1. Ahmed Mourad Asaad Y, Ashraf Izzeldin Abdalla S, Pizarro AB. Music therapy for autistic people: summary of a Cochrane review. Explore (NY). 2025; 22(1): 103288.

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2. Ahsan A, Kar O, Akter K, Ta HDK, Shen CJ, Datta K, Chatterjee B, Huang CC, Majumder P. Regulatory Functions of TDP-43 and FMRP in Non-Neuronal Diseases: Are Co-Targeted mRNAs the Keys?. Faseb j. 2025; 39(23): e71292.

RNA binding proteins (RBPs) act as the central nodal point in shaping the cellular transcriptome through their involvement in various aspects of RNA metabolism including stability, splicing, polyadenylation, modifications, translation and transport. Dysregulation in the function of various RBPs can be associated with different human pathophysiological conditions. Owing to their ability to regulate various RNA metabolism-associated processes, the same RBPs can functionally be involved in human pathologies with distinct underlying pathophysiological mechanisms. Two such important RBPs, namely TDP-43 and FMRP, have long been implicated respectively, in neurodegenerative diseases like amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD) etc. and in neurodevelopmental diseases like fragile-X syndrome (FXS). However, numerous recent reports indicate that these ubiquitously expressed proteins can regulate important cellular functions and signaling cascades, misregulation which results in different disease phenotypes. In this review, the association of TDP-43 and FMRP with different non-neuronal disease mechanisms has been discussed. Furthermore, to anticipate yet-to-be-explored non-neuronal disease mechanisms involving mismanagement in co-regulation of spatial and temporal transport/translation processes of TDP-43 and FMRP targeted RNAs, as observed in neuronal diseases for example, autism, RNA target databases of these two proteins are compared followed by GO and KEGG analysis. The lists of RNAs co-targeted by TDP-43 and FMRP are presumably involved in different non-neuronal diseases and disease-associated mechanistic pathways and will open up new phases of research to establish new disease mechanism(s). Different disease mechanisms and their interconnections expectantly will also lead to the discovery of new drug targets.

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3. Al Qadire M, Abdelrahman H. Behavioural interventions adapted for autistic adults with moderate-to-severe intellectual disabilities are feasible and acceptable for reducing anxiety. Evid Based Nurs. 2025; 29(1): 47.

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4. Al-Natsheh B, Imam A, Nahal MSH. Navigating Through the Path of Struggle and Building Resilience of Adversity: Lived Experiences of Mothers Having Children With Autism in the West Bank, Palestine. J Autism Dev Disord. 2025.

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5. Benedicto-Rodríguez G, Bellon-Berna P, Ferrández JM. Psychological perspectives on robotic assisted pivotal response treatment in autism. Sci Rep. 2025; 15(1): 43797.

The impact of Pivotal Response Treatment (PRT) assisted by the social robot Pepper on the emotional regulation and treatment adherence of children with autism spectrum disorder (ASD) and their caregivers is explored. Given the integration of technology and psychology, our study provides empirical evidence on the role of social robots not only as therapeutic tools but also as facilitators of family engagement and personalized ASD interventions. Our findings highlight significant improvements in children’s emotional responses with the use of a social robot and offer new insights into the variability of caregiver adherence.

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6. Capp S, De Burca A, Aydin Ü, Agnew-Blais J, Lautarescu A, Ronald A, Happé F, McLoughlin G. Depression and anxiety are increased in autism and ADHD: Evidence from a young adult community-based sample. JCPP Adv. 2025; 5(4): e70003.

BACKGROUND: Autism and attention-deficit/hyperactivity disorder (ADHD) overlap to a considerable degree and have been associated with mental health difficulties, yet there is limited research on this relationship. Young adulthood is a time of heightened risk for mental health problems in general. The risk may be greater for individuals with these conditions, for whom societal demands tied to this transitional time may heighten the impact of internalising behaviours. Elucidating the relationships between neurodevelopmental differences and vulnerability to psychopathology may inform future adaptations for specialised support. METHODS: This study explored whether autistic and ADHD traits and their interaction were associated with symptoms of depression and anxiety as well as meeting diagnostic criteria for internalising disorders in a sample of 556 young-adult twins (mean age 22 years 5 months, 52% female), controlling for sex, age, cognitive ability, and parental socioeconomic status. Four participant groups were created based on traits assessed in young adulthood: high autistic traits, high ADHD traits, high autistic and ADHD traits, and low ADHD and autistic traits. RESULTS: High autistic and ADHD traits were independently associated with higher self-reported depression and anxiety symptoms and likelihood of meeting diagnostic thresholds for an anxiety or low mood disorder. While co-occurrence of autism and ADHD exhibited the greatest risk for mental health challenges, no evidence was found for interaction effects between these traits at stringent corrected thresholds. Females with high levels of autistic traits exhibited particularly high risk for concomitant psychopathology. CONCLUSIONS: Our findings suggest that those with high levels of autistic and/or ADHD traits may require individualised care strategies, in light of the complex interplay between traits of neurodivergence and mental health outcomes. Future research may explore the efficacy of psychoeducation and specific adaptations to established therapeutic interventions needed to optimise outcomes for adults with these conditions.

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7. Celis C, Troncoso F, López E, Escudero-Guevara E, Acurio J, Escudero C. Dysregulated levels of proangiogenic proteins in the placentas of children with autism spectrum disorder and attention-deficit hyperactivity disorder. Front Med (Lausanne). 2025; 12: 1693975.

Placental vascularization may influence fetal brain development, but its long-term impact on neurodevelopment remains unclear. In this pilot study, we analyzed two ligand proteins: vascular endothelial growth factor (VEGF) and placental growth factor (PLGF), and their receptors mRNA and protein levels in placentas from children who later were diagnosed with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), or controls. ASD placentas showed lower VEGF, PLGF, and KDR protein levels but higher FLT1, while ADHD placentas had increased FLT1 and reduced VEGF mRNA. These findings suggest distinct placental vascular alterations in ASD and ADHD, highlighting a potential role of the placenta-brain axis in neurodevelopmental disorders and early-life mechanisms underlying impaired brain development.

