1. 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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2. Bradley CB, Ashner MC, Kepner MW, Garcia TP, Grosser KF, Hightshoe K, Moody EJ, Reyes N, Rosenberg SA, Tapia AL, Daniels JL. Mothers’ Ideas About Causes of Autism Spectrum Disorder (ASD): Differences Over Time and by Household Experience with ASD. J Autism Dev Disord. 2025.

To understand trends in mothers’ causal ideas about autism spectrum disorder (ASD) that may be important in targeting education efforts for parents and healthcare providers, as these may be associated with healthcare choices. Data from the Study to Explore Early Development (SEED) was used to examine the causal ideas mothers had, sociodemographic characteristics associated with causal ideas, and whether reported ideas differed over time. SEED included 8307 mothers of pre-school children, with and without ASD, who completed a maternal phone interview between 2007 and 2020. Less than half of mothers (39.3%) offered a causal idea. The most frequently offered causal ideas were genetics, vaccines, environment, parent lifestyle issues, pre/peri-pregnancy maternal medical issues, labor/delivery experiences, and child diet. Some aspects of sociodemographic characteristics, particularly ethno-cultural background, were significantly associated with reporting several causal ideas. Odds of reporting vaccines decreased over time while odds of reporting genetics, parent lifestyle, maternal medical, or labor/delivery issues increased over time. There were significant differences in odds of reporting several causal ideas between those with and those without a child with ASD in the household. Causal ideas reported were consistent with prior research but important differences between those with and those without household ASD as well as significant time trends for certain causes were noted. Implications for public health communication and future research are discussed.

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3. Conti MV, Breda C, Basilico S, Ruggeri S, Scalvedi ML, Cena H. Unlocking the Link: Exploring the Association Between Food Selectivity and Health Outcome in Autism Spectrum Disorder-A Systematic Review. Nutr Rev. 2025.

CONTEXT: Individuals with autism spectrum disorder (ASD) often face behavioral challenges during meals, such as food refusal and restricted food consumption, which encompass the concept of food selectivity (FS). The exclusion of food groups such as fruits and vegetables and preferences toward ultraprocessed foods, therefore, can expose this population to an increased risk of developing different types of malnutrition, such as overweight, obesity, and micronutrient deficiencies. OBJECTIVE: The aim of this systematic review was to assess if FS is a risk factor for poor health outcomes in individuals with ASD, based on findings in the literature published between 2012 and 2023. DATA SOURCES: Four databases (PubMed, Embase, Scopus, and Cochrane) were searched for relevant articles. The search was conducted in May 2023. DATA EXTRACTION: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A checklist was used for data extraction, including descriptive information, study design, study aim, participant information, data collection characteristics, and significant findings. A total of 15 articles were included. DATA SYNTHESIS: Individuals with ASD and with FS appear to have inadequate weight (particularly conditions of overweight and obesity), increased waist circumference, elevated waist-to-height ratio index, and insufficient nutritional intake, all of which increase their susceptibility to malnutrition. CONCLUSIONS: Food selectivity, common in this population, increases the risk of micronutrient deficiencies, gastrointestinal issues, eating disorders, hypertriglyceridemia, overweight, and obesity. However, outcomes vary due to differences in assessment tools and definitions of FS across studies. The lack of standardized methods for evaluating FS complicates the ability to draw consistent conclusions, emphasizing the need for ASD-specific validated tools. Future research should focus on standardizing assessments and exploring long-term health effects and interventions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42023435018.

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4. 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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5. 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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6. Günaydın M, Doğan Ö, Günay F, Çıkılı Uytun M, Çelik Büyükceran Ö, Öztop DB. COMPLEMENT SYSTEM DYSFUNCTION IN AUTISM SPECTRUM DISORDER: EVIDENCE FOR ALTERED C1Q AND C3 LEVELS (COMPLEMENT SYSTEM DYSFUNCTION IN ASD). Acta Neuropsychiatr. 2025: 1-31.

BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in social communication, repetitive behaviors, and restricted interests. Emerging evidence suggests that immune system dysregulation, particularly alterations in the complement system, may contribute to ASD pathophysiology. This study aimed to compare the serum levels of complement proteins (C1q, C2, C3, C4, MBL, L-Ficolin and hsCRP) between children with ASD and non-ASD controls. METHODS: A total of 88 children (44 with ASD and 44 age- and sex-matched healthy controls) participated in this study. Complement protein levels were measured using enzyme-linked immunosorbent assay (ELISA) from serum samples. The severity of ASD symptoms was assessed using standardized diagnostic tools, including the Childhood Autism Rating Scale (CARS), the Autism Behavior Checklist (ABC), and Repetitive Behavior Scale-Revised (RBS-R). RESULTS: Serum C1q levels were significantly lower in the ASD group (p < 0.001). C3 levels were lower (p = 0.033), while C2 levels were slightly higher (p = 0.015) in the ASD group. There are no significant differences in C4, MBL, or L-Ficolin levels. Logistic regression analysis identified reduced C1q levels as a significant predictor of ASD (p = 0.001). However, this study found no significant correlations between complement levels and ASD symptom severity scores. CONCLUSIONS: The findings suggest that alterations in complement system proteins, particularly reduced serum C1q levels, may be associated with ASD. Given C1q's critical role in synaptic pruning and neuroimmune regulation, these results support the hypothesis that complement system dysfunction may contribute to the pathophysiology of ASD.

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7. Hou W, Liang S, Li J. The Effects of Dialogic Reading Intervention on Verbal Interaction and Engagement in Young Autistic Children: A Randomized Controlled Preliminary Study. J Autism Dev Disord. 2025.

The current study investigated whether dialogic reading could improve the verbal response, initiation of communication (questioning and commenting), receptive vocabulary and task engagement in 14 children with autism by using a randomized controlled trial. Moreover, we explored whether the effect of dialogic reading could be generalized to new books. Nine children with autism (mean age = 5.32 years, SD = 1.08) were randomly assigned to the dialogic reading group and five children (mean age = 5.25 years, SD = 1.18) were assigned to the standard book reading group. All children participated in four stages: pre-test, intervention, post-test, and generalization. The intervention was conducted over a four-week period, with three sessions per week, for a total of 12 sessions. We found that during the intervention, children in the dialogic reading group showed significant improvements in responding to adult questions and initiating comments compared with children in the standard book reading group. In addition, the dialogic reading facilitated the vocabulary knowledge and reduced the level of disengagement of children with autism. Further, children in the dialogic reading group could generalize the learned communication skills to new books, although this effect merely reached a marginal significance. Overall, these findings provide unique evidence for the effects of dialogic reading on promoting verbal interaction in children with autism and have great implications for intervention practices.

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8. Huang WL, Leventhal B, Lin CC, Chien YL. Health anxiety and somatic symptoms in adults on the autism spectrum. Psychiatry Res. 2025; 350: 116550.

BACKGROUND: Somatic symptoms and health anxiety impact quality of life. Whether somatic symptoms and health anxiety correlate with autistic traits, anxiety/depression, sensory and personality characteristics has yet to be systematically investigated among autistic people. This study aimed to investigate somatic symptoms and health anxiety in autistic, and their clinical correlates. METHODS: This study recruited 221 autistic adults (aged 28.1±8.5), 514 somatic symptom disorder (SSD), 194 anxiety or depressive disorders (affective disorder group, AFD), and 555 non-autistic controls. All participants completed the Health Anxiety Questionnaire and Patient Health Questionnaire-15 scales to assess health anxiety and somatic symptoms. RESULTS: Autistic adults showed greater somatic symptoms and health anxiety than non-autistic controls. The level was similar to the AFD but lower than the SSD groups. Harm avoidance and low registration were associated with health anxiety and somatic symptoms in autism, while attention to details was positively associated with the needs of reassurance. Health-related anxiety was related to both depression and anxiety, and most domains on quality of life, with excessive health-related worries associated with greater anxiety and lower environmental life quality. CONCLUSION: Findings suggest significant somatic symptoms and health anxiety in autistic adults that warrants clinical attention.

