1. Alnıaçık M, Bengisu S. Dysphagia in Children With Autism Spectrum Disorder and Typical Development: A Comparative Study on the Symptoms and Impact on Parents. Int J Lang Commun Disord. 2025; 60(6): e70149.

OBJECTIVE: This study aims to comparatively examine dysphagia symptoms in children diagnosed with autism spectrum disorder (ASD) and children with typical development (TD), along with the impact on their families. METHODS: A total of 70 children aged 3-7 years and their parents took part in the study (35 children diagnosed with ASD and their parents, and 35 typically developing children and their parents). Swallowing disorders were assessed using the Pediatric Eating Assessment Tool (PEDI-EAT-10). The impact of children’s feeding and swallowing problems on their parents was measured through the Feeding/Swallowing Impact Survey (FS-IS). RESULTS: According to the PEDI-EAT-10 results, abnormalities in swallowing function were identified in 20% of children diagnosed with ASD, and in 8.57% of TD children. However, no statistically significant difference was found when the PEDI-EAT-10 total scores of both groups were compared (p = 0.833). An analysis of the FS-IS subscales revealed a statistically significant difference in the ‘daily activities’ subscale between the parents of children with ASD and TD (p = 0.036). In contrast, no significant difference was observed between the groups in terms of ‘worry,’ ‘feeding difficulties,’ and total FS-IS scores (p > 0.05). CONCLUSION: This study demonstrates that children with ASD carry a higher clinical risk for parent-reported swallowing and feeding difficulties compared to their typically developing peers, and that these problems negatively affect parents’ quality of life. The findings highlight the importance of early assessment of feeding skills and behaviour as well as swallowing function, and the development of child-family-centred holistic intervention approaches to support children’s functional development and improve families’ daily lives. WHAT THIS PAPER ADDS: What is already known on the subject Feeding and swallowing difficulties are more frequently observed in children with Autism Spectrum Disorder (ASD) than in their typically developing (TD) peers. These difficulties include food selectivity, chewing and swallowing problems, and disruptive mealtime behaviours. While these symptoms are not core diagnostic criteria for ASD, they significantly affect the child’s health and family dynamics. Previous research has mostly focused on behavioural aspects of feeding without extensively comparing clinical symptoms of dysphagia or their psychosocial impacts on caregivers. What this paper adds to the existing knowledge This study offers a comparative analysis of swallowing difficulties in children with ASD and TD children using validated tools (PEDI-EAT-10, FS-IS). It highlights that while clinical dysphagia risk is higher in children with ASD, the most significant impact observed is on caregivers’ daily functioning. Importantly, it shows that even without statistically significant differences in most metrics, parents of children with ASD experience greater disruptions in everyday routines. The study also confirms that the severity of children’s swallowing symptoms correlates with increased parental stress and reduced quality of life. What are the potential or actual clinical implications for this work? The findings underline the importance of early identification and intervention for feeding and swallowing difficulties in children with ASD. Paediatricians, speech-language pathologists, and interdisciplinary teams should consider both the physical and psychosocial dimensions of feeding problems. Child- and family-centred approaches are essential to address the functional impact on families. Tailoring interventions to alleviate caregiver burden and enhance daily life quality can improve outcomes for both children and their families. This study supports integrating caregiver support and education into clinical protocols for managing feeding difficulties in neurodevelopmental disorders.

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2. Ateş B, Ayaroğlu P, Cöngöloğlu MA. Evaluation of Nucleated Red Blood Cell Levels in Children With Autism Spectrum Disorder: Relationship With Disorder Severity. Int J Dev Neurosci. 2025; 85(6): e70058.

OBJECTIVES: Autism spectrum disorder (ASD) has a complex aetiology and a heterogeneous clinical presentation. Having easily accessible and interpretable parameters that can be correlated with disorder severity will provide important contributions to clinicians. This study aimed to investigate nucleated red blood cell (nRBC) count and other complete blood count parameters and their relationship with ASD severity in preschool children. METHODS: In this retrospective study, 68 ASD cases were included. The severity of the disorder was determined using the Childhood Autism Rating Scale. Regression history and intellectual disability data were obtained from the medical records. RESULTS: The nRBC count was positive in 11.5% of the participants. The nRBC count in male ASD cases was found to be statistically higher in mild/moderate cases than in severe cases. The nRBC count, the platelet count and intellectual disability were found to be predictors of ASD severity. CONCLUSIONS: Differences in some complete blood count parameters, especially nRBC, were found in the study’s ASD cases. The platelet count and the nRBC count may be predictive of ASD severity.

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3. Bittman B, White D, Bunstein T, Duty J. Outcomes Assessment of a Novel, Multisite, School-Based Inclusive Instrumental Music Program with Peer-Mentoring for Students with Intellectual and Developmental Disabilities. Adv Mind Body Med. 2025.