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8. Chen Q, Liu H, Cao X, Qian B, Wang G, Wang Y. Leveraging TabTransformer Deep Learning on Conventional MRI Radiomics for Accessible and Interpretable Diagnosis of Autism Spectrum Disorder. Neuropsychiatr Dis Treat. 2025; 21: 2783-93.

PURPOSE: This study aims to assess the diagnostic efficacy of a multi-region radiomics analysis utilizing conventional MRI sequences (T1-weighted imaging [T1WI] and T2-weighted imaging [T2WI]) for autism spectrum disorder (ASD), and to investigate the correlations between radiomics features and the severity of clinical symptoms, thereby exploring potential imaging biomarkers. METHODS: This retrospective study included 207 pediatric participants (91 ASD, 116 typically developing controls). Radiomics features were extracted from manually segmented bilateral hippocampus, thalamus, caudate nucleus, and lenticular nucleus on T1WI and T2WI images. Three distinct classifiers (T1WI-only, T2WI-only, T1WI+T2WI combined) were developed using logistic regression (LR), support vector machine (SVM), and a TabTransformer deep learning (DL) model. Diagnostic performance was evaluated via five-fold cross-validation. RESULTS: The TabTransformer DL model utilizing combined T1WI+T2WI features demonstrated superior performance, achieving an area under the curve of 0.900, accuracy of 0.834, sensitivity of 0.843, and specificity of 0.823. Specific radiomic features, predominantly from the left lentiform nucleus and bilateral caudate nucleus, were significantly correlated with clinical severity scores (ABC, CARS). CONCLUSION: Radiomics models leveraging routine MRI sequences demonstrate robust diagnostic utility for ASD. The identified subcortical features, correlating with core symptoms, may serve as viable imaging biomarkers. Future work requires external validation, exploration of automated segmentation, and investigation in larger, multi-center cohorts..

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9. Choate E, Hess CW, Maroney MR, Webster SN, Jehl N, Neville A, Minassians L, Simons L, Harrison LE. Understanding the lived experiences of youth with chronic pain who are neuro- and gender-diverse. Health Psychol. 2026; 45(1): 25-34.

OBJECTIVES: Pediatric chronic pain is a global health problem associated with psychological comorbidities and declines in functioning. Recent research indicates a large number of autistic youth experience chronic pain, and a significant number of autistic youth identify as gender-diverse. While the exact prevalence is unknown, there is growing recognition that a number of youth with chronic pain identify as gender-diverse. To date, little is known about the experiences of youth with these intersecting identities. This study sought to understand the lived experiences of youth with chronic pain who identify as gender-diverse and autistic. METHOD: Semistructured interviews with youth with chronic pain who identified as gender-diverse (N = 6) and self-reported the identity of autism were conducted to understand the individual, lived experiences of these youth. Data were analyzed using interpretative phenomenological analysis. RESULTS: Interpretative phenomenological analysis produced four group experiential themes consisting of nine personal experiential themes. Group experiential themes included: The compounding impact of identities, wrestling with labels, health care as a maze to be navigated, and the impact of society as the additional identity in the room. CONCLUSIONS: Youth with chronic pain who are autistic and gender-diverse experience unique stressors in the context of their identities. Understanding the experiences of these youth is essential for providing equitable and inclusive pain care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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10. Cirstian R, Forde NJ, Bučková BR, Dell’Acqua F, Charman T, Loth E, Oakley B, Mollà LC, Yorke I, Stones R, Banaschewski T, Murphy DGM, Buitelaar JK, Beckmann CF, Marquand AF. Linking White-Matter Development to Clinical Variation in Autism: Longitudinal Normative Modelling of FA in the EU-AIMS LEAP Cohort. bioRxiv. 2025.

BACKGROUND: Autism is characterised by marked neurobiological and clinical heterogeneity, which often limits the sensitivity of traditional group comparisons. Longitudinal normative modelling offers a way to capture heterogeneity and to describe an individual’s brain-behaviour relationships beyond diagnostic labels. METHODS: We analysed diffusion MRI scans from 3 waves of the EU-AIMS Longitudinal European Autism Project (LEAP). Using normative models of white matter fractional anisotropy (FA) we computed individual deviations relative to age typical norms. Our sample included 544 different individuals across all waves (Wave 1: 344 [autistic 189]; Wave 2: 297 [autistic 162]; Wave 3: 226 [autistic 145]), aged 7-37 years, with mean intervals of ∼1.5 years (W1-W2) and ∼6 years (W1-W3). We first tested for group level differences between autism and no-autism and then examined the associations with sensory, adaptive, cognitive, and behavioural measures across development within the autism group. RESULTS: Although mean FA differences between autistic and non-autistic participants were not significant, correlations between individual differences in FA and behaviour across repeated measurements yielded moderate but reproducible results. The cingulum bundle, uncinate fasciculus, callosal fibres (genu and splenium), and the superior longitudinal fasciculus were among the most frequently identified pathways associated with clinical traits. For these circuits, FA values were higher in individuals with better adaptive functioning (VABS) and lower in those reporting sensory processing (SSP) difficulties. Findings were mixed for associations between FA and symptom severity (ADOS). The largest cross-sectional signal appeared at Wave 2, and although some of the same circuitry re-appeared over about 7.5 years from Wave 1 to Wave 3, effect sizes remained modest and variable, consistent with heterogeneity and power differences across waves, but still pointing to a stable white matter tract pattern. CONCLUSIONS: Autism’s white-matter organisation reflects a dimensional and individually patterned architecture rather than a categorical distinction. Stable, person-specific deviations from shared neurodevelopmental pathways are linked to behavioural variation among autistic individuals. Longitudinal normative modelling therefore provides a practical approach to understand and quantify this heterogeneity.