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9. Hus Bal V, Szatmari P, Georgiades S, Gentles SJ, Girault J, Howlin P, Lai MC, Carter Leno V, Lord C, Madgett K, Sheinkopf SJ, Simonoff E, Williams ZJ, Zwaigenbaum L, Halladay A. Methodological challenges and opportunities when studying the course of autism. Autism. 2025: 13623613251341012.

Longitudinal research in autism has contributed a wealth of knowledge about etiological factors, development from childhood through adulthood, life course changes and needs, as well as longer-term adult outcomes for individuals on the spectrum and their family members. This research is essential to better understand the needs of individuals as they age. However, along with the as yet unrealized opportunities to understand an individual in more nuanced ways across time, there are challenges to utilizing this research design that should be considered. These include sample and measurement diversity, retention, outcome measures, analysis, and funding considerations. This article outlines some of the most pressing challenges together with potential solutions to maximize the value of longitudinal research designs that can help address questions that are of high priority to the autism community.Lay AbstractLongitudinal research has been critical to understand the life course of people with autism, including factors which increase the probability of an autism diagnosis, the emergence of early markers, co-occurring psychiatric conditions, predication of future educational and support needs across childhood and adulthood, and understanding what makes each person unique and contributes to the well-being of autistic people and their families. However, these studies take time, patience, investment of families and individuals, scientists and are challenging to all involved. This article will outline some of the issues that have occurred in the past and provide potential solutions to improve the quality of these studies to both the scientific and autistic communities. They include sample and measurement diversity, retention, outcome measures, analysis, and funding considerations. This understanding of the field is important for both scientific research and community engagement in the studies that include the autistic community.

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10. Iannuzzi V, Giuberti V, Formisano D, Poletti M. Long-Term Diagnostic Stability of Autism Before the Concept of Spectrum: An Italian Hub-Center Experience. Clin Neuropsychiatry. 2025; 22(2): 121-4.

OBJECTIVE: The diagnosis of autism is considered more longitudinally stable compared to other diagnoses for children and adolescents, although significant heterogeneity in longitudinal outcomes emerges between studies based on temporal intervals and diagnostic instruments. The introduction of the concept of Autism Spectrum Disorder (ASD) by DSM-5 may have impacted diagnostic stability. The current study aimed to investigate the longitudinal diagnostic stability of different diagnoses of autism according to the ICD-10 diagnostic system before the institutional move towards the utilization of a unique ASD diagnosis according to DSM-5. METHOD: A retrospective study based on medical records and the ELEA electronic database was performed on children attending the Autism Center of the Child and Adolescent Mental Health Service of the Azienda USL-IRCCS, Reggio Emilia, Italy, from January 1, 2005, to December 31, 2015. Diagnostic stability was evaluated according to the diagnosis at follow-up, which was set at 10 years from baseline or December 31, 2020. RESULTS: A total of 380 children were included at baseline, and 341 were included at follow-up (with a mean temporal interval of 8.74 ± 2.7 years). Among them, 251 individuals maintained a diagnosis within the F84 spectrum, resulting in a diagnostic stability of 73.6%. Specifically, diagnostic stability was 79.8% for the F84.0 diagnosis and 68.2% for the F84.9 diagnosis. CONCLUSIONS: Before the adoption of DSM-5 diagnostic criteria for ASD, ICD-10 diagnoses related to autism were relatively stable in the long run, with an 8-year follow-up. The next step is to assess the longitudinal diagnostic stability of ASD after the adoption of DSM-5 criteria.

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11. 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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12. K VRP, Hima Bindu C, Devi KRM. An Interpretable Deep Learning Approach for Autism Spectrum Disorder Detection in Children Using NASNet-Mobile. Biomed Phys Eng Express. 2025.

