1. Akbulut C, Bird G. Who Tweets for the autistic community? A natural language processing-driven investigation. Autism;2025 (Mar 25):13623613251325934.

The formation of autism advocacy organisations led by family members of autistic individuals led to intense criticism from some parts of the autistic community. In response to what was perceived as a misrepresentation of their interests, autistic individuals formed autistic self-advocacy groups, adopting the philosophy that autism advocacy should be led ‘by’ autistic people ‘for’ autistic people. However, recent claims that self-advocacy organisations represent only a narrow subset of the autistic community have prompted renewed debate surrounding the role of organisations in autism advocacy. While many individuals and groups have outlined their views, the debate has yet to be studied through computational means. In this study, we apply machine learning and natural language processing techniques to a large-scale collection of Tweets from organisations and individuals in autism advocacy. We conduct a specification curve analysis on the similarity of language across organisations and individuals, and find evidence to support claims of partial representation relevant to both self-advocacy groups and organisations led by non-autistic people. In introducing a novel approach to studying the long-standing conflict between different groups in the autism advocacy community, we hope to provide both organisations and individuals with new tools to help ground discussions of representation in empirical insight.Lay AbstractSome autism advocacy organisations are run by family members of autistic people, and claim to speak on behalf of autistic people. These organisations have been criticised by autistic people, who feel like autism charities do not adequately represent their true interests. In response to these organisations, autistic people have come together to form autistic self-advocacy organisations, or groups in which activists can spread awareness of autism from an autistic point-of-view. However, some people say that autistic self-advocacy organisations do not sufficiently represent the needs of all autistic people. These tensions between organisations and individuals have made it difficult to determine which organisations can make the claim that they represent all autism advocates individuals equally, instead of showing preference to a sub-group within the autism community. In this study, we try to approach this issue using computational tools to see if, in their Twitter posts, both kinds of organisations show a preference for the interests of autistic people or parents of autistic children. We do so by comparing a large body of Tweets by organisations to Tweets by autistic people and parents of autistic children. We find that both kinds of organisations match the interests of one group of autism advocates better than the other. The insight we provide has the potential to inspire new conversations and solutions to a long-standing conflict in autism advocacy.

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2. Alotaibi SS, Alghamdi TA, Alharthi R. Two-tier nature inspired optimization-driven ensemble of deep learning models for effective autism spectrum disorder diagnosis in disabled persons. Sci Rep;2025 (Mar 24);15(1):10059.

Autism spectrum disorder (ASD) includes a varied set of neuropsychiatric illnesses. This disorder is described by a definite grade of loss in social communication, academic functioning, personal contact, and limited and repetitive behaviours. Individuals with ASD might perform, convey, and study in a different way than others. ASDs naturally are apparent before age 3 years, with related impairments affecting manifold regions of a person’s lifespan. Deep learning (DL) and machine learning (ML) techniques are used in medical research to diagnose and detect ASD promptly. This study presents a Two-Tier Metaheuristic-Driven Ensemble Deep Learning for Effective Autism Spectrum Disorder Diagnosis in Disabled Persons (T2MEDL-EASDDP) model. The main aim of the presented T2MEDL-EASDDP model is to analyze and diagnose the different stages of ASD in disabled individuals. To accomplish this, the T2MEDL-EASDDP model utilizes min-max normalization for data pre-processing to ensure that the input data is scaled to a uniform range. Furthermore, the improved butterfly optimization algorithm (IBOA)-based feature selection (FS) is utilized to identify the most relevant features and reduce dimensionality efficiently. Additionally, an ensemble of DL holds three approaches, namely autoencoder (AE), long short-term memory (LSTM), and deep belief network (DBN) approach is employed for analyzing and detecting ASD. Finally, the presented T2MEDL-EASDDP model employs brownian motion (BM) and directional mutation scheme-based coati optimizer algorithm (BDCOA) techniques to fine-tune the hyperparameters involved in the three ensemble methods. A wide range of simulation analyses of the T2MEDL-EASDDP technique is accomplished under the ASD-Toddler and ASD-Adult datasets. The performance validation of the T2MEDL-EASDDP method portrayed a superior accuracy value of 97.79% over existing techniques.