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11. Dennison CA, Martin J, Shakeshaft A, Riglin L, Powell V, Kirov G, Owen MJ, O’Donovan MC, Thapar A. Early Manifestations of Neurodevelopmental Copy Number Variants in Children: A Population-Based Investigation. Biol Psychiatry. 2025; 98(12): 924-33.

BACKGROUND: There is clinical interest in recognizing copy number variants (CNVs) in children because many have immediate and long-term health implications. Neurodevelopmental (ND) CNVs are associated with intellectual disability, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD), conditions typically diagnosed by medical practitioners. However, ND CNVs may have additional, early developmental impacts that have yet to be examined in unselected populations. METHODS: Carriers of known ND CNVs were identified in 2 UK birth cohorts: ALSPAC (Avon Longitudinal Study of Parents and Children) (carriers = 144, controls = 6217) and MCS (Millennium Cohort Study) (carriers = 151, controls = 6559). In ALSPAC, we assessed associations between CNV carrier status and birth complications; preschool development; cognitive ability; ND conditions (ASD, ADHD, reading, language, and motor difficulties); and psychiatric, social, and educational outcomes. Corresponding phenotypes were identified in MCS and meta-analyzed, where available. RESULTS: In ALSPAC, ND CNVs were associated with low cognitive ability, ADHD, and ASD. ND CNV carriers showed a greater likelihood of preterm birth, fine and gross motor delay, difficulties in motor coordination, language, and reading, and special educational needs (SEND). Meta-analysis with available measures in MCS identified elevated likelihood of ASD, ADHD, low birth weight, reading difficulties, SEND, and peer problems. CONCLUSIONS: ND CNVs are associated with a broad range of developmental impacts. While clinicians who see children with intellectual disability, ASD, or ADHD may be aware of the impacts of CNVs and consider genetic testing, our investigation suggests that this training and awareness may need to extend to other professional groups (e.g., speech and language therapists).

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12. Ding JJ, Du DY, Li P. [Research progress on mechanisms and clinical management of comorbid constipation in children with autism spectrum disorder]. Zhongguo Dang Dai Er Ke Za Zhi. 2025; 27(12): 1549-55.

Children with autism spectrum disorder (ASD) frequently have comorbid gastrointestinal problems, with constipation being the most prevalent. The onset and severity of constipation are closely related to the core symptoms of ASD, and improving constipation can alleviate these core symptoms. However, the mechanisms underlying comorbid constipation in ASD remain unclear. Multidisciplinary assessment is the foundation of clinical management for comorbid constipation in ASD. Targeted pharmacological therapy, dietary interventions, gut microbiota modulation, and complementary and alternative medicine interventions can be chosen for personalized treatment. This review summarizes the mechanisms, assessment, and clinical management of comorbid constipation in ASD and aims to provide a reference for comprehensive interventions in ASD.

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13. Dwivedi S, Rajput P, Akhtar A, Goli SH, Dusane A. Preclinical models for autism spectrum disorder: past, present, and future. Neuroscience. 2025; 591: 186-204.

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders linked to neurobehavioral abnormalities in children. Despite substantial research suggesting the role of environmental and genetic variables in ASD development, the etiology and pathophysiology of autism still need exploration. To unveil the pathophysiology, genetics, and therapeutics of autism, many preclinical animal models are employed, with rodent models being most trusted. In the last two decades’ various non-rodent animal models and in vitro models for autism have been proposed, which are quick, economic, and trustworthy to investigate. However, there are concerns about mimicking behavioral and molecular features of autism. In this review, we have compiled the preclinical models that can help us comprehend the phenotypic and molecular characteristics of autism. The review discusses the reliability of available models along with their advantages and disadvantages. The inference from the review will provide insight to the researchers into all possible preclinical models for autism and select the best one to improve the translational value in ASD research.

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14. Ezedinma U, Burgess S, Greenhill J, Singh J, Jones E, Ladhams A, Campbell G, Fjaagesund S, Swierkowski P, Metse A, Downer T, Oprescu F. Home Polysomnography in Children With Autism Spectrum Disorder: A Prospective Observational Study. J Sleep Res. 2025: e70265.

This prospective observational study reports on the feasibility and adequacy of Level 2 polysomnography involving children with autism spectrum disorder during an interventional-randomised controlled trial. Multiple level 2 polysomnographic studies were performed using Nox-A1 devices worn between October 2023 and September 2024. Study feasibility was determined by the child’s compliance and primary caregiver report, while signal quality (key channels present for at least 90% of sleep time) was used to define study adequacy. A cost analysis was also conducted. Twenty children (6-12 years, 9.1 + 1.55 years; 16 males) with autism spectrum disorder (level 2) and reported sleep difficulties participated in the study. Eighty (89%) of 90 polysomnographic studies were feasible. All infeasible studies, except one, were unrelated to the study. Seventy-four (93%) of the eighty studies resulted in adequate study quality. Most (n = 6, 7%) inadequate studies were due to electroencephalogram signal artefact/absence. The participants did not have a sleep disorder requiring medical attention. The cost of a study was estimated at $AUD 258. The study indicates the feasibility, adequacy, and cost-effectiveness of level 2 polysomnography in evaluating sleep outcomes in children with autism spectrum disorder during an interventional randomised controlled trial. This preliminary study provides valuable insights into the field of paediatric sleep medicine. Repeat studies of this method using diverse and larger sample sizes are warranted.

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15. Freeth M, Poole D, Newell V, Scargill K. Participatory systems mapping: Can this approach improve how services work for autistic people?. Autism. 2025: 13623613251399656.

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16. Hechler FC, Tidoni E, Stark C, Aitken K, Cross ES, Caruana N. Autistic and nonautistic people evaluate eye contact cues in context to identify communicative opportunities. J Exp Psychol Hum Percept Perform. 2025.

