1. An P, Wang C. Preliminary findings on the different gaze patterns on animal-based and human-based picture books in autistic children. Sci Rep. 2025; 15(1): 17491.

Picture books are commonly used as teaching materials for young children. There is a lack of understanding about how autistic children view picture books, raising the question of the type of picture books suitable for children on the autism spectrum. The current study aimed to investigate gaze characteristics of autistic children compared to non-autistic children when viewing animal- and human-based picture books using eye-tracking technology. Twelve pictures were selected from existing picture books (six animal-based, six human-based). Each picture was presented to participants (29 autistic children, M(age) = 52.32 months, male: female = 25:4; 40 non-autistic children, M(age) = 49.56 months, male: female = 24:16; age range = 42-62 months) in a random sequence. Participants’ gaze data were recorded. Autistic children showed longer time to first fixation, shorter total fixation time, and less fixation points to characters in picture books compared to non-autistic children. Animal versus human characters shortened the time to first fixation in autistic but not non-autistic children. Both groups showed greater attention to socially relevant areas, hands and faces, in animal compared to human picture books. Autistic children showed reduced visual attention during picture book viewing compared to non-autistic children. Animal-based picture books were more effective at attracting and maintaining visual attention to socially relevant areas, suggesting their potential as educational tools for autistic children.

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2. Aragon-Guevara DA, Mattson JMG, Kim H. Prevalence of Anxiety and Depression in Autistic and Non-autistic College Students: A Brief Report. J Autism Dev Disord. 2025.

PURPOSE: As more autistic individuals transition into young adulthood, it is crucial to explore factors relevant to success in this period of life, including success in post-secondary education. Mental health challenges have been identified as a significant concern in post-secondary education; however, the majority of research only includes non-autistic students. METHODS: The current study utilized data from the 2021 National Survey of Student Engagement (NSSE) to compare rates of anxiety and depression, as well as gender differences, in autistic and non-autistic students. The sample included 1399 autistic and 146,220 non-autistic students from 342 universities in the US and Canada. RESULTS: Autistic students reported significantly higher rates of anxiety (64.5%), and depression (48.2%) compared to their non-autistic peers (9.4% and 7.6%, respectively). Female students reported elevated rates of depression and anxiety compared to male students in both the autistic and non-autistic samples. CONCLUSION: These findings highlight the elevated mental health challenges faced by autistic students and underscore the need for increased research and support in post-secondary settings. Future research on risk factors for mental health challenges of autistic post-secondary students might elucidate opportunities and timing for support and screening.

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3. Atsumi T, Ide M, Chakrabarty M, Terao Y. The role of anxiety in modulating temporal processing and sensory hyperresponsiveness in autism spectrum disorder: an fMRI study. Sci Rep. 2025; 15(1): 17674.

The atypical sensory features and high comorbidity of anxiety disorders in individuals with autism spectrum disorder (ASD) are attracting increasing attention. Among individuals with ASD, those who exhibit heightened sensory hyperresponsiveness tend to show enhanced temporal processing of sensory stimuli, despite no observed differences in stimulus detection thresholds. A previous study reported the role of anxiety in modulating emotion-cued changes of visual temporal resolution in ASD. Building on this, we hypothesized that elevated anxiety might contribute to increased activation of neural circuits for timing perception and sensory hyperresponsiveness. This study included 25 individuals with ASD and 25 typically developed (TD) participants. Using functional magnetic resonance imaging (fMRI), we examined neural activity during a visual temporal order judgment task pre-cued by facial emotions. In the TD group, but not the ASD group, the presence of fearful facial expressions enhanced temporal processing. However, a correlation of anxiety levels with emotion-cued task performance and sensory hyperresponsiveness, respectively, was evident in the ASD group. In the TD group, neuroimaging revealed greater activation of the right caudate compared with that in the ASD group and a functional connectivity between the amygdala and left supramarginal gyrus. Individuals with ASD showed a relationship between anxiety level and activation of the right angular gyrus. Moreover, anxiety mediated the link between right angular gyrus activation and sensory hyperresponsiveness in the ASD group. These findings suggest that enhancement of temporal processing by fear-related cues-reflecting an emotion-timing neural circuit-may be disrupted in individuals with ASD. Heightened anxiety and sensory hyperresponsiveness in ASD may be mediated by brain regions involved in timing perception.

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4. Castro K, Marchezan J. Correspondence to « Efficacy of oral folinic acid supplementation in children with autism spectrum disorder: a randomized double-blind, placebo-controlled trial ». Eur J Pediatr. 2025; 184(6): 352.

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5. Chavers Edgar T, Elmquist M, Schabes C, Mohammed L, Banasik A, Sterling A. Assessing Autism Co-Occurrence in Fragile X Syndrome: Proposing a Preliminary CARS-2 Cut-Off Score. J Autism Dev Disord. 2025.

The purpose of this study was to examine the agreement between autism classification from the Autism Diagnostic Observation Schedule (ADOS-2; as reported by Lord (Autism Diagnostic Observation Schedule, Second Edition, Western Psychological Services, 2012)) and the Childhood Autism Rating Scale, 2nd edition (CARS-2; as reported by Schopler (The childhood autism rating scale, second edition (CARS-2), Western Psychological Services, 2010) in individuals with fragile X syndrome (FXS) and to propose a preliminary optimal CARS-2 cut-off score for identifying co-occurring autism in FXS when using the ADOS-2 as gold-standard measure. Forty-three school-aged and adolescent individuals completed the ADOS-2, CARS-2, and cognitive assessments. We found a strong to very strong positive association between the CARS-2 total scores and ADOS-2 total scores for individuals with FXS, and fair agreement between the ADOS-2 and CARS-2 autism classification ratings. Using a receiver-operator characteristic curve, an optimal CARS-2 cut-off score of 24.25 was found for identifying autism in individuals with FXS. Our findings should be considered preliminary, as they represent an examination of measurement agreement rather than validation against comprehensive DSM-5 clinical diagnoses. Studies using CARS-2 in FXS should carefully evaluate the scores or consider using the CARS-2 as a continuous measure of autism traits until the results of this paper are replicated in a larger and more diverse sample.

