preschool and Primary Scale of Intelligence (WPPSI).

CONCLUSIONS

Although subthreshold autistic traits are difficult to define due to the sometimes vague border between typical and atypical development, there may be a large number of preschool children with subthreshold autistic traits, who may have an increased risk for a variety of different emotional/behavioral difficulties as well as lower cognitive functioning.

Emotional and behavioral problems in Japanese preschool children with motor coordination difficulties: the role of autistic traits

There has been little research on whether younger children with developmental coordination disorder (DCD) symptoms have an increased risk for emotional and behavioral problems. This study examined whether coordination difficulties are associated with emotional and behavioral problems (emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, reduced prosocial behavior) in preschool children and the role of autistic traits in this association. Data (N = 1042, age 58-71 months) were analyzed from the Tama Children's Survey (TCS). The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was used to measure coordination difficulty symptoms. Information was obtained on emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) and on autistic traits with the Social Responsiveness Scale (SRS). Higher autistic traits were based on SRS cutoff scores (53.5 for boys and 52.5 for girls). Logistic regression analysis was used to assess associations between the variables. In adjusted models, children with probable DCD (pDCD) were significantly more likely to score above the clinical thresholds on all SDQ emotional/behavioral domains. However, nearly all of these associations became nonsignificant after including autistic traits in the analysis. Additional analyses showed that children with pDCD with higher autistic traits had significantly increased odds for emotional problems (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.52-13.19), hyperactivity/inattention (OR: 3.74, 95% CI: 1.45-9.64), peer problems (OR: 15.81, 95% CI: 5.96-41.99), and total difficulties (OR: 28.78, 95% CI: 7.23-114.57), compared to children with pDCD alone. These results indicate that the increased risk of emotional/behavioral difficulties in preschool children with pDCD might be mediated by autistic traits.

Sensory and Social Subtypes of Japanese Individuals with Autism Spectrum Disorders

Studies have proposed that individuals with autism spectrum disorder (ASD) can be divided into several subtypes depending on their sensory features. However, consideration of social communication features is also crucial for configuring ASD subtypes, because social and sensory features are tightly interrelated. In this study, we asked Japanese individuals with ASD to answer the Short Sensory Profile (SSP) and the Social Responsiveness Scale, Second Edition (SRS-2), which measure sensory and social aspects, respectively. Consequent latent profile analysis demonstrated that the participants could be divided into five subgroups: two groups exhibited opposite or inconsistent patterns between the SSP and SRS-2 scores, while the other groups exhibited consistent patterns. Our findings indicate the existence of diverse phenotypes in individuals with ASD.

Relationship between parental autistic traits and parenting difficulties in a Japanese community sample

BACKGROUND

Previous studies have suggested an association between higher levels of parental autistic traits and negative aspects of parenting; however, the domain of autistic traits specifically associated with parenting difficulties has not been investigated yet. Moreover, it remains to be determined whether this association exists even after controlling for children's characteristics.

AIMS

This study examined the relationship between each domain of parental autistic traits and parenting difficulties after controlling for children's characteristics in a Japanese community sample.

METHODS AND PROCEDURES

Surveys were administered to 1373 Japanese adults who were parents to children in kindergartens, nursery schools, and elementary schools.

OUTCOMES AND RESULTS

The results showed that parents with higher levels of autistic traits had more parenting difficulties. Even after controlling for children's sex, age, and emotional/behavioral problems, paternal impaired communication and maternal poor attention switching, impaired communication, and lack of imagination were related to higher parenting difficulties, while a higher maternal level of attention to detail was associated with lower difficulties in parenting.

CONCLUSIONS AND IMPLICATIONS

The findings of this study highlight the importance of focusing on parental autistic traits and providing appropriate parenting support considering these traits.

A study on the examination of sense of coherence-related factors in Japanese junior high school students and their mothers

This study examined the relationship between the sense of coherence (SOC), which is conceptually the ability to successfully cope with stress, of Japanese junior high school students and their mothers, and investigated SOC-related factors among the students. We analyzed self-reported data from 134 junior high school students (aged 12–14 years) and their mothers (average age: 45.5 ± 4.1 years), based in an urban area of Japan. We found a weak correlation between the SOC total scores of female students and their mothers; further, few subscales showed weak correlations. However, the SOC of male students was not correlated with that of their mothers, including the three subcomponents that constitute the SOC. The results of multiple regression analysis indicated that the SOC of female students was negatively associated with ASD-related characteristics, sensitivity to evaluation, and avoidant help-seeking style, and positively associated with a sense of belonging to the school. However, male students’ SOC showed a negative relationship with excessive response to evaluation and a strong sense of parental control. To improve SOC in adolescents, it is necessary to consider their gender differences and support them, both at home and school.

