1. Chang C, Carandang RR, Silverberg J, Surkis C, Cunningham SD, Wang K, Qasba N. Patient Experiences in Accessing Reproductive Health Services for Women With Cognitive, Intellectual, and Developmental Disabilities: A Systematic Review. Womens Health Issues. 2025.

INTRODUCTION: Individuals with disabilities face barriers to care. Using a life-course and socio-ecological perspective, we reviewed studies on the experiences of individuals with cognitive, intellectual, and developmental disabilities (CIDD) in accessing sexual and reproductive health (SRH) services. METHODS: We systematically searched six online databases and gray literature, selecting studies published from January 2010 to June 2024 written in English. Narrative synthesis was used to identify key themes using the socio-ecological framework. Data were collected by using a standardized extraction form following the Population, Intervention, Comparator, and Outcome format. We conducted assessments of risk of bias and certainty of evidence using standardized tools. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for quantitative studies and Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) for qualitative studies. RESULTS: Of 5,595 studies screened, 26 were included in the final analysis, with almost perfect inter-rater reliability (kappa = .87). SRH service categories included preventive care, puberty/menarche, family planning, pregnancy and fertility, reproductive cancer treatment, and general SRH services. We found lower receipt of preventive care services, lower use of contraception, higher rates of sterilization, and worse obstetric outcomes for individuals with CIDD compared with those without CIDD. Caregiver support was an interpersonal factor well represented in the literature, whereas the patient perspective was underrepresented. CONCLUSIONS: Future research and policy efforts should prioritize the perspectives of individuals with CIDD, particularly during puberty/menarche and menopause. Studies indicate a need for patient-centered approaches, caregiver support, provider training in disability-inclusive care, and accessible healthcare infrastructure to reduce barriers to care.

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2. Chen J, Ismail AS, Xie X. Comparative evaluation of play environment design elements in autism schools using AHP and GRA. Sci Rep. 2025.

Autistic children have unique cognitive, sensory, and social needs, and play environments are key to their development, yet existing research lacks systematic quantitative evaluation frameworks. This study fills this gap by evaluating key design elements of play environments in autism schools within the Yangtze River Delta Region through an integrated Analytic Hierarchy Process (AHP) and Grey Relational Analysis (GRA) framework-an innovative methodological attempt in this field. Focusing on developmental outcomes for autistic children, the research systematically prioritizes ten critical design elements across four autism-specific institutions using structured expert evaluations. AHP assigned objective weights to each element, while GRA enabled a comparative assessment of environmental performance based on expert and teacher inputs. Results highlight safety and sensory-friendly design as the most critical factors, whereas personalization and spatial size showed lower significance. The findings advance evidence-based strategies for optimizing autism school play spaces, propose a balanced design framework harmonizing safety, sensory regulation, and social interaction, and provide support for formulating autism-friendly educational environment policies.

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3. Jiao Y, Wei X, He L, Zhang Y. A functional system-informed graph neural network framework to quantify interpretable brain dysfunction in ASD. Neural Netw. 2025; 195: 108295.

Autism Spectrum Disorder (ASD) is one of the most common neurodevelopmental disorders affecting patients from childhood to adulthood. Yet, its pathological mechanism has not been conclusively established, and its diagnosis mainly depends on subjective assessments of clinical or behavioral measures. In the human brain, connectivity is ubiquitous between brain regions that share functional properties, and groups of brain regions spontaneously assemble into large-scale systems as per their functions. In this study, we propose functional system-informed graph neural network (FS-GNN), a framework using functional magnetic resonance images (fMRI) to diagnose ASD and unveil new perceptions of ASD-related dysfunctions by fully leveraging the topological and functional information underlying the brain connectome. Specifically, we introduce a learnable positional encoding approach for brain regions of interest (ROIs) concerning their natural locations and functional interactions. The large-scale brain systems are integrated as prior knowledge into the graph representation learning to aid the model in identifying clusters of functionality. A graph readout with system-driven regularization is also developed to automatically weigh the ROIs in respect of their contribution to the classification. Experimental results on a multi-site database known as Autism Brain Imaging Data Exchange (ABIDE) validate the efficacy of FS-GNN by outperforming prevalent machine learning and GNN approaches, reaching 75.02 % accuracy, 73.22 % precision, and 71.64 % recall in ASD diagnosis. The brain dysfunctions detected by our model from both ROI and system levels achieve high agreement with previous fMRI-derived evidence of ASD biomarkers. The results demonstrate the strength of our proposed FS-GNN in discovering interpretable and trustworthy neural patterns for a more precise diagnosis of ASD.

