1. Akemoğlu Y, Hinton V. Early Interventionist-Guided and Parent-Implemented Behavior Support To Reduce Challenging Behaviors of Autistic Children. J Autism Dev Disord. 2025.

PURPOSE: Challenging behaviors (CB), including aggression, tantrums, and noncompliance, are common among children with autism spectrum disorder (ASD) and can significantly affect family well-being and child development. This pilot study examined the effectiveness of a hybrid intervention model that combined early intervention service provider (EISP) coaching with parent-implemented, function-based behavior support strategies. METHOD: Three EISPs delivered structured home visits that included video-based behavioral training modules to three families of young autistic children exhibiting persistent CB. A nonconcurrent multiple-probe across parent-child dyads design was used to evaluate parent fidelity in implementing behavior support plans and corresponding changes in child CB. RESULTS: Results indicated that exposure to video modules alone produced minimal improvements in parent fidelity. However, the addition of individualized EISP coaching led to immediate and sustained increases in parent fidelity, accompanied by notable reductions in child CB across all participants. Social validity data reflected high parental satisfaction with the intervention procedures and outcomes. CONCLUSION: Findings support the feasibility and promise of scalable, family-centered models that integrate remote, video-based training with individualized in-home coaching. Such hybrid interventions may help bridge service gaps and enhance timely access to positive behavior support for families of young children with ASD.

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2. Albin M, Phoenix M, Rosenbaum P. Applying the World Health Organization’s International Classification of Functioning, Disability and Health to speech-language pathology social communication interventions for autistic children and youth: A scoping review. Autism. 2025: 13623613251390609.

The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) aligns with the neurodiversity paradigm in viewing autistic people’s social communication holistically and in a strength-based manner. In this scoping review, we explored how social communication interventions for autistic children and youth map onto the domains of the International Classification of Functioning, Disability and Health in the field of speech-language pathology. OVID Medline, OVID Embase, OVID PsycINFO and Web of Science databases were searched to identify relevant articles. Population, intervention and study data were extracted, as well as data on each of the International Classification of Functioning, Disability and Health domains related to the social communication interventions. In total, 21 articles were included in our analysis. No studies explicitly mentioned the International Classification of Functioning, Disability and Health. All the studies focused on participation and environmental factors (e.g., people’s attitudes, physical environment), and some studies discussed other International Classification of Functioning, Disability and Health domains such as body structures and functions, personal factors and activities. The examples provided for each International Classification of Functioning, Disability and Health domain may be helpful for clinicians and researchers looking to understand how components of social communication interventions link to International Classification of Functioning, Disability and Health categories. Future work could analyse how social communication interventions in other fields (e.g., psychology, occupational therapy) map onto the International Classification of Functioning, Disability and Health.Lay abstractThis review article investigates how the World Health Organization’s International Classification of Functioning, Disability and Health can be applied to better understand speech-language pathology social communication interventions. In recent years, academic articles have supported thinking differently about how autistic people communicate, including the many strengths autistic people have and how other people and the environment influence communication. The International Classification of Functioning, Disability and Health is a holistic, widely used framework that provides a neurodiversity-affirming perspective on social communication interventions for autistic children. We did not find any published literature applying the International Classification of Functioning, Disability and Health to speech-language pathology social communication interventions for autistic children and youth and therefore wanted to explore whether and how social communication interventions reflect International Classification of Functioning, Disability and Health concepts. To answer this question, we searched the academic literature using several databases using a methodology called a scoping review. We included articles that had autistic children and youth as participants and focused on social communication interventions in the field of speech-language pathology. We found 21 articles that met our inclusion criteria. No studies talked explicitly about the International Classification of Functioning, Disability and Health. All the studies focused on participation and environmental factors (e.g., people’s attitudes, physical environment), and some studies discussed other International Classification of Functioning, Disability and Health domains such as body structures and functions, personal factors and activities. It is important for speech-language pathology social communication interventions to consider how the physical environment, social environment and personal factors impact social communication. Clinicians and researchers may find our application of the International Classification of Functioning, Disability and Health to social communication interventions useful to shape how they think about interventions.

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3. Altunkaya A, Kose S, Inal Kaleli I, Sari S, Senturk Pilan B, Bildik T. Understanding the interplay of autistic traits, depression and suicidal ideation in adolescents with major depressive disorder. Sci Rep. 2025; 15(1): 40215.

Adolescents with autistic traits (ATs) experience higher rates of depression and suicidal behavior. This study aims to investigate the relationship between ATs, depressive symptoms, and suicidal ideation (SI) in adolescents with major depressive disorder (MDD). Seventy adolescents, aged 11-18 and diagnosed with MDD, were included. Participants were evaluated with the ColumbiaSuicide Severity Rating Scale (CSSR-S), Beck Depression Inventory (BDI), and ATs using the Autism Spectrum Quotient (AQ). Three groups were compared: those without suicidal thoughts (ST-), suicidal thoughts (ST+), and suicide attempts (SA). While the SA group scored significantly higher on the C-SSRS, BDI, and AQ compared to the ST- group; ST + and SA groups didn’t differ. The mediating role of depression was investigated via a Bayesian mediator analysis for CSSR-S subheaders of current and lifetime suicidal ideation and ideation intensity. The effect of BDI scores on current suicidal ideation was β = 0.08 (CI[0.04-0.13]), which was consistent with lifetime suicidal ideation with the same effect size β = 0.08 (CI[0.03-0.13]). For current suicidal ideation and its intensity, autistic traits had an indirect effect through BDI scores, with an indirect mean of 0.050 (CI[0.02-0.10]). For lifetime suicidal ideation, autistic traits exhibited both a direct (β = 0.09, (CI[0.01-0.16]) and an indirect effect through depression scores, with a mean of 0.052 (CI [0.015-0.102]). The complex interplay between ATs, depressive symptoms, and SI in adolescents diagnosed with MDD suggests that interventions targeting autistic traits may be a useful component of comprehensive mental health strategies for adolescents with MDD and elevated suicidal risk.

