1. Aldakhil AF, Alasim KN. Diagnostic accuracy of AI-based models for autism spectrum disorder: A systematic review and meta-analysis with a focus on Arab populations. Res Dev Disabil. 2025; 167: 105166.

BACKGROUND: Autism Spectrum Disorder (ASD) is a prevalent neurodevelopmental condition globally, including in Arab countries, where stigma, limited awareness, and scarce specialized services often delay diagnosis and care. Artificial intelligence (AI) offers scalable solutions for screening, early diagnosis, and intervention programmes. AIMS: To evaluate the diagnostic accuracy of AI-based models for ASD with a specific focus on Arab cohorts, and to appraise methodological quality and potential cultural influences on model performance. METHODS: We searched PubMed, Scopus, and Web of Science for studies published between January 2019 and September 2025. Eligible studies evaluated supervised AI systems, machine learning (ML), or deep learning (DL) that classify individuals as ASD versus non-ASD against a clinician-confirmed reference standard. Study quality was assessed using QUADAS-2. Diagnostic accuracy metrics (sensitivity, specificity, likelihood ratios, diagnostic odds ratio) were pooled using a bivariate random-effects model. RESULTS: Fifteen studies were included in the systematic review; ten studies were eligible for meta-analysis (59 model evaluations; 26,569 instances), comparing AI models against clinician-confirmed autism diagnoses. Pooled sensitivity was 91.8 % (95 % CI [89.0, 94.2]) and specificity 90.7 % (95 % CI [87.6, 93.5]), yielding a diagnostic odds ratio (DOR) of 109.0 (95 % CI [59.5, 227.9]), positive likelihood ratio (LR⁺) of 9.8, and negative likelihood ratio (LR⁻) of 0.09. Subgroup analysis revealed hybrid models (deep feature extractors with classical classifiers) achieved the highest accuracy (sensitivity 95.2 %, specificity 96.0 %), followed by conventional ML (sensitivity 91.6 %, specificity 90.3 %), and DL alone (sensitivity 87.3 %, specificity 86.0 %). In Arab-only cohorts, models showed higher sensitivity (94.2 %) but lower specificity (87.6 %), suggesting stronger rule-out potential but more false positives. CONCLUSION: To our knowledge, this is the first systematic meta-analysis of AI-based ASD diagnostics confirms high accuracy, with hybrid models excelling compared to both traditional ML and DL alone. In Arab cohorts, models showed higher sensitivity but lower specificity, highlighting the importance of cultural and linguistic tailoring of assessment tools, diagnostic protocols, and datasets, alongside regional challenges such as stigma and limited resources. These findings support AI as a valuable tool for early detection and screening.

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2. Calikusu A, Ince MS, Bolay H, Atalar K, Yigman Z, Topa E, Dagidir HG, Kılınç H, Omeroglu S, Gozil R, Bukan N, Alim E, Barc D, Dizakar SOA, Bahcelioglu M. Targeting Brain Plasticity: Vagal Nerve Stimulation as a Therapy for Autism-Like Symptoms in a Valproic Acid Mouse Model. Dev Neurobiol. 2026; 86(1): e23019.

Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental condition defined by social deficits, stereotypical or repetitive behaviors, and anxiety. This study evaluates the therapeutic potential of transauricular vagal nerve stimulation (tVNS) in a valproic acid (VPA)-induced mouse model of ASD. The study comprised three groups: the control + sham (saline-treated offsprings receiving sham stimulation), the autistic + sham (VPA-treated offspring receiving sham stimulation), and the autistic + tVNS (VPA-treated offsprings receiving tVNS). Male C57BL/6 mice exposed to VPA on embryonic day 12.5 were evaluated for behavioral and neurobiological alterations. tVNS was applied twice weekly for 3 weeks to investigate its effects on sociability, anxiety-like behaviors, neurogenesis markers, and apoptosis pathways. Behavioral testing, including the three-chamber test, mirrored chamber test, open field test, and elevated plus maze, revealed that tVNS significantly improved sociability and social preference indices, reduced social anxiety, and decreased general anxiety-like behaviors in VPA-induced mice. Histological and immunohistochemical analyses have shown a decrease in neuron density, brain-derived neurotrophic factor (BDNF), and doublecortin (DCX) expression in the hippocampus, amygdala, and prefrontal cortex of VPA-induced mice. Additionally, the increase in caspase-3 immunoreactivity indicates increased apoptosis. tVNS treatment restored BDNF and DCX levels, promoting neurogenesis and synaptic plasticity while significantly reducing caspase-3-mediated apoptosis in affected brain regions. These findings suggest that tVNS may counteract the neural and behavioral deficits associated with ASD by modulating neurogenesis, neuronal plasticity, and apoptosis. The study highlights tVNS as a potential therapeutic intervention for ASD, emphasizing its role in targeting both behavioral alterations and underlying neurobiological mechanisms.

