1. Albin M, Chawrun I, Tint A. Rethinking Social Communication Support: Exploring Communication Partner Training for Autistic Adults and Their Neurotypical Communication Partners. Autism Adulthood. 2025; 7(5): 535-42.

Autistic and neurotypical people often have difficulty communicating effectively with one another and understanding each other’s experiences. Despite evidence that communication breakdowns occur at the interactional level, most social communication interventions focus only on behaviors to be changed by autistic adults, and rely heavily on teaching neurotypical social skills. In this Perspective, we draw on our experiences as a mixed-neurotype team of clinicians, researchers, and advocates to argue that a new framework for social communication support is needed. Specifically, we propose that communication partner training (CPT), an umbrella term for programs that teach strategies to people with communication differences and communication partners alike, is an appropriate framework to guide future social communication support for autistic adults and their neurotypical communication partners. We provide an overview of how CPT is currently used with adults with acquired communication differences (e.g., aphasia, traumatic brain injury) and their communication partners. We highlight three key components of such programs: (i) promoting increased knowledge and understanding of communication differences and each person’s unique communication profile; (ii) adapting the communication environment; (iii) and identifying collaborative strategies that people with communication differences and their communication partners can use to foster meaningful interactions. We acknowledge that there are important fundamental differences between autistic adults and people with acquired communication differences; however, we propose that CPT can be used to inform social communication support for autistic adults and their neurotypical communication partners. We provide recommendations for future CPT program development within autism research. Some recommendations include the need to acknowledge each person’s intersecting identities and the dynamic impact of intrinsic and extrinsic factors on communication. We also recommend future research to explore ways that CPT can be applied to newly diagnosed autistic adults, as well as autistic youth, and their communication partners. Finally, we highlight the importance of foregrounding future program development in the lived experience of autistic adults and their communication partners. COMMUNITY BRIEF: Why is this topic important?: Autistic and neurotypical communication partners often have difficulty understanding each other’s experiences and communicating effectively with each other. Most social communication interventions currently available focus only on changing autistic people’s behaviors, which can be harmful to their wellbeing, and do not consider the role of the communication partner.What is the purpose of this article?: The purpose of this article is to explore how an alternative type of social communication support, communication partner training (CPT), can be used to enhance communication effectiveness between autistic adults and their neurotypical communication partners. CPT is an evidence-based service delivery model in the field of speech-language therapy that provides education and training to people with communication differences and their communication partners. We propose that CPT may be an appropriate framework to guide future social communication supports for autistic adults and their neurotypical communication partners.What personal or professional perspectives do the authors bring to this topic?: We are a team of mixed-neurotype professionals (psychologist and speech-language therapist), researchers, and advocates with experiences supporting autistic adults and their communication partners across a range of clinical, educational, and residential settings.What is already known about this topic?: Past research has shown that many autistic adults want better social communication support that focuses on the interactional nature of mixed-neurotype miscommunications. CPT is commonly used with adults with traumatic brain injuries, dementia, aphasia, and other acquired communication differences and their communication partners. Three common principles of CPT include (i) promoting increased knowledge and understanding of communication differences and individual communication profiles; (ii) increasing awareness of and adapting the communication environment; (iii) identifying collaborative strategies that people with communication differences and their communication partners can use to minimize communication breakdowns.What do the authors recommend?: We recognize that there are important differences between autistic adults and people with acquired communication differences; however, we propose that helpful CPT techniques within the acquired communication differences literature can be used to inform social communication support for autistic adults and their neurotypical communication partners. Future research should be codesigned with autistic adults and their communication partners, and should consider how people’s communication preferences may fluctuate, and how intersectionality impacts communication experiences. We also recommend future research to understand ways that CPT can be used to support newly diagnosed autistic adults, as well as autistic youth, and their neurotypical communication partners.How will these recommendations help autistic adults now or in the future?: We hope that our recommendations will encourage researchers and clinicians to codevelop new social communication supports to improve communication success for autistic adults and their neurotypical communication partners.

Lien vers le texte intégral (Open Access ou abonnement)

2. Ashburner J, Glastonbury E, Bobir N, Sanders D, Swift E, Rietberg E, Hill J. In Search of a Good Person-to-Job Fit: Perspectives of Autistic Clients, Their Family Members, and Employers of a Pilot Autism-Specific Employment Program. Autism Adulthood. 2025; 7(5): 623-37.

Employment is an important factor contributing to the quality of life of autistic individuals. However, autistic people are substantially underrepresented in the workforce, and are more likely than non-autistic people to be in part-time/casual positions and/or in jobs for which they were overqualified. Current employment programs often cater to a limited range of autistic jobseekers. This project explored participants’ perceptions of an autism-specific, client-led employment program, Autism EmployABLE, with respect to (1) the program’s helpfulness and aspects that could be improved and (2) the clients’ happiness, confidence, and feelings of independence after gaining employment. We employed a hybrid approach for content analysis of semi-structured interviews to explore the perspectives of 15 autistic clients, 6 family members, and 5 employers. Interview data revealed that almost all participants perceived Autism EmployABLE to be helpful, and that it aligned well with the Person-Environment-Occupation (PEO) Model of Occupational Performance, in that it addressed the interaction between person (e.g., interests, strengths), environment (workplace factors), and occupation (e.g., job tasks). Perceived benefits of the program included enhanced client confidence and independence, and improved outcomes compared with generic disability employment services. Suggested improvements included opportunities for clients to meet and share experiences, access to industry-specific mentoring, provision of written materials, and aptitude testing for specific roles. This study provides preliminary support for the benefits of Autism EmployABLE and highlights the importance of sourcing positions that match each client’s skills and interests to achieve the outcome considered critical to employment success-good person-to-job fit. COMMUNITY BRIEF: Why was this program developed?: Despite the many strengths that autistic people can bring to the workplace, they are more likely than non-autistic people to be unemployed or to work in part-time/casual positions and/or in jobs for which they were overqualified. We developed Autism EmployABLE to help autistic people find satisfying and sustainable employment that matches their skills and interests.What does the program do?: The program aims to support autistic jobseekers to find satisfying jobs by matching their interests, strengths, and support needs (the person) with characteristics of the workplace (the environment) and job tasks (the occupation). The program is staffed by professionals with autism-specific knowledge (e.g., psychologists, occupational therapists, teachers) and staff with experience in the vocational sector and marketing skills. The staff therefore have the expertise to work effectively with both clients and businesses. Clients take a leading role by setting their own employment goals and developing « roadmaps » to help them communicate about their strengths and support needs. The program supports clients to apply for open employment opportunities that suit their skills and interests.How did the researchers evaluate the new program?: We asked the autistic clients who accessed Autism EmployABLE, their family members, and employers to participate in an interview, which explored the helpfulness of the program in finding a job and navigating the workplace, satisfaction with job placements, and client well-being after finding employment. We asked about aspects of the program that they liked and aspects that could be improved.What were the early findings?: The findings suggest that a good person-to-job fit can be achieved by matching the skills, interests, and support needs of clients with the needs of businesses. Participants observed improvements in the clients’ confidence and independence. They reported achievement of better employment outcomes than they had achieved through generic disability employment services. Suggested improvements included more opportunities for clients to meet and share experiences. Clients seeking employment in professions such as engineering or information technology (IT) would like access to mentors with profession-specific knowledge. One employer suggested aptitude testing for specific roles.What were the weaknesses of this project?: We are unsure whether the perspectives of the program reported here can be generalized to other cultures and communities.What are the next steps?: This study supports autism-specific, client-led employment programs that consider the unique skills and interests of autistic clients when finding a suitable job. Many of the clients and their family members perceived that the clients achieved more satisfying and sustainable employment through this program than through generic disability employment services. The next step would therefore be to provide more autistic jobseekers with access to this type of program.How will this work help autistic adults now or in the future?: If autistic people are supported to find employment that matches their skills and interests, they are more likely to find satisfying jobs and are more likely to be happy to continue working in these positions.