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4. Bamiou DE, Di Bonaventura S, Skuse D. Navigating auditory assessment in autistic individuals: a narrative review. Arch Dis Child. 2025.

Abnormal sensory responses have been a diagnostic criterion for autism since 2013, with auditory hypersensitivities representing one of the most frequently reported symptoms. It is not unusual for children with autism, some of whom are as yet undiagnosed, to present clinically to specialists with a history of auditory symptoms in the context of normal hearing. This narrative review paper provides a theoretical background and model to account for autism-associated characteristics that arise within the auditory nervous system. The review highlights the need to assess these symptoms by a multidisciplinary approach. There should be appropriate history taking, followed by psychoacoustic and neurophysiological assessments. We discuss a range of evidence-based management strategies. Affected individuals often present to a range of different clinical settings before their autism is recognised clinically. Nowadays, there is an increasing prevalence of neurodivergence. We emphasise the importance to audiologists and other clinicians that auditory-related symptoms can be the presenting problem in autistic children.

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5. Banjar MA, Sulaimani MF, Bagadood NH. A qualitative study on the effectiveness of naturalistic developmental behavioral interventions for children with autism Spectrum disorder in Saudi Arabia. Acta Psychol (Amst). 2025; 261: 105968.

This qualitative study explored the implementation of Naturalistic Developmental Behavioral Interventions (NDBIs) as an early intervention strategy for children with autism spectrum disorder (ASD) in Saudi Arabia, drawing on the perspectives of certified Applied Behavior Analysis (ABA) specialists. Data were collected through semi-structured interviews with five licensed practitioners, four based in Riyadh and one in Jeddah, who hold credentials from the Behavior Analyst Certification Board (BACB). The findings illuminate participants’ conceptual understanding of NDBIs, their motivations for adopting these interventions, and the mechanisms employed in their application. Additionally, the study identified several barriers impeding effective implementation, including insufficient specialist training, limited administrative support, logistical challenges, and family-related constraints. Based on these insights, the study recommends expanding practical training for ABA specialists, increasing community awareness of NDBIs, and ensuring ongoing supervision by experienced professionals. The findings underscore the need for further empirical studies on the application of NDBIs within culturally specific contexts, particularly in Arab settings, to promote more inclusive and effective early intervention services.

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6. Bey AL, Soderling S, Dawson G. Genetic and environmental influences in autism: guiding the future of tailored early detection and intervention. J Clin Invest. 2025; 135(22).

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7. Bogdanova OV, Bogdanov VB, Guillaud E, Laidi C, Houenou J, Delorme R, Ly-Le Moal M, Leboyer M, Bouvard M, Cazalets JR, Amestoy A. Pattern of fixation explains atypical eye processing during observation of faces with direct or averted gaze in autism (results of the INFoR Cohort). PLoS One. 2025; 20(11): e0334878.

One of the most reliable early predictors of autism is atypical social attention, particularly attenuated eye gaze contact. As a part of the InFoR cohort, a multicentric French longitudinal study, 88 autistic participants and 56 participants without autism performed a gaze discrimination task using 28 static pictures of faces with either direct or averted gaze. We monitored eye fixation behavior during face picture observation and analyzed subsequent key-press responses. The eyes of faces with direct gaze attracted more fixations than those of faces with averted gaze. Autistic participants showed significantly reduced Eye Fixations Indexes (EFI; a parameter derived from the number of fixations on eyes of the image; it reflects participant’s strategy of face observation) and longer response times (RTs), strongly and negatively correlated with each other. A mediational analysis demonstrated that the influence of group on RTs was mainly driven by the EFI. The EFI was related to the number of anticipatory saccades obtained for basic oculomotor tasks. The RTs were related to scores of Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS), Behavior Rating Inventory of Executive Function (BRIEF) and severity of autism as tested by the Social Responsiveness Scale (SRS-2), but not to the level of social anxiety. Altogether we demonstrate that the eye fixation index during face observation was associated with attentional control and influenced judgment response of participants, while the task performance is affected by a wider range of individual variables.

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8. Burke MM, Johnston AN, Ramos-Torres S, Singh S, DaWalt LS, Taylor JL. Exploring Parent and Autistic Youth Perspectives to Inform Adaptations for an Advocacy Program. J Dev Phys Disabil. 2025; 37(6): 1007-28.