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3. Camodeca A. Factor Analysis of the Autism Spectrum Rating Scales Parent Report 6-18 in a Complex Community Sample. J Autism Dev Disord;2025 (Mar 25)

There is a need for research on autism questionnaire psychometrics outside of the standardization sample. This study investigated the factor structure of the Autism Spectrum Rating Scales-Parent report for ages 6-18 (ASRS(p6)) in a well-characterized community sample of 696 children (autism [AUT] n = 231; non-autism [NOT] n = 465; X̄age = 10.03) prospectively evaluated with the Autism Diagnostic Observation Schedule-2, a gold-standard autism diagnostic measure. The original author-identified structure demonstrated poor model fit. Exploratory Factor Analysis with a randomly selected half of the sample (n = 346) suggested retaining 17-items on three factors (Rigid/Sensory, Social, and Executive Function [EF]), explaining 55% of the variance. Confirmatory Factor Analysis with the remaining participants (n = 350) indicated good model fit. Partial measurement invariance was observed for diagnostic (AUT/NOT) and gender (male/female) groups. Correlations with the DSM-5(p6) (an ASRS(p6) scale) were high. Mean differences were observed between AUT/NOT groups for Social; when controlling for age, marginal differences (p = 0.02 – 0.03) were observed for all factors but EF. Social also demonstrated significant AUC regardless of control variables. However, AUC values for Social and other factors, while significant, were in the poor range; correlations with ADOS-2 scores were weak or non-significant. Despite improving the factor structure, the Total-17 does not appear to measure ASD-specific traits. However, these findings provide a basis for further research on ASD questionnaires.

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4. Feng Y, Lu D, Ng TYC, Chau PH, Chan LML, Kwok JYY. Mindfulness and parenting stress among parents of autistic children: The mediation of resilience and psychological flexibility. Autism;2025 (Mar 25):13623613251328465.

High parenting stress is associated with diminished quality of life in parents and more problem behaviors in autistic children. Mindfulness-based interventions have demonstrated efficacy in mitigating parenting stress. Psychological flexibility and resilience have been recognized as protective factors against psychological distress. However, the extent to which psychological flexibility and resilience mediate the effect of mindfulness on parenting stress among parents of autistic children remains unclear. This cross-sectional study examined the mediating roles of psychological flexibility and resilience in the relationship between mindfulness and parenting stress. We recruited a convenience sample of 181 Chinese parents of autistic children from Shenzhen Longhua Maternity and Child Healthcare Hospital in Shenzhen, China. This study assessed characteristics, parents’ mindfulness, psychological flexibility, resilience, and parenting stress. Results indicated that parents experienced considerable parenting stress. Correlation analysis found that higher mindfulness, psychological flexibility, and resilience were associated with lower parenting stress. After controlling for children’s age, gender, core symptom severity, parents’ age, gender, marital status, and education levels, psychological flexibility and resilience completely mediated the relationship between mindfulness and parenting stress. These findings suggest that multicomponent psychological interventions may enhance the mental health of parents of children with autism, warranting further investigation.Lay AbstractRaising a child with autism spectrum disorder can be very stressful for parents, and this stress can lead to serious problems, like diminished quality of life in parents and more challenging behaviors in autistic children. But there’s something called mindfulness that can help parents feel less stressed. Mindfulness is like training your mind to stay calm and focused. It’s like learning to take a deep breath and find calm in a busy day. Our study in China investigated 181 parents of children with autism from Shenzhen Longhua Maternity and Child Healthcare Hospital in Shenzhen, China. We wanted to see if two things-being able to bounce back from hard times (resilience) and being flexible in how you think and act (psychological flexibility)-help mindfulness work its magic in easing stress. We found that more mindful parents also felt less stressed. Moreover, having psychological flexibility and resilience seemed to be the reason why mindfulness was so helpful. After controlling for covariates including children’s age, gender, core symptom severity, parents’ age, gender, marital status, occupational status, and education levels, the effects of mindfulness on stress still existed. This tells us that programs that teach mindfulness, along with how to build resilience and be more flexible in thinking, could make a difference for parents of children with autism. It could help them feel less stressed and more at peace.

