1. Agarwal M, McFadden TD, Schwebel DC. Developmental Considerations for Pediatric Unintentional Injury Prevention. Pediatr Clin North Am. 2025; 72(6): 1047-62.

Injuries are the leading cause of pediatric mortality, but risks vary across child and adolescent development. As children grow, they develop physical size and strength, cognitive skills, motor abilities, and different socialization patterns. Each of these changes impacts injury risk. The authors review developmentally relevant risk factors and prevention strategies, providing information clinicians can share while counseling pediatric patients and their families. Also addressed are considerations for children with developmental differences, including autism spectrum disorder, attention-deficit/hyperactivity disorder, and sensory impairments.

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2. Aivazidis A, Memi F, Rademaker K, Koko M, Roberts K, Trinh A, Petryszak R, Kleshchevnikov V, Tuck L, Lisgo S, Li T, Makarchuk S, Prete M, Nowakowski TJ, Martin HC, Bayraktar OA. A spatial transcriptomic atlas of autism-associated genes identifies convergence in the developing human thalamus. bioRxiv. 2025.

Autism is a highly heritable neurodevelopmental condition that manifests across a wide phenotypic spectrum. Rare and de novo loss-of-function mutations strongly predispose to autism and co-occurring developmental and intellectual disabilities in over 10% of autistic individuals. Understanding whether these variants converge on specific regional brain circuits or widely alter human brain development is crucial to understanding the etiology of profound autism. To date, transcriptomic atlases have mainly implicated the developing cerebral cortex, yet other brain areas have received relatively little attention. Here, we present a single-cell resolution spatial transcriptomic atlas of 250 autism susceptibility genes during human brain development. Profiling over 10 million cells across the midgestation forebrain, we found convergence of these genes across a small number of regional programs. The developing thalamus showed the most prevalent expression of autism susceptibility genes, followed by germinal zones throughout the brain. Within the thalamus, excitatory neurons showed the most enriched expression, which varied across thalamic nuclei harboring distinct circuits. Across the germinal zones, neural progenitors in the medial ganglionic eminences that generate parvalbumin- and somatostanin-positive interneurons showed highest expression. Our findings reveal the prevalent expression of autism associated genes beyond the developing cerebral cortex and implicate the developing human thalamus as a major hub of autism susceptibility.

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3. Aponte EA, Tillmann J, Gleissl T, Del Valle Rubido M, Murtagh L, Sanders K, Chatham CH, Wiese T, Suter EE. Anxiety, repetitive and restricted behaviors and interests, and social communication in autistic adults: an exploratory analysis of a phase 3, randomized clinical trial. Sci Rep. 2025; 15(1): 38912.

Autistic adults are highly vulnerable to mental health problems and yet, our understanding of co-occurring psychiatric disorders in this population is limited. Anxiety is one of the most pervasive psychiatric disorders that affects autistic adults. Here, we investigated the association between anxiety, restricted and repeated behaviors and interests (RRB), and challenges in social communication and interaction (CSCI) as a post-hoc analysis of a large Phase 3 clinical trial (NCT03504917). The study enrolled 322 adults (64 females, age 27 ± 10) assessed at baseline and weeks 12, 24, 36, and 52, with the Hamilton Anxiety Rating Scale, the Repetitive Behaviors Scale – Revised, and the Vineland-II for CSCI. All analyses were blind to treatment assignment as the primary study analysis had found no treatment effects. Anxiety levels were significantly correlated with RRB and CSCI at baseline (RRB: r = 0.19, P < 10(-3); CSCI=-0.13, P = 0.02) and across the entire study (RRB: r = 0.22, P < 10(-3); CSCI=-0.16, P < 0.01). However, a mediation analysis revealed that the effect of CSCI on anxiety was fully explained by RRB (P = 0.17). While no causal relationship between both symptom domains has been established yet, our findings suggest that anxiety symptoms are associated with increased RRB, warranting further exploration of a potential causal association and implications for treatment.Clinical trial registration: The research presented is registered at ClinicalTrials.gov with the code NCT03504917.

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4. Benevides TW, Pham HH, Andresen ML, Bahr MR, Corey T, Nicholson J, Faughnan K, Jaremski JE, Langer C, Siasoco V, Hernandez-Hons A, Shore SM. Engagement to Identify Health Priorities of People With Intellectual and/or Developmental Disability. OTJR (Thorofare N J). 2025: 15394492251385448.

People with lived experiences are often excluded from development of solutions and decision-making related to health research and policy. To describe and demonstrate how high-quality engagement supports partner and project outcomes. The ultimate project outcome was to identify health priorities desired by people with intellectual and/or developmental disability (IDD) and the people who support achieving those priorities, including caregivers, clinicians, and payers/regulators. This capacity-building project implemented and evaluated methods of engagement of IDD self-advocates, caregivers/partners, clinicians, payers/regulators, and researchers. Our reliance on a variety of engagement approaches, but particularly graphic illustration and other visual engagement, yielded productive conversations to advance areas of priority. Partners felt satisfied with engagement and continued to participate at multiple points throughout the 2-year project. We identified nine illustrated priority health outcomes useful for research, practice, and policy change. Our engagement and priority-setting approach resulted in findings that partners found compelling personally and professionally. Identifying Health Priorities for People with Intellectual and Developmental Disabilities Through EngagementWhy is this an important issue? People with intellectual and/or developmental disabilities (IDDs) don’t always get good health care.What was the purpose of the project? This project had a big goal: to find out what health outcomes are most important to people with IDD. We first needed to create ways for many different partners to work together and share ideas.What did the project team do? We worked with different people, including adults with IDD, caregivers, clinicians, and those in charge of health insurance plans. Together, our team developed ways of working together. We used videos, drawings, and easy-to-understand language. We made sure everyone, including those with different communication needs, could take part. In total, 58 people shared their ideas about important health goals in meetings and online sessions.What were the results of this project? We learned that using drawings and other ways of showing ideas visually without words was helpful for many different groups of people. For people with IDD, having 1-on-1 meetings to prepare for larger group meetings was helpful. Videos sent before meetings to describe the agenda and discussion questions were helpful for both people with IDD and caregivers. We learned that people with IDD and other partners want research to address nine health priorities that affect positive outcomes of people with IDD.What do these findings add to what we know? We learned that using artist-created drawings and using other visual tools like Miro(®) were helpful for all people to work together.What are the potential weaknesses? We need to talk with more people about these health outcome priorities to be sure they are complete.How will these findings help people now or in the future? These ideas for helping many different partners work together are useful for other teams. The project outcome with illustrated priorities can help make these ideas more accessible to a wider audience. eng.

