1. Altunel A, Muduroglu-Kirmizibekmez A, Onder A, Altunel O, Sever A, Kara I. Efficacy of ACTH therapy in children with Landau-Kleffner Syndrome and Autism Spectrum Disorder: A retrospective analysis. Epilepsy Behav. 2025; 165: 110308.

BACKGROUND: Landau-Kleffner Syndrome (LKS) and Autism Spectrum Disorder (ASD), both neurodevelopmental disorders, are frequently associated with epileptic seizures and characteristic epileptiform activity. Electrical Status Epilepticus during Sleep (ESES) is commonly observed in LKS, while Interictal Epileptiform Discharges (IEDs) are typical in ASD. Adrenocorticotropic hormone (ACTH) treatment has demonstrated the potential to reduce the indexes of these related discharges and the number of seizures. OBJECTIVE: This retrospective study aimed to assess the response to ACTH treatment in children diagnosed with LKS or ASD, both with and without epileptic seizures. METHODS: The study included 236 children, with separate analyses performed for those diagnosed with LKS or ASD. EEG recordings and treatment outcomes were retrospectively evaluated. Key assessments included changes in the indexes of ESES and IED, seizure control rates, and reported side effects. RESULTS: ACTH treatment led to significant improvements in indexes and seizure control in both LKS and ASD populations. In children with LKS and epileptic seizures, the mean ESES index reduction was 49.9 % (±17.7), with 50 % achieving complete seizure control. For children with ASD and epileptic seizures, the mean IED index reduction was 47.2 % (±16.7), with 41 % achieving complete seizure control. Rare side effects were transient and reversible, with no reports of serious adverse events. CONCLUSION: ACTH treatment demonstrates efficacy in reducing ESES and IED indexes and controlling seizures in children with LKS and ASD. These findings underscore the importance of early intervention and careful management of side effects in optimizing outcomes for these patient populations.

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2. Bottini S, Johnson L, McGinnis M, Scheithauer M. Prevalence and Predictors of Missed Appointments Within an Outpatient Behavioral Clinic for Autistic Children. J Autism Dev Disord. 2025.

Missed appointments are detrimental to the healthcare system and to the clients themselves. Autistic youth may be particularly impacted due to unique service needs and limited services available within the system. To date, there is limited literature specific to treatment attendance in autistic populations receiving behavioral services. This study examines prevalence, predictors of, and reasons for missed appointments in an outpatient clinic specializing in addressing behavioral concerns. This retrospective case review examines missed appointments in a sample of 306 autistic youths from an outpatient clinic from 2019 to 2022. An average of 5.2 appointments were cancelled and 9.0 were completed, resulting in an average individual cancellation rate of 38%. Statistically significant predictors of no shows and patient cancellations were younger age and a post-COVID appointment. The most common reasons for missed appointments was sickness, scheduling conflict, insurance authorization issues, and family emergency. Missed appointments may be common in outpatient behavioral settings for autistic youth. Resolving issues related to cancellations (e.g., sleep concerns), identifying families in need of targeted support strategies (e.g., assistance and flexibility with scheduling, transportation support), and advocating for systemic change may help meet the multifaceted needs of this population.

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3. Brennan J, Velasquez MJ, Davis TE. A Systematic Review of Family Accommodation in Autistic Youth: Anxiety Disorders, Obsessive-Compulsive Disorder, and Restricted and Repetitive Behaviors. J Autism Dev Disord. 2025.

Family accommodation (FA) is a term describing the change in behavior seen in parents and caregivers as they attempt to effect change in their child or adolescent’s anxious behavior-usually by allowing avoidance, attempting distraction, or attempting to manage distress. FA has been well-documented in children and adolescents with anxiety and obsessive-compulsive disorders; however, there has been less summarized on the degree to which autistic youth and families engage in accommodation. This review aims to establish the phenomenology of FA in autistic youth related to comorbid anxiety, obsessive-compulsive disorders, and restricted and repetitive behaviors (RRBs). This review also aims to summarize how FA is currently addressed in treatment within this population. Using PRISMA guidelines, peer-reviewed articles were included if (a) participants included caregivers of autistic youth, (b) there was a clearly delineated autism participant group, and (c) at least one quantitative outcome measure of FA was included. Seventeen articles were included in the review. Several themes emerged including (1) high rates of FA in autistic youth across OCD, anxiety, and RRBs, (2) some form of parental involvement in treatment, and (3) decreased rates of FA post-treatment. Overall, family accommodation appears to be present to at least the same degree, if not more so, in families of anxious autistic children and adolescents as their non-autistic but anxious counterparts. Family accommodation also often appears to be an important consideration with treatments for anxiety and OCD in autistic youth.

