1. Abromeit A, Hooijmans CR, LeMaoult C, Drion CM, Kas M. Animal studies reveal downregulation of the Beclin-1 autophagy pathway as shared mechanism in Autism Spectrum Disorder: a systematic review and meta-analysis. Mol Psychiatry;2025 (Apr 17)

BACKGROUND: Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental condition with complex etiology, involving genetic and environmental influences on brain development and behavior. Dysregulation of mammalian target of rapamycin (mTOR) signaling alters neuronal growth and synaptic plasticity, and has emerged as a potential underlying pathway in ASD. GOAL AND METHODS: To investigate mTOR dysregulation as a common mechanism in ASD, we performed a systematic review, and a meta-analysis of 192 studies examining mTOR signaling in diverse genetic and environmental animal models. RESULTS: Our random-effects model identified significant alterations in mTOR pathway-related proteins. For several proteins (p-AKT, PTEN, p-mTOR, p-EIF4e, LC3-II, p-S6K and p-S6), subgroup analyses revealed clear species-, sex-, age-, or brain region-specific effects. Interestingly, Beclin-1 was consistently downregulated across all subgroups. CONCLUSION: Our findings support mTOR-pathway dysregulation in ASD. The observed consistent downregulation of Beclin-1 highlights autophagy as a common mechanism, and provides new leads for novel ASD biomarker and treatment development.

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2. Bai Y, Brillinger M, Karlinsky A, Poliakoff E, Welsh TN, Gowen E. Speed-accuracy trade-offs in action perception, motor imagery, and execution of hand movements in autistic and non-autistic adults. Sci Rep;2025 (Apr 17);15(1):13255.

Action perception, execution, and imagery share motor-cognitive processes. Given prevalent sensory and motor coordination difficulties in autism, the processes of action perception and imagery may also be altered. This study investigated whether autistic adults can engage in motor imagery by testing potential differences in executing, perceiving, and imagining hand movements between autistic and non-autistic adults. Twenty autistic individuals and twenty age- and IQ-matched controls completed execution, imagination, and perception tasks using a Fitts’ Law paradigm in an online session. For the execution and imagination tasks, participants performed or imagined making aiming movements between two targets. For the action perception task, participants indicated whether they could perform as accurately as the movements in presented videos. Target size and distance were manipulated into three difficulty levels and systematically varied across all tasks. Results showed Fitts’ Law relationships for all tasks for both groups, with significant positive correlations between movement times and difficulty level. Movement times were longest in the imagination task and shortest in the perception task for both groups. These findings suggest motor imagery processes are relatively intact in autistic adults, highlighting that further investigation of motor imagery as a therapy for motor coordination difficulties in autistic individuals is warranted.

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3. Ben-Ari Y, Danchin É. Limitations of genomics to predict and treat autism: a disorder born in the womb. J Med Genet;2025 (Apr 17);62(5):303-310.

Brain development involves the sequential expression of vulnerable biological processes including cell proliferation, programmed cell death, neuronal migration, synapse and functional unit formation. All these processes involve gene and activity-dependent events that can be distorted by many extrinsic and intrinsic environmental factors, including stress, microbiota, inflammatory signals, hormonal signals and epigenetic factors, hence leading to disorders born in the womb that are manifested later in autism spectrum disorders (ASDs) and other neurodevelopmental disorders. Predicting and treating such disorders call for a conceptual framework that includes all aspects of developmental biology. Here, taking the high incidence of ASDs as an example, we first discuss the intrinsic limitations of the genetic approach, notably the widely used twin studies and SNPs. We then review the long list of in utero events that can deviate developmental sequences, leading to persistent aberrant activity generated by immature misplaced and misconnected neuronal ensembles that are the direct cause of ASD. In a clinical perspective, we suggest analysing non-genetic maternity data to enable an early prediction of babies who will develop ASD years later, thereby facilitating early psycho-educative techniques. Subsequently, agents capable of selectively silencing malformed immature networks offer promising therapeutic perspectives. In summary, understanding developmental processes is critical to predicting, understanding and treating ASD, as well as most other disorders that arise in the womb.

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4. Binan L, Jiang A, Danquah SA, Valakh V, Simonton B, Bezney J, Manguso RT, Yates KB, Nehme R, Cleary B, Farhi SL. Simultaneous CRISPR screening and spatial transcriptomics reveal intracellular, intercellular, and functional transcriptional circuits. Cell;2025 (Apr 17);188(8):2141-2158.e2118.

Pooled optical screens have enabled the study of cellular interactions, morphology, or dynamics at massive scale, but they have not yet leveraged the power of highly plexed single-cell resolved transcriptomic readouts to inform molecular pathways. Here, we present a combination of imaging spatial transcriptomics with parallel optical detection of in situ amplified guide RNAs (Perturb-FISH). Perturb-FISH recovers intracellular effects that are consistent with single-cell RNA-sequencing-based readouts of perturbation effects (Perturb-seq) in a screen of lipopolysaccharide response in cultured monocytes, and it uncovers intercellular and density-dependent regulation of the innate immune response. Similarly, in three-dimensional xenograft models, Perturb-FISH identifies tumor-immune interactions altered by genetic knockout. When paired with a functional readout in a separate screen of autism spectrum disorder risk genes in human-induced pluripotent stem cell (hIPSC) astrocytes, Perturb-FISH shows common calcium activity phenotypes and their associated genetic interactions and dysregulated molecular pathways. Perturb-FISH is thus a general method for studying the genetic and molecular associations of spatial and functional biology at single-cell resolution.

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5. Bonnycastle K, Nawaz MS, Kind PC, Cousin MA. Convergent depression of activity-dependent bulk endocytosis in rodent models of autism spectrum disorder. Mol Autism;2025 (Apr 16);16(1):26.