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3. D MS, Su M, Beeler-Duden S, Bernier RA, Bookheimer SY, Dapretto M, McPartland JC, Jeste S, Horn JDV, Pelphrey K, Venkataraman A. Harnessing Trial-to-Trial Variability of EEG Spectral Characteristics to Understand Autism. J Autism Dev Disord. 2025.

PURPOSES: There is a great need for mechanistically informed biomarkers to understand autism spectrum disorder (ASD) and guide treatment. Electroencephalography (EEG) is a non-invasive method for identifying objective biomarkers, but traditional trial-averaged metrics may mask neural variability, a meaningful feature of ASD reflecting sensory, attentional, and cognitive differences. METHODS: This study investigates whether across-trial EEG variability enhances ASD classification compared to conventional mean EEG features. We hypothesize that capturing dynamic within-subject neural variability improves classification accuracy and offers deeper insights into ASD-related neural disruptions. We analyzed EEG power spectral features in individuals with and without ASD, extracting across-trial variability in five frequency bands alongside traditional mean EEG power metrics. Using machine learning, we compared classification performance and identified the most predictive neural markers. RESULTS: Results show that across-trial EEG variability outperformed mean EEG metrics, achieving 70.7% classification accuracy. Variability in delta and gamma bands is critical for distinguishing ASD, with robust cross-validation results and significant correlations with behavioral scores, supporting the clinical relevance and generalizability of neural variability as an ASD biomarker. CONCLUSIONS: By incorporating neural variability into machine learning models, this study introduces a novel framework for improving biomarker-driven assessments. These findings highlight the potential for personalized tools that inform targeted interventions while offering insights into ASD neurophysiology. Future research should integrate longitudinal EEG analyses and multimodal neuroimaging to advance precision diagnostics in autism.

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4. Fodstad JC, Russell R, Bryant LO, Tadevich LJ, Dwenger D, Gray MA. Improving Care for Autistic Youth in Correctional Settings. J Am Acad Psychiatry Law. 2025.

Youth on the autism spectrum who engage in delinquent or violent crimes can be adjudicated to juvenile correctional settings. These settings, which are meant to successfully reintegrate youth back into the community through education, counseling, and skills programs, are often ill-equipped to navigate the unique needs of youth on the autism spectrum. As a result, autistic youth in juvenile correctional settings often do poorly, minimizing the likelihood that successful reintegration occurs. The purpose of this review is to summarize the literature on the prevalence of autistic youth in correctional settings and their needs, as well as the standard of care often afforded to them in these settings. Finally, we will present suggested strategies informed by the literature whereby adjudicated autistic youth are provided services and support that are feasible in a correctional setting and align with autism-informed, evidence-based practices.

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5. Ghosh A, Nasarre-Nacenta N, Baumeister S, Holz NE, Banaschewski T, Brandeis D, Aggensteiner PM, Kaiser A. Neurophysiological alterations during sensory processing in autism – a meta-analysis. Eur Child Adolesc Psychiatry. 2025.

