1. Alharbi NM, Baaboud WF, Shawky H, Alrofaidi AA, Farsi RM, Algothmi KM, Hassoubah SA, Basingab FS, Azhari SA, Alharbi MG, Yahya R, Alhazmi S. Molecular Screening Reveals De Novo Loss-of-Function NR4A2 Variants in Saudi Children with Autism Spectrum Disorders: A Single-Center Study. Int J Mol Sci. 2025; 26(12).

Dysregulated expression of nuclear receptor superfamily 4 group A member 2 (NR4A2) has recently been associated with autistic spectrum disorder (ASD), speech impairment, and neurodevelopmental delay (NDD); however, its precise role in the prevalence and etiopathogenesis of ASD has not been fully elucidated. Herein, we aimed to explore the role of NR4A2 variants in the genetic underpinnings of ASD among Saudi children of different age ranges and phenotype severities. A total of 338 children with ASD from 315 unrelated families (293 simplex, 2 quads, and 1 quintet) were screened for NR4A2 variants via exome sequencing (ES) of the genomic DNA extracted from peripheral blood mononuclear cells (PBMCs), after which the probands with identified NR4A2 variants were further subjected to trio genetic analyses. ES analysis revealed 10 de novo NR4A2 variants (5 indels/nonsense, 2 missense, and 3 variants affecting splicing) in 8 unrelated probands (2.37%) and 2 affected siblings from 8 unrelated families (6 simplex (2.04%) and 2 quads (8.7%)). Three NR4A2 variants were notably recurrent among both affected and unaffected carriers. All identified indels and two splicing variants met the criteria for pathogenic/loss-of-function (LoF) variants according to the ACMG classification (PVS1), whereas the missense variants were classified as of uncertain significance (VUS). This study is among the first to identify such a high frequency of recurrent variants in an ASD cohort, suggesting their significant contribution to the etiopathogenesis of ASD within this population.

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2. Angelova S, Konstantinova D, Nenova-Nogalcheva A, Pancheva R. Significance of Oral Care for Children with Autism Spectrum Disorder-A Narrative Literature Review. Children (Basel). 2025; 12(6).

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition in children that typically involves challenges in cognition, behavior, and communication. While many children with ASD exhibit significant impairments in both verbal and non-verbal communication, the severity and nature of these difficulties can vary widely. In addition to its impact on overall health, ASD also affects oral health, leading to increased vulnerability to dental disease. AIM: This narrative review aims to summarize key oral health challenges and care strategies for children with ASD, focusing on clinical risks, behavioral barriers, caregiver roles, and effective interventions. MATERIALS AND METHODS: A comprehensive literature search was conducted using four databases-PubMed, Scopus, Web of Science, and Google Scholar-as well as relevant study registries where applicable. Peer-reviewed articles published in English between 2010 and 2024 were identified using keywords and their synonyms, such as autism spectrum disorder, children, oral care, dental practitioners, and parents. Studies were included based on relevance to oral health challenges and interventions in children diagnosed with ASD. RESULTS: Children with ASD experience a range of sensory sensitivities, attention deficits, hyperactivity, and behavioral resistance, which significantly hinder the performance of adequate oral hygiene practices. These challenges contribute to a lack of effective dental prophylaxis and limited access to regular preventive care, ultimately resulting in poorer oral health outcomes and reduced oral health-related quality of life. CONCLUSION: Due to the multifaceted characteristics of ASD, children with this condition face significant barriers in accessing appropriate and individualized oral care. This increases their risks of developing oral health disorders, underscoring the need for coordinated efforts between caregivers and dental professionals to improve oral health outcomes in this vulnerable population.

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3. Bamicha V, Pergantis P, Skianis C, Drigas A. Computational Neuroscience’s Influence on Autism Neuro-Transmission Research: Mapping Serotonin, Dopamine, GABA, and Glutamate. Biomedicines. 2025; 13(6).

Autism spectrum disorder is a complex and diverse neurobiological condition. Understanding the mechanisms and causes of the disorder requires an in-depth study and modeling of the immune, mitochondrial, and neurological systems. Computational neuroscience enhances psychiatric science by employing machine learning techniques on neural networks, combining data on brain activity with the pathophysiological and biological characteristics of psychiatric-neurobiological disorders. The research explores the integration of neurotransmitter activity into computational models and their potential roles in diagnosing and treating autism using computational methods. This research employs a narrative review that focuses on four neurotransmitter systems directly related to the manifestation of autism, specifically the following neurotransmitters: serotonin, dopamine, glutamate, and gamma-aminobutyric acid (GABA). This study reveals that computational neuroscience advances autism diagnosis and treatment by identifying genetic factors and improving the efficiency of diagnosis. Neurotransmitters play a crucial role in the function of brain cells, enhancing synaptic conduction and signal transmission. However, the interaction of chemical compounds with genetic factors and network alterations influences the pathophysiology of autism. This study integrates the investigation of computational approaches in four neurotransmitter systems associated with ASD. It improves our understanding of the disorder and provides insights that could stimulate further research, thereby contributing to the development of effective treatments.

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4. Barabás Á, Erdei RJ, Móré M, Pázmány V, Sárváry A, Toldy-Schedel E, Grestyák AM, Nagy AC, Kiss OP, Takács P. Health Behavior of Young People Aged 12-18 with Autism Spectrum Disorder and Intellectual Disabilities in Hungary. Children (Basel). 2025; 12(6).

INTRODUCTION: People with disabilities are characterized by suboptimal health and lower self-rating health. Their need for health care is greater, they often have a higher prevalence of health problems and they have more difficulty accessing health care. The aim of this study was to assess the health behaviors and health indicators of 12-18-year-old young people with intellectual disabilities and autism spectrum disorder, and to explore their school-related perceptions in the Northern Great Plain region of Hungary. MATERIALS AND METHODS: A cross-sectional questionnaire survey was conducted with the participation of 185 young people. A custom questionnaire was used, based on the Health Behavior in School-aged Children (HBSC) survey, assessing eating habits, oral care, physical activity, mental well-being, and self-reported health status. The sample was categorized into three groups: the ID1 (Intellectual Disability level 1) group, encompassing young individuals with mild intellectual disability; the ID2 group, encompassing young people with moderate intellectual disability; and the ID+ASD group, encompassing young individuals affected by both intellectual disability and autism spectrum disorder. RESULTS: Consumption of various food types was below optimal levels. Low intake of fruits and vegetables was common, with only 21.6% of the respondents consuming fruit daily and 23.8% consuming vegetables daily. ID1 group reported significantly higher rates of nervousness several times a week (17.8% vs. 5.6% and 6.9%, p < 0.001), sleep difficulties (28.8% vs. 7.4% and 15.5%, p = 0.032), and dizziness (9.6% vs. 1.9% and 3.4%, p = 0.022) compared to the other two groups. A third school-related factor, related to negative emotions, showed a near-significant difference (p = 0.064), suggesting that students with both autism spectrum disorder and intellectual disability perceive lower levels of acceptance from teachers. On school-free days, computer usage was significantly highest in the ID+ASD group; 50% of them used a computer for at least 4 h per day. CONCLUSIONS: To improve mental well-being among affected children, psychological support and the implementation of mental health programs are recommended. In addition to teaching stress management techniques and coping mechanisms, integrating relaxation techniques into comprehensive developmental programs-both individually and in groups-is advised. For teachers, it is recommended to acquire disability-specific communication strategies.

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5. Benjamin LR, Neece CL, McIntyre LL, Fenning RM, Edwards A, Gwaltney A, Wheeler AC. A Transdiagnostic Comparison of Mindfulness and Parenting Stress in Mothers of Children With Autism, Developmental Delay, and Fragile X Syndrome. Am J Intellect Dev Disabil. 2025; 130(4): 249-64.

This study compared mindfulness and parenting daily hassles (PDH) among mothers of children with autism spectrum disorder (ASD), developmental delay (DD), and Fragile X syndrome (FXS), and explored diagnostic group as a moderator of the relationship between mindfulness and PDH. Mothers of children with ASD (n = 166), DD (n = 113), and FXS (n = 74) completed measures of PDH, trait mindfulness, and mindful parenting. Mothers reported comparable levels of trait mindfulness and PDH, but the FXS group (versus ASD and DD) reported higher levels of mindful parenting. The mindful parenting/PDH relationship was negative for all groups but weaker for mothers of children with ASD (versus DD and FXS). Implications for research and practice are discussed.