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6. Conti MV, Breda C, Basilico S, Zambon I, Sofroniou A, Ruggeri S, Scalvedi ML, Cena H. Improving Meal Acceptance of Individuals With Autism Spectrum Disorder (AUT-MENU Project): Protocol for a Bicentric Intervention Study. JMIR Res Protoc. 2025; 14: e57507.

BACKGROUND: Individuals with autism spectrum disorder (ASD) often exhibit low dietary diversity due to food selectivity, leading to various forms of malnutrition, such as obesity or micronutrient deficiencies. OBJECTIVE: The main objective of the AUT-MENU project is to improve meal acceptance among individuals with ASD. A secondary goal is to evaluate the effectiveness of a nutrition education course for parents of enrolled participants to reduce food selectivity. METHODS: The study is a bicentric intervention conducted in 3 care centers (Pavia and Milan) and 1 secondary school (Rome), involving approximately 200 participants with ASD aged 3 to 35 years. The study consists of an observational phase (T0) and an intervention phase (T1). At T0, biographical data, clinical characteristics, and dietary patterns of participants are collected. Based on T0 findings and existing nutritional recommendations for individuals with ASD, targeted menus are developed and tested. At T1, the same assessment tools used at T0 will be applied to evaluate intervention effects. Additionally, a nutrition education course for caregivers will be implemented between T0 and T1, with a pre- and postcourse knowledge questionnaire to assess its effectiveness. RESULTS: Due to different timelines depending on the centers and schools involved, participant enrollment and data collection will take place at different times between Pavia, Milan, and Rome. In September 2024, enrollment was held in the Pavia and Milan care centers for a total of 74 participants enrolled. In Rome, the enrollment phase has not yet started; activities are expected to be carried out similar to those in Pavia and Milan. CONCLUSIONS: The AUT-MENU study is expected to yield significant insights and improvements in meal acceptance among individuals with ASD, particularly through the introduction of targeted menus in collective catering settings both in care centers and schools. TRIAL REGISTRATION: ClinicalTrials.gov NCT06266377; https://clinicaltrials.gov/study/NCT06266377. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57507.

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7. Cundari M, Vestberg S, Hansson A, Kennberg J, Gustafsson P, Rasmussen A. Sensorimotor functions, visuospatial perception and visuospatial abilities in adult attention deficit hyperactivity disorder and autism spectrum disorder. J Int Neuropsychol Soc. 2025: 1-13.

OBJECTIVE: The aim of this study was to investigate sensorimotor functions that require cerebellar processing, and visuospatial perception and visuospatial abilities in adult patients with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). METHOD: We included patients with unmedicated ADHD (n = 52), medicated ADHD (n = 39), ASD (n = 33), the combination of unmedicated ADHD and ASD (n = 31) and controls (n = 78). A multimodal set of neurocognitive tests and motor tasks were administrated to evaluate cognitive and motor skills. RESULTS: All patient groups exhibited significantly worse performances than controls in sensorimotor functions, visuospatial perception, and visuospatial abilities. We observed significant associations between sensorimotor functions and visuospatial perception and visuospatial abilities. We conducted a regression analysis to evaluate the impact of potential confounders on neurocognitive outcomes. The results indicated that age, level of education, and insomnia, but not anxiety or depression, affected the performance on some tests. CONCLUSIONS: Our results reveal deficits in sensorimotor functions, visuospatial perception, and visuospatial abilities in patients with neuropsychiatric disorders. Clear deficits emerged, despite the majority of patients showing a mild degree of severity index of ADHD/ASD across all groups (61-84%). The results are consistent with the idea that these disorders are linked to cerebellar deficits. Our results suggest that these objective tests have the potential to enhance clinical evaluations.

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8. Danandeh K, Masoudi M, Ahmadi NS, Parvar TA, Heidarzadeh A, Shayestehfar M, Khomeijani-Farahani M, Nakhostin-Ansari A, Memari A. Behavioral and emotional profiles of school-age children with autism spectrum disorder and intellectual disability in Iran: a cross-sectional study. BMC Psychiatry. 2025; 25(1): 516.

BACKGROUND: To date, no study has compared the psychopathologies and unique characteristics of Intellectual Disability (ID) and Autism Spectrum Disorder (ASD) among Iranian children. This study aimed to compare the behavioral and emotional profiles of school-age children with ASD and ID. METHODS: Data were extracted from a large survey consisting of 250 children with ASD and 463 with ID, aged 6-17 years. Diagnoses were based on DSM-V criteria. The parent version of the Child Behavior Checklist (CBCL) was used to evaluate psychopathologies. Scores regarding the sub-scales and specific items were extracted from CBCL and compared in two groups. In the end, the diagnostic value of some specific scores for diagnosing ASD was calculated. RESULTS: The final sample included 250 individuals with ASD and 463 with ID. The mean age of participants was 11.16 (SD = 2.67) and 12.67 (SD = 3.04) years for the ASD and ID groups, respectively. More than 95% of the ASD group were male, while in the ID group, 216 participants were male (46.7%). After adjusting subscale scores for parents’ education, age, gender, and comorbidity in a linear regression model, ASD was only associated with higher withdrawn (P < 0.001), thought problems (P < 0.001), and attention problems (P < 0.001). CONCLUSIONS: This study highlights the distinct behavioral profiles in ASD and ID only using CBCL. Introducing this inventory as a comprehensive scale for understanding developmental disorders. Yet, our findings call for more accurate assessment and intervention strategies for each condition.