BACKGROUND: The key pathological mechanisms underlying autism spectrum disorder (ASD) remain relatively undetermined, potentially due to the heterogenous nature of the condition. Targeted studies of a series of monogenic ASDs have revealed postsynaptic dysfunction as a central conserved mechanism. Presynaptic dysfunction is emerging as an additional disease locus in neurodevelopmental disorders; however, it is unclear whether this dysfunction drives ASD or is an adaptation to the altered brain microenvironment. METHODS: To differentiate between these two competing scenarios, we performed a high content analysis of key stages of the synaptic vesicle lifecycle in primary neuronal cultures derived from a series of preclinical rat models of monogenic ASD. These five independent models (Nrxn1(+/-), Nlgn3(-/y), Syngap(+/-), Syngap(+/Δ-GAP), Pten(+/-)) were specifically selected to have perturbations in a diverse palette of genes that were expressed either at the pre- or post-synapse. Synaptic vesicle exocytosis and cargo trafficking were triggered via two discrete trains of activity and monitored using the genetically-encoded reporter synaptophysin-pHluorin. Activity-dependent bulk endocytosis was assessed during intense neuronal activity using the fluid phase marker tetramethylrhodamine-dextran. RESULTS: Both synaptic vesicle fusion events and cargo trafficking were unaffected in all models investigated under all stimulation protocols. However, a key convergent phenotype across neurons derived from all five models was revealed, a depression in activity-dependent bulk endocytosis. LIMITATIONS: The study is exclusively conducted in primary cultures of hippocampal neurons; therefore, the impact on neurons from other brain regions or altered brain microcircuitry was not assessed. No molecular mechanism has been identified for this depression. CONCLUSION: This suggests that depression of activity-dependent bulk endocytosis is a presynaptic homeostatic mechanism to correct for intrinsic dysfunction in ASD neurons.

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6. Chu S, Ince HY. Letter: Collaborating with Applied Behavior Analysis Teams to Optimize Telehealth Pharmacologic Management of Catatonia in Nonverbal Youth with Autism Spectrum Disorder. J Child Adolesc Psychopharmacol;2025 (Apr 17)

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7. Corrêa GGS, Soares FVM, Vasconcelos ZFM, Costa ACC, Rocha AD. Clinical and nutritional profile of children and adolescents with autism spectrum disorder in Brazil: a nationwide online survey. J Pediatr (Rio J);2025 (Apr 17)

OBJECTIVE: To characterize the clinical and nutritional profile of children and adolescents with ASD in Brazil and their eating problems. METHOD: This is a cross-sectional study using a national online survey, with a sample of 613 children and adolescents with ASD aged between 2 and 17 years. Data analysis consisted of descriptive analysis, followed by Pearson’s chi-square test with a statistical significance of 0.05 and a 95% confidence interval. RESULTS: Food allergy was reported by 33.8% of the participants, the most frequent being cow’s milk (70.2%), among those who reported gastrointestinal problems, constipation was the most frequent (54.1%). The presence of pica was reported by 25% and food selectivity was present in 77.2%, with greater refusal of fruit, vegetables and pasty textures. Most of the participants do not have follow-ups with a nutritionist and 44.5% are on some special diet, excluding gluten/wheat (75.4%) and without casein/animal milk (76.1%). More than half of the participants did not eat fruit (50.6%), vegetables (68.1%), or leafy greens (83.6%) frequently. A positive correlation was found between food selectivity and gastrointestinal symptoms (p-value < 0.050); food allergy and gastrointestinal symptoms (p-value < 0.001) and pica and gastrointestinal symptoms (p-value < 0.001). CONCLUSIONS: The results of this study show changes in food consumption and increased risk of nutritional deficiencies for children and adolescents with ASD in Brazil.

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8. Cramer DW. Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Obstet Gynecol;2025 (May 1);145(5):e146-e147.

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9. Dastgheib SS, Kaufmann JM, Kowallik AE, Schweinberger SR. Attention to Social and Non-Social Stimuli in a Continuous Performance Test in Autistic and Typically Developed Participants: An ERP Study. J Autism Dev Disord;2025 (Apr 16)

Autism spectrum disorder (ASD) is characterized by a range of symptoms, including restrictive behaviors and deficient social skills. We investigated EEG correlates of social attention, face, and non-face perception by applying a continuous performance test (CPT) with two different sets of stimuli (letters and faces). The CPT required participants to respond to a specific target stimulus (e.g., « X ») only when it followed a specific preceding stimulus (e.g., « O »). Event-related potential (ERP) components, including P100, N170, P200, N250, P300, and continuous negative variation (CNV), were analyzed in 19 young adults with ASD and 19 typically developed (TD) individuals that were matched for intelligence, age, and gender. TD participants had higher accuracies only for the target condition and regardless of stimulus type. No ERP differences between the two groups were found for the CPT with letter stimuli. By contrast, autistic individuals exhibited lower amplitudes of P300 and CNV during face CPT. Results suggest diminished allocation of attentional resources and response preparation towards socially relevant face stimuli.

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10. de Boer EN, Scheper AJ, Hendriksen D, Charbon B, van der Vries G, Ten Berge AM, Grootscholten PM, Lemmink HH, Jongbloed JDH, Bosscher L, Knoers N, Swertz MA, Sikkema-Raddatz B, Dijkstra DJ, Johansson LF, van Diemen CC. Nanopore Long-Read Sequencing as a First-Tier Diagnostic Test to Detect Repeat Expansions in Neurological Disorders. Int J Mol Sci;2025 (Mar 21);26(7)

Inherited neurological disorders, such as spinocerebellar ataxia (SCA) and fragile X (FraX), are frequently caused by short tandem repeat (STR) expansions. The detection and assessment of STRs is important for diagnostics and prognosis. We tested the abilities of nanopore long-read sequencing (LRS) using a custom panel including the nine most common SCA-related genes and FraX and created raw data to report workflow. Using known STR lengths for 23 loci in 12 patients, a pipeline was validated to detect and report STR lengths. In addition, we assessed the capability to detect SNVs, indels, and the methylation status in the same test. For the 23 loci, 22 were concordant with known STR lengths, while for the last, one of three replicates differed, indicating an artefact. All positive control STRs were detected as likely pathogenic, with no additional findings after a visual assessment of repeat motifs. Out of 226 SNV and Indel variants, two were false positive and one false negative (accuracy 98.7%). In all FMR1 controls, a methylation status could be determined. In conclusion, LRS is suitable as a diagnostic workflow for STR analysis in neurological disorders and can be generalized to other diseases. The addition of SNV/Indel and methylation detection promises to allow for a one-test-fits-all workflow.

