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Autism spectrum disorder (ASD) is associated with neurocognitive impairment, including executive dysfunctioning and social cognition (SC) deficits. Cognitive remediation (CR) is a behavioral training-based intervention aiming to improve cognitive processes. Its first use in psychiatry interested patients with schizophrenia, in whom promising results have been shown. Integrated CR programs targeting both social and non-social cognition have demonstrated to be effective in improving both cognitive domains and functional outcomes. CR studies in children and adolescents with ASD are still new, those regarding CR approaches combining social and executive functioning remediation are scares. One study examining the efficacy of cognitive enhancement therapy (CET) for improving cognitive abilities in ADS adults, showed significant differential increases in neurocognitive function and large social-cognitive improvements. Therefore, taking into account the overlap between ASD and schizophrenia, and considering the close link between executive functions (EF) and SC, we suggest that integrative approach in ASD could result in better outcomes. The present perspective aimed to highlight cognitive remediation (CR) programs contributions in ASD (especially in children and adolescents), and to discuss the value of combining social and non-social programs.

Background: Facial expressions transmit information about emotional state, facilitating communication and regulation in interpersonal relationships. Their acute recognition is essential in social adaptation and lacks among children suffering from autism spectrum disorders. The aim of our study was to validate the “Recognition of Facial Emotions: Tunisian Test for Children” among Tunisian children in order to assess facial emotion recognition in children with autism spectrum disorders (ASD).Methods: We conducted a cross-sectional study among neurotypical children from the general population. The final version of or test consisted of a static subtest of 114 photographs and a dynamic subtest of 36 videos expressing the six basic emotions (happiness, anger, sadness, disgust, fear and surprise), presented by actors of different ages and genders. The test items were coded according to Ekman’s “Facial Action Coding System” method. The validation study focused on the validity of the content, the validity of the construct and the reliability.Results: We included 116 neurotypical children, from 7 to 12 years old. Our population was made up of 54 boys and 62 girls. The reliability’s study showed good internal consistency for each subtest: the Cronbach coefficient was 0.88 for the static subtest and 0.85 for the dynamic subtest. The study of the internal structure through the exploratory factor analysis of the items of emotions and those of intensity showed that the distribution of the items in sub-domains was similar to their theoretical distribution. Age was significantly correlated to the mean of the overall score for both subtests (p < 10–3). Gender was no significantly correlated to the overall score (p = 0.15). High intensity photographs were better recognized. The emotion of happiness was the most recognized in both subtests. A significant difference between the overall score of the static and dynamic subtest, in favor of the dynamic one, was identified (p < 10–3).Conclusion: This work provides clinicians with a reliable tool to assess recognition of facial emotions in typically developing children.

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Contrary to phenothiazines, butyrophenones are very seldom associated with hepatitis. In particular, the incidence of hepatitis on haloperidol is about 0.002%. Almost all these cases consisted of cholestatic hepatitis. Cytolytic hepatitis induced by haloperidol seems to be exceptional. Objective: To outline the occurrence of haloperidol-induced cytolytic hepatitis. Methods: Case report and review Results: We report the case of a male patient aged 22, with a family history of schizophrenia in two cousins and with a personal history of generalized epilepsy on carbamazepine. The patient was admitted to our department for behavioral disturbances. Psychiatric interview found mystical and grandiosity delusions as well as auditory and visual hallucinations. The patient was started on haloperidol 5mg bid. Routine liver enzymes obtained on day-10 revealed eight-fold elevated transaminases with no associated biological signs of cholestasis. The patient did not report any symptoms suggestive of hepatitis. Serology for viral hepatitis (A, B, and C), EBV and CMV was negative. Hepatic ultrasound examination was normal. Antinuclear, anti-LMK and anti-mitochondrial antibodies were negative. Serum and urine copper levels were normal. The diagnosis of a drug-induced hepatitis was made. Haloperidol was withdrawn and switched to olanzapine. Transaminase levels slowly dropped then normalized within two months, thus consolidating our diagnosis. Conclusions: Cytolytic hepatitis induced by haloperidol is very rare and can be asymptomatic. Routine liver tests when starting antipsychotics are crucially important to diagnose this possibly hazardous side effect.