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According to the principle of neuroplasticity, early repeated and intense exposure to stimuli can lead to changes in brain structure. In line with this view, it has been argued that early interventions for autistic children could have an impact on their neural development. In the present systematic review, we synthesised the available evidence on neural outcomes after early behavioural, developmental and Naturalistic Developmental Behavioural interventions in young autistic children or children at elevated likelihood for autism. Six out of seven selected studies observed post-intervention differences in neural activity and connectivity. However, we observed significant methodological variation and limitations across studies (e.g., small sample sizes). Here we discuss the field-wide need to address these issues.

Background Language abilities of autistic children and children at elevated likelihood for autism (EL-siblings) are highly heterogeneous, and many of them develop language deficits. It is as of yet unclear why language abilities of autistic children and EL-siblings vary, although an interaction of multiple influential factors is likely at play. In this review, we describe research articles that identify one or multiple of such factors associated with the receptive or expressive language abilities of autistic children and EL-siblings since the introduction of the DSM-5. Aims Our aim was to identify and summarize factors that are linked to language development in autistic children and siblings in the recent literature to ultimately gain insight into the heterogeneity of language abilities in these children. Method The search strategy of this review followed the PRISMA guidelines. The following databases were consulted: Embase, MEDLINE, Web of Science Core Collection and Scopus. Inclusion criteria for studies were the presence of a sample of autistic children no older than seven years old who were diagnosed with autism spectrum disorder per the criteria of the DSM-5. Intervention studies and studies without an explicitly reported language measure were excluded. Risk of bias assessment was completed using the Newcastle-Ottawa Scales. Ultimately 54 articles were included in this review. Results 56 factors were identified to be related to receptive or expressive language abilities of autistic children and EL-siblings. They were grouped into three main categories: biological factors; psychosocial and environmental factors; and age-related and developmental factors, each with different subcategories. Although many of the identified variables were only examined in one article, some well-researched associated factors stood out, in particular joint attention, nonverbal cognitive abilities and frontal EEG power. Better insight in these factors shaping language abilities in autistic children and siblings at elevated likelihood can inform future intervention strategies to reduce language deficits and its corresponding negative consequences in these children Conclusions Our results confirm that multiple different factors likely underlie language deficits in autism. Important aspects that should be considered in such a model are, amongst others, social factors such as joint attention, child characteristics such as nonverbal cognition, and neurocognitive factors.

English-speaking autistic children use the hesitation marker “um” less often than non-autistic children while they use “uh” at a similar rate. It is unclear why this is the case. We examined hesitation marker usage of Dutch-speaking autistic and non-autistic preschoolers with the aim to 1) make a crosslinguistic comparison of hesitation marker usage and 2) examine two hypotheses regarding the underlying linguistic mechanisms of hesitation markers: the symptom hypothesis and the signal hypothesis. We replicated group differences in “um” usage and showed significant effects of age and biological sex in the selection of hesitation marker (“uh” versus “um”). We found that “uh” usage is correlated with structural language abilities while “um” is not. “Um” may be related to pragmatic language abilities, which were not examined here. The findings support the notion that hesitation markers are not involuntary utterances but deliberate language features, which is in line with the signal hypothesis.

Play of younger siblings of children with autism spectrum disorder (ASD) (siblings; n = 44), very preterm children (preterms; n = 44), and children at typical likelihood for ASD (n = 36) was observed at 24 months. Children with ASD and atypical development engaged less in spontaneous (pre-)symbolic play than typically developing children. Total duration of spontaneous and elicited (pre-)symbolic play was associated with later ASD traits in siblings. However, no association between most play variables and ASD traits was found in preterms. This suggests possible different ASD-trajectories between siblings and preterms. Thus, spontaneous (pre-)symbolic play may be indicative of developmental challenges across several populations, and results highlight the need to move beyond studying only siblings in order to broaden our understanding of ASD.

