(Scholarly Journal Articles) Reading Textbook Strategies for Autistic Students

Introduction

The autism spectrum disorder (ASD) has been recognized as the fastest growing developmental disability with ane in 88 children diagnosed having ASD (1). People with ASD feel a range of language deficits, which have a life-long impact on their psychosocial operation (two). These deficits include difficulties in comprehension of spoken communication and writing, especially misinterpreting and understanding circuitous instructions (3). Although individuals at the higher stop of the autistic spectrum announced to take good reading abilities, several studies have shown that these individuals take difficulties in different components of written language comprehension. For instance, they fail to make inferences most social scripts and understand metaphors, which interfere with successful social communication (4). Many individuals with ASD are unable to derive the gist or significant of written documents (5–seven). Studies show that people with high-performance ASD have excellent phonetic decoding (power to capture the meaning of unfamiliar words by translating groups of messages back into the sounds that they represent, link them to i'southward verbal vocabulary, and access their pregnant) but poor comprehension (6, 8, 9). Similar results were reported by Huemer and Mann (10) who compared reading accuracy with reading comprehension in a population with ASD. This study found that error patterns observed in the participants suggested that children with ASD are more focused on accurately decoding text than on preserving the pregnant of the passage. This was supported in another study where readers with ASD were skillful at decoding sounds but had poor comprehension (11). These findings also support the bear witness that the skill in both decoding and linguistic comprehension is necessary if skill in reading is to accelerate (12). In addition, people with ASD are non able to use their groundwork knowledge to construct an agreement of text (13).

Traditionally, the difficulty with reading comprehension has been related to the cognitive profile of these readers particularly with their bug to comprehend the perspectives of others (xiv). Saldana and Frith (15) have found that people with ASD accept difficulty with inferences, which appear to exist greater in text with social content and suggest that these difficulties may be related to mentalizing deficits and could too influence other reading processes such as referential inferences or attributions of authors' aims. Furthermore, comprehension difficulties have been associated with differences in linguistic information processing causing a negative impact in the metaphor comprehension (xvi).

Several problems with the pragmatic aspects of language take been found among people with ASD (xvi, 17). For instance, Dennis et al. (4) studied the dissimilar ability to sympathise businesslike inferences well-nigh given or presupposed noesis in mental state words. This study confirmed that children with loftier-performance ASD struggle to understand metaphors and brand inferences about social scripts. These results are too consistent with those of Beversdorf et al. (18) who showed that people with loftier-operation ASD recall less of emotional sentences than nonemotional ones. On the other mitt, contempo evidence propose that the chance for reading comprehension difficulties is a specific characteristic of the social-communication phenotype of many high performance ASD children and adolescents (nineteen–22).

Although there is an abundance of research on reading difficulties for children with autism, there seems to exist a considerable gap in investigation of this effect beyond adolescence. All the same, a few studies that accost language disorders in adults with autism indicate that, although reading accuracy improves with age in loftier functioning children with autism, they proceed to struggle with many linguistic phenomena such as homographs, multiple pregnant words, phrases, and metaphors (ten).

To the knowledge of the authors, there are no reading comprehension interventions tested amid adults with autism, and there are very few studies involving adolescents. In a contempo review about reading comprehension interventions for school-aged children and adolescents with ASD (23), 12 studies were identified, 3 using treatment comparison designs and 8 using unmarried-example designs. These interventions included strategy instruction (24–27), explicit educational activity (28–30), and anaphoric cueing (6, 31). None of these interventions have been tested using an experimental design or including a big sample. Even so, these interventions were time consuming and required a facilitator, which increased the cost of the intervention (23). The field of reading interventions for people with ASD had followed the research involving students with reading difficulties in general (32, 33), and most of the interventions tested for students with ASD have included reading expert recommendations (34). Even so, it seems that at that place is high need for research-based knowledge to enhance reading comprehension operation in people with ASD, especially amid older adolescents and adults (23).

Assistive engineering has been used to enhance communication and academic skills for children with disabilities (35, 36). The use of technology to teach several academic and social skills to students with ASD has a long history, since the first report reporting the use of a figurer to increase understanding of how letters and sounds grade words, and how texts can class expressions (37, 38). However, very few studies have explored or tested the utilise of assistive technology to facilitate reading comprehension among ASD subjects (39).