Lien vers le texte intégral (Open Access ou abonnement)

3. Atturu H, Naraganti S, Rao BR. Effectiveness of Artificial Intelligence-Based Platform in Administering Therapies for Children With Autism Spectrum Disorder: 12-Month Observational Study. JMIR Neurotechnol. 2025; 4: e70589.

BACKGROUND: A 12-month longitudinal observational study was conducted on 43 children aged 2-18 years to evaluate the effectiveness of the CognitiveBotics artificial intelligence (AI)-based platform in conjunction with continuous therapy in improving therapeutic outcomes for children with autism spectrum disorder (ASD). OBJECTIVE: This study evaluates the CognitiveBotics software’s effectiveness in supporting children with ASD through structured, technology-assisted learning. The primary objectives include assessing user engagement, tracking progress, and measuring efficacy using standardized clinical assessments. METHODS: A 12-month observational study was conducted on children diagnosed with ASD using the CognitiveBotics AI-based platform. Standardized assessments, include the Childhood Autism Rating Scale (CARS), Vineland Social Maturity Scale, Developmental Screening Test, and Receptive Expressive Emergent Language Test (REEL), were conducted at baseline (T1) and at the endpoint (T2). All participants meeting the inclusion criteria were provided access to the platform and received standard therapy. Participants who consistently adhered to platform use as per the study protocol were classified as the intervention group, while those who did not maintain continuous platform use were designated as the control group. Additionally, caregivers received structured training, including web-based parent teaching sessions, reinforcement strategy training, and home-based activity guidance. RESULTS: Participants in the intervention group demonstrated statistically significant improvements across multiple scales. CARS scores reduced from 33.41 (SD 1.89) at T1 to 28.34 (SD 3.80) at T2 (P<.001). Social age increased from 22.80 (SD 7.33) to 35.76 (SD 9.09; mean change: 12.96, 56.84% increase; P<.001). Social quotient increased from 53.26 (SD 11.84) to 64.75 (SD 16.12; mean change: 11.49, 21.57% increase; P<.001). Developmental age showed an improvement from 30.93 (SD 9.91) to 45.31 (SD 11.20; mean change: 14.38, 46.49% increase; P<.001), while developmental quotient increased from 70.94 (SD 10.95) to 81.33 (SD 16.85; mean change: 10.39, 14.65% increase; P<.001). REEL scores showed substantial improvements, with receptive language increasing by 56.22% (P<.001) and expressive language by 59.93% (P<.001). In the control group, while most psychometric parameters showed some improvements, they were not statistically significant. CARS scores decreased by 10.62% (P=.06), social age increased by 52.27% (P=.06), social quotient increased by 19.62% (P=.12), developmental age increased by 44.88% (P=.06), and developmental quotient increased by 11.23% (P=.19). REEL receptive and expressive language increased by 34.69% (P=.10) and 40.48% (P=.054), respectively. CONCLUSIONS: Overall, the platform was an effective supplement in enhancing therapeutic outcomes for children with ASD. This platform holds promise as a valuable tool for augmenting ASD therapies across cognitive, social, and developmental domains. Future development should prioritize expanding the product's accessibility across various languages, ensuring cultural sensitivity and enhancing user-friendliness.

Lien vers le texte intégral (Open Access ou abonnement)

4. Benoit CR, Sattler LB, Aylward AJ, Pembridge O, Kim B, Muratore CR, Liao M, He A, Ashour N, Fancher SB, Lish AM, Pearse RV, Buxbaum JD, Young-Pearse TL. POU3F2 regulates canonical Wnt signalling via SOX13 and ADNP to expand the neural progenitor population. Brain. 2025; 148(12): 4325-44.

Loss-of-function mutations in the transcription factor POU3F2 have been identified in individuals with neurodevelopmental disorders. To elucidate the mechanistic role of POU3F2 in human neurodevelopment, we induced POU3F2 disruption in human neural progenitor cells (NPCs). Mutation of POU3F2 in NPCs causes reduced baseline canonical Wnt signalling and decreased proliferation, resulting in premature specification of radial glia. Additionally, POU3F2 levels across genetically diverse NPCs significantly associate positively with baseline canonical Wnt signalling and negatively with markers of radial glia specification. Through a series of unbiased analyses, we show that SRY-box transcription factor 13 (SOX13) and activity dependent neuroprotector homeobox (ADNP) are transcriptional targets of POU3F2 which mediate POU3F2’s effects on Wnt signalling in human NPCs. Finally, we describe five individuals with autism spectrum disorder that harbour loss-of-function mutations in POU3F2, enhancing the genetic evidence for its critical role in human neurodevelopment. Together, these studies define POU3F2 as an activator of canonical Wnt signalling and mechanistically link two high-confidence autism genes, ADNP and POU3F2, in the regulation of neurodevelopment.

Lien vers le texte intégral (Open Access ou abonnement)

5. Byiers B, Merbler A, Lockhart E, Burkitt C, Symons F. Reliability of Actigraphy for the Assessment of Sleep and Circadian Rhythms in Rett and Related Syndromes. J Intellect Disabil Res. 2025.

PURPOSE: Actigraphy is being increasingly used to assess sleep and circadian rhythms among populations with intellectual and developmental disabilities and genetic syndromes, including Rett syndrome and related disorders, but the reliability of these measures in these populations is unclear. The primary purpose of the current study was to evaluate the impact of recording duration on the reliability of various measures of sleep and circadian rhythm in Rett and related syndromes. METHOD: Two 14-day recordings were collected between 4 and 12 weeks apart in a sample of 30 individuals (aged 2-36 years; 97% female). Reliability was estimated by calculating statistics based on 3, 5, 7, 10 or 13-14 nights of recording. RESULTS: Most measures of average sleep quality could be reliably estimated with 7-10 nights. Measures of night-to-night variability in sleep timing showed poor reliability at all recording durations, whereas night-to-night variability in sleep duration showed adequate reliability at 5-7 days of recording. The reliability of measures of circadian rhythm was highly variable. CONCLUSIONS: The results suggest that the optimal recording durations for actigraphy in this population vary based on the specific metrics of interest, but most can be measured reliably.

Lien vers le texte intégral (Open Access ou abonnement)

6. Davies J, Redmayne B, Allain L, Portway L, Mandy W, Cooper K, Crane L. The Codesign and Initial Evaluation of a Peer Support Program for Autistic Young Adults. Autism Adulthood. 2025; 7(5): 650-62.