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4. Dreyfuss G. RNA-binding proteins in disease etiology: fragile X syndrome and spinal muscular atrophy. Rna. 2025; 31(3): 277-83.

All RNAs exist in complexes (RNPs) with RNA-binding proteins (RBPs). Studies in my lab since the 1980s have identified, sequenced and characterized the major pre-mRNA- and mRNA-RBPs (hnRNPs/mRNPs), revealing RNA-binding domains and common features of numerous RBPs and their central roles in posttranscriptional gene regulation. The first links between RBPs and RNPs to diseases emerged serendipitously for fragile X syndrome, as its gene (FMR1) encoded RBP (FMRP), and spinal muscular atrophy (SMA), caused by deficits in survival motor neurons (SMN). Discoveries of the SMN complex and its unanticipated function in RNP assembly, essential for spliceosomal snRNP biogenesis, advanced understanding of RNA biology and pathogenesis. I reflect on how these and other contributions (e.g., nucleocytoplasmic shuttling, telescripting) originated from curiosity-driven exploration and highly collaborative lab culture. The vast RNA and RBP assortments are beneficial, but increase complexity and chances of disorders, making the RNP sphere a rich source for future discoveries.

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5. Fortini PS, Toibaro JJ, Caraballo RH. Purified cannabidiol leads to improvement of severe treatment-resistant behavioral symptoms in children with autism spectrum disorder. Pharmacol Biochem Behav. 2025; 249: 173971.

OBJECTIVE: The aim of our study was to evaluate the efficacy and safety of purified cannabidiol as an add-on medication in pediatric patients with autism spectrum disorder (ASD) associated with treatment resistant repetitive behaviors, behavior disorders, and intellectual disability and unresponsive to conventional medications and behavioral interventions. MATERIAL AND METHODS: A prospective, observational, before-and-after study was conducted including 20 patients with severe ASD who initiated treatment with purified CBD. Patients were evaluated using different scales at baseline and at three-month intervals during followup. RESULTS: The median total CBD dose was 363.5 mg (range, 100-700), and the median follow-up was 11 months (range, 6-12). As to the primary outcome evaluating symptoms reported by parents, improvement in at least one was observed after CBD initiation in 18 patients (90 %) and no improvement in two (10 %) (1 worsening, 1 no response). In the responders, 83.5 % (n = 76) of all reported symptoms improved. Regarding the secondary outcomes based on the assessment with different scales, improvement of around 30 % was found in irritability, social withdrawal, hyperactivity. Restricted and repetitive behavior improved in nine (50 %), while no changes were seen in seven (38.8 %). Sleep patterns were found to be slightly improved. Adverse effects were reported in 13 patients (65 %), mainly consisting of increased irritability and decreased appetite, but were mild or moderate and transient in all. In 40 % of the children, concomitant medication could be reduced or partially discontinued. CONCLUSION: Our results suggest that treatment with purified CBD is effective and safe and could benefit patients with severe ASD by improving some of the core symptoms, including repetitive behaviors and social interaction, as well as associated comorbidities. The families considered the quality of life to have improved.

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6. Gao L, Qiao S, Zhang Y, Zhang T, Lu H, Guo X. Parsing the heterogeneity of brain structure and function in male children with autism spectrum disorder: a multimodal MRI study. Brain Imaging Behav. 2025.

Autism spectrum disorder (ASD) is a neurodevelopmental condition with high structural and functional heterogeneity. Multimodal fusion of structural and functional magnetic resonance imaging (MRI) allows better integration of ASD features from multiple perspectives. This study aimed to uncover the potential ASD subtypes by fusing the features of brain structure and function. An unsupervised learning method, similarity network fusion (SNF), was used. Resting-state functional MRI and structural MRI from the Autism Brain Imaging Data Exchange database of 207 male children were included in this study (105 ASD; 102 healthy controls (HC)). Gray matter volume (GMV) and amplitude of low-frequency fluctuation (ALFF) were utilized to represent structural and functional features separately. Structural and functional distance networks were constructed and fused by SNF. Then spectral clustering was carried out on the fused network. At last, the multivariate support vector regression analysis was used to investigate the relationship between the multimodal alterations and symptom severity of ASD subtypes. Two ASD subtypes were identified. Compared to HC, the two ASD subtypes demonstrated opposite GMV changes and distinct ALFF alterations. Furthermore, the alterations of ALFF predicted the severity of social communication impairments in ASD subtype 1. However, no significant associations were found between the multimodal alterations and symptoms in ASD subtype 2. These findings demonstrate the existence of heterogeneity with distinct structural and functional patterns in ASD and highlight the crucial role of combining multimodal features in investigating the neural mechanism underlying ASD.

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7. Işık-Uslu AE, Çetin Z. Living with the delusion of autism recovery: A grounded theory study on the experiences of mothers. J Pediatr Nurs. 2025.

