1. Aguiar Soares T, Neves M, Penha R, Couto D. Lost in Transition: Delayed Diagnosis of Autism Spectrum Disorder Following Early Migration. Cureus. 2025; 17(4): e82883.

We present the case of a 16-year-old male whose diagnosis of autism spectrum disorder (ASD) was significantly delayed due to the masking effect of early migration. At the age of five, during a critical window for neurodevelopmental identification, he migrated from Portugal to the United Kingdom following an eight-month separation from his primary caregiver. In the years that followed, early autistic features such as language regression, sensory sensitivities, and social withdrawal were attributed to cultural adjustment and second-language acquisition. A comprehensive retrospective developmental assessment in adolescence ultimately revealed that these behaviours were not solely adaptive responses but reflected longstanding features of ASD. This case underscores how environmental transitions during key developmental periods may hinder early identification of neurodevelopmental conditions. It highlights the need for meticulous developmental history-taking and culturally sensitive assessment, particularly when evaluating migrant children whose presentation may be shaped by both intrinsic vulnerabilities and external contextual factors.

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2. Amestoy A, Mallet J, Iftimovici A, Lefebvre A, Stéphan F. [Sensory anomalies: an objective and quantifiable dimension in mental health]. Med Sci (Paris). 2025; 41(5): 469-76.

Sensory anomalies, which are trans-diagnostic in mood disorders, autism spectrum disorders, and schizophrenia, affect social interactions, behaviors, and cognitive functions. Affecting multiple sensory channels (auditory, visual, olfactory), they appear to be central to these pathologies. Animal models, which reveal glutamate-GABA imbalances associated with cognitive alterations and excitation/inhibition dysregulation, facilitate the transfer of findings to humans through the applicability of the paradigms. The French Minds cohort, which studies brain mechanism using clinical tools, functional magnetic resonance imaging and electroencephalogram, is exploring these dimensions to redefine diagnostic and personalized therapeutic approaches to these disorders.

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3. Bi F, Jia Z, Lv L, Zhang Y, Zhu C, Wan C. Analysis of brain functional connectivity in children with autism spectrum disorder and sleep disorders: a fNIRS observational study. Front Psychol. 2025; 16: 1544798.

INTRODUCTION: Autism spectrum disorder (ASD) is often associated with sleep disorders, although the neurophysiological reasons behind these issues are poorly understood. In this cross-sectional study, functional near-infrared spectroscopy (fNIRS) was used to compare differences in brain functional connectivity (FC) in children with ASD and sleep disorders and those with ASD that was not complicated by sleep disorders. METHODS: A total of 88 children (4-9 years old, either sex) were included in the study. The children were divided into three groups: those with ASD and sleep disorders (ASD with sleep disorder group; n = 29), those with ASD and no sleep disorders (ASD without sleep disorder group; n = 29), and those with typical development (TD group; n = 30). All children with ASD met the diagnostic criteria for the « Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-V). » The ASD group with sleep disorders showed typical sleep disorder symptoms, with a total score of ≥41 on the Children’s Sleep Habits Questionnaire. All children were assessed using the Autism Diagnostic Observation Scale, the Vineland Adaptive Behavior Scale, third edition, the Social Response Scale, and the Children’s Sleep Habits Questionnaire. The fNIRS detection was conducted in a quiet environment. RESULTS: The fNIRS data revealed that under resting-state conditions, the supramarginal gyrus [SMG:Cohen’s f = 0.981(L)f = 0.467(R)], inferior frontal gyrus [IFG:Cohen’s f = 0.415(L)f = 0.443(R)], frontopolar area [FPA:Cohen’s f = 0.620(L)f = 0.634(R)], dorsolateral prefrontal cortex [DLPFC:Cohen’s f = 0.593(L)f = 0.547(R)], and visual association cortex [VAC:Cohen’s f = 0.500(L)f = 0.524(R)] of the brain showed lower activity in ASD with sleep disorder group compared with the TD group (p < 0.01). The FC values for the SMG [Cohen's f = 0.981(L)f = 0.467(R)], RFPA (Cohen's f = 0.634), DLPFC [Cohen's f = 0.593(L)f = 0.547(R)], and VAC [Cohen's f = 0.500(L)f = 0.524(R)] were also lower in the ASD with sleep disorder group than the ASD without sleep disorder group (p < 0.01). The FC values of the LIFG showed a mild negative correlation with social affect scale scores (r = -0.34, p = 0.07), while FC values in the RDLPFC were negatively correlated with restricted repetitive behavior (RRB) (r = -0.41, p = 0.03). The Children's Sleep Habits Questionnaire scores showed a positive correlation with FC values in the RIFG region of the brain (r = 0.37, p = 0.05). CONCLUSION: The results indicate that FC in the resting brain of children with ASD complicated with sleep disorders was weaker than that of children with ASD without sleep disorders. Both groups showed weaker FC compared with the TD group. However, due to the limited sample size, the generalizability of the findings requires further validation in multicenter, large-sample studies.