Trajectories of Adaptive Behaviors During Childhood in Females and Males in the General Population

Little is known about the trajectory patterns and sex differences in adaptive behaviors in the general population. We examined the trajectory classes of adaptive behaviors using a representative sample and examined whether the class structure and trajectory patterns differed between females and males. We further explored sex differences in neurodevelopmental traits in each latent class. Participants (n = 994) were children in the Hamamatsu Birth Cohort for Mothers and Children (HBC Study)-a prospective birth cohort study. Adaptive behaviors in each domain of communication, daily living skills, and socialization were evaluated at five time points when participants were 2.7, 3.5, 4.5, 6, and 9 years old using the Vineland Adaptive Behavior Scales-Second Edition. Parallel process multigroup latent class growth analysis extracted sex-specific trajectory classes. Neurodevelopmental traits of children at age 9, autistic traits, attention deficit hyperactivity disorder (ADHD) traits, and cognitive ability were examined for females and males in each identified class. A 4-class model demonstrated the best fit. Moreover, a 4-class model that allowed for differences in class probabilities and means of growth parameters between females and males provided a better fit than a model assuming no sex differences. In the communication domain, females scored higher than their male counterparts in all four classes. In the daily living skills and socialization domains, the two higher adaptive classes (Class 1: females, 18.6%; males, 17.8%; Class 2: females, 48.8%; males, 49.8%) had similar trajectories for males and females, whereas in the two lower adaptive behavior classes (Class 3: females, 27.5%; males, 29.4%; Class 4: females, 5.1%; males, 3.0%), females had higher adaptive scores than their male counterparts. In Class 4, females were more likely to have autistic and ADHD traits exceeding the cutoffs, while males were more likely to have below-average IQ. Different trajectories in females and males suggest that adaptive skills may require adjustment based on the sex of the child, when standardizing scores, in order to achieve better early detection of skill impairment.

Association between autistic tendency and mental health for studying abroad

BACKGROUND

To identify the association between autistic tendencies and mental health among university students who study abroad.

METHODS

We conducted a historical cohort study at a Japanese university, targeting students who went overseas from 2012 to 2014 as part of study abroad program. We administered questionnaires to students before and after they completed the overseas study program. These questionnaires included items about sex, age, academic degrees, department affiliations, past experience of studying abroad, type of overseas program, and schedule of departures and returns. To determine students' mental health problems, we considered cross-cultural maladaptation while studying abroad as the outcome by two reviewers. We also administered the Autism-Spectrum Quotient, Japanese version (AQ), and the General Health Questionnaire 60 Japanese version. We utilized the logistic regression model after adjusting for the General Health Questionnaire and country or region with programs to estimate odds ratios (OR) for considering outcomes.

RESULTS

Of the 585 who participated in this study excluding two students for cancellations, 352 (60.2%) completed to following-up. The prevalence of mental health problems was 6.0% (21/406) and categorized when studying abroad. The mean AQ score was 19.3 (standard deviation = ±7.12). High AQ (a score of 33 and more) was prevalent among 3.7% (18/486). Students with high AQ had more mental health problems compared to those without high AQ (adjusted ORs 5.87; 95% confidence interval, 1.24-27.9, P = 0.03).

CONCLUSIONS

We clarified the association between autistic tendencies and mental health for students studying abroad.

A common variant of CNTNAP2 is associated with sub-threshold autistic traits and intellectual disability