Purpose To compare mothers and fathers perceptions of the impact of autism spectrum disorder on their Quality of Life (QoL), we used the Parental-Developmental Disorders-Quality of Life scale (Par-DD-QoL). Method The perception of QoL of mothers and fathers was compared for 130 pairs of parents of children with ASD and the associated variables were investigated. Results Mothers perceived a significantly greater impact of ASD on their QoL than fathers. Parents perceived a higher impact of ASD on global QoL when their child's adaptive skills were low and when the level of aberrant behaviors was high. More precisely, the perception of QoL by the mothers was negatively associated with their child's internalized disorders, whereas the perception of QoL by the fathers was negatively associated with their child's externalized disorders. Neither the mothers' nor the fathers' perception of the impact on QoL was associated with their children's age or the severity of their autistic symptoms. Some parental factors, such as being members of a family association, having benefited from training in ASD and having experienced a disruption in professional activity were associated with a greater impact on their QoL. Conclusion Our finding that the perceived impact of ASD on QoL differed between mothers and fathers argues for individualized psychosocial support. Moreover, the strong correlation between the child's clinical characteristics and the perception by parents of a higher impact of ASD on QoL should be seen as red flag concerning the needs of the parents in terms of social and educational support. Trial registration number NCT02625116 (October 2015).

Dans les quinze dernieres annees, la recherche sur les signes precoces du trouble du spectre de l’autisme (TSA) a evolue, passant de modeles retrospectifs a des etudes longitudinales prospectives d’enfants presentant un risque eleve de developper un TSA. Alors qu’au depart, les etudes se concentraient presque exclusivement sur les freres et sœurs ayant un aine atteint de TSA, d’autres populations, en premier lieu les bebes tres prematures, sont de plus en plus examinees. Les principaux objectifs sont l’identification des marqueurs precoces et des trajectoires neurodeveloppementales des TSA afin d’ameliorer la fiabilite du diagnostic et des interventions. Dans cet article, quelques decouvertes initiales de nos recherches en cours a l’universite de Gand sont presentees, qui peuvent etre considerees comme des pistes prometteuses pour de futurs travaux. Nous soutenons cependant que des projets transdisciplinaires multi-sites a grande echelle au niveau national et international sont clairement necessaires pour realiser des progres substantiels dans ce domaine. Dans le meme temps, une attention particuliere aux preoccupations et aux dilemmes ethiques sont extremement importants.

Aim Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder usually diagnosed at primary-school-age. This systematic review aimed to summarize available standardized motor assessments before five years of age predicting DCD, complex Minor Neurological Disorder (cMND) and motor delay assessed by a standardized motor test. Methods A systematic search was performed in MEDLINE, CINAHL, WoS, Scopus, CENTRAL and ERIC. A hand search was executed. Only data of non-Cerebral Palsy children was included. Results At or before two years, the BSID, motor subtests of GMDS, NOMAS, and NSMDA might be valuable in detecting school-aged motor delay, while starting at three years, the PDMS, motor subtests of GMDS, NSDMA, M-ABC-2, and CAMPB show promising results. General movements Assessment is associated with cMND, but does not seem sensitive enough to detect DCD. Predictive values are superior in high-risk groups and improve as children age. However, no assessment instrument reached 80% sensitivity and specificity. Conclusion Standardized motor assessments before five years seem valuable in detecting early motor problems. More longitudinal research commencing in infancy, including multiple assessments over time and the implementation of clear diagnostic criteria is imperative.

