1. Al-Beltagi M, Al Zahrani AA, Mani BS, Hantash EM, Saeed NK, Bediwy AS, Elbeltagi R. Challenges and solutions in managing dental problems in children with autism. World J Clin Pediatr;2025 (Sep 9);14(3):106778.

BACKGROUND: Children with autism spectrum disorder (ASD) face unique challenges in maintaining oral health due to sensory sensitivities, communication difficulties, and behavioral barriers. These factors, along with limited access to ASD-trained dental professionals, increase their risk of dental caries, periodontal disease, bruxism, and other oral health issues. Despite growing awareness of these challenges, a comprehensive synthesis of evidence-based solutions remains lacking. AIM: To review synthesizes existing research on dental problems in ASD, barriers to care, management strategies, and future directions for improved oral health outcomes. METHODS: A systematic search of PubMed, Cochrane Library, and Scopus was conducted using predefined search terms. Related to ASD, dental health, and management strategies. Inclusion criteria encompassed studies focusing on children with ASD, dental health issues, and interventions. Data extraction included study design, participant characteristics, key findings, and intervention outcomes. The quality of studies was assessed using appropriate tools such as the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. A narrative synthesis approach, incorporating thematic analysis, was utilized to evaluate the findings. RESULTS: A total of 165 studies met the inclusion criteria. Children with ASD exhibited a higher prevalence of dental caries, gingivitis, bruxism, and malocclusion compared to neurotypical peers. Barriers to dental care included sensory sensitivities, communication difficulties, financial constraints, and a shortage of ASD-trained dental professionals. Effective interventions included desensitization programs, behavioral therapy, digital applications, and interdisciplinary collaboration. Parental education and professional training were crucial for improving oral health outcomes. CONCLUSION: Tailored dental care strategies, including sensory adaptations, behavioral interventions, and interdisciplinary collaboration, are essential for children with ASD. Standardized guidelines and long-term studies are needed to refine evidence-based protocols. Future research should explore digital interventions and probiotic applications in ASD dental care.

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2. Charman T, Bazelmans T, Pasco G, Begum Ali J, Johnson MH, Jones EJH. Mid-childhood developmental and behavioural outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder. J Child Psychol Psychiatry;2025 (Sep 9)

BACKGROUND: Prospective studies of autism family history infants primarily report recurrence and predictors of autism at 3 years. Less is known about ADHD family history infants and later childhood outcomes. We characterise profiles of mid-childhood developmental and behavioural outcomes in infants with a family history of autism and/or ADHD to identify potential support needs and patterns of co-occurrence across domains. METHODS: Two hundred and sixty-three infants (51% male; N = 198 autism/ADHD family history; N = 65 no family history) were assessed at 6-12 years. A latent profile analysis (LPA) with indicator variables measuring developmental abilities (IQ, adaptive function) and behavioural traits (autism, ADHD, anxiety) identified dimensional, data-derived outcome classes. RESULTS: A seven-class solution was the most robust and clinically meaningful. Two classes (27% and 23%) had typical development; two classes had high autism, ADHD, and anxiety traits-one with low IQ and adaptive function (10%) and one with average IQ but low adaptive function (13%); one class had elevated autism and ADHD but not anxiety traits (10%); and the final two classes had elevated ADHD (9%) and anxiety (8%) traits in isolation. Sex distribution was balanced across all classes. Children with autism were found in all classes but predominantly in the classes with low IQ/adaptive functioning and high behavioural traits, as well as in the class with elevated autism and ADHD traits. We found only partial continuity between membership of similarly derived 3-year LPA classes and mid-childhood LPA classes. CONCLUSIONS: Many autism/ADHD family history infants develop typically. However, by mid-childhood, in addition to those with autism, others show elevated neurodevelopmental (autism, ADHD) and neuropsychiatric (anxiety) behavioural traits. Lower developmental abilities (IQ and adaptive function) are primarily seen in children with an autism diagnosis. Family history infants should be monitored through childhood, and support provided should challenges emerge.

