1. Almubark NM, Spencer TD, Foster ME. AAC narrative intervention for children with autism. Augment Altern Commun. 2025: 1-14.

In research, augmentative and alternative communication (AAC) interventions have primarily focused on teaching children to make requests; however, AAC intervention should not stop there. There is a dearth of AAC intervention research targeting other communicative functions, despite there being a significant need to enhance children’s communication competence in a variety of social and educational contexts. The purpose of this study was to examine the initial efficacy and feasibility of an AAC narrative intervention on the picture-supported retelling skills of three children with autism, aged 6-9 years old. This multiple baseline across participants design study was preregistered at Open Science Framework (https://doi.org/10.17605/OSF.IO/29SFP). We measured the effect of the intervention on children’s inclusion and complexity of story grammar elements and the variety of symbols used to retell untrained stories during a baseline condition, just before each intervention session, immediately following each intervention session, and three weeks after the last intervention session. Parents completed a feasibility questionnaire and documented their children’s generalized use of AAC. The AAC narrative intervention improved children’s AAC retells, with ascending trends in the intervention condition and scores elevated above baseline after 3 weeks. Parents reported that they perceived the intervention to be appropriate, effective, enjoyable, and planned to use it themselves after the study. Generalized use of AAC outside of intervention sessions was documented for all three participants.

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2. Cavallaro R, Carollo A, Balboni G, Gómez LE, Dimitriou D, Esposito G. Beyond disability: A scientometric review of quality of life in developmental disabilities. Res Dev Disabil. 2025; 158: 104919.

Quality of Life (QoL) is a crucial concept that pertains to an individual’s perception of their position in life. In the context of developmental disabilities, QoL is pivotal for improving evidence-based practices, providing support and organizing services for individuals, thereby enabling them to achieve their potential with dignity and equality. Despite its importance, QoL has often not been the primary focus in many studies on developmental disabilities and remains less developed compared to other research areas. This study aims to provide a comprehensive understanding of the existing knowledge in this thematic area. A document co-citation analysis was conducted to identify the most impactful publications and main thematic domains of research in the literature (N = 2141 documents and their 97,547 citations). A total of 21 impactful documents were identified, most of which focused on issues related to the conceptualization and assessment of QoL. Nine major thematic domains of research were outlined. In line with the impactful publications, some research themes focused on conceptual issues (e.g., self-reported QoL and QoL reported from others) and assessment approaches. Furthermore, the literature has transitioned towards broadening the QoL perspective in the context of family and social systems. The study provides an overview of how QoL has been studied in the context of developmental disabilities, highlighting the interdependence of individuals, families, and communities in ensuring a fulfilling life through the lens of QoL.

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3. Chase J, Li JJ, Lin WC, Tai LH, Castro F, Collins AG, Wilbrecht L. Genetic changes linked to two different syndromic forms of autism enhance reinforcement learning in adolescent male but not female mice. bioRxiv. 2025.

Autism Spectrum Disorder (ASD) is characterized by restricted and repetitive behaviors and social differences, both of which may manifest, in part, from underlying differences in corticostriatal circuits and reinforcement learning. Here, we investigated reinforcement learning in mice with mutations in either Tsc2 or Shank3 , both high-confidence ASD risk genes associated with major syndromic forms of ASD. Using an odor-based two-alternative forced choice (2AFC) task, we tested adolescent mice of both sexes and found male Tsc2 and Shank3B heterozygote (Het) mice showed enhanced learning performance compared to their wild type (WT) siblings. No gain of function was observed in females. Using a novel reinforcement learning (RL) based computational model to infer learning rate as well as policy-level task engagement and disengagement, we found that the gain of function in males was driven by an enhanced positive learning rate in both Tsc2 and Shank3B Het mice. The gain of function in Het males was absent when mice were trained with a probabilistic reward schedule. These findings in two ASD mouse models reveal a convergent learning phenotype that shows similar sensitivity to sex and environmental uncertainty. These data can inform our understanding of both strengths and challenges associated with autism, while providing further evidence that sex and experience of uncertainty modulate autism-related phenotypes. SIGNIFICANCE STATEMENT: Reinforcement learning is a foundational form of learning that is widely used in behavioral interventions for autism. Here, we measured reinforcement learning in adolescent mice carrying genetic mutations linked to two different syndromic forms of autism. We found that males showed strengths in reinforcement learning compared to their wild type siblings, while females showed no differences. This gain of function in males was no longer observed when uncertainty was introduced into the reward schedule for correct choices. These findings support a model in which diverse genetic changes interact with sex to generate common phenotypes underlying autism. Our data further support the idea that autism risk genes may produce strengths as well as challenges in behavioral function.