Sub-threshold autistic traits are common in the general population. Children with sub-threshold autistic traits have difficulties with social adaptation. Contactin-associated protein-like 2 (CNTNAP2) is associated with the development of Autism spectrum disorder (ASD) and the single-nucleotide polymorphism rs2710102 (G/A) of CNTNAP2 is suggested to contribute to sub-threshold social impairments and intellectual disabilities. We recruited 67 children with Autistic disorder (AD) (49 boys, 18 girls, aged 38–98 months) and 57 typically developing (TD) children (34 boys, 23 girls, aged 53–90 months). We assessed the participants’ intelligence and social reciprocity using the Kaufman Assessment Battery for Children (K-ABC) and the Social Responsiveness Scale (SRS), respectively. Genomic DNA was extracted from the buccal mucosa and genotyped for rs2710102. A chi-square test revealed a significant association between genotype and group [χ²(2) = 6.56, p = 0.038]. When a co-dominant model was assumed, the results from linear regression models demonstrated that TD children with A-carriers (AA + AG) presented higher SRS T-scores [t(55) = 2.11, p = 0.039] and lower simultaneous processing scale scores of K-ABC [t(55) = -2.19, p = 0.032] than those with GG homozygotes. These associations were not significant in children with ASD. TD children with the rs2710102 A-allele may have more sub-threshold autistic traits than those with GG homozygotes, reflected in higher SRS scores and lower simultaneous processing scale scores. These results support the use of genetic evidence to detect sub-threshold autistic traits.

Psychometric properties of the Persian version of social responsiveness scale-second edition (SRS-2)

Purpose

To quantitatively measure the subtle and general symptoms of autism spectrum disorder (ASD), one of the instruments that have been designed and used is the social responsiveness scale (SRS). The purpose of this study is to translate the second edition of the SRS into Persian and to examine its psychometric properties in school and preschool children with ASD.

Design/methodology/approach

The present study is a methodological study of the psychometric type; the study population consisted of school and preschool children from 3 to 12 years of age with ASD and an intelligence quotient of approximately 70. In total, 10 professors and occupational therapists with research and clinical experience in the field of children, were selected for the translation and content validation stages by expert sampling. To determine the validity of the instrument, the content validity index (CVI) and the content validity ratio (CVR) were used; in addition, to determine the reliability, the internal consistency determination method with Cronbach’s alpha number report and inter-rater reliability method within-class correlation coefficient report were used.

Findings

The calculated CVI and CVR of the instrument for all instrument items were 0.82 and 0.86, respectively. The intra-class correlation coefficient performed by different raters was 0.80 and Cronbach’s alpha for all items was 0.93.

Originality/value

The reliability and validity of the Persian version of the social responsiveness scale-second edition are appropriate and acceptable so that this instrument can be used to assess the social performance skills of 3–12-years-old children with ASD for research and clinical study.

Changes in self-efficacy in Japanese school-age children with and without high autistic traits after the Universal Unified Prevention Program: a single-group pilot study

BACKGROUND

Research has shown the efficacy of school-based programs for mental health problems in children. However, few studies have focused on the strengths of children, such as resilience, which is essential in preventing mental health problems. Moreover, no research has investigated the effect of a universal school-based program on children with increased autistic traits in mainstream classes. We examined the changes in children's self-efficacy, social skills, and general mental health after the implementation of a newly developed universal program, the Universal Unified Prevention Program for Diverse Disorders (Up2-D2), and whether similar changes occurred in children with and without higher autistic traits.

METHODS

To assess possible changes associated with the program, questionnaires were collected from 396 children (207 boys and 189 girls) aged 9-12 years old before (T1), immediately after (T2), and three months after (T3) the implementation of the program.

RESULTS

Results from a linear mixed-effects model showed a significant increase in children's self-efficacy at T2 (adjusted difference 0.49, 95% CI 0.03-0.94; p < 0.05) and T3 (0.78, 95% CI 0.32-1.23; p < 0.001). There were also significant positive changes in social skills and general mental health. Similar changes were observed in children with high autistic traits. Autistic traits at T1 did not contribute to the degree of change in self-efficacy.

CONCLUSIONS

Our pilot study suggests that a universal program has the potential to promote positive attitudes and mental health in both at-risk and not-at-risk children.

Whole Brain White Matter Tract Deviation and Idiosyncrasy From Normative Development in Autism and ADHD and Unaffected Siblings Link With Dimensions of Psychopathology and Cognition

OBJECTIVE

The heterogeneity of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) preclude definitive identification of neurobiomarkers and biological risks. High clinical overlap suggests multifaceted circuit-level alterations across diagnoses, which remains elusive. This study investigated whether individuals with ADHD or ASD and their unaffected siblings constitute a spectrum of neurodevelopmental conditions in terms of white matter etiology.