Postdiagnostic support can be useful for any autistic person, but it may be especially important for young adults (16-25 years) who may be negotiating their autistic identity while also navigating the transition to adulthood. Yet there is a lack of tailored support for this group. In this study, we document the process of codesigning a six-session online peer support program aiming to support young people to navigate their autistic identity in the transition to adulthood. Through documenting discussions within our research team, we provide three key reflections underpinning the success of our codesign process as follows: (1) maximizing success through preparation; (2) facilitating effective, respectful communication; and (3) empowering meaningful collaboration. We also collected qualitative feedback from program attendees, which we analyzed using reflexive thematic analysis. This feedback highlighted how attendees appreciated the opportunity for self-discovery and to develop their understanding of autism. They also valued the social connections formed during the program. Finally, they said they benefited from the practical strategies they developed. Overall, these insights contribute to the growing body of knowledge on participatory autism research and highlight good practices when meaningfully involving autistic people in shaping the support programs that directly impact their lives. The peer support program, Understanding You, Discovering You, warrants further, more rigorous evaluation in future studies. COMMUNITY BRIEF: Why was this program developed?: It is important to design and test support groups that aim to improve the well-being of autistic young adults (ages 16-25) during the transition to adulthood.If support groups are not codesigned, they are less likely to be considered acceptable by autistic people. By codesign, we mean different groups of people (e.g., autistic people, clinicians, researchers) working together to create something.In this study, our team of autistic young adults, clinicians, researchers, and an autism charity representative codesigned a program to support autistic young adults during the transition to adulthood. The program was developed because a UK charity-Ambitious about Autism-identified that there was a need for specific support for autistic young adults.What does the program do?: The program-called Understanding You, Discovering You-is designed to help autistic young adults embrace and understand their autistic identity. The program is designed to be delivered by two facilitators, one of whom is autistic, and includes up to 10 autistic young people at a time. Autistic young adults decided the content of the program, and how it was organized.How did the researchers evaluate the development of the new program?: In this article, we report our team’s reflections about involving autistic young adults in the program’s design, to guide the creation of similar projects in the future. We also gathered initial feedback about the program from program attendees to understand their experience and learn how to make the program better in the future.What were the early findings?: We identified the following three main things that were important when involving autistic young adults in the codesign of our program: good preparation, effective and respectful communication, and making sure the collaboration is meaningful. Program attendees reported that they liked learning about autism, found value in the social connections they made, and gained practical skills from the program. These findings tell us that codesigning programs with autistic people is a good way to make sure they are useful.What were the weaknesses of this project?: One weakness of this project was that only a small number of people filled out our postprogram evaluation, which meant that we did not get as much feedback as we would have liked.What are the next steps?: Our next steps will involve adjusting the program based on participant feedback before doing a larger and more rigorous evaluation of the program.How will this work help autistic adults now or in the future?: This work provides a valuable example of how diverse teams (which include autistic young adults) can work collaboratively to codesign support programs for autistic people.

Lien vers le texte intégral (Open Access ou abonnement)

7. de Almeida CA, Siqueira ES, Maior M, Brandt KG. Children with autism spectrum disorder and alterations in eating behavior: could it be Gastroesophageal reflux disease?. J Pediatr (Rio J). 2025: 101487.

OBJECTIVE: Describe the occurrence of warning signs of gastroesophageal reflux disease (GERD) and esophagitis in children with eating behavior (EB) alterations associated with autism spectrum disorder (ASD). METHOD: Descriptive study of 115 children aged 3 to 12 years, followed at a tertiary hospital and previously diagnosed with ASD. The BREB-ASD instrument was applied to identify children with EB alterations, and the 17-ATN-GISSI instrument was applied to identify those with warning signs of GERD. The selected children were invited for a medical consultation to identify those with suspected esophagitis and an indication for upper gastrointestinal (GI) endoscopy with biopsies. RESULTS: Sixty-nine children (60 %) were classified with alterations in the EB and, among these, 62 (89.8 %) presented warning signs of GERD. Eighteen children had suspected esophagitis and an indication for upper GI endoscopy. Among the 8 children who underwent the exam, 1 child had grade A erosive esophagitis, 1 child had grade B erosive esophagitis, and 1 child had eosinophilic esophagitis. CONCLUSION: A high frequency of EB alterations was found in children with ASD. The high frequency of GERD warning signs may be related to EB alterations in this group. Cases of esophagitis highlight the possibility of an organic disease. In these cases, performing upper GI endoscopy with biopsies is essential for diagnosis.

Lien vers le texte intégral (Open Access ou abonnement)

8. Ezaddoustdar J, Tristani L, McEvenue T, Bassett-Gunter R. The Effectiveness of an e-Learning Program for Educating Physical Activity Professionals on Supporting Autistic Individuals in Physical Activity. Adapt Phys Activ Q. 2025: 1-9.

Physical activity (PA) benefits autistic1 individuals, yet barriers including limited support from PA professionals hinder PA engagement. Guided by the theory of planned behavior and the diffusion of innovations theory, this study used a quasi-experimental one-group pretest-posttest design to investigate the effectiveness and practicality of an e-learning program in changing PA professionals’ intention and confidence to support autistic individuals in PA. PA professionals (N = 49) completed the Strong Minds Through Active Bodies e-learning program, as well as pre- and postevaluations. Results showed significant improvements in all theory of planned behavior constructs and positive feedback on the module’s practicality. Tailored e-learning can enhance PA professionals’ understanding and confidence in meeting the unique needs and preferences of autistic individuals in PA. Further research is warranted to understand how e-learning may be leveraged as a tool to foster more inclusive programs, ultimately encouraging greater participation by creating accessible and engaging PA environments that are supportive and conducive to active engagement for autistic individuals.

Lien vers le texte intégral (Open Access ou abonnement)

9. Foster SJ, Jones DR, Pinkham AE, Sasson NJ. Facial Affect Differences in Autistic and Non-Autistic Adults Across Contexts and Their Relationship to First-Impression Formation. Autism Adulthood. 2025; 7(5): 581-93.