The assistive tool tested in this written report was developed in the project FIRST (Flexible Interactive Reading Support Tool) by a multinational group of interdisciplinary researchers that involved collaboration betwixt clinical, auto-learning, and Natural language Processing (NLP) experts in the UK, Spain, and Republic of bulgaria. Nosotros adapted Language Technologies resource to blueprint a system called Open Book in iii languages—English, Castilian, and Bulgarian. Further details of this project tin be plant in previous publications (40–42).

Open Book is a noncommercial electronic platform that can be personalized to meet and support the specific reading needs of people with autism. It uses Natural Language Processing (NLP) to make documents for people with autism more accessible. Some of the processes utilized by Open Book include the following: detection of language obstacles in the text; calculation definition to terms or infrequent (rare) words; adding images to words in society to assistance word visualization; providing synonyms for infrequent words; providing options to change text format (e.g., groundwork color, text color); and "magnify" characteristic which highlights particular sentence to ease focusing users' attending and back up when following specific text sections. This approach is supported past several studies proverb that text comprehension depends on understanding words and integrating their pregnant into a mental model of the text (43–45).

Open Book can convert a standard document into a personalized and simplified version, which was hypothesized that it would be easier to understand. Some other characteristic of the platform is that it encompasses two different interfaces—for independent users with autism and for caregivers such every bit parents or teachers. The Open Book independent user can benefit from assistive elements using features such equally "Explain word," "Explain with image," "Provide summary," or "Ask caregiver" to make the text clearer. The program also simplifies circuitous text structures by shortening long sentences and clarifies ambiguities. Not relying purely on textual changes, the conversion software also provides illustrative pictures to selective words and offers concise document summaries.

The interface designed for caregivers provides them with a semiautomatic plan where they cannot only convert text using the NLP technologies implemented in the software just can also brand their own editions to the text. They can upload images, review texts from their user's library, suggest other support if needed, and/or create new documents. All the documents are collected in the user's personal library, which can exist arranged with different folders and labels. A privacy function allows the user to go along select documents private and not share them with their caregiver.

The initial software prototype was produced in English, Spanish, and Bulgarian.

The aim of this study was to assess the accessibility, utility, and the effectiveness of Open Volume in simplifying complex texts past making them easier to empathise for adolescents and adults with high-functioning ASD in UK, Republic of bulgaria, and Kingdom of spain.

The hypothesis was that texts simplified through Open Volume would be easier to encompass compared to original texts for participants with ASD. It was expected that, when participants were tested near written texts' comprehension, they would give more than correct responses on the simplified texts compared to original (not-simplified) documents. It was also hypothesized that participants would blindly charge per unit simplified texts every bit easier to cover compared to original texts.

By improving access of people with autism to written information, nosotros ultimately aim to facilitate their empowerment and social inclusion. Open Book is expected to aid individuals with autism to increase their independence past improving access to the wealth of textual data that is bachelor in the data society.

Fabric and Methods

Report Design

Crossover design was used to test (46–48) the effectiveness of Open Book to improve reading comprehension among adolescents and adults with autism spectrum disorder.

Participants

All participants who met the following criteria were included in the report: a) a formal ICD-10 diagnosis of ASD based on diagnostic clinical interview conducted by psychiatrists or clinical psychologists; b) 12–17 years one-time in the adolescents co-operative of the written report undertake in Spain and Bulgaria, and ≥xviii years onetime in the adult branch of the study carried out in the U.k. and Spain; and c) a score of ≥70 in a measure of an intelligence test confirmed by clinical records. The study exclusion criteria were as follows: a) not native speakers of the respective languages, i.e., English, Spanish, and Bulgarian; b) documented history of learning disabilities; c) additional diagnosis of dementia or other organic encephalon disorder that could affect memory; and d) presence of a sensory impairment that could foreclose reading, writing, or hearing.

Upstanding Approval

All written report procedures were in accordance with the ethical standards of the respective institutional and/or national inquiry committees and with the 1964 Helsinki announcement and its later amendments or comparable ethical standards.

Full upstanding approval for the project was sought and received from each center separately.

In the United kingdom, total upstanding approval was sought and received by East of Scotland Research Ethics Service (ref: 13/ES/0059). Dissever ethical approvals were also received past local Research and Development teams from each NHS site that participated in recruitment.

