Vaccine-Induced Viral Reactivation and Autism Spectrum Disorder: A Review, Hypothesis and Implications. (preprint)

Understanding the origins of autism spectrum disorder is imperative given its increasing prevalence and significant global impact. This review examines existing research on the role of viral infections in the etiology of autism and scrutinizes emerging data on post-vaccination viral reactivation. It introduces a novel hypothesis, that vaccines may inadvertently reactivate latent viral infections, triggering the onset or exacerbation of autism. Through a comprehensive literature review across multiple databases and search engines, this review analyzed studies, case reports, and observational research focusing on viral infections, post-vaccination viral reactivation, and autism. This search yielded 12 studies implicating viral infections and viral encephalitis as potential causal factors in the development of autism spectrum disorder. Moreover, 10 studies were identified suggesting an association of viral reactivation following vaccination. This connection raises important questions about the potential role of vaccines in the onset of autism. The findings advocate for continued vigilance in vaccine safety research, particularly concerning neurodevelopmental disorders.

The Human Microglia Atlas (HuMicA) Unravels Changes in Homeostatic and Disease-Associated Microglia Subsets across Neurodegenerative Conditions (preprint)

Dysregulated microglia activation, leading to neuroinflammation, is currently considered to be of major relevance in the development and progression of neurodegenerative diseases. The initial M1/M2 dual activation classification for microglia is now considered outdated. Even the "disease-associated microglia" (DAM) phenotype, firstly described in mice, has proven insufficient to precisely represent the multitude of microglia phenotypes in pathology. In this study, we have constructed a transcriptomic atlas of human brain immune cells by integrating single-nucleus (sn)RNA-seq datasets from multiple neurodegenerative conditions. Sixteen datasets were included, comprising 295 samples from patients with Alzheimer's disease, autism spectrum disorder, epilepsy, multiple sclerosis, Lewy body diseases, COVID-19, and healthy controls. The integrated Human Microglia Atlas (HuMicA) dataset included 60,557 nuclei and revealed 11 microglial subpopulations distributed across all pathological and healthy conditions. Among these, we identified four different homeostatic clusters as well as pathological phenotypes. These included two stages of early and late activation of the DAM phenotype and the disease-inflammatory macrophage (DIM) phenotype, which was recently described in mice, and is also present in human microglia, as indicated by our analysis. The high versatility of microglia is evident through changes in subset distribution across various pathologies, suggesting their contribution to the establishment of pathological phenotypes. Our analysis showed overall depletion of four substates of homeostatic microglia, and expansion of niche subpopulations within the DAM and DIM spectrum across distinct neurodegenerative pathologies. The HuMicA is an invaluable resource tool used to support further advances in the study of microglia biology through healthy and disease settings.

A systematic review of the impact of the COVID-19 pandemic on the mental health of adolescents and young people with disabilities aged 15-29 years (preprint)

Background The COVID-19 pandemic has exacerbated the psychological burden on young people around the world and may have disproportionately large impacts for young people with disabilities. This review aims to systematically review the quantitative evidence on the impact of the COVID-19 pandemic on the mental health of young people with disabilities and evaluate the quality of included studies.Methods A systematic search was conducted using 5 electronic databases. The quality of the studies was assessed using the SIGN risk of bias assessment tool. A narrative synthesis was performed to synthesize the results of included studies.Results The initial search yielded 1935 studies, of which two met the eligibility criteria, one longitudinal study and one cross-sectional study, both assessed to be of low quality. In the cross-sectional study, young people with intellectual and developmental disabilities self-reported an increase in mental health symptoms. The longitudinal study found no evidence of a change in mental health symptoms from pre-pandemic to during the pandemic among young people with autism spectrum disorder, although these individuals reported negative impacts of the COVID-19 pandemic on their emotional or mental health.Conclusions The findings of this review provide some weak evidence of a negative impact of the COVID-19 pandemic on the mental health of young people with disabilities. Importantly, the findings highlight the lack of research in this area. More research is needed to investigate the impact of the pandemic on the mental health of young disabled people, in order for governments to develop emergency preparedness plans to safeguard the well-being of this population.