Autistic Youth and their parents often struggle to access adult disability services. It is important to garner feedback from autistic youth and their parents to inform interventions to facilitate access to adult services. In this study, 128 parents of transition-aged autistic youth and 78 autistic youth completed individual interviews to inform adaptations to an advocacy program designed to improve access to adult services. Parents reported wanting a navigator (versus a group) program to help them learn to navigate adult services. However, parents reported concerns about the quality of navigators. Autistic youth reported wanting to learn about diverse issues in adulthood including types of adult services; most youth wanted to learn about services via videos. Implications for research and practice are discussed.

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9. Chintalapally S, Rajanala K, Upadhyay A. Autism spectrum disorder and the role of nuclear hormone receptors: insights and therapeutic implications. Front Neurosci. 2025; 19: 1655348.

Autism spectrum disorder is a neurological and developmental condition known to impact a person’s learning, communication, and interpersonal interactions. Recent research has highlighted the role of nuclear hormone receptors (NHRs) in neurodevelopment and synaptic function, suggesting their potential involvement in ASD pathophysiology. NHRs regulate gene expression that are critical for neural differentiation, plasticity, and metabolic processes. Dysregulation of these receptors can lead to altered neural circuit formation and neurotransmitter imbalances, which are commonly observed in ASD. Understanding the interplay between NHRs and ASD could open new avenues for therapeutic interventions, providing hope for more personalized approaches to managing the disorder. One key receptor is retinoic acid-related orphan receptor-alpha (RORA), which was shown to be reduced in individuals with ASD. Among its numerous functions during development, RORA was shown to regulate the transcription of genes involved in neuronal differentiation, synaptic function, and neuroprotection. Studies have identified that RORA expression is reduced in individuals with ASD, particularly in the prefrontal cortex and cerebellum, affecting transcription of multiple ASD-associated genes. In the present review, we discuss the underlying mechanisms leading to ASD pathophysiology, various treatment modalities, the prospects of the RORA gene therapy approach, and future perspectives.

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10. Diamandis N, van den Anker JN, Denisova K. Effect of Alzheimer’s disease medications on neurocognitive outcomes in children and adolescents with autism spectrum disorder and low IQ: a scoping review. Transl Psychiatry. 2025; 15(1): 475.

BACKGROUND: Individuals with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) are particularly vulnerable to poor developmental trajectories. These individuals are at increased risk of Alzheimer’s disease (AD) relative to those without comorbid ID and the general population. Considering that there could be an important mechanistic link underlying ASD and AD, individuals with these conditions may stand to benefit from similar psychopharmacological treatments. METHODS: This scoping review aimed to evaluate and synthesize the evidence on the effect of AD medications on neurocognitive outcomes in children and adolescents with ASD and low intelligence quotient (IQ). We performed the search according to PRISMA guidelines from inception to May 21(st), 2025 in four databases: PubMed, PsycInfo, Scopus, and Web of Science. We included studies of children and adolescents (2 – 21 years) with ASD and low IQ (<85) treated with at least one Food and Drug Administration (FDA)-approved AD medication (donepezil, galantamine, rivastigmine, benzgalantamine, memantine, aducanumab, lecanemab or donanemab) and investigating neurocognitive outcomes. RESULTS: Twelve studies met the eligibility criteria. Six studies reported on neurocognitive outcomes from N-methyl-D-aspartate (NMDA) receptor antagonist treatment and six studies from cholinesterase inhibitor treatment. Among studies reporting on cholinesterase inhibitors, significant improvement was detected in language (60% of five reporting studies), executive function (100% of two reporting studies), complex attention (100% of one reporting study), and general cognitive ability (50% of two reporting studies). Among the NMDA receptor antagonist studies, evidence of improvement was detected in language (60% of five reporting studies), executive function (75% of four reporting studies), learning and memory (100% of two reporting studies), perceptual-motor functioning (66.6% of three reporting studies), complex attention (100% of one reporting study), and general cognitive ability (50% of two reporting studies). Across studies, treatment with either a cholinesterase inhibitor or an NMDA receptor antagonist was associated with improvements in language, executive function, complex attention, and general cognitive ability. A pattern of significance was detected with age, in that younger children may benefit more from these medications than adolescents. CONCLUSION: This scoping review identified promising evidence of neurocognitive improvement in children and adolescents with ASD and low IQ following treatment with either a cholinesterase inhibitor or an NMDA receptor antagonist. Considering the lack of FDA-approved treatments for the cognitive deficits associated with ASD and an absence of medications approved to treat core features of ASD, our findings highlight an opportunity for innovative directions in autism research and treatment.

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11. Hamed NF, Alqahtani AM, Alshaibani F, Elsharif SM, Alamri SAS, Serhan A. Genetic and Environmental Risk Factors for Autism Spectrum Disorder in Saudi Arabia: A Systematic Review. Cureus. 2025; 17(10): e94607.