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3. Clarke L, Hodge DA, Walls SC, Santiago C. Caring for Patients with Intellectual or Developmental Disabilities – A Curriculum for Residents. N Engl J Med;2025 (Sep 6)

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4. Derguy C, Frybourg L, Dexet M, Cappe E. Adults with Autism Have Numerous Needs, and So Do Their Parents!. J Autism Dev Disord;2025 (Sep 9)

Parents of adults with autism spectrum disorders (ASD) face significant challenges, including high vulnerability to stress and a lack of adequate support services. However, there are currently few support systems based on a genuine assessment of their needs. This is particularly true in the French context, where there are delays in supporting families and addressing autism in adulthood. This exploratory study aims to identify the specific needs of parents of adults with ASD, both with and without intellectual disabilities, in order to inform the development of relevant support strategies. Thirty parents of adults with autism spectrum disorders (ASD) participated in semi-structured interviews. An inductive thematic analysis was performed. Our findings identified five overarching themes of needs, encompassing 13 sub-themes. The analysis also highlighted differences in the nature of reported needs based on whether the autistic adult has an associated intellectual disability. Our results are discussed to propose practical recommendations for formalizing a support offer for parents that takes into account the reality of their needs.

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5. Ferrara R, Iovino L, Ricci L, Avallone A, Latina R, Ricci P. Food selectivity and autism: A systematic review. World J Clin Pediatr;2025 (Sep 9);14(3):101974.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests in the first years of life, with a complex pathogenesis influenced by biological, genetic and epigenetic factors. Many children with ASD display marked food selectivity, often restricting themselves to a narrow range of foods. The problems associated with feeding children with ASD can vary widely, from mild cases that pose no immediate health risks, to more severe situations with a risk of malnutrition or, conversely, overeating. This scoping review aims to provide an in-depth overview of the frequency, nature and factors related to food selectivity in children with autism. AIM: To comprehensively review the literature on food selectivity in ASD. METHODS: A systematic review of the literature was conducted using the PubMed, Web of Science and EBSCO databases, to identify articles published in English from 2014 until 2024. Studies on a sample diagnosed with ASD and food selectivity were included. The selected databases were chosen for their broad coverage of the scientific literature. These databases represent reliable sources of high-quality articles, ensuring a comprehensive and up-to-date search. RESULTS: We evaluated 222 studies on food selectivity in autism, from which duplicates were removed and unrelated titles were filtered out. Finally, 9 articles were included in the review. Five articles provide a general overview of the phenomenon, analysing its nature and factors. Two studies delve into sensory sensitivity, in particular the impact of food textures, tastes and smells. Finally, two studies focus on problem behaviour during mealtimes. CONCLUSION: Children with ASD have greater food selectivity than the neurotypical population. The diet should contain a greater variety of fruit, vegetables, yoghurt, while reducing the consumption of rice and pasta.

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6. Grumbach P, Kasper J, Hipp JF, Forsyth A, Valk SL, Muthukumaraswamy S, Eickhoff SB, Schilbach L, Dukart J. Local activity alterations in individuals with autism correlate with neurotransmitter properties and ketamine-induced brain changes. Nat Commun;2025 (Sep 9);16(1):8248.

Autism is a neurodevelopmental condition associated with altered resting-state brain function. An increased excitation-inhibition ratio is discussed as a pathomechanism but in-vivo evidence of disturbed neurotransmission underlying functional alterations remains scarce. We compare local resting-state brain activity and neurotransmitter co-localizations between autism (N = 405, N = 395) and neurotypical controls (N = 473, N = 474) in two independent cohorts and correlate them with excitation-inhibition changes induced by glutamatergic (ketamine) and GABAergic (midazolam) medication. Autistic individuals exhibit consistent reductions in local activity, particularly in default mode network regions. The whole-brain differences spatially overlap with glutamatergic and GABAergic, as well as dopaminergic and cholinergic neurotransmission. Functional changes induced by NMDA-antagonist ketamine resemble the spatial pattern observed in autism. Our findings suggest that consistent local activity alterations in autism reflect widespread disruptions in neurotransmission and may be resembled by pharmacological modulation of the excitation-inhibition balance. These findings advance understanding of the neurophysiological basis of autism. Trial registration number: ACTRN12616000281493.

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7. Jutla A, Shuffrey LC, Guter SJ, Jr., Anderson GM, O’Reilly KC, Montgomery AK, Sutcliffe JS, Cook EH, Veenstra-VanderWeele J. Maternal Serotonin Levels and Neurodevelopmental Severity in Autistic Children: A Partial Replication and Extension. JAACAP Open;2025 (Sep);3(3):749-757.

