1. Aboul-Fotouh S, Zohny SM, Hassan GA, Eissa AM, Elshahawi HH, Abdelraouf SM, Ahmed MY, Rabei MR, Hassan FE, Mahmoud AN, Eltantawy EH, Khedr S, Ramadan Y, El-Ashry MK, Elnahas EM. Blockade of NMDA-receptors mitigates autistic and cognitive behaviors via modulation of TLR-4/NLRP3 inflammasomes and microglia/astrocyte crosstalk in rat model of autism. Neurotoxicology. 2025; 111: 103350.

Converging evidence proposed NMDA-receptor dysfunction as a real challenge underlying excitotoxicity implicated in neurological changes of autism spectrum disorder (ASD). Nevertheless, the role of NMDA receptors in relation to toll-like receptor-4 (TLR-4), NOD-like receptor-3 (NLRP3), and microglia/astrocyte activity in autism-related neuroinflammation has not been investigated hitherto. METHODS: The present study was designed to explore the potential role of NMDA-receptor blockade in autism by chronic memantine (MEM) treatment (20 mg/kg/d, i.p.) in male Wistar rats, prenatally exposed to valproic acid (VPA). RESULTS: Prenatal VPA exposure exhibited autistic-like core symptoms and cognitive deficits that were accompanied by gene and protein overexpression of NMDAR-GluN1 & GluN2B subunits, TLR-4, and NF-κB in the prefrontal cortex (PFC). Additionally, VPA increased oxidative/nitrosative stress and inflammasome markers (NLRP3, procaspase-1, and caspase-1). Similarly, histopathological and immunohistochemical studies confirmed neurodegenerative changes, together with microglia/astrocyte reactivity, increased inflammatory and apoptotic markers, along with elevated Ki-67, β-amyloid expression, and the number of neurofibrillary tangles in prefrontal and cerebellar cortices. Chronic treatment with MEM ameliorated the above-mentioned behavioral, neurochemical, and histopathological abnormalities, and interestingly, these effects significantly correlated with NMDAR expression. CONCLUSION: To the author’s knowledge, this study is the first to confirm the potential modulatory effect of NMDA-receptor blockade, via memantine, on TLR-4/NLRP3 inflammasome pathway and microglia/astrocyte crosstalk, in relation to its role in mitigating the autistic behaviors and cognitive deficits in autism. These findings therefore lend further support to the hypothesis that NMDA-receptor blockade may represent a novel and promising pharmacotherapeutic strategy for ASD.

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2. Cacciato-Salcedo S, Lao-Rodríguez AB, Malmierca MS. Sex- and age-specific effects on auditory brainstem responses in the valproic acid-induced rat model of autism. Hear Res. 2025; 468: 109470.

Prenatal exposure to valproic acid (VPA) provides a well-established rodent model of autism, yet its effects on auditory brainstem/midbrain processing across sex and development remain elusive. We recorded click-evoked auditory brainstem responses (ABRs) in Long-Evans rats that received prenatal VPA (400 mg/kg, gestational day 12) and in matched controls at prepubertal (postnatal days 30-45) and adult (65-120) stages under urethane anesthesia. We analyzed peak amplitudes, latencies, inter-peak intervals, and amplitude ratios across sound levels. Auditory thresholds remained comparable among groups. In controls, females showed larger amplitudes for waves I-II, shorter latencies for waves I, II, and IV, and steeper amplitude-intensity slopes for waves II, III, and V than males, indicating stronger level-dependent recruitment. Maturation enhanced early brainstem and midbrain responses by increasing amplitude growth (wave II) and shortening latencies (waves II-V), with effects more pronounced in females. Prenatal VPA exposure reduced wave II amplitude and delayed early peaks (I-III) in females, accompanied by elevated amplitude ratios, whereas in males it mainly affected later responses by reducing amplitudes for waves III-V and prolonging inter-peak latencies (I-III, III-V). These findings show that sex, age, and prenatal VPA exposure distinctly shape auditory brainstem/midbrain function.

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3. Concepción JLJ, Montañez N, Felizola G, Prieto LA, Columna L. « I’ve always tried to introduce it »: how Latina mothers support physical activity for their autistic children. Disabil Rehabil. 2025: 1-12.