In Republic of bulgaria, Parallel Globe received approval from the Upstanding Commission of Plovdiv Academy St. Paisii Hilendarski. In addition, for the command grouping, permissions were received from the school direction where the tests were conducted. Parallel World is a Registered Administrator of Personal Data according to the Bulgarian Law for Protection of the Personal Data.

In Spain, consultations were conducted following internationally accepted ethical regulations, the legal normative applicable, and the Adept Clinical Do standards (CPMP/ICH/135/95). The guidelines of investigation compatible with those suggested by the American Psychological Association for investigations involving human participants were too followed.

The process for obtaining participant informed consent was in accord with the REC guidance and GCP. All participants provided written informed consent. The decision regarding participation in the projection was entirely voluntary. The research worker emphasized to participants that consent regarding projection participation could be withdrawn at any fourth dimension without penalisation or affecting the quality or quantity of their futurity medical care, or loss of benefits to which the participant was otherwise entitled. No projection-specific testing was washed before informed consent had been obtained.

The informed consent forms were signed and dated past all potential participants/parents before they entered the project. The inquiry worker explained the details of the projection and provided a participant information sheet, then allowed participants to consider whether they liked to exist involved in the project. The enquiry worker encouraged the participant to ask any questions that could help them make a conclusion on their potential involvement in the project.

Informed consent was collected from each participant before they underwent the reading comprehension test, including history taking related to the project. Ane re-create of the informed consent course was kept by the participant, while the other was kept by the research worker and was retained in the project Master File.

The study was granted past the FP7 EU Grant for Social Inclusion.

Sample Size

The sample size calculation was based on the precision with which we will exist able to estimate the proportion of participants who prefer the simplified text. Based on a clinical assumption that 80% of people with ASD would prefer the simplified text, and using a confidence level of 95%, a sample of 100 participants would allow u.s. to have lxxx% power to guess the true proportion that prefer the simplified text of between 72 and 88%.

Recruitment

Recruitment involved agile collaboration betwixt the clinicians in the specialist clinical centers and service user and carers.

The recruitment in the UK was expanded at a national calibration including several of import urban areas such equally Greater London, Leicester, Sheffield, and Plymouth. Bulk of the participants were recruited from the National Wellness Service (NHS). Voluntary and charity organizations also played a very important role in reaching recruitment targets. Thus, the National Autistic Society played a major function in recruitment activity in the Great britain.

In Spain, the recruitment was focused in the whole province of Madrid, and it involved specialized diagnostic and treatment centers, public and private schools, centers for work mediation for people with ASD, and leisure facilities for people with ASD.

Although the autism diagnostic assessment provision in Bulgaria is sporadic, we have adult a successful collaborative work with clinical centers who have autism expertise in Sofia and Stara Zagora and Parallel World Association (clemency organization) in Plovdiv.

All participant services across the 3 countries used identical recruitment strategy.

A researcher arranged to see the adults and the parents of children with ASD who expressed an interest in participating in the project. Consent was given by adult participants, and for children, it was obtained by their parents.

A total of 243 people who met the inclusion criteria completed the study. A detailed description of the participants is provided in Table 2.

Randomization

Reading comprehension testing that was conducted in a controlled environs under exam weather condition.

I hundred fifty-three participants prepare reading tests in groups of 20 participants. Each participant received three simplified and three original documents. Participants were blind to text conditions. Both participants and researchers were blinded to text allotment sequence, which was cake randomized past an contained researcher in the United kingdom of great britain and northern ireland using a one:one ratio.

Materials

The reading comprehension tests for adults used documents that covered a range of topics: education about full general and mental health, sexual health issues, newspapers manufactures, capacity from electronic novels, and full general knowledge manufactures. The texts for adolescents were selected through children and young books, schoolhouse material, and the Net.

Text selection. Each clinical centre in UK and Republic of bulgaria identified 12 texts that were appropriate to reading abilities and interests of respective age groups (adolescents and adults). The enquiry squad in Spain identified 24 texts in total: 12 for adolescents and 12 for adults. Texts for adults were selected from comprehension examination batteries used to examine reading comprehension in language proficiency, e.g., International English Language Testing System (IELTS) and Cambridge English language Proficiency. All texts identified by clinical teams were inspected and analyzed by Natural Language Processing (NLP) specialists, partners in the FIRST project. NLP specialists selected 6 out of 12 texts in each language, which were matched between languages for word length, complication, and number of obstacles. Thus, each adult text used in Spain was matched for word length and complexity with the texts used in the United kingdom of great britain and northern ireland. The aforementioned was done for adolescent texts in Espana and Republic of bulgaria.