Effective gaze-based joint attention requires distinguishing between communicative gaze and private gaze. Eye contact and repeated averted gaze shifts to the same location are key cues for gaze-based communication, but the temporal and perceptual dynamics of these cues in signaling communicative intent remain unclear. This study examines three perceptual properties of dynamic eye gaze displays and their influence on the perception of communicative intent. Autistic and nonautistic participants completed a semi-interactive task with an onscreen agent displaying dynamic eye movements searching for an object. Participants decided whether the agent was privately inspecting the objects or requesting the participant to « give » them one (i.e., attempting to communicate). We manipulated whether the agent displayed eye contact, made repeated gaze shifts at the same object, and the duration of gaze displays. We measured the frequency of « give » responses (indexing perceived communicative intent) and reaction times (indexing response certainty/bias). Participants were most likely to perceive communicative intent following displays comprising eye contact and repeated gaze. Gaze duration was a less potent signal, but increased perceptions of communicative intent in the absence of eye contact and repeated gaze. Autistic and nonautistic participants exhibited similar patterns, challenging the view that autistic people have broad « deficits » in understanding social gaze cues. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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17. Hurtado Ruíz MG, Arranz Calderón MJ, Pérez Solá V, Hervás Zúñiga A. Interplay between motor stereotypies, emotional dysregulation, and sensory reactivity in adolescents and adults with autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci. 2025.

OBJECTIVE: Motor stereotypies (MS), emotional dysregulation (ED), and altered sensory reactivity (SENS) are highly prevalent in children with autism spectrum disorder (ASD). Various studies suggest a relationship among these variables. This study aimed to examine the relationship between ED and sensory patterns and to analyse their combined influence on MS in adolescents and adults with ASD. METHODS: In total, 97 adolescents and adults with ASD were evaluated using the Stereotyped Behavior Scale, the Emotion Dysregulation Inventory, and the Adolescent/Adult Sensory Profile. Correlation coefficients and multiple linear regression models were used to analyse the data. RESULTS: In the multivariate analysis, age, sensory hyporeactivity, and sensory seeking together with ED, explained MS frequency. Conversely, sensory hypo- and hiperreactivity, and ED explained MS severity. ED was correlated with both sensory hypo-/hyperreactivity, but not with sensory seeking. This relationship influenced the effect of ED on MS frequency and severity in regression models both with and without sensory variables. Intellectual disability did not demonstrate a significant influence on MS. The presence of psychopathological comorbidity had a partial influence-greater than that of ED-on MS severity. CONCLUSION: The relationship between MS, ED, and SENS persists in adolescents and adults with ASD, varying according to the sensory patterns analysed. These findings support the importance of studying each pattern separately. The relationship between ED and sensory hypo-/hyperreactivity modulates the effect of ED on MS. Age and psychopathological comorbidity also influenced the results. The factors influencing the frequency and severity of motor stereotypies diverge. These results could improve our comprehension of MS, thereby facilitating more appropriate MS treatment strategies.

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18. Jose S, Rajendran SS, Naidu VN, Sundarsingh WT, Rajaram U, Kannadasan G, Jose S. Nurse-led health session: Impact on parental burnout and well-being among mothers of autistic children. Bioinformation. 2025; 21(8): 2720-3.

A nurse-led health session on reduce parental burnout and enhancing well-being among mothers of children with autism. Using a quasi-experimental design with 60 participants, this study evaluated the effect of a nurse-led health session on lowering parental burnout and improving well-being among mothers of autistic children in Egmore, Chennai. Following the intervention, the experimental group’s well-being increased by 17.79% and their burnout decreased by 13.53%. Burnout ratings dropped from 82.07 (SD = 11.61) to 63.40 (SD = 5.71), and mean well-being scores rose from 37.97 (SD = 10.35) to 52.20 (SD = 5.89), both of which were statistically significant (p = 0.001). Age, occupation, family type, and information source all showed substantial correlations.

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19. Kafami Khorasani Z, Upadhyaya S, Ståhlberg T, Arrhenius B, Heinonen E, Sourander A. Time Trends in Treated Incidence, Socio-demographic Risk Factors, and Co-occurring Psychiatric Disorders in Diagnosed Autism Spectrum Disorder With or Without Intellectual Disability: A Finnish Nationwide Register Study. J Autism Dev Disord. 2025.

PURPOSE: Research on Autism spectrum disorder (ASD) trends and risk factors, particularly relating to by intellectual disability (ID), is limited. This study examined the incidence, sociodemographic risk factors and co-occurrence conditions of ASD, including categorization by ID, using national registers. METHODS: This study included singletons born in Finland between 1998 and 2015 who had been diagnosed with ASD by 2018, with cases categorized into ASD with ID and ASD without ID. We divided the study sample into four birth cohorts (1998-2002, 2003-2007, 2008-2011 and 2012-2015) to analyze changes in incidence over time. Cases (n = 10,171) were matched with controls (n = 49,391) by age, gender, and birthplace. Associations between sociodemographic risk factors and ASD were analyzed using conditional logistic regression. Co-occurrence with other psychiatric disorders was examined only in the oldest cohort (1992-2002). RESULTS: The cumulative incidence of ASD without ID increased from 0.52 to 0.89% by age 10, while ASD with ID remained stable at 0.17%. Several socio-demographic risk factors were associated with both groups, while parental immigration status was only associated with cases with ID. A total of 59.0% of cases had one co-occurring psychiatric disorder, with a significant difference in prevalence between the groups (p < .05). CONCLUSION: The increase in diagnosed ASD, particularly without ID, recorded by specialized services in Finland between 1998 and 2018 may reflect a real increase in incidence, or changes in diagnostic criteria and practices, improved mental health services, greater public and professional awareness or treatment seeking behavior.

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20. Kanina A, Sjölander A, Martini MI, Butwicka A, Larsson H, Hughes AM, Radó MK, Taylor MJ, Havdahl A, Ask H, Rosenqvist MA. Prenatal exposure to adverse life events and autism and autistic-like traits in children in the Norwegian Mother, Father and Child Cohort Study (MoBa). JCPP Adv. 2025; 5(4): e70002.