PURPOSE: Physical activity has been shown to support motor development, socialization, and overall well-being in autistic children. However, little is known about how Latina mothers manage the challenges of promoting physical activity for their children. The purpose of this study was to explore Latina mothers’ experiences, challenges, and strategies for supporting physical activity participation. METHODS: Nine Latina mothers of autistic children (ages 5-14) participated in semi-structured interviews conducted in Spanish or English. A qualitative descriptive approach with a constructivist lens guided the thematic reflexive analysis. RESULTS: Three themes characterizing how Latina mothers supported their autistic children’s physical activity were constructed: (a) Prioritizing children’s needs over external opinions, (b) Confidence from past experiences and present challenges, and (c) I’ve always tried to introduce it. CONCLUSION: Mothers showed strong commitment to supporting their autistic children’s physical activity, even when facing challenges such as financial constraints, limited access to inclusive programs, and safety concerns. Interventions should focus on providing bilingual resources, affordable options, and flexible programming that reflect the realities of Latino families and support long-term participation in physical activity. Latina mothers played an important role in supporting their autistic children’s participation in physical activity by adapting activities, seeking alternatives, and prioritizing their children’s needs despite financial and other systemic constraints.The lack of inclusive and affordable physical activity programs creates challenges for families, emphasizing the need for rehabilitation professionals to develop or promote accessible options that consider both the physical and sensory needs of autistic children.Rehabilitation professionals should consider how physical activity programs can address common barriers faced by Latino families, including financial constraints, safety concerns, and limited access to culturally relevant programs.Providing parents with bilingual resources, practical strategies, and advocacy skills can help sustain long-term participation in physical activity for autistic children in Latino communities. eng.

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4. Feng D, Li D, Hu C, Tian Y, Xu X, Hagerman RJ, Xu Q, Li R. Age-varying distinct neuroanatomy in young children with autism spectrum disorder and fragile X syndrome. Mol Psychiatry. 2025.

Autism spectrum disorder (ASD) is a commonly associated behavioral diagnosis in individuals with fragile X syndrome (FXS). The present study aimed to identify the neuroanatomical profiles and the age effects on brain’s developing trajectories that might be distinct or shared in FXS and idiopathic ASD. A total of 190 children were consecutively recruited including 46 with FXS (5.39 ± 2.68 years), 90 with idiopathic ASD (3.38 ± 1.36 years), and 54 typically developing children (5.40 ± 2.90 years). T1-weighted structural magnetic resonance imaging scans of the brain were acquired, and behavioral assessments were collected from all participants. Age-varying, voxel-based morphometry (VBM) was conducted to identify neuroanatomical differences between groups. The most pronounced differences in brain morphological patterns were observed in the FXS group. Children with FXS had increased gray matter volume (GMV) in subcortical regions including caudate and Crus I of the cerebellum, but decreased GMV in frontal insular regions and cerebellar vermis lobules VIII/IX compared to the ASD and TD groups. Children with ASD had significantly faster growth rates of GMV. The identified neuroanatomical profiles correlated with behavior assessments and differed between diagnosis groups. Our findings suggest that FXS and ASD have distinct neuroanatomical signatures during early childhood, particularly in subcortical and cerebellar regions, which are associated with divergent developmental trajectories. Together with their distinct brain-behavior associations, we conclude that these two conditions have distinct neurobiological underpinnings at spatial and temporal scales, despite their overlapping clinical symptoms. These findings have important implications for diagnosis and targeted interventions for children with ASD and FXS.

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5. Fysh MC, Kallitsounaki A, Williams DM, Kennedy E, Spinner L. Gender Identity Profiles in Autistic and Non-Autistic Cisgender and Gender Diverse Youth, and Their Caregivers. Autism Res. 2025.

This preregistered study examined whether the gender identity phenotype differs between autistic and non-autistic children and adolescents, as well as whether gender identity traits aggregate similarly within their families. Study 1 involved four matched groups of autistic and non-autistic gender diverse youth referred to a UK specialist gender clinic, as well as cisgender autistic and non-autistic youth (n = 45 per group). Participants completed measures of gender typicality, discontentedness, anticipated future identity, and (parent-reported) dysphoria. Despite large and significant differences between cisgender and gender diverse youth across all gender-related measures, there were no significant differences between autistic and non-autistic participants within either gender group. Study 2 assessed recalled childhood gender behaviors and current gender dysphoria in the caregivers of participants from each group (N = 203). Caregivers of gender-referred youth, regardless of autism status, reported higher current dysphoric traits than caregivers of cisgender youth, but no differences were observed in recalled childhood gender-related behavior. Overall, the findings indicate that the gender phenotype of autistic youth is comparable to that of non-autistic youth within the same gender identity group, challenging the assumption that gender diversity in autism arises from different underlying mechanisms. Clinically, these results support equitable access to gender-related care for autistic and non-autistic gender diverse youth.