While sensory processing alterations in autism are well-documented, the neurophysiological correlates remain unclear. This meta-analysis examined differences in early event-related potentials (ERP) and event-related fields (ERF) between autistic and non-autistic individuals using electroencephalography and magnetoencephalography to identify neurophysiological alterations that may underlie variations in sensory perception, communication, and social interaction in autism. Following PRISMA guidelines, a database search was conducted for peer-reviewed studies published from January 1980 onwards. Random-effects meta-analyses were performed using the metafor package in R. Standardised mean-group differences in early ERP/ERF latencies and amplitudes were analysed with moderator analyses exploring demographic and methodological factors, including neurophysiological technique, sensory modality, age group, sex, and language impairment. 145 studies (3778 autistic, 3484 non-autistic participants) were included. Autistic individuals exhibited significantly longer latencies in P/M50 (SMD = 0.44; SE = 0.21; 95% CI 0.03-0.86; p = 0.04), P/M100 (SMD = 0.18; SE = 0.08; 95% CI 0.01-0.36; p = 0.03), N170 (SMD = 0.33; SE = 0.12; 95% CI 0.10-0.56; p = 0.01), and P/M200 (SMD = 0.30; SE = 0.09; 95% CI 0.12-0.48; p = 0.00) components. P/M50 showed the greatest latency alteration, with an effect-size nearing medium, especially in individuals with language impairment (Q(B)(2) = 7.70, p = 0.02), followed by N170 most notable in autistic adolescents and adults (Q(B) (3) = 12.30, p = 0.01). No significant amplitude alterations were found, and substantial heterogeneity was observed. Neurophysiological characteristics of sensory processing in autism implicate multiple mechanisms and stages given prolonged P/M50- and N170-latency (associated with sensory filtering challenges and social perception alterations, respectively). These component timings show potential as biomarkers, though heterogeneity and modest effect-sizes limit clinical application, highlighting the need for further research.

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6. Giorlandino C, Margiotti K, Fabiani M, Mesoraca A, D’Emidio L, Raffio R, Coco C, Mastrandrea ML, Pasquale C, Cupellaro M, Giorlandino F, Pignataro F, Milite V. Maternal Folate Receptor Alpha Autoantibodies and Increased Fetal Nuchal Translucency as Potential Early Markers of Autism Spectrum Disorder. Brain Behav. 2025; 15(11): e71088.

PURPOSE: To investigate the association between increased fetal nuchal translucency (NT) and maternal folate receptor alpha autoantibodies (FRAA) positivity, and to evaluate the subsequent risk of non-syndromic autism spectrum disorder (ASD) in offspring. METHODS: A total of 3600 first-trimester ultrasounds were screened at a fetal medicine center. Among these, 27 fetuses with markedly increased NT (≥ 3.5 mm) underwent invasive prenatal diagnosis, including karyotyping, CGH array, and postnatally whole-exome sequencing (WES) when standard tests were negative. Maternal serum samples were tested for FRAA using ELISA. Eleven pregnancies with negative genetic testing were followed longitudinally, and neurodevelopmental outcomes in children were assessed up to 36 months using ADOS-2 and DSM-5 criteria. FINDINGS: Among the 11 fetuses with negative genetic outcomes, 4 mothers tested positive for FRAA. All four FRAA-positive offspring were later diagnosed with ASD, while only one of the seven FRAA-negative offspring received an ASD diagnosis. FRAA-positive cases exhibited markedly increased NT (≥ 3.5 mm) but no pathogenic genetic variants, suggesting an immune-mediated etiology. FRAA levels persisted in maternal and neonatal serum, implying ongoing exposure during gestation. CONCLUSION: FRAA positivity in pregnancies with isolated markedly increased NT may serve as an early biomarker of increased ASD risk in offspring. These findings support the hypothesis of an immune-metabolic mechanism contributing to ASD and suggest potential preventive interventions such as folinic acid supplementation.

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7. Gonzalez D, Jonak CR, Bernabucci M, Molinaro G, Collins K, Assad SA, Gibson JR, Binder DK, Huber KM. Enhanced CB1 receptor function in GABAergic neurons mediates hyperexcitability and impaired sensory-driven synchrony of cortical circuits in Fragile X Syndrome model mice. Mol Psychiatry. 2025.