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4. Brambilla C, Nicora ML, Romeo L, Storm FA, D’Orazio T, Malosio M, Scano A. Biomechanical analysis on neurotypical and autism spectrum disorder people during human-cobot interaction. Appl Ergon. 2025; 128: 104557.

Biomechanical analysis is essential for assessing subjects interacting with robotic setups and platforms. However, in industrial scenarios, workers’ biomechanics are assessed mainly through questionnaires and scales which provide limited objectivity. Very few studies analyzed the biomechanics of workers in multiple sessions, and no study assessed diverse populations of workers. Therefore, we collected tracking data from 14 neurotypical and 7 participants with autism spectrum disorder (ASD) performing assembly tasks in a lab-based industrial collaborative workcell. Human tracking data were acquired by an Azure Kinect and elaborated with a biomechanical model that allowed to compute human kinematics and dynamics. The biomechanics of neurotypical and ASD operators were compared across two working sessions. Both neurotypical and people characterized by ASD decreased torque and power in the second session with respect to the first one, indicating adaptation to the working activity. Interestingly, ASD people expended more energy than neurotypical, suggesting a higher risk of fatigue. Overall, ASD people performed similarly to neurotypical people from a biomechanical point of view. In this study, we showed a protocol for multisession biomechanical monitoring of workers during industrial human-robot collaboration tasks that can be employed in real scenarios and with ASD workers. This approach can be useful in human-robot collaboration to design minimum-fatigue collaborative tasks, support physical health, and improve ergonomics for workers.

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5. Chetcuti L, Hardan AY, Spackman E, Baker E, Frazier TW, Uljarevic M. Factor Structure and Psychometric Properties of the Child Social Preference Scale-3 in Children With Autism. Autism Res. 2025.

Considerable variability in social engagement among individuals with autism is well documented. Since multiple processes may contribute to this heterogeneity, validating tools to assess these differences is crucial. Originally developed in the general population, the Child Social Preference Scale (CSPS-3) aims to assess distinct forms of social disengagement arising from different combinations of approach and avoidance motivations and holds promise for delineating variability in social behaviors within autism spectrum disorder (ASD). This study investigated the factor structure and psychometric properties of the CSPS-3 in a sample of 689 children diagnosed with autism (Mage = 11.23, SD = 3.56; 76% male). The results suggest that a bifactor model, consisting of a general factor and three subscales (shyness, unsociability, and social avoidance), provided the best fit to the data, with the general factor accounting for most of the variance. While the subscales demonstrated adequate internal consistency, their construct reliability and stability varied, with much of the reliable variance attributed to the general factor. The structure was consistent across age and sex subgroups, and the subscales showed distinct patterns of associations with key clinical correlates. These findings support the CSPS-3’s utility in assessing diverse forms of social disengagement in the autism population, while indicating that the subscales could be refined to better capture their unique aspects.

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6. Fathollahzadeh F, Azizi M, Nazeri A, Mirzakhani Araghi N, Mousavi SZ, Borna A, Karimi SE. Persian Pediatric Hyperacusis Questionnaire: Translation and Psychometric Evaluation in Children with and without Autism. J Am Acad Audiol. 2025.

Background: Hyperacusis is an auditory perception disorder causing decreased sound tolerance to everyday sounds. Children with autism often exhibit symptoms of hyperacusis. This comorbidity can significantly impact the adaptability and social development of the children.Purpose: This study’s objectives were to translate and psychometrically evaluate the Persian Pediatric Hyperacusis Questionnaire (P-HQ-P) and the prevalence determination of hyperacusis among children with or without autism.Study Sample: The study was conducted by assigning 60 parents of children diagnosed with level 1 autism spectrum disorder (ASD) and 30 parents of typical children to the ASD group and control group, respectively.Data Collection and Analysis: In the first stage, the Pediatric Hyperacusis Questionnaire (P-HQ) was translated into Persian, and in the second stage, its reliability and validity were assessed by the classical test theory methods. The P-HQ-P results were compared with the Persian Sensory Profile 2 (SP2-P).Results: The P-HQ-P demonstrated acceptable validity and reliability, with content validity ratio > 0.99, content validity index > 0.92, face validity > 0.90, cross-cultural validity > 0.94, α = 0.8, and intraclass correlation coefficient = 0.85. Spearman’s rank correlation coefficient showed a strong correlation (r = 0.83) between the P-HQ-P score and a group of seven items from SP2-P. There was not a statistically significant difference in hyperacusis between genders.Conclusions: The psychometric properties of the P-HQ-P were found to be acceptable, which made it suitable for clinical and research usage. The prevalence of hyperacusis was reported at 27.8 percent of the total sample and 38.3 percent in the ASD group. Our findings suggest the need for further research on hyperacusis in the Iranian pediatric population.

