1. Benedicto-Rodríguez G, Hongn A, Juan CG, Garrigós-Guerrero J, Bonomini MP, Fernandez-Jover E, Ferrández-Vicente JM. Physiological Response in Children with Autism Spectrum Disorder (ASD) During Social Robot Interaction. Int J Neural Syst. 2025: 2550066.

In a world where social interaction presents challenges for children with Autism Spectrum Disorder (ASD), robots are stepping in as allies in emotional learning. This study examined how affective interactions with a humanoid robot elicited physiological responses in children with ASD, using electrodermal activity (EDA) and heart rate variability (HRV) as key indicators of emotional arousal. The objectives were to identify emotionally salient moments during human-robot interaction, assess whether certain individual characteristics – such as age or ASD severity – modulate autonomic responses, and evaluate the usefulness of wearable devices for real-time monitoring. Thirteen children participated in structured sessions involving a range of social, cognitive, and motor tasks alongside the robot Pepper. The results showed that the hugging phase (HS2) often generated greater autonomic reactivity in children, especially among younger children and those with higher levels of restlessness or a higher level of ASD. Children with level 2 ASD displayed higher sympathetic activation compared to level 1 participants, who showed more HRV stability. Age also played a role, as younger children demonstrated lower autonomic regulation. These findings highlight the relevance of physiological monitoring in detecting emotional dysregulation and tailoring robot-assisted therapy. Future developments will explore adaptive systems capable of adjusting interventions in real time to better support each child’s unique needs.

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2. Choi TY, Gunawan A, Seo D, Park J, Ahn EH, Suh SW, Fuccillo MV, Choi K. Applying biologically anchored subtypes to advance precision medicine in autism spectrum disorder. Neurobiol Dis. 2025: 107219.

Autism spectrum disorder (ASD) is heterogeneous at every level, from behavior to molecular pathways, limiting the value of subgrouping schemes built on surface phenotypes alone. We synthesize evidence that biologically anchored subtypes, defined by convergent genetics, developmental timing, and brain-body crosstalk, offer a tractable path to precision medicine. Leveraging advances in large-scale genomic resources and computational analytics, we propose a multi-axis framework: (i) genetic architecture spanning rare variants and polygenic load, (ii) developmental windows from mid-gestation to infancy divergence and regression, and (iii) brain-body interactions shaping plasticity and symptom expression. This framework enables mechanism-guided therapeutic strategies through biomarker-stratified enrollment, target-engagement readouts, and circuit-anchored outcomes. Preclinical platforms, genetically engineered mice and patient-derived induced pluripotent stem cells (iPSCs), demonstrate convergence onto limited synaptic and connectivity « neurotypes, » enabling causal links from gene to circuit to behavior and proof-of-concept rescue. We close with priorities: standardized multi-platform characterization, decision tools linking subtype labels to interventions, and stratified trials that co-report clinical and biological endpoints, with ethical guardrails to ensure early stratification expands opportunity while advancing individualized care.

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3. Corona LL, Weitlauf A, Wagner L, Dixon A, Foster TE, Lavanderos AM, Honaker M, Nicholson A, Stone C, Swanson A, Vehorn A, Warren Z. Use of a Novel Tele-Assessment Tool for the Identification of Autism in Preschool-Aged Children. J Autism Dev Disord. 2025.