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6. Jones DR, Sasson NJ. Intersectional effects of race and gender on first impressions of Black and White autistic adults. Autism. 2025: 13623613251389291.

Non-autistic adults often harbor negative attitudes about autism and show a reluctance to interact with autistic people. For autistic people with multiple marginalized identities, the compounding effects of stigma based on race and disability may worsen peer attitudes. This study investigated first impressions of Black and White autistic adults made by non-autistic observers. Autistic adults (N = 29) stratified by race (15 Black, 14 White) completed a videotaped semi-structured conversation, and non-autistic raters provided their first impressions of each participant. Black autistic people were rated as more likable and trustworthy, and raters endorsed a greater interest in interacting with them, compared to White autistic people. Evidence of intersectional effects of race, gender, and autism was also observed. White autistic men, but not Black autistic men, were evaluated less favorably than non-male autistic participants, with Black autistic men being evaluated more favorably on some items. These results suggest that the intersection of race and autism may, in some cases, counter stereotypes about Blackness and autism, and that holding multiple marginalized identities can modify the characteristics of peer stigma toward autistic adults.Lay abstractMany non-autistic adults have negative feelings about autism and may not want to interact with autistic people. For people who face more than one kind of discrimination, like being part of a racial minority and being disabled, a combination of racism and ableism might make others’ opinions even more negative. This study looked at how people’s race, gender, and how others judge them are connected when people view videos of Black and White autistic adults. In the first part of the study, 29 autistic adults (15 Black, 14 White) had a conversation with the main researcher, which was recorded on video. In the second part, people who were not autistic watched these videos and shared their thoughts about each person. The results showed that Black autistic people were seen as more likable and trustworthy, and the people watching the videos were more interested in getting to know them compared to White autistic people. The study also found that race, gender, and autism together influenced how people were judged. Black autistic men were often judged similarly to, or better than, non-male participants, while White autistic men were judged less positively than non-male participants. This means that having more than one identity that is discriminated against can change the ways that people view autistic adults, such as allowing Black autistic men to avoid common stereotypes.

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7. Karhson DS, LaFrance EM, Cuttler C. Acute effects of cannabis on core and co-occurring features associated with autism spectrum disorder in adults. Sci Rep. 2025; 15(1): 39849.

Pharmacological interventions that treat core and co-occurring features of autism spectrum disorder (ASD) are a persistent unmet need. As such, use of cannabis to manage ASD features is common in the autistic community. Yet, few studies have examined the acute effects of cannabis on symptoms associated with ASD. Therefore, we measured changes in symptom ratings from before to after cannabis use in a sample of 111 self-identified autistic adults. Anonymized archival data sourced from the Strainprint(®) app were analyzed. A subset of tracked information that reflected changes in core and co-occurring symptoms associated with ASD (i.e., Sensory Sensitivity, Repetitive Behaviors, Mental Control, and Negative Affect) were used to assess the impacts of cannabis on symptom severity. Overall, symptom severity ratings were reduced by 73.09% from before to after cannabis use. More severe symptoms were associated with greater reductions in severity ratings after use. Higher doses predicted greater reductions in severity of Repetitive Behaviors, Mental Control, and Negative Affect but dose of cannabis used to manage all symptoms remained static across time. Results from this first empirical examination of the perceived acute effects of cannabis in autistic adults suggest that cannabis provides temporary relief from symptoms associated with ASD.

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8. Kong H, Xie J, Dou F, Li X, Wang X, Huang Y. « I feel bad about myself »: mediating roles of social camouflaging, self-concept clarity, and self-disgust between autistic traits and depressive symptoms. Psychol Health Med. 2025: 1-18.

Autistic traits are frequently associated with depressive symptoms. However, the underlying mechanisms involved in this association still need further examination. The present study explored chain mediation pathways, examining the impact of camouflaging autistic traits on the self and its subsequent influence on depressive symptoms. According to the diathesis-stress models, the dynamic interactionist model of vulnerability, the dual vulnerability model, the disconnect theory, and the unified model of depression, the present study examined two potential chain mediation pathways (i.e. social camouflaging – self-concept clarity and social camouflaging – self-disgust) of the association between autistic traits and depressive symptoms. Four hundred sixty-three undergraduate and graduate students completed an online survey measuring autistic traits, depressive symptoms, social camouflaging, self-concept clarity, and self-disgust. Autistic traits were directly and indirectly associated with increased depressive symptoms in the general population. Specifically, autistic traits were related to depressive symptoms through the chain mediation pathways of social camouflaging to self-concept clarity and social camouflaging to self-disgust. The results demonstrate the relationship between autistic traits and depressive symptoms when individuals engage in social camouflaging, particularly focusing on self-aspects (i.e. self-concept clarity and self-disgust). These findings underscore the complexities of mental health challenges associated with camouflaging autistic traits and highlight the importance of considering self-factors as critical intervention points for depressive symptoms.