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4. De Risi M, Cusimano L, Bujanda Cundin X, Pizzo M, Gigante Y, Monaco M, Di Eugenio C, De Leonibus E. D1 dopamine receptor antagonists as a new therapeutic strategy to treat autistic-like behaviours in lysosomal storage disorders. Mol Psychiatry. 2025.

Lysosomal storage disorders characterized by defective heparan sulfate (HS) degradation, such as Mucopolysaccharidosis type IIIA-D (MPS-IIIA-D), result in neurodegeneration and dementia in children. However, dementia is preceded by severe autistic-like behaviours (ALBs), presenting as hyperactivity, stereotypies, social interaction deficits, and sleep disturbances. The absence of experimental studies on ALBs’ mechanisms in MPS-III has led clinicians to adopt symptomatic treatments, such as antipsychotics, which are used for non-genetic neuropsychiatric disorders. However, they have limited efficacy in MPS-III and lead to higher extrapyramidal effects, leaving ALBs in MPS-IIIA as an unmet medical need with a significant burden on patients and their families. Using mouse and cellular models of MPS-IIIA, we have previously shown that ALBs result from increased proliferation of mesencephalic dopamine neurons during embryogenesis. In adulthood, MPS-IIIA mice exhibit an imbalance of dopaminergic receptor subtypes, resulting in striatal overstimulation of the D1 dopamine receptor (D1R)-direct pathway, contrasting with a downregulation of the D2 dopamine receptor (D2R)-indirect pathway. In this study, we aimed to provide an evidence-based pharmacological approach for managing ALBs in MPS-IIIA. We hypothesized that rebalancing dopaminergic receptor signalling with a D1R antagonist, rather than a D2 antagonist, would lead to safe and effective treatment. Neither risperidone nor methylphenidate improves ALBs in the MPS-IIIA mouse model, with the former showing increased cataleptic (extrapyramidal-like) side effects compared to littermate wild-type animals. Methylphenidate, however, showed some beneficial effects on neuroinflammation and later manifesting dementia-like behaviours. In contrast, ecopipam, a D1 antagonist already used in the clinic for other neuropsychiatric disorders, rescues ALBs, cognition, D1 hyperactivity, and does not worsen neurodegenerative signs. These results align with recent evidence highlighting the clinical relevance of D1 antagonists for neuropsychiatric disorders and pave the way for their use in managing psychotic symptoms in neurodegenerative disorders such as dementia with Lewy bodies.

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5. Hammerl M, Zimmermann M, Posod A, Peglow UP, Höck M, Griesmaier E, Kiechl-Kohlendorfer U, Neubauer V. Comparative analysis of developmental outcomes in very preterm infants: BSID-II versus Bayley-III German norms. PLoS One. 2025; 20(1): e0318263.

INTRODUCTION: After the release of the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), US norms, an overestimation of outcome was observed. But, the conformity between the Bayley Scales of Infant Development, second edition (BSID-II), and the Bayley-III German norms is unknown. This retrospective analysis aimed to compare outcomes of very preterm infants tested with BSID-II and Bayley-III German norms. METHODS: Infants born from November 2007 to July 2018 were included. Exclusion criteria were death or missing outcome. Infants underwent testing with either BSID-II until December 2013 or Bayley-III from January 2014 onward, at 12 and/or 24 months. BSID-II Mental Developmental Index (MDI) was compared to Bayley-III cognitive score and a combined Bayley-Score (CB-III) consisting of the cognitive and language composite score. BSID-II Psychomotor Developmental Index (PDI) was compared to Bayley-III motor composite score. Abnormal outcomes were defined as scores <85 (delay) or <70 (impairment). RESULTS: 649 infants were included. At 12 months, the Bayley-III cohort achieved higher scores in all domains compared to the BSID-II cohort (all p<0.05), with lower rates of motor delay in the Bayley-III cohort (p<0.001). At 24 months, only Bayley-III motor composite scores were higher than the BSID-II PDI (p<0.001). Rates of cognitive impairment were higher in the Bayley-III cohort (p = 0.013). INTERPRETATION: Our findings indicate that the Bayley-III German norms effectively identify children needing interventions, particularly at 24 months corrected age. This supports both clinical application and scientific comparability with the BSID-II.

