Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 7 appraisals
The Spanish journal of psychology
A Systematic Review of the Risk and Protective Factors for Suicide in Autism Spectrum Disorder
The shorter lifespan and increased prevalence of physical and psychiatric comorbidities in autistic people is a challenge for mental health. There is a high risk of suicide-related behaviors in autism, which are related to mental health issues, social isolation, and other factors. Here we aimed to systematically review the evidence on risk and protective factors of suicidal behaviors in autistic people. Electronic datasets (PubMed, Scopus, Web of Science, and PsycInfo) were searched for empirical articles on the risk and protective factors for suicide in autism. The PRISMA guidelines were followed, and a series of inclusion and exclusion criteria were applied to the retrieved data. This review included 19 studies reporting multiple risk factors associated with suicide-related behaviors. Noteworthy contributors among these factors include psychiatric comorbidities, bullying, cyberbullying, teacher harassment, and cognitive functions. The evidence for protective factors is limited; however, social relationships are highlighted. Identifying risk and protective factors is paramount for detecting early warning signs and enabling the prevention and intervention of suicidal behavior. Our review identified key sociodemographic, clinical, and cognitive risk factors to take into account as alarm-signs when identifying suicidal behaviors in autism.
31 July 2026
Read appraisal →Neuropsychologia
Number of types of synaesthesia can be predicted by structural and functional neuroimaging data.
It has been suggested that synaesthetes have a distinct neurocognitive profile with a broad variety of cognitive and behavioural differences. Recent studies have shown that people with more types (relative to fewer types) of synaesthesia are easier to classify using machine learning of questionnaires and cognitive test data. This suggests a spectrum within synaesthesia, despite synaesthesia itself being typically defined in categorical terms. This study uses the same basic approach applied to 13 brain-based biomarkers. These have previously been shown to distinguish synaesthetes from controls, but it is not known whether they explain heterogeneity amongst synaesthetes. Using machine learning methods (elastic net regression), we were able to find several biomarkers that predict above chance the number of types of synaesthesia. These include both functional MRI (the extent to which brain regions act as hubs) and structural MRI (e.g., intracortical myelination) measures. This is the first project that explores whether it's possible to predict the breadth of synaesthesia from brain-based measures.
29 July 2026
Read appraisal →Science advances
Curiosity-driven development of action and language in robots through self-exploration
Infants acquire language with generalization from minimal experience, whereas large language models require billions of training tokens. What underlies efficient development in humans? We investigated this problem through experiments wherein robotic agents learn to perform actions associated with imperative sentences (e.g., push red cube) via curiosity-driven self-exploration. Our approach amortizes active inference using Q-learning, enabling intrinsically motivated developmental learning. The simulations reveal key findings corresponding to observations in developmental psychology. (i) Generalization improves markedly as the scale of compositional elements increases. (ii) Curiosity-driven exploration enables faster learning. (iii) Rote pairing of sentences and actions precedes compositional generalization. (iv) Exception handling induces U-shaped developmental performance, a pattern like representational redescription in child language learning. These results suggest that curiosity-driven active inference accounts for how intrinsically motivated sensorimotor-linguistic learning supports scalable compositional generalization and exception handling in humans and artificial agents.
25 July 2026
Read appraisal →Current psychiatry reports
Artificial Intelligence in Child and Adolescent Psychiatry: A Narrative Review of Recent Clinical Applications and Ethical Considerations
PURPOSE OF REVIEW: This narrative review examines recent literature of artificial intelligence (AI) in child and adolescent psychiatry. With increasing mental health disorders in young people along with persistent workforce shortages, AI has emerged as a potential tool to improve efficiency and support clinical decision making. However, using AI raises important ethical concerns which are summarized in our review. RECENT FINDINGS: Most AI applications in child and adolescent psychiatry remain early in development and are not ready for routine clinical use. AI scribes are likely impractical in many child psychiatry settings because of multiparty visits, consent concerns, and sensitive clinical discussions. Many multimodal diagnostic tools using machine learning still require further testing and can be impractical when relying on costly diagnostics like neuroimaging. Similarly, AI-assisted therapeutics requiring physical hardware like robotics and virtual or augmented reality devices can also be prohibitively expensive. One of the few exceptions includes AI-enabled video and eye-tracking approaches for autism diagnosis. Chatbots and robot companions may provide modest improvements for depression, but evidence remains limited in the pediatric population with risk of serious harm. Concerns of AI include misinformation, algorithmic biases, privacy risks, crisis mismanagement, and excessive emotional attachments to chatbots. AI may eventually support child and adolescent psychiatry, but current evidence supports cautious, supervised use rather than broad clinical adoption. Clinicians should help families understand AI's limits, encourage digital literacy, and ensure that AI remains an adjunct to human care rather than a substitute.
