Repetitive transcranial magnetic stimulation (rTMS) in autism spectrum disorder: protocol for a multicentre randomised controlled clinical trial

Introduction There are no well-established biomedical treatments for the core symptoms of autism spectrum disorder (ASD). A small number of studies suggest that repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, may improve clinical and cognitive outcomes in ASD. We describe here the protocol for a funded multicentre randomised controlled clinical trial to investigate whether a course of rTMS to the right temporoparietal junction (rTPJ), which has demonstrated abnormal brain activation in ASD, can improve social communication in adolescents and young adults with ASD. Methods and analysis This study will evaluate the safety and efficacy of a 4-week course of intermittent theta burst stimulation (iTBS, a variant of rTMS) in ASD. Participants meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ASD (n=150, aged 14–40 years) will receive 20 sessions of either active iTBS (600 pulses) or sham iTBS (in which a sham coil mimics the sensation of iTBS, but no active stimulation is delivered) to the rTPJ. Participants will undergo a range of clinical, cognitive, epi/genetic, and neurophysiological assessments before and at multiple time points up to 6 months after iTBS. Safety will be assessed via a structured questionnaire and adverse event reporting. The study will be conducted from November 2020 to October 2024. Ethics and dissemination The study was approved by the Human Research Ethics Committee of Monash Health (Melbourne, Australia) under Australia’s National Mutual Acceptance scheme. The trial will be conducted according to Good Clinical Practice, and findings will be written up for scholarly publication. Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN12620000890932)

Educational neuroscience: progress and prospects

Educational neuroscience is an interdisciplinary research field that seeks to translate research findings on neural mechanisms of learning to educational practice and policy, and to understand the effects of education on the brain. Neuroscience and education can interact directly, by virtue of considering the brain as a biological organ that needs to be in the optimal condition to learn (‘brain health’); or indirectly, as neuroscience shapes psychological theory and psychology influences education. In this article, we trace the origins of educational neuroscience, its main areas of research activity, and the principal challenges it faces as a translational field. We consider how a pure psychology approach that ignores neuroscience is at risk of being misleading for educators. We address the major criticisms of the field, respectively comprising a priori arguments against the relevance of neuroscience to education, reservations with the current practical operation of the field, and doubts about the viability of neuroscience methods for diagnosing disorders or predicting individual differences. We consider future prospects of the field and ethical issues it raises. Finally, we discuss the challenge of responding to the (welcome) desire of education policymakers to include neuroscience evidence in their policymaking, while ensuring recommendations do not exceed the limitations of current basic science

Attention and basic literacy and numeracy in children with Autism Spectrum Disorder: a one-year follow-up study

Little is known about the link between Executive Functioning (EF) and academic performance in children with Autism Spectrum Disorder (ASD) and how such links develop over time. This study examined word reading, basic mathematics, attention switching, sustained attention and their development. Two age, gender and perceptual IQ matched groups of cognitively able 7-12 year olds (ASD N = 40; typical developing [TYP] N = 40) were assessed at baseline and one year later, completing Word Reading and Numerical Operations tests and computerized tasks tapping attention switching and sustained attention. Children with ASD had similar word reading and numerical operations performance and similar development of these skills relative to TYP children. A delay in attention switching but similar development was found in children with ASD relative to TYP children. The EF tasks were correlated with reading and mathematics in ASD children only, however, in regression analyses these factors were not significant predictors of Time 2 reading and mathematics after accounting for Time 1 reading and mathematics scores. These findings indicate similar word reading and mathematics development but atypical attention profiles in cognitively able children with ASD. Implications for educators are discussed

Random number generation in low functioning individuals with autism: A case for a compromised lateral orbito-frontal circuit

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Processi di generazione casuale di numeri nell' Autismo

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The developmental trajectory of parent-report and objective sleep profiles in autism spectrum disorder: Associations with anxiety and bedtime routines

The present study compared the course of parent-report and actigraphy-derived sleep profiles over a 1-year period, in school-age children with autism spectrum disorder and typically developing children. The Children’s Sleep Habits Questionnaire and 14 nights of actigraphy were used to assess sleep profiles. Parents also completed the Spence Children’s Anxiety Scale, the Social Worries Questionnaire and the Bedtime Routines Questionnaire. Between-group differences in parent-reported sleep problems were less pronounced at follow-up compared to baseline. The course of objective sleep was comparable between groups, with a significant reduction in sleep duration over time in both groups. Children with autism spectrum disorder were further characterised by significantly more night-to-night variability in sleep quality, across both time points. Reductions over time in parent-reported sleep problems were significantly associated with reduced anxiety. Reductions in actigraphy-derived sleep efficiency were associated with an increased frequency of maladaptive activities in the hour before bedtime, in both children with and without autism spectrum disorder