BACKGROUND: Autistic people often receive unfavorable first impressions from non-autistic people, likely because of stigma related to divergent social presentations and expressive behaviors. Although facial expressivity influences first impressions in the general population, no research has examined whether expressivity differences in autism relate to the formation of first impressions by non-autistic people. It is also unclear whether facial expressivity in autism varies depending upon contextual demands and whether this affects first impressions. METHODS: We video-recorded 21 autistic and 21 non-autistic adults in two contexts, interviewing for their ideal job and discussing a personal interest, and quantified the percentage of video frames displaying positive, neutral, and negative facial affect using iMotions software. We also compared facial affect between the autistic and non-autistic groups within and between contexts. Later, 335 non-autistic undergraduates rated participants using the First Impression Scale to assess whether impressions were modulated by context and showed associations with facial expressivity. RESULTS: Findings demonstrated that autistic and non-autistic adults differed in overall emotional expressivity, with non-autistic participants displaying more positive affect at a trend-level than autistic participants. Autistic adults also received less favorable first impressions, and these showed some correspondence with their emotional expressivity. For example, their displays of negative affect were moderately to strongly related to worse impressions in the job interview context, a pattern not found to the same degree for non-autistic participants. Impressions of autistic participants also improved more than for non-autistic ones when talking about a personal interest compared with the job interview context, and when their diagnosis was disclosed to observers. DISCUSSION: Collectively, these findings indicate that autistic people demonstrate divergent facial emotional expressivity that relates to the less favorable impressions they receive from non-autistic observers. Context and diagnostic disclosure also affect how autistic people are perceived. COMMUNITY BRIEF: Why is this an important issue?: Autistic people are often stigmatized in professional and personal settings. It is important to understand the factors that relate to stigma in everyday contexts to create more inclusive environments for autistic people.What was the purpose of this study?: To understand whether autistic differences in how emotions are expressed in the face relate to how autistic people are perceived in personal and professional contexts.What did the researchers do?: We asked autistic and non-autistic adults to describe a personal interest and sit for a mock job interview. Later, non-autistic people provided their first impressions of adults and reported on how successful they believed participants were in communicating a personal interest, and in getting hired from their interview. We also examined the facial expressions of participants to see if expressions related to the first impressions autistic and non-autistic people received.What were the results of the study?: We found that autistic and non-autistic adults differ in how they display emotions in their faces, and these differences related to how autistic adults were perceived by non-autistic observers. Autistic expressions were less often categorized as displaying positive emotion, and their displays of negative emotion were related to poorer first impressions in job interviews. Context also affected these judgments. Autistic participants received poorer first impressions in a professional context relative to a personal context, and they were rated as more successful when observers were informed that the person they rated was autistic.What do these findings add to what was already known?: These findings indicate that autistic people express emotion differently in their faces and this is associated with non-autistic people viewing them less favorably than non-autistic people. Furthermore, autistic people were evaluated more positively when talking about personal interests than when interviewing for a job, which did not happen to the same degree for non-autistic people. These findings suggest that biases toward divergent displays of facial expressions may contribute to the disparities autistic people face in personal and professional contexts.What are potential weaknesses in the study?: The software used to analyze facial expressions was developed on non-autistic people and may not accurately measure autistic facial emotion. The autistic sample included in the study was also limited in size and lacked diversity. Future research should include other groups of autistic people, such as those with higher support needs.How will these findings help autistic adults now or in the future?: The results may be used to inform non-autistic people of their biases toward the expressive differences of autistic adults in personal and professional contexts to help minimize discrimination and exclusion.

Lien vers le texte intégral (Open Access ou abonnement)

10. Irwin DJ. Where do PDD and DLB SYNdromes fit in neuronal alpha-SYNuclein biological frameworks?. J Neural Transm (Vienna). 2025.

Lewy body disorders (LBD) are a spectrum of neurodegenerative diseases characterized by the presence of misfolded neuronal alpha-synuclein (aSYN) pathology in the central and peripheral nervous system. LBDs have heterogeneous clinical presentations, which include dementia with Lewy bodies (DLB), Parkinson’s disease (PD), and PD with dementia (PDD). Thus, LBD clinical syndromes (PD/PD/DLB) represent clinicopathologic entities (i.e. constellations of symptoms and supportive biomarkers with a high specificity for underlying aSYN pathology), but clinical features between PDD and DLB largely overlap. Indeed, there is longstanding debate over the utility of the clinical designation between PDD and DLB due to shared underlying pathology, genetic risk factors and prodromal features. Recent advances in the ability to detect pathological aSYN from peripheral fluids/tissues in living patients has ushered in a new era of biological classification of LBD, providing opportunity to improve antemortem diagnosis and facilitate disease-modifying therapeutic trials. The clinical interpretation of these and future aSYN-specific biological tests will be complex, and the reconciliation of classic LBD syndromes with emerging biological classification schemes for LBD and other neurodegenerative disorders is a priority. Indeed, varying burden of aSYN is also found postmortem in > 50% of clinical Alzheimer’s disease (AD), and to a lesser frequency as co-pathology in other neurodegenerative disorders, and incidentally in adults without neurologic disease. This review summarizes autopsy-confirmed data on the clinical expression of LBDs and the boundaries between PDD, DLB and mixed-pathology AD to inform the interpretation of emerging biological tests for aSYN and biological classification schemes for LBD and AD.

Lien vers le texte intégral (Open Access ou abonnement)

11. Kuzminski R, Bölte S, Lawson W, Falkmer M, Black MH, Girdler S, Milbourn B. A Coproduced Exploration of Factors Influential to Quality of Life from the Perspective of Autistic Adults. Autism Adulthood. 2025; 7(5): 594-611.

PURPOSE: Autistic adults reportedly experience poorer quality of life (QoL) than their non-autistic peers. However, many tools used to measure their QoL were not developed for autistic adults, but for the general population. It is possible that factors contributing to the QoL of autistic individuals could vary from that of the general population, meaning commonly used tools may inadequately capture the nuances of autistic QoL. It is, therefore, imperative that autistic QoL is comprehensively conceptualized from the perspective of autistic adults. METHODS: We used a qualitative semi-structured interview methodology guided by an overarching coproduction approach to capture factors contributing to autistic QoL. A research team, including an autistic researcher and a steering group of five autistic adults, worked together throughout the entire research process. An additional autistic researcher provided consultation about how to authentically coproduce this research. Coproducing this research included the steering group and autistic researcher in developing the methodology, the interview guide, and the thematic analysis and naming of the themes. We interviewed 29 autistic adults aged 18-55 who lived in Australia. RESULTS: Coproduced thematic analysis identified five themes: activities and routines; relationship supports and socialization; mind and body; personal experiences; and environment. Participants described how subthemes within each theme positively and/or negatively impacted their QoL. Examples of subthemes that may represent factors uniquely impacting QoL for autistic adults include understanding their self-identity, sensory experiences, and the impact of societal attitudes. CONCLUSION: While some elements identified by autistic adults also appear in non-autistic conceptualizations of QoL, the impact and importance of these factors may vary from non-autistic experiences. We also identified some factors that may uniquely impact QoL for autistic adults. COMMUNITY BRIEF: Why is this an important issue?: Quality of life (QoL) is an important but underresearched outcome for autistic adults. Supports are often provided with the aim of improving QoL, but our understanding of QoL is based on understandings from non-autistic populations. The factors contributing to QoL in autistic adults might be different from non-autistic adults, and assessments used by health professionals to measure QoL may not accurately measure autistic QoL. Understanding the factors that support QoL for autistic adults is important for ensuring accurate assessment and for providing more effective support to enhance QoL for autistic individuals.What was the purpose of this study?: This study wanted to understand what factors influence autistic adults’ QoL. It is the first step toward understanding autistic QoL, which could inform the measurement of autistic QoL.What did the researchers do?: The research involved in this study used a participatory approach, working with a steering group that included five autistic adults. An autistic researcher is also part of the research team, and a second autistic researcher provided advice about how to authentically coproduce the study. The steering group and research team developed an interview guide about QoL. We used it in interviews with 29 autistic adults aged 18-55 years. The research team and steering group analyzed the interviews to represent the perspectives of the participants. The research team and steering group developed the themes together.What were the results of the study?: We identified five themes summarizing the factors that influence autistic QoL: activities and routines; relationships supports and socialization; mind and body; personal experiences; and environment. Participants described how subthemes within each theme positively and negatively impacted their QoL. Some subthemes include understanding their self-identity, sensory experiences, socialization, relationships, health, and the impact of societal attitudes.How do these findings add to what is already known?: This research provides an in-depth understanding of the factors that influence autistic adults’ QoL. Until now, there has been a limited understanding of these factors.What are the potential weaknesses of the study?: The participants in this study were generally highly educated, and most were diagnosed in adulthood. Only one participant reported having an intellectual disability, and all participants communicated verbally. This could mean that the results do not represent all factors important to the QoL of those with an intellectual disability or who use other forms of communication.How will these findings help autistic people now and in the future?: These findings highlight the factors that health professionals should consider when working with autistic adults to enhance their QoL. These results can also inform the development of better assessments to measure autistic QoL.