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5. Blanco-Gomez G, O’Reilly C, Webb SJ, Elsabbagh M. The Development of Lateralized Brain Oscillations in Infants: Lessons From Autism. Dev Psychobiol. 2025; 67(6): e70101.

The lateralization of brain activity is important for language processing and attention, and atypical patterns of lateralization have been linked to many neurodevelopmental disorders, including autism spectrum disorder (ASD). However, the developmental timing of these patterns and their relationship to emerging ASD characteristics are unclear. In this study, we used data from EEG-IP (International Infant EEG Data Integration Platform), a longitudinal cohort bringing together infants at elevated likelihood for ASD and age-equivalent controls across two sites. We examined brain lateralization in electroencephalography (EEG) power during the first year of life. Overall, we identified differences in gamma band lateralization in infants later diagnosed with ASD at 12 months but not at 6 months. Additionally, we observed a shift from high left gamma band asymmetry at 6 months toward more symmetry by 12 months in our control group, highlighting between-group differences in developmental trajectories in brain oscillatory activity. We found key differences in the lateralization across groups in brain regions within the auditory network, which is thought to be important for language learning. Overall, examining the developmental trajectories of lateralization is a crucial step toward creating more accurate models of brain development and better understanding the underlying mechanisms of neurodevelopmental disorders.

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6. Chhetri S, Belbase U, Poudel M, Dhakal D, Bhandari A, Cantó-Cerdán M, Subedi A, Shrestha O. Outcomes of Vision Therapy on Visual Skills and Oculomotor Functions in Children with Autism Spectrum Disorder: A Prospective Study. Clin Optom (Auckl). 2025; 17: 341-51.

PURPOSE: Visual skills and Oculomotor function deficits are common in children with Autism Spectrum Disorder (ASD), potentially affecting their development and quality of life. This study aimed to evaluate the effectiveness of vision therapy in visual perceptual skills and oculomotor function in children with ASD. PATIENTS AND METHODS: This prospective interventional study was conducted using a convenience sampling method between February and May 2025. All children with a prior diagnosis of ASD who met the inclusion criteria were included in the study and underwent 45 sessions of vision therapy guided by the Developmental, Individual-Differences, Relationship-Based (DIR) model. Visual skills and oculomotor functions were assessed before and after vision therapy using the Wachs Analysis of Cognitive Structures (WACS) and the Northeastern State University College of Optometry (NSUCO) Oculomotor test, respectively. The paired t-test with Hedge’s g effect size was used to compare pre and post vision therapy outcomes for normally distributed data, while the Wilcoxon signed-rank test with effect size r was applied for non-normally distributed variables. Analysis of Covariance was used to examine the effect of ASD severity on post-therapy outcomes while controlling for age and gender. RESULTS: Among the 42 children with ASD enrolled in the study, 36 completed all 45 sessions of vision therapy. Significant post-therapy improvements with large effect size were observed in visual perceptual skills (WACS) and oculomotor functions (NSUCO). Children with mild to moderate ASD showed greater improvements than those with severe ASD. Analysis of covariance revealed a significant effect of ASD severity on post-therapy outcomes: WACS (F(1,32) = 36.80, p < 0.001, R(2) = 0.55), saccades (F(1,32) = 36.75, p < 0.001, R(2) = 0.54), and pursuits (F(1,32) = 35.54, p < 0.001, R(2) = 0.54). Age and gender showed no statistically significant effects on the outcomes. CONCLUSION: This prospective study provides preliminary evidence that DIR-guided vision therapy, particularly when combined with occupational and behavioral therapy, may enhance visual perceptual and oculomotor functions in children with ASD. However, randomized controlled studies with longer follow-up are needed to confirm these results.

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7. Chien YL, Chen C, Hsieh MH, Gau SS. Correlation of auditory network hyperconnectivity with P3a amplitude and set-shifting in individuals with autism spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2025; 143: 111552.

BACKGROUNDS: Individuals with autism spectrum disorder (ASD) exhibit aberrant intrinsic connectivity and altered mismatch negativity responses. Both mismatch negativity and intrinsic connectivity are associated with pre-attentive mechanisms. However, the potential link between mismatch negativity and alterations in intrinsic connectivity in ASD has not been thoroughly explored. This study aimed to investigate the resting-state functional connectivity of the auditory network in ASD and examine its association with mismatch negativity and set-shifting performance. METHODS: This study recruited 75 ASD participants and 50 neurotypical controls (NAC). All participants underwent clinical assessments, mismatch negativity on the oddball paradigm, and resting-state functional MRI. We compared the resting-state brain connectivity of the auditory network between ASD and NAC using independent component analysis. We then examined correlations between this connectivity, mismatch negativity, and executive function measured by the Intra-Extra Dimensional Set Shift task (IED). RESULTS: The ASD group demonstrated resting-state hyperconnectivity between the auditory network and the regions of the posterior cingulate gyrus, left inferior frontal gyrus, right angular gyrus, and right caudate/thalamus. In ASD, the connectivity between the auditory network and the left inferior frontal gyrus was positively correlated with higher P3a amplitude and a greater number of completed stages on the IED task, indicating enhanced cognitive flexibility. CONCLUSION: Findings suggest heightened functional connectivity between the auditory network and various brain regions in ASD. Specifically, connectivity to the left inferior frontal gyrus at rest may predict enhanced attention reorientation and cognitive flexibility in autistic individuals. Further research is warranted to elucidate these relationships.