Psychosocial Well-Being and Adaptation in Children and Adolescents with Asperger's Syndrome during Covid-19 Pandemic (preprint)

Mental health could worsen in children and adolescents with autism spectrum disorder during the Covid19 pandemic. In addition, their parents could be more at risk for an increase in anxiety and depression symptomatology. This study aims to understand the adaptation and the psychosocial well-being in a sample of 16 males aged 10-21 years old with Asperger syndrome after the quarantine for Covid19 when they return to school and partially to their activities in September 2020, The approach adopted is multi-informant with a battery of questionnaires on psychological health and adaptation given by a secure online web data Qualtrics both to adolescents and also to their parents. Paralleling matched peers with typically development were assessed adopting the same methodology. The results evidenced several difficulties in Asperger’s psychological health, especially in anxiety and socialization. Also adaptation is put in crisis, even if they reported a good comprehension and adoption of the behaviors anti-Covid19. Parents of children with Asperger reported similar psychological difficulties and general health than those of the group of children typically developing. Some clinical indications could be discussed for psychologists who follow children and adolescents with Asperger.

Utility of Diagnostic Classification for Children 0-5 to Assess Features of Autism: Comparing In-person and COVID-19 Telehealth Evaluations.

Logistic regression was used to examine the use of Autism Spectrum diagnostic categories from pre-COVID-19 in-person evaluations and COVID-19 telehealth evaluations at a specialist community mental health clinic. The diagnostic classification for children 0-5 (DC: 0-5) affords a wider range of diagnoses that allowed for inferences of clinician certainty of diagnosis. Use of full criteria diagnoses was significantly lower from telehealth evaluations during the pandemic, and was less certain for younger children, some non-English speakers, and children reporting Native American/Alaska Native race. Higher Child Behavior Checklist (CBCL) ASD subscale scores, lower CBCL total scores, and global developmental delay diagnoses predicted greater use of full ASD diagnoses. Findings suggest factors that could identify children appropriate for telehealth evaluations.

A randomised controlled trial of clinical and cost-effectiveness of the PASS Plus intervention for young children with autism spectrum disorder in New Delhi, India: Study protocol for the COMPASS trial. (preprint)

Background: Autism Spectrum Disorders (ASD) is a neurodevelopmental disability affecting at least 5 million children in South Asia. Majority of these children are without access to evidence-based care. The UK Pre-school Autism Communication Therapy (PACT) is the only intervention to have shown sustained impact on autism symptoms. It was systematically adapted for non-specialist community delivery in South Asia; as the 'Parent-mediated Autism Social Communication Intervention for non-Specialists (PASS) and extended ‘PASS Plus’ interventions. RCTs of both showed feasibility, acceptability and positive effect on parent and child dyadic outcomes. Methods: The Communication-centred Parent-mediated treatment for Autism Spectrum Disorder in South Asia (COMPASS) trial is now a scale-up two centre, two arm single (rater) blinded random allocation parallel group study of the PASS Plus intervention in addition to treatment as usual (TAU) compared to TAU alone, plus health economic evaluation – embedded in the India health system. 240 children (approximately 120 intervention/120 TAU) with ASD aged 2-9 years will be recruited from two tertiary care government hospitals in New Delhi, India. Accredited Social Health Activists will be one of the intervention delivery agents. Families will undertake up to 12 communication sessions over 8 months and will be offered the Plus modules which address coexisting problems. The trial’s primary endpoint is at 9 months from randomization, with follow-up at 15 months. The primary outcome is autism symptom severity; secondary outcomes include parent-child communication, child adaptation, quality of life and parental wellbeing. Primary analysis will follow intention-to-treat principles using linear mixed model regressions with group allocation and repeated measures as random effects. The primary cost-effectiveness analysis will use a societal perspective over the 15-month period of intervention and follow-up. Discussion: If clinically and cost effective, this programme will fill an important gap of scalable interventions delivered by non specialist health workers within the current care pathways for autistic children and their families in low resource contexts. The programme has been implemented through the COVID-19 pandemic when restrictions were in place; intervention delivery and evaluation processes have been adapted to address these conditions. Trial Registration: ISRCTN; ISRCTN21454676; Registered 22 June 2018; https://www.isrctn.com/ISRCTN21454676?q=21454676;

Molecular autism research in Africa: a scoping review comparing publication outputs to Brazil, India, the UK, and the USA (preprint)