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6. Homayounnia Firouzjah M, Nazari Kakvandi S, Ramezanzade H. The effect of implicit and explicit motor learning on a targeting task in children with autism spectrum disorder (ASD). Acta Psychol (Amst). 2025; 253: 104731.

This study aims to investigate the effect of different implicit and explicit instructions on learning a fundamental motor skill (throwing task) in autistic children with a high propensity for reinvestment. A total of 48 male volunteer students with special educational needs aged between 7 and 9 years old were conveniently selected to practice a novel throwing motor task (slingerball). The study includes a 1-week the acquisition phase with five phases of measurements involving four groups: a) analogy, b) explicit instruction, c) errorless, and d) errorful paradigms. It was conducted in five phases: pre-test, acquisition, retention, transfer, and dual-task, using a quasi-experimental design. The task in this study was to throw a slingerball’ towards a horizontal target on the ground. Mixed-design analysis of variance (ANOVA) and LSD post-hoc test performed to determine the interaction and main effects on throwing accuracy. The results indicated that participants in the analogy and errorless instruction groups had higher throwing accuracy in all phases of acquisition, retention, transfer and dual task compared to the explicit and errorful instruction groups (P ≤ 0.05). Moreover, both implicit learning groups performed more accurately in the dual task test than the explicit group (P ≤ 0.05). The results of this study support the theoretical framework that implicit practice can improve motor skill learning in children with autism spectrum disorder more than explicit practice. So, the application of errorless learning and analogy instruction is recommended for developing of motor performance and learning as implicit learning methods in educational environments.

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7. Horien C, Mandino F, Greene AS, Shen X, Powell K, Vernetti A, O’Connor D, McPartland JC, Volkmar FR, Chun M, Chawarska K, Lake EMR, Rosenberg MD, Satterthwaite T, Scheinost D, Finn E, Constable RT. What is the best brain state to predict autistic traits?. medRxiv. 2025.

Autism is a heterogeneous condition, and functional magnetic resonance imaging-based studies have advanced understanding of neurobiological correlates of autistic features. Nevertheless, little work has focused on the optimal brain states to reveal brain-phenotype relationships. In addition, there is a need to better understand the relevance of attentional abilities in mediating autistic features. Using connectome-based predictive modelling, we interrogate three datasets to determine scanning conditions that can boost prediction of clinically relevant phenotypes and assess generalizability. In dataset one, a sample of youth with autism and neurotypical participants, we find that a sustained attention task (the gradual onset continuous performance task) results in high prediction performance of autistic traits compared to a free-viewing social attention task and a resting-state condition. In dataset two, we observe the predictive network model of autistic traits generated from the sustained attention task generalizes to predict measures of attention in neurotypical adults. In dataset three, we show the same predictive network model of autistic traits from dataset one further generalizes to predict measures of social responsiveness in data from the Autism Brain Imaging Data Exchange. In sum, our data suggest that an in-scanner sustained attention challenge can help delineate robust markers of autistic traits and support the continued investigation of the optimal brain states under which to predict phenotypes in psychiatric conditions.

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8. Karim A, Alromema N, Malebary SJ, Binzagr F, Ahmed A, Khan YD. eNSMBL-PASD: Spearheading early autism spectrum disorder detection through advanced genomic computational frameworks utilizing ensemble learning models. Digit Health. 2025; 11: 20552076241313407.