PURPOSE: This study employs Charmaz’s (2014) constructivist Grounded Theory (GT) approach to explore and construct a theory about the experiences of mothers raising children diagnosed with autism spectrum disorder (ASD). METHODS: Data were collected over 1.5 years from online forum posts written by 10 mothers and in-depth qualitative interviews conducted with nine mothers. During the theoretical sampling phase, an additional four mothers were interviewed face-to-face. The analysis adhered to Charmaz’s constructivist GT methodology, encompassing initial coding, focused coding, and theoretical coding. RESULTS: The study introduces the grounded theory, « Living with the Delusion of Autism Recovery, » which encapsulates mothers’ oscillation between hope and despair as they navigate their children’s developmental journeys. This longitudinal analysis traces mothers’ experiences from the pre-diagnosis phase through special education, addressing a significant gap in the literature by examining the progression of experiences rather than isolated moments. CONCLUSIONS: The findings underscore the urgent need for timely interventions and robust support systems. Delays in diagnosis, driven by healthcare professionals’ reluctance to diagnose early and the lack of a formal early intervention system, exacerbate developmental challenges. This research provides a unique contribution to the literature by centering on the experiences of Turkish mothers, shedding light on cultural nuances and the dynamic nature of parenting a child with ASD in Türkiye. It is notable as the first study of its kind in Türkiye, offering invaluable insights into the evolving experiences of these mothers.

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8. Jarvers I, Sommer M, Ullmann M, Simmel V, Blaas L, Gorski S, Krüger-Lassen S, Vogel M, Langguth B. Reading between the lines: exploring the discriminative ability of the Short-Story Task in identifying autistic individuals within autism outpatient services. Front Psychiatry. 2025; 16: 1500396.

INTRODUCTION: The correct diagnosis of autistic individuals is an everyday challenge within autism outpatient services. While the short-story task (SST), a task measuring fiction-based mentalizing, has demonstrated promise in differentiating between autistic and non-autistic adults, its discriminative ability has not been investigated in a sample of individuals seeking autism diagnostics at outpatient services. METHODS: This study aimed to evaluate the utility of the SST in individuals seeking autism diagnostics between 2016 and 2022 at the Clinic and Polyclinic for Psychiatry & Psychotherapy of the University of Regensburg at medbo District Hospital Regensburg. The sample consisted of 211 individuals. In 100 of them an autism spectrum disorder has been diagnosed and 111 individuals were diagnosed with other conditions or none at all. RESULTS: Performance on the SST did not significantly differ between the two groups, and receiver operator curve analysis did not support the SST as a reliable discriminator. However, linear regression analyses revealed that autism diagnosis was the sole significant predictor of SST mentalizing performance. Additionally, specific items of the SST showed significant differences between autistic and non-autistic individuals and constituted a significant predictor of autism diagnosis. DISCUSSION: While the SST may not be robust enough to accurately identify autistic individuals on its own, it does offer clinicians valuable insights into how individuals interpret others’ actions and whether they grasp the broader context of a story versus focusing solely on details.

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9. Jung S, Richter JD. Trinucleotide repeat expansion and RNA dysregulation in fragile X syndrome: emerging therapeutic approaches. Rna. 2025; 31(3): 307-13.

Fragile X syndrome (FXS) is characterized by intellectual impairment caused by CGG repeat expansion in the FMR1 gene. When repeats exceed 200, they induce DNA methylation of the promoter and the repeat region, resulting in transcriptional silencing of the FMR1 gene and the subsequent loss of FMRP protein. In the past decade or so, research has focused on the role of FMRP as an RNA-binding protein involved in translation inhibition in the brain in FXS model mice, particularly by slowing or stalling ribosome translocation on mRNA. More recent advances have shown that FMRP has a profound role in RNA splicing, at least in some cases by modulating the translation of splicing factor mRNAs. In a surprise, the human FMR1 gene is transcribed in most cases even with a full CGG expansion. However, much of the FMR1 that is produced is misspliced, which can be corrected by splice-switching antisense oligonucleotide (ASO) administration. Other recent findings suggest that inhibition of multiple kinases can demethylate the FMR1 gene and induce the formation of an R-loop in the CGG repeat region, leading to contraction of the repeat and FMRP restoration. These insights are paving the way for possible future therapeutic approaches for this disorder. We highlight the importance of FMRP restoration by ASO-mediated splice switching or CGG repeat modulation as key advances that may lead to successful treatments for FXS.

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10. LaSalle JM. DNA methylation biomarkers of intellectual/developmental disability across the lifespan. J Neurodev Disord. 2025; 17(1): 10.