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9. Deane KE, Binder DK, Razak KA. Cortical layer-specific abnormalities in auditory responses in a mouse model of Fragile X Syndrome. Neurobiol Dis. 2025; 212: 106963.

Fragile X Syndrome (FXS) is a leading genetic cause of autism spectrum disorders (ASD)- associated behaviors, including sensory processing deficits. Sensory sensitivity and temporal processing deficits in the auditory domain will affect development of language and cognitive functions. The mouse model for FXS, Fmr1 KO, has shown remarkably similar auditory processing phenotypes to patients with FXS. In vitro cortical slice recordings show layer-specific differences in Fmr1 KO mouse local circuits, but it is unclear how these differences translate to changes in sensory processing. In this study, we used a depth multielectrode to record in vivo spikes and local field potentials across layers of the auditory cortex in Fmr1 KO and wildtype mice (WT), converting the latter to current source density (CSD) profiles for improved spatial resolution analysis. We observed reduced CSD sink amplitudes and inter-trial phase coherence, and an increase in trial-to-trial variability for temporally modulated stimuli in the KO mice. Results indicated a differential cortical layer pattern of activity in KO mice, with higher baseline gamma power in superficial and deep layers and higher resting delta and theta power in granular layers. Significantly elevated inter-trial variability was observed for CSD and spikes in KO mice. Auditory steady state responses to clicks or gaps at 40 Hz showed considerable trial-to-trial variability in a layer-specific manner in KO mice. Neural generators in the Fmr1 KO mouse auditory cortex failed to detect short gaps in noise, indicating severe temporal processing deficits. Altogether, this study indicates layer-specific cortical mechanisms of sensory hypersensitivity and temporal processing deficits in FXS.

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10. Dobrachinski F, Ribeiro KA, Bezerra IC, da Silva AJ, Pereira CMM, Vellasques K, Padilha HA, Haas SE, Ávila DS, Gubert P. Nutraceutical approaches for Autism Spectrum Disorder treatment. Behav Brain Res. 2025; 492: 115653.

The Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that has been increasing in prevalence and is characterized by some degree of difficulty with social interaction, communication, and sensory response. According to the World Health Organization, ASD affects 1 in 100 children, and many factors may cause brain alterations, such as genetic and environmental factors. Currently, there is no standard treatment for ASD. Notably, one of the hallmarks of this condition is neuroinflammation since it has been suggested that autism results from central nervous system derangements due to chronic inflammatory reactions, with activation of microglial cells. Therefore, antioxidant and anti-inflammatory compounds may be nutraceutical supplements of interest to attenuate the impacts of neuroinflammation in ASD subjects. This review highlights the main molecules that have been successful in preclinical and clinical trials, as well as potential associations that might be further strategies to investigate.

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11. Espinoza S, Navia C, Torres RF, Llontop N, Valladares V, Silva C, Vivero A, Novoa-Padilla E, Soto-Covasich J, Mella J, Kouro R, Valdivia S, Pérez-Bustamante M, Ojeda-Provoste P, Pineda N, Buvinic S, Lee-Liu D, Henríquez JP, Kerr B. Neuronal Plasticity-Dependent Paradigm and Young Plasma Treatment Prevent Synaptic and Motor Deficit in a Rett Syndrome Mouse Model. Biomolecules. 2025; 15(5).

Classical Rett syndrome (RTT) is a neurodevelopmental disorder caused by mutations in the MECP2 gene, resulting in a devastating phenotype associated with a lack of gene expression control. Mouse models lacking Mecp2 expression with an RTT-like phenotype have been developed to advance therapeutic alternatives. Environmental enrichment (EE) attenuates RTT symptoms in patients and mouse models. However, the mechanisms underlying the effects of EE on RTT have not been fully elucidated. We housed male hemizygous Mecp2-null (Mecp2(-/y)) and wild-type mice in specially conditioned cages to enhance sensory, cognitive, social, and motor stimulation. EE attenuated the progression of the RTT phenotype by preserving neuronal cytoarchitecture and neural plasticity markers. Furthermore, EE ameliorated defects in neuromuscular junction organization and restored the motor deficit of Mecp2(-/y) mice. Treatment with plasma from young WT mice was used to assess whether the increased activity could modify plasma components, mimicking the benefits of EE in Mecp2(-/y). Plasma treatment attenuated the RTT phenotype by improving neurological markers, suggesting that peripheral signals of mice with normal motor function have the potential to reactivate dormant neurodevelopment in RTT mice. These findings demonstrate how EE and treatment with young plasma ameliorate RTT-like phenotype in mice, opening new therapeutical approaches for RTT patients.

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12. Garrison SR, Schweinert SA, Boyer MW, Singh M, Vadapalli S, Engelmann JM, Schwartz RA, Hartig MM. Polypharmacy and pharmacogenomics in high-acuity behavioral health care for autism spectrum disorder: a retrospective study. Child Adolesc Psychiatry Ment Health. 2025; 19(1): 60.