OBJECTIVE: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition influenced by various genetic and environmental factors. Currently, there is no definitive clinical test, such as a blood analysis or brain scan, for early diagnosis. The objective of this study is to develop a computational model that predicts ASD driver genes in the early stages using genomic data, aiming to enhance early diagnosis and intervention. METHODS: This study utilized a benchmark genomic dataset, which was processed using feature extraction techniques to identify relevant genetic patterns. Several ensemble classification methods, including Extreme Gradient Boosting, Random Forest, Light Gradient Boosting Machine, ExtraTrees, and a stacked ensemble of classifiers, were applied to assess the predictive power of the genomic features. TheEnsemble Model Predictor for Autism Spectrum Disorder (eNSMBL-PASD) model was rigorously validated using multiple performance metrics such as accuracy, sensitivity, specificity, and Mathew’s correlation coefficient. RESULTS: The proposed model demonstrated superior performance across various validation techniques. The self-consistency test achieved 100% accuracy, while the independent set and cross-validation tests yielded 91% and 87% accuracy, respectively. These results highlight the model’s robustness and reliability in predicting ASD-related genes. CONCLUSION: The eNSMBL-PASD model provides a promising tool for the early detection of ASD by identifying genetic markers associated with the disorder. In the future, this model has the potential to assist healthcare professionals, particularly doctors and psychologists, in diagnosing and formulating treatment plans for ASD at its earliest stages.

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9. Kasari C, Shire S, Shih W, Kaiser A, Lord C, Levato L, Smith T, Almirall D. Adaptive Intervention for School-Age, Minimally Verbal Children With Autism Spectrum Disorder in the Community: Primary Aim Results. J Am Acad Child Adolesc Psychiatry. 2025.

OBJECTIVE: The goal of this study is to construct a 16-week, two-stage, adaptive intervention consisting of DTT ([discrete trials training], largely considered usual care for children with autism), JASP-EMT (a blended, naturalistic, developmental behavioral intervention involving JASPER [joint attention, symbolic play, engagement and regulation] and EMT [enhanced milieu teaching]), and parent training (P) for improving spontaneous, communicative utterances in school-aged, minimally verbal autistic children. Intervention was delivered both at school (DTT, JASP-EMT) and home (P). This manuscript reports results for the study’s primary aim and a closely related secondary aim. METHOD: The study used a two-stage, sequential, multiple-assignment randomized trial design. In stage 1 (weeks 1-6), 194 minimally verbal (< 20 functional words), 5-8 year- old autistic children were randomized initially to DTT vs. JASP-EMT (stage 1, weeks 0-6). Early vs slower response status was determined at the end of stage 1. In stage 2 (weeks 7-16), early responders were re-randomized to stay the course vs. P; whereas, slow responders were re-randomized to stay the course vs. combined DTT+JASP-EMT). The primary aim was to test whether there is a difference between starting with DTT vs. starting with JASP-EMT on average change in socially communicative utterances (SCU; primary outcome) from baseline to week 16. A secondary aim was to estimate which of the 8 pre-specified interventions was most favorable (i.e., the largest average SCU at week 16). The secondary outcomes were: total number of novel words, joint engagement, play diversity, requesting and joint attention gestures from independent, blinded assessments. RESULTS: There was no evidence to reject the null hypothesis of no difference between starting with DTT or JASP-EMT on primary outcome (p=0.41). The most favorable of the 8 interventions was the adaptive intervention which starts with DTT, augments with P for early responders, and augments with JASP-EMT for slow responders. For this adaptive intervention, average change on SCU from baseline to week 16 for this intervention was estimated to be 7.68 (95%CI 2.13 to 13.24). CONCLUSION: The results showed no difference in treatment starting with JASP-EMT or DTT and the differences between the eight adaptive interventions of the secondary aim were modest. Based on these results, reflections on next steps are discussed.

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10. Lozano I, Campos R, Belinchón M. Sensitivity to temporal synchrony in audiovisual speech and language development in infants with an elevated likelihood of autism: A developmental review. Infant Behav Dev. 2025; 78: 102026.

Detecting temporal synchrony in audiovisual speech in infancy is fundamental for socio-communicative development, especially for language acquisition. Autism is an early-onset and highly heritable neurodevelopmental condition often associated with language difficulties that usually extend to infants with an elevated likelihood of autism. Early susceptibilities in still unclear basic mechanisms may underlie these difficulties. Here, we discuss why sensitivity to temporal synchrony in audiovisual speech should be investigated in infants with an elevated likelihood of autism as a candidate mechanism underlying language difficulties. We then review direct and indirect eye-tracking evidence. Although scarce, some studies suggest that detection of temporal synchrony in audiovisual speech may be reduced in infant siblings (but evidence is mixed); however, this does not seem to account for language difficulties. Instead, a lack of relationship between selective attention to the articulating mouth and language development may be a plausible candidate mechanism. However, longitudinal studies tracking both sensitivity to temporal synchrony and selective attention to talking faces in the first year are needed for further clarification. Our discussion highlights gaps in the literature, future research directions and implications for domain-general approaches to the emergence of autism.