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9. Lim HA, Kim S, Arevalo A, Lee H, Nossaman S. Reciprocal Communication Training Through Music (RCTM) for Autistic Children. J Music Ther. 2025; 62(2).

Challenges in social responsiveness and social communicative behaviors are often observed in autistic children. It is imperative to develop effective treatment methods to enhance social communication and reciprocity in autistic children. This study examines the efficacy of two particular treatment methods to improve social communication including Reciprocal Communication Training (RCT) and Reciprocal Communication Training through Music (RCTM). Ten autistic children participated in this study and engaged in musical and nonmusical interventions that addressed greeting, receptive communication, imitation, initiation, and emotional congruence with facial expression, emotion identification, and emotional attunement. To analyze the impact of these interventions, the study included dependent samples t-tests to explore the differences in reciprocal communicative behaviors of autistic children between RCT and RCTM. A paired t-test analysis indicated that there were significant differences between RCT and RCTM on greeting, imitating behavior, initiating behavior, and emotional (happy vs. sad) congruence. The results indicated that participants who underwent RCTM demonstrated enhanced reciprocal communicative skills, particularly evident in the participants’ improved greeting and imitation behaviors. This improvement was observed across both early and late intervention stages. Moreover, the study suggests that RCTM had a positive influence on various aspects of reciprocal and affective communication, optimizing the effects of music to create a sensory-rich environment for enhanced engagement. RCTM emerges as a promising method for fostering social communication skills in autistic children, offering potential benefits for their educational and therapeutic outcomes.

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10. Mathée-Scott J, Venker CE. Beyond Mean Length of Utterance: Novel Measures for Characterizing the Spoken Language of Autistic Children. Am J Speech Lang Pathol. 2025: 1-10.

PURPOSE: Mean length of utterance (MLU) is a common measure of expressive language complexity in young children, including autistic children. However, means, by nature, obscure some information about spread and variability in data. Thus, we aimed to examine a new approach to characterizing linguistic complexity in autistic children by investigating the validity of two novel measures-range of length of utterance (RLU), standard deviation of length of utterance (SDLU)-alongside established measures: MLU and total utterances (TU). METHOD: Participants were 40 autistic children (12 girls, 28 boys; M(age) = 41.78 months). Children participated in 10-min, play-based language samples with their caregivers. Language samples were transcribed and measures (MLU, TU, SDLU, and RLU) were derived. To examine the criterion validity of these measures, we used regression analyses to examine how well each measure explained variance in children’s expressive language, as measured by the Preschool Language Scales-Fifth Edition (PLS-5). RESULTS: All measures (MLU, SDLU, RLU, and TU) significantly predicted PLS expressive language (ps < .001). Effect size comparisons revealed that all four predictors had large effect sizes (R(2) > .6). In absolute terms, MLU had the smallest effect size (R(2) = .682), followed by TU (R(2) = .72) and RLU (R(2) = .781), and SDLU had the largest effect size (R(2) = .822). CONCLUSIONS: Findings suggest that these novel measures (SDLU and RLU) explained significant variance in children’s expressive language, as measured by the PLS-5, as did MLU and TU. SDLU had the largest explanatory power, in absolute terms, followed by RLU and TU. MLU had the smallest effect size, indicating that it had the lowest explanatory power for explaining variance in children’s expressive language as compared to the other three measures. Thus, examining spread and variability in utterance length data might provide important, previously overlooked, information about the complexity of autistic children’s spoken language. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30559880.

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11. Naviaux RK. A 3-hit metabolic signaling model for the core symptoms of autism spectrum disorder. Mitochondrion. 2025: 102096.