Satisfaction with the detection process of autism and its determinants was investigated using data from the Autism Spectrum Disorder in the European Union (2015–2018) network. A total of 1342 family members, including 1278 parents, completed an online survey collecting information about their experience and satisfaction with the early detection of autism in their child. Overall, the level of satisfaction varied considerably from one respondent to another. Difficulty in finding information about detection services, lack of professional guidance and support in response to first concerns, finding a diagnostic service on one’s own, and a delay of more than 4 months between the confirmation of concerns and the first appointment with a specialist were all experiences individually associated with greater odds of being less satisfied. Using a dominance analysis approach, we further identified professional guidance and support in response to first concerns as the most important predictor of the level of satisfaction. These findings highlight the aspects of the process that need to be improved to enhance the experience of the detection process and are therefore relevant to guide health administrations toward actions to be implemented to this effect. Lay abstract Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one’s own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent–professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral features that appear early in life. Although studies have shown that atypical brain functional and structural connectivity are associated with these behavioral traits, the occurrence and initial alterations of brain networks have not been fully investigated. The current study aimed to map early brain network efficiency and information transferring in infants at elevated likelihood (EL) compared to infants at typical likelihood (TL) for ASD in the first year of life. This study used a resting-state functional near-infrared spectroscopy (fNIRS) approach to obtain the length and strength of functional connections in the frontal and temporal areas in 45 5-month-old and 38 10-month-old infants. Modular organization and small-world properties were detected in both EL and TL infants at 5 and 10 months. In 5-month-old EL infants, local and nodal efficiency were significantly greater than age-matched TL infants, indicating overgrown local connections. Furthermore, we used a support vector machine (SVM) model to classify infants with or without EL based on the obtained global properties of the network, achieving an accuracy of 77.6%. These results suggest that infants with EL for ASD exhibit inefficiencies in the organization of brain networks during the first year of life. Lay Summary The brain networks of 5- and 10-month-old infants are able to support efficient communication of information in the brain. Neural networks of 5-month-old with an elevated likelihood (EL) for autism spectrum disorder (ASD) show an overgrowth in local functional connection, which may not support efficient communication between distant brain regions, while we found no such differences in 10-month-old infants with or without EL for ASD.

Objectives Research on typically developing (TD) children and those with neurodevelopmental disorders and genetic syndromes was targeted. Specifically, studies on autism spectrum disorder, Down syndrome, Rett syndrome, fragile X syndrome, cerebral palsy, Angelman syndrome, tuberous sclerosis complex, Williams-Beuren syndrome, Cri-du-chat syndrome, Prader-Willi syndrome, and West syndrome were searched. The objectives are to review observational and computational studies on the emergence of (pre-)babbling vocalisations and outline findings on acoustic characteristics of early verbal functions. Methods A comprehensive review of the literature was performed including observational and computational studies focusing on spontaneous infant vocalisations at the pre-babbling age of TD children, individuals with genetic or neurodevelopmental disorders. Results While there is substantial knowledge about early vocal development in TD infants, the pre-babbling phase in infants with neurodevelopmental and genetic syndromes is scarcely scrutinised. Related approaches, paradigms, and definitions vary substantially and insights into the onset and characteristics of early verbal functions in most above-mentioned disorders are missing. Most studies focused on acoustic low-level descriptors (e.g. fundamental frequency) which bore limited clinical relevance. This calls for computational approaches to analyse features of infant typical and atypical verbal development. Conclusions Pre-babbling vocalisations as precursor for future speech-language functions may reveal valuable signs for identifying infants at risk for atypical development. Observational studies should be complemented by computational approaches to enable in-depth understanding of the developing speech-language functions. By disentangling features of typical and atypical early verbal development, computational approaches may support clinical screening and evaluation.

Language acquisition in the first year of life plays an important role in human development. Although recent research has increased our knowledge of early language development, the origins and developmental trajectories of language processing during infancy are still being debated. One important issue is whether the infant brain has already developed adult-like functional cortical specialization and lateralization for speech and language processing. Although a relatively large number of previous studies have investigated the cortical specialization for speech processing in newborns by comparing responses to normal speech with responses to time-reversed speech as a control, the subsequent development of this differential response is less well understood. In the current study, our primary goal was, therefore, to expand our knowledge of functional speciali-zation for speech during the first year of life. By using functional near-infrared spectroscopy (fNIRS), we examined the hemodynamic responses in the temporal cortex to forward-going speech in the native language, Dutch, and backward Dutch in seventy-eight infants aged 5 and 10 months. We observed that five-month-old infants show bilateral activation to both forward and backward speech without obvious hemispheric lateralization for language, while ten-month-old infants show greater left-lateralized inverted responses (e.g., reduction in oxyhaemoglobin and increase in deoxyhaemoglobin) to forward speech than to backward speech. Overall, our findings indicate that the neural correlates of language processing undergo developmental changes in the first year of life.