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5. Gao P, Wu J, Chang L, Jiang Z, Cui Y, Fan A, Ren S, Fu W, Xia S, Wei S, Ye D, Fang X. The impact of autistic traits on non-suicidal self-injury behavior among vocational high school students: A moderated mediation model. J Psychiatr Res;2025 (Mar 15);184:447-456.

BACKGROUND: Non-suicidal self-injury (NSSI) is a growing public health concern, yet its prevalence among vocational high school students is underexplored. The relationships between autistic traits, sleep patterns, and life satisfaction in relation to NSSI remain poorly understood. METHODS: This cross-sectional study was conducted on 10,252 vocational high school students with an average age of 20.1 from June 2022 to June 2023. Utilizing the PROCESS 3.4.1 macro in SPSS, analyses were performed to investigate the potential mediation of sleep disturbances in the relationship between autistic traits and non-suicidal self-injury behavior. Furthermore, we investigated the moderating effect of life satisfaction on this relationship. RESULTS: 8.2 % of vocational high school students in this study showed signs of NSSI issues. We found that sleep problems partially mediated the relationship between autistic traits and NSSI, accounting for 36.37 % of the mediation effect. Lastly, life satisfaction played a regulatory role in both direct and indirect paths of the aforementioned mediating model, with the mediation model remaining valid. CONCLUSION: Among vocational high school students, the prevalence of NSSI is notable, with high autistic traits influencing the development of NSSI by impacting sleep. Furthermore, life satisfaction plays a modifying role in this pathway.

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6. Gold WA, Percy AK, Neul JL, Cobb SR, Pozzo-Miller L, Issar JK, Ben-Zeev B, Vignoli A, Kaufmann WE. Publisher Correction: Rett syndrome. Nat Rev Dis Primers;2025 (Mar 24);11(1):19.

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7. Lai CC, Wu CC. Caries pattern and dental treatment features of children with autism spectrum disorder under general anesthesia. Medicine (Baltimore);2025 (Mar 21);104(12):e41867.

Difficulty in the cooperation of children with autism spectrum disorder (ASD) leads to a poor diagnosis of caries patterns and poor clinical and radiographic findings. This study aimed to investigate the association between caries patterns and treatment characteristics in children with ASD and compare these variables with those in healthy children treated under general anesthesia. The medical records of children with ASD undergoing dental treatment under general anesthesia (n = 40) were analyzed in this study. The collected data included demographic profile, medical status (ASD severity and associated comorbidities), dental history (behavior, care approach, past dental treatment, and follow-up period), caries pattern (surface and depth), and clinical and radiographic findings (e.g., percussion/palpation pain, fistula, furcation involvement, and pathologic resorption). We compared the caries patterns and treatment of children with ASD to those of their healthy counterparts (n = 40). In children with ASD, age and severity were significantly associated with presentation behavior (P = .03 and P = .04) and the chosen care approach (P = .03). Clinical and radiographic examinations revealed that furcation involvement or pathological resorption was more frequent in children with ASD from families with lower average monthly income (P = .05) and in those with associated comorbidities (P = .02). Caries involving 1 or 2 surfaces were more prevalent in children with ASD, with a significant proportion extending to the dental pulp (P < .001). Dental caries characteristics and patterns among children with ASD differ from those of healthy children, which influences dental treatment decisions.