Text simplifications. The original texts were forwarded to the technical teams who uploaded them into Open up Book and simplified them automatically. The outcome was postedited by the clinical teams through Open up Book caregiver platform. Reading obstacles and their resolutions are described in Table i.

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Tabular array 1 Reading obstacles and resolutions.

Measures

Primary Effect: Comprehension Score

The study participants undertook a reading comprehension exam nether exam conditions. Multiple selection questions (MCQs) were generated by each clinical team for their respective texts, with the assist of technical partners' input. MCQs were selected based on the original texts so that they could tap into the full general comprehension of the text's content, especially parts of the text with identified obstacles. The MCQs were the aforementioned for both original and simplified texts, and an example of two text versions followed by the MCQ is provided in Effigy 1.

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Figure ane Example of 2 text versions followed by a multiple-choice question (MCQ).

Each adult text was followed by vi MCQs, and each adolescents' texts had four MCQs. This selection was done to accommodate adolescents' performance within the aforementioned timeframe as the adults.

Each center created a library of 12 texts, half dozen original and half dozen modified (simplified) version of original texts, while the MCQs were the same for each respective text. The test battery was comprised of 3 original and 3 simplified texts randomly selected for each participant. Both adolescents and adult participants were given x min to read each text and answer all MCQs per text.

The chief outcome was the comprehension score calculated by adding the text scores for each question. Scores from the simplified texts were compared with scores from the original texts. Developed texts were followed by six questions each. Every right respond was scored as 1, and each wrong answer was scored as 0. Therefore, each text score could range from 0 (no right answer) to six (all correct answers) for adults, and 0–4 for adolescents. The overall score for original and simplified texts was calculated separately by adding the score for each of the three corresponding texts. The overall range of scoring values are 0–18 for adults (6 questions × 3 texts) and 0–12 for adolescents (4 questions × 3 texts).

Secondary Event: Self-Reported Text Complication

The secondary effect was self-reported text complication that was measured on a Likert-type scale, where participants were asked to blindly rate how piece of cake it was to understand each text. The scores ranged from 1 (very piece of cake) to 5 (very difficult). Therefore, the range of scores for each text was 1–5, and overall (for three texts) iii–15. Higher subjective scores indicated self-reported higher level of comprehension difficulty, while lower scores indicated that the texts were easier to understand.

Data Assay

Full general features. Descriptive statistics are presented as numbers and percentages for categorical variables and means with standard deviations for continuous data.

Primary analyses for master and secondary outcomes. The principal analyses tested the effectiveness of the tool using repeated measures t-tests for primary and secondary outcomes. The event size using the Cohen'due south d was also calculated (49).

Secondary analyses. Correlation analyses were performed to appraise the association between original and simplified text scores and subjective rating to test if participants were able to identify which text was original and which 1 was simplified. The scores of the MCQ tests were compared betwixt the original and simplified versions of each text and between the individuals. Paired t-tests for analyses of comparisons between the original and simplified texts and independent sample t-tests for comparisons between individuals were used. Finally, univariable and adjusted regression analyses were performed to assess the association between participants´ characteristics and simplified text scores.

All data were stored electronically and analyzed with SPSS.

Results

General Features

We invited 445 people to participate in the evaluation task, 140 of whom were excluded because they did not encounter inclusion criteria, declined to participate, or did not respond to our invitation. Three hundred v people consented to participate; 11 of them dropped out and did not deport out the reading examination. The master reason for the drop out was poor health on the day of the test. Two hundred ninety-iv people completed the test, and all their data were analyzed. For detailed data, encounter Figure 2.

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Effigy 2 Participant catamenia diagram.

A total of 243 subjects (29%, female person) participated in this study. Overall age ranged from 12 to lxx years former [adolescents, mean = 14.0 years erstwhile (SD = 2.1); adults, mean = 35.3 years old (SD = thirteen.i)]. The sample was predominantly male person. Considering the moderately homogenic ethnic composition of Bulgaria and Espana, the sample was principally (93%) of white ethnic background. Adult participants had higher IQ scores [109.25 ± 21.4 (75–168)] than boyish participants [85.97 ± 13.ii (70–127)] p < 0.001.