BACKGROUND: Psychosocial skills developed in an inclusive learning environment can benefit students with intellectual and developmental disabilities (IDD). However, the inclusion of students with disabilities in classroom-based learning environments often remains challenging. OBJECTIVE: This multisite, cohort-based observational study, spanning a school year (August-September through May-June), examined the psychosocial development of 60 new musicians-students with IDD who participated in an inclusive school-based instrumental music program with peer mentoring for the first time. METHODS: Students from eight public schools participated in the United Sound instrumental music program for an average of 45 minutes per week throughout the school year. Special education teachers assigned volunteer student musicians, referred to as peer mentors, to work closely with and support new musicians who were trained to play an instrument and perform in ensembles, bands, and orchestras. Peer-mentor training by special education teachers focused on the established United Sound curriculum and three key strategies: Communicate, Modify, and Empower. New musicians underwent psychosocial evaluations conducted by special education teachers familiar with them at the beginning and end of the school year, utilizing a novel, newly developed 10-measure direct observation assessment tool. RESULTS: Statistically significant findings were noted in pre- and post-tests across all measures. Improvements over the baseline ranged from 8.2% to 29.8%. These include willingness to participate in non-preferred activities (9.8%), peer appropriate communications (9.1%), positive peer interactions (8.2%), empathy (14.6%), appropriate assertiveness (13.0%), impulse control (24.7%), self-confidence (18.8%), pride (13.2%), resilience (24.5%), and the ability to endure stressful environments (29.8%). CONCLUSION: This unique, inclusive instrumental music program with peer mentoring should be considered an integral component of the educational framework in all schools, as it has the potential to improve the psychosocial development and the future potential of students with IDD. KEYWORDS: inclusive music education, intellectual and developmental disabilities, peer mentoring, psychosocial outcomes.

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4. Blake M, Nikahd M, Hyer JM, Patterson BW, Wolf BJ, Bishop L, Hand BN. Comparing Autistic and Non-Autistic Older Adults’ Fall-Related Hospitalization Care and Outcomes. J Gen Intern Med. 2025.

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5. Carnevali L, Valori I, Longa LD, Mantovani G, Mason G, Bin F, Farroni T. Time contingency and social engagement shape interaction choices in autism and neurotypical development. Sci Rep. 2025; 15(1): 36757.

In social interactions, the coordination of biobehavioural rhythms – interpersonal synchrony (IS) – fosters cooperation, enhances prosocial behaviours, and moulds lifelong social attitudes. At the core of synchronous interactions is the ability to detect and respond contingently to communicative signals. Atypicalities in these processes may emerge along diverse developmental trajectories and contribute to socio-communicative difficulties commonly observed in Autism Spectrum Disorder (ASD), where social disconnection is often reported. Our exploratory research simulates interactions to delve into factors influencing IS in ASD and typically developing (TD) peers, examining the impact of time contingency and social engagement on preferences for social partners across the lifespan. Using a tablet-based task, 116 participants (n = 58 ASD, n = 58 TD; age range: 3.8-33 years) repeatedly interacted with faces that transitioned from side to front upon selection. Stimuli responses varied in time contingency (immediate or delayed response) and social engagement (smiley direct gaze vs. neutral averted gaze). Our results show that TD participants consistently prioritized social engagement, even in the absence of time contingency. In contrast, ASD participants prioritized contingency as a cue but only when this was paired with social engagement. We argue that the combination of time contingency and social engagement enhances social agency, which is particularly relevant for ASD. We discuss how creating predictable and engaging social environments could help autistic individuals feel more connected in social settings.

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6. D’Incal CP, Dierickx B, Vingerhoets C, van Haelst M, Annear DJ, Van Dijck A, Bastini L, Konings A, Elinck E, Mateiu L, van Eeghen AM, Kooy RF. A missense variant in the KH0-domain of FMRP downregulates the protein in a patient with the clinical hallmarks of fragile X syndrome. Eur J Hum Genet. 2025.

The majority of patients affected by fragile X syndrome (OMIM #300624), a common inherited form of autism spectrum disorders and intellectual disability, displays a CGG triplet repeat expansion in the Fragile X messenger ribonucleoprotein 1 (FMR1) gene promotor, resulting in hypermethylation and epigenetic silencing of the associated FMRP protein. Only a handful of missense variants have been described as causative for fragile X syndrome and only the p.Arg138Gln variant has been reported as recurrent. Here, we present a 23-year-old male subject with the clinical characteristics of fragile X syndrome who is diagnosed with the maternally inherited missense variant c.500A>C, that translates proline at amino acid residue 167 instead of glutamic acid (p.Gln167Pro), but without an FMR1 repeat expansion. Western blotting experiments demonstrated that the Gln167Pro mutant showed a remarkable reduction of FMRP expression in lymphoblastoid cell lines, paralleled by similar observations in a HEK293T overexpression system. Subsequent lymphoblastoid transcriptome analysis showed a dysregulated gene signature with significant overlap with that observed in patients with a fragile X repeat expansion. Genome-wide methylation analysis confirmed hypomethylation of the FMR1 promotor region, indicative for expression of the gene. This report suggests that the FMR1 c.500A>C (p.Gln167Pro) missense variant is causative for a fragile X syndrome phenotype with a disrupted molecular gene signature characteristic for the syndrome and illustrates the use of an ID gene panel as a complementary diagnostic tool in case of a negative CGG repeat expansion test.

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7. Forby L, Porto GG, Kingstone A. Mind wandering during five minutes of rest: Autistic traits, visual thought, and thinking about others. Acta Psychol (Amst). 2025; 261: 105746.