PURPOSE: This work evaluates use of the TELE-ASD-PEDS-Preschool (TAP-P), a telemedicine-based autism assessment tool for the preschool age range. The TAP-P is a play-based instrument with varied administration and scoring procedures based on a child’s language level. This study compared tele-assessment using the TAP-P to in-person autism assessment. METHODS: Participants were 116 children (aged 36-71 months) referred for autism evaluation. Participants first completed in-home tele-assessment (administration of the TAP-P, clinical interview, and Developmental Profile 4). All participants then completed in-person assessment with a different psychological provider, including cognitive or developmental assessment, adaptive behavior assessment, and autism-focused assessment (ADOS-2). Caregivers completed questionnaires after each appointment assessing their perceptions. RESULTS: When asked to make a binary decision about presence or absence of autism, tele-assessment and in-person clinicians agreed for 82% of participants (n = 95). In most instances of diagnostic disagreement (n = 17), tele-assessment clinicians indicated the absence of autism and in-person clinicians indicated the presence of autism. When given the option to select « unsure, » tele-assessment clinicians reported uncertainty for 28% of participants assessed using Form 1 of the TAP-P (designed for children with less verbal language, defined as two-word phrases or less) and 52% of children assessed using Form 2 (for children with more verbal language). Families reported broad satisfaction with tele-assessment procedures. CONCLUSION: This work highlights potential utility of tele-assessment for identification of autism in preschool-aged children with less verbal language, while emphasizing the critical need for additional research related to use of tele-assessment for children using more complex and flexible verbal language.

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4. Deng Z, Wu S, Zhao Y, Song A, Wu H, An Z, Wang F, Xu X. iTBS Improves Behavioral Abnormalities and Synaptic Defects in Fmr1 KO Rats by Regulating the Autophagy Pathway. Mol Neurobiol. 2025; 63(1): 257.

Synaptic dysfunction resulting from abnormal autophagy may contribute to the pathogenesis of fragile X syndrome (FXS). Intermittent theta burst stimulation (iTBS) is a novel magnetic stimulation mode that has shown promising therapeutic potential in various neurological disorders. However, the therapeutic effects of iTBS on FXS-related behavior abnormality and its underlying mechanism remain unclear. In this study, we investigated whether iTBS could ameliorate behavioral abnormalities and synaptic dysfunction associated with FXS by modulating the autophagy pathway. This study utilized Fmr1 knockout (KO) rats as experimental models. The rats underwent a 2-week iTBS intervention, and behavioral changes were assessed through a series of behavioral tests. Electrophysiological recordings were performed to examine alterations in hippocampal neural oscillations. Golgi staining and Western blotting were utilized to evaluate changes in synaptic structure and synaptic related proteins, while Western blotting and immunofluorescence were employed to assess alterations in autophagy-related proteins. Our results demonstrated that iTBS significantly improved behavioral deficits in Fmr1 KO rats. Furthermore, iTBS effectively attenuated abnormally heightened hippocampal theta-gamma phase-amplitude coupling in these rats. Treatment with iTBS also led to sustained improvements in synaptic defect, along with the restoration of CaMKK2 activity and autophagy defect in the hippocampus of Fmr1 KO rats. These findings underscored the beneficial effects of iTBS on aberrant behavior and synaptic defects in Fmr1 KO rats, highlighting the involvement of the CaMKK2-dependent autophagy pathway in this process and suggesting the potential therapeutic value of iTBS for individuals with FXS.

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5. Guan S, Takahashi F, Wada M, Takashina HN, Ueda M, Kawashima M, Kawaguchi Y, Kato T, Ogawa S, Tsuchiya K, Oshima F. Understanding autistic identity contingencies: The chain mediation effect of autism acceptance and loneliness in ableist microaggressions and social camouflage. Autism. 2025: 13623613251389876.