Autism spectrum disorder (ASD) is a multifaceted neurodevelopmental disorder featuring impaired social interactions and communication abilities engaging the individuals in a restrictive or repetitive behaviour. Though incurable early detection and intervention can reduce the severity of symptoms. Structural magnetic resonance imaging (sMRI) can improve diagnostic accuracy, facilitating early diagnosis to offer more tailored care. With the emergence of deep learning (DL), neuroimaging-based approaches for ASD diagnosis have been focused. However, many existing models lack interpretability of their decisions for diagnosis. The prime objective of this work is to perform ASD classification precisely and to interpret the classification process in a better way so as to discern the major features that are appropriate for the prediction of disorder. The proposed model employs neural architecture search network – mobile(NASNet-Mobile) model for ASD detection, which is integrated with an explainable artificial intelligence (XAI) technique called local interpretable model-agnostic explanations (LIME) for increased transparency of ASD classification. The model is trained on sMRI images of two age groups taken from autism brain imaging data exchange-I (ABIDE-I) dataset. The proposed model yielded accuracy of 0.9607, F1-score of 0.9614, specificity of 0.9774, sensitivity of 0.9451, negative predicted value (NPV) of 0.9429, positive predicted value (PPV) of 0.9783 and the diagnostic odds ratio of 745.59 for 2 to 11 years age group compared to 12 to 18 years group. These results are superior compared to other state of the art models Inception v3 and SqueezeNet.

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13. Lindly OJ, Abate D, Fuchu PL, Kuhn JL, Mudnal Bharath PS, Asantewaa SM, Feinberg E, Broder-Fingert S. The impact of state policy on early autism diagnosis: A qualitative investigation. Autism. 2025: 13623613251336813.

Autism diagnosis before age three to expedite access to critical services is a public health priority in the United States. Still, the average age of autism diagnosis is 49 months with substantial variability across states. By examining policy-defined as laws, regulations, procedures, administrative actions, incentives, or voluntary practices of governments or other institutions-modifiable structural drivers of early (or late) autism diagnosis may be identified. We, therefore, sought to identify policies impacting early autism diagnosis in five states that are part of a larger initiative to improve autism diagnosis (Arizona, California, Connecticut, Massachusetts, and Pennsylvania) and those that exist nationally. We conducted semi-structured interviews from 2021 to 2023 with a purposive sample of 57 autism policy or research experts. The following four themes were identified through conventional content analysis: (1) developmental monitoring is critical; however, developmental screening policies vary within and across states; (2) myriad policy and contextual factors shape early diagnosis pathways within states; (3) early intervention by the state and community-based early childhood programs influence early autism diagnosis; and (4) persistent disparities in early autism diagnosis pathways are affected by policies. Study findings highlight the importance of advancing certain state and federal policies to increase early autism diagnosis.Lay abstractIn the United States, when children on the spectrum are diagnosed before age three, it can help them get the services they need to thrive. There are many differences between states as far as how many children are diagnosed with autism and the average age when they are diagnosed. Some work suggests these differences may be due to state polices, which include the laws and processes governments and organizations follow. Little research has tried to understand the similarities and differences between state policies related to autism diagnosis. Because of this, our study looked at how state policies impact the timing of autism diagnosis in the United States. We interviewed 57 experts in five states and nationally from 2021 to 2023. Four key themes were identified including (1) developmental monitoring often leads to screening, but there is much variation in and across states; (2) family, community, and healthcare factors shape pathways to autism diagnosis in states; (3) early intervention and education programs play a role in autism diagnosis; and (4) systematic differences in access to diagnosis services persist for certain groups of children and families such as those with limited English-speaking abilities. This study’s findings point to certain state and federal policy changes or enhancements to reduce the age of autism diagnosis and ameliorate persistent disparities in autism diagnosis.

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14. Mammarella V, Randazzo L, Romano S, Breda M, Bruni O. Pharmacological management for insomnia in children and adolescents with autism and attention deficit and hyperactivity disorder. Expert Opin Pharmacother. 2025: 1-20.