METHODS

Sex-specific white matter tract normative development was modeled from diffusion MRI of 626 typically developing control subjects (ages 5-40 years; 376 of them male). Individualized metrics estimating white matter tract deviation from the age norm were derived for 279 probands with ADHD, 175 probands with ASD, and their unaffected siblings (ADHD, N=121; ASD, N=72).

RESULTS

ASD and ADHD shared diffuse white matter tract deviations in the commissure and association tracts (rho=0.54; p<0.001), while prefrontal corpus callosum deviated more remarkably in ASD (effect size=-0.36; p<0.001). Highly correlated deviance patterns between probands and unaffected siblings were found in both ASD (rho=0.69; p<0.001) and ADHD (rho=0.51; p<0.001), but only unaffected sisters of ASD probands showed a potential endophenotype in long-range association fibers and projection fibers connecting prefrontal regions. ADHD and ASD shared significant white matter tract idiosyncrasy (rho=0.55; p<0.001), particularly in tracts connecting prefrontal regions, not identified in either sibling group. Canonical correlation analysis identified multiple dimensions of psychopathology/cognition across categorical entities; autistic, visual memory, intelligence/planning/inhibition, nonverbal-intelligence/attention, working memory/attention, and set-shifting/response-variability were associated with distinct sets of white matter tract deviations.

CONCLUSIONS

When conceptualizing neurodevelopmental disorders as white matter tract deviations from normative patterns, ASD and ADHD are more alike than different. The modest white matter tract alterations in siblings suggest potential endophenotypes in these at-risk populations. This study further delineates brain-driven dimensions of psychopathology/cognition, which may help clarify within-diagnosis heterogeneity and high between-diagnosis co-occurrence.

Autism-associated biomarkers: test-retest reliability and relationship to quantitative social trait variation in rhesus monkeys

Background

Rhesus monkeys (Macaca mulatta) exhibit pronounced individual differences in social traits as measured by the macaque Social Responsiveness Scale-Revised. The macaque Social Responsiveness Scale was previously adapted from the Social Responsiveness Scale, an instrument designed to assess social and autistic trait variation in humans. To better understand potential biological underpinnings of this behavioral variation, we evaluated the trait-like consistency of several biological measures previously implicated in autism (e.g., arginine vasopressin, oxytocin, and their receptors, as well as ERK1/2, PTEN, and AKT(1–3) from the RAS-MAPK and PI3K-AKT pathways). We also tested which biological measures predicted macaque Social Responsiveness Scale-Revised scores.

Methods

Cerebrospinal fluid and blood samples were collected from N = 76 male monkeys, which, as a sample, showed a continuous distribution on the macaque Social Responsiveness Scale-Revised. In a subset of these subjects (n = 43), samples were collected thrice over a 10-month period. The following statistical tests were used: “Case 2A” intra-class correlation coefficients of consistency, principal component analysis, and general linear modeling.

Results

All biological measures (except AKT) showed significant test–retest reliability within individuals across time points. We next performed principal component analysis on data from monkeys with complete biological measurement sets at the first time point (n = 57), to explore potential correlations between the reliable biological measures and their relationship to macaque Social Responsiveness Scale-Revised score; a three-component solution was found. Follow-up analyses revealed that cerebrospinal fluid arginine vasopressin concentration, but no other biological measure, robustly predicted individual differences in macaque Social Responsiveness Scale-Revised scores, such that monkeys with the lowest cerebrospinal fluid arginine vasopressin concentration exhibited the greatest social impairment. Finally, we confirmed that this result held in the larger study sample (in which cerebrospinal fluid arginine vasopressin values were available from n = 75 of the subjects).

Conclusions

These findings indicate that cerebrospinal fluid arginine vasopressin concentration is a stable trait-like measure and that it is linked to quantitative social trait variation in male rhesus monkeys.

Supplementary information

The online version contains supplementary material available at 10.1186/s13229-021-00442-w.

Relationships between cortical, cardiac, and arousal-motor activities in the genesis of rhythmic masticatory muscle activity across sleep cycles in primary sleep bruxism children

STUDY OBJECTIVES

The present study aimed to clarify the physiological relationships between rhythmic masticatory muscle activity (RMMA) and cyclic changes in cortical, autonomic, and arousal-motor activities during sleep in sleep bruxism (SB) children.