Neurotypicals mind wander between 20% and 50% of their waking hours, during which they engage in mental tasks such as problem-solving, planning, mulling current concerns, and self-reflection. Despite extensive literature dedicated to mind wandering (MW) in neurotypicals, very little is known about what Autistic individuals or those high in autistic traits might think about while MW. Also unclear is whether they are predisposed to thinking in visual rather than verbal form. To investigate the effects of autistic traits on MW, we asked 92 participants to sit in a quiet room for five minutes with their eyes closed. Following the resting period, participants completed the 10-item Autism quotient (AQ-10) and the Amsterdam Resting-State Questionnaire (ARSQ), which measures 10 factors of MW. The ARSQ factor Theory of Mind (ToM-A) was modestly and negatively correlated with AQ-10 score, driven by fewer reports of thinking about others. Notably, neither correlational nor group-level analyses provided evidence that autistic traits were linked with placing oneself in others’ shoes or Visual Thought. For both high and low AQ-10 scorers, Bayesian analyses indicated extreme evidence for a positive correlation between thinking about others and Visual Thought, and moderate evidence for a positive correlation between thinking about others and thinking about the self. These exploratory findings contribute to the limited literature on MW content in individuals high in autistic traits and provide directions for future research with larger, more diverse samples.

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8. Friedman L, Maltman N, Sterling A, Hudock RL, DaWalt LS. Filled Pause Use in Autistic Adults and Their First-Degree Relatives: Gender Differences and Within-Family Associations. J Speech Lang Hear Res. 2025: 1-15.

PURPOSE: Prior research indicates that filled pauses (e.g., um and uh) are a marker of pragmatic language. Although pragmatic language features run in families of autistic individuals, it is not clear whether variation in filled pause production of autistic adults is also familial. It is also possible that filled pause use is a subtle meaningful marker of gender differences. The present study examined filled pause production, a potential marker that may be linked to genetic liability, in autistic adults and their parents, and evaluated relationships with autism traits and the broad autism phenotype (BAP). METHOD: Autistic adults (n = 33 males, 10 females) and their parents (n = 15 fathers, 40 mothers) provided a monologic language sample, which were transcribed and analyzed for filled pauses, including um rate (ums out of total words), uh rate (uhs out of total words), and um ratio (ums out of total filled pauses). RESULTS: Autistic adult males and fathers produced higher rates of uhs and lower um ratios than autistic adult females and mothers, respectively. Among autistic adults, more autism traits were associated with lower um ratios and higher uh rates. Adult-filled pause use was associated with maternal filled pause use and paternal BAP features. CONCLUSIONS: Our findings build on research on gender differences in autism. The association between lower um ratio and more autism traits indicates that um may be a pragmatic marker related to core features of autism. The differential relationships in filled pauses of autistic adults and filled pauses and BAP features of their parents suggest that filled pauses may be familial. Findings have implications for examining the utility of filled pauses as markers of genetic liability for autism.

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9. Haid NW, Failla MD, Sturm A. Autistic women report high levels of pain, pain-related anxiety, and pain interference. Pain Rep. 2025; 10(6): e1346.

INTRODUCTION: Evidence suggests autistic adults experience pain in different ways compared with nonautistic people. Autistic adults report greater pain-related anxiety, which is associated with increased pain sensitivity, and experience high rates of generalized anxiety. It is not yet clear how generalized anxiety may be related to pain-related anxiety for autistic people. Nonautistic women generally experience more pain sensitivity and pain interference. Thus, autistic women may be at greater risk of experiencing the impact of pain-related anxiety on their daily lives. OBJECTIVES: We sought to examine the relationship between pain-related anxiety, generalized anxiety, and pain’s interference (eg, daily activities, mood) in autistic women’s lives. METHODS: The present study included N = 52 autistic adults, assigned female at birth (AFAB), who reported on their pain (Brief Pain Inventory), pain-related anxiety (Pain Anxiety Symptoms Scale-20) and generalized anxiety (Generalized Anxiety Disorder 7-Item scale). RESULTS: In this sample, 65.4% of participants reported pain in the last 24 hours and high rates of pain interference overall. Autistic AFAB people reported high rates of generalized anxiety (11.75 ± 5.19) and pain-related anxiety (48.80 ± 13.54). Only the cognitive pain-related anxiety subscale was significantly correlated with generalized anxiety (r = 0.30, P < 0.05). Total pain-related anxiety was associated with pain interference (enjoyment of life, r = 0.39, P < 0.01). CONCLUSION: Autistic AFAB people are experiencing high rates of pain, pain interference, anxiety, and pain-related anxiety. Given the relationship between pain and anxiety reported for autistic women, therapies that specifically target pain-related anxiety may have profound impacts on autistic women's quality of life.