BACKGROUND: This study evaluated pharmacogenomic (PGx) testing in children and adolescents with autism spectrum disorder (ASD). ASD frequently presents with co-occurring depression and anxiety. This complex phenotype often results in psychotropic medication polypharmacy. Incorporating PGx testing into the medical work-up may reduce polypharmacy and improve quality of life with symptom reduction. METHODS: A retrospective electronic health record (EHR) review between January 2017 and May 2023. Individuals either received PGx testing or treatment as usual (TAU). The co-primary outcomes were instance of polypharmacy and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Secondary outcomes included length of stay, average number of psychotropic medications, readmissions and assessments measuring severity of symptoms or behavioral impact. When at least one daily psychotropic medication was prescribed and reported to have an increased probability of gene-drug interactions, the individual was classified as « incongruent » (PGx-I). Individuals were categorized as « congruent » (PGx-C) if all prescribed psychotropic medications were without potential gene-drug interactions. Polypharmacy was evaluated and compared within the PGx-C and PGx-I subgroups. RESULTS: A total of 99 individuals with ASD were analyzed. At the time of admission, 93% of individuals were prescribed at least one psychotropic medication and over half of these individuals were prescribed medications with potential gene-drug interactions. Following PGx testing, there was an overall reduction in prescribed medications with potential gene-drug interactions. No differences were observed between the PGx and TAU groups in polypharmacy, quality of life, or symptom assessments of depression, anxiety, obsessive-compulsive disorder and body-focused repetitive behaviors. Subanalysis comparing congruent (« use as directed ») or incongruent (« use with caution »), as well as exploratory analysis of only CYP2D6 and CYP2C19 gene-drug interactions, were observed to have a similar profile between treatment groups for all primary and secondary outcomes, except for the average number of psychotropic medications prescribed. CONCLUSIONS: Incorporating PGx testing into the medical workup did not improve outcomes, with all treatment groups achieving similar levels of polypharmacy and quality of life. Analysis of secondary outcomes revealed some differences in medication prescribing when stratifying by congruency; however, no differences were observed between treatment groups for all other secondary outcomes.

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13. Gong T, Sun R, Bai J, Liu X, He C, Jiang Q, Wang Q, Qi Y, Ding W, Shen J, Lei L, Shan Z. Calcitriol Modulates Hippocampal Axon Guidance Through Enhanced EfnA4-Mediated PI3K/AKT Signaling in an Autism Mouse Model. CNS Neurosci Ther. 2025; 31(5): e70429.

AIMS: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition arising from the interplay of genetic predispositions and environmental influences. Recent studies have suggested that vitamin D (VitD) supplementation play a role in reducing the risk of ASD and alleviating some of its core symptoms. However, variations in individual responses to VitD due to biological heterogeneity have led to inconsistent clinical outcomes, and the precise molecular mechanisms through which VitD might exert its effects on ASD remain poorly understood. METHODS: We investigated the effects of calcitriol, the biologically active form of VitD, on ASD-associated phenotypes in BTBR mice, a well-established autism model. Behavioral assessments were used to evaluate social and repetitive behaviors. Mechanistic insights were obtained through RNA sequencing, immunohistochemistry, biochemical assays, and stripe guidance assays. RESULTS: Calcitriol supplementation significantly improved autism-like behaviors in BTBR mice, alleviating hippocampal hypoplasia and correcting axon guidance abnormalities. These effects were mediated by modulation of the EfnA4-PI3K signaling pathway in hippocampal neural progenitor cells and other brain regions, highlighting its role in neurodevelopmental processes. CONCLUSION: Our findings demonstrate that calcitriol targets axon-guidance-related signaling pathways, providing a theoretical framework and potential clinical strategy for targeted ASD interventions.

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14. Hanawa Y, Hayashi W, Nakamura D, Suzuki H, Aoyagi K, Iwami Y, Yamauchi M, Seki S, Iwanami A. Comparison of ADOS-2 scores in adults with attention deficit hyperactivity disorder and autism spectrum disorder. PCN Rep. 2025; 4(2): e70118.

AIM: Attention deficit hyperactivity disorder (ADHD) symptoms persist significantly into adulthood; however, only a few studies have examined the overlap between ADHD and autism spectrum disorder (ASD) symptoms in adults. This study compared ASD symptoms in adults with ASD, ADHD, and neurotypical controls using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). METHODS: In total, 150 adults (69 with ADHD [mean age, 34.5 years; 43 men], 50 with ASD [mean age, 33.8 years; 35 men], and 31 controls [mean age, 38.7 years; 17 men]) completed Module 4 of the ADOS-2, the Autism Spectrum Quotient, Conners’ Adult ADHD Rating Scale, and the Wechsler Adult Intelligence Scale. RESULTS: Consistent with juvenile studies, adults with ADHD exhibited significant ASD symptoms, which were between those with ASD and neurotypical individuals. Item-level analysis suggested more similarities than differences between the two disorders; the differences may be of degree rather than quality. CONCLUSION: This study shows the importance of assessing full ASD symptoms in adults with ADHD.

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15. Jha SA, Bolde SM, Hurvitz EA, Caird MS, Whitney DG. Fracture Characteristics Among Adults With Intellectual Disabilities and Autism Spectrum Disorders to Inform Fracture Prevention Strategies: A Descriptive Study. J Intellect Disabil Res. 2025.

BACKGROUND: Adults with intellectual disabilities (ID) and autism spectrum disorders (ASD) have a higher risk of fracture; yet little is known about key fracture characteristics that may inform fracture prevention efforts. The objective was to describe the reported activities that lead to a fracture event, the energy of fractures (e.g., low-energy such as fragility fractures and high-energy such as fractures from a motor vehicle accident) and the location of fractures for adults with ID and ASD. METHODS: In this retrospective cohort study from the United States, medical records from a single clinical site were abstracted to gather information on fracture characteristics (i.e., fracture location, energy of fracture and activities that lead to the fracture event) from adults ≥ 18 years old with intellectual disabilities (ID) and/or autism spectrum disorders (ASD) that sustained ≥ 1 fracture between 1 November 2012 and 2 November 2021. The fracture characteristics were described for the entire cohort and by the following subgroups: ID only, ASD only and ID + ASD. RESULTS: Of the 126 adults with ID and/or ASD, there were a total of 147 fractures for analysis: 84.9% had one fracture, 13.5% had two fractures and 1.6% had three fractures. For the entire cohort, 32.0% were defined as high-energy fractures, but this varied by subgroup: 24.1% for ID only (n = 69 participants, n = 87 fractures), 50.0% for ASD only (n = 35 participants, n = 36 fractures) and 33.3% for ID + ASD (n = 22 participants, n = 24 fractures). The remaining fractures were defined as low-energy or unknown energy. The most common activities that lead to a fracture event were broadly categorised as ‘low-impact falls, unwitnessed falls, transfers’ for ID only (47.1%), ASD only (27.8%) and ID + ASD (41.7%). The most common skeletal region of fractures occurred in the lower extremities for ID only (42.5%) and ID + ASD (50.0%) and in the upper extremities for ASD only (33.3%). CONCLUSIONS: Despite the age being 18 years and older (i.e., not exclusively elderly), most fractures were considered to be low-energy and occurred in the extremities, but this varied by subgroup. This study identified the activities that led to a fracture event, which may inform fracture prevention efforts such as adjunct therapies.

