The present study examined individual differences in theory of mind (ToM) among a group of 60 children (7-11 years-old) with autism spectrum disorder (ASD) and average intelligence. Using open-ended and structured tasks to measure affective ToM, cognitive ToM, and spontaneous social attribution, we explored the nature of ToM and assessed whether ToM predicts the phenotypic heterogeneity in ASD through structural equation modeling. Affective ToM uniquely predicted social symptom severity, whereas no ToM types predicted parent reported social functioning. Our findings suggest that differentiating among theoretical components is crucial for future ToM research in ASD, and ToM challenges related to reasoning about others' emotions may be particularly useful in distinguishing children with worse social symptoms of ASD.

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This randomized, controlled study examined the initial efficacy of an executive function training program for children with autism spectrum disorder. Seventy 7- to 11 year-olds with autism spectrum disorder and intelligence quotients ⩾80 were randomly assigned to receive a web-based set of executive function training games combined with in-person metacognition coaching or to a waitlist. Primary outcomes were evaluated for neural responses related to executive function, lab-based executive function behavior, and generalization of executive function skills. Secondary outcomes included measures of social function. Post-testing and analyses were conducted by staff naïve to group assignment. Children exhibited a change in neural response following training relative to the waitlist group [Formula: see text]. Training effects were not detected via lab-based tasks [Formula: see text] or generalized to caregiver-reported executive function skills outside the lab [Formula: see text]. However, the training group demonstrated reduced symptoms of repetitive behavior [Formula: see text] following training. There were no adverse events or attrition from the training group. Findings suggest that brief, targeted computer-based training program accompanied by coaching is feasible and may improve neural responses and repetitive behaviors of school-aged children with autism spectrum disorder. Lay abstract Executive function, which is a set of thinking skills that includes stopping unwanted responses, being flexible, and remembering information needed to solve problems, is a challenge for many children on the autism spectrum. This study tested whether executive function could be improved with a computerized executive function training program under the guidance of a coach who reinforced the use of executive function skills. Seventy children with autism spectrum disorder from age 7 to 11 years of age participated in the study. They were randomly assigned to receive training or to a waiting group. The tests most likely to determine whether the training may be effective were chosen from a larger battery before the study started and included one task measuring brain responses, two measures of executive function in the lab, and a parent questionnaire. Changes in social functioning and repetitive behaviors were also explored. All children assigned to training completed the program and families generally reported the experience was positive. Brain responses of the training group changed following training, but not within the waiting group during a similar time period. Children who received training did not exhibit behavioral changes during the two the lab-based tasks. Parent report on questionnaires indicated that neither group showed a significant change in their broad use of executive function in other settings. Yet, children who received training were reported to have fewer restricted and repetitive behaviors following training. These initial findings suggest that short executive function training activities are feasible and may improve some functioning of school-aged children on the autism spectrum.

Objective:The N2 ERP component is used as a biomeasure of executive function in children with autism spectrum disorder (ASD). The aim of the current study was to evaluate the test-retest reliability of N2 amplitude in this population.Methods: ERPs were recorded from 7 to 11-year-old children with ASD during Flanker (n = 21) and Go/Nogo tasks (n = 14) administered at two time points separated by approximately three months. Reliability of the N2 component was examined using intraclass correlation coefficients (ICCs).Results: Reliability for mean N2 amplitude obtained during the Flanker task was moderate (congruent: ICC = 0.542, 95% CI [0.173,0.782]; incongruent: ICC = 0.629, 95% CI [0.276,0.831]). Similarly, reliability for the Go/Nogo task ranged from moderate to good ('go': ICC = 0.817, 95% CI [0.535,0.937]; 'nogo': ICC = 0.578, 95% CI [0.075,0.843]).Conclusions: These findings support the use of N2 amplitude as a biomeasure of executive function in school-aged children with ASD.Significance: This research addresses a critical gap in clinical neurophysiology, as an understanding of the stability and reliability of the N2 component is needed in order to