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11. Gurbuz Ozgur B, Canlan Ozaydin B, Eren R, Uyar U, Ozaydin Y, Aksu H. The Relationship Between Avoidant/Restrictive Food Intake Disorder in Children Diagnosed with Autism Spectrum Disorder and Orthorexia Nervosa in Their Mothers. J Autism Dev Disord;2025 (Apr 17)

The aim is to examine the relationship between Avoidant/Restrictive Food Intake Disorder (ARFID) symptoms and sensory sensitivities in children diagnosed with Autism Spectrum Disorder (ASD), as well as the relationship between maternal orthorexia nervosa (ON) and ARFID, and to identify the factors influencing ARFID. The symptom severity of 104 children was assessed using the Childhood Autism Rating Scale (CARS), maternal ON symptoms with ORTO-11, ARFID symptoms with the Nine-Item Avoidant/Restrictive Food Intake Disorder Screening Tool (NIAS), and sensory sensitivities with the Eyuboglu Sensory Reactivity Scale (ESRS). Multiple regression analyzed predictors of NIAS scores, and moderator analysis examined whether ORTO-11 moderated the ESRS-NIAS relationship. ON was present in 58% of the mothers. Mothers with ON had significantly higher total NIAS scores and NIAS Fear subscale scores. A positive and statistically significant relationship was found between the CARS scores and the hyporeactivity and sensory-seeking subscales of the ESRS scale. When NIAS was taken as the dependent variable, a significant regression relationship was found between CARS-9 and ORTO-11. However, ORTO-11 does not play a moderating role in the effect of ESRS on NIAS. ARFID symptoms are predicted by maternal ON symptoms and CARS-9 scores in children. We emphasize the importance of evaluating the eating attitudes and food perspectives of caregivers when atypical eating behaviors are identified in the clinical follow-up of children diagnosed with ASD. Since the study was conducted solely with mothers’, further research is needed to examine the effects of ON symptoms in fathers and other caregivers.

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12. Hata M, Xu M, Hakuno Y, Yamamoto E, Minagawa Y. Emerging sensitivity to talking mouth in infants with low and elevated likelihood of autism spectrum disorder: A longitudinal study. Infant Behav Dev;2025 (Apr 16);79:102057.

The talker’s mouth provides significant multimodal information that supports language development. Studies have revealed that infants over 6 months of age show increased attention to the mouth of a talking face, which results in vocabulary growth. However, few studies have reported the relationship between early gaze behavior and later language development in infants with an elevated likelihood of autism spectrum disorder (ASD) (EL infants). Since ASD cannot be diagnosed in infancy, these infants provide a valuable opportunity to investigate early developmental differences in visual attention that may be associated with ASD. Therefore, we conducted a longitudinal eye-tracking experiment at ages 6, 9, 12, 18, and 24 months to investigate differences in gaze behavior between infants with a low likelihood of ASD (LL infants) and EL infants. We found that, exclusively in LL infants, the proportion of mouth-looking time significantly increased from 6 months to 9 months of age and remained relatively constant thereafter. In contrast, in EL infants, although the proportion of mouth-looking time gradually increased with age up to 24 months, their attentional change to talking mouth started later than that in LL infants. Furthermore, our results showed a conditionally positive relationship between mouth-looking and expressive vocabulary size in LL infants but not in EL infants. These findings indicate that EL infants may not utilize audiovisual information as valuable cues for language acquisition during infancy and toddlerhood, which may be a factor in their slow language development.

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13. Hewitt LT, Marron AM, Brager DH. Higher hyperpolarization activated current (I(h)) in a subpopulation of interneurons in stratum oriens of area CA1 in the hippocampus of Fragile X mice. J Neurophysiol;2025 (Apr 17)

Fragile X syndrome is the most common inherited form of intellectual disability and the leading monogenetic cause of autism. Studies in mouse models of autism spectrum disorders, including the Fmr1 knockout (FX) mouse, suggest that abnormal inhibition in hippocampal circuits contributes to behavioral phenotypes. In FX mice, changes in multiple voltage-gated ion channels occur in excitatory pyramidal neurons of the hippocampus. Whether there are also changes in the intrinsic properties of hippocampal inhibitory interneurons, however, remains largely unknown. We made whole-cell current clamp recordings from both fast-spiking (FS) and low threshold spiking (LTS) interneurons in the stratum oriens region of the hippocampus. We found that LTS, but not FS, interneurons in FX mice had lower input resistance and action potential firing compared to wild type. When we subdivided LTS interneurons into low-threshold high I(h) (LTH) and putative oreins-lacunosum moleculare (OLM) cells (Hewitt et al., 2021), we found that it was the LTH subgroup that had significantly lower input resistance in FX mice. The difference in input resistance between wild type and FX LTH interneurons was absent in the presence of the h-channel blocker ZD7288, suggesting a greater contribution of I(h) in FX LTH interneurons. Voltage clamp recordings found that indeed, I(h) was significantly higher in FX LTH interneurons compared to wild type. Our results suggest that altered inhibition in the hippocampus of FX mice may be due in part to changes in the intrinsic excitability of LTH inhibitory interneurons.

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14. Jiang TT, Li XQ, Zhao TT, Li HY, Tang Q. [Advances in research on gender differences in autism spectrum disorders]. Zhongguo Dang Dai Er Ke Za Zhi;2025 (Apr 15);27(4):480-486.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social impairments, repetitive behaviors, and restricted interests. Studies have shown that it is more prevalent in males than females. Although this issue has attracted academic attention since the 20th century, the specific mechanisms underlying the gender differences in ASD remain unclear. This paper reviews the impact of gender differences in ASD, focusing on the female protective effect, DNA methylation, hormone levels, and clinical manifestations. It also discusses corresponding treatment options, particularly suggesting improvements in the diagnostic process, which is often overlooked, in order to provide valuable references for the clinical diagnosis and treatment of ASD.

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15. Kasahara S, Yoshimoto T, Oka H, Sato N, Morita T, Niwa SI, Uchida K, Matsudaira K. Correlation between attention deficit/hyperactivity disorder and chronic pain: a survey of adults in Japan. Sci Rep;2025 (Apr 16);15(1):13165.

This cross-sectional epidemiological internet survey assessed whether attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) symptoms are associated with pain chronicity and intensity and explored the relationship between developmental disorder symptoms and pain. Participants were 4028 adults aged 20-64 years who experienced pain, assessed using an 11-point numerical rating scale (NRS), in any body part in the previous 4 weeks. ADHD and ASD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS) and autism spectrum quotient, respectively. Problems with mental health (PMH) were assessed using the shortened Profile of Mood States. Pathway analyses were performed to examine the association between ADHD symptoms and pain. The chronic pain symptoms (CP) group (N = 1465) scored higher than the non-CP group (N = 2563) for all ASRS variables. ASRS positivity was associated with CP symptoms and increased with increasing NRS score; the CP group showed particularly high positivity (38.3%) with extreme pain. ADHD symptoms were more strongly associated with CP symptoms and intensity than was PMH (0.26 vs. 0.09). ADHD symptoms, but not ASD symptoms, were associated with CP symptoms. ADHD medications reportedly improve coexisting CP; therefore, ADHD screening and treatment may be important for patients with CP, especially those with extreme pain.