Epigenetic mechanisms, including DNA methylation, act at the interface of genes and environment by allowing a static genome to respond and adapt to a dynamic environment during the lifespan of an individual. Genome-wide DNA methylation analyses on a wide range of human biospecimens are beginning to identify epigenetic biomarkers that can predict risk of intellectual/developmental disabilities (IDD). DNA methylation-based epigenetic signatures are becoming clinically useful in categorizing benign from pathogenic genetic variants following exome sequencing. While DNA methylation marks differ by tissue source, recent studies have shown that accessible perinatal tissues, such as placenta, cord blood, newborn blood spots, and cell free DNA may serve as accessible surrogate tissues for testing epigenetic biomarkers relevant to understanding genetic, environmental, and gene by environment interactions on the developing brain. These DNA methylation signatures may also provide important information about the biological pathways that become dysregulated prior to disease progression that could be used to develop early pharmacological interventions. Future applications could involve preventative screenings using DNA methylation biomarkers during pregnancy or the newborn period for IDDs and other neurodevelopmental disorders. DNA methylation biomarkers in adolescence and adulthood are also likely to be clinically useful for tracking biological aging or co-occurring health conditions that develop across the lifespan. In conclusion, DNA methylation biomarkers are expected to become more common in clinical diagnoses of IDD, to improve understanding of complex IDD etiologies, to improve endpoints for clinical trials, and to monitor potential health concerns for individuals with IDD as they age.

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11. Lee Masson H. Dynamic functional adaptations during touch observation in autism: connectivity strength is linked to attitudes towards social touch and social responsiveness. Mol Autism. 2025; 16(1): 11.

BACKGROUND: Autistic adults experience differences in social interactions involving physical contact. Brain imaging studies suggest that these differences may be related to atypical brain responses to social-affective cues, affecting both the experience of receiving touch and observing it in others. However, it remains unclear whether these atypical responses are limited to specific brain regions or represent broader alterations in brain connectivity. The current study investigated how the functional network architecture is modulated during touch observation associated with autism and explored the extent to which changes in this architecture are associated with individual differences in social touch preferences and social responsiveness. METHODS: By integrating generalized psychophysiological interaction (gPPI) analysis with independent component analysis (ICA), the current study analyzed existing fMRI datasets, in which 21 autistic and 21 non-autistic male adults viewed videos of social and nonsocial touch while undergoing MRI scans. RESULTS: A gPPI analysis of regions of interest revealed that autistic adults exhibited increased connectivity between sensory and social brain regions. The strength of some of these connections was positively associated with a higher preference for social touch and greater social responsiveness, suggesting neural compensatory mechanisms that may help autistic adults better understand the meaning of touch. At the level of large-scale brain networks extracted using ICA, atypical connectivity was predominantly observed between the sensorimotor network and other networks involved in social-emotional processing. Increased connectivity was observed in the sensorimotor network during nonsocial touch, suggesting that embodied simulation, the process by which individuals internally simulate touch experience of others in this context, may be more engaged when observing human-object interactions than during human-to-human touch. LIMITATIONS: This study focused on a specific subgroup of 21 autistic male adults with minimal support needs. Future research would benefit from including a more diverse autistic sample. CONCLUSIONS: This study reveals atypical context-dependent modulation of functional brain architecture associated with autism during touch observation. Neural compensatory mechanisms in autistic individuals who enjoy social touch and show higher social responsiveness may function as adaptive social responses. However, these compensations may be limited to specific brain regions, rather than occurring at the level of large-scale brain networks.

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12. Lestarevic S, Mihailovich M, Vlaisavljevic M, Kalanj M, Grujicic R, Maravic VM, Mitkovic-Voncina M, Holingue C, Pejovic-Milovancevic M. Assessing Internal Consistency of the Autism Spectrum Disorder Gastrointestinal and Related Behaviors Inventory and the Frequency and Socio-Emotional Correlates of Gastrointestinal Difficulties in Children With the Autism Spectrum Disorder: A Cross-Sectional Study. Autism Res. 2025.