A prominent feature of our adult participants sample is that they were well educated with simply one person educated to elementary level (run across Tabular array 2). More than half of the sample were educated to secondary school level (55.7%) followed by graduates (35.57%), and MSc and PhD holders (4.03%, respectively). Notwithstanding, although adult participants are very well educated, high percentages are unemployed, unmarried, and do not live independently (see Table 2).

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Table two Participants' characteristics.

Psychiatric comorbidities were prevalent in our adult sample, especially depression (25.five%) and anxiety (23.five%), merely no psychiatric comorbidities were identified among adolescents.

Primary Analyses Results

Principal Result: Comprehension Score

The scores in Table 3 indicate the summary of the results of correct answers to the MCQs for the original and simplified texts. The scores ranged from 0 to xviii for adults' texts and 0–12 for adolescents' texts, with each score meaning a correct respond to a question related to text comprehension. The two sets of text scores were compared through related t-tests. All participants had a higher score on the simplified texts than on the original texts, meaning that overall both adults and adolescents gave more correct responses for simplified texts compared to original texts. This departure was statistically meaning in all groups, with the exception amid adolescents in Bulgaria. When all participants were included in the assay, deviation in the scores for simplified texts (One thousand = 11.two, SD = 4.ane) and original texts (M = 10, SD = 4.one) conditions was statistically significant (p < 0.001, event size = 0.3). Among different groups, the outcome sizes were of medium magnitude (d = 0.3–0.vii). These findings were also consistent beyond age groups. Examining age groups separately, adults performed better on questions almost simplified texts (Chiliad = 13.three, SD = iii.3) compared to original texts (M = 12, SD = three.v; p < 0.001, Northward = 153). Adolescents also gave more correct responses on questions almost simplified content (M = vii.viii, SD = 2.eight) compared to questions most original texts (M = 6.6, SD = 2.6; p < 0.001, N = 90).

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Tabular array 3 Text score analysis.

Secondary Upshot: Self-Reported Text Complication

A similar set of analyses were performed for the participants' blind rating nigh text complication. Overall, all participants blindly rated simplified texts as easier to understand than the original texts. This difference was statistically significant in all groups, with the exception among adolescents in Kingdom of spain. When all participants were included in the analysis, the original text was considered more difficult to understand (M = 7.6, SD = ii.4) than the simplified text (Thou = eight.7, SD = 2.6; p < 0.001, N = 243). The findings were consistent for our subgroups of adults and adolescents. See Table 4.

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Table 4 Analysis of subjective scoring.

Secondary Analyses Results

Association Between Text and Self-Reported Text Complexity Scores

The correlation coefficients and p values between the original text and subjective scores was 0.03 (p = 0.56) and betwixt the simplified text and subjective scores was 0.03 (p = 0.67).

Association Betwixt Participants' Characteristics and Simplified Text Scores

The univariable and adapted regression analyses between participants' characteristics and simplified text scores are presented in Table five. The majority of variables examined were associated with the simplified text scores in the univariable analyses. The exception was occupation and ADHD, which were not found to exist pregnant. Female participants scored higher than male participants, with scores 1.6 units higher. Participants with college IQ values achieved college text scores on simplified texts. A 10-unit of measurement increase in IQ was associated with a 0.9-unit increase in text score. A higher level of education was too associated with higher outcome values. Those with academy pedagogy had scores that were half-dozen.6 units higher, on average, than those with no or merely elementary teaching. In that location was little difference in scores betwixt married and divorced/widowed participants. However, single participants had the highest scores.

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Table 5 Univariable and multivariable regression models.

In the multivariable analyses, the results suggested that higher teaching was significantly associated with the text scores.

Discussion

The study provides the offset clinical evaluation of novel assistive technology, Open Volume, that aims to assist reading comprehension of written texts in adults and adolescents with ASD. While this is not a reading comprehension intervention per se, we take found that Open up Book can aid convert written texts into simpler forms, which are easier to understand by people with ASD. Open Volume can be used either autonomously or with the online assist of a carer or teacher, which makes the tool adjustable to different ages and levels of comprehension. Open Book is bachelor in English, Spanish, and Bulgarian. It automatically simplifies written text by splitting long sentences; replacing metaphors, slangs, and idioms with ordinarily used synonyms; resolving anaphors, etc. It likewise has the selection of replacing some complex words with pictures, which was especially used by adolescents and their teachers.