AIM: This study aimed to systematically synthesize evidence on the genetic and environmental risk factors associated with autism spectrum disorder (ASD) in the Saudi population. BACKGROUND: ASD is a complex neurodevelopmental disorder with a strong etiological basis in genetic and environmental interactions. The high rate of consanguinity in Saudi Arabia may amplify the burden of recessive genetic variants, making the investigation of region-specific risk factors a critical public health priority. MATERIALS AND METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search across PubMed, Web of Science, Scopus, and ScienceDirect was performed to identify studies on ASD risk factors in Saudi Arabia. Two independent reviewers screened records, extracted data, and assessed the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool and the Newcastle-Ottawa Scale (NOS). RESULTS: Thirteen studies met the inclusion criteria. Genetic analyses revealed significant risk associations with specific Y-chromosome haplotypes, NR4A2 loss-of-function variants, TBX1 copy number variations (CNVs), and MTHFR single-nucleotide polymorphisms (SNPs). Key environmental risk factors identified were prenatal phthalate exposure, maternal stress, vitamin D deficiency, and consanguinity. Several studies also implicated neuroinflammatory markers (e.g., PGE2, IFN-γ) and lipid metabolism dysregulation in the disorder’s pathophysiology. CONCLUSION: The etiology of ASD in Saudi Arabia is characterized by a complex interplay between genetic predisposition, often exacerbated by consanguinity, and prenatal environmental exposures. While these findings are consistent with global research, they highlight distinct regional patterns. Future investigations should employ larger, balanced cohorts and integrate epigenetic and prospective designs to facilitate the development of targeted preventive and therapeutic strategies.

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12. Iwata Y, Kusayanagi Y. Visual Acuity Assessment in Children With Autism Spectrum Disorder Using a Child-Friendly Minimum-Separable Chart: A Five-Case Report. Cureus. 2025; 17(10): e94705.

Children with autism spectrum disorder (ASD) often have eye disorders, such as strabismus and amblyopia; thus, it is important to evaluate their visual function. However, achieving their cooperation for visual acuity testing is challenging. We developed a child-friendly minimum separable chart (CFMS chart) using meaningful pictures and two-choice answers. In this study, visual acuity tests were performed using both Landolt rings and CFMS charts in five children with ASD. For the Landolt ring test, only one patient was cooperative, whereas for the CFMS chart, all the patients were cooperative for evaluating the visual acuity of at least one eye. The meaningful visual targets and the two-choice format promoted understanding and interest among children with ASD, making it easier to obtain their cooperation for visual acuity testing. This is the first study to demonstrate the potential of the CFMS chart as a method for assessing visual acuity in children with ASD.

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13. Kanzari C, Hawani A, Mkaouer B, Mrayeh M, Marsigliante S, Muscella A. Cognitive, social, and behavioral effects of music and motor intervention in children with autism spectrum disorder: the role of time of day. Front Pediatr. 2025; 13: 1683930.

This study aimed to determine the effect of 12 weeks of specific training (combining movement and music intervention) on children with autism spectrum disorders (ASD), specifically by comparing the time of day (morning vs. afternoon) with cognitive functions, mood, and social integration. Thirty children (19 males, 11 females; mean age 7.8 ± 1.27 years) were randomly assigned to two groups: an Intervention Group and a Control Group (CG). The intervention protocol consisted of combined sessions of training, music, and motor activities, administered in a counterbalanced order: one session in the morning (9:00-9:45 a.m.) and one in the afternoon (4:00-4:45 p.m.). The control group continued their regular physical activity. Children were assessed at baseline and post-intervention for cognitive functions (Trail Making Test), maladaptive behaviors (RCS), and enjoyment (PACES). A repeated-measures ANOVA was used to analyze the interaction between the music and movement intervention and time of day. Results showed a significant increase in enjoyment in both experimental groups (morning and afternoon) compared to the control group (p < 0.001), with no significant difference between the morning and afternoon groups (p = 0.743). After 12 weeks, the experimental groups showed significant improvements in both stereotypical behaviors (p < 0.001) and cognitive functions (p < 0.001). However, the time of day did not significantly influence these improvements (p = 0.133 for stereotypical behaviors and p = 0.681 for cognitive functions). Significant improvements were observed in affective/emotional (p < 0.001) and motor control behaviors (p < 0.001), which partially reflect reductions in maladaptive behaviors. However, specific measures of social engagement did not show statistically significant changes (p > 0.05). Our study found no effect of time of day on the outcomes for children with autism spectrum disorders.

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14. Kavanaugh BC, St Pierre DG, Schremp C, Robbins A, Best CR, Jones RN, Sheinkopf SJ, Morrow EM. Later Age of Autism Diagnosis in Children with Multiple Co-Occurring Psychiatric Disorders. J Autism Dev Disord. 2025.

PURPOSE: In children with autism spectrum disorder (ASD), early diagnosis permits early access to therapeutic interventions which may improve outcomes. Factors affecting the age of diagnosis in ASD are not fully understood. METHODS: Here, two large independent datasets were analyzed to investigate age of autism diagnosis and co-occurring psychiatric conditions, including bipolar disorder, depressive disorder, anxiety disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Clinical characteristics examined included demographics, verbal status, intellectual disability, restricted/repetitive behaviors, adaptive behaviors, and psychiatric medication use. RESULTS: Over 50,000 participants with ASD were analyzed from the Rhode Island Consortium for Autism Research and Treatment study (RI-CART; n = 823) and the Simons Foundation Powering Autism Research for Knowledge (SPARK) database (n = 52,611). In RI-CART, age of diagnosis differed between those with no co-occurring conditions (mean age at diagnosis = 4.3 years), those with one or two co-occurring conditions (7.1 years), and those with three or more co-occurring conditions (8.5 years; p < .001). This pattern was observed in the SPARK database (age of diagnosis 4, 7.1, and 10 years, respectively; p < .001). Controlling for age, sex, and symptom severity, more co-occurring psychiatric conditions was associated with later age of ASD diagnoses in both samples. Depression and ADHD were associated with later ASD diagnoses; OCD and ID were associated with earlier ASD diagnoses. CONCLUSION: These findings indicate that those children with high co-occurring psychiatric conditions, who are ultimately diagnosed with ASD, experience later diagnosis. This group of children may represent a distinct subtype of autism.