Gastrointestinal (GI) difficulties are common in children diagnosed with autism spectrum disorder (ASD). However, these difficulties can frequently remain unrecognized. Therefore, we aimed to translate a newly developed instrument, The Autism Spectrum Disorder Gastrointestinal and Related Behaviors Inventory in Children (ASD-GIRBI), to assess its reliability and to explore the frequency of various gastrointestinal difficulties and related behaviors, as well as to explore the association of GI difficulties with the measures of social functioning and emotional and behavioral difficulties in children with ASD. A total of 98 children and adolescents (aged 4-18 [M(age) = 10.67 ± 3.705], 82.7% male), previously diagnosed with ASD at the Institute of Mental Health in Belgrade, Serbia, took part in this research. Their parents filled out the following questionnaires: ASD-GIRBI (an assessment of gastrointestinal and related symptoms), Stanford Social Dimensions Scale (SSDS) (a measure of social functioning) and Strengths and Difficulties Questionnaire (SDQ) (a measure of emotional and behavioral problems). Our results indicate that the ASD-GIRBI is a reliable instrument for GI difficulties assessment (Cronbach’s α = 0.841) with the total score successfully discriminating between the participants with and without a GI disorder diagnosis (p = 0.040). Any gastrointestinal symptom was present in 54.1% of the participants, most commonly flatulence, diarrhea, and constipation. The severity of gastrointestinal difficulties correlated to emotional problems (r = 0.261, p < 0.01), conduct problems (r = 0.219, p < 0.05), hyperactivity (r = 0.381, p < 0.01), peer problems (r = 0.266, p < 0.01), total difficulties (r = 0.454, p < 0.01) and total difficulties impact (r = 0.321, p < 0.01). Our data emphasize the potential importance of GI difficulties for various areas of functioning of individuals with ASD.

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13. Li Z, Niu X, Wong PCM, Zhang H, Wang L. Factors influencing timely diagnosis of autism in China: an application of Andersen’s behavioral model of health services use. BMC Psychiatry. 2025; 25(1): 143.

BACKGROUND: Timely diagnosis of autism is pivotal for accessing crucial supports and services. However, achieving it remains a persistent challenge, particularly in countries like China where the healthcare system is characterized by its intricate network and often resulting in fragmented care delivery and disparities in access. METHODS: A cross-sectional questionnaire survey was conducted among families with autistic children aged between 1 and 17 years in Chinese Mainland. Andersen’s Behavioral Model guided the assessment of predisposing, enabling, and need factors. RESULTS: The study revealed that 86.24% of Chinese children did not receive a formal diagnosis until after 24 months, with an average gap of 10.93 months between parents/caregivers’ initial concerns and diagnostic confirmation. Predisposing factors of the child’s current age emerged as a significant predictor for timely diagnosis. Enabling factors, including residence-hospital distance and experience of misdiagnosis were significant. Additionally, the severity level at diagnosis was identified as a predictor for timely diagnosis. CONCLUSIONS: Our findings revealed that predisposing, enabling, and need factors contributed to the complex landscape of autism diagnosis in China. Strategies including implementing routine screening programs and adopting a multidisciplinary approach are crucial for timely identification and diagnosis, particularly for mild and moderate cases. Additionally, there is an urgent need for specialized autism training for healthcare professionals, the development of structured referral systems, and the expansion of telehealth solutions to ensure equitable access to diagnosis services across regions. By addressing these challenges, policymakers and healthcare providers can improve the accessibility and timeliness of autism diagnosis, ultimately enhancing the quality of life for affected individuals and their families.

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14. Pablo JN, Shires J, Torrens WA, Kemmelmeier LL, Haigh SM, Berryhill ME. Identifying overlapping and distinctive traits of autism and schizophrenia using machine learning classification. Cogn Neuropsychiatry. 2025: 1-23.

INTRODUCTION: Autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) share some symptoms. We conducted machine learning classification to determine if common screeners used for research in non-clinical and subclinical populations, the Autism-Spectrum Quotient (AQ) and Schizotypal Personality Questionnaire – Brief Revised (SPQ-BR), could identify non-overlapping symptoms. METHODS: 1,397 undergraduates completed the SPQ-BR and AQ. Random forest classification modelled whether SPQ-BR item scores predicted AQ scores and factors, and vice versa. The models first used all item scores and then the least/most important features. RESULTS: Robust trait overlap allows for the prediction of AQ from SPQ-BR and vice versa. Results showed that AQ item scores predicted 2 of 3 SPQ-BR factors (disorganised, interpersonal), and SPQ-BR item scores successfully predicted 2 of 5 AQ factors (communication, social skills). Importantly, classification model failures showed that AQ item scores could not predict the SPQ-BR cognitive-perceptual factor, and the SPQ-BR item scores could not predict 3 AQ factors (imagination, attention to detail, attention switching). CONCLUSIONS: Overall, the SPQ-BR and AQ measure overlapping symptoms that can be isolated to some factors. Importantly, where we observe model failures, we capture distinctive factors. We provide guidance for leveraging existing screeners to avert misdiagnosis and advancing specific/selective biomarker identification.

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15. Rios-Vega L, Rising K, Fields M, Freedman B, Toole N, Ramos J, Schaaf R. Engaging Diverse Stakeholders to Improve Therapy Access for Hispanic and Latino Autistic Individuals and Families. Am J Occup Ther. 2025; 79(2).