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16. Lamônica D, Rosa KG, Ribeiro E, da Rocha E, Martins MF, Giacheti CM. Clinical features, behaviour and language in Wolf-Hirschhorn syndrome. BMJ Case Rep. 2025; 18(5).

Wolf-Hirschhorn syndrome (WHS) is associated with intellectual disability and multiple congenital anomalies. A female patient with WHS was evaluated at two different times, in childhood and adolescence. Clinical examinations of various medical specialties and assessments of language and behaviour were carried out. In childhood, she showed signs of autism spectrum disorder, as well as other phenotypic characteristics. The impact of this chromosomal anomaly has had repercussions on neurodevelopment and needs to be better understood. This case highlights the serious impairment in both language and behaviour, despite investments in lifelong intervention processes. More research is required to understand WHS’ deleterious effects on development, specifically on language and behaviour.

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17. Maffei MF, Chenausky KV, Tager-Flusberg H, Green JR. An Acoustic Analysis of Speech Motor Performance in Autistic Children. J Speech Lang Hear Res. 2025: 1-23.

PURPOSE: Despite known motor and spoken language impairments in autism spectrum disorder (ASD), the motor skills underlying speech production and their relationship with language skills have rarely been directly investigated in this population. METHOD: Thirty-nine autistic children (14 minimally verbal [MV], 25 verbal [V]) and 11 non-autistic [NA]) children aged 4-7 years were audio-recorded producing multiple repetitions of single syllables. Acoustic features quantifying speech precision, coordination, and consistency were compared among groups. Correlations between acoustic speech features and language measures were examined. RESULTS: The MV group showed significant differences from the V and NA groups in speech precision, coordination, and consistency. Across all the ASD children (MV + V), there were significant correlations between numerous acoustic speech features and expressive and receptive language. CONCLUSIONS: These results are an initial step toward establishing acoustic-based speech motor profiles and understanding the connections between motor and language development in ASD. Measures of early oromotor function have the potential to play a role in the early identification of language impairments and in predicting language outcomes in this population. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.29042162.

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18. Malvania-Damani E, Prabhu S, Shah ND, Patel HP, Shah KP, Patel RH. A cross-sectional study on oral hygiene practices, home care challenges, and barriers to seek dental care for children with autism spectrum disorder from the caregiver’s perspective. J Family Med Prim Care. 2025; 14(4): 1259-65.

OBJECTIVES: To collect and analyse data regarding the oral hygiene practices, home care challenges, and the barriers faced by children with autism in seeking dental care from the caregiver’s perspective. METHODS: A cross-sectional study was conducted on 80 subjects comprising 40 subjects in the autism spectrum disorder (ASD) group and 40 in the comparison group of the typically developing peer (TDP) group. Caregivers of children diagnosed with ASD aged between 4 and 12 and attending therapy centres in Ahmedabad city were included. Matching was done between the ASD and TDP groups for age and sex for both children and caregivers as well as educational qualification of the caregiver. Data were collected using a self-designed, validated questionnaire and analysed using Chi-square test at a 5% level of significance. RESULTS: ASD individuals were brushing less frequently, needing more supervision during brushing and using fingers to clean the teeth over TDPs. Caregivers of ASD individuals display significantly lower awareness of various dental issues explored, less proactive engagement with dental professionals, and significantly more barriers in seeking dental care for their ward for all the variables explored than caregivers of the TDP group. CONCLUSIONS: Caregivers of children with ASD were not adequately aware about their child’s oral health and encountered increased difficulty in maintaining routine oral hygiene for their children at home and accessing suitable dental care compared to the caregivers of children from the TDP.

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19. Meza N, Franco JV, Sguassero Y, Núñez V, Escobar Liquitay CM, Rees R, Williams K, Rojas V, Rojas F, Pringsheim T, Madrid E. Atypical antipsychotics for autism spectrum disorder: a network meta-analysis. Cochrane Database Syst Rev. 2025; 5(5): Cd014965.