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8. Liu SJ, Zhao G, Zhang QZ, Wu HM, Jin YS, Liu WL, Li Y, Dai SX, Zhang XJ, Wang LL, E YM. Factors of families resilience in children with autism spectrum disorder: a latent profile analysis. Psychol Health Med;2025 (Mar 25):1-14.

PURPOSE: The purpose of the study was to explore distinct profiles of family resilience in a sample of Chinese families with children diagnosed with autism spectrum disorder (ASD). Moreover, we identified socio-demographic predictors of these latent profiles. METHODS: The cross-sectional study included 229 children (74.4% boys) diagnosed with ASD from maternity and child healthcare hospitals and comprehensive hospitals in three cities (Shenzhen, Xiamen and Tianyang), China. The socio-demographic characteristics questionnaire and the Chinese version of the Family Resilience Assessment Scale (FRAS) were complicated by parents (229) of children with ASD. Latent profile analysis (LPA) was used to identify and describe profiles of family resilience. Multinomial logistic regression was then performed to identify significant predictors. RESULTS: Three profiles were found after LPA [low family resilience (28.3%), moderate family resilience (41.9%), and high family resilience (29.7%)]. Multinomial logistic regression revealed the severity of illness, cost of treatment and father employment status were significant factors predicted family resilience. CONCLUSION: We found that most of the families with children affected by ASD had low or moderate family resilience. Family resilience profiles were predicted by socio-demographic characteristics which included the severity of illness, cost of treatment and father employment status. Intervention is suggested to higher the level of family resilience.

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9. Milbourn B, Cairns L, Cartwright C, Painter S, Wedgewood C, Girdler S. ‘That connection with community… it is just a positive thing’: Mentoring autistic adolescents participating in community coding programmes. Aust Occup Ther J;2025 (Apr);72(2):e70012.

INTRODUCTION: Little is known regarding the experiences of mentoring autistic adolescents. The aim of the study was to explore the process of mentoring autistic youth participating in community coding programmes through the perspective of mentors and facilitators. METHOD: A descriptive qualitative research design was used involving focus groups or one-on-one interviews with mentors (n = 5) and facilitators (n = 5) volunteering at two community coding programmes in Western Australia and Victoria. Data were thematically analysed through an iterative process. CONSUMER AND COMMUNITY INVOLVEMENT: An autistic individual was involved in piloting the discussion guide for the semi-structured interviews. FINDINGS: Thematic analysis identified three primary themes, including (1) the mentoring process; (2) Mentor outcomes including sub-themes of development of mentor attributes, professional development and personal wellbeing and satisfaction; and (3) support needs and opportunities. CONCLUSION: Practical supports and training within community coding clubs may aid mentors and facilitators in supporting the needs of autistic youth in the community. PLAIN LANGUAGE SUMMARY: In this project, we explored the views of mentors and facilitators of community coding clubs for autistic adolescents. The community clubs were run on Saturdays for 2-4 hours during school term time. A total of 10 participants (five mentors and five facilitators) agreed to meet with the research team to discuss their experiences. We found that mentors and facilitators needed support to develop their mentoring skills which helped them to grow, made them feel better and gave them a feeling of satisfaction. Our study showed the importance of understanding autism spectrum and supporting mentors and facilitators. We showed how mentoring programmes are an emerging approach that occupational therapists can engage with to better support autistic youth with their strengths and passions.

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10. Moser C, Smith DaWalt L, Burke MM, Taylor JL. Correlates of self-reported life satisfaction among autistic youth with and without intellectual disability. Autism;2025 (Mar 25):13623613251327347.

