While it has been suggested that alterations in the composition of gut microbial metabolites may play a causative role in the pathophysiology of autism spectrum disorder (ASD), it is not known how gut microbial metabolites are associated with ASD-specific brain alterations. In this cross-sectional, case-control observational study, (i) fecal metabolomics, (ii) task-based functional magnetic resonance imaging (fMRI), and (iii) behavioral assessments were obtained from 43 ASD and 41 neurotypical (NT) children, aged 8–17. The fMRI tasks used socio-emotional and sensory paradigms that commonly reveal strong evoked brain differences in ASD participants. Our results show that fecal levels of specific tryptophan-related metabolites, including kynurenate, were significantly lower in ASD compared to NT, and were associated with: 1) alterations in insular and cingulate cortical activity previously implicated in ASD; and 2) ASD severity and symptoms (e.g., ADOS scores, disgust propensity, and sensory sensitivities). Moreover, activity in the mid-insula and mid-cingulate significantly mediated relationships between the microbial tryptophan metabolites (indolelactate and tryptophan betaine) and ASD severity and disgust sensitivity. Thus, we identify associations between gut microbial tryptophan metabolites, ASD symptoms, and brain activity in humans, particularly in brain regions associated with interoceptive processing.

Developmental Coordination Disorder (DCD) is one of the least studied and understood developmental disorders. One area that has been minimally investigated in DCD is potential issues with sensory modulation. Further, in other neurodevelopmental disorders (e.g., autism spectrum disorder (ASD)) sensory modulation is related to many other challenges (e.g., social issues, repetitive behaviors, anxiety); however, such potential relationships in children with DCD have been largely unexplored. The purpose of this study is to explore sensory modulation differences in DCD and to understand the relationships between sensory modulation and social emotional measures, behavior, and motor skills in DCD in comparison to ASD and typically developing (TD) peers. Participants (aged 8–17) and their caregivers (DCD, N = 26; ASD, N = 57; and TD, N = 53) completed behavioral and clinical measures. The results indicated that 31% of the DCD group showed sensory modulation difficulties, with the DCD group falling between the ASD and TD groups. In the DCD group, sensory modulation was significantly associated with anxiety, empathic concern, repetitive behaviors, and motor skills. Data are compared to patterns seen in ASD and TD groups and implications for interventions are discussed.

Prior studies show differences in empathy and affect-recognition ability between those with autism spectrum disorder (ASD) and typically developing (TD) individuals. Autistic individuals also exhibit increased behavioral, gastrointestinal, and sleep issues. In the current study, we explored the differences in empathy and affect recognition between the ASD and TD groups; and we investigated their associations with conditions co-occurring in ASD. A total of 54 TD and 56 ASD children (8–17 years) were included. As compared to the TD group, the ASD group showed lower scores for affect recognition and perspective taking (PT) and higher scores for personal distress (PD). Interestingly, results from hierarchical linear regressions suggested that disparities in the PD and PT between the groups were primarily attributable to attenuated levels of alexithymia, rather than being mediated by the presence of an autism diagnosis. Differences in affect-recognition ability, however, were mediated by both an autism diagnosis and alexithymia. We also found significant correlations between empathy and affect recognition and measures of related conditions common in ASD. Alexithymia, hence, contributes to difficulties in empathy while both alexithymia and autism are associated with affect-recognition ability in ASD. Additionally, the association between affect recognition and empathic ability with co-occurring conditions in ASD needs to be considered during assessments and interventions.

Neuro-occupation was developed to study the relationship between the nervous system and occupation. Pragmatic implications of neuro-occupation have not been previously summarized. This study aimed to determine how neuro-occupation has been defined, applied across relevant fields, and evolved over time. We performed a scoping review following the Arksey and O’Malley framework. Twenty-five works related to neuro-occupation published between 1997 and 2020 were included. We found that neuro-occupation evolved from utilization primarily in the United States to an international term applied to different clinical populations. Common themes were: (a) the reciprocal relationship between the nervous system and occupations; (b) the Intention, Meaning, and Perception (IMP) model of neuro-occupation; and (c) pragmatic implications for occupational therapy practice and interventions. We suggest an updated definition of neuro-occupation. In addition, we contend that although the term neuro-occupation was developed in response to historical debates in occupational therapy, continued use creates more confusion than clarity.

Purpose: The brain-gut-microbiome (BGM) system encompasses a bidirectional communication network between the gut microbiome and the brain and plays a critical role in maintaining gut function and modulating behavior. Here, we specifically focus on the interactions between sensory over-responsivity (SOR), a common phenotype in Autism Spectrum Disorder (ASD), and the BGM system and discuss potential mechanisms underlying these interactions. Methods: We examine key constructs and frameworks related to sensory processing, autism, and the BGM system, synthesize literature to identify knowledge gaps, and propose a model linking the BGM system and SOR in autism. Results: Grounded in prior literature, we propose a conceptual model involving the brain, the gut microbiome, and SOR in autism. In this model sensory features of foods commonly associated with SOR contribute to atypical eating behaviors, resulting in differences in dietary intake, which in turn affect the gut and oral microbiomes. The gut microbiome can impact neural activity and brain structure via the connection between the gut and the brain, further contributing to SOR. Conclusion: The interdisciplinary nature of this topic is emphasized, bridging research from neuroscience, microbiology, pediatrics, nutrition, psychology, and occupational therapy/occupational science. Reflecting on the intersection of autism characteristics and microbiome health, this analysis offers critical insights for research and clinical practice.

Introduction: There has been a recent spike in mental health concerns among college students, with a history of stress and traumatic experiences contributing to feelings of anxiety and depression. Expressive drawing has been shown to improve mental health, but numerous factors can impact its efficacy, for example, the relationship between expressive drawing and one’s emotional expressiveness (EE). Understanding the impact of EE and ambivalence over emotional expressiveness (AEE) on expressive drawing therapies may help guide clinical application. Methods: This pilot study assessed the effects of trauma and gratitude-focused expressive drawing in college students (N=71) who self-reported experiencing a traumatic event. Participants were randomly assigned to trauma, gratitude, or control drawing conditions. Participants drew for up to 30 minutes weekly for 4 weeks. Depression, anxiety, EE, and AEE were collected before and after the intervention. Results: EE and AEE moderated changes in depression and anxiety in expressive drawing groups relative to the control group. Depression was significantly reduced in participants with low AEE after trauma-focused drawing, and in participants with low EE after trauma and gratitude drawing. Discussion: These results suggest that expressivity profiles should be considered when clinicians utilize drawing interventions to reduce anxiety and depression in college students.