RATIONALE: Individuals with autism spectrum disorder (ASD) exhibit a wide variety of symptoms related to social interaction and behaviour. Atypical antipsychotics have been widely evaluated and prescribed to treat distressing symptoms (e.g. irritability, aggression, obsessions, repetitive behaviours, etc.) in children and adults with ASD. Still, their effects and relative efficacy remain unclear. OBJECTIVES: Primary: to assess the comparative benefits of atypical antipsychotics for irritability through network meta-analyses in children and adults with ASD at short-term follow-up. Secondary: to assess the benefits and harms of atypical antipsychotics, compared to placebo or any other atypical antipsychotic, for different symptoms (e.g. aggression, obsessive-compulsive behaviours, inappropriate speech) and side effects (e.g. extrapyramidal symptoms, weight gain, metabolic side effects) in children and adults with ASD at short-, medium- and long-term follow-up. SEARCH METHODS: We searched CENTRAL, MEDLINE, 10 other databases, and two trial registers, together with reference checking, citation searching and contact with study authors to identify studies for inclusion. The latest search was 3 January 2024. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) comparing any atypical antipsychotic drug with placebo or another atypical antipsychotic drug for adults and children with a clinical diagnosis of ASD. OUTCOMES: Critical outcomes included irritability, aggression, weight gain, extrapyramidal side effects, obsessive-compulsive behaviours and inappropriate speech. RISK OF BIAS: We used the Cochrane RoB 2 tool to assess risk of bias in the included studies. SYNTHESIS METHODS: We performed statistical analyses using a frequentist network meta-analysis for combined estimates for the outcome irritability and a random-effects model for pairwise comparisons for other outcomes. We rated the certainty of the evidence using GRADE. INCLUDED STUDIES: We included 17 studies with 1027 randomised participants. One study evaluated adults (31 participants); the remaining 16 studies evaluated children (996 participants). The interventions were risperidone, aripiprazole, lurasidone and olanzapine. SYNTHESIS OF RESULTS: Comparative efficacy on irritability Based on the network meta-analysis, risperidone and aripiprazole may reduce symptoms of irritability compared to placebo in the short term in children with ASD (risperidone: mean difference (MD) -7.89, 95% confidence interval (CI) -9.37 to -6.42; 13 studies, 906 participants; low-certainty evidence; aripiprazole: MD -6.26, 95% CI -7.62 to -4.91; 13 studies, 906 participants; low-certainty evidence). Lurasidone probably results in little to no difference in irritability compared to placebo in the short term (MD -1.30, 95% CI -5.46 to 2.86; 13 studies, 906 participants; moderate-certainty evidence). Efficacy and safety on other outcomes We are very uncertain about the effects of atypical antipsychotics on aggression compared to placebo at short-term follow-up in children with ASD (risk ratio (RR) 1.06, 95% CI 0.96 to 1.17; 1 study, 66 participants; very low-certainty evidence). The certainty of the evidence was very low due to concerns about risk of bias and serious imprecision. We are very uncertain about the effects of atypical antipsychotics on the occurrence of weight gain (above predefined levels) compared to placebo in the short term in children with ASD (RR 2.40, 95% CI 1.25 to 4.60; 7 studies, 434 participants; very low-certainty evidence). We are also very uncertain about the effects of atypical antipsychotics on weight gain (in kilograms) compared to placebo in the short term in children with ASD (MD 1.22 kg, 95% CI 0.55 to 1.88; 3 studies, 297 participants; very low-certainty evidence). In both, the certainty of the evidence was very low due to concerns about risk of bias and serious imprecision. We are very uncertain about the effects of atypical antipsychotics on the occurrence of extrapyramidal side effects compared to placebo in the short term in children with ASD (RR 2.36, 95% CI 1.22 to 4.59; 6 studies, 511 participants; very low-certainty evidence). The certainty of the evidence was very low due to concerns about risk of bias and serious imprecision. Atypical antipsychotics may improve obsessive-compulsive behaviours compared to placebo in the short term in children with ASD (MD -1.36, 95% CI -2.45 to -0.27; 5 studies, 467 participants; low-certainty evidence). The certainty of the evidence was low due to concerns about risk of bias and heterogeneity. Atypical antipsychotics may reduce inappropriate speech compared to placebo in the short term in children with ASD (MD -1.44, 95% CI -2.11 to -0.77; 8 studies, 676 participants; low-certainty evidence). The certainty of the evidence was low due to concerns about risk of bias and heterogeneity. We were unable to evaluate the effects of other atypical antipsychotics. Furthermore, our findings on adults with autism were scarce due to the lack of available studies. AUTHORS’ CONCLUSIONS: Risperidone and aripiprazole may reduce symptoms of irritability compared to placebo in children with ASD in the short term, but lurasidone probably has little to no effect on irritability compared to placebo. Other benefits and potential harms observed ranged from moderate- to very low-certainty evidence. The available data did not allow comprehensive subgroup analyses. New randomised controlled trials with larger sample sizes are needed to balance the efficacy and safety of interventions with enough certainty, which are currently scarce (or even absent in the case of the adult population). Authors should report population and intervention characteristics transparently, providing disaggregated or individual patient data when possible. Furthermore, consistent measurement methods for each outcome should be reported to avoid problems during the data synthesis process. FUNDING: This Cochrane review had no dedicated funding. REGISTRATION: Protocol available via 10.1002/14651858.CD014965.

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20. Nijhof D, Sosenko F, Mackay D, Fleming M, Jani BD, Pell JP, Hatton C, Cairns D, Henderson A, Ward LM, Rydzewska E, Gardani M, Millington E, Melville C. A Population-Based Cross-Sectional Investigation of COVID-19 Hospitalizations and Mortality Among Autistic People. J Autism Dev Disord. 2025.

Current evidence suggests the possibility that autistic people may be at more risk of COVID-19 infection, hospitalisation, and mortality than the general population. Previous studies, however, are either limited in scale or do not investigate potential risk factors. Research into risk factors focused on general population samples. The current study aims to investigate these risk factors in the autistic population. Using data-linkage and a whole-country population, this study modelled associations between autism and COVID-19 hospitalisation and mortality risk in adults, investigating a multitude of clinical and demographic risk factors. Autistic adults had higher rates of hospitalisation, Standardised Incident Ratio 1.6 in 2020 and 1.3 in 2021, and mortality, Standardised Mortality Ratio 1.52 in 2020 and 1.34 in 2021, due to COVID-19 than the general population. In both populations, age, complex multimorbidity and vaccination status were the most significant predictors of COVID-19 hospitalisation and mortality. Effects of psychotropic medication varied by class. Although similar factors exhibited a positive association with heightened risk of severe COVID-19 in both the autistic and general populations, with comparable effect sizes, mortality rates were elevated among the autistic population compared to the general population. Specifically, complex multimorbidity and classification of prescribed medications may emerge as particularly significant predictors of severe COVID-19 among individuals within the autistic population due to higher prevalence of complex multimorbidity in the autistic population and variability in the association between medication classes and severe COVID-19 between both populations, though further research is needed.