22 June 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
Augmentative and Alternative Communication Generative Language Intervention: A Randomized Controlled Trial
PURPOSE: Children with a wide range of impairments such as cerebral palsy and childhood apraxia of speech can benefit from augmentative and alternative communication (AAC). When AAC is provided, it frequently focuses on improving basic pragmatic skills such as requesting or on early semantic skills such as vocabulary acquisition. To address this issue, the primary goal of this study was to evaluate the effects of implementing the AAC Generative Language Intervention (AAC-GLI) program on the aided expressive grammar of preschoolers with relatively intact receptive language skills who could benefit from AAC. METHOD: A randomized controlled trial was used to evaluate the results. A total of 40 children who required AAC participated in the control group, intervention group, or both groups. The families of both the control and intervention group participants received a half-day AAC workshop. The intervention group also received 28 play-based AAC-GLI sessions. Weighted mean length of utterance in symbols (W-MLUSym), which was developed specifically for aided communicators, was used to measure progress. RESULTS: The intervention group demonstrated superior effects on W-MLUSym compared with the control group. Additionally, growth modeling demonstrated that the intervention condition was a significant moderator of change over time, with children in the intervention condition having statistically significantly greater increases in W-MLUSym, while W-MLUSym for children in the control condition remained similar to baseline. DISCUSSION: AAC-GLI can be used to teach preschoolers with a range of impairments to improve their expressive grammar skills. Providing AAC intervention that focuses on grammatical growth is an important part of expressive language development for these young children.
13 June 2026
Read appraisal →Medical science monitor : international medical journal of experimental and clinical research
Impact of Gross Motor Coordination Exercises on Perceptual Processes and Praxis in Early School Children With Symptoms of Developmental Coordination Disorder: Preliminary Report of Randomized Controlled Study
BACKGROUND Physical activity has a general impact on cognitive processes, but evidence on the effects of specific exercises on particular cognitive or executive functions remains limited. Previous studies suggest that movements crossing the body's midline stimulate excitability and plasticity in the dorsolateral prefrontal cortex and superior parietal cortex. This study aimed to investigate whether such exercises produce long-term functional changes in these areas. MATERIAL AND METHODS The study involved 22 children aged 6 to 8 years with symptoms of developmental coordination disorder (DCD), divided into 2 equal groups. Both groups completed approximately 9 weeks of coordination training based on Bilateral Integration by Sheila Dobie OBE (the total diagnostic and therapeutic cycle lasted approximately 16 weeks, including a break). The intervention group performed exercises involving midline crossing, while the control group performed exercises without this element. Assessments (sensory integration and praxis tests and the bilateral motor coordination test) were conducted 3 times: before intervention, after 9-week program, and at follow-up. RESULTS Significant improvements were observed in both groups in sequencing praxis (P=0.041 in the control group; P<0.001 in the intervention group) and bilateral motor coordination (P=0.013; P=0.020), but at different rates. In the intervention group, improvements appeared after the intervention, while in the control group only at follow-up. Large effect sizes were found (η² ϵ [0.293, 0.670]), with high statistical power. No significant changes were observed in other functions. CONCLUSIONS The Bilateral Integration method improves sequencing praxis and interhemispheric integration in children with DCD symptoms. Midline-crossing exercises may yield relatively fast improvements in short-term programs.
11 June 2026
Read appraisal →The Journal of clinical endocrinology and metabolism
Diazoxide Choline Extended-release Tablets in Prader-Willi Syndrome: A Randomized, Double-blind, Withdrawal Period Study
CONTEXT: The hallmark condition of Prader-Willi syndrome, a rare, genetic neurobehavioral/metabolic disorder, is life-threatening hyperphagia. OBJECTIVE: We assessed the efficacy and safety of diazoxide choline extended-release (DCCR) tablets for the treatment of hyperphagia in adults and children four years of age and older with Prader-Willi syndrome. METHODS: We conducted a 16-week, randomized withdrawal study in children and adults with Prader-Willi syndrome and hyperphagia. Participants who previously completed randomized (13-week DCCR or placebo) and open-label (2.5-4.5 years DCCR) studies were randomized 1:1 to receive once-daily DCCR or placebo. The primary endpoint was Hyperphagia Questionnaire for Clinical Trials (HQ-CT) total score change from baseline to 16 weeks. Secondary endpoints included Clinical Global Impression of Severity (CGI-S) and Improvement (CGI-I); exploratory endpoints included weight and body mass index (BMI) z-score. RESULTS: Seventy-seven participants were randomized (DCCR:38; placebo:39). Statistically significant increases in HQ-CT from baseline to week 16 were observed with placebo vs DCCR [least square (LS) mean (standard error) change 7.6 (1.09)] with placebo and 2.6 (1.12) with DCCR; P = .0022. CGI scores favored DCCR but were not significantly changed. Consistent with the hyperphagia response, the placebo cohort gained more weight and increased their BMI z-score more than the DCCR cohort [LS mean weight difference (95% confidence interval) -1.6 kg (-3.1, -0.1)]; LS mean z-score difference was -0.09 (-0.17, -0.01). Adverse events were similar with both treatments, with no serious adverse events in the DCCR arm. CONCLUSION: Continued DCCR treatment was superior to placebo for hyperphagia. DCCR appears to offer meaningful therapeutic benefits for people with Prader-Willi syndrome.
19 May 2026
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