Electroencephalographic (EEG) recordings in individuals with Fragile X Syndrome (FXS) and the mouse model of FXS (Fmr1 KO) display cortical hyperexcitability at rest, as well as deficits in sensory-driven cortical network synchrony. A form of circuit hyperexcitability is observed in ex vivo cortical slices of Fmr1 KO mice as prolonged persistent activity, or Up, states. It is unknown if the circuit mechanisms that cause prolonged Up states contribute to FXS-relevant EEG phenotypes. Here we examined the role of endocannabinoids (eCB) in prolonged Up states in slices and resting and sensory-driven EEG phenotypes in awake Fmr1 KO mice. Bidirectional changes in eCB function are reported in the Fmr1 KO that depend on synapse type (excitatory or inhibitory). We demonstrate that pharmacological or genetic reduction of Cannabinoid Receptor 1 (CB1R) in GABAergic neurons rescues prolonged cortical Up states and deficits in sensory-driven cortical synchrony in Fmr1 KO mice. In support of these findings, recordings from Fmr1 KO cortical Layer (L) 2/3 pyramidal neurons revealed enhanced CB1R-mediated suppression of inhibitory synaptic currents. In contrast, genetic reduction of Cnr1 in glutamatergic neurons did not affect Up state duration, but deletion of Fmr1 in the same neurons was sufficient to cause long Up states. These findings support a model where loss of Fmr1 in glutamatergic neurons leads to enhanced CB1R-mediated suppression of GABAergic synaptic transmission, prolonged cortical circuit activation and reduced sensory-driven circuit synchronization. Results suggest that antagonism of CB1Rs may be a therapeutic strategy to correct sensory processing deficits in FXS.

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8. Lee BK, Stephansson O, Gardner RM. Paracetamol (acetaminophen) use in pregnancy and risk of autism and ADHD. Bmj. 2025; 391: r2438.

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9. Long J, Liao X, Tang Z, Han K, Chen J, Wang X, Liu J, Zhang Y, Zhang H. Investigating the clinical efficacy, safety and molecular mechanism of sulforaphane in autism spectrum disorder: an integrated study combining meta-analysis, network pharmacology, and computational biology. BMC Pharmacol Toxicol. 2025.

BACKGROUND: Sulforaphane, a natural antioxidant rich in cruciferous vegetables, has emerged as a promising dietary supplement for autism spectrum disorder (ASD). However, its therapeutic efficacy remains controversial, and the pharmacological mechanisms are not fully elucidated. METHODS: Eligible randomized controlled trials were retrieved from PubMed, Web of Science, Embase, and Cochrane Library databases. Review Manager 5.4 was used for meta-analysis and bias risk assessment. Network pharmacology, Mendelian randomization, GEO data analyses, molecular docking, and molecular dynamics simulation were employed to explore the mechanisms of sulforaphane in ASD. RESULTS: Six trials involving 333 participants were included in the meta-analysis. Pooled results demonstrated that both 4-5 weeks and 8-10 weeks of sulforaphane supplementation significantly decreased the scores on the Social Responsiveness Scale compared to placebo controls. No significant difference was observed in the incidence of adverse events. Network pharmacology identified 10 core targets of sulforaphane in ASD, including AKT1, EGFR, HSP90AA1, SRC, CASP3, STAT1, MAPK1, MMP9, MAPK8, and JAK2. These targets were implicated in the PI3K-Akt signaling pathway, MAPK signaling pathway, Chemokine signaling pathway, Chemical carcinogenesis – reactive oxygen species, TNF signaling pathway, Th17 cell differentiation, mTOR signaling pathway, and IL-17 signaling pathway. Mendelian randomization further revealed an inverse association between STAT1 levels and ASD risk. GEO transcriptomic data provided independent validation for the network pharmacology predictions. The binding energies between sulforaphane and the top 10 core targets are all ≤ -4.0 kcal/mol. Molecular dynamics simulations further validated the stable interaction between MMP-9 and sulforaphane. CONCLUSION: Sulforaphane may serve as an efficacious and safe adjunctive therapy for ASD, mediated by its anti-oxidant and anti-inflammatory effects along with the modulation of autophagy. PROSPERO REGISTRATION NUMBER: CRD42025635045.