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4. 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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5. 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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6. Martín Echave M, Schnack HG, Díaz-Caneja CM, Pina-Camacho L, Janssen N, Gordaliza PM, Kho KH, Buimer EEL, van Haren NEM, Cahn W, Kahn RS, Hulshoff Pol HE, Arango C, Janssen J. Individualized cortical thickness asymmetry in autism spectrum disorder and schizophrenia. Mol Psychiatry. 2025.

Cortical thickness asymmetry has been proposed as a latent biomarker for autism spectrum disorder (ASD) and schizophrenia (SZ). However, the degree of abnormal asymmetry at the individual level in ASD and SZ remains unclear. To investigate this, we employed a normative modeling approach. Normative ranges for the whole brain and regional (160 cortical parcels) cortical thickness asymmetry index (AI) were established using a training set of healthy subjects (n = 4904, 45.15% male, age range: 6-95 years), controlling for age, sex, image quality, and scanner. We calculated z-scores to quantify individual deviations from the normative median in a test set consisting of healthy controls (HC(test), n = 526, 40% male), participants with ASD (n = 135, 83% male), and SZ (n = 287, 81% male). Regional deviance was assessed by counting the number of individuals with significant deviations below (infra-normal, z-score ≤ -1.96) or above (supra-normal, z-score ≥ 1.96) the normative median in each parcel. We also evaluated individual deviance by counting the number of regions with significant deviations for each participant. A multivariate approach was employed to determine whether regional deviance could separate the three groups. There were no differences for deviance of whole brain AI between any of the groups. Distributions of individual deviances overlapped across all 160 regions, with one superior temporal region in which SZ individuals showed a higher proportion of supra-normal AI values compared to HC(test) (HC(test) = 1.14%, SZ = 5.92%, χ(2) = 15.45, P(FDR) < 0.05, ω = 0.14). The SZ group had a higher average number of regions with significant deviations than HC(test) (infra-normal: z = 4.21, p < 0.01; supra-normal: z = 4.33, p < 0.01) but this group difference had limited predictive diagnostic accuracy at the individual level (Area Under the Curve≅60%). The multivariate analysis showed no association between regional deviance and diagnosis. Results were consistent when using a different parcellation, alternative asymmetry calculations, analysis restricted to males, and after controlling for handedness and IQ. Normative modelling revealed little to no evidence of atypical individualized cortical thickness asymmetry in ASD and SZ. The results of this study challenge the utility of cortical thickness asymmetry as a biomarker for ASD and SZ.

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7. 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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8. Suhardita K, Dharmayanti PA, Dewa Ayu Eka Purba Dharma Tari I, Saputra R, Arizona A, Datuti S, Ulfah, Badriyah RDU, Soejanto LT, Ramadhani E, Padillah R. Enhancing peer connection in autism: Evaluating the impact of robot-mediated role-play hug interventions. Asian J Psychiatr. 2025; 115: 104772.

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9. Taluri S, Percy AK, Ananth AL. Living With Rett Syndrome: From Discovery to Clinical Advancements and Emerging Therapies. Pediatr Neurol. 2025; 175: 67-71.

There has been remarkable progress made in the understanding of Rett syndrome, with only 57 years between the description of a phenotype and its first FDA-approved treatment. In this review, we will discuss this history and the genetics of Rett syndrome and examine the clinical features of the condition, with particular attention to the progression of symptoms over time. Genotype-phenotype correlations will be reviewed. Clinical management strategies, including specific symptom management and disease modifying therapy, will be discussed. The review will end with a brief discussion of current and future research directions.

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