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7. Fukuda T, Kyozuka H, Murata T, Yasuda S, Yamaguchi A, Sato A, Ogata Y, Go H, Hosoya M, Yasumura S, Hashimoto K, Fujimori K, Nishigori H. Labor epidural analgesia and autism spectrum disorder in 3-year-old offspring based on data from the Japan Environment and Children’s Study: a prospective cohort study. J Matern Fetal Neonatal Med. 2025; 38(1): 2509147.

OBJECTIVE: To evaluate the association between labor epidural analgesia (LEA) and autism spectrum disorder (ASD) in 3-year-old offspring in Japan. METHODS: Prospective cohort study utilizing the Japan Environment and Children’s Study, the largest nationwide birth cohort study. A total of 65,742 live singleton offspring were enrolled between January 2011 and March 2014. Offspring born via cesarean delivery or with confirmed chromosomal abnormalities were excluded. Multivariate logistic regression analyses were conducted to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI), accounting for maternal, paternal, and perinatal covariates. Subgroup analyses were performed based on the sex of the offspring. The primary outcome was the diagnosis of ASD at age 3. RESULTS: Among the 65,742 offspring (33,684 boys [51.2%]; mean maternal age, 31.1 [4.9] years), 1,324 (2.0%) were exposed to LEA. ASD was diagnosed in 14 (1.1%) offspring exposed to LEA and 257 (0.4%) not exposed to LEA by age 3. After adjusting for potential confounders, multivariate logistic regression revealed that LEA was associated with an increased risk of ASD (aOR: 2.23; 95% CI: 1.28-3.87). Subgroup analysis indicated that the association was significant in male offspring (aOR: 2.55; 95% CI: 1.40-4.65), but not in female offspring (aOR: 1.41; 95% CI: 0.34-5.91). CONCLUSION: This study suggests a mild association between LEA and ASD in 3-year-old male offspring. However, the findings should be cautiously interpreted given the limited number of ASD cases in this study. Causal relationships cannot be established since this was an observational study.

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8. Fukuoka A, Kitada R, Makita K, Makino T, Sakakihara N, Nummenmaa L, Kosaka H. Reduced relationship-specific social touching and atypical association with emotional bonding in autistic adults. Mol Autism. 2025; 16(1): 31.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by social communication deficits, repetitive behaviors and restricted interests. Studies have reported aberrant sensory responses, including altered experiences of social touch, in individuals with ASD. However, the relationship between atypical social touch and social networks in ASD remains poorly understood. Social touch is used to strengthen and manage social networks in many species. Studies in general populations across diverse cultures show that the extent of permissible touch is consistently linked to the strength of emotional bonds between the toucher and the touched individual. This study examined relationship-specific patterns of social touch and their association with emotional bonding in individuals with ASD. METHODS: Seventy adults with ASD and 70 typically developed (TD) adults rated their emotional bonds with different social network members (e.g., partners, fathers, strangers) and the pleasantness of being touched by each. Participants also identified body regions where they allowed touch. We hypothesized that patterns of interpersonal touch allowance and emotional bonding, and their relationship, would differ between ASD and TD adults. RESULT: In all social network members except children and female friends, ASD adults allowed significantly less social touching than TD adults. Compared to TD adults, ASD adults also reported having significantly weaker emotional bonds with one social network member and experiencing significantly less pleasantness when touched by multiple members of their social network. In both groups, strength of emotional bond was significantly correlated with permissible touch area. Linear regression analyses showed that our ASD participants were more reliant on bodily touch allowance for emotional bonding than the TD controls. LIMITATIONS: More participants are necessary to secure sufficient number of social network members in ASD. CONCLUSIONS: Our results suggest that adults with ASD generally prefer less social touch from most social network members and show reduced emotional bonding with only a specific connection. In addition, touch allowance was more strongly associated with emotional bonding in ASD than TD adults. These findings highlight the influence of autistic traits on the relationship between social touch and emotional bonding within social networks.

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9. Iftimovici A, Jardri R, Lefebvre A, Mallet J, Lefrere A. [Neurodevelopment: a transnosographic dimension]. Med Sci (Paris). 2025; 41(5): 451-9.