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6. Borkhoff CM, Imsirovic H, Bayoumi I, Macarthur C, Nurse KM, To T, Feldman ME, Lau E, Knight B, Birken CS, Maguire JL, Parkin PC. Screening for developmental delay at 18 months using the Infant Toddler Checklist: A validation study. PLoS One. 2025; 20(6): e0326751.

OBJECTIVE: The Infant Toddler Checklist (ITC) may be promising as a single tool at the 18-month visit to detect a range of developmental concerns. We examined the predictive validity of the ITC; and the association between positive ITC screening and health care utilization (HCU). METHODS: Prospective cohort study of children at average-risk for developmental delay attending their 18-month visit in primary care in Toronto, Canada. Parents completed the ITC. HCU from the single-payer provincial health system was collected from health administrative databases ensuring complete follow-up. Physician billing code for a neurodevelopmental consultation was the primary outcome and criterion measure. Six other HCU types were assessed. RESULTS: Of 1460 children with a mean age at screening of 18 months, 11% screened ITC positive. Mean age at follow-up was 8 years, 2.6% had a neurodevelopmental consultation. Screening test properties (with neurodevelopmental consultation as the criterion measure): 40% sensitivity (95% CI 24%, 57%), 90% specificity (95% CI 88%, 91%), 10% false positive rate (95% CI 9%, 12%). Using multivariable negative binomial regression, a positive ITC was associated with higher rates of 6 of 7 HCU types, including neurodevelopmental consultation (aRR 2.78, 95% CI 1.37, 5.67, p = 0.005). CONCLUSION: The ITC had high specificity and a low false positive rate, suggesting that most children with a negative ITC will not have a later neurodevelopmental consultation, and use of the tool may minimize unintended harms such as anxiety and resource use. The low sensitivity highlights the importance of ongoing developmental surveillance. Low sensitivity of other screening tools is discussed.

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7. Brillinger M, Bai Y, Karlinsky A, Welsh TN, Poliakoff E, Gowen E. A mixed methods exploration of motor imagery in autistic and non-autistic adults: Diverse experiences and implications for interventions. PLoS One. 2025; 20(6): e0326542.

Research on motor imagery (MI) in non-autistic individuals suggests that there are shared neural circuitries between imagery and execution. The relationship between imagined and executed movements, and the use of MI in autistic adults is poorly understood. This study explored MI comprehension, prior use of MI, and subjective experiences during MI in autistic and non-autistic adults. Twenty autistic and twenty non-autistic individuals responded to a series of questions probing their understanding of and engagement in MI. Participants then completed the Kinesthetic and Visual Imagery Questionnaire (KVIQ), and reported on their subjective experiences during MI. Although there were no differences between the autistic and non-autistic individuals in their understanding of MI, the non-autistic group may have more prior use of MI in their everyday lives. Additionally, autistic participants generally reported less vivid imagery on the KVIQ compared to non-autistic participants, however experiences during MI varied widely across both groups ranging from vivid/intense images/sensations to the inability to imagine. In summary, some autistic individuals are able to engage in MI, but, similar to their non-autistic peers, MI ability and experiences vary across individuals. This work has important implications for MI interventions aimed at improving motor coordination.

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8. Chen L, Li Z, Fan Y. Neurodevelopmental disorders and gut-brain interactions: exploring the therapeutic potential of pycnogenol through microbial-metabolic-neural networks. Front Cell Infect Microbiol. 2025; 15: 1601888.

Neurodevelopmental disorders (NDDs), characterized by cognitive impairments and behavioral abnormalities, represent a clinically diverse group of conditions typically emerging during childhood or adolescence. Major subtypes encompass autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), and epilepsy. The pathogenesis of these disorders involves multifactorial interactions between genetic susceptibility (Shank3 mutations in ASD), environmental triggers (prenatal toxins), neurotransmitter dysregulation (dopamine (GA) and γ-aminobutyric acid (GABA) systems) and immune dysregulation. Growing research highlights the gut-brain axis disruption as a potential contributor to NDDs pathophysiology, though systematic evaluation of therapeutic approaches targeting this axis and related gastrointestinal comorbidities (GIDs) remains limited. This review comprehensively examines the pathological mechanisms underlying ADHD, ASD, and epilepsy, while analyzing the reciprocal relationship between gut-brain axis dysregulation and GID manifestations in NDDs. Notably, abnormal activation of key signaling pathways including NF-κB, MAPK and PI3K/AKT/mTOR is strongly associated with the pathogenesis of NDDs. We further propose pycnogenol (PYC), a polyphenol extract of pine bark, as a natural compound with multiple bioactivities such as anti-inflammatory and antioxidant, can directly or indirectly affect the function of the gut-brain axis by regulating the structure of the intestinal microbial community (increasing the abundance of Akkermansia muciniphila and butyric acid-producing bacteria) and its metabolites, providing a new strategy for the treatment of NDDs.

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9. Couture M, Courteau J, Brodeur S, Chiu YM, Courteau M, Dubé É, Thomas N, Alain L, Fombonne É, Dufour I. Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status?. Autism Res. 2025.

The aim of this study was to compare the healthcare trajectories (HCTs) 2 years after a first diagnosis of autism according to sex, age at diagnosis, and intellectual or developmental disabilities (IDD) status. This is a retrospective cohort study using health administrative data from Québec, Canada. The cohort included all individuals with a first diagnosis of autism registered by a physician between April 2012 and March 2015. HCTs were stratified by sex, presence of IDD, and age at diagnosis (youth, adult), and analyzed using state sequence analysis across healthcare settings, providers, and reasons for use. Our cohort included 5289 individuals, 76.6% were male, and 26.3% were adults at the time of diagnosis. The healthcare use decreased slightly over time, though intensity was higher in females. Sex differences in HCTs were strongly influenced by IDD status and age at diagnosis. While no significant sex differences were observed in HCTs for individuals with IDD diagnosed with autism in adulthood, the psychiatric condition profiles showed notable differences between males and females. Hospital days nearly doubled for females diagnosed in childhood compared to males, while males with IDD diagnosed with autism in childhood and males without IDD diagnosed in adulthood had fewer physical illness visits. Although physical and mental health challenges appear largely managed in ambulatory care during youth, high hospitalization rates in those diagnosed in adulthood, particularly females and those with IDD, highlight concerns about continuity of care and avoidable hospitalizations for these subgroups of patients.

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10. DeWitt S, Mills K, Briggs AM. An Exploratory Network Analysis of Discussion Topics About Autism Across Subreddit Communities. Behav Sci (Basel). 2025; 15(6).

Using an inductive computational approach, our present data exploration sought to use machine learning methodology to define and identify patterns and gain insight into autism-related discussions on Reddit across three different categories of subreddits: (a) individuals who self-identify as autistic, (b) parents of individuals on the autism spectrum, and (c) behavior therapists. By doing so, we sought to review authentic autism-related discussions and identify important topics that emerged across these three demographic groups, including insights related to assessing and treating challenging behavior. Following basic and advanced preprocessing, our extraction resulted in 57 subreddits and 46,914 comments from autism spectrum subreddit members, 46 subreddits and 27,838 comments from parent subreddit members, and six subreddits with 3163 comments from behavior therapist subreddit members. Subsequent network analyses revealed interesting patterns of discussion within and across subreddit groups that may be used to inform support and resources, practice considerations, and future directions for research.

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11. Dow M, Wang T. Health Knowledge About Early Diagnosis of Autism Spectrum Disorders: A Case for Soft Transdiagnostic Approaches to Better Represent the Clinical and Scientific Reality of ASD. Int J Environ Res Public Health. 2025; 22(6).

OBJECTIVE: This study explores the current state of science regarding DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD) in young children. It examines the effectiveness of existing diagnostic methods and evaluates the potential of transdiagnostic approaches for early intervention. METHOD: A systematic literature review was conducted using MEDLINE, PsycINFO, and the Psychology and Behavioral Sciences Collection, focusing on peer-reviewed studies published between 2020 and 2023. The search followed PRISMA guidelines, selecting articles investigating ASD diagnosis in toddlers and preschoolers using DSM-5 criteria, behavioral assessments, and emerging diagnostic tools. RESULTS: Findings indicate that DSM-5 provides a structured framework for ASD diagnosis, but it has limitations in early identification. It is necessary to integrate multiple assessment tools. Recent research highlights transdiagnostic models, which move beyond rigid diagnostic categories to capture the complexities of ASD presentation in young children. CONCLUSION: The literature supports a shift towards a transdiagnostic approach that combines behavioral, biological, and environmental assessments. This study underscores the need for interdisciplinary collaboration to refine ASD diagnostic frameworks to ensure more accurate and timely diagnoses that better serve affected children and their families.