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8. Collins E, Al-Jaishi A, Farrow A, Amankwah N, Georgiades S, Salt M, Holmes K, Edjoc R. Household income among families with autistic children and youths in Canada: a cross-sectional matched cohort study. BMJ Open. 2025; 15(11): e096019.

OBJECTIVE: Within the Canadian context, we sought to examine the relationship between households with autistic children/youths and household income. DESIGN: We used data from the 2019 Canadian Health Survey on Children and Youth (CHSCY) to analyse households with a child/youth aged 1-17. Propensity-score matching was used to pair records for children/youths with a reported autism diagnosis to those without. We used linear regression for continuous outcomes (eg, total household income) and Poisson regression for binary outcomes (eg, low household income). All analyses were adjusted for the correlation between matched pairs. PRIMARY OUTCOME MEASURE: Total annual income of all household members. SECONDARY OUTCOME MEASURES: Low household income; single-parent or single-income status; and whether at least one parent was not working or absent from work during the past week. RESULTS: Among a total of 39 951 CHSCY records, we identified a cohort of 815 autistic children/youths. The characteristics of the matched cohort were well-balanced. Households with an autistic child/youth had a mean annual household income that was lower (mean difference: $C16 489; 95% CI $C6384 to $C27 149) compared with matched households without an autistic child/youth. Households with an autistic child/youth were also 26% more likely to be classified as having a low household income (Relative risk (RR) 1.26; 95% CI 1.17 to 1.35) and 20% more likely to rely on a single income (RR 1.20; 95% CI 1.10 to 1.33) compared with households without an autistic child/youth. CONCLUSIONS: Compared with households without an autistic child/youth, those with an autistic child/youth often face more economic challenges, including lower household income and greater risk of food insecurity. Households with an autistic child/youth are more likely to rely on a single income.

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9. Duerden EG, Neufeld J, Crafa D. Social perception and cognition in autism. Sci Rep. 2025; 15(1): 38660.

Autism is a neurodevelopmental condition characterized by social communication differences and repetitive behaviors. Recently, autism research has shifted to reflect the need for individualized, ecologically valid models of social cognition difficulties. This Special Issue brings together innovative studies exploring how autistic individuals perceive and respond to social interactions, using a broad range of methodological approaches including psychophysical experiments, neuroimaging and behavioral measures. Emerging themes include differential processing in individuals on the spectrum in social cognition, social perception, eye contact, emotion regulation/arousal, and interpersonal synchrony. The collection also introduces novel translational approaches, such as using motion synchrony during diagnostic interviews and characterizing individual motor-sensory profiles. Together, the articles in the Special Issue reflect a paradigm shift in autism research from the previous more static views of social difficulties and moving toward a nuanced understanding of heterogeneity, compensation and adaptive potential. This body of work underscores the value of precision approaches to improve social cognition and lays the foundation for inclusive, strengths-based interventions.

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10. Eilon I, Novogrodsky R. The Development of Mental State Verb Use Among Autistic Children. Autism Dev Lang Impair. 2025; 10: 23969415251389127.

BACKGROUND & AIMS: Mental state verbs (MSVs) describe people’s internal states and processes. Reports on the use of MSVs in school-age children with autism spectrum disorder (ASD) are contradictory, and little is known about the developmental trajectories of these verbs in this population during early childhood. In contrast, among young, typically developing (TD) children, research has shown that the use of desire, perception, and physiological verbs precedes the use of cognitive and emotion verbs. This study aimed to describe the development of MSV use among autistic children as compared to TD children and investigate the variables that influence this development. METHODS: A total of 118 children participated in the study (59 autistic and 59 TD children), aged 3-10 years. Parents of all children completed an MSV questionnaire indicating whether their child produced the MSVs included in it. Additionally, two variables influencing MSV use were examined: sentence repetition for estimating syntax and measures of theory of mind (TOM) ability, which included three tasks: diverse desires and first- and second-order false belief. RESULTS: According to the parental questionnaire, cognitive and emotion verbs have a more protracted developmental trajectory in both autistic and TD children than other MSV categories (desire, perception, and physiological verbs), and they are more challenging for autistic children than for TD children. Cognitive and emotion verbs are also less common in preschoolers’ speech than in that of school-aged children. In addition, language abilities, TOM, and group (autistic vs. TD) explained the variance in the development of cognitive and emotion verb use beyond age. CONCLUSIONS AND IMPLICATIONS: These findings demonstrate the development of MSVs from all five semantic categories from the age of three years to the age of ten in autistic children. In addition, our results indicate a specific linguistic difference between autistic and TD children in the development of cognitive and emotion verbs, as was found in the MSV parental questionnaire. The study also highlights the role of syntax, TOM, and autism in relation to the development of these verbs, supporting the notion of complex developmental conditions associated with MSV development and, thus, the need to evaluate them in autistic children.

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11. Galvez-Merlin A, Arqueros M, Fuentes-García N, Diaz-González S, de la Torre-Luque A, Lopez-Villatoro JM, Díaz-Marsa M, Carrasco JL. Autistic traits in borderline personality Disorder: Relationship to interpersonal traumatic experiences. J Psychiatr Res. 2026; 192: 332-6.