Lien vers le texte intégral (Open Access ou abonnement)

12. Li X, Xu G, Geng G, Wang W, Hu J, Li Z, Li S. Subtyping Autism Spectrum Disorder With a Population Graph-Based Dual Autoencoder: Revealing Two Distinct Biotypes. CNS Neurosci Ther. 2025; 31(12): e70675.

AIM: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by significant heterogeneity in clinical symptoms and underlying neurobiology. This study aimed to identify distinct ASD biotypes and uncover their neurobiological underpinnings using a novel graph-based subtyping approach. METHODS: Resting-state fMRI and clinical data from 443 males with ASD (17.22 ± 8.63 years) were analyzed. We proposed a population graph-based dual autoencoder for subtyping (PG-DAS), a deep clustering framework that integrates imaging data and nonimaging data to extract deep features for biotype identification. Statistical analyses were conducted to compare clinical scores and functional connectivity patterns between biotypes. Correlation analyses examined the associations between intra- and internetwork connectivity and clinical symptoms. Predictive modeling using support vector regression assessed the ability of network connectivity to predict clinical scores. RESULTS: Two distinct ASD biotypes were identified. ASD1 exhibited significantly lower clinical scores and reduced network integration, characterized by weaker intra- and internetwork connectivity, particularly in core networks such as the cingulo-opercular network, linked to communication symptom scores. In contrast, ASD2 exhibited greater network segregation, with internetwork connectivity in sensorimotor-related networks correlating with total symptom scores. Predictive modeling further revealed biotype-specific brain-behavior associations, with ASD1 and ASD2 showing positive correlations with social and communication scores, respectively. CONCLUSION: This study underscores the critical role of biotype-specific brain network patterns in understanding ASD heterogeneity. The proposed PG-DAS framework proved effective in ASD subtyping and holds promise for broader applications in exploring other neuroheterogeneous disorders.

Lien vers le texte intégral (Open Access ou abonnement)

13. Ma LL, Lv QQ, Xiao Y. Efficacy of the early start Denver model combined with the TEACCH program in children with autism spectrum disorder. Front Psychiatry. 2025; 16: 1669476.

BACKGROUND: Early intervention plays a crucial role in improving outcomes for children with autism spectrum disorder (ASD). The Early Start Denver Model (ESDM) and the Treatment and Education of Autistic and Communication-Handicapped Children (TEACCH) program are commonly used approaches. This study aimed to evaluate whether combining ESDM with TEACCH provides greater clinical benefits than ESDM alone in young children with ASD. METHODS: A retrospective observational study was conducted involving 264 children aged 24-60 months diagnosed with ASD. Participants were divided into two groups based on treatment period: the control group (n = 128) received ESDM-only therapy, while the observation group (n = 136) received ESDM combined with TEACCH over six months. Outcomes were assessed using the Autism Treatment Evaluation Checklist (ATEC) and the Psycho-Educational Profile, Third Edition (PEP-3). Baseline comparability was confirmed by the Chinese version of the Childhood Autism Rating Scale (CCARS). RESULTS: Both groups showed significant within-group improvement after intervention, but the combined observation group demonstrated greater gains. Post-treatment ATEC scores decreased from 84.56 ± 20.90 to 68.76 ± 17.96 versus 92.84 ± 18.20 to 84.91 ± 17.50 in controls (between-group difference = 16.32 ± 4.35; P < 0.001; Hedges' g = 0.45). Cognitive scores on the PEP-3 improved by 11.31 points in the observation group compared to 8.15 in controls (P = 0.026). Reductions in maladaptive behaviors also favored the combined intervention (P = 0.036). CONCLUSIONS: The integrated ESDM and TEACCH intervention was more effective than ESDM alone in enhancing cognitive development and reducing symptom severity in young children with ASD.

Lien vers le texte intégral (Open Access ou abonnement)

14. O’Brien C, Jellett R, Flower RL. « Basically, it’s that she accepts me as I am »: Autistic Adults’ Positive Experiences with Psychologists in Australia. Autism Adulthood. 2025; 7(5): 568-80.

BACKGROUND: Despite their increased need for mental health support, Autistic adults often report dissatisfaction with the care they receive. Although research focused on barriers and limitations to health care for Autistic adults is informative, it may not offer guidance to professionals looking to learn about how to meet the needs of Autistic clients. Limited research has explored Autistic adults’ interactions with psychologists, and no known study has explored their positive therapy experiences. METHODS: We conducted semi-structured online interviews with nine Autistic adults (aged 20-46 years) in Australia to learn about their positive experiences working with psychologists. RESULTS: We developed four primary themes and nine subthemes using Reflexive Thematic Analysis. Primary themes included (1) « A Clear Sense of Direction, » (2) « Understand the Autistic Brain, » (3) « Creating a Safe Space, » and (4) « A Huge Flow on Impact. » Participants described having worked with psychologists who understood Autism, were flexible and accommodating, followed a strengths-based approach, and facilitated self-understanding and self-acceptance through helping clients to feel heard and validated. CONCLUSION: There are actions psychologists can take to promote a positive therapy experience for Autistic adults, and relational factors that facilitate a positive experience. A positive therapy experience can contribute to Autistic adult clients feeling heard and validated, which can have a flow on impact to improve their self-perception. We have developed a proposed model of care that outlines accommodations psychologists can consider when providing therapy to Autistic adults. COMMUNITY BRIEF: « Why is this an important issue? »: Autistic adults are more likely to have mental health concerns than non-Autistic adults. Yet, when asked about their experiences of seeking professional support and care, Autistic adults report mental health services are not well matched to their needs. It is important to understand what helps create a positive experience for Autistic adults when receiving care for their mental health. »What was the purpose of this study? »: We wanted to learn from Autistic adults who have had a positive experience when seeing a psychologist in Australia because their experiences could help us understand what works well in therapy. »What did the researchers do? »: We interviewed nine Australian Autistic adults who had a positive experience with a psychologist. We developed the interview questions in collaboration with an Autistic advisor. Participants told us about what made the therapeutic experience positive for them. We then looked at what each person told us and interpreted common patterns or themes. »What were the results of the study? »: We interpreted four themes that helped summarize the positive experiences with psychologists that participants told us about. (1) A Clear Sense of Direction: When the psychology sessions were structured, clear, and consistent, the participants knew what to expect so felt more comfortable. (2) Understand the Autistic Brain: The psychologist having a good understanding of Autism meant they could share their knowledge, and use the knowledge to make sense of the client’s experiences. (3) Creating a Safe Space: The participants felt more comfortable when the psychologist was genuine and authentic, which meant they felt safe in the therapeutic relationship. They felt safe when the psychologist was flexible, accommodating, and strengths-based. (4) A Huge Flow on Impact: The Autistic adults in the study told us through supportive therapy, they felt validated, and this helped them be more self-accepting and self-compassionate.We used these themes to create an initial model of therapy that could be used to guide psychologists wanting to learn more about working with Autistic adults. »What do these findings add to what was already known? »: This study brings in new information about positive experiences working with psychologists. The stories participants told us, and the model we built from their data, might help other psychologists adapt their practice to provide positive therapy experiences to Autistic adults. Participants’ stories offer insights into the importance and meaning they have made from attending therapy with a supportive psychologist. »What are potential weaknesses in the study? »: Our study captures the experiences of a small group of Autistic adults in Australia. Many of the participants were late-diagnosed and assigned female at birth. Exploring perspectives from a more diverse group would help to further our understanding of this topic. »How will these findings help Autistic adults now or in the future? »: The model of care we developed has the potential to improve the mental health support provided to Autistic adults from psychologists. The information could be shared with more psychologists as part of their training or professional development.