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10. Hou Y, Huang W, Lin L, Li X, Dai S, Shen Y, Ou J. Patterns and Stability of Repetitive and Restricted Behaviors in Chinese Children With Autism: A 1-3 Year Follow-Up Study. Autism Res. 2025.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by significant clinical heterogeneity. Sex-based differences are observed in the core symptoms of ASD. This study investigated the patterns and stability of restricted and repetitive behaviors (RRBs) among Chinese children with ASD. For cross-sectional comparisons, researchers recruited 1760 male and 350 female participants whose ages ranged from 4 to 17 years. The Social Responsiveness Scale-2 (SRS-2) was used to measure the core symptoms of ASD. Compared with males, females exhibited lower severity and incidence rates of RRB both overall and at the symptom level. Furthermore, multigroup confirmatory factor analyses demonstrated that sex-related differences did not significantly affect the conceptualization of RRBs. An online follow-up study involving a subset of participants (166 males and 41 females) revealed that RRB symptoms remained stable between the two visits for males; however, only specific symptoms were highly consistent over time for females. This study revealed potential sex-related differences in RRBs among Chinese individuals with ASD and revealed sex-dependent variations in symptom-level presentation patterns and stability. These findings may contribute to a better understanding of the mechanisms underlying sex-related differences and aid in the development of sex-specific diagnostic criteria.

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11. Lin X, Deng S, Li X. Multilevel Resting-State Dysfunctional Connectivity in People With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Autism Res. 2025.

Autism spectrum disorder (ASD) has been linked to dysfunctional communication among brain regions and functional networks, as reflected by abnormal resting-state functional connectivity (rsFC). However, the consistent findings thus far have been elusive. To examine whether individuals with ASD show rsFC differently than healthy individuals at multiple seed levels, we performed a systematic analysis and meta-analysis at all prior seeds, functional network seeds, and single seed levels. This study was registered in the PROSPERO (registration number CRD42024559418). Publications were identified in PubMed, Embase, and PsycINFO from database inception until December 20, 2023. Publications were included that provided seed-based whole-brain rsFC contrasts between a sample with ASD and controls at rest. Seed and peak effect coordinates and intergroup effects were extracted for analysis. Random-effects meta-analysis was performed using the Seed-based d Mapping software. This study included 26 studies from 709 people with ASD and 705 controls. The frontal regions, right medial cingulate gyrus (MCG) (g = -0.51; 95% CI, -0.69 to -0.33) of the ventral attention network (VAN), and medial left superior frontal gyrus (g = -0.42; 95% CI, -0.60 to -0.24) of the DMN were the most robust peak clusters at all prior seeds, functional network seeds, and medial prefrontal cortex seed level respectively. The findings not only support DMN dysfunction in people with ASD but also provide the first evidence of meta-analysis to suggest VAN dysfunction in individuals with ASD.

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12. Manopetchkasem A, Leelataweewud P, Srimaneekarn N, Smutkeeree A. Parental acceptance of behaviour guidance techniques used with Thai autistic patients in dental practice. Eur Arch Paediatr Dent. 2025.

PURPOSE: To evaluate parental acceptance of nine behaviour guidance techniques (BGTs) for Thai autistic patients in dental treatment and to assess the factors associated with this acceptance. METHODS: A cross-sectional study was conducted among 110 parents of autistic patients using an online questionnaire. The study examined nine BGTs: tell-show-do (TSD), positive reinforcement (PR), distraction (DIS), nitrous oxide/oxygen inhalation (NOOI), active restraint by parent (ARBP), active restraint by staff (ARBS), passive restraint by device (PRBD), oral sedation (OS), and general anaesthesia (GA). The questionnaire collected demographic data and measured parental acceptance using a visual analog scale (VAS) from 0 to 100 after participants viewed portraying each BGT in scenarios simulating potentially cooperative autistic patients. Data were analysed using the Mann-Whitney U test, Kruskal-Wallis test with Bonferroni correction and linear regression analysis. RESULTS: All BGTs received mean VAS score above 60. PR was rated highest, followed by DIS, TSD, PRBD, ARBS, ARBP, GA, OS, and NOOI. Parental acceptance was significantly influenced by previous BGTs experience, past dental experiences, autistic severity level, and parental education level. CONCLUSION: All BGTs evaluated were generally accepted by parents of autistic patients in Thailand. PR was the most accepted technique, whereas NOOI received the lowest acceptance.

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13. Menge S, Segura I, Hartmann M, Decker L, Kiran S, Danzer KM, Iben S, Harbauer AB, Oeckl P, Freischmidt A. Comparing loss of individual fragile X proteins suggests strong links to cellular senescence and aging. Cell Mol Life Sci. 2025; 82(1): 358.

Members of the fragile X protein (FXP) family (FMR1, FXR1 and FXR2) are differentially expressed in most types of cancer and major neurodegenerative diseases. While increased expression of FXR1 in cancer has been linked to senescence evasion and consequently tumor initiation and progression, decreased expression of FXPs in neurodegeneration may contribute to pathogenic protein aggregation and death of vulnerable neurons. However, due the causal role in fragile x syndrome, most data are available about loss of FMR1 in neurons while functions of FXR1 and especially FXR2 remain largely unexplored. To address this knowledge gap, and to directly compare functions of the FXPs, we used proteomics of CRISPR/Cas9 edited HAP1 cells carrying knockouts of the individual FXPs for identification of cellular mechanisms associated with these proteins. Further exploration of proteomic findings suggests roles of the FXPs in ribosome biogenesis, autophagy and mitochondrial health linked to organismal aging, and cellular senescence. Validation of FXP induced defects relevant for neurodegenerative diseases in neuroblastoma cell line SH-SY5Y upon FXP knockdown revealed high cell type specificity of individual FXP functions. Overall, we provide a comprehensive overview and comparison of cellular mechanisms related to the individual FXPs, as well as starting points for further studying this protein family in respective cell types of FXP associated diseases, and in aging in general.