INTRODUCTION: Detecting autistic spectrum disorder (ASD) traits in BPD patients is challenging due to overlapping symptoms such as impulsivity, emotion instability, self-injury behavior and interpersonal difficulties. Theory of mind impairments and other ASD features may increase vulnerability to interpersonal trauma and therefore to BPD symptoms. This study examines ASD traits in BPD patients and their impact on interpersonal trauma exposure. METHOD: 65 BPD patients and 40 controls were assessed using the Autism Spectrum Quotient (AQ 10) and the Social Responsiveness Scale (SRS-2). Interpersonal traumatic experiences were also collected (physical abuse in childhood, sexual abuse in childhood, rape in adulthood, school bullying and mobbing). ASD scores were compared between patients and controls through a t-test for mean difference. The sex variable was controlled using ANCOVA. Finally, the relationship between ASD scores and interpersonal trauma was analyzed by using linear regression analysis. RESULTS: Patients with BPD had higher ASD scores for both the AQ-10 (p < .04) and the SRS-2 (p < .001) than the control group. In the BPD group, ASD features were significant predictors for reporting interpersonal trauma experiences (p < .001). CONCLUSIONS: ASD traits are significantly present in BPD patients than in healthy subjects and are associated with the intensity of interpersonal trauma in BPD. According to these results, the clinical relevance of ASD traits in developing BPD and in the clinical manifestations of the disorder should be further investigated in greater samples.

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12. Gülbetekin E, Yıldırım Z. Digital Training Program with Mothers of Toddlers on Weaning, Toilet Training and Autism Knowledge: A Randomized Controlled Trial. J Community Health Nurs. 2025: 1-12.

PURPOSE: In recent years, research has emphasized the need to increase mothers’ awareness of important issues, particularly toilet training, breastfeeding termination training, and autism. The aim of this study is to increase the awareness levels of mothers through a training program on sensitive issues in the 18-36 months group, such as toilet training, autism and breastfeeding termination. DESIGN AND METHODS: The study was conducted as a randomized controlled trial. The study population consisted of 90 mothers with children aged 18 to 33 months living in a province in eastern Turkey between September 2024 and February 2025. A « Personal Information Form, » the « Toilet Training Knowledge Attitude Scale, » the « Autism Awareness Scale Mother Form, » the « Weaning Scale » and the « Informed Voluntary Consent Form » were used to collect the data. Animation-supported digital education prepared by the researchers was applied to the mothers in the experimental group for a duration of six weeks. FINDINGS: The difference between the knowledge levels of the experimental and control groups in terms of toilet training, autism awareness and breastfeeding termination after the training was found to be statistically significant (p < 0.05). The pre-post score difference between the experimental group and the control group was significantly higher in all groups. CONCLUSIONS: The animation-supported digital education given to the mothers in the experimental group was found to have a positive effect on their toilet training, autism awareness and breastfeeding termination knowledge levels. CLINICAL RELEVANCE: Nurses working and specializing in pediatrics and public health should explore ways to use technology-based training.

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13. Gümüş M, Teklu SW. Mathematical modeling and optimal control of autism spectrum disorder stigma dynamics with compartmental framework and awareness campaigns. Comput Biol Med. 2025; 198(Pt B): 111275.

This study addresses the significant public health challenge of stigma propagation against Autism Spectrum Disorder (ASD) by modeling it as a dynamic social process. We develop a novel five-compartment mathematical model that segments the population based on their awareness and perspectives towards ASD, ranging from complete unawareness to active stigmatization and eventual recovery. The primary objective is to analyze the dynamics of this social contagion and identify optimal intervention strategies. The methodology combines rigorous analytical techniques, including stability and bifurcation analysis, with sensitivity analysis to pinpoint the most influential factors driving stigma spread. We then formulate an optimal control problem to evaluate the effect of three time-dependent intervention strategies: preventative education, media campaigns, and rehabilitation programs. The forward-backward sweep algorithm is employed numerically to solve the resulting optimality system. Our key finding is that while preventative education is the most effective single intervention, a combined strategy of education and rehabilitation proves to be the most potent and efficient approach for reducing stigma prevalence. This research provides a quantitative framework to guide public health policies aimed at fostering a more inclusive society for individuals with ASD.

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14. Hosseinzadeh N, Mahalleh M, KamaliZonouzi S, Alikarami S, Gouravani M, Arevalo JF. Optical coherence tomography measurements of retina and choroid in autism spectrum disorder: a systematic review and meta-analysis. Ophthalmic Res. 2025: 1-25.

INTRODUCTION: The purpose of this systematic review and meta-analysis is to compare optical coherence tomography (OCT) retinal measurements between patients with autism spectrum disorder (ASD) and the neurotypical controls, exploring the potential of OCT as a non-invasive biomarker for ASD-related neurodevelopmental alterations. METHODS: PubMed, Embase, and Scopus databases were explored to determine eligible articles reporting OCT measurements of retina and choroid in patients with ASD compared to healthy controls. Statistical analysis of OCT metrics was performed if reported in at least three discrete studies. In the process, fixed and random effects models were utilized, depending on the heterogeneity level between studies. Subgroup analysis based on the age group of cases, the method of eye selection, age and sex matching of cases and controls, and the OCT device used was also conducted. RESULTS: Ten studies with 373 ASD cases (with a total of 640 eyes) and 443 controls (with a total of 760 eyes) were included in this study. No significant alteration was observed in the average total macular layer, macular inner nuclear layer (INL), macular inner plexiform layer (IPL), macular ganglion cell layer (GCL), and macular retinal nerve fiber layer (RNFL) thickness. There was also no significant difference in the peripapillary retinal nerve fiber layer (pRNFL) thickness of the eyes of cases with ASD compared to healthy controls, except for the inferonasal portion of the pRNFL, which was significantly thicker in ASD subjects when compared to controls (p = 0.02). CONCLUSION: The findings of the present meta-analysis indicate a localized thickening of the inferonasal pRNFL with no alteration of other portions of pRNFL and macular layers (IPL, INL, GCL, RNFL). Although OCT may reflect subtle neurodevelopmental differences in ASD, current evidence is limited by small sample sizes, methodological heterogeneity, and potential confounders.