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15. Kielty K, Luo K, Siegel M, Mazefsky CA. Epilepsy in Autism: Prevalence and Associated Factors in a Large Inpatient Psychiatric Sample. J Autism Dev Disord. 2025.

PURPOSE: The co-morbidity of epilepsy in individuals with autism spectrum disorder has been reported as a wide range of 2.4% to 46%. The purpose of this study is to examine the relationship between epilepsy and autism in a novel, clinically relevant, and historically underrepresented cohort-youth hospitalized in a psychiatric setting. METHODS: Data was analyzed from the Autism Inpatient Collection, a multi-site study of youth with ADOS-2-confirmed autism hospitalized in specialized psychiatric units (n = 1354; age range 4-21.) Two-sample t-tests for continuous variables and Pearson’s chi square test for categorical variables were used to examine differences between two cohorts (autistic individuals with and without epilepsy) in age, sex, non-verbal IQ, co-morbidities, family history, genetic evaluation, and medication use. RESULTS: Criteria for epilepsy was met in 18.9% of participants. A high percentage of the sample had profound autism, with 72% having either intellectual disability, minimal verbal communication, or very low adaptive functioning scores. Presence of epilepsy was significantly associated with older age, lower non-verbal IQ, higher rates of genetic testing and significant results, first-degree family history of seizures, headaches, gastrointestinal problems, and a higher number of medications. CONCLUSIONS: In this cohort of psychiatrically hospitalized autistic individuals, epilepsy prevalence and factors previously reported to be associated with epilepsy in autism were replicated. New associations with epilepsy were identified, including increased likelihood of prior genetic testing and pharmacologic burden. These results may inform providers regarding care of patients and counselling of families of autistic individuals seeking psychiatric care.

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16. Lee QN, Lee JK, Harvey DJ, Liu P, Nordahl CW, Fan AP. Sex-specific cerebrovascular reactivity differences in autistic children related to functional connectivity. Imaging Neurosci (Camb). 2025; 3.

Many studies utilize resting-state functional magnetic resonance imaging (rs-fMRI) metrics, such as functional connectivity (FC), to investigate the neuronal underpinnings of autism and identify functional brain networks related to autistic behaviors. However, fMRI indirectly measures neuronal activity by imaging local fluctuations in the blood oxygen level dependent (BOLD) signal, which, in turn, rely on the cerebrovascular system to efficiently direct oxygenated blood flow. Most rs-fMRI studies of autism interpret group differences in FC as autism-related changes in neuronal activity, without considering the underlying vascular function. Yet, atypical cerebrovasculature has been identified in preclinical and post-mortem studies of autism, strongly underscoring the need to characterize cerebrovascular differences to enhance our neurobiological understanding of autism. We evaluated relative cerebrovascular reactivity (rCVR) in autistic and non-autistic children using a novel measure of local brain vasodilatory capacity based on rs-fMRI. We leveraged the cross-sectional Autism Brain Imaging Data Exchange repository to quantify rCVR in 199 non-autistic (74 female) and 95 autistic (16 female) children, 9-12 years old. We identified sex-specific differences in rCVR in autism, particularly in right-frontal brain regions, where rCVR was increased in autistic females compared to non-autistic females. Then, within the same rs-fMRI scans, we demonstrated that rCVR in the right inferior frontal gyrus was positively associated with its FC to regions associated with attentional control in girls, suggesting that cerebrovascular differences may differentially affect FC findings between regions and sexes in children. Our study highlights potential sex differences in cerebrovascular function in autism that enhance our neurobiological understanding of autism and improve interpretations of rs-fMRI findings in children.

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17. Moerman F, Warreyn P, Boterberg S, de Vries L, Erdogan M, Madarevic M, Noens I, Schaubroeck S, Steyaert J, van Esch L, Roeyers H. The emergence of object play in young children at elevated likelihood for autism. Br J Dev Psychol. 2025.

This prospective study investigated object exploration and combination play, in addition to (pre-)symbolic play in children at elevated likelihood for autism (EL; younger siblings of autistic children and very preterm children). Play of EL-children with (n = 22) and without (n = 61) a best-estimate research diagnosis of autism at 36 months was measured using detailed coding of direct observations at the (corrected) age of 10 and 14 months. As expected, autistic and non-autistic EL-children progressed to (pre-)symbolic play following the onset of combination play. There were no significant differences between both groups for most play behaviours at 10 and 14 months. Non-autistic EL-children did engage in more general combination play acts than autistic EL-children at 10 months. Moreover, 25% of the non-autistic EL-children showed general combination play, versus none of the autistic EL-children at 10 months. At 14 months, non-autistic EL-children spent slightly more of their playtime in spontaneous (pre-)symbolic play than autistic EL-children at 14 months. Object play behaviours were more similar than different between autistic and non-autistic EL-children at 10 and 14 months when playing alone. Our findings do not offer strong support for using solitary object play assessment as a method to identify autism in these very young EL-children.