METHODS

Polysomnographic recordings were performed on fifteen SB children (9 boys, 6 girls, 10.3 ± 2.5 years) and eighteen control children (5 boys, 13 girls, 10.7 ± 3.1 years) free from sleep and developmental disorders. Sleep and RMMA were scored by the standard rules. Sleep cycle was divided into NREM and REM sleep segments and the frequency of RMMA, transient arousal and movement, and cortical and cardiac activities were then quantitatively analyzed in relation to sleep cycles.

RESULTS

Neither sleep architecture nor sleep stage distribution of RMMA significantly differed between two groups. In sleep cycles, SB children showed more frequent RMMA in all segments than controls, while cyclic changes in cortical and autonomic activities did not significantly differ between two groups. In SB children, RMMA was the most frequent in the last NREM segment before REM sleep and was associated with increases in cortical beta activity and arousal; more than 70% of RMMA time-dependently occurred with cortical and motor arousals.

CONCLUSIONS

This is the first study to suggest that the potentiation of RMMA occurrence was associated with transient arousal under cyclic sleep processes in primary SB children.

Practical applications of brief screening questionnaires for autism spectrum disorder in a psychiatry outpatient setting

OBJECTIVES

This study was designed to examine the diagnostic performance of the social and communication disorders checklist (SCDC) and strength and difficulties questionnaire (SDQ) to detect autism spectrum conditions (ASC), along with the social responsiveness scale-second edition (SRS-2) as reference, in a psychiatry outpatient setting.

METHODS

We translated the SCDC into Japanese since its Japanese version was unavailable. We examined its test-retest reliability as well as the internal consistency reliability and diagnostic performance of the three questionnaires among 41 Japanese psychiatric outpatients, using the best-estimate diagnosis of ASC based on the diagnostic interview for social and communication disorders, as a gold standard.

RESULTS

The test-retest reliability was high for the SCDC. Although the internal consistency reliability was high for the SCDC and SRS-2, that was low for the prosocial and peer problem subscales of the SDQ. The performance of the SCDC, SDQ, and SRS-2 to detect ASC was moderate: the area under the ROC curve of 0.78, 0.78, and 0.84, respectively.

CONCLUSIONS

Although questionnaires to detect ASC, including the three examined, generally have only moderate performance in this setting, these can be successfully applied to high-risk populations such as psychiatry outpatients, when multi-level rather than dichotomous likelihood ratios are used.

Attention-deficit/hyperactivity disorder symptoms and sleep problems in preschool children: the role of autistic traits

BACKGROUND

Sleep problems are elevated in children with attention-deficit/hyperactivity disorder (ADHD). However, until now there has been comparatively little research on the role of autistic traits in this association. The current study examined the association between ADHD symptoms and sleep problems in Japanese preschool children and whether autistic traits might also be important for this relationship.

METHODS

Data were analyzed from 1053 children (average age 64.14 months, range 58-71; 50.3% male) that were drawn from the Tama Children's Survey (TCS). Parent-reported information was obtained on ADHD symptoms using the Strengths and Difficulties Questionnaire (SDQ) and autistic traits with the Social Responsiveness Scale Second Edition (SRS-2). Parents also provided information on three different categories of sleep problems experienced by their children - parasomnias, sleep disordered breathing and awakening/daytime problems. Ordinal logistic regression analysis was used to examine the associations.

RESULTS

In analyses adjusted for sociodemographic factors, the mother's mental health and child's emotional problems, compared to children with no ADHD symptoms or autistic traits, children with only ADHD symptoms had significantly increased odds for only one of 11 individual sleep problems - waking in a negative mood. In contrast, children with comorbid ADHD symptoms and autistic traits had elevated odds for five sleep problems with odds ratios ranging from 2.10 (takes time to become alert in the morning) to 3.46 (excessive body movement while sleeping).

CONCLUSIONS

Sleep problems may be especially elevated in children with comorbid ADHD symptoms and autistic traits.