INTRODUCTION: Insomnia is common in children and adolescents with autism spectrum disorder (ASD) and/or attention deficit and hyperactivity disorder (ADHD), with significant implications for quality of life and prognosis. Although non-pharmacological interventions represent the first-line approach, they are not always effective. Therefore, it is important to determine when a pharmacological treatment can be indicated and which compound to prefer based on evidence of efficacy and safety. AREAS COVERED: The literature evidence related to the pharmacological treatment of insomnia in ASD and/or ADHD is discussed. We present data on drugs and supplements used and considerations about the choice of starting a pharmacological therapy, suggesting clinical advice that may guide clinicians. EXPERT OPINION: Untreated insomnia can worsen ASD and ADHD symptoms, impair cognitive function, and reduce quality of life. Targeted interventions are essential. Behavioral strategies, with or without melatonin, are recommended after evaluating comorbidities and medications. Off-label treatments for children with ASD include antihistamines, alpha-adrenergics, trazodone, antidepressants, antipsychotics, anticonvulsants, and hypnotics. For ADHD, options include iron supplementation for restlessness and low ferritin levels, and alpha2-adrenergics like guanfacine and clonidine for their sedative effects.

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15. Medeiros S, Cohn N, Foulsham T, Coderre EL. Association of autistic traits with inference generation in visual narratives. Sci Rep. 2025; 15(1): 17746.

Individuals with higher levels of autistic traits sometimes demonstrate differences with narrative comprehension compared to those with lower levels of autistic traits. One particular aspect of narrative processing that is thought to be affected by autistic traits is inferencing. Some studies using verbal narratives (i.e., written or spoken stories) have documented differences in inferencing skills among autistic participants. However, fewer studies have investigated how inferencing abilities using visual narratives (e.g., comics) are modulated by autistic traits, despite mounting evidence that narrative comprehension shares similar cognitive mechanisms across verbal and visual domains. Here, we report two studies examining inference generation during visual narrative comprehension in adults with a range of autistic traits. Experiment 1 used a deletion recognition paradigm to examine participants’ accuracy (ACC) and reaction time (RT) to identify where a panel had been removed from a visual sequence. Experiment 2 used a self-paced viewing paradigm to examine viewing times on sequences that required an inference; ACC and RT on comprehension questions were also examined. In both experiments, individual differences in autistic traits and visual language fluency were examined. In Experiment 1 we did not see any effects of these predictors; however, for Experiment 2 we found that autistic traits and visual language fluency may be influential in narrative comprehension for measures of offline processing. Subsequent analyses identified differences in imaginative abilities as potentially underlying these modulations.

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16. Miller PK, Bowden SL, Dewison N, Ingham B, Thwaites R, Dagnan D. ‘Sometimes I’m feeling baffled and they’re probably feeling baffled’: On the experiences of psychological therapists working with autistic people in a structured primary care service for anxiety disorders and depression. Autism. 2025: 13623613251341610.

Autistic people are more likely to experience mental health problems such as anxiety disorder and depression than are the general population. This study reports a qualitative analysis of interview data provided by 12 psychological therapists regarding their experiences of working with autistic people with anxiety disorders and/or depression within a structured primary care mental health service in the north of England. Interviews were analysed using thematic analysis. Four main themes were identified: (1) Experience and Trepidation, (2) Wrong Service, Only Service, (3) Therapeutic Environment and (4) Training and Adaptations. Participating therapists identified challenges in the structure of the services they worked in, the applicability of conventional therapies and the need for autism-specific therapy training ideally led by autistic people. Centrally, participants did not routinely feel fully equipped to separate endemic aspects of autism itself from features of a mental health disorder in an autistic person, which had left some feeling powerless to help in certain cases, or as if they may have done more harm than good. All participants were, however, able to identify positive adaptations made from practical experience, and most reported a growing confidence in working with autistic people.Lay AbstractThe experiences of psychological therapists working with autistic people in a primary care service for anxiety disorders and depressionWe are a group of autistic people, academic researchers and psychological therapists, with some of us being more than one of those things. We started from the knowledge that autistic people are particularly prone to have anxiety disorders and depression. We were, therefore, interested in how current ‘talking therapy’ services in England might, or might not, be helping autistic people with those problems. To address this issue, we interviewed 12 psychological therapists in the north of England who had experience of working with autistic people with an anxiety disorder, depression or both. We found that the therapists often felt that they were not prepared or trained to give autistic people their best service. The therapists were also concerned that some of the therapies they usually applied did not always work with autistic people, or sometimes even made things worse. They felt it was important, however, that autistic people should keep using the service, as there was no other service available to them if they had an anxiety disorder or depression. There was evidence, however, that talking therapies still had positive effects for autistic people, and that therapists had therefore probably underestimated their positive impact in a lot of cases. Consequently, training was recommended such that psychological therapists might better understand mental health and specific therapy adaptations that help autistic people.