Compared to their nonautistic peers, lower levels of life satisfaction have been reported by autistic individuals. It is unclear, however, whether autistic individuals with intellectual disability report similar levels of life satisfaction as autistic individuals without intellectual disability or which characteristics are associated with life satisfaction. This study sought to examine differences in levels of self-reported life satisfaction across those with and without intellectual disability and explore correlates of life satisfaction in a sample of 35 autistic youth with intellectual disability and 99 autistic youth without intellectual disability. No difference in self-reported life satisfaction was detected between autistic youth with and without intellectual disability. Greater self-reported life satisfaction was associated with higher self-determination for autistic youth without intellectual disability. For autistic youth with intellectual disability, greater self-reported life satisfaction was related to more frequent social participation, lower parent stress, and fewer unmet service needs. Unmet service needs and parent stress were significantly stronger correlates of life satisfaction for youth with intellectual disability compared to youth without intellectual disability. Although the sample size of autistic youth with intellectual disability was small, these findings suggest the importance of considering heterogeneity among individuals on the autism spectrum when seeking to understand their well-being.Lay abstractAutistic people report lower life satisfaction compared to people without autism. It is unclear whether autistic people with intellectual disability report similar levels of life satisfaction to autistic people without intellectual disability. In this study, we did not find a difference in levels of life satisfaction for autistic youth with intellectual disability compared to autistic youth without intellectual disability. We also identified factors that might promote better life satisfaction. Higher self-determination was related to higher life satisfaction for autistic youth without intellectual disability. For autistic youth with intellectual disability, more frequent social participation, lower parent stress, and fewer unmet service needs were associated with higher life satisfaction. Unmet service needs and parent stress were more strongly related to life satisfaction for youth with intellectual disability compared to youth without intellectual disability. Our findings suggest that taking a more individualized approach to support the well-being of autistic youth is important.

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11. Shamblen SR, Richard BO, Abadi MH, Thompson KT, Aramburu C, Young LC, Ely J, Dukka H, Johnson KW. An Oral Health Promotion Strategy for Persons With Intellectual and Developmental Disability: An Exploratory Randomized Trial Comparing Intervention and Control Group Homes. J Public Health Dent;2025 (Mar 25)

INTRODUCTION: Individuals with intellectual or developmental disabilities (IDD) often experience more negative oral health outcomes. METHODS: We implemented and tested a comprehensive strategy in 39 IDD group homes to examine whether skills-based training for direct support professionals (DSP) and individualized oral health planning for residents could improve DSP assistance and provision of oral health care for residents and oral health status. Our sample comprised 19 intervention homes and 20 control group homes, with 61 residents with IDD and 77 DSP. The strategy involved providing didactic and experiential skills-based training, combined with in-home coaching to DSP with resident participation over the course of 16 weeks. DSP in control homes received educational brochures. DSP attitudes, skills, and behaviors; and resident oral health outcomes were measured at baseline, 4 months later (post-intervention), and 12 months after baseline. Analyses compared the intervention and control conditions at 4-months and 12-months. RESULTS: Results suggest that the intervention influenced DSP skills and behaviors. Among residents, results showed improved outcomes for teeth in the lower anterior sextant only; intervention effects largely abated by 12-month follow-up. DISCUSSION: Findings demonstrate that skills-based, experiential training with coaching can be effective in enhancing skill sets and increasing behaviors about oral health among DSP. In addition, results showed that the strategy used can improve oral health outcomes for residents. However, given that there were only improved outcomes in residents’ lower anterior sextant, more research is needed to determine how to adequately assess and improve resident outcomes.

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12. Smith H, Shaw SCK, Doherty M, Ives J. Reasonable adjustments for autistic clinicians: A qualitative study. PLoS One;2025;20(3):e0319082.