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14. Moorthy RS, Hari Krishnan R, Pugazhenthi S. A mechatronic shirt kit to enhance psychomotor and life skills in autistic children: a pilot study. Sci Rep. 2025; 15(1): 36718.

Training autistic children has become a global challenge, as the number of children diagnosed with it is increasing drastically. The conventional therapies to train autistic children have their own limitations. Technology-enabled training kits can be developed to help impart psychomotor skills to these children. Studies have reported that robot or robot-like features attract autistic children. Taking this as a leverage, in this work, a mechatronic kit has been developed to impart psychomotor and cognitive skills that are useful in day-to-day activities, especially when wearing a shirt. The psychomotor skills addressed are pincer grasp, elbow movement and hand-eye coordination, while the cognitive skills addressed are identification of shirt, colour identification and matching. Pilot trials have been conducted with seven autistic children to study how useful the kit is in imparting the targeted skills. The trials consisted of pre-assessment, training, and post-assessment sessions, having 15 tasks spanning over 7 sessions and 68 trials. After the training, from pre-assessment to post-assessment, an improvement of around 80% has been observed in the Daily Life Skills (DLS) of connecting the shirt with velcros and its associated psychomotor skills.

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15. Mournet AM, Kukaj G, Libsack EJ, Wilkinson E, Bober I, Walker E, Bal VH. Service-level feasibility analysis of a mental health monitoring program for autistic college students. Autism. 2025: 13623613251380445.

Screening for mental health concerns is essential to identify individuals whose risk would otherwise go unnoticed. Recognizing the need to address growing mental health concerns among autistic college students, we implemented a mental health screening and monitoring protocol within a university program devoted to supporting autistic college students. This article describes the process and service-level feasibility of implementing this program over the course of one academic year at a large public university in the Northeast United States. Anxiety, depression, and suicide risk were measured at four time points. Students with elevated risk of mental health symptoms were connected to mental health supports and received suicide risk assessments. Thirty-two individuals took part in the monitoring process across the academic year. The monitoring process identified 53 instances where monitoring, checking-in, or a risk assessment was indicated. Fourteen risk assessments occurred, and 12 students received at least one mental health referral. Leveraging interdisciplinary collaborations, the mental health monitoring program was able to connect numerous autistic college students facing mental health challenges to clinical resources. Rates of follow-up and referral highlight the significance of monitoring. Attention to the feasible integration of mental health supports into existing academic support programs for autistic students is warranted.Lay abstractAutistic college students often face conditions like depression, anxiety, and suicide risk. Recognizing a need to address these mental health concerns, we created a system to track aspects of mental health to help more quickly identify autistic college students who may need support. This article describes the monitoring process that took place primarily over one academic year. Thirty-two students were asked about their anxiety, depression, and suicide risk four times during the academic year. On 53 occasions, students were monitored or had a check-in with clinicians. Fourteen assessments took place to assess suicide risk, and 12 students were connected to mental health resources. This process involved many individuals working together to be able to help autistic students connect to mental health supports. The process required thoughtful collaboration across many people to make sure that it could be successful, and insights are provided to support other schools in doing something similar. Including this type of monitoring within existing academic programs for autistic students may help to make this easier to do at other universities.

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16. Muthiga M, Mbwayo A, Kang’ethe R, Horn N. Pathways and delays in the diagnosis of autism spectrum disorder in Kenya: a cross-sectional study from tertiary hospitals in Nairobi. Child Adolesc Psychiatry Ment Health. 2025; 19(1): 114.

BACKGROUND: Autism Spectrum Disorder (ASD) contributes significantly to the disease burden among children and adolescents. Early diagnosis and intervention significantly improve outcomes; however, in Africa, children and adolescents with ASD are frequently identified and diagnosed late. This has been attributed to long and tortuous pathways to diagnosis. The objective of the study was to document and evaluate the pathways to a diagnosis of ASD, measure the delay in diagnosis, and document factors influencing these. METHODS: A cross-sectional survey of 70 caregivers of children aged 2-18 years with ASD. The Encounter Form, developed by the World Health Organisation, was used to describe pathways to diagnosis, and structured clinical interviews and assessments were used to determine how children’s clinical factors, caregiver socio-demographic factors, and cultural and contextual factors influence the pathways and delays in diagnosis. ASD was diagnosed by a consultant psychiatrist or paediatrician using the Diagnostic and Statistical Manual version 5. SPSS version 23.0 was used for data analysis. Correlations between variables were analysed using Kruskal-Wallis, Mann-Whitney U tests, and logistic regression models. RESULTS: A mainstream (healthcare) and traditional/spiritual-based pathway was utilized by N = 51 (73%) and N = 19 (27%) caregivers, respectively. The mean age of diagnosis was five years, with a delay of 34.9 ± 33.5 months between caregiver symptom recognition and diagnosis. A median of four points of contact was made with care providers before diagnosis, with special needs teachers serving as the primary referral source. Clinical factors associated with a delay in diagnosis included: echolalia (p = 0.03), delayed walking (p = 0.01), attention deficit hyperactivity disorder (p = 0.04), and intellectual developmental disorder (p = 0.02). Conversely, challenges in recognizing, interpreting, and responding to emotional cues (p = 0.03) and « selectiveness in clothing » (p = 0.01) were associated with an earlier diagnosis. CONCLUSION: Despite early recognition of ASD symptoms by caregivers and the predominant use of mainstream healthcare-based pathways, diagnosis was often delayed in this Kenyan sample. Distinct factors associated with the delay in diagnosis were identified, and further research is needed in larger and more diverse groups to facilitate earlier diagnosis and intervention.