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12. Ellegood J, Beauchamp A, Yee Y, Devenyi G, Ziolkowski J, Qiu L, Askalan R, Ayub M, Suetterlin P, Donovan A, Basson MA, Quesnel KM, Berube NG, Woo T, Beversdorf D, Bjornsson H, Blakely R, Crawley J, Crosbie J, Orr BO, Davis GW, Genestine M, DiCicco-Bloom E, Egan S, Fink KD, Asbury S, Lai J, Rilett K, Foster JA, Vincent JB, Frankland P, Georgiades S, Penagarikano O, Geschwind D, Giger RJ, Markx S, Gogos J, Golzio C, Pagani M, Gozzi A, Pacey LK, Hampson D, Huang TN, Yen TL, Hsueh YP, Iaboni A, Amar M, Iakoucheva LM, Jones JK, Kelly E, Kieffer B, Bae M, Jung H, Kim H, Park H, Roh JD, Kim E, Konopka G, Laliberte C, Lefebvre JL, Eagleson K, Levitt P, Bach AM, Cunningham TJ, Fisher E, Miller K, Mills A, Muotri A, Nicolson R, Noakes LS, Nieman BJ, Canales CP, Nord AS, Nutter LM, Tam E, Osborne LR, Clipperton-Allen A, Page D, Babineau B, Palmer TD, Yan K, Picketts D, Xia Q, Powell CM, Raznahan A, Robins DM, Rumbaugh G, Sengar AS, Salter MW, Schachar RJ, D’Abate L, Bradley CA, Scherer SW, Copping NW, Petkova SP, Silverman JL, Singh KK, Kim NS, Yoon KK, Ming GL, Song H, Spring S, Nakatani J, Nakai N, Nomura J, Takumi T, Taylor M, Tsai P, Bruce M, Jones KL, Van de Water J, Van Eede MC, Kerr TM, Muller CL, VanderWeele JV, Vandewouw M, Weksberg R, Wevrick R, Belinson H, Wynshaw-Boris A, Zarbalis K, Trost B, Mars RB, Chakravarty M, Kushki A, Anagnostou E, Lerch JP. Assigning Targetable Molecular Pathways to Transdiagnostic Subgroups Across Autism and Related Neurodevelopmental Disorders. bioRxiv. 2025.

Significant genetic, behavioural and neuroanatomic heterogeneity is common in autism spectrum- and related- neurodevelopmental disorders (NDDs). This heterogeneity constrains the development of effective therapies for diverse patients in precision medicine paradigms. This has led to the search for subgroups of individuals having common etiologic factors/biology (e.g., genetic pathways), thus creating potential uniformity in prognosis and/or treatment response. Despite NDDs having a strong genetic component, only ~15-20% of individuals will present with a specific rare genetic variant considered clinically pathogenic, and therefore, subtyping efforts tend to focus on using clinical, cognitive, and/or brain imaging phenotypes to group individuals. Here we delineated mechanisms via mouse to human translational neuroscience. Using MRI derived structural neuroanatomy and a spatial transcriptomic comparison, we linked subgroups of 135 NDD relevant mouse models (3,515 individual mice) separately to two human databases, with 1,234 and 1,015 human individuals with NDDs, composed of autism, attention-deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), other related NDDs, and typically developing controls. Subgroups were significantly linked by consistent neuroanatomy across all three datasets, mouse and human, indicating that direct cross-species subgrouping and translation is consistent and reproducible. Ultimately, four specific neuroanatomical clusters were found and linked to precise molecular mechanisms: two showing a chromatin/transcription motif, with one of those showing specific links to G-protein coupled receptors (GPCR) and Notch signalling, and another two being mainly synaptic in origin, with one off those showing specific connections to axon guidance and Wnt signaling. Assigning molecular pathways, and thus genetic information, from the mouse to individual participants provides an insight into undetected and/or related genetic variants that could be working in combination or interacting with an environmental influence. Moreover, the subgroups found are transdiagnostic, including participants with autism, ADHD, and OCD, which indicates that NDDs as a whole can be subdivided into consistent neuroanatomical clusters with cohesive underlying biological mechanisms. This work allows us to bridge the gap between preclinical models and human disorders, linking previously idiopathic human patients to pertinent genetics, molecular mechanisms, and pathways.

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13. Esposito M, Fadda R, Ricciardi O, Mirizzi P, Mazza M, Valenti M. Ins and Outs of Applied Behavior Analysis (ABA) Intervention in Promoting Social Communicative Abilities and Theory of Mind in Children and Adolescents with ASD: A Systematic Review. Behav Sci (Basel). 2025; 15(6).

Social-communicative abilities and theory of mind (ToM) are crucial for successful social interactions. The developmental trajectories of social and communicative skills characterizing individuals with Autism Spectrum Disorder (ASD) are rather complex and multidimensional, including components related to theory of mind. Due to its mentalistic nature, theory of mind has been rarely addressed as an outcome for Applied Behavior Analysis (ABA) intervention in children and adolescents with ASD. However, there is evidence that ABA intervention might be effective in promoting social abilities in individuals with ASD. Thus, this topic is worth investigating. We present a systematic review to explore the Ins and Outs of an ABA approach to promote social and communicative abilities and ToM in children and adolescents with ASD. We applied a PRISMA checklist to consider studies published up to December 2024. The keywords that we used were ToM, perspective-taking, false belief, social cognition, and mental states, in combination with ABA intervention and ASD (up to age 18). We searched for studies using Scopus, Google Scholar, and Medline. We included twenty studies on perspective-taking, identifying emotions, helping, detecting eye gazing, and social engagement, reviewing fifteen dedicated to teaching the interpretation of mental states (involving 49 children and 10 adolescents). The ToM was addressed with a multiple baseline design on target behaviors associated with ToM components such as identifying emotion, helping behaviors, and mental states. The intervention included a behavioral package consisting of Behavioral Skill Training, Derived Relations, video modeling, and role playing. The results indicated a significant number of participants who followed ABA intervention to promote social abilities and mastered the target behavior in ToM tasks; however, they showed maintenance and generalization issues across trials and settings. The role of predictors was highlighted. However, the studies are still rare and exhibit specific methodological limitations, as well as some clinical and ethical considerations. More research is needed to define best practices in ABA intervention to promote social abilities in individuals with ASD.

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14. Fernell E, Landberg S, Miniscalco C, Fagerudd R, Johnels J, Johnson M, Hadjikhani N, Gillberg C. Bumetanide Treatment in 15 Children With Autism: A Randomised Waitlist-Control Study. Acta Paediatr. 2025.

AIM: Bumetanide, a diuretic, influences neuronal chloride homeostasis and potentially restores GABAergic inhibition and neuronal signalling balance. This mechanism may contribute to improvements in autism-related symptoms. The present study builds on the preclinical research and on previous clinical research on bumetanide treatment for children with autism. METHODS: Fifteen children (10 boys, 5 girls), aged 4-12 years with a clinically confirmed autism diagnosis, with and without intellectual disability and with and without ADHD were enrolled in this 9-month randomised waitlist-control study. Participants were randomly assigned to either begin bumetanide treatment immediately or wait 3 months before starting. Parents completed rating scales assessing symptoms, behaviours and functioning at baseline and after 3, 6 and 9 months. RESULTS: Two children had to be excluded in the first treatment period with bumetanide due to emerging behavioural problems. Of the remaining 13, 4 discontinued after the 4-6 months period with bumetanide, and 9 completed the full 9-month study. According to parent reports, 4 of these 9 children experienced significant clinical improvements, leading parents to opt for continued bumetanide treatment for their child after study completion. CONCLUSION: This small, waitlist-control study provides further support that bumetanide may have beneficial effects for some children with autism.

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15. Garcha J, Smith AP, James A. Mental Health Correlates of Autistic and ADHD Traits in Secondary School Students. Brain Sci. 2025; 15(6).