Children with autism spectrum disorder (ASD) have been shown to exhibit fewer instances of social referencing compared to their typically developing peers. The current study evaluated the effectiveness of multiple-exemplar training, prompting, and social reinforcement to teach social referencing. We used a single-blind randomized control trial with a multiple-baseline design nested within the experimental group to evaluate treatment effects. Twenty-five children with ASD participated. Participants in the treatment group showed significantly higher social referencing scores. However, there were no statistically significant differences between the groups in the posttraining initiating and responding to joint attention scores. The clinical implications of our findings are discussed.

This study explored regression patterns in 100 children with ASD (3-11 years) using several approaches to enhance the validity of retrospective parent report. Both early development and outcome were examined in regression groups defined by 36 months age cut-off and two underlying empirical patterns based on type and onset age. Results over regression groups were generally consistent. During early development, children with regression showed a similar amount of social atypicalities and stereotyped behaviour as compared to children without regression. However, parents indicated less communication skills which could be a valuable predictor of regression. Development after regression was characterised by early language delay and more restricted and repetitive behaviour. The findings provide insight into the diagnosis and prognosis of regression in ASD.

Previous studies on naming have presented the object and its name simultaneously during both training and testing, and thus the training component may establish a transformation of function directly between the object and the name. Successful tests for listener naming may thus not require the emergence of a novel (entailed) transformation of function. The current study aimed to control for this possibility by presenting the object and the name sequentially and nonsimultaneously. Eight typically developing toddlers participated in the current study. During name training, objects and names were presented nonsimultaneously, and all participants failed to emit listener-naming responses during the first test session. Subsequently, 4 participants received multiple exemplar training, which led to improvements in listener naming for all 4; and speaker naming for only 1 participant. As a control condition, the remaining 4 participants were tested repeatedly, without multiple exemplar training, and did not show any consistent improvements in their listener or speaker performances. Multiple exemplar training thus appeared to be effective in establishing generalized listener responses, which involved generating entailed transformation of functions. The strategy of using nonsimultaneous stimulus presentations could allow for greater precision in identifying the behavioral processes involved in listener-naming.

BackgroundA recent genome-wide association study (GWAS) identified 12 independent loci significantly associated with attention-deficit/hyperactivity disorder (ADHD). Polygenic risk scores (PRS), derived from the GWAS, can be used to assess genetic overlap between ADHD and other traits. Using ADHD samples from several international sites, we derived PRS for ADHD from the recent GWAS to test whether genetic variants that contribute to ADHD also influence two cognitive functions that show strong association with ADHD: attention regulation and response inhibition, captured by reaction time variability (RTV) and commission errors (CE).MethodsThe discovery GWAS included 19 099 ADHD cases and 34 194 control participants. The combined target sample included 845 people with ADHD (age: 8–40 years). RTV and CE were available from reaction time and response inhibition tasks. ADHD PRS were calculated from the GWAS using a leave-one-study-out approach. Regression analyses were run to investigate whether ADHD PRS were associated with CE and RTV. Results across sites were combined via random effect meta-analyses.ResultsWhen combining the studies in meta-analyses, results were significant for RTV (R2 = 0.011, β = 0.088, p = 0.02) but not for CE (R2 = 0.011, β = 0.013, p = 0.732). No significant association was found between ADHD PRS and RTV or CE in any sample individually (p > 0.10).ConclusionsWe detected a significant association between PRS for ADHD and RTV (but not CE) in individuals with ADHD, suggesting that common genetic risk variants for ADHD influence attention regulation.