BACKGROUND: Mothers’ experience of adverse life events (ALEs, e.g., divorce, bereavement, injury) during pregnancy has been linked with neurodevelopmental conditions like autism, and related traits like social communication difficulties and repetitive behavior in children. However, both the cumulative association and the underlying mechanism are unclear, and these associations might be confounded by unmeasured genetic or other early environmental factors shared within families. METHOD: This longitudinal population-based cohort study included 114,247 children, born in Norway between 1999 and 2009, who participated in the Norwegian Mother, Father and Child Cohort Study. During week 30 of pregnancy, mothers of 51,940 children (of whom 12,597 were siblings) reported whether they had experienced ALEs. We estimated associations between mothers’ cumulative exposure to and perception of ALE and their children’s clinical diagnosis of autism, and maternal reports on their children’s autistic traits at ages 3 and 8 years through the Social Communication Questionnaire (SCQ). Sibling comparisons were conducted to account for unmeasured familial confounding. RESULTS: Each additional prenatal ALE was associated with increased adjusted hazard ratios [HR: 1.23, 95% CI: 1.16-1.30] of autism diagnosis, compared to unexposed children. Adjusting for unmeasured familial confounding in sibling comparisons, the association attenuated: HR = 0.53, 95% CI [0.31-0.90]. ALEs perceived as more painful were associated with a 12% elevated likelihood of autism diagnosis [95% CI: 7%-16%], but this association attenuated after sibling comparisons. SCQ scores in children exposed to cumulative prenatal ALE compared to unexposed children were higher at age 3 (β-coefficient: 0.24 (95%CI [0.21-0.27])), but only slightly at age 8 (β-coefficient: 0.07 [95% CI: 0.04-0.10]) with differences nullified in the sibling comparison analysis. CONCLUSION: The association between maternal prenatal exposure to cumulative ALEs and diagnosis of autism and autism-associated traits is likely due to unmeasured familial confounding rather than a direct causal relationship.

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21. Kim E, LaPier G, Rockhill C, Kim SJ. Clinical Characteristics Associated With Overweight and Obesity Status in Youth With Autism Spectrum Disorder: A Focus on Second-generation Antipsychotics. J Clin Psychopharmacol. 2025.

BACKGROUND: The use of second-generation antipsychotics (SGAs) for managing challenging behaviors in youth with autism spectrum disorder (ASD) is increasing, but studies on antipsychotic-induced weight gain in this population remain limited. Overweight/obesity [body mass index (BMI) ≥85th percentile] could increase health complications and health care costs. This study examines clinical factors associated with overweight/obesity in youth with ASD. METHODS: Electronic medical records of youth (ages 5 to 17 years) with ASD, seen at a university-affiliated Autism Center from 2018 to 2022, were analyzed. RESULTS: There were 97 youths with ASD prescribed SGAs and 261 who were not. The rate of overweight/obesity (BMI≥85th percentile) did not differ by SGA use. Youth prescribed SGAs were more likely to have public insurance (63.9% vs. 45.2%, P=0.002) and a comorbid disruptive behavior disorder (DBD) diagnosis (69.1% vs. 24.1%, P<0.001). Youth with overweight/obesity were more likely to have public insurance (61.6% vs. 42.5%, P<0.001) and a DBD diagnosis (46.6% vs. 29.2%, P<0.001). Youth with SGAs and stimulants were less likely to be overweight or obese than youth with SGAs without stimulant co-treatment. CONCLUSIONS: Mean BMI percentile and the rate of overweight/obesity did not differ by SGA use. Public insurance and DBD diagnosis have positive relationships with overweight/obesity, whereas stimulant co-treatment with SGA had a negative relationship. It is important to carefully consider the risks and benefits of SGA use, especially in under-resourced youth and those with disruptive behaviors.

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22. Landberg S, Johnels J, Galazka M, Hadjikhani N. Eye gaze discomfort: Associations with autistic traits, alexithymia, face recognition, and emotion recognition. Emotion. 2025.

Varying levels of traits associated with autism can be observed in the general population. One key feature associated with autism is reduced eye contact with others. Eye contact is often described as uncomfortable by autistic individuals, yet little is still known about how reduced eye contact impacts social cognition, and to what extent eye contact difficulties are specific to autism. For example, difficulties in recognizing emotions in facial expressions have been reported in autism, but it has not been established whether they are associated with reduced eye contact. Here, using a large sample of participants tested online, drawn from the general public and varying along different symptom scales, we examined self-reported eye contact discomfort as a mediating factor in reduced emotion recognition ability associated with autistic traits, while controlling for alexithymia, prosopagnosia, general sensory perception, and gender. Results showed that self-reported eye gaze discomfort was predicted by levels of autistic traits as well as by levels of alexithymic traits. Along with eye gaze discomfort, coping strategies were reported and differed in those with high autistic traits and high alexithymic traits. Furthermore, levels of autistic traits and levels of prosopagnosic traits both predicted slower emotion recognition. However, eye gaze discomfort was not a significant predictor of emotion recognition, resulting in an inconclusive mediating effect. This study was part of the novel trend of research studies conducted online, providing effective and potentially more inclusive data collection. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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23. Lin L, Zhang Y, Zhou D, Wang Q, Wang X, Sun J, Li H, Cong F. Burden and risk factors of autism spectrum disorder: global study and analysis. Pediatr Res. 2025.