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16. Khadija A, Korsah KA, Farhan AA. Psychological and spiritual well-being of adolescents with autism spectrum disorder in Ghana. BMC Psychiatry;2025 (Apr 17);25(1):394.

BACKGROUND: Adolescents with Autism Spectrum Disorder (ASD) face significant psychological and spiritual challenges that impact their overall quality of life. This study explores the psychological well-being (e.g., mood instability, financial burdens) of adolescents with ASD, including mental health challenges and coping mechanisms. We also studied the role of spirituality (e.g., participation in religious activities) as a coping mechanism for adolescents with ASD within the Ghanaian cultural context. METHODS: This qualitative study utilized semi-structured interviews with 13 parents of adolescents with ASD in Accra, Ghana. Participants were selected through purposive sampling. Data were analyzed thematically to identify patterns related to psychological well-being and spiritual practices as experienced by adolescents with ASD and their families. RESULTS: Two main themes emerged: (1) Psychological well-being of adolescents with autism, with parents reporting issues such as mood disturbances, depression, and social stigma affecting both adolescents and their families; and (2) Spiritual well-being, where religious engagement served as a coping resource, though sensory sensitivities posed participation challenges for some adolescents. CONCLUSION: The study highlights the importance of accessible mental health resources and supportive spiritual communities for adolescents with ASD in Ghana. Community-based mental health services and inclusive spiritual support can help families address the psychological and spiritual needs of adolescents with autism more effectively.

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17. Klibaite U, Li T, Aldarondo D, Akoad JF, Ölveczky BP, Dunn TW. Mapping the landscape of social behavior. Cell;2025 (Apr 17);188(8):2249-2266.e2223.

Social interaction is integral to animal behavior. However, lacking tools to describe it in quantitative and rigorous ways has limited our understanding of its structure, underlying principles, and the neuropsychiatric disorders, like autism, that perturb it. Here, we present a technique for high-resolution 3D tracking of postural dynamics and social touch in freely interacting animals, solving the challenging subject occlusion and part-assignment problems using 3D geometric reasoning, graph neural networks, and semi-supervised learning. We collected over 110 million 3D pose samples in interacting rats and mice, including seven monogenic autism rat lines. Using a multi-scale embedding approach, we identified a rich landscape of stereotyped actions, interactions, synchrony, and body contacts. This high-resolution phenotyping revealed a spectrum of changes in autism models and in response to amphetamine not resolved by conventional measurements. Our framework and large library of interactions will facilitate studies of social behaviors and their neurobiological underpinnings.

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18. Lee S, Moon H, Kim E. NMDAR dysfunction in autism spectrum disorders: Lessons learned from 10 years of study. Curr Opin Neurobiol;2025 (Apr 15);92:103023.

Over the past decade or so, mouse models of autism spectrum disorders (ASD) have been extensively studied in the search for key mechanisms underlying the disorder. Numerous intriguing mechanisms have been proposed, spanning various levels of the neural system, including molecular, synaptic, neuronal, circuit, and systems-level processes. However, no single mechanism has emerged as universally applicable, highlighting the heterogeneous nature of the genetic and neurobiological underpinnings of ASD. Among these, the NMDA receptor (NMDAR) dysfunction hypothesis has garnered significant attention. Many mouse models exhibit NMDAR dysfunction, with NMDAR hypofunction appearing more prevalent than hyperfunction. Nevertheless, not all mouse models display this dysfunction, suggesting that NMDAR abnormalities may not be ubiquitous across models, or that we have yet to fully explore the spectrum of NMDAR-related dysfunction in ASD. These findings underscore the need to consider multiple factors when studying ASD mouse models, including different mutations within the same gene, gene deletion dosage, genetic background, sex, age, brain regions, cell types, and neural circuits.

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19. Lenker KP, Li Y, Fernandez-Mendoza J, Mayes SD, Calhoun SL. Autism Spectrum Disorder Phenotypes Based on Sleep Dimensions and Core Autism Symptoms. J Autism Dev Disord;2025 (Apr 17)

Previous studies have used cluster analysis to address the diagnostic heterogeneity of autism spectrum disorder, but have been limited by identifying subgroups solely on the basis of core autism symptoms. The present study aimed to identify sleep phenotypes and their clustering with core autism symptoms in youth diagnosed with autism. 1397 patients (1-17y, M = 6.1 ± 3.3y; M IQ = 88.5 ± 27.2; 81.2% male, 89.0% white) with autism. Principal component analysis (PCA) was performed on 10 sleep items from the Pediatric Behavior Scale. Latent class analyses (LCA) determined phenotypes characterized by core autism symptoms and sleep clusters, accounting for age, sex, Intelligence Quotient (IQ), and medication use.PCA identified three distinct sleep clusters (disturbed sleep, insufficient sleep and hypersomnolence) explaining 48.4% of the variance. LCA revealed four phenotypes based on core ASD symptoms and sleep clusters. Compared to Class 1 (54.8%) as the reference group, Class 2 (26.3%) had a similar degree of sleep problems, higher IQ and milder autism symptoms, less problems with selective attention/fearlessness; Class 3 (14.5%) was characterized by insufficient and disturbed sleep, perseveration and somatosensory disturbance, and higher medication use, while Class 4 (4.4%) was by hypersomnolence, problems with social interactions, and higher medication use.We found four distinct clustering of core autism symptoms and sleep problems differing in their sleep profiles as well as in relation to clinical characteristics, demographics, internalizing/externalizing symptoms, and functional outcomes. Our findings underscore the heterogeneity of autism based on sleep-wake problems, advocating for personalized therapeutic interventions targeting nighttime sleep and daytime alertness.

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20. Matyjek M, Bast N, Faraco SS. Preference for Social Motion in Autistic Adults. Psychophysiology;2025 (Apr);62(4):e70053.

Autism is often linked to attenuated social attention, including a lowered looking preference for biological motion in autistic compared to non-autistic children. This looking preference has been suggested as an autism marker in childhood. However, few studies have investigated whether this bias persists into adulthood. Furthermore, the underlying cognitive mechanism of this group difference is largely unknown. Pupillary responses have been established as an index of salience processing and are thus a promising measurement of the cognitive bases of looking preference. The present study examined differences in looking preference and pupillary responses to social versus geometric motion between autistic and non-autistic adults (N = 66). In terms of preference, autistic adults demonstrated a reduced spontaneous looking toward social stimuli compared to the non-autistic group. Whereas the former displayed no clear preference for either motion type, the latter showed a strong preference for social motion. In terms of pupillary responses, the autistic group showed faster and larger pupil dilation for social motion compared to the non-autistic group, which indicated heightened cognitive effort and arousal. These results suggest persistent differences in social attention across the developmental lifespan in autism.