The neurodevelopmental dimension represents a major challenge for the future of precision psychiatry. It provides a transdiagnostic framework, that allows for the redefinition of psychiatric disorders beyond traditional diagnostic categories, such as autism spectrum disorders, attention-deficit/hyperactivity disorder, schizophrenia, and bipolar disorder. This model is based on the identification of deviations in brain developmental trajectories during critical periods of vulnerability. Using multimodal approaches that integrate clinical, biological, neuroimaging, and neurophysiological data, this framework aims to define an individualized neurodevelopmental burden, opening up new prospects for stratification and the development of personalized treatments tailored to each developmental profile.

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10. Kakei S, Tanaka H, Mitoma H, Manto M. The Cerebellum as a Predictor: Recent Insights Into Cognitive Control and Extension of Kalman Filter Theory to Cognition. Discov Med. 2025; 37(196): 791-800.

Traditionally viewed as a motor control center, the cerebellum is increasingly recognized as a crucial component of a neural network that enables adaptive behavior across various domains, including cognition, affect, emotion, and social interactions. Recent clinical studies have linked cerebellar dysfunction to impairments in mentalizing and narrative coherence in autism spectrum disorder (ASD). Given that narratives involve the temporal sequencing of causally related events and actions, these findings imply the potential role of the cerebellum in predictive sequence. The aim of this review is to dissect the neural circuitry and computational mechanisms underlying cerebellar predictive cognitive control. We propose that the Kalman filter model, which has been applied successfully to the motor cerebrocerebellum, can be extended to the non-motor (cognitive/affective/social) regions. In sharp contrast, the cerebral cortex employs a recurrent network architecture, as evidenced by intracortical connections, which underlies hierarchical processing in areas such as the visual and motor cortices. Surprisingly, the computational principles of the cerebrocerebellar loop have received relatively little attention in computational and theoretical neuroscience. We stress the need for a comprehensive theory on cerebrocerebellar connectivity that integrates the distinct neural mechanisms of the cerebrum and cerebellum, to help understand the role of this network in cognitive, affective, and social functions. Our theory provides a theoretical framework that explains how the cerebellum deals with motor and non-motor operations. The Kalman filter theory fits with two major requirements: sequencing and predictions. We propose a core operational mechanism for motor, cognitive, affective and social operations handled by the cerebellar circuitry.

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11. Kawamura A, Fujii K, Tamada K, Abe Y, Nitahara K, Iwasaki T, Yagishita S, Tanaka KF, Takumi T, Takao K, Nishiyama M. Duplication of the autism-related gene Chd8 leads to behavioral hyperactivity and neurodevelopmental defects in mice. Nat Commun. 2025; 16(1): 4641.

Mutations in the gene encoding chromodomain helicase DNA-binding protein 8 (CHD8) are strongly associated with autism spectrum disorder (ASD). Although duplications of the chromosomal locus including CHD8 have also been detected in individuals with neurodevelopmental disorders, the contribution of CHD8 duplication to clinical phenotypes and the underlying mechanisms have remained unknown. Here we show that Chd8 knock-in (KI) mice that overexpress CHD8 as a model of human CHD8 duplication manifest growth retardation, microcephaly, impaired neuronal differentiation, and behavioral abnormalities including hyperactivity and reduced anxiety-like behavior. Chd8 overexpression affects the transcription and chromatin accessibility of genes related to neurogenesis, with these changes being associated with aberrant binding of CHD8 to enhancer regions. Furthermore, pharmacological intervention partially ameliorates the hyperactivity of Chd8 KI mice. Our results thus indicate that Chd8 KI mice recapitulate key features of CHD8 duplication syndrome in humans, providing insight into pathogenic mechanisms underlying neurodevelopmental disorders.

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12. Khedr MA, Adly BAE, Hussein RM. Efficacy of resilience-based intervention on psychological capital and satisfaction with life among mothers of children with autism spectrum disorders. J Pediatr Nurs. 2025; 84: 88-96.

PURPOSE: Examine the impact of a resilience-focused intervention on psychological capital and overall life satisfaction of mothers who provide care to children with autism spectrum disorders. DESIGN AND METHODS: A quasi-experimental design was executed at the Abdullah Altamimi Centre in Unaizah City, Qassim region. Eighty mothers of children with autism spectrum disorders participated, divided into intervention and control groups. Participants completed self-administered questionnaires, including the 24-item Psychological Capital Questionnaire and the five-item Satisfaction with Life Scale. The intervention consisted of eight weekly sessions on building resilience and psychological capital. RESULTS: The results revealed significant improvements in psychological capital and life satisfaction among mothers in the intervention group (p = 0.000). Specifically, mean scores for overall psychological capital increased from 62.7 to 100.7, while life satisfaction scores rose from 12.8 to 28.3. Additionally, strong correlations were found between psychological capital and life satisfaction post-intervention (p < 0.001), indicating that enhanced psychological resources were associated with improved life satisfaction. CONCLUSION: The study found that resilience-based training can improve psychological capital and life satisfaction among mothers of children with autism spectrum disorder. This cost-effective method provides essential tools and resources for parents, particularly mothers, who play a vital role in their children's development. PRACTICE IMPLICATIONS: By enhancing psychological capital-encompassing optimism, hope, self-efficacy, and resilience-healthcare providers can equip these mothers with effective coping strategies to manage caregiving challenges. Nurses and mental health professionals should consider developing tailored training sessions and support groups that focus on building resilience, which can significantly improve the well-being and life satisfaction of caregivers.