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15. Jameson M, Bean A. Mutual Understanding: The Role of Neurotype-Matching and Perceptions in Communication Effectiveness. Am J Speech Lang Pathol. 2025; 34(6): 3164-82.

PURPOSE: The purpose of this study was to investigate the communication success of partners with matched or mixed neurotypes and to explore how these differences influence the identification of neurotypes during interactions. METHOD: Thirty-three autistic adults and 37 non-autistic adults were paired in either a matched-neurotype or mixed-neurotype condition and were not told their assigned condition. The pairs completed two structured communication tasks (20 questions and tangram identification), for which accuracy and efficiency of completion were measured. Participants completed a survey about rapport in their interactions and their perception of their partner’s neurotype. RESULTS: Matched autistic pairs communicated significantly more accurately (p = .037) but significantly less efficiently (p = .047) than matched non-autistic pairs. Mixed-neurotype pairs reported significantly lower rapport than the matched-neurotype pair conditions (p = .023), which did not differ significantly from one another. Matched autistic pairs were significantly more accurate (p = .009) and more confident (p = .035) in their guesses about their partner’s neurotype than participants in other conditions. However, participants’ guesses were not significantly related to their communication success in the experimental tasks. CONCLUSIONS: Neurotype-matching is associated with stronger rapport development and greater communication success, suggesting that autistic and non-autistic communication styles differ. Autistic participants demonstrated strengths in perceiving others’ neurotypes, but communication success factors were not associated with neurotype perceptions.

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16. Kim JI, Lee DW, Lee YJ, Lee YA, Shin CH, Hong YC, Kim BN, Lim YH. Prenatal exposure to heavy metals and the trajectory of autistic traits in childhood. Environ Res. 2025; 288(Pt 1): 123269.

BACKGROUND: The association between prenatal heavy-metal exposure and autistic traits remains underexplored. OBJECTIVES: This study aims to investigate the association between prenatal heavy-metal exposure and autistic traits in offspring, and their trajectories during childhood. METHODS: In a prospective birth cohort of 540 mother-child pairs, we measured maternal blood levels of lead, cadmium, mercury, and manganese during the second trimester. Autistic traits were assessed at ages 4, 6, 8, and 10 years, and trajectories were identified using latent class growth modeling. Regression models examined associations between individual and mixture effects of prenatal heavy-metal exposure and autistic traits at each age, as well as their trajectories (low vs. high score classes). RESULTS: Prenatal lead exposure was significantly associated with autistic traits at 8 years (15.8 % increase per doubling; 95 % confidence interval [CI], 2.1-31.4). In girls, prenatal lead exposure was associated with autistic traits at 6 (46.4 % increase; 95 % CI, 19.0-80.1), 8 (57.9 % increase; 95 % CI, 26.0-98.0), and 10 (32.3 % increase; 95 % CI, 5.8-65.4) years. Prenatal lead exposure was associated with trajectory class only in girls, with an odds ratio (OR) of 2.7 (95 % CI, 1.0-6.9) for belonging to the high-score class per doubling of exposure. Maternal heavy-metal mixtures were marginally associated with autistic trait trajectories. CONCLUSION: This is the first study to link prenatal heavy-metal exposure with autistic trait trajectories. Prenatal lead exposure showed consistent associations across multiple childhood stages in girls, highlighting the need to reduce prenatal exposure and to consider sex-specific developmental pathways in neurodevelopmental research.

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17. Krawczyk M, Pinkham A, Okruszek Ł. Similar or opposite? Differences in the recognition of communicative intentions from biological motion in adults with autism and schizophrenia. J Psychiatr Res. 2025; 193: 32-40.

Potential similarities between autism and schizophrenia have been studied for decades, with overlap within various social cognitive (SC) domains including mentalizing and emotion recognition difficulties. However, no direct comparison of low-level communicative intention recognition is available to date. To address this gap, we compared individuals with autism (ASD; N = 29), schizophrenia (SCZ; N = 58) and a non-clinical control group (NCC; N = 29) on their ability to recognize communicative intentions from biological motion (BM). Participants completed two BM tasks assessing communicative cues recognition with either single or dyadic point-light displays (PLDs) and one BM emotion recognition task. Additionally, two batteries of neurocognitive and SC functioning were administered. Both clinical groups scored lower than NCC in the dyadic task, with the SCZ group also performing lower than the ASD group (SCZ < ASD < NCC). Although accuracy in the categorization of single-agent actions was only decreased in SCZ participants (SCZ < ASD, NCC), accuracy of freely-generated descriptions in this task was lower in both clinical groups compared to NCC, with no significant difference between ASD and SCZ (ASD, SCZ < NCC). Finally, only the SCZ group scored lower than NCC in emotion recognition from BM. The SCZ group also scored lower than the ASD group on the majority of neurocognitive and SC measures. The obtained results confirm that both schizophrenia and autism might be associated with difficulties in low-level intention recognition based on BM stimuli, although these deficits were generally more prominent in the SCZ group, with exception of a Gestures subtask that required freely-generated verbal responses. Obtained results suggest the existence of potentially diverging mechanisms of SC alterations in autism and schizophrenia. Thus, including sensitive, BM-based measures of communicative intention recognition into research practice may help to address this issue.

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18. Kuhn J, Menon N, Nunez-Pepen R, Barnard E, Patel R, Much-Hichos M, Brody-Fialkin J, Hooker J, Slate E, Wetherby A, Feinberg E. Parent Use and Perceptions of Problem-Solving Education in the Context of Parent-Implemented Intervention for Toddlers With Early Signs of Autism. J Autism Dev Disord. 2025.