IMPORTANCE: Stakeholder engagement in research is essential to assure that the perspectives of diverse populations studied are represented. OBJECTIVE: To describe the process and experiences of engaging Hispanic and Latino stakeholders in research. DESIGN: A mixed-methods prospective design was used to plan, prepare, and evaluate stakeholder engagement. SETTING: Online, via Zoom. PARTICIPANTS: Twenty-two stakeholder partners, including 7 Spanish-speaking Hispanic and Latino parents and caregivers of autistic children, 3 Hispanic and Latino autistic individuals, 3 teachers, 3 occupational therapists, 3 Hispanic and Latino cultural experts, and 3 autism experts working with Hispanic and Latino autistic populations were recruited via snowball sampling and engaged in various project activities. INTERVENTION: Activities for each engagement phase were implemented in Spanish and English. Stakeholder advisory boards were formed following the Patient-Centered Outcomes Research Institute’s engagement principles. Training modules were provided to the stakeholders to support engagement. OUTCOMES AND MEASURES: Stakeholder partners’ feedback was collected. The Acceptability of Intervention Measure (AIM) assessed stakeholders’ perceptions of the training modules. Additionally, two surveys were developed to evaluate the accessibility of and satisfaction with the modules. RESULTS: Three advisory boards were created, each comprising culturally diverse, multilingual stakeholders dedicated to a particular project area. The stakeholder partners found the training modules acceptable and accessible as a learning strategy with high satisfaction levels. CONCLUSIONS AND RELEVANCE: Partnerships and capacity building are essential for fostering genuine engagement. Implementing and evaluating training and its acceptability is crucial for effective stakeholder participation. Meaningful engagement of culturally diverse populations is necessary for inclusive and equitable occupational therapy research. Plain-Language Summary: Occupational therapists use evidence-based interventions. There is a need for culturally sensitive interventions, but many autism treatments are based on research with mostly White participants, which may not be effective for people from other cultures. To make the interventions more culturally relevant, occupational therapists must include the communities they serve. In this study, we formed three stakeholder advisory boards with Hispanic and Latino parents and caregivers of autistic children, autistic adults, occupational therapists, cultural experts, teachers, and autism experts. The purpose of the stakeholder advisory boards is to help us guide a project that will culturally adapt an evidence-based intervention for autistic children and improve access to and the use of occupational therapy services for Hispanic and Latino autistic communities. The authors share the engagement process they used and the feedback they received on the training modules. Positionality Statement: The term Hispanic has historically been applied to individuals with ancestry from Spain or those whose primary language is Spanish. Although some embrace the term, others find it problematic because of its association with the Spanish colonization and its inability to reflect the identities of many people from Central and South America (Martínez & Gonzalez, 2020). The term Latino and its variations are used for individuals with origins in Latin America, including Central America, South America, and the Caribbean (Martínez & Gonzalez, 2020); this term is preferred by many. Research reveals varying preferences for these terms across populations (Martínez & Gonzalez, 2020). Given the diverse preferences, and to promote inclusivity, we use Hispanic and Latino throughout this article. Furthermore, we implement the identity-first terminology for autistic persons based on autistic individuals’ preferences for using identity-first language (Taboas et al., 2023). The first author, Lady Rios-Vega, identifies as a Latina. She has served minoritized families in early intervention, which revealed the disparities and inequities in access to and utilization of occupational therapy services within the Hispanic and Latino autistic communities. Her experiences have strengthened her commitment to prioritizing the voices and needs of marginalized groups in occupational therapy interventions and research. We acknowledge that her perspectives may influence how data are presented. In addition, the diverse backgrounds and experiences of all contributing authors shape our work, guiding us to pursue our objectives with a strong focus on equity and inclusivity. The senior author, Roseann Schaaf, identifies as a White Caucasian woman from a middle-class background. She is an occupational therapist, neuroscientist, and an experienced autism researcher. She acknowledges the potential impact of her privileged positionality when studying the experiences of marginalized communities, and she is committed to mitigating any biases that may arise from her own perspective.

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16. Siqueira E, Velasco CD, Tarrasón A, Soler M, Srinivas T, Setién F, Oliveira-Mateos C, Casado-Pelaez M, Martinez-Verbo L, Armstrong J, Esteller M, Alves LF, Llobet A, Guil S. NEAT1-mediated regulation of proteostasis and mRNA localization impacts autophagy dysregulation in Rett syndrome. Nucleic Acids Res. 2025; 53(4).