Diagnosing Autism Spectrum Disorder Without Expertise: A Pilot Study of 5- to 17-Year-Old Individuals Using Gazefinder

Atypical eye gaze is an established clinical sign in the diagnosis of autism spectrum disorder (ASD). We propose a computerized diagnostic algorithm for ASD, applicable to children and adolescents aged between 5 and 17 years using Gazefinder, a system where a set of devices to capture eye gaze patterns and stimulus movie clips are equipped in a personal computer with a monitor. We enrolled 222 individuals aged 5–17 years at seven research facilities in Japan. Among them, we extracted 39 individuals with ASD without any comorbid neurodevelopmental abnormalities (ASD group), 102 typically developing individuals (TD group), and an independent sample of 24 individuals (the second control group). All participants underwent psychoneurological and diagnostic assessments, including the Autism Diagnostic Observation Schedule, second edition, and an examination with Gazefinder (2 min). To enhance the predictive validity, a best-fit diagnostic algorithm of computationally selected attributes originally extracted from Gazefinder was proposed. The inputs were classified automatically into either ASD or TD groups, based on the attribute values. We cross-validated the algorithm using the leave-one-out method in the ASD and TD groups and tested the predictability in the second control group. The best-fit algorithm showed an area under curve (AUC) of 0.84, and the sensitivity, specificity, and accuracy were 74, 80, and 78%, respectively. The AUC for the cross-validation was 0.74 and that for validation in the second control group was 0.91. We confirmed that the diagnostic performance of the best-fit algorithm is comparable to the diagnostic assessment tools for ASD.

Genetic architecture of reciprocal social behavior in toddlers: Implications for heterogeneity in the early origins of autism spectrum disorder

Impairment in reciprocal social behavior (RSB), an essential component of early social competence, clinically defines autism spectrum disorder (ASD). However, the behavioral and genetic architecture of RSB in toddlerhood, when ASD first emerges, has not been fully characterized. We analyzed data from a quantitative video-referenced rating of RSB (vrRSB) in two toddler samples: a community-based volunteer research registry (n = 1,563) and an ethnically diverse, longitudinal twin sample ascertained from two state birth registries (n = 714). Variation in RSB was continuously distributed, temporally stable, significantly associated with ASD risk at age 18 months, and only modestly explained by sociodemographic and medical factors (r2 = 9.4%). Five latent RSB factors were identified and corresponded to aspects of social communication or restricted repetitive behaviors, the two core ASD symptom domains. Quantitative genetic analyses indicated substantial heritability for all factors at age 24 months (h2 ≥ .61). Genetic influences strongly overlapped across all factors, with a social motivation factor showing evidence of newly-emerging genetic influences between the ages of 18 and 24 months. RSB constitutes a heritable, trait-like competency whose factorial and genetic structure is generalized across diverse populations, demonstrating its role as an early, enduring dimension of inherited variation in human social behavior. Substantially overlapping RSB domains, measurable when core ASD features arise and consolidate, may serve as markers of specific pathways to autism and anchors to inform determinants of autism's heterogeneity.

Atypical Sensory Processing Profiles and Their Associations With Motor Problems In Preschoolers With Developmental Coordination Disorder

The aims of this study were to identify sensory processing profiles specific to preschoolers with DCD in a community sample and examine the association of sensory processing problems with motor coordination difficulties in these children. Sixty-three 5-year-old children with DCD and without other neurodevelopmental disorders and 106 age-matched typically developing children participated in this study. Sensory processing problems were assessed using the Sensory Profile. Our results demonstrated problems in wide sensory processing patterns (low registration, sensitivity and avoiding) and areas (auditory, vestibular, touch and oral) in children with DCD compared with typically developing children. Additionally, the association of problems in sensory processing patterns (sensitivity and avoiding) and areas (touch and auditory) with motor coordination difficulties were identified in children with DCD alone. Our findings indicate that sensory processing abnormalities may contribute to the pathophysiology of DCD, suggesting the importance of assessing sensory processing functions in children with DCD.

Mapping the Research Domain Criteria Social Processes Constructs to the Social Responsiveness Scale

OBJECTIVE

Research Domain Criteria (RDoC) operationalizes a set of basic social dimensions that can be used to deconstruct sources of variation in social impairments across affected individuals, regardless of their diagnostic status. This is a necessary step toward the development of etiologically based and individualized treatments. The main objective of this investigation was to derive estimations of the RDoC social constructs from the Social Responsiveness Scale (SRS-2).

METHOD

Exploratory structural equation modeling and confirmatory factor analysis were conducted using individual SRS-2 items from six distinct databases ( N = 27,953; mean age = 9.55 years, SD = 3.79; 71.7% male participants) spanning normative (33.8%) and atypical (66.2%) development. The following models were estimated: a one-factor model; a three-factor model with separate attachment and affiliation, social communication, and understanding of mental states factors; and a four-factor model where social communication was further split into production of facial and non-facial communication.