Background: Recent research has examined the associations between autistic traits and the well-being of students. This research has also included measures of ADHD and mental health. Methods: To understand the association and interaction of well-being and mental health with autistic traits (AQ) and attention deficit hyperactivity disorder (ADHD) traits, a survey was given to 578 secondary school students. The survey used the well-being process questionnaire (WPQ), the autism spectrum quotient, the ADHD self-report scale, and the Strengths and Difficulties questionnaire (SDQ). Results: The analysis conducted using SPSS showed that there was a significant correlation between anxiety, depression, AQ, and ADHD. Anxiety and depression were also significantly correlated with all well-being and SDQ variables. The regression analysis, including psychosocial predictors of well-being, anxiety, depression, ADHD, and AQ, showed that anxiety and depression were strongly associated with well-being outcomes. In contrast, AQ and ADHD were associated with hyperactivity, peer problems, and reduced prosocial behaviour. The associations between anxiety, depression, and well-being outcomes were stronger than with either AQ or ADHD. Conclusions: This study extends previous research from university samples to a secondary school sample. This shows the importance of investigating associations between subclinical traits and psychological symptoms in early adolescence, as this will lead to better-informed prevention and early intervention strategies.

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16. Glenn E, Meyer A, Blakeley-Smith A. Anxiety Self-Report in Autistic Adolescents With Intellectual Disability: Predictors of Parent-Youth Agreement. Am J Intellect Dev Disabil. 2025; 130(4): 323-36.

The use of self-report to assess anxiety in adolescents with intellectual disability (ID) is notably underexplored. This study examined the impact of youth-level factors (i.e., age, verbal and cognitive ability, adaptive skills) on anxiety self-report completion and parent-youth agreement among 72 autistic adolescents with ID. We also examined if parent accommodation behaviors, such as reassurance or routine modification, served as predictors of parent-youth agreement of anxiety. Results showed that 83% of adolescents completed the self-report measure, with verbal, cognitive, and adaptive ability predicting completion. Parental accommodation predicted parent-youth agreement on physical anxiety symptoms, but not global anxiety symptoms. Youth-level factors did not significantly predict agreement. Results highlight the need for expanded assessment approaches for assessing anxiety in youth with ID.

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17. Gullo G, Gentile A, Alesi M. Enriched Motor Program [EMP]: Adaptation of a Physical Activity Intervention for Enhancing Executive Functions in Children with ASD. Int J Environ Res Public Health. 2025; 22(6).

BACKGROUND: Recent studies indicate that physical activity (PA) may improve executive functions (EFs) in children with Autism Spectrum Disorder (ASD). The Enriched Motor Program (EMP), which combines aerobic and cognitive exercises, shows potential for enhancing EFs in these children. The EMP was originally created for typically developing preschoolers and includes locomotor and fine motor activities enriched by cognitive stimuli to help the development of EFs in children with ASD. The current study aims to adapt a shorter version of EMP for these children’s needs. METHODS: The research will use a cross-sectional, quasi-experimental design with a forecasted sample of 40 children, with the age ranging from six to eight, with a diagnosis of ASD. The children’s working memory and inhibitory control will be measured before and after the intervention. RESULTS: According to the literature, the experimental group should obtain higher scores, especially in working memory tasks. DISCUSSION: This is the first implementation of EMP, which merges physical activities with cognitive stimuli to enhance EFs in children with ASD. It could be used by specialized centers and clinicians to support EFs through engaging activities, and it could be potentially recommended as a best practice for EF treatments in children with ASD.

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18. Helfrich C. Intellectual and Developmental Disabilities Nursing. Am J Nurs. 2025; 125(7): 31.

These nurses provide training and care for individuals in residential settings.

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19. Hong CC. Rapid Eye Movements in Sleep Furnish a Unique Probe into the Ontogenetic and Phylogenetic Development of the Visual Brain: Implications for Autism Research. Brain Sci. 2025; 15(6).

With positron emission tomography followed by functional magnetic resonance imaging (fMRI), we demonstrated that rapid eye movements (REMs) in sleep are saccades that scan dream imagery. The brain « sees » essentially the same way while awake and while dreaming in REM sleep. As expected, an event-related fMRI study (events = REMs) showed activation time-locked to REMs in sleep (« REM-locked » activation) in the oculomotor circuit that controls saccadic eye movements and visual attention. More crucially, the fMRI study provided a series of unexpected findings, including REM-locked multisensory integration. REMs in sleep index the processing of endogenous visual information and the hierarchical generation of dream imagery through multisensory integration. The neural processes concurrent with REMs overlap extensively with those reported to be atypical in autism spectrum disorder (ASD). Studies on ASD have shown atypical visual processing and multisensory integration, emerging early in infancy and subsequently developing into autistic symptoms. MRI studies of infants at high risk for ASD are typically conducted during natural sleep. Simply timing REMs may improve the accuracy of early detection and identify markers for stratification in heterogeneous ASD patients. REMs serve as a task-free probe useful for studying both infants and animals, who cannot comply with conventional visual activation tasks. Note that REM-probe studies would be easier to implement in early infancy because REM sleep, which is markedly preponderant in the last trimester of pregnancy, is still pronounced in early infancy. The brain may practice seeing the world during REM sleep in utero before birth. The REM-probe controls the level of attention across both the lifespan and typical-atypical neurodevelopment. Longitudinal REM-probe studies may elucidate how the brain develops the ability to « see » and how this goes awry in autism. REMs in sleep may allow a straightforward comparison of animal and human data. REM-probe studies of animal models of autism have great potential. This narrative review puts forth every reason to believe that employing REMs as a probe into the development of the visual brain will have far-reaching implications.

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20. Hu J, Fu P, Qiao S, Yan X. Knowledge and stigma of autism spectrum disorders in Chinese university students in the context of inclusive education. PLoS One. 2025; 20(6): e0320033.

This study investigated knowledge of autism spectrum disorder and associated stigma among Chinese university students, utilizing the cross-culturally validated Chinese version of the Autism Stigma and Knowledge Questionnaire. A total of 2,081 students from 25 provinces participated in an online survey. Independent-samples t-tests and one-way ANOVAs revealed that female students, upper-grade students, normal-education students, special education majors, and those who had completed inclusive education courses demonstrated significantly higher levels of ASD knowledge and lower levels of stigma. Prior interactions with autistic people were also associated with greater understanding of ASD and more accepting attitudes. These findings emphasize the significance of incorporating autism-related content into both general and special education curricula, fostering high-quality interactions with autistic communities, and critically considering the types of knowledge that most effectively mitigate stigma. As inclusive education reforms progress in China, enhancing professional training and awareness of neurodiversity will be crucial for preparing future educators to establish inclusive and supportive learning environments.

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21. Iadarola S, Cai P, Porto M, Mustian K. Mindfulness and Psychoeducation Are Associated With Improved Perceived and Physiological Health Outcomes in Caregivers of Children With Autism. Am J Intellect Dev Disabil. 2025; 130(4): 280-93.

Parents of autistic children can experience less favorable outcomes than the general population on objective health measures. Accordingly, interventions including behaviorally-oriented and mind-body programs are associated with decreased stress and increased mental health. Caregivers (n = 22) of autistic children (aged 5-12) were randomized to group psychoeducation or mindfulness program for 8 weeks. Psychological and physiological measures included heart rate variability (HRV), sleep, parental stress, and perceived health. Both groups demonstrated improvement HRV, perceived parental stress, and perceived global health. The mindfulness group showed some advantage, including on root mean squared successive difference, somatization, and perceptions of their child’s behavior. Although preliminary, results highlight the promise of short-term interventions for improving health for caregivers of autistic children.

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22. Keating BA, Ogru Y, Duthy TG, Douglas L, Lichkus K, Isikgel E, Fahey MC, Ellaway C. Full-Spectrum Medicinal Cannabis Plant Extract 0.08% THC (NTI164) Improves Symptoms of Rett Syndrome: An Open-Label Study. J Paediatr Child Health. 2025.