ABSTRACT The increased awareness of autism spectrum disorders (ASD) is accompanied by burgeoning ASD research, and concerted research efforts are trying to elucidate the molecular ASD aetiology. However, much of this research is concentrated in the Global North, with recent reviews of research in Sub-Saharan Africa (SSA) highlighting the significant shortage of ASD publications from this region. The most limited focus area was molecular research with only two molecular studies ever published from SSA, both being from South Africa (SA). We examine the molecular ASD research publications from 2016 to 2021 from all African countries, with a special focus on SA. The SSA publications are compared to Brazil and India, two non-African, low-to-middle-income countries (LMICs), and to the UK and USA, two high-income countries (HICs). There were 228 publications across all regions of interest; only three publications were from SA. Brazil (n=29) and India (n=27) had almost 10 times more publications than SA. The HICs had more publications than the LMICs, with the UK (n=62) and the USA (n=74) having approximately 20 to 25 times more publications than SA, respectively. Given that SA has substantial research capacity as demonstrated by its recent research on SARS-CoV-2, we explore potential reasons for this deficit in molecular ASD publications from SA. We compare mental health research outputs, GDP per capita, research and development expenditure, and the number of psychiatrists and child psychiatrists per 100,000 people across all regions. The UK and the USA had significantly higher numbers for all these indicators, consistent with their higher publication output. Among the LMICs, SA can potentially produce more molecular ASD research, however, there are numerous barriers that need to be addressed to facilitate increased research capacity. These include cultural stigmas, challenges in accessing mental healthcare, shortages of specialists in the public sector, and the unreliability of ASD diagnostic tools across the 11 official SA languages. The unique genetic architecture of African populations presents an untapped reservoir for finding novel genetic loci associated with ASD. Therefore, addressing the disparity in molecular ASD research between the Global North and SSA is integral to global advancements in ASD research.

Deep Mobile Linguistic Therapy for Patients with ASD.

Autistic spectrum disorder (ASD) is one of the most complex groups of neurobehavioral and developmental conditions. The reason is the presence of three different impaired domains, such as social interaction, communication, and restricted repetitive behaviors. Some children with ASD may not be able to communicate using language or speech. Many experts propose that continued therapy in the form of software training in this area might help to bring improvement. In this work, we propose a design of software speech therapy system for ASD. We combined different devices, technologies, and features with techniques of home rehabilitation. We used TensorFlow for Image Classification, ArKit for Text-to-Speech, Cloud Database, Binary Search, Natural Language Processing, Dataset of Sentences, and Dataset of Images with two different Operating Systems designed for Smart Mobile devices in daily life. This software is a combination of different Deep Learning Technologies and makes Human-Computer Interaction Therapy very easy to conduct. In addition, we explain the way these were connected and put to work together. Additionally, we explain in detail the architecture of software and how each component works together as an integrated Therapy System. Finally, it allows the patient with ASD to perform the therapy anytime and everywhere, as well as transmitting information to a medical specialist.

REACH-ASD: A UK randomised controlled trial of a new post-diagnostic psycho-education and acceptance and commitment therapy programme against treatment-as-usual for improving the mental health and adjustment of caregivers of children recently diagnosed with Autism Spectrum Disorder (preprint)

Background: Autism is a neurodevelopmental disability affecting over 1% of UK children. The period following a child’s autism diagnosis can present real challenges in adaptation for families. Twenty to fifty percent of caregivers show clinically significant levels of mental health need within the post-diagnostic period and on an ongoing basis. Best practice guidelines recommend timely post-diagnostic family support. Current provision is patchy, largely unevidenced, and a source of dissatisfaction for both families and professionals. There is a pressing need for an evidenced programme of post-diagnostic support focusing on caregiver mental health and adjustment, alongside autism psycho-education. This trial tests the clinical and cost effectiveness of a new brief manualised psychosocial intervention designed to address this gap. Methods: This is a multi-centre two-parallel-group single (researcher)-blinded randomised controlled trial of the Empower-Autism programme plus treatment-as-usual versus usual local post-diagnostic offer plus treatment-as-usual. Caregivers of children aged 2-15 years with a recent autism diagnosis will be recruited from North West England NHS or local authority centres. Randomization is individually by child, with one “index” caregiver per child, stratified by centre, using 2:1 randomisation ratio to assist recruitment and timely intervention. Empower-Autism is a group-based, manualised, post-diagnostic programme that combines autism psycho-education and psychotherapeutic components based on Acceptance and Commitment Therapy to support caregiver mental health, stress management and adjustment to their child’s diagnosis. The comparator is any usual local group-based post-diagnostic psycho-education offer. Receipt of services will be specified through health economic data. Primary outcome: caregiver mental health (General Health Questionnaire-30) at 52-week follow-up. Secondary outcomes: key caregiver measures (wellbeing, self-efficacy, adjustment, autism knowledge) at 12-, 26- and 52-week follow-up and family and child outcomes (wellbeing and functioning) at 52-week endpoint. Sample: N=380 (approximately 253 intervention/127 treatment-as-usual). Primary analysis will follow intention-to-treat principles using linear mixed models with random intercepts for group membership and repeated measures. Cost-effectiveness acceptability analyses will be over 52 weeks, with decision modelling to extrapolate to longer time periods. Discussion: If effective, this new approach will fill a key gap in the provision of evidence-based care pathways for autistic children and their families. Trial registration ISRCTN ID:45412843. https://www.isrctn.com/ISRCTNISRCTN45412843. Prospectively registered on 11 September 2019