Lien vers le texte intégral (Open Access ou abonnement)

15. Ridgway K, Cooke K, Demmer DH, Hooley M, Westrupp E, Stokes MA. Camouflaging Autism in Pursuit of Friendship and Intimate Relationships: A Systematic Review. Autism Adulthood. 2025; 7(5): 543-57.

BACKGROUND: Difficulties in making and maintaining social relationships is common among autistic people. These difficulties are thought to be due to differences in autistic social interaction and social communication that have been theorized to be the result of reduced social motivation. We argue that this theory does not account for camouflaging, a combination of strategies that are employed frequently by many autistic individuals in pursuit of obtaining social relationships; however, its utility in achieving satisfactory friendship and intimate relationships for the individual is not clear. METHOD: This review synthesizes empirical evidence of camouflaging as a strategy for achieving friendships and/or intimate relationships among autistic adolescents and adults. A systematic search yielded 1421 records. Forty-nine full texts were screened, and eight qualitative studies were retained. RESULTS: Results reveal that camouflaging was a main strategy in pursuit of friendship, with little evidence for intimate relationships, in this sample of autistic adolescents and adults. For most, camouflaging is exhausting, often ineffective and inefficient, and ultimately a challenge to one’s social authenticity. DISCUSSION/CONCLUSION: Research suggests that many autistic individuals rely on camouflaging in pursuit of friendship and intimate relationships, although this is often a nonpreferred strategy. Some autistic individuals seek to replace camouflage with alternative strategies to obtain social relationships, yet outcomes typically remain dissatisfying. This demonstrates that we need to reconsider the social motivation theory, and to better understand alternative strategies that can help autistic individuals to obtain authentic, satisfactory social relationships, and to support opportunities to achieve these desired outcomes. COMMUNITY BRIEF: Why is this topic important?: Many autistic individuals feel dissatisfied with the quality and quantity of their social relationships and are, therefore, more vulnerable to loneliness and reduced well-being. This may be because autistic people communicate and interact differently to non-autistic individuals. These differences can, at times, be misinterpreted as a lack of motivation to socialize and connect with other people. But many autistic individuals are motivated to build meaningful friendships and intimate relationships and often rely on camouflaging to achieve these outcomes. Regardless of their efforts, many autistic people continue to struggle to make the social connections they desire. Therefore, the effectiveness of camouflaging on building friendships and intimate relationships needs to be better understood.What was the purpose of this review?: We set out to understand the impact that camouflaging has the friendships and intimate relationships of autistic individuals by examining the existing research.What are the results of this review?: We found that camouflaging is a common strategy used by many autistic individuals to connect with others in aim to build and maintain friendships, especially with non-autistic people. Pressure to camouflage began early in life, for many autistic participants, and continued to increase in both complexity and use across the lifespan. However, many autistic individuals remained dissatisfied with the friendships and intimate relationships gained through its use. For many, camouflaging prevented genuine social interactions, and the friendships that resulted from its use were often lacking in closeness and authenticity for the autistic individual. To reduce the reliance on camouflaging, some autistic individuals socially withdrew, or attempted to find friendship within the autistic community or in social contexts where camouflaging felt less necessary. Yet, many autistic participants remained feeling lonely, frustrated, and dissatisfied with their social relationships.What were the weaknesses of this review?: Only half of the eight studies involved an autistic researcher and author, while most studies incorporated community participation in the design of the study. We found that participants were mostly female, from countries such as the United Kingdom and United States of America, and most participants were above18 years of age. Results may be impacted by a lack of researcher and sample diversity, and minimal autistic input in study design and interpretation; thus, generalization of these findings may be limited. Camouflaging is an evolving area of research, and we recognize that there may be terminology or perspectives that were not captured by our review.What do the authors recommend and how will this help autistic adults in the future?: More research is needed to better understand autistic social interactions and to support alternative strategies to camouflaging, including environmental modifications and changes in the way non-autistic people understand and interact with autistic people. We recommend that autistic individuals’ strengths and needs drive this area of research, and that supports address ways that all people can help to enhance autistic social outcomes. We anticipate that these strategies will promote more authentic social relationships, reduce reliance on camouflage, help to decrease loneliness, and improve well-being among autistic individuals.

Lien vers le texte intégral (Open Access ou abonnement)

16. Smethurst LJ, Thompson AR, Freeth M. « I’ve Absolutely Reached Rock Bottom and Have No Energy »: The Lived Experience of Unemployed and Underemployed Autistic Adults. Autism Adulthood. 2025; 7(5): 638-49.

BACKGROUND: Autistic adults are underrepresented in the employment market, and those in work are commonly underemployed. Our study aimed to gain an understanding of autistic adults’ experiences of unemployment and underemployment. METHODS: Eight autistic adults who self-identified as currently unemployed or underemployed who were actively seeking to change their employment status participated in semi-structured interviews, analyzed using interpretative phenomenological analysis. RESULTS: Four group experiential themes were identified: feeling paralyzed (the past weighs heavy; fragile self-confidence); powerlessness (lack of agency; systemic support failures); negative perceptions (feeling misunderstood; fear of judgment; pressure to meet societal expectations); and recognizing our needs (managing mental health difficulties; importance of self-understanding). Participants felt paralyzed by employment experiences, which impacted their confidence to progress with their career aspirations. Autistic people felt misunderstood, judged, and powerless within support systems, which had implications for their mental health. Participants recognized the importance of managing their mental health needs during times of unemployment and underemployment via self-care and seeking psychological support. CONCLUSION: Putting resource into understanding, acknowledging, and addressing processes within and around employment should be priorities for policy makers if they are serious about improving support to help autistic people find and stay in work. COMMUNITY BRIEF: Why is this an important issue?: Autistic people are less likely to have a job than non-autistic people. Autistic people who do have a job are likely to work fewer hours than they want, be in a job that that doesn’t fully use their skills or education, or not get paid enough to meet their basic needs.What was the purpose of this study?: To communicate autistic adults’ experiences of unemployment and underemployment to improve understanding of what this is like and what may help.What did the researchers do?: We developed interview questions in collaboration with two autistic adults. We interviewed eight autistic adults who identified as being unemployed or underemployed who were actively seeking to change their employment status. We asked them about the impact their experiences had on their day-to-day lives. We identified themes from what the interviewees said using interpretative phenomenological analysis (IPA).What were the results?: Interviewees described feeling paralyzed and stuck at their current employment status because of previous traumatic experiences both within the workplace and around employment processes. They felt misunderstood, judged, and powerless within systems surrounding employment. This impacted their mental health and ability to return to work or progress within their career. Most participants were discovered autistic in adulthood, which increased self-understanding, awareness of employment needs, and the importance of managing their well-being.What do these findings add to what was already known?: The findings demonstrate that prior negative experiences around employment can have profound, enduring effects on autistic adults. This study highlights the challenges faced by autistic adults throughout the employment process and the impact these experiences have on their well-being and ability to progress back into work or within work. Autistic adults experienced a lack of understanding of both autism in general and a lack of empathy toward them as individuals on the part of the employer and colleagues. Further, there was no evidence of responsibility being taken by the employer to mitigate their gaps in knowledge. There is a clear need to work toward practical solutions as highlighted within this study. As such, there is a need for investing resource into understanding, acknowledging, and addressing insufficient and inadequate employment processes, both pre- and post-recruitment.What are potential weaknesses in the study?: Our findings reflect the experiences of a small group of people, so their experiences will not apply to everyone. The majority of the interviewees were discovered autistic in adulthood, and there is a lack of diversity, in that the interviewees were well educated, mostly over the age of 45 years, and mostly White British.How will these findings help autistic adults now or in the future?: This study helps us better understand the experiences of unemployed and underemployed autistic adults and the barriers they face. Our findings highlight the importance of putting resource into understanding, acknowledging, and addressing these issues around employment for autistic people. This will be imperative for organizations and policy makers if they are serious about improving the employment rates and addressing needs of autistic people.