Rett syndrome (RTT) is a severe neurodevelopmental disorder primarily caused by loss-of-function mutations in the MECP2 gene, resulting in diverse cellular dysfunctions. Here, we investigated the role of the long noncoding RNA (lncRNA) NEAT1 in the context of MeCP2 deficiency using human neural cells and RTT patient samples. Through single-cell RNA sequencing and molecular analyses, we found that NEAT1 is markedly downregulated in MECP2 knockout (KO) cells at various stages of neural differentiation. NEAT1 downregulation correlated with aberrant activation of the mTOR pathway, abnormal protein metabolism, and dysregulated autophagy, contributing to the accumulation of protein aggregates and impaired mitochondrial function. Reactivation of NEAT1 in MECP2-KO cells rescued these phenotypes, indicating its critical role downstream of MECP2. Furthermore, direct RNA-RNA interaction was revealed as the key process for NEAT1 influence on autophagy genes, leading to altered subcellular localization of specific autophagy-related messenger RNAs and impaired biogenesis of autophagic complexes. Importantly, NEAT1 restoration rescued the morphological defects observed in MECP2-KO neurons, highlighting its crucial role in neuronal maturation. Overall, our findings elucidate lncRNA NEAT1 as a key mediator of MeCP2 function, regulating essential pathways involved in protein metabolism, autophagy, and neuronal morphology.

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17. Tenev A, Markovska-Simoska S, Müller A, Mishkovski I. Entropy, complexity, and spectral features of EEG signals in autism and typical development: a quantitative approach. Front Psychiatry. 2025; 16: 1505297.

Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects the brain’s function. Electroencephalography (EEG) is a non-invasive technique that measures the electrical activity of the brain and can reveal its dynamics and information processing. This study explores an eyes-opened resting state quantitative EEG analysis of 49 children with ASD and 39 typically developing (TD or Control) children, using various features of entropy and complexity. Time and frequency domain features were applied for all EEG channels, such as the power spectra, brain rate, sample entropy, permutation entropy, spectral entropy, Tsallis entropy, Rényi entropy, Lempel-Ziv complexity, and Higuchi fractal dimension. The features were compared between the ASD and TD groups and tested for statistical significance. The results showed that the ASD group had a lower brain rate, higher Tsallis entropy and Rényi entropy, and lower Lempel-Ziv complexity than the TD group. The entropy results show impaired neural synchronization, increased randomness, and noise in ASD. The Lempel-Ziv complexity results showed that it is a potential indicator of the existence of focal spikes in the EEG signals of ASD. The brain-rate results show a low level of arousal in ASD. The findings suggest that entropy and complexity measures can be useful tools for characterizing the EEG features of ASD and provide insights into the neurophysiological mechanisms of the disorder.

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18. Vargas C, Paoletti D, De Stasio S, Berenguer C. Sleep disturbances in autistic children and adolescents: A systematic review and meta-analysis of randomized controlled trials. Autism. 2025: 13623613251319391.

Sleep disorders are common in people on the autistic spectrum and can affect their development, daily function, and overall well-being. This study examined the effectiveness of non-pharmacological intervention to improve sleep in autistic children and adolescents without intellectual disability. We considered 11 studies of non-pharmacological treatments for autistic children and adolescents. The results indicate that these interventions help to improve several sleep parameters, either by increasing, for example, the total time and quality of sleep, or by reducing the time needed for falling asleep. These approaches offer important treatment options especially for those cases where medication is not feasible, allowing physicians and specialists to propose more targeted and safer solutions for managing sleep difficulties in this population.

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19. Verdes A, Bhattachan S, Kolevzon A, King BH, McDougle CJ, Sanders KB, Kim SJ, Spanos M, Chandrasekhar T, Rockhill C, Palumbo M, Minjarez M, Nowinski L, Marler S, Siecinski S, Giamberardino S, Gregory SG, Veenstra-VanderWeele J, Sikich L, Jutla A. Predictors of Placebo Response in the Study of Oxytocin in Autism to Improve Reciprocal Social Behaviors. J Child Adolesc Psychopharmacol. 2025.

Background: Although randomized clinical trials (RCTs) have investigated several treatments for social communication difficulties and repetitive behavior in autism, none has yet shown consistent superiority over placebo. Placebo response in autism RCTs may impede the ability to detect meaningful treatment effects. Objective: We sought to identify individual-level predictors of placebo response in Study of Oxytocin in Autism to improve Reciprocal Social Behaviors (SOARS-B), a 24-week RCT of intranasal oxytocin for social impairment in autistic youth. In our primary analysis, we examined predictors of change in the Aberrant Behavior Checklist-modified Social Withdrawal (ABC-mSW) score at 24 weeks in SOARS-B participants taking placebo. Secondary analyses examined predictors of ABC-mSW change at 12 weeks and of Clinical Global Impressions-Improvement at 24 and 12 weeks. We also examined predictors of response among SOARS-B participants taking oxytocin. Methods: For each analysis, we first used lasso (least absolute shrinkage and selection operator) regression to identify potentially influential predictors from a large group that included demographic factors, rating scale data, and prescribed medications. We then estimated an unpenalized linear regression model for the outcome of interest that included only variables retained by the optimal lasso. We considered variables with statistically significant coefficients to be influential predictors. Results: Higher baseline ABC-mSW score was the only significant predictor of greater ABC-mSW change in the placebo group at 24 and 12 weeks. Conclusions: In SOARS-B, higher baseline severity on a measure of reciprocal social communication predicted greater placebo response. This is consistent with the finding that lower social communication adaptive functioning was associated with greater placebo response in recent RCTs of balovaptan for social impairment in autism. However, it contrasts with findings from a trial of citalopram for repetitive behavior in autism, in which lower baseline severity of a composite of autistic and mood symptoms predicted greater placebo response. This may indicate that different factors contribute to placebo response in different symptom domains.