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21. Matyjek M, Kita S, Cuello MT, Faraco SS. Multisensory Integration of Naturalistic Speech and Gestures in Autistic Adults. Autism Res;2025 (Apr 17)

Seeing the speaker often facilitates auditory speech comprehension through audio-visual integration. This audio-visual facilitation is stronger under challenging listening conditions, such as in real-life social environments. Autism has been associated with atypicalities in integrating audio-visual information, potentially underlying social difficulties in this population. The present study investigated multisensory integration (MSI) of audio-visual speech information among autistic and neurotypical adults. Participants performed a speech-in-noise task in a realistic multispeaker social scenario with audio-visual, auditory, or visual trials while their brain activity was recorded using EEG. The neurotypical group demonstrated a non-linear audio-visual effect in alpha oscillations, whereas the autistic group showed merely additive processing. Despite these differences in neural correlates, both groups achieved similar behavioral audio-visual facilitation outcomes. These findings suggest that although autistic and neurotypical brains might process multisensory cues differently, they achieve comparable benefits from audio-visual speech. These results contribute to the growing body of literature on MSI atypicalities in autism.

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22. Mulraney M, Rincones O, Bryant C, Saredakis D, Ghezzi E, Lampit A. A mixed methods systematic review of assistance dogs for people with autism. Neurosci Biobehav Rev;2025 (Apr 15);173:106160.

OBJECTIVES: To critically examine and synthesise the available evidence regarding the impact of assistance dogs on individuals with autism. STUDY DESIGN: Mixed methods systematic review with meta-analysis of quantitative data and meta-aggregation of qualitative data. Studies were eligible for inclusion if they included participants with autism and data describing the impact, effectiveness, or participant experience with an assistance dog or a companion dog. DATA SOURCES: CENTRAL, Embase, MEDLINE, and PsycINFO. DATA SYNTHESIS: Fourteen studies (one randomised controlled trial, three cohort, seven cross-sectional, and three single-arm studies) were included in the meta-analysis and 13 studies (eight cross-sectional, three longitudinal, and two case studies) were included in the meta-aggregation. There was some quantitative evidence that assistance dogs may be associated with benefit, but the pooled effect sizes are similar to those associated with companion dogs. The qualitative data suggested that parents perceived a broad range of benefits of assistance dogs but may be unprepared for the challenges associated with owning an assistance dog. CONCLUSION: There is a lack of compelling evidence to suggest that assistance dogs confer unique benefits for individuals with autism. The evidence base is limited and of poor quality thus the potential benefits identified need to be interpreted with caution. Interpreting the quantitative and qualitative studies together, the findings indicate many potential benefits of assistance dogs for people with autism could be achieved by a companion dog.

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23. Ogura Y, Sun X, Zhang Z, Kawata K, Wu J, Matsubara R, Ozeki AN, Taniue K, Onoguchi-Mizutani R, Adachi S, Nakayama K, Goda N, Akimitsu N. Fragile X messenger ribonucleoprotein 1 (FMRP) regulates glycolytic gene expression under chronic hypoxia in HCT116 cells. Sci Rep;2025 (Apr 17);15(1):13273.

Oxygen shortage, known as hypoxia, occurs commonly in both physiological and pathological conditions. Transcriptional regulation by hypoxia-inducible factors is a dominant regulatory mechanism controlling hypoxia-responsive genes during acute hypoxia; however, recent studies suggest that post-transcriptional regulation, including RNA degradation, also involves hypoxia-induced gene expression during the chronic hypoxia. In this study, we developed a method to quantify the contributions of RNA synthesis and degradation to differential gene expression, and identified 102 genes mainly regulated via RNA degradation under chronic hypoxia in HCT116 cells. Bioinformatics analysis showed that the genes mainly regulated by RNA degradation were involved in glycolysis. We examined changes in the RNA-binding ability of RNA-binding proteins by RNA interactome capture and statistical analysis using public databases. We identified fragile X messenger ribonucleoprotein 1 (FMRP) as an RNA-binding protein involved in the chronic hypoxia-induced increase in mRNAs encoding rate-limiting enzymes. This study emphasizes the importance of post-transcriptional gene regulation under chronic hypoxia in HCT116 cells.

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24. Pehlivanidis A, Kouklari EC, Kalantzi E, Korobili K, Tagkouli E, Papanikolaou K. Self-reported symptoms of attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and affective lability in discriminating adult ADHD, ASD and their co-occurrence. BMC Psychiatry;2025 (Apr 17);25(1):391.

BACKGROUND: To diagnose and manage adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), or their co-occurrence (ADHD + ASD), clinicians must identify specific features that differentiate these diagnostic categories. Self-report questionnaires targeting specific features are widely used and, together with clinical assessments, provide reliable diagnoses. Although affective lability is present in various psychiatric disorders, it lacks specificity when screening for ADHD in the general population, and its discriminant value for ADHD, ASD, and ADHD + ASD has not been studied. METHODS: This study involved 300 adults without intellectual developmental disorder (188 male) who received an ADHD (n = 174), ASD (n = 68), or ADHD + ASD (n = 58) diagnosis after a multidisciplinary consensus decision according to DSM-5 criteria. Before clinical assessment, all patients requesting evaluation for one of these diagnoses completed questionnaires on an online platform. The assessment instruments included a modified version of the Barkley Adult ADHD Rating Scale (BAARS IV) for ADHD, the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ) for ASD features, and the Affective Lability Scale (ALS) for affective lability. Total scores and sub-scores of the instruments were compared among the three groups. Additionally, stepwise logistic regression analyses were conducted to identify specific measures that contribute to group discrimination. RESULTS: Results revealed distinct patterns in symptomatology as expected. The ADHD and the ADHD + ASD groups presented significantly higher ALS total score compared to ASD. Stepwise logistic regression analyses identified specific measures contributing to group differentiation. ASD vs. ADHD + ASD discrimination included BAARS IV current total score and EQ total score. The subscale anger from ALS in addition with BAARS IV past total score and AQ total score were the factors that discriminated ADHD diagnosis from the co-occurrence of ADHD and ASD. Finally, BAARS IV past total score, BAARS IV current inattention, AQ total score, and EQ total score were found to differentiate ADHD from ASD. CONCLUSIONS: The study highlights the significance of incorporating emotional dimensions in diagnostic frameworks and may contribute valuable insights for clinicians differentiating neurodevelopmental conditions.