OBJECTIVE: The serotonin system has long been implicated in autism spectrum disorder. A previous study reported lower whole blood serotonin (WB5-HT) concentrations in the mothers of children with more severe autism. This study attempted to replicate this finding in an independent cohort. METHOD: A latent profile analysis was conducted in 259 children with autism using indicator variables across autistic traits, cognition, and adaptive function. In a subgroup of 162 participants with maternal WB5-HT data, maternal WB5-HT in children with the highest severity profile was compared with maternal WB5-HT in children with other profiles, both overall and across 5 quantiles of the maternal WB5-HT distribution. RESULTS: A latent profile analysis solution was identified that stratified participants into low-, medium-, and high-severity profiles. Although this solution was broadly similar to the prior work, the high-severity profile showed different scores in restricted and repetitive behavior, nonverbal IQ, and adaptive function. Median WB5-HT in the high-severity profile did not differ significantly from other profiles, but was lower at the 90th percentile of severity (by 59.40 ng/mL, 95% CI 6.42 to 101.51 ng/mL, adjusted p < .01). In exploratory models, maternal WB5-HT was negatively associated with social impairment. CONCLUSION: In contrast to the previous study, this study did not find lower group levels of maternal WB5-HT in children with highest autism symptom severity. However, children in the high-severity group were less likely to have maternal WB5-HT values in the upper range of the distribution. This comparative absence of values in the upper range of maternal WB5-HT in this high-severity group warrants further investigation. DIVERSITY & INCLUSION STATEMENT: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex balance in the selection of non-human subjects. This study explored the link between serotonin levels in mothers and the severity of autism in their children. Data analyzed from 259 autistic children drawn from the Simons Simplex Collection cohort separated them into three “latent profiles” of low, medium, and high severity. The relation between severity profile and maternal serotonin level was assessed in a subset of 162 children for whom these data were available. Although previous work suggested that serotonin levels were overall lower in the mothers of severely affected children, the present study did not find a significant difference in overall serotonin levels. However, the present study found that fewer mothers of severely affected children had high serotonin levels, which warrants further investigation. eng

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8. Kaplan-Kahn EA, Rando J, Ames JL, Bekelman TA, Camargo CA, Jr., Croen LA, Dager SR, Dickerson AS, Dunlop AL, Elliott AJ, Giardino AP, Hazlett HC, Hertz-Picciotto I, Hirtz D, Joseph RM, Landa RJ, McEvoy CT, Messinger DS, Koinis-Mitchell D, Neiderhiser JM, Newschaffer CJ, Northrup JB, Ozonoff S, Schmidt RJ, Volk HE, Lyall K. Describing Multidomain Health Outcomes in Autistic Children in the ECHO Program. JAACAP Open;2025 (Sep);3(3):618-633.

OBJECTIVE: The goal of this study is to characterize health outcomes across 3 domains-overall well-being, behavioral health, and physical health-in a large sample of autistic and non-autistic children and adolescents in the Environmental influences on Child Health Outcomes (ECHO) program. METHOD: First, we examined differences in health outcomes between autistic (N = 286) and non-autistic (N = 4,225) children and adolescents in the ECHO Program. Using a subsample of 1,809 participants (116 autistic participants) with complete outcome data, we conducted latent profile analyses (LPAs) to define profiles of health outcomes for autistic children and adolescents and for the combined sample of autistic and non-autistic participants. Finally, we examined demographic factors in relation to the health outcome profiles. RESULTS: Autistic participants demonstrated poorer health outcomes than non-autistic participants for most outcome measures across the domains of overall well-being, behavioral health, and physical health. In the combined sample LPA, 3 profiles, representing more positive health (n = 566, 31.3%), poorer health (n = 462, 25.5%), and mixed health (n = 781, 43.2%), were identified. The profile with the poorer health outcomes had the highest proportion of autistic participants (n = 64, 13.9%). However, within the autistic group, LPA revealed 2 profiles of autistic participants, with 1 profile (n = 70, 60.3%) having more positive health outcomes across all domains. CONCLUSION: Although autistic participants demonstrated poorer health outcomes than non-autistic participants on most measures, examining latent profiles within the group of autistic participants highlighted variability in the health outcomes among autistic youth. Results emphasize the importance of examining variability within autistic samples to better understand multidimensional health influences and outcomes of individuals on the autism spectrum. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. This study compared health outcomes in a large sample of autistic and non-autistic children and adolescents within the Environmental influences on Child Health Outcomes (ECHO) program. While autistic participants demonstrated poorer health outcomes than non-autistic participants on most measures, examining profiles within the group of autistic participants highlighted variability in the health outcomes among autistic youth. Results emphasize the importance of examining variability within autistic samples to better understand multidimensional health influences and outcomes of individuals with autism spectrum disorder. eng