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13. Li D, Liu L. Letter to the editor concerning « Do all symptomatic adjacent segment diseases (ASD) require surgery? A prognostic classification and predictors of surgical treatment of lumbar ASD » by RM Kanna, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08797-x). Eur Spine J. 2025.

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14. Maggu J, Mohanty S, Sundaravadivel K. Adaptive yoga for psychological health of children having autism spectrum disorder and with intellectual disability: single case experimental design. Sci Rep. 2025; 15(1): 18360.

Children with multiple disabilities have developmental issues in psychological domains. Adaptive yoga tailored to individual abilities promises positive results on children with special needs. This study applies multiple baseline single-case experimental design (SCED) to establish functional relationship between yoga and psychological health of children with autism spectrum disorder (ASD) and intellectual disability (ID). A multiple baseline SCED (AB1B2), with phases (A) baseline without intervention, (B1) intervention in the institute with a yoga teacher and caregiver, and (B2) intervention at home with the caregiver. The experiment was replicated across six children aged 7-12 years with mild ASD and ID. The study assessed the impact of a 180-day adaptive yoga intervention on twelve parameters across cognitive, behavioural, and emotional domains. Assessments were administered using the Indian Scale for Assessment of Autism (ISAA) and Behavioural Assessment Scales for Indian Children with Mental Retardation (BASIC-MR) tools. The study involved caregivers, yoga teacher, and clinical psychologists. The visual analysis established the functional effect of yoga intervention. The effectiveness of impact was supplemented by percentages of non-overlapping pairs and Cohen’s d shows moderate to significant impact among all the participants in at least three instances across psychological domains. The experiment establishes both internal and external validity.Trial registration CTRI/2021/08/035389; DoR: 04/08/2021.

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15. 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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16. McNealis M, Kent J, Paskov K, Dunlap K, Lane J, Phillips B, Armstrong-Brine M, Kralovic S, Dimitropoulos A, Abbeduto L, Wall DP. Identifying understudied correlations between autism & phenotypic attributes in a large family dataset. BMC Psychol. 2025; 13(1): 561.

BACKGROUND: Autism Spectrum Disorder (ASD), a neurodevelopmental condition marked by restricted, repetitive behaviors and social communication difficulties, is one of the fastest-growing pediatric behavioral health concerns in the United States. Long-term outcomes significantly improve with early intervention, but diagnosis and treatment are complicated by the large range of phenotypic presentations that can be moderated by identity factors like gender and culture. Many physical and behavioral characteristics associated with the autism phenotype are not included in the screening and diagnostic instruments used in research. METHODS: We have built a multi-site registry of diverse families with children with autism to collect longitudinal data on their physical and behavioral attributes to study the heterogeneous autism phenotype. Our KidsFirst registry contains 6,951 participants (hereafter « children ») from 4,120 families, 1,865 of which have more than one child. In addition to collecting standard clinical instruments such as the Social Communication Questionnaire (SCQ), we have collected information on the phenotypic attributes of hearing issues, noise sensitivity, vision challenges, irregular sleep, impaired motor skills, metabolic disorders, gastrointestinal (GI) problems, infections, seizures, and premature birth for both ASD and non-ASD children. After validating parent-reported diagnoses against SCQ scores, we analyzed the association of each attribute with the ASD diagnosis and the other attributes using a logistic regression model and permutation tests. RESULTS: Noise sensitivity, impaired motor skills, irregular sleep, GI problems, infections, and seizures attributes were significantly associated with autism diagnosis. These attributes also share correlation structures amongst themselves, suggesting that groupings of attributes may help to define subtypes of autism. LIMITATIONS: The attributes analyzed in this study are not a comprehensive list of suspected traits of autism. Parent-reported diagnoses may not always be accurate, although we validated diagnoses. Despite accounting for family structure in our experiments, the relationships between attributes and diagnosis are likely stronger in the general population because our « control » sample is comprised of biological siblings who may still possess subclinical autistic traits, given the heritability of autism. CONCLUSIONS: A more expansive conceptualization of the autism phenotype is likely to be useful to both researchers and families for identifying a more targeted approach to intervention.