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25. Petit N, Geoffray Cassar MM, Baltazar M. Some (but not all) Pragmatic Inferences are Difficult for Autistic Children. J Autism Dev Disord;2025 (Apr 17)

Autism is classically associated with difficulties in pragmatic inferences, resulting in an over-literal interpretation of language. This has mostly been observed with figurative language (e.g., metaphors). In contrast, more recent investigations of another type of inference, scalar implicatures, have mostly failed to spot any difference between autistic and neurotypical individuals, raising concerns about any general claim of pragmatic difficulties in autism. However, both lines of research face issues: language demands rather than pragmatic competence might actually explain group differences on metaphor tasks, and scalar implicatures have mostly been assessed with truth judgment tasks, which might bias their results. This work aims to assess whether this contrast between metaphors and scalars can be observed within a single group of autistic children. A group of autistic children (N = 23) was compared to a larger sample of neurotypical children (N = 237), using innovative scalar implicatures and metaphors tablet tasks that address the methodological concerns raised in the literature. The autistic group showed a reverse contrast from what was expected, with poorer scalar implicature but similar metaphor comprehension, consistently at accuracy and response times levels. We discuss the possibility that, complementary to previous accounts, a dimension opposing guided to spontaneous pragmatic processes might explain this result and the challenges faced by autistic individuals in daily situations.

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26. Schibler BM, Kanne SM, Stoddard GJ, Carbone PS. Autism Spectrum Disorder and Health-Determining Behaviors: Assessing Physical Activity, Screen Time, and Sleep with the National Survey of Children’s Health. J Autism Dev Disord;2025 (Apr 17)

To compare the national prevalence of meeting physical activity, screen time, and sleep guidelines between autistic and nonautistic children and identify factors associated with meeting these guidelines. Prevalences for each health-determining behavior were estimated using the 2022 National Survey of Children’s Health, using national guidelines. Complex survey-weighted logistic regression, adjusted for demographic covariates, was used to measure associations between autism and meeting each guideline, and to identify potential child, family, community, and policy-level determinants of each behavior among autistic children. The prevalence of meeting all three guidelines was low among autistic and nonautistic children across age groups. Physical activity guidelines were met at similarly low rates among autistic and nonautistic children; however, autistic children of all age groups were less likely to meet screen time guidelines, and those in the 3-5 and 6-11 years age groups were less likely to meet sleep guidelines. Moderate/severe autism, irregular bedtime, low parental education, and lacking a medical home were associated with lower likelihood of meeting sleep guidelines. Irregular bedtime and high income were associated with lower likelihood of meeting physical activity guidelines. Autistic children meet guidelines for physical activity, screen time, and sleep at a low prevalence and less than their nonautistic peers. Clinicians should develop individualized plans to facilitate adherence to guidelines among autistic children. Interventions should address modifiable factors, including bedtime regularity and access to medical homes. Further research and policy efforts should be made to improve adherence to guidelines among autistic children and subsequently reduce health disparities.

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27. Shaw KA, Williams S, Patrick ME, Valencia-Prado M, Durkin MS, Howerton EM, Ladd-Acosta CM, Pas ET, Bakian AV, Bartholomew P, Nieves-Muñoz N, Sidwell K, Alford A, Bilder DA, DiRienzo M, Fitzgerald RT, Furnier SM, Hudson AE, Pokoski OM, Shea L, Tinker SC, Warren Z, Zahorodny W, Agosto-Rosa H, Anbar J, Chavez KY, Esler A, Forkner A, Grzybowski A, Agib AH, Hallas L, Lopez M, Magaña S, Nguyen RHN, Parker J, Pierce K, Protho T, Torres H, Vanegas SB, Vehorn A, Zhang M, Andrews J, Greer F, Hall-Lande J, McArthur D, Mitamura M, Montes AJ, Pettygrove S, Shenouda J, Skowyra C, Washington A, Maenner MJ. Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years – Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR Surveill Summ;2025 (Apr 17);74(2):1-22.

PROBLEM/CONDITION: Autism spectrum disorder (ASD). PERIOD COVERED: 2022. DESCRIPTION OF SYSTEM: The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2022, a total of 16 sites (located in Arizona, Arkansas, California, Georgia, Indiana, Maryland, Minnesota, Missouri, New Jersey, Pennsylvania, Puerto Rico, Tennessee, Texas [two sites: Austin and Laredo], Utah, and Wisconsin) conducted surveillance for ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2022. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in a comprehensive developmental evaluation, 2) autism special education eligibility, or 3) an ASD International Classification of Diseases, Ninth Revision (ICD-9) code in the 299 range or International Classification of Diseases, Tenth Revision (ICD-10) code of F84.0, F84.3, F84.5, F84.8, or F84.9. Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had an evaluator’s suspicion of ASD documented in a comprehensive developmental evaluation. RESULTS: Among children aged 8 years in 2022, ASD prevalence was 32.2 per 1,000 children (one in 31) across the 16 sites, ranging from 9.7 in Texas (Laredo) to 53.1 in California. The overall observed prevalence estimate was similar to estimates calculated using Bayesian hierarchical and random effects models. ASD was 3.4 times as prevalent among boys (49.2) than girls (14.3). Overall, ASD prevalence was lower among non-Hispanic White (White) children (27.7) than among Asian or Pacific Islander (A/PI) (38.2), American Indian or Alaska Native (AI/AN) (37.5), non-Hispanic Black or African American (Black) (36.6), Hispanic or Latino (Hispanic) (33.0), and multiracial children (31.9). No association was observed between ASD prevalence and neighborhood median household income (MHI) at 11 sites; higher ASD prevalence was associated with lower neighborhood MHI at five sites.Record abstraction was completed for 15 of the 16 sites for 8,613 children aged 8 years who met the ASD case definition. Of these 8,613 children, 68.4% had a documented diagnostic statement of ASD, 67.3% had a documented autism special education eligibility, and 68.9% had a documented ASD ICD-9 or ICD-10 code. All three elements of the ASD case definition were present for 34.6% of children aged 8 years with ASD.Among 5,292 (61.4% of 8,613) children aged 8 years with ASD with information on cognitive ability, 39.6% were classified as having an intellectual disability. Intellectual disability was present among 52.8% of Black, 50.0% of AI/AN, 43.9% of A/PI, 38.8% of Hispanic, 32.7% of White, and 31.2% of multiracial children with ASD. The median age of earliest known ASD diagnosis was 47 months and ranged from 36 months in California to 69.5 months in Texas (Laredo).Cumulative incidence of ASD diagnosis or eligibility by age 48 months was higher among children born in 2018 (aged 4 years in 2022) than children born in 2014 (aged 8 years in 2022) at 13 of the 15 sites that were able to abstract records. Overall cumulative incidence of ASD diagnosis or eligibility by age 48 months was 1.7 times as high among those born in 2018 compared with those born in 2014 and ranged from 1.4 times as high in Arizona and Georgia to 3.1 times as high in Puerto Rico. Among children aged 4 years, for every 10 children meeting the case definition of ASD, one child met the definition of suspected ASD.Children with ASD who were born in 2018 had more evaluations and identification during ages 0-4 years than children with ASD who were born in 2014 during the 0-4 years age window, with an interruption in the pattern in early 2020 coinciding with onset of the COVID-19 pandemic.Overall, 66.5% of children aged 8 years with ASD had a documented autism test. Use of autism tests varied widely across sites: 24.7% (New Jersey) to 93.5% (Puerto Rico) of children aged 8 years with ASD had a documented autism test in their records. The most common tests documented for children aged 8 years were the Autism Diagnostic Observation Schedule, Autism Spectrum Rating Scales, Childhood Autism Rating Scale, Gilliam Autism Rating Scale, and Social Responsiveness Scale. INTERPRETATION: Prevalence of ASD among children aged 8 years was higher in 2022 than previous years. ASD prevalence was higher among A/PI, Black, and Hispanic children aged 8 years than White children aged 8 years, continuing a pattern first observed in 2020. A/PI, Black, and Hispanic children aged 8 years with ASD were also more likely than White or multiracial children with ASD to have a co-occurring intellectual disability. Identification by age 48 months was higher among children born in 2018 compared with children born in 2014, suggesting increased early identification consistent with historical patterns. PUBLIC HEALTH ACTION: Increased identification of autism, particularly among very young children and previously underidentified groups, underscores the increased demand and ongoing need for enhanced planning to provide equitable diagnostic, treatment, and support services for all children with ASD. The substantial variability in ASD identification across sites suggests opportunities to identify and implement successful strategies and practices in communities to ensure all children with ASD reach their potential.