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9. Lee EY, Cho S, Ju R, Kim H, Choi TY, Yoo JH, Joung YS. Development of a Social Communication Intervention Mobile App for Adolescents With Autism Spectrum Disorder and Social Communication Disorder: Protocol for a Pilot Randomized Clinical Trial. JMIR Res Protoc;2025 (Sep 9);14:e66419.

BACKGROUND: Autism spectrum disorder (ASD) and social communication disorder (SCD) are neurodevelopmental disorders characterized by deficits in social communication that hinder social adaptation, with limited pharmacological options for therapy owing to the absence of identified biomarkers. Individuals with ASD or SCD require lifelong interventions tailored to their development stages. However, most existing interventions primarily focus on early childhood, leaving adolescents relatively underserved. Moreover, timely access to interventions is often limited by geographic and economic barriers as specialized clinics and therapists tend to be concentrated in major urban areas. OBJECTIVE: This pilot randomized clinical trial aimed to evaluate the initial safety and efficacy of NDTx-01, a digital therapeutic (DTx) for adolescents with ASD or SCD. NDTx-01 was designed to overcome the accessibility limitations by integrating cognitive behavioral therapy principles, story-based interventions, and gamification elements. METHODS: We introduce a protocol for a multicenter, prospective, assessor-blinded pilot randomized clinical trial involving children and adolescents aged 10 to 18 years diagnosed with ASD or SCD. Participant enrollment was conducted at 3 major medical hospitals. Enrolled participants were randomly assigned to either the intervention group (NDTx-01 and treatment as usual [TAU]) or the control group (TAU only). TAU included medications and therapeutic services. Participants were instructed to use the app approximately 10 minutes per day, 5 days a week. To evaluate the efficacy of NDTx-01, standardized tools were administered, including the Korean version of the Vineland Adaptive Behavior Scales, Second Edition (K-VABS-II); the Social Responsiveness Scale, Second Edition; Clinical Global Impressions-Severity (CGI-S); Clinical Global Impressions-Improvement (CGI-I); the Social Communication Questionnaire; and the Korean version of the Stress Index for Parents of Adolescents. Assessments were conducted in weeks 0, 1, 2, 4, and 6, except for K-VABS-II, CGI-S, and CGI-I, which were administered only in weeks 0, 4, and 6. Statistical analyses were conducted using the SAS software. Between-group differences were assessed using independent 2-tailed 2-sample t tests or Wilcoxon rank sum tests. Within-group changes were evaluated using paired t tests or Wilcoxon signed rank tests. RESULTS: From August 2024 to December 2024, a total of 42 individuals were screened, 39 (93%) participants who met the inclusion criteria were enrolled, and 1 participant withdrew consent; the remaining participants completed the study. The pilot randomized clinical trial was successfully completed, and the results were published in April 2025. As of 2025, we are conducting a confirmatory clinical trial at 5 major hospitals across South Korea. CONCLUSIONS: The results of this pilot clinical trial provided important insights into the initial safety and efficacy of DTx as interventions for adolescents with ASD and SCD. Both groups demonstrated statistically significant improvements in adaptive skills and socialization. TRIAL REGISTRATION: Clinical Research Information Service KCT0009140; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=26713. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66419.

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10. Lin S, Sun X, Zhou Y, Ding Z, Jiang K, Feng J. Phelan-McDermid syndrome in a Chinese pediatric patient: A case report – new heterozygous mutations lead to PMS. Medicine (Baltimore);2025 (Sep 5);104(36):e44114.