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17. Némorin H, Michelon C, Peyre H, Monnier M, Périés M, Baghdadli A. Profiling clinical heterogeneity in Autism Spectrum Disorder at time of children’s diagnosis: A cluster analysis from the ELENA cohort. Res Dev Disabil. 2025; 163: 105040.

BACKGROUND: Autism Spectrum Disorder (ASD) encompass a heterogeneous group of neurodevelopmental conditions characterized by deficits in social communication and repetitive behaviors. The rising prevalence of ASD highlights the urgent need for effective diagnostic and intervention strategies. However, the significant clinical, cognitive and etiological heterogeneity within ASD populations poses substantial challenges to these efforts. AIMS: This study aimed to identify distinct ASD subtypes at time of diagnosis within the ELENA cohort by incorporating not only DSM-5 criteria but also measures of adaptive functioning and behavioral problems. MATERIAL AND METHODS: Data from 458 children and adolescents with ASD were analyzed using hierarchical agglomerative clustering. Variables included autistic symptoms, intellectual quotient, adaptive behavior and behavioral problems. Clusters were identified based on these parameters, and post-hoc analyses were conducted to assess statistically significant differences in sex and age among the four clusters using Chi-square test and Student’s t-tests. RESULTS: Four distinct clusters were identified from the analysis: (1) High Autistic Symptom Severity with Lowest Behavioral Problems, (2) High Autistic Symptom Severity with High Behavioral Problems, (3) Low Autistic Symptom Severity with Highest Behavioral Problems and (4) Low Autistic Symptom Severity with low behavioral problems, while significant age differences were observed across clusters, no significant sex differences were found. DISCUSSION: These clusters exhibited significant variability in adaptive functioning and behavioral problems, suggesting that DSM-5 criteria alone do not fully capture the complexity of ASD. The findings underscore the importance of incorporating measures of adaptive functioning and behavioral problems into ASD assessments and interventions. Future research should aim to validate these clusters in larger and more diverse populations and explore the integration of genetic and neuroimaging data to further refine the characterization of ASD subtypes. Additionally, longitudinal studies are needed to assess the stability and clinical relevance of these subtypes over time. TRIAL REGISTRATION NUMBER: NCT02625116.

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18. 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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19. Palmeter S, O’Donnell S, Smith S. Primary caregivers of individuals with developmental disabilities or disorders in Canada: highlights from the 2018 General Social Survey – Caregiving and Care Receiving. Health Promot Chronic Dis Prev Can. 2025; 45(5): 256-63.

Using data from the 2018 General Social Survey – Caregiving and Care Receiving, we examined the characteristics of caregivers of people with developmental disabilities or disorders (DD) and the impacts of caregiving on these caregivers. The proportion of DD caregivers with optimal general and mental health was smaller than the proportion of non-caregivers. About two-thirds of DD caregivers reported feeling worried or anxious, or tired and almost half reported unmet support needs. However, compared with caregivers of individuals with other conditions, a significantly higher proportion of DD caregivers described their caregiving experiences as rewarding. Characteristics of caregivers of individuals with developmental disabilities or disorders (“DD caregivers”) were compared with those of caregivers of individuals with other conditions and with those of non-caregivers. A smaller proportion of DD caregivers than non-caregivers reported optimal general and mental health. Many DD caregivers reported feeling worried or anxious, feeling tired and spending less time taking care of themselves due to their caregiving responsibilities. Almost half of DD caregivers reported unmet support needs, particularly financial support, government assistance or tax credits, occasional relief or respite care, and home care or support. Despite these challenges, a significantly higher proportion of DD caregivers described their caregiving experiences as rewarding or very rewarding compared with other caregivers. eng.