RESULTS

The one-factor solution showed poor fit. The three-factor solution had adequate fit (comparative fit index = 0.952, Tucker Lewis Index = 0.937, root mean square error of approximation = 0.054). However, the four-factor solution had superior fit (comparative fit index = 0.973, Tucker Lewis Index = 0.961, root mean square error of approximation = 0.042) and was robust across age, sex, and clinical status.

CONCLUSION

To our knowledge, this is the first study examining estimations of the RDoC social constructs from an existing measure. Reported findings show promise for capturing important RDoC social constructs using the SRS-2 and highlight crucial areas for the development of novel dimensional social processing measures.

Cross-Cultural Validation and Normative Data of the Social Responsiveness Scale in a Group of Iranian General Child Population

This study aimed to assess the validity and normative statistics of the Farsi version of the Social Responsiveness Scale-2 (SRS-2). Among the mainstream elementary schools, 191 boys and 342 girls with a mean age of 9.46 (+ 1.72) years were recruited. Teachers and parents completed the SRS-2. The parents also answered the Social Communication Questionnaire (SCQ) and the Vineland Adaptive Behavior Scale (VABS). There were not any significant differences regarding the parents' and teachers' ratings of the SRS mean scores in terms of gender, academic level, and age. The SRS was significantly correlated with the SCQ (0.438) and VABS (- 0.142) mean scores. The study supported the validity of the SRS as a screening instrument for social communication problems in Farsi-speaking school-aged children.

Brief Report: Odour Awareness in Young Children with Autism Spectrum Disorders

The elucidation of odour awareness in children with autism spectrum disorders (ASD) is important. We compared the odour awareness of young children with ASD with those of typical development (TD) children using the Children's Olfactory Behavior in Everyday Life (COBEL) questionnaire, which is a self-report measure that mainly assesses odour awareness. Forty-five young boys (aged 5-6 years), including 20 children with ASD and 25 TD children, participated in this study. The total COBEL score of the young children with ASD was lower than that of the TD children (p < 0.01). Moreover, the total COBEL score was significantly correlated with the total VABS II score (p < 0.05). Our results improve understanding of the odour awareness in children with ASD.

Different associations between intelligence and social cognition in children with and without autism spectrum disorders

Autism spectrum disorders (ASD) are characterized by impaired social cognition and communication. In addition to social impairment, individuals with ASD often have intellectual disability. Intelligence is known to influence the phenotypic presentation of ASD. Nevertheless, the relation between intelligence and social reciprocity in people with ASD remains unclear, especially in childhood. To elucidate this relation, we analyzed 56 typically developing children (35 male, 21 female, aged 60–91 months) and 46 children with ASD (35 male, 11 female, aged 60–98 months) from university and affiliated hospitals. Their cognitive function was evaluated using the Kaufman Assessment Battery for Children. Their social cognition was assessed using the Social Responsiveness Scale. We used linear regression models to ascertain whether the associations between intelligence and social cognition of typically developing children and children with ASD are significantly different. Among the children with ASD, scores on the Kaufman Assessment Battery for Children correlated significantly with social cognition, indicating that higher intelligence is associated with better social cognition. For typically developing children, however, no significant correlation was found. One explanation might be that children with ASD fully use general intelligence for successful learning in social cognition, although extensive use of intelligence might not be necessary for TD children. Alternatively, autistic impairment in social cognition can be compensated by intelligence despite a persistent deficit in social cognition. In either case, when using the SRS as a quantitative phenotype measure for ASD, the influence of intelligence must be considered.

Examining criterion-oriented validity of the Repetitive Behavior Scales for Early Childhood (RBS-EC) and the Video-Referenced Rating of Reciprocal Social Behavior (vrRSB)

Improved characterization of quantitative traits and dimensionally distributed complex behaviors during toddlerhood may improve early identification of autism spectrum disorder and related neurodevelopmental disorders. Parents of 205 community-ascertained toddlers (age: mean = 20.2, SD = 2.6 months) completed the Repetitive Behavior Scales for Early Childhood (RBS-EC) and the Video-Referenced Rating of Reciprocal Social Behavior (vrRSB), with longitudinal follow-up of behavioral assessments and/or another round of parent-report questionnaires. Criterion validity was examined both concurrently and longitudinally using the Infant Toddler Social Emotional Assessment (ITSEA) as a criterion anchor. Reciprocal social behavior as measured by the vrRSB was significantly associated with social competence as measured by the ITSEA, longitudinally and concurrently. Reciprocal social behavior was not associated with the externalizing subscale on the ITSEA, providing evidence of discriminant validity. Higher-order repetitive behaviors (restricted interests; rituals and routines) as measured by RBS-EC subscales were associated with the dysregulation and internalizing subscales of the ITSEA, longitudinally and concurrently. All RBS-EC subscales (excepting repetitive motor) were associated concurrently and longitudinally with the dysregulation subscale of the ITSEA. We report evidence of criterion-oriented and discriminant validity for the constructs/domains captured by the RBS-EC and vrRSB. These instruments may be particularly useful in characterizing dimensional variability across the typical-to-atypical continuum.