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17. Nazari S, Ramos Cabo S, Nalabolu S, Carter Barnes C, Andreason C, Zahiri J, Esquivel A, Arias SJ, Grzybowski A, Lombardo MV, Lopez L, Courchesne E, Pierce K. Large-scale examination of early-age sex differences in neurotypical toddlers and those with autism spectrum disorder or other developmental conditions. Nat Hum Behav. 2025.

Autism spectrum disorder (ASD) is clinically heterogeneous, with ongoing debates about phenotypic differences between boys and girls. Understanding these differences, particularly at the age of first symptom onset, is critical for advancing early detection, uncovering aetiological mechanisms and improving interventions. Leveraging the Get SET Early programme, we analysed a cohort of 2,618 toddlers (mean age: ~27 months) through cross-sectional, longitudinal and clustering analyses, performed using statistical and machine learning approaches, to assess sex differences in groups with ASD, developmental delay and typical development across standardized and experimental measures, including eye tracking. The results revealed no significant sex differences in toddlers with ASD across 17 of 18 measures, including symptom severity based on the Autism Diagnostic Observation Schedule, receptive and expressive language based on the Mullen Scales of Early Learning and social attention based on the GeoPref eye-tracking test. In contrast, girls with typical development outperformed boys on several measures. Subtyping analyses stratifying toddlers into low, medium and high clusters similarly showed virtually no sex differences in ASD. Overall, our findings suggest that phenotypic sex differences are minimal or non-existent in those with ASD at the time of first symptom onset.

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18. Plate SN. The State of Natural Language Sampling in Autism Research: A Scoping Review. Autism Dev Lang Impair. 2025; 10: 23969415251341247.

BACKGROUND AND AIMS: Caregiver reports and standardized assessments have been the primary methods used to study language development in autism. However, these forms of measurement are often coarse, complicated by floor effects and reporter bias, and limited by the fact that they only capture how children can use language at a single moment in time, rather than how children actually use language during everyday interactions. These limitations have led to recent calls for the use of natural language sampling (NLS) as a fine-grained, developmentally appropriate, and contextually relevant measure of everyday communication. The number of studies using NLS to study language in autism has increased substantially in the last 15 years, resulting in a wide array of sampling methods and measures. Given both the increasing prevalence of NLS methods in the autism literature and the variability in sampling approaches and measures, this scoping review addresses the following questions: 1. What populations have been studied using NLS?2. Which data collection methods are most prevalent in NLS research?3. How are measures of language derived from NLS? METHOD: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search for studies published in the last 15 years across three databases was conducted. After removing duplicates, 4,671 titles and abstracts were screened and 59 papers met inclusion criteria. Sample characteristics, natural language collection methods, and derived measures were extracted and tabled for each study. The most prevalent NLS methods and measures in autism language research are reviewed and the benefits and drawbacks of various methods are discussed. MAIN CONTRIBUTION: This scoping review highlights subgroups of the autistic population that have been underrepresented in NLS studies-in particular, minimally/nonspeaking school-aged autistic children. This article also examines means to collect a « naturalistic » sample of language. Notably, studies did not address whether autistic children exhibit different social communication skills when talking to different types of social partners. Broadly, research has underreported key methodological details, making comparisons across studies difficult. CONCLUSIONS: This review highlights the appropriate use of NLS across development in autism and makes recommendations for NLS future research. IMPLICATIONS: Additional work is needed to address the gaps described in this article and replicate previous findings to identify patterns of natural language across the literature.

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19. Roggero OM, Gualandi N, Ciraci V, Berutto V, Carosati E, Tongiorgi E. A Computational Approach to Identify Novel Protein Targets Uncovers New Potential Mechanisms of Action of Mirtazapine S(+) and R(-) Enantiomers in Rett Syndrome. J Neurochem. 2025; 169(5): e70093.