Lien vers le texte intégral (Open Access ou abonnement)

17. Stephenson H, Thom-Jones S, Lowe J, Milne L. « I Know It’s Very Spectrum-y »: Autistic Women Reflect on Sensory Aspects of Food and Eating. Autism Adulthood. 2025; 7(5): 612-22.

BACKGROUND: There is scant research on autism-related eating challenges in autistic adults. Characteristics often associated with autism (e.g., sensory sensitivities, cognitive rigidity) may underpin issues with food and eating in autistic adults. Contextual factors also play a role, although they are rarely accounted for. METHODS: This study explored autistic women’s experiences of sensory aspects of food and eating utilizing a critical realism orientation and reflexive thematic analysis. Ten semi-structured interviews explored autistic women’s food and eating experiences. Interviews were conducted online, audio recorded, and transcribed. RESULTS: Three core themes were identified from qualitative data analysis: (a) sensory factors influence experiences of food, eating, and eating environments; (b) impact of trauma; and (c) internalization of societal stereotypes. A novel finding was the high prevalence of participants who reported seeking pleasurable sensory stimulation via food and eating. Distress was linked to lack of understanding of autistic sensory food and eating needs by nonautistic individuals. Participants also used nonautistic experiences and societal stereotypes as a benchmark for which food and eating tendencies are acceptable. CONCLUSIONS: Further research is urgently needed to develop our understanding of how sensory factors and societal stigma influence food and eating experiences of autistic women and the broader autistic community. COMMUNITY BRIEF: Why was this study done?: Autistic people are often described as having problems with food and eating. Most of the research has looked at infants and children, through the eyes of parents and professionals. Very few studies have focused on autistic adults, or included autistic voices. These approaches see differences in autistic ways of eating as problems to be solved.What was the purpose of this study?: In this study, we talked to autistic women about food and eating. We wanted to understand the things that influence what they eat, the way they eat, where they eat, and how they feel about food.What did the researchers do?: We conducted online video interviews with 10 autistic women who responded to an invitation to participate in the study posted on social media. Interviews lasted an average of 51 minutes. The research team consisted of two autistic autism researchers and two nonautistic psychologists with experience researching and working with autistic women.What were the results of the study?: The women described how sensory aspects of food can make eating enjoyable or distressing. Rules and rituals around eating provide comfort. Other people’s negative reactions to their natural ways of eating can cause distress and trauma.What do these findings add to what was already known?: Our findings suggest that autistic ways of eating may be functional rather than harmful. Eating safe foods and following routines help autistic people manage complex sensory and social challenges.What are potential weaknesses in the study?: This was a small sample and predominantly Caucasian, higher socioeconomic status, highly educated, younger adult women, limiting the generalizability to the broader population of autistic people.How will these findings help autistic adults now or in the future?: The findings highlight the nuances and utility of autistic food and eating approaches, opening a discussion beyond neurotypical norms and social constructions. This may support autistic people to de-pathologize these approaches and deconstruct internalized negative stereotypes, supporting their agency and self-determination. Understanding the functions of autistic food and eating experiences could help families and service providers support autistic people. We hope that this study will encourage more research in this area, as well as the development of sensory-appropriate, autism-friendly food and eating environments, and address misperceptions among clinicians and caregivers that our eating behaviors are problems to be « fixed. ».

Lien vers le texte intégral (Open Access ou abonnement)

18. Takahashi Y, Takamatsu N, Okada N, Yagishita S, Kasai K. Meta-analysis of (1)H-MRS glutamate profiles in adult schizophrenia spectrum disorders and autism spectrum disorder: Study protocol. PCN Rep. 2025; 4(4): e70260.

BACKGROUND: Schizophrenia spectrum disorders (SSDs) and autism spectrum disorder (ASD) share social-cognitive deficits, genetic architecture, and overlapping animal models, yet the neurochemical signatures that differentiate them remain unclear. This protocol describes a systematic review and meta-analysis of proton magnetic resonance spectroscopy ((1)H-MRS) studies examining glutamate, glutamine, and their combined signals. The primary aim is to establish a human neurochemical benchmark to guide translational research. METHODS: Eligible studies will be those measuring (1)H-MRS glutamatergic metabolites at ≥3 T field strength in at least one of five brain regions: anterior cingulate cortex, dorsolateral prefrontal cortex, hippocampus, striatum, or thalamus. Adults (≥18 years) with SSD (stratified as ultra-high risk, first-episode psychosis, and treatment-resistant schizophrenia) and ASD diagnosed using standardized criteria will be compared to healthy controls. Systematic searches will be conducted in databases. Two independent reviewers will assess the risk of bias using the AXIS (Appraisal Tool for Cross-Sectional Studies) and MRS-Q (Magnetic Resonance Spectroscopy Quality Assessment Tool). Primary outcomes will be regional differences in metabolite concentrations. We will conduct random-effects meta-analyses integrating direct and indirect comparisons, with subgroup analyses by illness stage and medication status. RESULTS: We expect to identify both shared and distinct glutamatergic alterations across SSD subgroups and ASD, with potential stage-specific patterns in cortical and subcortical regions. CONCLUSIONS: This comprehensive analysis aims to identify regional brain glutamatergic biomarkers differentiating SSD and ASD. These neurochemical signatures will provide an essential reference framework for validating and guiding reverse-translational research. PROSPERO REGISTRATION NUMBER: CRD420251003550.

Lien vers le texte intégral (Open Access ou abonnement)

19. Tang K, Thompson C, Hill E, Pellicano E, Wan P, Myers B. Barriers to and Enablers of the Transition From Child to Adult Mental Health Services for Autistic Young People and/or Those With Attention Deficit Hyperactivity Disorder: A Scoping Review. Child Care Health Dev. 2026; 52(1): e70201.