RATIONALE: Phelan-McDermid syndrome, also known as chromosome 22q13.3 deletion syndrome, is a genetic disorder primarily caused by a chromosome 22q13.3 deletion or mutation. The primary clinical manifestations include intellectual disability, delayed language development, behavioral delays, hypotonia, autism spectrum disorder, mild deformities, and epilepsy. The clinical symptoms of this disease are associated with chromosomal deletions, and mild cases may be easily misdiagnosed as autism spectrum disorder. PATIENT CONCERNS: A 3-year-old girl was admitted for « chromosomal abnormality (heterozygous deletion) and developmental delay. » After admission, we found that the child’s overall growth retardation (mainly language and movement) and accompanied by obvious social disorders, but the muscle strength and muscle tension were basically normal; brain magnetic resonance imaging and electroencephalography were not obvious abnormalities. Gene copy number variation analysis showed that there was a new pathogenic heterozygous deletion of 1.21 Mbp in the chromosome 22:50014294-51220722 region, and the genomes of both parents were wild-type. DIAGNOSES: Combined with the clinical manifestations of the child, the child was finally diagnosed with mild Phelan-McDermid syndrome. INTERVENTIONS: The children received systematic rehabilitation treatment. OUTCOMES: Her language, social, and motor abilities were significantly improved. LESSONS: Phelan-McDermid syndrome may be easily misdiagnosed as autism spectrum disorder. Our report enriches the clinical phenotype of Phelan-McDermid syndrome and provides a realistic and reliable basis for clinicians.

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11. Lopez-Arvizu C, Steelesmith DL, Hand BN, Huang R, Thompson AJ, Llamocca EN, Quinn BA, Fontanella CA, Campo JV. Correlates of Deliberate Self-Harm in Youth With Autism and/or Intellectual Disability. JAACAP Open;2025 (Sep);3(3):477-484.

OBJECTIVE: To identify correlates of deliberate self-harm (DSH) in youth with autism and/or intellectual disability (ID). METHOD: This retrospective longitudinal cohort analysis used claims data for youth ages 5 to 24 years continuously enrolled in Medicaid in a midwestern state for 6 months and diagnosed with autism and/or ID between 2010 and 2020 (N = 41,230). Cox proportional hazards regression examined associations between demographic and clinical variables and time to DSH for study cohorts with autism and/or ID. RESULTS: Autism was diagnosed in 34.3% of the sample, ID was diagnosed in 30.6%, and both autism and ID were diagnosed in 35.1%. Sample youth were predominantly male (73.4%) and had an internalizing (74.8%) or externalizing (62.1%) mental health condition. At least 1 DSH event was identified for 734 youths (2.6%) with autism and 686 youths (2.7%) with ID during follow-up. Increased risk of DSH was associated with older age; female sex; history of abuse or neglect; and co-occurring externalizing problems, internalizing problems, substance use, and thought problems for the autism cohort and ID cohort and with the presence of a chronic complex medical condition in the autism cohort. Risk of DSH was significantly lower for youth with moderate ID and youth eligible for Medicaid via disability and foster care. CONCLUSION: Risk factors for DSH in youth with autism and ID are similar to those in neurotypical youth and include increasing age, trauma, mental health conditions, substance use, and female sex. Clinician and consumer education regarding suicide risk and its correlates in youth with autism and ID warrants study. This study of youth aged 5 to 24 enrolled in Ohio Medicaid found that 2.6% of youth with autism and 2.7% of youth with intellectual disabilities (ID) had at least one deliberate self-harm (DSH) event between 2010 and 2020. Youth who were older, female, had a history of abuse or neglect, and had co-occurring externalizing, internalizing, substance use, or thought problems, had increased risk for DSH. Risk of DSH was lower for youth with moderate ID and those eligible for Medicaid via disability and foster care. eng

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12. Macaskill TA, Du Toit M, Eccles R, Graham MA, Van der Linde J. Developmental outcomes of small infants at a high-risk clinic: A short-term longitudinal study. S Afr J Commun Disord;2025 (Aug 14);72(1):e1-e10.