Cortical signatures in behaviorally clustered autistic traits subgroups: a population-based study

Extensive heterogeneity in autism spectrum disorder (ASD) has hindered the characterization of consistent biomarkers, which has led to widespread negative results. Isolating homogenized subtypes could provide insight into underlying biological mechanisms and an overall better understanding of ASD. A total of 1093 participants from the population-based "Healthy Brain Network" cohort (Child Mind Institute in the New York City area, USA) were selected based on score availability in behaviors relevant to ASD, aged 6-18 and IQ >= 70. All participants underwent an unsupervised clustering analysis on behavioral dimensions to reveal subgroups with ASD traits, identified by the presence of social deficits. Analysis revealed three socially impaired ASD traits subgroups: (1) high in emotionally dysfunctional traits, (2) high in ADHD-like traits, and (3) high in anxiety and depressive symptoms. 527 subjects had good quality structural MRI T1 data. Site effects on cortical features were adjusted using the ComBat method. Neuroimaging analyses compared cortical thickness, gyrification, and surface area, and were controlled for age, gender, and IQ, and corrected for multiple comparisons. Structural neuroimaging analyses contrasting one combined heterogeneous ASD traits group against controls did not yield any significant differences. Unique cortical signatures, however, were observed within each of the three individual ASD traits subgroups versus controls. These observations provide evidence of ASD traits subtypes, and confirm the necessity of applying dimensional approaches to extract meaningful differences, thus reducing heterogeneity and paving the way to better understanding ASD traits.

Examining the Treatment Efficacy of PEERS in Japan: Improving Social Skills Among Adolescents with Autism Spectrum Disorder

This study examines the efficacy of the Japanese version of the Program for the Education and Enrichment of Relational Skills (PEERS), which focuses on improving social functioning through making friends and maintaining good relationships for adolescents with autism spectrum disorder (ASD) without intellectual disabilities. Originally developed in the United States, PEERS is one of the few evidence-based social skills training programs for youth with ASD. The present study shows that with linguistic and cultural modifications, PEERS is effective in improving social functioning for adolescents with ASD in Japan. Positive results were found specifically in the areas of socialization, communication, knowledge of social skills, autistic mannerisms, and behavioral and emotional problems. In addition, most treatment gains were maintained at a 3-month follow-up assessment. These findings suggest that the Japanese version of PEERS is beneficial across multiple socio-emotional and behavioral domains for adolescents with ASD.

Visual Body Part Representation in the Lateral Occipitotemporal Cortex in Children/Adolescents and Adults

The lateral occipitotemporal cortex (LOTC) that responds to human bodies and body parts has been implicated in social development and neurodevelopmental disorders like autism spectrum disorder (ASD). Neuroimaging studies using a representational similarity analysis (RSA) revealed that body representation in the LOTC of typically developing (TD) adults is categorized into 3 clusters: action effector body parts, noneffector body parts, and face parts. However, its organization of younger people (i.e., children and adolescents) and its association with individual traits remain unclear. In this functional MRI study, TD adults and children/adolescents observed photographs of hands, feet, arms, legs, chests, waists, upper/lower faces, the whole body, and chairs. The univariate analysis showed that fewer child/adolescent participants showed left LOTC activation in response to whole-body images (relative to those of chairs) than adult participants. Contrastingly, the RSA on both age groups revealed a comparable body representation with 3 clusters of body parts in the bilateral LOTC. Hence, this result indicates that, although response to whole-body images can differ, LOTC body part representations for children/ adolescents and adults are highly similar. Furthermore, sensory atypicality is associated with spatial LOTC organization, suggesting the importance of this region for understanding individual difference, which is frequently observed in ASD.