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28. Srikar M, Meera SS, Raju R, Swaminathan D, Green J, Wan MW. Caregiver-infant interactions in infants at elevated familial likelihood for autism in India. Infant Behav Dev;2025 (Apr 15);79:102060.

Prospective studies of infants at elevated likelihood for autism (EL-A) have identified differences in caregiver-infant interactions (CII) when compared to infants at typical likelihood (TL). These differences begin to emerge prior to the infant’s first birthday and may impact social opportunities essential for facilitating social-communicative development. To our knowledge, all studies to date have focused on Western samples (Australian, European, and US). However, parenting science has long recognised cultural variability in CII. This study investigated whether global features of CII differed between EL-A and TL infants in India. Caregiver-infant free-play videos involving 33 EL-A and 15 TL infants aged 9-15 months were rated using the Manchester Assessment of Caregiver-Child Interaction-Infant (MACI). EL-A infants received lower sensitive responsiveness and psychological stimulation compared to TL infants in age-controlled analyses. No significant group differences were found in caregiver directiveness or in infant or dyadic MACI scales. Furthermore, caregiver sensitive responsiveness and psychological stimulation (incorporating social and cognitive stimulation) were positively associated with concurrent parent-reported infant play and leisure, lending support for ecological validity. This first study in a South Asian context demonstrates a partial replication of previous CII studies. Early pre-emptive interventions targeting caregiver-infant interaction are recommended for Indian families to enhance infant exposure to responsive and stimulating social interactions. The strength of findings is understood in the context of utilising caregiver self-recorded CII, the sample size and broad age range.

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29. Stanley J, Rabot E, Reddy S, Belilovsky E, Mottron L, Bzdok D. Large language models deconstruct the clinical intuition behind diagnosing autism. Cell;2025 (Apr 17);188(8):2235-2248.e2210.

Efforts to use genome-wide assays or brain scans to diagnose autism have seen diminishing returns. Yet the clinical intuition of healthcare professionals, based on longstanding first-hand experience, remains the gold standard for diagnosis of autism. We leveraged deep learning to deconstruct and interrogate the logic of expert clinician intuition from clinical reports to inform our understanding of autism. After pre-training on hundreds of millions of general sentences, we finessed large language models (LLMs) on >4,000 free-form health records from healthcare professionals to distinguish confirmed versus suspected autism cases. By introducing an explainability strategy, our extended language model architecture could pin down the most salient single sentences in what drives clinical thinking toward correct diagnoses. Our framework flagged the most autism-critical DSM-5 criteria to be stereotyped repetitive behaviors, special interests, and perception-based behaviors, which challenges today’s focus on deficits in social interplay, suggesting necessary revision of long-trusted diagnostic criteria in gold-standard instruments.

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30. Tan H, Xu M, Ren T, Deng L, Zhang L, Wang S, Cao M, Yuan TF, Li F. Evaluating the feasibility, safety and efficacy of accelerated continuous theta-burst stimulation targeting the left primary motor cortex to improve social communication impairment in children with autism. Gen Psychiatr;2025;38(2):e102012.

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31. Taugher-Hebl RJ, Berns A, Jones M, Townsend A, Eagen AK, Ferri SL, Langbehn DR, Janouschek H. Age-Dependent Effects of Loss of Contactin-Associated Protein-Like 2, an Autism-Associated Gene, on the Acquisition and Recall of Fear Memory. Autism Res;2025 (Apr 17)

The contactin-associated protein-like 2 (Cntnap2) gene is relevant to autism spectrum disorder (ASD), which is associated with age-specific structural alterations in limbic brain regions. The Cntnap2 gene encodes for the contactin-associated protein-like 2 (CASPR2) protein, and CASPR2 protein levels are high in the amygdala, a limbic region that is essential for the processing of fear and anxiety. In humans, reduced levels of this protein arising from CNTNAP2 mutations could potentially account for the autism-associated increase in fear and anxiety. Here, we report the extent to which loss of CASPR2 in mice contributes to the development of fear- and anxiety-related behaviors. Pavlovian fear conditioning experiments revealed that loss of CASPR2 has age-dependent effects on the acquisition of fear memory, recall of both cue-evoked and context-related fear memory, and stability of cue-evoked fear memory. Additionally, data from the elevated zero maze suggest that CASPR2 deficiency contributes to anxiety-related behaviors, especially in juvenile (29-day old) mice. These are the first reports of age-dependent effects of CASPR2 deficiency on fear and anxiety-related behaviors, and they set the stage for a better understanding of developmental alterations of fear and anxiety in ASD.