BACKGROUND: Small infants face more developmental risks than their full-term peers, necessitating early intervention and long-term monitoring. OBJECTIVES: This study examined the longitudinal developmental and hearing outcomes of small infants attending a high-risk clinic in a South African low-income community setting. METHOD: A short-term longitudinal within-subject descriptive study design was employed, where 28 participants underwent hearing and developmental screenings and assessments at two follow-up appointments (T1 and T2), at 6- and 12-month corrected age. Developmental outcomes, such as communication, motor and daily living skills, were evaluated using developmental screening tools (Parents Evaluation of Developmental Status [PEDS]), hearing screening (ABR MB11) and developmental assessments (Vineland-3). RESULTS: All participants underwent hearing screening, with four (14.3%) failing twice (T1 and T2) and being referred for diagnostic evaluation. Developmental screening at T1 identified concerns in communication, gross motor and social-emotional skills (28.5%). Concerns persisted across T1 and T2 in the PEDS tool, with fine motor skills emerging as a key issue at T2. Vineland-3 assessments showed improvement from T1 to T2; initial concerns in daily living (M = 104.12; standard deviation [s.d.] = 38.99) and motor skills (M = 88.82; s.d. = 45.26) were no longer present at T2, where all participants had age-appropriate developmental scores. CONCLUSION: The findings highlight the need for comprehensive, routine developmental monitoring and early intervention to address delays in small infants. Continued follow-up care and support from birth to 12 months corrected age can improve outcomes and caregiver developmental literacy. Contribution: This study provides valuable insights for caregivers, healthcare policymakers and early intervention professionals by emphasising the importance of early screening, continuous monitoring and caregiver education in optimising developmental outcomes for small infants.

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13. Mete Yeşil A, İskender HC, Cihan Çam E, Ömercioğlu E, Kılınç Ş, Özmert EN. Recognizing the overlooked: rethinking autism spectrum disorder symptom presentation in girls. Turk J Pediatr;2025 (Sep 1);67(4):514-521.

BACKGROUND: Autism spectrum disorder (ASD) is more frequently diagnosed in boys than in girls, possibly due to gender-based differences in symptom presentation or referral patterns. This study investigates gender-related variations in symptom severity and clinical presentation among preschool children referred for suspected ASD. METHODS: This study included 125 children (boys: n=103; girls: n=22) aged 2-5 years suspected of having ASD. The Childhood Autism Rating Scale (CARS) was used to evaluate autism-related symptoms, focusing on presenting complaints and gender-specific differences in nonverbal communication and social interaction. RESULTS: Girls had a significantly younger median age at assessment (28 months) compared to boys (33 months, p=0.03). In the minimal to no symptoms group, girls had significantly higher total CARS scores (median 26 vs. 22.5, p < 0.001) and elevated ratings in domains such as nonverbal communication (p=0.03), relationship to people (p=0.01), imitation (p < 0.001), and visual response (p < 0.001). In the severe group, girls also showed significantly higher scores in adaptation to change, taste, smel, and touch response and use, and fear or nervousness. Effect sizes ranged from small to strong. A negative correlation was found between assessment age and total CARS score (r= -0.45, p < 0.01), particularly among girls. CONCLUSION: This study highlights that girls may exhibit more prominent symptoms by the time they are referred for clinical evaluation, raising concerns about missed or delayed recognition of milder symptom profiles.

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14. Salama RA, Sharmin AR, Hamouda H, Al-Hashmi F, Hamdy HA, Wadid NA. Caregivers’ perspectives on the healthcare experiences of children with autism spectrum disorder and associated family impacts in Ras Al Khaimah, UAE. Arch Psychiatr Nurs;2025 (Oct);58:151966.

BACKGROUND & OBJECTIVES: The global rise in autism spectrum disorder (ASD) has highlighted the burden on healthcare systems and the significant impact on affected families. This study explored caregivers’ perspectives on the healthcare experiences of children with ASD and the related challenges faced by families in Ras Al Khaimah, UAE. METHODS: A descriptive, cross-sectional study was conducted among caregivers of 38 children with confirmed ASD attending two autism centers. Children included had a formal diagnosis of ASD documented in their medical records. Data were collected using a semi-structured, interviewer-administered questionnaire developed through a comprehensive literature review. The tool was reviewed for content validity by three experts and was pre-tested with caregivers of children with special needs to assess clarity and feasibility. Informed consent and confidentiality were maintained. RESULTS: Barriers to healthcare access were reported by 52.7 % of caregivers, and 68.5 % experienced difficulties with family support services. Financial hardship affected 63.2 % of families, while 36.8 % reported psychological distress. Unmet healthcare needs were associated with younger child age (OR = 1.32), non-Emirati nationality (OR = 2.91), and lower caregiver education (OR = 1.74). Financial difficulties were linked to younger age (OR = 1.68), lower education (OR = 2.60), and single-mother households (OR = 1.22). Qualitative analysis revealed emotional distress, social stigma, and strained family dynamics, particularly among mothers. Recurring concerns included anxiety about the child’s future, reluctance to have more children, and dissatisfaction with healthcare communication. CONCLUSION: Caregivers of children with ASD face significant barriers to care and family well-being, highlighting the need for targeted, empathetic, and culturally sensitive interventions.