AIM: The aim of this Phase I/II open-label study was to assess the safety and efficacy of NTI164, a novel full-spectrum medicinal cannabis plant extract 0.08% Δ-9-tetrahydrocannabinol (THC), in Rett syndrome (RTT). METHODS: Eleven female participants (5-16 years) with a pathogenic variant in the MECP2 gene were recruited to this study, receiving NTI164 twice daily for 12 weeks. The primary outcome measure was the Clinical Global Impression-Improvement (CGI-I) Scale, with secondary outcomes measured using the CGI-Severity (CGI-S), RTT Behaviour Questionnaire (RSBQ), RTT-Symptom Index Score (RTT-SIS), RTT-Domain-Specific Concerns-Visual-Analog Scale (RTT-DSC-VAS), Impact of Childhood Neurological Disability/Quality of Life (ICND+QoL), and RTT-Caregiver Burden Inventory (RTT-CBI). Paired-samples t-test was used to assess significance between baseline and Week 12. RESULTS: Improvements were seen in the total CGI-I score (p = 0.028), with improvements in communication skills (p = 0.003), mental alertness (p = 0.033), socialisation/eye contact (p = 0.0004), attentiveness (p = 0.001), and anxiety (p = 0.004). CGI-S also demonstrated better outcomes after NTI164 administration (p = 0.008). RSBQ showed improvements in total score (p = 0.0005), general mood (p = 0.0003), breathing problems (p = 0.041), repetitive face movements (p = 0.004), and fear/anxiety (p = 0.006). RTT-DSC-VAS showed positive developments in abilities to communicate choices (p = 0.041). ICND total score was improved (p = 0.003), as well as cognition (p = 0.027) and Quality of Life (p = 0.0002). Total score on the RTT-CBI was improved (p = 0.006). CONCLUSION: NTI164 demonstrated safety and improved some clinical and functional outcomes in RTT. These improvements justify ongoing research into NTI164, which may be a potential adjunct therapy in RTT.

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23. Li H, Yang Y, Yu B, Zhang Y. The Metabolic Signature of Autism Spectrum Disorders Using Dried Blood Spots at Birth. Psychiatry Investig. 2025; 22(6): 678-86.

OBJECTIVE: This study aims to evaluate the metabolic impact of the autism spectrum disorder (ASD) at birth, while such insight may lead to increased understanding of the etiology. METHODS: We performed tandem mass spectrometry (TMS) in a large sample of dried blood spots (DBS) derived at birth from 106 autistic patients and 401 controls, to identify a metabolic signature for ASD. We also examined trait-specific metabolomic patterns within ASDs, focusing on the age, sex, and the comorbidities including the language delay (LD) and global developmental delays. RESULTS: The results showed that there were no significant differences in metabolism data between ASD patients and controls. The forest plot analysis revealed distinct associations between genetic metabolic substances and autism in male and female populations. Among males, the variable C0 demonstrated a statistically significant association (odds ratio [OR]=1.05, 95% confidence interval [CI]: 1.006-1.096, p=0.024). For females, a significant association was observed with C3 (OR=2.541, 95% CI: 1.089-6.140, p=0.032). Based on their chronological ages of the first diagnosis, autistic individuals were divided in two groups: younger (n=59) or older than 3 years (n=47). The metabolism of succinic acid is increased (p<0.05), as well as carnitines C5:1. CONCLUSION: Most analytes included in the TMS screen had no significant differences between the autism group and the control group at birth; however, sex, the age of first diagnose for ASD, and comorbidities may be the important factors affecting metabolic characteristics, as well as the genetic metabolic changes arise after birth.

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24. Liu H, Zhu X, Ge B, Huang M, Li X. The association between screen exposure and autism spectrum disorder in children: meta-analysis. Rev Environ Health. 2025; 40(2): 437-44.

INTRODUCTION: The goal is to provide light on the contentious relationship between screen exposure and childhood autism spectrum disorder (ASD). By conducting two meta-analyses that showed a potential association, including screen exposure effect by ASD and ASD risk by screen exposure, we aimed to clarify the potential causality between screen exposure and childhood ASD. CONTENT: The literature published up to December 2023 were systematically collected, and the combined effect values of weighted mean difference (WMD) and 95 % confidence interval (CI) and odds ratio (OR) and 95 % CI were calculated using two meta-analyses using the STATA 12.0. A total of 197,357 children, including 4,599 childhood ASD, were finally included in 10 studies. The results showed that children with ASD had higher levels of screen time exposure than healthy controls (combined effect value WMD=0.27, 95 % CI: 0.12-0.41, p<0.001). An increased risk of ASD was also found in children with high screen exposure compared to the low screen exposure group (OR=1.5395 % CI: 1.14-2.06). SUMMARY AND OUTLOOK: The development of childhood ASD may be associated with screen exposure. Future prospective studies are needed to verify the relationship between screen exposure and ASD in children.

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25. Liu Z, Chen Y, Dong X, Liu J. An Autism Spectrum Disorder Identification Method Based on 3D-CNN and Segmented Temporal Decision Network. Brain Sci. 2025; 15(6).

(1) Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and repetitive behaviors. Functional MRI (fMRI) has been widely applied to investigate brain functional abnormalities associated with ASD, yet challenges remain due to complex data characteristics and limited spatiotemporal information capture. This study aims to improve the ability to capture spatiotemporal dynamics of brain activity by proposing an advanced framework. (2) Methods: This study proposes an ASD recognition method that combines 3D Convolutional Neural Networks (3D-CNNs) and segmented temporal decision networks. The method first uses the 3D-CNN to automatically extract high-dimensional spatial features directly from the raw 4D fMRI data. It then captures temporal dynamic properties through a designed segmented Long Short-Term Memory (LSTM) network. The concatenated spatiotemporal features are classified using Gradient Boosting Decision Trees (GBDTs), and finally, a voting mechanism is applied to determine whether the subject belongs to the ASD group based on the prediction results. This approach not only enhances the efficiency of spatiotemporal feature extraction but also improves the model’s ability to learn complex brain activity patterns. (3) Results: The proposed method was evaluated on the ABIDE dataset, which includes 1035 subjects from 17 different brain imaging centers. The experimental results demonstrate that our method outperforms existing state-of-the-art approaches, achieving an average accuracy of 0.85. (4) Conclusions: Our method provides a new solution for ASD classification by leveraging the spatiotemporal information of 4D fMRI data, achieving a significant improvement in classification performance. These results not only offer a new computational tool for ASD diagnosis but also provide important insights into understanding its neurobiological mechanisms.

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26. Lunia D, Smith AP. Exploring the Associations Between Autistic Traits, Sleep Quality, and Well-Being in University Students: A Cross-Sectional Study. Brain Sci. 2025; 15(6).

BACKGROUND: Very few studies have examined associations between autistic traits, sleep, and the well-being of university students, and the aim of the present study was to address this knowledge gap. METHODS: Three hundred and eight university students carried out an online survey consisting of the Comprehensive Autistic Traits Inventory (CATI), the Short-Form Well-Being Process Questionnaire (SWBPQ), the Short-Form Strengths and Difficulties Questionnaire (SDQ), and the Short-Form Sleep Questionnaire. RESULTS: Univariate analyses revealed significant correlations between the CATI subscales and the SDQ outcomes, but there were few associations between the CATI scales and the well-being outcomes, which were associated with the sleep scores and the well-being predictors. No interactions were found between the predictor variables. This profile was confirmed in the multivariate analyses, which also showed significant associations between the CATI scores and well-being predictors. CONCLUSIONS: CATI scores were associated with the outcomes of strengths and difficulties but showed few significant associations with the WPQ outcomes, which were predicted by sleep and well-being predictors. However, evidence of the indirect effects of the CATI scores on well-being came from the associations between the CATI scales and the well-being predictors.

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27. Ma M, Yang Z, Wang L, Lu S, Han J, Li X. Resting Electroencephalography Microstates and Alpha Power Modulation in Preschool-Aged Children with Autism Spectrum Disorder. Brain Sci. 2025; 15(6).

Background/Objectives: Emerging evidence suggests that individuals with autism spectrum disorder (ASD) exhibit altered neural connectivity and disrupted brain network dynamics, which can be captured through EEG microstate analysis. Most research to date has focused on older children, adolescents, or adults with ASD, while studies focusing on preschool-aged children with ASD remain limited. Given that early brain development is critical for understanding the onset and progression of ASD, more research targeting this age group is essential. Methods: In this study, resting EEG data were collected from 59 preschool-aged children with ASD and 59 typically developing (TD) participants. Results: The results revealed a reduction in global explained variance and coverage of microstate in children with ASD, indicating poorer social performance that was independent of alpha power after the removal of the 1/f-like aperiodic signal. These findings reflect the social symptoms commonly observed in ASD. Additionally, alpha power was found to modulate the occurrence and duration of microstates in both groups. Conclusions: Our findings highlight that atypical microstates can serve as reliable biomarkers for ASD, offering valuable insights into the neurophysiological mechanisms underlying the disorder and paving the way for future research directions.