Ableist microaggressions-subtle forms of disability-based discrimination-constitute a key minority stressor. Amplified by autistic identity contingencies that shape how autistic identity is judged and treated in social contexts, these factors drive social camouflage in autistic adults, compelling them to conceal autistic characteristics for adapting to non-autistic groups, often resulting in negative mental health outcomes. This study proposes a novel autistic identity contingencies model to explore how autism acceptance and loneliness mediate the relationship between ableist microaggressions and social camouflage. An online survey of 330 autistic adults was conducted, followed by hierarchical multiple regression and chain mediation analyses. Results revealed that, ableist microaggressions positively predicted three social camouflage phenotypes: compensation, masking, and assimilation, with loneliness also positively predicting assimilation. Furthermore, after controlling for personal attributes, general stress and mental health conditions, lower external autism acceptance and higher loneliness mediated the positive relationship between ableist microaggressions and assimilation, whereas internal autism acceptance showed no significant effect. Assimilation is uniquely shaped by social autistic identity threats and loneliness, distinguishing it from compensation and masking. These findings highlight social camouflage as responses to minority stressors driven by social autistic identity contingencies, rooted in stigmatised behaviours rather than in stigmatised personal autistic identity.Lay AbstractSociety’s perceptions of autism, reflected in subtle discrimination against autistic people, cause autistic adults to hide their true selves. They may hide their autistic traits to fit in with others, especially in groups that do not understand autism. Although this can help autistic people be accepted, it often leads to exhaustion and problems with mental health. However, the invisible ways in which autistic adults are judged and treated in daily social activities and how this impacts their strategies for camouflaging their autistic traits is poorly understood. This study examined the effects of feeling accepted as an autistic person, either by oneself or by others, and experiencing loneliness on how autistic adults camouflage being autistic when facing subtle discrimination related to their disability status. We surveyed 330 autistic adults using online questionnaires. After accounting for personal differences, subtle discrimination was positively associated with three camouflaging strategies: compensating for social challenges, covering up differences, and blending in with others. Feeling lonely was also positively associated with blending in with others. Additionally, after accounting for personal differences, stress levels, and mental health, feeling accepted by others as an autistic person and feeling lonely affected how subtle discrimination led to blending in with others. However, self-acceptance of being autistic was not associated with this relationship.This suggests that treatment by others shapes autistic adults’ need to hide their identity more than their self-acceptance of being autistic. Therefore, addressing how autistic adults are judged and treated in daily social activities is more critical than focusing on personal change.

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6. Harrison AJ, Bowman KL, Bub KL, Brown JA, Lieberman-Betz RG, Vail CO. Examining Sociodemographic Factors Related to Autism Screening Rates of Children in Early Intervention. J Autism Dev Disord. 2025.

PURPOSE: Routine developmental screening is essential for early identification of autism. Reliable autism screening is even more valuable for individuals from minoritized groups who are often under-detected and receive later diagnoses. Despite this importance, disparities in access to screening and accurate identification persist. Given these disparities, we were interested in examining group differences in autism screening rates at 18 and 24 months of age among children referred to Georgia’s Part C Babies Can’t Wait (BCW) program between 2018 and 2022. METHOD: Among a sample of 52,282 infants and toddlers enrolled in BCW, as hypothesized males and children with private insurance had higher screening likelihoods compared to females and children with public insurance. RESULTS: Unexpectedly, Black and Hispanic children were more likely to be screened than their counterparts. To examine this further, an examination of screening timing revealed that White and male children were more likely to be screened before their referral to BCW compared to peers. CONCLUSION: This reveals continued inequities in screening timing but suggests that BCW providers serve an important role in identifying children who may have been missed in other settings.

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7. Jiang S. Retraction Note: Bridging the gap: explainable ai for autism diagnosis and parental support with TabPFNMix and SHAP. Sci Rep. 2025; 15(1): 43184.

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8. Long J, Liao X, Chen J, Han K, Tang Z, Dong L, Wang X, Liu J, Zhang Y, Zhang H. New insights into mechanisms of valproic acid-induced neurodevelopmental toxicity in autism spectrum disorder: An integrative network toxicology approach combined with in vivo validation. Food Chem Toxicol. 2025; 208: 115882.