Autism spectrum disorder (ASD) likely emerges from a complex interaction between pre-existing neurodevelopmental vulnerabilities and the environment. The interaction with parents forms a key aspect of an infant's social environment, but few prospective studies of infants at elevated likelihood (EL) for ASD (who have an older sibling with ASD) have examined parent-child interactions in the first year of life. As part of a European multisite network, parent-child dyads of free play were observed at 5 months (62 EL infants, 47 infants at typical likelihood (TL)) and 10 months (101 EL siblings, 77 TL siblings). The newly-developed Parent-Infant/Toddler Coding of Interaction (PInTCI) scheme was used, focusing on global characteristics of infant and parent behaviors. Coders were blind to participant information. Linear mixed model analyses showed no significant group differences in infant or parent behaviors at 5 or 10 months of age (all ps >= 0.09, d

Background Sound perception in autism spectrum disorder (ASD) is usually at typical levels, even when auditory stimuli carry a social value, as it is the case for speech. Nevertheless, orienting to sounds in a speech context might be atypical in some individuals with ASD, which in ERP studies is reflected by a diminished P3a component. As P3 values and cognitive abilities seem to be inversely related under some circumstances, the current study investigates whether diminished attentional orienting to sounds in speech is equally observable in children with ASD with and without developmental delay (DD). Method Children with typical development (TD, n = 17) or ASD, with or without comorbid DD (ASD/DD, n = 22, and ASD/noDD, n = 12), aged 1.5 through 4 years took part in a passive auditory oddball task while EEG data were recorded. The paradigm consisted in the presentation of two deviant stimuli (one vowel sound and one complex tone) either in a speech or in a non-speech context. Results We found overall more negative MMN voltages in both ASD groups compared to TD. For P3a mean voltages, we found an attenuated response in children ASD/noDD when deviant tones were presented in speech, but not in other conditions. Children with ASD/DD did not differ from TD in P3a mean voltages. Conclusion Atypical speech sound processing might be more accentuated in children with ASD/noDD than in their peers with comorbid DD. This finding is interpreted within the theoretical framework of neural adaptation.

Pragmatic language (PL) is defined as the ability to use language effectively in communicative exchanges. Previous findings showed that deficits in PL are a core characteristic of the communicative profile of individuals with autism spectrum disorder (ASD). While different lines of research have revealed a close link between PL and theory of mind (ToM), and between PL and executive functions (EFs), to our knowledge, few studies have explored the relationship between these three domains in children with ASD, and their results have been contradictory. The present study thus aimed to contribute to our understanding of PL in children with ASD and to analyze the underlying mediating role of ToM and EFs. PL is a complex and multifaceted construct. In the present study, we focused on two specific aspects, such as the comprehension of nonliteral language, and the ability to make inferences. After testing 143 participants (73 with ASD), our results confirmed that impairments in PL are a crucial feature of the ASD profile. Children with ASD were also more impaired than their typically developing peers in both ToM and EFs. When the mediating role of ToM and EFs on PL was considered, it emerged that only ToM contributed significantly to the relationship between group and PL. We discussed the potential importance of interventions not focused exclusively on PL, but also involving ToM. LAY SUMMARY: In everyday life, we use pragmatic language to interact successfully with others. Individuals with autism experience significant difficulty in pragmatic language, showing consequent impairments in communication. This study compared the comprehension of nonliteral language, and the ability to make inferences of children with autism and children with typical development, focusing on the role of social and cognitive abilities. Children with autism had difficulties in pragmatic language compared to children with typical development. In addition, the capacity to consider the perspective, intentions and beliefs of other people contributed significantly to the pragmatic language. Autism Res 2021, 14: 932-945. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

SARS-CoV-2 is the virus causing COVID-19 and is spread through close person-to-person contact. The use of face masks has been described as an important strategy to slow its transmission. We evaluated the effects of coaching caregivers via telehealth technologies to teach face mask wearing to children with autism spectrum disorder. Six participants with a history of challenging behavior associated with mask wearing were recruited from different parts of the world, and trained using graduated exposure, shaping, and contingent reinforcement. By the end of the intervention, all participants wore a face mask for a period of 10 min without exhibiting challenging behavior. The skills generalized to a novel mask or a community setting. Mask wearing did not affect the percentage of oxyhemoglobin saturation of participants, and caregivers found the intervention useful. The findings support previous tolerance training treatment evaluations in children with developmental disorders exhibiting resistance to healthcare routines.