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28. Machado CF, Flôres F, Gomes TVB, Ortigas PR, Cordovil R, Benda RN. Motor Affordances of Children with Autism Spectrum Disorder in Southern Brazil. Phys Occup Ther Pediatr. 2025: 1-15.

AIM: To investigate the affordances available to children, 6-9 years-old, with autism spectrum disorder (ASD) in southern Brazil. The initial assumption of this study was that children with ASD would present low opportunities for motor stimulation as observed in children with typical development, and that richer motor affordance contexts (higher movement opportunities) would be associated with higher socioeconomic status and parents’ education. METHODS: 52 guardians of children of both sexes diagnosed with ASD participated in the investigation. The Childhood Autism Assessment Scale was used to classify the level of ASD, and the Affordances for Motor Behavior of Schoolchildren (AMBS) to analyze affordances in children’s main environments. The statistical analysis was performed using univariate and multivariate analysis and a logistic regression model. RESULTS: The findings indicate that children with ASD have low opportunities for motor stimulation. Multivariate analysis showed this is particularly noticeable in families with lower income levels. Also, materials made available for children with ASD usually do not encourage gross motor skills, which does not help to prevent their sedentary lifestyle. CONCLUSION: Better knowledge about the opportunities for motor stimulation of children with ASD can help to create individualized strategies that support their caregivers and improve children’s developmental outcomes.

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29. Matos DC, Brito R, Silva FB, Costa JRR, Bagaiolo L, Pacífico CR, Soares PG. Training University Psychology Students to Teach Multiple Skills to Children with Autism Spectrum Disorder. Behav Sci (Basel). 2025; 15(6).

Training people interested in implementing Applied Behavior Analysis (ABA) interventions to children with autism spectrum disorder (ASD) is important to promote skill gains. A recommended training package is called behavioral skills training (BST), which involves four components (didactic instruction, modeling, role-play, and performance feedback). BACKGROUND/OBJECTIVES: The purpose was to assess the effects of BST on the accurate teaching of multiple skills via DTT by six psychology university students to a confederate and six children diagnosed with ASD. Generalization and maintenance assessments were conducted. RESULTS: Through the research conditions, all university participants were able to teach ten different skills (sitting still, motor imitation, making requests, vocal imitation, receptive identification of non-verbal stimuli, making eye contact, following instructions, intraverbal, labeling, receptive identification of non-verbal stimuli by function, feature and class) with a high integrity level to the children. In addition, across four months after training, all participants maintained high teaching integrity levels while teaching skills to the children related to their individualized curriculum goals. Each child accumulated over 1000 correct responses across several sessions. The university participants rated their training with the highest possible score in a social validity assessment. CONCLUSIONS: BST successfully trained psychology university students to accurately teach multiple skills via DTT to children with ASD and involved long lasting effects. Limitations and new avenues for research were discussed.

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30. Morton HE, Bottini SB, McVey AJ, Gillis JM, Romanczyk RG. Different Tools, Different Results: Comparing Methods for Bullying Assessment in Autistic and ADHD Youth. J Autism Dev Disord. 2025.

Autistic and ADHD youth face heightened risk of peer victimization and subsequent poor educational and mental health outcomes. Yet, bullying interventions have had limited success in these groups, potentially due to variability in bullying assessment methods across studies. Additionally, general tools validated for community samples may fail to capture the unique victimization experiences of these youth. This study evaluated the agreement and sensitivity of three bullying assessment methods-a single-item assessment, the Olweus Bullying Questionnaire (OBQ), and the disability-specific Assessment of Bullying Experiences (ABE)-and examined group differences in victimization risk. Caregivers of 516 autistic, ADHD, and community youth completed all three bullying assessments. Agreement across measures was examined overall and within groups using percent agreement, Cohen’s kappa and McNemar’s tests. Logistic regression models were used to evaluate group differences in bullying classification within each measure. Agreement between the OBQ and ABE was moderate overall, but weaker in each of the autism and ADHD groups. The single-item assessment underestimated bullying prevalence compared to multi-item questionnaires and also failed to detect any between-group differences. Youth with ADHD were nearly three times more likely to be bulled compared to community youth when measured by both the ABE (OR = 2.81; 95% CI [1.34, 5.92]) and the OBQ (OR = 2.76; 95% CI [1.37, 5.57]) whereas increased vulnerability for autistic youth with co-occurring ADHD was only identified by the ABE (OR = 2.34; 95% CI [1.42, 3.85]). Findings highlight the limitations of single-item assessments and general measures in capturing disability-specific bullying. By including disability-specific behaviors, the ABE provides greater sensitivity for assessing bullying in autistic and ADHD youth. Integrating theory-driven frameworks may further improve assessment and intervention approaches for understanding and addressing bullying risk in autistic and ADHD youth.

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31. Peters SU, Fu C, Shelton AR, Neul JL, Malow B. Sleep Problems and Clinical Severity in Rett Syndrome. J Child Neurol. 2025: 8830738251347561.

Rett syndrome is a neurodevelopmental disorder that primarily affects females and is often associated with sleep problems. To date, few studies have examined how sleep problems correspond to aspects of clinical severity in Rett syndrome. In this study, we examined how sleep architecture and sleep-disordered breathing correspond to psychometrically validated outcome measures that are being used in clinical trials. Thirteen participants (mean [M] = 5.96 years, standard deviation [SD] = 2.6), all with confirmed pathogenic variants in MECP2, were enrolled. Participants underwent polysomnography and formal clinical assessments. Six of thirteen participants had obstructive sleep apnea, which was worse during rapid eye movement (REM) sleep with associated hypoxemia and disruptions in sleep architecture. Decreased REM sleep time significantly correlated with higher overall clinical severity (r = -.57; P = .04), lower functional skills (r = -.56; P = .04), and lower social skills (r = -.57; P = .04) using the Revised Motor Behavioral Inventory. Results of t tests revealed that those with obstructive sleep apnea had significantly increased wake time. Those with obstructive sleep apnea also had more behavioral difficulties (higher anxiety, mood disturbance) as captured using the Rett Syndrome Behavior Questionnaire. Taken together, the results of this study show that reduced REM sleep is very common in Rett syndrome and is associated with more impairments in functional and social skills. Obstructive sleep apnea is also very common, and is associated with changes to sleep architecture, higher anxiety, and more mood disturbances. This suggests that providers should routinely screen for sleep problems and implement interventions that can positively impact the quality of life of individuals with Rett syndrome and their families.

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32. Reis SM, Renzulli SJ. Research-Based Strength-Based Teaching and Support Strategies for Twice-Exceptional High School Students with Autism Spectrum Disorder. Behav Sci (Basel). 2025; 15(6).

In the last five years, several scholars have collaborated in an integrated research program focused on students identified with both academic talents and autism spectrum disorder (2eASD) with support from a Javits Gifted and Talented Students Education grant. Several different empirical studies were initiated and completed during this period, investigating the ways in which some of these twice-exceptional students have been able to be successful in secondary school and highly competitive colleges. In this article, we summarize findings from several of these studies, synthesizing implications and recommendations with a goal of offering research-based practices, especially related to healthy social and emotional development and strong academic achievement in students identified as 2eASD.

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33. Rodrigues É, Livanos A, Garbin JAL, Fernandes SMS, Simcsik AO, Crocetta TB, Dias ED, Monteiro CBM, Magalhães FH, Ré AHN, Moraes Í AP, Silva-Magalhães TD. Heart Rate Variability in Adolescents with Autistic Spectrum Disorder Practicing a Virtual Reality Using Two Different Interaction Devices (Concrete and Abstract): A Prospective Randomized Crossover Controlled Trial. Healthcare (Basel). 2025; 13(12).

Individuals with autism spectrum disorder (ASD) often experience dysregulation of the autonomic nervous system, as evidenced by alterations in heart rate variability (HRV). It can be influenced by virtual reality (VR), which affects physiological responses due to its sensitivity to environmental and emotional stimuli. Objectives: This study aimed to assess HRV in individuals with ASD before, during, and after VR-based tasks over a 10-day period, specifically examining how HRV fluctuated in response to concrete (touchscreen) and abstract (webcam) interactions. Methods: Twenty-two male participants were randomly assigned to two sequences based on the order of tasks performed (starting with either the concrete or abstract task). Results: The findings revealed significant changes in HRV indices (RMSSD, SD1, SDNN, and SD2) between the two task types. Conclusions: The participants engaged in abstract tasks demonstrated higher motor demands, which were indicated by decreased parasympathetic activity and an increased LF/HF ratio, suggesting greater activation of the sympathetic nervous system.