Autism spectrum disorder (ASD) is a neurodevelopmental condition with growing evidence linking its etiology to chemical exposures, including valproic acid. This study employed an integrative approach combining network toxicology, molecular docking, Mendelian randomization (MR), GEO data analysis, and experimental validation to systematically elucidate the mechanisms of valproic acid (VPA)-induced neurodevelopmental toxicity in ASD. Computational toxicity predictions identified hepatotoxicity, respiratory toxicity, and pronounced blood-brain barrier penetration as key features of VPA. Network toxicology analysis predicted core targets, including epigenetic regulators (HDAC1, SIRT1), drug-metabolizing enzymes (CYP3A4, CYP2C19), and signaling mediators (RXRA, ESR1, RELA, NOS1), as pivotal in mediating VPA’s neurodevelopmental toxicity. KEGG enrichment analysis highlighted alterations in neuroactive ligand-receptor interactions, CYP450 metabolism, and estrogen signaling. MR analysis only suggested a weak causal link between SIRT1 and ASD risk (OR = 1.073, p = 0.022), underscoring that VPA may contribute to ASD more through environmental perturbation than through strong genetic predisposition. Prenatal VPA-exposed rats exhibited core autistic-like behaviors (social deficits and repetitive behaviors), with neuronal degeneration in the prefrontal cortex, hippocampal dentate gyrus, and striatum. Western blotting and GEO data revealed downregulated HDAC1 and ESR1 expression, while fecal metabolomics identified 383 differentially abundant metabolites. Importantly, we establish CYP450-dependent metabolic dysregulation as a novel core mechanism in VPA-induced ASD, significantly affecting steroid hormone biosynthesis and arachidonic acid metabolism. This study underscores VPA’s multi-target toxicity in ASD via epigenetic dysregulation, neuroinflammation, CYP450-dependent pathways, and gut-brain axis neurotransmitter disturbances, providing a framework for understanding chemical contributions to ASD pathogenesis.

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9. McLennan Y, Aliashrafzadeh H, Zirkelbach-Ngai F, McKenzie F, Dufour BD, Becerra-Hernández LV, Escobar AS, Tassone F, Hagerman P, Hagerman R, Martínez-Cerdeño V. Oligodendrocyte Inclusion Pathology in Fragile X-Associated Tremor/Ataxia Syndrome. Mov Disord. 2025.

BACKGROUND: Fragile X-associated tremor/ataxia syndrome (FXTAS) is a neurodegenerative disorder marked by white matter degeneration and intranuclear inclusions. While astrocytic and neuronal inclusions are well-documented, oligodendrocytes were previously thought to lack such pathology. OBJECTIVE: To demonstrate that oligodendrocytes in the prefrontal cortex of FXTAS patients do harbor intranuclear inclusions, with significantly higher burden in white matter than gray matter. METHODS: Ubiquitin and p62 immunofluorescence and enzymatic staining were employed to confirm the presence of intranuclear inclusions in oligodendrocytes across multiple brain regions. RESULTS: Oligodendrocytes contain inclusions and inclusion burden is correlated with FMR1 CGG repeat length (ρ = 0.97, P < 0.001) in white matter. CONCLUSIONS: These findings implicate oligodendrocyte dysfunction in FXTAS pathogenesis which may contribute to demyelination and white matter degeneration. Our data emphasize the need to consider cell type-specific mechanisms in FXTAS and support future therapeutic efforts aimed at restoring glial proteostasis. © 2025 International Parkinson and Movement Disorder Society.

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10. Pereira J, Ramos N, Snyder LG, Veenstra-VanderWeele J, Jutla A. Transgender and gender-diverse autistic adolescents are at elevated risk of depression. Autism. 2025: 13623613251396712.