A 3-hit metabolic signaling model of the causes of autism spectrum disorder (ASD) is described. The 3-hits required for ASD are: 1) inheritance of a genotype that sensitizes mitochondria and/or eATP-stimulated, intracellular calcium signaling to environmental change, 2) early exposure to environmental triggers that activate the metabolic features of the cell danger response (CDR), and 3) recurrent or persistent exposure to CDR-activating triggers for at least 3-6 months during the critical neurodevelopmental window from the late 1st trimester of pregnancy to the first 18-36 months of life. The three hits associated with an increased risk of ASD can be functionally classified as primers, triggers, and amplifiers of the CDR, respectively. Since the CDR is maintained by metabolic signaling, this new model creates a unified intellectual framework for understanding how the diverse features of ASD are connected. The example of phenylketonuria (PKU) is given to show that even disorders with very strong genetic predispositions can follow this 3-hit developmental paradigm and still be treatable using the principles of metabolic signaling. Since the 2nd and 3rd hits are modifiable, this model predicts that if the children at greatest risk can be diagnosed and treated before symptoms occur, as many as 40-50 % of these children may never develop ASD, and if diagnosed after symptoms occur, the core symptoms that are most disabling can be decreased significantly. Lay summary. A 3-hit developmental model for autism spectrum disorder is described. New methods in systems biology have identified a pattern of changes in mitochondrial function and metabolism that underlie the core symptoms of ASD. The metabolic features of the cell danger response (CDR), maintained by abnormalities in ATP-related purinergic signaling, have emerged as a common denominator for each of the genetic and environmental causes of ASD studied to date.

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12. Özkan S. Impact of the COVID-19 pandemic on early childhood development assessed with the Denver II developmental screening test in a single center. Sci Rep. 2025; 15(1): 39915.

The COVID-19 pandemic has disrupted early childhood development globally by altering social environments and limiting access to early stimulation and care. While the broader consequences of the pandemic on child development have been widely speculated, objective data from structured developmental assessments remain limited. This retrospective cross-sectional study compared developmental outcomes of children aged 0 to 6 years who underwent the Denver II Developmental Screening Test at a single child psychiatry center in Kütahya, Turkey. The study included 709 children, with 431 assessed in 2019 (pre-pandemic) and 278 assessed in 2021 (during the pandemic). Developmental domains analyzed included personal-social, fine motor, language, and gross motor. Mean delay scores in the language and personal-social domains significantly increased during the pandemic period (p < 0.001), while fine motor delays significantly decreased (p < 0.001 ). No significant changes were observed in the gross motor domains or global developmental delays. Notably, the proportion of children with isolated language delays rose from 3.2% to 11.5%. Additionally, girls were found to be more affected, with significantly higher rates of developmental delays compared to boys. These findings suggest that the pandemic selectively impaired language development and personal social skills while potentially preserving or enhancing fine motor skills through increased home-based play. Public health efforts in post-pandemic recovery should prioritize early language and other interventions, especially for children and young girls exposed to the pandemic during critical language acquisition periods.

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13. Pant S. AAP: Leucovorin Not Recommended for Autism. Jama. 2025.

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14. Pettitt L, Satherley RM, Hale L. « No one was coming to save us »: an interpretative phenomenological analysis exploring the experience of parents supporting their autistic daughter through anorexia nervosa. J Eat Disord. 2025; 13(1): 264.

BACKGROUND: Caring for someone with anorexia nervosa is associated with high levels of carer burden and burnout, however, there is a lack of research into caring for individuals who have anorexia nervosa and are also autistic, despite high levels of co-occurrence. This study aimed to offer an in-depth exploration of experiences for this group of caregivers. METHODS: Semi-structured interviews were conducted with six parents with an autistic daughter who had experienced anorexia nervosa. Data was analysed using Interpretative Phenomenological Analysis which enabled in-depth exploration of carers’ lived experience. RESULTS: Three themes and seven sub-themes were identified. These explored the experience of eating disorders services as largely unprepared to work with dual diagnosis; the impact of their daughter being autistic on carers’ experience of anorexia nervosa treatment and recovery, with variation depending on several factors; the journey of parenting through anorexia nervosa, and changes to parenting as a result. CONCLUSIONS: This adds to our understanding of the lived experience of this group of carers, highlighting a need for early detection of autism spectrum conditions, enhanced staff understanding of autism spectrum conditions, tailored treatment, and specific carer support for this group. Parents of a young person who is autistic and also has anorexia nervosa face unique challenges because of the needs that come with both conditions. The study looked at the experience of parents supporting their autistic child through Anorexia Nervosa. Parents told us that eating disorders services did not feel prepared to meet their child’s needs. In response to this, many felt that they had to change or even stop treatments because they didn’t work well for their child. Parents also spoke about the impact this had on their own wellbeing and their family. They described how they often had to step into unexpected roles, such as advocating for their child with professionals. The findings suggest that treatment for anorexia nervosa may be more helpful if it included adaptations for autistic people, and that providing support for carers could make a big difference for both parents and their children. eng.