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10. Mallaret G, Canaguier J, Callebert J, Caramello N, Fabregat-Safont D, Glaichenhaus N, Pozo OJ, Launay JM, Davidovic L. The autism-linked gut microbial metabolite p-cresol inhibits host catecholamine biosynthesizing enzymes to elicit social deficits. Commun Biol. 2025.

Autism spectrum disorder (ASD) is associated with altered gut microbiota and elevated levels of the microbial metabolite p-cresol. We previously demonstrated that -cresol induces social deficits in male mice, alongside reduced excitability of dopamine neurons in the ventral tegmental area, a key catecholamine region in the reward circuit known to control social behavior. Here, we explore the molecular mechanisms underlying these effects. We investigated p-cresol and its host conjugate, p-cresol sulfate, biodistribution in peripheral and central matrices. We show that both metabolites accumulate in the brainstem and impair catecholamine biosynthesis by inhibiting tyrosine hydroxylase (TH) and dopamine-β-hydroxylase (DBH). In silico docking predicts competitive binding of both metabolites to the catalytic pockets of TH and DBH. DBH inhibition alone was sufficient to recapitulate p-cresol-induced social deficits. These findings identify inhibition of host enzymes as a mechanism by which microbial metabolites alter brain function and behavior, linking gut microbiota to ASD-relevant social impairments.

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11. Meerman J, Dewinter J, Boer J, Noot K, van der Klink J, Glas G. Identification of Capabilities of Autistic Young Adults: Towards an Understanding of Autistic Flourishing. Child Psychiatry Hum Dev. 2025.

Views on autism shifted from a biomedical view to a neurodiversity-framework, with a parallel change in views on the nature of wellbeing. In this qualitative study the Capability Approach (CA), a theory of wellbeing, has been operationalized to identify (a) capabilities of young autistic adults in the Netherlands, as well as (b) important aspects in the process of converting resources on a personal, social and environmental level to realize valuable beings and doings. Fourteen young autistic adults with mental health problems and a self-chosen important other were interviewed twice using a semi-structured interview protocol driven by the central capability concepts. Thematic analysis revealed eight capability themes: autonomy, human connection, peace of mind, personal development, health, enjoyment, work and education, and meaning in life. Specific capabilities identified were to be free of sensory overload, participating in specific interests, to be understood by others, and access to autism-friendly care. Preconditions for capability realization related to the interaction between being autistic and social conditions (e.g. feeling misunderstood or bullied), but also to living conditions and resources (e.g. unsafety, poverty). The CA and identified capabilities offer a framework to discuss wellbeing, individual capabilities, and the conversion process with young autistic adults and their important others.

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12. Renteria RA, Grineski SE, Gomez J, Bilder D, Collins TW, Bakian AV. Associations between prenatal PM(2.5) exposures and intellectual disability: Are there differential impacts based on co-occurrence of autism spectrum disorder?. Environ Res. 2025: 123378.

Prenatal fine particulate matter (PM(2.5)) has been associated with intellectual disability (ID) and autism spectrum disorder (ASD), separately. Its role in co-occurring ID with ASD (ID+ASD) is less understood. To address this gap, this study uniquely disaggregates ID-only from ID+ASD to assess the associations between prenatal PM(2.5) exposure and odds of ID-only and ID+ASD across multiple exposure windows and measures. For children born in Utah, U.S.A., children with ID (ID-only and ID+ASD) were matched 1:3 with non-ID affected controls. PM(2.5) exposure was estimated across four prenatal periods (i.e., preconception, 1(st), 2(nd), and 3(rd) trimester) using long-term averages and exceedances of WHO and U.S. NAAQS 24-hour thresholds and assigned to children. Associations were examined using multilevel multinomial logistic regressions. Results show that increase in long-term PM(2.5) during preconception and first trimester was associated with increased odds of ID-only and ID+ASD. Exceedances of the WHO 24-hour threshold (15 μg/m(3)) during preconception were linked to ID-only, while first trimester WHO 24-hour exceedances were linked to both ID-only and ID+ASD. U.S. NAAQS 24-hour threshold (35 μg/m(3)) exceedances during preconception and first trimester were associated with ID+ASD. Results reveal that long-term PM(2.5) exposure during preconception and the first trimester elevates risk for both ID-only and ID+ASD. ID+ASD appears particularly sensitive to preconception and first trimester exceedances of the U.S. NAAQS 24-hour threshold, whereas ID-only may be more sensitive to exceedances of the WHO 24-hour threshold during preconception. By distinguishing these neurodevelopmental outcomes, these results underscore timing and magnitude of prenatal PM(2.5) exposure differentially influence neurodevelopmental risk. They also highlight the need for targeted public health interventions and stronger air quality regulations to protect early neurodevelopment.