PURPOSE: We examined parents’ use of and perspectives after receiving Problem-Solving Education (PSE) in tandem with parent-implemented early autism intervention strategies (Early Social Interaction [ESI]). PSE is a preventive intervention grounded in cognitive behavioral therapy that has been shown to improve coping skills, decrease stress, and prevent depressive symptoms in parents – including for parents of toddlers on the autism spectrum. METHODS: We used explanatory sequential mixed methods to: (1) examine the types of problems that parents (n = 72) chose to focus on during PSE sessions and how their problem selection differed by larger clinical trial treatment group assignment (PSE + ESI with or without parent coaching); and (2) to explore the experiences and perspectives of a subset of parents (n = 14) who engaged in these interventions as part of a larger clinical trial. RESULTS: Approximately half of the problems discussed during PSE sessions were about the child with early signs of autism and half were about the parent or another member of the nuclear family. Parents who received PSE without ESI parent coaching were more likely to discuss child-related problems at PSE sessions (aOR = 2.24). Parents reported overall agreement that PSE was acceptable and feasible. Qualitative findings provided insight into problem selection, the complementariness of PSE with ESI, facilitators and barriers to acceptability, and actionable suggestions for future delivery. CONCLUSION: Our combined quantitative and qualitative findings suggest that PSE can enhance and complement parent-implemented interventions for many children with early signs of autism and their parents.

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19. Mencattini A, Curci G, Riccardi A, Casti P, D’Orazio M, Filippi J, Antonelli G, Debbi E, Daprati E, Zhang W, Meng Q, Martinelli E. MEA-Based Graph Deviation Network for Early Autism Syndrome Signatures in Human Forebrain Organoids. Cyborg Bionic Syst. 2025; 6: 0441.

Multi-electrode arrays (MEAs) are a key enabling technology in the development of cybernetic systems, as they provide a means to understand and control the activity of neural populations linking brain microtissue dynamics with electronic systems. MEAs allow high-resolution, noninvasive recordings of neuronal activity, creating a powerful interface for investigating in vitro brain development and dysfunction. In this work, we introduce a novel deep learning framework based on a graph deviation network (GDN) to analyze spiking activity from human forebrain organoids (hFOs) and predict network-level alterations associated with autism spectrum disorder (ASD) risk. Our method extends traditional spike and burst analysis by encoding amplitude-modulated spike trains as dynamic graphs, enabling the extraction of meaningful topological descriptors. These graph-based features are then processed to detect deviations in network organization induced by neurodevelopmental perturbations. As proof of concept, we examine the impact of valproic acid (VPA), a known environmental ASD risk factor. VPA disrupts synaptic signaling in hFOs, reducing efficiency, increasing path length, and decreasing input connectivity. Despite biological variability, the GDN consistently detects early dysfunction within 24 h post-exposure and captures transient millisecond-level events. This supports MEA-coupled hFOs as predictive platforms for ASD risk assessment and real-time neurotoxicity screening.

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20. Onyeka OC, Riddle DB, Tan SXL, Guzick A, Storch EA. Utilizing Parent-Led, Internet-Delivered Cognitive Behavioral Therapy for Autistic Adolescents with Anxiety-Related Disorders: Preliminary Insights from the Development of the Learning to Understand and Navigate Anxiety for Adolescents Program. Psychiatr Clin North Am. 2025; 48(4): 723-36.

Autism affects 2% to 3% of youth, approximately half of whom experience a co-occurring anxiety disorder. Left untreated, anxiety symptoms show a worsening trajectory into adulthood and increase the functional impact of the core autism symptoms. Innovative treatment approaches such as Internet-CBT adapted for autistic youth demonstrate preliminary effectiveness in symptom reduction while overcoming barriers and increasing accessibility. Insights and considerations regarding the development of the Learning to Understand and Navigate Anxiety for Adolescents (LUNA-Adolescent) program are presented as a promising approach to treatment for autistic adolescents and their families.

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21. Paolizzi E, Cavalli G, Lee NR, Vivanti G. Visual statistical learning and social attention in neurotypical, minimally speaking and speaking autistic preschoolers. Sci Rep. 2025; 15(1): 38952.

Autistic children experience atypical patterns of spoken language acquisition, yet the mechanisms underlying these differences remain poorly understood. In typical development, spoken language acquisition is gated by statistical learning abilities (the ability to detect patterns) and social attention (preferential engagement with social vs. non-social stimuli). The potential role of these mechanisms in the spoken language atypicalities seen in autism are under-researched, partly due to the methodological barriers when assessing children with minimal spoken language in this population. Here we examined statistical learning and social attention in 13 autistic preschoolers who use spoken language (mean chronological age = 34.38, SD = 8.16), 15 autistic preschoolers with minimal or no spoken language (mean chronological age = 30.20, SD = 7.07), and 15 neurotypical peers (mean chronological age = 36.73, SD = 6.51) using novel eye-tracking paradigms. Participants across groups showed evidence of statistical learning (anticipation of future events based on previous events) and showed preferential attention for social over non-social stimuli, with no between-groups differences. Within-group analyses revealed no association between spoken language skills, measured via the Mullen Scales of Early Learning Expressive Language and the Vineland Adaptive Behavior Scales Expressive Communication subscales, and total fixation duration indexes of statistical learning and social attention in the eye-tracking paradigms. Our findings point to previously unknown strengths in autistic children who are minimally speaking across statistical learning and social attention, suggesting that spoken language differences in this population might be unrelated to these domains.

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22. Richter C, Gilbert R, Smith BM, Jarvis E, Hollingue C, Showell N, Morris S, Choueiri R. Teaching Pediatric Residents to Evaluate and Screen for Autism in Primary Care Clinics with the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T). Acad Pediatr. 2025: 103175.