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34. Shabudin NSM, Shuid AN. Screening for Potential Compounds Using Drug-Repurposing of N-Methyl-D-Aspartate (NMDA) Receptor for Autism Spectrum Disorder (ASD). Trop Life Sci Res. 2025; 36(1): 223-44.

In Malaysia, the study on autism spectrum disorders (ASD) is limited. Most studies only focus on gene neuroligin 3 (NLGN3), NLGN4X, neurexin 1 (NRXN1) and SH3. This study focuses on the N-methyl-D-aspartate (NMDA) that was believed to have a significant effect on ASD. In this study, potential compounds and drugs that can restore receptor function in autistic patients were analysed. This research used an effective in silico method known as drug-repurposing to discover and rediscover drugs and analyse the binding of potential compounds or drugs to the NMDA receptor. AMPA and DOCK4 were used as controls in this study. Using a trusted server, Drug ReposER, 13 potential compounds or drugs that bind to NMDAR were identified. Then, proceed to the docking of potential compounds or drugs that bind to the NMDA receptor using Autodock Vina, Autodock, Hdock and CB dock and three drugs were selected that have the best binding score to NMDA, AMPA and DOCK4. The drugs were alitretinoin, salicylic acid and indinavir, respectively. Next, molecular dynamics simulations were performed with all selected compounds to study drug-protein binding, with detailed analysis of bond stability using root-mean-square fluctuation (RMSF) oscillations. Finally, ADMET (Absorption, Distribution, Metabolism, Excretion and Toxicity) predictions identify 4-androstenedione, tryptophan, carbocisteine and vitamin A as having minimal toxic effects. This study showed that alitretinoin, which was known to treat skin lesions from Kaposi’s sarcoma, might have the ability to reverse the effect in ASD, particularly in NMDA receptors, potentially making a significant impact on the field of neurology and psychiatry.

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35. Smith LD, Powell RM, Khanna A, Simas TAM, Mitra M. Attitudes, Assumptions, and Beliefs of Obstetric Care Clinicians Regarding Perinatal Care of Women With Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil. 2025; 130(4): 294-308.

This study examines clinician attitudes, beliefs, and assumptions regarding perinatal care of women with intellectual and developmental disabilities (IDD) from the perspectives of both clinicians and women with IDD. We conducted semistructured individual interviews with women (n = 16) and individual interviews and one focus group with clinicians (n = 17). Data were analyzed using a content analysis approach. Analysis revealed both supportive and restrictive categories. Supportive: (a) accommodating needs, (b) respecting autonomy, and (c) supporting motherhood. Restrictive: (a) unwillingness to accommodate, (b) assumptions about decision-making capacity, (c) questioning parenting abilities, and (d) biased contraception and sterilization practices. Clinician training to address attitudes, beliefs, and assumptions is needed to improve perinatal care for women with IDD.

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36. Spaargaren KL, Roke Y, Begeer SM, Straten AV, Riper H, Greaves-Lord K, Scheeren AM. A randomized controlled trial into the effectiveness of a mobile health application (SAM) to reduce stress and improve well-being in autistic adults. Autism. 2025: 13623613251346885.

Autistic adults experience more daily stress compared to non-autistic adults. However, stress recognition is often delayed, potentially leading to chronic stress and significant (mental) health risks. We evaluated the effectiveness of Stress Autism Mate (SAM), a stress-monitoring mobile health application co-created with autistic individuals. We ran a two-arm, parallel, superiority randomized controlled trial. Autistic adults (n = 214) (mean age: 50.5 years; 66.4% female) were randomized to 1-month SAM usage or waitlist control. Participants self-reported on primary (Perceived Stress Scale; Warwick-Edinburgh Mental Wellbeing Scale), and secondary outcomes (Coping Self-Efficacy Scale) at baseline and 4 weeks later, after which the control group could start using the app. Hierarchical multiple regression analyses revealed that the intervention group had significantly lower perceived stress (d = 0.27), greater mental well-being (d = 0.35), and improved coping self-efficacy (d = 0.16) compared to the control group after 1 month. No intervention effect moderators could be identified. More frequent app usage was significantly associated with a stronger decrease in perceived stress (r = -0.293). However, 42.9% of app users indicated increased stress from app use, warranting further investigation. Our results suggest that SAM may be effective in reducing perceived stress and improving mental well-being for some autistic individuals. Further refinement and investigation are recommended.Lay abstractAutistic adults often experience more daily stress than non-autistic individuals, but they may not always recognize this stress timely, which can lead to long-term health problems. To help address this, we tested an app called Stress Autism Mate (SAM), which was designed together with autistic individuals to help autistic adults monitor and manage their stress. In our study, 214 autistic adults (average age: 50.5 years; 66.4% female) were randomly assigned to either use the app for 1 month or wait before using it. We asked participants to complete surveys before and after the 1-month period to measure changes in their stress levels, mental well-being, and confidence in coping. Results showed that participants who used the app reported lower stress, improved mental well-being, and better coping skills compared to those who did not use the app. We also found that the more often someone used the app, the more their stress levels decreased. However, 42.9% of users felt more stressed using the app, which needs further study. Overall, our findings suggest that SAM can help reduce stress and improve well-being for some autistic adults, but more work is needed to improve the app and better understand its effects.Trial registry ISRCTN Registry: ISRCTN17394910.

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37. Superson W, Prokopiak A, Wodziński M. Experiences of an Autism Diagnosis in Adulthood: The Role of Grassroots Epistemology in Clinical Settings. J Clin Med. 2025; 14(12).

Background: Our research problem mainly concerns the following question: what are the consequences of an autism spectrum condition diagnosis for everyday functioning and self-understanding? Method: The research methodology is based on a semi-structured interview, which allows respondents to share their experiences freely while maintaining the structure and standards necessary to collect consistent data. The research was conducted remotely, using the ZOOM platform and the Messenger application. Six individuals with autism spectrum condition (ASC) diagnosed in adulthood, selected intentionally, participated in the study. Interviews lasted between 20 and 60 min. Results: The analysis of the experiences of individuals with ASC diagnosed in adulthood highlights the complexity of the diagnosis process and its far-reaching consequences. The diagnostic process, which varied in time and depended on the availability of specialists, was often evaluated positively. Obtaining an ASC diagnosis proved to be a crucial moment for the interviewees, enabling them to better understand themselves and their needs. It led to a better adjustment of their work, education, and private life environment. Relationships with loved ones tended to remain unchanged or improved, highlighting the importance of the diagnosis in improving the understanding and acceptance of individuals with ASC. Conclusions: The study sheds light on the positive impact of diagnosis on self-awareness and quality of life for individuals with ASC, revealing the need to improve the availability of specialised diagnostic and support services. Further research should focus on the development and adaptation of support methods to meet the individual needs of individuals with ASC and on promoting awareness of ASC in the community and among mental health professionals.

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38. Velasco-Benítez CA, Rojas-Cerón CA, Ortiz-Rivera CJ, Velasco-Suárez DA, Juvinao-Quintero MC, Zubiri CE, Fernández JM, Bigliardi R, Zosi A, Chanis Águila RA, Guzmán Acevedo C, Reynoso Zarzosa FA, Zablah Cordova RA. Exploring Disorders of Gut-Brain Interaction in Schoolchildren and Adolescents with Autism. Life (Basel). 2025; 15(6).

BACKGROUND: Disorders of Gut-Brain Interaction (DGBIs) are present in 23.0% of the paediatric population, according to Rome IV. Latin American (LA) prevalence of DGBIs in children with Autism Spectrum Disorder (ASD) is unknown. The aim of this study was to determine the prevalence of DGBIs and possible associations in schoolchildren and adolescents with ASD from LA. METHODS: An observational analytical study was conducted in LA cities. Caregivers of children with ASD completed the Rome IV Questionnaire for Pediatric Gastrointestinal Symptoms to identify DGBIs. Sociodemographic, clinical, and family variables were included. Statistical analysis involved central tendency measures, univariate and bivariate analysis, calculation odds ratios (ORs), and 95% confidence intervals (95%CIs), with p < 0.05 significance. RESULTS: The study included 353 children with ASD. Predominantly male (78.8%), white (56.1%), attending private schools (79.3%), altered nutritional status (43.9%), born by c-section (57.5%), firstborn (54.7%), level of autism not classified at the time of the study (49.0%). A total of 58.9% presented DGBI. Functional constipation (FC) was the most frequent (27.2%). Those from Central America (CA) had a higher likelihood of presenting a DGBI (OR = 1.98, 95% CI = 1.25-3.12, p = 0.0018). CONCLUSIONS: Over half of LA schoolchildren and adolescents with ASD presented DGBI, FC being the most common, and higher likelihood of DGBI in CA.