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11. Makin L, Zesch E, Meyer A, Mondelli V, Tchanturia K. Autism, ADHD, and Their Traits in Adults With Bulimia Nervosa and Binge Eating Disorder: A Scoping Review. Eur Eat Disord Rev. 2025.

OBJECTIVE: This review maps existing literature on the prevalence of autism and ADHD in adult patients with Bulimia Nervosa (BN) and Binge Eating Disorder (BED); patient and stakeholder perspectives on this comorbidity; clinical differences in this population; and potential treatment adaptations or adjunct therapies. This is with the aim to inform future research priorities to improve clinical practice. METHOD: As pre-registered, and following PRISMA guidelines, six databases (Embase, MEDLINE via Ovid, PsycINFO, Web of Science, CENTRAL, and Scopus) were searched for studies regarding autism and/or ADHD (diagnosed, probable, or traits) in adult patients with BN or BED. Screening and data extraction were conducted twice independently for each record. RESULTS: Twenty-nine studies were included, with 25,416 participants, mostly women (69.3%). Thirteen prevalence studies suggested autism and ADHD are more common in BN or BED than non-ED populations. One study explored the expert perspectives on autism and ADHD in BED, while 15 studies considered treatment options, mainly medications. CONCLUSION: This review highlights a need for more research on the experiences, clinical differences, and non-medical treatment options for Autistic/ADHD patients with BN or BED. Findings suggest these conditions commonly co-occur but remain under-explored in terms of patient-centred interventions and clinical outcomes.

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12. Mehan S, Kumar A, Utage PR, Hegde A, Naik N, Kondekar S, Yardi N, Desai N, Panigrahi D, Chattopadhyay A, Agarwal SD, Gupta VB, Tiwari A, Reddy SC, Saraf S, Das D, Detroja M, Paliwal C. Efficacy and Safety of Altibrain® as an Adjunctive Therapy for Autism Spectrum Disorder: An Open Label Trial Targeting Core Symptoms. Curr Pharm Des. 2025.

OBJECTIVE: This study aimed to evaluate the effectiveness and safety of Altibrain® in combination with standard Autism Spectrum Disorder (ASD) treatment compared to standard ASD treatment alone in individuals diagnosed with ASD. METHOD: A randomized, open-label trial was conducted involving 120 participants aged 3 to 17 years, randomly assigned to either the Standard ASD Treatment group or the Altibrain® + Standard ASD Treatment group. Sixty patients were randomly allocated to each Standard ASD Treatment group or the Altibrain® + Standard ASD Treatment group. participant allocation was done by computer-generated randomization. Participants had confirmed ASD diagnoses based on DSM-IV or ICD-11 criteria and demonstrated moderate to severe core ASD symptoms. Informed consent was obtained from caregivers. A total number of 120 subjects were included, consisting of 71 male and 49 female patients. Participants received either standard ASD treatment alone or Altibrain® in addition to standard ASD treatment orally once daily for 24 weeks. A total of 7 study visits/24 weeks to analyze the intervention efficacy of the Standard ASD Treatment group or the Altibrain ® + Standard ASD Treatment group. Primary outcomes included changes in core ASD symptoms measured by the Autism Diagnostic Observation Schedule (ADOS) and safety assessments. Secondary outcomes included alterations in social communication skills, reduction in repetitive behaviors, overall functional improvements, and safety and tolerability of Altibrain®. RESULTS: Altibrain® significantly improved qualitative deficits in social interaction and repetitive behaviors compared to standard ASD treatment alone (p < 0.0001). The Altibrain® + Standard ASD Treatment group demonstrated significant improvements in social functioning, social awareness, cognition, communication, and motivation compared to the Standard ASD Treatment group (p < 0.0001). Additionally, Altibrain® showed superior efficacy in reducing hyperactivity/noncompliance, inappropriate speech, irritability, lethargy/ social withdrawal, stereotypic behavior, and aberrant behavior compared to standard treatment alone (p < 0.0001). Additionally, Altibrain® exhibited a favorable safety profile as per the 4-week post-treatment safety follow-up. CONCLUSION: Further research is warranted to confirm and expand upon these results, including longer-term studies with larger cohorts and investigations into underlying mechanisms. Overall, Altibrain® holds promise as a valuable therapeutic option for individuals with ASD and their families. Limitations of the study include neuroimaging and biomarkers analysis.