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15. Reilly A, Walsh N, O’Reilly D, Smyth M, Gorman K, Ostadabbas S, Power C. The role of machine learning in autism spectrum disorder assessment and management. Pediatr Res. 2025.

Autism Spectrum Disorder (ASD) presents significant challenges in diagnosis and treatment, driven by its heterogeneous nature and complex aetiology. Recent advances in machine learning (ML) have facilitated exploration of novel approaches to ASD detection, stratification, and intervention opportunities. This narrative review explores the current ML and artificial intelligence (AI) research landscape across several key domains, including early ASD screening, phenotypic stratification, diagnostic biomarkers, neuroimaging, personalised therapies, and the role of automation and robotics in the treatment of this complex condition. Detailed analyses of these approaches emphasise the transformative but not yet realised potential of ML to improve outcomes for individuals with ASD. IMPACT: Highlights emerging trends, including multimodal AI integration, digital phenotyping, and use of AI to achieve biomarker-driven precision medicine. Provides first comprehensive synthesis of AI advancements in screening, diagnosis and treatment of ASD. Identifies current gaps in AI ASD research, such as dataset heterogeneity, validation issues, and clinical trust barriers.

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16. Silva ES, Drijvers L, Trujillo JP. Exploring auditory perception experiences in daily situations in autistic adults. Autism. 2025: 13623613251391492.

Autistic individuals often show differential sensory perception, including hypo- or hypersensitivities to sound. Previous research also suggests that autistic individuals often have difficulty processing intentional and affective cues in speech acoustics. However, general speech processing difficulties remain underexplored. We investigated self-reported auditory perception using the Speech, Spatial, and Qualities of Hearing Questionnaire among autistic (self-identifying (n = 18) and clinically diagnosed (n = 45)) and non-autistic adults (N = 66). The study was conducted in the Netherlands, but the questionnaire and call for participation were in English and open to anyone regardless of country of residence. Both clinically diagnosed and self-identifying individuals with autism reported significantly lower scores on the Speech, Spatial, and Qualities of Hearing Questionnaire score and on the Speech subscale compared with non-autistic individuals, indicating challenges in overall quality of auditory perception, speech comprehension. Clinically diagnosed individuals also showed lower scores on the quality and spatial subscales compared with non-autistic individuals. Post hoc analysis further suggested that speech hearing is particularly challenging for many autistic individuals. In addition, our finding that self-identifying and clinically diagnosed autistic individuals show similar patterns of hearing difficulties emphasizes the need for more inclusive research practices that collect the experiences of all the individuals in the autistic community in the study of sensory perception in autism.Lay abstractAutistic individuals often have very different sensory experiences compared with non-autistic individuals. One anecdotally mentioned, but not well-researched phenomenon is difficulty processing what we are hearing. Rather than challenges related to language understanding, such as nonliteral or indirect language, autistic people may also have more difficulty making sense of the sounds of their environment. This may be hearing where particular sounds are coming from, or understanding what is being said, particularly in noisy situations. To bring more attention and clarity to this challenge, we asked autistic and non-autistic adults to fill out a short survey that measures one’s hearing experiences in daily life. We found that autistic individuals report more difficulty across several types of hearing, and most prominently regarding speech hearing, when compared with non-autistic individuals. This finding highlights that reports of auditory processing difficulties when there is no hearing loss are not niche experiences, but rather reflect a common experience in autistic adults. In addition, we found that clinically diagnosed and self-identifying individuals reported very similar experiences. This highlights the validity of self-identification/self-diagnosis for research aimed at understanding autistic experiences. This study, therefore, emphasizes the need for more research and awareness regarding auditory perception and hearing in autistic adults. The study also emphasizes the value of more inclusive research practices that collect the experiences of all individuals within the autism community.

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17. Torices Callejo L, Herrero L, Pérez Nieto M. Anxiety and autistic traits in adults: a systematic review and meta-analysis. Front Psychol. 2025; 16: 1680267.