Mental-health before and during the COVID-19 pandemic in adults with neurodevelopmental disorders. (preprint)

The COVID-19 pandemic negatively impacted mental health globally. Individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), are at elevated risk of mental health difficulties. Therefore, we investigated the impact of the pandemic on anxiety, depression and mental wellbeing in adults with NDDs using longitudinal data from the Avon Longitudinal Study of Parents and Children study (n=3,058). Mental health data were collected pre-pandemic (age 21-25) and at three timepoints during the pandemic (ages 27-28) using the Short Mood and Feelings Questionnaire, Generalised Anxiety Disorder Assessment-7, and Warwick Edinburgh Mental Wellbeing Scale. ADHD and ASD were defined using validated cut-points of the Strengths and Difficulties Questionnaire and Autism Spectrum Quotient, self-reported at age 25. We used multi-level mixed-effects models to investigate changes in mental health in those with ADHD and ASD compared to those without. Prevalences of depression, anxiety and poor mental wellbeing were higher at all timepoints (pre-pandemic and during pandemic) in those with ADHD and ASD compared to those without. Anxiety increased to a greater extent in those with ADHD ({beta}=0.8 [0.2,1.4], p=0.01) and ASD ({beta}=1.2 [-0.1,2.5], p=0.07), while depression symptoms decreased, particularly in females with ASD ({beta}=-3.1 [-4.6,-1.5], p=0.0001). On average, mental wellbeing decreased in all, but to a lesser extent in those with ADHD ({beta}=1.3 [0.2,2.5], p=0.03) and females with ASD ({beta}=3.0 [0.2,5.9], p=0.04). To conclude, anxiety disproportionately increased in adults with NDDs during the pandemic, however, the related lockdowns may have provided a protective environment for depressive symptoms in the same individuals.

Exploring psychosocial impacts of COVID-19 mandates in children with and without autism spectrum disorder (preprint)

Children with autism spectrum disorder (ASD) are particularly at risk for adverse psychosocial consequences as a result of unexpected challenges such as the COVID-19 pandemic. These children experience a higher prevalence of depression and anxiety, difficulties with cognitive flexibility, and a reduction in support services during the pandemic. Higher executive function (EF) has been previously found to be protective against negative mental health outcomes. Here we probed the psychosocial impacts of pandemic responses in children with ASD by relating pre-pandemic (EF) measures with mental health outcomes measured several months into the pandemic. We found that pre-existing inhibition and shift difficulties measured by the Behavior Rating Inventory of Executive Function predicted higher risk of anxiety symptoms, with shift difficulties also predicting elevated depressive symptoms during the pandemic. These findings are critical for promoting community recovery and maximizing clinical preparedness to support children at increased risk for adverse psychosocial outcomes.

Context-aware deconvolution of cell-cell communication with Tensor-cell2cell (preprint)

Cell interactions determine phenotypes, and intercellular communication is shaped by cellular contexts such as disease state, organismal life stage, and tissue microenvironment. Single-cell technologies measure the molecules mediating cell-cell communication, and emerging computational tools can exploit these data to decipher intercellular communication. However, current methods either disregard cellular context or rely on simple pairwise comparisons between samples, thus limiting the ability to decipher complex cell-cell communication across multiple time points, levels of disease severity, or spatial contexts. Here we present Tensor-cell2cell, an unsupervised method using tensor decomposition, which is the first strategy to decipher context-driven intercellular communication by simultaneously accounting for multiple stages, states, or locations of the cells. To do so, Tensor-cell2cell uncovers context-driven patterns of communication associated with different phenotypic states and determined by unique combinations of cell types and ligand-receptor pairs. As such, Tensor-cell2cell robustly improves upon and extends the analytical capabilities of existing tools. We show Tensor-cell2cell can identify multiple modules associated with distinct communication processes (e.g., participating cell-cell and ligand receptor pairs) linked to COVID-19 severities and Autism Spectrum Disorder. Thus, we introduce an effective and easy-to-use strategy for understanding complex communication patterns across diverse conditions.