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13. Morgan CH, Mercier A, Stein B, Guest KC, O’Kelley SE, Schwebel DC. A Qualitative Analysis of Unintentional Injuries in Autism Spectrum Disorder. J Autism Dev Disord. 2025.

PURPOSE: Prior research demonstrates that children with autism are more likely to experience unintentional injuries than the general population. Limited research exists on the symptoms or traits directly related to autism and this elevated injury rate, especially from the perspective of families with children with autism. This study used qualitative methodology to elucidate risk factors that may contribute to unintentional injuries in children with autism from the perspective of mothers raising children with autism. METHODS: Participants included 15 mothers reporting on their children with autism. The mothers engaged in a semi-structured qualitative interview consisting of questions related to child characteristics, injury concerns and experiences, injury prevention strategies and resources, and safety behaviors. Interviews were transcribed and coded in NVivo following a systematic, deductive approach. RESULTS: Injury risk and concern among mothers was generally related to both the diagnostic and associated features of ASD as well as commonly co-occurring behaviors or disorders. Mothers reported that deficits in social communication and social interaction, plus restricted or repetitive patterns of behavior, contributed to increased unintentional injury risk. Additionally, mothers reported that general developmental differences and behavior during play or exploration increased risk of injury. CONCLUSIONS: By considering the lived experiences of families of children with autism, this study reveals that specific diagnostic features, associated features, and other behaviors often co-occurring with autism underlie parental perceptions of increased risk of and concern for unintentional injury in children with autism. These findings guide where intervention is needed and inform development of evidence-based, practical safety interventions.

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14. Must A, Eliasziw M, Bandini LG, Curtin C, Magaña S, Rancaño KM. The Full Range of Weight Status by Race and Ethnicity in Children with and without Autism: A Cross-sectional Study of US Children. J Pediatr. 2025: 114482.

OBJECTIVE: To identify and characterize how race and ethnicity influence the relationship between autism and weight status, across all categories of weight from underweight to severe obesity. STUDY DESIGN: We developed a propensity score-matched cross-sectional dataset of children with and without parent-reported autism in the National Survey of Children Health (NSCH, 2016-2022) and Adolescent Brain and Cognition Development Study (ABCD, 2016-2018). We included non-Hispanic Asian, non-Hispanic Black, non-Hispanic White, and Hispanic children aged 6 to 17 years. Prevalence ratios for autistic and non-autistic children were estimated with multinomial regression models across Centers for Disease Control-defined categories for underweight, healthy weight, overweight, mild-to-moderate obesity, and severe obesity, based on parent-reported height and weight (NSCH) and measured heights and weights (ABCD). RESULTS: Prevalence disparities across racial and ethnic groups were evident and the pattern of prevalence ratios (autistic:non-autistic) showed remarkably consistent U- or J-shaped prevalence ratios. Prevalence ratios were elevated in underweight and severe obesity for autistic Asian, Black, White, and Hispanic children compared with their non-autistic peers of the same race or ethnicity, with the exception of underweight prevalence where autistic and non-autistic Asian children did not differ. CONCLUSIONS: The largely consistent pattern of prevalence ratios comparing autistic and non-autistic children for underweight and severe overweight in the 4 major racial and ethnic groups in the US suggests that health care and other providers should be aware of these risks in autistic children, actively monitor their weight status, and intervene early to prevent excess weight loss or weight gain.

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15. Patil TA, Qadri SY, Shirk DV. Neurodivergence and Threat: A Case Study on the Risk of Violent Fixations in Autism Spectrum Disorder. Cureus. 2024; 16(12): e76379.

Mass shootings have increasingly captured public attention in recent decades, prompting closer examination of the mental health of those responsible. This scrutiny often focuses on individuals with neurodevelopmental disorders, such as autism spectrum disorder (ASD). While epidemiological evidence is mixed on whether these individuals are more likely to commit acts of violence than the general public, certain behavioral characteristics may make them more vulnerable to extremist ideations. This case study focuses on a 17-year-old male patient who initially presented with suicidal behavior, later diagnosed with ASD following clinical evaluation. He was also found to have additional comorbidities such as major depressive disorder, gender dysphoria, and unspecified eating disorder, while harboring threats of extreme violence. Despite displaying characteristics similar to previous mass shooters with ASD, the patient has never acted on his violent thoughts, a pattern consistent with most individuals with violent ideations. The case overviews the complexity of assessing when such threats are legitimate and the potential consequences of misinterpretation. There is urgent need for standardized protocols to differentiate between behaviors stemming from ASD and violence unrelated to ASD. The findings highlight the importance of understanding the vulnerabilities and presentations of neurodivergent individuals to provide appropriate care and prevent potential tragedies.