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21. Panda PK, Sharawat IK. Reply to letter: Correspondence to « Efficacy of oral folinic acid supplementation in children with autism spectrum disorder: a randomized double-blind, placebo-controlled trial. Eur J Pediatr. 2025; 184(6): 351.

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22. Pretorius L, Coetzee JA, Santos APD, Smith C. Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut. Mol Med. 2025; 31(1): 198.

Autism spectrum disorder (ASD) affects approximately 1% of the population directly, but also a much higher proportion (family and caregivers) indirectly. Although ASD is characterized by high prevalence of anxiety and poor gastrointestinal health, current treatment strategies are mainly focused on neurological symptomatic treatment, with little to no attention to gut health. Furthermore, many psychiatric drugs used for management of secondary neurological symptoms, are known to exacerbate gut health issues and neurological dysregulation across the gut-brain axis.Trace amines are neurotransmitter-like substances synthesized endogenously in the human brain – in trace amounts – but also in high abundance by the microbiome. Emerging evidence suggests dysregulation of the trace amine system in ASD. Since trace aminergic signalling is central to regulatory system homeostasis, we hypothesize targeting this system in the ASD context. Given the various sources of trace amines, we suggest that normalization of functional dysbiosis in terms of trace aminergic signalling – rather than microbial compositional dysbiosis – should be a focus in medicines development. In addition, a holistic consideration including also other factors at play in determining trace aminergic signalling outcome – such as receptor binding, enzymatic role players, etc. – is required to fully elucidate and therapeutically modify the pathophysiology of regulatory systems implicated in ASD.This review firstly provides a brief overview of trace amine dysregulation in ASD for context. Secondly, we formulate our hypothesis on how this may therapeutically address symptomology, with consideration of cellular and molecular mechanism interplay across the gut-brain axis. Finally, we provide a critical assessment of advances in therapeutics development and drug re-purposing, gaps in knowledge and priorities for medicines development going forward.

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23. Sharma A, Fogler J, Van Scoyoc A, Phelps R, Augustyn M. Clinical Presentation and Questions of Identity, Camouflaging, and Self-diagnosed Autism in a Nonbinary Young Adult. J Dev Behav Pediatr. 2025.

Vee is a nonbinary (sex assigned at birth: female) 16-year-old 11th grader presenting for their initial multidisciplinary team assessment (including developmental-behavioral pediatrics and psychological assessment). Vee’s family first became concerned about their development when they were in pre-kindergarten. The school had concerns related to autism and provided Vee with an Individualized Education Plan (IEP) for autism-related services, although a formal medical diagnosis was never made. Vee « lost » the autism classification and associated services when they were in the first grade and no longer qualified for an IEP. However, concerns regarding social skills and identity persist 10 years later, and Vee is now questioning whether they are on the autism spectrum. Vee has carried historical diagnoses of obsessive-compulsive disorder (OCD), anxiety, depression, attention-deficit hyperactivity disorder, and specific learning disabilities-none of these diagnoses entirely explaining or satisfying Vee’s long-standing sense of neither understanding nor being understood by others. Although symptoms of OCD, including intrusive thoughts, have significantly improved with therapeutic intervention, Vee still struggles with mood and anxiety. Their anxious tendencies include hair pulling and storing the hair in boxes. They « hate » school and often engage in school refusal; this has notably worsened since Vee entered middle school. Upon the start of high school, Vee disclosed that they identify as nonbinary to their parents, best friends, and school counselor.Vee struggles with social interactions, especially in novel social situations, and there is a history of bullying. They have 2 best friends, who both recently moved away. Most of their friends are in the online community. Vee has always preferred independent play, loves anime and rescuing animals, and is very imaginative and artistic. Vee has an early history of lining up items, toe-walking, and sensory sensitivities to loud noises, aesthetics of rooms and clothing, and textures of clothing. Vee can be aggressive toward their mother when they are frustrated and may even punch walls. They are not aggressive with any other individuals. Her mother wonders where « nonbinary begins and neurodiversity ends, never mind just being a teenager! »During the course of the assessment, which included Module 4 of the Autism Diagnostic Observation Schedule, Second Edition, Vee used little to no eye contact to manage their social interactions. They spoke in a flat monotone, and their use of gestures was greatly reduced for age; their gestures were also stiff and poorly coordinated. During the course of the assessment, Vee narrated their thought process in what they characterized as their « vocal stim »: silly voices, catch-phrases and blurted swear-words. Vee explained how they use their vocal stim at different times to discharge nervous energy, entertain friends, and cope with challenging situations. Vee and their family are desperately seeking an answer to why they are so « different » from other young adults. Ultimately, the team conferred a diagnosis of autism spectrum disorder, much to the relief and expressed appreciation of Vee and their family. How can the team proceed from here and support Vee and their family?

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24. Wang J, Dou HH, Liang QY. Causal relationship between gut microbiota, blood metabolites and autism spectrum disorder: a Mendelian randomization study. R Soc Open Sci. 2025; 12(5): 250158.