BACKGROUND: Autistic traits are distributed along a continuum, and some individuals exhibit subclinical characteristics without meeting diagnostic criteria for autism spectrum disorder (ASD). This population, referred to as the broader autism phenotype (BAP), has been associated with increased prevalence of anxiety symptoms. Given that these individuals often do not access clinical services or receive interventions, understanding how anxiety manifests within this group is essential for improving psychological well-being and quality of life. Although research on autism and psychopathology has expanded in recent years, few studies have explored this relationship in adults with BAP from a dimensional and transdiagnostic perspective. OBJECTIVE: This study aimed to systematically review and synthesize recent empirical evidence on the relationship between autistic traits and anxiety symptoms in adults, and to assess whether this association is statistically significant. METHODS: A systematic search was conducted across four databases (PubMed, Web of Science, Scopus, Dialnet) for peer-reviewed articles published between 2013 and 2023. Studies were included if they used validated instruments to assess autistic traits (e.g., AQ, ADOS-2) and anxiety (e.g., HADS, STAI, GAD-7, BAI). A total of 18 independent samples from 13 studies were included. Effect sizes (Hedges’ g) were calculated and synthesized using a random-effects model. Heterogeneity and publication bias were also examined. RESULTS: Findings were mixed: 55% of the included studies reported positive effect sizes and 45% negative. However, the overall effect size was not statistically significant (g = 0.0234, SE = 0.235, 95% CI: -0.438 to 0.483, p = 0.921), with substantial heterogeneity across studies (I (2) = 99.83%). Larger studies tended to report positive associations, while smaller studies yielded negative or inconsistent effects. Inconsistencies in measurement tools, particularly across AQ versions, contributed to this variability. CONCLUSION: Although a significant association was not confirmed, the high heterogeneity highlights the need for more standardized approaches to evaluating autistic traits in non-clinical adult populations. These findings underscore the complexity of subclinical autism and support the relevance of transdiagnostic research frameworks to better understand its relationship with anxiety.

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18. Valentine GC, Collett B, Wallie S, Mhango J, Engmann C, Sullivan E, Seferovic M, Willoughby M, Shayo B, Walson JL, Milgrom P, Aagaard K, Juul SE. The Prevention of Developmental Delay and Xylitol (PDDaX) trial: study protocol of a nested cohort follow-up from the PPaX (Prevention of Prematurity and Xylitol) trial examining neurodevelopmental outcomes among offspring at 4-8 years of age in Malawi. Trials. 2025; 26(1): 506.

BACKGROUND: We recently conducted the cluster-randomized, Prevention of Prematurity and Xylitol (PPaX) trial which demonstrated a significant reduction in the occurrence of delivery of preterm and low birthweight deliveries from mothers who used twice-daily xylitol-containing chewing gum in pregnancy as compared to active control among n = 10,069 enrolled pregnant participants in Lilongwe, Malawi. We seek to determine the neurodevelopmental outcomes, including any benefits or harm, of a nested cohort of n = 1000 children delivered among participants of the PPaX trial. METHODS: The Prevention of Developmental Delay and Xylitol (PDDaX) trial is a prospective, nested cohort study of 1000 randomly selected 4-8-year-old children born to gravid participants who completed the parent PPaX trial. We will assess the neurodevelopmental outcomes of the 1000 children at 4-8 years of age and evaluate any differences in neurodevelopmental outcomes related to xylitol exposure or lack thereof by assessing children’s (a) cognition, (b) executive functioning, (c) social-emotional development, (d) gross motor skills, (e) fine motor skills, and (f) language. These neurodevelopmental outcomes will be assessed via the Kaufman Assessment Battery for Children-2nd Edition (KABC-II), the EF Touch, the Strengths and Difficulties Questionnaire, the Malawi Developmental Assessment Tool, the Anchor Items in Measuring Early Childhood Development, and the International Development and Early Learning Assessment. The primary outcome will be the overall cognitive score, as determined by the KABC-II mental processing index. All children will also undergo hearing, vision, and comprehensive oral health examinations. Investigators from the participating sites developed and approved the research question and protocol. Each site obtained its own institutional review board and ethics approval. Patient recruitment started in July 2022 and will continue through 2027. DISCUSSION: Xylitol-containing chewing gum reduces the risk of delivery of a preterm or low birthweight neonate and neonatal demise. It also reduces gingival inflammation in gravidae. The findings from the PDDaX follow-up study will explore whether there are any long-lasting risks or benefits to offspring exposed to xylitol during gestation. If either benefit or lack of benefit (but no harm) occurs to offspring, then xylitol-containing chewing gum has strong potential to change obstetric-related care for individuals in Malawi and similar settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT05361122. Registered on April 27 2022.