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17. P LL, E SK, Radhakrishnan A, G S. Real-Time Classification for EEG Data in Children With ASD Using Deep Learning Techniques. Dev Neurobiol. 2025; 85(4): e23009.

Autism spectrum disorder (ASD) presents unique challenges in diagnosis and treatment, necessitating innovative approaches to understanding its underlying neurophysiological mechanisms. Real-time classification of electroencephalography (EEG) data in children with ASD faces significant challenges due to variability in EEG signals caused by individual differences in brain activity, age, and behavioral states, complicating robust algorithm development. This study develops and validates a deep learning-based framework for real-time EEG classification in children with ASD, aiming to enhance diagnostic accuracy and enable timely interventions. The dataset includes EEG recordings from 60 children (30 with ASD and 30 typically developing), representing diverse age groups and behavioral profiles to improve generalizability. Pre-processing removes noise and artifacts through segmentation, short-time Fourier transform (STFT), and independent component analysis (ICA). Grid search optimization (GSO) enhances model performance by systematically searching hyperparameter combinations to find the optimal configuration. A hybrid convolutional neural network (CNN)-long short-term memory (LSTM) framework is proposed, combining convolutional layers for spatial feature extraction with LSTM layers for temporal sequence modeling. This hybrid model is the primary proposed solution for real-time EEG classification due to its ability to capture both spatial and temporal features critical for interpreting sequential EEG data in children with ASD. The model achieves an accuracy of 87.5%, a precision of 85.0%, a recall of 90.0%, and an F1 score of 87.5% implemented using MATLAB software. In comparison, ResNet, a baseline deep CNN model, achieves slightly higher accuracy (89.1%) but lacks temporal modeling capabilities essential for sequential EEG interpretation. Despite ResNet’s marginally higher accuracy, the hybrid CNN-LSTM is favored as the final model for its superior temporal modeling, critical in EEG analysis. Future work may include real-time feedback mechanisms, mobile application development, and longitudinal data expansion.

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18. Paranjapye A, Ahmad R, Su S, Waldman AJ, Phillips-Cremins JE, Zhang S, Korb E. Autism spectrum disorder-risk genes have convergent effects on transcription and neuronal firing patterns in primary neurons. Genome Res. 2025.

Autism spectrum disorder (ASD) is a highly heterogenous neurodevelopmental disorder with numerous genetic risk factors. Notably, a disproportionate number of risk genes encode transcription regulators including transcription factors and proteins that regulate chromatin. Here, we test the function of nine such ASD-linked transcription regulators by depleting them in primary cultured neurons. We then define the resulting gene expression disruptions using RNA sequencing and test effects on neuronal firing using multielectrode array recordings. We identify shared gene expression signatures across many ASD-risk genes that converge on the disruption of critical synaptic genes. Fitting with this, we detect robust disruptions to neuronal firing throughout neuronal maturation. Together, these findings provide evidence that the loss of multiple ASD-linked transcriptional regulators disrupts transcription of synaptic genes and has convergent effects on neuronal firing that may contribute to enhanced ASD risk.

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19. Philippou S, Voskarides K, Chatzittofis A. Prevalences of Anorexia, Autism, and Schizophrenia, Are Strongly Associated With Average Annual Temperatures: Systematic Review and Linear Regression Analysis. Brain Behav. 2025; 15(10): e70999.

BACKGROUND: The impact of potential environmental influences, like temperature changes and latitudinal gradient, has not been investigated in depth in psychiatric diseases. The aim of this project was to investigate the association of geographical latitude and temperature with the prevalence of psychiatric disorders. METHODS: Linear regression analysis was performed for 201 countries by analyzing average annual temperatures and age-standardized rates (prevalence) of seven major psychiatric entities. A systematic review was also performed, investigating if these correlation data were supported by published original studies. RESULTS: Linear regression analysis showed a significant correlation between average annual temperatures and age-standardized rates (p < 0.0001) for three psychiatric disorders: anorexia, autism, and schizophrenia. Systematic review analysis showed that the prevalence of autism and schizophrenia is potentially influenced by geographic and climatic factors. However, no published data were identified to support the findings for anorexia. CONCLUSION: These preliminary findings underscore the complexity of interactions between environmental, genetic, and socioeconomic factors for psychiatric diseases. The association between temperature and prevalence of psychiatric diseases needs further investigation to reveal any unknown epidemiological factors that contribute to disease pathogenesis.

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20. Rohil A, Jauhari P, Malik R, Charabarty B, Gulati S. Mitigating Feeding Disorders and Malnutrition in Children with Developmental Disabilities: A Narrative Review. Indian Pediatr. 2025.