The Modified Checklist for Autism in Toddlers-revised/follow-up (M-CHAT-R/F) was developed to reduce the number of cases requiring telephone verification. The aim of this study was to validate a Spanish version of the M-CHAT-R/F in the Spanish public health system. The M-CHAT-R/F was translated, culturally adapted, and then administered to 6625 children. Of the 39 positive screening cases, 15 children were diagnosed with autism spectrum disorder (ASD) and 24 with non-ASD disorders or delays. The sensitivity was 0.79 and specificity of 0.99. Positive and negative predictive values were 0.39 and 0.99, respectively. These results are similar to the English equivalent, though observed prevalence was lower. This study supports Spanish National Health System policy makers to consider a universal ASD screening program.

Mutations in FARS2 are known to cause dysfunction of mitochondrial translation due to deficient aminoacylation of the mitochondrial phenylalanine tRNA. Here, we report three novel mutations in FARS2 found in two patients in a compound heterozygous state. The missense mutation c.1082C > T (p.Pro361Leu) was detected in both patients. The mutations c.461C > T (p.Ala154Val) and c.521_523delTGG (p.Val174del) were each detected in one patient. We report abnormal in vitro aminoacylation assays as a functional validation of the molecular genetic findings. Based on the phenotypic data of previously reported subjects and the two subjects reported here, we conclude that FARS2 deficiency can be associated with two phenotypes: (i) an epileptic phenotype, and (ii) a spastic paraplegia phenotype., Highlights • Three novel mutations in FARS2 were detected in two patients. • Abnormal in vitro aminoacylation of mt-tRNA Phe was demonstrated. • FARS2 deficiency is associated with an epileptic or a spastic paraplegia phenotype.

The impact of ASD on parental QOL was evaluated in the EpiTED cohort study at early adulthood. Two-third of parents of young adults with ASD (66.7%) reported that their QoL was at least moderately altered. The perceived impact of ASD on parental QoL was related to the young adults' level of adaptive skills, as well as to symptom severity and the presence of challenging behaviors, which appeared to be the main risk factor. The study of change between adolescence and early adulthood showed that parents whose children had a decrease in challenging behaviors perceived a decreased impact on their QoL. These results argue for the importance to propose specific interventions to target associated challenging behaviors in ASD.

Little ethical recommendations on returning children's individual research findings are available for researchers in behavioral sciences, especially when compared to genetic research. Anecdotic evidence suggests that since parents are often interested in their child's individual research findings, researchers tend to offer this information as a form of compensation for research participation. Despite good intentions, these practices are not without potential harmful consequences for children. We were confronted with these difficulties and with the paucity of available guidance on this topic, being involved in a longitudinal, infant development study, i.e. tracking infants at risk for autism (TIARA). First, we review current ethical recommendations and discuss their limitations in the light of the TIARA study. Second, we will suggest to revise these recommendations, by identifying and applying the relevant bioethical principles and concepts at hand. Third, as an example of practical implementation, the adopted 'return of research findings'-policy for the TIARA-study is presented. The principles and concepts we engage with are the ancillary care responsibilities of the researcher, non-maleficence and beneficence, the right to an open future of the child, and the avoidance of therapeutic misconception. Ultimately, we present the concrete return of research findings policy implemented in the TIARA-study. Here, we suggest restricting the systematic return of children's individual research findings to cases where findings are considered clinically significant and actionable for the child. We discuss the broader implications for designing and conducting research in behavioral sciences with children.