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18. Mohammadi F, Shahrokhi H, Asadzadeh A, Pirmoradi S, Moghtader A, Rezaei-Hachesu P. Artificial Intelligence in Autism Spectrum Disorder Diagnosis: A Scoping Review of Face, Voice, and Text Analysis Methods. Health Sci Rep. 2025; 8(11): e71476.

BACKGROUND: Autism is a complex neurodevelopmental condition affecting social interaction and behavior. Traditional diagnostic methods, relying on observational techniques and interviews conducted by trained professionals, remain the gold standard for ASD diagnosis. However, these methods can be time-consuming and may be influenced by subjective factors. Recent advancements in artificial intelligence (AI) offer promising approaches to augment existing methods, potentially enhancing efficiency and providing additional objective data through facial, vocal, and textual analysis. OBJECTIVE: The objective of this study was to conduct a comprehensive review of artificial intelligence applications in autism spectrum disorder (ASD) diagnosis, specifically focusing on facial, vocal, and textual analysis methods. METHODS: A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google Scholar. The findings were reported in accordance with the PRISMA checklist. Data were collated and summarized, and results were reported qualitatively, adopting a narrative synthesis approach. RESULTS: In facial image analysis, deep learning algorithms demonstrated high accuracy in identifying autism-related facial features, algorithms such as Xception achieved 98% accuracy, while hybrid approaches like the combination of Random Forest (RF) and VGG16-MobileNet showed accuracy at 99%. Voice analysis studies utilized both traditional machine learning methods and advanced deep learning techniques, achieving accuracies between 70% and 98% in detecting atypical speech patterns and prosodic abnormalities associated with autism. Text-based analyses showed potential in identifying linguistic markers of autism through natural language processing techniques. Overall, Deep learning approaches were mainly employed in facial image analysis for autism diagnosis. In contrast, voice and text recognition studies utilized machine learning algorithms. CONCLUSIONS: This review demonstrates artificial intelligence’s significant role in diagnosing autism spectrum disorder (ASD). These AI-driven approaches can complement traditional diagnostic methods, potentially leading to earlier interventions and improved outcomes for individuals with ASD.

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

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

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20. Parry JA, Newton JT, Ryan C. Patterns and Predictors of Toothbrushing Frequency in Irish Adolescents: The Role of Autism and Intellectual Disability. Community Dent Oral Epidemiol. 2025.

OBJECTIVE: To visualise and explore patterns of daily toothbrushing frequency in Irish adolescents and contribute to the understanding of predictors of toothbrushing habits in autistic adolescents and adolescents with intellectual disability. METHODS: Data from the Growing Up in Ireland national longitudinal child study were explored to visualise patterns of toothbrushing in children between 9 and 17/18 years. Data for 17/18-year-olds were examined using descriptive and logistic regression analysis to gain insight into predictors of twice-a-day toothbrushing within the full adolescent dataset and a subgroup of autistic adolescents and adolescents with intellectual disability. RESULTS: Gender, eating breakfast every day and experience of orthodontics positively predicted twice-a-day toothbrushing for young people in general. Oral health rating below excellent, infrequent dental checkups, obesity and drinking soft drinks (not diet) daily negatively predicted twice-a-day toothbrushing. For autistic adolescents and adolescents with intellectual disability, results suggested that the lowest self-rating of oral health, drinking soft drinks (not diet) daily and being autistic with intellectual disability may be factors that influence less than twice-a-day toothbrushing. CONCLUSION: Regular contact with the dental team and healthy lifestyle habits may positively influence twice-a-day toothbrushing. Frequency of toothbrushing and actionable targets to support oral health, where high support and more complex oral health challenges exist, require further research.

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21. Schaubroeck S, Demurie E, Begum-Ali J, Bölte S, Boterberg S, Buitelaar J, Charman T, Falck-Ytter T, Hunnius S, Johnson MH, Jones E, Oosterling I, Pasco G, Pijl M, Van den Boomen C, Warreyn P, Roeyers H. The stability of the Autism Diagnostic Observation Schedule-2 in children aged 14-36 months with elevated likelihood for autism. J Child Psychol Psychiatry. 2025.

BACKGROUND: This study investigated the stability of Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) classifications in a cohort of 304 siblings at elevated likelihood for autism (EL-siblings). METHODS: ADOS-2 assessments were conducted at 14, 24 and 36 months, with Clinical Best Estimate (CBE) autism diagnoses determined at 36 months. RESULTS: Our findings indicate that while some children have stable ADOS-2 classifications from early on, a significant proportion of the children show inconsistent classifications over time. The overall stability of ADOS-2 autism spectrum classifications increased from 14 to 36 months and agreement with CBE autism clinical diagnosis was moderate and increased with age. CONCLUSIONS: Caution is warranted when interpreting individual ADOS-2 results, as they should always complement, and can never replace, a comprehensive clinical evaluation. These findings highlight the importance of continued follow-up beyond 14 months in young EL-children, a group for whom early assessment may be both feasible and beneficial and emphasises the need to integrate multiple assessment measures and multiple informants for accurate early autism identification.