BACKGROUND: Many autistic young people and/or those with attention deficit hyperactivity disorder (ADHD) have co-occurring mental health conditions. These individuals can experience significant challenges when transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). However, barriers and enablers to the transition from CAMHS to AMHS are poorly understood for this population. This scoping review sought to synthesise the available evidence on barriers and enablers to the transition from CAMHS to AMHS for autistic young people and/or those with ADHD. METHODS: Arksey and O’Malley’s six-step framework for scoping reviews was used to map out the evidence available and report the findings with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines (PRISMA-ScR). Electronic databases of Medline, PsycINFO, CINAHL, Scopus and ProQuest Central were searched for relevant studies published in English with no date limitations. The review included studies that focused on young people with a primary diagnosis of autism spectrum disorder (ASD) and/or ADHD (population) and their care transition barriers and/or enablers (concept) from CAMHS to AMHS (context). A socioecological framework informed data extraction and narrative synthesis of data on barriers and enablers to transition. RESULTS: This review identified 1677 studies, of which 66 proceeded to full-text screening, and 10 were included. Most studies focused on institutional-level transition barriers, including poor communication between CAMHS and AMHS and lack of clarity about their role in the transition process. Involvement of the neurodivergent young person in decision-making processes about their mental health care and clinicians who tailored their approaches to the needs of the neurodivergent young person emerged as key enablers of a positive transition experience. Studies largely failed to examine community and policy-related barriers to mental health care transitions. Most studies examined the perspectives of providers or carers, with only five representing the perspectives of neurodivergent people. CONCLUSION: Young people who are autistic and/or have ADHD experience many barriers to their transition from CAMHS to AMHS; however, few studies have examined barriers and enablers to the service transition process.

Lien vers le texte intégral (Open Access ou abonnement)

20. Tatode A, Gupta T, Qutub M, Umekar M, Taksande B, Premchandani T. Targeting exercise triggered irisin for therapeutic intervention of autism-associated social anxiety. J Psychiatr Res. 2025; 193: 247-60.

Autism spectrum disorder (ASD) is frequently complicated by debilitating social anxiety, which exacerbates social impairments and reduces quality of life. This review explores the therapeutic potential of exercise-induced irisin, a myokine released during physical activity, in mitigating ASD-associated social anxiety. Irisin, derived from the cleavage of skeletal muscle FNDC5 protein, crosses the blood-brain barrier and modulates key neurobiological pathways implicated in ASD. It enhances neurogenesis and synaptic plasticity via BDNF upregulation, suppresses neuroinflammation by reprogramming microglia and reducing pro-inflammatory cytokines, and normalizes HPA axis hyperactivity to reduce stress responses. Preclinical evidence demonstrates irisin’s efficacy in improving social behaviour and reducing anxiety in ASD rodent models, while clinical studies correlate exercise with reduced anxiety in ASD individuals, though direct irisin measurements remain limited. Despite heterogeneity in exercise responsiveness and adherence challenges in ASD populations, irisin represents a promising endogenous mediator for novel therapeutic strategies, including optimized exercise regimens and pharmacological mimetics.

Lien vers le texte intégral (Open Access ou abonnement)

21. Wu X, Huangfu J, Zhang W, Hu Y, Yang L, Wei J, Chen Z, Geng S, Xue S, Yi P, Mao Y, Qian D, Wang X, Zhang P, Long H. Efficacy and Safety of Neuromodulation Interventions for Autism Spectrum Disorders with Comorbidities: A Systematic Review. Neuropsychiatr Dis Treat. 2025; 21: 2759-82.

PURPOSE: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and stereotyped, repetitive behaviors or interests. Neuromodulation interventions have been employed in ASD, which can improve behavioral and cognitive outcomes in ASD, especially relief of comorbidities, as shown in preliminary evidence. However, their efficacy and safety remain unclear owing to the lack of high-quality synthetic evidence. We aim to systematically evaluate the therapeutic potential of neurostimulation in ASD and explore its underlying mechanisms. PATIENTS AND METHODS: A narrative synthesis of peer-reviewed literature from 2000 to 2025 was conducted, sourced from the PubMed, Web of Science, and Cochrane Library. Seventy-three relevant studies were identified in this paper. RESULTS: Up to date, noninvasive brain stimulation has become a potential intervention to reduce autism-related symptoms and improve neuropsychological function in ASDs, while a marked alleviation of comorbidities including aggression, anxiety and epilepsy was observed following invasive brain stimulation interventions. Both of the neuromodulation techniques are believed to be safe and well-tolerated. CONCLUSION: Neuromodulation interventions could be a hopeful option to improve patients’ symptoms and control comorbidities of ASD. Further high-quality trials should be conducted to optimize long-term prognosis of ASD.

Lien vers le texte intégral (Open Access ou abonnement)

22. Zhu EH, Yip BH, Fyfe C, Merzon E, Kodesh A, Askling J, Reichenberg A, Yin W, Levine SZ, Sandin S. Maternal rheumatoid arthritis and the risk of offspring autism spectrum disorder: two national birth cohorts and a meta-analysis. Mol Autism. 2025; 16(1): 61.

BACKGROUND: Prenatal maternal rheumatoid arthritis (RA) is postulated to increase the risk of offspring with Autism Spectrum Disorder (ASD), yet findings of the association are inconsistent, potentially owing to small sample sizes and insufficient consideration of the timing of RA onset. This study aimed to examine the association between maternal RA, particularly its timing, and offspring ASD risk. METHODS: Two Israeli birth cohorts with national coverage and a meta-analysis were analyzed. Two harmonized birth cohorts of individuals born between 2003 and 2014 from Israeli Health Maintenance Organizations were followed up to 2021–05-01. Meta-analysis included all studies published up to 2023–06-07. Two exposures differentiated the timing of RA onset through maternal RA diagnosed before or after delivery. The association between maternal RA and the risk of offspring ASD was quantified by separate and pooled hazard ratios (HRs) from Cox proportional hazards regression with adjusted confounders. In the meta-analysis, the association was quantified using odds ratios (OR) fitted with random effects models with sensitivity analyses testing heterogeneity. RESULTS: Two Israeli birth cohorts included Cohort I (Population = 251,903; ASD = 1,939 [0.77%]) and Cohort II (Population = 309,696; ASD = 3,008 [0.97%]), contributing a total of 5.9 million person-years. Meta-analysis included 13 eligible studies (9 eligible estimates, population = 4,015,055, ASD = 45,124). Maternal RA before delivery increased the risk of offspring ASD (Cohort I HR = 1.55, 95% CI = 0.98–2.46; Cohort II HR = 1.83, 95% CI = 1.30–2.58; Combined I + II HR = 1.77, 95% CI = 1.45–2.17. Meta-analysis: OR = 1.57, 95% CI = 1.31–1.87). LIMITATIONS: Very few cases of seronegative RA compared to seropositive cases; RA subtype analysis was not feasible. It is important to acknowledge that the inclusion of the exposure “RA after delivery” also encompasses future RA information after the diagnosis of ASD, which may introduce biases. The association between RA drugs and offspring ASD risk has not been established due to a lack of data. CONCLUSIONS: Drawing on the strengths of two parallel birth cohorts from Israel and supported by meta-analysis, the current study indicates a modest but robust increase in the risk of ASD among offspring of mothers diagnosed with RA before delivery, but not when diagnosed only after delivery. This temporal specificity argues against shared genetic etiology and points toward maternal inflammatory status during pregnancy as a causal factor in offspring ASD risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13229-025-00694-w.

Lien vers le texte intégral (Open Access ou abonnement)