We aimed at identifying early non-social behavioural indicators that predict later ASD. Likewise, we were interested in the moment in which non-social signs discriminate between children at elevated likelihood for ASD with a later diagnosis of ASD, and children at elevated likelihood for ASD with a typical developmental outcome. In addition, we intended to explore the developmental evolution of children's symptomatology over time. A systematic literature search was conducted for longitudinal studies on early non-social behavioural indicators among siblings at elevated likelihood for ASD. The following databases were searched: PUBMED, Web of Science, PsycINFO, CINAHL and EMBASE. The study identification process was conducted by two reviewers independently. Compared to siblings at elevated likelihood for ASD with a typical developmental outcome, siblings at elevated likelihood for ASD with later ASD show impairments in attention disengagement, in gross and fine motor development and characteristic restricted and repetitive interests and behaviours, starting at 12 months of age. Moreover, early attention disengagement exerts a predictive role towards a later ASD diagnosis, given that from 12 months siblings at elevated likelihood for ASD who will receive an independent ASD diagnosis towards 24-36 months present marked difficulties in disengaging in comparison with siblings at elevated likelihood for ASD that will not satisfy the criteria for an ASD diagnosis. The findings call for a more comprehensive vision on early indicators of ASD. Further research is needed to extend results to other behavioural domains. Open Access funding provided by Projekt DEAL. This study was funded by The Autism Spectrum Disorders in the European Union project (ASDEU). The ASDEU project has been granted by DG-SANTÉ, European Commission [Grant number SANCO/2014/C2/035]. Sí

Little ethical recommendations on returning children’s individual research findings are available for researchers in behavioral sciences, especially when compared to genetic research. Anecdotic evidence suggests that since parents are often interested in their child’s individual research findings, researchers tend to offer this information as a form of compensation for research participation. Despite good intentions, these practices are not without potential harmful consequences for children. We were confronted with these difficulties and with the paucity of available guidance on this topic, being involved in a longitudinal, infant development study, i.e. tracking infants at risk for autism (TIARA). First, we review current ethical recommendations and discuss their limitations in the light of the TIARA study. Second, we will suggest to revise these recommendations, by identifying and applying the relevant bioethical principles and concepts at hand. Third, as an example of practical implementation, the adopted ‘return of research findings’-policy for the TIARA-study is presented. The principles and concepts we engage with are the ancillary care responsibilities of the researcher, non-maleficence and beneficence, the right to an open future of the child, and the avoidance of therapeutic misconception. Ultimately, we present the concrete return of research findings policy implemented in the TIARA-study. Here, we suggest restricting the systematic return of children’s individual research findings to cases where findings are considered clinically significant and actionable for the child. We discuss the broader implications for designing and conducting research in behavioral sciences with children. ispartof: European Child & Adolescent Psychiatry vol:30 issue:8 pages:1-9 ispartof: location:Germany status: Published online

Known comorbidities for Attention-Deficit Hyperactivity Disorder (ADHD) include conduct problems, substance use disorder and gaming. Comorbidity with conduct problems may increase the risk for substance use disorder and gaming in individuals with ADHD. The aim of the study was to build a causal model of the relationships between ADHD and comorbid conduct problems, and alcohol, nicotine, and other substance use, and gaming habits, while accounting for age and sex. We used a state-of-the-art causal discovery algorithm to analyze a case-only sample of 362 ADHD-diagnosed individuals in the ages 12–24 years. We found that conduct problem severity mediates between ADHD severity and nicotine use, but not with more severe alcohol or substance use. More severe ADHD-inattentive symptoms lead to more severe gaming habits. Furthermore, our model suggests that ADHD severity has no influence on severity of alcohol or other drug use. Our findings suggest that ADHD severity is a risk factor for nicotine use, and that this effect is fully mediated by conduct problem severity. Finally, ADHD-inattentive severity was a risk factor for gaming, suggesting that gaming dependence has a different causal pathway than substance dependence and should be treated differently. By identifying these intervention points, our model can aid both researchers and clinicians.