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32. Winarni TI, Aishworiya R, Culpepper H, Zafarullah M, Mendoza G, Wilaisakditipakorn TJ, Likhitweerawong N, Law J, Hagerman R, Tassone F. In Utero Alcohol and Unsuitable Home Environmental Exposure Combined with FMR1 Full Mutation Allele Cause Severe Fragile X Syndrome Phenotypes. Int J Mol Sci;2025 (Mar 21);26(7)

We investigated the molecular and clinical profile of five boys carrying the fragile X messenger ribonucleoprotein 1 (FMR1) mutation and who suffered from the effects of prenatal alcohol exposure. Fragile X syndrome (FXS) testing was performed using PCR and Southern Blot analysis, and fragile X messenger ribonucleoprotein protein (FMRP) expression levels were measured by Western blot analysis. Clinical evaluation included cognitive functions, adaptive skills, autism phenotype, and severity of behavior measures. Fetal Alcohol Spectrum Disorder (FASD) was also assessed. Five adopted male siblings were investigated, four of which (cases 1, 2, 3, and 4) were diagnosed with FXS, FASD, and ASD, and one, the fraternal triplet (case 5), was diagnosed with FASD and ASD and no FXS. The molecular profile of case 1 and 2 showed the presence of a hypermethylated full mutation (FM) and the resulting absence of FMRP. Cases 3 and 4 (identical twins) were FM-size mosaics (for the presence of an FM and a deleted allele), resulting in 16% and 50% FMRP expression levels, respectively. FMRP expression level was normal in case 5 (fraternal twin). Severe behavioral problems were observed in all cases, including aggression, tantrum, self-harming, anxiety, and defiant behavior, due to different mutations of the FMR1 gene, in addition to biological exposure, home environmental factors, and potentially to additional background gene effects.

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33. Yang J, Li X, Tan J, Zhou P, Hu L, Chen J, Li T, Liu Y, Chen L. Prenatal Exposure To Valproic Acid Induces Increased Autism-Like Behaviors and Impairment of Learning and Memory Functions in Rat Offspring by Upregulating ADAM10 Expression. Neurochem Res;2025 (Apr 17);50(3):146.

Autism spectrum disorder (ASD) involves a complex neurodevelopmental pathogenesis. A disintegrin and metalloproteinase 10 (ADAM10) plays a crucial role in embryonic brain development and neural network stability. This study aimed to investigate the influence of ADAM10 on excitation/inhibition (E/I) balance, autism-like behaviors, and learning and memory dysfunction in rats prenatally exposed to valproic acid (VPA) and determine potential intervention strategies. The VPA-exposed group exhibited increased levels of ADAM10 and secreted amyloid precursor protein-α (sAPPα). Moreover, overexpression of glutamate decarboxylase 1 and N-methyl-D-aspartate receptors was observed. High-performance liquid chromatography-mass spectrometry revealed elevated levels of glutamate, glutamine, and γ-aminobutyric acid, as well as an E/I imbalance in the VPA group. Additionally, narrower synaptic clefts as well as increased postsynaptic density and synaptic vesicles were observed. Remarkably, intraperitoneal administration of ADAM10 inhibitor during the critical period of synaptic development significantly improved ASD-like behavior and learning and memory function in VPA-exposed rats. This intervention effectively reduced abnormally high sAPPα levels in the prefrontal cortex and corrected abnormal E/I balance. Thus, inhibiting ADAM10 overexpression may improve the E/I imbalance, alleviate core symptoms of ASD, and improve learning and memory dysfunction. The use of ADAM10 inhibitor represents a potential therapeutic strategy for treating ASD patients with intellectual disabilities.

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34. Ye QY, Zhou BR, Zhang Y, Hu CC, Gu YZ, Li XY, Li HP, Xu Q, Jia FY, Zhang L, Xu X. [Analysis of the intervention effects of skill training for parents with autism child on toddlers with autism spectrum disorder]. Zhonghua Er Ke Za Zhi;2025 (Apr 16);63(5):491-497.

Objective: To explore the intervention effects of the skill training for parents with autism child (STPAC) on toddlers with autism spectrum disorder (ASD). Methods: A multicenter non-randomized concurrent controlled study design was conducted. Thirty children with ASD aged 15-30 months, first diagnosed at the Children’s Hospital of Fudan University, the First Hospital of Jilin University, and Chengdu Women’s and Children’s Central Hospital from 2019 to 2020, were enrolled in the STPAC group. Thirty children with ASD who visited the same hospitals during the same period but refused the STPAC intervention were selected as the control group. The STPAC group received an 8-week intervention (3 h/week) followed by quarterly follow-ups for 1 year, while the control group voluntarily chose community-based routine interventions. The Griffiths development scales-Chinese (GDS-C) was used to assess the developmental levels, and the communication and symbolic behavior scales developmental profile infant-toddler checklist (CSBS-DP-ITC) was completed by the primary caregivers to evaluate social, language and symbolic behavior. The independent samples t-tests or Mann-Whitney U tests, etc.was used for inter-group comparison. The paired t-tests or Wilcoxon signed-rank tests, etc. was used for inter-group pre-post intervention comparison. Results: The STPAC group included 30 children (22 males and 8 females, aged (23.9±2.2) months), and the control group included 30 children (20 males and 10 females, aged (24.2±2.6) months). Before the intervention, there were no statistically differences in GDS-C development quotient (DQ) and CSBS-DP-ITC scores between groups (all P>0.05). After 1-year intervention, GDS-C DQ in personal-social, hearing-language, hand-eye coordination, performance domains of STPAC group and GDS-C DQ in personal-social, hearing-language domains of control group were all increased (all P<0.01). After 1-year intervention, CSBS-DP-ITC scores of both groups were all improved in socia, language, symbolic behavior, and total scores (all P<0.001). GDS-C DQ changes before and after 1 year of intervention in hearing-language, hand-eye coordination, performance domains of the STPAC group were all higher the those of control group (34(15, 48 vs. 10(-4, 39), 11±20 vs. -1±19, 23±25 vs. 8±22, all P<0.05). CSBS-DP-ITC scores changes before and after 1 year of intervention in social and total scores of the STPAC group were both higher the those of control group (10(5, 30) vs. 3(1, 7), 26±17 vs. 11±8, both P<0.001). Conclusion: Compared with the community routine interventions, the STPAC better improves the language, hand-eye coordination, visual-spatial, social communication, and play skills in ASD toddlers.

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