Autistic people are more likely to be transgender and gender diverse than the general population. Furthermore, co-occurring trait-level autism and transgender and gender-diverse identity are associated with symptoms of depression and anxiety, and autistic adolescents who identify as transgender and gender diverse have more internalizing behaviors than both non-transgender and gender-diverse autistic adolescents and non-autistic transgender and gender-diverse adolescents. However, no study has yet examined the extent to which transgender and gender-diverse identity predicts specific co-occurring mental health diagnoses in autistic adolescents. In a sample of 9027 autistic adolescents aged 13 to 17 drawn from the Simons Powering Autism Research for Knowledge cohort, 36 of whom we identified as transgender and gender diverse, we estimated univariate models of transgender and gender-diverse identity as a predictor of individual diagnoses. Depression, but no other diagnosis, remained statistically significant after adjustment for multiple comparisons. In a multiple regression model that incorporated known risk factors for adolescent depression (e.g. language impairment and disturbed sleep), transgender and gender-diverse identity remained a significant predictor (odds ratio: 4.01, 95% confidence interval: 1.87-8.67, p = 5.94 × 10(-4)) with an effect size at least as strong as that of a depression family history. This suggests transgender and gender-diverse autistic adolescents, who often face stigma and discrimination, are particularly vulnerable to depression.Lay abstract »Transgender and gender diverse » (TGD) people have gender identities that differ from the sex they were assigned at birth. Many autistic people have a TGD identity. Autistic adolescents who are TGD have more « internalizing symptoms, » which include symptoms of depression and anxiety, than autistic adolescents who are not TGD. In this study, we examined a group of 9027 autistic adolescents, 36 of whom had a TGD identity, to determine which, if any, mental health diagnoses would be associated with TGD identity, and whether those associations would remain even after accounting for known risk factors for a diagnosis. We found that depression, but no other diagnosis, was associated with TGD identity. This association remained even when accounting for known risk factors for depression, and in fact, TGD identity was associated with depression at least as strongly as a family history of that diagnosis. This strong association is perhaps not surprising. TGD adolescents often face stigma, social rejection, and discrimination, which can lead to depression. Autistic adolescents can face similar difficulties. Autistic youth who also have a TGD identity may therefore be at particular risk of developing depression. Our study highlights that providers who work with autistic youth in the community should be aware of this risk so they can identify and treat depression when it is present. Future studies should investigate the relationship between depression and TGD identity in autism further, to determine how providers and caregivers can support these youth.

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11. Protic D, Bascarevic D, Dimitrijevic S, Pesovic J, Nikolic V, Nikolic S, Novicevic V, Markovic J, Arandjelovic I, Savic-Pavicevic D, Diricks M, Belheouane M, Merker M. Microbiome modulation and behavioural improvements in children with fragile X syndrome following probiotic intake: A pilot study. Sci Rep. 2025.

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12. Quetsch L, Shah E, Kiefer J. Collaborating with an autism community advisory board to develop a family-based, neurodiversity-affirming intervention: PCIT-Autism. Res Involv Engagem. 2025.

BACKGROUND: Parent-Child Interaction Therapy (PCIT) has been effectively implemented for autistic youth and their families who need help reducing disruptive behaviors, promoting language development, and enhancing the parent-child relationship. However, like most autism-based interventions, the PCIT protocol was originally adapted for (rather than with or by) the autism community. A new wave of intervention research calls for input from autism advocates throughout each phase of the research process. The present study signifies the first step in the development and implementation of a pilot PCIT program with autistic youth and their families (i.e., PCIT-Autism). METHODS: Academic researchers collaborated alongside an Autism Community Advisory Board (CAB) comprised of autistic adults (N = 10) and caregivers of autistic youth (N = 14) to understand the current state of therapeutic services and their values for the development of an intervention to address autistic youth aggressive behaviors, when present. RESULTS: Five primary themes were generated from qualitative interviews with the Autism CAB related to psychological interventions: (1) Barriers to Accessibility, (2) Effectiveness, (3) Therapist Competence, (4) Topics, and (5) Format. CONCLUSIONS: Recommendations from the Autism CAB encouraged a hybrid (in-person, group-based + individualized telehealth), time-limited PCIT model which incorporated autism-affirming psychoeducation and practice, childcare, as well as opportunities for community-building. The following article details the perspectives of members of a newly formed advisory board made up of autistic adults and caregivers of autistic youth. These individuals provided their insights into how a specific treatment for young autistic children and their caregivers should be structured. The intervention, Parent-Child Interaction Therapy (PCIT), has extensive research supporting its use in reducing aggression for autistic youth who experience these challenges; however, the intervention has not previously included the perspectives of autistic community members to create an affirming protocol. From the interviews, five primary themes were generated: (1) Barriers to Accessibility, (2) Effectiveness, (3) Therapist Competence, (4) Topics, and (5) Format. The manuscript highlights the direct quotes from advisory board members and details the next steps in the creation of a protocol for PCIT with autistic youth and their families. eng.