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13. Rodgers J, Bhattarai N, Goodwin J, Gordon I, Heslop P, Nielsen E, O’Connor RC, Ogundimu E, Pelton M, Ramsay S, Townsend E, Vale L, Wagnild J, Wilson C, Cassidy S. Adapted Safety Plans to Address Self-Harm and Suicide Behaviours in Autistic Adults: single arm feasibility trial and external pilot RCT. Public Health Res (Southampt). 2025; 13(10): 1-19.

BACKGROUND: Suicide prevention is a national priority for United Kingdom government policy, and autistic people have recently been identified as a high-risk group in both the Department of Health and Social Care suicide prevention strategy and National Institute for Health and Care Excellence suicide prevention guidelines. No suicide prevention interventions have been developed specifically for autistic people. Safety plans are a simple, cost-effective, potentially life-saving intervention. AIMS: To evaluate the feasibility and acceptability of the use of Autism Adapted Safety Plans for autistic adults and to undertake an external pilot to explore whether a larger future definitive trial is achievable. METHODS: Stage 1 involved focus groups with autistic adults (n = 15), family members (n = 5) and service providers (n = 10) to inform adaptations to the Autism Adapted Safety Plans. Stage 2 was an interventional single-arm feasibility trial where autistic adults (n = 8) completed an Autism Adapted Safety Plans with a supporter (n = 8). Data on recruitment, completion of study measures and participant feedback informed final adaptations to the Autism Adapted Safety Plans and research methods prior to stage 3. Stage 3 was a pilot feasibility randomised controlled trial of Autism Adapted Safety Plans. Autistic adults were recruited via non-National Health Service organisations and self-referral. Participants were randomised without stratification to usual care ± Autism Adapted Safety Plans. The Autism Adapted Safety Plan was completed by the autistic adults with someone trained to support them. Research staff completing follow-up assessments were blind to participant allocation. Primary outcomes were feasibility and acceptability of the Autism Adapted Safety Plans to inform the parameters of a definitive randomised controlled trial. Participants were assessed at baseline, 1 and 6 months. RESULTS: Stage 1 and 2 interviews highlighted the conditions needed to make the process of creating the Autism Adapted Safety Plans acceptable for autistic adults. Stage 2 also informed modifications to recruitment (to include self-referral) in stage 3. In stage 3, 53 participants consented, 49 were randomised to either Autism Adapted Safety Plans + usual care (n = 25) or usual care (n = 24). Sixty-eight per cent of participants were satisfied with the Autism Adapted Safety Plans and 41% rated it as usable. Feedback on the Autism Adapted Safety Plans and study processes employed in the trial were positive with suggested minor adaptations to some outcome measures. Retention of those randomised was 95% at 6-month follow-up. Completion rates for outcome measures were generally high (> 85%). Fidelity ratings for delivery of the Autism Adapted Safety Plans were 94% for therapeutic components and 91% for adherence to content. CONCLUSION: Autism Adapted Safety Plans are a potentially valuable intervention for autistic adults, provided that the process of creating it is flexible and sensitive to individual needs. The parameters of a future definitive trial of the clinical and cost-effectiveness of Autism Adapted Safety Plans are achievable, with minor recommended adaptations. Further testing of the Autism Adapted Safety Plans to assess its clinical and cost-effectiveness in National Health Service clinical services is urgently needed. LIMITATIONS: The sample size was below the initially intended sample of 70 participants due to difficulties with recruitment during the COVID-19 pandemic. As autistic participants self-referred into the study, data are not available regarding how many participants were approached to take part in the study. The majority of the study sample was White. FUTURE WORK: A full definitive trial testing the clinical and cost-effectiveness of Autism Adapted Safety Plans in National Health Service clinical services is warranted. This fully powered trial will need to recruit a more diverse sample than was possible in the pilot trial. Results suggest that minor adaptations to the Autism Adapted Safety Plans could make this more personalised and accessible, such as through an app or website. FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR129196. Autistic people are more likely to experience self-harm and suicidal behaviour than non-autistic people. No suicide prevention interventions have been developed specifically for autistic people. Interventions to support autistic people tend to work best when developed specifically to meet their needs. Safety plans are developed by people with help from staff to identify their own warning signs and what or who could help them when they are in crisis. Research shows that safety plans help keep people safe from self-harm and suicide. Safety plans may be potentially useful to autistic people. We need to adapt safety plans to make sure they are useful for autistic people. We asked autistic people, their families, and service providers, what they thought about a draft autism adapted safety plan. Their feedback helped us refine the safety plan for autistic people. Next, autistic adults completed a safety plan with a service provider. This helped us to refine the safety plan and study processes. Next, 25 autistic adults completed a safety plan with support and 24 autistic adults received usual care. We asked autistic adults to complete some questionnaires before, 1 and 6 months after consenting to take part in the study. We asked participants who completed an autism adapted safety plan what they thought about it. Most (68%) of the autistic adults were satisfied with their safety plan. Less than half of the autistic adults thought their safety plan was usable (41%). Autistic people said their experience of using their safety plan was positive. Autistic adults suggested minor changes to some questionnaires to make them clearer. Most participants remained in the study regardless of whether they received the autism adapted safety plan or not. The Autism Adapted Safety Plans were delivered to autistic participants very consistently by support workers. We conducted the first study to develop and test a safety plan intervention with autistic adults. Our findings suggest that autistic people are satisfied with Autism Adapted Safety Plans and with taking part in the study. This means that it is possible to undertake a larger study testing if Autism Adapted Safety Plans can reduce self-harm and suicidal behaviour in autistic adults. This further work could potentially help prevent the high rates of self-harm and suicide in autistic adults. eng.