Rapid Evidence Review of Community Engagement in The UK During The COVID-19 Pandemic: How Can Community Assets Redress Health Inequities? (preprint)

Background Community-based engagement has been crucial during the COVID-19 pandemic, fostering informal and local mutual aid between individuals, community groups, charities, community interest companies and local authorities. The current rapid evidence review examines the emergence of community-based arts, nature, music, theatre and other types of cultural engagement amongst UK communities in response to the COVID-19 pandemic. It focuses on all community engagement with a sub-focus on provisions accessed by and targeted towards vulnerable groups.Methods Two hundred and fifty-six resources created between February 2020 and January 2021 were reviewed. Resources were identified through Google Scholar, PubMed, Web of Science, MedRXic, PsycharXiv, and supplemented with searches for grey literature and items in the public domain. The majority reported services that had been adapted to become online, telephone based or delivered at a distance from doorsteps. Over a third of identified resources (37%) were targeted towards socioeconomic outcomes, such as social isolation, financial difficulty or caregiver responsibilities. Over a quarter of resources (28%) were targeted towards psychological outcomes, including individuals with mild to moderate anxiety and depression, acute mental health needs, or neurodevelopmental conditions such as Autism Spectrum Disorder. Under a fifth of resources (17%) were targeted towards physiological outcomes, including individuals with health conditions such as dementia, chronic pain, immunological conditions, or other conditions requiring shielding. The remaining resources were open to everyone, or targeted towards other groups that did not fall into vulnerability categories such as parents or university students. Several quality assessment frameworks were used to evaluate the quality of data. Whilst a number of peer reviewed, grey literature and public domain items were identified, less than half of the identified literature met quality thresholds. The pace of the response to the pandemic may have meant robust evaluation procedures were not always in place.Conclusions Outreach to vulnerable audiences was generally observed via a plethora of organisations, however more robust and longitudinal evidence is needed as to the efficacy and impact of community programmes, services and activities.

Autism Spectrum Disorder on Twitter during COVID-19: Account Types, Self-Descriptions and Tweeting Themes (preprint)

Social media can be used to share experiences of health-related conditions, such as Autism Spectrum Disorder (ASD), and to advertise support. Knowledge about how this occurs can inform those seeking to guide those with the condition. This article reports three related studies to investigate ASD on Twitter in the USA, derived from COVID-19 tweets between March 10 and June 30, 2020. Study 1: Twitter accounts mentioning ASD in author biographies were classified with content analysis by type, finding parents and people declaring ASD to be both common, with support, advocates and specialists also represented. Study 2: The biographies of these accounts were analysed using word association thematic analysis (WATA), finding a strong family relationships theme amongst the parent tweeters, for example. The results also suggested common identity aspects of people declaring ASD, including gaming and artistic interests. Study 3: COVID-19-related tweets from the same accounts were analysed using WATA, finding no ASD-specific themes for parents or people declaring ASD. The results suggest that ASD in the USA is represented for COVID-19 through parents, individuals declaring it, and supporters, but without raising concerns particular to the disorder.

Impact of COVID-19 in Individuals with Autism Spectrum Disorders: Analysis of a National Private Claims Insurance Database (preprint)

The COVID-19 pandemic continues to have a detrimental impact on individuals with disabilities. Data from FAIR Health FH NPIC (National Private Insurance Claims) database, one of the largest national databases of private insurance claim records, were analyzed to understand the experiences of individuals with ASD in COVID-19 pandemic. Multivariate logistic regression models revealed that individuals with ASD + ID were nine times more likely to be hospitalized (OR = 9.3; 95% CI: 6.9, 12.5) and were nearly six times more likely have an elevated length of hospital stay(OR = 5.9; 95% CI: 3.5, 10.1) compared those without ASD + ID. These findings point to their need for prioritization in access to vaccines for preventing COVID-19 infection and morbidities.