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20. Sessiz R, Ayan G, Sezer B, Tosun İ. Evaluation of oral health and dental hygiene habits in adolescents with intellectual and developmental disabilities: a longitudinal pilot study. Quintessence Int. 2025; 56(5): 402-10.

OBJECTIVES: Adolescents with intellectual and developmental disabilities are at increased risk of oral diseases due to physical limitations, poor oral health awareness, and inadequate dental hygiene practices. The aim of this study was to evaluate the oral health status of adolescents with intellectual and developmental disabilities and to analyze changes in their dental hygiene habits following subsequent visits and oral hygiene education. METHOD AND MATERIALS: This pilot longitudinal observational study involved students with mild to moderate intellectual and developmental disabilities from a special needs school. Oral health was assessed using the decayed, missing, and filled teeth (DMFT) index, International Caries Detection and Assessment System (ICDAS-II), Basic Erosive Wear Examination (BEWE), Developmental Defects of Enamel (DDE), and Simplified Oral Hygiene (OHI-S) indices. Participants received oral hygiene training, and their brushing techniques were evaluated using the Oral Hygiene Skills Survey. Data on brushing frequency, skills, toothpaste use, and OHI-S scores were collected at baseline and at 1-, 3-, and 6-month follow-ups. RESULTS: Twenty-three participants aged 14 to 19 years were evaluated, showing high DMFT scores (mean 10.91 ± 6.06), advanced caries in 78.3%, and enamel defects and erosive tooth wear in 65.2%. Significant improvements were observed in toothbrushing frequency (P = .008), with reductions in OHI-S scores (P = .001) and enhanced brushing skills (P = .016) during follow-ups. CONCLUSION: The findings indicate a high prevalence of dental caries, enamel defects, and erosive tooth wear among adolescents with intellectual and developmental disabilities. Despite poor baseline oral hygiene practices, regular follow-ups and oral hygiene education significantly improved oral hygiene habits and outcomes.

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21. Tafla TL, Woodcock KA, Mecca TP, Teixeira M. Cross-Cultural Comparison of Adaptive Behaviour Between British and Brazilian Clinical Samples With Neurodevelopmental Disorders. Child Care Health Dev. 2025; 51(3): e70098.

Adaptive behaviour deficits are limitations in executing daily activities and difficulties in responding to environmental changes, which impact social participation and independence across contexts. Adaptive behaviour measures can be used to guide interventions for individuals with neurodevelopmental disorders. Cross-cultural studies can contribute to the understanding of adaptive functioning of neurodivergence across countries. PURPOSE: The purpose of this study is to evaluate and compare the adaptive behaviour profiles of children and adolescents with neurodevelopmental condition from different countries. METHODS: Forty-eight children with an autism spectrum diagnosis were equally separated into country groups (Brazil and the United Kingdom) and ages (5-10 and 11-17 years old) and were evaluated with the Adaptive Behavior Assessment System, 3rd Edition (ABAS-3), the Parent Form (Ages 5-21), using the raw scores of the questionnaire. RESULTS: The only scale in which a difference between nationality groups was identified was the self-direction scale, which evaluates skills needed for independence, responsibility and self-control, with older Brazilians scoring higher than their British peers in the same age group. CONCLUSION: Similar profiles of adaptive functioning in individuals with ASD were found across cultures, with a singular difference in the self-direction scale. The study’s findings shed light on the need for interventions to increase adaptive functioning skills acquisition, regardless of the culture or country in which the individual is.

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22. Traynor BP, Patrascu A, Attumalil T, Alkasab M, Gamal A, Ong G, Fam NP, Alnasser SM. Multiple ASDs Closure Using the Interleaving Method: A Refined Strategy Utilizing GORE CARDIOFORM Occluder Devices. JACC Cardiovasc Interv. 2025.

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23. 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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