Author(s): Zhang, Dajie; Bedogni, Francesco; Boterberg, Sofie; Camfield, Carol; Camfield, Peter; Charman, Tony; Curfs, Leopold; Einspieler, Christa; Esposito, Gianluca; De Filippis, Bianca; Goin-Kochel, Robin P; Hoglinger, Gunter U; Holzinger, Daniel; Iosif, Ana-Maria; Lancioni, Giulio E; Landsberger, Nicoletta; Laviola, Giovanni; Marco, Eva M; Muller, Michael; Neul, Jeffrey L; Nielsen-Saines, Karin; Nordahl-Hansen, Anders; O'Reilly, Mark F; Ozonoff, Sally; Poustka, Luise; Roeyers, Herbert; Rankovic, Marija; Sigafoos, Jeff; Tammimies, Kristiina; Townend, Gillian S; Zwaigenbaum, Lonnie; Zweckstetter, Markus; Bolte, Sven; Marschik, Peter B

Correction: J Autism Dev Disord. 2019 Nov 28. doi: 10.1007/s10803-019-04303-7. Online ahead of print. The original version of this article unfortunately contained a mistake in one of the co-author's family name. The correct name should be María Victoria Martín-Cilleros instead of María Victoria Cilleros-Martín. https://link.springer.com/article/10.1007/s10803-019-04303-7 Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents' opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child's age, delays in accessing services, and active stakeholders' participation when looking to improve services. This study was funded by the Spanish Ministry of Economy and Competitiveness [Grant PSI2016-80575-R], the European Union, DGSANCO, [Ref.: SANCO/2014/C2/035], and the Spanish Ministry of Education, Culture and Sport [Ref.: BOE-B-2017-2646]. info:eu-repo/semantics/publishedVersion

Objective: The present study investigated differences in attentional networks in typically developing (TD) boys and boys with ADHD or autism spectrum disorder (ASD). In addition, we investigated the relationship between networks and the relationship with effortful control (EC). Method: An Attention Network Test was used to assess alerting, orienting, and executive attention in 25 TD boys, 25 boys with ADHD, and 25 boys with ASD. Results: In the absence of warning signals, boys with ADHD performed poorer than other children. In all groups, the orienting and executive control networks and the alerting and orienting networks interacted. Executive attention and EC were unrelated. Conclusion: Results provided evidence of impaired tonic alertness in ADHD and support the idea of functional integration of attentional networks. Finally, findings suggest that the link between EC reports and indices of neural systems involved in the effortful regulation of behavior may not be as unambiguous as previously thought.

This study was the first to longitudinally explore the extent to which early temperament and sensory processing were of predictive value for cognitive development and Autism Spectrum Disorder (ASD) symptomatology in a sample of preterm children (N = 50, 22 girls, mean gestational age 27 weeks). At the corrected ages of 10, 18, and 24 months, sensory processing and temperament were assessed, as were cognitive development and ASD symptoms at 36 months. Better cognitive development was predicted by fewer hospitalisation days at birth and by lower Activity Level at 18 months. Temperamental subscales of Negative Affect showed associations with both parent-reported and observational measures of ASD symptomatology, whereas sensory processing only had predictive value for parent-reported symptoms of ASD. The usefulness of temperament and sensory processing for prediction of ASD symptom severity and cognitive outcomes became clear in the second year of life. The results indicate that this area of research is worth additional investigation in the extreme and very preterm population, to explore in further detail whether these two concepts might be able to provide information about which preterms are more likely to develop ASD or cognitive impairments.

Language problems are highly prevalent in younger siblings of children with autism spectrum disorder (HR-sibs), yet little is known about early predictors. There is growing evidence that motor and language development are linked and this connection might be mediated by joint attention. Developmental changes in motor abilities change how children interact with objects and people (e.g., by showing), which may influence language development. This association has however not yet been studied in HR-sibs. The interrelationship between motor, joint attention and language skills was explored in younger siblings of typically developing children (LR-sibs, N = 31) and HR-sibs (N = 32). In both groups, motor skills (composite of fine and gross motor skills) at 10 months influenced receptive and expressive language at 36 months directly and indirectly through joint attention at 14 months. Group status moderated this direct and indirect effect with mainly significant effects in HR-sibs. This indicates that lower motor skills can have cascading effects on joint attention and language in HR-sibs. Consequently, assessment of early motor skills in HR-sibs might hold promise for early identification of motor difficulties but can also be indicative of language difficulties later in life, especially when difficulties with joint attention are also present.