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16. Reed DD, Greer BD, Wenzell ML, Balser S, Devine JK, Choynowski J, Graham ME, Hursh SR. Anxiety and Depression Affect Sleep Quality: A Preliminary Investigation in Crowdsourced Samples of Autistic and Non-Autistic Adults. J Autism Dev Disord. 2025.

We aimed to compare sleep problems in autistic and non-autistic adults with co-occurring depression and anxiety. The primary research question was whether autism status influences sleep quality, after accounting for the effects of depression and anxiety. We hypothesized that autistic adults would report higher levels of depression, anxiety, and sleep problems compared to non-autistic adults, after controlling for these covariates. We recruited 208 adults (109 non-autistic, 99 autistic) through a crowdsourcing platform, Prolific. Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the Generalized Anxiety Disorder 7-item scale. Statistical analyses included Mann-Whitney U tests to compare group scores and a generalized linear model to assess the effect of autism status on sleep problems while controlling for depressive and anxiety symptoms. Autistic adults reported significantly higher levels of depressive and anxiety symptoms compared to non-autistic adults. However, after controlling for depression and anxiety, autism status alone did not have a statistically significant effect on overall sleep quality. The findings suggest that while autistic adults experience more severe sleep problems, these issues are closely related to higher levels of depression and anxiety rather than autism status itself. This study contributes to the understanding of sleep difficulties in autistic individuals, highlighting the importance of addressing co-occurring mental health conditions. Further research should explore the specific factors that exacerbate sleep problems in this population.

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17. Segers J, van Esch L, Mađarević M, Moerman F, Roeyers H, Steyaert J, Warreyn P, Noens I. Contextual differences in parent-child interactions: A study on toddlers at elevated likelihood of autism and their mothers. Infant Behav Dev. 2025; 78: 102030.

Parent-child interactions are important for children’s emotional and behavioral development. In autism research, parent-child interactions are typically observed during free play. Yet, studies outside the autism field underscored the importance of observing parent-child interactions during other contexts, as parents’ behaviors may depend on the context, and different contexts may reveal different relationships between parents’ and children’s behaviors. Therefore, we observed interactions between 102 mothers and their 24-month-old children at elevated likelihood of autism during two scenarios: free play and goal-directed play. Participating children had an older autistic sibling (n = 68) or were born very preterm (born before 30 weeks; n = 34). We found that mothers adapt their behaviors to contextual cues, which supports and expands on previous findings regarding older autistic children, and children without autism. Furthermore, as expected, the relationship between mothers’ and children’s outings of negative affect only became apparent during the goal-directed play scenario. A relationship between mothers’ and children’s outings of positive affect was found in both scenarios, thus regardless of the context. Parent-reported emotional and behavioral difficulties of children were not related to maternal behaviors during either context, nor to fluctuations in maternal behaviors across contexts. This contrasts with studies with older children, which did find such relationships. Therefore, our findings suggest that predictable patterns might not yet be visible when children’s emotional and behavioral difficulties first become apparent.

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18. Smith JR, Lim S, Bindra S, Marler S, Rajah B, Williams ZJ, Baldwin I, Hossain N, Wilson JE, Fuchs DC, Luccarelli J. Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism With Intellectual Disability: An Observational Study. Autism Res. 2025.