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19. Xu X, Wang J, Hu K, Luo Y, Su D, Huang Q, Fan X, Fan X. Single-cell Isoform Sequencing Reveals Transcriptional Dysregulation in ASD Mouse Cortex Development. Genomics Proteomics Bioinformatics. 2025.

RNA splicing is pivotal in neural development, yet the role of isoform diversity across cell types remains unclear. Here, we combined metabolic RNA labeling and single-cell full-length transcriptome sequencing to capture transcriptional dynamics in developing mouse cortices. We observed predetermined cell states supported by nascent RNAs and characterized the driving isoforms of transcription factors that regulated the development of deep- and upper-layer neurons. Additionally, we investigated isoform regulation associated with autism spectrum disorder (ASD) during the embryonic development of BTBR T + Itpr3tf mice. Our findings indicated premature emergence of callosal projection neurons (CPNs) with an immature identity in ASD-affected cortices. These CPNs exhibited abnormal transcript usage, and the related RNA binding proteins included nearly 60% that have been reported to be ASD risk genes. We identified isoform switching events modulating neurogenesis and ASD development. Finally, we observed reduced isoform diversity in ASD potentially linked to dysregulated H3K27ac levels. Collectively, our study represents a significant advancement in understanding the molecular basis of cortical development and functions.

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20. Yoon CD, Xia Y, Terol AK, Meadan H, Shic F. Eye Tracking as a Treatment Monitoring Tool for Autism: A Multilevel Meta-Analysis. Autism Res. 2025.

There is a growing body of evidence suggesting a concurrent association between attentional indices measured via eye tracking and autism symptoms. This meta-analysis examined the utility of eye tracking within longitudinal frameworks for autism interventions, including treatment monitoring and prediction of treatment response. We conducted a multivariate random-effects meta-analysis with a multilevel structure on 25 studies (828 autistic participants; M(age) = 3-28 years) to estimate: (a) changes in eye-tracking outcomes from pre- to post-treatment (k = 179); and (b) the correlation between baseline eye-tracking profiles and changes in developmental outcomes following treatment (k = 39). Our analysis revealed a moderate and significant summary effect size for changes in eye-tracking outcomes from pre- to post-treatment (Hedge’s g = 0.32, p = 0.010). Additionally, a moderate but non-significant summary effect size was revealed for the correlation between baseline eye-tracking outcomes and changes in developmental outcomes following treatment (Fisher’s z = 0.20, p = 0.115), with moderation effects observed based on developmental domain and sex. These findings highlight the potential of eye tracking as a tool for monitoring treatment-induced changes in autistic individuals, while its predictive utility remains less supported. Limitations and implications are discussed.

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21. Zhao S, Zhang M, Luo T, Li L, Jiang Y, Situ M, Huang Y. Glymphatic system dysfunction in children with autism spectrum disorder as evidenced by the diffusion tensor imaging along perivascular spaces index. Front Psychiatry. 2025; 16: 1701816.

INTRODUCTION: This study aims to evaluate glymphatic system function in autism spectrum disorder (ASD) by employing diffusion tensor imaging along perivascular spaces (DTI-ALPS), and investigate its relationship with visual-motor integration (VMI) function. MATERIALS AND METHODS: A total of 78 individuals with ASD and 48 typically developing (TD) children were enrolled. All participants underwent diffusion tensor imaging on a 3-T MRI scanner. The DTI-ALPS index was calculated, and data on IQ and VMI function were obtained. Independent-samples t-test was used to compare the DTI-ALPS index between groups. Correlation analysis was conducted to examine the relationships between the DTI-ALPS index and clinical variables, including core symptoms, within the ASD group. Mediation analysis explored the relationship among the DTI-ALPS index, core symptoms, and VMI function. RESULTS: Compared to the TD group, ASD patients showed significantly reduced DTI-ALPS indices in the left hemisphere (DTI-ALPS-L), right hemisphere (DTI-ALPS-R), and for the whole-brain mean (Mean DTI-ALPS). In the ASD group, these indices were negatively correlated with the Autism Diagnostic Interview-Revised (ADI_R) communication score but positively correlated to the VMI score. Mediation analysis revealed that the VMI score significantly mediated the relationship between DTI-ALPS-R and the ADI_R communication score (indirect effect β = -0.082, p< 0.001). CONCLUSIONS: Our preliminary findings indicate impaired glymphatic system function in ASD, which may contribute to its pathogenesis. Furthermore, VMI function mediates the relationship between altered glymphatic system function and communication deficits in ASD.

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