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15. Scherer N, Kuper H. Urgent need for services to support children with and at risk of developmental disabilities in low- and middle-income countries. Dev Med Child Neurol;2025 (Sep 9)

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16. Selvanathan T, Oloomi S, Guo T, Ufkes S, Chau V, Branson H, Synnes A, Ly LG, Kelly EN, de Vries LS, Grunau RE, Miller SP. Association of Early-Life or Term-Equivalent White Matter Injury With Neurodevelopmental Outcomes in Very Preterm Infants. Neurology;2025 (Sep 9);105(5):e214016.

BACKGROUND AND OBJECTIVES: We determined whether white matter injury (WMI) severity and location on early-life vs term-equivalent age (TEA) brain MRI were more strongly associated with 36-month neurodevelopment. METHODS: Very preterm infants were recruited across 3 tertiary NICUs and underwent early-life and TEA MRI. Moderate-severe WMI severity and anterior or posterior location were scored. 36-month neurodevelopmental assessments were completed with Bayley Scales of Infant Development, Third Edition; delay was defined as a composite score <85 points. Multivariable logistic regressions adjusting for birth gestational age, site, infection, retinopathy of prematurity, moderate-severe intraventricular hemorrhage, and antenatal magnesium sulfate were used to determine associations of WMI severity and location at each scan with neurodevelopment. RESULTS: A total of 393 neonates (postmenstrual age median 27.6, SD 2.3 weeks, 47% female) completed early-life and TEA MRI scans. Cognitive delay was associated with early-life moderate-severe (OR 3.82, 95% CI 1.17-9.14) and anterior (OR 5.47, 95% CI 1.72-17.29) WMI. Motor delay was associated with early-life anterior WMI (OR 3.02, 95% CI 1.12-8.2). These associations were not observed at TEA in multivariable logistic regressions. DISCUSSION: Moderate-severe and anterior WMI on early-life, but not TEA, MRI were associated with neurodevelopmental outcomes. Early-life MRI may represent a more optimal time point for assessing WMI in very preterm infants.

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17. Trew S. Our Challenges, Our Solutions: The Impact of Autism on Families. J Autism Dev Disord;2025 (Sep 9)

This study investigated how autism impacts the relationships between family members and the family unit. It aimed to provide a deeper qualitative understanding by incorporating the perspectives of autistic adolescents and their family members, adding depth to existing quantitative findings. This qualitative study involved audio-recorded semi-structured in-depth interviews with 40 participants, including mothers, fathers, siblings, and autistic adolescents, recruited through autism and disability agencies in Canberra, Australia. Data collection and analysis followed a constructivist grounded theory approach. Reflexive journaling and iterative member checking ensured the accuracy and validity of the findings. The study found that autism significantly influenced family dynamics, leading to behaviors such as self-harm, anxiety, overstimulation, anger, and limited social and emotional awareness, which strained family relationships. Families reported increased stress and tension, particularly in the absence of regular support and respite. Despite these challenges, families employed various strategies to maintain close relationships and foster resilience, such as sharing memories, setting boundaries, and establishing routines. Positive outcomes included improved teamwork and strengthened bonds. Participants emphasized the importance of patience, understanding, and methodical problem-solving in maintaining a cohesive family dynamic. The study concludes that while autism poses significant challenges to family relationships, families can develop effective strategies to manage these challenges and foster resilience. The findings align with social identity theory, highlighting the role of family connectedness and social buffering in mitigating the negative impacts of autism on the family. Strong family bonds and a supportive environment are crucial for reducing stress and promoting positive identity formation. Continued support and targeted interventions are essential for enhancing family dynamics and improving the well-being of autistic individuals and their families.

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18. Vanegas Navarro P, Apuy Rodríguez F, Arias Alvarado MJ, Chacón Quirós M. Early Diagnosis and Intervention for Autism Spectrum Disorder. Cureus;2025 (Aug);17(8):e89591.