Rett syndrome (RTT) is a progressive neurodevelopmental disorder that affects approximately 1:10000 newborn girls and is primarily caused by mutations in the X-linked gene MECP2. Due to reduced brain monoamine levels in RTT, antidepressants have been explored as potential therapies. In previous studies, we demonstrated that the antidepressant mirtazapine (MTZ) alleviates symptoms in Mecp2-mutant mice and RTT adult patients. However, the mechanism of action of MTZ, a racemic mixture that binds to multiple receptors, remains unclear. This study introduces a computational approach to screen the « human pocketome, » comprising over 25 K ligand-bound pockets derived from more than 210 K human protein structures available in the RCSB Protein Data Bank, aiming to identify binding pockets with high affinity for each MTZ enantiomer. Novelty concerns the approach to compare the two enantiomers of MTZ to other drugs experimentally determined as inactive for RTT. This approach introduces a new metric, the ZZscore, which ranks tested proteins and pockets based on their degree of interaction with the tested drugs. This enables the identification of potential drug-protein interactions relevant to the disease and/or phenotypic traits under study. Initial relaxed settings and thresholds parameters suggested over 30 potential targets, among which the RASH/SOS1 complex, but in vitro experiments on cultured hippocampal neurons from Mecp2-KO mice excluded any MTZ effect on it. Thus, we refined the procedure with more stringent parameters and identified 16 protein targets for S(+)MTZ and 14 for R(-)MTZ, with 5 common targets. Pathway enrichment analysis revealed 25 pathways for S(+)MTZ and 24 for R(-)MTZ, with 11 common pathways, many related to MeCP2 functions disrupted in RTT, such as epigenetic chromatin regulation, intracellular signaling, energy metabolism, cholesterol and lipid metabolism, and catecholamine biosynthesis. Overall, the presented computational modeling strategy for target identification allowed us to hypothesize new mechanisms of action for the two MTZ enantiomers.

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20. Simpson I, Saldaña D, Vulchanova M, Scattoni ML, Micai M. Feedback-Driven Learning Through Eye Movements in Autism Spectrum Disorder. Autism Res. 2025.

Individuals with Autism Spectrum Disorder (ASD) face challenges in cognitive flexibility and rule-shifting. This study investigated a computerized Wisconsin Card Sorting Task (WCST) paired with eye-tracking to understand the cognitive dynamics of set-shifting difficulties in autistic children and adolescents. The study included 21 Spanish-speaking autistic children and adolescents (mean age: 14.5 years) and 22 typically developing peers (mean age: 15.1), matched by gender, age, language, working memory, and intelligence. Participants sorted cards by number, color, or shape, receiving feedback after each trial. The sorting criterion changed after 10 correct responses without participants’ prior knowledge. The task included 128 trials, followed by three strategy-related verbal questions. Behavioral and eye movement data showed that the autistic group performed worse, completing fewer sets and making more errors. Both groups had increased fixations and dwell time after feedback, but controls had a greater increase after incorrect responses. Autistic individuals may struggle with error monitoring and response inhibition, impacting their adaptability and less efficient learning of sorting rules. They engaged less in error analysis and correction than controls. Targeted interventions to enhance feedback processing and adaptive learning strategies could benefit autistic individuals. Future research should explore mechanisms behind eye-movement differences and the effectiveness of related interventions.

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21. Tkalcec A, Baldassarri A, Junghans A, Somasundaram V, Menks WM, Fehlbaum LV, Borbàs R, Raschle N, Seeger-Schneider G, Jenny B, Walitza S, Cole DM, Sterzer P, Santini F, Herbrecht E, Cubillo A, Stadler C. Gaze behavior, facial emotion processing, and neural underpinnings: A comparison of adolescents with autism spectrum disorder and conduct disorder. J Child Psychol Psychiatry. 2025.

BACKGROUND: Facial emotion processing deficits and atypical eye gaze are often described in individuals with autism spectrum disorder (ASD) and those with conduct disorder (CD) and high callous unemotional (CU) traits. Yet, the underlying neural mechanisms of these deficits are still unclear. The aim of this study was to investigate if eye gaze can partially account for the differences in brain activation in youth with ASD, with CD, and typically developing youth (TD). METHODS: In total, 105 adolescent participants (N(CD) = 39, N(ASD) = 27, N(TD) = 39; mean age = 15.59 years) underwent a brain functional imaging session including eye tracking during an implicit emotion processing task while parents/caregivers completed questionnaires. Group differences in gaze behavior (number of fixations to the eye and mouth regions) for different facial expressions (neutral, fearful, angry) presented in the task were investigated using Bayesian analyses. Full-factorial models were used to investigate group differences in brain activation with and without including gaze behavior parameters and focusing on brain regions underlying facial emotion processing (insula, amygdala, and medial prefrontal cortex). RESULTS: Youth with ASD showed increased fixations on the mouth compared to TD and CD groups. CD participants with high CU traits tended to show fewer fixations to the eye region compared to TD for all emotions. Brain imaging results show higher right anterior insula activation in the ASD compared with the CD group when angry faces were presented. The inclusion of gaze behavior parameters in the model reduced the size of that cluster. CONCLUSIONS: Differences in insula activation may be partially explained by gaze behavior. This implies an important role of gaze behavior in facial emotion processing, which should be considered for future brain imaging studies. In addition, our results suggest that targeting gaze behavior in interventions might be potentially beneficial for disorders showing impairments associated with the processing of emotional faces. The relation between eye gaze, CU traits, and neural function in different diagnoses needs further clarification in larger samples.