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20. Wang X, Bouton S, Kojovic N, Giraud AL, Schaer M. Atypical audio-visual neural synchrony and speech processing in early autism. J Neurodev Disord. 2025; 17(1): 9.

BACKGROUND: Children with Autism Spectrum disorder (ASD) often exhibit communication difficulties that may stem from basic auditory temporal integration impairment but also be aggravated by an audio-visual integration deficit, resulting in a lack of interest in face-to-face communication. This study addresses whether speech processing anomalies in young autistic children (mean age 3.09-year-old) are associated with alterations of audio-visual temporal integration. METHODS: We used high-density electroencephalography (HD-EEG) and eye tracking to record brain activity and gaze patterns in 31 children with ASD (6 females) and 33 typically developing (TD) children (11 females), while they watched cartoon videos. Neural responses to temporal audio-visual stimuli were analyzed using Temporal Response Functions model and phase analyses for audiovisual temporal coordination. RESULTS: The reconstructability of speech signals from auditory responses was reduced in children with ASD compared to TD, but despite more restricted gaze patterns in ASD it was similar for visual responses in both groups. Speech reception was most strongly affected when visual speech information was also present, an interference that was not seen in TD children. These differences were associated with a broader phase angle distribution (exceeding pi/2) in the EEG theta range in children with ASD, signaling reduced reliability of audio-visual temporal alignment. CONCLUSION: These findings show that speech processing anomalies in ASD do not stand alone and that they are associated already at a very early development stage with audio-visual imbalance with poor auditory response encoding and disrupted audio-visual temporal coordination.

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21. Ward C, Childress A, Martinko K, Chen D, Larsen KG, Shah A, Sheridan P, Hefting N, Knutson J. Safety and Efficacy of Brexpiprazole in the Treatment of Irritability Associated with Autism Spectrum Disorder: An 8-Week, Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial and 26-Week Open-Label Extension in Children and Adolescents. J Child Adolesc Psychopharmacol. 2025.

Introduction: The effective management of irritability is a key need in young people with autism spectrum disorder (ASD). We evaluated the efficacy and safety of brexpiprazole in children and adolescents with irritability associated with ASD. Methods: This was an 8-week, phase 3, randomized, double-blind, placebo-controlled trial (NCT04174365) and 26-week, open-label extension (OLE, NCT04258839) of brexpiprazole (0.25-3 mg/day based on body weight) in children and adolescents (5-17 years) with a diagnosis of ASD, score ≥18 on the Aberrant Behavior Checklist-Irritability (ABC-I) subscale, and score ≥4 on the Clinical Global Impressions-Severity scale. Results: Of the 119 randomized participants (brexpiprazole = 60, placebo = 59), 104 completed double-blind treatment, and 95 enrolled and 70 completed the OLE. Similar reductions in mean ABC-I subscale score were seen in both groups (least-squares mean ± standard error reduction from double-blind baseline of -10.1 ± 1.3 with brexpiprazole vs -8.9 ± 1.3 with placebo). Thus, the primary endpoint did not show a significant treatment effect (LS-mean [95% confidence interval] treatment difference: -1.22 [-4.49, 2.05], p = 0.46) and the hierarchical efficacy analysis ended at this point. At the end of the OLE, participants had a mean ± SD reduction from open-label baseline of -6.1 ± 8.2 in ABC-I subscale score. During double-blind treatment, 51.7% participants treated with brexpiprazole had ≥1 treatment-emergent adverse event (TEAE) versus 35.1% with placebo; no severe or serious TEAEs were reported. The only potentially treatment-related TEAE that occurred in ≥5% of participants was somnolence (12.1% for brexpiprazole vs 5.3% for placebo). During the OLE, the most commonly reported TEAE was increased weight (n = 13, 13.7%). Conclusions: Treatment with brexpiprazole did not demonstrate significant efficacy versus placebo for the treatment of irritability associated with ASD. The safety profile was consistent with that observed in adult and adolescent patients with schizophrenia.

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