Open Book was evaluated by adults and adolescents in UK, Spain, and Bulgaria. Significant piece of work went towards developing reading comprehension testing methodology and materials that were age specific and matched for the level of complication across 3 languages.

The evaluation of Open Book indicates that adult and young people with ASD benefit from automated text simplification. Participants in our study achieved significantly better tests' results when they processed simplified than original texts, which indicates that their understanding of the text content was enhanced when the written data was modified past the assistive technology.

The effect sizes were of medium magnitude overall, and for the adolescent sample in Spain, the effect size was large. The subjective, blind ratings of self-reported text complication indicated in all instances that simplified versions were deemed every bit easier to comprehend compared to original texts.

Advanced pedagogy (university studies vs. lower education) was associated with higher text scores. Nosotros may hypothesize that reading skills meliorate with educational activity, but it may exist explained by having improve cerebral abilities. However, other findings support the idea that individuals with ASD continue to struggle with complex linguistic phenomena (10).

There are some limitations in this study. Fifty-fifty though Open Books seems to have a positive impact in immediate reading comprehension of written texts, we are not able to determine if there is a longer-term effect in the reading abilities of our target group. Furthermore, nosotros could non evaluate the effect of the apply of this assistive applied science in the functionality of our participants and their quality of life. Although we have demonstrated the potential benefits for high-performance individuals, the results may not exist generalizable to other people on the autistic spectrum.

Conclusions

The report indicates that assistive technologies could exist useful in supporting agreement of written text for people with ASD. The written texts simplified past the Open Book platform were significantly easier to sympathize by both adults and adolescents with high operation ASD. This demonstrates a novel direction in translational autism research that opens the doors of interdisciplinary collaboration and innovation to benefit people with this disabling condition.

The side by side footstep would be to assess the feasibility of Open up Volume, its uptake and utility past both people with ASD and their carers in real-life conditions.

Ethics Statement

All study procedures were in accordance with the ethical standards of the respective institutional and/or national research committees and with the 1964 Helsinki declaration and its later amendments or comparable upstanding standards. Total ethical approval for the projection was sought and received from each centre separately. In the UK full ethical approval was sought and received by East of Scotland Research Ideals Service (ref: thirteen/ES/0059). Separate upstanding approvals were as well received by local Research and Development teams from each NHS site that participated in recruitment. In Republic of bulgaria Parallel Earth received approval from the Ethical Commission of Plovdiv University St. Paisii Hilendarski. Also, for the control group, permissions were received from the Schoolhouse management where the tests were conducted. Parallel World is a Registered Administrator of Personal Data co-ordinate to the Bulgarian Constabulary for Protection of the Personal Data. In Spain consultations were conducted following internationally accepted ethical regulations, the legal normative applicative and the Adept Clinical Practice standards (CPMP/ICH/ 135/95). The guidelines of investigation compatible with those suggested by the American Psychological Clan for investigations involving human being participants were too followed.

Writer Contributions

AC-P, AS and VJ designed and executed the study, assisted with the information analyses and wrote de paper. JG assisted with the data analyses and collaborated with the writing of the results and the whole paper.

Funding

The study was granted by the FP7 Eu Grant for Social Inclusion. This study was supported by the Key and Due north W London NHS Foundation Trust, with assist from M. Keats and A. Bela. The writing contribution of the author JG was supported by Millennium Science Initiative of the Ministry of Economy, Development and Tourism, grant "Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay."

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of whatsoever commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We gratefully acknowledge the contribution of all the partners of the FIRST study from Wolverhampton University (Prof. R. Mitkov, Dr. C. Orasan, and R. Evans); Deletrea Spain (Sandra Freire Prudencio, Juan Martos, A. Gonzalez, and D. Gill); University of Jaen (Yard. T. Valdivia, East. M. Cámara, E. Barbu, and A. Ureña López); University of Alicante (P. Moreda and Eastward. Lloret); iWeb Technologies Ltd; Kodar OOD, Bulgaria; Autism Europe (A. Baranger).

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Source: https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00546/full

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