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22. Shen M, Jing Y, Liu Q, Li C, Xu N. Visualization analysis for emotional characteristics of autism spectrum disorder from cinemetrics perspective. Front Public Health. 2025; 13: 1608608.

The attention paid to Autism Spectrum Disorder (ASD) in film art and audiovisual communication has promoted the popularization of ASD knowledge and the development of treatment and education measures. As society pays more attention to ASD research and education, the limitations of traditional qualitative research methods are gradually becoming apparent, particularly in the dynamic and nuanced quantification of emotional characteristics, which hinders the practical application of research results. As an emerging research paradigm, cinemetrics provides new perspectives for film research. In this paper, 20 Chinese autism-themed films with 2,627 shots are selected and statistically analyzed in terms of style, rhythm, and space for their emotional character clips. Average Shot Length (ASL) and Median Shot Length (MSL) are compared using a Paired Samples t-test (t = 5.620, p < 0.001) to verify the statistical significance of rhythmic differences. The results indicate that the emotional characteristics of autistic individuals in various films differ significantly in terms of shot length, editing rate, camera movement, and composition. It is found that ASL values are consistently higher than MSL values indicates a systematic rhythmic pattern rather than random fluctuation, providing a reliable quantitative basis for further analysis. These quantitative analyses provide objective data support for the study of the emotional characteristics of ASD, and also offer potential references for practical applications such as expression recognition training and movement regulation programs. This paper can help the public to understand the emotional state of ASD people and open up new paths for future investigation of ASD intervention.

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23. Siracusano M, Arturi L, Riccioni A, Medoro A, Savino R, Scapagnini G, Davinelli S, Mazzone L. Feeding difficulties, eating disorders and therapeutic approaches in autism spectrum disorder: An overview. Pharmacol Res. 2025; 222: 108040.

Feeding problems are highly prevalent in individuals with autism spectrum disorder (ASD) from early developmental stages. Difficulties during the transition to solid foods, limited dietary variety, and reluctance to try new foods since infancy, combined with gastrointestinal disorders, represent significant concerns for both parents and clinicians from diagnostic and, more importantly, therapeutic perspectives. The primary clinical link between atypical eating behaviors and core autistic symptoms lies in aberrant sensory processing and an insistence on sameness, which have important implications for intervention strategies. Additionally, the increased risk of gastrointestinal disorders and altered gut microbiome composition in individuals with ASD constitute another critical factor, opening avenues for novel therapeutic approaches. Therefore, the aim of this review is to summarize the existing literature on therapeutic approaches for feeding problems in ASD, with a focus on evidence-based practices across pharmacological, psychological, and nutritional domains.

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24. Tsompanidis A, Chang KM, Khan YT, Radecki MA, Dorschmidt L, Hampton S, Aydin E, Allison C, Tait R, Bethlehem RAI, Kyriakopoulou V, Austin T, Suckling J, Holt R, Baron-Cohen S. Perinatal brain growth and autistic traits in toddlers. Transl Psychiatry. 2025; 15(1): 474.

Autism is a heterogeneous set of neurodevelopmental conditions with a significant heritable component and perinatal origins. The earliest observable behavioural traits, with which a diagnosis can be made, emerge at 18 months of age. Previous studies have reported increased head circumference and brain growth in autistic children, but less is known about whether this extends to the wider spectrum of traits or to early brain development in the first 6 months of life. Data from two independent cohorts, the developing Human Connectome Project (dHCP) and Cambridge Human Imaging and Longitudinal Development (CHILD), were assessed in late fetal and early infancy for brain structure with MRI. Global and regional brain volumes in the dHCP, were studied prenatally (n = 106, mean age = 29.27 [SD = 3.8] gestational weeks) and postnatally (n = 454, mean age = 41.28 [SD = 1.93] weeks post-conception) in association with later autistic traits after 18 months of age, as captured on the parent-report Quantitative Checklist for Autism in Toddlers (‘Q-CHAT’). The results informed a region-of-interest analysis in the smaller independent CHILD cohort, where participants were scanned during pregnancy (mean = 31.98 weeks gestation, SD = 1.52) and postnatally (mean scan age = 50.45, SD = 2.8 weeks post-conception)(n = 27). After controlling for cohort covariates, such as maternal age, birth weight, sex and age post-conception at the time of scan, postnatal total brain volume, cortical grey matter volume, and white matter volume were all negatively associated with autistic traits in toddlerhood. This was found for postnatal volumes in both the dHCP and the CHILD cohort but was not apparent when assessing prenatal brain volume or perinatal growth rates of total brain volume in the same individuals. Regional analyses in the dHCP cohort, after controlling for total brain volume, showed patterns of note in the temporal lobe, which warrant further research. In conclusion, reduced total brain volume in the first two months of life is associated with a higher number of autistic traits, as reported by parents at 18 months of life. Further research is required to understand if this extends to later ages, to children later diagnosed with autism and how it affects the development and connectivity of specific regions, particularly in the temporal lobes.