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14. Straiton-Webster D, Ingersoll B. Short report: Disparities in hours of applied behavior analysis services for Medicaid-enrolled autistic youth. Autism. 2025: 13623613251392495.

To date, no studies have investigated whether disparities in hours of applied behavior analysis (ABA) exist in the Medicaid system. We used multilevel modeling to analyze Medicaid billing claims for 1,028 autistic youth under the age of 21 years to examine the extent to which there were disparities in hours of ABA services for Medicaid-enrolled youth based on race/ethnicity and rurality. Although younger children received more hours of ABA, F(1, 964.63) = 118.28, p < .001, there were no statistically significant differences in hours of ABA based on minoritized race/ethnicity status or sex. On average, youth served in rural areas received significantly less hours of ABA per month than those in non-rural areas, F(1, 122.13) = 7.89, p = .006; youth in rural areas received 10.86 less hours per month than those in non-rural areas. Results suggest that publicly funded service systems like Medicaid may reduce ABA service disparities by race/ethnicity. Policymakers should focus on improving service provision for youth in rural areas.Lay AbstractWe used Medicaid billing claims from 1,028 autistic youth to see if there were differences in hours of applied behavior analysis (ABA) services per month for youth from different racial/ethnic groups, different service settings (rural or non-rural), different sexes, and different ages. We found that younger autistic youth received more hours of ABA per month compared to older youth, and and youth served in rural areas received about 11 hours less per month compared to youth in non-rural areas. There were no differences among different race/ethnic groups or sexes. Policymakers should focus on improving service availability for autistic youth served in rural areas. No studies of the Medicaid system have shown whether children of color receive less hours of applied behavior analysis (ABA) than White children or whether children in rural areas receive less services than those in non-rural areas. We used Medicaid billing claims to see if these disparities exist. We found that younger children received more hours of ABA per month, and children from rural areas received an average of 10.86 hr less per month than children in non-rural areas. There were no disparities based on race/ethnicity or sex. Publicly funded service systems like Medicaid may help reduce disparities by race/ethnicity, but policymakers should improve services for children living in rural areas. eng.