BACKGROUND: Autism spectrum disorder (ASD) is increasingly prevalent globally, making it vital to understand its patterns and contributing factors. METHODS: This study utilized Global Burden of Disease 2021 data to analyze ASD trends from 1990-2021 and project to 2030. Mendelian randomization (MR) was used to investigate links between ASD and brain characteristics, metabolism, blood markers, and gut bacteria. RESULTS: High-income Asia Pacific countries, notably Japan (299.14 per 100,000), exhibit the highest age-standardized disability-adjusted life year (DALY) rates. Our findings also show that as countries advance socially and economically, reported ASD rates tend to be higher (ρ = 0.57). The overall global impact of ASD, measured in DALYs, is predicted to rise by nearly 59% by 2030, largely driven by population growth. The MR analysis suggested connections between ASD risk and specific factors like the size of certain brain areas (e.g., the right parahippocampal gyrus), levels of particular metabolic substances (e.g., methionine sulfone), and the presence of certain gut bacteria (e.g., Bacteroides). CONCLUSIONS: ASD is a growing global health concern with unequal community impact. Identifying potentially modifiable factors related to brain health, metabolism, and gut bacteria offers important clues for developing better strategies for ASD prevention, early diagnosis, and support. IMPACT: Significant disparities in ASD burden exist, with the highest rates in high-income Asia Pacific nations. Global ASD-attributable disability is projected to increase by 2030, posing an urgent public health issue. Mendelian randomization suggests potential causal links between ASD risk and neural, metabolic, and gut microbiota factors. This study provides updated global burden estimates and systematically explores modifiable biological factors for ASD, moving beyond prior observational research. This study emphasizes the need for integrated strategies in ASD prevention, early detection, and intervention to address growing global burden.

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24. Liu Y, Ma C, Zhang M, Ma X, Liu T, Jia F, Du L. Efficacy of gamified digital health interventions for children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health. 2025.

BACKGROUND: Autism spectrum disorder is a neurodevelopmental condition with a rising prevalence and limited effective pharmacological treatments. As non-pharmacological interventions gain traction, gamified digital health interventions have emerged as a promising alternative due to their accessibility and scalability. This systematic review and meta-analysis evaluated the efficacy of gamified digital health interventions in improving key functional domains in children and adolescents with autism spectrum disorder. METHODS: Following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions, a systematic search was conducted in six electronic databases (PubMed, Web of Science, EMBASE, Cochrane Library, PsycINFO, and Scopus) and reference lists of relevant articles up to November 2024. A total of 21 randomized controlled trials (RCTs) comprising 1,050 participants met the inclusion criteria. Standardized mean differences (SMDs) were pooled using a random-effects model, and subgroup analyses were conducted to explore the effects of different types of interventions. RESULTS: Meta-analysis revealed significant improvements in emotional skills (SMD = 0.56), social skills (SMD = 0.45), executive functions (SMD = – 0.43), and motor skills (SMD = 1.53). Subgroup analyses indicated that sensor-based games demonstrated superior efficacy. However, no significant effect was observed in reducing behavioral problems (SMD = – 0.14). CONCLUSIONS: Gamified digital health interventions show promise in enhancing emotional, social, executive, and motor skills in children and adolescents with autism spectrum disorder. Future research should focus on optimizing intervention strategies, refining behavioral outcome measures, and conducting high-quality longitudinal studies to evaluate long-term effectiveness.

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25. Longo B, Nunes RKS, Cazarin CA, Silva T, Sievers J, Nilz A, Venzon L, da Silva LM, Willrich CH, Cury BJ, Costa RA, de Souza MM, Stern CAJ, Zampronio AR, da Silva LM. Valproic Acid-Induced Autistic-Like Behavior Is Accompanied by Intestinal Damage Driving Changes in Gut Permeability in a Sex-Dependent Way in Rats. J Neurochem. 2025; 169(12): e70316.

A significant proportion of individuals with autism spectrum disorder (ASD) experience gastrointestinal disturbances exacerbating behavioral symptoms. Therefore, this study investigated alterations in the intestinal mucosa that influence intestinal permeability in rats exposed to valproic acid (VPA) in utero, as well as the sexual differences in it. After assessing social behavior, intestinal permeability was assessed using FITC-dextran, and vascular permeability was evaluated through Evans blue dye tests in the intestine and blood-brain barrier (BBB) of male and female offspring. Furthermore, microscopic analyses were performed to assess mucosal architecture and quantify mucin levels, while inflammatory and oxidative parameters, 5-HT and 5-HIAA levels, and serum lipopolysaccharide (LPS) concentrations were measured. Males, but not females, exposed to VPA exhibited reduced social interaction time. Only VPA males showed increased intestinal and vascular permeability, histological changes, elevated mucin levels, and higher serum LPS levels. Male, but not female, rats exposed to VPA displayed increased BBB permeability, and both showed reduced intestinal muscular layer thickness. Additionally, males showed increased levels of reactive oxygen species (ROS) and malondialdehyde (MDA) and enhanced glutathione S-transferase (GST) and myeloperoxidase (MPO) activities. Conversely, females exhibited no elevation in ROS or MDA intestinal levels. Moreover, a reduction in 5-HT turnover was evidenced in VPA-females compared to VPA-males. These findings support the validity of this model as a tool for investigating the role of intestinal barrier dysfunction in ASD and for identifying novel pharmacological targets in this field, considering the sexual differences in search of the practice of personalized and precision medicine.

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26. Möhrle D, Ma D, Xue W, Yan J, Cheng N. Altered Auditory Maturation in Fragile X Syndrome and Its Involvement in Audiogenic Seizure Susceptibility. Autism Res. 2025.