Associativity between COVID-19 Pandemic and Serious Mental Illness: Rapid Systematic Review within Salutogenesis Model for Public Health Management (preprint)

The COVID-19 Pandemic, SARS-COV-2 virus-form transformations, and ensuing psychosocial stress stemming from environmental change and isolation, has led to the conjecture that there would be a surge in psychosis cases. Intuitively, patients with Serious Mental Illness (SMI), like Schizophrenia Spectrum Disorder and Major Depression, would be particularly susceptible. Existing literature illustrates psychological distress as a primary effect of the Pandemic - on people with/without SMI. We initiated a rapid review to determine the impact of the SARS-COV-2 virus - in symptomatic and asymptomatic cases - on people with/without psychosis. We envisioned that this would provide insights on effective clinical-intervention methods for psychotic-patients, during and after the Pandemic. Our review draws from papers, published in 2020, that considered participants - with/without psychiatric illness and exposure to SARS-COV-2 infection. The Salutogenesis Model was used to comprehend observations from the systematic-review, leading to suggestions and recommendations for preventive and promotive public health strategies.

Food Insecurity in Households of People with Autism Spectrum Disorder during the COVID-19 Pandemic (preprint)

Objectives: To explore differences in food insecurity for individuals and families of people with autism spectrum disorder (ASD) during the COVID-19 pandemic by individual, family, and neighborhood characteristics. Methods: We surveyed a convenience sample of households of people with ASD. We calculated food insecurity using items from the US Census Bureau Household Pulse Survey. Results: Over half of all respondents reported being food insecure (51.8%). Respondents who reported being food insecure were more likely to be minority, have a high school education or less, be on public insurance or uninsured, live in urban/rural communities, and say that their community is not supportive. The majority of respondents did not get free food or groceries (53.2%). Food insecure respondents who got free food was most likely to get them from schools (34.2%). Conclusion: This is the first study of its kind to explore food security in households of people with ASD. The pandemic has exacerbated existing neighborhood disparities. The federal response to food insecurity caused by the pandemic needs to be further explored especially for preferred and medically necessary foods for people with ASD.

Food Insecurity in the Households of Children with Autism Spectrum Disorders and Intellectual Disabilities in the U.S.: Analysis of the National Survey of Children’s Health Data 2016 - 2018 (preprint)

Individuals with Autism Spectrum Disorder and co-occurring Intellectual Disabilities (ASD + ID) experience substantial challenges in accessing needed supports. This research aimed to understand the prevalence and factors associated with food insecurity among families of children with ASD + ID. Utilizing the National Survey of Children’s Health (2016-18) data, this paper illustrated that the households of children with ASD + ID were about two times more likely to be food insecure than the households of children without disabilities. Further, the households of children with ASD were 1.5 times more likely, and those with other disabilities were 1.3 times more likely to be food insecure than the households of children without disabilities. Implications of these findings in the context of the COVID19 pandemic are discussed. Lay Abstract Families of children with ASD are more likely to experience financial strain and resulting food insecurity due to additional cost of care, disparate access to needed services, and loss of income resulting from job loss. Utilizing nationally representative data, this analysis indicates that the families of children with ASD + ID are twice as likely to experience food insecurity than families of children without disabilities after adjusting for various factors. Several factors, ranging from state-level policies such as Medicaid expansion to individual-level factors such as higher utilization of emergency room services, were associated with the higher prevalence of food insecurity in families of children with ASD + ID. Implications of these findings on programs and policies supporting families in the COVID19 pandemic are discussed.

Preprint: Parent-reported social-communication changes in Children diagnosed with Autism Spectrum Disorder during the COVID-19 pandemic in the UK. (preprint)

The current coronavirus pandemic has swept across the United Kingdom (UK), causing the devolved governments to implement nationwide lockdowns and local restrictions. Given the ever-evolving situation, little is known about the repercussions of coronavirus and the subsequent lockdowns for children diagnosed with Autism Spectrum Disorder (ASD). However, the hallmark features of ASD, such as chronic social-communication challenges, put autistic children at greater risk of being negatively impacted by the coronavirus pandemic. Therefore, this study explores the social-communicative impact of the first lockdown (March 2020 – July 2020) in the UK and the return to school period (September 2020 – October 2020), following prolonged disruption to routine, in children diagnosed with ASD. 176 parents of autistic children from across the UK completed 2 separate online surveys. The results suggested that self-regulation skills ( P < .05) and co-operation skills ( P < .05) were most affected over the course of the lockdown. Additionally, children’s physical activity levels were perceived to significantly increase during the return to school (P < .0001), and this was positively associated with better social-communication outcomes (P < .05). The results also suggested the importance of school support (P < .01), maintaining contact with friends and family during the lockdown period (P < .01), and also attending school regularly during the return to school period (P < .01) for protecting against social skills worsening during these times. Future work is needed to confirm and further explore the findings of this study. Such work could be implemented to protect and improve the social-communicative outcomes of autistic children.