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13. Saniee S, Pouretemad HR, Mokhtari S, Kiani M, Rezapour MM. How Extrinsic and Intrinsic Motivation Impact Cognitive Flexibility in Children With Autism. J Autism Dev Disord. 2025.

PURPOSE: Cognitive flexibility is a key neurocognitive process that is often challenging in children with autism. Recent research has highlighted the potential influence of motivation on cognitive flexibility; however, the impact of different types of motivation (intrinsic vs. extrinsic) on the cognitive flexibility performance of children with autism remains unclear. METHOD: This study aims to investigate the impact of intrinsic and extrinsic motivation on cognitive flexibility in 43 children with autism and 89 typically developing children (TDC) (age range 36-84 months), using the three versions of dimensional change card sorting task (standard, extrinsic reward and intrinsic motivation versions). RESULTS: Results indicate that manipulating cognitive flexibility through motivation can improve performance, particularly in children with autism, with a significant impact of intrinsic motivation on this group. In the age range of 36-48 months, intrinsic motivation enhance accuracy in children with autism but not in TDC. From 49 to 60 months of age, both intrinsic and extrinsic motivation contribute to improved accuracy in children with Autism, with intrinsic motivation having a more significant impact. In TDC, however, only intrinsic motivation is associated with enhanced accuracy. In older children, both intrinsic and extrinsic motivation enhance performance in both groups, suggesting the maturation of cognitive systems. This evidence suggests that, in children with autism, the impact of motivation emerges at an earlier age than in typically developing children. Notably, intrinsic motivation has a more significant and profound effect at a younger age compared to extrinsic rewards. CONCLUSION: The study provides insights into the developmental trajectory of cognitive flexibility in children with autism and highlights the significance of leveraging motivation to enhance this essential cognitive function.

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14. Sato H, Akisue T, Yamamoto A, Ono K, Sato T, Tonogaki R, Nagao T. Physical fitness of adolescents with intellectual and developmental disabilities in special support schools: Insights from Japan’s 2023 national survey. Disabil Health J. 2025: 102012.

BACKGROUND: Adolescents with intellectual and developmental disabilities (IDD) often demonstrate lower physical fitness than their typically developing (TD) peers. Physical fitness is influenced by factors such as body size, physical activity, ethnicity, and environmental conditions; however, large-scale studies in Asian populations remain limited. OBJECTIVE: This study aimed to assess physical fitness in Japanese adolescents with IDD, accounting for height, weight, and physical activity levels. METHODS: Data were obtained from Japan’s 2023 National Survey on Physical Fitness, Athletic Ability, and Exercise Habits. Participants included 2,216 adolescents with IDD attending special support schools and 921,297 TD students. Variables included height, weight, total weekly physical activity time, and eight physical fitness tests: handgrip strength, sit-ups, sit-and-reach test, repetitive side jump, 20-m shuttle run, 50-m run, standing long jump, and handball throw. After propensity score matching by sex, Mann-Whitney U tests and ordinal logistic regression analyses were performed. RESULTS: After adjusting for height, weight, and physical activity level, adolescents with IDD showed consistently lower performance across all test items than their TD peers, regardless of sex (effect sizes r = 0.35-0.74). Longer total weekly physical activity time was positively associated with better comprehensive evaluations. The IDD group had approximately twice the prevalence of obesity and significantly less weekly physical activity time. CONCLUSIONS: Japanese adolescents with IDD demonstrate lower physical fitness, higher obesity rates, and reduced physical activity than TD peers. Targeted interventions, including increased physical activity, are needed to improve health and functional outcomes in this population.