Catatonia is a highly morbid psychomotor and affective disorder, which can affect autistic individuals with and without intellectual disability. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments in autistic individuals has not been described. We conducted a prospective observational cohort study of patients with autism and co-morbid catatonia who received outpatient care in a specialized outpatient clinic from July 1, 2021 to May 31, 2024. Data investigating pharmacologic interventions, and clinical measures including the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), Kanner Catatonia Examination (KCE), and Clinical Global Impression-Improvement (CGI-I) were collected. Forty-five autistic patients with co-morbid catatonia were treated during the study period. The mean age was 15.6 (SD = 7.9) years [Mdn = 16.0, range 6.0-31.0]. Forty-one patients (91.1%) met criteria for autism with co-occurring intellectual disability. All patients received pharmacotherapy. Forty-four (97.8%) were treated with benzodiazepines with a mean maximal daily dose of 17.4 mg (SD = 15.8) lorazepam equivalents. Thirty-five patients (77.8%) required more than one medication class for treatment. Sixteen (35.6%) patients received electroconvulsive therapy. Fourteen patients (31.1%) attempted to taper off benzodiazepines after achieving clinical improvement during the study period; of these, 5 patients (11.1%) were successfully tapered off, and the remaining 9 (17.8%) discontinued the taper due to a return of catatonic symptoms. Statistically significant improvement was observed across all clinical domains except the KCS. However, the majority remained at least partially symptomatic over the study period. Three patients (6.7%) died over the study period. Despite clinical improvements while receiving the gold standard for psychopharmacologic management of catatonia, chronic symptoms remained for the majority of catatonia patients over the study period, and few were able to taper and discontinue benzodiazepine treatment. Notably, the open label design of this study is a limiting factor when interpreting the results.

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19. van den Heuvel RM, Teunisse JP, Radhoe TA, van der Putten WJ, Torenvliet C, Wen S, Wensing M, Geurts HM. Social Network Types in Autistic Adults and Its Associations with Mastery, Quality of Life, and Autism Characteristics. J Autism Dev Disord. 2025.

Research shows heterogeneity in experiences of social contact and social networks in autistic adults. In this study, we aim to identify clusters of social support networks and investigate associations of clusters with mastery, quality of life, and autism characteristics. Autistic adults (N = 381; 45.7% female) aged between 30 and 90 years completed questionnaires on social support characteristics, mastery, autism characteristics, and quality of life. A two-step cluster analysis was used to identify clusters based on social support network items. The cluster analysis revealed three clusters: Cluster 1 (n = 238) with two or more close persons, sometimes including a romantic partner; Cluster 2 (n = 102) with solely a romantic partner as close person; and Cluster 3 (n = 41) without any close persons. Level of emotional support was the most important clustering indicator. People in Cluster 3 reported lower quality of life regarding social relationships and mastery, autism characteristics, and other quality of life scales were similar across clusters. Absence or presence of close persons significantly impacts quality of life regarding social relationships in autistic adults, which highlights the importance of addressing (satisfaction with) social support. In order to enhance quality of life, offering social network interventions to increase social support seems especially relevant for autistic people belonging to Cluster 3.

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20. Yıldız Bayındır B, Coskun M, Karayagmurlu A. Sleep disturbances in autistic youth with and without bipolar disorder: A matched case-control study. Sleep Med. 2025; 127: 152-7.

BACKGROUND: Sleep disturbances are common in individuals with autism spectrum disorder (ASD) or bipolar disorder (BD). However, to the best of our knowledge, there has been no study investigating prevalence and features of sleep disorders in youth with ASD with and without comorbid BD. The aim of this case-controlled study was to investigate sleep disturbances in autistic youth with and without comorbid BD. METHODS: The study included 43 individuals with both ASD and BD as the case group, and 43 age and gender-matched participants with ASD but no mood disorders as the control group. Both groups were assessed using the Sleep Disturbance Scale for Children (SDSC), the Childhood Autism Rating Scale (CARS), and the Aberrant Behavior Checklist (ABC). RESULTS: The case group exhibited significantly higher levels of sleep breathing disorders, disorders of arousal, disorders of excessive somnolence, and sleep hyperhidrosis on the SDSC compared to the control group (p < 0.05). Partial correlation analysis revealed a significant association between total SDSC scores and total ABC scores in the case and control groups (r = 0.424, p = 0.005; r = 0.629, p < 0.001, respectively) CONCLUSIONS: Sleep disturbances are common in youth with ASD with further increased rates in the presence of comorbid BD. Sleep disturbances are also associated with more behavioral problems among youth with ASD regardless of comorbid BD diagnosis. Clinicians working with youth with ASD should routinely assess sleep habits and related problems and should give particular attention in the presence of comorbid mood disorders. This study highlights the importance of recognizing and managing sleep disturbances in this unique population.

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