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23. Rosenberg SA, Holst BL, Schmiege SJ, Reynolds A, Reyes N, Bolt M, Hightshoe K, Croen LA, Daniels J, Crume TL, Levy SE, Thomas KC, Rosenberg CR. Factors Associated With the Use of Complementary and Alternative Medicine by Autistic Preschoolers. J Autism Dev Disord. 2025.

PURPOSE: Complementary and alternative medicines (CAM) are treatment approaches that are not typically part of conventional medical care. This study examined factors associated with the use of CAM by autistic preschoolers. METHODS: Children aged 2-5 years were enrolled in a multi-site case control study in six areas throughout the United States (California, Colorado, Georgia, Maryland, North Carolina, and Pennsylvania). Mothers reported types of conventional services, prescription medications, and CAM ever used by their child. Analyses included 778 preschoolers classified with autism after a comprehensive evaluation. Factors associated with CAM use were examined using Poisson regression. RESULTS: CAM was used by a third of autistic preschoolers in our sample. The predominant forms of CAM used were special diets, particularly gluten or casein free diets, followed by dietary supplements. Preschoolers using higher numbers of conventional services and having higher levels of behavioral and emotional problems had an increased probability of CAM usage. CONCLUSION: These findings suggest that CAM is most often used in conjunction with standard treatments; thus, CAM use is primarily « complementary » rather than « alternative. » Since CAM are commonly used but not well established for the treatment of autism and co-occurring conditions, this information can help providers promote awareness of evidence-based treatments of autism while engaging in shared decision making with caregivers when developing treatment plans.

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24. Schleiss MR. The urgent search for predictive biomarkers in the emerging era of universal congenital cytomegalovirus screening. Philos Trans R Soc Lond B Biol Sci. 2025; 380(1938): 20240434.

In utero acquisition of cytomegalovirus (CMV) represents the most common infectious cause of paediatric developmental disability. With a global prevalence of approximately 0.7%, congenital CMV (cCMV) infection can produce wide-ranging injury to the developing fetal and neonatal central nervous system, leading to microcephaly, intracranial calcifications, neuronal migration defects and damage to the developing cochlea and retina. Clinical sequelae include cerebral palsy, seizure disorder, intellectual disabilities, developmental delay, autism spectrum disorders, sensorineural hearing loss (SNHL) and visual impairment. It has been generally believed that most cCMV infections are asymptomatic in nature, and are not associated with long-term neurodevelopmental impairment. This dogma, however, has been called into question in the context of several state and provincial universal cCMV screening programmes that have been implemented in recent years in the United States and Canada. Moreover, the full spectrum of neurodevelopmental sequelae amongst asymptomatic cCMV cases is just starting to be recognized. Host and/or viral factors that predict which asymptomatic infants will have sequelae, including SNHL, are unknown. This review summarizes the current state of the art with respect to the search for predictive biomarkers that can inform the prognosis of asymptomatic cCMV, and aid in decision-making about therapeutic intervention.This article is part of the discussion meeting issue ‘The indirect effects of cytomegalovirus infection: mechanisms and consequences’.

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25. Shimono K, Kashida N, Nishigori K, Iwasaki T, Mizui R, Yamamuro K, Ishida R, Toritsuka M, Takeda T, Tanakoshi H, Nagata H, Iwata N, Makinodan M. Comparative study of ERP habituation to tones and fearful vocalizations in autism spectrum disorders: a translational biomarker for sensory hypersensitivity. Mol Psychiatry. 2025.

Sensory issues are common in autism spectrum disorders (ASD) and can significantly affect daily living. The phenomena of gating and habituation of event-related potentials (ERPs) to repetitive stimuli have been suggested as potential biomarkers reflecting atypical sensory processing in ASD. Sensory hypersensitivity and anxiety are closely related in ASD, and habituation to emotionally evocative stimuli may serve as a more sensitive biomarker for sensory hypersensitivity symptoms. However, previous studies have primarily used tonal stimuli, and there has been little investigation into whether habituation to emotionally evocative sounds is impaired in ASD patients. In this study, we compared the degree of habituation of the P1-N1 peak-to-peak amplitude in response to repeated tones and fearful vocalizations between control and ASD groups. Contrary to expectations, no significant difference was observed for fearful vocalizations between the groups, while ASD patients showed significantly reduced habituation to tonal sounds in the left parieto-occipital region. Furthermore, we found a significant correlation between the degree of habituation to tonal sounds in the left parieto-occipital region and sensory hypersensitivity symptoms in ASD patients, and similar abnormalities in BTBR mice, an animal model of ASD. These results suggest that habituation to tonal sounds, rather than emotionally evocative stimuli, may serve as a translational biomarker reflecting sensory hypersensitivity symptoms.

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26. Shwetabh RK, Singh A, Mandal K, Naranje K, Verma A. Congenital disorder of glycosylation type IIb in an infant with developmental and epileptic encephalopathy. BMJ Case Rep. 2025; 18(11).

We report a term infant presenting in early infancy with progressive developmental delay, feeding difficulties, recurrent seizures and failure to thrive. The infant initially exhibited symptoms from early neonatal age, including vomiting, lethargy and seizures, necessitating multiple hospitalisations. Progressive neurological deterioration, hepatomegaly, bilateral nephromegaly, hypothyroidism, gastro-oesophageal reflux disease and auditory neuropathy were noted. MRI showed cerebral atrophy and dilated ventricles. Extensive investigations ruled out infections, metabolic acidosis and structural brain malformations. Whole exome sequencing identified a homozygous missense mutation in the mannosyl-oligosaccharide glucosidase (MOGS) gene (c.2090T>C; p.Leu697Ser), previously reported in MOGS CDG (congenital disorder of glycosylation type IIb). A mannose-based diet led to partial improvement. This case highlights the importance of considering neurometabolic conditions such as CDG in infants with early-onset developmental and epileptic encephalopathy and multisystem involvement. Early diagnosis and supportive multidisciplinary care are vital for improving outcomes and guiding family counselling.