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15. Selau T, da Silva MA, Prenassi MS, Dos Santos LF, Costa ARL, Bandeira DR. Sensitivity and Specificity of the EFA Adaptive Functioning Scale for Autism Spectrum Disorder and Intellectual Disability. J Autism Dev Disord. 2025.

PURPOSE: The assessment of adaptive functioning is essential in neurodevelopmental disorders, such as Intellectual Disability (ID) and Autism Spectrum Disorder (ASD), as a diagnostic criterion and as a definer of the level of severity or support. The Adaptive Functioning Scale (Escala de Funcionamento Adaptativo – EFA) is a Brazilian instrument for assessing adaptive functioning in children and adolescents aged 6 to 15. This study aimed to investigate evidence of the validity of EFA criteria as a screening instrument FA difficulties in individuals with ID and ASD. METHOD: 917 EFA children and adolescents without diagnoses of neurodevelopmental disorders participated, 76 with a diagnosis of ID, and 65 with ASD. RESULTS: Variance analyses indicated differences in Z values in the three dimensions for the three groups. The differences presented a medium effect size, with the following partial Eta squared values: Social = 0.40; Practical = 0.43; Conceptual = 0.58. Sensitivity values ranged from 90 to 91% and 87 to 94%, while specificity values ranged from 64 to 74% and 63 to 90% in the ASD and ID groups respectively. The AUC values obtained for the EFA indicate that it has an excellent discriminatory capacity between the different aspects of adaptive functioning in the three domains of the instrument. CONCLUSION: The EFA showed a greater ability to identify individuals with ASD and ID compared to individuals without diagnosis for all domains.

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16. Yoon NH, Hwang J, Heo J, Choi J, Oh Y, Nam Y. Type 2 Diabetes-Related Avoidable Mortality Risk Among Individuals with Developmental Disabilities: A Comparison With Individuals With Other Disabilities and Those Without Disabilities : T2DM-Related Avoidable Mortality among Developmentally Disabled Individuals. J Autism Dev Disord. 2025.

PURPOSE: This study aimed to assess type 2 diabetes mellitus (T2DM)-related avoidable mortality in individuals with developmental disabilities using national claims data, comparing outcomes with those of other disabilities and non-disabled controls. METHODS: We used de-identified national claims data from the National Health Insurance Service merged with Causes of Death Statistics. The cohort included individuals over 30 years old with developmental disabilities who were newly diagnosed with T2DM between 2012 and 2016. Matched controls (non-disabled, mild, and severe disabilities) were selected based on sex, age, income proxy, and region. T2DM-related avoidable mortality (ICD-10 code « E11 ») within 1, 3, and 5 years was assessed using multiple logistic regression, adjusted for sociodemographic factors and comorbidities. RESULTS: T2DM-related avoidable mortality rates in the developmental disability group were 0.05%, 0.23%, and 0.55% at 1, 3, and 5 years post-diagnosis, respectively-lower than those in individuals with severe disabilities but higher than those of individuals without disabilities. Multiple logistic regression revealed no significant difference in 1-year mortality between individuals with developmental disabilities and those without disabilities; however, the risk was significantly higher at 3 years (OR = 4.84; 95% CI: 1.80-13.00) and 5 years (OR = 3.82; 95% CI: 2.14-6.81). Compared with individuals with mild disabilities, the 5-year mortality risk was also higher (OR = 2.41; 95% CI: 1.38-4.21). CONCLUSION: Individuals with developmental disabilities exhibit significantly higher T2DM-related avoidable mortality than non-disabled and mild disability groups, highlighting critical gaps in healthcare accessibility. Strengthening targeted interventions and support services is essential to reducing avoidable deaths and improving health outcomes in this population.

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