Thirty to 80% of children with autism spectrum disorder also have symptoms of attention-deficit hyperactivity disorder. Many children with autism spectrum disorder and attention-deficit hyperactivity disorder experience difficulties carrying out goal-directed behaviors, particularly when it comes to inhibiting responses. The aim of this study was to better understand the relative strengths and weaknesses across different measures of inhibition in children with autism spectrum disorder, attention-deficit hyperactivity disorder, autism spectrum disorder + attention-deficit hyperactivity disorder, and children who are typically developing. Inhibition of distracting information, motor responses, response speed, and selections with the potential for greater loss was measured in 155 school-aged children across these four groups. Results indicate that, for children with autism spectrum disorder + attention-deficit hyperactivity disorder, inhibition varied across the different outcomes assessed. Relative to typically developing children, children with autism spectrum disorder + attention-deficit hyperactivity disorder showed greater difficulty inhibiting behavioral responses. Conversely, inhibition of distracting information and strategic slowing of response speed differed between the children with autism spectrum disorder + attention-deficit hyperactivity disorder and those with either autism spectrum disorder or attention-deficit hyperactivity disorder. Avoidance of potential losses did not significantly differ between the four groups. The unique pattern of inhibition abilities shown in the autism spectrum disorder + attention-deficit hyperactivity disorder group suggests the need for special consideration in the context of targeted intervention. Lay Abstract Many children with autism spectrum disorder (ASD) also have symptoms of attention-deficit hyperactivity disorder (ADHD). Children with ASD and ADHD often experience difficulties with inhibition. This study had the goal of understanding inhibition in children with ASD, ADHD, ASD + ADHD, and children who are typically developing (TD) using tasks that measured several aspects of inhibition. Results indicate that children with ASD + ADHD had greater difficulty inhibiting behavioral responses than TD children. Children with ASD + ADHD also differed from children with ASD and with ADHD in their inhibition of distracting information and strategic slowing of response speed. The four groups did not differ in their avoidance of potential losses. Children with ASD + ADHD exhibit a unique profile of inhibition challenges suggesting they may benefit from targeted intervention matched to their abilities.

Zika virus (ZIKV) was identified as a teratogen in 2016 when an increase in severe microcephaly and other brain defects was observed in fetuses and newborns following outbreaks in French Polynesia (2013–2014) and Brazil (2015–2016) and among travelers to other countries experiencing outbreaks. Some have questioned why ZIKV was not recognized as a teratogen before these outbreaks: whether novel genetic changes in ZIKV had increased its teratogenicity or whether its association with birth defects had previously been undetected. Here we examine the evidence for these two possibilities. We describe evidence for specific mutations that arose before the French Polynesia outbreak that might have increased ZIKV teratogenicity. We also present information on children born with findings consistent with congenital Zika syndrome (CZS) as early as 2009 and epidemiological evidence that suggests increases in CZS‐type birth defects before 2013. We also explore reasons why a link between ZIKV and birth defects might have been missed, including issues with surveillance of ZIKV infections and of birth defects, challenges to ZIKV diagnostic testing, and the susceptibility of different populations to ZIKV infection at the time of pregnancy. Although it is not possible to prove definitively that ZIKV had teratogenic properties before 2013, several pieces of evidence support the hypothesis that its teratogenicity had been missed in the past. These findings emphasize the need for further investments in global surveillance for emerging infections and for birth defects so that infectious teratogens can be identified more expeditiously in the future.

The relative difference of resting EEG frontal alpha activation between left and right hemispheres (FAA; i.e., asymmetry) correlates with global approach and avoidance tendencies. FAA may relate to problems with executive and affective functioning in children with neurodevelopmental differences, including autism and ADHD. We (1) characterize relative left vs. right FAA in autistic, ADHD, and neurotypical children (NT) and (2) investigate whether FAA predicts “hot” executive function or emotion dysregulation. Participants were 97 7- to 11-year-old autistic, ADHD, and NT Children. Children with ADHD displayed greater left (relative to right) FAA compared to autistic and neurotypical children. Children with ADHD displayed greater challenges with “hot” EF on a gambling task than autistic children, whereas children with co-occurring autism and ADHD had greater parent-reported emotion dysregulation than NT and autism-only groups. Greater left FAA predicted worse hot EF for all children but was not significantly related to emotion dysregulation. Regardless of clinical diagnosis, relatively greater left FAA relates to hot EF. While hot EF deficits may be specific to ADHD rather than autism, both together confer additive risk for emotion dysregulation. Future research should explore the functional relation between FAA, reward processing, and affect for children with different EF-related neurodevelopmental differences.

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