Autistic people experience barriers to accessing healthcare. Autistic clinical professionals may be able to help improve this situation. Previous research, however, has shown that Autistic clinical professionals experience numerous challenges in the workplace. If there is a ‘substantial’ and ‘long-term’ negative effect on the person’s ability to do normal daily activities, then Autism may be considered a disability under The Equality Act 2010; the jurisdiction of which covers Great Britain. Autistic clinical professionals working in healthcare settings across England, Wales, and Scotland are therefore entitled to reasonable adjustments to aid them in their clinical practice. This is a qualitative study. We recruited 82 Autistic clinical professionals via social media to complete an online survey. Questions broadly explored: 1) the challenges they faced in their clinical workplaces; and 2) the reasonable adjustments that they needed, had, or needed but did not have. Data were analysed quasi-thematically, also drawing on the principles of content analysis. Respondents reported multiple challenges from our analysis, from which we developed 8 themes: gaining and attending employment, reasonable adjustments under the radar, connecting and integrating (specifically, the communication mismatches between Autistic professionals and non-autistic colleagues, and fitting in socially and professionally), executive functioning, change, working environment, working practices/cultures, and the consequences and effects on Autistic clinical professionals). We recommend that Autistic clinical professionals and their employers individually discuss and iteratively revisit the unique combination of reasonable adjustments suitable for each person. In this way, employers may provide equitable workplaces for their staff which will benefit not only them, but their patients, and healthcare as a whole.

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13. Tian HL, Wang L, Ma CL, Yang B, Li L, Ye C, Zhao D, Lin ZL, Cui JQ, Liu YK, Zhu WY, Zhou SL, Li N, Chen QY. [Fecal microbiota transplantation for the treatment of intestinal disorders: An analysis of treatment of 15 000 patients]. Zhonghua Wei Chang Wai Ke Za Zhi;2025 (Mar 25);28(3):296-303.

Objective: To examine the long-term efficacy and complications of fecal microbiota transplantation (FMT) for the treatment of diseases related to intestinal dysbiosis. Methods: This was a retrospective descriptive study. Relevant data were collected from the records of 15 000 patients who had undergone FMT and been followed up for more than 3 months during the period from May 2017 to September 2024. The patient cohort comprised 3746 male and 11 254 female patients aged (45.3±12.2) years. The inclusion criterion was meeting the indications for FMT. Application of this criterion yielded 8258 patients with constipation, 684 with Clostridium difficile infection, 1730 with chronic diarrhea, 510 with inflammatory bowel disease, 432 with radiation enteritis, 1940 with irritable bowel syndrome, 365 with autism, 870 with postoperative gastrointestinal dysfunction, and 211 with neurodegenerative diseases. The three routes of delivering FMT comprised infusion of an enterobacterial solution through a nasoenteric tube into the jejunum for 6 consecutive days (upper gastrointestinal FMT group, 11 125 patients), oral intake of enterobacterial capsules for 6 consecutive days (oral capsule FMT, 3597 patients), and a single injection of a bacterial solution into the colon via colonoscopy (lower gastrointestinal FMT group, 278 patients). Other treatments were discontinued during the treatment and follow-up period and administration of other medications was not recommended unless absolutely necessary. The primary outcomes were the efficacy of FMT after 3, 12 and 36 months of treatment, and improvement in chronic constipation, C. difficile infection, chronic diarrhea, inflammatory bowel disease, radiation enteritis, irritable bowel syndrome, post-surgery gastrointestinal dysfunction, and autism. Other outcomes included the occurrence of short-term (within 2 weeks after treatment) and long-term (within 36 months after treatment) adverse reactions. Results: At 3, 12 and 36 months after treatment, the overall rates of effectiveness of treatment were 71.8% (10 763/15 000), 64.4% (7600/11 808) and 58.8% (3659/6218), respectively. Specifically, the rates of clinical improvement were 70.3% (5805/8258), 62.6% (3970/6345), and 56.5% (1894/3352), respectively, for constipation; 85.8% (587/684), 72.3% (408/564), and 67.3% (218/324), respectively, for C.difficile infection; 81.0% (1401/1730), 78.1% (1198/1534), and 72.3% (633/876), respectively, for chronic diarrhea; 64.3% (328/510), 52.3% (249/476), and 46.6 % (97/208), respectively, for inflammatory bowel disease; 77.3% (334/432), 65.4% (212/324), and 53.6% (82/153), respectively, for radiculitis; 70.6% (1370/1940), 64.5% (939/1456), and 60.4% (475/786), respectively, for irritable bowel syndrome; 75.3% (275/365), 70.0% (201/287), and 63.6% (112/176), respectively, for autism; 65.3% (568/870), 54.3% (355/654), and 46.5% (114/245), respectively, for post-surgical gastrointestinal dysfunction; and 45.0% (95/211), 40.5% (68/168), and 34.7% (34/98), respectively, for neurodegenerative diseases. At 3, 12, and 36 months post-treatment, clinical improvement rates were 77.1% (8580/11 125), 67.1% (6437/9595), and 62.1% (3196/5145), respectively, in the upper gastrointestinal route group; and 57.3% (2062/3597), 53.6% (1115/2081), and 45.0% (453/1006), respectively, in the oral capsule group; and 43.5% (121/278) , 36.4% (48/132) and 14.9% (10/67), respectively, in the lower gastrointestinal route group. No serious adverse reactions occurred during treatment or follow-up. The most common adverse reactions in the upper gastrointestinal route group, oral capsule group, and lower gastrointestinal route group were respiratory discomfort (20.4%, 2269/11 125), nausea and vomiting on swallowing the capsule (7.6%, 273/3597), and diarrhea (47.5%, 132/278), respectively; these symptoms resolved at the end of treatment. At 36 months of follow-up, 19 patients reported exacerbation of symptoms of pre-existing diseases and there had been 16 deaths that were not directly related to FMT. Additionally, no systemic diseases had developed after FMT. Conclusion: FMT for the treatment of intestinal dysfunction associated with disorders of the intestinal flora and related extraintestinal diseases is effective and not associated with serious adverse events.