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39. Venkatesh S, Shwetha TS, Janarthanan SD, Naaz S, Srinivasan K. Development and Impact of a Communication Module on Eye Examination Testability Among Individuals with Autism Spectrum Disorder. J Autism Dev Disord. 2025.

This study aimed to develop and validate a communication module for eye examination and to determine its effectiveness in enhancing the testability among individuals with ASD. A Social Story based communication module was developed and validated in both English and Kannada languages. The module primarily focused on visual acuity testing, refraction, sensory and motor evaluation. A single-blinded cross-sectional study was conducted to determine the impact of the communication module on the testability of eye examination among individuals with ASD. Thirty individuals aged 5 to 10 years with a clinical diagnosis of mild to moderate ASD were enrolled and randomly allocated to the intervention (n = 15) or the control group (n = 15). Examiner 1 oriented the participants in the intervention group with the module. Examiner 2, blinded to the module’s implementation, examined all the participants’ eyes. All the procedures were carried out in a community setting. The average scoring for relevancy, appropriateness, understandability and simplicity of content ranged from 4.45 to 4.78 out of 5. The testability ranged from 40 to 100% in the intervention group and 20-100% in the control group for various tests. The odds of testability were 2.01 times greater for overall eye examination in the intervention group (OR = 2.01, 95% CI [1.82, 2.20]). For each test the odds of testability were 1.96-3.89 times higher in the intervention group. The developed and validated English and Kannada communication modules are effective in improving the testability of eye examination among individuals with ASD.

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40. Wang D, Ding W. Innovative biomarker exploration in ASD: Combining Graph Neural Networks and permutation testing on fMRI data. Neuroimage Rep. 2025; 5(2): 100249.

This study employed Graph Neural Networks (GNNs), specifically an unsupervised GNN, to extract node embeddings from brain regions in both Autism Spectrum Disorder (ASD) and control groups. The objective was to identify potential biomarkers by analyzing node embeddings extracted from a graph model based on functional Magnetic Resonance Imaging (fMRI) data. Permutation tests were conducted to identify regions with significant differences in their embeddings between the two groups. Our results revealed several regions exhibiting significant differences, including the cerebellum, temporal lobe, and occipital lobe. These findings align with previous studies on ASD. Moreover, novel regions such as Vermis_3, Vermis_4_5, Fusiform areas, Parietal, and Cuneus were identified, emphasizing the need for further investigation. This study underscores the potential of GNNs in analyzing brain networks for ASD biomarker discovery. The identified regions warrant additional validation and exploration to understand their association with specific domains of ASD symptoms. Our approach presents a promising avenue to advance the diagnosis of ASD and to improve our understanding of its underlying neural basis.

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41. Wasiuk PA, Cook BA, Irwin JR. Masked-Speech Recognition and Self-Reported Functional Listening in Autistic Young Adults. J Speech Lang Hear Res. 2025: 1-17.

PURPOSE: Autistic adults consistently report difficulties understanding speech in adverse listening environments, which may be related to differences in social communication and participation. Research examining masked-speech recognition in autistic adults is limited, particularly in competing speech backgrounds with high degrees of informational masking. This work characterizes speech-in-speech and speech-in-noise recognition in young adults on the autism spectrum, as well as evaluates self-reported functional listening abilities and listening-related fatigue. METHOD: Masked-speech recognition was evaluated in both autistic (n = 20) and non-autistic (n = 20) young adults with normal hearing. Speech reception thresholds were adaptively measured in two-talker speech and speech-shaped noise using target sentences that were either semantically meaningful or anomalous. Functional listening abilities and listening-related fatigue were assessed using the Speech, Spatial, and Qualities of Hearing Scale and the Vanderbilt Fatigue Scale for Adults. Autism characteristics and social communication experiences were quantified using the Social Responsiveness Scale-Second Edition. RESULTS: Autistic adults displayed significantly poorer speech-in-speech recognition than their non-autistic peers, while speech-in-noise recognition did not differ between groups. Functional listening difficulties in daily life and listening-related fatigue were significantly higher for autistic participants. Autism characteristics strongly predicted functional listening abilities and listening-related fatigue in both groups. CONCLUSIONS: Autistic young adults experience objective speech-in-speech recognition difficulties that correspond with listening challenges in daily life. Autism characteristics and social communication experiences predict functional listening abilities reported by both autistic and non-autistic young adults with normal hearing. Speech-in-speech recognition difficulties observed here may amplify social communication challenges for adults on the autism spectrum. Future work must prioritize improved awareness of autistic listening differences.

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42. White J, McGarry S, Williams PJ, M HB. ‘We think differently, we learn differently, but at the end of the day we’re not that different’: Strengths-based approaches in high school from the perspectives of autistic adolescents. Autism. 2025: 13623613251348557.

Emerging evidence supports the use of strengths-based approaches for autistic students, yet limited research has explored these approaches from the perspectives of autistic adolescents in mainstream high schools. This study used a descriptive phenomenological methodology to examine the perspectives of 16 autistic adolescents who were either in high school or had recently completed high school in Australia. Semi-structured interviews were conducted and analysed using a modified seven-step Colaizzi method. Eight themes were identified, grouped under two overarching categories: (1) benefits of leveraging strengths and interests, and (2) support needed for strengths application and development. Adolescents described increased engagement and motivation when learning aligned with their interests, the value of connecting with like-minded peers, and the role of strengths in shaping future aspirations. They also highlighted supports they found helpful, including trusting teacher-student relationships, opportunities for autonomy through accommodations, interest-driven and hands-on learning, structured social experiences, and future-focused planning. These findings provide new insights into how strengths-based approaches can be implemented in high schools. Including autistic adolescents’ voices is essential to bridging the gap between inclusive education theory and classroom practice. This study offers actionable guidance for developing strengths-based approaches that foster motivation, confidence, and long-term success for autistic students.Lay abstractThis study explored autistic adolescents experiences and perspectives of strengths-based approaches in mainstream high schools. While there is growing support for recognising and building on students’ strengths, little is known about how these approaches are understood and experienced by autistic students themselves. We interviewed 16 autistic adolescents in Australia who were either still in high school or had recently finished. They shared their experiences in one-on-one conversations, and their insights were carefully analysed using a method designed to highlight key themes in how people describe their lived experiences. Autistic students described how learning became more engaging and meaningful when it connected with their interests and strengths. They valued being with like-minded peers and felt more motivated when they could see a link between their strengths and future goals. They also identified helpful supports, such as having teachers who understood them, being given choices in how they learn, doing practical or interest-based tasks, opportunities to build social skills, and support with future planning. By listening directly to autistic students, this study shows how schools can better support them to thrive. The findings offer practical ideas for making high schools more inclusive, motivating, and future-focused for autistic students in Australia and around the world.

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43. Zhao Y, Lai S, Lyu W, Zhao M, Li S, Zhang M, Qi J. [Effect of music therapy on brain function of autistic children based on power spectrum and sample entropy]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2025; 42(3): 537-43.

This study aims to explore whether Guzheng playing training has a positive impact on the brain functional state of children with Autism Spectrum Disorder (ASD) based on power spectral and sample entropy analyses. Eight ASD participants were selected to undergo four months of Guzheng playing training, with one month as a training cycle. Electroencephalogram (EEG) signals and behavioral data were collected for comparative analysis. The results showed that after Guzheng playing training, the relative power of the alpha band in the occipital lobe of ASD children increased, and the relative power of the theta band in the parietal lobe decreased. The differences compared with typically developing (TD) children were narrowed. Moreover, some channels exhibited a gradual increase or decrease in power with the extended training period. Meanwhile, the sample entropy parameter also showed a similar upward trend, which was consistent with the behavioral data representation. The study shows that Guzheng training can enhance the brain function of ASD patients, with better effects from longer training. Guzheng playing training could be used as a daily intervention for autism.

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