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22. Vakil P, Gow ML, Roberts LM, Woolfenden S, Eapen V, Davis GK, Rowe C, Craig ME, Henry A. Infant psychomotor development after intrauterine exposure to hypertensive disorders of pregnancy: a P4 study. J Dev Orig Health Dis. 2025; 16: e22.

This study aimed to assess the impact of hypertensive disorders of pregnancy on infant neurodevelopment by comparing 6-month and 2-year psychomotor development outcomes of infants exposed to gestational hypertension (GH) or preeclampsia (PE) versus normotensive pregnancy (NTP). Participating infants were children of women enrolled in the Postpartum Physiology, Psychology and Paediatric (P4) cohort study who had NTPs, GH or PE. 6-month and 2-year Ages and Stages Questionnaires (ASQ-3) scores were categorised as passes or fails according to domain-specific values. For the 2-year Bayley Scales of Infant and Toddler Development (BSID-III) assessment, scores > 2 standard deviations below the mean in a domain were defined as developmental delay. Infants (n = 369, male = 190) exposed to PE (n = 75) versus GH (n = 20) and NTP (n = 274) were more likely to be born small for gestational age and premature. After adjustment, at 2 years, prematurity status was significantly associated with failing any domain of the ASQ-3 (p = 0.015), and maternal tertiary education with increased cognitive scores on the BSID-III (p = 0.013). However, PE and GH exposure were not associated with clinically significant risks of delayed infant neurodevelopment in this study. Larger, multicentre studies are required to further clarify early childhood neurodevelopmental outcomes following hypertensive pregnancies.

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23. Werner N, Eckert A. Prevalence, Treatment, and Impact of the Self-Injurious Behavior of Autistic Adults with Intellectual Disability Living in Residential Care Facilities. J Autism Dev Disord. 2025.

Self-injurious behavior (SIB) is highly prevalent in autistic individuals with an intellectual disability (ID). However, only a few studies have focused on autistic adult populations, and no data on prevalence, treatment, and impact on the day-to-day lives of adult residents is available for Germany, in particular. We conducted a postal survey of residential care facilities. We assessed different topographies, severities, and frequencies of SIB, as well as treatment strategies and the impact of SIB on day-to-day life. The overall prevalence of SIB reported by 60 residential care facilities was 51.3%. Autistic residents with ID who exhibit SIB displayed more than 4 topographies of SIB, on average, nearly half (47%) displayed multiple topographies daily, and approximately 17% engaged in severe SIB daily. Of those residents, 67.7% were reported to receive some systematic intervention within the facility, and 95.6% experienced at least one type of impact on their day-to-day life due to SIB. This study provides the first prevalence data for SIB in autistic adults with an ID in Germany and the first data on treatment within facilities, as well as the potential impacts on day-to-day life. The prevalence results fell in line with previous research, and we provide a more detailed picture of the forms, frequencies, and severities of self-injurious behavior in the German adult autistic population.

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24. Wilkinson CL, Chung H, Dave A, Tager-Flusberg H, Nelson CA. Changes in Early Aperiodic EEG Activity Are Linked to Autism Diagnosis and Language Development in Infants With Family History of Autism. Autism Res. 2025.

Delays in language often co-occur among toddlers diagnosed with autism. Despite the high prevalence of language delays, the neurobiology underlying such language challenges remains unclear. Prior research has shown reduced EEG power across multiple frequency bands in 3-to-6-month-old infants with an autistic sibling, followed by accelerated increases in power with age. In this study, we decompose the power spectra into aperiodic (broad band neural firing) and periodic (oscillations) activity to explore possible links between aperiodic changes in the first year of life and later language outcomes. Combining EEG data across two longitudinal studies of infants with and without autistic siblings, we assessed whether infants with an elevated familial likelihood (EFL) exhibit altered changes in both periodic and aperiodic EEG activity at 3 and 12 months of age, compared to those with a low likelihood (LL), and whether developmental change in activity is associated with language development. At 3 months of age (n = LL 59, EFL 57), we observed that EFL infants have significantly lower aperiodic activity from 6.7 to 55 Hz (p < 0.05). However, change in aperiodic activity from 3 to 12 months was significantly increased in infants with a later diagnosis of autism, compared to EFL infants without an autism diagnosis (n = LL-NoASD 41, EFL-noASD 16, EFL-ASD 16). In addition, greater increases in aperiodic offset and slope from 3 to 12 months were associated with worse language development measured at 18 months (n = 24). Findings suggest that early age-dependent changes in EEG aperiodic power may serve as potential indicators of autism and language development in infants with a family history of autism.

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