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14. Ye CW, Lin CH, Wang SJ. Olanzapine-Associated Hyperbilirubinemia in an Adolescent With Autistic Spectrum Disorder Comorbid With Schizophrenia: A Case Report. J Clin Psychopharmacol;2025 (Mar 26)

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15. Zhang L, Zhang C, Yuan X, Ji Y. The impact of exercise interventions on core symptoms of 3-12-year-old children with autism spectrum disorder: a systematic review and network meta-analysis. Eur Child Adolesc Psychiatry;2025 (Mar 25)

Exercise interventions targeting Fundamental Movement Skills (FMS) represent a critical approach for mitigating functional impairments in children with autism spectrum disorder (ASD). This study, for the first time, based on motor development theory, employed a Network Meta-analysis (NMA) to examine the effects of four types of exercise interventions-Isolation of Fundamental Movement Skills (FMS-I), Combination of Fundamental Movement Skills (FMS-C), Fine Motor Movement (FMM), and Specialized Movement Skills (SMS)-on the core symptoms of ASD in children aged 3-12, including social communication deficits and stereotyped and repetitive behaviors. Five electronic databases were systematically searched up to May 22, 2024. Included studies compared exercise interventions with control groups and assessed at least one core symptom of ASD. Study quality and evidence certainty were evaluated using the Risk of Bias tools (RoB 2.0, ROBINS-I) and the Confidence in Network Meta-Analysis (CINeMA) framework. Data analysis was performed via Stata 17.0 software. The systematic review included 26 studies encompassing 878 children, with 19 studies eligible for NMA. Ranking probabilities indicated that FMS-I emerged as the most promising intervention for addressing social communication deficits (SMD: -0.99, 95%CI: -1.46 to -0.52; SUCRA: 86.9%) and stereotyped and repetitive behaviors (SMD: -2.73, 95% CI: -3.76 to -1.70; SUCRA: 100%). The FMS-C showed potential for enhancing overall features (SMD: -0.90; 95%CI: -1.32 to -0.49; SUCRA: 74.7%). To conclude, exercise interventions should be grounded in FMS, transitioning from isolated movements to integrated actions, to enhance the overall behavior of children with ASD.

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