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25. Wu Y, Chan SSM, Leung PWL, Lo HHL, Ho SWS, Mo FYM, Ho CSW, Shea CKS, Su Q, Leung TF, Chan FKL, Ng SC, Wong OWH. The Mediating Role of Eating Behaviors Between Autistic Symptoms and Dietary Issues Among Chinese Children With Autism. J Autism Dev Disord. 2025.

PURPOSE: Eating and dietary challenges are common among children with autism, but their associations with clinical symptoms remain unclear. This study aims to describe dietary issues, including nutritional problems and overexposures to food additives in autistic children, and their associations with clinical symptoms. METHODS: This case-control study involved 836 children (469 with autism and 367 without autism; mean age = 8.3 years) profiled on autistic symptoms, eating behaviors, and dietary patterns with parent-reported questionnaires. Nutritional insufficiencies, dietary quality and food additives exposures were compared using regression models adjusted for age and sex. Multivariate logistics or linear regression models were used to identify clinical symptoms that predict dietary issues, with mediation analyses examining eating behaviors’ roles. RESULTS: Autistic children had lower protein intake, more vitamin and mineral insufficiencies, higher exposure to food additives, and poorer diet quality. They consumed fewer fruits/vegetables and more animal-based fats, with 38.2% exceeding 125% of the Estimated Energy Requirement (vs. 22.9% controls), suggesting energy-dense, ultra-processed food preferences. Diminished food enjoyment and increased food fussiness mediated between low social motivation and nutritional insufficiencies, as well as poorer diet quality. Further, difficulties with food responsiveness and emotional eating patterns mediated between more restricted and repetitive behaviors and higher exposures to emulsifiers/thickeners. CONCLUSION: Autistic children, especially those with severe core symptoms, are susceptible to multifaceted dietary issues such as preference for low-quality food and nutrient deficiencies. It is crucial to implement personalized treatment strategies that target their specific eating behaviors to effectively address dietary challenges.

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26. Xiong Y. Future Directions for Studying the Potential of Mammalian Dscam in Autism Spectrum Disorder and Alzheimer’s Disease: Insights from Dose Sensitivity. Mol Neurobiol. 2025; 63(1): 61.

Down syndrome cell adhesion molecule (Dscam), a macromolecular member of the immunoglobulin (Ig) superfamily, is widely distributed in the nervous system. Over the past few decades, significant progress has been made in studies of the Dscam gene and its protein products across multiple species, advancing our understanding of its alternative splicing mechanisms, isoform-specific homophilic binding properties, and crucial neurological functions during neural development. In Drosophila, the Dscam gene undergoes extensive alternative splicing, generating thousands of isoforms that differ in their extracellular and/or transmembrane domains. These isoforms confer unique cellular identities and mediate cell-cell recognition and downstream signaling cascades primarily via homophilic interactions. In contrast, mammalian Dscam lacks the extreme alternative splicing and vast isoform diversity found in Drosophila, yet it retains crucial neurological functions. Studies indicate that the expression levels serve as an important regulator of Dscam-dependent neural processes, underlying its dosage-sensitive phenotypes. Abnormal Dscam expression has been implicated in the pathology of several neurological diseases. For example, heterozygous loss of Dscam function is convincingly associated with autism spectrum disorder (ASD), while trisomy of the Dscam gene is linked to Down syndrome (DS). Recent studies also suggest a connection between Dscam overexpression and Alzheimer’s disease (AD), implicating Dscam in previously unrecognized neurodegenerative mechanisms. However, efforts to clarify Dscam’s role in the neuropathology of diseases are severely hampered by the etiological and phenotypic heterogeneity of these diseases, necessitating novel approaches. This review integrates cross-species evidence on Dscam’s dose sensitivity to elucidate the molecular mechanisms behind its dosage-dependent phenotypes in mammals, thereby advancing the understanding of how dysregulated Dscam expression contributes to phenotypic heterogeneity in ASD and disease onset in AD. Insights into Dscam’s dose sensitivity highlight that alterations in dosage likely perturb genetic regulatory networks, leading to nonlinear phenotypic consequences through multi-level molecular interactions. Therefore, we propose a biphasic framework to address current mechanistic challenges in future research: (1) systematic identification of key regulatory nodes within genetic networks using emerging big-data methodologies, followed by (2) mechanistic validation through targeted experimental studies of prioritized molecular pathways. These efforts may establish Dscam as a promising therapeutic target for modulating pathological cascades in both ASD and AD.

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27. Yang X, Zhan L, Wang Y. Semantic projection as a method to measure individual differences in semantic scale length: insights from autism-related traits. Sci Rep. 2025; 15(1): 40119.

Human perceive and navigate the world using internal scales constructed for various semantic features (e.g., danger, weight), and these scales vary considerably in length and endpoints among individuals. Quantifying these scale lengths is critical for understanding cognitive diversity, yet existing methods face reliability challenges. Here, we extend Grand et al.’s semantic projection approach through a free-response paradigm to measure individual differences in scale length. Applying this framework to autistic traits, we uncover a dissociation: in male participants, those with high Autism-Spectrum Quotient (AQ) scores exhibited significantly shorter scale lengths for abstract features compared to low-AQ males, revealing compressed conceptual representations in neurodivergent cognition. In contrast, no such differences were observed among females or for physical features. Potential implications and accounts are discussed.

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