This study explored the causal relationships between gut microbiota, blood metabolites and autism spectrum disorder (ASD) in children and assessed whether metabolites mediate the relationship between microbiota and ASD. Using Mendelian randomization (MR), causal links between gut microbiota, blood metabolites and ASD were analysed, alongside reverse MR to examine reverse causality. A two-step MR mediation analysis was used to assess metabolite mediation. The study identified 15 gut microbiota types significantly associated with ASD, with Marinilabiliaceae showing the strongest positive link (odds ratio (OR) = 5.206, 95% confidence interval (CI) = 1.2783-21.2017, p = 0.0213) and Poseidoniaceae the strongest negative association (OR = 0.1466, 95% CI = 0.0306-0.7035, p = 0.0164). Among 52 blood metabolites, 4-methylcatechol sulphate was positively associated with ASD risk (OR = 1.6776, 95% CI = 1.0482-2.6849, p = 0.0311), while the glucose-to-maltose ratio showed a negative relationship (OR = 0.6358). No significant reverse causal effects of ASD on microbiota or metabolites were found. Nine metabolites mediated the relationship between microbiota and ASD, with 1-methyl-5-imidazoleacetate showing the strongest negative mediation effect (mediating effect = -0.0862, mediation proportion = 12.30%). This study reveals complex causal pathways involving microbiota and metabolites in ASD, suggesting metabolites may mediate the microbiota-ASD relationship, offering insights into ASD mechanisms and potential interventions.

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25. Wang W, Xiao J, Diao L. The Effects of Robots on Children with Autism Spectrum Disorder: A Meta-analysis. J Autism Dev Disord. 2025.

This study aimed to evaluate the effectiveness of robotic interventions in fostering the development of children with Autism Spectrum Disorder (ASD) and to identify key factors influencing these effects through a meta-analysis. A meta-analysis was conducted on 14 studies published between 2015 and 2024, incorporating 58 independent effect sizes and data from 408 children with ASD. A random-effects model was used to compute overall effect sizes, and moderator analyses were performed to examine factors influencing the impact of robotic interventions. The meta-analysis revealed that robotic interventions had a substantial positive impact on the development of children with ASD, with an overall effect size of d = 0.829 (95% CI = [0.657, 1.000]), indicating a large effect. Significant variability in effect sizes was observed based on the functional role of robots, specific developmental domains assessed, geographical regions, experimental design, and the inclusion of control groups. Notably, the effect size decreased as teacher involvement in interventions diminished. Additionally, meta-regression analysis showed that longer instructional session durations were positively associated with intervention effectiveness. Robotic interventions are effective in supporting the development of children with ASD, particularly when teachers are actively involved and instructional sessions are of sufficient duration. Future research should focus on optimizing intervention protocols and exploring the impact of different robot functionalities and regional contexts.

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26. Wu X, Cao T, Ye J, Shi R, Bao X, Ge Y, Li D, Hao S, Liu F, Liu X. Supplementation of 2′-Fucosyllactose during the Growth Period Improves Neurodevelopmental Disorders in Offspring Mice Induced by Maternal Immune Activation. J Agric Food Chem. 2025; 73(20): 12292-307.

Autism spectrum disorder is a serious neurodevelopmental disorder whose early onset significantly affects an individual’s social interactions and cognitive function. Recent research suggests that modulating the gut microbiota could be a potential intervention strategy for autism spectrum disorder symptoms. 2′-Fucosyllactose has been identified as a regulator of gut microbiota homeostasis, however, its effectiveness in addressing autism spectrum disorder remains unclear. In this study, the effects of daily supplementation of 2′-FL in 3-week-old male offspring mice for 5 weeks were examined. The results showed that 2′-fucosyllactose significantly improved autism spectrum disorder-like behavioral deficits. Furthermore, supplementation with 2′-fucosyllactose restored intestinal barrier integrity and increased relative abundance of beneficial gut bacteria, particularly Akkermansia and Bifidobacterium that are closely related to bile acid metabolism. Notably, 2′-fucosyllactose treatment elevated the content of bile acids and upregulated the expression of bile acid receptors in the brain. Co-housing experiments further confirmed the crucial role of gut microbiota in mediating the beneficial effects of 2′-fucosyllactose. Overall, this study suggests that 2′-fucosyllactose could alleviate maternal immune activation-induced behavioral deficits and neuroinflammation through the regulation of the gut-brain axis, offering potential therapeutic value.

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27. Zhang H, Liang Z, Zhuang H, Wang M, Huang Y, Cao X, Chen H, Shen L, Feng C. Proteomic study of plasma and L1CAM-captured exosomal proteins in children with autism spectrum disorders. J Pharm Biomed Anal. 2025; 264: 116965.

Autism spectrum disorder (ASD) has become a neurodevelopmental disorder that seriously endangers the health of infants and children. In order to explore the pathogenesis of the disease and search for early diagnostic biomarkers. In this study, plasma exosomes (PEs) and neural cell adhesion molecule L1 (L1CAM)-captured exosomes (LCEs) of ASD and controls were extracted and lysed to obtain proteins. Isobaric tags for relative and absolute quantitation (iTRAQ) proteomics were applied to investigate the differences in the expression of PEs and LCEs proteins between the two groups. Twenty-eight plasma exosomal differentially expressed proteins (DEPs) were identified, which were mainly associated with immunity, inflammation, complement and coagulation, and lipoprotein metabolism and transport. Twenty L1CAM-captured exosomal DEPs were identified, which were mainly involved in cytoskeleton, tight junctions, focal adhesion, and platelet-associated pathways. Meanwhile, our results suggested that processes or signaling pathways associated with the DEPs from plasma exosomes may be activated, whereas those associated with L1CAM-captured exosome may be inhibited. These processes or signaling pathways have been reported to be associated with ASD in previous studies. These DEPs have the potential to be diagnostic markers. This study provides new insights into disease mechanisms and diagnostic markers of ASD.

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