Autism spectrum disorder (ASD) is a neurodevelopmental syndrome that impacts two main areas: social communication and restrictive or repetitive behaviors. Other symptoms and comorbidities may be manifested, according to the different clinical presentations and severity levels. ASD diagnosis can be performed by two years of age; however, certain diagnostic challenges may lead to a late diagnosis and significant intervention delay. Studies have shown that early diagnosis and interventions have a positive impact on the child’s development, acquisition of social or language skills, and overall quality of life. This review aims to explore the appropriate implementation of standardized, efficient diagnostic methods and criteria at primary care routine consultations, and prompt interventions that must follow in high-risk children.

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19. Yang Y, Sun Z, Zhu F, Chen A. Blood-based DNA methylation markers for autism spectrum disorder identification using machine learning. Epigenomics;2025 (Sep 9):1-14.

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder lacking objective biomarkers for early diagnosis. DNA methylation is a promising epigenetic marker, and machine learning offers a data-driven classification approach. However, few studies have examined whole-blood, genome-wide DNA methylation profiles for ASD diagnosis in school-aged children. METHODS: We analyzed genome-wide DNA methylation data from GEO dataset GSE113967, including 52 children with ASD and 48 typically developing (TD) controls. Differentially methylated positions (DMPs) were identified, and feature selection was performed using support vector machine-recursive feature elimination with cross-validation (SVM-RFECV). Classification models were developed using random forest (RF), extreme gradient boosting (XGBoost), and decision tree (DT) classifiers. A nomogram visualized feature contributions. RESULTS: A total of 138 DMPs differentiated ASD from TD children. Eleven CpG sites selected by SVM-RFECV formed the basis for model construction. RF and XGBoost achieved the highest accuracy (75%), with DT reaching 70%. Functional annotation indicated enrichment in cell adhesion and immune-related pathways. CONCLUSIONS: This exploratory study demonstrates the feasibility of integrating peripheral blood DNA methylation data with machine learning to distinguish children with ASD. While limited by sample size and moderate accuracy, this study provides methodological insights into the feasibility of integrating epigenetic and computational approaches for ASD-related biomarker exploration. Autism spectrum disorder (ASD) is a condition that affects how children communicate, interact with others, and behave. Right now, doctors diagnose ASD by watching a child’s behavior, which can take time and delay early help. In this study, we looked at small chemical changes in the blood that may affect how genes work. These changes can sometimes show if a child has ASD. We used computer programs to find patterns in these changes that could help tell children with ASD apart from those without it. While the study included a small number of children and more research is needed, our results suggest that a simple blood test could one day help doctors detect ASD earlier and more accurately. eng

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20. Yeom JS, Kim YS. Parenting stress in autism spectrum disorder: A comparative analysis with other developmental disabilities. Brain Dev;2025 (Sep 8);47(5):104436.

OBJECTIVE: To compare parenting stress between parents of children with autism spectrum disorder (ASD) and other developmental disabilities (DDs) and to examine ASD’s influence on parenting stress through mediation analysis. METHODS: We retrospectively analyzed 48 children with ASD (ASD group) and 77 with non-ASD DDs (non-ASD group), along with one of their parents, at the Gyeongsang National University Hospital between May 2021 and August 2024. All underwent developmental assessments and completed the Korean version of the Parenting Stress Index-4 and the Child Interactive Behavior Test (CIBT). RESULTS: The ASD group’s median age was 37.5 months, with 37 boys (77.1 %). No significant difference was found in child age, sex, or parental demographics between the groups. Total parenting stress was significantly higher in the ASD group (p = 0.01), primarily due to higher child domain scores (p<0.01) than in the non-ASD group. Among the child domain subscales, Distractibility/Hyperactivity, Adaptability, Reinforces Parent, and Acceptability were significantly higher in the ASD group, while only the Attachment subscale differed in the parent domain. For high parenting stress (>85th percentile), Initiative Interaction-a CIBT subscale-was the only independent predictor, rather than ASD diagnosis. Mediation analysis showed no direct effect of ASD on parenting stress (β = 4.28, p = 0.42) but an indirect effect via reduced initial interaction (β = 3.68, p<0.05). CONCLUSIONS: Parenting stress was higher in the ASD group, mainly due to child-related factors. ASD influenced parenting stress indirectly through reduced initiative interaction. These findings provide further insight into parenting stress in families of children with ASD.

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