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27. van Arnhem MML, van Teeseling HC, van den Berg L, Braun KPJ, Jansen FE. Intelligence outcomes in 17 patients with developmental and/or epileptic encephalopathy with spike-wave activation in sleep ((D)EE-SWAS) after remission of SWAS. Epilepsy Behav. 2025; 173: 110806.

Developmental and/or Epileptic encephalopathy with spike-wave activation in sleep ((D)EE-SWAS) is an age related epilepsy syndrome that is associated with, often profound, cognitive deterioration in childhood. Although the EEG pattern in (D)EE-SWAS resolves, cognitive deficits persist during adulthood. Studies assessing objective cognitive outcomes after resolution of the EEG SWAS pattern are scarce. In this study we assessed intelligence quotient (IQ) scores after remission of SWAS in seventeen patients with a history of (D)EE-SWAS. In all patients with IQ data available before the onset of SWAS there was a profound decline in IQ during (D)EE-SWAS (mean decline -22.1 IQ points, sd 9.3). When we plotted change in IQ over time we observed two different developmental trajectories: in 8 children there was a further decrease of IQ after remission of SWAS (mean decrease of 8.1 IQ points, sd 4.8) and in 9 children an increase (mean increase of 15.9 IQ points, sd 11.0). The group with a decrease of IQ had a significantly earlier first assessment of SWAS. Our results reinforce the classification of (D)EE-SWAS as a true epileptic encephalopathy and suggest that an earlier onset of SWAS is related to poorer neurodevelopmental outcome.

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28. van Huizen JC, Staal WG, van der Voort MC, van Dijk J. Empowered by design: Findings from a supportive technology research project with autistic young adults. Assist Technol. 2025: 1-11.

Central to Design Your Life (DYL) is a toolkit that helps autistic young adults develop their own supportive devices. Within a seventeen-month period, fifteen participants worked on a wide variety of devices related to decision-making, nutrition, social interaction, and more. DYL aims to empower end users by (1) providing a supportive device with practical value and (2) offering an insightful and enjoyable design process with intrinsic value. This paper presents the main findings. We used data from fourteen evaluation interviews and ten follow-up interviews, conducted two weeks and three months after the design process. Interview transcripts were thematically analyzed and the outcomes were discussed in a multistakeholder meeting involving members of the autistic community. Overall, participants attributed the most value to supportive technology in the areas of management, self-confidence, and social support. Supportive technology helped several participants better explain their support needs to trusted others. Supportive technology was also described as a sense-making tool, to explore how to navigate a world that is largely shaped for and by non-autistic people. These and other findings bolster new appreciations of supportive technology by autistic young adults.

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29. Vassall SG, Wallace MT. Intact Audiovisual Spatial Integration in Autistic Children. J Autism Dev Disord. 2025.

PURPOSE: In addition to the core domains of social communication impairments (SCI) and patterns of restricted and repetitive behaviors and interests (RRBIs), autism is characterized by changes in sensory processing, including in the integration of information across the different sensory modalities. While there is significant evidence that audiovisual (AV) integration is altered in the temporal domain in autism-and that these differences are associated with presentation of SCI and RRBIs-very little is known about how autistic individuals integrate AV information in the domain of space. METHODS: We conducted a free-response AV spatial localization task in autistic and non-autistic children aged 7-17 years to understand better AV localization abilities, as well as how these abilities relate to SCI, RRBIs, and other clinical features of autism. RESULTS: While we found no group differences in AV spatial performance, an exploratory analysis revealed three clusters of autism features that were significantly predictive of performance across groups: a motor/somatosensory cluster, a sensory responsivity cluster, and a social communication cluster. CONCLUSIONS: Although autistic children appear to have intact audiovisual spatial integration ability, we believe that specific autism features and their links to AV spatial integration need to be further explored in future research. Limitations and future research directions are discussed.

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30. Wang L, Li W, Yao Y, Jiang X, Ma D, Liu Y, Deng Y, Sun L, Li H, Zhao Y, Peng G, Wei G, Luo X, Peng S, Yang J, Zhong Z, Zhou J, Wang X, Dai T, Cai X, Guo P, Lv Z. Maternal exposure to indoor and outdoor air pollution during pregnancy increases offspring risk of autism spectrum disorder. Environ Res. 2025; 288(Pt 2): 123274.

BACKGROUND: The impact of indoor and outdoor air pollution during pregnancy on offspring ASD risk remains under-investigated. This multi-center study aimed to assess the impact of both indoor and ambient air pollution on offspring ASD risk. METHODS: We recruited 1501 participants from child healthcare department across 8 representative regions of China. High-resolution air pollution datasets and a well-validated indoor air pollution index were utilized to estimate prenatal outdoor and indoor air pollution exposure. Multilevel logistic regression models were performed to evaluate the above relationships after controlling for confounding factors including socio-economic and demographic variables, maternal health and behavioral factors. An adverse outcome pathway framework was constructed to explore underlying biological mechanisms. RESULTS: The results showed that indoor air pollution index exhibited a significant positive correlation with the risk of ASD (OR: 1.69, 95 % CI: [1.25, 2.27]). As for outdoor air pollutants, across the three models, the occurrence of ASD was positively correlated with O(3) (OR: 1.54, 95 % CI: [1.16, 2.03]) and CO (OR: 1.72, 95 % CI: [1.40, 2.12]). For NO(2), the results from Model 3 indicated a significant association with the occurrence of ASD (OR: 1.28, 95 % CI: [1.08, 1.52]). CONCLUSIONS: This study provides robust evidence of the detrimental effects of prenatal exposure to both indoor and outdoor air pollution on offspring ASD risk, with significant exposure-response relationships. These findings underscore the urgency of implementing air pollution control measures, and targeted public health interventions to mitigate ASD risk.

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