CONTEXT: Pediatric feeding disorder (PFD) is characterized by age-inappropriate oral intake associated with dysfunction in feeding skills, medical, nutritional, or psychosocial domains. Children with developmental disabilities (DD), such as cerebral palsy (CP), often meet the criteria for PFD due to underlying neurological, motor, and sensory impairments, compounded by psychosocial stressors. These challenges contribute to undernutrition, poor growth, and adverse developmental outcomes, but remain undiagnosed. This review evaluates the burden and spectrum of feeding problems in children with developmental disabilities and aims to bridge gaps in clinical awareness, assessment, and intervention. Evidence acquisition A literature search was conducted using PubMed, Scopus, and Google Scholar for studies published between January 2015 and January 2025. Keywords included: « children » OR « childhood » AND « feeding problems » OR « feeding disorders » OR « malnutrition » OR « dysphagia » OR « drooling » OR « food aversion » OR « oral sensory processing disorders » AND « cerebral palsy » OR « developmental disabilities » OR « neurological impairment. » RESULTS: Forty studies were included wherein feeding disorders were observed in 33-80% of these children. Physical anomalies, swallowing dysfunction, restricted diets, and socio-cultural factors were observed to be responsible for feeding difficulties which ranged from dysphagia, swallowing dysfunction, gastroesophageal reflux disease, constipation, sensory issues and food aversions. A systematic approach-objective assessment of nutritional status, calculating dietary needs, evaluating safety and efficiency of oral feeding, optimizing intake, considering enteral nutrition when indicated-can improve outcomes. CONCLUSION: Feeding disorders are a significant yet modifiable source of morbidity in children with DD. Early recognition and multidisciplinary, evidence-based approach are critical to improving their quality of life.

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21. Sağlam Şahinoğlu Y, Bakırhan H. Holistic approach to Turkish children with autism spectrum disorder: diet quality and diversity, gastrointestinal and nutritional problems and quality of life perspective. BMC Pediatr. 2025; 25(1): 834.

BACKGROUND: Because of behaviors specific to autism spectrum disorder (ASD), children with ASD may have a poor quality of life, and maintain their nutritional and gastrointestinal (GI) health can be quite challenging. This study aimed to holistically examine the diet quality and diversity, quality of life, and nutritional and GI problems in children with ASD and compare their outcomes with healthy peers. METHODS: Nutritional and GI problems were evaluated through a questionnaire according to the parents’ responses. Healthy Eating Index-2015 (HEI-2015) was used to evaluate diet quality, diet diversity score (DDS) was used to examine the food groups consumed, and Pediatric Quality of Life (PedsQL) was used to evaluate the quality of life. RESULTS: A total of 56.0% of children with ASD had a normal body weight for their age, 66.0% had a normal height for their age, and 70.0% had a normal body mass index (BMI) for their age. Various parameters were evaluated for ASD and healthy children, respectively and children with ASD had lower BMI Z scores (ASD = 0.35 ± 0.90, Healthy = 1.03 ± 1.44), lower quality of life (5–7 years ASD = 49.0 ± 5.94, Healthy = 89.0 ± 13.24; 8–12 years ASD = 47.1 ± 7.59, Healthy = 86.9 ± 14.07) and lower diet quality (Healthy = 73.8 ± 3.92, ASD = 71.5 ± 4.11) (p < 0.05). No significant difference was found between the two groups in terms of diet diversity (p > 0.05). Gastrointestinal system problems, food refusal, food neophobia, food obsession and fast eating were seen more frequently in children with ASD compared to healthy children (p < 0.05). CONCLUSION: In conclusion, children with ASD were found to have more nutritional and GI problems, a lower quality of life, and poorer diet quality compared to their peers. Growth curves, diet quality and diversity, quality of life, nutrition and GI problems of children with ASD should be carefully monitored and individualized nutrition strategies should be developed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-025-06207-1.

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22. Seçer I, Çimen F, Ulaş S, Tatlı E, Saatçı F, Pakiş A. Autism traits and mental well-being: the mediating role of social camouflaging and the moderating role of social exclusion and public stigma. Sci Rep. 2025; 15(1): 36633.

There is a strong relationship between autism and mental health problems. Autistic individuals are more frequently exposed to stigma and social exclusion in social life, which may lead them to engage in socially desirable behaviors to camouflage themselves. Within this framework, the present study aimed to examine the relationship between autism traits and mental well-being, focusing on social camouflaging behaviors in the context of social exclusion and perceived stigma. The study sample consisted of 548 adults across Turkey, including 432 women (78.8%) and 116 men (21.2%). To test the proposed model, Model 4 and Model 21 developed by Hayes were used. Data were analyzed using SPSS 21 and PROCESS Macro. The findings indicated a negative and significant relationship between autism traits and mental well-being, with social camouflaging mediating this relationship. In addition, the relationship between autism traits and social camouflaging was found to be influenced by social exclusion, while the relationship between social camouflaging and mental well-being was moderated by perceived public stigma. The findings are expected to contribute to broadening perspectives in autism research.