Auditory hypersensitivity is a prominent symptom in Fragile X syndrome (FXS), the most prevalent monogenic cause of autism and intellectual disability. FXS arises through the loss of the protein encoded by the FMR1 (Fragile X Messenger Ribonucleoprotein 1) gene, FMRP, required for normal neural circuit excitability. In the brainstem, FMRP is necessary for normal development of acoustic reactivity, and its loss has been implicated in audiogenic seizures (AGS) in Fmr1 knockout (KO) mice, modeling auditory hypersensitivity and seizures in FXS patients. The present study investigated the correlation between auditory brainstem function and behavioral expression of AGS at the early (postnatal day P20, infancy) and late (P32, juvenile) stages of auditory development in Fmr1 KO mice compared with wildtype (WT) mice, and in both females and males. We tested responsiveness to pure tones of select auditory pathway elements through auditory brainstem responses, and neural synchronization to amplitude envelopes of modulated acoustic stimuli through auditory steady-state responses. AGS behavior was categorized for severity during 5-min exposure to loud sound. Expression of the immediate early gene cFos was quantified as a marker for neuronal activity in the inferior colliculus. During infancy, more severe AGS expression in Fmr1 KO mice compared with WT mice was accompanied by increased responsiveness to acoustic stimuli at the level of the superior olivary complex and inferior colliculus, and stronger neural synchronicity in subcortical auditory neurons. Fmr1 KO mice also had higher cFos positive cell counts in the inferior colliculus after exposure to loud sound. With age, both AGS susceptibility and exaggerated acoustic stimulus-evoked activity in the Fmr1 KO mice subsided. Intriguingly, Fmr1 KO mice displayed an altered developmental profile in both the threshold and amplitude of auditory brainstem response. Our findings support evidence that AGS activity relies upon hyperexcitability in the auditory system, including in the lower brainstem, possibly due to disturbed auditory maturation. Hyper-synchronization to modulated sounds in subcortical auditory neurons seemed to predict AGS severity. The developmental trajectory of the auditory hyperresponsiveness and hypersynchrony suggests a transient processing alteration underlying heightened AGS susceptibility in Fmr1 KO mice. A better understanding of FXS-related circuit and behavioral symptoms of auditory processing across development provides the potential to identify therapeutic strategies to achieve auditory function recovery in FXS. Many people with Fragile X syndrome, a genetic condition linked to autism, experience heightened sensitivity to everyday sounds. In this study, we found that young mice with a genetic model of this condition showed stronger responses to sound in certain brain areas involved in hearing, which may explain their heightened reactions to loud noises. These brain responses and sound sensitivity lessened with age, suggesting that early development may be an important period for addressing sound sensitivity through targeted approaches. eng.

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27. Mortaş Kum A, Bilmez H. Teaching home safety skills to children with autism spectrum disorders. Front Psychiatry. 2025; 16: 1688922.

Children diagnosed with autism spectrum disorder (ASD) are 2 to 3 times more likely to experience injury or abuse than their typically developing peers of the same age. Parents have limited knowledge about the home safety skills of children with autism and often do not know how to respond in risky situations. In addition, fathers are generally less involved in the educational processes of children with ASD compared to mothers. The purpose of this study was to evaluate the effectiveness of the video modelling presented by fathers in teaching home safety skills (avoiding chemicals) to children with ASD. This study designed a single-subject multiple probe design with probe phases across four preschool-aged children with ASD (ages 3-4) and their fathers. Results demonstrated that all children acquired, generalized, and maintained the targeted safety skill with 100% success after six instructional sessions. Social validity findings indicated positive perceptions from fathers.

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28. Oakley B, Boatman CA, Baldoza S, Hearn A, Larkworthy C, Kent R, Ozsivadjian A, Doswell S, Dittner A, Roestorf A, Rawal D, Carter B, Simonoff E. Feasibility Study of a Novel App-Based Anxiety Intervention for Autistic People. Autism Res. 2025.

At least 50% of autistic people experience clinically relevant anxiety symptoms. However, reasons for elevated rates of anxiety in autism remain poorly understood and there is a high unmet need for novel and adapted therapies for anxiety that are accessible to autistic people. This study aimed to establish the feasibility of a novel app-based anxiety management tool (« Molehill Mountain ») that has been developed with, and adapted for, autistic people. A single-centre, single-arm feasibility study design was employed, whereby autistic people (≥ 16 years) with mild-to-severe symptoms of anxiety were recruited to a 13-week intervention period (King’s College London, UK; clinicaltrials.gov identifier NCT05302167). Of 123 prospective participants screened, 100 (81%) participants aged 16-74 years (n = 69 female) were enrolled within approximately 15 months. n = 76 (76%) completed an anxiety measure at ~15 weeks (Generalized Anxiety Disorder-7 Item Scale; GAD-7). Most adhered to the full intervention duration: 65% (n = 47), with most using the app weekly (1-6 days per week; 58%). 73% of participants agreed that they found the app easy to use overall and that an app is a good format for offering anxiety support to autistic people. There was a significant reduction in self-reported anxiety symptom severity with mean difference 2.88 (95% CI 1.88, 3.89; p < 0.001; Cohen's d = 0.45). We found that an autism-adapted app-based anxiety management tool is acceptable to the community and associated with reduced anxiety symptom severity in autistic adults, on average. Following optimization to further enhance usability, the efficacy of the Molehill Mountain app for reducing anxiety must now be tested under randomized controlled conditions in a full-scale clinical trial.

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29. Ringeling LT, Liang J, Cetin H, Bahmany S, Hermans RA, Dierckx B, Koch BCP, de Winter BCM. Optimizing Dried Blood Spot Sampling for Children and Adolescents With Autism Spectrum Disorder. Ther Drug Monit. 2025.

BACKGROUND: Dried blood spot (DBS) sampling offers several advantages for therapeutic drug monitoring, including minimal invasiveness, low blood volume requirements, and potential for home sampling. However, obtaining spots of sufficient quality for reliable analysis remains a key challenge of DBS. This study aimed to evaluate the impact of enhanced visual and textual guidance on the quality of DBS by analyzing data from a prospective multicenter study involving children and adolescents. METHODS: In total, 108 DBS cards from 56 children were assessed for spot quality. Rejection criteria included spot diameter <6 mm, smeared or irregularly shaped spots, and overlapping spots. Approval and rejection rates, overall success rates of DBS cards, and the most common rejection reasons were compared between the groups that did and did not receive the enhanced visual and textual support (intervention). RESULTS: Pre-intervention: 47.6% of the DBS cards contained at least 1 spot qualitatively acceptable for analysis, and 25.7% of all spots qualified for analysis. Post-intervention: the acceptance rates increased to 86.6% and 64.3%, respectively. In both the pre- and post-intervention groups, the most common reason for rejection was the presence of smeared or irregularly shaped spots. CONCLUSIONS: Continued improvements in DBS quality rely on effectively addressing challenges associated with home sampling challenges, which is critical for the seamless incorporation of DBS into clinical practice.