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15. Taylor L. CDC website altered to suggest possible link between vaccines and autism. Bmj. 2025; 391: r2470.

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16. Triyono T, Febriani RD, Kasih F. Broadening the evidence for hug-robot-mediated communication in autism spectrum disorder. Asian J Psychiatr. 2025; 115: 104775.

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17. Xu J, Xu Y, Su W, Chen L, Wang Y, Li H. Clinical use of whole-genome sequencing in children with developmental delay or intellectual disability. BMC Med Genomics. 2025; 18(1): 188.

BACKGROUND: Determining the underlying cause of developmental delay or intellectual disability (DD/ID) is challenging yet crucial. Establishing a genetic basis for cases of unexplained DD/ID is integral to informing clinical decisions and anticipating patient outcomes. In this report, we share our institutional insights derived from employing whole-genome sequencing (WGS) to investigate unexplained DD/ID in pediatric populations. METHODS: A retrospective study was conducted on 115 children aged 1 month to 16 years with unexplained DD/ID who underwent WGS. We analyzed demographic profiles and catalogued genetic variants identified, in conjunction with examining clinical variables potentially associated with diagnostic yield. RESULTS: WGS data from 115 pediatric patients identified a total of 33 pathogenic or likely pathogenic single nucleotide variants and small insertions/deletions, of which 22 were classified as diagnostic cases and 11 as carriers. In addition, 11 pathogenic or likely pathogenic copy number variations were detected. Clinical attributes such as gender, age at diagnosis, gestational maturity, birth weight, perinatal complications (anoxia, jaundice), comorbid symptoms, hereditary background, neuromuscular function (muscle tone and strength), presence of epilepsy, neuroimaging, and electroencephalography patterns did not show a significant association with WGS findings. Nonetheless, a noteworthy association emerged between earlier age at diagnosis and increased diagnostic yield via WGS. CONCLUSIONS: WGS serves as a powerful tool for uncovering genetic etiologies in children with unexplained DD/ID, with meaningful implications for clinical care, genetic counseling for families, and long-term management planning.

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18. Zhang Y, Liu Y. The evolving landscape: A bibliometric and visual analysis of language interventions research for children with ASD. Res Dev Disabil. 2025; 167: 105169.

PURPOSE: This study conducts a multi-database bibliometric analysis to map the intellectual landscape of language intervention research for children with ASD from 2001 to 2024, seeking to identify foundational and trending topics, map collaborative networks, and trace thematic evolution, thereby offering data-driven guidance for setting research priorities, fostering international cooperation, and informing clinical practice translation. METHODS: We systematically searched Web of Science Core Collection, EBSCOhost, and PubMed. After deduplication and screening, 2720 publications were retained for bibliometric analysis using CiteSpace. Co-citation analysis, time-zone map, burst detection, and network visualization identified research clusters and temporal evolution trajectories. RESULTS: Publications exhibited three distinct growth phases: initial exploration (2001-2012), accelerated expansion (2013-2017), and exponential growth (2018-2024). Ten major research clusters comprising 573 nodes demonstrated high structural validity (mean silhouette=0.835, modularity Q=0.812). Augmentative and Alternative Communication (AAC) exhibited the highest structural importance (burst=17.34, sigma=17.15), while computational methods, particularly machine learning (323 citations), showed rapid growth despite peripheral network positions (centrality=0.09), indicating they are emerging yet not central to the mainstream discourse. The United States dominated collaborative networks (betweenness=0.68, 57 connections), with emerging contributions from China, UK, and Canada. CONCLUSION: The temporal analysis reveals that the field has successfully navigated multiple paradigm expansions, evolving from initial behavioral approaches to encompass technological and neurobiological perspectives. Five emerging frontiers warrant strategic investment: computational-clinical integration, telehealth implementation science, AI-enhanced AAC systems, neurobiological phenotyping, and community-based early detection. Future research should prioritize implementation science, foster interdisciplinary collaboration, and embed participatory principles.

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