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23. Smith J, Rabba AS, Coverdale G, Datta P, Hall G, Heyworth M, Hudry K, Lawson W, Lilley R, Pellicano E. « I Just Feel Like the Teacher Understood Me, and She Knew What I Needed »: School Experiences of Autistic Students from Diverse Backgrounds. Autism Dev Lang Impair. 2025; 10: 23969415251377973.

BACKGROUND AND AIMS: Gathering Autistic young people’s testimony is critical for understanding their lived experience of education and designing settings in which these students can thrive. Despite increasing knowledge in this field, we lack perspectives from a broad range of Autistic students which necessarily limits our ability to build inclusive, supportive environments for all. This study explored the educational experiences of preschool and school-aged Autistic students from diverse age groups, backgrounds, and educational settings. METHODS: Thirty-six Autistic students (aged 4-18 years) from Chinese, Vietnamese, Somali, Lebanese, and White Australian backgrounds shared their thoughts and experiences of their education. Through semi-structured interviews, students told their stories using words and pictures. Interview transcripts were analyzed using reflexive thematic analysis. RESULTS: Students described experiencing significant overwhelm within education settings, which led them to value access to safe spaces and having autonomy over decisions in their school day. A strong sense of fairness and justice was reported with students frustrated by inequitable application of school rules, as well as being discouraged by educators’ low expectations of them. Students preferred teachers who were clear and direct in their communication and genuinely cared about them as individuals. Students were mindful of others’ differences and perspectives, striving for mutual respect and friendship with their peers. CONCLUSIONS: Findings from this research indicate that to thrive academically, emotionally and socially, Autistic students need thoughtfully designed education settings with high expectations for every student, together with individualistic care from teachers. IMPLICATIONS: Our findings reinforce how classroom design and education practices must consider the needs of all students for Autistic students to thrive. From a practice perspective, promoting student autonomy around aspects of their educational environment-such as the ability to use headphones in class or provision of spaces in which to retreat to prevent or manage sensory/social overwhelm-could be « quick wins » for schools wanting to foster safer, more secure settings for Autistic learners. Broadly, educators should aim to embed as much certainty as possible into Autistic students’ educational environments to lay a solid foundation for learning. This foundation is likely to be most effective when educators are partners in discovery with each individual Autistic student, seeking to understand their unique strengths, needs, personalities and identities, and build trusting student-teacher relationships. While our research examined the perspectives of a diverse range of Autistic students, future research should attempt to elicit the educational experiences of both younger Autistic children (e.g., preschoolers) and non- or semi-speaking children, exploring methods suited to this purpose.

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24. Sohl K, Linstead E, Heinz K, Lledo EE, Brewer Curran A, Mahurin M, Nanclares-Nogués V, Salomon C, Seal M, Taraman S. Integration of an Artificial Intelligence-Based Autism Diagnostic Device into the ECHO Autism Primary Care Workflow: Prospective Observational Study. JMIR Form Res. 2025; 9: e80733.

BACKGROUND: Pediatric specialist shortages and rapidly rising autism prevalence rates have compelled primary care clinicians to consider playing a greater role in the autism diagnostic process. The ECHO Autism: Early Diagnosis Program (EDx) prepares clinicians to screen, evaluate, differentiate, diagnose, and provide longitudinal care for children with autism in primary care settings. Canvas Dx is a prescription-only Software as a Medical Device designed to support clinical diagnosis or rule out of autism, including in primary care settings. It is authorized by the Food and Drug Administration for use, in conjunction with clinical judgment, in 18- to 72-month-olds with indicators of developmental delay. OBJECTIVE: This study aims to assess the feasibility and impact of integrating the device into the ECHO Autism: EDx workflow. Time from the first clinical question of developmental delay to autism diagnosis is the primary endpoint. Secondary endpoints explore clinician and caregiver experience of device use. METHODS: Children aged 18 to 72 months with concern for developmental delay indicated by either a caregiver or health professionals were eligible to participate in this prospective observational study. Experienced ECHO Autism: EDx clinicians were recruited to evaluate the inclusion of the device as part of their diagnostic evaluations. Outcome data were collected via a combination of electronic questionnaires, standard clinical care record reviews, and analysis of device outputs. Institutional review board approval was provided by the University of Missouri-Columbia (project number 2075722). RESULTS: Eighty children and 7 clinicians completed the study. On average, time from clinical concern at study enrollment to final autism diagnosis was 39.22 days, compared to 180- to 264-day waits at adjacent specialist referral centers. The vast majority (93%, 50/54) of caregivers reported being satisfied with the ECHO Autism: EDx plus device evaluation their child received and endorsed that they would recommend it to others and that they felt comfortable using the device. The device produced determinate autism predictions or rule-outs for 52.5% of participants, and in all cases, these were consistent with the final clinical determination. Participating clinicians reported that device use was feasible and reduced several challenges associated with their previous diagnostic process; however, they noted it did not obviate the need for additional structured observation in every case. CONCLUSIONS: The ECHO Autism: EDx plus device workflow offers considerable time savings compared to specialty center referral and was strongly endorsed by caregiver participants. Embedding the device into the ECHO Autism: EDx workflow was feasible and helped streamline several workflow efficiencies. Clinicians still utilized their training and application and interpretation of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria when formulating the diagnosis for indeterminate cases.

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