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30. Stahmer AC, Lau AS, Roesch S, Rangel E, Aarons GA, Brookman-Frazee L. Understanding mechanisms of multi-level implementation strategies for autism interventions in a randomized trial across service systems. Implement Sci. 2025; 20(1): 54.

BACKGROUND: Understanding the effectiveness of implementation strategies to support uptake of evidence-based interventions (EBIs) requires examining activation of mechanisms targeted by implementation strategies. This study uses data from the TEAMS (Translating Evidence-Based Interventions for Autism) hybrid type III implementation-effectiveness trial to examine whether leader-level and provider-level implementation strategies, when paired with provider training in AIM HI (An Individualized Mental Health Intervention for Autism) in mental health programs (Study 1) and CPRT (Classroom Pivotal Response Teaching) in schools (Study 2) successfully activated proposed implementation mechanisms (3 for leader level strategy and 2 for the provider-level strategy). We also examined whether any of the identified mechanisms associated with the leader-level strategy mediated the previously reported effect of the strategy on implementation and child outcomes. METHODS: Organizations were randomized to receive a leader-level strategy (TEAMS Leadership Institute [TLI]), provider strategy, both strategies, or neither strategy (EBI provider training only). Leader participants were recruited from enrolled programs/districts and then supported recruitment of provider/child dyads. Children ranged in age from 3 to 13 years. The combined sample included 65 programs/districts, 95 TLI leaders, and 385 providers/child dyads. Multi-level modeling was used to test hypotheses. The hypothesized mechanisms were implementation leadership, implementation climate, and implementation support strategies for TLI and EBI attitudes and motivation for training for TIPS. RESULTS: The leader-level strategy engaged the most proximal of the three hypothesized mechanisms (implementation support strategies). The provider-level intervention did not engage any of the hypothesized mechanisms. There was an interaction between the leader-level and provider-level strategies on implementation climate and provider motivation mechanisms favoring groups that received both implementation strategies compared to those that only received the provider-level strategy. No mechanisms significantly mediated the effect of the leader-level strategy on implementation or clinical outcomes. CONCLUSIONS: This study provides support that a brief implementation leadership and climate training, TLI, increases leader use of specific actions to promote autism EBIs across two public service systems, children’s mental health and public education. This does not fully account for strategy effects on fidelity or clinical outcomes. Findings advance the study of implementation mechanisms by examining how leadership training might work and identifying a clear need to focus on leader-level implementation strategies in these systems of care. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03380078.

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31. Tokunaga A, Akiyama T, Maruta M, Imamura A, Iwanaga R. Sensory processing at 18 months is associated with social challenges at 3 years. Pediatr Int. 2025; 67(1): e70286.

BACKGROUND: This study investigated the relationship between sensory processing characteristics at 18 months and social responsiveness at 3 years of age in children, to explore the potential utility of sensory processing assessments in the early detection of autism spectrum disorder (ASD). METHODS: Participants included 180 children (91 boys, 89 girls) born at an obstetrics and gynecology clinic. Mothers completed the Infant/Toddler Sensory Profile (ITSP) when children were 18 months old and the Social Responsiveness Scale Second Edition (SRS-2) at 3 years. The ITSP assesses sensory processing patterns based on neurological threshold and behavioral response/self-regulation, while the SRS-2 measures ASD severity, including Social Communication, Interpersonal Interactions, and Restricted Interests/Repetitive Behaviors. RESULTS: The results revealed significant correlations between the ITSP quadrant and section scores at 18 months and SRS-2 scores at 3 years, suggesting that sensory processing characteristics in early childhood may be associated with subsequent social difficulties associated with ASD. CONCLUSION: These findings highlight the potential value of assessing sensory processing in young children to improve early identification of ASD risk. Incorporating sensory processing evaluation into screening protocols may provide a new perspective and enhance the accuracy of early detection efforts, enabling earlier intervention and support for children with ASD and their families.

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32. Yang J, Chen Y, Dong G, Ma Y, Lin R, Yuan Y. Immune-metabolic perspective on the association of seven psychiatric disorders and five common auditory diseases: a bidirectional two-sample Mendelian randomization study and mediation analysis. J Affect Disord. 2025; 391: 120044.

INTRODUCTION: Although the relationship between psychiatric disorders and common auditory diseases has been discovered in observational studies, the causal linkage between them remains inconclusive. METHODS: The bidirectional two-sample Mendelian randomization (MR) analysis was performed, drawing on the most recent and expansive genome-wide association studies (GWAS) data for seven psychiatric disorders and five common auditory diseases. Additionally, a mediation analysis was conducted using data on 731 immune cell phenotypes and 1400 metabolite levels to explore potential mediating factors influencing the causal pathways. RESULTS: Autism Spectrum Disorder (ASD) could increase the risk of presbycusis (odds ratio [OR] = 1.161 [95 % confidence interval (CI), 1.042-1.295], P-value = 0.007) through CD25 on CD45RA- CD4 not regulatory T cell (Mediation effect β = 0.017), and Major Depressive Disorder (MDD) could increase the risk of vertigo (OR = 1.215 [95 % CI, 1.043-1.415], P-value = 0.012) through CD33+ HLA DR+ CD14dim Absolute Count (Mediation effect β = 0.007). Alzheimer’s Disease (AD) could reduce the risk of presbycusis through four metabolite levels related to lipid metabolism. And Bipolar Disorder I (BD I) could reduce the risk of vertigo, as well as sudden sensorineural hearing loss (SSNHL) could reduce the risk of Post Traumatic Stress Disorder (PTSD). CONCLUSION: This study underscores the intricate causal links between psychiatric disorders and auditory diseases. Mediation analyses indicate that immune cells are facilitators of positive effects, while metabolite levels play a protective role. These insights offer potential pathways for more effective clinical diagnosis and treatment.

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